Seroprevalence and epidemiology of hepatitis B and C viruses in pregnant women in Spain. Risk factors for vertical transmission

Background & aim Worldwide, measures are being implemented to eradicate hepatitis B (HBV) and C (HCV) viruses, which can be transmitted from the mother during childbirth. This study aims to determine the prevalence of HBV and HCV in pregnant women in Spain, focusing on country of origin, epidemiological factors and risk of vertical transmission (VT). Methodology Multicentre open-cohort study performed during 2015. HBV prevalence was determined in 21870 pregnant women and HCV prevalence in 7659 pregnant women. Epidemiological and risk factors for VT were analysed in positive women and differences between HBV and HCV cases were studied. Results HBV prevalence was 0.42% (91/21870) and HCV prevalence was 0.26% (20/7659). Of the women with HBV, 65.7% (44/67) were migrants. The HBV transmission route to the mother was unknown in 40.3% of cases (27/67) and VT in 31.3% (21/67). Among risk factors for VT, 67.7% (42/62) of the women had viraemia and 14.5% (9/62) tested HBeAg-positive. All of the neonates born to HBV-positive mothers received immunoprophylaxis, and none contracted infection by VT. In 80% (16/20) of the women with HCV, the transmission route was parenteral, and nine were intravenous drug users. Viraemia was present in 40% (8/20) of the women and 10% (2/20) were HIV-coinfected. No children were infected. Women with HCV were less likely than women with HBV to breastfeed their child (65% vs. 86%). Conclusions The prevalences obtained in our study of pregnant women are lower than those previously documented for the general population. Among the women with HBV, the majority were migrants and had a maternal family history of infection, while among those with HCV, the most common factor was intravenous drug use. Despite the risk factors observed for VT, none of the children were infected. Proper immunoprophylaxis is essential to prevent VT in children born to HBV-positive women.This study received financial assistance from the following: Ciberehd, Fondo de Investigaciones Sanitarias del Instituto de Salud Carlos III. ISCIII, Proyecto del Plan Nacional I+D+i 2013-2016 (PI13/01925), Confinanciacio´n Fondos FEDER. Gilead Fellowship Program (GLD14-00292 and GLD15-00307)

AA-NAT, MT1 and MT2 Correlates with Cancer Stem-Like Cell Markers in Colorectal Cancer: Study of the Influence of Stage and p53 Status of Tumors

The characterization of colon cancer stem cells (CSCs) may help to develop novel diagnostic and therapeutic procedures. p53 loss increases the pool of CSCs in colorectal cancer (CRC). Recent reports suggest that the oncostatic effects of melatonin could be related to its ability to kill CSCs. Although there are no data linking the loss of p53 function and melatonin synthesis or signaling in cancer, melatonin does activate the p53 tumor-suppressor pathway in this disease. In this work, we analyze whether the expression of melatonin synthesis and signaling genes are related to the expression of CSC markers and the implication of p53 status in samples from patients with CRC. Arylalkylamine N-acetyltransferase (AA-NAT), MT1, and MT2 expression decreased in tumor samples versus normal mucosa samples in mutated p53 (mtp53) tumors versus those with wild-type p53 (wtp53). Further, AA-NAT and MT2 expression were lower in advanced stages of the disease in wtp53 tumors. On the contrary, CD44 and CD66c expression was higher in tumor versus normal mucosa in wtp53 tumors. Additionally, CD44 expression was higher in advanced stages of the disease regardless of the p53 status. Patients with CD44highCD66chigh and wtp53 tumors in advanced stages showed low expression of AA-NAT and MT2 in wtp53 tumors. These results could indicate a possible interaction of these pathways in CRC.This research was supported by grants from the Consejería de Salud de la Junta de Andalucía (PI-0677-2013). Josefa León acknowledges sponsorship from the Servicio Andaluz de Salud “Nicolás Monardes” program

Fever of unkown origin in children. An approach to diagnosis and intervention in primary health care

