Epidemiology, diagnosis, treatment and follow-up of cystic echinococcosis in asymptomatic carriers.

Background: Río Negro Province is endemic for cystic echinococcosis (CE). A CE control program includes early diagnosis in humans. During 1980-1996, screening was done with serology and surgery was the unique choice of treatment. Since 1997, ultrasound (US) has been the method of choice for screening, and new choices of treatment for asymptomatic carriers are discussed in the CE guidelines. Methods: Between 1997 and 2016, 42 734 abdominal USs were performed, 192 new asymptomatic cases were diagnosed and underwent a protocol according to the size, location and type of cyst. Treatment options included active surveillance (US monitoring, 83 [43.3%]), antiparasitic (albendazole, 92 [47.9%]) and surgery (17 [8.8%], including percutaneous treatment). Results: After 7.7 y of follow-up, of the cases under active surveillance, 28 (33.7%) had to change treatment: 5 (6%) to surgery and 22 (26.5%) to albendazole. Of the patients treated with albendazole, 3 (3.2%) were operated on and 13 (14%) were treated with a second cycle of albendazole. Conclusion: As a result of the present study, resolution of CE in a non-surgical way with albendazole is confirmed to be effective in asymptomatic carriers with CE1 or CE3a cysts. An update eliminates the strategy of active surveillance in type CE1 cysts <3 cm and is replaced by treatment with antiparasitic in all asymptomatic cases with CE1 or CE3a cysts <10 cm. The update also limits follow-up to 12-18 months to evaluate those cases with non-response to antiparasitic and switch to a surgical option.

Perfil epidemiológico de los intentos de suicidio atendidos en el hospital Dr. Lucio Molas, Santa Rosa, La Pampa, 2011 / Epidemiological Profile of Suicide Atempts Treated at the Hospital Dr. Lucio Molas, Santa Rosa, La Pampa, 2011

INTRODUCCIÓN: El suicidio es una de las principales causas de mortalidad en el mundo. En 2000, la tasa mundial de mortalidad por suicidio fue de 14,5 por 100.000 habitantes. En 2008, la tasa en Argentina fue de 7,84 y en La Pampa de 15,03.. OBJETIVO: Describir el perfil epidemiológico de los intentos de suicidio atendidos en la Guardia de Salud Mental del Hospital Dr. Lucio Molas durante 2011. MÉTODOS: Se realizó un estudio descriptivo transversal. Las fuentes de datos fueron los libros de Guardia de Salud Mental e historias clínicas. RESULTADOS: Se registró un total de 199 casos; 128 de ellos correspondieron al sexo femenino (64,3%). El rango de edades fue de 13 a 65 años. El 82,5% de los pacientes residían en Santa Rosa. Los motivos desencadenantes más frecuentes fueron: conflictos de pareja (25,6%) y conflictos familiares (17,1%). El mecanismo más utilizado fue la ingesta de medicamentos (56,8%). Las características clínicas más frecuentes fueron: intento de suicidio previo (51,8%), antecedentes psiquiátricos (25%) y consumo de alcohol o drogas ilegales (23,2%). Se registraron más casos los días lunes (19,6%) y domingos (18,6%). CONCLUSIONES: Las mujeres fueron las principales afectadas, con una razón mujer/hombre de1,8. Los conflictos familiares y/o de pareja fueron los motivos desencadenantes más frecuentes del intento de suicidio, por tal motivo, se sugieren intervenciones que incluyan un abordaje familiar y comunitario

INTRODUCTION: Suicide is one of the leading causes of death in the world. In 2000, the global suiciderate was 14.5 per 100000 population. In 2008, the ratewas 7.84 in Argentina and 15.03 in the province of La Pampa. OBJECTIVE: To describe the epidemiological profile of suicide attempts treated in the Mental Health emergency room of Hospital Dr. Lucio Molas in 2011. METHODS: A descriptive cross-sectional study was conducted. Data sources were records of the Mental Health emergency service as well as clinical records. RESULTS: The total number of cases was 199; 128 of them were females (64.3%). The age range of the patients was between 13 and 65 years, and 82.5% of them lived in Santa Rosa, the provincial capital. The most frequent triggers were couple conflicts (25.6%) and family conflicts(17.1%). The most commonly used mechanism was drug intake (56.8%). The most frequent clinical features were previous suicide attempt (51.8%), psychiatric history(25%) and consumption of alcohol or illegal drugs(23.2%). There were more cases on Mondays (19.6%) and Sundays (18.6%). CONCLUSIONS: Women were primarily affected, with a ratio female/male of 1.8. The most frequent triggers of suicide attempts were couple conflicts and family conflicts, for that reason, family and community related interventions are recommendable

