[Thyrotropin reference ranges during pregnancy in the province of Huelva, Spain]. / Intervalos de referencia de la tirotropina durante la gestación en la provincia de Huelva.

OBJECTIVE: The correct diagnosis of hypothyroidism during pregnancy requires knowledge of the local trimester-specific thyrotropin (TSH) reference ranges. When these are not available, the guidelines recommend upper limits of 2.5, 3.0, and 3.0µU/ml for the 1st, 2nd, and 3rd trimesters, respectively. The aim is to establish the reference range for our local population. MATERIAL AND METHODS: A population-based observational study was performed on healthy pregnant women from 11 healthcare centres in the province of Huelva. Women were recruited consecutively during 2016 through the pregnancy process. Women were excluded who had a history of thyroid or medical disease, a poor obstetric history, multiple pregnancy, thyroid autoimmunity, and extreme TSH values (<0.4µU/ml or>10µU/ml), as well as women treated with levothyroxine for thyroid dysfunction. RESULTS: The study included a total of 186 pregnant women, with a mean age of 30.7 years (95% CI: 29.8-31.6) and a body mass index (BMI) of 23.6 (95% CI: 23.2-24.0). Most of them had the first laboratory tests performed before week 11 of pregnancy. Valid subjects for analysis were 145, 105, and 67 pregnant women in the 1st, 2nd, and 3rd trimesters, respectively, after excluding those due to abortion (18.9%), autoimmunity (6.5%), hypo/hyperthyroidism (2.2%), and levothyroxine treatment during the 2nd/3rd trimester (18.6%). The 97.5% TSH percentile for the 1st, 2nd, and 3rd trimester was 4.68, 4.83, and 4.57µU/ml, respectively. Thyroid dysfunction was identified in 80 women (55.2%), 33 of whom received treatment with Levothyroxine (22.7%). With the new criteria, thyroid dysfunction prevalence would be reduced to 6.2%, and the need for treatment to 4.1%. CONCLUSION: The reference range for TSH in our population differs from that proposed by the guidelines. Unnecessary treatment was being given to 18.6% of pregnant women.

[Hepatitis virus B, C and delta infection in carriers of the human immunodeficiency virus]. / Infección por los virus de la hepatitis B, C y delta en portadores del virus de la inmunodeficiencia humana.

BACKGROUND: Human immunodeficiency virus (HIV) shares transmission mechanisms with some hepatotropic viruses, such as hepatitis B (HBV), C (HCV) and delta (HDV) viruses. METHODS: To evaluate the prevalence of infection in a group of 100 male prisoners, carriers of the human immunodeficiency virus, the serologic markers of these viruses were investigated with radioimmunoassay and enzyme immunoassay. RESULTS: In 96 and 65% of individuals, respectively, some marker of HBV and HCV were found. The association anti-HBs and anti-HBc was present in 51 cases; 36 of them (71%) were carriers of anti-HCV. HBsAg was found in 7 individuals, 5 of which had antibodies against HDV. The pattern anti-HBs, anti-HBc, anti-HCV, HIV anti-env and anti-core was found in 34 individuals. CONCLUSIONS: These data show the high prevalence of HBV and HCV in the study population, indicating the need to systematically investigate markers of these viruses to establish measures for prevention and control.

[Fungal peritonitis during continuous ambulatory peritoneal dialysis (CAPD)]. / Peritonitis fúngica en diálisis peritoneal continua ambulatoria (DPCA).

We report three cases of fungal peritonitis in patients undergoing CAPD, representing 1.3% of 228 episodes recorded during an 8 year period. The three patients, who had been catheterized for a long time, had previous episodes of bacterial peritonitis and had received antibiotic therapy. The culture was decisive to make the diagnosis. The change of the catheter and the treatment with antifungal agents contributed to cure the infection, although the three patients died from other causes. One case of peritonitis was caused by Candida lusitaniae.