Retinal Detachment Associated With Giant Retinal Tears: Surgical Management and Outcomes in the Past 2 Decades.

Purpose: To describe the surgical outcomes of rhegmatogenous retinal detachments (RRDs) associated with giant retinal tears (GRTs) and define factors associated with primary anatomic failure. Methods: This retrospective consecutive study comprised primary GRT-RRD surgeries between 1999 and 2021 at a single institution. Exclusion criteria were a follow-up of less than 3 months and incomplete surgical data. Results: The series included 69 eyes (64 patients). Single-surgery anatomic success (SSAS) was achieved in 75% and final anatomic success (FAS) in 90%. The mean logMAR visual acuity improved from 1.5 ± 1.1 to 0.6 ± 0.9. Preoperative factors significantly associated with redetachment were proliferative vitreoretinopathy (PVR) (odds ratio [OR], 6.2; P < .01), hypotony (OR, 13.6; P < .01), and a 180-degree or larger GRT (OR, 3.3; P = .04). All cases were treated with pars plana vitrectomy (PPV) and perfluoro-N-octane (PFCL). Perfluoropropane (C3F8) was used in 59% and silicone oil in 41%; the redetachment rate was significantly lower in gas cases (15% vs 39%) (P = .02). An encircling band, placed in 84% eyes, had a tendency to reduce redetachment (22% vs 36%) (P = .32). Lensectomy was performed in 61% of phakic eyes, with no effect on redetachment (20% vs 21%) (P = .92). On multivariate analysis, PVR and hypotony were significantly associated with redetachment. Conclusions: PPV with PFCL achieved high SSAS and FAS rates. PVR and hypotony were the main preoperative factors associated with anatomic failure. In cases without PVR, C3F8 tamponade significantly increased SSAS. Encircling scleral buckling showed a nonsignificant tendency toward an increase in SSAS. Lensectomy had no effect on SSAS.

Gonorrhoea diagnoses in a network of STI clinics in Spain during the period 2006-2010: differences by sex and transmission route.

BACKGROUND: Gonorrhoea infection is one of the most common bacterial sexually transmitted infections and an important cause of morbidity and serious complications. The objectives of this paper are: a) to describe gonorrhoea cases diagnosed in a network of 15 (out of 16) STI clinics in Spain during 2006-2010; b) to analyse differences among men who have sex with men (MSM), men who have sex exclusively with women (MSW) and women; and c) to evaluate factors associated to with HIV co-infection. METHODS: All gonorrhoea cases diagnosed in the network were included (25.7% of total cases notified in Spain). Data were collected by clinical staff. Descriptive/bivariate analyses were carried out stratifying by sex and transmission category; association and trends were evaluated using the chi-square test. Factors associated with HIV co-infection were estimated using a logistic regression model. RESULTS: 2385 cases were included: 55.3% among MSM, 31.3% among MSW and 13.3% among females; cases among MSM increased from 55.8% in 2006 to 62.9% in 2010 while no trends were found among the other two groups.Most MSM cases were Spaniards (72%), aged 25-34 years (46%), 49% reported previous STI and 25% concurrent STI (excluding HIV); casual partners were the commonest source of infection, and 21% of cases had rectal gonorrhoea. MSW cases did not differ from MSM by age, origin or source of infection, but frequencies of prior or concurrent STI were lower. Female cases were younger than male, were mostly foreigners (58%), and 41% were sex workers; concurrent STI (other than HIV) were diagnosed in 30%; 20.4% had symptoms (72.5% and 89.2% in MSM and MSW), and pharyngeal location was present in 30%.HIV co-infection was highest in MSM (20.9%). Co-infection was associated with age > 35 years, low educational level, being Western European or Latin-American, being MSM, having previous or concurrent STI and reporting contact with an HIV-infected partner; it was inversely associated with female sex. CONCLUSION: Differences by sex, transmission route and origin should be considered when implementing care and preventive programmes for gonorrhoea, and MSM are a priority group for intervention, in particular HIV-infected MSM.

Implantación de una prueba rápida de VIH en Asturias (España) / Introduction of a rapid HIV test in Sexually Transmitted Infections Units

Introducción: El estudio de la implantación de una prueba rápida de VIH en Asturias. Métodos Previa campaña de divulgación, se realizó en dos Unidades de ITS mediante el reactivo Determine® VIH1/2.ResultadosSe realizó en 1.011 usuarios. El 65,3% no tenían pruebas previas y el 71,4% eran heterosexuales. 21 pruebas fueron confirmadas por EIA/WB. Se produjo un aumento en el diagnóstico de VIH. Conclusión Campañas de sensibilización y pruebas rápidas de VIH parecen ser instrumentos eficaces para su diagnóstico precoz (AU)

Introduction: The aim of the study was to analyze the implementation of a rapid HIV test in Asturias(Spain).Methods: The study was conducted in two STI Units using the Determine®HIV-1/2 test. Results: A total of 1011 people were tested, of whom 65.3% had never been tested for HIV previously, and 71.4% were heterosexual men. Twenty-one tests were confirmed positive by Enzyme Immunoassay/Western Blot (EIA/WB) assay An increase was observed in the diagnosis of HIV. Conclusion: Awareness campaigns and rapid tests could be effective methods for the early diagnosis of HIV (AU)

[Introduction of a rapid HIV test in Sexually Transmitted Infections Units]. / Implantación de una prueba rápida de VIH en Asturias (España).

