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1.
In. Argentina. Ministerio de Salud. Comisión Nacional Salud Investiga. Becas de investigación Ramón Carrillo - Arturo Oñativia: anuario 2010. Buenos Aires, Ministerio de Salud, 2012. p.152-153. (127614).
Monografia em Inglês, Espanhol | ARGMSAL | ID: biblio-992243

RESUMO

INTRODUCCION: Una mujer embarazada con sífilis puede transmitir al niño la sífilis congénita (SC), cuya definición de caso incluye a hijos de mujeres con sífilis que no recibieron tratamiento adecuado. La sífilis cuenta con tratamiento efectivo desde 1943, y la SC puede prevenirse con estrategias simples de atención primaria. La enfermedad produce morbilidad por causas prevenibles, agrava la mortalidad infantil y afecta a un número de niños mayor que cualquier otra infección neonatal. Además, impacta en poblaciones con vulnerabilidad incrementada. Su persistencia es un problema de salud pública y constituye un evento centinela de la infección en la población.OBJETIVO: n los factores asociados a la SC y los obstáculos de su vigilancia epidemiológica en dos hospitales públicos de la Ciudad de Buenos Aires durante cuatro meses de 2010.METODOS: Se utilizó un diseño de estudio de caso de niños expuestos a transmisión vertical de sífilis de carácter descriptivo, longitudinal y prospectivo, a partir del evento "mujer con serología positiva para sífilis en puerperio". El estudio incluyó además a la pareja.RESULTADOS: Se analizó la atención del embarazo en 46 mujeres (2 con gemelares), de las cuales 37 accedieron a serología para sífilis, 21 recibieron al menos una dosis de penicilina y solamente 3 tratamiento completo y adecuado. Hubo 48 casos de niños con SC según definición de caso, de los cuales 4 (8%) fallecieron y 12 (25%) tuvieron diagnóstico negativo, mientras que de 32 (67%) no se obtuvo el diagnóstico definitivo. Hubo 22 niños (46%) sin seguimiento.CONCLUSIONES: La búsqueda activa de casos mostró resultados que deben funcionar como alerta. La investigación se realizó en un escenario con disponibilidad de recursos asistenciales, diagnósticos y terapéuticos, pero los datos demuestran que aún hay dificultades para realizar un abordaje integral y efectivo de la infección, lo que revela deficiencias estructurales y técnicas en los servicios de salud.


INTRODUCTION: A pregnant woman with syphilis can pass the congenital syphilis (CS) to the child. CS definition includes children of women with syphilis who did not receive an appropiate treatment. Syphilis has an effective treatment since 1943, and the CS can be prevented with simple strategies for primary care. The disease produces morbidity from preventable causes, increasing child mortality and affecting a higher number of infants than any other neonatal infection. It also has a negative impact on populations with increased vulnerability, and its persistence poses a public health problem and can be considered a sentinel event.OBJECTIVE: To investigate the factors associated with CS and the obstacles for epidemiological surveillance in two hospitals of Buenos Aires City during four months in 2010.METHODS: A case study of children exposed to vertical transmission of syphilis was conducted, with a descriptive, longitudinal and prospective design. It took into account the event "woman with positive serology for syphilis in puerperium", including also her partner.RESULTS: The process was analyzed in 46 women (2 with twins), of which 37 agereed to perform serology for syphilis, 21 received at least one dose of penicilin and only 3 were administered a full and adequate treatment. There were 48 cases of children with CD as defined by case, of which 4 (8%) died, 12 (25%) had negative diagnosis and 32 (67%) did not obtain a definitive diagnosis. There were 22 children (46%) without follow-up.CONCLUSIONS: The active search for cases showed results which should be a warning. The research was conducted in a scenario with availability of health care, diagnostic and therapeutic resources, but the data revealed that there are still dificulties to provide a comprehensive and effective approach of the infection, showing structural and technical deficiencies in health services.


