Frequent Infectious Diseases Research Articles

Health status and healthcare trajectory of vulnerable asylum seekers hosted in a French Reception Center

BackgroundEurope lacks studies related to asylum-seekers’ health. MethodsWe described the health status, healthcare and follow-up of men seeking asylum, accommodated in a primary reception center in Paris (CPA). This observational study included volunteer patients presenting for care at the CPA primary care unit (PCU) from January to March 2018. They could be referred to on-site GPs and psychiatrists or to surrounding healthcare facilities. After their asylum application, patients were transferred to other French accommodation centers. PCU healthcare professionals could make referrals for close medical reassessments after transfer. ResultsThe 728 included men came mostly from Central Asia or Middle East (65%) and Africa (34%). Seventy percent reported violence during migration. Seventy-five percent (547/728) were referred to on-site GPs, 20% to psychiatrists. During patients’ stay at CPA, 67% (144/214) of referrals to surrounding healthcare facilities led to performed consultations. Seven percent of all the included patients (49/728) were referred for frequent communicable infectious diseases screening. Final diagnoses (n = 1108) included 31% infectious diseases and 7% psychiatric disorders. When post-transfer accommodation centers could be reached, 69% (33/48) of the medical referrals had led to a scheduled appointment. ConclusionsThe healthcare trajectory at CPA could benefit from optimization of infectious and psychiatric screenings, and improved coordination of care and follow-up.

The Evaluation of Neutropenia in X-linked Agammaglobulinemia Patients

Objectives: X-linked Agammaglobulinemia (XLA) is a primary immunodeficiency disease, characterized by severe hypogammaglobulinemia and the low numbers of peripheral B cells. Neutropenia is a rare complication among the XLA patients, which may lead to a higher rate of infections and morbidity. The aim of the authors is to assess the correctness of this issue. Methods: In this study, we compared demographic, clinical and laboratorial data between two groups of XLA patients, with and without neutropenia. Results: Frequency of neutropenia was 15% in our population. Infectious complications were the most prevalent clinical manifestations, regardless of the presence of neutropenia. However, Lymphoproliferative complication was significantly higher in the neutropenic patients (p = 0.001). No significant difference in mortality rate was observed between the groups. Conclusion: Neutropenia is a rare complication among the XLA patients, and significantly decreases the mean age of XLA diagnosis in the patients. But it is not related to the higher frequency of infectious diseases in the neutropenic patients compared to non-neutropenic ones.

Comparative analysis of bacteriuria results on routine urinalysis and urine culture: a retrospective study

Bacterial urinary tract infections (UTI) are among the most frequent infectious diseases of small animals. Although antimicrobial therapy is recommended for treating bacterial UTIs, the current consensus is that treatment may not be necessary for asymptomatic animals. The aim of this study was to evaluate the diagnostic ability of urinalysis to detect bacteriuria and to compare it with urine culture (gold standard method) to assess the risk of false-positive results. A retrospective study was conducted from January 2016 to July 2019 and urine samples of 119 dogs were analyzed. Diagnostic validation was performed for urinalysis, based on the morphological classification and intensity of bacteriuria. Agreement between the results was assessed using the kappa (k) index. When the presence of cocci was used as a diagnostic criterion to suggest bacteriuria, it was observed that the agreement (k = -0.006) was lower than that expected by chance. However, a poor agreement (k = 0.22) was also found for bacilli during urinalysis (k = 0.23). A significant degree of agreement was observed in cases with high intensity of bacteriuria. Therefore, urine culture must be performed for conclusive evidence of bacteriuria to avoid false-positive results during urinalysis.

COVID-19 Pandemic Impact on Respiratory Infectious Diseases in Primary Care Practice in Children.