[Surveillance of viral hepatitis in Argentina: analysis of information from sentinel units 2007-2010]. / Vigilancia de hepatitis virales en Argentina: análisis de información obtenida por las Unidades Centinela 2007-2010.

In Argentina, the four strategies of epidemiological surveillance from the National System of Health Surveillance (SNVS) are Diseases of Mandatory Report (C2), Sentinel Units (SU), Laboratory Surveillance (SIVILA) and National Programs (National Plan of Blood, information from blood banks). They collect information about viral hepatitis (VH). The objective of this work was to analyze the information recorded by the SUs of VH for hepatitis B and C in the period between January 1th 2007 and December 31h 2010. In this period, out of the 1,769 cases recorded (entered by 21 of 24 SUs), 806 entries were hepatitis B, 848 hepatitis C and 115 belonged to other definitions. The relative proportions between hepatitis B and hepatitis C were heterogeneous between the SUs. The age distribution was homogeneous, being the predominant group in acute hepatitis B the 25- to 34-year-old group. In hepatitis C, the age distribution was broader. The distribution by sex and risk factors was heterogeneous between the different SUs. In hepatitis C, genotype 1 was the predominant one. In conclusion, the information provided by the SUs contributes as an evidence of the public health problem posed by this pathology in our country.

Seroprevalencia de anticuerpos contra dengue en niños de uno a nueve años luego de una epidemia, Aguilares, Tucumán, 2009 / Seroprevalence of Dengue Antibodies in One-to Nine-Year-Old Children after an Outbrea, Aguilares, Tucumán 2009

INTRODUCCIÓN: El brote de dengue de 2009 constituyó el primero con casos autóctonos en Tucumán. Los departamentos de Río Chico y Capital fueron los más afectados. Hubo baja notificación de niños de uno a nueve años (2,6/1.000). Este hallazgo impulsó a conocer el real impacto del brote en la población infantil. OBJETIVO: Estimar la incidencia de dengue en niños de uno a nueve años. MÉTODOS: Se realizó un estudio transversal de sero prevalencia(IgG) en julio de 2009 en Aguilares (Departamento de Río Chico),con una muestra probabilística de niños de uno a nueve años que habían residido allí en los últimos seis meses. Los criterios de exclusión fueron: hogar inhabitado, rechazo a participar o niño con enfermedad aguda. Se utilizó una prueba de neutralización por reducciónde placas. RESULTADOS: Se obtuvieron muestras de 118 niños. Hubo 18 rechazos a participar. El 24...

INTRODUCTION: The 2009 dengue outbreak became the first with autochthonous cases in Tucumán. The departments of Río Chico and Capital were the most affecte dones. There was low incidence in one- to nine-year-old children(2.6/1000). This finding led to a study to know the real impact of the outbreak on children. OBJECTIVE: To estimate dengue incidence in one- to nine-year-old children. METHODS: Across-sectional seroprevalence (IgG) study was carried out in July 2009 in Aguilares (Department of Río Chico), with aprobability sample composed by one- to nine-year-old children who had lived there in the last six months. Exclusion criteria were: uninhabited home, refusal to participate or seriously illchild. The laboratory study consisted of a plaque reduction neutralization test. RESULTS: A total of 118 samples were obtained. There were 18 refusals to participate. 24...

Incidence of influenza-associated mortality and hospitalizations in Argentina during 2002-2009.

