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In this paper, we present a hybrid semiconductor structure for biosensing applications that features the co-integration of nanoelectromechanical systems with the well-known metal oxide semiconductor technology. The proposed structure features an MOSFET as a readout element, and a doubly clamped beam that is isolated from the substrate by a thin air gap, as well as by a tunnel oxide layer. The beam structure is functionalised by a thin layer of biotargets, and the main aim is to detect a particular set of biomolecules, such as enzymes, bacteria, viruses, and DNA/RNA chains, among others. In here, a three-dimensional finite element analysis is performed in order to study the behaviour of the functionalised, doubly clamped beam. Preliminary results for the fabrication and characterisation processes show good agreement between the simulated and measured characteristics.
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DNA , Semicondutores , Óxidos/químicaRESUMO
BACKGROUND: Chronic kidney disease (CKD) is one of the pathologies with the greatest impact on the public health system. Over the last few decades, the relevance of CKD in Mexico has increased, with associated overwhelming costs for care of renal disease. There are no reliable CKD statistics in Mexico. METHODOLOGY: In June 2018, the government of Aguascalientes called on all Health Institutions to create a state registry of treated end-stage renal disease (ESRD). In the same system, a renal biopsy result registry included all the native kidney biopsies obtained in the state of Aguascalientes since 2012. We herein describe the prevalence, incidence and characteristics of the patients included in the CKD and renal biopsy registry in the state of Aguascalientes. RESULTS: As of April 2020, the state has documented 2827 patients on renal replacement therapy (RRT), 1877 on dialysis and 950 that have been transplanted. The prevalence of patients on dialysis is 1326 per million population (p.m.p.), and if transplanted individuals are included, it is 1997 p.m.p. The incidence of treated ESRD in 2019 was 336 p.m.p. (n = 474) in individuals with an average age of 45.6 years (standard deviation ±18), and in a higher proportion of men (61%). There is a bimodal distribution of the age at which RRT was initiated. The first and the most significant peaks are between the ages of 20 and 40 years and are usually the result of CKD of unknown cause (73%). The second peak is between 50 and 70 years of age, and CKD is usually the result of diabetes mellitus and systemic arterial hypertension (59.6%). Since January 2012, 423 biopsies have been recorded. The patient's ages were between 20 and 30 years (n = 112), and the most frequent diagnosis was focal segmental glomerulosclerosis (FSGS) (54%). CONCLUSIONS: The prevalence of treated ESRD in the state of Aguascalientes is high. The disease mostly afflicts young people between 20 and 40 years of age, and there is a clear male predominance. In this age group, the main clinical diagnosis is CKD of unknown origin, and the most frequent biopsy diagnosis was FSGS.
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The antibody immobilization compatible with low-cost materials and label-free strategies is a challenge for biosensor device fabrication. In this study, ZnO thin film deposition was carried out on corning glass substrates by ultrasonic spray pyrolysis at 200 °C. The thin films were analyzed as platforms for enteropathogenic Escherichia coli (E. coli EPEC) antibody immobilization. The modification of thin films from the functionalization and antibody immobilization steps was visualized using Fourier transform infrared spectroscopy (FTIR) spectroscopy, and surface changes were observed by atomic force microscopy. The obtained FTIR spectra after functionalization showed a contribution of the amino group (NH2) derived from silane (3-aminopropyltrimethoxysilane). The antibody immobilization showed an amide I conserved signal corresponding to the C=O stretching vibrations and the amide II signal related to the N-H scissor vibration mode. In this way, the signals observed are correlated with the presence of antibody immobilized on the film. The ZnO film morphology changes after every stage of the process and allows observing the antibody distribution on the immobilized surface. In order to validate the antibody recognition capability as well as the E. coli EPEC detection in situ, polymerase chain reaction was used.
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El documento sobre el comportamiento de la mortalidad por enfermedades crónicas en población menor de 70 años de edad residente en Bogotá entre los años 2005 a 2016 muestra los resultados estadísticos frente a la mortalidad atribuible a enfermedades crónicas no transmisibles en personas menores de 70 años, el comportamiento según localidad, el número promedio anual de muertes por enfermedades crónicas no transmisibles en menores de 70 años y finalmente el comportamiento para los últimos dos años de las variables sociodemográficas.
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Humanos , Causa Básica de Morte , Doença Crônica , Mortalidade , População , Registros , Doenças não TransmissíveisRESUMO
OBJECTIVE: To establish characteristics and the trend of mortality from thyroid cancer in Colombia. MATERIAL AND METHODS: This is a study of mortality from thyroid cancer in Colombia using official national mortality databases (1998-2010). Year of death, sex, age and department of residence were analyzed. Proportions, arithmetic mean and median were used. The p-value for statistical significance was 0.05. Crude, specific and age-adjusted rates were calculated. RESULTS: Overall, 2 570 people died of thyroid cancer; 1 827 (71.1 %) deaths occurred in women. Median age at death was 68 years for men and 70 years for women. The age-adjusted average annual mortality rate (2006-2010) for thyroid cancer was 0.52 cancer deaths per 100 000 (both sexes), 0.32 deaths per 100 000 men and 0.70 per 100 000 women. CONCLUSIONS: Further studies showing potential factors associated with earlier age at death among Colombian women should be made.
