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1.
Respirar (Ciudad Autón. B. Aires) ; 16(2): 127-136, Junio 2024.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1556122

ABSTRACT

Introducción: La neumonía por COVID-19 puede presentarse con dos patrones radio-lógicos: daño alveolar difuso o neumonía organizativa. Estos patrones tienen diferente evolución y pronóstico en pacientes sin infección por COVID-19. Nuestro objetivo fue evaluar la prevalencia del patrón radiológico de neumonía organizativa y su asociación con los desenlaces clínicos.Métodos: Se realizó un estudio de cohorte retrospectivo que incluyó a pacientes adultos hospitalizados por COVID-19 grave/crítica a los que se les realizó una tomografía computarizada de tórax en los 21 días posteriores al diagnóstico. Los patrones radiológicos fueron revisados y clasificados por dos radiólogos expertos. Resultados: De los 80 pacientes incluidos, el 89% (n=71) presentaron un patrón compatible con neumonía organizativa. Los principales hallazgos radiológicos fueron la distribución multilobar (98,7%) y bilateral (97,6%) con opacidades en vidrio esmerilado (97,6%). El 44% (n=33) de los sujetos requirió ingreso en cuidados intensivos, de los cuales el 24% (n=19) recibió ventilación mecánica. La presencia de neumonía organizativa se asoció de forma independiente con una disminución de las probabilidades de ventilación mecánica o muerte (Odds ratio 0,14; intervalo de confianza del 95%: 0,02 - 0,96; valor de p 0,045) en un modelo multivariado que incluía la edad, el sexo, el IMC y la afectación pulmonar en la TC.Conclusiones: Un patrón radiológico de neumonía organizativa es altamente prevalen-te en pacientes con COVID-19 grave/crítico y se asocia con mejores resultados clínico


Introduction: COVID-19 pneumonia can present with two distinct radiologic patterns: diffuse alveolar damage or organizing pneumonia. These patterns have been linked to different outcomes in non-COVID-19 settings. We sought to assess the prevalence of organizing pneumonia radiologic pattern and its association with clinical outcomes. Methods: We performed a retrospective cohort study including adult patients hospita- lized for severe/critical COVID-19 who underwent chest computed tomography within 21 days of diagnosis. Radiologic patterns were reviewed and classified by two expert radiologists. Results: Among 80 patients included, 89% (n=71) presented a pattern consistent with organizing pneumonia. The main radiologic findings were multilobar (98.7%) and bilateral (97.6%) distribution with ground glass opacities (97.6%). Intensive care admission was required for 44% (n=33) of subjects, of which 24% (n=19) received mechanical ventilation. The presence of organizing pneumonia was independently associated with a decreased odds of mechanical ventilation or death (Odds ratio 0.14; 95% confidence interval 0.02 - 0.96; p value 0.045) in a multivariate model including age, gender, BMI and lung involvement on CT. Conclusion: A radiologic pattern of organizing pneumonia is highly prevalent in patients with severe/critical COVID-19 and is associated with improved clinical outcomes.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Pneumonia/diagnostic imaging , SARS-CoV-2 , COVID-19/epidemiology , Argentina/epidemiology , Respiration, Artificial , Comorbidity , Clinical Diagnosis , Polymerase Chain Reaction/methods , Prevalence , Cohort Studies , Critical Illness , COVID-19 Serological Testing
2.
Respirar (Ciudad Autón. B. Aires) ; 16(2): 137-150, Junio 2024.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1556149

ABSTRACT

Introducción: SARS-CoV-2 ha causado millones de muertes a nivel global desde su primer caso reportado en China. En Guatemala existen pocos estudios que describan los factores pronósticos. Nuestro objetivo fue determinar los factores asociados de mortalidad a 30 días en pacientes con neumonía (Nm) por SARS-CoV-2 y construir un modelo predictor. Material y Métodos: Estudio retrospectivo en 144 sujetos en el Hospital Roosevelt de marzo a diciembre 2020 con criterios de Nm por SARS-CoV-2. Se revisó el expediente médico para datos clínicos y de laboratorio desde ingreso hasta alta hospitalaria o muerte. Resultados: Se evaluaron 105 hombres y 39 mujeres con media de edad 53 años. El 47% tenía comorbilidades como diabetes mellitus 2 e hipertensión arterial sistémica. Promedio de días de hospitalización: 13. Cuadros leves a moderados de Síndrome de Distrés Respiratorio Agudo (SDRA): 92%. Se indicó ventilación mecánica invasiva (VMI) a 46 pacientes. La mortalidad general fue 35%. Factores asociados a mortalidad a 30 días: edad ≥50 años, inicio de síntomas ≥7 días, SDRA severo, radio NL >4,4, recibir VMI, alteración en LDH y procalcitonina. Nuestro modelo mostró que los mejores predictores de mortalidad eran alteración en procalcitonina (OR: 4,45), recibir VMI (OR: 112) y días de estancia hospitalaria (OR: 1,12) con precisión de 91,5% y área bajo la curva de 94,4%. Conclusiones: Los factores pronósticos de mortalidad en pacientes guatemaltecos con Nm por SARS-CoV-2 son múltiples e incluyen rasgos demográficos, clínicos y serológicos; identificarlos y contar con un modelo pronóstico ayudará a brindar atención médica de precisión.


Introduction: SARS-CoV-2 has caused millions of deaths globally since its first case was reported in China. In Guatemala, few studies describe prognostic factors. Our objective was to determine the factors associated with 30 day mortality in patients with Pneumonia (Nm) due to SARS-CoV-2 and to build a predictor model. Material and Methods: Retrospective study in 144 subjects at Roosevelt Hospital from March to December 2020 with Nm criteria for SARS-CoV-2. The medical record was rviewed, obtaining clinical and laboratory data from admission to hospital discharge or death. Results: 105 men and 39 women with an average age of 53 years were evaluated. 47% had comorbidities, with type 2 diabetes mellitus and systemic arterial hypertension being common. The average number of days of hospitalization was 13. 92% had mild to moderate acute respiratory distress syndrome (ARDS). Invasive mechanical ventila-tion (IMV) was indicated for 46 patients. Overall mortality was 35%. The factors asso-ciated with 30-day mortality were age ≥50 years, the onset of symptoms ≥7 days, severe ARDS, N/L ratio >4.4, receiving IMV, alterations in LDH, and procalcitonin. Our model showed that the best predictors of mortality were altered procalcitonin (OR: 4.45), receiving IMV (OR: 112), and days of hospital stay (OR: 1.12) with precision of 91.5% and area under the curve of 94.4%. Conclusions: The prognostic factors of mortality in Guatemalan patients with Nm due to SARS-CoV-2 are multiple and include demographic, clinical and serological features; identifying them and having a prognostic model will help provide precision medical care.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Pneumonia/mortality , Prognosis , SARS-CoV-2 , COVID-19/epidemiology , Oxygen Inhalation Therapy , Respiration, Artificial , Respiratory Distress Syndrome, Newborn/mortality , Comorbidity , Polymerase Chain Reaction , Ultrasonography , Age Factors , Guatemala/epidemiology
3.
Rev. chil. infectol ; 41(2): 212-217, abr. 2024. ilus, tab
Article in Spanish | LILACS | ID: biblio-1559675

ABSTRACT

INTRODUCCIÓN: Helicobacter pylori afecta a más de 50% de la población mundial, siendo más prevalente en poblaciones de nivel socioeconómico bajo; esta bacteria constituye la principal causa de cáncer gástrico a nivel global. OBJETIVO: Determinar la frecuencia y los factores asociados a la infección por H. pylori en personas adultas que viven en el centro histórico de la ciudad de Cajamarca, en el norte del Perú. MATERIAL Y MÉTODO: Estudio descriptivo que incluyó 124 personas encuestadas mediante un cuestionario y evaluadas mediante endoscopía y cultivo de biopsia gástrica. Una biopsia por persona fue sometida a prueba de ureasa y los cultivos se confirmaron por reacción de polimerasa en cadena (RPC). RESULTADOS: La frecuencia de infección fue de 60,5 % (IC 95% 51,3 - 69,2). El análisis univariado demostró asociación significativa entre la infección y la edad (p = 0,002), y entre la infección y el antecedente de patología gástrica (p = 0,015). El análisis multivariado reveló dos factores asociados: edad (OR = 0,94; IC95% 0,90-0,97) y antecedente de infección por H. pylori (OR = 0,23; IC95% 0,08 - 0,67). CONCLUSIONES: Existe alta frecuencia de infección por H. pylori en esta población; la edad y el antecedente de infección constituyen factores asociados que deben evaluarse con mayor profundidad.


