We reviewed the management of 167 patients with foreign body ingestion from 1980 to 1986. Two patients (1.1%) refused treatment. Nonoperative management was attempted in 14 (8.4%) patients. Endoscopy was performed on 117 patients with an overall success rate of 85.5% and a complication rate of 1.7%. Surgical treatment was required in 51 (30.0%) patients, 14 of whom had previous unsuccessful endoscopy.
BackgroundCHIKV is suspected based on epidemiological and clinical criteria, however confirmation of the disease is only achieved by laboratory tests. Laboratory diagnosis is made by two approaches: the detection of viral RNA and identification of the specific immune response by serological methods. Serological tests are the most frequently used laboratory methods for the diagnosis of CHIKV. IgM is the first detected antibodies during 4 to 6 days after onset of symptoms followed by IgG. In Colombia, CHIKV's probable cases are not mandatory to be confirmed, so there is no standardization for laboratory confirmation testsObjectivesTo evaluate the performance of IgM and IgG antibodies against CHIKV in a cohort of patients with CHIKVMethodsIgM and IgG antibodies against CHIKV were measured by ELISA (AbcamÒ ab177835 and ab177835 anti-chikungunya virus IgM and IgG human ELISA kit, Cambridge, UK) technique in 604 patients with CHIKV suspicion. A typical case of CHIKV with high sensitivity and specificity obtained from a previous study was used as gold standard for diagnosis of CHIKV. Since CHIKV epidemic of 2014–2015 was the first to be reported in our country (Colombia), no second measurements of IgG were needed to confirmed infection.ResultsCut off point for IgG was 14,3 SU and for IgM was 11,2 SU. Mean values for IgG was 36,7 SU (±22,7) in patients with CHIKV and 8,6 SU (SD± 6,3) for IgM. Statistical significance was obtained for both IgG and IgM (p<0,0001) when comparing patients with and without CHIKV. Receiver operating characteristic (ROC) curves showed and area under the curve (AUC) of 0,81 for IgG and 0,65 for IgM (figure 1).ConclusionsOur study revealed a good performance of IgG and regular performance of IgM for the diagnosis of CHIKV in a cohort of CHIKV patients from Colombia's epidemic. Cut off points for both IgG and IgM were measured for future reference.Disclosure of InterestNone declared
BackgroundSpondyloarthritis (SpA) are a group of interconnected inflammatory arthritides that include ankylosing spondylitis (AS), reactive arthritis (ReA), and undifferentiated SpA (uSpA). Periodontal disease (PD) is a chronic inflammatory disease that may increase the risk for immune diseases like rheumatoid arthritis and AS.ObjectivesTo evaluate the periodontal condition and presence of Porphyromona gingivalis (P. gingivalis) and P. gingivalis IgG1 and IgG2 antibodies within three subgroups of SpA (AS, uSpA and ReA) and establish possible associations with disease activity measures.MethodsA cross-section observational study was designed. Seventy-nine subjects were included (AS: 19, ReA: 14 and uSpA: 46). Clinical evaluation of rheumatologic and periodontal condition was performed. P. gingivalis presence by polymerase chain reaction (PCR) and P. gingivalis IgG1 and IgG2 antibodies as well as erythrocyte sedimentation rate (ESR), high sensitive C reactive protein (hsCRP), rheumatoid factor, cyclic citrullinated peptide antibody (ACPAs), HLA-B27 and disease activity measures were assessed. A descriptive analysis of frequency distributions for clinical, laboratory and demographic data was made. Associations between clinical and microbiological markers of P. gingivalis infection, including IgG1 and IgG2 antibodies, and SpA disease activity measures were evaluated. Chi-squared test was performed to determine associations. Comparisons between groups were made with Kruskal Wallis, Mann-Whitney U and Wilcoxon test. The study was approved by local ethics committee.ResultsForty-four (55.7%) patients with SpA presented PD, of which uSpA had a higher frequency (65.2%). Most patients had moderate PD (AS: 26.3%, uSpA: 50.0%, ReA: 21.4%). A high frequency of retired uSpA patients (87.5%) had moderate PD (p=0.044). The clinical attachment level (CAL) ≥4mm (8.1 ± 10.5) and % of CAL ≥4mm (5.7 ±7.7) was more frequent in uSpA patients (p=0.033 and p=0.034 respectively). P. gingivalis presence in uSpA patients was associated with the use of sulfasalazine (p=0.017), and in retired patients (p=0.028). In AS patients, positive IgG1 to P gingivalis was associated with % periodontal pocket depth ≥4mm (p=0.04) and % sites with sample pocket depth (SPD) ≥4mm (p=0.02). Also in this subtype, positive IgG2 was associated with bacterial plaque index (p=0.03). Positive levels of IgG2 in uSpA were associated with bleeding of probing (BOP) (p=0.03) and the number of compromised periodontal interproximal sites (p=0.05). See Table 1.ConclusionsWe found a high frequency of PD in patients with SpA without significant statistical differences between each subtype. The differences in clinical periodontal variables in SpA subtypes probably suggest a better oral hygiene in these patients. P. gingivalis IgG antibodies may be a useful tool for the physician to assess periodontal condition in these patients.Disclosure of InterestNone declared
