Prevalence, incidence and associated factors for HBV infection among male and female prisoners in Central Brazil: A multicenter study.

BACKGROUND: Prison populations are at high risk for hepatitis B virus (HBV) infection. The aim of this study was to assess the prevalence, incidence, HBV associated factors and circulating genotypes/subtypes. METHODS: A total of 3,368 prisoners from 12 closed prisons were randomly recruited for a cross-sectional study. In addition, a cohort study was conducted 12 months later and included 1,656 individuals. Participants underwent an interview and blood collection for the detection of HBV serological markers and HBV-DNA phylogenetic analysis. RESULTS: HBV exposure (anti-HBc+) was 9.8% (95% CI: 8.8-10.8); 11.2% were female and 9.6% were male. HBsAg+ was 0.6%. Only 31.4% of the participants had HBV vaccination-like profile (anti-HBs+ alone; 30.4% male vs. 36.8% female; p=0.004). Most individuals were susceptible to HBV (60.2% female vs. 52.2% male, p=0.001). HBV isolates were classified as genotypes A (45.4%), D (27.3%) and F (27.3%). In males, HBV exposure was associated with increased age. Male prisoners had more evidence of HCV/HBV co-infection (10.7%) than females (3.4%) and the frequency of Treponema pallidum infection among prisoners who had been exposed to HBV was higher in female prisoners when compared with male (39.7% vs. 19.1%). The incidence of HBV was 0.18/100 person-years (95% CI: 0.12%-0.25%). CONCLUSIONS: Our results indicate a high prevalence of HBV exposure in prisoners. Despite the low incidence of this infection, the occurrence of new cases indicates the need to implement preventive measures.

Use of synthetic oligonucleotides for determination of HTLV-1 proviral load by real-time PCR: a helpful alternative approach in the clinical management.

AIMS: To evaluate the potential use of synthetic oligonucleotides as a standard curve for proviral load (PVL) of human T-cell leukaemia virus type 1 (HTLV-1) quantification in peripheral blood mononuclear cells (PBMC) of HTLV-1-infected individuals by quantitative real-time polymerase chain reaction (qPCR) analysis. METHODS AND RESULTS: Synthetic oligonucleotides based on HTLV-1 genome were customized to use as a standard curve. Twelve anti-HTLV-1-positive samples with known HTLV-1 PVL, previously quantified by qPCR assay using TARL-2 cells as a conventional standard curve, were submitted to the new protocol. The proviral quantification levels had a high concordance with qPCR results using a conventional standard curve. The results demonstrate that the conventional standard curve can be replaced by a synthetic standard curve due to its ability to quantification based on the linearity and qPCR efficiency and similar results with a validated qPCR assay using a conventional standard curve. CONCLUSIONS: Synthetic oligonucleotides standard curves could be a very useful tool on HTLV-1 diagnosis and absolute HTLV-1 PVL quantification. SIGNIFICANCE AND IMPACT OF THE STUDY: HTLV-1 PVL determination using synthetic oligonucleotides standard curve by qPCR could be a helpful alternative for the laboratories that monitor infected patients as an important prognostic factor in HTLV-1-associated diseases progression. Also, it can decrease costs and overcome the biological limitations of the plasmid curve.

Epidemiological study of hepatitis B virus among prisoners with active tuberculosis in Central Brazil.

BACKGROUND: Due to environmental and social conditions inherent to incarceration, tuberculosis (TB) and hepatitis B virus (HBV) are major diseases among prison inmates. OBJECTIVE: To determine overall and occult HBV infection (OBI) prevalence rates, risk factors and genotype distribution among inmates with active TB. STUDY DESIGN: A cross-sectional study was conducted among 216 inmates with active TB recruited at the largest prisons in Campo Grande, Mato Grosso do Sul, Central Brazil. The participants were interviewed and tested for the presence of serological markers for HBV infection. RESULTS: The overall prevalence of HBV infection (total hepatitis B core antibodies) was 10.2% (95%CI 6.2-14.2). HBV surface antigen (HBsAg) prevalence was 1.4% (3/216). HBV DNA was detected in all three HBsAg-positive samples and in 10.5% (2/19) of the anti-HBc-positive samples (OBI), giving a HBV-TB co-infection prevalence of 2.3% (5/216). A multivariate analysis of risk factors showed that history of sharing cutting instruments, length of incarceration and homosexual sex were associated with HBV infection. CONCLUSION: Our findings indicate that HBV remains an important public health concern among prison inmates and active TB-HBV co-infection needs to be addressed for effective treatment.

Estudio de prevalencia de infecciones nosocomiales en una unidad médica de alta especialidad / Study of prevalence of hospital-acquired infections in Medical unit of high speciality

