Confirmed cases of COVID-19 after vaccination against COVID in health personnel in Bogotá, Colombia.

OBJECTIVE: The present study aims to estimate the frequency of COVID 19 infections in vaccinated health personnel at a Los CObos Medical Center in Bogotá, Colombia. The percentage of people positive to the PCR test and their clinical characteristics were analyzed. METHODS: We performed a cross-sectional study. The primary study variable was the COVID vaccination registry. We analyzed sex, age, signs, and symptoms. Multivariable logistic regression was applied to assess changes over time and to identify variables associated with vaccination in target groups. RESULTS: A cohort of 999 people working at Los Cobos Medical Center and followed from March to August 2021. The average age of this cohort was 37.0 years (devest = 10.5 years), 67.7 % were women. Two hundred eleven physicians, 287 nurses, 305 assistants, and 196 clerks follows. In addition, 8.4 % to be PCR positive after vaccination. The average age was 36.0 (devest = 23.4 years), 59 women and 25 men. Of these, 15 were administrative, 14 were doctors, 29 nurses, and 26 nursing assistants. The vaccination status found that 21.4 % do not vaccinates, 7.1 % were partially vaccinated, and 71.4 % with a complete schedule. When questioned about symptoms in these patients, 4.0 % were symptomatic, and 5.9 % were asymptomatic. CONCLUSIONS: A recent epidemiological study involving 12,364 health workers with a mean age of 38 years quantifies the protection in six months from the vaccine. The presence of antibodies was associated with 83 % protection against active SARS-CoV-2 infection (PCR positivity during the study period), which confirms the existence of protective Immunity at levels comparable to those obtained by the approved vaccines; our study found effectiveness of 92.6 %. Higher than that found in this study, possibly explained by the characteristics of the individuals included.

Variations of lipoprotein(a) levels in the metabolic syndrome: a report from the Maracaibo City Metabolic Syndrome Prevalence Study.

BACKGROUND: Lipoprotein(a) [Lp(a)] is a known risk factor for cardiovascular disease, yet its influence on metabolic syndrome (MS) is still controversial. The purpose of this study was to assess the impact generated by this diagnosis in serum Lp(a) concentrations. MATERIALS AND METHODS: A total of 1807 subjects of both genders (55.3% women and 44.7% men) belonging to the Maracaibo City Metabolic Syndrome Prevalence Study were evaluated. Results were expressed as Mean ± SD, determining differences through Student's t-test and One-Way ANOVA test. Multiple logistic regression models were utilized for analyzing factors associated with elevated serum Lp(a) levels and MS. Total cholesterol and LDL-C were corrected according to Lp(a)-Cholesterol when necessary. RESULTS: No differences were found in Lp(a) values between genders; P = 0,292. The association between MS and the classification of Lp(a) was statistically significant (χ (2) = 28.33; P < 0,0001), with greater levels in subjects with this diagnosis. In the univariate analysis, subjects with each of the separate diagnostic criteria showed higher serum Lp(a) concentrations, except for hyperglycemia. CONCLUSIONS: Lp(a) values exhibit important variations regarding MS and each of its components. Impaired fasting glucose appeared as a protecting factor against elevated Lp(a) concentrations, whereas its association with LDL-C and hs-CRP suggests a potential pro-inflammatory role.

Detección de la mutación S315T en el gen katg como estrategia para identificación de Mycobacterium tuberculosis resistente a isoniacida en un laboratorio de referencia / Detection of S315T mutation in the katg gene as a strategy for identification of isoniazid-resistant Mycobacterium tuberculosis in a reference laboratory

Introduction: The emergence of strains of Mycobacterium tuberculosis resistant to drugs is a public health problem. Aim: To characterize the resistance to isoniazid (INH) in M. tuberculosis. Methods: Phenotypic and genotypic methods were used to determine the contribution of mutations at 315 codon of katG gene to the phe-notypic expression of resistance. The analysis of susceptibility to antibiotics was performed by the proportional method of Canetti and nitrate reductase method.Genotypic analysis of INH resistance was performed by PCR-RFLP. Results: 193 strains of M. tuberculosis from patients with respiratory symptoms were analyzed. Nineteen (9.8%) strains resistant to INH were identified, of which 12 (63.2%) showed resistance to other drugs. Genotypic analysis allowed to detect the mutation S315T in the katG gene in 15 of 17 strains phenotypically resistant to INH, showing a sensitivity of 88.24%, 100% specificity, 100% positive predictive value, 92% negative predictive value and high concordance with phenotypic methods (kappa = 0.85 (p < 0.01). Conclusion: The S315T mutation in the katG gene is the predominant mechanism of INH resistance in our circulating strains. This feature could be used as a rapid diagnostic tool with potential to detect at least 88% of isoniazid resistant strains, with great impact on the therapeutic management of patients.

