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Abstract Introduction: Tracheostomy (TCT) is the most frequently performed surgical procedure among COVID-19 patients. In Argentina, survival and decannulation rates are unknown. The main objectives of this study were to evaluate mortality and decannulation rates after 90 days of the percutaneous TCT performance. Secondarily, airway injury rate, days on invasive mechanical ventilation (IMV) and days of hospitalization in the intensive care unit (ICU) were also evaluated. Methods: This observational analytic prospective cohort study included patients over 18 years old with SARS-CoV-2 who were admitted into the ICU requiring IMV and percutaneous TCT in the period covering from 1 February 2021 to 31 July 2021. Results: the mortality rate in 95 patients was 66.3%. Among the survivors, 67% were decannulated. The youngest patients were the ones who survived [mean 50.6 (SD 10.2) years versus mean 58.9 (SD 13.4) years; p = 0.001] and presented lower Charlson index scores [median 1 (IQR 0-2) versus 2 (1-3) points; p = 0.007]. Patients who were tracheostomized ten days before the start of IMV were fewer days on IMV and had a shorter stay in the ICU, p < 0.01 and p = 0.01, respectively. Charlson Index was identified as an independent factor of mortality for both decannulation mortality at 90 days. Discussion: In our cohort of patients, those who were younger and presented less c omorbidities benefited from TCT. Charlson Index could be used as a prognostic marker among this patient population.

Resumen Introducción: La traqueostomía (TQT) es el procedimiento quirúrgico más frecuentemente realizado en pacientes COVID-19. La tasa de supervivencia y decanulación en Argentina se desconoce. El objetivo principal de este estudio fue evaluar la mortalidad y la tasa de decanulación al día 90 de realizada la TQT percutánea. Secundariamente se evaluó la tasa de lesión en la vía aérea, días de ventilación mecánica invasiva (VMI) y días de internación en unidad de cuidados intensivos (UCI). Métodos: Estudio observacional analítico de cohorte prospectiva que incluyó 95 pacientes mayores de 18 años infectados por SARS-CoV-2 ingresados de forma consecutiva a la UCI con requerimiento de VMI y TQT percutánea en el periodo compren dido entre 1 de febrero al 31 de julio del 2021. Resultados: La mortalidad fue del 66.3%. De los supervivientes se logró decanular al 67%. Los supervivientes fueron más jóvenes [media 50.6 (DE 10.2) años versus media 58.9 (DE 13.4) años; p = 0.001] y presentaron puntajes más bajos de índice de Charlson [mediana 1 (RIQ 0-2) versus 2 (1-3) puntos; p = 0.007]. Los pacientes TQT antes del día 10 desde el inicio de VMI tuvieron menos días de VMI y menor estadía en UCI, p < 0.01 y p = 0.01 respectivamente. El índice de Charlson se identificó como factor independiente de mortalidad a los 90 días y de decanulación a los 90 días. Discusión: En nuestra cohorte de pacientes fueron los más jóvenes y con menos comorbilidades los que se beneficiaron con la TQT. El índice de Charlson podría utilizarse como marcador pronóstico en esta población de pacientes.

Comparación entre la primera y segunda ola de pacientes con COVID-19 que requirieron ventilación mecánica invasiva en una unidad de cuidados intensivos de Argentina
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Musso, Gabriel

; Gonzalez, Cecilia

; Gomez, María Celeste

; Appendino, Gabriel

; Clemente, Lucio

; Abarca, Analía

; Friscione, Luciano

; Plotnikow, Gustavo A.

; Montagner, Florencia

; Abbondanzieri, Ornela

; Id Betan, Lucas

; Braconi, Faustino

; Bianco, Azul

; Guerrero, Paloma

; Garrido, Yamila

; Carranza, Hernán

; Berloni, Luciano

; Lovesio, Carlos

; Managó, Martín

Medicina (Buenos Aires)

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sep 2022, Volume 82 N. 4 Pages 487 - 495

