Association of body mass index with anal human papillomavirus infection and histologically confirmed high-grade squamous intraepithelial lesions in people who receive services at the Anal Neoplasia Clinic in Puerto Rico.

Objective: This study aimed to assess the association of body mass index (BMI) with anal high-risk human papillomavirus (HR-HPV) and biopsy-confirmed histologic anal high-grade squamous intraepithelial lesions (HSIL) among a clinic-based sample of Hispanics in Puerto Rico. Methods: This cross-sectional study evaluated medical records of adults who received services at the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center between October 2014 and December 2022. The study included 543 records with complete clinical information regarding anal HR-HPV and anal HSIL status. Chi-square and logistic regression analyses were performed. Results: Mean age of participants was 44.10 ± 13.24 years, 65.2% were men, 71.7% were HIV-infected, 74.4% had anal HR-HPV infection, and 37.9% had biopsy-confirmed HSIL. Regarding BMI, 2.4% were underweight, 31.9% normal weight, and 39.0 % overweight; while 17.3 % had class I, 5.2% class II, and 4.2% class III obesity. No significant association was observed between BMI and anal HR-HPV infection in adjusted analyses. Lower odds of anal HSIL were observed among overweight individuals (OR: 0.63, 95% CI: 0.41 - 0.99) and those with class II/III obesity (OR: 0.48, 95% CI: 0.22 - 1.01) compared to adults with underweight/normal BMI, after adjusting for potential confounders. No significant association was observed for class I obesity. Conclusion: BMI was not associated with anal HR-HPV infection. Overweight and obese individuals had lower odds of having anal HSIL than adults with underweight/normal BMI. This finding could suggest underdiagnosis of HSIL among overweight/obese individuals, or reduced risk in this group.

Association of tobacco use and the presence of anal warts in people who attend the anal Neoplasia clinic in Puerto Rico.

Background: Limited research exists regarding the association between smoking and anal warts. In this study, we evaluated this association among a clinic-based Hispanic population in Puerto Rico. Methods: Cross-sectional study among eligible patients seen at the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (2016-2023) (n = 920). Sociodemographic and clinical variables were collected from medical records. Patients underwent a high-resolution anoscopy (HRA) during the clinical visit; physicians assessed anal condylomas on HRA. Poisson regression models with robust standard errors were used to evaluate the association between smoking and anal warts. Demographic and clinical factors were also assessed. Results: The mean age of participants was 45.8 ± 13.1 years, 66.4 % were men, and 21.6 % were current smokers. While 10.8 % self-reported a history of anogenital condylomas, 18.9 % had anal condylomas on clinical evaluation. A higher prevalence of anal condylomas was observed among current smokers (PR = 1.28, 95 % CI: 0.94-1.75) in comparison to non-smokers in adjusted analysis, but this was not statistically significant. However, a higher prevalence of anal condylomas was observed among younger individuals (PR = 0.96, 95 % CI: 0.96-0.98) and individuals with anal high-grade squamous intraepithelial lesions (HSIL) as compared to those with benign histology (PR = 1.74. 95 % CI: 1.09-2.77). Conclusions: Although current smoking seemed to be positively associated with anal condylomas in this high-risk Hispanic population, this finding was not statistically significant as the power to detect an association was limited. However, younger age and HSIL diagnosis were associated with a higher prevalence of anal condylomas.

Evaluating the performance of anal cytology and high-risk HPV genotyping for detecting anal HSIL in a clinic-based sample of people living with and without HIV in Puerto Rico.