Background: The coronavirus disease 2019 (COVID-19) pandemic led to day care and school closures and children staying home for several months. When they gradually returned, aggressive regulations were implemented in New York State to reduce viral transmission.Method: An ongoing prospective study occurring in the Rochester, NY region, focused on early childhood respiratory infectious diseases, afforded an opportunity to assess the impact of the pandemic on the incidence of these illnesses in a primary care outpatient setting. Physician-diagnosed, medically attended infection visits were assessed in two child cohorts, age 6–36 months old: from March 15 to December 31, 2020 (the pandemic period) compared to the same months in 2019 (prepandemic). Nasopharyngeal colonization by potential otopathogens during healthy/well-child and acute otitis media (AOM) visits was evaluated.Results: One hundred and forty-four children were included in the pandemic cohort and 215 in the prepandemic cohort. The pandemic cohort of children experienced 1.8-fold less frequent infectious disease visits during the pandemic (p < 0.0001). Specifically, visits for AOM were 3.7-fold lower (p < 0.0001), viral upper respiratory infections (URI) 3.8-fold lower (p < 0.0001), croup 27.5-fold lower (p < 0.0001), and bronchiolitis 7.4-fold lower (p = 0.04) than the prepandemic cohort. Streptococcus pneumoniae (p = 0.03), Haemophilus influenzae (p < 0.0001), and Moraxella catarrhalis (p < 0.0001) nasopharyngeal colonization occurred less frequently among children during the pandemic.Conclusion: In primary care pediatric practice, during the first 9 months of the COVID-19 pandemic, significant decreases in the frequency of multiple respiratory infections and nasopharyngeal colonization by potential bacterial respiratory pathogens occurred in children age 6–36 months old.

Acute arthritis of the right temporomandibular joint due to Lyme disease: a case report and literature review

BackgroundLyme disease is the most frequent tick-borne infectious disease in Europe. It often presents with a wide variety of symptoms. For this reason, affection of the temporomandibular joint (TMJ) caused by Lyme disease (LD) can be misdiagnosed as a common temporomandibular disorder (TMD).Case presentationThe purpose of this case report of a 25-year-old woman presenting to the Departments of Orthodontics and Oral and Maxillofacial Surgery with extensive symptoms of temporomandibular disorder is to illustrate the delayed diagnosis of Lyme disease which was only made after extensive therapy of the temporomandibular joint. The specialist literature only reports a few cases of patients suffering from Lyme disease with TMJ manifestations.ConclusionThis case report and the relevant literature review aim to emphasize the importance of accurate request of medical history and differential diagnosis of acute TMJ arthritis and arthralgia. Early interdisciplinary diagnosis of Lyme disease and early antibiotic therapy are essential to avoid misdiagnosis and unnecessary, sometimes invasive, therapies.

β-Caryophyllene ameliorates the Mycoplasmal pneumonia through the inhibition of NF-κB signal transduction in mice.

BackgroundPneumonia is a frequent infectious disease that mainly affects the children and the global death rate is nearly 19% among children at the below 5 age. β-caryophyllene is an active compound, mainly occurs in the spices and it possesses immense biological activities.ObjectiveThis investigation deliberated to scrutinize the beneficial actions of β-caryophyllene against the M. pneumoniae induced pneumonia.MethodsThe pneumonia was stimulated to the BALB/c mice by infecting them with 100 µl of M. pneumonia for 2 days via nasal drops with the concomitant treatment with 20 mg/kg of β-caryophyllene. The total cells in the BALF of test mice were counted by using the Neuber chamber. The total protein and the pro-inflammatory cytokines status were examined by using the commercial ELISA kits. The PCR technique was used to measure the M. pneumoniae bacterial load. The NF-ƙB expression was investigated using western blotting. The lung tissues were analyzed microscopically.ResultsThe β-caryophyllene notably diminished the total protein status, total cell count, and bacterial load in the pneumonia provoked mice. The marked reduction in the status of pro-inflammatory regulators was seen in the β-caryophyllene supplemented pneumonia mice. β-caryophyllene also down-regulated the expression of NF-ƙB thereby reduced the lung inflammation and tissue damages as seen in the result of histological analysis.ConclusionThese findings were confirmed the therapeutic potential of β-caryophyllene against the M. pneumoniae-activated pneumonia in animals.

