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Corma-Gómez A, Cabello A, Orviz E, Morante-Ruiz M, Ayerdi O, Al-Hayani A, Muñoz-Gómez A, Santos IDL, Gómez-Ayerbe C, Rodrigo D, Riestra SDLR, Reus-Bañuls S, Silva-Klug A, Galindo MJ, Santos M, Serrano-Fuentes M, Faro-Míguez N, Pérez-Camacho I, Corona-Mata D, Morano L, López-Ruz MÁ, Montero M, Anaya-Baz B, Merino D, Castillo-Navarro A, Pineda JA, Macías J. Long or complicated mpox in patients with uncontrolled HIV infection. J Med Virol 2024; 96:e29511. [PMID: 38469884 DOI: 10.1002/jmv.29511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/13/2024]
Abstract
To date, former research about the impact of HIV infection on mpox poor outcomes is still limited and controversial. Therefore, the aim of this study was to assess the impact of HIV on the clinical course of mpox, in a large population of patients from Spain. Nationwide case-series study. Patients from 18 Spanish hospitals, with PCR-confirmed mpox from April 27, 2022 to June 30, 2023 were included in this study. The main outcome was the development of long or complicated (LC) mpox, defined as: (i) duration of the clinical course ≥ 28 days, or; (ii) disseminated disease, or: (iii) emergence of severe complications. One thousand eight hundred twenty-three individuals were included. Seven hundred eighty-six (43%) were people living with HIV (PLWH), of whom 11 (1%) had a CD4 cell count < 200 cells/mm3 and 33 (3%) <350 cells/mm3 . HIV viral load ≥ 1000 cp/mL was found in 27 (3%) PLWH, none of them were on effective ART. Fifteen (60%) PLWH with HIV-RNA ≥ 1000 cp/mL showed LC versus 182 (29%) PLWH with plasma HIV-RNA load < 1000 copies/mL and 192 (24%) individuals without HIV infection (p < 0.001). In multivariate analysis, adjusted by age, sex, CD4 cell counts and HIV viral load at the time of mpox, only plasma HIV-RNA ≥ 1000 cp/mL was associated with a greater risk of developing LC mpox [adjusted OR = 4.06 (95% confidence interval 1.57-10.51), p = 0.004]. PLWH with uncontrolled HIV infection, due to lack of ART, are at a greater risk of developing LC mpox. Efforts should be made to ensure HIV testing is carried out in patients with mpox and to start ART without delay in those tested positive.
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Affiliation(s)
- Anaïs Corma-Gómez
- Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Sevilla, Spain
- Grupo de Virología Clínica e ITS, Hospital Universitario Virgen de Valme, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Alfonso Cabello
- Unit of Infectious Diseases, Hospital Universitario Fundación Jiménez Diaz, Madrid, Spain
| | - Eva Orviz
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid
| | - Miguel Morante-Ruiz
- Unit of Infectious Diseases, Hospital Universitario Fundación Jiménez Diaz, Madrid, Spain
| | - Oskar Ayerdi
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid
| | - Aws Al-Hayani
- Unit of Infectious Diseases, Hospital Universitario Fundación Jiménez Diaz, Madrid, Spain
| | - Ana Muñoz-Gómez
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid
| | - Ignacio De Los Santos
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Servicio de Medicina Interna-Enfermedades Infecciosas, Hospital Universitario de la Princesa, Madrid, Spain
| | - Cristina Gómez-Ayerbe
- Unit of Infectious Diseases, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - David Rodrigo
- Unit of Infectious Diseases, Consorcio Hospital General de Valencia, Valencia, Spain
| | - Sandra De la Rosa Riestra
- Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Infectious Diseases and Microbiology Clinical Unit, University Hospital Virgen Macarena, Valencia, Spain
- Department of Medicine, School of Medicine, University of Sevilla, Sevilla, Spain
| | - Sergio Reus-Bañuls
- Unit of Infectious Diseases, Hospital General Universitario de Alicante, Sevilla, Spain
| | - Ana Silva-Klug
- Unit of Infectious Diseases, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Sevilla, Spain
| | - María José Galindo