BACKGROUND: Given the disproportionately elevated anal cancer risk in high-risk populations, it is important to assess the performance of commonly used anal cancer screening tools to improve the effectiveness of detection and treatment methods. This study evaluates 1) the concordance between anal cytology and histology results and 2) the performance of cytology and high-risk human papillomavirus (HR-HPV) genotyping as screening tools for detecting histologically confirmed anal high-grade squamous intraepithelial lesions (HSIL). METHODS: Data from the Anal Neoplasia Clinic in Puerto Rico (2014-2021; n = 466) was used. The clinical performance of anal cytology and HR-HPV genotyping to detect HSIL was compared to the gold standard: high-resolution anoscopy-guided biopsy. Sensitivity, specificity, positive predictive value, negative predictive value, and κ coefficients were calculated. RESULTS: A total of 66.95% of the patients were men, 74.0% were people living with HIV, 76.2% had anal HR-HPV infection, and 40.34% had histologically confirmed anal HSIL. The weighted κ statistic between the tests (cytology and histology) was 0.25 (p < .001). The sensitivity and specificity of cytology alone to detect anal HSIL were 84.3% (95% confidence interval [CI], 78.3%-89.1%) and 36.0% (95% CI, 30.3%-42.0%), respectively. Anal HR-HPV genotyping had higher sensitivity (92.2%; 95% CI, 87.4%-95.6%) and similar specificity (34.8%; 95% CI, 29.2%-40.7%) compared to cytology. The two tests combined (positive results following cytology or HR-HPV test) improved sensitivity to detect anal HSIL (97.9%; 95% CI, 94.8%-99.4%), but specificity was compromised (19.2%; 95% CI, 14.7%-24.4%). CONCLUSION: Although HR-HPV genotyping improved the detection of anal HSIL, HR-HPV testing had lower specificity than anal cytology alone.

Association of smoking with anal high-risk HPV infection and histologically confirmed anal high-grade squamous intraepithelial lesions among a clinic-based population in Puerto Rico.

INTRODUCTION: Current smoking is a risk factor for anal cancer. Yet, its association with anal human papillomavirus infection (HPV) and anal high-grade squamous intraepithelial lesions (HSIL) remains unclear. We assessed the association of smoking with 1) anal high-risk HPV (HR-HPV) infection and 2) anal HSIL. METHODS: Data from the baseline visit of patients from the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (May 2015- June 2021) was analyzed. Patients were eligible if they had information on smoking status, complete high-resolution anoscopy (HRA) with biopsy, and HR-HPV testing (n =  427). Logistic regression models estimated the odds ratio (OR) with 95% confidence intervals (CIs) adjusting for covariates. RESULTS: Mean age was 44 ± 13 years, 69% were men, 74% were HIV-infected, and 25% reported being current smokers. 74% had anal HR-HPV infection. HSIL was diagnosed in 40% of patients. Current smokers had significantly higher odds (OR: 1.71, 95% CI: 1.04-2.82) of having HSIL compared to non-smokers after adjusting for age, sexual risk group, lifetime number of sexual partners, HIV status, and HR-HPV infection. Smoking was not associated with HR-HPV infection (OR: 1.56, 95% CI: 0.83-2.95) after adjusting for age, sexual risk group, lifetime number of sexual partners, and HIV status. CONCLUSIONS: Current smoking was associated with histologically confirmed HSIL but not with HR-HPV infection among this high-risk Hispanic population. Results highlight the need to explore targeted smoking cessation campaigns among populations at higher risk of developing HSIL, as an anal cancer prevention strategy.

Biochar impacts on soil chemical properties, greenhouse gas emissions and forage productivity: A field experiment.

Biochar is a promising alternative to agricultural productivity and climate change mitigation. However, quantitative data are needed to better understand the productivity and greenhouse gas (GHG) emissions from agricultural fields amended with biochar. To assess the impacts of the four biochars on soil properties, forage productivity, and GHG emissions, a 1-year field experiment was conducted in a Humic Haploxerands (Andisol). Three manure-derived biochars and one wood residue biochar (all pyrolyzed at 550 °C) were applied at rates of 1% (equivalent to 11 t ha-1) in two parallel and independent experiments. The changes in (i) soil chemical properties and yield of Sorghum sudangrass (S. bicolor×S. bicolor var. Sudanese) and (ii) soil CO2 and N2O emissions were monitored. Two controls, with and without NPK, were included. The added amendments produced from residues of poultry and pig systems increased soil pH by 0.73 and 0.19 units, respectively. Increased sorghum yield were associated with fertilizer and the liming potential of the added biochar. Soil total carbon (TC) increased with the addition of different biochars, especially during the wood biochar treatment. Biochar application, regardless of the feedstock, had no significant impact on the cumulative soil CO2 emitted after a year. Soil N2O fluxes decreased (23%-50%) in treatments containing biochars with low mineral N contents and high C stability (i.e., low H:OC and Cox:TC ratios). NPK treatment resulted in the highest N2O emissions. Wood residue-derived biochar has a great potential in mitigating climate change, reducing soil N2O emissions, and promoting soil C storage. Manure-derived biochars could be instrumental in circular economy livestock systems, where pyrolyzed animal manure can satisfy the demand for nutrients and/or liming of Andisols under sustainable forage models.