Ventilation Assessment by Carbon Dioxide Levels in Dental Treatment Rooms

It is important for dental care professionals to reliably assess carbon dioxide (CO2) levels and ventilation rates in their offices in the era of frequent infectious disease pandemics. This study was to evaluate CO2 levels in dental operatories and determine the accuracy of using CO2 levels to assess ventilation rate in dental clinics. Mechanical ventilation rate in air change per hour (ACHVENT) was measured with an air velocity sensor and airflow balancing hood. CO2 levels were measured in these rooms to analyze factors that contributed to CO2 accumulation. Ventilation rates were estimated using natural steady-state CO2 levels during dental treatments and experimental CO2 concentration decays by dry ice or mixing baking soda and vinegar. We compared the differences and assessed the correlations between ACHVENT and ventilation rates estimated by the steady-state CO2 model with low (0.3 L/min, ACHSS30) or high (0.46 L/min, ACHSS46) CO2 generation rates, by CO2 decay constants using dry ice (ACHDI) or baking soda (ACHBV), and by time needed to remove 63% of excess CO2 generated by dry ice (ACHDI63%) or baking soda (ACHBV63%). We found that ACHVENT varied from 3.9 to 35.0 in dental operatories. CO2 accumulation occurred in rooms with low ventilation (ACHVENT ≤6) and overcrowding but not in those with higher ventilation. ACHSS30 and ACHSS46 correlated well with ACHVENT (r = 0.83, P = 0.003), but ACHSS30 was more accurate for rooms with low ACHVENT. Ventilation rates could be reliably estimated using CO2 released from dry ice or baking soda. ACHVENT was highly correlated with ACHDI (r = 0.99), ACHBV (r = 0.98), ACHDI63% (r = 0.98), and ACHBV63% (r = 0.98). There were no statistically significant differences between ACHVENT and ACHDI63% or ACHBV63%. We conclude that ventilation rates could be conveniently and accurately assessed by observing the changes in CO2 levels after a simple mixing of household baking soda and vinegar in dental settings.

A 5-year retrospective study of canine and feline patients referred to an isolation unit for infectious diseases.

BackgroundReferral of cases is becoming more and more frequent in companion animal practice. The Infectious Diseases Isolation Unit (IDIU) admits first opinion, second opinion and referred patients with a confirmed infectious disease (ID) or a clinically suspected ID that is awaiting laboratory diagnosis. The primary aims of this study were to describe the annual number and characteristics of patients referred to the IDIU and identify the most frequent IDs in referred dogs and cats. A secondary aim was to investigate possible differences in the length of the hospitalisation and the clinical outcome among referred cases and those admitted to the IDIU after first and second opinion appointments.MethodsA retrospective study was carried out on patients hospitalised at the unit over 5 years from 9th October 2013 to 31st December 2018.ResultsThe study population consisted of 365 dogs and 515 cats to give a total of 880 patients hospitalised at the IDIU from October 2013 to December 2018. Among the 96 referred dogs, parvovirosis (37.7%) and leptospirosis (31.1%) were the most frequent IDs. Feline upper respiratory tract infection (38.2%) and feline leukaemia virus infections (36.4%) were the main causes in the 80 referred cats. Worrying noncompliance rates of dog (51.0%) and cat (52.5%) vaccination schedules were identified. The analysis of the length of hospitalisation in the three groups of patients was not statistically different. In both animal species there were statistically significant higher clinical discharge rates on the first opinion patients’ group in comparison to referred patients and the second opinion group.ConclusionsParvovirosis and leptospirosis in dogs and upper respiratory disease and feline leukaemia virus infection in cats were the most common diagnoses for patients admitted to the IDIU, reinforcing the need for accurate vaccination. Discharge rates results pinpoint the need for timely accurate reference.

Prevalence of Hepatitis B and C Infections and Associated Risk Factors in Pars Cohort Study, Southern Iran.