Assuntos
Países em Desenvolvimento , Neoplasias da Glândula Tireoide/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Colômbia/epidemiologia , Bases de Dados Factuais , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Introducción. El reconocimiento de la sintomatología inicial de la leucemia linfoblástica aguda (LLA) podría contribuir a su diagnóstico temprano. Este estudio busca identificar las manifestaciones clínicas que anteceden al diagnóstico de la LLA pediátrica desde la perspectiva materna y determinar el tiempo transcurrido desde la primera manifestación hasta el diagnóstico. Métodos. Estudio de casos. Seis hospitales ubicados en Bogotá y Bucaramanga (Colombia) participaron. Los casos fueron menores de 15 años con diagnóstico incidente de LLA entre enero de 2000 y marzo de2005. Una entrevista realizada a la madre recolectó información sobre características sociodemográficas, manifestaciones clínicas prediagnósticas, primer síntoma y tiempo hasta el diagnóstico. Se calcularon medianas, rangos y proporciones. Los valores p menores de 0,05 fueron considerados significativos. Resultados. Se analizaron 128 casos. La palidez (83,6%), la pérdida del apetito (72,6%), la pérdida de peso (62,5%) y el sangrado en piel (39,1%) fueron los síntomas más frecuentes antes del diagnóstico. La demora entre la aparición del primer síntoma y el diagnóstico de la LLA depende de cuál es la primera manifestación y ella es menor cuando hay evidencia de hemorragia (mediana= 14 días). La presencia de ganglios palpables en las axilas fue más significativa en niñas que en niños (p= 0,04). Conclusión. La sintomatología de la LLA pediátrica en su etapa prediagnóstica no es específica de esta enfermedad; no obstante, el signo clínico y el tiempo desde su aparición podrían llegar a ser orientadores en la fase temprana de la enfermedad.
Introduction. Recognizing early symptoms of acute lymphoblastic leukemia (ALL) may help to make an early diagnosis. The objective of this study is to identify clinical manifestations preceding the diagnosis of childhood ALL from the maternal perspective and to establish the time elapsed from the first manifestation to the diagnosis. Methods. Case study. Six hospitals located in Bogotá and Bucaramanga (Colombia) participated. Cases consisted of children under 15 years old with incidental diagnosis of ALL between January 2000 and March 2005. Data on sociodemographic characteristics, pre diagnostic clinical manifestations, first symptom, and time to diagnosis were collected during interviews with mothers. Medians, ranges and proportions were estimated. P values below 0.05 were considered significant. Results. One hundred and twenty-eight cases were analyzed. Pallor (83.6%), loss of appetite (72.6%), weight loss (62.5%), andbleeding into the skin (39.1%) were the most common symptoms preceding diagnosis. The delay between the occurrence of the first symptom and the diagnosis of ALL depends on what the first manifestation is, and it maybe shorter when there is evidence of hemorrhage (median= 14 days). The presence of palpable lymph nodes in the armpits was more significant in girls than in boys (p= 0.04). Conclusion. Childhood ALL symptomatology in the prediagnostic stage is not specific to this disease; however, the clinical sign and time since its occurrence may serve as a guide in the early stage of this disease.
