Very Low Vitamin D Levels are a Strong Independent Predictor of Mortality in Hospitalized Patients with Severe COVID-19.

BACKGROUND: There is controversy regarding the association between hypovitaminosis D and COVID-19 outcomes. AIM OF THE STUDY: We assessed the association between 25-hydroxyvitamin D levels and COVID-19 outcomes in hospitalized subjects with severe SARS-CoV-2 infection. METHODS: Retrospective cohort study. Serum 25-hydroxyvitamin D levels of subjects with severe COVID-19 pneumonia were measured at hospital admission, between March 17th, 2020, and March 1st, 2021. RESULTS: Out of 2,908 patients, 571 (19.6%) had vitamin D deficiency (defined as a serum 25-hydroxyvitamin D level <12.5 ng/mL [<31.25 nmol/L]), and 1069 (36.7%) had levels between 12.5 ng/mL (31.25 nmol/L) and 20 ng/mL 850 nmol/L). Compared to subjects without vitamin D deficiency, those with 25-hydroxyvitamin D level <12.5 ng/mL had higher rates of in-hospital mortality at 30 d (28.0 vs. 17.3%; p <0.001), global mortality (31.9 vs. 20.8%; p <0.001), mechanical ventilation requirement (23.8 vs. 17.2%; p <0.001), and significantly longer hospital stay (median [interquartile range] of 9 [6-17 d] vs. 7 [5-12 d], p <0.001). In the unadjusted analysis, the risk of in-hospital death was greater for patients with vitamin D deficiency (HR 1.43; 95% CI, 1.20-1.70; p <0.001). After adjusting for confounders, the risk of in-hospital death within 30 d remained significantly greater in patients with vitamin D deficiency (HR 1.46; 95% CI, 1.21-1.76; p <0.001). The risk was reduced but remained significant with 25-hydroxyvitamin D levels between 12.5 ng/mL and 20 ng/mL (HR 1.31; 95% CI 1.10-1.55, p = 0.02). In comparison with other clinical biomarkers, vitamin D deficiency was an independent predictive marker of in-hospital mortality after adjusting for confounders. CONCLUSION: Very low 25-hydroxyvitamin D levels measured at hospital admission were significantly associated with in-hospital mortality and are a useful prognostic biomarker in severe COVID-19 patients.

Quiste de duplicación gástrico en paciente adulto: Reporte de caso y revisión de la literatura / Gastric duplication cyst in an adult patient: Case report and literature review

Introducción. Los quistes gástricos de duplicación son malformaciones congénitas muy infrecuentes del tracto gastrointestinal. Se definen como una lesión quística tapizada por epitelio gastrointestinal que comparte una capa de músculo liso con la pared gástrica. Se han propuesto diferentes teorías sobre su patogénesis, sin embargo, los eventos embriológicos que conducen a la malformación no han logrado ser dilucidados. Debido a su localización y presentación clínica, el diagnóstico se realiza con mayor frecuencia durante los primeros años de vida y existen pocos casos reportados en adultos, en quienes el hallazgo suele ser incidental. Caso clínico. Se presenta el caso de una mujer de 65 años quien consultó por dolor abdominal crónico y síntomas digestivos inespecíficos. Por medio de Tomografía Axial Computarizada se evidenció una lesión quística en contacto con el páncreas y la pared gástrica. Se realizó exploración quirúrgica que, junto con los hallazgos histopatológicos, confirmó el diagnosticó de quiste de duplicación gástrico. Discusión. Los quistes de duplicación gástrica son anomalías excepcionales que se localizan más frecuentemente en la curvatura mayor. Su tratamiento es quirúrgico y la confirmación del diagnóstico se realiza mediante la histología