BACKGROUND: We estimated rates of influenza-associated deaths and hospitalizations in Argentina, a country that recommends annual influenza vaccination for persons at high risk of complications from influenza illness. METHODS: We identified hospitalized persons and deaths in persons diagnosed with pneumonia and influenza (P&I, ICD-10 codes J10-J18) and respiratory and circulatory illness (R&C, codes I00-I99 and J00-J99). We defined the influenza season as the months when the proportion of samples that tested positive for influenza exceeded the annual median. We used hospitalizations and deaths during the influenza off-season to estimate, using linear regression, the number of excess deaths that occurred during the influenza season. To explore whether excess mortality varied by sex and whether people were age <65 or ≥ 65 years, we used Poisson regression of the influenza-associated rates. RESULTS: During 2002-2009, 2411 P&I and 8527 R&C mean excess deaths occurred annually from May to October. If all of these excess deaths were associated with influenza, the influenza-associated mortality rate was 6/100,000 person-years (95% CI 4-8/100,000 person-years for P&I and 21/100,000 person-years (95% CI 12-31/100,000 person-years) for R&C. During 2005-2008, we identified an average of 7868 P&I excess hospitalizations and 22,994 R&C hospitalizations per year, resulting in an influenza-associated hospitalization rate of 2/10,000 person-years (95% CI 1-3/10,000 person-years) for P&I and 6/10,000 person-years (95% CI 3-8/10,000 person-years) for R&C. CONCLUSION: Our findings suggest that annual rates of influenza-associated hospitalizations and death in Argentina were substantial and similar to neighboring Brazil.

Vigilancia de hepatitis virales en Argentina: análisis de información obtenida por las Unidades Centinela 2007-2010 / [Surveillance of viral hepatitis in Argentina: analysis of information from sentinel units 2007-2010].

In Argentina, the four strategies of epidemiological surveillance from the National System of Health Surveillance (SNVS) are Diseases of Mandatory Report (C2), Sentinel Units (SU), Laboratory Surveillance (SIVILA) and National Programs (National Plan of Blood, information from blood banks). They collect information about viral hepatitis (VH). The objective of this work was to analyze the information recorded by the SUs of VH for hepatitis B and C in the period between January 1th 2007 and December 31h 2010. In this period, out of the 1,769 cases recorded (entered by 21 of 24 SUs), 806 entries were hepatitis B, 848 hepatitis C and 115 belonged to other definitions. The relative proportions between hepatitis B and hepatitis C were heterogeneous between the SUs. The age distribution was homogeneous, being the predominant group in acute hepatitis B the 25- to 34-year-old group. In hepatitis C, the age distribution was broader. The distribution by sex and risk factors was heterogeneous between the different SUs. In hepatitis C, genotype 1 was the predominant one. In conclusion, the information provided by the SUs contributes as an evidence of the public health problem posed by this pathology in our country.

Mortality, severe acute respiratory infection, and influenza-like illness associated with influenza A(H1N1)pdm09 in Argentina, 2009.

INTRODUCTION: While there is much information about the burden of influenza A(H1N1)pdm09 in North America, little data exist on its burden in South America. METHODS: During April to December 2009, we actively searched for persons with severe acute respiratory infection and influenza-like illness (ILI) in three sentinel cities. A proportion of case-patients provided swabs for influenza testing. We estimated the number of case-patients that would have tested positive for influenza by multiplying the number of untested case-patients by the proportion who tested positive. We estimated rates by dividing the estimated number of case-patients by the census population after adjusting for the proportion of case-patients with missing illness onset information and ILI case-patients who visited physicians multiple times for one illness event. RESULTS: We estimated that the influenza A(H1N1)pdm09 mortality rate per 100,000 person-years (py) ranged from 1.5 among persons aged 5-44 years to 5.6 among persons aged ≥ 65 years. A(H1N1)pdm09 hospitalization rates per 100,000 py ranged between 26.9 among children aged <5 years to 41.8 among persons aged ≥ 65 years. Influenza A(H1N1)pdm09 ILI rates per 100 py ranged between 1.6 among children aged <5 to 17.1 among persons aged 45-64 years. While 9 (53%) of 17 influenza A(H1N1)pdm09 decedents with available data had obesity and 7 (17%) of 40 had diabetes, less than 4% of surviving influenza A(H1N1)pdm09 case-patients had these pre-existing conditions (p ≤ 0.001). CONCLUSION: Influenza A(H1N1)pdm09 caused a similar burden of disease in Argentina as in other countries. Such disease burden suggests the potential value of timely influenza vaccinations.