Assuntos
Seguimentos , Serviços de Saúde , Sífilis Congênita , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Argentina , Saúde Pública
2.
In. Argentina. Ministerio de Salud. Comisión Nacional Salud Investiga. Becas de investigación Ramón Carrillo - Arturo Oñativia: anuario 2010. Buenos Aires, Ministerio de Salud, 2012. p.152-153. (127548).
Monografia em Inglês, Espanhol | BINACIS | ID: bin-127548

RESUMO

INTRODUCCION: Una mujer embarazada con sífilis puede transmitir al niño la sífilis congénita (SC), cuya definición de caso incluye a hijos de mujeres con sífilis que no recibieron tratamiento adecuado. La sífilis cuenta con tratamiento efectivo desde 1943, y la SC puede prevenirse con estrategias simples de atención primaria. La enfermedad produce morbilidad por causas prevenibles, agrava la mortalidad infantil y afecta a un número de niños mayor que cualquier otra infección neonatal. Además, impacta en poblaciones con vulnerabilidad incrementada. Su persistencia es un problema de salud pública y constituye un evento centinela de la infección en la población.OBJETIVO: n los factores asociados a la SC y los obstáculos de su vigilancia epidemiológica en dos hospitales públicos de la Ciudad de Buenos Aires durante cuatro meses de 2010.METODOS: Se utilizó un diseño de estudio de caso de niños expuestos a transmisión vertical de sífilis de carácter descriptivo, longitudinal y prospectivo, a partir del evento "mujer con serología positiva para sífilis en puerperio". El estudio incluyó además a la pareja.RESULTADOS: Se analizó la atención del embarazo en 46 mujeres (2 con gemelares), de las cuales 37 accedieron a serología para sífilis, 21 recibieron al menos una dosis de penicilina y solamente 3 tratamiento completo y adecuado. Hubo 48 casos de niños con SC según definición de caso, de los cuales 4 (8%) fallecieron y 12 (25%) tuvieron diagnóstico negativo, mientras que de 32 (67%) no se obtuvo el diagnóstico definitivo. Hubo 22 niños (46%) sin seguimiento.CONCLUSIONES: La búsqueda activa de casos mostró resultados que deben funcionar como alerta. La investigación se realizó en un escenario con disponibilidad de recursos asistenciales, diagnósticos y terapéuticos, pero los datos demuestran que aún hay dificultades para realizar un abordaje integral y efectivo de la infección, lo que revela deficiencias estructurales y técnicas en los servicios de salud.


INTRODUCTION: A pregnant woman with syphilis can pass the congenital syphilis (CS) to the child. CS definition includes children of women with syphilis who did not receive an appropiate treatment. Syphilis has an effective treatment since 1943, and the CS can be prevented with simple strategies for primary care. The disease produces morbidity from preventable causes, increasing child mortality and affecting a higher number of infants than any other neonatal infection. It also has a negative impact on populations with increased vulnerability, and its persistence poses a public health problem and can be considered a sentinel event.OBJECTIVE: To investigate the factors associated with CS and the obstacles for epidemiological surveillance in two hospitals of Buenos Aires City during four months in 2010.METHODS: A case study of children exposed to vertical transmission of syphilis was conducted, with a descriptive, longitudinal and prospective design. It took into account the event "woman with positive serology for syphilis in puerperium", including also her partner.RESULTS: The process was analyzed in 46 women (2 with twins), of which 37 agereed to perform serology for syphilis, 21 received at least one dose of penicilin and only 3 were administered a full and adequate treatment. There were 48 cases of children with CD as defined by case, of which 4 (8%) died, 12 (25%) had negative diagnosis and 32 (67%) did not obtain a definitive diagnosis. There were 22 children (46%) without follow-up.CONCLUSIONS: The active search for cases showed results which should be a warning. The research was conducted in a scenario with availability of health care, diagnostic and therapeutic resources, but the data revealed that there are still dificulties to provide a comprehensive and effective approach of the infection, showing structural and technical deficiencies in health services.