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción: la información sobre características y resultados ventilatorios que comparen la primera (O1) y segunda (O2) ola de COVID-19 en Argentina son limitados. El objetivo principal de este estudio fue describir las características generales y variables ventilatorias en pacientes COVID-19 que requirieron ventilación mecánica invasiva (VMI) y comparar las diferencias entre olas. Secundariamente se es tudiaron factores asociados con mortalidad en la unidad de cuidados intensivos (UCI). Métodos: Realizamos un estudio observacional analítico de cohorte prospectiva que incluyó pacientes mayores de 18 años infectados por SARS-CoV-2 ingresados de forma consecutiva a la unidad de cuidados intensivos, con requerimiento de VMI, entre el 1 de agosto de 2020 y el 30 de junio de 2021. Se incluyeron 412 pacientes. Resultados: Encontramos diferencias estadísticamente significativas (p < 0.001) en: la edad [O1 64 (55-72) años versus O2 59 (50-66) años]; presencia de EPOC [O1 n = 41 (19.8%) versus O2 n = 13 (6.3%)]; Presión meseta [O1 27 (25-30) cmH2O versus O224 (22-27) cmH2O],presión de conducción (ΔP) [O1 15 (13-17) cmH2O versus O2 12 (11-14) cmH2O]; complacencia [O1 40 mL/cmH2O (32-46) versus O2 33 mL/cmH2O (27-40)]; reintubación [O1 30.4% (n=63/207) versus O2 13.7% (n=28/205)]. Se identificaron como factores independientes asociados a mortalidad las siguientes variables: edad [(OR 1.07 (IC 95% 1.05-1.09)], el ΔP en las primeras 24 h [(OR 1.19 (IC 95% 1.10-1.28)] y O2 [OR 1.81 (IC 95% 1.12-2.93); p = 0.015]. Discusión: Durante O2, los pacientes eran más jóvenes. Fue posible lograr una mecánica ventilatoria más ajustada a una estrategia de ventilación protectora. Como conclusión, en los pacientes estudiados la edad y ΔP fueron predictores independientes de mortalidad.

Abstract Introduction: the information regarding characteristics and ventilatory results comparing the first (W1) and the second wave (W2) in Argentina are limited. The main objective of this study was to describe general charac teristics and ventilatory variables in COVID-19 patients who required invasive mechanical ventilation (IMV) and compare differences between waves. Secondarily, factors associated with mortality in intensive care unit (ICU) were studied. Methods: We conducted a prospective observational cohort study that included patients older than 18 years infected with SARS-CoV-2 consecutively admitted to ICU with IMV between August 1, 2020, and June 30, 2021. We included 412 patients. Results: We found statistically significant differences (p < 0.001) in age [W1 64(55-72) vs W2 59 (50-66) years], presence of COPD [W1 n = 42 (19.8%) vs. W2 n = 13(6.3%)], plateau pressure [W1 27(25-30) cm H2O vsW2 24 (22-27) cmH2O], driving pressure (ΔP) [W1 15 (13-17) cmH2O vs. W2 12 (11-14) cm H2O] compliance [W1 40 mL/cmH2O (32-46) vs. W2 = 33 mL/cm H2O (27-40)]; reintubation [W1 30.4% (n = 63/207) vs. W2 13.7% (n = 28/205)]. We identified as independent factors associated with mortality the following variables: age [OR 1.07(95% CI 1.05-1.09)], the ΔP in the first 24 hours [OR 1.19(95% CI 1.10- 1.28)] and W2 [OR 1.81 (95% IC1.12-2.93); p = 0.015. Discussion: During W2 the patients were younger. It was possible to achieve ventilatory mechanics more adjusted to a protective ventilation strategy. In conclusion, in the patients studied, age and ΔP were independent predictors of mortality.

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Differences between COVID-19-induced acute kidney injury and chronic kidney disease patients
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Aroca-Martínez, Gustavo

; Musso, Carlos G.

