RESUMO
Dengue is a disease of high interest for public health in the affected localities. Dengue virus is transmitted by Aedes species and presents hyperendemic behaviors in tropical and subtropical regions. Colombia is one of the countries most affected by the dengue virus in the Americas. Its central-west region is a hot spot in dengue transmission, especially the Department of Antioquia, which has suffered from multiple dengue outbreaks in recent years (2015-2016 and 2019-2020). In this article, we perform a retrospective analysis of the confirmed dengue cases in Antioquia, discriminating by both subregions and dengue severity from 2015 to 2020. First, we conduct an exploratory analysis of the epidemic data, and then a statistical survival analysis is carried out using a Cox regression model. Our findings allow the identification of the hazard and socio-demographic patterns of dengue infections in the Colombian subtropical region of Antioquia from 2015 to 2020.
RESUMO
Ocular features may occur in longstanding rheumatoid arthritis. Among them, scleritis represents the most frequent manifestation of ophthalmologic rheumatoid disease. There are three types of anterior scleritis: diffuse, nodular, and necrotizing with and without inflammation (scleromalacia perforans). Nodular scleritis is the second cause of anterior scleritis representing 20% of all types of scleritis. The conventional treatment of nodular scleritis consists in topical steroids and DMARDS. In severe cases, the therapy with immunosuppressive agents to avoid complications is necessary. We describe a 46-year-old woman presented right nodular scleritis with rheumatoid arthritis. She was treated initially with topical steroids and DMARDs but was unable to received systemic steroids due to left open angle glaucoma in the opposite eye. After an ocular exacerbation, we initiated adalimumab with complete resolution of nodular scleritis. This is the first report of adalimumab in the treatment of nodular scleritis. Adalimumab could be a good alternative in patients with severe nodular scleritis who fail to have conventional treatment with DMARDs and unable to receive systemic steroids.