Seroprevalence of viral transfusion transmissible infections (HBsAg, anti-HCV, anti-HIV, Syphilis) and coinfection among healthy volunteer blood donors during 5-years in Luanda, Angola

Abstract Background The transmission of diseases by blood products continues to be a worldwide health problem, especially in Africa. Seroprevalence rates of the Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human Immunodeficiency Virus (HIV), Syphilis, and Coinfection in Angola are poorly documented. This study aims to identify the seroprevalence of markers with positive results for Hepatitis B, C, HIV, Syphilis, and Coinfection in blood donors. Material and methods A retrospective study was conducted using a database of positive serological markers for these infections and coinfection in 2734 blood donors traced from 2011 to 2016 in Luanda, Angola. The Chi-Square test (χ2) or Fisher's exact test was used to evaluate serological positivity and donors' characteristics. A p-value < 0.05 was considered statistically significant. Results 2734 blood donors aged 18 to 64 (median age 32 ± 9) were screened from 2011 to 2016. 73.9 % of the donors were positive for one Transfusion-Transmitted Infection (TTI), and 5.9 % showed evidence of multiple infections. The overall seroprevalence rate was 50.2 % (1373) for HBV, 20 % (436) for Syphilis, 7 % (191) for HIV, 5.1 % (140) for HCV, and 5.8 % for coinfected donors. 2467 (90 %) were men, and 267 (10 %) were women. We identified 118 (5.8 %) coinfected donors. Of those, 40 (33.9 %) simultaneously presented Hepatitis B virus surface antigen (HBsAg)/Syphilis, 24 (20.3 %) HBsAg/HIV, 22 (18.6 %) HBsAg/HCV, 20 (16.9 %) HIV/Syphilis, 8 (6.8 %) HCV/Syphilis, and 4 (3.4 %) HIV/HCV. Conclusion A high transfusion-transmissible infection prevalence was found compared to some countries in Sub-Saharan Africa. Therefore, intensifying the screening for these transfusion-transmitted infections in blood donors is critical to ensure blood safety.

Enfermedad arterial coronaria y sus características clínico-angiográficas: Realidad de un centro de atención terciaria privado en Angola / Coronary artery disease and its clinical-angiographic characteristics: Reality of a private tertiary care center in Angola

RESUMEN Introducción: La enfermedad arterial coronaria ha experimentado un aumento entre los angolanos debido a la transición epidemiológica resultante de los nuevos estilos de vidas desfavorables para la salud cardiovascular. Objetivo: Realizar una caracterización clínico-angiográfica de los pacientes con sospecha de enfermedad arterial coronaria llevados a coronariografía. Método: Estudio observacional retrospectivo, realizado en la Clínica Girassol, con 450 pacientes llevados a coronariografía durante enero del 2012 a diciembre del 2018. Se incluyeron variables clínicas (sexo, edad, tipo de procedimiento, factores de riesgo, indicación clínica) y angiográficas (vía de acceso, vasos afectados, dominancia coronaria, estrategia de tratamiento y complicaciones). Resultados: Predominó el sexo masculino (71,6%) con edad media de 59,7(11,2 años. La hipertensión arterial fue el factor de riesgo predominante (76,0%). El 56,2% de los procedimientos fueron realizados de urgencia siendo el síndrome coronario agudo con elevación del ST (37,3%) el más frecuente. La mayoría de los procedimientos (81,1%) fueron por vía femoral. La descendente anterior estuvo afectada en el 37,6% de los casos y la dominancia derecha fue la más prevalente (94,0%). El hematoma femoral constituyó la complicación más frecuente (0,9%). Conclusiones: En los pacientes intervenidos predominó el sexo masculino, las edades avanzadas, la hipertensión arterial y la realización urgente del procedimiento, mayoritariamente por síndromes coronarios agudos con elevación del segmento ST, con muy baja incidencia de complicaciones.