BACKGROUND: Helicobacter pylori affects more than 50% of the world's population, being more prevalent in populations of low socioeconomic status. H. pylori is the main cause of gastric cancer globally. AIM: To establish the frequency and factors associated with H. pylori infection in adults living in the historic center of Cajamarca City, in northern Peru. METHODS: This was a descriptive study that included 124 individuals surveyed through a questionnaire and evaluated through endoscopy and gastric biopsy culture. One biopsy per person underwent the urease test, and the cultures were confirmed by PCR. RESULTS: The frequency of infection was 60.5% (95% CI 51.3 - 69.2). In the univariate analysis, there was a significant association between the infection and age (p = 0.002), and between the infection and a history of gastric pathology (p = 0.015). The multivariate analysis revealed two associated factors: age (OR = 0.94; 95% CI 0.90 - 0.97), and history of H. pylori infection (OR = 0.23; 95% CI 0.08 - 0.67). CONCLUSIONS: There is a high frequency of H. pylori infection in this population, and the age and history of H. pylori infection are factors that should be further evaluated.


Subject(s)
Humans , Male , Female , Middle Aged , Helicobacter Infections/diagnosis , Helicobacter Infections/epidemiology , Peru/epidemiology , Urease/analysis , Biopsy , Polymerase Chain Reaction , Cross-Sectional Studies , Multivariate Analysis , Surveys and Questionnaires , Risk Factors , Endoscopy, Gastrointestinal , Helicobacter pylori/isolation & purification , Helicobacter pylori/genetics , Helicobacter Infections/microbiology , Gastric Mucosa/microbiology , Gastric Mucosa/pathology
4.
Rev. chil. infectol ; 41(1): 27-35, feb. 2024. tab
Article in Spanish | LILACS | ID: biblio-1559663

ABSTRACT

INTRODUCCIÓN: El virus del papiloma humano de alto riesgo (VPH-AR) es responsable del cáncer de cuello uterino y sus lesiones preneoplásicas. Los genotipos VPH16 y VPH18 son los más frecuentes en este cáncer. La integración del VPH-AR en el genoma de la célula hospedera es crucial en la carcinogénesis cervical, pero la etapa en que ocurre en la población chilena es incierta. OBJETIVO: Evaluar la integración de VPH16 y VPH18 en lesiones pre-neoplásicas de cuello uterino. MÉTODOS: Se analizaron 108 muestras de raspados cervicales. El VPH se genotipificó mediante reacción de polimerasa en cadena (RPC) e hibridación no radiactiva. La integración de VPH16 y VPH18 se determinó por presencia del gen E2 mediante RPC. RESULTADOS: VPH16 y VPH18 se detectaron en 36,1% y 12,0% de las muestras, respectivamente. El VPH16 se integró en 23,1% de los casos de VPH16, mientras que VPH18 se integró en 100% de las muestras positivas para este genotipo. CONCLUSIONES: La integración VPH-AR es un evento temprano en la carcinogénesis cervical que ocurre en casi la mitad de las lesiones pre-neoplásicas y es más frecuente en VPH18 que en VPH16. La evaluación de la integración VPH-AR puede ser una herramienta útil para detectar el virus en la población chilena.


BACKGROUND: High-risk Human Papillomaviruses (HR-HPVs) are the etiological agents of cervical cancer and its preneoplastic lesions. HPV16 and 18 are the most frequent HR-HPV genotypes detected in cervical cancer. HR-HPV genome integration into the host cell is an important event in the carcinogenic process. However, it remains uncertain which stage of cervical carcinogenesis HPV16 and 18 integration occurs in the Chilean population. AIM: The goal of this study was to evaluate HPV16 and HPV18 integration in preneoplastic lesions of the cervix. METHODS: DNA was extracted from 108 cervical scrape samples with preneoplastic lesions. HPV was genotyped using PCR and non-radioactive hybridization. The integration status of HPV16 and HPV 18 was determined by evaluating the E2 gene presence through PCR. RESULTS: HPV16 and HPV18 tested positive in 36.1% and 12.0% of samples, respectively. HPV16 was found integrated in 23.1% of HPV 16 cases, while HPV 18 in 100% of samples positive for this viral genotype. CONCLUSIONS: HR-HPV integration is an early event in cervical carcinogenesis, occurring in nearly half of preneoplastic lesions and being more frequent in HPV18 than in HPV16. The evaluation of HR-HPV integration can be utilized as a complementary tool for detecting HPV in the Chilean population.


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Young Adult , Precancerous Conditions/virology , Cervix Uteri/virology , Virus Integration/genetics , Papillomaviridae/isolation & purification , Papillomaviridae/genetics , Precancerous Conditions/genetics , DNA, Viral/genetics , Cervix Uteri/pathology , Chile , Polymerase Chain Reaction , Cross-Sectional Studies , Human papillomavirus 16/isolation & purification , Human papillomavirus 16/genetics , Human papillomavirus 18/isolation & purification , Human papillomavirus 18/genetics , Genotyping Techniques , Genotype
5.
AlQalam Journal of Medical and Applied Sciences ; 7(2): 213-221, 2024. figures, tables
Article in English | AIM | ID: biblio-1552710

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by a novel strain of coronavirus belonging to the genus Beta coronavirus named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged as a major pandemic worldwide. This contagious virus had spread in many different forms, and patients have demonstrated a wide range of symptoms, ranging from moderate to severe illness. This study aims to highlight the important associations between SARS-CoV-2 infection, vaccination, and possible complications at the Libyan International Medical University, Benghazi. This crosssectional survey was conducted among students and their families at Libyan International Medical University in Benghazi, Libya. Among the 100 participants, 72% were between the ages of 18 and 39. Up to (59%) of participants were men. As for the infection with COVID-19, 77% of participants were infected. Most of the participants had no chronic diseases (69%); however, the most common chronic disease was diabetes mellitus (13%). 82% of participants were vaccinated; the most common types of vaccines administered were Sinopharm and Sputnik V (24%). Following vaccination, 71% of participants had no COVID-19 infection, while 29% did get the infection. Regarding this study, after COVID-19 infection, 66% of participants had no complications; however, 17% had pulmonary complications, which was the most common complication among the participants. As for the complications following the vaccination, 81% of participants had none, while there were pulmonary and neurological complications in 7­6%. The results of the study showed that the most frequent complications noticed among the participants following the COVID-19 infection and vaccination were pulmonary and neurological complications.


