[Seroprevalence of Leptospira spp. in draft horses from indigenous communities in the Araucanía Region, Chile]. / Seroprevalencia de Leptospira spp. en equinos de tiro de comunidades indígenas mapuche de la Región de la Araucanía Chile.

In the Araucanía Region there are no studies on the seroprevalence of leptospirosis in horses. Serological samples from 100 draft horses from Mapuche communities of four communes in the region were analyzed using the microMAT technique. The seroprevalence was 35% for at least one serovar of Leptospira spp. being the most frequent serovars canicola (22%), grippotyphosa (21%), hardjo (13%) and pomona (10%). It was evident that the equine populations studied are exposed to infection by Leptospira spp. and reveal a potential risk of transmission to their owners.

Seroprevalencia de Leptospira spp. en equinos de tiro de comunidades indígenas mapuche de la Región de la Araucanía Chile / Seroprevalence of Leptospira spp. in draft horses from indigenous communities in the Araucanía Region, Chile

Resumen En la Región de la Araucanía no existen estudios sobre seroprevalencia de leptospirosis en equinos. Se analizaron muestras serológicas provenientes de 100 equinos de tiro de comunidades mapuche de cuatro comunas de la región mediante la técnica de microMAT. La seroprevalencia fue de 35% para al menos un serovar de Leptospira spp., siendo los serovares más frecuentes canicola (22%), grippotyphosa (21%), hardjo (13%) y pomona (10%). Se evidenció que las poblaciones equinas estudiadas están expuestas a la infección por Leptospira spp. y revelan un riesgo potencial de transmisión a sus propietarios.

Abstract In the Araucanía Region there are no studies on the seroprevalence of leptospirosis in horses. Serological samples from 100 draft horses from Mapuche communities of four communes in the region were analyzed using the microMAT technique. The seroprevalence was 35% for at least one serovar of Leptospira spp. being the most frequent serovars canicola (22%), grippotyphosa (21%), hardjo (13%) and pomona (10%). It was evident that the equine populations studied are exposed to infection by Leptospira spp. and reveal a potential risk of transmission to their owners.

Clinical characteristics and outcomes of people living with HIV hospitalized with COVID-19: a nationwide experience.

In this prospective, multicentric, observational study, we describe the clinical characteristics and outcomes of people living with HIV (PLHIV) requiring hospitalization due to COVID-19 in Chile and compare them with Chilean general population admitted with SARS-CoV-2. Consecutive PLHIV admitted with COVID-19 in 23 hospitals, between 16 April and 23 June 2020, were included. Data of a temporally matched-hospitalized general population were used to compare demography, comorbidities, COVID-19 symptoms, and major outcomes. In total, 36 PLHIV subjects were enrolled; 92% were male and mean age was 44 years. Most patients (83%) were on antiretroviral therapy; mean CD4 count was 557 cells/mm3. Suppressed HIV viremia was found in 68% and 56% had, at least, one comorbidity. Severe COVID-19 occurred in 44.4%, intensive care was required in 22.2%, and five patients died (13.9%). No differences were seen between recovered and deceased patients in CD4 count, HIV viral load, or time since HIV diagnosis. Hypertension and cardiovascular disease were associated with a higher risk of death (p = 0.02 and 0.006, respectively). Compared with general population, the HIV cohort had significantly more men (OR 0.15; IC 95% 0.07-0.31) and younger age (OR 8.68; IC 95% 2.66-28.31). In PLHIV, we found more intensive care unit admission (OR 2.31; IC 95% 1.05-5.07) but no differences in the need for mechanical ventilation or death. In this cohort of PLHIV hospitalized with COVID-19, hypertension and cardiovascular comorbidities, but not current HIV viro-immunologic status, were the most important risk factors for mortality. No differences were found between PLHIV and general population in the need for mechanical ventilation and death.

[Pharmacotherapy follow-up of Chilean inpatients with HIV/AIDS in a high complexity hospital during one year]. / Seguimiento farmacoterapéutico de pacientes chilenos con infección por VIH/SIDA hospitalizados en un centro de alta complejidad durante un período de un año.