; Avendaño-Echavez, Lil

; Vélez-Verbel, María

; Chartouni-Narvaez, Stefani

; Hernandez, Sandra

; Hinojosa-Vidal, Mauricio Andres

; Espitaleta, Zilac

; Cadena-Bonfanti, Andrés

Brazilian Journal of Nephrology

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jun 2022, Volume 44 N. 2 Pages 155 - 163

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Introdução: Este artigo descreve as principais diferenças entre a lesão renal aguda induzida por COVID-19 (LRA-COVID19) em pacientes com função renal normal prévia (LRA-FRN) e aqueles com doença renal crônica (LRA-DRC) atendidos em uma clínica de alta complexidade em Barranquilla (Colômbia). Material e Métodos: Os pacientes incluídos neste estudo (n: 572) foram aqueles com um diagnóstico positivo de COVID-19 confirmado pela detecção de PCR positivo para SARS-CoV-2. Destes pacientes, 188 desenvolveram LRA durante sua internação. Foram registrados os dados epidemiológicos, os parâmetros séricos e o estado de fragilidade clínica dos pacientes. Foram feitas a análise estatística e a comparação entre pacientes com LRA-FRN, LRA-DRC, e pacientes sem LRA. Resultados: A incidência de LRA induzida por COVID-19 foi de 33%, com a maioria classificada como AKIN 1, 16% exigindo terapia renal substitutiva, e a mortalidade por LRA-COVID19 foi de 68%. Foi registrada uma prevalência significativamente mais alta de hipertensão, doença cardíaca e proteína C reativa sérica e valores mais baixos de albumina em pacientes com LRA-DRC. A taxa de mortalidade, a necessidade de ventilação invasiva e os níveis de dímero-D foram significativamente mais altos em pacientes com LRA-FRN. Conclusão: Foram documentados padrões clínicos diferentes entre LRA-FRN e LRA-DRC.

Abstract Introduction: This article describes the main differences between COVID-19-induced acute kidney injury (AKI-COVID19) in patients with previous normal renal function (AKI-NRF) and those with chronic kidney disease (AKI-CKD) treated in a high complexity clinic in Barranquilla (Colombia). Material and Methods: The patients included in this study (n: 572) were those with a positive diagnosis of COVID-19 confirmed by detection of a positive PCR for SARS-CoV-2. Of these patients, 188 developed AKI during their hospital stay. Patients’ epidemiological data, serum parameters, and clinical frailty status were recorded. Statistical analysis and comparison among AKI-NRF, AKI-CKD, and non-AKI patients were performed. Results: The incidence of COVID-19-induced AKI was 33%, with the majority classified as AKIN 1, 16% requiring renal replacement therapy, and AKI-COVID19 mortality of 68%. A significantly higher prevalence of hypertension, cardiac disease, and serum reactive C-protein and lower albumin values in AKI-CKD patients was recorded. Mortality rate, invasive ventilation requirement, and D-dimer levels were significantly higher in AKI-NRF patients: Conclusion: Different clinical patterns between AKI-NRF and AKI-CKD were documented.

https://doi.org/10.1590/2175-8239-jbn-2021-0161

COVID-19-induced acute kidney injury and chronic kidney disease: correspondence response
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Musso, Carlos G.

; Aroca-Martinez, Gustavo

Brazilian Journal of Nephrology

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2022, N. ahead

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/2175-8239-jbn-2022-0115rep-en

Differences between COVID-19-induced acute kidney injury and chronic kidney disease patients
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Aroca-Martínez, Gustavo

; Musso, Carlos G.

; Avendaño-Echavez, Lil

; Vélez-Verbel, María

; Chartouni-Narvaez, Stefani

; Hernandez, Sandra

; Hinojosa-Vidal, Mauricio Andres

; Espitaleta, Zilac

; Cadena-Bonfanti, Andrés

Brazilian Journal of Nephrology

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2022, N. ahead

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/2175-8239-jbn-2021-0161

Covid-19 in 40 dialysis facilities. A prospective multicenter cohort study in Spain
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Deira, Javier L.

; González-Sanchidrián, Silvia

; Rocha, André

; Musso, Carlos G.

; Ruiz-Calero, Rosa M.

; Puello, Suleyka

; Gómez, Belén

; Ramos, Manuel

; Stefan, George

; Lopez, Francisca

; Torregrosa, Eduardo

; Lerma, José L.