Introduction. Gastric duplication cysts are very rare congenital malformations of the gastrointestinal tract. They are defined as a cystic lesion lined by gastrointestinal epithelium that shares a layer of smooth muscle with the gastric wall. Different theories have been proposed about its pathogenesis, however, the embryological events that lead to the malformation have not been elucidated. Due to its location and clinical presentation, the diagnosis is made more frequently during the first years of life and there are few cases reported in adults, in whom the finding is usually incidental. Clinical case. We present the case of a 65-year-old woman who consulted for chronic abdominal pain and nonspecific digestive symptoms. A CT scan evidenced a cystic lesion in contact with the pancreas and the gastric wall. A surgical exploration was performed which, along with the histopathological findings, confirmed the diagnosis of a gastric duplication cyst. Discussion. Gastric duplication cysts are exceptional anomalies that are more frequently located in the greater curvature. Its treatment is surgical and the confirmation of the diagnosis is made by histology

Drug purchase price volatility in an academic medical center.

PURPOSE: Inpatient drug purchase price trends at an 811-bed academic medical center are described. SUMMARY: Recent highly publicized drug price increases by pharmaceutical manufacturers have generated public interest in regulatory solutions to reduce drug costs. Monitoring drug price changes through internal dashboards has been demonstrated to aid in purchasing decisions to reduce the impact of drug price changes on inpatient pharmacy drug budgets. In this research, University of Chicago Medicine created an internal dashboard to detail specific inpatient drug purchase price trends. Dashboard data input included all medications purchased through the organization's group purchasing organization over a 25-month time frame. A total of 69,245 drug purchases of 2,432 unique medications and/or dosage strengths were analyzed in the study. Within the 25-month time period, 706 medications (29%) had a net drug purchase price increase, while 898 (37%) had a net drug purchase price decrease. The range of net price percentage changes for medications with price increases was 0.01% to 733.6%; the range for medications with price decreases was 0.01% to 97.5%. CONCLUSION: Relative to previous purchase prices, drug purchase prices decreased or remained the same more often than they increased over a 25-month time frame. However, drug purchase price percentage changes were far greater for medications whose prices increased rather than decreased.

Clinical factors associated with early and persistent hypocalcaemia after parathyroidectomy in patients on dialysis with severe hyperparathyroidism.

AIM: Severe hypocalcaemia following parathyroidectomy for secondary or tertiary hyperparathyroidism (SHPT/THPT) is scarcely studied. We aimed to describe and identify risk factors for early and persistent hypocalcaemia after parathyroidectomy. METHODS: Retrospective pair-matched cohort study. We assessed 87 dialysis patients with SHPT (n = 73) or THPT (n = 14) paired with 146 subjects with primary hyperparathyroidism (PHPT) who underwent parathyroidectomy and were followed for 12 months. Early severe hypocalcaemia was defined as a free Ca ≤0.8 mmol/L [3.2 mg/dl] or corrected Ca ≤1.87 mmol/L [7.5 mg/dl] within 48 h. After parathyroidectomy and persistent hypocalcaemia, as an elemental Ca intake >3.0 g/day to achieve corrected Ca >2 mmol/L [8.0 mg/dl]. RESULTS: Early severe hypocalcaemia occurred in 77% (67/87) versus 6.8% (10/146) of subjects with SHPT/THPT and PHPT, respectively (p < .001). In SHPT/THPT cases, persistent hypocalcaemia occurred in 77% (49/64) and 64% (35/54) after 6 and 12 months of parathyroidectomy, respectively. In PHPT cases, persistent hypocalcaemia occurred in 6.8% (10/146) after 4-12 months of parathyroidectomy. Preoperative serum alkaline phosphatase (ALP) was the only risk factor associated to early severe hypocalcaemia (OR 7.3, 95% C.I. 1.7-10.9, p = .006) and persistent hypocalcaemia (OR 7.1, 95% C.I: 2.1-14.2, p = .011). Subjects with persistently low intact parathormone (iPTH) (<5.3 pmol/L [50 ng/ml]), suggestive of adynamic bone disease) showed higher Ca increases and less oral calcium requirements compared to those who progressively increased iPTH after parathyroidectomy. CONCLUSION: Early and persistent hypocalcaemia after parathyroidectomy in severe HPT were a common event associated directly to preoperative ALP levels. Subjects with persistently low postoperative iPTH normalized serum Ca more frequently after 1 year of follow up.

