Comparative performance of vulvovaginal swab sampling versus endocervical sampling for the detection of Chlamydia, Gonorrhea, Mycoplasma genitalium, and Trichomoniasis: a cross-sectional study in Spain.

INTRODUCTION: The global increase in sexual transmitted infections (STI) makes it necessary to seek public health strategies that facilitate rapid and minimally invasive diagnosis. The objective was to evaluate the concordance between vaginal and endocervical samples for STI diagnosis. MATERIALS AND METHODS: A retrospective cross-sectional study was carried out on vaginal and endocervical samples from women attended in our reference area with symptoms suggestive of vulvovaginitis or for STI screening during the study period. RESULTS: A total of 130 paired samples were analyzed; fifty-seven and 59 samples were positive for vaginal and endocervical specimens (Kappa index of 0.969 (Standard error = 0.022). The sensitivity of the vaginal samples was 96.5% (IC95%: 87.2-99.4), with a specificity of 100% (IC95%: 93.0-100). DISCUSSION: The introduction of STI screening in vaginal samples in our environment can facilitate rapid and effective diagnosis and allow early treatment of STI. Additionally, it facilitates sample collection and diagnosis in the community setting, essential for optimal screening.

El diagnóstico en medicina tropical en países con pocos recursos / Medical diagnosis in resource-poor tropical countries

Cuando se trabaja en centros sanitarios de países en vías de desarrollo, ante la limitación de recursos diagnósticos, las habilidades clínicas resultan de gran importancia. En este trabajo se presentan las herramientas diagnósticas disponibles en zonas de bajos recursos. La anamnesis y exploración son claves para alcanzar un diagnóstico correcto. En el laboratorio se dispone de hemograma, bioquímica sanguínea básica y uroanálisis elemental. Las pruebas microbiológicas básicas disponibles son el estudio en fresco de las heces, frotis para malaria, baciloscopia de esputo y tinción de Gram de exudados clínicos. Las radiografías elementales de tórax, abdomen, huesos y partes blandas son de gran ayuda, pero tampoco están disponibles en todos los centros. La ecografía puede resultar de gran utilidad por su sencillez y versatilidad. El diagnóstico en condiciones de bajos recursos debe agudizar nuestras habilidades clínicas y debe apoyarse en el uso de pruebas complementarias elementales (AU)

When working in healthcare centers in developing countries where diagnostic resources are limited, clinical skills are of considerable importance. This study presents the diagnostic tools available in resource-poor areas. Anamnesis and physical examination are key components for reaching a correct diagnosis. The laboratory has at its disposal hemograms, basic blood chemistry and urinalysis. The available basic microbiological tests are the study of fresh feces, smears for malaria, direct smears for bacilli in sputum and Gram staining of clinical exudates. Basic radiography of the chest, abdomen, bones and soft tissues are of considerable usefulness but are not available in all centers. Ultrasonography can be of considerable usefulness due to its simplicity and versatility. The diagnosis in low resource conditions should sharpen our clinical skills and should be supported by the use of additional basic tests (AU)

Medical diagnosis in resource-poor tropical countries. / El diagnóstico en medicina tropical en países con pocos recursos.

When working in healthcare centers in developing countries where diagnostic resources are limited, clinical skills are of considerable importance. This study presents the diagnostic tools available in resource-poor areas. Anamnesis and physical examination are key components for reaching a correct diagnosis. The laboratory has at its disposal hemograms, basic blood chemistry and urinalysis. The available basic microbiological tests are the study of fresh feces, smears for malaria, direct smears for bacilli in sputum and Gram staining of clinical exudates. Basic radiography of the chest, abdomen, bones and soft tissues are of considerable usefulness but are not available in all centers. Ultrasonography can be of considerable usefulness due to its simplicity and versatility. The diagnosis in low resource conditions should sharpen our clinical skills and should be supported by the use of additional basic tests.

Escherichia coli 0157:H7 y síndrome hemolítico urémico en un paciente VIH positivo / Escherichia coli 0157:H7 and hemolityc-uremic syndrome in a HIV positive patient

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