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1.
Int Braz J Urol ; 45(6): 1227-1237, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31808412

RESUMO

INTRODUCTION: Children with a solitary post-nephrectomy kidney (SNK) are at potential risk of developing kidney disease later in life. In response to the global decline in the number of nephrons, adaptive mechanisms lead to renal injury. The aim of this study was to determine the prevalence and time of onset of high blood pressure (HBP), proteinuria, glomerular filtration rate (GFR) disruption and renal tubular acidosis (RTA) in children with SNK. MATERIALS AND METHODS: After obtaining the approval from our institution's ethics committee, we reviewed the medical records of patients under 18 years of age who underwent unilateral nephrectomy between January 2005 and December 2015 in three university hospitals. RESULTS: We identifi ed 43 patients, 35 (81.4%) cases of unilateral nephrectomy (UNP) were due to a non-oncologic pathology and Wilm's tumor was identified in 8 (18.6%) cases. In patients with non-oncologic disease, 9.3% developed de novo hypertension, with an average time of onset of 7.1 years, 25% developed proteinuria de novo, with an average time of onset of 2.2 years. For GFR, 21.8% presented deterioration of the GFR in an average time of 3.4 years. Ten (43.5%) patients developed some type of de novo renal injury after UNP. Patients with oncolo-gic disease developed the conditions slowly and none of them developed proteinuria. CONCLUSIONS: Taking into account the high rate of long term postoperative renal injury, it can be considered that nephrectomy does not prevent this disease. The follow-up of children with SNK requires a multidisciplinary approach and long-term surveillance to detect renal injury.


Assuntos
Nefrectomia/efeitos adversos , Rim Único/epidemiologia , Rim Único/fisiopatologia , Acidose Tubular Renal/epidemiologia , Acidose Tubular Renal/fisiopatologia , Adolescente , Idade de Início , Criança , Pré-Escolar , Colômbia/epidemiologia , Feminino , Seguimentos , Taxa de Filtração Glomerular/fisiologia , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Lactente , Recém-Nascido , Masculino , Período Pós-Operatório , Prevalência , Prognóstico , Proteinúria/epidemiologia , Proteinúria/fisiopatologia , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/fisiopatologia , Estudos Retrospectivos , Fatores de Risco
2.
Rev Soc Bras Med Trop ; 53: e20190132, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31859943

RESUMO

INTRODUCTION: In Colombia, there is insufficient epidemiological surveillance of zoonotic hemorrhagic viruses. METHODS: We performed a sero-epidemiological study in indigenous populations of Wayuü, Kankuamos, and Tuchin communities using Maciel hantavirus and Junin arenavirus antigens for IgG detection by ELISA. RESULTS: IgG antibodies to hantavirus and arenavirus were found in 5/506 (1%) and 2/506 (0.4%) serum samples, respectively. CONCLUSIONS: Arenavirus and hantavirus circulate in indigenous populations from the Colombian Caribbean region, and the results indicate that the indigenous populations are exposed to these zoonotic agents, with unknown consequences on their health, despite low seroprevalence.


Assuntos
Anticorpos Antivirais/sangue , Infecções por Arenaviridae/epidemiologia , Arenavirus/imunologia , Infecções por Hantavirus/epidemiologia , Hantavirus/imunologia , Imunoglobulina G/sangue , Índios Sul-Americanos , Adulto , Infecções por Arenaviridae/diagnóstico , Colômbia/epidemiologia , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Infecções por Hantavirus/diagnóstico , Humanos , Masculino , Fatores de Risco , Estudos Soroepidemiológicos
3.
Rev Chilena Infectol ; 36(4): 447-454, 2019 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-31859768

RESUMO

BACKGROUND: Escherichia coli is a common cause of a broad spectrum of infections, from non-complicated urinary tract infection, to severe sepsis and septic shock, that are associated to high impact outcomes, such as ICU admission and mortality. AIMS: To establish differences in mortality, ICU admission, ESBL positive strains and antibiotic treatment, between patients with E. coli related severe sepsis and septic shock, with or without bacteremia and its variability based on the source of infection. METHOD: Secondary data analysis of a multicentric prospective cohort study. RESULTS: From 458 patients with E. coli isolation, 123 had E. coli exclusively in blood culture, 222 solely in urine culture, and 113 in both samples. Escherichia coli isolation exclusively in blood culture was associated with higher frequency of ICU admission (n = 63; 51.2%), higher rate of mechanical ventilation requirement (n = 19; 15.5%), higher mortality and longer hospital stay (n = 22; 18%; median of 12 days, IQR= 7 - 17, respectively); but with a lower occurrence of ESBL strains, compared to patients with positive urine culture and positive blood/urine cultures (n = 20; 17.7% and n = 46; 20.7%, respectively). 424 patients (92.6%) received antibiotic treatment in the first 24 hours. The most commonly prescribed was piperacilin/tazobactam (n = 256;60.3%). The proportion of patients empirically treated with carbapenems vs non-carbapenems was similar in the three groups. DISCUSSION: The source of infection, associated with ESBL strains risk factors, are useful tools to define prognosis and treatment in this population, because of their clinical and microbiological variability. CONCLUSION: Patients with E. coli isolation exclusively in the blood culture had higher frequency of non-favorable outcomes in comparison to patients with E. coli in urine culture with or without bacteremia. Additionally, in our population patients with E. coli solely in blood culture have lower prevalence of ESBL positive strains.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Infecções por Escherichia coli/mortalidade , Escherichia coli/isolamento & purificação , Sepse/microbiologia , Choque Séptico/microbiologia , Adulto , Idoso , Colômbia/epidemiologia , Escherichia coli/efeitos dos fármacos , Infecções por Escherichia coli/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sepse/tratamento farmacológico , Sepse/mortalidade , Choque Séptico/tratamento farmacológico , Choque Séptico/mortalidade
4.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 46(4): 143-147, oct.-dic. 2019. graf
Artigo em Espanhol | IBECS | ID: ibc-184301

