Recomendaciones médicas para uveítis no infecciosas en adultos

Justificación: Las uveítis no infecciosas constituyen una importante causa de pérdida visual a nivel mundial; por su complejidad y gravedad de complicaciones requieren un abordaje temprano y multidisciplinario. En Costa Rica se desconoce hasta el momento la incidencia global de estas entidades y todavía no existe ningún consenso en cuanto a su manejo. Objetivos: Resumir las recomendaciones terapéuticas vigentes para uveítis no infecciosas en adultos y ofrecer una guía adaptada a la realidad costarricense. Métodos: Se efectuó una revisión no sistemática de bibliografía médica indexada en las plataformas PubMed y Scielo, sobre el manejo médico de las uveítis no infecciosas. De igual manera, se compararon los esquemas terapéuticos recomendados actualmente en América y Europa con el abordaje realizado en los centros hospitalarios costarricenses, para crear una guía adaptada a la realidad nacional. En la elaboración de estas recomendaciones participaron médicos especialistas de todas las clínicas multidisciplinarias especializadas en uveítis del país. Conclusiones: En Costa Rica se cuenta con la mayoría de las opciones disponibles para el tratamiento de uveítis idiopáticas en el sistema público de salud. Se logró la creación de algoritmos de tratamiento para las diferentes patologías.

Summary Background: Noninfectious uveitis represents an important cause of visual loss worldwide, which in view of the severity and complexity of complications demands an early and multidisciplinary approach to therapy. In Costa Rica there is no statistical records of incidence nor consensus of management of these entities to this date. Objectives: To summarize the therapeutic recommendations for non-infectious uveítis according to the scientific evidence and adapt them to the Costa Rican conditions. Methods: A non-systematic review of medical literature indexed on PubMed and Scielo, concerning medical and surgical management of non-infectious uveitis was carried out. Likewise, the recommended therapeutic schemes in America and Europe were compared to the approach used in the Costa Rican hospital centers. In the elaboration of these recommendations participated physicians, specialists of all multidisciplinary clinics for uveitis of the country. Conclusions: In Costa Rica, the majority of alternatives available for the treatment of idiopathic uveitis in the public health system are available. It was possible to create therapeutic algorithms for the different diseases.

The bacteriology of the water supplies of Rangoon.II.Cool dry and hot dry seasons

Water samples from 19 piped and natural sources in Rangoon were examined bacteriologically during the cool dry season of 1966-67 and the hot dry season of 1967 for the Presumptive Coliform Count, the Presumptive Enterococcus Count and the presence of Presumptive Clostridium perfringens. Bacteria isolated from Mac Conkey bile salt lactose peptone water (Cruickshank, 1965) and sodium azide medium (Hannay and Norton, 1947) primary cultures were identified. Using as criteria the Presumptive Coliform Count and the isolation of Escherichia coli and/or Klebsiella aerogenes and for Streptococcusfaeca.zis, for the cool dry season, all of the 15 samples tested were found unsatisfactory for drinking purposes. Again, for tile cool dry season, all of the 16 samples tested were found unsatisfactory.

The bacteriology of the water supplies of Rangoon.1.Monsoon and post-monsoon seasons

38 water samples taken from piped and natural sources in Rangoon during the monsoon and post-monsoon seasons of 1966 were examined bacteriologically using Mac Conkey broth as a primary culture medium. 31 of the 38 samples were found unsatisfactory for drinking purposes. The species isolated included Escherichia coli, Klebsiella aerogenes, an Entero-bacter sp., Alcaligenes faecalis, Chromobacterium janthinum, Proteur, Pseudomonas aeruginosa, P. fluorescens and Serratia marcescens. Viabilities at 4C of E. coli, the Enterobacter strain, A. faecalis and P.fluorescens varied from 7-56 days, that of C. janthinum and s. marcescens was a minimum of 7 days. At room temperature (22.8C to 31.1C) E. coli and P. fluorescens were viable for 28, and K. aerogenes for less than 7 days.