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1.
Cureus ; 15(10): e47584, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38022207

RESUMO

Multiple sclerosis (MS) is a chronic demyelinating disorder resulting in demyelination, neuroaxonal degeneration, and sclerosis. This often-debilitating disease affects young females mainly. Literature describing the pathology and phenotypic features is vast. Although there are extensive descriptions of new-onset MS presentations, few document the initial presentation as a transient ischemic attack or ischemic stroke. The case we present highlights the rarity of such presentation. In the literature, we found scarce reports about MS as presenting as a stroke mimicker with some studies quoting from 2.2% to 4.4% of the cases having MS. Our case serves as a reminder that MS can mimic acute ischemic strokes and the importance of maintaining MS apart of the differential in a young female with no significant history present with acute neurological deficits to reduce the complications of MS and the healthcare-associated costs.

2.
3.
Angle Orthod ; 91(6): 815-821, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34096985

RESUMO

OBJECTIVES: To evaluate the horizontal condylar angle (HCA) in mandibular lateral displacement (MLD). MATERIALS AND METHODS: HCA in MLD malocclusions were examined using cone-beam computed tomography data in subjects with MLD and control subjects. RESULTS: HCA in joints of control patients and contralateral side joints of MLD patients were not significantly different. The mean HCA on the shifted side was larger than on the contralateral side (P < .001) in the different HCA groups. HCA was significantly larger on the shifted side than on the contralateral side in skeletal Class I, Class II, and Class III groups (P < .001). CONCLUSIONS: (1) There was no statistically significant difference between HCA in control patients and on the contralateral side in MLD patients. (2) HCA was significantly larger on the shifted side than on the contralateral side. (3) HCA on the shifted side and the contralateral side in MLD Class I, Class II, and Class III are significantly different.


Assuntos
Má Oclusão , Mandíbula , Tomografia Computadorizada de Feixe Cônico , Humanos , Imageamento Tridimensional , Má Oclusão/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Côndilo Mandibular/diagnóstico por imagem
4.
Rev. méd. hondur ; 88(1): 27-32, ene.- jun. 2020. tab, map
Artigo em Espanhol | LILACS | ID: biblio-1128540

RESUMO

Antecedentes: Aproximadamente un sexto de la población mundial tiene el hábito de fumar para una prevalencia de 24%. La OMS considera que, de no cambiar las tendencias durante el siglo XXI, el tabaco será responsable de la muerte prematura de mil millones de personas. Objetivo: Determinar la prevalencia del consumo de tabaco y la medición de desigualdades socioeconómicas en la población Lenca, Municipio de Intibucá, Intibucá, Honduras, 2015. Métodos: Estudio descriptivo transversal con análisis de asociación. Se aplicó formulario estructurado para recolectar datos generales, sociodemográficos y tabaquismo, previo consentimiento informado. Dependencia al tabaco fue evaluada con test Faguerström. Se prepararon bases de datos en Epi-info-7 y SPSS-18. Se calcularon razones de disparidad (OR). Resultados: De un total de 602 entrevistados,se identificaron 167 fumadores para una prevalencia de consumo de tabaco de 27.7%. El 76.6% (128) de fumadores tuvo dependencia baja a nicotina y 23.4% (39) dependencia moderada. La media de ingreso familiar mensual fue USD$193 en fumadores y USD$168 en no fumadores. El 40.1% (67) de fumadores gastó mensualmente en tabaco un mínimo de USD$95. No se encontró relación entre consumo de tabaco e ingreso familiar mensual (OR=0.87, IC95% 0.7-1.0) ni con analfabetismo (OR=1.20, IC95% 0.7-2.0). Discusión: No se observaron diferencias significativas entre consumo de tabaco y las variables socioeconómicas, se encontró una elevada prevalencia de consumo de tabaco en esta población en relación con otros estudios realizados en el país. Los resultados apoyan la necesidad de políticas enfocadas en prevención del tabaco en indígenas...(AU)


Assuntos
Humanos , Masculino , Feminino , Etnicidade/classificação , Uso de Tabaco , Tabagismo/complicações , Disparidades nos Níveis de Saúde
5.
Case Rep Med ; 2019: 5787206, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31485233