; Grande, Jesús

; Hernández, Esther

; Martín, Jesús

; Gascón, Antonio

; Dorado, Pedro

Portuguese Journal of Nephrology & Hypertension

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sep 2021, Volume 35 N. 3 Pages 153 - 159

Abstract: En | Text: En | PDF: En

ABSTRACT Aims: Assess the incidence of COVID-19 during the first wave of the pandemic in 40 hemodialysis units in Spain. Material and methods: We analyzed 396 Rt-PCR performed March 14th to April 28th, 2020 in a cohort of 2398 hemodialysis (HD) patients corresponding to 19 hospital units and 21 satellite centers. Results: We performed Rt-PCR in 14% of the patients, with a marked variability depending on the location. The overall COVID-19 incidence was 3.2% (range 0-15.9%). It was significantly higher in the hospital units (4.5%) than in the satellite units (1.9%) (p=0.0003). There was a positive and significant correlation between the COVID-19 incidence in the units and their proximity to Madrid (R2=0.6235, p=0.0013), which was the main epidemic focus. Conclusion: Our study showed a low incidence of COVID-19 in HD, higher in hospital units and closer to Madrid.

https://doi.org/10.32932/pjnh.2021.10.140 64 downloads

Cranberry dosed extract: an effective therapy for recurrent Escherichia coli cystitis in elderly patients. The GerHogar Cysticlean® study
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Macías Núñez, Juan Florencio

; Pablos Hernández, Carmen

; Cuadrado Blanco, Jesús

; Tamame Gonzalez, Guzmán

; Gómez Villa, Agapito

; del Cañizo Álvarez, Amparo

; Guido Musso, Carlos

Revista Colombiana de Nefrología

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jun 2021, Volume 8 N. 1 elocation e205

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción: la cistitis es la infección del tracto urinario más común a nivel mundial y los antibióticos son su terapia convencional; sin embargo, la tasa de prevalencia de la resistencia de los uropatógenos a los antibióticos ha aumentado significativamente en los últimos tiempos. El tratamiento con arándano rojo se ha asociado con la inhibición de la adherencia de la Escherichia coli a las células uroepiteliales debido a la propiedad antiadherente relacionada con su contenido de proantocianidinas. La cysticlean® (CYS) es un extracto de arándano rojo que contiene 240 mg de PAC por cápsula. Objetivo: estudiar la eficacia y seguridad de la CYS en el tratamiento de la cistitis como reemplazo de los antibióticos en personas adultas mayores. Material y métodos: se estudiaron dos grupos, uno (G1) en el que el primer episodio de cistitis se registró dentro de los últimos 3 meses antes del inicio del estudio y otro (G2) en el que se registraron episodios recurrentes de cistitis frecuentes (≥1-2 al mes) en los últimos 3 meses antes del inicio del estudio. Los pacientes del G1 fueron tratados con 1 cápsula de CYS cada 12 horas durante 1 mes, mientras que los del G2 fueron tratados por 12 meses con el mismo esquema. La evaluación comparativa se realizó mediante la prueba de Student. Resultados: en el estudio participaron 160 pacientes ambulatorios de la tercera edad residentes de hogares de ancianos y con diagnóstico de cistitis recurrente. De estos, 38 se incluyeron en G1 y 122, en G2. El tratamiento de la cistitis a base de arándano rojo tuvo éxito en el 81,57 % y el 81,96 % de los pacientes de G1 y G2, respectivamente. Conclusión: la CYS demostró ser una terapia alternativa eficaz a los antibióticos para tratar las recurrencias de cistitis causadas por E. coli al no presentarse efectos secundarios ni reacciones adversas.

Abstract Introduction: Cystitis is the most prevalent urinary tract infection (UTI), and antibiotics are its conventional therapy. However, the prevalence rate of antibiotic resistance to uropathogens is significantly increased. Cranberry treatment has been associated with the inhibition of Escherichia coli (Ec) adherence to uroepithelial cells due to the anti-adhesive property related to its proanthocyanidins content, and cysticlean® (CYS) is a cranberry extract which contains 240 mg PACs per capsule. Since elderly people is one of the populations mostly exposed to cystitis and bacteria antibiotic resistance, it was decided to originally study the efficacy and safety of CYS, to treat cystitis instead of antibiotic, in elderly individuals. Material & Methods: Two groups were studied: Group 1 (G1): first cystitis episode was recorded within the last 3 months before the study initiation. Group 2 (G2): frequent cystitis recurrent episodes (1-2/month or more) within the last 3 months before the study initiation. G1 patients were treated with 1 capsule of CYS every 12 h for 1 month, while G2 patients were treated up to 12 months. Comparative evaluation was performed using Student test. Results: 160 elderly ambulatory and nursing home patients suffering from recurrent cystitis were treated with CYS. G1 and G2 had 38 and 122 subjects, respectively. Cranberry-based cystitis treatment was successful in 81.57 % and 81.96 % in G1 and G2 patients, respectively. Conclusion: CYS showed to be an effective alternative therapy to antibiotics to treat cystitis recurrences caused by Ec. Neither side effects nor adverse reactions have been reported.

