Chagas disease in Latin American pregnant immigrants: experience in a non-endemic country.

PURPOSE: Chagas disease is a systemic chronic parasitic infection by Trypanosoma cruzi endemic in Latin America. Migration of women of childbearing age from Latin America to developed countries may spread the disease to non-endemic areas through vertical transmission. METHODS: Prospective study of seroprevalence of T. cruzi infection in immigrant Latin American pregnant women during a 5-year period (from 2006 to 2010) in Spain. RESULTS: Seven out of 545 participants were seropositive for T. cruzi [prevalence 1.28%, 95% confidence interval (CI) 0.06-2.56]. Four (57%) were from Bolivia and three (43.%) from Paraguay. The seroprevalence in pregnant women from Bolivia was 10.26% (95% CI 4.06-23.58) and in participants from Paraguay was 6.52% (95% CI 2.24-17.5). No congenital transmission occurred. CONCLUSIONS: Seroprevalence of T. cruzi infection in Latin American pregnant women coming from Bolivia and Paraguay is high. Those women should be screened for T. cruzi to control mother-to-child transmission in non-endemic areas.

Seroprevalence of HTLV infection among immigrant pregnant women in the Mediterranean coast of Spain.

BACKGROUND: Universal HTLV antenatal screening is currently not mandatory in European countries. However, the large number of immigrants coming from HTLV-I endemic areas might force to change this recommendation in the near future. OBJECTIVES: To determine the prevalence of HTLV infections in immigrant pregnant women attended in a general Hospital in the Mediterranean coast of Spain. STUDY DESIGN: From February 2006 to December 2009, a cross-sectional study was carried out on all immigrant pregnant women attended at a reference obstetric unit in Elche, Spain. An enzyme immunoassay (EIA) was used for testing HTLV-I/II antibodies in serum, being reactive samples further confirmed by Western blot. RESULTS: A total of 1439 immigrant pregnant women were examined. Overall, 520 (36.1%) came from Central and South America and 90 (6.2%) from Sub-Saharan Africa, where HTLV infection is endemic. Three samples were EIA-seroreactive for HTLV-1/2. One of them was a woman infected with HTLV-I coming from Brazil and the other two were women infected with HTLV-II coming from Bolivia and Colombia, respectively. Thus, the overall HTLV seroprevalence in the study population was 2.1 per 1000 (95% CI: 0.5-6.6/1000), although it reached to 0.58% in the subset of women from Central and South America. CONCLUSIONS: HTLV antenatal screening should be considered in pregnant women coming from Central and South America, in whom the prevalence of infection is relatively high and avoidance of breastfeeding may effectively prevent vertical HTLV transmission.

Estudio de colonización por Streptococcus agalactiae en gestantes extranjeras y españolas, en Elche y Comarca / Colonization by Streptococcus agalactiae in foreign and spanish gestating women in the area of Elche(Spain)

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[Prenatal screening for Trypanosoma cruzi and human T lymphotropic virus types 1 and 2 in pregnant Latin American women]. / Cribado prenatal de la infección por Trypanosoma cruzi y virus linfotrópico humano de células T en gestantes latinoamericanas.

INTRODUCTION: To estimate the seroprevalence of infection by Trypanosoma cruzi and human T lymphotropic virus (HTLV) in pregnant Latin American women. METHODS: Serological survey carried out in pregnant Latin American women attending the antenatal care clinic of a Spanish hospital from January 2006 to June 2007. RESULTS: Of the 229 women enrolled, 4 had antibodies against T. cruzi (1.75%; 95% confidence interval [95% CI], 0.68-4.4); 2 of these women came from Bolivia (13.33%; 95% CI, 3.73-37.88) and the other 2 from Paraguay (11.76%; 95% CI, 3.29-34.33). None of the women had anti-HTLV-1 antibodies (95% CI, 0-1.6), and 2 had HTLV-2 antibodies (0.87; 95% CI, 0.24-3.12). CONCLUSIONS: A notable percentage of pregnant immigrant women from Latin American had T. cruzi infection. The seroprevalence of HTLV infection is low.

Cribado prenatal de la infección por Trypanosoma cruzi y virus linfotrópico humano de células T en gestantes latinoamericanas / Prenatal screening for Trypanosoma cruzi and human T lymphotropic virus types 1 and 2 in pregnant Latin American women

Introducción: estimar la seroprevalencia de infección por Trypanosoma cruzi y por el virus linfotrópico humano (HTLV) en mujeres gestantes latinoamericanas. Métodos: estudio serológico en mujeres gestantes latinoamericanas que acudieron a la consulta de fisiopatología fetal de un hospital español desde enero de 2006 hasta junio de 2007. Resultados: de las 229 gestantes estudiadas, 4 fueron positivas frente a T. cruzi (1,75%; intervalo de confianza [IC] del 95%, 0,68¿4,4): 2 de Bolivia (13,33%; IC del 95%, 3,73¿37,88) y 2 de Paraguay (11,76%; IC del 95%, 3,29¿34,33). Ninguna mujer presentó anticuerpos frente al HTLV-1 (IC del 95%, 0¿1,6) y 2 presentaron anticuerpos frente al HTLV-2 (0,87%; IC del 95%, 0,24¿3,12). Conclusiones: una proporción apreciable de las gestantes inmigrantes latinoamericanas presenta anticuerpos frente a T. cruzi. La seroprevalencia frente a HTLV es baja (AU)