BACKGROUND Hepatitis B and C virus (HBV and HCV) infections rank among the most frequent infectious diseases with a rising worldwide burden. However, their epidemiology and risk factors are understudied in many regions, including Iran. METHODS This study was conducted as part of the Pars Cohort Study (PCS) in Valashahr district, Fars province (2012-2014). Participants received venipuncture for HBsAg and HCV antibody, followed by Polymerase Chain Reaction (PCR) testing. All infected people and their comparison groups completed a risk assessment questionnaire. RESULTS Overall, 9,269 people participated in the study; the majority were women and of Fars ethnicity. Prevalence of HBsAg and HCV antibody was 2.3% (n = 215) and 0.3% (n = 26), from whom 23% (n = 47) and 13% (n = 3) had indications for treatment, respectively. During follow-up, among HBsAg-positive individuals who were not on treatment, 62% tested negative for HBsAg, and in 2% HBV DNA had risen to treatment levels. Risk factors for HBV infection were illiteracy [OR = 3.43, 95% CI = 1.1, 10.3], and Turk ethnicity compared to Fars [OR = 1.58, 95% CI = 1.1, 2.3]. History of blood transfusion [OR = 2.00, 95% CI = 1.1, 3.5] and history of drug use [OR = 2.85, 95% CI = 1.1, 7.4] were associated with HCV infection, after adjustment. CONCLUSION Further epidemiological studies are needed to identify at-risk populations in different regions. Preventive interventions, including educational programs and transfusion safety strategies, are crucial for reducing the hepatitis burden.

#25: Survival and Risk Factors Associated with Mortality due to Invasive Aspergillosis in Pediatric Oncology Patients in Mexico City

Abstract Background Invasive Aspergillosis (IA) has been reported as the most frequent life-threatening opportunist mold infectious disease in immunocompromised subjects, mainly in oncology patients Its incidence has been increasing over the years, with a reported mortality from 35% to 70%. Risk factor for IA mortality has been poorly described in middle-income settings. We aimed to identify risk factors associated with IA mortality and to report the survival in a middle-income setting. Methods Case–control study at Hospital Infantil de México Federico Gómez (HIMFG) in Mexico City from January 2004 to April 2017. We identified patients &amp;lt;18 years old with cancer and diagnosis of proven or probable IA, according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria. Neutropenia, chemotherapy, use of steroids, hematopoietic stem cell transplantation (HSCT), graft vs. host disease (GVHD) and disseminated disease (defined as the affection of 2 or more sites) were compared between surviving and deceased patients with IA. Fisher exact test or Student’s t-test were performed to identify independent risk factors for IA-related mortality, and a binary logistic regression model was used. Kaplan–Meier analysis was performed to calculate survival rates at days 30 and 90 after IA diagnosis. Results Seventy-four IA events in 72 patients were identified. The mean age was 8.4 years, 63% were male. 89% of IA presented in hematologic malignances, being ALL the most frequent diagnosis in 54% of cases; 8.1% (6) were in HSCT patients (5 allogeneic HSCT). Of the 74 IA, 42% and 58% were classified as proven and probable AI respectively. Localized disease (76%) was more frequent than disseminated. Lungs were the most frequent sites of primary infection (84%) but an unusual site of infections, such as heart, pericardium, pulmonary artery, bowel, skin, and spleen, were reported by histopathology. Aspergillus flavus was the most frequent species isolated (42%) followed by A. fumigatus (27%). Voriconazol was first line of therapy in 95% of cases, while combined therapy was used during the course of infections in 53% of cases. The disseminated disease was an independent risk factor associated with IA mortality (OR 4.2 95% CI, 1.5 – 15.2, P = 0.007). Overall mortality was 64%; however, directed IA-related mortality was 35%. On day 30 and day 90 after IA diagnosis, overall survival was 66% and 32%, respectively. Two IA were diagnosed post mortem. IA-related mortality was 67% in HSCT (P = 0.009). All HSCT patients which death was associated with IA presented GVHD. Conclusions In our population, IA-related mortality (35%) was similar to that reported globally, nevertheless IA-related mortality in HSCT was high (67%). Disseminated disease and neutropenia were identified as risk factors for mortality due to IA. Efforts should be made to early identification of IA and prompt start of antifungal treatment, to reduce the incidence and consequences of disseminated disease.