https://doi.org/10.22265/acnef.8.1.545 43 downloads

Consenso de manejo del paciente con diabetes mellitus y patología cardiovascular. Sociedad Argentina de Cardiología (SAC)-Sociedad Argentina de Diabetes (SAD)
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Giorgi, Mariano Aníbal

; Litwak, León E.

; Sanabria, Hugo

; Lavalle Cobo, Augusto

; Musso, Carla

; Salmeri, Emiliano

; Álvarez, José

; Aranguren, Florencia

; Belcastro, Fernando

; Brites, Fernando

; Buso, Carlos

; Calvagno, Marta

; Caroli, Christian

; Celano, Leonardo

; Cohen Arazi, Hernán

; Comtesse, Daniel

; Corral, Pablo

; Costabel, Juan Pablo

; Elbert, Alicia

; Faingold, Cristina

; Fuente, Graciela

; García Merletti, Pablo

; Giorgi, Mariano Aníbal

; Giunta, Gustavo

; Gómez Santamaría, Héctor

; González Naya, Enrique

; Hadid, Claudio

; Kraselnik, Ariel

; Lavalle Cobo, Augusto

; Litwak, León

; Lobo, Martín

; Lozada, Alfredo

; Majul, Claudio

; Masson, Walter

; Musso, Carla

; Nogueira, Juan

; Persi, Gabriel

; Rodríguez, Martín

; Salmeri, Emiliano

; Sanabria, Hugo

; Schraier, Silvio

; Sinay, Isaac

; Siniawski, Daniel

; Thierer, Jorge

; Salzberg, Susana

; Suárez Cordo, Cristian

; Lerman, Jorge

; Sosa Liprandi, Álvaro

Revista de la Sociedad Argentina de Diabetes

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mar 2021, Volume 55 Suppl. 1 Pages 3 - 70

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract This Consensus comes to light in the midst of one of the worst global health crises in the last 100 years. SARS-CoV-2 and its clinical manifestation, COVID-19, have caused a disruption in how doctors and patients interact. Although it is an infectious disease, one of the most notable characteristics is that its mortality increases in patients with chronic non-communicable diseases and, in particular, with a history of diabetes and cardiovascular disease. In this context, then, we believe that the recommendations made in this document, which aim to identify and protect these patients, become more relevant, while the implementation, beyond the statements, of specific cardiometabolic prevention policies becomes a priority. Methodology: this consensus is the result of the will of two Scientific Societies that have recognized the need to complement the focus on the same problem: that of patients with diabetes mellitus (DM) and cardiovascular disease (CVD), or who are at risk to suffer it. Both the Argentine Society of Cardiology (SAC) and the Argentine Society of Diabetes (SAD) have a recognized track record in the production of practice guidelines and consensus documents, although each has different work practices and cultures. Consequently, the first task that was faced was to agree, not only on the agenda and the approach to the different issues, but also on common working methods: general objective of the document, how to analyze and evalua-te the weight of the information, define the levels of evidence and determine the degrees of recommendation. It was agreed to adopt the modality used by the SAC in all the documents produced by the Consensus and Standards Area, set out in the following table: The experts who collaborated in the drafting of the Consensus were selected and invited to participate with the unanimous agreement of the group of Directors and Secretaries belonging to both Scientific Societies. Colleagues with recognized experience in the disciplines addressed were summoned to analyze the evidence and write the recommendations. All the methodological aspects and the final recommendations of this document were defined by agreement between the group of Directors and Consensus Secretaries.The information consolidation process was slow: from the decision of both companies until the writing of this document, the field of DM and CVD management underwent profound transformations that transcend the appearance of new therapeutic agents. What has been developed is a new approach model that is, in the words of Dr. Alicia Elbert, transdisciplinary. This has implied waiting and being able to understand and "process" all the information that has emerged in these years. This document, which aims to assist physicians in daily practice, has tried to adopt this new integrative perspective.

