[Prevalence of asthma and associated risk factors in schoolchildren from an area of indigenous population]. / Prevalencia de asma y factores de riesgo asociados en escolares provenientes de una zona de pueblos indígenas.

INTRODUCTION: The prevalence of asthma in Chile ranges from 10.2 to 14.9%. In previous studies, the Araucanía Region has not been included. OBJECTIVE: To determine the prevalence of asthma in the school po pulation of the Araucanía Region. SUBJECTS AND METHOD: The ISAAC questionnaires were used for asthma symptoms in addition to a questionnaire for recording sociodemographic data, belonging to the Mapuche ethnicity, type of heating, exposure to indoor air pollution, and family history. The Binomial Regression Model was used to evaluate the effect of each of the different variables of inter est, adjusting by age groups (6-7 and 13-14 years). The model also evaluated the additive interaction between these variables and age. RESULTS: 823 surveys were applied, where the prevalence of asthma was 14.2% and 23.2% in the 6-7 year old group and the 13-14 year old group, respectively. 43.7% de clare to be Mapuche, 32.9% live in rural areas, and 81.4% use firewood as a heating method. Through binomial regression model analysis, where for the study group, living in the coastal commune was significantly associated with a lower prevalence of asthma (-13.2% [CI: -17.7 to -8.6]. The history of an asthmatic mother was significantly associated with a higher prevalence of asthma (17.9% [CI: 2.7 to 33.1]. Living in a rural area, to be Mapuche or the type of heating used, showed differences statistically significant (p 0.18, p 0.609 and p 0.480, respectively) Conclusion: 13-14 year-olds school children in the Araucanía Region presented a higher prevalence of asthma. There was an association with asthma in the mother where this increase is not associated with living in a rural area, to be Ma puche or type of heating.

[Indirect immunofluorescence technique versus polymerase chain reaction for the diagnosis of respiratory viruses in children admitted to a hospital in the Metropolitan Region]. / Inmunofluorescencia indirecta versus reacción de polimerasa en cadena para el diagnóstico de virus respiratorios en niños ingresados en un hospital de la Región Metropolitana.

BACKGROUND: Early viral detection in acute respiratory infections (ARI) is essential to establish appropriate therapy and prevent nosocomial transmission. OBJECTIVE: To compare the efficacy of indirect immunofluorescence technique (IIF) with the polymerase chain reaction (PCR) to identify respiratory viruses in children hospitalized for ARI. METHODS: 47 nasopharyngeal aspirates of children ≤ 2 years with ARI were included. IFI included respiratory syncytial virus (RSV), adenovirus, influenza A and B and parainfluenza. PCR also included the detection of metapneumovirus, enterovirus/rhinovirus, bocavirus and coronavirus. Sensitivity, specificity, positive and negative predictive value (VPP/NPV) and kappa correlation for RSV were estimated by IIF compared to PCR. RESULTS: The IIF detected only RSV (29; 61.7%). PCR detected several viruses, including RSV in 26 cases (55.3%), followed by bocavirus (29.8%), rhinovirus/enterovirus (21.3%), adenovirus (14.9%) and parainfluenza (4,3%) among others, with 35.5% of coinfection. The IIF presented sensitivity: 85.7%, specificity: 73.6%, PPV: 82.7%, NPV: 77.7% and kappa: 0.5990 (95% CI, 0.3636-0.8346) for RSV. CONCLUSION: The IIF presents good sensitivity, but moderate specificity for RSV. However, IIF fails to detect other respiratory viruses. The introduction of PCR would improve the etiological diagnosis of ARI of viral origin.

