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Keiserman M.,University of Porto | Handa R.,Apollo Indraprastha Hospitals | Xibille-Friedmann D.,Autonomous University of the State of Morelos | Mysler E.,Organizacion Medica de Investigacion | And 2 more authors.
Expert Review of Clinical Immunology | Year: 2014

Biologic therapies, predominantly TNF-α inhibitors, have revolutionized the treatment of rheumatoid arthritis (RA). However, their clinical utility can be limited by the development of antidrug antibodies (ADAs). Immunogenicity is a complex phenomenon related to various drug, disease, and patient characteristics, and may be more common with the monoclonal antibodies than with etanercept, a soluble TNF receptor-Fc immunoglobulin fusion protein. Neutralizing antibodies-those that hinder bioactivity by preventing drug molecules from binding to TNF-are correlated with reduced serum drug concentrations, loss of therapeutic response, adverse events, and treatment discontinuation. Cost-effective use of these agents will depend on further research into drug and ADA assays, and how they should guide dose reduction or switching strategies. © 2014 Informa UK, Ltd.


Segovia M.,Central University of Venezuela | Carrasco H.J.,Central University of Venezuela | Martinez C.E.,Central University of Venezuela | Messenger L.A.,London School of Hygiene and Tropical Medicine | And 10 more authors.
Emerging Infectious Diseases | Year: 2013

Oral outbreaks of Chagas disease are increasingly reported in Latin America. The transitory presence of Trypanosoma cruzi parasites within contaminated foods, and the rapid consumption of those foods, precludes precise identification of outbreak origin. We report source attribution for 2 peri-urban oral outbreaks of Chagas disease in Venezuela via high resolution microsatellite typing.


Aguiar H.,University of Carabobo | Goni N.,Instituto Venezolano Of Los Seguros Sociales | Pinto L.,Medico Obstetra Ginecologo | Carrozza M.,Profesora de la Maestria de Ciencias Biomedicas MCB | And 4 more authors.
Revista de Obstetricia y Ginecologia de Venezuela | Year: 2015

Objective: To determine by Polymerase Chain Reaction the presence of the human papillomavirus in female patients attending a screening for lesions of uterine neck in the outpatient network of Francisco Linares Alcantara Municipality and to relate the results to anatomopathological findings. Methods: After obtaining informed consent from patients, samples of vaginal swabs were taken from 301 women that were used for cytology and colposcopy studies. Also, DNAs were isolated and they were used for Polymerase Chain Reaction test coupled to restriction enzyme digestion. Statistical tests were performed to analyze the relationship between the human papillomavirus positivity and the variables: stratus age, the onset of sexual activity, number of sexual couple, cytology and colposcopy findings. Results: Out of 43 human papillomavirus positive samples, 17 (39.53 %) were genotype 16, 3 (6.98 %) genotype 18 and 1 (12.33.%) genotype 33; 14 (32.56 %) samples showed coinfection and 8 (18.60 %), samples were not digested with the restriction enzymes used. The relationship between the presence of human papillomavirus and the others studied variables (stratus age, the onset of sexual activity, number of sexual couple and cytological results) was statistically significant. Conclusions: The presence of human papillomavirus genotypes, of so-called high risk in the 48.84 % of the women with a positive HPV test is a particular concern, because they are associated with the development of cervical cancer.


Nasser B.Z.,University of Zulia | Jose U.M.,University of Zulia | Alfi C.B.,Instituto Venezolano Of Los Seguros Sociales
Revista Chilena de Obstetricia y Ginecologia | Year: 2011

Background: Female sexual function is an important indicator of quality of life, which may be affected to reach menopause. Aims: To compare sexual function in women with natural and surgical menopause attending at the gynecology consultation in the "Dr. Pedro García Clara" Hospital, Zulia state, Venezuela. Methods: A comparative and applied type research with non-experimental, contemporary and field design, which included a sample of 80 patients diagnosed with menopause, divided into two groups according to type of menopause and evaluated by the Female Sexual Function Index (FSFI). Results: We found a significant differences (p<0.05) in hysterectomized women as to indicators excitation frequency, frequency of orgasm and pain after penetration, as well as the dimensions desire orgasm and pain. While the points achieved in both groups showed no significant differences between them, hysterectomized women showed better scores. Conclusion: It is concluded that there are no differences in the general sexual function between natural or surgical menopause, except for desire, orgasm and pain.