Subject(s)
Humans , Male , Female , Polymerase Chain Reaction , Vaccination , Drug-Related Side Effects and Adverse Reactions , COVID-19 Vaccines , COVID-19 , Comorbidity , Diagnosis , Pandemics
6.
São Paulo; s.n; 2024. 16-130 p. ilus, graf, tab.
Thesis in Portuguese | LILACS, CONASS, ColecionaSUS, SES-SP, SESSP-CTDPROD, SES-SP, SESSP-ACVSES, SESSP-TESESESSP, SES-SP | ID: biblio-1555568

ABSTRACT

O bocavírus humano (HBoV) foi descrito pela primeira vez em 2005 e desde então associado como agente etiológico causador de doenças respiratórias e diarreia em todo mundo. Há 4 genótipos de HBoV identificados até o momento. HBoV-1 é comumente associado as infecções respiratórias, enquanto o HBoV-2, HBoV-3 e HBoV-4 são frequentemente detectados em amostras fecais. Coinfecções envolvendo o HBoV e outros agentes virais entéricos são frequentes. Vírus entéricos podem ser preservados em fezes congeladas por longos períodos. O objetivo do presente estudo foi investigar a frequência e a diversidade genotípica dos HBoV em amostras fecais históricas armazenadas e coletadas antes de 2005, a fim de compreender a história natural dos HBoV em pacientes com diarreia nas regiões Centro Oeste, Sul e Sudeste do Brasil. A associação do HBoV com outros vírus gastroentéricos de importância epidemiológica na doença diarreica também foi explorada. Um total de 3347 amostras foram selecionadas e testadas para HBoV por qPCR. As amostras positivas foram genotipadas por PCR convencional seguido de sequenciamento Sanger. As amostras positivas para HBoV por qPCR também foram testadas para a presença de Norovírus (NoV) por RT-qPCR e para Adenovirus Humano (HAdV) por PCR convencional e sequenciamento. HBoV foi detectado em 5,8% (195/3347). Coinfecção com NoV foi encontrada em 25,6% (50/195), HAdV 8,2% (16/195) e a tripla-infecção em 1% (2/195), totalizando 34,9% (68/195) de casos de coinfecções. Esses achados indicam que o HBoV pode ter um papel epidemiológico importante como único agente causador de doença diarreica em pacientes (65,2% de monoinfecções). A taxa de detecção variou significativamente de acordo com os anos de 2000-2001, 2002-2003 e 2003-2004 (p<0,05).


The human bocavirus (HBoV) was first described in 2005 and has since been associated as an etiological agent causing respiratory diseases and diarrhea worldwide. There are four genotypes of HBoV identified so far. HBoV-1 is commonly associated with respiratory infections, while HBoV-2, HBoV-3, and HBoV-4 are often detected in fecal samples. Coinfections involving HBoV and other enteric viral agents are common. Enteric viruses can be preserved in frozen feces for long periods. The aim of this study was to investigate the frequency and genotypic diversity of HBoV in stored historical fecal samples collected before 2005, in order to understand the natural history of HBoV in patients with diarrhea in the South and Southeast regions of Brazil. The association of HBoV with other gastroenteric viruses of epidemiological importance in diarrheal disease was also explored. A total of 3347 selected samples were tested for HBoV by qPCR. Positive samples were genotyped by conventional PCR followed by Sanger sequencing. Samples positive for HBoV by qPCR were also tested for the presence of Norovirus (NoV) by RT-qPCR and Human Adenovirus (HAdV) by conventional PCR and sequencing. HBoV was detected in 5.8% (195/3347) of samples. Coinfection with NoV was found in 25.6% (50/195), HAdV in 8.2% (16/195), and triple infection in 1% (2/195), totaling 34.9% (68/195) of coinfection cases. These findings indicate that HBoV may play an important epidemiological role as a single causative agent of diarrheal disease in patients (65.2% of monoinfections). The detection rate varied significantly according to the years 2000-2001, 2002-2003, and 2003-2004 (p<0.05), reinforcing that HBoV is an important pathogen in childhood diarrhea. The genotype was obtained in 32.8% (64/195) of positive HBoV samples, and genetic analysis identified the circulation of HBoV-1


Subject(s)
Polymerase Chain Reaction , Molecular Typing , Public Health Surveillance , Gastroenteritis
7.
Chinese Journal of Medical Genetics ; (6): 20-24, 2024.
Article in Chinese | WPRIM | ID: wpr-1009347

ABSTRACT

OBJECTIVE@#To assess the effectiveness and feasibility of carrier detection for Spinal muscular atrophy (SMA) by using digital PCR assay.@*METHODS@#Peripheral blood samples were collected from 214 pregnant women who were routinely screened for SMA carriers, of which 204 were randomly selected samples and 10 were samples with known copy numbers of SMN1 exons 7 and 8. Samples with known copy numbers of SMN1 exons 7 and 8 were randomly mixed into the experiment to validate the performance of the digital PCR assay.@*RESULTS@#The copy numbers of SMN1 exons 7 and 8 and SMN2 exons 7 and 8 in peripheral blood samples were detected by digital PCR assay. The results of SMN1 exons 7 and 8 were compared with those of the quantitative PCR method to assess the reliability and clinical performance of the digital PCR assay. Among the 204 random samples, digital PCR has detected five samples with simultaneous heterozygous deletion of SMN1 exons 7 and 8, three samples with heterozygous deletion of SMN1 exon 8 only, and 196 samples with no deletion of SMN1 exons 7 and 8. Ten samples with known SMN1 exons 7 and 8 copy numbers were detected with the expected values. The digital PCR test results were fully consistent with that of the quantitative PCR.@*CONCLUSION@#The results of digital PCR for the detection of copy number variation of SMN1 exons 7 and 8 were consistent with qPCR. Digital PCR assay was able to clearly distinguish the copy number of the target genes, therefore can be used for SMA carrier screening. Moreover, it can also detect copy number of SMN2 exons 7 and 8, which can provide more information for genetic counseling.


Subject(s)
Humans , Female , Pregnancy , DNA Copy Number Variations , Reproducibility of Results , Muscular Atrophy, Spinal/genetics , Polymerase Chain Reaction/methods , Nucleic Acid Amplification Techniques , Survival of Motor Neuron 1 Protein/genetics
8.
Rev. bras. oftalmol ; 83: e0004, 2024. graf
Article in English | LILACS | ID: biblio-1535601

ABSTRACT

ABSTRACT This report was aimed at presenting a case of neurotrophic keratitis and concomitant SARS-CoV-2 infection in a patient who has recently undergone a corneal DALK transplant. One month after corneal transplantation with adequate corneal epithelialization, the patient presented neurotrophic keratitis with a torpid course of the corneal transplant coinciding with a SARS-CoV-2 infection, with an excessive host immune response. In addition, the patient presented a re-positivization of nasopharyngeal polymerase chain reaction of SARS-CoV-2 with past disease after starting treatment with autologous serum eye drops. The implications at the ophthalmological level of SARS-CoV-2 infection may be clarified as the time the illness progresses and we learn more about how it acts. In this case, the disparity of signs and symptoms, the antecedent of corneal surgery, and the possibility of a herpetic infection as a cause of the primary leukoma suggested neurotrophic keratitis. Nonetheless, the involvement of systemic SARS-CoV-2 infection in the process, triggering an excessive host immune response at the corneal level with an increase in inflammatory cytokines must be taken into account. No relationship was found between treatment with autologous serum and re-positivization of nasopharyngeal polymerase chain reaction, presenting the patient a favorable response to treatment.