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Humanos , Pré-Escolar , Criança , Adolescente , Leucemia Linfoide , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , MãesRESUMO
Introducción. El reconocimiento de la sintomatología inicial de la leucemia linfoblástica aguda (LLA) podría contribuir a su diagnóstico temprano. Este estudio busca identificar las manifestaciones clínicas que anteceden al diagnóstico de la LLA pediátrica desde la perspectiva materna y determinar el tiempo transcurrido desde la primera manifestación hasta el diagnóstico. Métodos. Estudio de casos. Seis hospitales ubicados en Bogotá y Bucaramanga (Colombia) participaron. Los casos fueron menores de 15 años con diagnóstico incidente de LLA entre enero de 2000 y marzo de2005. Una entrevista realizada a la madre recolectó información sobre características sociodemográficas, manifestaciones clínicas prediagnósticas, primer síntoma y tiempo hasta el diagnóstico. Se calcularon medianas, rangos y proporciones. Los valores p menores de 0,05 fueron considerados significativos. Resultados. Se analizaron 128 casos. La palidez (83,6%), la pérdida del apetito (72,6%), la pérdida de peso (62,5%) y el sangrado en piel (39,1%) fueron los síntomas más frecuentes antes del diagnóstico. La demora entre la aparición del primer síntoma y el diagnóstico de la LLA depende de cuál es la primera manifestación y ella es menor cuando hay evidencia de hemorragia (mediana= 14 días). La presencia de ganglios palpables en las axilas fue más significativa en niñas que en niños (p= 0,04). Conclusión. La sintomatología de la LLA pediátrica en su etapa prediagnóstica no es específica de esta enfermedad; no obstante, el signo clínico y el tiempo desde su aparición podrían llegar a ser orientadores en la fase temprana de la enfermedad.(AU)
Introduction. Recognizing early symptoms of acute lymphoblastic leukemia (ALL) may help to make an early diagnosis. The objective of this study is to identify clinical manifestations preceding the diagnosis of childhood ALL from the maternal perspective and to establish the time elapsed from the first manifestation to the diagnosis. Methods. Case study. Six hospitals located in Bogotá and Bucaramanga (Colombia) participated. Cases consisted of children under 15 years old with incidental diagnosis of ALL between January 2000 and March 2005. Data on sociodemographic characteristics, pre diagnostic clinical manifestations, first symptom, and time to diagnosis were collected during interviews with mothers. Medians, ranges and proportions were estimated. P values below 0.05 were considered significant. Results. One hundred and twenty-eight cases were analyzed. Pallor (83.6%), loss of appetite (72.6%), weight loss (62.5%), andbleeding into the skin (39.1%) were the most common symptoms preceding diagnosis. The delay between the occurrence of the first symptom and the diagnosis of ALL depends on what the first manifestation is, and it maybe shorter when there is evidence of hemorrhage (median= 14 days). The presence of palpable lymph nodes in the armpits was more significant in girls than in boys (p= 0.04). Conclusion. Childhood ALL symptomatology in the prediagnostic stage is not specific to this disease; however, the clinical sign and time since its occurrence may serve as a guide in the early stage of this disease.(AU)
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INTRODUCTION: Recognizing early symptoms of acute lymphoblastic leukemia (ALL) may help to make an early diagnosis. The objective of this study is to identify clinical manifestations preceding the diagnosis of childhood ALL from the maternal perspective and to establish the time elapsed from the first manifestation to the diagnosis. CASE STUDY: Six hospitals located in Bogotá and Bucaramanga (Colombia) participated. Cases consisted of children under 15 years old with incidental diagnosis of ALL between January 2000 and March 2005. Data on sociodemographic characteristics, pre diagnostic clinical manifestations, first symptom, and time to diagnosis were collected during interviews with mothers. Medians, ranges and proportions were estimated. P values below 0.05 were considered significant. RESULTS: One hundred and twenty-eight cases were analyzed. Pallor (83.6%), loss of appetite (72.6%), weight loss (62.5%), andbleeding into the skin (39.1%) were the most common symptoms preceding diagnosis. The delay between the occurrence of the first symptom and the diagnosis of ALL depends on what the first manifestation is, and it maybe shorter when there is evidence of hemorrhage (median= 14 days). The presence of palpable lymph nodes in the armpits was more significant in girls than in boys (p= 0.04). CONCLUSION: Childhood ALL symptomatology in the prediagnostic stage is not specific to this disease; however, the clinical sign and time since its occurrence may serve as a guide in the early stage of this disease.
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Mães , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , MasculinoRESUMO
La leucemia linfoide aguda (LLA) es la enfermedad maligna más frecuente durante la niñez. Aunque sus causas no son claras, algunos factores demográficos y ambientales podrían estar jugando algún papel en su origen. Objetivo: Identificar los factores demográficos y ambientales a los que estaban expuestos pacientes con LLA pediátrica antes de su diagnóstico. Metodologia: Estudio descriptivo basado en el grupo de casos de un estudio de casos y controles dirigido a determinar los factores de riesgo para LLA. Los casos fueron pacientes menores de 15 os diagnosticados con LLA entre enero de 2000 y marzo de 2005 que consultaron a instituciones de Bucaramanga y Bogotá (Colombia). La información detallada de exposiciones demográficas y ambientales de las viviendas fue recolectada por encuestadores entrenados usando entrevistas estructuradas. Ambos progenitores fueron entrevistados. Los valores p de 0.05 o menores fueron significativos. Resultados: En este análisis 99 casos fueron incluidos. La edad media al diagnóstico fue de 6.6 a±os para ni±os y 5.7 para ninas. La edad mediana materna fue de 26 a±os y la paterna de 30. El 67.7% de los pacientes vivian en nivel socioeconómico bajo antes de diagnóstico. Los químicos usados o almacenados mas frecuentemente en la vivienda de estos pacientes fueron: petróleo, gasolina, queroseno y diluyente (n = 19, 19.2%) e insecticidas (n=18; 18.2%). Conclusiones: Este estudio mostrá que los pacientes pudieron estar en contacto cercano con exposiciones potencialmente carcinogÚnicas previa al diagn¾stico.