Jose U.M.,University of Zulia | Ana R.S.,University of Zulia | Jose G.I.,University of Zulia | Mery G.V.,University of Zulia | And 2 more authors.
Revista Chilena de Obstetricia y Ginecologia | Year: 2011

Background: Postpartum depression (PPD) is a major mental health disorder in women, which have been attributed to various risk factors for it presentation. Objective: To determine the PPD's risk factors present in the postpartum patients taken care of Maternity "Dr Armando Castillo Plaza" at the University Hospital of Maracaibo, Venezuela. Method: A descriptive study was conducted with non-experimental design, which included a sample of 100 postpartum women, as measured by the scale of the Edinburgh Postpartum Depression (EDPS). Results: The results demonstrated a prevalence of the positive test in 91% of the sample, with a confirmed prevalence of postpartum depression by the DSM-IV of 22%, determined that the characteristics assessed only medical disorders during pregnancy, the disease of the newborn, not having the support from your partner, have a history of depression or melancholy, or have a primary or lower education level, showed a significant association with the development of PPD. For its part, the birth by caesarean section and not having family support showed a significant association with the risk of PPD, while vaginal delivery or have reached a level higher than primary education showed a protective effect with this condition. Conclusion: There is a high prevalence of postpartum depression, with several risk factors that would take action for a timely diagnosis of disease.


Jose Urdaneta M.,University of Zulia | Ana Rivera S.,University of Zulia | Jose Garcia I.,University of Zulia | Mery Guerra V.,University of Zulia | And 2 more authors.
Revista Chilena de Obstetricia y Ginecologia | Year: 2010

Background: Today the depressive upheavals represent an important public health's problem, being more frequent in the women and with greater risk during the pregnancy and Puerperium. Objective: To compare the prevalence of postpartum depression in nulliparous and multiparous women taken care of Maternity "Dr. Armando Castillo Plaza" at the University Hospital of Maracaibo, Venezuela. Method: A comparative investigation with non experimental design was realized, it which included a sample of 100 women in later Puerperium, divided in two even groups of 50 subjects according to her parity, evaluated by Edinburgh Postnatal Depression Scale. The results demonstrated a prevalence of the positive test in 91% of the sample, with a confirmed prevalence of postpartum depression by the DSM-IV of 22%, presenting a highly frequency of suicidal ideas in the multiparous group (p<0.05); also, don't found statistically significant association between parity and postpartum depression. Conclusion: The studied population show a highly prevalence of postpartum depression, without majors differences according to the parity.


Diaz E.C.V.,Instituto Venezolano Of Los Seguros Sociales | Jaimes O.R.,Central University of Venezuela | Oliver M.,Central University of Venezuela | Kanne C.,Central University of Venezuela
Medicina Cutanea Ibero-Latino-Americana | Year: 2015

This study is a review of histopathological diagnoses of inflammatory and tumor diseases in the Dermathopathology Service of Instituto de Biomedicina in Caracas, Venezuela, obtained from a 0-18 year population in a period of 2 years (2009-2010). The aim of this study is to determine inflammatory pathologies and tumor skin diseases which are more frequently diagnosed by biopsy. Each patient's data were recorded in a database, and the following variables were studied: distribution of patients by age and sex, distribution of histopathological diagnoses according to frequency and age, classifying inflammatory and tumor diseases in specific groups. Results: 4,472 histopathological diagnoses were made between 2009 and 2010, of which 359 (8%) diagnoses belonged to pediatric population; 181 males and 178 females, with an average of 13.8 years of age. Inflammatory pathology dominated with 273 cases, being superficial perivascular dermatitis the most frequently observed, followed by tumor pathology: telangiectatic granuloma and warts dominated in 86 biopsies. This study reflects us the importance of the dermopathological analysis to reach a final diagnosis of both inflammatory and tumor pathologies, and to ensure patient the most appropriate treatment. © 2015, Catedra Universitario, Facultad de Medicina. All rights reserved.


