RESUMO
La enfermedad de los legionarios es un importante problema de salud pública particularmente por su frecuente presentación en forma de brotes, tanto comunitarios como nosocomiales, y por su letalidad, especialmente en personas de edad avanzada o con otras enfermedades. La notificación oportuna de casos y/o brotes de enfermedad y la investigación epidemiológica permiten la identificación de la/s fuentes de exposición y la adopción de medidas de prevención y control adecuadas. Las infecciones por Legionella son más frecuentes entre adultos mayores de 50 años, hombres, fumadores y huéspedes inmunocomprometidos o con ciertas enfermedades crónicas subyacentes. La infección en niñas/os es rara, con ≤ 1% de los casos de neumonía causada por Legionella, y puede ser asintomática o leve y no detectada. La Legionella puede multiplicarse si el agua no es tratada de manera adecuada o si los sistemas de agua no son mantenidos adecuadamente.
Assuntos
Legionelose/prevenção & controle , Legionelose/tratamento farmacológico , Surtos de Doenças , Monitoramento EpidemiológicoRESUMO
We performed a descriptive study to characterize effects from COVID-19 among chronic dialysis patients compared with the general population in Argentina during March 2020-February 2021. COVID-19 case-fatality rate of chronic dialysis patients was 10 times the national rate; the age-standardized mortality ratio was 6.8 (95% CI 6.3-7.3).
Assuntos
COVID-19 , Pandemias , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , Argentina/epidemiologia , Diálise RenalRESUMO
RESUMEN INTRODUCCIÓN : Los estudios de seroprevalencia permiten monitorear la circulación del SARS-CoV-2 y dan información para evaluar medidas sanitarias. El objetivo fue conocer la proporción y evolución de la seropositividad en puntos de gran circulación de la Ciudad Autónoma de Buenos Aires (CABA) y las características clínico-epidemiológicas de los seropositivos, de abril a octubre de 2020. MÉTODOS : Se realizó un estudio descriptivo transversal de seis rondas de testeos rápidos serológicos y una encuesta de datos epidemiológicos. Se realizó un muestreo por conveniencia en tres estaciones ferroviarias cabeceras de CABA consideradas puntos de alto tránsito bidireccional del Área Metropolitana de Buenos Aires. RESULTADOS : Participaron 7339 personas. La proporción de seropositivos fue 0,6% (IC95%: 0,2-0,9) en la primera ronda y aumentó a 5,6% en la última (IC95%: 4,3-7). Al inicio aumentó la seropositividad en residentes de CABA y de la zona sur de la Región Metropolitana de Buenos Aires. El antecedente de haber presentado síntomas y el de contacto con personas con COVID-19 fueron las únicas variables relacionadas con el resultado de inmunoglobulina G positivo (p <0,05). El 56,1% (n = 97) de los seropositivos no tuvo síntomas. El 78,4% (n = 134) no fue diagnosticado en la etapa aguda. DISCUSIÓN : La seropositividad fue en ascenso en cada ronda, en coincidencia con la situación epidemiológica de la zona de residencia. Las características epidemiológicas como la proporción de seropositivos sin antecedentes de síntomas, reafirman la importancia de las medidas sanitarias poblacionales.
ABSTRACT INTRODUCTION : Seroprevalence studies allow monitoring the circulation of SARS-CoV-2, providing information to evalúate public health measures. The aim of this study was to determine the proportion and evolution of seropositivity in high circulation points in the Ciudad Autónoma de Buenos Aires (CABA) and clinical and epidemiological characteristics of seropositive individuals from April to October 2020. METHODS : A descriptive cross-sectional study was conducted during six rounds, using rapid serological testing together with an epidemiological data survey. A convenience sample was selected in three CABA railway stations considered as high bi-directional traffic points in the Buenos Aires Metropolitan Area (AMBA). RESULTS : 7,339 people participated. The seropositive proportion was 0.6% (95%CI: 0.2-0.9) in the first round, and rose to 5.6% in the last one (95%CI: 4.3-7). Initially, seropositivity increased in CABA residents and those living in the southern part of the Buenos Aires Metropolitan Region. Having presented symptoms and history of contact with COVID-19 cases were the only variables found to be related to positive IgG results (p<0.05). Among seropositive participantes, 56.1% (n=97) had no symptoms and 78.4% (n=134) didn't receive a COVID-19 diagnosis in the acute stage. DISCUSSION : Seropositivity increased between rounds, according to the epidemiological situation in the area of residence. Epidemiological characteristics, such as the proportion of seropositive individuals with no history of symptoms, reaffirm the importance of public health and social measures.