Introduction: To estimate the seroprevalence of infection by Trypanosoma cruzi and human T lymphotropic virus (HTLV) in pregnant Latin American women. MethodsSerological survey carried out in pregnant Latin American women attending the antenatal care clinic of a Spanish hospital from January 2006 to June 2007. Results: Of the 229 women enrolled, 4 had antibodies against T. cruzi (1.75%; 95% confidence interval [95% CI], 0.68¿4.4); 2 of these women came from Bolivia (13.33%; 95% CI, 3.73¿37.88) and the other 2 from Paraguay (11.76%; 95% CI, 3.29¿34.33). None of the women had anti-HTLV-1 antibodies (95% CI, 0¿1.6), and 2 had HTLV-2 antibodies (0.87; 95% CI, 0.24¿3.12). Conclusions: A notable percentage of pregnant immigrant women from Latin American had T. cruzi infection. The seroprevalence of HTLV infection is low (AU)

Seroprevalencia frente a Toxoplasma gondii, virus de la rubéola, virus de la hepatitis B, VIH y sífilis en gestantes extranjeras en Elche y comarca / Seroprevalence of antibodies against Toxoplasma gondii, rubella virus, hepatitis B virus, HIV and Treponema pallidum in foreign pregnant women in Elche (Spain)

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Biweekly docetaxel and vinorelbine as first-line chemotherapy in metastatic breast cancer.

This study was designed to evaluate the antitumor activity and tolerance of biweekly docetaxel plus vinorelbine as first-line chemotherapy in patients with metastatic breast cancer (MBC). Forty-one patients with measurable disease and no prior chemotherapy for MBC were treated with docetaxel 60 mg/m(2) plus vinorelbine 30 mg/m(2) on day 1, every 2 weeks for a maximum of 12 courses. Median age was 58 years (range, 23-75). Fourteen patients (34.1%) were premenopausal and 27 (65.9%) were postmenopausal. Most patients had received prior neoadjuvant/adjuvant chemotherapy (n = 27, 65.9%), radiation therapy (n = 22, 53.6%), and hormone therapy (n = 21, 51.2%). The most frequent sites of metastasis were bone (n = 18, 43.9%), pleuropulmonary (n = 16, 39%), and liver (n = 14, 34.1%). Twenty-seven patients (65.9%) had more than one site of metastasis. Three hundred and thirty-nine courses were given (median, 8 courses per patient; range, 1-12). Median relative dose intensity was 85% for both docetaxel and vinorelbine. Grade 3/4 toxicities included neutropenia (14 patients, 34.1%), febrile neutropenia (n = 14, 34.1%), and stomatitis (n = 4, 9.8%). No treatment-related deaths were reported. All patients were assessed for response in an intent-to-treat analysis. Four patients (9.8%) had a complete response and 19 (46.3%) had a partial response (overall response rate, 56.1%; 95% CI, 42%-70%). Six patients (14.6%) had stable disease and 12 patients (29.3%) had progressive disease. With a median follow-up of 15.1 months or until death, median duration of response is 12.6 months. Median time to progression is 12.4 months. Median survival time is 19.6 months. This biweekly combination of docetaxel plus vinorelbine is feasible and active as first-line chemotherapy in patients with MBC. This regimen is safe and well tolerated.

A phase II trial of cisplatin and vinorelbine in patients with recurrent or metastatic squamous cell carcinoma of the head and neck.

OBJECTIVE: We assessed the response rate and the toxicity of cisplatin plus vinorelbine in patients with this condition. PATIENTS AND METHOD: Forty-two patients were included. Therapy consisted of cisplatin, 100 mg/m(2) on day 1, and vinorelbine, 25 mg/m(2) on days 1 and 8, given every 21 days. Therapy was continued up to six courses or progressive disease. RESULTS: One hundred fifty-nine courses were given (median, three per patient). Dose reduction was applied in 13% of courses and 43% of patients. Grade 3 to 4 neutropenia appeared in 11% of courses and 35% of the patients. One patient died of febrile neutropenia. Ten percent of patients attained a complete response, and 23% attained a partial response (overall 33%, 95%CI 19%-47%). The median duration of response and median survival were 6 months. Twenty-four percent of patients remain alive at 1 year. CONCLUSIONS: The combination of cisplatin and vinorelbine is moderately active in patients with recurrent or metastatic carcinomas of the head and neck and avoids the inconvenience of prolonged infusions of 5-fluorouracil.