BACKGROUND: Pharmaceutical follow-up consists on the detection, prevention, and resolution of drug-related problems (DRP) in a continuous, systematized, and documented way. DRP is a health problem connected to pharmacotherapy, which can interfere with the expected health outcomes in the patient. AIM: To make a pharmacotherapeutic surveillance in HIV/AIDS inpatients attended at "Hospital San Juan de Dios" throughout a year prospective study (January to December 2012). RESULTS: 88.6% (93/105) of patients were in stage AIDS with a median of CD4+ lymphocytes of 29 cells/mm³ and a viral load of 107,000 RNA copies/mL. The 16.2% were admitted to a intensive care unit ICU. 296 DRP (DRP 2.8 per patient) were detected, 72% of DRP (n; 213) were associated with treatment safety, 94 were adverse reactions, 19 required dose adjustments, and 6 interactions had a negative clinical impact; 23.3% (n: 69) experimented the necessity to add or remove a drug and 4.7% (n: 14) presented problems associated with effectiveness. A statistically significant relation was observed when associating the number of DRP with admittance to the ICU and the use of more than six drugs. CONCLUSION: The results allow the conclusion that inpatients present drug-related problems mainly related to toxicity, becoming risk factors for the development of them admittance to ICU, and concomitant use of more than 6 drugs.

Seguimiento farmacoterapéutico de pacientes chilenos con infección por VIH/SIDA hospitalizados en un centro de alta complejidad durante un período de un año / Pharmacotherapy follow-up of Chilean inpatients with HIV/AIDS in a high complexity hospital during one year

Background: Pharmaceutical follow-up consists on the detection, prevention, and resolution of drug-related problems (DRP) in a continuous, systematized, and documented way. DRP is a health problem connected to pharmacotherapy, which can interfere with the expected health outcomes in the patient. Aim: To make a pharmacotherapeutic surveillance in HIV/AIDS inpatients attended at "Hospital San Juan de Dios" throughout a year prospective study (January to December 2012). Results: 88.6% (93/105) of patients were in stage AIDS with a median of CD4+ lymphocytes of 29 cells/mm³ and a viral load of 107,000 RNA copies/mL. The 16.2% were admitted to a intensive care unit ICU. 296 DRP (DRP 2.8 per patient) were detected, 72% of DRP (n; 213) were associated with treatment safety, 94 were adverse reactions, 19 required dose adjustments, and 6 interactions had a negative clinical impact; 23.3% (n: 69) experimented the necessity to add or remove a drug and 4.7% (n: 14) presented problems associated with effectiveness. A statistically significant relation was observed when associating the number of DRP with admittance to the ICU and the use of more than six drugs. Conclusion: The results allow the conclusion that inpatients present drug-related problems mainly related to toxicity, becoming risk factors for the development of them admittance to ICU, and concomitant use of more than 6 drugs.

Introducción: El seguimiento farmacoterapéutico, consiste en la detección, prevención y resolución de los problemas relacionados con los medicamentos (PRM), en forma continua, sistematizada y documentada. Un PRM es un problema de salud vinculado con la farmacoterapia, que interfiere o puede interferir con los resultados de salud esperados en el paciente. Objetivo y Métodos: Realizar un seguimiento farmacoterapéutico a pacientes hospitalizados con infección por VIH/SIDA del Hospital San Juan de Dios, a través de un estudio prospectivo de un año (enero a diciembre 2012). Resultados: El 88,6% (93/105) de los pacientes se encontraba en etapa SIDA, con una mediana de linfocitos TCD4+ de 29 céls/mm³ y una carga viral de 107.000 copias ARN/mL. El 16,2% de los pacientes ingresó a una unidad de paciente crítico. Se detectaron 296 PRM (2,8 PRM por paciente); el 72% de los PRM (n: 213) estuvieron asociados a seguridad del tratamiento, objetivándose 94 reacciones adversas, 19 eventos con necesidad de ajustes de dosis y seis interacciones con repercusión clínica negativa; 23,3% (n: 69) a la necesidad de incorporar o eliminar algún fármaco y 4,7 % (n: 14) a problemas asociados a efectividad. Se observó una relación estadísticamente significativa al asociar el N° de PRM con la unidad de pacientes críticos y uso de más de seis fármacos. Conclusión: Los resultados permiten concluir que los pacientes hospitalizados presentan problemas relacionados al uso de medicamentos, principalmente asociado a toxicidad, encontrándose como factores de riesgo para el desarrollo de éstos la permanencia en una unidad de paciente crítico y el uso concomitante de más de seis fármacos.