- Unit of Infectious Diseases, Hospital Clínico Universitario de Valencia, Sevilla, Spain
| | - Marta Santos
- Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Sevilla, Spain
- Grupo de Virología Clínica e ITS, Hospital Universitario Virgen de Valme, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Miriam Serrano-Fuentes
- Servicio de Medicina Interna, Hospital de Gran Canaria Dr Negrín, Las Palmas De Gran Canaria, Spain
| | - Naya Faro-Míguez
- Unit of Infectious Diseases, Hospital Universitario San Cecilio, Granada, Spain
| | - Inés Pérez-Camacho
- Unit of Infectious Diseases· Hospital Regional Universitario Málaga, Sevilla, Spain
| | - Diana Corona-Mata
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Infectious Diseases Unit, Reina Sofía University Hospital of Córdoba, Spain
- Maimonides Institute of Biomedical Research of Córdoba (Instituto Maimónides de Investigación Biomédica de Córdoba IMIBIC), Cordoba, Spain
- Department of Medicine, University of Córdoba, Cordoba, Spain
| | - Luis Morano
- Unit of Infectious Diseases, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - Miguel Ángel López-Ruz
- Unit of infectious Diseases, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Marta Montero
- Unit of infectious Diseases, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Blanca Anaya-Baz
- Unit of Infectious diseases, Hospital Universitario Puerto Real, Spain
| | - Dolores Merino
- Unit of Infectious Diseases, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
| | | | - Juan A Pineda
- Department of Medicine, School of Medicine, University of Sevilla, Sevilla, Spain
| | - Juan Macías
- Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Sevilla, Spain
- Grupo de Virología Clínica e ITS, Hospital Universitario Virgen de Valme, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Department of Medicine, School of Medicine, University of Sevilla, Sevilla, Spain
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Monge-García V, Gimeno-Gascón A, Ventero MP, Climent-Barberá JM, Cholbi-Llobell F, Rodríguez JC, Baño-Ruiz E, Caminero-Canas MA, Reus-Bañuls S. New contributions on chronic low back pain: disc infection or contaminated cultures? APMIS 2023; 131:277-283. [PMID: 36905320 DOI: 10.1111/apm.13307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND There is controversy about the likely infectious origin of chronic low back pain, because it has been suggested the possibility of a relationship with infection by Cutibacterium acnes (C. acnes). HYPOTHESIS The aim of this study is to compare four methods to determine the presence of a likely infection caused by C. acnes in surgical disc samples. PATIENTS AND METHODS This work is a cross-sectional observational study in which there are included 23 patients with microdiscectomy indication. Disc samples were taken during surgery and analysis was done by culture, Sanger sequencing, Next-Generation Sequencing (NGS), and real-time PCR (qPCR). Furthermore, clinical data collection was conducted, and it was analysed the presence of the Modic-like changes on the magnetic resonance imaging. RESULTS In 5 of the samples from among the 23 patients (21.7%) C. acnes was isolated by culture. However, in none of the samples could its genome be detected through Sanger sequencing, the less sensitive method. Only the qPCR and NGS were able to detect very few copies of the genome of this microorganism in all the samples, with no significant quantitative differences being observed between the patients in whom isolation of the microorganism by culture was evident or not. Further, there were no significant relationships identified between the clinical variables, including Modic alterations and positive cultures. DISCUSSION The most sensitive methods to the detect C. acnes were NGS and qPCR. The data obtained do not suggest association between the presence of C. acnes and the clinical process and support the hypothesis that C. acnes is found in these samples only because it is a contamination from the skin microbiome.
