Cystic echinococcosis (CE) is present in all continents, except for the Antarctica. Characteristically, CE lesions are found in the liver and the lungs, but virtually any part of the body may be ...affected (the spleen, kidneys, heart, central nervous system, bones, among others). It is estimated that the incidence of bone involvement in CE is 0.5% to 4%.
A retrospective study was performed of patients with osseous CE treated at the National Reference Unit of Tropical Diseases of the Ramon y Cajal Hospital, Madrid, Spain, between 1989 and December 2017. Epidemiological, clinical, diagnostic and therapeutic data of patients with long-term follow-up were collected.
During the study period, of the 104 patients with CE, 27 exhibited bone involvement (26%). The bones most frequently affected were the spine, followed by the ribs, pelvis, femur, tibia and the scapula. The most common symptom was pain followed by medullar syndrome and pathologic fracture. In total, 81.5% of patients underwent surgery for osseous CE at least once. As many as 96% received albendazol either in (mostly long-term) monotherapy or in combination with praziquantel.
The diagnosis and management of osseous CE is challenging. In many cases osseous CE should be considered a chronic disease and should be managed on a case-by-case basis. Lifelong follow-up should be performed for potential recurrence and sequels.
Una cantidad importante de estudios ha evidenciado que la personalidad influye de manera positiva en el ámbito de la ingeniería de software. Sin embargo, solo unos pocos estudios empíricos han ...analizado la influencia de la personalidad en los atributos de calidad del software. El objetivo de este trabajo es evaluar los efectos que tiene la formación de grupos homogéneos bajo la dimensión de la meticulosidad, con respecto a la mantenibilidad en sistemas orientados a objetos y la adecuación funcional del producto software. Se contó con un total de 76 participantes, y se empleó una herramienta computacional basada en un mecanismo de algoritmo genético, considerando la personalidad de los estudiantes como criterio de agrupación. Como resultado, se evidenció que no existe una diferencia significativa que permita afirmar que la formación de grupos homogéneos haya obtenido mejores resultados con respecto a las métricas Chidamber & Kemerer (CK) y a la adecuación funcional. A pesar de estos resultados, las puntuaciones promedio de las métricas Coupling Between Objects (CBO) y Response for a Class (RFC) en el grupo experimental estuvieron ligeramente por encima del umbral deseado y ligeramente por debajo del promedio del grupo de control. Esto indica que la meticulosidad en la formación de grupos podría afectar la complejidad del diseño, la modularidad, la propensión a fallas y la facilidad de realizar pruebas en las clases. Se sugiere seguir explorando qué dimensiones específicas de la personalidad pueden influir en los diferentes atributos de calidad del software y en general de la ciencia de la computación.
To determine the epidemiologic and clinical characteristics of patients in Spain with imported arbovirus infections, we analyzed 22,655 records from a collaborative network for January 2009-December ...2018. Among 861 arbovirus infections, 845 were monoinfections (456 53% dengue, 280 32.5% chikungunya, 109 12.7% Zika) and 16 (1.8%) were co-infections. Most patients were travelers (56.3%) or immigrants returning to Spain after visiting friends or relatives (31.3%). Median patient age was 37 years; most (62.3%) were women and some (28.6%) had received pretravel advice. Only 12 patients were immunosuppressed. Six cases (all dengue monoinfections, none in immunosuppressed patients) were severe. Since 2014, nondengue arbovirus infections increased; until 2016, chikungunya and Zika were most common. Imported arbovirus infections (mostly dengue) were frequently diagnosed, although increased chikungunya and Zika virus infections coincided with their introduction and spread in the Americas. A large proportion of cases occurred in women of childbearing age, some despite receipt of pretravel advice.