Introducción: La emergencia de cepas de Mycobacterium tuberculosis multi-resistentes a antimicrobianos constituye un problema de salud pública. Objetivo: Caracterizar la resistencia a isoniacida (HIN) en cepas de M. tuberculosis. Métodos: Se aplicaron métodos fenotí-picos y genotípicos para determinar la contribución de mutaciones en el codón 315 del gen katG a la expresión fenotípica de resistencia. El análisis fenotípico de susceptibilidad a antimicrobianos se realizó por métodos de las proporciones de Canetti y nitrato reductasa. El análisis genotípico se realizó por RPC-PLFR. Resultados: Se analizaron 193 cepas de M. tuberculosis aisladas de pacientes sintomáticos respiratorios. Se identificaron 19 (9,8%) cepas resistentes a HIN, de las cuales, 12 (63,2%) exhibieron resistencia a otros antimicrobianos. El análisis genotípico permitió detectar la mutación katG S315T en 15/17 cepas fenotípicamente resistentes a HIN, exhibiendo una sensibilidad de 88,24%, especificidad de 100%, valor predictor positivo de 100%, valor predictor negativo de 92% y alta concordancia al comparar con los métodos fenotípicos (kappa = 0,85 (p < 0,01). Conclusión: La mutación S315T en el gen katG representa un mecanismo de desarrollo de resistencia a HIN predominante en las cepas circulantes en nuestro medio, característica que podría ser utilizada como herramienta diagnóstica rápida para detectar al menos 88% de las cepas resistentes a isoniacida, con gran impacto en el manejo terapéutico de los pacientes.

[Detection of S315T mutation in the katg gene as a strategy for identification of isoniazid-resistant Mycobacterium tuberculosis in a reference laboratory]. / Detección de la mutación S315T en el gen katg como estrategia para identificación de Mycobacterium tuberculosis resistente a isoniacida en un laboratorio de referencia.

INTRODUCTION: The emergence of strains of Mycobacterium tuberculosis resistant to drugs is a public health problem. AIM: To characterize the resistance to isoniazid (INH) in M. tuberculosis. METHODS: Phenotypic and genotypic methods were used to determine the contribution of mutations at 315 codon of katG gene to the phenotypic expression of resistance. The analysis of susceptibility to antibiotics was performed by the proportional method of Canetti and nitrate reductase method.Genotypic analysis of INH resistance was performed by PCR-RFLP. RESULTS: 193 strains of M. tuberculosis from patients with respiratory symptoms were analyzed. Nineteen (9.8%) strains resistant to INH were identified, of which 12 (63.2%) showed resistance to other drugs. Genotypic analysis allowed to detect the mutation S315T in the katG gene in 15 of 17 strains phenotypically resistant to INH, showing a sensitivity of 88.24%, 100% specificity, 100% positive predictive value, 92% negative predictive value and high concordance with phenotypic methods (kappa = 0.85 (p < 0.01). CONCLUSION: The S315T mutation in the katG gene is the predominant mechanism of INH resistance in our circulating strains. This feature could be used as a rapid diagnostic tool with potential to detect at least 88% of isoniazid resistant strains, with great impact on the therapeutic management of patients.

Cuando se justifica la colostomía en trauma de colón? / When is colostomy justified in colon trauma

Se trata de un estudio descriptivo prospectivo, en el cual se incluyen los pacientes que ingresaron a el Hospital Simón Bolivar con heridas del Colón intraperitoneal, quienes adicionalmente no presentaron shock intraoperatorio y no tuviesen más de 12 horas de evolución desde el trauma inicial; a estos pacientes se les realizó reparo primario de la lesión del colon sin procedimientos derivativos adicionales tipo colostomía. Durante un período comprendido desde Junio 1993; un total de 75 pacientes cumplían con los requisitos, encontramos una morbilidad cercana a el 20por ciento, sin que ésta se pueda atribuir a el reparo primario y si se encuentra en una estrecha relación con la severidad del trauma inicial. Se analizaron otras variables: sexo, puntaje P.A.T.I., clasificación de Flint, transfusiones sanguíneas, shock, severidad de peritonitis, localización de la herida. Todos los pacientes fueron seguidos hasta 30 días después de ser dados de alta del hospital.