Accidental Poisoning with Nerium Oleander in Dairy Goat in the Santiago Metropolitan Region in Chile / Intoxicación accidental con Nerium oleander en lechería caprina en la Región Metropolitana de Santiago en Chile / Intoxicação acidental com oleandro de Nerium em laticínios de cabras na região metropolitana de Santiago, no ChileResumo

Abstract A small dairy goat farm in central Chile stocked their troughs with ornamental plants and grasses, which were obtained after pruning the gardens of neighboring sectors. Twelve hours after the goats ingested this food, the farm registered a death toll of eight goats, all of which were adult females in their productive stage, before entering the milking parlor. The mortality episode lasted 84 hours and produced mortality and morbidity values of 48 and 54 percent, respectively (n = 52). During a visit to the farm, clinic inspections, autopsies, and sample tissues were obtained for microscopic analysis (the tissues specimens were fixed in 10% buffered formaldehyde solution). The clinic inspection and microscopic analysis both confirmed that the animals had cardiovascular disease. The lesions were compatible with those produced by cardiac glycosides. During the site visit, Nerium oleander was found in the troughs, which suggested that the animals were poisoned by eating this plant. There was a high presence of this plant in the poisoned area, and it was not associated with the mortality episode before the on-site visit, which indicates that the authors should conduct training and inform producers about the handling and feeding of their animals.

Resumen En establecimiento de pequeño productor caprino (n = 52) en la zona central de Chile, se les administraron en comederos plantas ornamentales y pastos que fueron obtenidos posterior a la poda de jardines en sectores aledaños. A las 12 horas post ingesta de este alimento se encuentran 8 caprinos, hembras, adultos, productivos muertos previo al ingreso a sala de ordeña. El episodio de mortandad se extendió por 84 horas generando una mortalidad del 48 % y una morbilidad del 52 %. Se realizó visita, inspección clínica, necropsia y análisis microscópico de especímenes fijados en solución formolada tamponada al 10 %. La inspección clínica confirma la presencia de animales con afección cardiovascular, al igual que el análisis microscópico. Las lesiones son compatibles con las producidas por glucósidos cardiotóxicos, al recorrer el lugar se observa la presencia de Nerium oleander en comederos de lote afectado, lo que sugiere la intoxicación de estos animales. La presencia de esta planta en la zona de la intoxicación es elevada y antes de nuestra visita no fue asociada al episodio de mortandad, lo que nos indica que se debe realizar capacitación e informar a productores sobre el manejo y alimentación de sus animales.

Resumo No estabelecimento de um pequeno produtor de cabras (n = 52) na zona central do Chile, plantas ornamentais e pastagens foram administradas em alimentadores que foram posteriormente podados por jardins em setores próximos. Às 12 horas após a ingestão deste alimento, são oito cabras, fêmeas, adultos, mortos produtivos antes de entrar na sala de ordenha. O episódio da morte prolongou-se por 84 horas, gerando uma mortalidade de 48% e uma morbidade de 52%. Foram realizadas visita, inspeção clínica, necropsia e análise microscópica das amostras fixadas em solução formolada tamponada a 10%. A inspeção clínica confirmou a presença de animais com doença cardiovascular e a análise microscópica. As lesões são compatíveis com as produzidas pelos glicosídeos cardiotóxicos, ao atravessar o local, observa-se a presença de oleandro de Nerium nos alimentadores do lote afetado, o que implica na intoxicação desses animais. A presença desta planta na zona de envenenamento é alta e, antes da nossa visita, não estava associada ao episódio da morte, o que indica que o treinamento deve ser realizado e informa os produtores sobre o manuseio e a alimentação de seus animais.

