Risk of Pulmonary Fibrosis and Persistent Symptoms Post-COVID-19 in a Cohort of Outpatient Health Workers.

Background: Infection by SARS-CoV-2 has been associated with multiple symptoms; however, still, little is known about persistent symptoms and their probable association with the risk of developing pulmonary fibrosis in patients post-COVID-19. Methods: A longitudinal prospective study on health workers infected by SARS-CoV-2 was conducted. In this work, signs and symptoms were recorded of 149 health workers with a positive PCR test for SARS-CoV-2 at the beginning of the diagnosis, during the active infection, and during post-COVID-19 follow-up. The McNemar chi-square test was used to compare the proportions and percentages of symptoms between the baseline and each follow-up period. Results: The signs and symptoms after follow-up were cardiorespiratory, neurological, and inflammatory. Gastrointestinal symptoms were unusual at the disease onset, but unexpectedly, their frequency was higher in the post-infection stage. The multivariate analysis showed that pneumonia (HR 2.4, IC95%: 1.5−3.8, p < 0.001) and positive PCR tests still after four weeks (HR 5.3, IC95%: 2.3-12.3, p < 0.001) were factors associated with the diagnosis of post-COVID-19 pulmonary fibrosis in this study group. Conclusions: Our results showed that pneumonia and virus infection persistence were risk factors for developing pulmonary fibrosis post-COVID-19, after months of initial infection.

[Salivary pH and culture determinations in HIV infected and non-HIV infected patients with oral candidosis]. / Determinación de pH salival y cultivo en pacientes con candidosis bucal VIH positivos y VIH negativos.

The aim of the present study was to determine the salivary pH in HIV (Human Immunodeficiency Virus) positive(+) and negative(-) patients and in a control group, for assessing if variations or changes in pH are related to the development of oral candidosis and the species isolated. The sample comprised 120 patients from the Infectology Unit of the Mexico General Hospital, and from the School of Dentistry, UNAM. Three study groups were performed: with oral candidosis HIV+, with oral candidosis HIV-, and a control group. All patients filled out a clinical data questionnaire and signed an informed consent document. A 2 ml sample of non-stimulated saliva was obtained from each patient. The pH was measured and the sample was cultured on dextrose Sabouraud agar. The Candida species determinations were performed by the API 20 C AUX system and statistically analyzed. In the HIV+ group, the pH mean was 6.17, with most prevalence of Candida albicans type I and pseudomembranous candidosis. In the HIV- group prosthesis users, the pH mean was 6.29, with most prevalence of C. albicans type I, but with erythematous candidosis. The control group showed a mean pH of 6.78. A statistically significant difference among pH values was found (F= 15.45 p<0.01). The present study revealed that in HIV+ patients, the most significant predisposing factors are: immunosuppression, antibiotic therapy, bad hygiene, anemia, leucoplakia, and diabetes. The salivary pH with acidic values (more in HIV+ patients) significantly favors candidosis development, specially for C. albicans and C. glabrata species and primarily the pseudomembranous and erythematous clinic types. The pH is not a determinant for Candida growth, but could affect the adherence and invasiveness of the yeast.

Angiomatosis bacilar en el material quirúrgico del Hospital General de México de la SSa / Bacillary angiomatosis in surgical specimens at the Mexico Cyti General Hospital

La angiomatosis bacilar es una proliferación pseudotumoral de los vasos pequeños de diversos órganos o tejidos y que afecta principalmente a individuos con SIDA. Esta comunicación se fundamenta en el estudio de 118,483 reportes quirúrgicos, de los cuales 32 fueron calificados como sercoma de Kaposi, de estos últimos en 6 el diagnóstico correcto fué el de angiomatosis bacilar. Los seis pacientes fueron jóvenes con edad promedio de 30.2 años. cinco fueron hombres y una mujer; todos padecían SIDA. Clínicamente mostraban lesiones semejantes al sarcoma de Kaposi. Histológicamente los casos presentaban una imagen similar al hemangioma epitelioide y se identificaron bacilos con la tinción de Warthin-Starry y con microscopio electrónico de transmisión. En este reporte se describe la evolución de las lesiones cutáneas desde las etapas tempranas hasta las avanzadas y la involución que presentan con el tratamiento antibiótico; así mismo se establecen criterios de diagnóstico diferencial con otros padecimientos.

Alteraciones pulmonares en pacients con sindrome de inmunodeficiencia adquirida / Pulmonary manifestations in patients with adcquired immunodeficiency syndrome

Las alteraciones pulmonares en pacientes con SIDA son muy frecuentes y comunmente se deben a infecciones por gérmenes oportunistas. En las series estadounidenses predominan las infecciones por Pneumocystis carinii y citomegalovirus; en otras poblaciones, las infecciones por microbacterias son frecuentes. En el Hospital General de México predominaron las neumonías agudas e infecciones por citomegalovirus, Mycobacterium tuberculosis, Pneumocystis carinii y las neumonías intersticiales. El diagnóstico precoz y tratamiento adecuado de estas complicaciones son esenciales en el cuidado de los pacientes con SIDA

Metodología del estudio de los pacientes infectados por virus de la inmunodeficiencia humana y criterios actuales para el diagnóstico de SIDA / Methodology for the study of patients infected with the human immunedeficiency virus and current criteria for the diagnosis of AIDS

Este artículo resume los métodos y criterios diagnósticos que se utilizan en la actualidad para la clasificación clínica de los pacientes infectados por virus de la inmunodeficiencia humana. Se señalan los métodos de laboratorio más empleaddos y su interpretación. También se proporciona la última revisión de los criterios diagnósticos elaborada por el Centro para el Control de Enfermedades de Atlanta, Georgia, para el diagnóstico de síndrome de inmunodeficiencia adquirida .