INTRODUCTION: The aim of the study was to analyze the implementation of a rapid HIV test in Asturias (Spain). METHODS: The study was conducted in two STI Units using the Determine® HIV-1/2 test. RESULTS: A total of 1011 people were tested, of whom 65.3% had never been tested for HIV previously, and 71.4% were heterosexual men. Twenty-one tests were confirmed positive by Enzyme Immunoassay/Western Blot (EIA/WB) assay An increase was observed in the diagnosis of HIV. CONCLUSION: Awareness campaigns and rapid tests could be effective methods for the early diagnosis of HIV.

Combination of qualitative and quantitative methods for developing a new Health Related Quality of Life measure for patients with anogenital warts.

BACKGROUND: Anogenital warts are the most easily recognized sign of genital Human Papilloma Virus infection. The objective was to develop a short, valid and reliable questionnaire to measure Health Related Quality of Life (HRQL) in patients with anogenital warts. METHODS: First a literature review was performed to identify relevant papers describing the impact of anogenital warts in HRQL; second the main domains were identified by some experts in a focus group, and third in-depth-semi-structured interviews were conducted in patients with anogenital warts to identify the initial set of items. A qualitative reduction of the initial set of items was performed based on the mean scoring of the experts for the three scales: clarity, frequency and importance. The initial questionnaire was pilot tested in 135 patients. Rasch analysis was performed with the results of the questionnaire in order to refine the instrument. Spearman's correlation was calculated between the initial questionnaire and the reduced version. Additionally the measurement properties (validity and reliability) of the resulting final questionnaire were tested and compared using standard procedures (Cronbach's Alpha and item-total correlation). RESULTS: the main domains identified as affected in patient's life were: sexual, colleagues and partner relationships. After a proper qualitative reduction the initial set of 134 items was reduced to 22. The questionnaire was pilot tested in 135 patients and two dimensions were identified after the multifactorial analysis: emotional dimension and sexual activity dimension. As a result of the Rasch analysis the questionnaire was reduced to 10 items. High correlation was found between the initial and the reduced version for the two dimensions. Cronbach's alpha values were acceptable (0.86). CONCLUSION: The initial 22 items questionnaire was reduced by Rasch analysis to a version of 10 items, with two dimensions: emotional and sexual. The results suggest the adequacy of the 10 items to evaluate HRQL of patients with anogenital warts in a valid and reliable way.

Prevalencia de VIH entre las personas de ocho ciudades españolas que se realizan la serología tras exposiciones heterosexuales, 1992-2003 / HIV prevalence among individuals having had serology performed in eight spanish cities following heterosexual exposure, 1992-2003

Fundamento: La epidemia de infecciones por el virus de la inmunodeficiencia humana (VIH) en España se caracterizó durante los primeros años por el predominio de casos en personas usuarias de drogas inyectadas, pero en la actualidad todo parece apuntar a un progresivo predominio de la transmisión sexual. El objetivo de este trabajo es describir la evolución en la prevalencia de VIH en varios grupos de población heterosexual y caracterizar las situaciones en las que se produjeron las infecciones. Métodos: Estudio descriptivo de las personas que se realizaron la prueba por primera vez en nueve centros de diagnóstico de VIH entre 1992 y 2003 por exposiciones heterosexuales de riesgo, excluyéndose a los usuarios de drogas inyectadas. Resultados: El número de personas en las que se determinó la serología fue de 47.870. La prevalencia de VIH en la población estudiada descendió del 3,2% al 1,0% (p<0,001). En las personas con pareja con diagnóstico de infección por VIH la prevalencia se mantuvo en torno al 10%, en hombres usuarios de prostitución descendió del 1,9% al 1,0% (p=0,049), en las mujeres que ejercen la prostitución del 1,4% al 0,7% (p=0,008), y en el resto de heterosexuales disminuyó del 1,6% al 1,0% en hombres (p=0,014) y del 1,1% al 0,7% en mujeres (p=0,012). Conclusiones: Los resultados indican avances en el control de la transmisión heterosexual del VIH, principalmente en mujeres, aunque todavía se requiere insistir en la prevención (AU)