Hemorragia subaracnoidea aneurismática en la unidad de cuidados intensivos del Hospital Luis Vernaza, Guayaquil, Ecuador / Aneurysmal subarachnoid hemorrhage in the intensive care unit of Luis Vernaza Hospital, Guayaquil, Ecuador

La hemorragia subaracnoidea puede producirse por un traumatismo cráneo encefálico o cuando el denominado aneurisma (defecto en la estructura de la pared de un vaso sanguíneo) se rompe produciendo flujo de sangre en el espacio subaracnoideo. Al respecto, se desarrolló un estudio con enfoque mixto, de tipo no experimental, descriptivo, longitudinal prospectivo; cuyo fin fue describir la hemorragia subaracnoidea aneurismática en pacientes atendidos en la unidad de cuidados intensivos del Hospital Luis Vernaza, en la ciudad de Santiago de Guayaquil, Ecuador, durante el período comprendido desde enero hasta septiembre de 2016. En el mismo participa-ron 31 pacientes con diagnóstico de hemorragia subaracnoidea aneurismática, los que fueron atendidos en ese servicio de la institución en cuestión. Entre los resultados observados se puede destacar que: 24 de los 31 involucrados eran de género femenino, más del 90% de la población de estudio tenían más de 40 años de edad; la arteria comunicante posterior resultó la más afecta-da en los pacientes estudiados (32,26 %); el 58,33% de los casos tuvo compromiso cerebral con distintos grados de afectación; el 38,71% de la población de estudio desarrolló isquemia cere-bral tardía; se estableció una relación estadísticamente significativa entre esa última complica-ción y la administración de ácido tranexámico como parte del tratamiento para evitar resangra-do, el que se presentó solamente en el 16,13% de los pacientes participantes.

Subarachnoid hemorrhage can be caused by a traumatic brain injury or when the so-called aneu-rysm (defect in the structure of the wall of a blood vessel) ruptures causing blood flow in the subarachnoid space. Based on this, it was developed a study with a mixed approach, of a non-ex-perimental, descriptive, longitudinal, prospective type in order to describe aneurysmal subara-chnoid hemorrhage in patients treated in the intensive care unit of Luis Vernaza Hospital, in the city of Santiago de Guayaquil, Ecuador, during the period from January to September 2016. The study population was constituted by 31 patients diagnosed with aneurysmal subarachnoid hemo-rrhage and treated at the service mentioned above. The results were: 24 of the 31 patients were female, more than 90% of the study population were over 40 years of age. The posterior commu-nicating artery was the most affected in the patients representing 32.26%, 58.33% of the cases had cerebral involvement with different degrees of involvement, 38.71% of the patients develo-ped late cerebral ischemia. A statistically significant relationship was established between this last complication and the administration of tranexamic acid as part of the treatment to avoid rebleeding, which occurred only in 16.13% of the participating patients.

Human Papillomavirus Correlates With Histologic Anal High-Grade Squamous Intraepithelial Lesions in Hispanics With HIV.