Abstract Background In non-endemic countries, malaria can be transmitted through blood donations from imported cases. To ensure standards of quality and safety of human blood, the European Union and ...Spanish national law, requires a deferral period, or a screening by immunological or genomic test among those donors with potential risk of malaria. Scientific societies, European Committee on Blood Transfusion, and Spanish Society of Haematology and Haemotherapy, refer only to the result of the immunological test. Methods An observational retrospective study was performed in potential donors with a positive immunological test for malaria done in the Regional Transfusion Center in Madrid and referred to the National Reference Unit for Tropical Diseases in Madrid between 2015–2020. At consultation a Polymerase Chain Reaction (PCR) for malaria was performed. Results During the study period, 121 possible donors attended for consultation at NRU-Trop. Median age: 38.5 (IQR:33–48); median time to consultation was 32 months (IQR:12.5–110). Eighty-two (67.8%) donors were migrants and thirty-nine were travellers (32.2%). ELISA values were available for 109 subjects (90.1%), 56 individual left malaria endemic area > 3 years before. All donors tested negative for Plasmodium spp PCR test (n = 121, 100%). Conclusions None of the subjects with a positive immunologic test deferred as blood donors had a positive genomic test. The presence of Plasmodium spp in collected blood was not detected by molecular techniques. To avoid the loss of potential blood donors, especially those with low incidence red blood cell antigens, as more precise microbiology techniques become available, updating the existing legislation becomes necessary to increase the availability of donated blood.
Imported strongyloidiasis is increasingly being diagnosed in non-endemic areas. The aim of this study was to describe the epidemiological, clinical and microbiological characteristics of patients ...with imported strongyloidiasis in Spain.
This is an observational retrospective study that included all patients diagnosed of strongyloidiasis registered in the +REDIVI Collaborative Network from 2009 to 2017. Demographic, epidemiological and clinical information was collected from the +REDIVI database, and extra information regarding microbiological techniques, treatment and follow-up was requested to participant centers.
Overall, 1245 cases were included. Most of them were immigrants (66.9%), and South America was the most frequent area of origin. Detection of larvae in stool samples was observed in 21.9% of the patients, and serological tests allowed making the diagnosis in the rest of the cases. Eosinophilia was present in 82.2% of cases. Treatment with ivermectin (compared with albendazole) was the most strongly associated factor to achieve the cure (OR 2.34).
Given the long latency of the infection and the risk of developing a severe presentation, screening of S. stercoralis infection should be mandatory in patients coming from or had traveling to endemic areas, especially in those with immunosuppressant conditions.
Schistosomiasis is a highly prevalent disease, especially in immigrant populations, and is associated with significant morbidity and diagnostic delays outside endemic areas. For these reasons, the ...Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Tropical Medicine and International Health (SEMTSI) have developed a joint consensus document to serve as a guide for the screening, diagnosis and treatment of this disease outside endemic areas. A panel of experts from both societies identified the main questions to be answered and developed recommendations based on the scientific evidence available at the time. The document was reviewed by the members from both societies for final approval.
La esquistosomiasis es una enfermedad de elevada prevalencia, especialmente en población inmigrante, asociada a importante morbilidad y retraso diagnóstico fuera de zona endémica. Por estas razones, la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC) y la Sociedad Española de Medicina Tropical y Salud Internacional (SEMTSI) han elaborado un documento conjunto de consenso que sirva de guía para el cribado, diagnóstico y tratamiento de esta patología en zonas no endémicas. Un panel de expertos de ambas sociedades identificó las principales preguntas a responder y elaboró las recomendaciones siguiendo la evidencia científica disponible en el momento. El documento fue revisado por los miembros de ambas sociedades para su aprobación final.
Chagas disease in Europe Gonzalez-Sanz, Marta; Crespillo-Andújar, Clara; Chamorro-Tojeiro, Sandra ...
Tropical medicine and infectious disease,
12/2023, Letnik:
8, Številka:
12
Journal Article
Recenzirano
Odprti dostop
Chagas disease is currently present in many non-endemic countries and remains a neglected tropical disease globally. A review of the literature identified significant gaps and scarcity of updated ...information from European countries, with most studies reporting data from Spain and Italy. The index of underdiagnosis May be as high as 70%, affecting mainly females of child-bearing age. Standardized screening of fertile, non-pregnant, women from endemic countries and subsequent treatment is considered an essential strategy to control transmission and prevent new cases, yet no uniform legislation for screening risk groups exists. There is heterogeneity in Europe in terms of preventive strategies to avoid transfusion-related transmission of Chagas disease, not necessarily in line with the European directives, with some countries conducting systematic screening for T. cruzi infection in blood donors, whilst others rely on pre-transfusion questionnaires. The growing burden of the infection in resource-rich areas May provide an opportunity for progress in certain aspects of control and prevention. Options for improving screening strategies, management and linkage to care are reviewed.
