Assuntos
Anticorpos Antivirais/sangue , Doadores de Sangue , Segurança do Sangue , Dengue/transmissão , Doenças Endêmicas/prevenção & controle , Reação Transfusional , Viremia/epidemiologia , Adolescente , Adulto , Idoso , Doenças Assintomáticas , Segurança do Sangue/estatística & dados numéricos , Estudos Transversais , Dengue/sangue , Dengue/epidemiologia , Dengue/prevenção & controle , Vírus da Dengue/classificação , Vírus da Dengue/imunologia , Notificação de Doenças , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Programas de Rastreamento , México/epidemiologia , Pessoa de Meia-Idade , Risco , Sensibilidade e Especificidade , Estudos Soroepidemiológicos , Sorogrupo , Viremia/diagnóstico , Adulto JovemRESUMO
We studied serotypes circulating dengue virus (DENV) cases, entomological Breteau index, rain-fall index and epidemiology of groups affected during the 2010 outbreak in Nuevo Leon, Mexico. From 2,271 positive cases, 94% were dengue classic and 6% dengue hemorrhagic fever; DENV1 was mainly isolated (99%) (Central-American lineage of American-African-genotype). We found correlation between two environmental phenomena (Increment of rainfall and vector-indexes) (p ≤ 0.05) with epidemiological, clinical and risk of DENV-1 ongoing transmission.
Assuntos
Vírus da Dengue , Dengue/epidemiologia , Dengue/virologia , Surtos de Doenças , Dengue Grave/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Dengue/história , Vírus da Dengue/classificação , Vírus da Dengue/genética , Feminino , Genótipo , História do Século XXI , Humanos , Lactente , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Filogenia , Vigilância da População , Estações do Ano , Sorogrupo , Dengue Grave/epidemiologia , Dengue Grave/história , Adulto JovemRESUMO
We evaluated the incidence of anti-Dengue virus (DENV) antibodies and dengue viremia in a region of Mexico with a high prevalence of dengue. DENV is the most important arthropod-borne virus in terms of human morbidity and mortality in America We tested 800 blood donors from a tertiary care teaching hospital that provides care in Northeast Mexico, to identify anti-DENV IgM and IgG antibodies by enzyme-linked immunosorbent assay (ELISA) and DENV genome by reverse transcription polymerase chain reaction (RT-PCR). In addition, routine tests for donors including Brucella, Hepatitis C virus (HCV), Venereal Disease Research Laboratory (VDRL), HIV-1 and HBsAg identification were performed. We found that 59% of donors were reactive for anti-DENV IgG and none of them had reported recent DENV infection; however, 16 (2%) were reactive for anti-DENV IgM antibodies. None of them were viremic at the time of donation. Routine tests showed that the prevalence of anti-Brucella was 0.71%, anti-HCV 0.71%, anti-HIV-1-2 0.14%, HBsAg 0.14% and VDRL test 0.57%. Although DENV transmission by blood transfusion had not been confirmed in Mexico, the finding of a high prevalence of anti-DENV IgM-positive donors with asymptomatic manifestations and the recent viremia reported in blood donors suggests that this route of transmission might be possible.
Assuntos
Anticorpos Antivirais/sangue , Doadores de Sangue , Dengue/sangue , Doenças Endêmicas , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Adolescente , Adulto , Idoso , Anticorpos Antibacterianos/sangue , Anticorpos Antivirais/imunologia , Brucella/imunologia , Dengue/epidemiologia , Dengue/transmissão , Vírus da Dengue/imunologia , Feminino , HIV-1/imunologia , Hepacivirus/imunologia , Humanos , Imunoglobulina G/imunologia , Imunoglobulina M/imunologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Infecções Sexualmente Transmissíveis/sangue , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/imunologia , Viremia/sangue , Viremia/epidemiologia , Viremia/imunologiaRESUMO
Genotypic characteristics of human immunodeficiency virus type 1 (HIV-1) in Mexico were investigated in a multicenter study that involved centers in five geographic regions of the country. Study samples (n = 65) collected from male patients in 1998-1999 were sequenced within the C2-V5 region of the gp120 env gene. Phylogenetic analysis revealed that subtype B predominates in Mexico. The level of interpatient nucleotide diversity (mean value of 8.9%) was congruent with multiple introductions of the virus and the "aging" epidemic in Mexico. One-third of samples (30.8% of cases) showed polymorphism within the crown of the V3 loop demonstrating non-GPGR motifs. Two new motifs in the V3 loop crown - HPGG and GPEG - were observed. The evolution of the AIDS epidemic in Mexico should be closely monitored since non-B HIV-1 subtypes might be introduced. The nucleotide sequences were deposited in the GenBank under accession numbers AF200855-AF200869, AF200871-AF200892, and AF200894-AF200921.