RESUMO O objetivo deste relato foi apresentar um caso de ceratite neurotrófica e infecção concomitante por SARS-CoV-2 em paciente submetido recentemente a transplante de córnea DALK. Um mês após o transplante de córnea com adequada epitelização da córnea, o paciente apresentou ceratite neurotrófica com curso tórpido do transplante de córnea, coincidindo com infecção por SARS-CoV-2, com resposta imune excessiva do hospedeiro. Além disso, o paciente apresentou repositivização da reação em cadeia da polimerase nasofaríngeo de SARS-CoV-2, com doença pregressa após iniciar tratamento com colírio de soro autólogo. As implicações a nível oftalmológico da infecção por SARS-CoV-2, podem ser esclarecidas à medida que a doença progride e aprendemos mais sobre sua forma de atuação. Neste caso, a disparidade de sinais e sintomas, o antecedente de cirurgia de córnea e a possibilidade de infecção herpética como causa do leucoma primário sugeriram ceratite neurotrófica. No entanto, deve-se levar em consideração o envolvimento da infecção sistêmica por SARS-CoV-2 no processo, desencadeando uma resposta imune excessiva do hospedeiro no nível da córnea, com aumento de citocinas inflamatórias. Não foi encontrada relação entre o tratamento com soro autólogo e a repositivização da reação em cadeia da polimerase nasofaríngea, apresentando ao paciente uma resposta favorável ao tratamento.


Subject(s)
Humans , Male , Aged , Corneal Ulcer/diagnosis , Corneal Ulcer/therapy , Corneal Transplantation , Keratoplasty, Penetrating , COVID-19/complications , COVID-19/diagnosis , Postoperative Complications , Immune Adherence Reaction , Corneal Ulcer/etiology , Polymerase Chain Reaction , Azithromycin , Cefixime , Serum , Tomography, Optical Coherence , Slit Lamp Microscopy , SARS-CoV-2 , COVID-19 Drug Treatment , Hydroxychloroquine , Immunity , Keratitis
9.
Vive (El Alto) ; 6(18): 827-838, dic. 2023. ilus
Article in Spanish | LILACS | ID: biblio-1530580

ABSTRACT

A la fecha las vacunas para prevenir el COVID-19, representan la mejor esperanza para combatir el virus, además que éstas constituyeron un reto en la cadena de participación de reparto y distribución para las autoridades estatales en Perú, con respecto a priorizar dentro de la ciudadanía la adecuada administración por parte de quienes participaron en el proceso de vacunación. Objetivo. Analizar la gestión de la distribución y aplicación de la vacuna contra el COVID-19 en el Hospital de Huaycán. Materiales y Métodos. Se diseñó un estudio no experimental, de nivel aplicativo de enfoque cuantitativo, tipo de análisis descriptivo de corte transversal. La población estuvo conformada por 700 profesionales que laboran en dicho hospital. Las técnicas que fueron utilizadas fue la entrevista y la encuesta usando como instrumento un formulario de tipo cuestionario. Resultados. En cuanto a las medidas de prevención del virus en el personal de salud se realizaban pruebas diagnósticas a los trabajadores (pruebas rápidas y PCR) para identificar los casos sospechosos a un total de 2590 trabajadores, de los cuales 2372 se les realizó pruebas rápidas y 218 hisopados. En cuanto al nivel de ejecución de la vacunación se pudo determinar que totalidad de los trabajadores del Hospital de Huaycán, no alcanzaron a estar vacunados en el tiempo de aplicación de vacuna. Conclusiones. La gestión de la distribución y aplicación de la vacuna contra el COVID-19 en el Hospital de Huaycán revela una serie de aspectos tanto positivos como preocupantes. Si bien se observan indicadores de gestión adecuados en la administración de la vacuna, es evidente que la cobertura no ha alcanzado el 100%, lo cual implica retos en términos de alcance y eficacia de la inmunización en la población hospitalaria.


To date, vaccines to prevent COVID-19 represent the best hope for combating the virus, and they represent a challenge in the chain of distribution and distribution participation for state authorities in Peru, with respect to prioritizing the adequate administration by those who participated in the vaccination process among the citizens. Objective. To analyze the management of the distribution and application of the vaccine against COVID-19 in the Huaycán Hospital. Materials and Methods. A non-experimental study was designed, with a quantitative approach, descriptive cross-sectional analysis. The population consisted of 700 professionals working in the hospital. The techniques used were the interview and the survey using a questionnaire-type form as an instrument. Results. Regarding virus prevention measures in health personnel, diagnostic tests were performed on workers (rapid tests and PCR) to identify suspected cases in a total of 2,590 workers, of whom 2,372 underwent rapid tests and 218 swabs. As for the level of implementation of vaccination, it was determined that all the workers of the Hospital de Huaycán were not vaccinated at the time of vaccine application. Conclusions. The management of the distribution and application of the vaccine against COVID-19 in the Huaycán Hospital reveals a series of both positive and worrying aspects. Although adequate management indicators are observed in the administration of the vaccine, it is evident that coverage has not reached 100%, which implies challenges in terms of scope and efficacy of immunization in the hospital population.


Até o momento, as vacinas para prevenir a COVID-19 representam a melhor esperança para o combate ao vírus e têm representado um desafio na cadeia de participação na distribuição e distribuição para as autoridades estatais no Peru, com relação à priorização da administração adequada por parte dos envolvidos no processo de vacinação entre os cidadãos. Objetivo. Analisar a gestão da distribuição e aplicação da vacina contra a COVID-19 no Hospital Huaycán. Materiais e métodos. Foi projetado um estudo não experimental, com uma análise quantitativa, descritiva, transversal e transversal. A população foi composta por 700 profissionais que trabalham no hospital. As técnicas utilizadas foram entrevistas e pesquisas usando um formulário do tipo questionário como instrumento. Resultados. Em termos de medidas de prevenção do vírus entre o pessoal de saúde, foram realizados testes diagnósticos nos trabalhadores (testes rápidos e PCR) para identificar casos suspeitos em um total de 2.590 trabalhadores, dos quais 2.372 foram submetidos a testes rápidos e 218 a swabs. Em termos do nível de implementação da vacinação, foi determinado que todos os trabalhadores do Hospital Huaycán não foram vacinados dentro do período de vacinação. Conclusões. O gerenciamento da distribuição e aplicação da vacina contra a COVID-19 no Hospital Huaycán revela uma série de aspectos positivos e preocupantes. Embora sejam observados indicadores de gestão adequados na administração da vacina, é evidente que a cobertura não atingiu 100%, o que implica desafios em termos de alcance e eficácia da imunização na população do hospital.


Subject(s)
Humans , Polymerase Chain Reaction
10.
Medicentro (Villa Clara) ; 27(3)sept. 2023.
Article in Spanish | LILACS | ID: biblio-1514493

ABSTRACT

No existe medicación específica contra el SARS-CoV-2 y el tratamiento consiste fundamentalmente en medidas de soporte. La transfusión de plasma de convalecientes consiste en administrar pasivamente anticuerpos policlonales, que generan una respuesta inmune inmediata y disminuyen la carga viral. El objetivo del estudio fue describir la estadía hospitalaria y negativización de reacción en cadena de la polimerasa en tiempo real en pacientes positivos persistentes con el uso de plasma de convalecientes. Se realizó un estudio descriptivo transversal, prospectivo, en 8 pacientes positivos persistentes que recibieron dicho plasma, en el Hospital Universitario Clínico Quirúrgico «Cmdte. Manuel Fajardo» de septiembre a noviembre de 2020. El mayor por ciento de casos necesitó una dosis de plasma de convalecientes para negativizar el PCR-TR. La estadía hospitalaria más frecuente fue de 14 a 19 días, el 62,50 % de los pacientes, 24 horas después de administrada la última dosis de este plasma, negativizó el RCP-TR evolutivo.