Este trabajo obtuvo el Primer “Premio Colegio Oficial de Médicos” de Granada en la convocatoria 15 de Diciembre de 2009.Introducción. La fiebre es un motivo de consulta frecuente. Debido a que gran parte de lo publicado se refiere a atención Hospitalaria, nuestro objetivo es evaluar su diagnóstico, manejo e intervención en Pediatría de Atención Primaria. Material y métodos. Estudio transversal descriptivo, sobre población menor de 14 años con diagnóstico Fiebre 780.6 del CIE 9 (FSF), en dos consultas de pediatria. Se utiliza como comparativo el Proceso Fiebre en el Niño. Los datos se procesan con SPSS 15 y software de soporte para datos tabulados Epidat 3.1, se utiliza en su análisis la frecuencia 2 relativa y el test de la ÷ , como diferencia significativa p < 0,05. Resultados. Porcentaje medio de FSF 0,55 %, predominio de niños sobre niñas (p<0,05), del grupo de 3-36 meses de edad 59, 2%. Derivados a hospital 3,9 %. Bajo registro del grado de temperatura 26,2 %. Consulta en menos de 24 h del inicio febril 72,3 %. Solicitud exámenes complementarios 27,2 %, tira de orina en < 1 año 48,9 % y en fiebre de más de 48 h 19 %. Ausencia de registro antitérmico prescrito 34 %, vacunados contra neumococo 64,5 %. Revisión tras consulta inicial 34,5 % de ellos que se llego a un diagnóstico 88,7 %. Conclusiones. Bajo registro de FSF en AP. Rápida consulta por parte de los padres tras comienzo de fiebre. Más casos en el grupo de 3-36 meses. Bajo registro de temperatura y antitérmico recomendado. Escasa derivación al hospital, mayor en menor edad. Probable auto resolución de muchos casos. Poca variabilidad entre profesionales.Introduction. Fever is a common complaint leading patients to seek medical attention. Since majority of published papers deals with hospital attention, our aim is to evaluate its diagnosis, management and intervention in Paediatric consultations in Primary Health Care (PHC). Materials and methods. Transverse descriptive study, performed on <14-year-old population diagnosed with Fever 780.6 of the CIE 9 (FUO), in two paediatric surgeries. Procedure Fever in Child is used as comparative. The data is 2 processed with SPSS 15 and tabulated data support software Epidat 3.1. Relative frequency and the ÷ test was used in the analysis, with the p <0,05 significant difference. Results. Average percentage of FUO 0,55 %, predominant in boys (p < 0,001) and in 3-36 month-old age group 59, 2 %. Percentage sent to hospital 3,9 %. Actual temperature level recorded in few cases 26,2 %. Medical assistance sought in less than 24 h from the onset of fever. Complementary tests requested in 27,2 %, urine strips in <1 year olds 48,9 % and in fever lasting longer than 48 h 19 %. Register of antithermics prescribed absent in 34 %, vaccinated against pneumococcus 64,5 %. Follow-up appointment after the first consultation 34,5 % with diagnosis in 88,7 %. Conclusions. Low recordings of FUO in PHC. Fever checked briefly by parents on its onset. More cases found in the 3-36 months-old age group. Low percentage of temperatures documented and antipyretics prescribed. Few cases hospitalised, higher in younger age groups. In many cases fever resolved itself. Minor differences between professionals

Case-Control Study On Generalised Joint Hypermobility In Schoolchildren With Functional Gastrointestinal Disorders According To Rome IV Criteria In Spanish

INTRODUCTIONAlthough results show an association between the presence of generalised joint hypermobility (GJH) and functional gastrointestinal disorders (FGIDs) in children, they are limited and controversial. OBJECTIVETo determine the association between GJH and FGIDs and the search for risk factors for GJH in girls from a Public Educational Institution of Tuluá, Colombia. PATIENTS AND METHODSThe students completed the Rome IV Questionnaire to identify FGIDs. Each girl with a diagnosis of some FGIDs was matched with a healthy control of the same age. Joint laxity was assessed according to the Beighton score and was considered as GJH when it was ≥ 4. The prevalence of GJH was compared in girls with and without FGIDs. RESULTSOut of a total of 921 girls between 10 and 18 years of age that participated in the study, 219 (23.8%) of them had some FGIDs. The analysis was performed on a total of 169 girls with FGIDs and 169 healthy control girls. There were no significant differences in GJH between girls with and without a diagnosis of some FGIDs (OR=1.12: 95% CI; 0.71-1.77, P=.5838), nor were there any risk factors. CONCLUSIONIn this study, no relationship or any risk factor was found between GJH and the presence of FGIDs

Variation of Transaminases, HCV-RNA Levels and Th1/Th2 Cytokine Production during the Post-Partum Period in Pregnant Women with Chronic Hepatitis C