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Affiliation(s)
- V Monge-García
- Physical Medicine and Rehabilitation Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - A Gimeno-Gascón
- Microbiology Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - M P Ventero
- Microbiology Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - J M Climent-Barberá
- Physical Medicine and Rehabilitation Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - F Cholbi-Llobell
- Physical Medicine and Rehabilitation Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - J C Rodríguez
- Microbiology Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - E Baño-Ruiz
- Neurosurgery Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - M A Caminero-Canas
- Neurosurgery Service, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - S Reus-Bañuls
- Infectious Diseases Unit, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
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Corma-Gómez A, Macías J, Téllez F, Morano L, Rivero A, Serrano M, Ríos MJ, Vera-Méndez FJ, Santos M, Real LM, Palacios R, Santos IDL, Geijo P, Imaz A, Merino D, Galindo MJ, Reus-Bañuls S, López-Ruz MÁ, Galera C, Pineda JA. Kinetics of emergence of liver complications in hepatitis C virus infected patients and advanced fibrosis, with and without HIV-coinfection, after sustained virological response. AIDS 2021; 35:2119-2127. [PMID: 34049354 DOI: 10.1097/qad.0000000000002959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE There is scarce available evidence on the distribution over time of liver complications emergence in hepatitis C virus (HCV)-infected patients who achieve sustained virological response (SVR) with direct-acting antiviral (DAA)-based therapy. Therefore, we aimed at describing the kinetics of liver-related events appearance in this setting. DESIGN A multicentric prospective cohort study. METHODS HCV-monoinfected and HIV/HCV-coinfected patients from GEHEP-011 cohort, whose inclusion criteria were had achieved SVR with DAA-based therapy; liver stiffness prior to starting treatment at least 9.5 kPa; and available liver stiffness measurement at SVR. SVR was considered as the baseline time-point. RESULTS One thousand and thirty-five patients were included, 664 (64%) coinfected with HIV. Before DAA-based therapy, 63 (6.1%) individuals showed decompensated cirrhosis. After SVR, 51 (4.9%) patients developed liver complications. Median (Q1-Q3) time to the emergence of hepatic events was hepatic encephalopathy 11 (7-24) months, ascites 14 (6-29) months, hepatocellular carcinoma (HCC) 17 (11-42) months and portal hypertension gastrointestinal bleeding (PHGB) 28 (22-38) months (P = 0.152). We define two profiles of liver complications: those emerging earlier (encephalopathy and ascites) and, those occurring continuously during the follow-up (HCC, PHGB) [median (Q1-Q3) time to emergence 12.7 (6.6-28.2) months vs. 25.4 (12.5-41.53) months, respectively (P = 0.026)]. CONCLUSION The vast majority of HCV-infected patients who develop liver complications after reaching SVR with DAA do it within 3 years after SVR time-point. Specifically, hepatic encephalopathy and ascites do not usually emerge after this period. Conversely, HCC and PHGB may occur in longer term. It is critical to identify patients at risk of developing hepatic events to continue performing surveillance for them.
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Affiliation(s)
- Anaïs Corma-Gómez
- Unit of Infectious Diseases and Microbiology. Hospital Universitario de Valme, Seville
| | - Juan Macías
- Unit of Infectious Diseases and Microbiology. Hospital Universitario de Valme, Seville
| | - Francisco Téllez
- Unit of Infectious Diseases, Hospital Universitario de Puerto Real, Faculty of Medicine, Cadiz
| | - Luis Morano
- Unit of Infectious Pathology, Hospital Universitario Alvaro Cunqueiro, Vigo
| | - Antonio Rivero
- Unit of Infectious Diseases, Hospital Universitario Reina Sofia, Córdoba
| | - Miriam Serrano
- Unit of Infectious Diseases, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria
| | - María José Ríos
- Unit of Infectious Diseases, Hospital Universitario Virgen Macarena, Sevilla
| | - Francisco Jesús Vera-Méndez
- Section of Infectious Medicine/Service of Internal Medicine, Hospital General Universitario Santa Lucía, Cartagena
| | - Marta Santos
- Unit of Internal Medicine, Hospital Universitario del SAS de Jerez, Cadiz
| | - Luis Miguel Real
- Unit of Immunology, Biochemistry, Molecular Biology and Surgery, Faculty of Medicine, Universidad de Málaga
| | - Rosario Palacios
