Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: Hemolytic disease of the fetus and newborn (EHFRN) consists of the incompatibility present between maternal and fetal erythrocyte antigens, which triggers an immune reaction in the mother against fetal erythrocytes, causing their destruction. The most serious complication is hydrops fetalis, which consists of symptoms of hemodynamic origin, derived from heart failure due to the decrease in oxygen supply or the lack of albumin production. Objective: Make an updated review of the EHFRN, exposing mainly hydrops fetalis as one of its major complications. Methodology: Bibliographic review was carried out from 2018 to 2021 in databases such as Science Direct, Pubmed and Medline based on the following MeSH terms: hemolytic anemia, Rh isoimmunization, erythroblastosis fetalis, hydrops fetalis. Conclusion: EHFRN is a frequent cause of severe hemolytic disease in these patients; but thanks to the anti-D Immunoglobulin G, the majority of cases of Rh incompatibility have been prevented. However, hydrops fetalis has a high mortality rate, which makes it important to promote timely diagnosis and the use of prophylaxis.

No summary.

Introduction: 5 alpha reductase deficiency is a rare disease that produces alterations in sexual development whose prevalence is unknown but has been described in populations with common genealogy in areas of the Dominican Republic, Turkey, Lebanon and Papua New Guinea. Material and methods: We present a preschool patient who attends a review consultation due to the presence of masses in bilateral labia majora and slight growth of the clitoris since birth from an area in the south of the country known to present cases of abnormalities of sexual differentiation due to 5 alpha reductase deficiency. Female-looking external genitalia, bilateral 2ml masses in the labia majora, 2cm clitoris with slight hypertrophy and vaginal introitus. Karyotype, baseline testosterone and dihydrotestosterone determinations, as well as sonographic studies were performed. Dihydrotestosterone gel at 0.2 mg/kg daily was applied to the genital area for 4 months prior to surgery. Results: The karyotype was 46xy. Testosterone/Dihydrotestosterone ratio: 41.25 Genital ultrasound: 2 structures with characteristics of testicles with preserved dimensions and morphology. masculinizing genitoplasty was performed. After 4 months of daily application of the preparation, a longitudinal growth of the phallus of 4.5 cm and a circumference of 4 cm were confirmed. Conclusion: Reconstruction or genitoplasty at an early age offers better results with the prior application of local dihydrotestosterone.

Introduction: The COVID-19 pandemic has posed challenges and unknowns in the control of Tuberculosis (TB), having an economic and social impact on the Dominican population. Objective: To analyze the impact of the COVID-19 pandemic on Tuberculosis control in the Dominican Republic. Methods: Document review research using databases and open access platform. Statistical data on COVID-19 and Tuberculosis were obtained from the DIGEPI and TB Division databases and presented in tables and graphs, comparing 2019 and 2020. Results: There is evidence of a decrease in the detection and diagnosis of TB cases and the start of treatment before and after the pandemic; decreasing case notification by 28%, the number of people suspected of TB investigated to confirm or rule out TB decreased from 54,062 (2019) to 14,985 (2020); the number of people in contact with a TB case evaluated to confirm or rule out TB from 3,824 (2019) to 2,044 (2020) and the number of patients who started anti-TB treatment from 3,737 (2019) to 2,423 (2020). Likewise, a decrease in diagnosed TB/HIV cases, TB cases with HIV testing, TB/HIV cases receiving antiretroviral treatment and preventive therapy with cotrimoxazole. Conclusions: The COVID-19 pandemic and the measures adopted for its control produced a disruption in the activities of detection, diagnosis and initiation of treatment of TB cases and TB/AIDS coinfection.

Introduction: Diphtheria is an infectious disease caused mainly by toxigenic strains of Corynebacterium diphtheriae, local infections can affect both the respiratory tract and the integumentary system (1)(2). In the Dominican Republic, the last diphtheria outbreak occurred in 2004. The incidence of this disease has experienced a considerable decrease, registering an average of 2.6 cases per year (range = 1-7) in the last 5 years. The objective of this research is to describe 21 probable cases of Diphtheria notified during the period January-May 2021. Method: a descriptive report was made based on the retrospective analysis of the single individual case notification form, and the records of 21 patients with diagnosis of probable diphtheria, which were admitted to the Dr. Robert Reid Cabral Children’s Hospital, during the period January-May 2021. Results: The age group most affected was children between 1-4 years with 11 cases (52 %). A history of incomplete immunization status was presented in 19 cases (90.5 %). The diagnosis of diphtheria was confirmed in 9 cases (42.9 %). Diphtheria antitoxin (DAT) was administered in 17 cases (81 %), 11 of these patients died and 6 survived, of the 4 patients who did not receive (DAT) (19 %) 1 died (p = 0.272). The epidemiological week with the highest record of case onset was week fifteen with 6 cases (28 %). The most frequent type of complication was respiratory failure, presented in 50 % of the cases. Conclusions: Of the 21 cases, 12 died, which represents a 58 % fatality rate, figures that exceed the 32 % fatality rate recorded in the 2004 outbreak. A history of incomplete immunization status was presented in 19 cases (90.5 %), which suggests that one of the triggers for the outbreak is the fall in immunity induced by vaccines over time, and the lack of booster doses. Considering the limitations of production and distribution of the toxin that still prevail and affect mostly developing countries, the fact that 81 % of all patients received DAT is an outstanding fact compared to other countries in the America.