10.

Infecções sexualmente transmissíveis em mulheres afrodescendentes de comunidades quilombolas no Brasil: prevalência e fatores associados
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Dias, Jerusa Araujo

; Luciano, Thaís Verly

; Santos, Maria Carmen Lopes Ferreira Silva

; Musso, Carlos

; Zandonade, Eliana

; Spano, Liliana Cruz

; Miranda, Angelica Espinosa

Cadernos de Saúde Pública

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2021, Volume 37 N. 2 elocation e00174919

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo: O objetivo do estudo foi estimar a prevalência de infecções sexualmente transmissíveis (IST) e fatores associados sobre mulheres quilombolas no Brasil. Trata-se de estudo transversal de base populacional com mulheres quilombolas no período de março de 2017 a janeiro de 2019. Utilizou-se um questionário com informações sociodemográficas, comportamentais e clínicas. Foi realizado exame ginecológico para coleta de células cervicais para citologia oncótica e para detecção de Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis e papilomavírus humano (HPV), por meio de teste de reação em cadeia pela polimerase. Foi realizado teste rápido para HIV e sífilis. O desfecho principal foi definido como a infecção por um ou mais agentes infecciosos de transmissão sexual. Para a análise, utilizou-se o teste do qui-quadrado e regressão logística hierárquica. De um total de 380 mulheres, 352 (92,6%) foram incluídas no estudo. A prevalência de, pelo menos, uma IST foi de 18,5% (IC95%: 14,76-22,85). A maior prevalência foi de 11,1% por HPV, seguido de 6,3% por T. vaginalis e de 4,3% por C. trachomatis. Não houve nenhum caso de N. gonorrhoeae. Para o HIV, a prevalência foi de 0,3%, e de sífilis foi de 4,3%. A citologia cervicovaginal estava alterada em 7,7%. A detecção de uma ou mais IST foi significativamente associada a idade entre 25 e 44 anos (OR = 2,33; IC95%: 1,05-5,18), a consumo de álcool (OR = 1,96; IC95%: 1,06-3,64), a resultado alterado da citologia (OR = 3,96; IC95%: 1,65-9,48) e a vaginose bacteriana (OR = 3,61; IC95%: 2,01-6,47). Em mulheres quilombolas houve elevada prevalência de uma ou mais IST, o que torna importante a elaboração de estratégias de prevenção direcionadas a essas mulheres.

Abstract: The study aimed to estimate the prevalence of sexually transmissible infections (STIs) and associated factors in women in quilombola (maroon) communities in Brazil. This was a population-based cross-sectional study of quilombola women from March 2017 to January 2019. A questionnaire was used with sociodemographic, behavioral, and clinical information. A gynecological examination was performed for the collection of uterine cervical cells for oncotic cytology and the detection of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and human papillomavirus (HPV) via polymerase chain reaction. Rapid tests for HIV and syphilis were performed. The main outcome was defined as infection with one or more sexually transmissible pathogens. The analysis used chi-square test and hierarchical logistic regression. From a total of 380 women, 352 (92.6%) were included in the study. Prevalence of at least one STI was 18.5% (95%CI: 14.76-22.85). The highest prevalence was for HPV, with 11.1%, followed by 6.3% for T. vaginalis and 4.3% for C. trachomatis. There were no cases of N. gonorrhoeae. Prevalence was 0.3% for HIV and 4.3% for syphilis. Cervical-vaginal cytology was altered in 7.7% of the women. Detection of one or more STIs was significantly associated with age 25 to 44 years (OR = 2.33; 95%CI: 1.05-5.18), alcohol consumption (OR = 1.96; 95%CI: 1.06-3.64), altered cervical cytology (OR = 3.96; 95%CI: 1.65-9.48), and bacterial vaginosis (OR = 3.61; 95%CI: 2.01-6.47). Quilombola women showed high prevalence of one or more STIs, emphasizing the importance of organizing prevention strategies targeted to these women.

