[Prevalence of positive markers for hepatitis B (HBV Ags) and hepatitis C (Anti-HCV) in health personnel at the Social Security Institute of Mexico State and Municipalities]. / Prevalencia de marcadores positivos para hepatitis B (Ags-VHB) y hepatitis C (Anti-VHC) en personal de salud del ISSEMYM.

BACKGROUND: The prevalence of serum markers of viral hepatitis in health-care workers seems to be similar to that described in the general population, even though this group would appear at increased risk because exposure to potentially infectious material. There is scarce information available in Mexico in this regard. AIM: To define the prevalence of serum markers for hepatitis C (anti-HCV antibodies) and hepatitis B (hepatitis B surface antigen, HBsAg) in health-care workers at the Instituto de Seguridad Social del Estado de Mexico y Municipios (ISSEMYM) and to establish the presence of viremia in subjects with positive serum markers. METHOD: Health-care workers from ISSEMyM with unknown hepatitis serologic status participated voluntarily in this trial. They completed a written questionnaire detailing potential risk factors for viral hepatitis and provided a blood sample. RESULTS: A total of 374 health-care workers were included. Seven subjects (1.8%) were positive, 5 for anti-HCV antibodies (1.3%) and 2 for HBsAg (0.5%). None of these subjects had detectable serum HCV RNA or HBV DNA on further testing. CONCLUSIONS: The frequency of positive serum markers for viral hepatitis in this group of healthcare workers is similar to the estimated prevalence among the general population in Mexico. No case of active infection defined by positive viremia was encountered in this group of subjects.

[Neonatal consequences of maternal autoimmune thrombocytopenic purpura]. / Repercusión neonatal de la púrpura trombocitopénica autoinmune materna.

PURPOSE: To describe the clinical characteristics in newborns of mothers with autoimmune thrombocytopenic purpura (ATP), as well as to evaluate the mother's platelet count in the prediction of the neonatal thrombocytopenia. PATIENTS AND METHODS: We included 33 mothers with their 40 newborns, who were classified in four groups: Group I: ten newborns whose mothers suffered of chronic autoimmune thrombocytopenic purpura who during the pregnancy remained in haematologic remission. Group II: nine newborns whose mothers were splenectomized for ATP in the preceding treatment but without symptoms during the actual pregnancy. Group III: eleven newborns whose mothers had chronic ATP and splenectomy, but during the actual pregnancy showed purpuric activity. Group IV: Ten newborns whose mothers had acute ATP during actual gestation with clinical data for bleeding. RESULTS: None of the newborns belonging to the group I presented thrombocytopenia. Mean platelet count at birth was 150 x 10(9)/L in group I, 124 x 10(9)/L u/L in group II, 47 x 10(9)/L in group III and 89 x 10(9)/L in group IV. There were significant differences between the focus groups (p < .01). The mean platelet count in groups III and IV, presented the lower values between days three and fourteen of postnatal age. In these same groups, we observed more morbility related with haemorrhagical activity or infectious complications derived from treatment with steroids. The presence of maternal thrombocytopenia was associated in the 86.7% of the cases with platelet count < 100 x 10(9)/L at the time of birth. CONCLUSION: The maternal background with low probability of fetal or neonatal thrombocytopenia included mothers with inactive ATP and the antecedent of splenectomy. On the contrary, the greatest probability of fetal and neonatal affection happens when the mother presents active chronic ATP and the previous antecedent of being refractory to the treatment with splenectomy or when acute ATP occurred during pregnancy.