Assuntos
Sífilis Congênita , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Seguimentos , Serviços de Saúde , Argentina , Saúde Pública
3.
Medicina (B Aires) ; 64(5): 413-8, 2004.
Artigo em Espanhol | MEDLINE | ID: mdl-15560542

RESUMO

We studied the prevalence of antibodies against HTLV-1 among every HIV-infected outpatients assisted in our hospital between January 1st 2000 and June 30th 2003. We reviewed the epidemiological data, clinical findings, viral load and CD4 cells-count, comparing coinfected with non HTLV-1 coinfected. We found a prevalence of HTLV-1 infection of 8.1% (23/282); 8.5% (12/141) in men and 7.8% (11/141) in women [[OR=0.91 (0.36

Assuntos
Infecções por HIV/epidemiologia , Infecções por HTLV-I/epidemiologia , Adolescente , Adulto , Argentina/epidemiologia , Contagem de Linfócito CD4 , Feminino , Infecções por HIV/imunologia , Infecções por HIV/virologia , Infecções por HTLV-I/imunologia , Infecções por HTLV-I/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Estudos Prospectivos , Estudos Soroepidemiológicos , Fatores Sexuais , Carga Viral
4.
Medicina (B Aires) ; 64(4): 325-31, 2004.
Artigo em Espanhol | MEDLINE | ID: mdl-15338975

RESUMO

Osteonecrosis, also known as avascular necrosis, is chiefly characterized by death of bone caused by vascular compromise. The true incidence of osteonecrosis in HIV-infected patients is not well known and the pathogenesis remains undefined. Hypothetical risk factors peculiar to HIV-infected individuals that might play a role in the pathogenesis of osteonecrosis include the introduction of protease inhibitors and resulting hyperlipidemia, the presence of anticardiolipin antibodies in serum leading to a hypercoagulable state, immune recovery and vasculitis. Hereby we present a series of 13 HIV-infected patients with osteonecrosis. The most common symptom upon presentation was arthralgia. The majority of the patients had received steroids, 9 had developed hyperlipidemia after the introduction of HAART, 8 were smokers and 4 patients were alcoholics. In 2 patients, seric anticardiolipin antibodies were detected. Twelve patients had AIDS and were on HAART (11 were on protease inhibitors). We believe that osteonecrosis should be included as differential diagnosis of every HIV-infected patient who complains of pain of weight bearing joints. Likewise, it seems prudent to rule out HIV infection in subjects with osteonecrosis.


Assuntos
Infecções por HIV/complicações , Osteonecrose/complicações , Síndrome de Imunodeficiência Adquirida/complicações , Adulto , Artralgia/diagnóstico , Diagnóstico Diferencial , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Osteonecrose/diagnóstico , Osteonecrose/etiologia , Inibidores de Proteases/efeitos adversos , Fatores de Risco
5.
Medicina (B.Aires) ; 64(4): 331, 2004. tab
Artigo em Espanhol | LILACS | ID: lil-401069

RESUMO

Según la literatura, la osteonecrosis tiene una mayor incidencia en los pacientes infectados con HIV que en la población general. Ello sería resultado de la confluencia de factores de riesgo clásicos y de otros propios de esta población o más prevalentes en ella, como el tratamiento con inhibidores de proteasa, la dislepemia producto de su consumo, la presencia de anticuerpos anticardiolipina séricos, la hipercoagulabilidad, la restauración inmune y las vasculitis. Presentamos una serie de 13 pacientes infectados con HIV con osteonecrosis. El motivo de consulta fue dolor en grandes articulaciones. Cuatro eran alcoholistas, 8 tabaquistas y 9 tenían dislipemia. Once habían recibido esteroides en algún momento de la vida aunque sólo uno estaba reciciéndolos al momento de inicio del dolor. En 2 se detectaron anticuerpos anticardiolipina séricos. Doce tenían sida y recebían tratamiento antirretroviral de alta eficacia (11 con inhibidores de proteasa). Ellos lograron una adecuada recuperacíon inmunológica. Consideramos necesario incluir la osteonecrosis como diagnóstico diferencial de artralgia persistente en pacientes infectados con HIV e investigar infección por HIV en todo paciente con osteonecrosis sin claros factores predisponentes.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Infecções por HIV/complicações , Osteonecrose/complicações , Síndrome de Imunodeficiência Adquirida/complicações , Artralgia/diagnóstico , Diagnóstico Diferencial , Osteonecrose/diagnóstico , Osteonecrose/etiologia , Inibidores de Proteases/efeitos adversos , Fatores de Risco
6.
Medicina (B.Aires) ; 64(4): 325-31, 2004.
Artigo em Espanhol | BINACIS | ID: bin-38655

