RESUMO
OBJECTIVE AND DESIGN: Oriented hepatitis C virus (HCV) screening on the basis of transfusion, previous or current parenteral drug addiction, invasive procedures, and in family members of patients with hepatitis C, was recommended in France by the 'Direction Générale de la Santé' (DGS). The aim of this study was to estimate the frequency of these risk factors in patients admitted in hospital emergency departments in Picardy. METHODS: Between 1 June and 31 July 1996, physicians of the emergency units of seven hospitals in Picardy were asked to question admitted patients about risk factors mentioned in the DGS recommendations, and to suggest a screening test when at least one of these risk factors was present. RESULTS: Among 1648 patients, 68.7% had at least one of these risk factors. Screening was accepted by 723 patients, 58.7% of those with at least one risk factor, and more than 70% of those with history of transfusion and/or drug addiction. It was immediately performed in 451, and 2.4% had anti-HCV antibodies. The prevalence of anti-HCV antibodies was 1.5% in patients without history of transfusion or drug addiction and 7.9% in those with at least one of these two risk factors. CONCLUSION: Oriented screening based on transfusion or drug addiction history seems to have better efficiency than the screening policy recommended by the DGS. Poor reliability of answers about medical history was observed probably because of stress related to emergency circumstances. A screening test proposed to patients with these major risk factors by their usual physician would be probably more efficient.
Assuntos
Hepatite C/diagnóstico , Hepatite C/epidemiologia , Programas de Rastreamento , Idoso , Transfusão de Sangue , Serviço Hospitalar de Emergência , Ensaio de Imunoadsorção Enzimática , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Fatores de Risco , Transtornos Relacionados ao Uso de SubstânciasAssuntos
Injúria Renal Aguda/líquido cefalorraquidiano , Ceftazidima/líquido cefalorraquidiano , Ceftazidima/intoxicação , Cefalosporinas/líquido cefalorraquidiano , Cefalosporinas/intoxicação , Injúria Renal Aguda/complicações , Injúria Renal Aguda/metabolismo , Idoso , Overdose de Drogas , Humanos , Masculino , Pneumonia Bacteriana/complicações , Pneumonia Bacteriana/tratamento farmacológico , Pseudomonas aeruginosaAssuntos
Biomarcadores/sangue , Tromboembolia/sangue , Tromboembolia/diagnóstico , Adulto , Idoso , Diagnóstico Diferencial , Serviço Hospitalar de Emergência , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Embolia Pulmonar/sangue , Embolia Pulmonar/diagnóstico , Tromboflebite/sangue , Tromboflebite/diagnósticoRESUMO
We report one patient with paralysis of the right upper extremity, bilateral cerebellar syndrome, and cognitive changes after treatment with interleukin-2 for metastatic renal cell carcinoma. Focal neurologic disturbances were associated with multiple images of cerebral infarcts but also with extraneurologic signs and autoantibodies. We suggest that this is a case of cerebral vasculitis with an autoimmune mechanism triggered by interleukin-2 therapy.
