Parvovirus B19 remains an underestimated pathogen among infections during gestation in Argentina: Insights through the study of symptomatic and asymptomatic pregnant patients and newborns from Córdoba.

BACKGROUND: Parvovirus B19 (B19 V) infection during pregnancy can cause adverse fetal outcomes. Our aim was to characterize both clinical and asymptomatic maternal and neonatal cases by studying virological and serological markers of B19 V infection, and to sequence the complete genome of the circulating virus in Argentina. METHODS: Symptomatic patients were included based on maternal and/or fetal-neonatal signs attributable to B19 V infection during gestation. Pregnant patients were analyzed in either the timely diagnosis group (TD, samples obtained when symptoms were present and infection was suspected) or the retrospective diagnosis group (RD, samples collected immediately postpartum), and newborns were analyzed at birth. A sample of asymptomatic individuals was also analyzed. Diagnostic tests (PCR/qPCR/serology) and sequencing were performed on archived serum samples from 2018 to 2023, and clinical data were obtained from medical records. RESULTS: We studied 328 symptomatic patients, including 185 pregnant patients (73 TD and 112 RD) and 143 newborns. Among them, we identified 27/328 (8.2 %) positive cases (B19V+): 12/73 (16.4 %) in the TD group, 6/112 (5.4 %) in the RD group, and 9/143 (6.3 %) newborns. Within the 77 mother-newborn pairs included, there were 8 (10.4 %) B19 V infections and 6 cases of vertical transmission. Additionally, B19 V infection was detected in 26/310 (8.4 %) asymptomatic patients. Phylogenetic analysis identified genotype 1a as a circulating strain in Argentina. CONCLUSIONS: Our findings highlight the need to raise awareness and enhance diagnostic approaches in Argentina to more effectively identify and manage B19 V infections during pregnancy in our region.

Human parvovirus B19 infection in a pregnant patient resulting in severe hydrops, foetal death and persistent infection.

Human parvovirus B19 (B19V) is the aetiological agent of erythema infectiosum. Primary infection during pregnancy can be transmitted to the foetus and cause foetal abnormalities related to depletion of erythrocyte progenitor cells, including congenital anaemia, hydrops, and foetal death. In this paper we report the detection of B19V infection in a pregnant patient, which onset occurred without appreciable signs and symptoms until she developed inappropriate contractions for gestational age and fluid loss. B19V infection resulted in severe hydrops fetalis with a fatal course for the foetus, while persisted in the mother at least 12 months after foetal death. The objective of this report is to highlight the importance of optimizing B19V diagnosis through early suspicion and testing during pregnancy. Knowing the mother's immune status before or at the beginning of gestation can contribute, together with early diagnosis, to improve the management of patients at risk.

Molecular screening of the human parvoviruses B19 and bocavirus 1 in the study of congenital diseases as applied to symptomatic pregnant women and children.

INTRODUCTION: B19 virus (B19V) and bocavirus 1 (HBoV1) are human pathogenic parvoviruses that are prevalent worldwide and are responsible for a diverse and not yet fully established spectrum of clinical manifestations. OBJECTIVE: To screen B19V and HBoV1 in patients with clinical manifestations associated with acquisition of the infection during gestation. METHODS: A retrospective, observational study was performed that included serum samples from patients without a previous known aetiology. B19V and HBoV1 were determined by end-point PCR. Positive samples were genotyped. RESULTS: A total of 106 serum samples were analysed, 61 from pregnant women and 45 from neonates and paediatric patients. None were positive for HBoV1, while B19V was detected in 37/106 [34.9 %, 95 % confidence interval (CI): 26.5-44.4] of the samples studied. In the group of pregnant women, 28/61 (45.9 %, 95 % CI: 34.0-58.3) were B19V-positive, and 2 of them had foetal anaemia followed by hydrops and foetal death, 3 were associated with a history of recurrent pregnancy loss and there was 1 case of spontaneous abortion. B19V was also detected in cases of maternal febrile exanthema, polyhydramnios, oligohydramnios and foetal ascites. In the group of children, 9/45 (20.0 %, 95 % CI: 10.9-33.8) neonatal patients were B19V-positive, and this was associated with foetal hydrops, TORCH syndrome and cardiac alterations. The nucleotide sequences analysed confirmed the identity of B19V genotype 1. CONCLUSIONS: We found no evidence to indicate the presence of HBoV1 in maternal blood or in the newborns/paediatric patients (hence providing no support for the supposed vertical transmission). On the other hand, the high frequency of B19V in the pathologies studied indicates the importance of molecular diagnosis in both the mother and the child. Future efforts should contribute to early detection and characterization of infections.

Trasplante de tejido vascular: recuento histórico y utilización clínica / Vascular tissue transplant: review and clinical utilization

Se realiza un recuento histórico y se muestra nuestra experiencia clínica en el trasplante de tejido vascular. Desde febrero de 1986 a febrero de 2003, se han implantado aloinjertos arteriales a 13 enfermos, obtenidos de donante cadáver en muerte encefálica. Las indicaciones operatorias fueron diversas y la localización de los injertos fue múltiple. El comportamiento biológico de los aloinjertos se evaluó regularmente desde el punto de vista clínico y ecográfico, la trombosis del injerto resultó la complicación más frecuente. Los aloinjertos son altamente resistente a la infección y sustitutos arteriales con perspectiva de utilización a corto y mediano plazo

Eficacia del tratamiento con acupuntura en pacientes con várices en miembros inferiores / Effectiveness of acunpuntural treatment in patients with varicous veins in the lower limbs

Se realizó un ensayo clínico fase II temprana abierto y secuencial en 80 pacientes con várices en miembros inferiores que fueron remitidos, desde el Servicio de Angiología al de Medicina Natural y Tradicional del Hospital Provincial de la Ciudad de Camagüey desde marzo hasta agosto de 1999. Se comprobó la eficacia de la terapéutica a partir de la quinta sesión de tratamiento, alcanzando significaciones estadísticas relevantes a la décima. El 93.75% de pacientes presentó una buena evolución. Desapareció el edema, la pesadez y la parestesia en el 100 % de los enfermos. Demostró además ser una terapéutica de corta duración, de elevado beneficio y reincorporación social rápida, sin reacciones adversas.

A clinical, phase II open, early and sequiential essay was performed in 80 patients with varicous veins of lowe limbs. They were remitted from the Angiology Service to the natural and Traditional Service of the Provincial Hospital Camagüey City within the period from March to August 1999. The importance of this treatment was proved in the fifth session, and statistic significance was reached at the tenth. The 93,75% of patients had a goog evolution. Swelling, heainess and parestesia disappeared in 100% of patiens . It was also short term therapeutic , of great and rapid social reicorporation withouh adverse reactions.