Background: The human immunodeficiency virus (HIV) epidemic in Spain was characterized throughout the first few years by the predominance of infections among injected drug users (IDU's), but everything currently points to a progressive predominance of sexual transmission. This study is aimed at describing the trend in HIV infection among several heterosexual populations groups and at characterizing the situations in which the infections occurred. Methods: Descriptive study of the individuals who had the test conducted for the first time at nine HIV diagnosis centres within the 1992-2003 period due to high-risk heterosexual exposures, not including injected drug users. Results: A total of 47,870 individuals had serology performed during the period under study. The HIV prevalence among the population under study dropped from 3.2% to 1.0% (p< 0.001). Among the individuals with an HIV infected partners, the prevalence remained at around 10%, the male users of prostitution having dropped from 1.9% to 1.0% (p=0.049); among women involved in prostitution, from 1.4% to 0.7% (p=0.008); and among all other heterosexuals, having dropped from 1.6% to 1.0% among males (p=0.014) and from 1.1% to 0.7% among women (p=0.012). Conclusions: The results indicate advances in the control of heterosexual human immunodeficiency virus transmission, mainly among women, although it is necessary to still continue stressing prevention (AU)

[Up to date in sexually transmitted infections: epidemiology, diagnostic approaches and treatments]. / Actualización en infecciones de transmisión sexual: epidemiología, diagnóstico y tratamiento.

In the last years, there have been important advances in sexually transmitted infections such as genome sequencing of Treponema pallidum, Chlamydia trachomatis or Mycoplasma genitalium; the new taxonomic position of Calymmatobacterium granulomatis; commercial diagnostic systems based on nucleic acid amplification; the emergence of quinolone resistance in Neisseria gonorrhoeae; new therapeutic approaches in vulvovaginal candidiasis that include boric acid; the demonstration that valacyclovir reduces the risk of transmission of genital herpes or the availability of immune-response modifier in the treatment of genital warts, and that are questions in the goal of this review. Viral hepatitis and HIV were no reviewed by space reasons.

Actualización en infecciones de transmisión sexual: epidemiología, diagnóstico y tratamiento / Up to date in sexually transmitted infections: epidemiology, diagnostic approaches and treatments

En los últimos años ha habido importantes novedades en el campo de las infecciones de transmisión sexual como la secuenciación del genoma de Treponema pallidum, de Chlamydia trachomatis o de Mycoplasma genitalium; la reclasificación taxonómica de Calymmatobacterium granulomatis; la implantación de sistemas comerciales de diagnóstico basados en la amplificación de ácidos nucleicos; la aparición de resistencias a quinolonas en Neisseria gonorrhoeae; nuevos esquemas de actuación en las candidiasis vulvovaginales que incluyen compuestos como el ácido bórico; la demostración que valaciclovir reduce la transmisibilidad del herpes genital o el empleo de inmunomoduladores en las verrugas genitales, y que constituyen el objetivo entre otros de esta revisión. Por razones de espacio, y por constituir unidades con cierta independencia, no se abordan cuestiones relativas al virus de la inmunodeficiencia humana ni a las hepatitis virales (AU)

[HIV prevalence among individuals having had serology performed in eight Spanish cities following heterosexual exposure, 1992-2003]. / Prevalencia de VIH entre las personas de ocho ciudades Españolas que se realizan la serología tras exposiciones heterosexuales, 1992-2003.

BACKGROUND: The human immunodeficiency virus (HIV) epidemic in Spain was characterized throughout the first few years by the predominance of infections among injected drug users (IDU's), but everything currently points to a progressive predominance of sexual transmission. This study is aimed at describing the trend in HIV infection among several heterosexual populations groups and at characterizing the situations in which the infections occurred. METHODS: Descriptive study of the individualls who had the test conducted for the first time at nine HIV diagnosis centres within the 1992-2003 period due to high-risk heterosexual exposures, not including injected drug users. RESULTS: A total of 47,870 individuals had serology performed during the period under study. The HIV prevalence among the population under study dropped from 3.2% to 1.0% (p< 0.001). Among the individuals with an HIV infected partners, the prevalence remained at around 10%, the male users of prostitution having dropped from 1.9% to 1.0% (p=0.049); among women involved in prostitution, from 1.4% to 0.7% (p=0.008); and among all other heterosexuals, having dropped from 1.6% to 1.0% among males (p=0.014) and from 1.1% to 0.7% among women (p=0.012). CONCLUSIONS: The results indicate advances in the control of heterosexual human immunodeficiency virus transmission, mainly among women, although it is necessary to still continue stressing prevention.

Prevalencia de Chlamydia trachomatis en población de riesgo de Asturias / Prevalence of Chlamydia trachomatis in an Asturian population at risk

No disponible