Host immune response as well as virulence factors are key in disease susceptibility. There are no known association studies of HLA class I and II alleles with chikungunya (CHIKV) infection in Latin American population. We aim to identify Human Leukocyte Antigen (HLA) alleles present in patients with CHIKV infection when compared to healthy controls, as well as allele association with the clinical spectrum of the disease. A cross-sectional analysis nested in a community cohort was carried out. We included patients 18 years and older with serological confirmation of CHIKV infection. HLA typing of HLA-A, HLA-B and HLA-DRB1 alleles was performed. Two-by-two tables were used to establish associations between allele presence and clinical characteristics. Data from 65 patients with confirmed CHIKV infection were analyzed for HLA typing. CHIKV infection was associated with the presence of HLA-A*68, HLA-B*35, HLA-DRB*01, HLA-DRB1*04 and HLA-DRB1*13 alleles with statistical significance when compared to healthy subjects. A statistically significant relationship was found between the presence of rash in the face or the abdomen and the presence of HLA-DRB1*04. Our study demonstrated that in our cohort, HLA type I as well as type II alleles are associated with CHIKV infection, and specifically an HLA type II allele with dermatological symptoms. Further research is needed to set a path for future investigation on genes outside the HLA system to improve knowledge in the pathophysiology of CHIKV infection and its host-pathogen interaction.
BackgroundRheumatic diseases are the leading cause of permanent disability. In our country are the fourth cause of consultation in health institutions. The COPCORD model constitutes an effective tool in the determination of the prevalence of diseases. Globally, this model has been carried out in Asia, Europe and in some countries of Latin America. In Colombia the epidemiology of rheumatic diseases is not known globally; this would be the first national study that uses the data collection questionnaire using the COPCORD instrumentObjectivesTo estimate the prevalence of rheumatic disease and related factors in a Colombian population over 18 years of age in six Colombian citiesMethodsA Cross-sectional analytical study was designed in people older than 18 years. A probabilistic stratified sampling method using three stages. The first stage of sampling was the selection of cartographic sectors in each city. The second stage of sampling was the blocks of each sector. The third stage of sampling was the homes of each block. All household members were surveyed. The sample size was calculated to be 6,528 people (2336 from Bogotá, 1220 from Medellín and Cali each, 746 from Barranquilla, 503 from Bucaramanga and Cúcuta each). The COPCORD questionnaire adapted for Colombia, was applied in the first stage by standardized interviewers. Positive cases were reviewed at home by a first year rheumatology fellow. To assess whether it is a rheumatic disease; the positive cases for a probable rheumatic disease were reviewed by a second year rheumatology fellow and reviewed again with laboratory and image studies by a certified rheumatologist to establish the definitive diagnosisResults3,146 men and 3,547 women were included. Pain in the last 7 days not associated with trauma was reported in 3,213 (48%) participants. The most frequent sites were knees (right 31%, left 29%), hands (right 25%, left 24%), lumbar spine (18%) and shoulders (right 16%, left 14%). Table 1 depicts the prevalence of rheumatic diseases in ColombiaTable 1.Prevalence of Rheumatic Disease in ColombiaPrevalence (%)Variation CoefficientCI 95% Osteoarthritis10,8169,68–12,06Gout0,56260,33–0,92Fibromyalgia0,72220,47–1,11Soft Tissue Rheumatism25,82611,60–19,93Mechanic Low Back Pain7,2476,28–8,34Inflammatory Low Back Pain0,65280,38–1,12Spondyloarthritis0,39510,08–0,48Rheumatoid Arthritis1,49151,12–1,98Systemic Lupus Erythematosus0,05560,02–0,16Sjögren Syndrome0,08610,02–0,27Dermatomyositis0,031000,00–0,23Scleroderma0,021000,00–14CHIKV infection6,6885,73–7,78CI: confidence interval; CHIKV: chikungunya virus.ConclusionsOur study shows a similar prevalence to those worldwide in scleroderma, dermatomyositis, systemic lupus erythematosus, and spondyloarthritis. A lower prevalence was observed in Sjögren Syndrome, fibromyalgia, gout and osteoarthritis. A slightly higher prevalence of rheumatoid arthritis was observed in our population. The high prevalence of rheumatoid arthritis and soft tissue rheumatism should increase awareness in our governmental health entities given thei...
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