Inmunofluorescencia indirecta versus reacción de polimerasa en cadena para el diagnóstico de virus respiratorios en niños ingresados en un hospital de la Región Metropolitana / Indirect immunofluorescence technique versus polymerase chain reaction for the diagnosis of respiratory viruses in children admitted to a hospital in the Metropolitan Region

Resumen Introducción: La temprana detección viral en infecciones respiratorias agudas (IRA) es esencial para establecer una terapia apropiada y prevenir el contagio intrahospitalario. Objetivo: Comparar la eficacia de la técnica de inmunofluorescencia indirecta (IFI) con la reacción de polimerasa en cadena (RPC) para identificar virus respiratorios en niños hospitalizados por IRA. Métodos: Se incluyeron 47 aspirados nasofaríngeos de niños ≤ 2 años con IRA. La IFI incluyó virus respiratorio sincicial (VRS), adenovirus, influenza A y B y parainfluenza. La RPC incluyó, además, la detección de metapneumovirus, enterovirus/rinovirus, bocavirus y coronavirus. Se estimó sensibilidad, especificidad, valor predictor positivo y negativo (VPP/VPN) y correlación kappa para VRS mediante IFI en comparación a la RPC. Resultados: La IFI detectó únicamente VRS (29; 61,7%). La RPC detectó diversos virus, entre ellos VRS en 26 casos (55,3%), seguido por bocavirus (29,8%), enterovirus/ rinovirus (21,3%), adenovirus (14,9%) y parainfluenza (4,3%) entre otros, con 35,5% de co-infección. La IFI presentó sensibilidad: 85,7%, especificidad: 73,6%, VPP: 82,7%, VPN: 77,7% y kappa: 0,5990 (IC 95%; 0,36360,8346) para VRS. Conclusión: La IFI presenta buena sensibilidad, pero moderada especificidad para VRS. Sin embargo, falla en la detección de otros virus respiratorios. La introducción de RPC permitiría mejorar el diagnóstico etiológico de las IRA de origen viral.

Background: Early viral detection in acute respiratory infections (ARI) is essential to establish appropriate therapy and prevent nosocomial transmission. Objective: To compare the efficacy of indirect immunofluorescence technique (IIF) with the polymerase chain reaction (PCR) to identify respiratory viruses in children hospitalized for ARI. Methods: 47 nasopharyngeal aspirates of children ≤ 2 years with ARI were included. IFI included respiratory syncytial virus (RSV), adenovirus, influenza A and B and parainfluenza. PCR also included the detection of metapneumovirus, enterovirus/rhinovirus, bocavirus and coronavirus. Sensitivity, specificity, positive and negative predictive value (VPP/NPV) and kappa correlation for RSV were estimated by IIF compared to PCR. Results: The IIF detected only RSV (29; 61.7%). PCR detected several viruses, including RSV in 26 cases (55.3%), followed by bocavirus (29.8%), rhinovirus/enterovirus (21.3%), adenovirus (14.9%) and parainfluenza (4,3%) among others, with 35.5% of coinfection. The IIF presented sensitivity: 85.7%, specificity: 73.6%, PPV: 82.7%, NPV: 77.7% and kappa: 0.5990 (95% CI, 0.3636-0.8346) for RSV. Conclusion: The IIF presents good sensitivity, but moderate specificity for RSV. However, IIF fails to detect other respiratory viruses. The introduction of PCR would improve the etiological diagnosis of ARI of viral origin.

Immunogenicity of a 23-valent pneumococcal polysaccharide vaccine in elderly residents of a long-term care facility

S. pneumoniae is a significant cause of community-acquired pneumonia in the elderly, and accounts for the majority of the pneumonia deaths among the elderly. We conducted this randomized double-blind study to evaluate the immune response to a 23-valent pneumococcal polysaccharide vaccine and the persistence of antibodies two years after the vaccination in an elderly population in Santiago, Chile. A total of 118 elderly nursing home residents received either the pneumococcal or a tetanus control vaccine. Serum samples were taken at enrolment, at two months, and at two years post-vaccination. Pre-vaccination anti-pneumococcal antibody geometric mean concentrations (GMC) were similar in both study groups, with increased levels of antibodies found only against serotype 14. The pneumococcal vaccine was highly immunogenic at 2 months, and titers remained high two years after the vaccination for the 10 serotypes studied in this elderly population. The results thus support the benefits of this pneumococcal vaccine in this elderly population who are at increased risk of invasive pneumococcal disease.

