[Cerebral venous sinus thrombosis and ulcerative colitis]. / Trombosis de senos venosos cerebrales y colitis ulcerosa.

Hypercoagulability is a extraintestinal manifestation of inflammatory bowel disease, which could provoke thromboembolic phenomena. Central nervous system venous thrombosis is a rare complication and could be unnoticed. We report on a patient with ulcerative colitis who presented cerebral venous sinus thrombosis as the first manifestation of a hypercoagulable state. We review the literature and discuss about the pathogenic mechanisms of such complication.

Trombosis de senos venosos cerebrales y colitis ulcerosa / Cerebral venous sinus thrombosis and ulcerative colitis

La EEI se acompaña de múltiples manifestaciones extraintestinales, entre ellas un estado de hipercoagulabilidad que puede dar lugar a fenómenos tromboembólicos. Entre estos últimos están las trombosis venosas cerebrales (TVC) que son raras y pueden dar lugar a un cuadro poco llamativo, pasando desapercibidas. Describimos el caso de un paciente diagnosticado previamente de colitis ulcerosa que presentó TVC como primera manifestación de un síndrome de hipercoagulabilidad. Se revisa la literatura y se comentan los mecanismos patogénicos (AU)

[Pregnancy and HIV infection: the need for routine serological evaluation]. / Embarazo e infección por VIH: necesidad de la evaluación serológica rutinaria.

OBJECTIVES: To determine the frequency of pregnancies among HIV-infected women in a sanitary area. To evaluate the proportion of women not receiving anti-retroviral treatment to decrease vertical transmission and the reasons why this treatment was not administered. PATIENTS AND METHODS: Point prevalence study performed on all women followed for 1997 at the HIV Infection Unit in a 360-bed hospital. The following variables were obtained: social class, civil status and place of residence, risk factors for HIV infection, obstetric antecedents (pregnancies, number of term pregnancies, living newborns) as well as prescription or not of anti-retroviral therapy during pregnancy. RESULTS: Out of 85 women included in the study, 51 (60%) reported to have had a pregnancy and 17 of these (33%) had interrupted the pregnancy at some time. No significant differences were found between pregnancy or abortion and the analyzed socio-demographic variables or risk factors for HIV infection. Only 12% of women with a full length pregnancy received anti-retroviral therapy. Of women with term pregnancy who were not treated, most (63%) did not know they were infected before delivery and an additional 10% refused therapy. Forty-four percent of women with children continued with pregnancy despite knowing they were infected. Vertical transmission occurred in a 13% of cases in which no therapy was instituted and in no case in which zidovudine was administered during pregnancy. CONCLUSIONS: The frequency of pregnancies among HIV-infected women is high in our area and a substantial number of women do not know they are infected. These data support the serological study to HIV in all pregnant women and the necessity of a higher level of information in order that the seropositive women be aware of the responsibility she takes when she decides to go on with her pregnancy.