Introducción: En unidades de atención médica de tercer nivel existen factores que propician mayor frecuencia de Infecciones Nosocomiales (IN). Por lo anterior; es fundamental; evaluar periódicamente la sensibilidad de los sistemas de vigilancia epidemiológica; para comprobar su funcionamiento y el logro de objetivos. Objetivo: Conocer la prevalencia puntual de IN de una Unidad Médica de Alta Especialidad; como indicador de las acciones implementadas por la Unidad de Vigilancia Epidemiológica Hospitalaria (UVEH). Así como conocer los factores de riesgo asociados a la prevalencia de IN. Metodología: Es un estudio observacional de tipo transversal. La población estuvo conformada por 383 pacientes hospitalizados. Resultados: Se encontró que el 73.9% tenían procedimientos invasivos terapéuticos. Se identificaron 68 casos con infección nosocomial; lo que corresponde a una prevalecía puntual de 17.8%. Los sitios de IN más frecuentes fueron las bacteremias (38.2%) y neumonías (20.6%). Los microorganismos identificados con mayor frecuencia fueron pseudomona sp; enterobacter aglomerans; serratia marcescens y staphylococo coagulasa negativa; así como Escherichia Coli. Además de ser neonato y lactante otros factores asociados a las IN por RM; fueron el estar inmunocomprometido; el tener catéter venoso por disección; diálisis peritoneal; sonda orogástrica; intubación orotraqueal; ventilación mecánica; nutrición parenteral y el tener una cirugía contaminada. Factores que están significativamente asociados (p = 0.05) al riesgo de IN. Conclusiones: El desarrollo del estudio permitió conocer la prevalencia puntual y caracterizar las IN; como un indicador del funcionamiento de la UVEH; para el establecimiento de medidas de control de infecciones.

Objective: The purpose of this research was to analyze the intIntroduction: Within third level medical attention units, there are factors which lead to a higher frequency of Hospital Infections (HI). Because of this, it is fundamental to assess periodically the epidemiologic surveillance systems sensibilities in order to verify their functionalities as well as the objective achievements. Objective: To assess the prevalence of HI in one high Specialty Medical Units, as an indicator of the actions taken by the Hospital Epidemiologic Surveillance Unit (HESU),and also to assess the risk factors associated with the prevalence of HI. Methodology: Basic observational study with a population of 383 hospitalized patients. Results: We found that 73.9% had invasive processes. We identified 68 cases with Hospital Infection (17.8).The most frequent HI were general bacterial invasions (38.2%) and pneumonias (20.6%).The most frequently identified microorganisms were pseudomona sp, enterobacter aglomerans, serratia marcescens, staphylococcus aureus, and Escherichia coli. Besides to be newborn and nursing other factors associated to IN bt RM they were inmunocomprometed to be, having venous catheter by dissection, peritoneal intubation, mechanical ventilation, parenteral nutrition and having a contaminated surgery, factors that are significantly (p ≤ 0.05) to the risk of IN. Conclusions: This study allowed us assesses and characterize the prevalence of HI as an indicator of the HESU functionality in order to establish infection control measurements.

Methylprednisolone for the treatment of children with refractory epilepsy.

Epilepsy is a disease characterized by unprovoked epileptic seizures resulting from a bioelectrical brain dysfunction. Antiepileptic treatment controls 75% of all epileptic patients; the other 25% continue to have epileptic seizures in spite of a combination of multiple antiepileptic drugs. The purpose of this work was to evaluate the use of methylprednisolone in the treatment of children with refractory epilepsy. Fourteen children with refractory epilepsy at the Hospital de Especialidades No. 25 of the Instituto Mexicano del Seguro Social in Monterrey, Northeast Mexico were included. For five consecutively days, each patient received methylprednisolone by intravenous administration at a dosage of 15 mg/kg/day each 8 h, once a month for 3 months. The frequency of epileptic seizures and possible related side effects were evaluated every month during the three months before, during, and after administration of methylprednisolone. The frequency of epileptic seizures was reduced by more than 50% in 12/14 patients during methylprednisolone treatment. The median number of seizures before treatment with methylprednisolone was 8, 8, and 7; during the treatment: 1, 1, and 1; and after treatment: 2, 2, and 3 (p=0.000). We conclude that methylprednisolone reduces the frequency of epileptic seizures in children with refractory epilepsy.

Development of the Spanish version of the Systematized Nomenclature of Medicine: methodology and main issues.

This presentation features linguistic and terminology management issues related to the development of the Spanish version of the Systematized Nomenclature of Medicine (SNOMED). It aims at describing the aspects of translating and the difficulties encountered in delivering a natural and consistent medical nomenclature. Bunge's three-layered model is referenced to analyze the sequence of symbolic concept representations. It further explains how a communicative translation based on a concept-to-concept approach was used to achieve the highest level of flawlessness and naturalness for the Spanish rendition of SNOMED. Translation procedures and techniques are described and exemplified. Both the computer-aided and human translation methods are portrayed. The scientific and translation team tasks are detailed, with focus on Newmark's four-level principle for the translation process, extended with a fifth further level relevant to the ontology to control the consistency of the typology of concepts. Finally the convenience for a common methodology to develop non-English versions of SNOMED is suggested.

[Acquired immunodeficiency syndrome associated with infection by HTLV-1 virus: a clinical case]. / Síndrome de inmunodeficiencia asociado a infección por virus HTLV-1: caso clínico.

A 51 year old man with acquired immune deficiency syndrome for 2 years developed a chronic leukemia/T cell lymphoma. Anti HTLV-1 antibodies were confirmed by Western Blot. In the last months he developed hypercalcemia and leukocytosis of 130,000. Necropsy confirmed the diagnosis of Leukemia/T cell lymphoma without cutaneous involvement.

Nefrolitiasis: bases fisiopatologicas y metabolicas. / Nephrolithiasis: pathophysiological and metabolic basis

Esta revision analiza las bases metabolicas de la nefrolitiasis. La litiasis calcica es la mas frecuente, siendo sus causas mas comunes la hipercalciuria idiopatica; la hiperuricosuria; el hiperparatiroidismo primario; la acidosis tubular distal y la hiperoxaluria secundaria. Las litiasis de acido urico, cistina y estruvita le siguen en orden decreciente de frecuencia. En cada uno de los tipos de litiasis urinaria mencionados se detallan los mecanismos fisiopatologicos que llevan a la alteracion metabolica calculogenica