There is no specific medication against SARS-CoV-2 and the treatment consists mainly of supportive measures. Convalescent plasma transfusion consists of passively administered polyclonal antibodies, which generate an immediate immune response and decrease viral load. The objective of the study was to describe hospital stay and real-time polymerase chain reaction negativization in persistently positive patients with the use of convalescent plasma. A prospective, cross-sectional and descriptive study was carried out in 8 persistently positive patients who received such plasma at "Cmdte. Manuel Fajardo" Clinical and Surgical University Hospital from September to November 2020. The highest percentage of cases required a dose of convalescent plasma to make the RT-PCR negative. The most frequent hospital stay was from 14 to 19 days; 62.50% of the patients had a negative evolutionary RT-PCR, 24 hours after administering the last dose of this plasma.


Subject(s)
Polymerase Chain Reaction , COVID-19 Serotherapy
11.
Med. infant ; 30(2): 133-136, Junio 2023. ilus
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1443516

ABSTRACT

Los métodos diagnósticos clásicos de tuberculosis (TB) se basan en la utilización de baciloscopía y cultivo. La identificación del agente etiológico desde la positivización del cultivo requiere entre 10 y 15 días, mientras que el empleo de la reacción en cadena de la polimerasa (PCR) disminuye el tiempo a 24 h, lo que permite no solo identificar las subespecies del complejo Mycobacterium tuberculosis (CMTB) sino también diferenciarlas de otras especies ambientales clínicamente importantes (MOTT) facilitando el diagnóstico y tratamiento. El objetivo del presente trabajo fue determinar la utilidad de la PCR en la identificación temprana de las micobacterias pertenecientes al CMTB, a partir de cultivos positivos, de pacientes con sospecha de TB, atendidos en un hospital pediátrico de alta complejidad, durante un período de cuatro años. A cada muestra, se le realizó baciloscopía y cultivo en medio líquido. A los cultivos positivos, una inmunocromatografía lateral (TBIDR) y luego PCR. El 4,6% del total de muestras (510/11.162) pertenecientes a 198 pacientes presentó cultivos positivos. Cuatrocientos veintiseis (84%) correspondieron a muestras respiratorias. El rendimiento de la baciloscopía directa fue del 41% (194/470). Cuatrocientos treinta y ocho (86%) resultaron M. tuberculosis, 21 (4%) Mycobacterium bovis, 7 (1%), M. bovis-BCG y 44 (9%) MOTT. La utilización de medios de cultivos líquidos junto con el empleo de PCR favorecen una rápida orientación microbiológica y constituye una estrategia útil para optimizar el manejo clínico de estas infecciones, desde el punto de vista terapéutico y epidemiológico, especialmente en pediatría (AU)


Classical diagnostic methods for tuberculosis (TB) are based on the use of smear microscopy and culture. The identification of the etiological agent from positive culture requires 10 to 15 days, while the use of the polymerase chain reaction (PCR) reduces the time to 24 h, which allows not only to identify the subspecies of the Mycobacterium tuberculosis complex (MTC) but also to differentiate them from clinically important environmental mycobacteria other than tuberculosis (MOTT), facilitating diagnosis and treatment. The aim of this study was to determine the usefulness of PCR in the early identification of mycobacteria belonging to the MTC, from positive cultures of patients with suspected TB seen in a pediatric tertiary hospital over a 4-year period. For each sample, smear microscopy and culture in liquid medium was performed. Positive cultures were subjected to lateral immunochromatography (TBIDR) and then PCR. Of the total number of samples (510/11,162) belonging to 198 patients, 4.6% showed positive cultures; 426 (84%) were respiratory samples. The direct smear microscopy yield was 41% (194/470). Overall, 438 (86%) were found to be M. tuberculosis, 21 (4%) Mycobacterium bovis, 7 (1%), M. bovis-BCG, and 44 (9%) MOTT. The use of liquid culture media together with the use of PCR favors a rapid microbiological orientation and is a useful strategy to optimize the clinical management of these infections, from a therapeutic and epidemiological point of view, especially in children (AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Tuberculosis/diagnosis , Tuberculosis/epidemiology , Polymerase Chain Reaction/instrumentation , Mycobacterium tuberculosis/isolation & purification , Mycobacterium tuberculosis/classification , Retrospective Studies
12.
Med. infant ; 30(2): 191-197, Junio 2023. ilus
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1443762

ABSTRACT

Las enfermedades autoinflamatorias (AIDs) son un grupo heterogéneo de desórdenes monogénicos o poligénicos, con características de disregulación inmune innata y/o adaptativa, cuyo mecanismo central es la autoinflamación pero también pueden presentarse con autoinmunidad e inmunodeficiencia. En estos últimos años el desarrollo de las tecnologías de secuenciación masiva han provocado una explosión en el descubrimiento de nuevos genes responsables de AIDs monogénicas. Esto remarca la importancia de implementar este tipo de estudios para llegar a un diagnóstico definitivo sobre todo en este grupo de patologías genéticamente muy diversas donde los fenotipos clínicos se solapan. Sin embargo, dada la presencia de variantes de significación incierta (VUS), los resultados pueden no ser concluyentes planteándose la necesidad de desarrollar pruebas funcionales para determinar la patogenicidad de dichas variantes genéticas. En nuestro grupo de trabajo estamos aplicando la PCR digital en gotas (ddPCR), una técnica cuantitativa de 3era generación altamente sensible, especifica y reproducible que no necesita de curvas de calibración, para desarrollar pruebas funcionales que permitan no sólo reclasificar variantes VUS para lograr diagnósticos definitivos sino también estudiar los mecanismos responsables de las principales AIDs que permitan una estratificación de las terapéuticas especificas a aplicar y de esta manera poder contribuir al diagnóstico, tratamiento y seguimiento de nuestros pacientes en forma personalizada. (AU)


Autoinflammatory diseases (AIDs) are a heterogeneous group of monogenic or polygenic disorders, with characteristics of inborn and/or adaptive immune dysregulation, whose central mechanism is autoinflammation but may also present with autoimmunity and immunodeficiency. In recent years the development of massive sequencing technologies has led to an exponential increase in the discovery of new genes responsible for monogenic AIDs. This emphasizes the importance of the implementation of this type of studies to make a definitive diagnosis, especially in this group of genetically very diverse diseases with overlapping clinical phenotypes. However, given the presence of variants of uncertain significance (VUS), the results may not be conclusive, raising the need to develop functional tests to determine the pathogenicity of these genetic variants. In our working group we are applying droplet digital PCR (ddPCR), a highly sensitive, specific and reproducible third generation quantitative technique that does not require calibration curves, to develop functional tests that allow not only to reclassify VUS variants to achieve definitive diagnoses but also to study the mechanisms responsible for the main AIDs that allow for the stratification of specific treatments to be used and thereby contribute to the individualized diagnosis, treatment, and follow-up of our patients (AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Autoimmune Diseases/diagnosis , Therapeutics/instrumentation , Polymerase Chain Reaction/methods , Hereditary Autoinflammatory Diseases/diagnosis , Hereditary Autoinflammatory Diseases/genetics , High-Throughput Nucleotide Sequencing , Laboratories, Hospital
13.
Rev. Inst. Adolfo Lutz ; 82: e39195, maio 2023. ilus, tab
Article in English | LILACS, CONASS, ColecionaSUS, SES-SP, VETINDEX, SESSP-ACVSES, SESSP-IALPROD, SES-SP | ID: biblio-1435630

