Sociodemographic predictors associated with the spectrum of non-opportunist neuroretinal disease of non-infectious etiology in patients with HIV/AIDS: A scoping review.

BACKGROUND: Non-infectious retinal disease, even in the HAART era, continues to be one of the most common diagnoses in patients with HIV, with prevalences of up to 27% of cases. This study aims to characterize the association between demographic variables and their role. As a risk factor for the development of non-opportunistic non-infectious retinal disease in patients with HIV/AIDS. METHODS: An integrative review of the literature was carried out according to Arksey O'Malley's approach, based on the PICO methodology and following the PRISMA recommendations; An exhaustive search was carried out in databases of articles that were filtered using established criteria, with their extraction and analysis carried out qualitatively. RESULTS: Ocular manifestations from any cause develop from 35 years of age in patients with HIV/AIDS, with the highest risk for age-related macular degeneration over the fourth decade of life and for the development of neuroretinal disorder on the fifth decade of life; some studies report a slight tendency to diagnose macular degeneration in women and those who acquired AIDS through sexual contact; data contrasted with increased risk for diagnosing neuroretinal disorder in homosexual men who also use intravenous drugs, possibly due to oversampling in studies; non-Hispanic whites and African Americans were the races most commonly affected by neuroretinal disease; the means between the 11.3-14.5 years elapsed since the HIV diagnosis were more frequently associated with cognitive impairment and both in those with high or low CD4 counts, and in patients with high or low viral loads, neuroretinal disease without Statistically significant differences. Adherence and early initiation of HAART had a modest impact on the development of neuroretinal disease. DISCUSSION: Even in the HAART era, non-infectious neuroretinal disease and cytomegalovirus retinitis remain the most frequent ocular diagnoses, however, different studies argue an increase in age-related non-infectious retinal diseases in patients with HIV, theories that are may explain by the increase in life expectancy, the metabolic effects of HAART itself or the generalized pro-inflammatory state in this group of patients, it is essential to recognize this new diagnostic challenge in order to direct preventive efforts through the use of cost-effective sociodemographic risk predictors towards that technological tools for diagnosis and treatment can be targeted. CONCLUSIONS: HIV/AIDS patients who present at the ophthalmological consultation with the suggested sociodemographic predictors have a high risk of visual impairment due to non-infectious retinopathy, therefore prevention, diagnosis and treatment efforts directed at these diseases should be increased.

Predictores sociodemográficos asociados al espectro de enfermedad neurorretiniana no oportunista de etiología no infecciosa en pacientes con VIH/SIDA: revisión integrativa / Sociodemographic predictors associated with the spectrum of non-opportunist neuroretinal disease of non-infectious etiology in patients with HIV/AIDS: a scoping review

Antecedentes La enfermedad retiniana no infecciosa, aun en la era del tratamiento antirretroviral de gran actividad (TARGA), continúa siendo uno de los diagnósticos más comunes en pacientes con el virus de la inmunodeficiencia humana (VIH), con prevalencias hasta del 27% de los casos. Este estudio se propone caracterizar la asociación entre unas variables demográficas y su papel como factor de riesgo para el desarrollo de la enfermedad retiniana no infecciosa no oportunista en pacientes con VIH/SIDA. Método Se realizó una revisión integrativa de la literatura, según el planteamiento de O’Malley, partiendo de la metodología PICO y siguiendo las recomendaciones elementos de informes preferidos para revisiones sistemáticas y metanálisis (PRISMA); se realizó una búsqueda exhaustiva en bases de datos de artículos que se filtraron mediante criterios establecidos, con la extracción y análisis de los mismos efectuada de forma cualitativa. Resultados Las manifestaciones oculares por cualquier causa se desarrollan desde los 35 años de edad en los pacientes con VIH/SIDA, con el mayor riesgo para la degeneración macular relacionada con la edad sobre la cuarta década de vida y para el desarrollo de trastorno neurorretiniano sobre la quinta; algunos estudios reportan una ligera tendencia para diagnosticar la degeneración macular en mujeres y en aquellas personas que adquirieron SIDA por contacto sexual; estos datos contrastan con un mayor riesgo para diagnosticar el trastorno neurorretiniano en los hombres homosexuales que también usan drogas intravenosas, posiblemente debido un sobremuestreo en los estudios; los blancos no hispánicos y los afroamericanos fueron las razas más comúnmente afectadas por la enfermedad neurorretiniana; las medias entre los 11,3 a 14,5 años transcurridos desde el diagnóstico de VIH se asociaron más frecuentemente con un trastorno cognitivo y tanto en aquellos con recuentos CD4 altos o bajos como en pacientes con cargas (AU)