RESUMO

Osteonecrosis, also known as avascular necrosis, is chiefly characterized by death of bone caused by vascular compromise. The true incidence of osteonecrosis in HIV-infected patients is not well known and the pathogenesis remains undefined. Hypothetical risk factors peculiar to HIV-infected individuals that might play a role in the pathogenesis of osteonecrosis include the introduction of protease inhibitors and resulting hyperlipidemia, the presence of anticardiolipin antibodies in serum leading to a hypercoagulable state, immune recovery and vasculitis. Hereby we present a series of 13 HIV-infected patients with osteonecrosis. The most common symptom upon presentation was arthralgia. The majority of the patients had received steroids, 9 had developed hyperlipidemia after the introduction of HAART, 8 were smokers and 4 patients were alcoholics. In 2 patients, seric anticardiolipin antibodies were detected. Twelve patients had AIDS and were on HAART (11 were on protease inhibitors). We believe that osteonecrosis should be included as differential diagnosis of every HIV-infected patient who complains of pain of weight bearing joints. Likewise, it seems prudent to rule out HIV infection in subjects with osteonecrosis.

7.
Medicina (B.Aires) ; 64(5): 413-8, 2004.
Artigo em Espanhol | BINACIS | ID: bin-38569

RESUMO

We studied the prevalence of antibodies against HTLV-1 among every HIV-infected outpatients assisted in our hospital between January 1st 2000 and June 30th 2003. We reviewed the epidemiological data, clinical findings, viral load and CD4 cells-count, comparing coinfected with non HTLV-1 coinfected. We found a prevalence of HTLV-1 infection of 8.1


(23/282); 8.5


(12/141) in men and 7.8


(11/141) in women [[OR=0.91 (0.36

(16/129) among patients users of illicit drugs and 4.6


(7/152) among non-users [OR=2.93 (1.09

(16/77) in injecting drugs users (IDU) and 3.4


(7/205) in non-IDU patients [p=0.000006 OR=7.42 (2.71

8.
Medicina (B.Aires) ; 64(4): 25, 2004. tab
Artigo em Espanhol | BINACIS | ID: bin-2350

RESUMO

Según la literatura, la osteonecrosis tiene una mayor incidencia en los pacientes infectados con HIV que en la población general. Ello sería resultado de la confluencia de factores de riesgo clásicos y de otros propios de esta población o más prevalentes en ella, como el tratamiento con inhibidores de proteasa, la dislepemia producto de su consumo, la presencia de anticuerpos anticardiolipina séricos, la hipercoagulabilidad, la restauración inmune y las vasculitis. Presentamos una serie de 13 pacientes infectados con HIV con osteonecrosis. El motivo de consulta fue dolor en grandes articulaciones. Cuatro eran alcoholistas, 8 tabaquistas y 9 tenían dislipemia. Once habían recibido esteroides en algún momento de la vida aunque sólo uno estaba reciciéndolos al momento de inicio del dolor. En 2 se detectaron anticuerpos anticardiolipina séricos. Doce tenían sida y recebían tratamiento antirretroviral de alta eficacia (11 con inhibidores de proteasa). Ellos lograron una adecuada recuperacíon inmunológica. Consideramos necesario incluir la osteonecrosis como diagnóstico diferencial de artralgia persistente en pacientes infectados con HIV e investigar infección por HIV en todo paciente con osteonecrosis sin claros factores predisponentes. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Osteonecrose/complicações , Infecções por HIV/complicações , Osteonecrose/diagnóstico , Osteonecrose/etiologia , Síndrome de Imunodeficiência Adquirida/complicações , Inibidores de Proteases/efeitos adversos , Fatores de Risco , Diagnóstico Diferencial , Artralgia/diagnóstico
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