RESUMO

Introducción: La fertilidad y la virilidad suelen relacionarse socialmente con el concepto de masculinidad; esto genera cierto grado de incertidumbre debido a que podría conllevar una serie de procesos emocionales al relacionar los conceptos anteriores con la palabra infertilidad. Objetivo: El objetivo del presente trabajo fue relacionar las respuestas sobre las percepciones de la calidad seminal con algunos conceptos relacionados con la masculinidad. Materiales y métodos: Se llevó a cabo una encuesta virtual anónima a 500 hombres en la cual se realizaron preguntas con relación a la percepción de algunas variables sobre la calidad seminal. Resultados: Respecto a la pregunta ¿para usted qué significa tener un conteo alto de espermatozoides?, en hombres con y sin pareja la respuesta más frecuente fue buena capacidad para fecundar, siendo mayor en hombres con pareja (p = 0,013); en contraste, la segunda respuesta más frecuente (buena salud) fue más alta en el grupo que no tenía pareja (p = 0,028), mientras que la mayoría de los participantes respondieron que no sentirían nada (58,8% sin pareja y 64,5% con pareja) frente a las preguntas ¿qué sentiría si tiene un conteo bajo de espermatozoides? y ¿qué sentiría si no tiene ningún espermatozoide?, respectivamente. Por otro lado, en cuanto a la respuesta «avergonzado», los participantes sin pareja decían sentirse más avergonzados en ambas preguntas (p = 0,011 y p = 0,0057). Conclusión: El termino infertilidad debería ser usado cuidadosamente, pues es de gran impacto en la vida del individuo, afecta tanto el bienestar de la pareja como el bienestar psicosocial y la propia satisfacción sexual


Introduction: Fertility and virility are often socially related to the concept of masculinity, and this generates a certain degree of uncertainty because it could lead to a series of emotional processes by relating these concepts with the word infertility. Objective: The objective of the present work was to relate the responses on the perceptions of seminal quality with some concepts related to masculinity. Materials and methods: An anonymous virtual survey of 500 men was carried out, in which questions were asked regarding the perception of some variables on seminal quality. Results: As regards the question, 'what does it mean for you to have a high sperm count?'; in men with and without partners, the most frequent response was, good ability to fecundate, being higher in men with a partner (P = .013). In contrast, the second most frequent response (good health) was higher in the group that had no partner (P = .028). While the majority of participants answered that they would not feel anything (58.8% without a partner, and 64.5% with a partner) in response to the questions, 'How would you feel if you have a low sperm count?', and 'How would you feel if you did not have any sperm?', respectively. On the other hand, as regards the response 'embarrassed', the participants without a partner said they felt more embarrassed in both questions (P = .011 and P = .0057). Conclusion: The term infertility should be used carefully, since it has a significant impact an individual's life. It affects the well-being of the couple, as well as psychosocial well-being and sexual satisfaction itself


Assuntos
Humanos , Masculino , Fertilidade/fisiologia , Análise do Sêmen , Comportamento Sexual/estatística & dados numéricos , Infertilidade Masculina/epidemiologia , Masculinidade , Coito/fisiologia , Contagem de Espermatozoides/estatística & dados numéricos , Colômbia/epidemiologia
5.
BMC Infect Dis ; 19(1): 963, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718580

RESUMO

BACKGROUND: Colombia was the second most affected country during the American Zika virus (ZIKV) epidemic, with over 109,000 reported cases. Despite the scale of the outbreak, limited genomic sequence data were available from Colombia. We sought to sequence additional samples and use genomic epidemiology to describe ZIKV dynamics in Colombia. METHODS: We sequenced ZIKV genomes directly from clinical diagnostic specimens and infected Aedes aegypti samples selected to cover the temporal and geographic breadth of the Colombian outbreak. We performed phylogeographic analysis of these genomes, along with other publicly-available ZIKV genomes from the Americas, to estimate the frequency and timing of ZIKV introductions to Colombia. RESULTS: We attempted PCR amplification on 184 samples; 19 samples amplified sufficiently to perform sequencing. Of these, 8 samples yielded sequences with at least 50% coverage. Our phylogeographic reconstruction indicates two separate introductions of ZIKV to Colombia, one of which was previously unrecognized. We find that ZIKV was first introduced to Colombia in February 2015 (95%CI: Jan 2015 - Apr 2015), corresponding to 5 to 8 months of cryptic ZIKV transmission prior to confirmation in September 2015. Despite the presence of multiple introductions, we find that the majority of Colombian ZIKV diversity descends from a single introduction. We find evidence for movement of ZIKV from Colombia into bordering countries, including Peru, Ecuador, Panama, and Venezuela. CONCLUSIONS: Similarly to genomic epidemiological studies of ZIKV dynamics in other countries, we find that ZIKV circulated cryptically in Colombia. More accurately dating when ZIKV was circulating refines our definition of the population at risk. Additionally, our finding that the majority of ZIKV transmission within Colombia was attributable to transmission between individuals, rather than repeated travel-related importations, indicates that improved detection and control might have succeeded in limiting the scale of the outbreak within Colombia.