This study analyses the evolution of liver disease in women with chronic hepatitis C during the third trimester of pregnancy and the post-partum period, as a natural model of immune modulation and reconstitution. Of the 122 mothers recruited to this study, 89 were HCV-RNA+ve/HIV-ve and 33 were HCV-RNA-ve/HIV-ve/HCVantibody+ve and all were tested during the third trimester of pregnancy, at delivery and post-delivery. The HCV-RNA+ve mothers were categorized as either Type-A (66%), with an increase in ALT levels in the post-partum period (>40 U/L; P<0.001) or as Type-B (34%), with no variation in ALT values. The Type-A mothers also presented a significant decrease in serum HCV-RNA levels in the post-delivery period (P<0.001) and this event was concomitant with an increase in Th1 cytokine levels (INFγ, P = 0.04; IL12, P = 0.01 and IL2, P = 0.01). On the other hand, the Type-B mothers and the HCV-RNA-ve women presented no variations in either of these parameters. However, they did present higher Th1 cytokine levels in the partum period (INFγ and IL2, P<0.05) than both the Type-A and the HCV-RNA-ve women. Cytokine levels at the moment of delivery do not constitute a risk factor associated with HCV vertical transmission. It is concluded that differences in the ALT and HCV-RNA values observed in HCV-RNA+ve women in the postpartum period might be due to different ratios of Th1 cytokine production. In the Type-B women, the high partum levels of Th1 cytokines and the absence of post-partum variation in ALT and HCV-RNA levels may be related to permanent Th1 cytokine stimulation.This work was supported by the Fondo de Investigaciones Sanitarias (FIS, Instituto de Salud Carlos III), [grant number PI080704]; Consejería de Salud (SAS), Junta de Andalucía, [grant number SAS111213] and Ciberehd (Ciber de Enfermedades Hepáticas y Digestivas (Instituto de Salud Carlos III)

Polymorphisms for predicting or forecasting the response to antiviral treatment

Número de publicación: ES2546153 B1 . Número de solicitud: 201430205.Polimorfismos para predecir o pronosticar la respuesta al tratamiento antiviral. Método de obtención de datos útiles para predecir o pronosticar la respuesta al tratamiento antiviral con interferón pegilado más ribavirina en pacientes con hepatitis crónica C genotipo 1 que presentan el alelo HLA-DQB1*0301, kit o dispositivo y sus usos.Universidad de Granad

Proceso seguimiento recién nacido de riesgo : proceso asistencial integrado

Publicado en la página web de la Consejería de Salud y Bienestar Social: www.juntadeandalucia.es/salud (Consejería de Salud / Profesionales / Nuestro Compromiso por la Calidad / Procesos Asistenciales Integrados / Atención temprana)YesConjunto de actividades coordinadas por el Sistema Sanitario Público de Andalucía que desarrollan profesionales de distintos sectores dirigidas a la población infantil, su familia y entorno, para confirmar un normal desarrollo o, en su defecto, detectar precozmente las alteraciones del mismo e instaurar las medidas terapéuticas oportunas que permitan su recuperación o su neurohabilitación, en función de su capacidad, para obtener el máximo de sus competencias, consiguiendo una mejora en su calidad de vida, a traves de una evaluación periódica del niño con riesgo neurosensorial, biológico, psicológico, sociofamiliar o asociación de los mismos detectado en la época neonatal; o en los que sin presentarlo se detectan señales de alerta

Seroprevalence and epidemiology of hepatitis B and C viruses in pregnant women in Spain. Risk factors for vertical transmission.

BACKGROUND & AIM:Worldwide, measures are being implemented to eradicate hepatitis B (HBV) and C (HCV) viruses, which can be transmitted from the mother during childbirth. This study aims to determine the prevalence of HBV and HCV in pregnant women in Spain, focusing on country of origin, epidemiological factors and risk of vertical transmission (VT). METHODOLOGY:Multicentre open-cohort study performed during 2015. HBV prevalence was determined in 21870 pregnant women and HCV prevalence in 7659 pregnant women. Epidemiological and risk factors for VT were analysed in positive women and differences between HBV and HCV cases were studied. RESULTS:HBV prevalence was 0.42% (91/21870) and HCV prevalence was 0.26% (20/7659). Of the women with HBV, 65.7% (44/67) were migrants. The HBV transmission route to the mother was unknown in 40.3% of cases (27/67) and VT in 31.3% (21/67). Among risk factors for VT, 67.7% (42/62) of the women had viraemia and 14.5% (9/62) tested HBeAg-positive. All of the neonates born to HBV-positive mothers received immunoprophylaxis, and none contracted infection by VT. In 80% (16/20) of the women with HCV, the transmission route was parenteral, and nine were intravenous drug users. Viraemia was present in 40% (8/20) of the women and 10% (2/20) were HIV-coinfected. No children were infected. Women with HCV were less likely than women with HBV to breastfeed their child (65% vs. 86%). CONCLUSIONS:The prevalences obtained in our study of pregnant women are lower than those previously documented for the general population. Among the women with HBV, the majority were migrants and had a maternal family history of infection, while among those with HCV, the most common factor was intravenous drug use. Despite the risk factors observed for VT, none of the children were infected. Proper immunoprophylaxis is essential to prevent VT in children born to HBV-positive women

Characteristics of the Type-A and Type-B mothers.

1<p>Mean ± the standard error of the mean (SEM) ns  =  non-significant</p>2<p>Values are absolute with percentages in parentheses VL = Viral Load</p>3<p>3–6 months post-partum-delivery; ρg/mL</p><p>Bivariate analysis: P-value by chi-squared test for qualitative variables and Student's t test for normally distributed quantitative variables and the Mann-Whitney Test for quantitative variables with a non-normal distribution.</p