Background Non-infectious retinal disease, even in the HAART era, continues to be one of the most common diagnoses in patients with HIV, with prevalences of up to 27% of cases. This study aims to characterize the association between demographic variables and their role. as a risk factor for the development of non-opportunistic non-infectious retinal disease in patients with HIV/AIDS Methods An integrative review of the literature was carried out according to Arksey O’Malley's approach, based on the PICO methodology and following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations; An exhaustive search was carried out in databases of articles that were filtered using established criteria, with their extraction and analysis carried out qualitatively. Results Ocular manifestations from any cause develop from 35 years of age in patients with HIV/AIDS, with the highest risk for age-related macular degeneration over the fourth decade of life and for the development of neuroretinal disorder on the fifth decade of life; some studies report a slight tendency to diagnose macular degeneration in women and those who acquired AIDS through sexual contact; data contrasted with increased risk for diagnosing neuroretinal disorder in homosexual men who also use intravenous drugs, possibly due to oversampling in studies; non-Hispanic whites and African Americans were the races most commonly affected by neuroretinal disease; the means between the 11.3 to 14.5 years elapsed since the HIV diagnosis were more frequently associated with cognitive impairment and both in those with high or low CD4 counts, and in patients with high or low viral loads, neuroretinal disease without Statistically significant differences. Adherence and early initiation of HAART had a modest impact on the development (AU)

Sociodemographic predictors associated with the spectrum of non-opportunist neuroretinal disease of non-infectious etiology in patients with HIV/AIDS: a scoping review. / Predictores sociodemográficos asociados al espectro de enfermedad neurorretiniana no oportunista de etiología no infecciosa en pacientes con VIH/SIDA: revisión integrativa.

BACKGROUND: Non-infectious retinal disease, even in the HAART era, continues to be one of the most common diagnoses in patients with HIV, with prevalences of up to 27% of cases. This study aims to characterize the association between demographic variables and their role. as a risk factor for the development of non-opportunistic non-infectious retinal disease in patients with HIV/AIDS METHODS: An integrative review of the literature was carried out according to Arksey O'Malley's approach, based on the PICO methodology and following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations; An exhaustive search was carried out in databases of articles that were filtered using established criteria, with their extraction and analysis carried out qualitatively. RESULTS: Ocular manifestations from any cause develop from 35 years of age in patients with HIV/AIDS, with the highest risk for age-related macular degeneration over the fourth decade of life and for the development of neuroretinal disorder on the fifth decade of life; some studies report a slight tendency to diagnose macular degeneration in women and those who acquired AIDS through sexual contact; data contrasted with increased risk for diagnosing neuroretinal disorder in homosexual men who also use intravenous drugs, possibly due to oversampling in studies; non-Hispanic whites and African Americans were the races most commonly affected by neuroretinal disease; the means between the 11.3 to 14.5 years elapsed since the HIV diagnosis were more frequently associated with cognitive impairment and both in those with high or low CD4 counts, and in patients with high or low viral loads, neuroretinal disease without Statistically significant differences. Adherence and early initiation of HAART had a modest impact on the development of neuroretinal disease. DISCUSSION: Even in the HAART era, non-infectious neuroretinal disease and cytomegalovirus retinitis remain the most frequent ocular diagnoses, however, different studies argue an increase in age-related non-infectious retinal diseases in patients with HIV, theories that are may explain by the increase in life expectancy, the metabolic effects of HAART itself or the generalized pro-inflammatory state in this group of patients, it is essential to recognize this new diagnostic challenge in order to direct preventive efforts through the use of cost-effective sociodemographic risk predictors towards that technological tools for diagnosis and treatment can be targeted. CONCLUSIONS: HIV/AIDS patients who present at the ophthalmological consultation with the suggested sociodemographic predictors have a high risk of visual impairment due to non-infectious retinopathy, therefore prevention, diagnosis and treatment efforts directed at these diseases should be increased.