RESUMO

Multiple sclerosis (MS) has classically been described as a disease of the young Caucasian female. While the prevalence may seem to be higher in Caucasians (CAs), recent studies suggest that the real incidence of MS may actually be higher in African Americans (AAs). Here, we discuss a nonclassical case of MS in an older African American male, prognostic factors, disease patterns in African Americans, and how a delay in diagnosis and socioeconomic factors can lead to worse outcomes. In patients that present with possible symptoms of MS, a high suspicion for MS should be entertained even in epidemiologically atypical patients to prevent delay in diagnosis and irreversible disability.

6.
Am J Case Rep ; 20: 705-708, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31097681

RESUMO

BACKGROUND Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is a technique used to provide prolonged cardiac and respiratory support to persons whose heart and lungs are unable to deliver adequate perfusion or gas exchange to sustain life. It is indicated in patients with severe ARDS, severe hypothermia, and cardiac and respiratory failure when other conventional methods fail. CASE REPORT We report the case of a 22-year-old gravid 2 Para 1 woman who presented to the Emergency Department with pyelonephritis, who subsequently developed sepsis that progressed to ARDS. She was managed successfully with extracorporeal membrane oxygenation [ECMO] for 5 days, with heparin used as an anticoagulant. After significant improvement, she was successfully de-cannulated and extubated. CONCLUSIONS The use of ECMO in pregnancy and post-partum can be associated with several complications to both mother and fetus. With appropriate patient selection, good knowledge of the procedure, and early initiation, successful outcomes can be attained.


Assuntos
Oxigenação por Membrana Extracorpórea , Complicações na Gravidez/terapia , Síndrome do Desconforto Respiratório/terapia , Feminino , Humanos , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/etiologia , Síndrome do Desconforto Respiratório/diagnóstico , Síndrome do Desconforto Respiratório/etiologia , Adulto Jovem
7.
Case Rep Cardiol ; 2019: 2458569, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31016050

RESUMO

Left atrial fibrous band is a rare clinical and echocardiographic finding characterized by the presence of a fibrous band attached to the mitral valve. Diagnosis is accomplished with transesophageal echocardiography (TEE), live 3D imaging, or cardiac MRI. Most patients are asymptomatic and incidental findings. However, in rare cases, an atrial fibrous band can produce symptoms such as dyspnea on exertion, fatigue, and lightheadedness secondary to mitral regurgitation (MR) which can lead to heart failure if unattended to. More serious complications such as cardioembolic phenomenon can occur. We herein report a case of a 55-year-old male with hypertension who presented with dyspnea on exertion and chest pain. Transthoracic echocardiography (TTE) showed mitral valve prolapse with moderate to severe mitral regurgitation. TEE showed an atrial fibrous band. Given the patient's poor exercise tolerance, he was taken to surgery for a mitral annuloplasty.

8.
Case Rep Med ; 2019: 2893056, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30853992

RESUMO

Acute chest syndrome (ACS) is a feared complication of sickle cell disease. Here is a case of a patient who presented with symptoms suggestive of acute chest syndrome yet had a delayed diagnosis presumably due to the lack of documented history of sickle cell disease of the patient, consequently evolving into acute respiratory distress syndrome (ARDS). He was subsequently diagnosed with heterozygous sickle cell SC disease on hemoglobin electrophoresis. After appropriate management with mechanical ventilator, broad-spectrum empiric intravenous antibiotics, exchange transfusion, and intravenous fluid resuscitation, the patient was medically optimized and safely discharged home, with significant improvement noted on successive follow-up visits.

9.
Case Rep Cardiol ; 2019: 5361529, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30729043

RESUMO

Simultaneous arteriovenous embolism is extremely rare. Herein, we present a rare case of systemic arteriovenous emboli in a healthy 33-year-old male after an episode of acute viral perimyocarditis. The culprits are postulated to be viral-induced myocardial necrosis and resulting proinflammatory state in the setting of negative malignant, autoimmune, genetics, and chronic infectious conditions. The patient was successfully managed with guideline-directed medical therapy and safely discharged to a subacute rehabilitation facility.