- Unit of Infectious Diseases and Microbiology, Hospital Virgen de la Victoria, Málaga
| | | | - Paloma Geijo
- Unit of Infectious Diseases, Hospital Virgen de la Luz, Cuenca
| | - Arkaitz Imaz
- HIV and STI Unit, Department of Infectious Diseases, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona
| | - Dolores Merino
- Unit of Infectious Diseases, Hospital Juan Ramón Jiménez, Huelva
| | - Maria José Galindo
- Unit of Infectious Diseases, Hospital Clínico Universitario de Valencia, Valencia
| | - Sergio Reus-Bañuls
- Unit of Infectious Diseases, Hospital General Universitario de Alicante, Alicante
| | | | - Carlos Galera
- Unit of Infectious Diseases, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Juan A Pineda
- Unit of Infectious Diseases and Microbiology. Hospital Universitario de Valme, Seville
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Corma-Gómez A, Macías J, Rivero A, Rivero-Juarez A, de los Santos I, Reus-Bañuls S, Morano L, Merino D, Palacios R, Galera C, Fernández-Fuertes M, González-Serna A, de Rojas I, Ruiz A, Sáez ME, Real LM, Pineda JA. A Genome-Wide Association Study on Liver Stiffness Changes during Hepatitis C Virus Infection Cure. Diagnostics (Basel) 2021; 11:1501. [PMID: 34441435 PMCID: PMC8394459 DOI: 10.3390/diagnostics11081501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 02/07/2023] Open
Abstract
Liver stiffness (LS) at sustained virological response (SVR) after direct-acting antivirals (DAA)-based therapy is a predictor of liver events in hepatitis C virus (HCV)-infected patients. The study aim was to identify genetic factors associated with LS changes from the moment of starting anti-HCV therapy to SVR. This prospective study included HCV-infected patients from the GEHEP-011 cohort who achieved SVR with DAA-based therapy, with LS pre-treatment ≥ 9.5 kPa and LS measurement available at SVR. Plink and Magma software were used to carry out genome-wide single-nucleotide polymorphism (SNP)-based and gene-based association analyses, respectively. The ShinyGO application was used for exploring enrichment in Gene Ontology (GO) categories for biological processes. Overall, 242 patients were included. Median (quartile 1, quartile 3) LS values at pre-treatment and at SVR were 16.8 (12, 28) kPa and 12.0 (8.5, 19.3) kPa, respectively. Thirty-five SNPs and three genes reached suggestive association with LS changes from the moment of starting anti-HCV therapy to SVR. GO categories related to DNA packaging complex, DNA conformation change, chromosome organization and chromatin organization were significantly enriched. Our study reports possible genetic factors associated with LS changes during HCV-infection cure. In addition, our results suggest that processes related to DNA conformation are also involved in these changes.
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Affiliation(s)
- Anaïs Corma-Gómez
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital de Valme, 41014 Sevilla, Spain; (A.C.-G.); (J.M.); (M.F.-F.); (A.G.-S.); (J.A.P.)
| | - Juan Macías
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital de Valme, 41014 Sevilla, Spain; (A.C.-G.); (J.M.); (M.F.-F.); (A.G.-S.); (J.A.P.)
- Departamento de Medicina, Universidad de Sevilla, 41009 Sevilla, Spain
| | - Antonio Rivero
- Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain; (A.R.); (A.R.-J.)
| | - Antonio Rivero-Juarez
- Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain; (A.R.); (A.R.-J.)
| | - Ignacio de los Santos
- Unidad de Medicina Interna y Enfermedades Infecciosas, Hospital de La Princesa, 28006 Madrid, Spain;
| | - Sergio Reus-Bañuls
- Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, 03010 Alicante, Spain;
| | - Luis Morano
- Unidad de Patología Infecciosa, Hospital Universitario Alvaro Cunqueiro, Instituto de Investigación Sanitaria Galicia Sur (IISGS), 36312 Vigo, Spain;
| | - Dolores Merino
- Unidad de Enfermedades Infecciosas, Hospital Universitario Juan Ramón Jiménez, 21005 Huelva, Spain;
| | - Rosario Palacios
- Unidad de Enfermedades Infecciosas y Microbiología, Hospital Virgen de la Victoria, 29010 Málaga, Spain;
| | - Carlos Galera
- Unidad de Medicina Interna, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain;
| | - Marta Fernández-Fuertes
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital de Valme, 41014 Sevilla, Spain; (A.C.-G.); (J.M.); (M.F.-F.); (A.G.-S.); (J.A.P.)
| | - Alejandro González-Serna
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital de Valme, 41014 Sevilla, Spain; (A.C.-G.); (J.M.); (M.F.-F.); (A.G.-S.); (J.A.P.)
| | - Itziar de Rojas
- Fundació ACE—Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain; (I.d.R.); (A.R.)