Assuntos
Genoma Viral , Infecção por Zika virus/virologia , Zika virus/genética , Aedes/virologia , Animais , Colômbia/epidemiologia , Surtos de Doenças , Evolução Molecular , Variação Genética , Humanos , Filogenia , Filogeografia , Zika virus/classificação , Zika virus/isolamento & purificação , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/transmissão
6.
BMC Infect Dis ; 19(1): 888, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651247

RESUMO

BACKGROUND: Several Zika virus (ZIKV) outbreaks have occurred since October 2015. Because there is no effective treatment for ZIKV infection, developing an effective surveillance and warning system is currently a high priority to prevent ZIKV infection. Despite Aedes mosquitos having been known to spread ZIKV, the calculation approach is diverse, and only applied to local areas. This study used meteorological measurements to monitor ZIKV infection due to the high correlation between climate change and Aedes mosquitos and the convenience to obtain meteorological data from weather monitoring stations. METHODS: This study applied the Bayesian structured additive regression modeling approach to include spatial interactive terms with meteorological factors and a geospatial function in a zero-inflated Poisson model. The study area contained 32 administrative departments in Colombia from October 2015 to December 2017. Weekly ZIKV infection cases and daily meteorological measurements were collected. Mapping techniques were adopted to visualize spatial findings. A series of model selections determined the best combinations of meteorological factors in the same model. RESULTS: When multiple meteorological factors are considered in the same model, both total rainfall and average temperature can best assess the geographic disparities of ZIKV infection. Meanwhile, a 1-in. increase in rainfall is associated with an increase in the logarithm of relative risk (logRR) of ZIKV infection of at most 1.66 (95% credible interval [CI] = 1.09, 2.15) as well as a 1 °F increase in average temperature is significantly associated with at most 0.79 (95% CI = 0.12, 1.22) increase in the logRR of ZIKV. Moreover, after controlling rainfall and average temperature, an independent geospatial function in the model results in two departments with an excessive ZIKV risk which may be explained by unobserved factors other than total rainfall and average temperature. CONCLUSION: Our study found that meteorological factors are significantly associated with ZIKV infection across departments. The study determined both total rainfall and average temperature as the best meteorological factors to identify high risk departments of ZIKV infection. These findings can help governmental agencies monitor at risk areas according to meteorological measurements, and develop preventions in those at risk areas in priority.


Assuntos
Infecção por Zika virus/epidemiologia , Aedes/virologia , Animais , Teorema de Bayes , Colômbia/epidemiologia , Surtos de Doenças , Humanos , Masculino , Conceitos Meteorológicos , Mosquitos Vetores/virologia , Chuva , Risco , Temperatura Ambiente
7.
Parasitol Res ; 118(12): 3449-3457, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31659453

RESUMO

We assessed the risk for toxoplasmosis in 10 school restaurants in Armenia (Quindio, Colombia). We analyzed the presence of Toxoplasma gondii DNA in the food, water, and living and inert surfaces of school restaurants, and we correlated these findings with the results of food safety inspection scores and with the prevalence of specific anti-T. gondii antibodies in children who ate at these restaurants. Of the 213 samples, 6.1% were positive using PCR to test for T. gondii DNA. Positive samples were found in meat, water, cucumber, guava juice, inert surfaces, and living surfaces. In 60% (6/10) of the public school restaurants, there was at least one PCR T. gondii-positive sample. In 311 serum samples from children who attended the restaurants, 101 (33%) were positive for IgG and 12 (3.9%) for IgM anti-T. gondii. The median of the compound score for the fulfillment of inspection for food safety conditions was of 60.7% (range 50-72). Higher T. gondii PCR positivity in surfaces, food, or water at each restaurant was correlated with lower inspection scores for water supply and water storage conditions. Lower scores in physical infrastructure and disinfection procedures and higher scores in furniture were correlated with a higher prevalence of IgG anti-T. gondii in children who ate at those restaurants. Inspection scores can identify restaurants with a higher risk for the presence of T. gondii.