Severe disseminated acute toxoplasmosis in an adult immunocompetent patient from the Colombian Pacific

We present the case of a 72-year-old immunocompetent patient from Chocó, Colombia, with a 12-day course of fever, headache, progressive neurological deterioration, and rapid evolution to multiorgan failure and death. In the histopathological study of tissues obtained at necropsy, tissue cysts morphologically suggestive of being bradyzoites of Toxoplasma gondii were identified and confirmed by immunohistochemistry in heart, brain, and striated muscle.

Toxoplasmosis aguda diseminada fatal en una paciente adulta inmunocompetente proveniente del Pacífico colombiano / Severe disseminated acute toxoplasmosis in an adult immunocompetent patient from the Colombian Pacific

Se presenta el caso de una paciente inmunocompetente de 72 años de edad, proveniente del departamento del Chocó, con un cuadro clínico de 12 días de fiebre, cefalea, deterioro neurológico progresivo y rápida evolución a falla orgánica múltiple y muerte. En el estudio histopatológico de los tejidos obtenidos en la necropsia, se identificaron quistes tisulares morfológicamente sugestivos de ser bradizoítos de Toxoplasma gondii, lo que se confirmó mediante inmunohistoquímica en corazón, cerebro y músculo estriado.

We present the case of a 72-year-old immunocompetent patient from Chocó, Colombia, with a 12-day course of fever, headache, progressive neurological deterioration, and rapid evolution to multiorgan failure and death. In the histopathological study of tissues obtained at necropsy, tissue cysts morphologically suggestive of being bradyzoites of Toxoplasma gondii were identified and confirmed by immunohistochemistry in heart, brain, and striated muscle.

Reliable information for cancer control in Cali, Colombia.

BACKGROUND: The Cali Population Cancer Registry (RPCC) has been in continuous operation since 1962 with the objective of producing valid statistics on the incidence of cancer, its patterns, trends and survival rates. METHODS: During the period 2008-2012, 23,046 new cases were registered and during 2011-2015 there were 12,761 cancer deaths. The trend of the rates was described with the APC average annual change rate and with the Joinpoint analysis. We analyzed the individual data of 38,671 adults (15-99 years) diagnosed with cancer between 1995-2009, and we calculated the standardized net survival by age for the 14 most common cancer body sites, using the Pohar-Perme method. RESULTS: Prostate and breast cancer were the first cause of cancer morbidity. The incidence rates in these were susceptible to early detection, tumors stabilized after decades of growth, while an increase in the incidence of colon cancer and papillary thyroid carcinoma was observed. The incidence rates of cervical and stomach cancer and conditions related to infectious agents decreased, although the number of absolute cases increased, due to the growth and aging of the population. Gastric cancer was responsible for the highest number of cancer related deaths. The types of cancer related to tobacco consumption (lung, oral cavity, esophagus, pancreas, urinary bladder) showed low numbers and a tendency to decrease. During the period 2000-2004, the 5-year net survival improved for cancers of the breast, cervix, prostate, melanoma and thyroid, although in the period 2005-2009 a stagnation was observed. In stomach, liver and lung cancer, the 5-year net survival was less than 15%. The 5-year overall survival in children was 51.0% (95% CI: 47.5, 54.3) and in adolescents 44.6% (95% CI: 36.0, 52.8). COMMENT: RPCC has been an advisor to the Colombian government in the evaluation of CPRs in the country and its data has contributed significantly to different aspects of cancer control in Colombia.

