RESUMO
BACKGROUND: Chile is a low-endemic HBV country, but countries with the highest migratory flow to Chile have an intermediate-high endemicity. In order to avoid vertical transmission of HBV, immunoprophylaxis (IP) in the newborn (NB) is a key factor. AIM: To identify HBsAg prevalence in pregnant immigrants and Chilean pregnant women with risk behaviors (RB) and to asses IP use in the NB. MATERIAL AND METHODS: Prospective HBsAg screening cohort of immigrant and Chilean pregnant women with RB, between July 1, 2017 and June 30, 2018 in CABL. IP of all NB of reactive HBsAg mothers was assessed. RESULTS: 1,415 HBsAg samples, 1,265 immigrants and 150 Chileans with RB. 37 reactive HBsAg. Two false positive. HBsAg prevalence in immigrant pregnant women was 2.7% and 0.66% in Chileans with RB (p < 0.05). 91.1% came from Haiti, with a prevalence of 3.5% in our region. All NB (36) received IP with a median of administration of 3:02 h. CONCLUSIONS: The prevalence in immigrant pregnant women was higher than that reported in the general population and in Chilean women with RB. We proposed the need for universal screening in pregnancy, especially in pregnant women from countries with intermediate-high endemicity.
Assuntos
Emigrantes e Imigrantes , Antígenos de Superfície da Hepatite B/análise , Hepatite B/epidemiologia , Hepatite B/transmissão , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Programas de Rastreamento/métodos , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Chile/epidemiologia , Feminino , Vírus da Hepatite B/isolamento & purificação , Humanos , Recém-Nascido , Masculino , Gravidez , Complicações Infecciosas na Gravidez/virologia , Estudos Prospectivos , Fatores de Risco , Assunção de Riscos , Estudos Soroepidemiológicos , Fatores de Tempo , Vacinação/métodos , Adulto JovemRESUMO
Resumen Introducción: Chile es un país de baja endemia de virus de hepatitis B (VHB), pero los países de mayor flujo migratorio hacia Chile tienen una endemia intermediaalta. La inmunoprofilaxis (IP) en el recién nacido (RN) es fundamental para evitar la transmisión vertical de VHB. Objetivos: Determinar la prevalencia de HBsAg en mujeres embarazadas: inmigrantes, y chilenas con conductas de riesgo (CR), y evaluar el cumplimiento de la indicación de IP a los RN de madre con HBsAg reactivo. Material y Métodos: Cohorte prospectiva de cribado de HBsAg a mujeres embarazadas inmigrantes, y chilenas con CR, entre julio 2017 y junio 2018 en CABL. Los RN de madre con HBsAg reactivo se les administró IP adecuada (antes de 12 h de vida). Resultados: Se realizó un total de 1.415 HBsAg: 1.265 a inmigrantes y 150 a chilenas con CR. Se obtuvieron 37 pacientes con HBsAg reactivos. Dos falsos positivos. La prevalencia HBsAg en inmigrantes fue 2,7% y 0,66% en chilenas con CR (p < 0,05). El 91,1% provenía de Haití, con una prevalencia de 3,5% en nuestra área. Todos los RN (36) recibieron IP. La mediana de administración de IP fue 3:02 h. Conclusiones: La prevalencia de VHB en mujeres gestantes inmigrantes fue superior a lo reportado en la población general y en mujeres chilenas con CR. Planteamos la necesidad de implementar el cribado universal en el embarazo, y en especial, en mujeres embarazadas provenientes de países con endemia intermedia-alta.
Background: Chile is a low-endemic HBV country, but countries with the highest migratory flow to Chile have an intermediate-high endemicity. In order to avoid vertical transmission of HBV, immunoprophylaxis (IP) in the newborn (NB) is a key factor. Aim: To identify HBsAg prevalence in pregnant immigrants and Chilean pregnant women with risk behaviors (RB) and to asses IP use in the NB. Material and Methods: Prospective HBsAg screening cohort of immigrant and Chilean pregnant women with RB, between July 1, 2017 and June 30, 2018 in CABL. IP of all NB of reactive HBsAg mothers was assessed. Results: 1,415 HBsAg samples, 1,265 immigrants and 150 Chileans with RB. 37 reactive HBsAg. Two false positive. HBsAg prevalence in immigrant pregnant women was 2.7% and 0.66% in Chileans with RB (p < 0.05). 91.1% came from Haiti, with a prevalence of 3.5% in our region. All NB (36) received IP with a median of administration of 3:02 h. Conclusions: The prevalence in immigrant pregnant women was higher than that reported in the general population and in Chilean women with RB. We proposed the need for universal screening in pregnancy, especially in pregnant women from countries with intermediate-high endemicity.
Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Adulto , Adulto Jovem , Complicações Infecciosas na Gravidez/epidemiologia , Programas de Rastreamento/métodos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Emigrantes e Imigrantes , Hepatite B/transmissão , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B/análise , Complicações Infecciosas na Gravidez/virologia , Assunção de Riscos , Fatores de Tempo , Estudos Soroepidemiológicos , Chile/epidemiologia , Vírus da Hepatite B/isolamento & purificação , Estudos Prospectivos , Fatores de Risco , Vacinação/métodosRESUMO
Mammals that live in arid and semi-arid environments in South America present physiological mechanisms that enable them to conserve water. Body water is lost through the kidneys, lungs, skin, and intestines. Regarding renal adaptation for water conservation, several indices have been used to estimate the capacity of the kidneys to produce a maximum urine concentration. Most studies were conducted at an inter-specific level, with only few performed at the intraspecific level. In this work, we compare renal function and morphology among five populations of Southern mountain cavy, Microcavia australis, present along an aridity gradient. We hypothesized that individuals from drier zones would present morphological and functional renal modifications that imply a greater capability to conserve body water. These features were studied considering the classical indices (RMT, PMT, PMA, and RMA) and three new indices that consider area measurements; the latter showed to be more adequate to reflect intraspecific differences. Our results suggest that the morphological modifications of kidneys, that is, the greater areas of renal inner medulla, would be related to the aridity gradient where populations of Southern mountain cavy occur.
Assuntos
Rim/fisiologia , Roedores/fisiologia , Animais , Clima Desértico , Herbivoria/fisiologia , Humanos , Umidade , Rim/anatomia & histologia , Córtex Renal/anatomia & histologia , Córtex Renal/fisiologia , Medula Renal/anatomia & histologia , Medula Renal/fisiologia , Roedores/anatomia & histologiaRESUMO
Los tumores pardos son lesiones focales óseas benignas que rara vez se presentan en el hiperparatiroidismo (HPT) primario o secundario.Evaluamos una paciente con HPT secundario e Insuficiencia Renal Crónica (IRCr ), que evolucionó con reabsorción ósea severa progresiva y múltiples tumores pardos y fue estudiada con cintigrafías del esqueleto y de paratiroides antes y después de realizar una paratiroidectomía subtotal y tratamiento con alfacalcidol ( 1 alfa hidroxivitamina D3 ) por 18 meses.Palabras Claves : Cintigrama de paratiroides con Tc99m MIBI, Tumores pardos , Hiperparatiroidismo , Osteodistrofia, Paratiroidectomia.
Assuntos
Humanos , Hiperparatireoidismo Secundário , Hiperparatireoidismo Secundário/complicações , Osteíte Fibrosa Cística , Distúrbio Mineral e Ósseo na Doença Renal Crônica , Distúrbio Mineral e Ósseo na Doença Renal Crônica/complicações , Tecnécio Tc 99m Sestamibi , Osso e Ossos/fisiopatologia , ParatireoidectomiaRESUMO
We report a 25 years old woman with a four years history of end stage renal disease on hemodialysis. During the last two years of follow up, multiple tender nodules appeared in the left clavicle and ribs. These were diagnosed as brown tumors, secondary to osteitis fibrosa cystica, in the context of a secondary hyperparathyroidism. A subtotal parathyroidectomy was performed and a homologous parathyroid implant was done in the right forearm. The pathological study of the surgical pieces confirmed the presence of the brown tumors and parathyroid hyperplasia. Nine months after surgery, parathormone levels and brown tumor calcifications decreased significantly and bone mineral density increased by 20%.