A Comprehensive Review of Infectious Granulomatous Diseases of the Gastrointestinal Tract.

A granuloma is defined as a localized inflammatory reaction or a hypersensitive response to a nondegradable product leading to an organized collection of epithelioid histiocytes. Etiologies of granulomatous disorders can be divided into two broad categories: infectious and noninfectious (autoimmune conditions, toxins, etc.) causes. The endless list of causalities may prove challenging for gastroenterologists and pathologists to formulate a list of clearly defined differentials. This is true when distinguishing these etiologies based on various clinical presentations and endoscopic and histological findings. We aim to provide a comprehensive review of some of the frequent and rare infectious granulomatous diseases of the gastrointestinal tract documented in the literature to date. We provide an overview of each infectious pathology with an emphasis on epidemiology, clinical presentation, and endoscopic and histologic findings, in addition to treatment.

MiR-21 Is Remotely Governed by the Commensal Bacteria and Impairs Anti-TB Immunity by Down-Regulating IFN-γ.

Tuberculosis (TB), which is a frequent and important infectious disease caused by Mycobacterium tuberculosis, has resulted in an extremely high burden of morbidity and mortality. The importance of intestinal dysbacteriosis in regulating host immunity has been implicated in TB, and accumulating evidence suggests that microRNAs (miRNAs) might act as a key mediator in maintaining intestinal homeostasis through signaling networks. However, the involvement of miRNA in gut microbiota, TB and the host immune system remains unknown. Here we showed that intestinal dysbacteriosis increases the susceptibility to TB and remotely increased the expression of miR-21 in lung. Systemic antagonism of miR-21 enhanced IFN-γ production and further conferred immune protection against TB. Molecular experiments further indicated that miR-21a-3p could specifically target IFN-γ mRNA. These findings revealed regulatory pathways implicating intestinal dysbacteriosis induced-susceptibility to TB: intestinal dysbiosis→lung miRNA→targeting IFN-γ→impaired anti-TB immunity. This study also suggested that deregulated miRNAs by commensal bacteria could become promising targets as TB therapeutics.

EVALUATION OF NUTRITIONAL STATUS AND RELATED FACTORS IN PRESCHOOL CHILDREN ADMITTED TO HOSPITAL DUE TO INFECTION

Aim: In this study, it was aimed to evaluate the nutritional status of preschool children who were admitted to the hospital due to infection, and to determine the relationship between the frequency of infection and their growth and development. Method: This descriptive cross-sectional study was conducted with a total of 110 children aged between 3 and 6 years who applied due to infection to a hospital in Istanbul. Data collection was made with face to face interviews with a questionnaire form including questions about the child's age, gender, health status, infection frequency, cleaning habits, anthropometric measurements, and food consumption frequency. Results: According to body mass index (BMI) Z scores, 8.1% of the children were severely thin, 9.1% thin, 44.5% normal, 21.8% overweight, and 16.4% obese. While 36.4% of the children having infection 1-3 times a year, 63.6% having infection 4 and more times a year. Children whose rooms were cleaned frequently had more infections (p&lt;0.05). There was no relationship between the children's daily energy and nutrient consumption and the infection frequency (p&gt;0.05) except vitamin D. Children who consumed less vitamin D had 4 or more infections yearly (p&lt;0.05). Conclusion: Frequent infectious diseases during childhood affect growth and development. Due to the bilateral relationship between infection and malnutrition, the nutritional status and growth developments of children with frequent infections should be followed closely.

РЕЦИДИВИРУЮЩАЯ СТРЕПТОКОККОВАЯ ИНФЕКЦИЯ У РЕБЕНКА С ВРОЖДЕННЫМ ДЕФИЦИТОМ МАННОЗОСВЯЗЫВАЮЩЕГО ЛЕКТИНА

Objective of the research: to present the clinical and laboratory features of a child with a congenital deficiency of mannose-binding lectin (MBL). Materials and methods: DNA samples of 112 children suffering from frequent infectious diseases were analyzed by high-throughput sequencing (Illumina) using a panel including 338 genes associated with the development of primary immunodeficiencies. A search for pathogenic alleles of MBL2 was performed. A homozygous mutation in the MBL2 gene was detected in one of 112 examined patients, heterozygous carriage of the pathogenic MBL2 allele in two children. The story of a child with a homozygous defect of this gene is presented. The role of MSL deficiency in the development of a recurrent course of a nasopharyngeal infection caused by group A streptococcus, the formation of a chronic disease of the tonsils and adenoids is demonstrated.

