[Tuberculous pericarditis. A case reported and a brief review]. / Pericarditis tuberculosa. Informe de un caso y revisión de la literatura.

Pericarditis in patients with tuberculosis is estimated from one to eight percent. The tuberculosis is considered endemic in developing countries and tuberculous pericarditis is found frequently in patients with the Acquired Immunodeficiency Syndrome (AIDS). This entity is characterized by mediastinal or hilar lymph nodes, sternum or spine with retrograde tracheobronchial extension. Spread may also take place by the hematogenous route. The beginning can be suddenly, like an unknown pericarditis, with cough, dyspnea, chest pain, ankle edema, fever, tachycardia, and night sweats. Clinical examination shows pericardial friction rub, liver congestion, ascites, edema and low intensity cardiac noise. Chest radiograph shows cardiomegaly. The two-dimensional echocardiography verifies pericardial effusion. The PPD skin test can be negative in 30% by the presence of anergy. Definitive diagnosis is the demonstration of pericardium inflammatory granulomas and the presence of acid-alcohol resistant bacilli in the pericardial biopsy. We conclude that the tuberculous pericarditis diagnosis should be established by clinical suspicion, two-dimensional echocardiography and pericardiocentesis and later pericardiectomy must be practiced as soon as possible before receiving pharmacological treatment with triple drug therapy and steroids.

[Prevalence of postnatal depression in women attending public hospitals in Durango, Mexico]. / Prevalencia de depresión posnatal en mujeres atendidas en hospitales públicos de Durango, México.

OBJECTIVE: To determine the prevalence of postnatal depression and associated epidemiological features in a population of women from Durango, Mexico. METHODS: Applying a cross-sectional design in public hospitals from Durango, we studied 178 women during their 1 to 13 weeks postpartum. The Edinburg Postnatal Depression Scale was applied and depression was evaluated by using the DSM-IV criteria. In addition, socio-demographic, clinical, and psychosocial data from participants were obtained. RESULTS: Of the 178 women, 58 were depressed (32.6%). The prevalence of depression was significantly higher in women with low level of education, with more than 3 years of living with her partner, and in rural, non-insured women. Multivariate analysis showed that postnatal depression was significantly associated with previous depression, history of postnatal depression, depression, anxiety and stress during pregnancy, stress after pregnancy, trauma, bad relationship with partner, abandonment by partner, unwanted pregnancy, family problems, and living without partner. CONCLUSIONS: The prevalence of postnatal depression in women living in Durango, Mexico, is high. Several socio-demographic, clinical, and psychosocial factors appear to contribute to this condition.

High seroprevalence of Toxoplasma gondii infection in a subset of Mexican patients with work accidents and low socioeconomic status.

BACKGROUND: Toxoplasma gondii has been associated with reflex impairment and traffic accidents. It is unknown whether Toxoplasma infection might be associated with work accidents. Therefore, using a case-control seroprevalence study design, 133 patients with a recent work accident and 266 control subjects of the general population from the same region were examined with enzyme-linked immunoassays for the presence and levels of anti-Toxoplasma IgG antibodies and anti-Toxoplasma IgM antibodies. Socio-demographic, work, clinical and behavioral characteristics from each worker were obtained. RESULTS: Eleven (8.3%) of 133 patients, and 14 (5.3%) of 266 controls had anti-T. gondii IgG antibodies. Anti-T. gondii IgG levels were higher than 150 IU/ml in 8 (6%) patients and 10 (3.8%) controls. Anti-T. gondii IgM antibodies were found in one (0.8%) of the workers, and in 6 (2.3%) of the controls. No statistically significant differences in the IgG seroprevalences, frequencies of high IgG levels, and IgM seroprevalences among patients and controls were found. In contrast, a low socio-economic level in patients with work accidents was associated with Toxoplasma seropositivity (P = 0.01). Patients with work accidents and low socioeconomic status showed a significantly (OR = 3.38; 95% CI: 0.84-16.06; P = 0.04) higher seroprevalence of T. gondii infection than controls of the same socioeconomic status (15.1% vs. 5%, respectively). Multivariate analysis showed a positive association of T. gondii infection with boar meat consumption (OR = 3.04; 95% CI: 1.03-8.94; P = 0.04). In contrast, a negative association between T. gondii infection and national trips (OR = 0.40; 95% CI: 0.17-0.96; P = 0.04), sausage consumption (OR = 0.20; 95% CI: 0.05-0.68; P = 0.01), and ham consumption (OR = 0.16; 95% CI: 0.05-0.51; P = 0.002) was found. CONCLUSIONS: In the study described here seropositivity to T. gondii was associated to work accidents in a subset of patients with low socioeconomic status. This is the first report of an association of T. gondii infection and work accidents. Further studies to confirm our results are needed. Results may help in designing optimal prevention strategies to avoid T. gondii infection.