ANTECEDENTES: El Registro Poblacional de Cáncer de Cali (RPCC) está en operación continua desde 1962 con el objetivo de producir estadísticas válidas sobre la incidencia de cáncer, sus patrones, tendencias y supervivencia. MÉTODOS: Durante el periodo 2008-2012, se registraron 23,046 casos nuevos y durante 2011-2015 se registraron 12,761 defunciones por cáncer. La tendencia de las tasas se describió con el porcentaje de cambio medio anual APC y con el análisis de Joinpoint. Se analizaron los datos individuales de 38,671 adultos (15-99 años) con diagnóstico de cáncer entre 1995-2009, y se calculó la supervivencia neta estandarizada por edad para las 14 localizaciones más comunes de cáncer, con el método de Pohar-Perme. RESULTADOS: Próstata y mama fueron la primera causa de morbilidad por cáncer. Las tasas de incidencia en estos tumores susceptibles de detección temprana se estabilizaron tras décadas de crecimiento, mientras que se observó un incremento de la incidencia de cáncer de colon y carcinoma papilar de tiroides. Las tasas de incidencia de cáncer de cuello uterino y estómago, afecciones relacionados con agentes infecciosos, disminuyeron, aunque el número de los casos absolutos aumentó, debido al crecimiento y envejecimiento de la población. El cáncer gástrico fue responsable del mayor número de muertes por cáncer. Los tipos de cáncer relacionados con el consumo de tabaco (pulmón, cavidad oral, esófago, páncreas, vejiga urinaria) mostraron cifras bajas y con tendencia al descenso. Durante el periodo 2000-2004, la supervivencia neta a 5 años mejoró para los cánceres de mama, cuello uterino, próstata, melanoma y tiroides, aunque en el periodo 2005-2009 se observó un estancamiento. En cáncer de estómago, hígado y pulmón, la supervivencia neta a 5 años fue inferior al 15%. La supervivencia global a 5 años en niños fue de 51.0% (IC 95%: 47.5, 54.3) y en adolescentes de 44.6% (IC 95%: 36.0, 52.8). COMENTARIO: El RPCC ha sido asesor del gobierno colombiano en la evaluación de RPCs en el país y sus datos han contribuido significativamente a diferentes aspectos del control del cáncer en Colombia.

[Rhino-orbito-cerebral mucormycosis from dental origin: Case report].

Rhino-orbito-cerebral mucormycosis from dental origin is an acute infection caused by opportunistic fungi belonging to the order of Mucorales, which affects mainly diabetic and immunocompromised patients.We report the case of a 63-year old diabetic man who performed a dental extraction on himself by his own means and subsequently developed a rhino-orbito-cerebral mucormycosis with cutaneous and palatal affection. The species isolated in the mycological culture was Rhizopus sp.

Reliable information for cancer control in Cali, Colombia / Información fiable para el control del cáncer en Cali, Colombia

Abstract Background: The Cali Population Cancer Registry (RPCC) has been in continuous operation since 1962 with the objective of producing valid statistics on the incidence of cancer, its patterns, trends and survival rates. Methods: During the period 2008-2012, 23,046 new cases were registered and during 2011-2015 there were 12,761 cancer deaths. The trend of the rates was described with the APC average annual change rate and with the Joinpoint analysis. We analyzed the individual data of 38,671 adults (15-99 years) diagnosed with cancer between 1995-2009, and we calculated the standardized net survival by age for the 14 most common cancer body sites, using the Pohar-Perme method. Results: Prostate and breast cancer were the first cause of cancer morbidity. The incidence rates in these were susceptible to early detection, tumors stabilized after decades of growth, while an increase in the incidence of colon cancer and papillary thyroid carcinoma was observed. The incidence rates of cervical and stomach cancer and conditions related to infectious agents decreased, although the number of absolute cases increased, due to the growth and aging of the population. Gastric cancer was responsible for the highest number of cancer related deaths. The types of cancer related to tobacco consumption (lung, oral cavity, esophagus, pancreas, urinary bladder) showed low numbers and a tendency to decrease. During the period 2000-2004, the 5-year net survival improved for cancers of the breast, cervix, prostate, melanoma and thyroid, although in the period 2005-2009 a stagnation was observed. In stomach, liver and lung cancer, the 5-year net survival was less than 15%. The 5-year overall survival in children was 51.0% (95% CI: 47.5, 54.3) and in adolescents 44.6% (95% CI: 36.0, 52.8). Comment: RPCC has been an advisor to the Colombian government in the evaluation of CPRs in the country and its data has contributed significantly to different aspects of cancer control in Colombia.