Effects of Rhein-8-O-β-D-glucopyranoside on the Biofilm Formation of Streptococcus mutans.

Dental caries is the most frequent biofilm-related human infectious disease in the oral cavity. Streptococcus mutans is one of the primary etiological agents of dental caries. The aim of our study was to investigate the effects of rhein-8-O-β-D-glucopyranoside (Rg) on the development of S. mutans biofilms. Growth curves were generated, and biofilm oxygen sensitivity was detected after Rg treatment. The expression levels of luxS, brpA, ffh, recA, nth, and smx were analyzed by real-time PCR. The trypan blue exclusion assay was used to measure the effect of Rg on monocyte viability. The results showed that Rg could significantly inhibit the growth of S. mutans and suppress the biofilm formation of S. mutans in a concentration-dependent manner. In Rg-treated biofilms, the expression levels of luxS, brpA, ffh, recA, nth, and smx were all decreased. Our results further showed that Rg was nontoxic, as Rg did not affect monocyte viability or lactate dehydrogenase activity in the exposed cells. These results suggested that Rg inhibited the biofilm formation of S. mutans, and the decrease in luxS, brpA, ffh, recA, nth, and smx expression might contribute to the antibacterial effects of Rg.

Pulmonary infections mimicking malignancy on bronchoscopy: A retrospective single-center study in Japan.

BackgroundPulmonary infections can imitate pulmonary neoplasms. Pulmonary tuberculosis (TB) is a typical example of an infection that mimics cancer and results in unexpected exposure of healthcare workers to TB. A large number of patients with suspected lung malignancy are referred to cancer centers, although the epidemiology of the final diagnosis is unclear in Japan. This study aimed to determine the frequency and nature of pulmonary infections that imitate malignancy among patients with presumed lung cancer that is subsequently diagnosed as a pulmonary infection based on bronchoscopy findings. We also aimed to identify the prevalence of formerly undiagnosed pulmonary tuberculosis that could pose an occupational risk to healthcare workers.MethodsThis single‐center retrospective cross‐sectional study included patients with suspected pulmonary malignancy who underwent bronchoscopy at a tertiary care cancer center in Japan between April 2017 and March 2020. Electronic medical records of the bronchoscopy database were reviewed to identify the final diagnoses recorded by physicians.ResultsAmong the 460 patients enrolled in the present study, 362 (78.7%) and 8 (1.7%) had primary or metastatic pulmonary lesions and benign lesions, respectively. Sixty‐six patients (14.3%) had nonspecific findings or other pulmonary diseases. Infection was confirmed in 24 patients (5.2%). Mycobacterial infections (n = 16) were the most frequent infectious disease; four patients had TB and 12 had nontuberculous mycobacterial infections.ConclusionsDespite the rare occurrence of TB in patients with suspected lung malignancy, healthcare workers should remain vigilant regarding the possibility of TB to prevent occupational exposure during invasive procedures such as routine bronchoscopy.

COVID-19 and Global Health Security: Overview of the Global Health Security Alliance, COVID-19 Response, African Countries' Approaches, and Ethics.

Public health emergencies can arise from a wide range of causes, one of which includes outbreaks of contagion. The world has continued to be threatened by various infectious outbreaks of different types that have global consequences. While all pandemics are unique in their level of transmission and breadth of impact, the 2019 coronavirus disease (COVID-19) pandemic is the deepest global crisis of the 21st century, which has affected nearly every country globally. Yet, going forward, there will be a continued need for global health security resources to protect people around the world against increasing infectious disease outbreaks frequency and intensity. Pandemic response policies and processes all need to be trusted for effective and ethical pandemic response. As the world can learn during the past few years about frequent infectious disease outbreaks, (these) diseases respect no borders, and, therefore, our spirit of solidarity must respect no borders in our efforts to stop the ongoing COVID-19 pandemic and be better prepared to respond effectively to a health crisis in the future.