OBJECTIVE: To estimate the magnitude of association between anal infection with high-risk human papilloma virus (HR-HPV) types and severity of biopsy-confirmed histopathological anal squamous intraepithelial lesions (SILs) among a clinic-based sample of HIV-infected adults in Puerto Rico. METHODS: This cross-sectional study analyzed data from medical records of adult patients who visited a specialized anal neoplasia clinic from June 2015 to December 2017 (n = 239); sociodemographics, behavioral risk factors, medical history, clinical data, and pathology reports were collected. The magnitude of association between anal HR-HPV and severity of anal SIL, adjusted for potential confounders, was assessed using a multinomial logistic model. RESULTS: A 78.7% of patients had anal HR-HPV infection, 43.9% had histopathological low-grade SIL (LSIL), and 37.7% had histopathological high-grade SIL (HSIL). The prevalence of anal HR-HPV infection was 63.6% among patients with no anal SIL, 70.5% for those with LSIL and 95.6% for those with HSIL. After adjusting for different predictors, patients with anal HR-HPV infection were more likely to have HSIL (odds ratio, 11.0; 95% confidence interval, 3.2-37.2) than those without anal HR-HPV infection, whereas no significant excess was observed for LSIL (odds ratio, 1.4; 95% confidence interval, 0.6-3.1). CONCLUSIONS: This study showed a strong association between anal HR-HPV infection and HSIL. Likewise, a high prevalence of anal HR-HPV infection and presence of anal SIL was observed among HIV-infected individuals. Our result highlights the importance of screening for anal HR-HPV infection and anal SIL and optimizing strategies for HPV vaccination in HIV-infected individuals.

Periodontitis and oral human papillomavirus infection among Hispanic adults.

INTRODUCTION: Research on the association between periodontitis and oral human papilloma virus (HPV) infection is inconsistent. The cross-sectional association of severe periodontitis with oral HPV infection was investigated in a sample of Hispanic adults. METHODS: Data from the 2014-2016 San Juan Overweight Adults Longitudinal Study (n = 740) was analyzed. Periodontitis assessment and self-collection of oral HPV samples followed the National Health and Nutrition Examination Survey methodology. Periodontitis was defined using the Centers of Disease Control and Prevention/American Academy of Periodontology definition. HPV typing was performed using polymerase chain reaction. Multivariate logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: 5.7% of participants had oral HPV infection and 20.3% had severe periodontitis. Adults with severe periodontitis had higher odds of oral HPV infection than those with none/mild disease (OR=2.9, 95% CI: 1.0-8.4, p < 0.05) in multivariable analysis. Adults with clinical attachment loss≥ 7 mm and pocket depth PD≥ 6 mm had 2- to 3-fold higher odds of HPV infection. CONCLUSIONS: Severe periodontitis was positively associated to oral HPV infection. Longitudinal evaluation of periodontal inflammation's role in acquisition and persistence of oral HPV infection is needed, as periodontitis screening could identify individuals at increased risk of HPV-related oral malignancies.

Association of marijuana use with oral HPV infection and periodontitis among Hispanic adults: Implications for oral cancer prevention.

BACKGROUND: Despite limited data, research suggests that marijuana use is associated with oral HPV infection and periodontitis, two potential oropharyngeal cancer risk factors. We assessed these associations in a Hispanic adult population in Puerto Rico. METHODS: A cross-sectional study of 735 adults assessed marijuana use, determined through an audio computer-assisted self-interview, and periodontitis and self-collection of oral HPV samples following the National Health and Nutrition Examination Survey methodology. The Centers of Disease Control and Prevention/American Academy of Periodontology definition was used for periodontitis. HPV typing was performed using polymerase chain reaction with modified L1 consensus primers (MY09/MY11). RESULTS: 26.5% of adults reported lifetime use of marijuana, 2.7% were frequent users (lifetime use ≥ 26 times, past year use ≥ 6 times, and past 30-day use ≥2 times), 5.7% had oral HPV infection, and 20.1% had severe periodontitis. The multivariate logistic regression analysis showed that frequent marijuana users were more likely to have severe periodontitis (OR = (2.93, 95%: 1.08-7.96)) than never/once lifetime users after adjusting for age, sex, healthcare coverage, smoking, binge drinking, number of oral sex partners, and oral HPV infection. However, frequent marijuana use was not associated with oral HPV infection. CONCLUSION: Marijuana use was associated with periodontitis, but not with oral HPV infection. Further evaluation of the role of marijuana use in oral HPV infection and periodontitis may inform novel preventive public health strategies, as marijuana users could be at increased risk of oral cancer.