In the Dominican Republic, the first confirmed cases of severe acute respiratory syndrome associated with Coronavirus type 2 (SARS-CoV-2) were reported in early March 2020, with a fluctuating increase between different hotspots within the territory, and more than 500,000 cases with a fatality rate that has hovered between 1.25-0.77%. Due to the impact of tourism on the Dominican economy, the first cases reported in the country were associated with visitors of European origin. The aim of this study was the postmortem detection of SARS-CoV-2 by quantitative reverse transcription polymerase chain reaction (qRT-PCR) in formalin-fixed paraffin-embedded (FFPE) tissue samples from of suspected cases of infection and describe the relationship with the histopathological findings. Likewise, to evaluate the use of qRT-PCR as a tool for the postmortem diagnosis of SARS-CoV-2 using FFPE tissue, especially in those cases in which the cause of death is unknown. Through a retrospective study carried out in a single center, two cases were selected that met the criteria. Nucleic acids were extracted from FFPE tissues archived six months due to international biosafety guidelines regulations, thus viral nucleic acid was obtained. The use of FFPE tissues could help epidemiological surveillance authorities assign a definitive diagnosis, mainly in suspected cases of SARS-CoV-2 infections and describe new histopathological findings of the disease.

Introduction: During the current confinement situation arising from COVID-19, the population has been exposed to states where their quality of sleep has been affected. For this reason, this research determined the impact of social confinement by COVID- 19 on sleep quality in adults aged 18 to 60 years in the Dominican Republic. Materials and methods: This cross-sectional observational study was conducted in the Dominican Republic in 2020, specifically in adults aged 18 to 60 years. The survey was spread virtually via Google Forms. The variables used were categorical (sex, marital status, area of residence, academic level, employment, substance use) and continuous (age, sleep quality, stress level). Similarly, internationally approved surveys such as the Pittsburgh Sleep Quality Index were used. Results: The study population consisted of 821 participants (mean age 30.94 years, 74.3% women). The overall prevalence of poor sleep quality was 80.7%. The average score of PSQI was 8.56 ± 4.20. Moreover, the relationship between stress and poor quality of sleep stands out, obtaining a p = 0.00. Independent related factors of poor sleep quality included age and female gender. Conclusions: This study shows an overview of the different causes related to alterations in sleep quality. It is worth highlighting the exposure to high levels of stress during social isolation as a result of the pandemic caused by COVID-19, associated with poor quality of sleep. In addition, the female gender showed a greater tendency to present sleep disorders, as did alcohol consumers.

Introduction: Disclosure of HIV status is a risk reduction strategy. This study aims to promote policies and actions that allow the prevalence of serodiscordance among couples living with HIV. Objective: Determine beliefs, knowledge, attitudes, and practices about HIV of serodiscordant couples who attended SAI Cinco Casas during the period April-June 2021 and promote serodiscordance. Methods: Observational, descriptive, and cross sectional study; data were obtained through both primary and secondary sources. Results: Correct answers did not exceed 68 % in any group. Beliefs about the cure for HIV/AIDS differ significantly between groups. 57.6 % of the sample affirms that they use condoms though only 55.3% always use it. Among the most used practices to maintain serodiscordance, we find treatment adherence (> 57%). Conclusions: In comparison, more seropositive than seronegative patients know the advantages of an undetectable viral load. The HIV-positive group has more optimistic ideas and beliefs. Attitudes at the time of diagnosis were generally positive, but a significant percentage wished for death.

Introduction: The levels of acceptance of the vaccine vary globally and it is necessary to take into account the prioritized clients, defined as the population with little access to health due to its sociodemographic characteristics, Haitian migrants and their descendants, with a high rate of mobility, scarce economic resources and a high percentage without documents that guarantee their immigration status in the Dominican Republic. This population is not reflected in any study found to date. Material and methods: The study was conducted using the knowledge, attitudes and practices (KAP) plus beliefs inquiry. Descriptive, observational and cross-sectional study. Results: Regarding the intention to be vaccinated, comparing whether there would be a difference according to the serological condition of the patients, no statistically significant difference was found when performing the chi-square test, a p-value of 0.080 was obtained. While when comparing whether there was any difference with illiterate people, no statistically significant difference was found. Since the p-value was 0.664. There was also no statistically significant difference when comparing the participants according to gender, since the p-value was 0.664. When performing the unpaired T test with a 95% confidence interval because it was comparing whether or not the patients would be vaccinated with the age at which a statistically significant difference was found since the p-value was 0.001. Conclusions: The acceptance of the vaccine may be determined by the age and educational level of the migrant population. Therefore, more studies would have to be carried out on other factors that could affect the intention and perception of the effectiveness of the vaccine. In addition to carrying out specific campaigns for this population.

Introduction: The Human Papilloma Virus (HPV) is an important factor in the development of cervical, head and neck cancer. HPV is classified into low-risk and high-risk genotypes, with the latter standing out as an important oncogenic factor. Formalin-fixed paraffin-embedded (FFPE) samples are a useful tool for molecular identification of the virus through systematic screening and identification of each separate genotype retrospectively. The objective of this research was to explore a method for detecting HPV in FFPE in carcinomas of the cervix and head and neck. Materials and methods: Samples preserved in FFPE were analyzed through molecular amplification assays Ampfire® HR HPV genotyping assay, to identify 15 high-risk genotypes and their potential accessibility in low-resource settings. A pilot trial was performed on samples previously diagnosed with squamous cell carcinoma in FFPE. Results: 12 cases with the presence of HPV were identified. Of these, 9 out of a total of 12 corresponded to HPV16, the others showed the presence of the HPV33, HPV39, and HPV52 genotypes. Conclusions: FFPE tissue samples allowed obtaining samples for the identification of valid high-risk HPV. The trial will study being a good candidate for the introduction of low-cost FFPE tissue genotyping techniques in the Dominican Republic.