HIV prevalence and sexual behaviour changes measured in an antenatal clinic setting in northern Tanzania.

OBJECTIVES: To assess the feasibility of collecting sexual behaviour data during HIV surveillance in antenatal care (ANC) clinics, and to establish whether these data can provide information about the correlates of HIV infection in this population. METHODS: Sexual behaviour surveys were conducted in the context of two HIV sentinel surveillance rounds in 11 ANC clinics in north west Tanzania between 2000 and 2002. Responses of individual women were anonymously linked to their HIV status. Three clinic catchment areas overlapped with a community based longitudinal study, which provided independent estimates of HIV prevalence and sexual behaviour. Changes between rounds and differentials between clinics were assessed and a two level logistic regression model used to identify behavioural and contextual correlates of HIV in 3689 women under 25 years of age. RESULTS: Women attending clinics were willing to participate in the study. The sexual behaviour data obtained were internally consistent and tallied reasonably well with sexual behaviour data collected in the community overlapping the clinic catchment. Clear relations emerged between HIV infection and measures of sexual exposure: OR 1.20 (95% CL 1.12 to 1.28) for each year of premarital exposure and 1.09 (1.04 to 1.16) for each year after first marriage; background prevalence OR 1.15 (1.04 to 1.26) associated with each percentage point increase in background prevalence at the clinic; and certain partnership variables such as partner's age OR 0.58 (0.45 to 0.76) if partner less than 10 years older. CONCLUSION: Conducting sexual behaviour surveys in the context of ANC clinics surveillance is feasible and yields useful data.

[Profile of drug users admitted to a hospital]. / Perfil de los usuarios de drogas ingresados en un hospital.

AIM: To know the clinical and epidemiological characteristics of drug users admitted to a hospital. METHOD: A descriptive-retrospective study. RESULTS: Of the 123 patients admitted to the hospital (a total of 155 admissions), 84,5% of them were admitted through the Emergency Department. Their main age was 33 +/- 6 and the 65,9% were male. The 90,2% were injecting drug users (IDU). The main age of initiation in the use of drugs was 21 years; and the time of addiction ranged from I to 30 years (69 patients remained addicted to drugs for 10 years or more). There were 102 HCV infections and 13 HBV infections, and 50 patients tested positive for at least I serological marker of hepatitis B infection; 65 were HIV positive (all ofthem were IDU) and 61 were coinfected with HCV. 34 patients had AIDS. Infectious diseases were responsible for 105 of the 155 admissions to hospital. In 134 occasions the patients were discharged and 11 died. CONCLUSIONS: Most of the patients were male. The admissions to hospital were mostly due to infectious diseases. The most commonly associated pathologies seen were to be HIV positive and to carry HCV. The outcome of patients was mainly the discharge from hospital, and those who died were all HIV positive.

Perfil de los usuarios de drogas ingresados en un hospital / Profile of drug users admitted to a hospital

Objetivo: Conocer las características clínico-epidemiológicas de los pacientes usuarios de drogas ingresados. Método: Estudio descriptivo-retrospectivo. Resultados: 123 pacientes (155 ingresos), 84,5 por ciento ingresaron por urgencias; edad media 33 ± 6. 65,9 por ciento hombres. 90,2 por ciento utilizó la vía parenteral; edad media de consumo 21 años (12-36). Años de adicción entre 1 y 30, (69 consumieron durante 10 años o más). 102 eran portadores crónicos de la hepatitis C, 13 de la B, 50 tenían algún marcador positivo de la B; 65 eran VIH (+) (todos UDVP) y 61 estaban coinfectados por el virus de la hepatitis C. 34 tenían sida. La patología infecciosa originó 105 ingresos. El destino mayoritario fue alta (134), 11 pacientes fallecieron. Conclusiones: La mayoría son varones. Los ingresos se deben, sobretodo, a procesos infecciosos. Las patologías asociadas más observadas son: ser VIH(+) y ser portador crónico de hepatitis C. El destino mayoritario fue alta y todos los fallecidos eran VIH(+) (AU)

Politraumatizados atendidos en un servicio de urgencias. Aproximación epidemiológica / Polytraumatized patients seen in the emergency service. Epidemiological approximation