[Nasal carriage of Streptococcus pneumoniae in elderly subjects according to vaccination status]. / Portación nasal de Streptococcus pneumoniae en adulto mayor y su respuesta frente a la vacunación antineumocócica.

BACKGROUND: S pneumoniae is the main cause of community-acquired pneumonia in the elderly, group that concentrates 95% of deaths. AIM: To assess the prevalence of nasal carriage of S pneumoniae in institutionalized elderly patients. MATERIAL AND METHODS: One hundred eighteen institutionalized subjects aged over 60 years (65 males) were enrolled. Since they were also participating in a controlled protocol related to the immunogenicity of an anti-pneumococcal vaccine, our investigation was also blind and randomized. According to randomization, they received pneumococcal or tetanic vaccine. Nasal swab cultures were taken at the beginning of the trial and two months after vaccination. According to recommended methods, we identified S pneumoniae, the serotypes and their antimicrobial susceptibility. RESULTS: In the first nasal sample, 16% of subjects were positive for S pneumoniae. The second sample was positive in 12%. Of the 33 isolated serotypes, 9.1% demonstrated intermediate resistance to penicillin and 3.3% were resistant to chloramphenicol. CONCLUSIONS: The study demonstrated a greater percentage of colonized patients than in the general population. The isolated serotypes are the same that cause invasive diseases in this age group, according to data of the Institute of Public Health of Chile. There were no differences in the percentage of colonization between subjects vaccinated against S pneumoniae and control groups, after two months of follow up. Isolated strains had a low resistance to penicillin. High level resistance was not observed.

Portación nasal de Streptococcus pneumoniae en adulto mayor y su respuesta frente a la vacunación antineumocócica / Nasal carriage of Streptococcus pneumoniae in elderly subjects according to vaccination status

Background: S pneumoniae is the main cause of community-acquired pneumonia in the elderly, group that concentrates 95 percent of deaths. Aim: To assess the prevalence of nasal carriage of S pneumoniae in institutionalized elderly patients. Material and methods: One hundred eighteen institutionalized subjects aged over 60 years (65 males) were enrolled. Since they were also participating in a controlled protocol related to the immunogenicity of an anti-pneumococcal vaccine, our investigation was also blind and randomized. According to randomization, they received pneumococcal or tetanic vaccine. Nasal swab cultures were taken at the beginning of the trial and two months after vaccination. According to recommended methods, we identified S pneumoniae, the serotypes and their antimicrobial susceptibility. Results: In the first nasal sample, 16 percent of subjects were positive for S pneumoniae. The second sample was positive in 12 percent. Of the 33 isolated serotypes, 9.1 percent demonstrated intermediate resistance to penicillin and 3.3 percent were resistant to chloramphenicol. Conclusions: The study demonstrated a greater percentage of colonized patients than in the general population. The isolated serotypes are the same that cause invasive diseases in this age group, according to data of the Institute of Public Health of Chile. There were no differences in the percentage of colonization between subjects vaccinated against S pneumoniae and control groups, after two months of follow up. Isolated strains had a low resistance to penicillin. High level resistance was not observed.

[In vitro activity of telithromycin against community acquired respiratory pathogens]. / Estudio de la actividad comparativa in vitro de telitromicina en patógenos respiratorios adquiridos en la comunidad en 13 centros clínicos chilenos.