Resumen: El objetivo del estudio fue estimar la prevalencia de enfermedades de transmisión sexual (ETS) y sus factores asociados en mujeres quilombolas en Brasil. Estudio transversal de base poblacional con mujeres quilombolas durante el período de marzo de 2017 a enero de 2019. Se utilizó un cuestionario con información sociodemográfica, comportamental y clínica. Se realizó un examen ginecológico, a fin de recoger células cervicales para la citología oncótica, así como para la detección de Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, y virus del papiloma humano (VPH) mediante un test de reacción en cadena de la polimerasa. Se realizó un test rápido para VIH y sífilis. El resultado principal, se definió como infección por uno o más agentes infecciosos de transmisión sexual. Para el análisis, se utilizó el test de chi-cuadrado y regresión logística jerárquica. De un total de 380 mujeres, 352 (92,6%) se incluyeron en el estudio. La prevalencia de por lo menos una ETS fue de 18,5% (IC95%: 14,76-22,85). La mayor prevalencia fue por VPH 11,1%, seguida de 6,3% por T. vaginalis y 4,3% por C. trachomatis. No hubo casos de N. gonorrhoeae. Para el VIH, la prevalencia fue de 0,3% y de sífilis fue de 4,3%. La citología cérvico-vaginal estaba alterada en un 7,7%. La detección de una o más ETS estuvo significativamente asociada con la edad entre 25 a 44 años (OR = 2,33; IC95%: 1,05-5,18), el consumo de alcohol (OR = 1,96; IC95%: 1,06-3,64), resultado alterado de la citología (OR = 3,96; IC95%: 1,65-9,48) y vaginosis bacteriana (OR = 3,61; IC95%: 2,01-6,47). Las mujeres quilombolas presentaron una elevada prevalencia por una o más ETS, por lo que es importante la elaboración de estrategias de prevención dirigidas a estas mujeres.

https://doi.org/10.1590/0102-311x00174919

11.

Sexually transmitted infections among women living with HIV in a Brazilian city
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Tosato Boldrini, Neide Aparecida

; Bondi Volpini, Lays Paula

; Freitas, Luciana Bueno

; Spano, Liliana Cruz

; Musso, Carlos

; Silva Santos, Maria Carmen Lopes Ferreira

; Barroso dos Reis, Helena Lucia

; Miranda, Angelica Espinosa

Brazilian Journal of Infectious Diseases

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2021, Volume 25 N. 1 elocation 101044

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Clinical improvements following highly active antiretroviral therapy (HAART) may increase high-risk behaviors resulting in sexually transmitted infections (STI). Optimism related to the success of HAART in slowing disease progression, reducing viral load, and improving health status might be important factors for increasing sexual risk behaviors such as less use of condoms. Objective: To determine the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis, hepatitis B and C, high-risk HPV, and cervical cytological abnormalities among women living with HIV (WLHIV) who attended a Reference Center for STI/AIDS in Brazil. Methods: A cross-sectional study was conducted among 151 WLHIV attending an STI Clinic in Vitória city, Brazil. A structured questionnaire, including demographic, behavioral, and clinical information, was used for data collection. Serological tests for HIV, syphilis, hepatitis C and B, CD4 counts, and viral load determination were performed. Cervical samples were collected for cytology and real-time PCR for HPV, Chlamydia, and Neisseria gonorrhoeae. Results: In this study, 59% of women had at least one diagnosed STI at the time of the first clinic visit; 31% had clinical forms of anogenital HPV, 10% syphilis, 8%Neisseria gonorrhoeae, 5.0% trichomoniasis, 3% Chlamydia trachomatis, 1% hepatitis B, and 1% hepatitis C; 6.7% of the women presented with cervical cytological abnormalities. Furthermore, 46.3% of women had HR-HPV, and 17.6% had HPV 16/18. Only 5% of the women had a CD4 count <200 cells/mm3, 61.6% had undetectable HIV viral load, and 81.3% were currently on HAART. Conclusion: A high prevalence of STI and HR-HPV infections were observed among HIV-infected women in this investigation. Prevention programs need to focus on counseling WLHIV and their regular partners with focused interventions such as couples counseling and education programs.

https://doi.org/10.1016/j.bjid.2020.101044 187 downloads

12.