Evaluación de la actividad antimicrobiana de los extractos etanólicos de Azadirachta indica / Evaluation of the antimicrobial activity of Azadirachta indica ethanolic extracts

La presencia del acné juvenil, es una enfermedad que repercute directamente en la autoestima del adolescente, provocando en ocasiones inseguridad para establecer comu nicación y relaciones con otras personas, debido a su falta de confianza y respeto a su imagen. Debido a los altos costo del tratamiento para esta patología, el siguiente trabajo tuvo como objetivo determinar la actividad antimicrobiana de la Azadirachta indica y preparar una fórmula magistral (crema) antiacné. Los resultados obtenidos de la actividad antibacteriana de los extractos etanólicos de las hojas de Azadirachta indica A. Juss, mostraron que el Staphylococcus aureus presentó la mayor sensibilidad con una zona de inhibición de 15 mm. a una dilución 1/10; E. faecalis, con una sensibilidad de 7 mm, tanto en las diluciones 1/10 y 1/100; K. pneumoniae, con una zona de inhibición de 8 mm. y E. coli; mostró ser resistente a todas las diluciones ensayadas. Esta búsqueda sugiere que los principios activos extraídos con etanol de las hojas, pueden jugar un rol significativo en la acción inhibitoria contra el Staphylococcus aureus responsable del acné juvenil.

The presence of the youthful acne, is a disease that directly repels in the self-esteem of the adolescent, causing sometimes insecurity to contact and relations with other people, due to its lack of confidence and respect to its image. Due to high the cost of the treatment for this pathology, the following work had as objective to determine the antimicrobial activity of the Azadirachta it indicates and to prepare a skillful formula (Cream) antiacne. The obtained results of the antibacterial activity of the etanólicos extracts of the leaves of Azadirachta indica A. Juss, showed that the Staphylococcus aureus presented/displayed greater sensitivity with a zone of inhibition of 15 mm to a dilution 1/10; E. faecalis, with a sensitivity of 7 mm, as much in dilutions 1/10 and 1/100; K. pneumoniae with a zone of inhibition of 8 mm and E. coli, showed to be resistant all the tried dilutions. This search suggests them extracted active principles with ethanol of the leaves, can play a significant roll in the inhibiting action against the Staphylococcus aureus responsible for the youthful acne.

Metástasis en clavícula y ovarios de carcinoma primario desconocido: a propósito de un caso / Metastasis in clavicle and ovaries of unknown primary carcinoma: a case report

Se presenta el caso de una paciente de sexo femenino, de 30 años de edad, quien consulta por un tumor en tercio distal de clavícula derecha desde octubre 2004 y en preoperatorio para protocolo óseo, acude en diciembre del mismo año por dolor intenso en región lumbosacra, hemipelvis izquierda y parestesia de miembros inferiores, con RMN de columna donde se aprecia tumor en S1-S2. Es hospitalizada y durante se permanencia aparece aumento de volumen abdominal con tumor palpable, ascitis, derrame pleural a predominio derecho por lo que se realiza laparotomía exploradora y protocolo óseo, concluyendo la biopsia definitiva: adenocarcinoma metastático de clavícula y ovarios. Se practicaron estudios en busca del tumor primario, no encontrándose lesión. La paciente recibe tratamiento paliativo de radioterapia a columna y se planifica para tratamiento sistémico con quimioterapia falleciendo a los seis meses. La combinación de la localización de las metástasis en este caso de carcinoma de primario desconocido, resultan interesantes para la presentación del mismo y la revisión de la literatura

Quantitative spectral analysis of EEG in psychiatry revisited: drawing signs out of numbers in a clinical setting.