Resumen Antecedentes: El Registro Poblacional de Cáncer de Cali (RPCC) está en operación continua desde 1962 con el objetivo de producir estadísticas válidas sobre la incidencia de cáncer, sus patrones, tendencias y supervivencia. Métodos: Durante el periodo 2008-2012, se registraron 23,046 casos nuevos y durante 2011-2015 se registraron 12,761 defunciones por cáncer. La tendencia de las tasas se describió con el porcentaje de cambio medio anual APC y con el análisis de Joinpoint. Se analizaron los datos individuales de 38,671 adultos (15-99 años) con diagnóstico de cáncer entre 1995-2009, y se calculó la supervivencia neta estandarizada por edad para las 14 localizaciones más comunes de cáncer, con el método de Pohar-Perme. Resultados: Próstata y mama fueron la primera causa de morbilidad por cáncer. Las tasas de incidencia en estos tumores susceptibles de detección temprana se estabilizaron tras décadas de crecimiento, mientras que se observó un incremento de la incidencia de cáncer de colon y carcinoma papilar de tiroides. Las tasas de incidencia de cáncer de cuello uterino y estómago, afecciones relacionados con agentes infecciosos, disminuyeron, aunque el número de los casos absolutos aumentó, debido al crecimiento y envejecimiento de la población. El cáncer gástrico fue responsable del mayor número de muertes por cáncer. Los tipos de cáncer relacionados con el consumo de tabaco (pulmón, cavidad oral, esófago, páncreas, vejiga urinaria) mostraron cifras bajas y con tendencia al descenso. Durante el periodo 2000-2004, la supervivencia neta a 5 años mejoró para los cánceres de mama, cuello uterino, próstata, melanoma y tiroides, aunque en el periodo 2005-2009 se observó un estancamiento. En cáncer de estómago, hígado y pulmón, la supervivencia neta a 5 años fue inferior al 15%. La supervivencia global a 5 años en niños fue de 51.0% (IC 95%: 47.5, 54.3) y en adolescentes de 44.6% (IC 95%: 36.0, 52.8). Comentario: El RPCC ha sido asesor del gobierno colombiano en la evaluación de RPCs en el país y sus datos han contribuido significativamente a diferentes aspectos del control del cáncer en Colombia.

Mucormicosis rino-órbito-cerebral de origen dental / Rhino-orbito-cerebral mucormycosis from dental origin: Case report

Resumen La mucormicosis es una infección aguda causada por hongos oportunistas pertenecientes al orden de los mucorales, que afecta principalmente a pacientes diabéticos e inmunosuprimidos. Se reporta el caso de un hombre diabético de 63 años de edad, que se extrajo una pieza dental por sus propios medios y, posteriormente, desarrolló una mucormicosis rino-órbito-cerebral con afección cutánea y palatina. La especie aislada mediante cultivos micológicos fue Rhizopus sp.

Abstract Rhino-orbito-cerebral mucormycosis from dental origin is an acute infection caused by opportunistic fungi belonging to the order of Mucorales, which affects mainly diabetic and immunocompromised patients. We report the case of a 63-year old diabetic man who performed a dental extraction on himself by his own means and subsequently developed a rhino-orbito-cerebral mucormycosis with cutaneous and palatal affection. The species isolated in the mycological culture was Rhizopus sp.

A comprehensive protocol to evaluate the use of blood and its components in Latin America and the Caribbean.

