Hepatitis C virus RNA (HCV-RNA) in blood donors and family members seropositive for anti-HCV antibodies.

BACKGROUND: Non-A, non-B virus is responsible for 75-90% of all cases of blood transfusion-related hepatitis. The aim of this work was to determine hepatitis C virus RNA (HCV-RNA) in a group of blood donors and their household contacts. Serotype and genotype of the isolates were also studied. METHODS: HCV antibodies were investigated in 44,588 blood donors with a commercial immunoassay. Forty-four seropositive donors and 72 household members were further studied. Quantitative analysis of viral RNA was performed with Amplicor HCV 2.0 test, while genotype was determined by INNO-LiPA test and serotype with Murex HCV test. RESULTS: Among the 44,588 donors studied, 333 (0.74%) were positive for anti-HCV. Viral RNA was found in 35 (80%) of the 44 seropositive cases studied. Among the 72 household members, HCV antibodies were detected in six (8.3%) and HCV-RNA in four of these individuals. Serotype 1 and genotype 1 were the most frequent types detected (48 and 64%, respectively). The genotype in the blood donor matched that of his seropositive family member in four of six cases. CONCLUSIONS: Our results suggest that intrafamilial transmission of HCV may occur and we stress the need to study household members of seropositive blood donors, as they have a high risk of infection. In this community, genotype 1 is the most prevalent type in blood donors and family members.

[Barrier family planning methods as risk factor which predisposes to preeclampsia]. / Los métodos de planificación familiar de barrera como factor de riesgo que predispone a la presencia de preeclampsia.

Preeclampsia is a pregnancy-specific syndrome, it occurs in approximately 5-10% of all pregnancies and the etiology remains unknown, but the primigravida adolescent as such as multigravid older women whom have conceived with a new sexual partner have a greater risk, this has been associated also with the use of barrier contraceptive methods that prevent exposure to sperm with the endometrial cavity. An immunological factor has been suspected because fetal antigen's could cause antigenic reaction with the maternal immunological apparatus, for first exposure at these antigens, since the fetus is considered like an allotransplantation. This is supported in some studies that report that the use of condoms, spermicides and withdrawal are associated with developing of preeclampsia in subsequent pregnancy, and another hand indicate at cohabitation preceded for long period, practiced oral sex and use of contraceptive methods that permit exposure to sperm viable with uterus decreased the prevalence of preeclampsia. To test this hypothesis, we initially used data from two groups of pregnant women, comparing the contraceptive and reproductive history of 73 pregnant women with preeclampsia and 70 pregnant women without preeclampsia. The odds ratio for preeclampsia indicated a 2.52-fold (with 95% confidence interval, 1.17 to 5.44, p < 0.05), increased risk of preeclampsia for users of barrier contraceptives compared with women using nonbarrier contraceptives methods. Other variables like socio-demographic and obstetrics analysis were not different between both groups. This study suggest that nonbarrier contraceptive methods or the exposure of paternal spermatic antigens is protective against development of preeclampsia. Further immunological studies are necessary to determine the role of contraception methods and preeclampsia.

Live varicella vaccine in both immunocompromised and healthy children.

BACKGROUND: There is no information on the use of live varicella vaccine in Mexican children. Our objective was to evaluate antibody response and safety of the live varicella vaccine in both healthy and immunocompromised Mexican children. METHODS: One hundred children with no history of varicella/zoster were vaccinated with a live attenuated varicella vaccine. According to their immune status, patients were divided into either a compromised (leukemia, solid tumors, chronic renal failure, and cirrhosis) or a healthy children group. Serum IgG antibodies against VZV were measured by ELISA at baseline and at 3 and 6 months after vaccination. RESULTS: A positive VZV-ELISA at baseline was detected in 36 of 67 (53.7%) immunocompromised children and in 22 of 33 (66%) healthy children. Among VZV-seronegative children, seroconversion at 6 months post-vaccination was observed in 90.3% of compromised children and in 100% of healthy children. Increases in serum antibody levels at 3 and 6 months post-vaccination was similar in both groups. VZV vaccine-related adverse reactions, mostly mild and local, were detected in 29% of the children. Three compromised children had a mild rash symptomatic of varicella after vaccination. CONCLUSIONS: About 50% of immunosuppressed children (mean age 8.8 +/- 3.6 years) with no varicella history were VZV-seronegative. Almost all of these compromised VZV-seronegative patients seroconverted 6 months after vaccine. In addition, antibody titers were similar in both compromised and healthy children.

Seroepidemiology of hepatitis E virus infection in Mexican subjects 1 to 29 years of age.