BACKGROUND: Telithromycin is a new ketolide antimicrobial, that can be useful for the treatment of respiratory infections. AIM: To compare in vitro activity of telithromycin against respiratory pathogens, isolated in outpatient clinics. MATERIAL AND METHODS: Two hundred eighty strains isolated from patients with respiratory infections, were studied. The strains studied were S pneumoniae, penicillin sensitive (SPNS:57); intermediate (SPNI:35), resistant (SPNR:25); S pyogenes (SP:57); H influenzae (HIN 51); M catarrhalis (MC:25) and S aureus meticillin sensitive (SAUS:30). Minimal inhibitory concentration (MIC) by broth microdilution was studied for telitrhomycin and levofloxacin in all strains. Other antimicrobials studied, but not in all strains were erythromycin, clindamycin, trimetoprim sulphamethoxazole, oxacillin, amoxicillin-clavulanic acid and cefuroxime. RESULTS: All strains were sensible to telithromycin at a concentration -4 microg/ml. MIC 90 and its range for SPNS was 0.03 microg/ml (-0.004-0.12), for SPNI was 0.03 microg/ml (-0.004-025), for SPNR was 0.06 microg/ml (-0.004-0.25), for HIN was 2 microg/ml (0.12-4), for SP was 0.5 microg/ml (-0.004-2), for MC was 0.5 microg/ml (0.06-2) and for SAU was 0.25 microg/ml (0.06-0.25). CONCLUSIONS: All studied pathogens were sensible to telithromycin in vitro. This antimicrobial is an alternative for the treatment of community acquired respiratory infections.

Estudio de la actividad comparativa in vitro de telitromicina en patógenos respiratorios adquiridos en la comunidad en 13 centros clínicos chilenos / In vitro activity of telithromycin against community acquired respiratory pathogens

Background: Telithromycin is a new ketolide antimicrobial, that can be useful for the treatment of respiratory infections. Aim: To compare in vitro activity of telithromycin against respiratory pathogens, isolated in outpatient clinics. Material and methods: Two hundred eighty strains isolated from patients with respiratory infections, were studied. The strains studied were S pneumoniae, penicillin sensitive (SPNS:57); intermediate (SPNI:35), resistant (SPNR:25); S pyogenes (SP:57); H influenzae (HIN 51); M catarrhalis (MC:25) and S aureus meticillin sensitive (SAUS:30). Minimal inhibitory concentration (MIC) by broth microdilution was studied for telitrhomycin and levofloxacin in all strains. Other antimicrobials studied, but not in all strains were erythromycin, clindamycin, trimetoprim sulphamethoxazole, oxacillin, amoxicillin-clavulanic acid and cefuroxime. Results: All strains were sensible to telithromycin at a concentration ¡4 µg/ml. MIC 90 and its range for SPNS was 0.03 µg/ml (¡0.004-0.12), for SPNI was 0.03 µg/ml (¡0.004-025), for SPNR was 0.06 µg/ml (¡0.004-0.25), for HIN was 2 µg/ml (0.12-4), for SP was 0.5 µg/ml (¡0.004-2), for MC was 0.5 µg/ml (0.06-2) and for SAU was 0.25 µg/ml (0.06-0.25). Conclusions: All studied pathogens were sensible to telithromycin in vitro. This antimicrobial is an alternative for the treatment of community acquired respiratory infections.

Perfil de resistencia a los antimicrobianos en agentes causantes de infección del tracto urinario en niños chilenos: programa de vigilancia PRONARES / Antimicrobial susceptibility of agents causing urinary tract infections in chilean children: PRONARES surveillance program

