BackgroundChikungunya virus (CHIKV) typically causes explosive epidemics of fever, rash and polyarthralgia after its introduction into naïve populations. Since its introduction in Panama in May of 2014, few autochthonous cases have been reported; most of them were found within limited outbreaks in Panama City in 2014 and Puerto Obaldia town, near the Caribbean border with Colombia in 2015. In order to confirm that Panama had few CHIKV cases compared with neighboring countries, we perform an epidemiological analysis of chikungunya cases reported from May 2014 to July 2015. Moreover, to understand this paucity of confirmed CHIKV cases, a vectorial analysis in the counties where these cases were reported was performed.MethodsChikungunya cases were identified at medical centers and notified to health authorities. Sera samples were analyzed at Gorgas Memorial Institute for viral RNA and CHIKV-specific antibody detection.ResultsA total of 413 suspected cases of CHIKV infections were reported, with incidence rates of 0.5 and 0.7 per 100,000 inhabitants in 2014 and 2015, respectively. During this period, 38.6% of CHIKV cases were autochthonous with rash and polyarthralgia as predominant symptoms. CHIKV and DENV incidence ratios were 1:306 and 1:34, respectively. A phylogenetic analysis of E1/E2 genomic segment indicates that the outbreak strains belong to the Asian genotype and cluster together with CHIKV isolates from other American countries during the same period. Statistical analysis of the National Vector Control program at the district level shows low and medium vector infestation level for most of the counties with CHIKV cases. This index was lower than for neighboring countries.ConclusionsPrevious training of clinical, laboratory and vector workers allowed a good caption and detection of the chikungunya cases and fast intervention. It is possible that low/medium vector infestation level could explain in part the paucity of chikungunya infections in Panama.

Isoniazid-monoresistant tuberculosis (HR-TB) is the most prevalent form of drug-resistant TB worldwide and in France and is associated with poorer treatment outcomes compared with drugsusceptible TB (DS-TB). The objective of this study was to determine the characteristics of HR-TB patients in France and to compare outcomes and safety of treatment for HR-TB and DS-TB. Methods: We performed a case-control multicenter study to identify risk factors associated with HR-TB and compare treatment outcomes and safety between HR-TB patients and DS-TB patients. Results: Characteristics of 99 HR-TB patients diagnosed and treated in the university hospitals of Paris, Lille, Caen and Strasbourg were compared with 99 DS-TB patients. Female sex (OR = 2.2; 1.0-4.7), birth in the West-Pacific World Health Organization region (OR = 4.6; 1.1-18.7) and resistance to streptomycin (OR = 77.5; 10.1-594.4) were found to be independently associated with HR-TB. Rates of treatment success did not differ significantly between HR-TB and DS-TB.

<p>[Clinical and radiological Characteristics of patients with diabetic foot ulcer with endovascular treatment of peripheral arterial disease. March 2015 to June 2017.]</p><p><br /><strong>Resumen</strong><br />Introducción: La Diabetes mellitus es un problema global, y junto a sus complicaciones representa la causa líder de muerte por enfermedades no transmisibles. El 50% de los pacientes con Diabetes presentan signos de compromiso vascular que al complicarse ameritan tratamiento con bypass quirúrgico que es el método convencional, pero se ha visto que la técnica endovascular ha ayudado a disminuir la morbilidad y la mortalidad de estos pacientes, reduciendo además, el número de amputaciones mayores en los pacientes con pie diabético y enfermedad arterial periférica Objetivo: Describir características clínicas e imagenológicas de pacientes diabéticos con tratamiento endovascular de la enfermedad periférica arterial. Metodología: Estudio descriptivo retrospectivo mediante revisión de expedientes clínicos y radiológicos. Utilizando un formulario para la recolección de datos y EpiInfo v7.2 para la creación y análisis la base de datos. Resultados: Participaron 50 pacientes, el 52% pertenecían al sexo femenino, la mayoría de los pacientes pertenecían al grupo de los 61-70 años. La hipertensión arterial fue la comorbilidad más frecuente (78%). La enfermedad arterial por debajo de la rodilla fue la más observada, con afectación de la arteria tibial anterior principalmente (84%). La angioplastia con balón se realizó en el 100% de los casos, con falló en el 8% de los casos. Conclusión: La enfermedad arterial periférica afecta en mayor medida a los vasos de la pierna por debajo de la rodilla. El tratamiento endovascular de las lesiones arteriales periféricas constituye un método con una gran tasa de éxito en el procedimiento inicial.<br /><br /><strong>Abstract</strong><br />Objective: Describe the clinical and imaging characteristics of diabetic patients who underwent endovascular treatment for peripheral arterial disease. Method: A retrospective descriptive study was carried out. We reviewed the data in the clinical and radiological file of the patients included in the study; they were collected in a survey sheet previously authorized by the Bioethics Committee of the Institution. The data obtained were tabulated in the EpiInfo v7.2 program and graphed using the Office Excel 2016 program. Results: Fifty patients who met the inclusion criteria were included in the study, 52% of them were women, mainly in the age group between 61-70 years. Arterial hypertension was the most frequent comorbidity in the study population with 78% of the total patients. Arterial disease below the knee was more frequent, with involvement of the anterior tibial artery in 84% of the patients evaluated. Balloon angioplasty was performed in 100% of the cases, while stent placement was necessary in 10% of the procedures performed. The result of the procedure was not successful only in 4/50 patients performed. 84% of the patients presented primary patency at 6 months of evaluation. Conclusion: Peripheral arterial disease mainly the vessels of the leg below the knee. Endovascular treatment of peripheral arterial injuries is a safe method with a high success rate in the initial procedure, as well as a low recurrence of intervention at least 6 months after the procedure.<br /><br /></p>

No abstract