Assuntos
Contaminação de Alimentos/análise , Parasitologia de Alimentos , Toxoplasma/isolamento & purificação , Toxoplasmose/epidemiologia , Animais , Anticorpos Anti-Idiotípicos/sangue , Anticorpos Antiprotozoários/sangue , Armênia/epidemiologia , Criança , Colômbia/epidemiologia , Feminino , Inocuidade dos Alimentos , Humanos , Masculino , Carne/parasitologia , Prevalência , Restaurantes/estatística & dados numéricos , Fatores de Risco , Instituições Acadêmicas/estatística & dados numéricos , Toxoplasma/classificação , Toxoplasma/genética , Toxoplasmose/sangue , Toxoplasmose/diagnóstico , Toxoplasmose/parasitologia
8.
Acta Odontol Latinoam ; 32(2): 71-74, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31664296

RESUMO

Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease of unknown etiology. OLP has recently been linked to thyroid disease, mainly hypothyroidism. The aim of this study was to determine the prevalence of thyroid disease in Colombian patients with OLP. A total of860 clinical records of patients attending the clinics of oral medicine and oral and maxillofacial surgery at IPS CES Sabaneta, Colombia, between 2010 and 2016 were reviewed. Fourteen patients (1.6%) had a diagnosis of OLP. The prevalence of hypothyroidism in patients with OLP was 35.7%, compared to 3.95% in the entire study population (OR 15.92, 95% CI: 5.63-50.09, P = 0.0001). Patients with concomitant hypothyroidism and OLP presented with less severe oral lesions compared to those without thyroid disease. This study supports the notion that patients with OLP should be screened for thyroid disease.


Assuntos
Hipotireoidismo/epidemiologia , Líquen Plano Bucal/epidemiologia , Idoso , Colômbia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
9.
Acta Odontol Latinoam ; 32(2): 88-96, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31664299

RESUMO

The aim of this study was to determine the differences in arch length, inter-canine distance, inter-premolar distance, intermolar distance and arch shape between dental discrepancies (crowding and spacing) in a sample of dental casts from the Afro-Colombian population of San Basilio de Palenque. An analytical, cross-sectional study was conducted on a convenience sample of 63 subjects aged 11 to 57years, of Afro-Colombian origin, with full dentition from first molar to first molar, without extensive caries or restorations, and excluding casts with defects due to loss. The differences between arch (upper and lower) variables were analyzed according to dental discrepancies. Plaster models digitalized with a TR1OS3 Mono scanner with exactitude (6.9 ± 0.9 pm) and precision (4.5 ± 0.9 pm) were analyzed with Orthonalyzer software. Statistical analyses were done on SPSS software (Version 20 for Windows) and Real Statistics. Spacing discrepancy of68.25% was found for upper arch and 66.66% for lower arch; crowding discrepancy of 19.04% for upper arch and 20.63% for lower arch, and an adequate ratio of 12.69% for both arches. No statistically significant difference (p>0.05) was found between arch parameters except for inter-premolar distance on the lower arch. The most frequent arch shape in the population was oval for both upper arch, with 76.19%, and lower arch, with 71.42%. Tooth size was larger in males than females but the difference was not statistically significant.


Assuntos
Arco Dental/patologia , Má Oclusão/etiologia , Coroa do Dente/patologia , Adolescente , Adulto , Cefalometria/estatística & dados numéricos , Criança , Colômbia/epidemiologia , Estudos Transversais , Coroas , Modelos Dentários , Diastema/etiologia , Feminino , Humanos , Masculino , Má Oclusão/epidemiologia , Má Oclusão/patologia , Maxila/patologia , Pessoa de Meia-Idade , Odontometria/estatística & dados numéricos , Tamanho do Órgão , Adulto Jovem
10.
Emerg Microbes Infect ; 8(1): 1490-1500, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31631794

RESUMO

In 2014, the chikungunya virus reached Colombia for the first time, resulting in a nationwide epidemic. The objective of this study was to describe the demographics and clinical characteristics of suspected chikungunya cases. Chikungunya infection was confirmed by enzyme-linked immunosorbent assay and 548 patients where included in the study. Of these patients, 295 were positive for antibodies against chikungunya (53.8%), and 27.6% (151/295) were symptomatic for chikungunya infection, with a symptomatic:asymptomatic ratio of 1.04:1. Factors associated with infection included low income and low socio-economic strata (odds ratio [OR]: 1.8; 95% confidence interval [CI]: 1.0-3.2, p = 0.003 and OR: 2.1; CI: 1.3-3.4, p = 0.002, respectively). Confirmed symptomatic cases were associated with symmetric arthritis (OR: 11.7; CI: 6.0-23.0, p < 0.001) of ankles (OR: 8.5; CI: 3.5-20.9, p < 0.001), hands (OR: 8.5; CI: 3.5-20.9, p < 0.001), feet (OR: 6.5; CI: 2.8-15.3, p < 0.001), and wrists (OR: 17.3; CI: 2.3-130.5, p < 0.001). Our study showed that poverty is associated with chikungunya infection. Public health strategies to prevent and control chikungunya should focus on poorer communities that are more vulnerable to infection. The rate of asymptomatic infections among confirmed cases was 48.8%. However, those with symptoms displayed a characteristic rheumatic clinical picture, which could help differentiate chikungunya infection from other endemic viral diseases.