Acute lymphoblastic leukemia is the most common pediatric malignant disease. Its causes are mostly unknown but some demographic and environmental factors might be playing a role in its beginning. Objective: To identify the demographic and environmental characteristics which pediatric patients were exposed prior to diagnosis of acute lymphoblastic leukemia (ALL). Methodology: We conducted a descriptive analysis based on the cases of a case-control study aimed to determine risk factors for ALL. Patients younger than 15 years, diagnosed between January 2000 and March 2005 that consulted some institutions located in Bucaramanga and Bogotß, Colombia. Trained interviewers collected detailed information on demographic and environmental exposures. Both parents were interviewed. A p-value equal or less than 0.05 was considered significant. Results: We included 99 cases in this specific analysis. The mean age at diagnosis was 6.6 years for boys and 5.7 for girls. Maternal and paternal mean ages were 26 and 30 years respectively. 67.7% of patients lived in low socioeconomic status before diagnosis. The chemicals most frequently used or stored at home of these patients were oil, gasoline, kerosene, paint thinner, (n = 19, 19.2%) and insecticides (n = 18, 18.2%). Conclusions: This study showed that these patients could be exposed to potentially carcinogenic agents before diagnosis.
A leucemia linfoblástica aguda (LLA) Ú a neoplasia maligna mais comum na infância. Embora as suas causas não sejam claras, certos fatores demográficos e ambientais poderiam desempenhar um papel na sua origem. Objetivo: Identificar os fatores demográficos e ambientais aos que foram expostos os pacientes pediátricos com LLA, antes do seu diagnóstico. Metodologia: O estudo é descritivo e tem como base, o grupo de casos de um estudo de casos e controles que teve como objetivo identificar os fatores de risco para a LLA. Os casos estudados foram pacientes com idade inferior a 15 anos diagnosticados com LLA entre janeiro de 2000 e marþo de 2005 que consultaram instituiçoes em Bucaramanga e Bogotá (Colómbia). A informação detalhada sobre as exposições demograficas e ambientais das casas foram coletadas por entrevistadores treinados, utilizando entrevistas estruturadas. Ambos os pais foram entrevistados. Os valores p de 0,05 ou menos foram significativos. Resultados: Nesta análise, foram incluídos 99 casos. O promedio da idade para o diagnóstico foi de 6,6 anos para os meninos e de 5,7 para as meninas. Nas mães a idade média foi de 26 anos e nos pais de 30. 67,7% dos doentes viviam em um nÝvel socioeconómico baixo, antes do diagnóstico. Os produtos químicos mais utilizados ou armazenados na casa desses pacientes foram: petróleo, gasolina, querosene e diluente (n = 19, 19,2%) e inseticidas (n = 18; 18,2%). Conclusões: Este estudo mostrou que os pacientes poderiam estar em estreito contato com as exposições potencialmente cancerígenas, antes do diagnóstico.
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Humanos , Masculino , Feminino , Criança , Adulto , Meio Ambiente , Relatos de Casos , Leucemia , Criança , Colômbia , OncologiaRESUMO
BACKGROUND: The role of maternal exposures and conditions in the origin of childhood cancer has been a subject of growing interest, but current evidence is inconclusive. CASE PRESENTATION: We present a case detected in a multicenter case-control study evaluating the association between parental risk factors and childhood acute lymphoblastic leukemia (ALL). The patient is a Colombian girl who was diagnosed with ALL-L1 when she was 2 years old. Her mother had been diagnosed with antiphospholipid syndrome before pregnancy and had also been treated with subcutaneous injections of heparin. Other potentially relevant maternal and patient exposures are also reported in this paper. CONCLUSION: We hypothesize that the maternal autoimmune disease could be a contributor in the causality network of the daughter's leukemia. However, the role of other exposures cannot be excluded.
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Síndrome Antifosfolipídica/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Anticoagulantes/uso terapêutico , Síndrome Antifosfolipídica/diagnóstico , Síndrome Antifosfolipídica/terapia , Pré-Escolar , Estudos Clínicos como Assunto , Feminino , Heparina/uso terapêutico , Humanos , Exposição Materna/efeitos adversos , Mães , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/etiologia , Gravidez , Fatores de RiscoRESUMO
Objetivo Establecer características y tendencia de la mortalidad por cáncer de tiroides en Colombia. Materiales y Métodos Estudio de la mortalidad por cáncer de tiroides empleando las bases oficiales nacionales de muertes en Colombia (1998-2010). Se analizaron año de defunción, sexo, edad y departamento de residencia. Se utilizaron proporciones, media aritmética y mediana. El valor de p límite para significación estadística fue 0,05. Se calcularon tasas crudas, específicas y ajustadas por edad. Resultados En total, 2 570 personas, 1 827 (71,1 %) muertes ocurrieron en mujeres. Las edades medianas a la muerte fueron de 68 años en hombres y de 70 años en mujeres. La tasa anual media de mortalidad por cáncer de tiroides ajustada (2006-2010) fue de 0,52 muertes por 100 000 personas (ambos sexos), 0,32 muertes por 100 000 hombres y 0,70 por 100 000 mujeres. Conclusiones Deben realizarse estudios que muestren posibles factores asociados a muerte a más temprana edad en mujeres colombianas.
