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Background: The association between subclinical atheromatosis and chronic hepatitis C virus (HCV) infection is unknown but is relevant now that antivirals are improving the survival of patients with the infection., Objectives: To determine whether HCV is an independent risk factor for subclinical atheromatosis and to analyse the changes in lipid profiles according to viral RNA levels and hepatic fibrosis., Patients and Methods: We conducted an observational, cross-sectional study that included 102 HCV-positive patients and 102 HCV-negative patients with parity in terms of sex and age, with no history of cardiovascular or kidney disease or diabetes. Atheromatosis (the presence of atheromatous plaques) and the carotid intima-media thickness (CIMT) were assessed using ultrasonography of the carotid and femoral arteries., Results: There was a greater presence of atheromatosis in any vascular territory in HCV-positive patients than in the patients without infection (58.8% vs. 28.4%, p<.0001). In the multivariate analysis, the factors significantly associated with atheromatosis included HCV infection (OR, 14.37 [5.5-37.3]; p<.001), age (OR, 1.12 [1.1-1.2]; p<.001), male sex (OR, 4.32 [1.9-9.5]; p<.001) and the triglyceride/HDL cholesterol coefficient (TG/HDL-indirect indicator of insulin resistance) (OR, 1.34 [1.1-1.6]; p=.007). The HCV-positive patients with atheromatous plaques had a higher TG/HDL coefficient but no significant differences in terms of the viral load or degree of hepatic fibrosis and with a 'low risk' lipid profile., Conclusions: HCV infection is an independent risk factor for subclinical atheromatosis. Systemic arterial ultrasonography for this population improves the cardiovascular risk assessment beyond lipid profile abnormalities and the risk calculation using SCORE tables., (Copyright © 2019 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.)

Introduction: Chronic infection with hepatitis C virus is a risk factor for developing atheromatous plaques, although the possible effect of virus clearance is unknown. Our aim was to determine whether or not subclinical atheromatosis improved and there was any modification in the composition of the plaques 12 months after eradication of hepatitis C virus by direct-acting antiviral agents., Materials and Methods: Prospective study that included 85 patients with chronic hepatitis C virus infection in different stages of fibrosis who were on direct-acting antiviral agents. Patients with a cardiovascular history, diabetes and kidney disease were excluded. An arterial ultrasound (carotid and femoral) was performed to diagnose atheromatous plaques (defined as intima-media thickness ≥1.5mm) and the composition (percentage of lipids, fibrosis and calcium with HEMODYN4 software) was analysed at the beginning of the study and 12 months after stopping the therapy., Results: After follow-up no changes were detected in the intima-media thickness (0.65mm vs. 0.63mm, P=.240) or in the presence of plaques (65.9% vs 71.8%, P=.063). There was also no significant change in their composition or affected vascular territory, with an increase in blood lipid profile (P<.001) after 12 months of treatment. These results were confirmed in subgroups by severity of liver disease., Discussion: The eradication of hepatitis C virus by direct-acting antiviral agents does not improve the atheroma plaques and nor does it vary their composition, regardless of liver fibrosis. More prospective studies are needed to evaluate residual cardiovascular risk after virus eradication., (Copyright © 2019. Publicado por Elsevier España, S.L.U.)

Background: Mutations in type II 3 beta hydroxysteroid Dehydrogenase (3 beta HSD) are found in male children with severe undervirilized genitalia. Mild undervirilization (isolated micropenis or with distal hypospadia) can be associated with a partial deficit in 3 beta HSD activity., Aim: To assess the frequency of abnormal adrenal response to ACTH, suggesting a deficit in adrenal enzymatic activity, in children with mild undervirilization., Patients and Methods: We studied 26 male children with micropenis, aged one to eight years. Children with evidences of puberal development or in treatment with drugs that affect steroidal metabolism were excluded from the study. Serum levels of androstenedione (A), dehydroepiandrosterone (DHEA), progesterone (P), 17 hydroxyprogesterone (17 P) and the ratios DHEA/A, P/17 P, 17 P/DHEA were measured after an adrenal stimulation with 0.25 mg/m2 intramuscular ACTH., Results: Two children had DHEA y DHEA/A values suggesting a defective 3 beta HSD activity. Other two children had high levels of 17 P, suggesting a deficiency of cytochrome p450c21. A CYP 21 gene mutation was found in one of the later children., Conclusions: A low proportion of children with micropenis have a deficient 3 beta HSD activity.

A genomic expression library of Trypanosoma cruzi (T. cruzi) was made using plasmid pcDNA3 as a vector, with which male mice from the Balb/c isogenic line were intramuscullary inoculated. It was used a positive control group that was administered soluble antigens of T. cruzi. Other 2 groups received genomic and plasmid DNA, respectively. One group was not immunized. Weekly blood samples were obtained from all the animals until the fourth week and 2 weeks after reimmunization to study the response of specific antibodies against the microorganism antigens by an indirect immunoenzymatic assay (ELISA). It was observed a significant increase of specific antibodies in the animals reimmunized with 50 micrograms of the library, as well as in the group immunized with soluble antigens of T. cruzi.

Background: Nosocomial infection represents a prolongation of hospital stay and an increase of costs. The aim of the study was to estimate attributable costs by means of two methods: calculation of costs resulting from an increase of hospital stay and calculation of costs attributed to services., Methods: A matched case-control study was carried out with a cohort population. An appropriate control was found for 63 patients with surgical site infection, for 30 patients with respiratory infection and for 55 with urinary infection. The estimation of costs attributable to services includes the case-control pairs with surgical site infection and was performed of the sum of costs of diagnostic and therapeutic services rendered in the care of the surgical site infection., Results: The median of postoperative stay was 21 days for cases with surgical site infection vs 10 days for controls (p < 0.001); the median length of stay was 21.5 days for cases with respiratory infection vs 11.5 days for controls (p < 0.01); and for urinary infection the median length of stay was 21 days for cases vs 15 days for controls (p < 0.01). The surgical site infection cost attributed to extra days was 310,310 pesetas and the surgical site infection cost attributed to service cost was 220,546 pesetas., Conclusions: Nosocomial infection produces a increase median hospital stay of 7-10 days. In absence of a precise accounting system, the prolongation of hospital stay was considered as the more objective date to estimate the costs.

A 7 year old boy presented with bilateral nodular testicular swelling, adult penis development and scrotal aspect. Laboratory studies revealed a bone age of 13 years, increased testosterone, estradiol, DHEA-S, and 17 ketosteroids levels. The GnRH test revealed puberal findings. Biopsy was consistent with Leydig cell tumor with presence of Reinke crystals. After enucleation of the tumor signs of necrosis and malignancy were shown. Orchiectomy will follow as chemotherapy and radiotherapy have been reported to be without value.

Cryptosporidiosis was observed in 23 undernourished infants of a nutritional center in Temuco. This represents a 34% incidence rate for the period (march to may 1990). Liquid stools (91%), vomiting (39%), resistance to feeding (74%), respiratory symptoms (61%) and weight loss (mean 25 g per day) were the main clinical manifestations. Only 9 patients received specific therapy and all showed clinical improvement and normalization of stool examinations within the study period.