Hepatitis E virus infection in pregnant women, Argentina.

BACKGROUND: Hepatitis E virus (HEV) infection is an important cause of acute hepatitis worldwide. In pregnant women, HEV can cause more severe symptoms, with high rates of fatal hepatic failure in endemic countries. However, HEV prevalence and circulation among pregnant women from South America is almost unknown. We aimed to investigate HEV infection in pregnant women for the first time in Argentina. METHODS: IgG and IgM anti-HEV antibodies and RNA-HEV were investigated (by ELISA assays and RT-Nested-PCR, respectively) in 202 serum samples from pregnant women collected in the central region of Argentina between 2015 and 2017. A control group of 155 non-pregnant women was included (year 2018). RESULTS: The IgG anti-HEV positivity rate was 8.4% (17/202), higher than the 2.6% (4/155) obtained for the non-pregnant women control group, and showing association between pregnancy and HEV infection (p = 0.023, OR = 3.5, CI95% = 1.1-10.5). Women younger than 25 years old presented higher levels of antibodies, and there were no differences in the prevalences between trimesters of pregnancy. Two samples were reactive for IgM anti-HEV, showing recent infections, although no symptoms were registered in these patients. All samples were negative for RNA-HEV amplification. CONCLUSIONS: HEV produces infections in pregnant women from Argentina, alerting health teams to consider it as a possible cause of liver disease.

Reporte de nuestra experiencia en la identificación del ganglio centinela en cáncer de mama: comparación entre la técnica de azul patente y la técnica combinada (azul patente + tecnecio 99) / Diagnostic accuracy of sentinel lymph node biopsy (sln) in the management of breast cancer at Hospital Privado Universitario de Córdoba: comparison of the detection rate between blue dye (patent blue) technique and combined technique (blue dye + radioactive coloid Tc99)

Objetivo Determinar la capacidad diagnóstica de la técnica del ganglio centinela (gc) en cáncer de mama temprano en el Hospital Privado Universitario de Córdoba. Comparar la tasa de detección entre la técnica de azul patente y la técnica combinada (azul patente + Tecnecio 99). Material y método Se estudiaron 640 pacientes con cáncer de mama en las que se realizó la biopsia del gc entre los años 2008 y 2016. Fueron divididas en: Grupo 1 (565 pacientes), en el que se utilizó solo azul patente como técnica para su identificación; y Grupo 2 (75 pacientes), en el que se empleó la técnica combinada. El estudio del gc se llevó a cabo con impronta citológica para el examen intraoperatorio y con hematoxilina y eosina (h/e) para el examen diferido. Se concretó la linfadenectomía axilar (la) en aquellos casos donde el gc fue positivo (por congelación o diferido) o bien en los que no pudo ser identificado. Resultados La tasa de detección global del gc fue del 94% (587), siendo del 91% (514) cuando se utilizó solo azul patente y de 97% (73) con la técnica combinada. El 18,6% (109) del total de los gc fueron positivos. La sensibilidad de la impronta citológica del gc fue del 69,7%. Conclusiones La biopsia del gc es el método de elección para la estadificación axilar en el cáncer mama inicial, ya que ha demostrado ser seguro, eficaz y asociarse a una baja morbilidad. Los porcentajes de identificación del gc ascendieron del 91% al 97% con la incorporación del Tc 99. Al comparar con series internacionales y nacionales, no hubo diferencias significativas en cuanto a la sensibilidad y tasa de falsos negativos del método intraoperatorio.

Objectives To determine the diagnostic accuracy of sentinel lymph node biopsy (sln) in the management of breast cancer at Hospital Privado Universitario de Córdoba. To compare the detection rate between blue dye (patent blue) technique and combined technique (blue dye + radioactive coloid Tc99). Materials and method 640 breast cancer patients treated with sln were studied between 2008 and 2016. They were divided in 2: Group 1, where snl was identified using blue dye; and Group 2, where a combined technique was used. The imprint cytology was used for intraoperative examination, and the evaluation with hematoxylin and eosin (h&e) was used for the deferred examination. An axillary lymph node dissection (alnd) was performed in positive sln cases and when the sln wasn´t founded. Results Overall detection rate of sln was 94% (587), while only 91% (514) when using patent blue, and 97% (73) when using blue dye and radioactive tracer combined. The 18,6% (109) of all sln were positive. The overall sensitivity of imprint cytology of sln was 69,7%. Conclusions sln biopsy is an accurate and safe technique to assess the axillary stage in our population. The identification percentage rose from 91% to 97% with the introduction of Tc 99. It was no difference in sensitivity and false negative rate between our results and national and international data.