Background: PRONARES (Programa Nacional de Vigilancia de Resistencia) is a national surveillance program for antimicrobial susceptibility, focused in different syndromes and among these, urinary tract infections. The work is done in a laboratory net that uses common protocols and whose data are centrally analyzed using the WHONET program. Aim: To analyze the pattern of antimicrobial susceptibility of agents causing urinary infections in children in the period 1997-1999. Material and methods: In the study period, 5,525 strains were analyzed. Of these, 2,307 came from pediatric patients (1,495 hospitalized and 803 ambulatory). Results: The most common causative agent was E. coli in 74,2 percent of cases, followed by Klebsiella spp in 8,2 percent and other agents in a lower frequency. Of E. coli strains, 74 percent were resistant to ampicillin, 52 percent to clotrimoxazole and 30 percent to first generation cephalosporins. These strains were sensitive to second and third generation cephalosporins, aminoglycosides, ciprofloxacin and nitrofurantoin. Strains from nosocomial or community infections had similar antimicrobial susceptibility. Klebsiella spp had a high rate of antimicrobial resistance (over 40 percent), that was even higher among nosocomial strains. It was 90 percent susceptible to ciprofloxacin and 100 percent to imipenem. All centers from which strains came had a similar pattern of susceptibility, with the exception of a pediatric center that had significantly higher resistance levels. Conclusions: The current therapeutic recommendations for urinary tract infections in children caused by E coli, are still pertinent, but the use of first generation cephalosporins must be cautious. The treatment of Klebsiella spp requires an individual antibiogram

Prevalencia de streptococcus pneumoniae resistente a penicilina en niños que asisten a jardines infantiles en Santiago / Penicillin resistant streptococcus pneumoniae among children attending day care centers

Las infecciones neumocócicas causan enfermedades graves en los niños. Se han observado cambios epidemiológicos en las infecciones por Streptococcus pneumoniae, como aumento de la incidencia, desarrollo creciente de resistencia antimicrobiana y brotes infecciosos epidérmicos.El estudio de portadores es útil para vigilar la aparición y desarrollo de la resistencia antimicrobiana y de los serotipos prevalentes. Con el propósito de determinar la prevalencia de cepas resistentes de S. pneumoniae en niños que asisten a jardines infantiles de Santiago y los serotipos más frecuentes en la nasofaringe, se efectuó cultivo de hisopado faríngeo y nasal obtenido entre noviembre de 1994 y agosto de 1995 de 200 de ellos, cuya edad era entre 3 meses y 4 años (97 < de 2 años y 103 > de 2 años). Las muestras fueron sembradas en agar sangre con 5 por ciento de sangre de cordero, con o sin gentamicina (5 µg/ml) e incubadas en ambiente con dióxido de carbono. La resistencia antimicrobiana se evaluó mediante disco de oxacilina,microdilución en caldo y E-test.En 60,2 por ciento de los casos se aisló S. pneumoniae de la nasofaringe; 28,4 por ciento de las cepas eran resistentes a penicilina (20,3 por ciento con resistencia moderada y 2,1 por ciento elevada), 2 por ciento eran resistentes a cloranfenicol. No se encontraron cepas resistentes a eritromicina, cefotaxima o vancomicina. La frecuencia de cepas resistentes a la penicilina fue similar en los niños menores y mayores de 2 años. E serotipo más frecuente fue el 6A

Inmunización y respuesta inmune a la vacuna neumocócica / Immunization and immune response to neumococcal vaccine

The aim of this work was to define antibody levels against four neumococcal serotypes, before and after neumococcal vaccination in patients with respiratory infections. Fifty one patients were studied, 19 children from 1 to 5 yeras old, 19 children from 6 to 18 years old and 22 adults from 27 to 65 years old. IgG anti-neumococcal, antibodies, against serotypes 3, 7F, 9N and 14 were measured using an enzyme immunoassay, before and four weeks after vaccination. There was a significant increase in antibody titers against all serotypes in subjects older 7 yeras. In children of less than 6 yeras, the response to serotype 14 was non significant. The intensity of response differed according to the studied serotypes and the percentage of patients that responded to each serotype increased with age. Five patients older than 18 years were identified as non responders to all four serotypes. It is concluded that neumococcal vaccine increases anti-neumococcal antibodies in patients with recurrent infections and allows the identification of patients with specific antibody deficiency syndromes and normal total immunoglobulin levels

CA 19-9 y antígeno carcino-embrionario en cáncer de la vesícula biliar / CA 19-9 and carcinoembryonic antigen in gallbladder cancer