Zika virus: An emerging player in the global scenario Pérez-Molina, José A; Tojeiro, Sandra Chamorro
Enfermedades infecciosas y microbiologia clinica (English ed.),
01/2018, Letnik:
36, Številka:
1
Journal Article
Information about incidence, clinical characteristics, and outcomes of HIV-infected individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is scarce. We characterised ...individuals with COVID-19 among a cohort of HIV-infected adults in Madrid.
In this observational prospective study, we included all consecutive HIV-infected individuals (aged ≥18 years) who had suspected or confirmed COVID-19 as of April 30, 2020, at the Hospital Universitario Ramón y Cajal (Madrid, Spain). We compared the characteristics of HIV-infected individuals with COVID-19 with a sample of HIV-infected individuals assessed before the COVID-19 pandemic, and described the outcomes of individuals with COVID-19.
51 HIV-infected individuals were diagnosed with COVID-19 (incidence 1·8%, 95% CI 1·3-2·3). Mean age of patients was 53·3 years (SD 9·5); eight (16%) were women, and 43 (84%) men. 35 (69%) cases of co-infection had laboratory confirmed COVID-19, and 28 (55%) required hospital admission. Age and CD4 cell counts in 51 patients diagnosed with COVID-19 were similar to those in 1288 HIV-infected individuals without; however, 32 (63%) with COVID-19 had at least one comorbidity (mostly hypertension and diabetes) compared with 495 (38%) without COVID-19 (p=0·00059). 37 (73%) patients had received tenofovir before COVID-19 diagnosis compared with 487 (38%) of those without COVID-19 (p=0·0036); 11 (22%) in the COVID-19 group had previous protease inhibitor use (mostly darunavir) compared with 175 (14%; p=0·578). Clinical, analytical, and radiological presentation of COVID-19 in HIV-infected individuals was similar to that described in the general population. Six (12%) individuals were critically ill, two of whom had CD4 counts of less than 200 cells per μL, and two (4%) died. SARS-CoV-2 RT-PCR remained positive after a median of 40 days from symptoms onset in six (32%) individuals, four of whom had severe disease or low nadir CD4 cell counts.
HIV-infected individuals should not be considered to be protected from SARS-CoV-2 infection or to have lower risk of severe disease. Generally, they should receive the same treatment approach applied to the general population.
None.
Morbilidad en un centro penitenciario de Colombia Riaño, Amanda Constanza; Chamorro Mora, Sandra Lucía
Revista de la Facultad Ciencias de la Salud, Universidad del Cauca,
01/2019, Letnik:
21, Številka:
1
Journal Article
Odprti dostop
El presente estudio analizó la situación de salud de los internos del Centro Penitenciario y Carcelario del Municipio de Mocoa, Putumayo, Colombia donde se presentan condiciones de hacinamiento y ...precariedad en la salud.Objetivo: Describir la situación de salud de los reclusos en el Centro Penitenciario y Carcelario del Municipio de Mocoa, Putumayo, durante el año 2013. Método: Estudio observacional, tipo descriptivo de corte transversal. Mediante la aplicación de encuestas estructuradas a una muestra de 103 internos, una guía observacional y la revisión documental de los registros individuales de prestación de servicio, se analizó la situación de salud de los internos del centro penitenciario. Resultados: Se identificó una población de predominio masculino entre los 20 y 49 años, donde 30.3% corresponde a grupos indígenas con una baja escolaridad. Se encontraron condiciones de hacinamiento e insalubridad. Adicionalmentelos internos cuentan con un limitado e inoportuno acceso a los servicios de salud. Un 77.9% de los internos estudiados manifestó enfermar luego de ingresar al penal. Conclusiones: Se concluye que este penal refleja de cierta forma las condiciones del Departamento del Putumayo, teniendo en cuenta las similitudes de las características sociodemográficas de los internos encuestados. El análisis de morbilidad permitió encontrar diferencias en cuanto al comportamiento comparado con otros penales del país, dados los escasos reportes de infecciones de transmisión sexual y enfermedades crónicas.
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