10.
Case Rep Infect Dis ; 2018: 2318539, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30510821

RESUMO

This is a case of a 38-year-old female with latent TB complicated by disseminated peritoneal TB with associated spontaneous abortion, who was initially thought to have an ovarian neoplasm, prompting extensive workup. Laparoscopy with biopsy later confirmed the patient's condition; she was initiated on the appropriate therapy and had a full recovery.

11.
Rev. cuba. estomatol ; 55(1): 34-41, ene.-mar. 2018. ilus, tab
Artigo em Espanhol | CUMED | ID: cum-72235

RESUMO

Objetivo: evaluar la dureza de diferentes grupos de alimentos a la masticación. Métodos: se realizó un estudio descriptivo in vitro, en el que se evaluó la dureza de diferentes golosinas, chicharrón y carne bovina. Para ello se utilizó un texturómetro EZ-S Shimadzu. El análisis estadístico de los datos obtenidos fue realizado de manera individual utilizando las pruebas estadísticas Shapiro Wilk, Kruskal-Wallis y la de comparación de Mann Whitney. Resultados: de los grupos de alimentos estudiados, presentó una alta dureza a la masticabilidad la golosina Coffe Deligth® (dulce de café duro) con la mayor fuerza requerida de 268,25 N, seguida de otra golosina Bon Bon Bum® (chupeta) con un valor de 179,5 N y luego las mentas (dulce de menta duro) con 165,25 N. En el caso de la carne bovina y las rosquillas horneadas se encuentraron valores más bajos. Conclusiones: debido a las elevadas fuerzas que hay que aplicar para lograr la fracturabilidad y masticabilidad de los alimentos de alta dureza, el consumo de estos es un eventual factor de riesgo para las restauraciones dentales y para los mismos dientes, con lo que se puede inducir a fracturas en los materiales restauradores o en los propios órganos dentarios(AU)


Objective: evaluate the hardness of various food groups for mastication. Methods: an in vitro descriptive study was conducted to evaluate the hardness of various tidbits, fried pork rinds and beef using the texture meter EZ-S Shimadzu. Statistical analysis of the data obtained was conducted on an individual basis with Shapiro Wilk and Kruskal-Wallis statistical tests, and Mann Whitney comparison test. Results: of the food groups studied, the ones standing out for their hardness were the tidbit Coffee Delight® (hard coffee candy) with 268.25 N, followed by another tidbit, Bon Bon Bum® (lollipop) with 179.5 N and mints (hard mint candy) with 165.25 N. Beef and baked donuts exhibited lower values. Conclusions: due to the intense force that must be applied to fracture and grind very hard food, its consumption constitutes a risk factor for natural teeth and dental restorations alike, since fractures may occur in restorative materials and dental organs(AU)


Assuntos
Humanos , Força de Mordida , Ingestão de Alimentos , Dureza , Epidemiologia Descritiva , Interpretação Estatística de Dados
12.
Rev. cuba. estomatol ; 55(1): 34-41, ene.-mar. 2018. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-960399

RESUMO

Objetivo: evaluar la dureza de diferentes grupos de alimentos a la masticación. Métodos: se realizó un estudio descriptivo in vitro, en el que se evaluó la dureza de diferentes golosinas, chicharrón y carne bovina. Para ello se utilizó un texturómetro EZ-S Shimadzu. El análisis estadístico de los datos obtenidos fue realizado de manera individual utilizando las pruebas estadísticas Shapiro Wilk, Kruskal-Wallis y la de comparación de Mann Whitney. Resultados: de los grupos de alimentos estudiados, presentó una alta dureza a la masticabilidad la golosina Coffe Deligth® (dulce de café duro) con la mayor fuerza requerida de 268,25 N, seguida de otra golosina Bon Bon Bum® (chupeta) con un valor de 179,5 N y luego las mentas (dulce de menta duro) con 165,25 N. En el caso de la carne bovina y las rosquillas horneadas se encuentraron valores más bajos. Conclusiones: debido a las elevadas fuerzas que hay que aplicar para lograr la fracturabilidad y masticabilidad de los alimentos de alta dureza, el consumo de estos es un eventual factor de riesgo para las restauraciones dentales y para los mismos dientes, con lo que se puede inducir a fracturas en los materiales restauradores o en los propios órganos dentarios(AU)


