Comparison of therapeutic effects between drainage blood reinfusion and temporary clamping drainage after total knee arthroplasty in patients with rheumatoid arthritis

OBJECTIVE: To compare the therapeutic effects between drainage blood reinfusion and temporary clamping drainage after total knee arthroplasty in patients with rheumatoid arthritis to provide a basis for clinical practice. METHODS: Data from 83 patients with rheumatoid arthritis undergoing total knee arthroplasty were retrospectively analyzed. The 83 patients were divided into a drainage blood reinfusion group (DR group, n = 45) and a temporary clamping drainage group (CD group, n = 38). In the DR group, postoperative drainage blood was used for autotransfusion. In the CD group, closed drainage was adopted, and the drainage tube was clamped for 2 h postoperatively followed by patency. The postoperative drainage amount, hemoglobin level, rate and average volume of allogeneic blood transfusion, swelling and ecchymosis of the affected knee joint, time to straight-leg raising and range of active knee flexion were compared between the two groups. RESULTS: The total drainage volume was higher in the DR group than in the CD group (P = 0.000). The average volume of postoperative allogeneic blood transfusion (P = 0.000) and the decrease in the hemoglobin level 24 h after total knee arthroplasty (P = 0.012) were lower in the DR group than in the CD group. Swelling and ecchymosis of the affected knee joint, time to straight-leg raising and the range of active knee flexion were improved in the DR group compared with the CD group (all P<0.05). CONCLUSION: Compared with temporary clamping drainage, drainage blood reinfusion after total knee arthroplasty can reduce the allogeneic blood transfusion volume and is conducive to early rehabilitation in patients with rheumatoid arthritis. .

Seroprevalence of human herpesvirus 8 infection in children born to HIV-1- infected women in São Paulo, Brazil

Human herpesvirus-8 (HHV-8) appears to be transmitted mainly by sexual contact. However, several studies suggest that in developing countries the infection may be acquired early in life by routes other than sexual transmission. The present study estimated the seroprevalence of HHV-8 in Brazilian children born to HIV-1-infected mothers. The serum samples were collected in a cross-sectional cohort study from 99 children born to HIV-infected mothers (median age 3.27 years; range 1.5-13.8 years) attending the outpatient clinic of the Federal University of São Paulo. IgG antibodies to HHV-8 latency-associated nuclear antigen and lytic phase antigens were detected by immunofluorescence assays. The samples tested were collected from children aged 12 months or older to exclude the possibility of cross-placental antibody transport. The total prevalence of anti-lytic antibodies in this population (5/99; 5 percent) reveals that HHV-8 infection can occur during childhood. Children aged 1.5 to 2 years had a seroprevalence of 2 percent (1/50) and children aged 3.25 to 13.8 years had a seroprevalence of 8 percent (4/49). This difference was not statistically significant, probably because of the small size of the sample, but it suggests that HHV-8 infection occurs more commonly late in infancy. Further prospective studies are necessary to evaluate the timing and risk factors for primary HHV-8 infection in the pediatric population.

Human herpesvirus 8 can be transmitted through blood in drug addicts

Human Herpes virus type-8 (HHV-8) seroprevalence was studied in a population of HIV positive intravenous drug users (IVDUs) from Argentina. Analysis of this population also indirectly made it possible to study HHV-8 blood transmission, because these individuals frequently engage in needle sharing behavior and are capable of acquiring a broad array of blood borne pathogens, including Hepatitis B/C virus. The seroprevalence of HHV-8 in IVDUs was compared to a group of non-IVDUs and HIV negative individuals. Of the 223 individuals tested, 13.45 percent were HHV-8 positive, 16.99 percent in the IVDUs group, and 5.71 percent in the non-IVDUs. Among HIV positive IVDUs, 25/144 (17.36 percent) were also HHV-8 seropositive. The seropositivity rate of HHV-8 in HIV negative IVDUs was 11.1 percent. In contrast, HHV-8 seroprevalence in HIV negative heterosexual individuals without drug usage behavior was even lower (5.71 percent). The rate of HHV-8 infection in HIV positive IVDUs was three times as high compared to the non IVDU HIV negative individuals, suggesting that IVDU is a risk for HHV-8 infection. Furthermore, it was found that IVDUs showed a very high rate of Hepatitis B/C (52.77 percent), which also correlate with HHV-8 infection in this population (23.68 percent). All Hepatitis B/C positive individuals were also HIV positive. Our data confirm other studies showing that individuals who share needles are at risk for acquiring Hepatitis B/C and HIV infections. In addition, our results suggest that they are also at risk to acquiring HHV-8 infection by the same route.

Os herpesvírus humanos no curso da síndrome da imunodeficiência adquirida / The human herpesvirus in curse of acquired immunodeficiency syndrome

As infecçöes provocadas pelos herpesvírus humanos formam um grupo de moléstias de distribuiçäo ubíqua. Nos pacientes imunodeprimidos, em especial nos HIV positivos, a infecçäo provocada pelos herpesvírus é causa importante de morbidade e mortalidade. Essas moléstias podem recorrer com mais freqüência e com curso mais grave e prolongado. Graças à grande carga viral existente, säo também mais propensos a desenvolver resistência às drogas antivirais. Säo discutidas as características mais relevantes da infecçäo pelos herpesvírus nos imunocomprometidos com especial ênfase em herpes simples, herpes-zóster, mononucleose e infecçäo peloCMV, HHV-6, HHV-7,e HHV-8.

Infecciones herpéticas / Herpetic infections

Los virus Herpes conforman una vasta familia de virus ADN, que están constituidos por un cápside formado por 162 subunidades o capsómeros, rodeado por una envoltura lipídica con espículas, las que al igual que los capsómeros representan sitios antigénicos que permiten la adhesión del virus a la superficie de las células susceptibles o permisivas a las cuales penetran y en los que se reduplican

Os vírus do herpes simplex e a infecçäo herpética / Herpes simplex viruses and herpetic infection

Este artigo de revisäo aborda as principais características dos vírus do herpes simplex (HSV) e os aspectos gerais das infecçöes causadas pelos sorotipos virais 1 e 2. Dá-se enfoque ás menigoencefalites e ás manifestaçöes observadas em pacientes imunodeprimidos. Os métodos diagnósticos clássicos e modernos säo citados, ressaltando-se a importância de técnicas rápidas, com alta especificidade e sensibilidade, como a reaçäo em cadeia da polimerase (PCR). O diagnóstico precoce é fundamental nos casos graves de pacientes imunocomprometidos e nas encefalites herpéticas, onde o uso de drogas antivirais específicas contribuem para o prognóstico do paciente. Finalmente, mostram-se aspectos relacionados às vacinas contra os HSV.