- CIBERNED Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Agustín Ruiz
- Fundació ACE—Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain; (I.d.R.); (A.R.)
- CIBERNED Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María E. Sáez
- Centro Andaluz de Estudios Bioinformáticos (CAEBI, SL), 41013 Sevilla, Spain;
| | - Luis M. Real
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital de Valme, 41014 Sevilla, Spain; (A.C.-G.); (J.M.); (M.F.-F.); (A.G.-S.); (J.A.P.)
- Departamento de Especialidades Quirúrgicas, Bioquímica e Inmunología, Universidad de Málaga, 29010 Málaga, Spain
| | - Juan A. Pineda
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital de Valme, 41014 Sevilla, Spain; (A.C.-G.); (J.M.); (M.F.-F.); (A.G.-S.); (J.A.P.)
- Departamento de Medicina, Universidad de Sevilla, 41009 Sevilla, Spain
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Neukam K, Morano-Amado LE, Rivero-Juárez A, Mancebo M, Granados R, Téllez F, Collado A, Ríos MJ, de los Santos-Gil I, Reus-Bañuls S, Vera-Méndez F, Geijo-Martínez P, Montero-Alonso M, Suárez-Santamaría M, Pineda JA. HIV-coinfected patients respond worse to direct-acting antiviral-based therapy against chronic hepatitis C in real life than HCV-monoinfected individuals: a prospective cohort study. HIV Clinical Trials 2017; 18:126-134. [DOI: 10.1080/15284336.2017.1330801] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Karin Neukam
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - Luis E. Morano-Amado
- Unit of Infectious Pathology, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain
| | - Antonio Rivero-Juárez
- Unit of Infectious Diseases, Hospital Universitario Reina Sofía, Maimónides Institute of Biomedical Investigation(IMIBIC), University of Cordoba, Cordoba, Spain
| | - María Mancebo
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - Rafael Granados
- Unit of Infectious Diseases, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - Francisco Téllez
- Unit of Infectious Diseases, Hospital La Línea, AGS Campo de Gibraltar, La Linea de la Concepcion, Spain
| | - Antonio Collado
- Infectious Diseases Unit, Hospital Universitario Torrecárdenas, Almeria, Spain
| | - María J Ríos
- Unit of Infectious Diseases, Hospital Virgen Macarena, Seville, Spain
| | | | - Sergio Reus-Bañuls
- Unit of Infectious Diseases, Hospital General Universitario de Alicante, Alicante, Spain
| | - Francisco Vera-Méndez
- Section of Infectious Medicine/Service of Internal Medicine, Hospital General Universitario Santa Lucía, Cartagena, Spain
| | | | - Marta Montero-Alonso
- Unit of Infectious Diseases, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Juan A. Pineda
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain
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Saiz de la Hoya-Zamácola P, Marco-Touriño A, Clemente-Ricote G, Portilla-Sogorb J, Boix-Martínez V, Núñez-Martínez O, Reus-Bañuls S, Teixidó I Pérez N. [Expert recommendations for the diagnosis and treatment of chronic hepatitis C infection in the prison setting]. Rev Esp Sanid Penit 2012; 9:21-32. [PMID: 23128612 DOI: 10.4321/s1575-06202007000100005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2005] [Accepted: 11/01/2006] [Indexed: 11/11/2022]
Abstract
The prevalence of HCV infection in Spanish prisons is very high (38.5%). The characteristics of the infected patients, particularly the high rate of HIV coinfection, makes it very likely that the morbidity and mortality produced by serious liver disease secondary to this infection will increase considerably in the coming years. A group of Spanish experts with experience in patients who are inmates has been invited to establish a series of recommendations for the diagnosis and treatment of chronic hepatitis C infection in Spanish prisons.