Objective To establish characteristics and the trend of mortality from thyroid cancer in Colombia. Material and Methods This is a study of mortality from thyroid cancer in Colombia using official national mortality databases (1998-2010). Year of death, sex, age and department of residence were analyzed. Proportions, arithmetic mean and median were used. The p-value for statistical significance was 0.05. Crude, specific and age-adjusted rates were calculated. Results Overall, 2 570 people died of thyroid cancer; 1 827 (71.1 %) deaths occurred in women. Median age at death was 68 years for men and 70 years for women. The age-adjusted average annual mortality rate (2006-2010) for thyroid cancer was 0.52 cancer deaths per 100 000 (both sexes), 0.32 deaths per 100 000 men and 0.70 per 100 000 women. Conclusions Further studies showing potential factors associated with earlier age at death among Colombian women should be made.
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Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Países em Desenvolvimento , Neoplasias da Glândula Tireoide/mortalidade , Colômbia/epidemiologia , Bases de Dados FactuaisRESUMO
INTRODUCTION: The objective of this study was to determine the risk factors for childhood acute lymphoblastic leukemia (ALL) and, in particular, the role of parental occupational exposure to carcinogenic and probably carcinogenic hydrocarbons before the child's conception. METHODS: For this case-control study, cases were children younger than 15 years who were newly diagnosed with ALL between January 2000 and March 2005 at 1 of 6 Colombian hospitals. An interview with both parents of 170 children (85 cases and 85 individually matched neighborhood controls) gathered information about each child's exposures and parental demographic and occupational characteristics, medical history, health risk behaviors, and pregnancy and birth history. A job-exposure matrix was used to classify parental exposure to hydrocarbons on the basis of the main industrial activity of each workplace where parents worked before (both parents) or during the index pregnancy (mother only). Conditional odds ratios and 95% confidence intervals were calculated by period of exposure (preconception, pregnancy, and childhood). RESULTS: The risk of childhood ALL was linked to 1) parental occupational exposure to hydrocarbons before conception, 2) parental smoking before conception, 3) maternal low socioeconomic status during pregnancy, and 4) higher maternal age (≥35 y) at the child's birth. CONCLUSION: These findings suggest an association between childhood ALL and parental occupational exposure to carcinogenic and probably carcinogenic hydrocarbons before conception. Outcomes depended on the parent exposed. Future research should investigate the additive or multiplicative role of other environmental sources of hydrocarbons.
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Carcinógenos/toxicidade , Exposição Ambiental , Poluentes Ambientais/toxicidade , Hidrocarbonetos/toxicidade , Leucemia-Linfoma Linfoblástico de Células Precursoras/induzido quimicamente , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Pré-Escolar , Colômbia/epidemiologia , Feminino , Humanos , Masculino , Idade Materna , Exposição Materna , Exposição Ocupacional , Exposição Paterna , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Fatores de Risco , Fumar , Fatores Socioeconômicos , Fatores de TempoRESUMO
Objetivos. Identificar las micosis oportunistas que afectan a los pacientes con VIH/sida, y determinar sus características demográficas, socioeconómicas y su relación con el número de células T CD4+. Métodos. Se trata de un estudio descriptivo de serie de casos basado en los participantes de un estudio diseñado para determinar el tipo y la frecuencia de las enfermedades oportunistas en pacientes con VIH/sida. Un caso se definió como un paciente con VIH/sida a quien se le diagnosticó una micosis oportunista, entre octubre de 2007 y mayo de 2010. Los pacientes elegibles estaban siendo tratados en dos instituciones médicas de Bogotá. Se recolectaron muestras respiratorias, de líquido cefalorraquídeo, de sangre y de raspado de lesión orofaríngea, para determinar la presencia de Histoplasma capsulatum, Paracoccidioides brasiliensis, Cryptococcus neoformans o Candida spp. Se utilizaron proporciones para resumir las variables cualitativas y medianas para las cuantitativas. Resultados. En 33 (9,8 %) pacientes con VIH/sida del estudio base (n=336), se diagnosticó una o más de las micosis evaluadas. El 75 % tenía entre 23 y 42 años. La frecuencia de estas infecciones fueron: H. capsulatum (n=1; 3,0 %), P. brasiliensis (n=1; 3,0 %), C. neoformans (n=25; 75,8 %), y Cándida spp. (n=7; 21,2 %). Los valores medianos de células T CD4+ fueron de 176 o menos, independientemente de sus manifestaciones clínicas. Conclusión. Se necesitan estudios adicionales para identificar los factores que podrían estar determinando la presencia de las micosis oportunistas en estos pacientes.