Objetivo: Conocer las características clínico-epidemiológicas de los politraumatizados atendidos en el Servicio de Urgencias del Hospital de Cabueñes. Métodos: Estudio descriptivo-retrospectivo de los pacientes atendidos durante el año 1997 incluídos en la definición de politraumatizado elegida. Se analizaron datos demográficos, factores temporales, mecanismo lesional, medio de transporte al hospital, órganos lesionados, pruebas complementarias y técnicas realizadas, intervención quirúrgica urgente y tipo, tiempos de estancia media, destino y mortalidad. Resultados: Se atendieron 46 politraumatizados (0,3 por ciento de las urgencias de causa accidental). La edad media fue de 48,4 DT 22,4; la razón hombre-mujer fue 1,4:1. El mecanismo lesional más frecuente fue el accidente de tráfico (64,4 por ciento), fundamentalmente el atropello. El 78,3 por ciento de los pacientes presentaban cuatro o más lesiones, siendo el traumatismo craneoencefálico (T.C.E.) la más frecuente (45,7 por ciento). El 50 por ciento precisó transporte secundario al hospital de referencia. De éstos, el 56 por ciento habían llegado a nuestro hospital en la UVI-móvil de transporte primario. La mortalidad hospitalaria fue del 13 por ciento. Conclusiones: Los politraumatizados presentan un riesgo vital elevado. Precisan tratamientos rápidos, complejos y multidisciplinarios, que conllevan la frecuente derivación al hospital de referencia para su tratamiento definitivo. Un elevado número de estos pacientes llegó a nuestro hospital en UVI-móvil medicalizada de transporte primario. Sería conveniente establecer pautas de derivación directa desde ésta hacia el centro donde puedan recibir con mayor rapidez un tratamiento definitivo e integral (AU)

[Description of 31 pediatric cases of infection caused by human Parvovirus B 19]. / Descripción de 31 casos pediátricos de infección por Parvovirus humano B19.

FUNDAMENTALS: [corrected] Human Parvovirus B19 has been identified as the etiological agent implicated in several clinical forms of disease. The aim of this study was to define the clinical aspects observed in the children with human parvovirus infection in our hospital. METHODS: A retrospective study was done in 31 pediatric cases observed in our hospital from January-92 to July-94; all had positive IgM against Parvovirus (determined by enzymoinmunoanalysis). RESULTS: The most frequent signs and symptoms were fever in 66.6% of the cases and skin findings in 48%, manifested as typical infectious erythema in 26% and polimorphic nonspecific exanthema in the rest. There were variable blood manifestations, observed in 11 children (35%): Immune Thrombocytopenic purpura, Chronic anemia in immunocompromised hosts, bone marrow erithrophagocytosis and hemolytic crises in non-hemolytic anemia patients. The abnormal blood findings were mostly observed in children with compromised immunity. Articular disease was presented in four children (12%). Long lasting fever was observed in only one case. CONCLUSIONS: In our sample the diversity of clinical forms of presentation of Parvovirus B19 infection is well documented as it is reported by several authors. Although other studies as polymerase chain reaction (PCR), nucleic acid hybridization, direct visualization of the virus or its particles, or viral antigen detection are desirable to confirm the serologic studies.

Effect of alanine supply on hepatic protein synthesis in animals maintained on a protein free diet.

In contrast to what it is observed during starvation, animals maintained on a protein-free isocaloric diet showed an increase in the rate of hepatic peptide chain elongation as determined by measuring the ribosomal transit time in vivo. The loss of body nitrogen per se is insufficient to generate the signal(s) which arrests hepatic peptide chain elongation. This observation suggests that it is an increase in gluconeogenic demand, and not the negative nitrogen balance, which is implicated in determining reciprocal changes in the rate of protein synthesis. The rate of protein synthesis, as expressed per mg of DNA, does not change in protein deprived animals, while the RNA to DNA ratio decreased. These data also agree with a higher ribosomal efficiency at the elongation step. The animals maintained on a protein-free diet have a decreased hepatic content of protein and an increased concentration of valine, indicating an increased proteolysis. The enhanced rate of polypeptide elongation observed in animals kept on a protein-free diet was accompanied by decreases in the state of aggregation of polyribosomes and in the ability of liver extracts to form eIF-2 catalyzed ternary complexes. These observations suggest that the activity of the hepatic initiation factor in vivo may not be rate limiting. The administration of alanine in vivo to animals maintained on a protein-free diet showed a preferential effect in reaggregating polyribosomes. This action was neither accompanied by detectable effects on the rate of eIF-2 catalyzed ternary complexes formation nor by significant changes in the rate of elongation.(ABSTRACT TRUNCATED AT 250 WORDS)