International journal of STD & AIDS
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The outcomes of HIV-infected patients requiring critical care have improved. However, in developing countries, information about HIV-infected patients admitted to intensive care units (ICUs) is scarce. We describe the prognosis of HIV-infected patients admitted to a Brazilian ICU and the factors predictive of short- and long-term survival. ⋯ Septic shock was also associated with long-term survival (hazard ratio, 3.0; 95% CI, 1.31-6.90). In-hospital and in-ICU mortality were higher than those reported for developed countries. ICU admission mostly due to AIDS-related diseases may explain these differences.
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Mondor's disease can manifest itself in the penile dorsal vein. It is a rare complaint with a quoted incidence of 1.39%. ⋯ He was managed with non-steroidal anti-inflammatory drugs and sexual abstinence and his symptoms resolved in the following two weeks. Practitioners need to beware of Mondor's disease as a differential diagnosis in the presence of penile swelling and not underestimate the anxiety it can cause the patient.
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The evolution of treatment guidelines for early syphilis to single-dose benzathine penicillin regardless of HIV status has been controversial in the UK. We describe the treatment response in patients treated by current and previous regimens of benzathine penicillin for early syphilis. We found no difference in treatment efficacy between single-dose benzathine and previously recommended benzathine treatment courses in HIV co-infected patients. ⋯ This may be due to the loss to follow-up in HIV-negative patients. HIV-infected patients were increasingly likely to be re-infected with syphilis compared to HIV-negative patients. Our findings also justify the screening of HIV patients with syphilis serology at each routine HIV follow-up.
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In incarcerated adolescents, 13% developed pelvic inflammatory disease (PID) between the time of testing and treatment for chlamydial and gonorrhoeal infection, and 13% developed PID in the 30 days following single-dose treatment for one or both of these infections.
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Long-term outcomes of HIV-infected patients admitted to the intensive care unit (ICU) since the advent of combination antiretroviral therapy (cART) have not been well described. We reviewed the long-term outcomes and clinical follow-up of HIV-infected patients admitted to the Prince of Wales Hospital ICU between 1999 and 2005 by a retrospective medical record review. Mortality was assessed in the ICU, in hospital and in the long-term. ⋯ Higher APACHE (acute physiology and chronic health evaluation) II scores (median 27 versus 12, P < 0.001), lower CD4 cell counts (median 45 versus 335 cells/μL, P = 0.041) and longer hospitalization times prior to ICU admission (median 4 versus 1 day, P = 0.02) were significantly associated with in-hospital mortality. We found 85% of the subjects who survived hospital admission were still alive at a median of 41 months (4 months to 5 years) of follow-up, all of who were functionally independent. HIV-infected patients who survived ICU admission at our institution had good long-term outcomes in the cART era.