Climate Change and Inpatient Dermatology.

Purpose of ReviewClimate change represents a major existential threat facing the global community, and it has already begun to affect human health in a multitude of ways. This review highlights and discusses the implications that climate change has already had and is expected to have for inpatient dermatologists.Recent FindingsThere are a variety of conditions affected by climate changes. The distribution and frequencies of infectious diseases and their vectors are changing in line with variations in climate conditions. Increased temperatures have already been associated with exacerbation of existing skin conditions, such as atopic dermatitis, and recent evidence suggests that higher temperatures will also magnify the effects of harmful ultraviolet radiation. Extreme weather events that result from climate change are followed by an array of dermatologic conditions that may be unusual for the given location. Inpatient dermatologists should be prepared to manage these potentially unfamiliar dermatologic consequences of climate change.SummaryClimate change will have widespread effects on the medical field, and inpatient dermatologists will be faced with their own unique set of challenges and practice variations. Practitioners should be familiar with the ongoing and predicted effects of climate change in their locations so that they can readily identify and treat associated conditions, and they should adjust their practice to reduce their carbon footprint and serve as a model for patients to do the same.

Glycogen-storage disease type 1: medical and social alertness

Orphan hereditary pathologies are an urgent medical problem. Metabolic diseases have a special place among them. Currently they include about 500 nosological forms, in particular glycogen diseases. Type 1b glycogen disease (GB1b) occupies a special place. In addition to metabolic disorders, patients with this disease have severe neutropenia, which leads to frequent recurrent infectious diseases, such as stomatitis, periodontitis, furunculosis, otitis, colitis, gingivitis. In addition, recent studies showed the presence of lymphocytic dysregulation in patients with GB1b which is associated with T-regulatory lymphocytes dysfunction. It leads to an increased risk of developing autoimmune diseases, such as autoimmune thyroiditis, myasthenia gravis, Crohns disease, ANA-associated vasculitis. In addition, there is evidence about the association of GB1b and oncological pathologies, such as giant bone cell tumor, acute myeloid leukemia. According to such a wide variety of clinical manifestations, knowledge of the pathogenesis and possible non-metabolic manifestations is necessary for proper diagnostics and therapy.

Perfil clínico y epidemiológico de gestantes con infección del tracto urinario y bacteriuria asintomática que consultan a un hospital de mediana complejidad de Antioquia (Colombia)

Objetivo: caracterizar el perfil clínico y epidemiológico de las mujeres embarazadas con diagnóstico de infección de vías urinarias. La infección del tracto urinario es una de las patologías infecciosas más frecuentes, que afecta en especial a las mujeres gestantes por las complicaciones inherentes a los cambios fisiológicos durante el embarazo. Materiales y métodos: se realizó un estudio de cohorte retrospectiva, empleando historias clínicas de pacientes gestantes entre los años 2017-2020, definiendo criterios para incluirlas en el presente estudio; la información se registró en una base de datos para facilitar su análisis.Resultados: 112 historias clínicas cumplieron con los criterios de elegibilidad. El microorganismo más frecuente en el urocultivo fue la Escherichia coli en el 34.8%. La mediana de días de manejo intrahospitalario fue de 3 días, por el tiempo que toma obtener el resultado del urocultivo para definir la sensibilidad al antibiótico. De las pacientes manejadas con aztreonam, solo una requirió escalar tratamiento antibiótico. Conclusiones: el aztreonam podría considerarse primera línea de elección empírica para manejo intrahospitalario, no obstante, se requieren estudios controlados al respecto; así mismo se requieren estudios de casos y controles que permitan detectar que condiciones predisponen a algunas gestantes frente a otras al desarrollo de estas infecciones.