ABSTRACT

Single nucleotide polymorphisms (SNPs, rs12979860 e rs8099917) in the Interferon Lambda 4 gene (IFNL4, formerly IFNL3and/or IL28B) has been associated with failure in the innate immune response, sustained virological response in hepatitis C, and HTLV-1-associated myelopathy (HAM) development. To search for these polymorphisms several methodologies can be employed, such as sequencing, real-time or quantitative polymerase chain reaction (qPCR), restriction fragment length polymorphism analysis in PCR products (PCR-RFLP), and tetra-primer PCR. The present study compared the performance of the tetra-primer PCR in relation to the PCR-RFLP, both optimized in the Research HTLV Laboratory of the Center of Immunology of Instituto Adolfo Lutz in São Paulo. One hundred DNA samples obtained from patients of STD/Aids Reference Centre in São Paulo, previously analyzed for IL28B SNPs by PCR-RFLP were selected for analysis, after confirming that they represent all IL28B SNPs patterns described in the literature. The results obtained showed concordance between the PCR-RFLP and the tetra-primer PCR SNPs results, and because of the low cost, easy to perform, and minor employment of biological specimen and reagents, the tetra-primer PCR is of choice to be used in routine. (AU)


Polimorfismos de nucleotídeos únicos (single nucleotide polymorphisms, SNPs rs12979860 e rs8099917) no gene que codifica o Interferon Lambda 4 (IFNL4, antigamente IFNL3 e/ou IL28B) têm sido associados às falhas na resposta imune inata e resposta virológica sustentada na hepatite C, e a mielopatia associada ao HTLV-1 (HTLV-1-associated myelopathy, HAM). A pesquisa destes polimorfismos pode empregar diversas metodologias: sequenciamento, reação em cadeia da polimerase em tempo real ou quantitativa (quantitative polymerase chain reaction, qPCR), análise de fragmentos de restrição enzimática em produtos de PCR (restriction fragment length polymorphism in PCR products, PCR-RFLP) e a tetra-primer PCR. Este estudo comparou o desempenho da tetra-primer PCR em relação a PCR-RFLP, ambas otimizadas no Laboratório de Pesquisa em HTLV do Centro de Imunologia do Instituto Adolfo Lutz de São Paulo. Foram selecionadas 100 amostras de DNA obtidas de pacientes do Centro de Referência e Treinamento em DST/Aids de São Paulo cujos SNPs na IL28B foram anteriormente determinados por PCR-RFLP e representaram todos os perfis descritos em literatura. Os resultados obtidos mostraram concordância entre elas, e pelo fato da tetra-primer PCR ter menor custo, ser de fácil execução, empregar menos tempo, insumos e material biológico, é a técnica de escolha para uso em rotina. (AU)


Subject(s)
Polymorphism, Restriction Fragment Length , Polymerase Chain Reaction , Interleukins , Polymorphism, Single Nucleotide , Interferon Lambda
14.
Rev. chil. infectol ; 40(2): 99-104, abr. 2023. tab
Article in Spanish | LILACS | ID: biblio-1441414

ABSTRACT

Introducción: La meningitis por Listeria monocytogenes (MLM) es una entidad grave con complicaciones a corto plazo. La reacción de polimerasa en cadena (RPC) puede ayudar a mejorar su diagnóstico y pronóstico. Objetivos: Conocer las características de los pacientes diagnosticados de meningitis por L. monocytogenes en los últimos años, a través de diferentes métodos microbiológicos. Pacientes y Métodos: Serie de casos de pacientes adultos ingresados con MLM en el Hospital Clínico San Carlos, Madrid, España, durante doce años (2009-2021). Se describieron variables epidemiológicas, clínicas, microbiológicas, radiológicas y terapéuticas. Resultados: Se registraron doce pacientes con MLM (edad media 67,5 años, 75% varones). En ocho se obtuvo un cultivo positivo a L. monocytogenes. La RPC en líquido cefalorraquídeo (LCR) fue positiva en los dos casos en los que se realizó la prueba. El tratamiento dirigido en todos los casos fue ampicilina durante 21 días. Se registraron complicaciones en un cuarto de los casos. Del total de pacientes uno falleció. Conclusiones: La MLM es una enfermedad poco frecuente y de difícil diagnóstico. En nuestra serie de casos los dos pacientes diagnosticados por RPC tuvieron resultado de cultivo de LCR negativo, y presentaron buena evolución. La determinación de RPC podría permitir diagnosticar un mayor número de casos y con mayor precocidad.


Background: Listeria monocytogenes meningitis (LMM) is a serious entity with short-term complications. Polymerase chain reaction (PCR) can help to improve its diagnosis and prognosis. Aim: To know the characteristics of patients diagnosed with meningitis by L. monocytogenes in recent years, through different microbiological methods. Methods: Case series of adult patients admitted with LMM at the Hospital Clínico San Carlos of Madrid, Spain, during twelve years (2009-2021). Epidemiological, clinical, microbiological, radiological and therapeutic variables were described. Results: Twelve patients with LMM were recorded (mean age 67.5 years, 75% male). Eight had a positive culture for L. monocytogenes. cerebrospinal fluid (CSF) PCR was positive in the two cases in which the test was performed. Treatment in all cases was ampicillin for 21 days. Complications were recorded in a quarter of the cases. One patient died. Conclusions: LMM is a rare and difficult to diagnose disease. In our series of cases, the two patients diagnosed by PCR had negative CSF culture results, and presented good evolution. PCR determination could allow a greater number of cases to be diagnosed earlier.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Meningitis, Listeria/diagnosis , Meningitis, Listeria/epidemiology , Cerebrospinal Fluid/microbiology , Polymerase Chain Reaction , Hospitals, University/statistics & numerical data , Listeria monocytogenes/isolation & purification , Meningitis, Listeria/microbiology , Meningitis, Listeria/drug therapy , Anti-Bacterial Agents/therapeutic use
15.
Rev. Hosp. Ital. B. Aires (2004) ; 43(1): 17-20, mar. 2023. ilus
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1434216

ABSTRACT

El síndrome urémico hemolítico (SUH), descripto en 1955, se caracteriza por la tríada de anemia hemolítica no inmunomediada, trombocitopenia y lesión renal aguda. En su patogenia interviene la toxina Shiga, producida con mayor frecuencia por E. coli O157:H. Puede manifestarse a cualquier edad, aunque es infrecuente en adultos, y se desarrolla en forma esporádica o en brote. Se presenta con un cuadro de dolor abdominal, diarrea, fiebre y vómitos. Puede afectar el sistema nervioso central, pulmones, páncreas y corazón. En adultos, el síndrome evoluciona tras un período de incubación de 1 semana posterior a la diarrea y tiene alta morbimortalidad, a diferencia de los casos pediátricos. Presentamos el caso de una paciente adulta, que cursó internación por síndrome urémico hemolítico. (AU)


Hemolytic uremic syndrome (HUS), described in 1955, is characterized by the triad of non-immune mediated hemolytic anemia, thrombocytopenia, and acute kidney injury. Shiga toxin, produced most frequently by E coli O157:H, is involved in its pathogenesis. Hus can manifest at any age, although it is rare in adults and develops sporadically or in outbreaks. HUS presents with a picture of abdominal pain, diarrhea, fever and vomiting. It can affect the central nervous system, lungs, pancreas, and heart.In adults, the syndrome evolves after an incubation period of 1 week after diarrhea, with high morbidity and mortality, unlike pediatric cases.We present the case of an adult patient who was hospitalized for hemolytic uremic syndrome. (AU)