Methods in HPV Surveillance: Experiences from a Population-Based Study of HPV Infection among Women in the San Juan Metropolitan Area of Puerto Rico.

This article describes the methodology of the first population-based study of human papillomavirus (HPV) infection among women aged 16-64 years residing in the San Juan Metropolitan Area of Puerto Rico (PR). The sample was identified through a complex sampling design of households. The sampling frame was selected in four stages, using census tracts maps from the Census Bureau. Women completed a face-to-face interview and a computer-assisted self-interview using the Audio CASI system, for the collection of demographic, clinical, and lifestyle variables, and sampling acceptability. Anal, cervical, and oral specimens were collected through self-collection methods for HPV DNA testing using a modified pool of MY09/MY11 consensus HPV L1 and human ß-globin amplification primers. Anthropometric measurements were taken using the Third National Health and Nutrition Examination Survey methodology. Blood samples were collected to create a bio-repository for future HPV-related studies. Fifty census tract blocks were randomly selected. We recruited 566 women, with a response rate of 83.4%. Response rates did not vary by age-group (p>0.05); although they varied by socioeconomic (SES) census block stratums (p<0.05), response rates were good (>75%) in all SES strata. All participants agreed to respond to the surveys and provide the requested anogenital and oral samples. Overall, more than 98% understood and more than 50% felt comfortable with the cervical, anal, and oral self-collection methods used. This article documents the feasibility of performing population-based studies for HPV surveillance in women in PR.

Metabolic fate of ellagitannins: implications for health, and research perspectives for innovative functional foods.

Consumption of dietary ellagitannins (ETs) has been associated with different health benefits. Nonetheless, ETs are not bioavailable as such and are metabolized in vivo. They are partially converted into ellagic acid (EA) in the upper gastrointestinal (GI) tract, but this first metabolite is also poorly bioavailable. In the lower GI tract, EA and residual ETs are metabolized by gut microbiota to produce urolithins, which, together with their conjugate relatives, persist at relatively high concentrations in plasma and urine for days after ingestion of dietary ETs. Thus, ETs and EA may exert local health benefits on the GI tract but systemic health benefits are more likely to result from urolithins. Cellular models suggest that, at physiological concentration, urolithins are active against chronic degenerative diseases. Health benefits have been proven in animal models and during clinical studies. Even so, the crucial involvement of gut microbiota in ET bioconversion induces important variability of physiological response among humans, giving rise to the concept of high and low urolithin producers. This variability among consumers in obtaining potential health benefits from dietary ETs raises new challenges for the functional food industry. Different research perspectives are discussed to tackle this significant issue for nutritionists, food technologists, and consumers.

Enfermedad de Kawasaki en niños hospitalizados en cinco centros de Barranquilla, Colombia, 2002-2008 / Kawasaki disease in children admitted to five centers in Barranquilla, Colombia, 2002-2008

Introducción: La enfermedad de Kawasaki se ha convertido en la principal causa de cardiopatíaadquirida en los niños. Sin embargo,aunque existen criterios diagnósticos bien definidos, éstos pueden presentarse dispersos a lo largo del curso de la enfermedad o simulardiferentes enfermedades, lo que ocasiona retraso en el diagnóstico y, con esto, mayor riesgo de afección cardiaca. El objetivo de este estudio fue reconocer las características clínicas y epidemiológicas de la enfermedad de Kawasaki en los niños hospitalizados en cinco centros de Barranquilla, entre 2002 y 2008. Pacientes y métodos: Se trata de un estudio retrospectivo, a partir de las historias clínicas de los pacientes menores de 14 añoshospitalizados en cinco centros asistenciales (Hospital Pediátrico, Hospital Niño Jesús, Clínica del Caribe, Clínica La Asunción y Clínica La Merced) de Barranquilla (Atlántico) desde el 1º de febrero de 2002 hasta el 31 de mayo de 2008, con diagnóstico de enfermedadde Kawasaki. Se estimaron parámetrosdescriptivos y prueba no paramétrica(test de los signos). Resultados: El 40% de los casos ocurrió en menores de un año. El 65% de los casos fueron niños procedentes del área urbana. La fiebre fue el principal motivo de consulta en 65% de los casos y el 95% se clasificó como enfermedad típica. Las alteraciones cardíacas se presentaron en el 30%. Los exámenes determinantes para medir la efectividad del tratamiento fueron los cambios en el recuento de plaquetas, la velocidad de sedimentación globular y la prueba de la proteína C reactiva (PCR). Conclusiones: La enfermedad de Kawasaki en nuestro medio presenta características clínicas y epidemiológicas similares a lasdescritas en otras latitudes. Se observaron variaciones en la velocidad de sedimentación globular, plaquetas y PCR en aquellos sujetos que recibieron gammaglobulina. La afección cardiaca es frecuente y se relaciona con la edad, el retraso en el diagnóstico y eltratamiento oportuno.