Blood transfusion safety is a critical part of appropriate health care. Considering the limited information available on the use of blood and its components in Latin America and the Caribbean, the Grupo Cooperativo iberoamericano de Medicina Transfusional (Ibero-American Cooperative Group for Transfusion Medicine; GCIAMT), through its Research and International Affairs committees, carried out a project to develop a protocol that would facilitate the evaluation of blood usage at the country, jurisdiction, and institutional levels in varied country contexts. Experts in blood safety from the Pan American Health Organization (Washington, DC, United States), the University of São Paulo (São Paulo, Brazil), the Hemocentro of São Paulo (São Paulo, Brazil), and GCIAMT designed a 2-step comprehensive blood-use evaluation protocol: step 1 collects data from blood requests, and step 2, from medical charts. At a minimum, 1 000 analyzed requests are necessary; as such, study periods vary depending on the number of transfusion requests issued. An Internet-based application, the Modular Research System-Study Management System (MRS-SMS), houses the data and produces reports on how hospitals request blood, how blood is issued, who requires blood and blood components, and as an added benefit, how many blood units are wasted and what the real demand for blood is.

A comprehensive protocol to evaluate the use of blood and its components in Latin America and the Caribbean / Un protocolo integral para evaluar el uso de la sangre y sus componentes en América Latina y el Caribe

Blood transfusion safety is a critical part of appropriate health care. Considering the limited information available on the use of blood and its components in Latin America and the Caribbean, the Grupo Cooperativo iberoamericano de Medicina Transfusional (Ibero-American Cooperative Group for Transfusion Medicine; GCIAMT), through its Research and International Affairs committees, carried out a project to develop a protocol that would facilitate the evaluation of blood usage at the country, jurisdiction, and institutional levels in varied country contexts. Experts in blood safety from the Pan American Health Organization (Washington, DC, United States), the University of São Paulo (São Paulo, Brazil), the Hemocentro of São Paulo (São Paulo, Brazil), and GCIAMT designed a 2-step comprehensive blood-use evaluation protocol: step 1 collects data from blood requests, and step 2, from medical charts. At a minimum, 1 000 analyzed requests are necessary; as such, study periods vary depending on the number of transfusion requests issued. An Internet-based application, the Modular Research System-Study Management System (MRS-SMS), houses the data and produces reports on how hospitals request blood, how blood is issued, who requires blood and blood components, and as an added benefit, how many blood units are wasted and what the real demand for blood is.

La seguridad de las transfusiones de sangre constituye una parte fundamental de una apropiada atención de salud. Teniendo en cuenta la limitada información disponible sobre el uso de la sangre y sus componentes en América Latina y el Caribe, el Grupo Cooperativo Iberoamericano de Medicina Transfusional (GCIAMT), mediante sus comités de Investigación y de Asuntos Internacionales, llevó a cabo un proyecto de elaboración de un protocolo que facilitara la evaluación del uso de la sangre a nivel de país, jurisdiccional e institucional, en diversos contextos de país. Expertos en seguridad de la sangre de la Organización Panamericana de la Salud (Washington, DC, Estados Unidos), la Universidad de São Paulo (São Paulo, Brasil), el Hemocentro de São Paulo (São Paulo, Brasil) y el GCIAMT diseñaron un protocolo integral de evaluación del uso de la sangre en 2 etapas: en la primera se recopilan datos de las solicitudes de sangre, y en la segunda, de las historias clínicas. Como mínimo, es preciso analizar 1 000 solicitudes; por ello, los períodos de estudio varían en dependencia del número de solicitudes de transfusión expedidas. Una aplicación basada en internet, el Modular Research System, Study Management System, alberga los datos y elabora informes sobre cómo solicitan sangre los hospitales, cómo se expide la sangre, quién requiere sangre y componentes sanguíneos y, como beneficio añadido, cuántas unidades de sangre se desperdician y cuál es la demanda real de sangre.

Pleural Effusion In A Patient With Primary Sjögren's Syndrome Successfully Treated With Corticosteroids.

Sjögren's syndrome is a systemic autoimmune disorder characterized by salivary insufficiency and lymphocytic infiltration of the exocrine glands. Bronchiolitis and bronchiectasis are common airway manifestations but interstitial pneumonitis, and lymphocytic interstitial pneumonitis may also occur. It rarely presents with pleuritis. We report a woman with primary Sjögren's syndrome who developed pleuritis with moderately large effusions and antibody levels for SS-A and SS-B in the serum without evidence of infection, malignancy or other collagen diseases. After the initial treatment, daily administration of 20 mg of oral prednisone has effectively controlled the serious manifestations of the disease with minimal side effects.