The aim of this work was to assess the diagnostic yield of serum tumoral markers, Ca 19-9 and carcinoembryonic antigen, in patients with gallbladder cancer. We studied 54 patients of whom 33 had gallbladder cancer and in 21 the tumor was removed previously and were presently free of disease. Twenty one patients with cholelithiasis were used as controls. Ca 19-9 was over 37 U/ml in 22 (65 percent) patients with cancer, in two patients free of disease and two controls. The sensitivity and specificity of Ca 19-9 was 0.66 and 0.90 respectively. Carcinoembryonic antigen was over 2.5 ng/ml in 25 patients with cancer (56 percent) and in sensitivity and specificity was 0.75 and 0.71 respectively. Using a cutoff point of 4 ng/ml, these figures were 0.51 and 0.9 respectively. The better predictive capacity was given by Ca 19-9 over 37 U/ml or a carcinoembryonic antigen over 4 ng/ml. It is concluded that, although the sensitivity and specificity of these markers was adequate in this work, one must hear in mind that studied patients had advanced tumors

Evaluación del antígeno prostático específico post tacto rectal: experiencia en 36 pacientes / Evaliuation of specific prostatic antigen after rectal examination: experience in 36 patients

Levels of prostatic epecific antigen may modified with procedures over the prostatic gland. We measured this antigen in 36 hospitalized patients before and inmediately after a digital rectal examination. Antigen levels were 8.3 ñ 21.3 ng/ml before and 13.8 ñ 27.5 ng/ml after the examination (NS). It is concluded that digital rectal examination did not modify antigen levels in our sample

La vacuna BCG no modifica las subpoblaciones linfocitarias de lactantes a los 3 meses de edad / The BCG vaccine does not modify lymphocite subpopulations in three months old infants

Los efectos de la vacuna BCG sobre el sistema inmune han dado resultados contradictorios y no se dispone en la actualidad de datos que demuestren fehacientemente su mecanismo de acción. Por estos antecedentes decidimos estudiar las modificaciones de las subpoblaciones linfocitarias T y la respuesta blastogénica en 60 lactantes de 3 meses de edad randomizados en 3 grupos 20 niños vacunados con PPD >8mm (BCG+PPD+), 20 niños vacunados anérgicos al PPD(BCG+PPD-) y 20 no vacunados con PPD negativo (BCG-PPD-). Los siguientes fueron los resultados obtenidos (xñDS) en el recuento de CD3, CD4, CD8 en los diferentes grupos: BCG+PPD+:56ñ10; 42ñ8.6; 33ñ7.3 porciento respectivamente. BCG+PPD-: 49ñ9.6 porciento; 45ñ10.6; 33ñ7.7 porciento. BCG-PPD-: 47ñ7.1 porciento; 40ñ7.4; 30ñ5.3 porciento (p:n.s.). Por su parte los índices de estimulación linfocitaria guardaron estrecha correlación con la respuesta in vivo al PPD. Nuestros resultados permiten concluir que el BCG no modifica los niveles de subpoblaciones linfocitarias T

Características inmunológicas de una población infantil no respondedora a la vacuna BCG / Immune responses among BCG vaccinated tuberculin negative infants