Objectives: To identify the opportunistic fungal infections affecting patients with HIV/AIDS, to determine their demographic and socioeconomic characteristics and the number of CD4+ T cells. Materials and methods: This is a descriptive case series study based on a major study aimed at determining the type and frequency of opportunistic diseases in HIV/AIDS patients. A case was defined as an HIV/AIDS patient who had evidence of fungal infection at baseline. Eligible patients were being treated at two clinical institutions located in Bogotá, Colombia, between October 2007 and May 2010. Respiratory, cerebrospinal fluid and blood samples and scrapping/swabs of oral lesions were collected in order to determine the presence of Histoplasma capsulatum, Paracoccidioides brasiliensis, Cryptococcus neoformans or Candida spp. Proportions were used for qualitative variables and medians for quantitative variables. Results: Overall, 33 (10,2%) patients were diagnosed as having one or more of the evaluated fungal infections , out of 336. Seventy five per cent of them were between the ages of 23 and 42. The frequencies of these fungal infections were: H. capsulatum (n=1; 3.0%), P. brasiliensis (n=1; 3.0%), C. neoformans (n=25; 75.8%), and Candida spp. (n=7; 21.2%). The median values of CD4+ T cells were 176 or less, independently of clinical manifestations. Conclusion: Further studies are required to identify factors contributing to the presence of fungal opportunistic infections in these patients.
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Humanos , Masculino , Feminino , Adulto , HIV , Micoses , Síndrome da Imunodeficiência Adquirida , Colômbia , Cryptococcus neoformans , Diagnóstico , HistoplasmaRESUMO
Introduction: The high polymorphism of the HLA system allows its typification to be used as valuable tool in establishing association to various illnesses, immune and genetic profiles; it also provides a guide to identifying compatibility among donors and receptors of organs transplants. Objective: To establish HLA-A, HLA-B, and HLA.DRB1 allele, genotype and haplotype frequencies among patients treated at Clinica Colsanitas SA. Methods: 561 patients coming from different regions in Colombia, who were attended in 8 centers of the clinical laboratory of the Clinica Colsanitas in different cities of the country from January 2004 to August 2008, were included in this study. All were HLA-A,-B, and -DRB1 typified via SSP PCR. Allele, genotype and haplotype frequencies were estimated with STATA Software Version 9.0 and the GENEPOP genetic analysis package. Results: 19, 28, and 15 different alleles were identified for loci HLA-A,-B and -DRB1, respectively. Alleles found most frequently were A*24 (26.2%), A*02 (26%), B*35(22.7%), and DRB1*04 (24%). The most frequent genotypes were A*02,24 (14.2%), B*07,35 (5.5%), DRB1*01,04, and DRB1*04,04 (6.9%); while most the frequent haplotypes were HLA A*24, B*35 (9.2%), A*24, DRB1*04 (8.1%); B*35, DRB1*04 (7.8%), A*2 DRB1*04 (7.4%). Conclusion: The results obtained provide a useful reference framework for the population studied, allowing compatibility probability calculations to be performed for organ transplants.
Introducción: El alto polimorfismo del sistema HLA, hace que su tipificación sea una herramienta de gran valor al establecer asociación con diferentes enfermedades, patrones inmunológicos, antropogenéticos, así como para establecer probabilidades de encontrar donantes compatibles con receptores de diferentes tipos de trasplante de órganos. Objetivo: Establecer las frecuencias alélicas, genotípicas y haplotípicas en pacientes atendidos en la Clínica Colsanitas SA. Metodología: Se incluyeron un total de 561 pacientes atendidos en el Laboratorio Clínico de La Clínica Colsanitas SA, en 8 sedes en diferentes ciudades del Colombia, durante el período comprendido entre enero de 2004 a agosto de 2008. Se realizó tipificación de HLA -A,-B,-DRB1 por PCR SSP. Las frecuencias alélicas, genotípicas y haplotípicas fueron estimadas mediante el paquete estadístico Stata y el paquete de análisis genético Genepop. Resultados: Fue posible la identificación de 19, 28 y 15 alelos de los loci HLA A-B-DRB1 respectivamente, de los cuales los más frecuentes fueron A*24 (26.2%), A*02 (26%), B*35 (22.7%), DRB1*04 (24%). Los genotipos más frecuentes encontrados fueron A*02,24 (14.2%), B*07,35 (5.5%), DRB1*01,04 y DRB1*04,04 (6.9%). Los haplotipos más frecuentes fueron: HLA A*24, B*35 (9.2%), A*24, DRB1*04 (8.1%); B* 35, DRB1*04 (7.8%), A*2 DRB1*04 (7.4%). Conclusión: Los resultados obtenidos permiten tener referencia para aplicaciones en la población estudiada, así como para establecer probabilidades de compatibilidad en la creciente área de trasplante de órganos.