Subject(s)
Humans , Female , Middle Aged , Escherichia coli O157/isolation & purification , Escherichia coli Infections/complications , Hemolytic-Uremic Syndrome/pathology , Hemolytic-Uremic Syndrome/diagnostic imaging , Polymerase Chain Reaction , Diarrhea/etiology , Hemolytic-Uremic Syndrome/diet therapy , Hemolytic-Uremic Syndrome/blood , Hemolytic-Uremic Syndrome/therapy , Infusions, Parenteral , Kidney Function Tests
16.
Int. j. morphol ; 41(1): 286-296, feb. 2023. ilus, tab, graf
Article in English | LILACS | ID: biblio-1430539

ABSTRACT

SUMMARY: Cancer is the second leading cause of death in the world and colorectal cancer is the only cancer that has shown a sustained increase in mortality in the last decade. In the search for new chemotherapeutic agents against cancer, extremophilic microorganisms have shown to be a potential source to obtain molecules of natural origin and with selective cytotoxic action towards cancer cells. In this work we analyzed the ability of a collection of Antarctic soil bacteria, isolated on Collins Glacier from the rhizosphere of Deschampsia antarctica Desv plant, to secrete molecules capable of inhibiting cell proliferation of a colorectal cancer tumor line. Our results demonstrated that culture supernatants from the Antarctic bacteria K2I17 and MI12 decreased the viability of LoVo cells, a colorectal adenocarcinoma cell line. Phenotypic and genotypic characterization of the Antarctic bacteria showed that they were taxonomically related and nucleotide identity analysis based on the 16S rRNA gene sequence identified the bacterium K2I17 as a species belonging to the genus Bacillus.


El cáncer es la segunda causa de muerte en el mundo y el cáncer colorrectal es el único que presenta un aumento sostenido de la mortalidad en la última década. En la búsqueda de nuevos agentes quimioterapeúticos contra el cáncer, se ha propuesto a los microorganismos extremófilos como una fuente potencial para obtener moléculas de origen natural y con acción citotóxica selectiva hacia las células cancerígenas. En este trabajo analizamos la capacidad de una colección de bacterias de suelo antártico, aisladas en el glaciar Collins desde rizosfera de la planta de Deschampsia antarctica Desv, de secretar moléculas capaces de inhibir la proliferación celular de una línea tumoral de cáncer colorrectal. Nuestros resultados demostraron que los sobrenadantes de cultivo de las bacterias antárticas K2I17 y MI12 disminuyeron la viabilidad de la línea celular de adenocarcinoma colorrectal LoVo, en un ensayo de reducción metabólica de MTT. La caracterización fenotípica y genotípica de las bacterias antárticas, demostró que estaban relacionadas taxonómicamente y el análisis de la identidad nucleotídica en base a la secuencia del gen ARNr 16S identificó a la bacteria K2I17 como una especie perteneciente al género Bacillus.


Subject(s)
Humans , Soil Microbiology , Bacillus/physiology , Colorectal Neoplasms/drug therapy , Cell Proliferation/drug effects , Phenotype , Bacillus/isolation & purification , Bacillus/genetics , In Vitro Techniques , RNA, Ribosomal, 16S , Adenocarcinoma/drug therapy , Cell Survival/drug effects , Polymerase Chain Reaction , Cell Line, Tumor/drug effects , Genotype , Antarctic Regions
17.
DST j. bras. doenças sex. transm ; 35: e23351382, jan. 31, 2023. ilus
Article in English | LILACS | ID: biblio-1513227

ABSTRACT

Introduction: Congenital syphilis is a serious public health problem that causes high rates of intrauterine morbidity and mortality, revealing flaws and weaknesses in the health system. Objective: to report a case of congenital syphilis in a university hospital in the Center-South Region of the State of Rio de Janeiro, Brazil. Case report: A pregnant woman, aged between 19 and 23 years old, carrying a Pregnant Woman's Handbook with a record of seven prenatal consultations and a note of the serological reaction for positive syphilis, but without any treatment, hospitalized at the University Hospital of Vassouras (RJ), in labor, gave birth to a newborn (NB) with a clinical picture and serological test of congenital syphilis. The NB required care in an intensive care unit and was discharged 28 days after birth. Scraping of skin lesions of the NB and placenta was performed for analysis by molecular biology (PCR in house) and genetic material of Treponema pallidum was detected. Conclusion: Congenital syphilis is a serious outcome of syphilis during pregnancy, consuming high financial resources and significant emotional distress for the mother, father, the whole family, as well as for the health teams. Our case report was the first that we are aware of in Brazil with a diagnosis by PCR for positive Treponema pallidum of skin scraping and placental fragment. It also showed poor quality prenatal care, a common factor in most cases of CS in our reality


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Young Adult , Placenta/microbiology , Syphilis, Congenital/diagnosis , Treponema pallidum/isolation & purification , Severity of Illness Index , Polymerase Chain Reaction
18.
Med. lab ; 27(2): 97-109, 2023. Tabs, Grafs
Article in Spanish | LILACS | ID: biblio-1435401

ABSTRACT

Introducción. Las infecciones de transmisión sexual (ITS) son y seguirán siendo un serio problema de salud pública en todo el mundo según los datos de la OMS, con el agravante que la mayoría de los casos son asintomáticos y, además, no existe otro reservorio distinto al humano. El diagnóstico se puede realizar con pruebas tradicionales y moleculares, estas últimas incluyen la reacción en cadena de la polimerasa (PCR), de las cuales existen varios tipos, entre ellas, la PCR múltiple que tiene la capacidad de detectar ITS polimicrobianas a partir de una sola muestra. El objetivo de este estudio fue establecer cuáles fueron las infecciones de transmisión sexual más frecuentes en diferentes grupos de pacientes, así como determinar la utilidad del uso de la técnica de PCR múltiple en el diagnóstico de las ITS. Metodología. Se trata de un estudio observacional de corte transversal realizado entre los años 2021 y 2022 con pacientes que acudieron al servicio de diagnóstico del Laboratorio Clínico VID por sospecha de ITS. Las muestras recolectadas fueron evaluadas utilizando una prueba comercial basada en la técnica de PCR múltiple e hibridación. Las muestras procesadas fueron: orina e hisopados de endocérvix, uretra, recto, faringe y úlceras. Resultados. Se estudiaron 1.027 pacientes, de estos, 228 (22,2 %) fueron positivos para diferentes agentes de trasmisión sexual, distribuidos así: 50 (21,9 %) mujeres, 129 (56,6 %) hombres heterosexuales y 49 (21,5 %) hombres que tenían sexo con hombres (HSH). La edad promedio de las mujeres fue 30 años, y la de ambos grupos de hombres fue 36 años. Los microorganismos más frecuentemente identificados en mujeres fueron: C. trachomatis (A-K) en 28,6 %, seguido de virus herpes simplex tipo 2 (VHS-2) en 26,8 % y N. gonorrhoeae en 17,9 %. En hombres heterosexuales fueron C. trachomatis (A-K) en 37,5 %, N. gonorrhoeae en 21,5 % y VHS-2 en 18,7 %. En HSH fueron C. trachomatis (L1-L3) en 32,7 %, seguido de N. gonorrhoeae en 27,6 %, y de C. trachomatis (A-K) y VHS-2, ambos en 13,8 %. En 11 hombres heterosexuales, 8 HSH y en 6 mujeres, se identificó infección polimicrobiana. Conclusiones. C. trachomatis (A-K) fue el microorganismo más prevalente causante de ITS, seguido de N. gonorrhoeae en ambos grupos de hombres, y de VHS-2 en las mujeres, muy similar a lo reportado a nivel mundial. La prueba de PCR múltiple permite la detección de infecciones polimicrobianas comúnmente asociadas a ITS y el diagnóstico es preciso y confiable, incluso en pacientes asintomáticos


