The best cardiovascular risk calculator to predict carotid plaques in rheumatoid arthritis patients

Clinical Rheumatology - Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in patients with rheumatoid arthritis (RA). Chronic inflammation and traditional risk factors...     

Comparative sensitivity of six serological tests and diagnostic value of ELISA using purified antigen in hydatidosis

Most serodiagnostic techniques have been evaluated for diagnosis of cystic hydatid disease caused by Echinococcus granulosus. Each, to varying degrees, has been shown to give false results, with considerable variation between laboratories. The comparative study was made concerning the sensitivity of the immunodiagnostic methods based on 58 sera from hydatid disease with different cyst locations. Latex agglutination, immunoelectrophoresis (IEP), and specific IgE, IgG enzyme-linked immunosorbent assay (ELISA) tests were studied. Specific IgG ELISA AgB (antigen B-rich fraction) was the most sensitive test (96.5%) and the least sensitive tests were specific IgE ELISA (24.1%) and IEP (25.8%). The low sensitivity of these two tests was due partly to the low reactivity detected in the sera of patients with lung hydatidosis. Initial laboratory studies showed purified antigens to be preferable to crude cyst fluid, regardless of the type of test used. For this reason, we evaluated the sensitivity and specificity of ELISA by using the purified antigen-B-rich fraction. In all, 117 sera were examined: 78 sera from patients with hydatidosis surgically confirmed, 15 sera from healthy control subjects, and 24 sera from patients with diseases other than hydatidosis. The method gave good results: 93.5% sensitivity, 89.7% specificity, and 92.3% diagnostic efficacy.     

Adaptation and validation of quality of life instrument Diabetes 39 for Mexican patients with type 2 diabetes mellitus

OBJECTIVE: To adapt and validate the Spanish language version of the Diabetes 39 instrument, which measures quality of life,for Mexican patients with type 2 diabetes mellitus (DM-2). MATERIALS AND METHODS: The Spanish language version of the instrument was adapted to make it more comprehensible to Mexican patients. In a cross-sectional survey, the instrument was administered on two different days to 260 patients with type DM-2. Glycated hemoglobin (HbAic), total cholesterol, triglycerides, blood pressure, body mass index and waist/hip ratio were measured. Information about age, sex, time since diagnosis of diabetes, diabetes related complications and comorbidity was obtained. RESULTS: A total of 249 subjects completed the study, 62.7% of which were women. Cronbach's alpha coefficient was > or = 0.80 for the domains and 0.95 for the total score.The test-retest consistency for the total score was r = 0.82, p = 0.01. The median of the total score was 29 (on a scale of 0-100), which was considered the cutoff value for defining "better" (<29) and "worse" > or =29) quality of life.A worse quality of life was associated with diabetes related complications > or =1 (OR = 1.73; IC 95% 1.05-3.06); total cholesterol >240 mg/dL (OR = 4.43; IC 95% 1.23-16.26); comorbidity > or =2 diseases (OR = 2.36; IC 95% 1.31-4.28); diabetes longer than 10 years (OR = 2.19; IC 95% 1.2-3.78), and HbA(IC) >8% (OR = 1.81; IC 95% 1.09-2.99). The last three were identified as predictor variables for worse quality of life by logistic regression (p < 0.05). CONCLUSIONS: The adapted Spanish language version of Diabetes 39 is a reliable and valid instrument for measuring the quality of life of Mexican patients with DM-2.     

Apoptosis and progression of hepatic fibrosis in liver diseases

Apoptosis is a Greek term that means "the fall of the old leaves of the autumn trees". This term describes the process by which undesirable, damaged or old cells are eliminated from the multicellular organisms. Pathologic cell death in the liver has traditionally been referred to as necrosis, but pathophysiologic process in the liver can lead to cell injury and death by apoptosis as well by necrosis. The first differs from the second, because it is actively controlled and the membrane integrity is maintained, avoiding extravasations of intracellular material and inflammatory response. Apoptosis can occur by two mechanisms: death receptor (DR) or extrinsic mechanism and mitochondrial or intrinsic mechanism. Liver cells express different death receptors: hepatocytes express Fas, TNF-R1, TRAIL-R1, TRAIL-R2; Stellate Cell (HCS) express Fas and TRAIL when is activated into myofibroblast-like phenotype and undergo apoptosis during resolution of liver injury in vivo. Cholangiocytes seem to be type II cells (in which the mitochondrial mechanism to apoptotic is essential) regarding signaling of Fas endothelial cells from rat livers express Fas, and their activation may lead to apoptosis of endothelial cells from hepatic sinusoids. Apoptosis mediated by these receptors have a major role in a variety of biological processes as tissue injury, protection against pathogenic microorganisms, and the role on hepatic injury and posterior progression to fibrosis has been well established in different hepatic diseases. Apoptosis may occur in the absence of significant transaminase elevations as happen in cellular necrosis. This paper is a review of this process.     

