Hepatitis: Martín L

Barril G, González Parra E, Alcázar R, Arenas D, Campistol JM, Caramelo C, Carrasco M, Carreño V, Espinosa M, García Valdecasas J, Górriz JL, López MD, Martín L, Ruiz P, Terruel JL, Anonymous00170. · Nefrólogo Hosp. Universitario de La Princesa, Madrid. · Nefrologia. · Pubmed #15085792 No free full text.

Abstract: The viric infections influence morbi-mortality in Chronic kidney Disease patients in hemodialysis therapy and can affect to the Staff of the Units. The guides considered the most relevant virus at the present moment: C Virus, B Virus and HIV. To prevent horizontal nosocomial transmission is necessary the observance always the universal precautions in the HD units, although sometimes can appeared seroconversions and epidemic bud when exist a break of these. Is analyzed different situations with special focus in units for acute patients. The following steps under the suspicious of the epidemic bud appeared in one of the annexes together with legislation according to this case. Respect to the staff in every one of the virus is shown prevention patterns, serologic markers to perform when an accident with infected blood occur, also is considered when treatment is indicated. The guides considered too the conditions necessary for include these patients on waiting list for kidney transplantation.

González-Guerra E, Haro R, Angulo J, Del Carmen Fariña M, Martín L, Requena L. · Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain. · Int J Dermatol. · Pubmed #18477157 No free full text.

Abstract: A 52-year-old black woman presented with a 5-year history of gradual swelling and slowed hair growth involving the vertex and both parietal regions of the scalp. Gradually, the swelling progressed to involve the entire scalp, only sparing a peripheral crown. She reported no history of trauma or medications. Slight pruritus of the involved area was the only accompanying symptom. There was no family history of a similar condition. Her past medical history included surgery for ovarian cysts, 10 years previously, and cholelithiasis. Physical examination revealed diffuse hair thinning and alopecia, more prominent along the vertex and parietal regions (Fig. 1a). There was no evidence of scalp inflammation, scaling, or increased hair fragility. The scalp was mildly tender on palpation and had a boggy, spongy consistency. The hairs which still remained in the involved areas were thin, short, and soft (Fig. 1b). The involved area was slightly hypopigmented when compared with adjacent noninvolved scalp. The rest of the physical examination was within normal limits. No abnormalities of the hair shaft were observed on microscopic examination of several plucked hairs. Laboratory investigations, including a complete blood cell count, blood chemistry, urinalysis, sedimentation rate, antinuclear antibodies, and serologic tests for syphilis, hepatitis B and C virus, and human immunodeficiency virus, were negative. A computed tomography scan of the skull demonstrated diffuse and regular thickening of subcutaneous fatty tissue of the scalp, disclosing a maximum scalp thickness of 15 mm at the vertex (Fig. 2). The biopsy from the vertex revealed a normal epidermis and dermis, with diffuse loss of hair follicles. The most striking feature consisted of a large increase in thickness of the subcutaneous fatty tissue (Fig. 3a). Pre-existing hair follicles were replaced by vertical fibrous tracts of lamellar fibroplasia with no inflammatory infiltrate (Fig. 3b). Adipocytes showed a normal size and shape, but the connective tissue septa, which are normally present separating the subcutaneous tissue into fat lobules, were lacking, and subcutaneous fatty tissue consisted of a continuous and diffuse sheet of mature adipocytes (Fig. 3c). Orcein stain revealed normal contents of elastic fibers with foci of condensation at the sites of disappeared pre-existing hair follicles (Fig. 3d). Colloidal iron and Alcian blue (pH 2.5) stains revealed no mucin deposits.

López-Caleya JF, Martín V, Martín L, Pérez-Simón R, Carro JA, Alcoba M. · Servicio de Medicina Interna, Hospital de León, León, España. · Enferm Infecc Microbiol Clin. · Pubmed #16792937 links to  free full text

Abstract: OBJECTIVE: To ascertain the prevalence of HIV and hepatitis C (HCV) coinfection in the Health Area of León in the period of 1992 to 2000. PATIENTS, MATERIAL AND METHODS: The study included patients with HIV infection, residing for at least two years in the area, and attended at the Department of Internal Medicine of León Hospital. Sociodemographic information and risk behavior were recorded. Data from the Municipal Census of 1 May 1996 were used to calculate prevalence. Statistical analyses were carried out with the chi-square test or analysis of variance, according to the cases. RESULTS: The prevalence of HCV infection among HIV-positive patients was 56.8%. Coinfected men were younger than women and coinfection was higher in the parenteral transmission than in the sexual transmission groups. Prevalence was estimated at 53.2 cases per 100,000 inhabitants of the Area (82.7 for men and 25.7 for women). The groups showing the highest prevalence were men aged 25-34 and 35-44 years. The epidemiology of the coinfection was mainly attributable to injected drug use. There was a decrease in the number of coinfection cases diagnosed during the study period. CONCLUSIONS: The prevalence of HIV/HCV coinfection in the León Health Area was lower than the rate estimated for Spain as a whole owing to a lower incidence of HIV infection and intravenous drug use. Nevertheless, HIV/HCV coinfection is a major public health problem, and resources should be allocated for its prevention and treatment.

Martín E, Rendón P, De Diego L, Soria MJ, Martínez MC, Martín L. · Servicio de Aparato Digestivo. Hospital Universitario Puerta del Mar. Cádiz. Spain. · Rev Esp Enferm Dig. · Pubmed #14640878 links to  free full text

Abstract: INTRODUCTION: hepatitis B virus (HBV) reactivation in immunocompromised states is a well-known event that may be a serious problem in endemic areas of infection. Presently, the investigation of hepatitis B status has been recommended prior to receiving cytotoxic treatment. Lamivudine has been used in the reactivation of HBV in immunocompromised states. We report our corresponding data for lamivudine in the treatment of HBV reactivation after intensive chemotherapy in patients with lymphoma and after kidney transplantation. CLINICAL OBSERVATION: we present two cases of HBV reactivation after chemotherapy for lymphoma and two cases after cadaveric renal transplantation treated with lamivudine (100-150 mg/day). RESULTS: we observed a prompt clinical improvement in all patients after lamivudine treatment. Furthermore, laboratory data showed a rapid biochemical and antiviral response. However, the response in lymphoma patients was quicker than in patients who had post-transplantation reactivation of HBV. Therapy was well tolerated and no relevant side effects appeared during follow-up (twenty four months). The HBV remained negative in three cases. CONCLUSION: lamivudine is effective and safe in the treatment of HBV reactivation in immunodepressed patients. Lamivudine therapy should be considered for the treatment of HBV reactivation in patients with prior hepatitis B or chronic hepatitis B with inactive viral replication.