Objective: evaluate the hardness of various food groups for mastication. Methods: an in vitro descriptive study was conducted to evaluate the hardness of various tidbits, fried pork rinds and beef using the texture meter EZ-S Shimadzu. Statistical analysis of the data obtained was conducted on an individual basis with Shapiro Wilk and Kruskal-Wallis statistical tests, and Mann Whitney comparison test. Results: of the food groups studied, the ones standing out for their hardness were the tidbit Coffee Delight® (hard coffee candy) with 268.25 N, followed by another tidbit, Bon Bon Bum® (lollipop) with 179.5 N and mints (hard mint candy) with 165.25 N. Beef and baked donuts exhibited lower values. Conclusions: due to the intense force that must be applied to fracture and grind very hard food, its consumption constitutes a risk factor for natural teeth and dental restorations alike, since fractures may occur in restorative materials and dental organs(AU)


Assuntos
Humanos , Força de Mordida , Ingestão de Alimentos , Dureza , Epidemiologia Descritiva , Interpretação Estatística de Dados
14.
Int. j. odontostomatol. (Print) ; 11(3): 327-332, set. 2017. tab
Artigo em Inglês | LILACS | ID: biblio-893269

RESUMO

ABSTRACT: This paper main objective is to estimate the level of association between lower anterior crowding and the presence of lower third molars on study models and panoramic dental radiographs of patients treated by the Orthodontics Postgraduate Students at the Dentistry Faculty at the University of Cartagena (Cartagena de Indias, Colombia) and also other dental and radiographs care centers in Cartagena de Indias. It was made using a cross-sectional study at the Dentistry Faculty at the University of Cartagena and others dental care centers in the city. There were 366 study models and panoramic dental radiographs selected by strict inclusion/exclusion criteria for patients. An instrument that includes age, gender, presence or absence of third molars, position of third molars according to Winter's classification, stage of formation of the third molars according to Nolla's classification, and crowding magnitude according to Harfin's classification was used. Data were analyzed based on frequency distributions and proportions; inferential analysis was performed through proportional odds model using the software package IBM SPSS Statistics v23. It was found that the patients with Nolla 6 from the right side are more likely to have mild-moderate crowding magnitude than patients with Nolla 10 on that same side. In conclusion, this research provides as main result the implication of the eruption of the lower third molars and particularly those erupting in mesioangular and horizontal positions in the anterior crowding (AA).


RESUMEN: El objetivo de este trabajo fue estimar el nivel de asociación entre el apiñamiento dentario anteroinferior y la presencia de terceros molares inferiores en modelos de estudio y radiografías panorámicas de los pacientes atendidos por estudiantes del posgrado de ortodoncia de laFacultad de Odontología de Cartagena de Indias, Colombia y también otros centros dentales y de radiografías en Cartagena de Indias. Se realizó un estudio transversal en la Facultad de Odontología de la Universidad de Cartagena y otros centros de atención odontológica de la ciudad. Se utilizaron 366 modelos de estudio y radiografías dentales panorámicas seleccionadas por estrictos criterios de inclusión / exclusión para los pacientes. Se utilizó un instrumento que incluía edad, sexo, presencia o ausencia de terceros molares, posición de los terceros molares de acuerdo con la clasificación de Winter, etapa de formación de los terceros molares de acuerdo con la clasificación de Nolla y magnitud de apiñamiento según la clasificación de Harfin. Los datos se analizaron en base a las distribuciones y proporciones de frecuencia; el análisis inferencial se realizó a través del modelo de probabilidades proporcional utilizando el software IBM SPSS Statistics v23. Se encontró que los pacientes con Nolla 6 en el lado derecho son más propensos a tener una magnitud de apiñamiento de leve a moderada en comparación a los pacientes con Nolla 10 en ese mismo lado. En conclusión, esta investigación proporciona como resultado principal la implicación de la erupción de los terceros molares inferiores y particularmente aquellos que erupcionan en posiciones mesioangulares y horizontales en el apiñamiento dentario anterior (AA).