[Antimicrobial susceptibility of Helicobacter pylori with chronic gastritis]. / Sensibilidad in vitro a amoxicilina y claritromicina de Helicobacter pylori obtenido de biopsias gástricas de pacientes en zona de bajo riesgo para cáncer gástrico.

INTRODUCTION: Infection by Helicobacter pylori is prevalent in approximately half the world´s population.However, the susceptibility of H. pylori to antimicrobial agents must be evaluated by in vitro methods in order to determine the susceptibility levels and to guide treatment regimes. OBJECTIVE: The prevalence of infection and antibiotic susceptibility was evaluated in gastric biopsies containing H. pylori. MATERIALS AND METHODS: The prevalence of infection and antibiotic susceptibility was investigated in 203 patients with chronic gastritis from Tumaco, Colombia. Diagnosis was confirmed by histopathological evidence (Dixon scale) and microbiological (culture on blood agar supplemented with antibiotics).The antibiotic resistance of H. pylori was measured by its response toantimicrobial amoxicillin and clarithromycin using the agar dilution method. RESULTS: The prevalence of infection for H. pylori with histopathological and microbiological tests was88.7% and 84.7% respectively. The prevalence of resistance of H. pylori to antimicrobial amoxicillin was 20.5%, to clarithromycin 19.8%, and to both antibiotics concurrently, 10.9%. CONCLUSIONS: A high incidence of clarithromycin-resistant and amoxicillin-resistant H. pylori was discovered in patients from Tumaco with chronic gastritis. Dual drug-resistant strains of H. pylori to clarithromycin and amoxicillin were also present.

[A case report of transfusion-transmitted Plasmodium vivax malaria from an asymptomatic donor to a premature newborn]. / Malaria por Plasmodium vivax transmitida por transfusión de un donante asintomático a un recién nacido prematuro.

Most of the Colombian territory is endemic for malaria. Autochthonous cases with low parasitemia occur in the Pacific coast and in large zones of Antioquia and Córdoba. According to the Colombian legislation no malaria screening test is mandatory for blood donors from non-endemic areas. However, if they have traveled to malaria transmission regions they are deferred for six months before they can donate. This report describes a transfusion- transmitted malaria case in Cali (Valle del Cauca, Colombia), where a preterm newborn received infected blood from a donor that lived in the same city, but he had traveled to the rural area of the municipality of Dagua (Valle del Cauca, Colombia) 9 months before the donation. Thick blood smears confirmed Plasmodium vivax infection in the newborn and the donor sample was analyzed by PCR, which confirmed P. vivax infection. This case suggests the need for reviewing donor selection criteria and deferral strategies to prevent possible cases of transfusion-transmitted malaria.

Sensibilidad in vitro a amoxicilina y claritromicina de Helicobacter pylori obtenido de biopsias gástricas de pacientes en zona de bajo riesgo para cáncer gástrico / Antimicrobial susceptibility of Helicobacter pylori with chronic gastritis

Introducción. La infección por Helicobacter pylori prevalece en más de la mitad de la población mundial. Es prioritario evaluar la sensibilidad actual in vitro de H. pylori a los antimicrobianos usados en los protocolos de erradicación, fundamentalmente para determinar los patrones y resolver la infección. Objetivo. Determinar la prevalencia de la infección y la sensibilidad antibiótica de H. pylori en biopsias gástricas. Materiales y métodos. Se investigan la prevalencia de la infección y la sensibilidad antibiótica de H. pylori de 203 pacientes con gastritis crónica procedentes de Tumaco (Nariño), mediante pruebas histopatológicas (escala Dixon) y microbiológicas (cultivo en agar sangre con suplemento de antibióticos) y, además, su resistencia a amoxicilina y claritromicina mediante el método de dilución en agar. Resultados. La prevalencia de la infección para H. pylori con pruebas histopatológicas y microbiológicas es de 88,7 % y 84,7 % respectivamente; la prevalencia de resistencia de H. pylori a amoxicilina y claritromicina y a ambos antibióticos, fue de 20,5 %, 19,8 % y 10,96 %, respectivamente. Conclusiones. Los resultados de este estudio indican que es alta la incidencia de H. pylori resistente a claritromicina y amoxicilina en pacientes de Tumaco con gastritis crónica. También, se encontraron cepas multirresistentes a claritromicina y amoxicilina.