Intrafamilial prevalence of hepatitis B virus in Western Brazilian Amazon region: epidemiologic and biomolecular study

BACKGROUND: Hepatitis B is endemic in the Amazon region. METHODS: Serological markers for hepatitis B virus (HBV) were determined in 266 household members for hepatitis B surface antigen (HBsAg)-positive women (G1) and 395 household members for HBsAg-negative women (G2), randomly selected in Acre State Women's Medical Care Program, in order to evaluate the prevalence of HBV in this population. Before blood sample collection an epidemiological questionnaire was applied. RESULTS: The overall prevalence of HBV carriers (HBsAg) and exposed individuals (anti-HBc, IgG) was, respectively, 21.1% and 60.5% in G1 and 2.8% and 27.4% in G2 (P < 0.0000001). The frequency of HBsAg was higher among siblings from group G1 (75%) compared to the absence of any HBsAg-positive sibling in G2 (P < 0.00006). The HBV markers in other family members was as follows: G1 parents, 27.3% vs 4.5% (P < 0.03), sexual partners, 21.1% vs 2.5% (P < 0.04), and offspring, 10.4% vs 1.5% (P < 0.04). A low prevalence of HBsAg and anti-HBc (IgG) was observed for the last offspring of G2 mothers compared to the high prevalence among children of G1 mothers (0% vs 18.2%, P < 0.01 and 2.3% vs 59.1%, P < 0.0000005, respectively), with children younger than 1 year being the most affected. The frequency of the habit of sharing toothbrushes and the presence of at least one HBsAg carrier were higher in G1 than in G2 (P < 0.0001 and P < 0.000002), respectively. Genotypes A, D and G were found to be predominant by Innolipa test. There were cases that reacted to more than one genotype. CONCLUSION: Intrafamilial transmission of HBV is evident in the present study and is possibly associated with the presence of more than one HBV carrier in the family and the shared use of toothbrushes among household contacts. Genotype analysis confirms intrafamilial transmission.     

High prevalence of hepatitis B virus and hepatitis D virus in the western Brazilian Amazon

Severe cases of hepatitis caused by hepatitis B virus (HBV) or hepatitis D virus (HDV) are often seen in the Brazilian Amazon, but there is a paucity of epidemiologic studies on viral hepatitis in this area. Thus, a cross-sectional study to investigate the prevalence of markers for HBV and HDV was performed. Serum samples were collected after participants completed an epidemiologic questionnaire. Markers for HBV and HDV were analyzed with an enzyme-linked immunosorbent assay. The HBV genotype was determined by sequencing of the gene for hepatitis B surface antigen (HBsAg). Of 2,656 samples, 89 (3.3%) were positive for HBsAg and 1,628 (61.5%) were positive for IgG antibody to hepatitis B core antigen. Markers for HDV were found in 47 cases (1.7%). Antibodies to HDV were associated with Amerindian ethnic origin, a lower educational level, a history of acute viral hepatitis, a history of malaria, male sex, a history of tattooing, and older age. The most frequent HBV genotypes were A and F. This study showed a high prevalence of HBV and HDV in the western Brazilian Amazon, as well as the predominance of HBV genotypes A and F.     

Rapid suppression of Onchocerca volvulus transmission in two communities of the Southern Chiapas focus, Mexico, achieved by quarterly treatments with Mectizan

The impact of quarterly Mectizan (ivermectin) treatments on transmission, microfiladermia, and ocular lesions was evaluated in two formerly hyperendemic communities (Las Golondrinas and Las Nubes II) located in the main endemic focus for onchocerciasis in Southern Chiapas, Mexico. The data suggest that Onchocerca volvulus transmission has been suppressed after elimination of microfiladermia in these two communities. Increasing the frequency of Mectizan treatment to four times per year appears to have resulted in the rapid suppression of transmission in communities with residual transmission.     

Viral detection profile in children with severe acute respiratory infection

Objectives

The role of viral co-detection in children with severe acute respiratory infection is not clear. We described the viral detection profile and its association with clinical characteristics in children admitted to the Pediatric Intensive Care Unit (PICU) during the 2009 influenza A(H1N1) pandemic.