Regional disparity of HIV incidence and prevalence among men who have sex with men.

BACKGROUND: HIV incidence can be estimated with cross-sectional studies using clinical, serological, and molecular data. Worldwide, HIV incidence data in only men who have sex with men (MSM) are scarce and principally focus on those with healthcare or under treatment. However, better estimates can be obtained through studies with national representativeness. The objective was to estimate the prevalence, incidence, and factors associated with acquiring HIV in a national sample of MSM who attend meeting places, considering geographical regions. METHODS: A nationally representative survey of MSM attending meeting places was performed in Mexico. Participants answered a questionnaire, and a dried blood spot (DBS) was collected. Samples were classified as recent infections using an algorithm with HIV status, antiretroviral therapy, and the result of BED-EIA assay. Parameters were analysed considering regions and demographic and sexual behaviour characteristics. RESULTS: The national HIV prevalence was 17.4% with regional differences; the highest prevalence (20.7%) was found in Mexico City, and the lowest prevalence was found in the West region (11.5%). The incidence was 9.4 per 100 p/y, with regional values from 6.2 to 13.2 for the Northeast and the Centre regions, respectively. Age, age at sexual debut, low wealth index, and rewarded sex were associated with HIV prevalence. Centre region, use of private clinics as health services, and having sex exclusively with men were associated with recent HIV infections. CONCLUSIONS: The incidence and prevalence showed regional differences, suggesting a difference in the dynamics of HIV transmission; some regions have a greater case accumulation, and others have a greater rate of new infections. Understanding this dynamic will allow developing health programs focused on HIV prevention or treating people already living with HIV.

Hematoma hepático subcapsular como complicación del síndrome de HELLP: reporte de caso / Subcapsular hepatic hematoma as a complication of the HELLP syndrome: Case report

Presentamos el caso de una paciente con diagnóstico de hematoma subcapsular hepático como complicación del síndrome de HELLP. Debido al bajo volumen de casos publicados, la conducta terapéutica en esta entidad no ha sido definida con claridad. En el caso presentado, la ejecución pronta de un estudio de imagen fue clave para el establecimiento del diagnóstico. En caso de tratarse de un hematoma sin compromiso hemodinámico, el tratamiento conservador puede ser exitoso, como se demostró en nuestro caso

A case is presented on a patient diagnosed with a hepatic subcapsular haematoma as a complication of the HELLP syndrome. Due to the low volume of published cases, the therapeutic behaviour of this condition has not been clearly defined. In the case presented, the early execution of an imaging study was a key factor in establishing the diagnosis. In the case of a haematoma without haemodynamic compromise, conservative treatment can be successful, as demonstrated in our case

[Intracranial meningioma in pregnancy. Case report and literature review]. / Meningioma intracraneal en el embarazo. Reporte de un caso y revisión de la bibliografía.

BACKGROUND: Brain tumors are the fifth leading cause of death in women of 20-39 years of age, including pregnant with similar onset and evolution. CASE REPORT: 33 years of age with neurological manifestations due to an intracranial meningioma and 37 weeks pregnant. The pregnancy was terminated and the tumor was removed; the results were favorable for the mother and child. CONCLUSIONS: The incidence of intracranial tumors during pregnancy is extremely low. Headache is the first symptom in almost 90% of cases, but are also common: nausea, vomiting, seizures and neurological deficits. MRI is the diagnostic study of choice. Meningiomas are the most common benign primary brain tumors of the central nervous system. They are a rare association; pregnant patients often experience more symptoms under accelerated tumor growth of a neoplasm usually slow growing. The treatment is surgical, although the current trend is the conservative treatment to achieve viable pregnancies. Emergency neurosurgery is reserved for cases with suspected increase in ICP, herniation, progressive neurological deterioration or other condition that threatens the life of the mother. The choice between Caesarean delivery and not only neurosurgery, there are multiple obstetrical, neurological and anesthesia to be taken into account factors. The prognosis is generally excellent with a 5-year survival greater than 90%.