BACKGROUND: Hepatitis E virus (HEV) infection causes an acute, self-limited hepatitis associated with high mortality in pregnant women. Community-based surveys are scarce and information on HEV infection in populations is needed. The aim of this work was to study seroprevalence to HEV in young adults and children in Mexico, using a community-based survey. METHODS: Serum samples from 3,549 individuals were studied; the population included subjects from 1 to 29 years old from all regions of the country representing all socioeconomic levels. IgG anti-HEV was determined by ELISA. RESULTS: Anti-HEV antibodies were found in 374 (10.5%) individuals. Seroprevalence increased with age from 1.1% in children younger than 5 years to 14.2% in persons 26 to 29 years of age (p = 0.006). Risk factors for infection included living in rural communities and a low educational level. Seroprevalence was not associated with the level of regional development. CONCLUSIONS: HEV infection is endemic in Mexico. Age, type of community, and educational level were identified as risk factors for infection.

[Janiceps cephalo-thoraco-abdominopagus pregnancy]. / Embarazo Janiceps, cefalotoracoabdominopago.

Cojoined twins was analyzed type cephalothoracoabdominopagus, is especially rare case of dysgenetic abnormalities, in which the heads, necs, thoraces and abdomen are joined. Twins births joined have been said to occur with a frequency of 1 per 100,000 deliveries, but the incidence of this malformations is one in three million conjoined twins. Conjoined twinning may be associated with a more fundamental failure of embryonic migration or may be associated with a more fundamental failure of ambryonic migration or fusion, 95% of conjoined twins are females. The Janiceps type of cephalothoracoabdominopagus derives its name from Janus, in Roman nythology, the god of doors and gateways, his statue with two faces, facing east and west for the beginning and ending of the day. The anatomic features with the Janiceps type of cephalothoracoabdominopagus are describe, and the mechanisms that may have played a role in the abnormal development of these twins are discussed. The mother was a 22-year-old, with last menstrual period January 12, 1997. She came to the other medical center, with an ultrasound study performed at 27 weeks' gestation, and possible multiple fetal anormalies, a second ultrasound examination, confirmed abnormalities, two hearts, as well as polihidramnios. Past history included normal espontaneous vaginal delivery of healthy term infant, who were alive and well, family history was negative for congenital anormalies, and no prior history of twinning. She denied use of drugs, alcohol, or cigarettes; had no fever, vaginal bleeding, or other problems with the pregnancy. The abdomen was gravid to 48 cm, and contractions were palpable, fetal heart tones were 1400 beats per minute. On the one day of admission the patient underwent delivery of conjoined infants, the Apgar scores were zero at 1 minute and at 5 minutes. The infants were joined front-to-front, with two faces, each a compositive of toth twins, each twin han four extremities, in each face resambled a one nose, with structure incomplete in one face, esophagi were fused. Each twin had its own skeletal system extending from the cervical spine downwards. The congenital malformations for each conjoined twin are listed in the autopsy report, abnormalities included absent ovary and uterus in both twin. COnjoined twins develop from a single zygote, the cause is unknown. We proposed, embryonic tissue divides incompletely, likely to result in twinning anomalies from the 15th to 16th day postovulation, during the late part of period six, about the third week.

Comparison of five methods for the detection of measles specific immunoglobulin G antibody.

In this work we compare the sensitivity, specificity and predictive values of hemagglutination inhibition (HI), immunofluorescent assay (IFA), biotin-streptavidin immunofluorescent assay (B/SA-IFA), enzyme-linked immunosorbent assay (EIA) and plaque neutralization test (PN). This study includes serum samples from children taken before and after vaccination, children with clinically diagnosed measles and household contacts. EIA were the most specific and better serological diagnostic test. HI and IFA had high sensitivity but low specificity. An alternative to EIA is B/SAIFA, which is cheaper than EIA and can be used in the study of small outbreaks or in isolated cases.

[Prevalence of rubella virus antibodies in pregnant women in two zones of Valle de Mexico]. / Prevalencia de anticuerpos para el virus de rubéola en mujeres gestantes de dos zonas del Valle de México.

The aim of this study was to determine the prevalence of specific antibodies against rubella virus in pregnant women from Iztapalapa and Nezahualcóyotl areas of the valley of Mexico, in order to evaluate susceptibility to this virus in these areas. Serum samples collected from 5535 women between 15 and 44 years old were studied by the hemaglutination inhibition test. 92.6% of positivity was obtained and no significant difference was observed between different age groups. The prevalence of rubella antibodies in pregnant women was 92.4% for Iztapalapa zone and 92.8% for Nezahualcóyotl. The titles of antibodies against rubella virus more frecuently presented were 1:16 (36.3%) and 1:32 (29.6%). The data obtained in this study suggest that women attending Medical Services of the Mexican Institute of Social Segurity in reproductive age from the Iztapalapa and Nezahualcóyotl areas, do not need massive vaccination against rubella virus.

