Neurodevelopmental assessment of normocephalic children born to Zika virus exposed and unexposed pregnant people.

BACKGROUND: Studies examining the association between in utero Zika virus (ZIKV) exposure and child neurodevelopmental outcomes have produced varied results. METHODS: We aimed to assess neurodevelopmental outcomes among normocephalic children born from pregnant people enrolled in the Zika in Pregnancy in Honduras (ZIPH) cohort study, July-December 2016. Enrollment occurred during the first prenatal visit. Exposure was defined as prenatal ZIKV IgM and/or ZIKV RNA result at enrollment. Normocephalic children, >6 months old, were selected for longitudinal follow-up using the Bayley Scales of Infant and Toddler Development (BSID-III) and the Ages & Stages Questionnaires: Social-Emotional (ASQ:SE-2). RESULTS: One hundred fifty-two children were assessed; after exclusion, 60 were exposed and 72 were unexposed to ZIKV during pregnancy. Twenty children in the exposed group and 21 children in the unexposed group had a composite score <85 in any of the BSID-III domains. Although exposed children had lower cognitive and language scores, differences were not statistically significant. For ASQ:SE-2 assessment, there were not statistically significant differences between groups. CONCLUSIONS: This study found no statistically significant differences in the neurodevelopment of normocephalic children between in utero ZIKV exposed and unexposed. Nevertheless, long-term monitoring of children with in utero ZIKV exposure is warranted. IMPACT: This study found no statistically significant differences in the neurodevelopment in normocephalic children with in utero Zika virus exposure compared to unexposed children, although the exposed group showed lower cognitive and language scores that persisted after adjustment by maternal age and education and after excluding children born preterm and low birth weight from the analysis. Children with prenatal Zika virus exposure, including those normocephalic and have no evidence of abnormalities at birth, should be monitored for neurodevelopmental delays. Follow-up is important to be able to detect developmental abnormalities that might not be detected earlier in life.

Microcephaly Outcomes among Zika Virus-Infected Pregnant Women in Honduras.

The impact of Zika virus (ZIKV) infection on pregnancies shows regional variation emphasizing the importance of studies in different geographical areas. We conducted a prospective study in Tegucigalpa, Honduras, recruiting 668 pregnant women between July 20, 2016, and December 31, 2016. We performed Trioplex real-time reverse transcriptase-PCR (rRT-PCR) in 357 serum samples taken at the first prenatal visit. The presence of ZIKV was confirmed in seven pregnancies (7/357, 2.0%). Nine babies (1.6%) had microcephaly (head circumference more than two SDs below the mean), including two (0.3%) with severe microcephaly (head circumference [HC] more than three SDs below the mean). The mothers of both babies with severe microcephaly had evidence of ZIKV infection. A positive ZIKV Trioplex rRT-PCR was associated with a 33.3% (95% CI: 4.3-77.7%) risk of HC more than three SDs below the mean.

Características clínico-epidemiológicas de los pacientes con pitiriasis versicolor en un centro de referencia de Colombia / Clinical-epidemiological characteristics of patients with tinea versicolor in a Colombian reference center

Resumen Objetivo: describir las características socio-demográficas, presentación clínica y condiciones extrínsecas que pueden favorecer el desarrollo de la pitiriasis versicolor. Material y métodos: estudio observacional descriptivo, de corte transversal y prospectivo, en el que se incluyeron pacientes con diagnóstico clínico y micológico de pitiriasis versicolor entre enero y diciembre de 2018, que asistieron al Hospital Universitario Centro Dermatológico Federico Lleras Acosta. Resultados: se incluyeron un total de 42 pacientes con diagnóstico de pitiriasis versicolor confirmado por examen directo, el 62% fueron hombres con una edad promedio de 33 años. La localización más común fue el tórax anterior (68%) y posterior (65%), en fototipos III y IV (78.5%), con una tonalidad hipocrómica. El 28% presentaron cuadros recurrentes, con síntomas hasta 7 años antes de la consulta. El signo de Besnier fue positivo en el 95% de los casos. El 64% refirió antecedente personal de hiperhidrosis y el 67% practicaba algún deporte como buceo, natación o gimnasia. Discusión: la identificación de las condiciones extrínsecas presentes esta población permite orientar medidas de prevención para evitar recurrencias de pitiriasis versicolor. Los viajes a lugares de clima cálido y la práctica de deportes son factores que favorecen el desarrollo de la micosis. En las formas clínicas atípicas se sugiere realizar siempre el examen micológico directo para confirmar el diagnóstico. El signo de Besnier es una maniobra útil para el diagnóstico clínico de la pitiriasis versicolor, particularmente cuando el acceso al examen directo es limitado.

Abstract Objective: to describe the sociodemographic aspects, clinical presentation and extrinsic conditions that may increase the risk of developing pityriasis versicolor. Materials and methods: a descriptive, cross-sectional and prospective observational study was conducted. Patients with clinical and mycological diagnosis of ptyriasis versicolor were included from january to december 2018 who attended to the Hospital Universitario Centro Dermatológico Federico Lleras Acosta. Results: a total of 42 patients were included in the study, all of them had confirmed mycological diagnosis of pityriasis versicolor. The most common location of the lesions was the anterior thorax (68%) and posterior thorax (65%), in III and IV phototypes (78.5%) with a hypochromic color. 28% had recurrent infection, with symptoms mean of 7 years before the consultation. The Besnier sign was positive in 95% of cases, 64% reported personal history of hyperhidrosis and 67% practiced some sports: diving, swimming and gymnastics. Discussion: recognizing extrinsic conditions that may increase the risk of developing pitiraisis versicolor in this population allows identifying control measures to prevent a relapse. The main factors involved in the development of pitiraisis versicolor were traveling to places with high temperatures and sport practice. In atypical clinical presentation it is mandatory to perform the mycological direct test to confirm the diagnosis. The Besnier sign is a useful method for the clinical diagnosis of pityriasis versicolor, particularly when access to direct examination is limited.