RESUMO
INTRODUCCIÓN: El objetivo de este estudio fue evaluar posibles factores de riesgo asociados a la mortalidad por COVID-19 y estimar la variabilidad de la fuerza de la asociación según grupo etario, en Argentina en 2020. MÉTODOS: Se realizó un estudio de cohortes retrospectivo. Se presentaron las frecuencias para las variables analizadas y se aplicó un análisis de supervivencia calculando los cocientes de riesgos diarios de fallecer en los primeros 30 días luego del inicio de síntomas (HR, IC95%). Se incluyeron como predictores categóricos la edad <60 años, el sexo, ausencia de comorbilidades, asma, hipertensión arterial (HTA), diabetes, enfermedad oncológica previa (EOP), enfermedad pulmonar obstructiva crónica (EPOC), insuficiencia cardíaca, enfermedad renal (ER), obesidad (OB) y tuberculosis estratificando por grupo etario. RESULTADOS: La comorbilidad más frecuente en fallecidos fue HTA. Los HR más bajos se observaron en personas <60 años (0,086; IC95%: 0,083-0,090) y sin comorbilidades (0,287; IC95%: 0,271-0,303). Los HR más elevados se observaron en personas con ER (2,05; IC95%: 1,94-2,16), insuficiencia cardíaca (1,66; IC95%: 1,59-1,73), EOP (1,65; IC95%: 1,57-1,74) y OB (1,53; IC95%: 1,46-1,6). En personas <60 años, las que mostraron una mayor asociación con la mortalidad fueron EOP y ER; en >80 años fueron ER, OB y sexo masculino. DISCUSIÓN: A medida que aumentó la edad, la magnitud de asociación entre las comorbilidades analizadas y el riesgo de fallecer fue menor. Dado que asma y HTA en >60 años no resultaron ser factores de riesgo en la presente investigación, se requiere profundizar su estudio.
Assuntos
Argentina , Sobrevida , Fatores de Risco , Mortalidade , Infecções por CoronavirusRESUMO
PURPOSE: This study aims to increase the knowledge about the characteristics of cutaneous melanoma in Argentina, their association with the risk of having Breslow ≥1 mm and mortality trends for the period 2002-2017. PATIENTS AND METHODS: Descriptive statistics and regression analyses were done for 10.199 cases within the Argentine Melanoma Registry in the period 2002-2018. Trends in age-standardised mortality rates (ASMR) were analysed using the Join point Regression Model. RESULTS: Cases showed lesions mainly located in males' trunk (37%) and in females' lower limbs (29%). The level of invasion was higher in males who also showed higher mortality. Cases from the North West and North East regions showed a major risk of Breslow >1 mm and harboured CM in lower limbs more frequently than in other regions. Nearly, 25% of tumours over 2 mm were in cases aged <50 years and 37.6% in patients ≥50 years. In the North West, North East and Patagonia, the frequency of cases in young people was higher than in older people. In 43% of cases, the melanoma subtype was not specified in the report. The number of superficial spreading melanomas, the most common histology, was nearly twice that of Nodular melanomas the following histology in importance (3,403 and 1,754, respectively). Melanoma mortality rates in all Argentine population increased in the elderly. Lower melanoma mortality rates were observed in the North West. In 2007-2017, ASMR decreased significantly in females (average 1.4% p/year) while it increased nonsignificantly in males (0.4% p/year).The tumours with the worst prognosis were associated with the elderly, males, nodular or acrolentiginous morphologies, residing somewhere other than Centro and Patagonia and with tumors located in the head/neck and legs. CONCLUSION: The geographical variations found for melanoma characteristics and their mortality in Argentina, makes it imperative that epidemiological research is continued to avoid generalisations and improve future preventive actions.
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The incidence and the mortality of gallbladder cancer (GBC) show significant variation worldwide, with high age-standardized rates in western South America (SA). Due to the lack of effective measures for prevention, the late diagnosis and the small benefit of systemic treatment, GBC has an ominous prognosis and became an important public health problem in this part of the continent, where the most important risk factors are gallstone disease, female gender, age, ethnic groups, and low socioeconomic status. Many genetic abnormalities have been described in series from SA, some of them similar and others unique in comparison to gene alterations in GBC from other regions of the world. Prophylactic cholecystectomy (PC) is one of the strategies to decrease the mortality but its cost-effectiveness is questionable. A way to improve the performance of PC is to identify molecular risk factors that in combination with currently known ones detect patients with very high risk for developing GBC. Also, more research studies are required to better understand the epidemiology and molecular biology in order to improve the prevention and treatment of this lethal disease.
Assuntos
Neoplasias da Vesícula Biliar/epidemiologia , Neoplasias da Vesícula Biliar/prevenção & controle , Feminino , Humanos , Masculino , Fatores de Risco , América do SulAssuntos
Humanos , Masculino , Feminino , Pediatria , Nutrição do Adolescente , Comportamento Alimentar , Epidemiologia Descritiva , Estudo Observacional , UruguaiRESUMO
We designed high-affinity primers for the mRNA sequence of human tyrosinase to test the value of molecular detection of circulating melanoma cells by reverse transcription-polymerase chain reaction (RT-PCR). The optimization process included in vitro settings and in vivo studies in a xenograft mouse model. We detected tyrosinase expression with at least 40 pg and 1.5 pg of total RNA extracted from cultured SKmel human melanoma cells, using a first round of PCR amplification and nested PCR, respectively. Human tyrosinase expression was found in the blood of nude mice bearing subcutaneous SKmel tumors, and the expression bands were stronger after manipulation of the tumor mass. We also examined the fate of circulating melanoma cells in the present melanoma model. Tyrosinase expression declined in blood 6 h after a direct intravenous injection of SKmel cells. A preliminary study in human blood samples demonstrated a baseline positive tyrosinase determination in 64% (16/25) of advanced melanoma patients using the RT-PCR nested assay. Baseline tyrosinase expression was significantly associated with disease progression after 12 months, and sequential determination during follow-up of the remaining disease-free patients showed a progressive increase of negative results.