Infecções sexualmente transmissíveis em mulheres afrodescendentes de comunidades quilombolas no Brasil: prevalência e fatores associados
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Dias, Jerusa Araujo

; Luciano, Thaís Verly

; Santos, Maria Carmen Lopes Ferreira Silva

; Musso, Carlos

; Zandonade, Eliana

; Spano, Liliana Cruz

; Miranda, Angelica Espinosa

Cadernos de Saúde Pública

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2021, Volume 37 N. 2 elocation e00174919

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.1590/0102-311x00174919 1763 downloads

13.

Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, el diagnóstico y el manejo de la lesión renal aguda por SARS-CoV-2/COVID-19
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González, Camilo

; Yama, Erika

; Yomayusa, Nancy

; Vargas, Juan

; Rico, Jorge

; Ariza, Amaury

; Aroca, Gustavo

; Baquero, Richard

; Ramírez, Roberto

; Chacón, Kelly

; Torres, Rodolfo

; Robayo, Adriana

; Peña, Adalberto

; Meza, Adriana

; Molano, Alejandra

; Lizarazo, Alexandra

; Caicedo, Andrea

; Acevedo, Andrés

; Calderón, Angélica

; Zambrano, Betty

; Musso, Carlos Guido

; Lozano, Carlos

; Buitrago, Cristóbal

; Ballesteros, David

; Chacón, Diana

; Vargas, Diana

; Gayón, Diana

; Villafañe, Douglas

; López, Francisco

; Ardila, Freddy

; Pinzón, Guillermo

; Guerrero, Gustavo

; Benavides, Helman

; Villanueva, Ignacio

; Raoch, Ingrid

; Galeano, Javier

; Gordon, Jennifer

; Cáceres, Jimena

; Pulido, Jorge

; Pérez, Jorge

; Contreras, Kateir

; Aristizábal, Leidy

; Valderrama, Luis

; Gómez, María

; Vargas, María José

; Carrascal, Martha

; Rodríguez, Martha

; Guerrero, Mauricio

; Alfaro, Mercedes

; Tobón, Natalia

; García, Paola

; Rodríguez, Paula

; Daza, Rodrigo

; Espitaleta, Zilac

Revista Colombiana de Nefrología

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dec 2020, Volume 7 Suppl. 2 Pages 89 - 117

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract Introduction: Acute kidney injury is a frequent complication in patients with COVID-19 and its occurrence is a potential indicator of multi-organ dysfunction and disease severity. Objective: Develop, through an expert consensus, evidence-based recommendations for the prevention, diagnosis, and management of acute kidney injury in patients with SARS CoV2 / COVID-19 infection. Materials and methods: Based on a rapid systematic review in Embase and Pubmed databases and documents from scientific societies, we made preliminary recommendations and consulted with an expert group through an online tool. Then we defined agreement after at least 70 % consensus approval. Quality evidence was evaluated according to the type of document included. The strength of the recommendations was graded as strong or weak. Results: Fifty clinical experts declared their conflict of interest; the consultation took place between May 2 and 29, 2020. The range of agreement ranged from 75.5 % to 100 %. Recommendations for prevention, diagnosis and management of acute kidney injury in patients with SARS CoV2 infection are presented. Conclusions: Although the good quality information available regarding acute kidney injury in patients with COVID-19 is scarce, the recommendations of clinical experts will guide clinical decision-making and strategies around patients with this complication, guaranteeing care focused on the people, with high quality standards, and the generation of safety, health and wellness policies for multidisciplinary care teams.

https://doi.org/10.22265/acnef.7.supl.2.73 434 downloads

14.

COVID-19 y lesión renal aguda: conocimientos actuales
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Avendaño Echavez, Lil Géraldine

; Musso, Carlos G.

Revista Colombiana de Nefrología

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dec 2020, Volume 7 Suppl. 2 Pages 371 - 372

Abstract: Es | Text: Es | PDF: Es

https://doi.org/10.22265/acnef.7.supl2.471 238 downloads

15.

ASIA case after injection of liquid silicone,
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Libardi, Camila Secco

; Diniz, Lucia Martins

; Musso, Carlos

; Badaró, Bruna Anjos

Anais Brasileiros de Dermatologia

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aug 2020, Volume 95 N. 4 Pages 542 - 544

Abstract: En | Text: En | PDF: En

https://doi.org/10.1016/j.abd.2019.12.006 295 downloads

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