Introduction. Infection by Helicobacter pylori is prevalent in approximately half the world´s population.However, the susceptibility of H. pylori to antimicrobial agents must be evaluated by in vitro methods in order to determine the susceptibility levels and to guide treatment regimes. Objective. The prevalence of infection and antibiotic susceptibility was evaluated in gastric biopsies containing H. pylori. Materials and methods. The prevalence of infection and antibiotic susceptibility was investigated in 203 patients with chronic gastritis from Tumaco, Colombia. Diagnosis was confirmed by histopathological evidence (Dixon scale) and microbiological (culture on blood agar supplemented with antibiotics).The antibiotic resistance of H. pylori was measured by its response toantimicrobial amoxicillin and clarithromycin using the agar dilution method. Results. The prevalence of infection for H. pylori with histopathological and microbiological tests was88.7% and 84.7% respectively. The prevalence of resistance of H. pylori to antimicrobial amoxicillin was 20.5%, to clarithromycin 19.8%, and to both antibiotics concurrently, 10.9%. Conclusions. A high incidence of clarithromycin-resistant and amoxicillin-resistant H. pylori was discovered in patients from Tumaco with chronic gastritis. Dual drug-resistant strains of H. pylori to clarithromycin and amoxicillin were also present.

Malaria por Plasmodium vivax transmitida por transfusión de un donante asintomático a un recién nacido prematuro / A case report of transfusion-transmitted Plasmodium vivax malaria from an asymptomatic donor to a premature newborn

Gran parte del territorio colombiano es endémico para malaria; sin embargo, los casos autóctonos con parasitemia baja se presentan principalmente en el área del Litoral Pacífico y zonas extensas de Antioquia y Córdoba. Según la legislación colombiana, no se requiere ninguna prueba obligatoria para el diagnóstico de malaria en los donantes de sangre de las áreas no endémicas. No obstante, si los donantes potenciales han viajado a las regiones endémicas, son diferidos por seis meses antes de que puedan donar. Este reporte describe un caso de malaria transmitida por transfusión en Cali (Valle del Cauca, Colombia), en el que un recién nacido prematuro recibió hemoderivados infectados de un donante que vivía en la misma ciudad que viajó a la zona rural de Dagua (Valle del Cauca) nueve meses antes de la donación. La prueba de la gota gruesa confirmó la enfermedad por Plasmodium vivax en el recién nacido y la muestra del donante se sometió a reacción en cadena de la polimerasa (PCR), que fue positiva para la misma especie. Este caso sugiere la necesidad de revisar los criterios de selección de donantes y las estrategias de aplazamiento, para evitar posibles casos de malaria transmitida por transfusión.

Most of the Colombian territory is endemic for malaria. Autochthonous cases with low parasitemia occur in the Pacific coast and in large zones of Antioquia and Córdoba. According to the Colombian legislation no malaria screening test is mandatory for blood donors from non-endemic areas. However, if they have traveled to malaria transmission regions they are deferred for six months before they can donate. This report describes a transfusion- transmitted malaria case in Cali (Valle del Cauca, Colombia), where a preterm newborn received infected blood from a donor that lived in the same city, but he had traveled to the rural area of the municipality of Dagua (Valle del Cauca, Colombia) 9 months before the donation. Thick blood smears confirmed Plasmodium vivax infection in the newborn and the donor sample was analyzed by PCR, which confirmed P. vivax infection. This case suggests the need for reviewing donor selection criteria and deferral strategies to prevent possible cases of transfusion-transmitted malaria.