Assuntos
Febre de Chikungunya/virologia , Vírus Chikungunya/isolamento & purificação , Adolescente , Adulto , Idoso , Anticorpos Antivirais/sangue , Febre de Chikungunya/sangue , Febre de Chikungunya/diagnóstico , Febre de Chikungunya/epidemiologia , Vírus Chikungunya/genética , Vírus Chikungunya/imunologia , Cidades/estatística & dados numéricos , Estudos de Coortes , Colômbia/epidemiologia , Estudos Transversais , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
11.
An Acad Bras Cienc ; 91(3): e20180860, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31553367

RESUMO

The first cases of Zika virus infection in Colombia were reported and confirmed in October 2015. The objective of the study was estimate the seroprevalence of ZIKV infection during the pre-epidemic phase in Barranquilla, Colombia, and demonstrate the presence of virus before the Colombian Ministry of Health confirmed the first case. We conducted a descriptive study of the seroprevalence of Zika virus in 390 samples obtained from a blood bank located in Barranquilla, Colombia - a city endemic for dengue, and with a recent history of a Chikungunya disease epidemic. The serum pools were tested using Euroimmun ZIKV ELISA kit. Seroprevalence of Zika virus IgG were: May 2015: 0%, June and July 2015: 2.62% (95% CI = 0.28-12.13) and August 2015: 5.35% (95% CI = 1.74-16.74). This brings to our attention the need for extending the surveillance period of this virus in order to adequately assess its teratogenic effects.


Assuntos
Anticorpos Antivirais/sangue , Doadores de Sangue/estatística & dados numéricos , Imunoglobulina G/sangue , Infecção por Zika virus/sangue , Zika virus/imunologia , Colômbia/epidemiologia , Ensaio de Imunoadsorção Enzimática , Humanos , Estudos Soroepidemiológicos
12.
BMC Infect Dis ; 19(1): 793, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31500584

RESUMO

BACKGROUND: The HLA-B*57:01 allele is associated with a hypersensitivity reaction to abacavir. Due to the lack of knowledge of HLA-B*57:01 prevalence in Colombia, routine screening is not performed and is not recommended by the national guidelines. We aimed to determine the prevalence of HLA-B*57:01 in HIV population from Colombia. METHODS: This cross-sectional study included naïve HIV-infected adults from 13 cities of the country. The presence of HLA-B*57:01 was determined by using SSP-PCR in blood samples. Prevalence rates were stratified by sex, race, and region of origin. RESULTS: HLA-B*57:01 allele prevalence in Colombian HIV-infected individuals was 2.7%. When stratifying for the race, the prevalence was 4% for whites, 2.6% for other race (mainly mestizo), and 1.9% for Afro-Colombians. The prevalence varied from 0% up to 11.4% depending on the department of origin. The highest prevalence rates were found in Caldas (11.4%), Antioquia (5%), Risaralda (4.8%), and Valle del Cauca (4.3%). When distributed by country zones, the central, with a racial predominance of Caucasians and mestizos, was the highest (6.0%, 0R = 4.1, CI 1.2-12.8, p = 0,016). CONCLUSIONS: The overall prevalence of HLA-B*57:01 in Colombia was lower than the reported rates for other Latin American countries such as Brazil, Costa Rica, and Argentina, but similar in comparison to Chile and Mexico. The diversity in the racial and ethnic heritage shown in our data supports the recommendation to implement routine screening for the HLA-B*57:01 allele before initiation of abacavir-containing antiretroviral therapy in the Colombian HIV management guidelines.


Assuntos
Hipersensibilidade a Drogas/genética , Infecções por HIV/epidemiologia , Antígenos HLA-B/genética , Adulto , Alelos , Antirretrovirais/uso terapêutico , Colômbia/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
13.
Malar J ; 18(1): 276, 2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31426810

RESUMO

BACKGROUND: Parasites from the genus Plasmodium, the aetiological agent of malaria in humans, can also infect non-human primates (NHP), increasing the potential risk of zoonotic transmission with its associated global public health concerns. In Colombia, there are no recent studies on Plasmodium spp. infecting free-ranging NHP. Thus, this study aimed to determine the diversity of Plasmodium species circulating in fragmented forests in central Colombia, both in Anopheles mosquitoes and in the four sympatric NHP in the region (Ateles hybridus, Cebus versicolor, Alouatta seniculus and Aotus griseimembra), in order to evaluate the risk of infection to humans associated with the presence of sylvatic hosts and vectors infected with Plasmodium spp. METHODS: Overall, there were collected 166 fecal samples and 25 blood samples from NHP, and 442 individuals of Anopheles spp. DNA extraction, nested PCR using mitochondrial (cox3 gene) and ribosomal (18S rDNA) primers, electrophoresis and sequencing were conducted in order to identify Plasmodium spp. from the samples. RESULTS: Plasmodium falciparum was detected in two fecal samples of Alouatta seniculus, while Plasmodium vivax/simium infected Ateles hybridus, Cebus versicolor and Alouatta seniculus. Co-infections with P. vivax/simium and Plasmodium malariae/brasilianum were found in three individuals. The highest prevalence from blood samples was found for Plasmodium malariae/brasilianum in two Alouatta seniculus while Plasmodium vivax/simium was most prevalent in fecal samples, infecting four individuals of Alouatta seniculus. Seven Anopheles species were identified in the study site: Anopheles (Anopheles) punctimacula, Anopheles (An.) malefactor, Anopheles (Nyssorhynchus) oswaldoi, Anopheles (Nys.) triannulatus, Anopheles (An.) neomaculipalpus, Anopheles (Nys.) braziliensis and Anopheles (Nys.) nuneztovari. Infection with P. vivax/simium was found in An. nuneztovari, An. neomaculipalpus, and An. triannulatus. Furthermore, An. oswaldoi and An. triannulatus were found infected with P. malariae/brasilianum. The effect of fragmentation and distance to the nearest town measured in five forests with different degrees of fragmentation was not statistically significant on the prevalence of Plasmodium in NHP, but forest fragmentation did have an effect on the Minimum Infection Rate (MIR) in Anopheles mosquitoes. CONCLUSIONS: The presence of Plasmodium spp. in NHP and Anopheles spp. in fragmented forests in Colombia has important epidemiological implications in the human-NHP interface and the associated risk of malaria transmission.