Assuntos
Humanos , Alelos , Genótipo , Genes/genética , Teste de Histocompatibilidade , Imunidade/genéticaRESUMO
Objetivo: Describir las características demográficas, clínicas y epidemiológicas de los pacientes que han fallecido por la nueva gripe pandémica (A H1N1) 2009 en Colombia hasta el 30 de julio de 2009. Materiales y métodos: Éste es un estudio descriptivo. La fuente de información primaria fue el Sistema Nacional de Vigilancia en Salud Pública. Las muestras respiratorias se recolectaron por medio de hisopado faríngeo y se analizaron con pruebas de PCR específicas (rRT-PCR) o secuenciación genética. En algunos casos fatales, se requirieron muestras de tejido pulmonar, traqueal o bronquial para confirmar el diagnóstico. Las variables cualitativas se resumen con proporciones y las cuantitativas, con medias aritméticas. Resultados: Hasta el 30 de julio, se habían presentado 16 muertes confirmadas por laboratorio, en pacientes infectados con el nuevo virus pandémico. De éstas, 9 eran mujeres y 15 estaban hospitalizados. El lugar de residencia más frecuente de los casos fatales era Bogotá y la edad media al fallecimiento era de 28,1 años. La dificultad respiratoria, la fiebre y la tos fueron síntomas presentes en todos los pacientes. Una mujer de 27 años estaba embarazada. Conclusiones: Los hallazgos en los pacientes colombianos fallecidos son similares a lo informado en otros países. Se necesitan nuevos estudios para reconocer los factores que incrementan el riesgo de fallecer por esta enfermedad en nuestro país.
Objective: To describe the demographic, clinical and epidemiologic characteristics of fatal cases in pandemic influenza A(H1N1) patients reported in Colombia by July 30, 2009. Materials and methods: This is a descriptive study. The primary source of information was the National System of Public Health Surveillance (SIVIGILA). Respiratory samples were gathered using throat swabs and analyzed with PCR specific tests (rRT-PCR) or genetic sequencing. In some of the fatal cases, lung, trachea and bronchia tissue samples were required to confirm the diagnosis. Qualitative variables were summarized using ratios and quantitative variables using arithmetic means. Results: By July 30, 16 deaths in patients infected by the new pandemic virus had been confirmed by laboratories. Out of these, nine were women and 15 had been hospitalized. The most frequent domicile among the fatal cases was Bogotá, and the mean age at death was 28.1. Shortness of breath, fever and cough were clinical manifestations present in all of the fatal cases. A 27 years-old woman who died was pregnant. Conclusions: The findings from deceased Colombian patients are similar to those reported in other countries. Further studies are required in order to determine the factors that increase risk of death from this disease in our country.
Assuntos
Epidemiologia Descritiva , Influenza Humana , Vírus da Influenza A Subtipo H1N1 , Surtos de Doenças , ColômbiaRESUMO
In the context of the public health surveillance, the situation room might be playing an interesting role as a strategy for early alert and follow-up of a specific public health event and its determinants. The implementation and proper functioning of an influenza situation room monitoring seasonal and pandemic influenza or any other public health event could help to mitigate the impact of the next pandemic on public health in any country regardless of its level of economic development. This paper is aimed to suggest some basic steps for implementing an Influenza Situation Room as a strategy of prevention of diseases with potential to cause human pandemics and its mitigation if it has already occurred.
Assuntos
Defesa Civil/métodos , Surtos de Doenças/prevenção & controle , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Vigilância de Evento Sentinela , Humanos , Influenza Humana/tratamento farmacológicoRESUMO
BACKGROUND: Germ cell testicular tumors have survival rate that diminishes with high tumor marker levels, such as human chorionic gonadotropin (hCG). hCG may regulate vascular neoformation through vascular endothelial growth factor (VEGF). Our purpose was to determine the relationship between hCG serum levels, angiogenesis, and VEGF expression in germ cell testicular tumors. METHODS: We conducted a retrospective study of 101 patients. Serum levels of hCG, alpha-fetoprotein (AFP), and lactate dehydrogenase were measured prior to surgery. Vascular density (VD) and VEGF tissue expression were determined by immunohistochemistry and underwent double-blind analysis. RESULTS: Histologically, 46% were seminomas and 54%, non-seminomas. Median follow-up was 43 +/- 27 months. Relapse was present in 7.5% and mortality in 11.5%. Factors associated with high VD included non-seminoma type (p = 0.016), AFP > or = 14.7 ng/mL (p = 0.0001), and hCG > or = 25 mIU/mL (p = 0.0001). In multivariate analysis, the only significant VD-associated factor was hCG level (p = 0.04). When hCG levels were stratified, concentrations > or = 25 mIU/mL were related with increased neovascularization (p < 0.0001). VEGF expression was not associated with VD or hCG serum levels. CONCLUSION: This is the first study that relates increased serum hCG levels with vascularization in testicular germ cell tumors. Hence, its expression might play a role in tumor angiogenesis, independent of VEGF expression, and may explain its association with poor prognosis. hCG might represent a molecular target for therapy.