OBJECTIVE: To evaluate the incidence, sensitivity and specificity of abnormal quantitative EEG (QEEG) measures in normal subjects and patients with mental disorders. METHODS: Normalized QEEG measures were blindly assessed in 67 normal human beings and 340 psychiatric patients. QEEG results were correlated to subject condition or diagnosis and magnetic resonance imaging (MRI) findings. RESULTS: QEEG was abnormal in 83% of patients, and 12% of normal subjects. The most frequent abnormality was a decrease in slow (delta and/or theta) bands, either alone, with beta increase, or with alpha decrease, followed by increase in beta band. No normal subject showed delta and/or theta decrease. Slow band decrease was more frequent in depression and mental disorders due to general medical condition, alcohol and drug dependence. However, no pattern was specific of any entity, and patients within the same diagnostic may present different patterns. Delta-theta decrease was correlated with cortical atrophy as seen in MRI. Beta increase was correlated with psychoactive medication. No association was found between any other QEEG pattern and MRI abnormalities, or medication. CONCLUSIONS: Decrease in the delta and theta bands of the QEEG can be regarded as a specific sign of brain dysfunction, and is correlated with cortical atrophy. However, this sign, as other QEEG abnormal patterns, can be found in many different disorders and none of them can be considered as pathognomonic of any specific disorder. SIGNIFICANCE: This work attempted to circumvent the alleged lack of Class I evidence of QEEG utility in the study of psychiatric patients by means of a prospective, blinded study, searching for specific signs of physiopathology in individual patients.

The seroprevalences of anti-hantavirus IgG antibodies among selected Venezuelan populations.

In Venezuela, the isolation of hantaviruses from rodents and the detection, in 1999, of a clinically confirmed human case of hantavirus infection led to increased interest in these viruses. In an attempt to estimate the problem posed by such viruses in Venezuela, ELISA based on purified, recombinant, nucleoprotein were used to check 1380 human serum samples for the presence of IgG antibodies to hantavirus. The ELISA results, as confirmed by indirect immunofluorescence and Western-blot assays, indicated that 23 (1.7%) of the serum samples contained antibodies to hantaviruses. Seroprevalences were similar among all age-groups and for both genders and were no higher among rural populations with a relatively high risk of exposure to rodents than among the overall study population. Although the numbers of samples involved were small, the seroprevalence among the subjects who were residents of Carabobo state was much higher than the overall value (10.3% v. 1.7%; P < 0.01). Human infection with hantavirus appears uncommon but widely distributed in Venezuela.

Estudio clínico de eficacia y tolerancia con sultamicilina fipexiam en procesos infecciosos de tratamiento ambulatorio / Clinic study of efficacy and toleration with sultamicilina fipeham in infectious process of ambulatory treatment

Se realizó un estudio abierto, multicéntrico, no comparativo donde se avaluó la eficacia y tolerancia de la combinación Ampicilina/Sulbatam por vía oral-Sultamicilina-(Fipexiam), en adultos y niños con infecciones del tracto respiratorio superior e inferior y con infeciones de piel y partes blandas, y adultos con Enfermedad Inflamatoria Pélvica (EIP). El estudio reunió los investigadores de 73 Centros. Se trataron un total de 195 pacientes obteniéndose una efectividad global de 93.3 por ciento. De estos pacientes 84 presentaron Otitis media aguda, resultando curas clínicas en el 89.2 por ciento, 67 presentaron procesos orofaríngeos con curación en el 94 por ciento; en los casos con infecciones de piel y partes blandas, así como en las mujeres tratadas con (EIP) la curación clínica fue de 100 por ciento. Se reportaron efectos adversos en 10.9 por ciento, siendo las molestias gastrointestinales más resaltantes con 8.7 por ciento de los casos reportados, siendo menores a lo reportado por la literatura médica