RESUMEN
BACKGROUND: The introduction in 2006 of the rapid HIV test by BCN Checkpoint in a non-clinical setting has been a successful step forwards in the uptake of testing. Nevertheless, HIV serostatus should be reported as HIV positive only when a reactive result has been tested again using a different assay (WHO guidelines 2015). The standard confirmation test has been the Western Blot (WB) test. However confirmation results take around 7 days to come back. AIMS: This study explores the possibility of Point of Care PCR testing for a same-day confirmation. MATERIALS AND METHODS: Between March 2015 and September 2016 a POC PCR test (Xpert® HIV-1 Qual) was performed in parallel to the Western Blot test after a reactive HIV rapid test (Alere Determine™ HIV-1/2 Ag/Ab Combo and Alere™ HIV Combo). HIV confirmed positive cases received emotional support by peers, were informed and prepared for treatment initiation and rapidly linked to HIV clinic. RESULTS: During the study period 11 455 tests were performed to 7163 clients. A total of 249 reactive rapid HIV tests were found. For analysis a total of 33 cases were excluded due to the lack of PCR and/or WB test. Results of comparison of the 216 cases showed 194 concordant positive confirmations and 14 concordant negative results. In three cases PCR was positive and WB negative. In five cases PCR was negative and WB positive. CONCLUSION: The POC PCR assay is easy to use and feasible in a community-based center. Reducing time for confirmation to 90 min has been possible in 91.2% (197/216) of cases with positive PCR result. In cases of a negative PCR result an additional test (WB, Elisa or PCR quantitative) was needed to distinguish false positive results (6.5%) from viral load results below level of detection (2.3%). Clients expressed satisfaction with same-day confirmation and less anxiety.
Asunto(s)
Servicios de Diagnóstico/organización & administración , Infecciones por VIH/diagnóstico , Sistemas de Atención de Punto , Ansiedad , Infecciones por VIH/psicología , Humanos , Inmunoensayo/métodos , Técnicas de Diagnóstico Molecular/métodos , Factores de TiempoRESUMEN
OBJECTIVE: Demonstrate the role of the virulence factors of Helicobacter pylori, the sex, and tobacco and alcohol use in the development of peptic ulcer in patients infected by H. pylori. PATIENTS AND METHODS: One hundred and seventy-four patient with dyspepsia were studied after they went consecutively for gastroscopy. The diagnosis of infection by H. pylori was carried out by culture and/or histology. Through western-blot the presence of specific anti-H. pylori antibodies was determined. The tobacco and alcohol use data were collected. RESULTS: One hundred and twenty-five patients (32 with ulceration, 12 with duodenitis and 81 with functional dyspepsia) showed H. pylori infection with anti-bacterium IgG antibodies. The detection of the proteins CagA and VacA, male sex and heavy consumption of alcohol and tobacco were associated with the finding of peptic ulcer. In the multivariate analysis only anti-CagA antibodies (OR: 4.1; 95% CI: 1.1-15.3; p = 0.036), anti-VacA (OR: 3.9; 95% CI: 1.4-10.8; p = 0.009) and male sex (OR: 3.1; 95% CI: 1.2-8.3; p = 0.02) were associated with the ulcerative disease. CONCLUSIONS: The proteins CagA and VacA, and the male sex, contribute independent risk factors for peptic ulcer in patients infected by H. pylori.
Asunto(s)
Antígenos Bacterianos/inmunología , Proteínas Bacterianas/inmunología , Infecciones por Helicobacter/microbiología , Úlcera Péptica/microbiología , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Antígenos Bacterianos/genética , Proteínas Bacterianas/genética , Femenino , Gastroscopía , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/inmunología , Humanos , Inmunoglobulina G/inmunología , Masculino , Persona de Mediana Edad , Úlcera Péptica/diagnóstico , Úlcera Péptica/genética , Fumar/epidemiología , Encuestas y CuestionariosRESUMEN
Objetivo. Determinar el papel de los factores de virulencia de Helicobacter pylori, el sexo y el consumo de tabaco y alcohol en el desarrollo de úlcera péptica en pacientes infectados por H. pylori. Pacientes y métodos. Se estudiaron 174 pacientes dispépticos que acudieron consecutivamente a realizarse una gastroscopia. El diagnóstico de infección por H. pylori se realizó por cultivo y/o histología. La presencia de anticuerpos específicos anti-H. pylori se determinó mediante western-blot. Se recogió el consumo de tabaco y alcohol. Resultados. Ciento veinticinco pacientes (32 con úlcera, 12 con duodenitis y 81 con dispepsia funcional) fueron diagnosticados de infección por H. pylori con anticuerpos IgG frente a la bacteria. La detección de las proteínas CagA y VacA, el sexo masculino y el consumo elevado de alcohol y tabaco se asociaron con el hallazgo de úlcera péptica. En el análisis multivariante sólo los anticuerpos anti-CagA (odds ratio [OR]: 4,1; intervalo de confianza [IC] 95 por ciento: 1,1-15,3; p = 0,036), anti-VacA (OR: 3,9; IC 95 por ciento: 1,4-10,8; p = 0,009) y el sexo masculino (OR: 3,1; IC 95 por ciento: 1,2-8,3; p = 0,02) se asociaron con la enfermedad ulcerosa. Conclusiones. Las proteínas CagA y VacA y el sexo masculino contribuyen de manera independiente al riesgo de padecer úlcera péptica en pacientes infectados por H. pylori (AU)
Asunto(s)
Persona de Mediana Edad , Adulto , Masculino , Femenino , Humanos , Tabaquismo , Infecciones por Helicobacter , Encuestas y Cuestionarios , Antígenos Bacterianos , Proteínas Bacterianas , Consumo de Bebidas Alcohólicas , Inmunoglobulina G , Gastroscopía , Infecciones por Helicobacter , Úlcera PépticaAsunto(s)
Gonorrea/microbiología , Neisseria gonorrhoeae/aislamiento & purificación , Niño , Exantema/etiología , Femenino , Gonorrea/diagnóstico , Gonorrea/tratamiento farmacológico , Gonorrea/etiología , Humanos , Neisseria gonorrhoeae/efectos de los fármacos , Penicilina G/uso terapéutico , Prurito/etiologíaRESUMEN
In 268 patients seen for sterility, sexual impairment or suspected prostatitis symptoms, first and midstream urine fractions, prostatic secretion and post-massage urine cultures as well as semen cultures and exfoliative cytologies of the first urine fraction and prostatic secretion were performed. Gram-positive bacteria were isolated in 160 cases. Of these, 111 (69.3%) had significant cultures (Meares and Stamey criteria). Nevertheless, when we repeated the study without previous therapy, the results could not be confirmed. This shows that Gram-positive bacteria do colonize urethra and/or prostatic ducts, but are not responsible for prostatic infection.