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Introduction: the COVID-19 pandemic has had a major impact on hepatitis C virus (HCV) diagnosis by hindering the path to elimination. Albeit, in an uneven manner, depending on the risk group and diagnostic strategy., Methods: the requests of antibodies/RNA by venipuncture at hospitals and Primary Care centers (centralized) and via venipuncture or dried blood spot tests at prison and drug treatment centers referred for central processing (integrated decentralized) were recorded for one year, before and after the onset of the COVID-19 health crisis., Results: a total of 20,600 tests (51 % male, 47.9 ± 1 5.8 years) were recorded. Among them, 96.5 % of the cases came from centralized and 3.5 % from decentralized settings, with an active infection rate of 0.2 % and 2.3 % (p < 0.001), respectively. There was a 31.3 % decrease in the number of requests during the pandemic compared to the pre-pandemic period, which was more pronounced in the decentralized than centralized diagnosis setting (60 vs 30 %, p < 0.001). In addition, there was a 31.5 % decline in screening and 18.2 % decrease in the diagnosis of new cases of active infection, with a statistically significant decrease in decentralized compared to centralized diagnosis., Conclusions: during the COVID-19 pandemic, a decline in HCV diagnostic effort was observed, especially in decentralized strategies, with a higher prevalence of infection. Our results suggest a diagnostic delay that will prevent Spain from reaching the elimination target in 2023. Therefore, the reactivation of strategies, particularly targeting the priority groups, is urgently required.

Introduction: Chronic infection due to hepatitis C virus (HCV) is frequently asymptomatic even in advanced stages of liver disease. Implementation of a screening program based on different HCV tests may enable an earlier diagnosis of HCV liver disease and subsequent application of highly effective treatment., Patients and Methods: A Markov model which compares three different screening strategies for hepatitis C versus no screening in low-risk prevalence (general population) and high-risk prevalence population (people who inject drugs or prison population) was designed, taking into account age at the start of screening and participation. The three strategies were: 1) serological detection of antibodies against the HCV, 2) dried blood spot test (DBS) to detect antibodies against HCV and 3) detection of RNA from HCV. Quality-adjusted life-years (QALY) were taken as a measurement of effectiveness. The incremental cost-effectiveness ratio (ICER) was calculated and a deterministic and probabilistic sensitivity analysis was performed., Results: All three screening strategies were found to be cost-effective with an ICER of €13,633, €12,015 and €12,328/QALY for AntiHCV, DBS-AntiHCV and DBS-RNA HCV, respectively. There was a decrease in mortality due to liver disease in comparison to no screening for AntiHCV (40.7% and 52%), DBS-AntiHCV (45% and 80%) and DBS-RNA HCV (45.2% and 80%) for low-prevalence and high-prevalence populations, respectively., Conclusion: All test interventions for HCV screening are cost-effective for the early detection of HCV infection, also achieving a reduction in mortality. Thus, implementation of screening programs for HCV should not be halted by decisions on monetary policy.

Objective: Determine nosocomial infection (NI) prevalence in seven University Hospitals of Havana., Method: A cross sectional survey was carry out in university hospital with more than 100 beds. Presence of NI was determined by an active screening procedure in all patients admitted in hospitals. Technical statistics of frequency distribution was used. Rates of NI were estimated for each hospital and in the special case of procedure, Odds Ratio and its confidence interval at 95 % were calculated (CI 95 %)., Results: Prevalence of NI was 9.2 %. The most frequent localization were: cardiovascular system (55 patients), surgical site (50 patients) and urinary tract (42 patients ). The 19.7 % of studied patient showed intravascular device. All patients showed NI associated with procedures, the highest intensity was association with an endotracheal tube (OR 7.83, IC 95 % 3.32-11.52)., Conclusion: Nosocomial infections in this hospital is a serious health problem; it is necessary to focus our medical work in this regard for the prevention and control of NI.

Extrapulmonary tuberculosis, and especially articular, is less frequent than their pulmonary form. We report a 59 year-old men that requests medical attention for suggestive symptoms of carpal tunnel syndrome, of which is operated, being demonstrated in the carpo a granulomatous tissue including the median nerve suggestive of sarcoidosis or tuberculosis. In sputum the presence of Micobacterium tuberculosis was demonstrated. The respiratory symptoms of pulmonary tuberculosis were for the patient less excellent symptoms in relation to those produced by compression of the median nerve. The relationship between the tuberculosis and the carpal tunnel syndrome is demonstrated.

The ultrasonic diagnosis of salivary gland tumors can give a more accurate information than clinical data alone. For example, it will help differentiate intraglandular from extraglandular tumors and benign from malignant processes. We conducted a prospective study in 39 patients with parotidal or submaxillary tumors. Patients were evaluated with a physical exam and a with ultrasound. Results indicate that only 53.86% of the physical examinations were correct in their diagnosis compared to 87.18% of the those done by ultrasound. Specificity and sensibility for malignancy was 96.43% and 81.81% respectively. These results were similar to those reported by other authors. We conclude that the use of ultrasound techniques in the study of salivary gland pathology is well justified, due to its capacity to provide high resolution, improving clinical diagnosis.

A study of lymphocytic sub-populations of patients with rheumatoid arthritis, their families and partners, is presented. The determination was carried out by means of monoclonal antibodies, analysing: T cells sub-population (CD3, CD4, CD8 and quotient CD4/CD8); B cells sub-population (B1); activated cells (OK1a); monocytes and NK cells (OKM1 and BMA 070). The results showed an increase of CD3 sub-population (T total lymphocytes) in patients with RA and their families. The meaning of these results is difficult to evaluate as lymphocyte sub-population is affected by several variables. The lack of modification of suppressor population, CD4/CD8 quotient and IKM1 cells in RA patients is probably due to the moderate activity of the disease.

The results of the comparison between phenotypic frequency of HLA antigen classes I and II in patients afflicted with rheumatoid arthritis (RA) and their relatives (study carried out in the east of Andalusian), showed a significant increase of HLA A24, B51, B44, CW1 ans CW5 class I antigen in the group of relatives. We found a statistically significant DR4 antigen class II increase in both, patients and relative groups. The marriage parther of patients with RA did not have variations in class I or II HLA antigens compared to the control group. We concluded that RA is probably related to the following antigens: A24, B51, B44, CW1, CW5 and DR4.