Toxoplasma gondii infection and schizophrenia: a case control study in a low Toxoplasma seroprevalence Mexican population.

There are conflicting reports concerning the association of Toxoplasma gondii infection and schizophrenia in humans. Therefore, we determined such association in a Mexican population of Mestizo ethnicity. Through a case-control study design, 50 schizophrenic patients and 150 control subjects matched by gender, age, residence place, and ethnicity were examined with enzyme-linked immunoassays for the presence and levels of T. gondii IgG antibodies and for the presence of T. gondii IgM antibodies. Schizophrenic patients attended a public psychiatric hospital in Durango City, Mexico, and the control group consisted of individuals of the general population of the same city. Socio-demographic, clinical and behavioral characteristics from the study subjects were also obtained. Both the seroprevalence and the level of T.gondii IgG antibodies were higher in schizophrenic patients (10/50; 20%) than in control subjects (8/150; 5.3%) (OR=4.44; 95% CI: 1.49-13.37; P=0.003). The IgG T. gondii levels higher than 150 IU/ml were more frequently observed in patients than in controls (10% versus 2%, respectively; P=0.02). One (50%) of the two patients with recently diagnosed schizophrenia and none of the controls had T. gondii IgM antibodies (P=0.01). T. gondii seropositivity was significantly higher in patients with a history of cleaning cat excrement (P=0.005), and suffering from simple schizophrenia (ICD-10 classification: F20.6) (P=0.03) than patients without these characteristics. Toxoplasma seroprevalence was also significantly higher in patients with simple schizophrenia (F20.6) than in those with paranoid schizophrenia (F20.0) (P=0.02). This study provides elements to clarify the controversial information on the association of T. gondii infection and schizophrenia.

Prevalencia de depresión posnatal en mujeres atendidas en hospitales públicos de Durango, México / Prevalence of postnatal depression in women attending public hospitals in Durango, Mexico

Objetivo: Determinar la prevalencia de depresión posnatal y las características epidemiológicas asociadas en una población de mujeres en Durango, México. Métodos: Mediante estudio transversal en hospitales públicos de Durango, se estudiaron 178 mujeres con una a 13 semanas posparto. Se les aplicó la Escala de Depresión Posnatal de Edinburgh, y la depresión se evaluó utilizando los criterios del DSM-IV. Además, se obtuvieron datos sociodemográficos, clínicos y psicosociales de las participantes. Resultados: De 178 mujeres, 58 se encontraban deprimidas (32.6 %). Se observaron frecuencias significativamente mayores de depresión en mujeres con escasa escolaridad, con más de tres años de vida con su pareja, no aseguradas y residentes del medio rural. El análisis multivariado mostró que la depresión posnatal se asoció significativamente con depresión previa, antecedente de depresión posnatal, depresión, ansiedad y estrés durante el embarazo, estrés después del embarazo, trauma, mala relación o abandono de la pareja, embarazo no deseado, problemas familiares, y vivir sin la pareja. Conclusiones: La prevalencia de la depresión posnatal en las mujeres estudiadas fue alta. Diversos factores sociodemográficos, clínicos y psicosociales contribuyeron a la depresión.

OBJECTIVE: To determine the prevalence of postnatal depression and associated epidemiological features in a population of women from Durango, Mexico. METHODS: Applying a cross-sectional design in public hospitals from Durango, we studied 178 women during their 1 to 13 weeks postpartum. The Edinburg Postnatal Depression Scale was applied and depression was evaluated by using the DSM-IV criteria. In addition, socio-demographic, clinical, and psychosocial data from participants were obtained. RESULTS: Of the 178 women, 58 were depressed (32.6%). The prevalence of depression was significantly higher in women with low level of education, with more than 3 years of living with her partner, and in rural, non-insured women. Multivariate analysis showed that postnatal depression was significantly associated with previous depression, history of postnatal depression, depression, anxiety and stress during pregnancy, stress after pregnancy, trauma, bad relationship with partner, abandonment by partner, unwanted pregnancy, family problems, and living without partner. CONCLUSIONS: The prevalence of postnatal depression in women living in Durango, Mexico, is high. Several socio-demographic, clinical, and psychosocial factors appear to contribute to this condition.