[Prevalence and cervical human papilloma virus associated factors in patients with rheumatoid arthritis]. / Prevalencia y factores asociados con infección por virus del papiloma humano cervical en pacientes con artritis reumatoide.

BACKGROUND: Nevertheless its association with cervicouterine cancer, there is no information about cervical human papillomavirus infection prevalence in patients with rheumatoid arthritis. OBJECTIVE: To evaluate human papillomavirus infection prevalence through molecular biology tests, and to analyze this infection related factors in patients with rheumatoid arthritis. MATERIAL AND METHOD: Analytic, transversal study to 250 patients: 61 women with rheumatoid arthritis selected from a rheumatologic external consult of a second level hospital, and 189 healthy women, with cervical cytology, of a first level hospital. They were polled to find infection risk factors. They were exfoliated to get cervix cells to extract its DNA and detect human papillomavirus (chain reaction of polymerase with specific consensus markers), and identification of restriction enzyme in high and low risks viruses. Prevalence was calculated, and adjusted factors analysis was performed through logistic regression with odds ratio and confidence intervals of 95%. RESULTS: Prevalence of papillomavirus infection in patients with rheumatoid arthritis was 30%, and in control group was 24%, with an odds ratio of 0.8 (CI 95% 0.42-1.6, p = 0.5). Ninety-four percent of the most frequent viral types in women with rheumatoid arthritis were high risk (mainly types 16, 58, and 18). Factors associated with higher human papillomavirus adjusted to rheumatoid arthritis were: more than one sexual partner (OR = 5.8 CI 95% 1.1-31.1, p = 0.04), more than one sexual intercourse weekly (OR = 6.7, CI 95% 0.9-51.6, p = 0.06), circumcised sexual partner (OR = 9.0, CI 95% 1.2-64.4, p = 0.02). Patients and controls had same values of marital status. Seventy-four percent of controls worked, compared to 44% of women with rheumatoid arthritis (p < 0.01). CONCLUSION: One out of three women with rheumatoid arthritis has human papillomavirus infection and 94% has the high-risk viral type. Infection associated factors mainly includes sexual partner ones; due to high risk of cervical dysplasia, it is necessary the early detection of the infection and surveillance.

Production and characterization of films based on blends of chitosan from blue crab (Callinectes sapidus) waste and pectin from Orange (Citrus sinensis Osbeck) peel.

The objective of this study was to develop and characterize films based on blends of chitosan and pectin, produced in laboratory scale, from industrial wastes. The chitosan was obtained by termoalcaline deacetylation of chitin, extracted from blue crab (Callinectes sapidus) waste and characterized according to degree of deacetylation (DD) and viscosimetric molecular weight (Mw); and pectin was extracted by conventional heating, from orange (Citrus sinensis Osbeck) peel and characterized according to degree of esterification (DE) and molecular weight (Mw). The Ch:P based films were prepared by the casting method in different Ch:P ratios [0: 100, 25:75, 50:50, 75:25 and 100:0], and compared to two controls [0:100 and 100:0], of commercial pectin and chitosan. Glycerol was used as a plasticizer at concentrations of 0.2g/g macromolecules. The addition of high concentrations of pectin in the formulations resulted in films with high solubility and an increase in moisture. No significant difference (P>0.05) in the degree of swelling (DS) and water vapor permeability (WVP) of the films was observed. Ch:P blend films were less stiff and therefore more elastic and flexible than films based on only one biopolymer. The control films presented better results in terms of color, being brighter and less opaque than other film formulations. These data suggest that chitosan or pectin obtained from agro-industrial waste is a potential matrix to produce biodegradable films for future food applications.

Psychiatric and social barriers to HIV medication adherence in a triply diagnosed methadone population.

Although antiretrovirals can prolong life, medication adherence also poses a constant challenge for HIV-infected individuals because the success of antiretroviral regimens demands nearly perfect adherence to medications. This paper describes the psychiatric and social barriers to adherence in a convenience sample of HIV-positive clients in methadone treatment in the Bronx, New York. The study sample was part of a national study of HIV treatment adherence and health care utilization among triply diagnosed populations, the HIV/AIDS Treatment Adherence Health Outcomes and Cost Study. The triply diagnosed study sample is defined here as HIV-infected individuals who screened into the study with at least one psychiatric diagnosis in addition to opioid dependence on agonist therapy (methadone treatment) and at least one substance use diagnosis. Interviewers utilized modified versions of the Structured Clinical Interview for DSM-IV Disorders (SCID-I), the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), and the Addiction Severity Index (ASI-Lite), among a battery of Cost Study instruments. Results showed that within this sample, borderline personality disorder was significantly associated with nonadherence to HIV medications. A related finding showed a significant relationship between serious social/family problems and nonadherence. These findings build on previous research on the impact of psychiatric illness on HIV medication adherence and suggest that psychiatric assessment and treatment options be linked to adherence interventions.

Psychiatric diagnoses in a sample of HIV-infected people of color in methadone treatment.

Little diagnostic information is available for those who represent a significant part of the HIV epidemic: substance-using members of racial and ethnic minority communities. Our paper describes the rates of psychiatric diagnoses in a convenience sample of HIV-positive, African American and Hispanic clients in methadone treatment in the Bronx, NY. Out of 139 HIV-positive volunteers, 99 subjects had diagnoses in addition to opioid dependence on agonist therapy. The mean number of diagnoses was 3.84 (SD = 1.41). These findings confirm the need to target mental health as part of the national response to the HIV/AIDS epidemic in inner cities.

Quantifying dissociations in neuropsychological research.

Double dissociations play an important role in neuropsychology, but they are often identified through subjective estimates of "high" versus "low" performance, without considering the probability that such an outcome might have occurred by chance. To determine whether two measures "come apart" in an interesting way in brain-damaged patients, it is important to know the degree to which variance in one measure can be predicted by variance in the other. This study introduces a statistical procedure to determine the probability of a double dissociation when the correlation between measures is taken into account. Different quantitative definitions of dissociations were compared in two large samples of neurological patients, and applied to four pairs of measures (two for language, two for hemispatial neglect) with different degrees of intercorrelation (ranging from +.21 to +.84). If the correlation between measures is not taken into account, large numbers of dissociated cases may be missed, especially for measures that are highly correlated. There are also qualitative differences between methods in the identity of those individuals who meet each definition.

Sindrome febril / Febrile syndrome

Durante siglos antes de la introduccion del termometro, la fiebre ha sido considerada como un signo de enfermedad; se puede presentar como sintoma unico o asociado. Es el motivo mas frecuente de consulta por enfermedad en el grupo de los ninos, casi todos experimentan en alguno momento fiebre entre 36-40 c. El presente articulo, describe la patogenesis de la respuesta de la fase aguda, patogenesis de la fiebre, importancia clinica de fiebre, causas; y acercamiento diagnostico del sindrome febril: etiologico, topografico y sindromatico, por ultimo se expresan algunas consideraciones sobre el tratamiento de la fiebre.