[Detection of Brucella canis by immunochromatography method in vague dogs captured in Temuco city, Chile, 2011]. / Detección de Brucella canis por método de inmunocromatografía en perros vagos capturados en la ciudad de Temuco, Chile, 2011.

BACKGROUND: Brucella canis is responsible for brucellosis in dogs, causing reproductive disorders and is considered a zoonoses, as described in several countries. The epidemiological data are scarce in our country. AIM: To determine the prevalence of Brucella canis in vague dogs in Temuco city and housed in the Temuco Kennel. METHODS: Quantitative and cross-section study. We used 400 samples of dogs of both sexes, different ages and mainly mixed race, which were tested by immunochromatography. RESULTS: Antibodies were detected in 4 samples Brucella canis which represented 1% of the population studied, 2 females (0.5%) and 2 males (0.5%). DISCUSSION: We conclude that dogs are infected by B. canis in a low range but remains a risk condition to the health of the human population if not maintained adequate sanitary control of pets, like vague dogs.

Detección de Brucella canis por método de inmunocromatografía en perros vagos capturados en la ciudad de Temuco, Chile, 2011 / Detection of Brucella canis by immunochromatography method in vague dogs captured in Temuco city, Chile, 2011

Background: Brucella canis is responsible for brucellosis in dogs, causing reproductive disorders and is considered a zoonoses, as described in several countries. The epidemiological data are scarce in our country. Aim: To determine the prevalence of Brucella canis in vague dogs in Temuco city and housed in the Temuco Kennel. Methods: Quantitative and cross-section study. We used 400 samples of dogs of both sexes, different ages and mainly mixed race, which were tested by immunochromatography. Results: Antibodies were detected in 4 samples Brucella canis which represented 1% of the population studied, 2 females (0.5%) and 2 males (0.5%). Discussion: We conclude that dogs are infected by B. canis in a low range but remains a risk condition to the health of the human population if not maintained adequate sanitary control of pets, like vague dogs.

Introducción: Brucella canis es responsable de la brucelosis en perros, provocándoles trastornos reproductivos y es considerada una zoonosis, ya descrita en varios países. Los datos epidemiológicos en nuestro medio son exiguos. Objetivo: Determinar la prevalencia de B. canis en perros vagos capturados en la ciudad de Temuco y albergados en el Canil Temuco. Materialy Métodos: Estudio de tipo cuantitativo y de corte transversal. Se utilizaron 400 muestras de perros de ambos sexos, diferentes edades y principalmente mestizos, procesadas mediante la prueba de inmunocromatografía. Resultados: Se detectaron anticuerpos anti-B. canis en 4 muestras lo cual representó 1% de la población estudiada, 2 hembras (0,5%) y 2 machos (0,5%). Conclusión: El hallazgo de perros serológicamente positivos a B. canis, es baja pero no deja de ser un indicador del riesgo en el que se encuentra la salud de la población humana si no se mantiene un adecuado control sanitario de las mascotas, como ocurre con los perros vagos.

[Prevalence of leptospirosis in vague dogs captured in Temuco City, 2011]. / Prevalencia de leptospirosis en perros vagos capturados en la ciudad de Temuco, 2011.

BACKGROUND: Leptospirosis, a bacterial disease of worldwide distribution, affects various animals and is considered a zoonosis. It can be transmitted directly or indirectly, mainly through contact with the carrier's urine and entering the body through mucous membranes or skin. In the city of Temuco, there are no epidemiological studies of canine leptospirosis and the country data are scarce. OBJECTIVE: To determine the prevalence of leptospirosis in stray dogs of the city of Temuco. MATERIAL AND METHODS: In a cross- sectional study, 400 dogs admitted to Temuco Kennel during the year 2011 were sampled. Blood samples were analyzed using a modified commercial ELISA kit. RESULTS: The prevalence of leptospirosis was 21.3%. Positive cases were concentrated in dogs 5 to 8 years of age, independent of gender. DISCUSSION: The high prevalence found demonstrates the need for further studies to better understand the epidemiology of the disease and to establish prevention and control measures.