Assuntos
Humanos , Erupção Dentária , Dente Impactado/complicações , Incisivo/patologia , Má Oclusão/etiologia , Dente Serotino/patologia , Dente Impactado/patologia , Dente Impactado/epidemiologia , Radiografia Panorâmica , Incidência , Estudos Transversais , Colômbia/epidemiologia , Arco Dental/patologia , Má Oclusão/patologia , Má Oclusão/epidemiologia
15.
Gac Sanit ; 18(2): 145-9, 2004.
Artigo em Espanhol | MEDLINE | ID: mdl-15104976

RESUMO

OBJECTIVE: To describe the epidemiological characteristics of new cases of HIV infection diagnosed from 1997-2001 and compare them with AIDS cases (1991-2001). METHODS: Data were retrospectively collected on new cases of HIV infection detected in the Basque Country (1997-2001) and were compared with AIDS cases (1991-2001). RESULTS: A total of 912 new cases of HIV infection were diagnosed. In 299 of the new cases (32.8%), HIV and AIDS were diagnosed simultaneously. The most common mechanism of transmission was heterosexual transmission, followed by intravenous and homo/bisexual transmission. Significant epidemiological differences (p < 0.001) were found with regard to AIDS cases. CONCLUSIONS: Sexual transmission has replaced intravenous drug use as the most common mechanism of HIV transmission. A large percentage of patients were simultaneously diagnosed with HIV and AIDS, indicating the need for new prevention strategies.


Assuntos
Infecções por HIV/epidemiologia , Síndrome da Imunodeficiência Adquirida/epidemiologia , Feminino , Infecções por HIV/transmissão , Humanos , Masculino , Vigilância da População , Estudos Retrospectivos , Espanha/epidemiologia
16.
Investig. segur. soc. salud ; 2: 93-11, 2000. ilus
Artigo em Espanhol | LILACS, COLNAL | ID: lil-595214