Assuntos
Anopheles/parasitologia , Malária/veterinária , Doenças dos Macacos/epidemiologia , Mosquitos Vetores/parasitologia , Plasmodium/isolamento & purificação , Platirrinos , Animais , Colômbia/epidemiologia , Meio Ambiente , Florestas , Malária/epidemiologia , Malária/parasitologia , Doenças dos Macacos/parasitologia , Prevalência
14.
Int J Gynaecol Obstet ; 147(2): 187-194, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31420869

RESUMO

OBJECTIVE: To investigate the association of socioeconomic status (SES) components (education, occupation, and household wealth) with number (1 or ≥2) and timing (planned/emergency) of cesarean delivery (CD) in Colombia, rates of which are well above the levels recommended by the World Health Organization. METHODS: A cross-sectional study using the 2015 Demographic and Health Survey (DHS) of Colombia was carried out; 38 718 women answered the woman only module. Binomial and multinomial logistic regression analyses were conducted to generate estimates of the association between markers of SES and likelihood of CD, timing of CD, and number of CDs. RESULTS: The analysis included 9977 women. Although education and wealth were strongly associated with CD (P<0.001), the association between occupation and CD suggested that women in agriculture were the least likely to experience CD (odds ratio [OR] 0.67, 95% confidence interval [CI] 0.44-1.03, P=0.061); and women in the "poorer" household wealth category were more likely to have emergency (OR 1.57, CI 1.29-1.90, P<0.001) and two or more (OR 1.64, CI 1.29-2.40, P<0.001) CDs. CONCLUSION: Markers of SES are associated with CD overuse in Colombia, as well as the number and timing of CD. More robust qualitative inquiry including additional questions to the DHS survey are needed to elucidate reasons driving the overutilization of CD in the country, particularly among vulnerable populations.


Assuntos
Cesárea/estatística & dados numéricos , Fatores Socioeconômicos , Adolescente , Adulto , Colômbia/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Razão de Chances , Fenótipo , Gravidez , Procedimentos Desnecessários/estatística & dados numéricos , Adulto Jovem
15.
Prev Vet Med ; 170: 104739, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31421501

RESUMO

This cross-sectional study aimed to determine Mycobacterium avium subsp. paratuberculosis (MAP) herd-level prevalence using a quantitative real-time PCR method (qPCR), performed on environmental samples. Secondly, the study aimed to explore herd-level risk factors associated with the presence of MAP in dairy herds with in-paddock milking facilities of the Northern region of the Province of Antioquia (Colombia). Study herds (n = 292) located in 61 different districts from six municipalities were randomly selected amongst 7794 dairies registered in the foot-and-mouth disease vaccination records from 2015. The sampling strategy considered a proportional allocation, both at municipality and district level. Participant herds were visited once between June and October 2016 to collect one composite environmental sample and to complete a risk assessment questionnaire. Each composite environmental sample contained material from six different sites of concentration of adult cattle and/or high traffic areas (e.g. areas surrounding waterers and feeders, areas surrounding the current mobile milking-unit places). Identification of MAP was achieved using a duplex qPCR (Bactotype MAP PCR Kit®, Qiagen). A herd was considered as MAP infected if the environmental sample was positive in the qPCR. Information about the general characteristics of the herd, management practices, and knowledge about the disease was collected using the risk-assessment questionnaire. The information on risk factors was analyzed using a multivariable logistic regression model. The apparent herd-level prevalence was 4.1% (12/292; 95% CI: 1.8-6.4). Herds with a history of mixed farming of cattle with other ruminants had higher odds of being MAP infected than herds without (OR = 3.9; 95% CI: 1.2-13.2). Our study demonstrates the MAP prevalence in dairy herds from Antioquia, Colombia and the possible relationship between MAP environmental positivity with the history of mixed farming of cattle with other susceptible ruminants.


Assuntos
Doenças dos Bovinos/epidemiologia , Mycobacterium avium subsp. paratuberculosis/isolamento & purificação , Paratuberculose/epidemiologia , Animais , Bovinos , Doenças dos Bovinos/microbiologia , Colômbia/epidemiologia , Estudos Transversais , Indústria de Laticínios , Feminino , Modelos Logísticos , Paratuberculose/microbiologia , Prevalência , Fatores de Risco
16.
BMC Pregnancy Childbirth ; 19(1): 282, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391005