Introduction: Kawasaki disease has become the leading cause of acquired heart disease in children. However, although there are well-defined diagnostic criteria, these can occur scattered throughout the course of the disease or simulate different pathologiesleading to delayed diagnosis and increased risk of a heart condition. The purpose of this study is to recognize the clinical and epidemiologicalcharacteristics of Kawasaki diseasein children admitted to five medical centers in Barranquilla from 2002 to 2008. Patients and Methods: This is a retrospective study based on the medical records of patients less than 14 years old hospitalized in five medical centers in the city of Barranquilla, Atlántico, (Pediatric Hospital, Hospital Niño Jesús, Clinics: Caribbean, Assumption and La Merced) and diagnosed with Kawasaki disease from February 1, 2002 to May 31, 2008. Descriptive statistical parameters and non-parametric tests (sign test) have been estimated. Results: Forty percent of the cases occurred in infants less than one year old. Sixty percent (65%) of the patients were male children from the urban area. Fever was the main reason for consulting in 65% of the cases, and 95% of the patients were classified as having the typical disease. Ultrasonographic cardiac abnormalities were documented in 30% of the instances. The test measures for determining the effectiveness of treatment were based on changes in theplatelet count, the sedimentation rate, and the C-reactive protein (CRP).Conclusions: Kawasaki disease in ourenvironment shows clinical and epidemiological features similar to those described in other latitudes. There are variations in the sedimentation rate (ESR), platelet count, and CRP in those subjects who received intravenousimmunoglobulin. The heart conditionis common and is associated to age, delayed diagnosis, and timely treatment.

Valor predictivo positivo de test de screening para drogas en orina / Positive predictive value for drugs in urine screening tests

Con el objeto de conocer el Valor Predictivo Positivo (VPP) del test de screening para canabinoides y cocaína, a 3049 trabajadores pertenecientes a una empresa del rubro comercio se les realizó una muestra de orina entre el 28 de noviembre de 1999 y el 28 de agosto de 2000. En una primera instancia, la muestra fue sometida a un test de screening (Enzimoinmunoensayo Rapid test d.a.u. de DADE BEHRING). Los test de screening con resultado positivo, en una segunda instancia fueron sometidos a un examen de confirmación con la técnica cromatografía gaseosa acoplada a espectrofotometría de masas (CG/MSD). Se realizaron 6098 test de screening para canabinoides y cocaína. 46 test de screening resultaron positivos para canabinoides, cocaína o ambas. El examen de confirmación fue positivo en 35 de 46 test de screening (76 por ciento). El porcentaje de confirmación para canabinoides y cocaína fue de 75,7 por ciento (25 de 33) y 76,9 por ciento (10 de 13), respectivamente; es decir, aproximadamente 1 de cada 4 test de screening positivo para canabinoides o cocaína no permite hacer el diagnóstico de consumo con certeza, para lo cual es necesario realizar una confirmación, la que puede ser instrumental (CG/MSD, por ejemplo) o preguntándole directamente al trabajador (verbal). En general, en el ámbito laboral propiciamos la confirmación verbal