Para analizar la respuesta inmunitaria producida por la vacuna BCG se estudiaron lactantes de tres meses inmunizados al momento de nacer con reacción PPD positiva (n:16) y negativa (n:16) y niños controles (n:15) de la misma edad no vacunados, mediante prueba específica de transformación blástica inducida por PPD en sus poblaciones de linfocitos T y estimulación inespecífica de la mitosis con fitohemaglutinina. En no vacunados la respuesta blastogénica a concentraciones de 25, 50 y 100 *g de PPD fue escasa, 770 a 1.700 cpm; en vacunados con PPD positivo 27.925 ñ 7.095, 34.297 ñ 8.717 y 45.354 ñ 8.453 cpm, respectivamente (p < 0,001). En vacunados con PPD negativo fue similar a la respuesta de no vacunados en diez, mientras seis respondieron como vacunados con reacción positiva, pero sólo a dosis de 100 *g de PPD, con 22.744 ñ 7.145 cpm (p > 0,05). Los índices de estimulación obtenidos con PPD y BCG fueron del todo comparables. La respuesta a fitohemaglutinina fue 124.945 ñ 53.200 cpm en no vacunados, 156.263 ñ 43.540 en vacunados PPD negativos y 138.217 ñ 22.345 en PPD positivos (p > 0,05). Los índices de estimulación con PPD, después de retirar las células con actividad supresora (monocitos), disminuyeron en todos los grupos, pero sólo en los vacunados no respondedores de manera significativa (p < 0,01). Las concentraciones séricas de anticuerpos IgG e IgM anti-PPD fueron semejantes en todos los grupos, entre éstos y sueros provenientes de dadores sanos de un banco de sangre, pero significativamente menores que en los pacientes con tuberculosis activa. Existe buena correlación de las respuestas in vivo a la tuberculina y las pruebas in vitro en niños no vacunados y vacunados con reacción positiva al PPD. Los niños no respondedores mostraron tres tipos distintos de respuesta y evidencia de ciertos mecanismos supresores. La excelente capacidad de respuesta T a mitógenos confirma la inmunocompetencia que existe a esta edad. El BCG no produjo concentraciones séricas de anticuerpos anti-PPD medibles por ELISA. La semejanza de la respuesta in vitro al BCG y el PPD confirma la existencia de una homología antigénica entre ambos compuestos

Tromboastenia de Glanzmann: déficit parcial del complejo glicoproteico IIb/IIIa de la membrana plaquetaria / Glanzmann's thromboasthenia

La tromboastenia de Glanzmann es un trastorno hemorrágico de herencia autosómica recesiva, caracterizado por la ausencia o déficit de complejo glicoproteico IIb/IIIa de la membrana de las plaquetas, que se traduce en alteración de la agregación plaquetaria y sangramientos. Se describre el caso clínico de una niña de tres años de edad con síndrome purpúrico-equimótico y antecedente de hemorragias desde el año de vida, con recuento y morfología plaquetaria normales, tiempo de sangría prolongado, modificación en la retracción del coágulo, ausencia de agregación plaquetaria frente a ADP, colágeno, araquinodato de Na, epinefrina, ionóforo A23187 y agregación subnormal con ristocetina. Mediante técnicas de inmunofluorescencia y anticuerpos monoclonales se confirmó disminución del complejo GP IIb/IIIa de la membrana plaquetaria y reducción en el número de sitios de fijación de este complejo por plaqueta, lo que permite catalogar a la paciente como una variante de tromboastenia de Glanzmann

Detección de chlamydia trachomatis por inmunofluorescencia directa con anticuerpo monoclonal / Detection of chlamydia trachomatis by direct immunofluorescence with monoclonal antibody

Se investigó la presencia de Chlamydia trachomatis por inmunofluorescencia directa con anticuerpo monoclonal (IFD+AcM) en muestras genitales de pacientes de policlínico de infecciones gíneco-obstétricas. De un total de 856 pacientes, sólo fue posible estudiar la presencia de C. trachomatis en 734, observándose resultado positivo (10 ó más C. trachomatis en 217 pacientes (29,5 por ciento ). La sintomatología asociada a la C. trachomatis positiva fue alteración del flujo blanco en 82 por ciento de los casos y prurito en 65 por ciento , asociados a cuadro clínico de cervicitis y proceso inflamatorio pelviano (PIP). No se demostró correlación entre la presencia de C. trachomatis y métodos anticonceptivos usados y el examen de Papanicolaou. Sólo 186 pacientes fueron tratadas con antibióticos y controladas, obteniéndose un resultado de mejoría en el 84,5 por ciento de ellas