ABSTRACT Introduction: Coronary artery disease has progressively increased among Angolans due to the epidemiological transition resulting from new lifestyles unfavorable to cardiovascular health. Objective: To perform a clinical-angiographic characterization of patients suspected of coronary artery disease undergoing coronary angiography. Method: Retrospective observational study, conducted at Clínica Girassol, with 450 patients who underwent coronary angiography from January 2012 to December 2018. Clinical variables such as sex, age, type of procedure, risk factors, clinical indication, and angiographic features (access route, vessels involved, coronary dominance, treatment strategy and complications) were included. Results: Male sex predominated (71.6%) with a mean age of 59.7±11.2 years. Hypertension was the predominant risk factor (76.0%). Emergency procedures accounted for 56.2% of the interventions; ST-segment elevation acute coronary syndrome (37.3%) was the most frequent. Most of the procedures (81.1%) were performed via the femoral artery. The left anterior descending artery was involved in 37.6% of the cases and right dominance was the most prevalent (94.0%). Femoral hematoma was the most frequent complication (0.9%). Conclusions: The patients who underwent surgery were predominantly male, older, hypertensive, and required urgent procedures, mostly for ST-segment elevation acute coronary syndromes, with very low rates of complications.

Acute acalculous cholecystitis in systemic lupus erythematosus: a rare initial manifestation / Colecistite aguda acalculosa no lúpus eritematoso sistêmico: uma manifestação inicial rara

ABSTRACT Acute acalculous cholecystitis is a very rare gastrointestinal manifestation in systemic lupus erythematosus and becomes rarer as an initial manifestation. There are only two cases reported. The authors report a 20-year-old black woman that presented acute acalculous cholecystitis revealed by abdominal computed tomography. During hospitalization, she was diagnosed systemic lupus erythematosus. Conservative treatment with antibiotics was performed with complete remission of the symptoms. Corticosteroid was started in ambulatory. Cholecystectomy has been the treatment of choice in acute acalculous cholecystitis as a complication of systemic lupus erythematosus. The patient responded well to conservative treatment, and surgery was not required. This case is unique in the way that corticosteroid was started in ambulatory care. We should not forget that the acute acalculous cholecystitis can be the initial presentation of systemic lupus erythematosus although its occurrence is very rare. Conservative treatment should be considered. Abdominal computed tomography was a determinant exam for better assessment of acute acalculous cholecystitis.

RESUMO A colecistite aguda acalculosa é uma manifestação gastrointestinal rara no lúpus eritematoso sistêmico e ainda mais rara como manifestação inicial. Foram descritos apenas dois casos até o momento. Os autores relatam o caso de uma mulher negra de 20 anos, com quadro de colecistite aguda acalculosa revelada pela tomografia computadorizada do abdome. Durante a hospitalização, a paciente foi diagnosticada com lúpus eritematoso sistêmico. Houve remissão completa dos sintomas após tratamento conservador com antibióticos. Iniciou-se tratamento com corticosteroides no ambulatório. Embora a colecistectomia seja o tratamento de escolha em casos de colecistite aguda acalculosa como complicação do lúpus eritematoso sistêmico, a paciente respondeu bem ao tratamento conservador; logo, a cirurgia não foi necessária. Este caso é único em razão do modo como o corticosteroide foi iniciado no atendimento ambulatorial. É importante lembrar que a colecistite aguda acalculosa pode ser a manifestação inicial do lúpus eritematoso sistêmico, embora sua ocorrência seja rara. Deve-se considerar a realização de tratamento conservador. A tomografia computadorizada do abdome foi determinante para que fosse feita uma melhor avaliação dacolecistite aguda acalculosa.

Paniculite no recém-nascido: relato de um caso / Panniculitis in the newborn: report of a case

The authors present a case of panniculitis in a newborn, a rare disease in the neonatal period discussing its causes and differential diagnosis, emphasizing a possible diagnosis of erythema nodosum.

Os autores apresentam um caso clínico de paniculite no recém-nascido, uma afecção rara no período neonatal, discutindo suas prováveis causas e diagnóstico diferencial, enfatizando possível diagnóstico de eritema nodoso.

Osteogênese imperfecta na forma grave: relato de caso / Severe osteogenesis imperfecta: case report

The authors present a case of Osteogenesis Imperfecta, emphasizing the clinical and epidemiological characteristics, forms of classification and treatment of the disease. This is an important case not only to the knowledge of pediatricians and orthopedists, but also for other professionals involved with the problem. This article has been jointly described by the Departments of Pediatrics and Neonatology of the Girassol Clinic in Luanda Capital of the Republic of Angola, Africa.

Os autores apresentam um caso clínico de Osteogenesis Imperfecta, dando ênfase às características clínicas, epidemiológicas, formas de classificação e tratamento da doença. Trata-se de um caso clínico importante para o conhecimento não só de pediatras e ortopedistas, mas também de outros profissionais envolvidos com o problema. O artigo foi descrito juntamente dos Serviços de Pediatria e de Neonatologia da Clínica Girassol, em Luanda, Capital da República de Angola, África.