RESUMO

Justificación y propósito Colombia se ubica en el cuarto lugar entre los países continentales de América Latina en cuanto al número total de casos reportados de VIH-SIDA, lo cual ha afectado la percepción de riesgo que significan las otras ETS, en especial las ulcerativas como sífilis y gonorrea, no sólo en la población general, sino también en los equipos de salud que atienden estas patologías. A tal punto ha llegado la situación que varias de ellas casi han desaparecido de los registros de notificación, aunque no del medio como han probado varias investigaciones recientes. Lo más lamentable de esta situación es que la prevención y el control de estas patologías se puede hacer con medios específicos, tratamientos relativamente baratos y efectivos, que además disminuyen el riesgo y la transmisión del VIH porque al realizar intervenciones de prevención en ETS también se previene el VIH-SIDA. Un ejemplo típico es el de la sífilis, que varios estudios del exterior y del país han probado que constituye un factor de riesgo para infección VIH y una infección indicadora del SIDA. No obstante, la respuesta a los esfuerzos para implementar el programa de erradicación de la sífilis con- génita antes del año 2000 que actualmente adelantan el Ministerio de Salud y la Secretaría de Salud de Bogotá, ha sido muy pobre. En estas circunstancias hay que buscar estrategias novedosas que favorezcan el control de las otras ETS a través de las que están en curso para VIH y viceversa. Este proyecto fue desarrollado para evaluar la magnitud del reservorio de sífilis en embarazadas de Bogotá, con un estudio simultáneo de infección VIH, intentando desarrollar algoritmos de diagnóstico y predicción de riesgo en los cuales se use la detección rutinaria a partir de la serología positiva confirmada para sífilis para detectar casos de infección VIH. Objetivos Evaluar la frecuencia de Infecciones por T. pallidum en el grupo de embarazadas seleccionadas de la dudad de Bogotá, al Igual que la frecuencia de infecciones por VIH, con miras a establecer la importancia de los posibles algoritmos de diagnóstico que permitan la detección de las dos patologías tanto en la madre como en sus hijos, iniciando por el estudio de la infección por T. pallidum. Evaluar la sensibilidad, especificidad, valor predictivo positivo y negativo de las pruebas que actualmente se tienen disponibles en Bogotá para la detección de estas patologías en el grupo de pacientes mencionados. Metodología Entre octubre de 1998 y octubre de 1999 se tomaron muestras de sangre, en el momento del parto, a las embarazadas que asistieron a los hospitales Simón Bolívar, Clínica Corpas, La Victoria, La Perseverancia, La Granja. La Samaritana, Clínica El Bosque y el Centro de Atención de Cafam en Ciudad Bolívar en Santa Fe de Bogotá. La muestra de embarazadas fue no probabilística y se les practicaron pruebas rápidas y convencionales para sífilis e infección VIH; además se obtuvieron datos sobre variables demográficas, clínicas y de laboratorio, y una muestra de suero para Nasba carga viral, pruebas no treponémicas y Elisa IgM trepónemica para detección de anticuerpos contra el T. pallidum. Para propósitos de comparación y validación de las pruebas usadas ante dudas que surgieron fuera del grupo de trabajo durante su ejecución, se incluyeron muestras obtenidas de trabajadoras sexuales durante un proyecto diferente en el Hospital de La Perseverancia y muestras de sangre de trabajadoras sexuales embarazadas que han asistido a consulta también al Hospital de La Perseverancia, tanto positivas como negativas. A estas últimas pacientes se le realizaron también pruebas convencionales deVDRL para sífilis en el Instituto de Virología y Elisa para VIH en el Hospital de La Perseverancia; una prueba no trepónemica para sífilis (RPR), Elisa IgM treponémica para detección de anticuerpos contra el T. pallidum, Elisa y Western Blot para VIH y Nasba carga viral.También se les llenó una ficha prediseñada donde se tomaron datos demográficos, clínicos y epidemiológicos, y una muestra de sangre que se procesó en forma similar a las de los hospitales ya mencionados. Resultados Se examinaron un total de 567 muestras procedentes de los hospitales mencionados. Se encontró un total de 2 (0.4%) muestras positivas para VIH y un total de 14 (2.5%) reactivas por VDRL y/o RPR; de ellas se confirmaron 9 (1.6%) por Elisa IgM para sífilis que corresponden al 30% de las que fueron inicialmente reactivas por VDRL y RPR. Conclusiones De acuerdo con los resultados de este estudio la frecuencia de infecciones confirmadas por T. pallidum es de 1.6% en el grupo de embarazadas estudiadas, lo cual corresponde a la literatura; esto podría deberse a la acumulación de casos por factores diferentes a los de riesgo. La frecuencia de infecciones por VIH estuvo en 0.4% que no corresponde a lo informado para la población general en Bogotá y no se correlacionó con la seropositividad para sífilis. Se evidenció también alta frecuencia de falsos reactivos o falsos positivos para sífilis en el embarazo que son detectados por las pruebas no treponémicas como VDRL y RPR, lo que hace obligatorio la confirmación por métodos más específicos como la ¡nmunofluorescencia y el Elisa IgM con antígenos treponémicos.