Sexually transmitted infections (STIs) are and will continue to be a serious public health problem throughout the world according to WHO data, with the aggravating factor that most cases are asymptomatic and, furthermore, there is no other reservoir other than humans. The diagnosis can be made with traditional and molecular tests, the latter include the polymerase chain reaction (PCR), of which there are several types, among them, multiplex PCR that has the capacity to detect polymicrobial STIs from a single sample. The objective of this study was to establish which were the most frequent sexually transmitted infections in different groups of patients, as well as to determine the usefulness of the multiplex PCR technique in the diagnosis of STIs. Methodology. This is an observational, cross-sectional study carried out between 2021 and 2022 with patients who attended the VID Clinical Laboratory for suspected STIs. The collected samples were evaluated using a commercial test based on the multiplex PCR technique and hybridization. The samples processed were: urine and swabs from endocervix, urethra, rectum, pharynx, and ulcers. Results. The study included 1,027 patients, of these, 228 (22.2%) were positive for different sexually transmitted agents, distributed as follows: 50 (21.9%) women, 129 (56.6%) heterosexual men and 49 (21.5%) men who had sex with men (MSM). The average age of the women was 30 years, and that of both groups of men was 36 years. The microorganisms most frequently identified in women were: C. trachomatis (A-K) in 28.6%, followed by herpes simplex virus type 2 (HSV-2) in 26.8% and N. gonorrhoeae in 17.9%. In heterosexual men they were C. trachomatis (A-K) in 37.5%, N. gonorrhoeae in 21.5% and HSV-2 in 18.7%. In MSM they were C. trachomatis (L1-L3) in 32.7%, followed by N. gonorrhoeae in 27.6%, and C. trachomatis (A-K) and HSV-2, both in 13.8%. Polymicrobial infection was identified in 11 heterosexual men, 8 MSM, and 6 women. Conclusions. C. trachomatis (A-K) was the most prevalent STI-causing microorganism, followed by N. gonorrhoeae in both groups of men, and HSV-2 in women, very similar to that reported worldwide. The multiplex PCR test allows the detection of polymicrobial infections commonly associated with STIs and the diagnosis is accurate and reliable, even in asymptomatic patients


Subject(s)
Humans , Polymerase Chain Reaction , Sexually Transmitted Diseases , Chlamydia trachomatis , Herpesvirus 2, Human , Molecular Diagnostic Techniques , Neisseria gonorrhoeae
19.
Braz. j. oral sci ; 22: e237697, Jan.-Dec. 2023. ilus
Article in English | LILACS, BBO | ID: biblio-1425466

ABSTRACT

Aim: To assess oral microbial status in patients with acute lymphoblastic leukemia (ALL) undergoing high-dose chemotherapy and to unravel possible associations between nosocomial pathogens and the establishment of chemotherapy-induced oral mucositis (CIOM). Methods: Oral mucosa, saliva, and peripheral blood samples were collected from 46 ALL subjects one day prior to chemotherapy (D0) and 2 weeks after treatment initiation (D14). Clinical intraoral inspection was performed by a single practitioner, with mucositis classification performed according to the WHO oral toxicity scale. Blood components were quantified by automatic flow cytometry, while oral Staphylococcus aureus and Pseudomonas aeruginosa were detected by Polymerase Chain Reaction with species-specific primers. Associations among bacteria and clinical findings were determined by Fisher's Exact test, longitudinal bacterial changes by paired Macnemar, and correlations among blood parameters and mucositis status or bacteria via Mann-Whitney. Results: S. aureus displayed higher detection rates at D14 (p < 0.05) and was positively associated with mucositis, adoption of a non-solid diet (all p < 0.001), nausea and fever (all p < 0.05). Conversely, P. aeruginosa did not correlate to CIOM clinical parameters. At the systemic standpoint, lower hemoglobin levels associated with CIOM and fever events (all p < 0.01). Conclusion: The study evidences S. aureus as a potential pathogen in ALL-CIOM, reaffirming microbial control as an important preventive measure during high-dose immunosuppressive therapy. The weight of non-white-blood-cell parameters should be validated as novel CIOM biomarkers in prospective research


Subject(s)
Humans , Male , Female , Middle Aged , Stomatitis , Bacteria , Polymerase Chain Reaction , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Antineoplastic Agents , Drug Therapy
20.
Health sci. dis ; 24(1): 1-5, 2023. figures, tables
Article in French | AIM | ID: biblio-1411406

ABSTRACT

Introduction. Au Mali, le dépistage de certains virus tels que la dengue, Zika et la fièvre de la vallée du Rift n'est pas systématique au centre national de transfusion sanguine (CNTS). Le risque peut être considérable en raison de leurs courtes périodes de virémie asymptomatique dans la population dont l'incidence est variable et parfois extrêmement élevée. Cette étude avait pour objectif d'explorer la possibilité de transmission de certains arbovirus à travers le don de sang au CNTS de Bamako. Méthodes. Il s'agissait d'une étude transversale, de juillet 2019 à juin 2020 à Bamako. Au total deux cents (200) donneurs de sang du CNTS ont été inclus. Les examens ont été réalisés au Centre d'Infectiologie Charles Mérieux (CICM) de Bamako avec le dépistage du génome des virus responsables de la Dengue, de la fièvre de la Vallée du Rift, et du Zika à l'aide de la technique de la RT-PCR en temps réel. Le Test de Dépistage Rapide (TDR) a été utilisé pour la détection des anticorps IgG et IgM spécifiques de la Dengue. Résultats. Le sexe masculin représente 84% (168/200). Le TDR a détecté 4,5% (9/200) de Dengue IgG positifs et aucun cas de Dengue IgM positif. La technique de RT-PCR n'a détecté aucun des trois virus. Conclusion. Cette étude prouve que le risque de transmission de certains arbovirus à travers le don de sang existe, mais il semble être minime au CNTS de Bamako


Background. In Mali, screening for certain viruses such as dengue, Zika, and Rift Valley fever is not systematic at the national blood transfusion center (CNTS). The risk can be considerable due to their short periods of asymptomatic viremia in the population with variable and sometimes extremely high incidence. The objective of this study was to explore the possibility of transmission of certain arboviruses through blood donation at the CNTS of Bamako. Methods. This was a cross-sectional study, from July 2019 to June 2020 in Bamako. A total of two hundred (200) blood donors from the CNTS were included. The examinations were performed at the Centre d'Infectiologie Charles Mérieux (CICM) in Bamako with the screening of the genome of viruses responsible for Dengue, Rift Valley fever, and Zika using the real-time RT-PCR technique. The Rapid Screening Test (RST) was used for the detection of Dengue-specific IgG and IgM antibodies. Results. Male sex represented 84% (168/200). The RDT detected 4.5% (9/200) of IgG positive Dengue and no IgM positive Dengue cases. The RT-PCR technique did not detect any of the three viruses. Conclusion. This study proves that the risk of transmission of certain arboviruses through blood donation exists, but it seems to be minimal at the CNTS of Bamako.


Subject(s)
Humans , Male , Female , Arboviruses , Rift Valley Fever , Blood Donors , Reverse Transcriptase Polymerase Chain Reaction , Dengue , Zika Virus , Polymerase Chain Reaction
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