Pandemic influenza A (H1N1) in HIV-1-infected patients.

OBJECTIVE: To characterize the clinical presentation, course and mortality of pandemic influenza in HIV-1-infected patients in Santiago, Chile. METHODS: Prospective observational study. RESULTS: Thirty patients were included (three hospitalized), 93% were on HAART, mean CD4(+) cell count was 423 cells/µl and viral load was undetectable in 77% of patients. All patients had fever, 90% had cough, 80% had myalgias, 70% had pharyngeal congestion, 47% had coryza, 47% had odynophagia, 37% had headache and 23% had vomiting. Four patients developed pneumonia. All patients received antiviral therapy and no patient died. CONCLUSIONS: HIV patients infected by the new influenza A pandemic (H1N1) virus behave similarly to the general population.

[Neurosyphilis in the patients with and without HIV infection: description and comparison of two historical cohorts]. / Neurosífilis en pacientes portadores y no portadores de VIH: descripción y comparación de dos cohortes históricas.

Neurosyphilis follows a more aggressive and different clinical course in HIV-infected patients compared to patients with normal immunity. Two historical series of patients with a diagnosis of neurosyphilis between 1995 and 2008 were compared: they included a group of 15 patients with y and 28 patients without HIV infection. Probability of neurosyphilis in patients with positive serum VDRL was increased in patients infected with HIV compared to HIV negative patients (OR: 62.37 IC:95% (32.1-119.1) p value:< 0,001). Predominant clinical manifestations in neurosyphilis in the HIV negative group were ocular abnormality, vascular encephalic and spinal cord lesions. In the HIV positive group, they were fever, ocular abnormalities and headache. There were no differences in cerebrospinal fluid characteristics between both groups. Neurosyphilis was diagnosed even in patients with blood VDRL of < 1:32, that happened in 17.8% of the HIV positive patients with blood and in 60% of t he HIV negative patients. Penicillin sodium given at dose >or= than 18.000.000 IU/day IV during 14 days was the most common treatment. In patients with clinical neurosyphilis, 93% of HIV negative group, and 54.2% of HIV positive group had persistent neurological after-effects. Three HIV positive patients died due to causes not related to neurosyphilis.

[Utility of real time polymerase chain reaction in the diagnosis of respiratory syncytial virus infection among adult patients]. / Utilidad de la reacción de polimerasa en cadena en tiempo real en el diagnóstico de infecciones por virus respiratorio sincicial en adultos.

INTRODUCTION: Viral respiratory infections (VRI) are a frequent cause of morbidity among adult population. Respiratory syncytial virus (RSV) produces 20%> of VRI, however diagnosis is limited for a low sensitivity of conventional (FDA and ELISA) tests. AIM: To assess the impact of real time reverse transcriptase-polymerase chain reaction (real time RT-PCR) technique in RSV diagnosis in adult hospitalized patients; to characterize RSV infection among these patients. PATIENTS AND METHODS: All adults hospitalized in Hospital Clínico Universidad Católica during 8 weeks of winter season, with clinical picture of VRI, and with negative DFA for influenza A and B, parainfluenza 1, 2, 3 and adenovirus were included. Real time RT-PCR was performed from nasopharyngeal sample. Clinical information, general laboratory exams and chest X ray reports were collected. RESULTS: Out of 114 patients with negative DFA, 17 (14.9%o) Debe decir: RSV cases were demonstrated using real time RT- PCR. Fever, pharyngeal congestion, cough and bronchial obstruction were present in 80%> of patients. Thirty percent of them had a baseline chronic disease and 47%> were immunocompromised. One out of 17 patients (6%) required mechanical ventilation. No mortality was observed. CONCLUSIONS: Use of RT-PCR allowed increasing detection of RSV infection over 100%> among adults with VRI without virological diagnosis with conventional techniques. It is necessary to consider RSV RT-PCR test among patients with clinical picture of VRI during RSV season, with negative virological screening tests.