Justification and purpose Colombia ranks fourth among the continental countries of Latin America in terms of the total number of reported cases of HIV-AIDS, which has affected the perception of risk posed by other STDs, especially ulcerative STDs such as syphilis and gonorrhea, not only in the general population, but also in the health teams that treat these pathologies. The situation has reached such a point that several of them have almost disappeared from the notification records, although not from the environment, as several recent investigations have proven. The most regrettable aspect of this situation is that the prevention and control of these pathologies can be done with specific means, relatively cheap and effective treatments, which also reduce the risk and transmission of HIV because by carrying out STD prevention interventions, HIV-AIDS is also prevented. A typical example is syphilis, which several studies from abroad and at home have proven to be a risk factor for HIV infection and an AIDS indicator infection. However, the response to the efforts to implement the program to eradicate syphilis before the year 2000, currently being carried out by the Ministry of Health and the Secretariat of Health of Bogota, has been very poor. In these circumstances, it is necessary to look for novel strategies that favor the control of other STDs through those that are underway for HIV and vice versa. This project was developed to evaluate the magnitude of the syphilis reservoir in pregnant women in Bogota, with a simultaneous study of HIV infection, trying to develop diagnostic and risk prediction algorithms in which routine screening from confirmed positive serology for syphilis is used to detect cases of HIV infection. Objectives To evaluate the frequency of T. pallidum infections in the group of selected pregnant women in the city of Bogotá, as well as the frequency of HIV infections, in order to establish the importance of possible diagnostic algorithms that allow the detection of both pathologies in the mother and her children, starting with the study of T. pallidum infection. To evaluate the sensitivity, specificity, positive and negative predictive value of the tests currently available in Bogota for the detection of these pathologies in the aforementioned group of patients. Methodology Between October 1998 and October 1999, blood samples were taken at the time of delivery from pregnant women attending the following hospitals: Simón Bolívar, Clínica Corpas, La Victoria, La Perseverancia, La Granja, La Samaritana, Clínica El Bosque and the Cafam Care Center in Ciudad Bolívar in Santa Fe, Bogotá. La Samaritana, Clínica El Bosque and the Cafam Care Center in Ciudad Bolívar in Santa Fe de Bogotá. The sample of pregnant women was non-probabilistic and they underwent rapid and conventional tests for syphilis and HIV infection; in addition, data on demographic, clinical and laboratory variables were obtained, as well as a serum sample for Nasba viral load, non-treponemal tests and Elisa IgM treponemal for detection of antibodies against T. pallidum. For purposes of comparison and validation of the tests used in case of doubts that arose outside the working group during its execution, samples obtained from sex workers during a different project at the Hospital de La Perseverancia and blood samples from pregnant sex workers who have also attended the Hospital de La Perseverancia, both positive and negative, were included. The latter patients also underwent conventionalVDRL tests for syphilis at the Instituto de Virología and Elisa for HIV at the Hospital de La Perseverancia; a non-treponemal test for syphilis (RPR), Elisa IgM treponemal for detection of antibodies against T. A pre-designed form was also filled out where demographic, clinical and epidemiological data were collected, and a blood sample was processed in a similar way to those of the aforementioned hospitals. Results A total of 567 samples from the aforementioned hospitals were examined. A total of 2 (0.4%) samples were found to be positive for HIV and a total of 14 (2.5%) reactive by VDRL and/or RPR; of these, 9 (1.6%) were confirmed by IgM Elisa for syphilis, corresponding to 30% of those initially reactive by VDRL and RPR. Conclusions According to the results of this study, the frequency of confirmed T. pallidum infections is 1.6% in the group of pregnant women studied, which corresponds to the literature; this could be due to the accumulation of cases due to factors other than risk factors. The frequency of HIV infection was 0.4%, which does not correspond to that reported for the general population in Bogotá, and did not correlate with seropositivity for syphilis. There was also a high frequency of false reactive or false positives for syphilis in pregnancy that are detected by non-treponemal tests such as VDRL and RPR, which makes confirmation by more specific methods such as ¡nmunofluorescence and IgM Elisa with treponemal antigens mandatory.


Assuntos
Humanos , Feminino , Gravidez , Sífilis , Infecções Sexualmente Transmissíveis , Infecções por HIV , Síndrome da Imunodeficiência Adquirida , Sistema Único de Saúde , Sangue , Ensaio de Imunoadsorção Enzimática , Gonorreia , Demografia , Valor Preditivo dos Testes , HIV , Estratégias de Saúde , Carga Viral , Gestantes , Diagnóstico , Profissionais do Sexo , Anticorpos
17.
Rev. colomb. neumol ; 10(1): 6-7, abr. 1998.
Artigo em Espanhol | LILACS | ID: lil-221007
18.
Rev. colomb. neumol ; 9(2): 49, jul. 1997.
Artigo em Espanhol | LILACS | ID: lil-220998
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