RESUMO

BACKGROUND: Until recently, Zika virus (ZIKV) infections were considered mild and self-limiting. Since 2015, they have been associated with an increase in microcephaly and other birth defects in newborns. While this association has been observed in case reports and epidemiological studies, the nature and extent of the relationship between ZIKV and adverse pregnancy and pediatric health outcomes is not well understood. With the unique opportunity to prospectively explore the full spectrum of issues related to ZIKV exposure during pregnancy, we undertook a multi-country, prospective cohort study to evaluate the association between ZIKV and pregnancy, neonatal, and infant outcomes. METHODS: At research sites in ZIKV endemic regions of Brazil (4 sites), Colombia, Guatemala, Nicaragua, Puerto Rico (2 sites), and Peru, up to 10,000 pregnant women will be recruited and consented in the first and early second trimesters of pregnancy and then followed through delivery up to 6 weeks post-partum; their infants will be followed until at least 1 year of age. Pregnant women with symptomatic ZIKV infection confirmed by presence of ZIKV RNA and/or IgM for ZIKV will also be enrolled, regardless of gestational age. Participants will be tested monthly for ZIKV infection; additional demographic, physical, laboratory and environmental data will be collected to assess the potential interaction of these variables with ZIKV infection. Delivery outcomes and detailed infant assessments, including physical and neurological outcomes, will be obtained. DISCUSSION: With the emergence of ZIKV in the Americas and its association with adverse pregnancy outcomes in this region, a much better understanding of the spectrum of clinical outcomes associated with exposure to ZIKV during pregnancy is needed. This cohort study will provide information about maternal, fetal, and infant outcomes related to ZIKV infection, including congenital ZIKV syndrome, and manifestations that are not detectable at birth but may appear during the first year of life. In addition, the flexibility of the study design has provided an opportunity to modify study parameters in real time to provide rigorous research data to answer the most critical questions about the impact of congenital ZIKV exposure. TRIAL REGISTRATION: NCT02856984 . Registered August 5, 2016. Retrospectively registered.


Assuntos
Anormalidades Congênitas/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Infecção por Zika virus/epidemiologia , Adolescente , Adulto , Anticorpos Antivirais/sangue , Brasil/epidemiologia , Estudos de Coortes , Colômbia/epidemiologia , Feminino , Retardo do Crescimento Fetal/epidemiologia , Guatemala/epidemiologia , Humanos , Imunoglobulina M , Lactente , Recém-Nascido , Masculino , Nicarágua/epidemiologia , Peru/epidemiologia , Pré-Eclâmpsia/epidemiologia , Gravidez , Primeiro Trimestre da Gravidez , Segundo Trimestre da Gravidez , Nascimento Prematuro/epidemiologia , Estudos Prospectivos , Porto Rico/epidemiologia , RNA Viral/sangue , Adulto Jovem , Zika virus
17.
Cien Saude Colet ; 24(8): 2793-2804, 2019 Aug 05.
Artigo em Espanhol | MEDLINE | ID: mdl-31389528

RESUMO

The scope of this paper was to analyze the trends, impact on life expectancy and effect of the main associated socioeconomic factors with the death rate by homicide in Colombia between 2000 and 2014 at the state level, by gender and age groups. Standardized mortality rates and years of life lost among those under 85 years of age were calculated and multivariate regression analysis was performed using negative binomial fixed effects regression models with panel data to analyze the associated socioeconomic factors with the incidence of homicide. The reduction of the death rate by homicide in Colombia was corroborated, which was generalized at state level, though it did not occur homogenously. A higher mortality risk was found among males, particularly between 15 and 49 years of age. Economic growth and inequality were negatively associated with death rates by homicide; unemployment was positively associated; and poverty had no effect on the mortality rate. Investigating the main associated factors with homicidal violence is complex, but is indispensable due to its impact on economic and social development, given that it mainly affects the population of productive age, with broad public health consequences and at a high cost to healthcare services.


Assuntos
Homicídio/tendências , Expectativa de Vida , Desemprego/estatística & dados numéricos , Violência/tendências , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Colômbia/epidemiologia , Feminino , Homicídio/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pobreza , Fatores Socioeconômicos , Violência/estatística & dados numéricos , Adulto Jovem
18.
Int J Pediatr Otorhinolaryngol ; 126: 109594, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31344554

RESUMO

INTRODUCTION: Congenital defects affecting the auditory and visual capacity of newborns represent a public health problem as they result in substantial disability, directly impacting the quality of life of newborns and their families. OBJECTIVE: To evaluate risk factors associated with congenital defects that alter hearing or vision in newborns in the city of Bogotá between 2002 and 2016. METHOD: Data from the Bogotá Birth Defects Surveillance and Follow-up Program was used, which consolidated data regarding 167 ECLAMC study (Estudio Colaborativo Latino Americano de Malformaciones Congénitas, in spanish) variables in a case-control design to identify risk factors for birth defects after parents provided signed informed consent. Cases were defined as any newborn (alive or stillborn) with a weight greater than 500 g with any visual or hearing abnormality. Controls were defined as newborn in the same hospital and month with no birth defects. Groups were formed according to the case presentation as follows: isolated eye anomaly, isolated ear anomaly, polymalformative, syndromic, and teratogenic. RESULTS: In total, 402,657 births were reviewed, of which 968 cases had some congenital defects that alter hearing or vision. An association was found between the presence of defects and prematurity, as well as between syndromic cases and increasing maternal age. When comparing cases and controls with the risk of having a birth defect, multiparity had an odds ratio (OR) of 1.47 (95% CI: 1.27-1.71), acute respiratory infection had an OR of 2.41 (95% CI: 1.04-5.58), low maternal education level had an OR of 1.34 (95% CI:1.10-1.62), low paternal education had an OR of 1.42, (95% CI:1.17-1.73), manual labor in the maternal occupation had an OR of 1.31 (95% CI:1.03-1.67), and a history of congenital anomalies in the family had an OR of 1.55 (95% CI:1.19-2.00). CONCLUSION: This research allowed the identification of epidemiological data and significant risk factors for congenital defects that alter hearing or vision in the population of Bogotá.


