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1.
Predictors of low CD4 count in resource-limited settings: based on an antiretroviral-naive heterosexual thai population 总被引:1,自引:0,他引:1
Costello C Nelson KE Jamieson DJ Spacek L Sennun S Tovanabutra S Rungruengthanakit K Suriyanon V Duerr A 《Journal of acquired immune deficiency syndromes (1999)》2005,39(2):242-248
A barrier to the appropriate provision of antiretroviral therapy to treat immunosuppressed HIV-infected persons in resource-poor countries is identifying who requires treatment. The World Health Organization (WHO) has suggested using a clinical algorithm combined with a total lymphocyte count (TLC) < 1200 cells/mm as a surrogate for a CD4 count less than 200 cells/mm when it is not possible to measure the CD4 count. We evaluated various TLC levels, anemia, and body mass index and compared our data with the WHO criteria to develop a more sensitive algorithm to predict CD4 counts of < 200 cells/mm and < 350 cells/mm in 839 men and women from Thailand infected with HIV-1 subtype E (CRF01_AE). The December 2003 WHO guidelines had a sensitivity of 34.1% in men and 31.8% in women to detect persons with a CD4 count < 200 cells/mm in this HIV-infected population from Thailand. The use of a TLC < 1500 cells/mm or TLC < 2000 cells/mm combined with anemia or WHO stage II infection doubled the sensitivity to detect persons with a CD4 count < 200 (63.0% in men, 68.2% in women) with less than a 6% decrease in specificity. 相似文献
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The case of a 20-year-old woman with systemic mastocytosis is reported. The disorder was not preceded by a clinically diagnosed local form of the disease; fibrous changes in organs, bone changes, eosinophilia and increased serotonin, heparin or histamine levels had not been observed. Clinical symptomatology was typical and the patient died one year after the first signs of the disease. 相似文献
4.
Kamya MR Semitala FC Quinn TC Ronald A Njama-Meya D Mayanja-Kizza H Katabira ET Spacek LA 《African health sciences》2004,4(2):94-101
Introduction
Total Lymphocyte Count (TLC) has been found to be an inexpensive and useful marker for staging disease, predicting progression to AIDS and death and monitoring response to ART. However, the correlation between TLC and CD4 has not been consistent. Access to HAART is expanding in Kampala, Uganda, yet there are no published data evaluating the utility of TLC as inexpensive surrogate marker of CD4 cell count to help guide therapeutic decisions.Objective
To evaluate clinical illnesses and total lymphocyte count (TLC) as surrogate markers of the CD4 cell count in HIV infected persons being considered for ART.Methods
A total of 131 patients were enrolled and evaluated by clinical assessment, TLC and CD4 count. Clinical illnesses and TLC dichotomized at various cut-point values were used to determine the sensitivity, specificity, and positive and negative predictive values (PPV and NPV) for the diagnosis of CD4 count <200 cells/mm3 among 100 participants fulfilling criteria for WHO clinical stage 2 and 3.Results
A strong correlation was observed between TLC and CD4 (r = 0.73, p<0.0001). For all clinical syndromes, except pulmonary tuberculosis, the positive predictive values (PPV) for a CD4 count <200 cells/mm3 were high (>80%) but the negative predictive values (NPV) were low. Using the WHO recommended TLC cut-off of 1200 cells/mm3 to diagnose a CD4 less than 200 cells/mm3, the PPV was 100%, and the NPV was 32%.Conclusion
Our data showed a good correlation between TLC and CD4 cell count. However, the WHO recommended TLC cutoff of 1200 did not identify the majority of WHO stage 2 and 3 patients with CD4 counts less than 200 cells/mm3. A more rational use of TLC counts is to treat all patients with WHO stage 2 and 3 who have a TLC <1200 and to limit CD4 counts to patients who are symptomatic but have TLC of >1200. 相似文献5.
Málek F Karel I Polásek R Spacek R Lisa L Dvorák J Stanka P 《Vnitr?ní lékar?ství》2000,46(10):693-696
The authors assessed serum copper and lipoprotein concentrations in a group of 67 patients hospitalized successively at the cardiological department. During hospitalization they were subjected to selective coronarography with assessment of the angiographic score. In 35 patients the angiographic examination was made during the chronic stage of IHD (group A), in 32 patients it was indicated on account of acute coronary syndrome (group B). The authors found that serum copper concentrations are significantly higher in patients with acute forms of IHD (group B, p < 0.001). Serum copper concentrations do not correlate significantly with lipoprotein concentrations nor with the extent of coronary atheroclerosis (angiographic score). 相似文献
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Michelle L. O'Donoghue Ajay Vaidya Rizwan Afsal Joakim Alfredsson William E. Boden Eugene Braunwald Christopher P. Cannon Tim C. Clayton Robbert J. de Winter Keith A.A. Fox Bo Lagerqvist Peter A. McCullough Sabina A. Murphy Rudolf Spacek Eva Swahn Fons Windhausen Marc S. Sabatine 《Journal of the American College of Cardiology》2012
9.
M. Spacek V. Jindrak R. Spunda P. Stadler J. Lindner P. Mitas’ 《Acta chirurgica Belgica》2013,113(6):405-413
Early diagnosis of an infected vascular prosthesis, a potentially life-threatening disease, is a precondition of adequate treatment. The most frequently used diagnostic imaging method is computer tomography. Non-acute infections caused by low grade agents may pose a challenge with ambiguous CT-images and other ancillary imaging methods are used for these cases, each offering different levels of diagnostic sensitivity. These methods come from the fields of radiology (magnetic resonance imaging - MRI) and nuclear medicine studies using labelled leukocytes (“‘In or 99mTc- HMPAO), 99mTc labelled antigranulocyte antibodies, 67Ga-citrate or labelled antibiotics (99mTc-ciprofloxacin) or avidin in combination with ‘“In-biotin. Positron emission tomography (PET) or hybrid PET/CT using 18F-FDG are becoming increasingly popular. The authors of this review article point out the diagnostic potential of the different methods and current trends, including the possibilities of microbiological demonstration of the agent, as well as their potential position in the diagnostic algorithm. 相似文献