Assuntos
Infecções por HIV/epidemiologia , HIV-1/genética , Epidemiologia Molecular , Proteína gp120 do Envelope de HIV/genética , Infecções por HIV/virologia , HIV-1/classificação , Humanos , Masculino , México/epidemiologia , Dados de Sequência Molecular , Filogenia , Análise de Sequência de DNARESUMO
OBJECTIVE: To compare the effect of octreotide (a long-acting somatostatin analog) to that of antidiarrheal therapy plus placebo on large-volume refractory AIDS-associated diarrhea. DESIGN: A randomized controlled trial. SETTING: Referral-based clinic and hospital in a tertiary care center. PATIENTS: Twenty male patients with AIDS and refractory diarrhea, with stool volume > 1000 ml/day who failed to improve after initial supportive management. All patients finished the study. INTERVENTIONS: Patients were randomly given either octreotide in doses of 100, 200 and 300 micrograms subcutaneously every 8 h, or high doses of loperamide and diphenoxylate orally plus placebo subcutaneously for 10 days. MAIN OUTCOME MEASURES: Bowel movements and stool volume were registered before and every day after treatment by the patients themselves and the nursing personnel. RESULTS: Patients from both groups were similar for age, time of AIDS diagnosis, duration of diarrhea and etiology. Baseline mean bowel movements per day (9.4 +/- 2.8 in the octreotide group versus 10 +/- 3.1 in controls) and baseline mean stool volume (2753 +/- 840 versus 2630 +/- 630 ml/day, respectively) were similar in both groups before therapy (P < 0.05). Mean bowel movements per day after 10 days of therapy was 2.1 +/- 1.6 in the octreotide group versus 7 +/- 3 in controls (P < 0.05). Mean stool volume after 10 days of therapy was 485 +/- 480 in the octreotide group versus 1080 +/- 420 ml/day in controls (P < 0.05). Complete response (stool volume < 250 ml/day) was observed in two patients from the octreotide group and none from controls; partial response (decrease > 50% in stool volume) in four and two; and no response (decrease < 50% or no change) in four and eight (P < 0.05), respectively. Side-effects occurred in eight out of 10 octreotide patients and three out of 10 controls (P < 0.05), but none were significant to result in discontinuation of medication. CONCLUSION: Octreotide proved to be superior to conventional therapy in this short-term treatment of large-volume refractory AIDS-associated diarrhea.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Diarreia/tratamento farmacológico , Octreotida/uso terapêutico , Adulto , Idade de Início , Diarreia/etiologia , Difenoxilato/uso terapêutico , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Humanos , Loperamida/uso terapêutico , Masculino , Pessoa de Meia-Idade , Octreotida/efeitos adversos , Placebos , Fatores de TempoRESUMO
We report here nine cases of encephalitis secondary to exanthematous diseases diagnosed from March to June 1990 at the University Hospital in Monterrey, Mexico. Two of the cases were secondary to measles, three to rubella, and four to varicella. One patient with varicella died, and the histopathological study showed findings compatible with viral encephalitis. The sex distribution was four males and five females with ages ranging from two to fourteen years. The most common clinical manifestations were hemiparesia, intracranial hypertension, meningism and altered consciousness. The CSF examination showed lymphocytic pleocytosis (mean = 295 cells), increased protein levels (mean = 118 mg/dL) and a normal glucose value in eight cases. These findings and the presence of an exanthematous disease suggested viral invasion of the CNS. Magnetic resonance imaging showed high intensity signal areas mainly in the frontal and temporal lobes. In this paper we compare the relative incidence of encephalitis secondary to exanthematous diseases in our geographical area during the last four years.
Assuntos
Varicela/complicações , Surtos de Doenças , Encefalite/epidemiologia , Sarampo/complicações , Rubéola (Sarampo Alemão)/complicações , Adolescente , Anticorpos Antivirais/líquido cefalorraquidiano , Varicela/epidemiologia , Criança , Pré-Escolar , Diagnóstico por Imagem , Eletroencefalografia , Encefalite/diagnóstico , Encefalite/microbiologia , Feminino , Humanos , Incidência , Masculino , Sarampo/epidemiologia , México/epidemiologia , Rubéola (Sarampo Alemão)/epidemiologiaRESUMO
We herein report a 30 years old male patient with AIDS and Cryptosporidium diarrhea diagnosed by intestinal biopsy. After some days of unsuccessful conventional anti-diarrheal treatment, an analog of somatostatin (octreotide acetate) Sandostatin was started. The stool volume and the bowel movements decreased dramatically and in spite of some collateral effects the patient could be clinically improved and discharged from the hospital.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Criptosporidiose/complicações , Diarreia/parasitologia , Somatostatina/uso terapêutico , Síndrome da Imunodeficiência Adquirida/parasitologia , Adulto , Animais , Criptosporidiose/parasitologia , Diarreia/tratamento farmacológico , Diarreia/etiologia , Humanos , Masculino , Infecções Oportunistas/complicações , Infecções Oportunistas/parasitologiaRESUMO
Se describe un caso con la rara asociacion de hemangioma gigante de la cara principalmente y grandes fistulas arteriovenosas del pulmon y del cuello que produjeron insuficiencia cardiaca irreversible y la muerte de una nina de ano y medio de edad.Se presentan los estudios especializados que permitieron fundar el diagnostico y se discute la fisiopatologia de esta asociacion