[Protection of health personnel against hepatitis B by DNA recombinant vaccine]. / Protección contra hepatitis B en trabajadores de salud con vacuna de DNA recombinante.

Hepatitis B (HVB) is a worldwide spread health problem. It has been assessed that there are more than 300 millions of carriers. HVB has a special concern for health care workers (HCW's) due to the high risk among them of getting the infection in clinic-setting areas. According to some estimation, the risk for hepatitis B among HCW's is 2 to 10 times higher than the risk for general population. The risk is related to the degree of direct contact with blood and body fluids, as well as, with the frequency of traumatic exposure in the work place. The control of this infection is based on the observance of universal precautions and the vaccination, since there is not treatment against this disease. The results of an efficacy-evaluation of DNA recombinant vaccine against hepatitis B are reported; 174 HCW's were studied; three dosages of vaccine were administered (0.1st and 6th month) by I.M. via. In addition, three serum samples were collected at 0, 1st and 9th month after vaccine administration. We did not find carriers of surface antigen of hepatitis B. With regards to seroconverted individuals we observed the following results: there were a satisfactory response to the vaccine in 163 individuals (93.7%); however, 8 (4.6%) persons did not reach titles of protective antibodies and 3 (1.7%) did not show seroconversion at all. Therefore, 11 persons (6.3% of the total) did not result immunized. The secondary reactions to the vaccines were low in frequency and mainly of local presentation. Among the study population we did not find chronic carries of hepatitis B.(ABSTRACT TRUNCATED AT 250 WORDS)

[Hepatitis B and delta: the prevalence of seroepidemiological markers in volunteer blood donors and their families]. / Hepatitis B y delta: prevalencia de marcadores seroepidemiológicos en donadores de sangre voluntarios y su grupo familiar.

41 volunteer blood donors and his relatives were studied in order to know about the prevalence of hepatitis B and D virus infections in selected groups. Frequency of HBsAg+ carriers was 0.34 per cent in the Centro Nacional de la Transfusión Sanguínea and 0.15 per cent in the Banco Central de Sangre, IMSS. Most of the HBsAg+ blood donors were 21 to 40 years old (87.8%); 21.9 per cent had IgM antibodies against HBc and just 2.4 per cent were HBeAg positive. Forty one (26.9%) of 152 relatives had one or more of the HBV markers, 3.9 per cent were HBsAg carriers and 1.3 per cent were HBeAg positive. In the infected relatives group 36.6 per cent were ancestory or brothers and just 14.6 per cent of wives were infected. None of the HBsAg+ blood donors or his relatives had antibodies against delta agent. These results support the fact that the frequency of asymptomatic carriers of HBsAg in the volunteer blood donors group is similar to he frequency in the general population and identifies the group of relatives as those with the highest risk to acquire HBV infection.

Extubación precoz en pacientes pediatricos sometidos a cirugía cardiovascular / Precocious extubation in pediatric patients subjected vascular to cardiovascular surgery

Está planteada la controversia entre el uso de la ventilación mecánica "profiláctica" y la extubación precoz de los pacientes sometidos a cirugía cardiovascular. En este trabajo analizamos morbilidad, mortalidad e incidencia de reintubación en 130 pacientes pediátricos operados en nuestro centro, en los cuales aplicamos parámetros definidos para decidir o no la extubación precoz al término de la operación. En los 93 pacientes extubados precozmente solo fueron reintubados 4 (4.3%), por complicaciones. La mortalidad de este grupo fue del 0%. En los 37 pacientes no extubados 27 (73%) presentaron complicaciones y la mortalidad fue 8 casos (21.6%). Concluimos que los parámetros de extubación precoz son confiables y que la ventilación mecánica no debe utilizarse en forma rutinaria e indiscriminada

Extubación precoz en pacientes pediatricos sometidos a cirugía cardiovascular / Precocious extubation in pediatric patients subjected vascular to cardiovascular surgery

Está planteada la controversia entre el uso de la ventilación mecánica "profiláctica" y la extubación precoz de los pacientes sometidos a cirugía cardiovascular. En este trabajo analizamos morbilidad, mortalidad e incidencia de reintubación en 130 pacientes pediátricos operados en nuestro centro, en los cuales aplicamos parámetros definidos para decidir o no la extubación precoz al término de la operación. En los 93 pacientes extubados precozmente solo fueron reintubados 4 (4.3%), por complicaciones. La mortalidad de este grupo fue del 0%. En los 37 pacientes no extubados 27 (73%) presentaron complicaciones y la mortalidad fue 8 casos (21.6%). Concluimos que los parámetros de extubación precoz son confiables y que la ventilación mecánica no debe utilizarse en forma rutinaria e indiscriminada (AU)