Machado J.U.,University of Zulia | Cabana J.V.,University of Zulia | Ildefonso J.G.,University of Zulia | Zambrano N.B.,University of Zulia | Benitez A.C.,Instituto Venezolano Of Los Seguros Sociales
Revista Chilena de Obstetricia y Ginecologia | Year: 2010

Background: Insulin resistance (IR) is a complex physiopathological alteration, present in the terminal organs, of high prevalence in women in fertile age and prepuberal stage, with recognized cardiovascular risk association and infertility. Objective: To determine the frequency of IR in infertile women and factors of risks associated in the patients which going to consultation of gynecology of the Maternity "Dr. Armando Castillo Plaza". Method: An applied and descriptive investigation was realised, with nonexperimental design, being applied the technique of the nonparticipant and structured direct observation, having as instrument the work card. Results: The prevalence of IR was 80%, with HOMA index of 5.4 ± 2.7. In infertile women were identified the following risk factors: increased serum androgens/obesity (OR: 1.51; p<0.001), dyslipidemia (OR: 6.53; p<0.001), arterial hypertension (OR: 8.41; p<0.02), acanthosis nigricans (OR: 9.0; p<0.002), and acne (OR: 2.65; p<0.01). Conclusion: We found a high frequency of IR between the infertile women, which can be corrected with changes in the life styles and low complexity interventions for the treatment of the infertility.


Urdaneta-Machado J.R.,University of Zulia | Uhia Gonzalez A.M.,University of Zulia | Cepeda de Villalobos M.,University of Zulia | Guerra Velasquez M.,University of Zulia | And 2 more authors.
Progresos de Obstetricia y Ginecologia | Year: 2011

To compare the effectiveness of uterine conization in high-grade cervical squamous intraepithelial lesions (HSIL) by means of surgical electrical excision with Trucone loop or Leep loop. Subjects and methods: We performed a comparative study that included 150 patients, aged between 20 and 45 years, with a diagnosis of HSIL. All patients underwent uterine conization with diathermy loop. The patients were separated into two groups according to the type of loop used. Results: Both loops were effective in the management of HSIL but significant differences were found in favor of the Trucone loop in surgical time (X: 3.7 ± 0.52, p < 0.01), lesser margin involvement (100% free margins, p < 0.05) and a lower frequency of residual lesions (94.7%, p > 0.01). Conclusions: Both diathermy loops were effective in the treatment of HSIL but the frequency of complications and residual lesions was lower with the Trucone loop. © 2010 SEGO.


Menendez A.G.A.,Centro Ambulatorio Dr Carlos Diez Del Ciervo | De Segura M.A.R.,Instituto Venezolano Of Los Seguros Sociales | Machado C.M.,Instituto Venezolano Of Los Seguros Sociales | Fernandez R.F.,Hospital General Dr Manuel Gea Gonzalez | Arenas R.,Hospital General Dr Manuel Gea Gonzalez
Dermatologia Cosmetica, Medica y Quirurgica | Year: 2014

Small, randomized trials with brief follow-ups fail to establish the increased incidence of fungal infections associated with anti-TNFα drugs. While several cases of deep mycoses have been reported, there are few documented instances of superficial fungal infections. This paper seeks to determine the prevalence of superficial fungal infections in patients with psoriasis under anti-TNFα biologic therapy in our dermatology department.

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