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Reus-Bañuls S, Bustos Terol S, Caro-Martínez E, Cama-Barbieri J. [Cerebral aspergillosis in an human immunodeficiency virus infected patient]. Enferm Infecc Microbiol Clin 2012; 30:350-1. [PMID: 22503112 DOI: 10.1016/j.eimc.2012.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 02/02/2012] [Accepted: 02/09/2012] [Indexed: 10/28/2022]
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Saiz de la Hoya-Zamácola P, Marco-Mouriño A, Clemente-Ricote G, Portilla-Sogorb J, Boix-Martínez V, Núñez-Martínez O, Reus-Bañuls S, Teixidó i Pérez N. [Expert recommendations for the diagnosis and treatment of chronic hepatitis C infection in the prison setting]. Enferm Infecc Microbiol Clin 2007; 24:568-75. [PMID: 17125677 DOI: 10.1157/13093878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The prevalence of HCV infection in Spanish prisons is very high (38.5%). The characteristics of the infected patients, particularly the high rate of HIV coinfection, makes it very likely that the morbidity and mortality produced by serious liver disease secondary to this infection will increase considerably in the coming years. A group of Spanish experts with experience in patients who are inmates has been invited to establish a series of recommendations for the diagnosis and treatment of chronic hepatitis C infection in Spanish prisons.
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Saiz de la Hoya-Zamácola P, Marco-Mouriño A, Clemente-Ricote G, Portilla-Sogorb J, Boix-Martínez V, Núñez-Martínez O, Reus-Bañuls S, Teixidó i Pérez N. Recomendaciones de expertos sobre el diagnóstico y tratamiento de la hepatitis C crónica en el medio penitenciario. Gastroenterología y Hepatología 2006; 29:551-9. [PMID: 17129550 DOI: 10.1157/13094351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The prevalence of HCV infection in Spanish prisons is very high (38.5%). The characteristics of the infected patients, particularly the high rate of HIV coinfection, makes it very likely that the morbidity and mortality produced by serious liver disease secondary to this infection will increase considerably in the coming years. A group of Spanish experts with experience in patients who are inmates has been invited to establish a series of recommendations for the diagnosis and treatment of chronic hepatitis C infection in Spanish prisons.
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Martí-Martínez S, Martín-Estefanía C, Turpín-Fenoll L, Pampliega-Pérez A, Reus-Bañuls S, García-Barragán N, Villarubia-Lor B. [Bilateral papilloedema as the initial symptom of POEMS syndrome]. Rev Neurol 2006; 43:531-4. [PMID: 17072808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
INTRODUCTION Oedema of the papilla, or papilloedema, is usually due to intracranial hypertension, but can sometimes be the initial symptom of systemic diseases like Guillain-Barre syndrome, neurosarcoidosis, Leber's disease, Lyme disease or POEMS syndrome, among others. We report on a case that occurred at the Hospital General Universitario in Alicante, in which papilloedema was the initial symptom of POEMS syndrome. CASE REPORT A 36-year-old female, with no relevant past history, who visited after suffering a left-side frontal oppressive headache for five days; onset was sudden, there was no concomitant nausea or vomiting, it did not get worse when Valsalva manoeuvres were performed and there were no other accompanying symptoms. The examination revealed nasal blurring in the visual field of the right eye and papilloedema in the left eye, hyperpigmentation of the skin on the face and upper chest area that respected creases in the skin, painful distal tactile hypaesthesia in the lower limbs and bilateral areflexia of Achilles' tendons and patellar hyperreflexia. After conducting a number of different complementary tests intracranial space-occupying lesions and intracranial hypotension were both ruled out and the patient was diagnosed with mixed-type sensory-motor chronic polyneuropathy in the upper limbs, and in the lower extremities with predominantly distal involvement, bilateral oedema of the papilla and skin photosensitivity. Two years later the patient had hepatomegaly, subclinical hypothyroidism and sclerodermiform alterations of the skin, which suggested a probable diagnosis of POEMS syndrome that was later confirmed by the presence of monoclonal component in blood and urine. CONCLUSIONS Papilloedema is rarely seen as the initial symptom of POEMS syndrome, but it must be included in the differential diagnosis of this pathology due to the diagnostic and therapeutic implications it entails.
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Affiliation(s)
- S Martí-Martínez
- Servicio de Neurología, Hospital General Universitario de Alicante, 03010 Alicante, España.
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