Assuntos
Biomarcadores Tumorais/sangue , Gonadotropina Coriônica/sangue , Neoplasias Embrionárias de Células Germinativas/sangue , Neovascularização Patológica/patologia , Neoplasias Testiculares/sangue , Adulto , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , L-Lactato Desidrogenase/sangue , Masculino , Estadiamento de Neoplasias , Neoplasias Embrionárias de Células Germinativas/irrigação sanguínea , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Testiculares/irrigação sanguínea , Neoplasias Testiculares/patologia , Fator A de Crescimento do Endotélio Vascular/biossíntese , alfa-Fetoproteínas/análiseRESUMO
OBJETIVO: Determinar la prevalencia y los factores determinantes de las infecciones vaginales en mujeres recluidas en una cárcel de Bucaramanga, Colombia. MÉTODO: Estudio de corte transversal. Se recolectaron factores sociodemográficos y clínicos, antecedentes de tabaquismo, síntomas previos y comportamiento sexual. Se tomaron muestras de flujo vaginal para determinar microscópicamente el agente causante de infección. Se utilizó regresión log-binomial para calcular razones de prevalencia (RP), intervalos de confianza (IC95%) y valores p. El ajuste global del modelo final se evaluó con la razón de probabilidad (likelihood ratio). RESULTADOS: La prevalencia global de las infecciones evaluadas fue del 28,2%. Los factores asociados con una mayor probabilidad de tener una infección vaginal al momento del estudio fueron: tabaquismo (RP: 1,71; IC95%: 1,08-2,71); edad mayor a 35 años (RP: 1,41; IC95%: 1,01-1,97); el antecedente de flujo vaginal maloliente (RP: 2,22; IC95%: 1,42-3,47) y duchas vaginales (RP: 1,71; IC95%: 1,08-2,71). CONCLUSIONES: Las mujeres que se encuentran en centros de reclusión podrían tener una mayor frecuencia de factores de riesgo para infecciones vaginales y de enfermedades sexualmente transmitidas. En este grupo es recomendable la realización de un programa de educación y de detección temprana de estas entidades como actividad regular de prevención.
OBJECTIVE.lo determine the prevalence and the determining factors of vaginal infections in women imprisoned in a prison in Bucaramanga, Colombia. METHOD: Cross-sectional study. Socio-demographic and clinical factors were collected, as well as smoking antecedents, previous symptoms and sexual behaviour. Specimens of discharge vaginal were collected by trained personal to microscopically determine the infection agent. Log-binomial regression was used to calculate prevalence ratios (PR), 95% confidence intervals (CI95%), and p-values. The likelihood ratio test was used to assess the overall significance of the model. RESULTS.lhe global prevalence of vaginal infections was 28.2%. The factors associated with a higher risk of vaginal infection at the time of the study were: a. smoking (PR: 1.71; 95%CI: 1.08-2.71); b. age over 35 (PR: 1.41; 95%CI: 1.01-1.97); c. the antecedent symptom of bad-smelling vaginal discharge (PR: 2.22; 95%CI: 1.42-3.47) and d. vaginal douches (PR: 1.71; 95%CI: 1.08-2.71). CONCLUSION:Those women imprisoned in penitentiaries may have a higher frequency of risk factors of vaginal infections. In this group, it is recommendable to create an awareness and early-detection program for these entities as a regular prevention activity.
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Prisões , Vaginite/epidemiologia , Infecções/epidemiologia , Comportamento Sexual , Fatores Socioeconômicos , Tabagismo/epidemiologia , Doenças Vaginais/microbiologia , Doenças Vaginais/epidemiologia , Prevalência , Estudos Transversais , Fatores de Risco , Análise de Variância , ColômbiaRESUMO
La planeación adecuada de una investigación en ciencias de la salud es necesaria para determinar la información que debe ser recolectada y que permitirá lograr los objetivos del estudio. Esta información conforma el grupo de variables que permiten, a su vez, realizar una aproximación a priori a la metodología de análisis de los datos. Este artículo académico busca aclarar la terminología empleada al hablar de variables y mostrar una forma sencilla de su presentación en un protocolo o proyecto de investigación. [Castro-Jiménez MA, Díaz-Martínez LA. Las variables en el proceso de investigación en salud: importancia, clasificación y forma de presentación en protocolos de investigación. MedUNAB 2009; 12:151-156]
A careful planning of any epidemiological of clinical research, including thesis in any area of the health sciences, is necessary to determine what information should be gathered in order to achieve the study's objectives. This information defines the set of variables that, in turn, make an a priori approach to the metodology of data analysis. This academic paper is aimed to clarify the terminology used when talking about variables and show a simple way to describe them on a research project or protocol. [Castro-Jiménez MA, Díaz-Martínez LA. Variables in health research process: importance, classification, and show way in research protocols. MedUNAB 2009; 12:151-156].