Assuntos
Perda Auditiva/congênito , Transtornos da Visão/congênito , Estudos de Casos e Controles , Colômbia/epidemiologia , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Humanos , Recém-Nascido , Masculino , Razão de Chances , Vigilância em Saúde Pública , Estudos Retrospectivos , Fatores de Risco , Saúde da População Urbana/estatística & dados numéricos , Transtornos da Visão/diagnóstico , Transtornos da Visão/epidemiologia , Transtornos da Visão/etiologia
19.
Int J Infect Dis ; 87: 60-66, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31330321

RESUMO

OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) represent a major clinical problem in Colombia. The aim of this study was to evaluate the risk factors associated with MRSA SSTI in Colombia. METHODS: A multicenter cohort study with nested case-control design was performed. Patients with an SSTI with at least 48h of inpatient care were included. Patients with an MRSA SSTI were considered the case group and patients with either a non-MRSA SSTI or with an Methicillin-susceptible S. aureus (MSSA) SSTI were the control groups. A multivariate logistic regression approach was used to evaluate risk factors associated with MRSA SSTI with two different statistical models. RESULTS: A total 1134 patients were included. Cultures were positive for 498 patients, of which 52% (n=259) were Staphylococcus aureus. MRSA was confirmed in 68.3% of the S. aureus cultures. In the first model, independent risk factors for MRSA SSTI were identified as the presence of abscess (P<0.0001), cellulitis (P=0.0007), age 18-44 years (P=0.001), and previous outpatient treatment in the previous index visit (P=0.003); surgical site infection was a protective factor (P=0.008). In the second model, the main risk factor found was previous outpatient treatment in the previous index visit (P=0.013). CONCLUSIONS: Community-acquired SSTIs in Colombia are commonly caused by MRSA. Therefore, clinicians should consider MRSA when designing the initial empirical treatment for purulent SSTI in Colombia, although there seems to be low awareness of this fact.


Assuntos
Staphylococcus aureus Resistente à Meticilina/fisiologia , Infecções dos Tecidos Moles/microbiologia , Infecções Cutâneas Estafilocócicas/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/administração & dosagem , Estudos de Casos e Controles , Estudos de Coortes , Colômbia/epidemiologia , Feminino , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Pessoa de Meia-Idade , Fatores de Risco , Infecções dos Tecidos Moles/tratamento farmacológico , Infecções dos Tecidos Moles/epidemiologia , Infecções Cutâneas Estafilocócicas/tratamento farmacológico , Infecções Cutâneas Estafilocócicas/epidemiologia , Adulto Jovem
20.
Rev Inst Med Trop Sao Paulo ; 61: e34, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31269110

RESUMO

After the introduction of the rotavirus vaccine, the number of rotavirus-associated deaths and the predicted annual rotavirus detection rate had slightly declined worldwide. Taking in account that in Colombia, Rotarix vaccine was introduced in 2009, the purpose of this study was to evaluate the presence of rotavirus A in children under five years who were treated for acute diarrhoea in Bucaramanga, Colombia and, moreover, to determine the genotypes of rotavirus present in those children. We performed an analytical cross-sectional study of rotavirus A in faecal samples from children up to five years of age. Stool samples were screened for rotavirus A using a lateral-flow immunochromatographic assay and confirmed using a VP6 sandwich ELISA. Genotyping of rotavirus A-positive samples was performed by PCR and sequencing of VP7 and VP4 genes. The overall prevalence of rotavirus was 30.53% (95% confidence interval [CI] 21.2 - 39.7). Most of the children with rotavirus (86.2%) had received two doses of the rotavirus vaccine. G3 strains accounted for the vast majority of cases (82.8%), followed by G12 strains (13.8%) and G3/G9 coinfections (3.4%). Among the P genotypes, P[8] was the most prevalent (69%), followed by P[9] (31%). The most common G[P] genotype combination was G3P[8], followed by G3P[9]. The main finding in this study was that rotavirus, in a Colombian region, is still an important pathogen in children under five years old, previously vaccinated. The results showed that different factors, such as kindergarten attendance, could explain the epidemiology and transmission of rotavirus in Bucaramanga.


Assuntos
Diarreia/epidemiologia , Infecções por Rotavirus/epidemiologia , Rotavirus/genética , Doença Aguda , Pré-Escolar , Colômbia/epidemiologia , Estudos Transversais , Diarreia/virologia , Ensaio de Imunoadsorção Enzimática , Fezes/virologia , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Tipagem Molecular , Filogenia , Reação em Cadeia da Polimerase , Prevalência , RNA Viral/genética , Rotavirus/classificação , Infecções por Rotavirus/virologia
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