Aspectos clínico-epidemiológicos de pacientes con infecciones asociadas a la atención de salud / Clinical-epidemiological aspects of patients with health-care associated infections

Introducción: las infecciones asociadas a la atención de salud constituyen un problema mundial por sus implicaciones económicas, legales, éticas y médicas. Objetivos: determinar el comportamiento de las infecciones asociadas a la atención de salud. Métodos: estudio descriptivo, retrospectivo y transversal de 105 pacientes con las infecciones asociadas a la atención de salud, quienes ingresaron en el servicio de medicina interna del Hospital Clínico Quirúrgico Manuel Fajardo, desde enero de 2013 hasta diciembre hasta 2015. Se utilizó la estadística descriptiva y se relacionó la información nacional e internacional con los resultados. Resultados: los pacientes afectados fueron principalmente de 60 o más años de edad, sin diferencias en el sexo. El diagnóstico más común fue la bronconeumonía (55,2 por ciento). Las principales comorbilidades resultaron ser la hipertensión arterial (52,4 por ciento), el accidente vascular encefálico (37,1 por ciento), diabetes mellitus (35,2 por ciento) y cardiopatía isquémica (35,2 por ciento). La biterapia antibiótica fue la modalidad más habitual y en la mayoría de los casos se utilizó un ciclo de antibioticoterapia, pero con frecuencia fue necesario hacer dos o más ciclos de tratamiento antibiótico. La mortalidad mostró relación significativa con la edad y predominó en pacientes de 60 o más años de edad y en los pacientes con bronconeumonía (40,3 por ciento). Conclusiones: las infecciones asociadas a la atención de salud predominaron en una población envejecida, frecuentemente asociada a comorbilidad y la mortalidad se agrupó principalmente en pacientes de la tercera edad y con bronconeumonía(AU)

Introduction: Health-care associated infections are a global problem due to their economic, legal, ethical, and medical implications. Objectives: To determine the behavior of health-care associated infections in the internal medicine service at Manuel Fajardo Hospital. Methods: Descriptive, retrospective and cross-sectional study of 105 patients with health-care associated infections was conducted. These patients were admitted to the Internal Medicine Service at Manuel Fajardo Hospital, from January 2013 to December 2015. Descriptive statistics and national and international information were related to the results. Results: The affected patients were mainly 60 or older, without differences in sex. The most common diagnosis was bronchopneumonia (55.2 percent). The main comorbidities were hypertension (52.4 percent), cerebrovascular accident (37.1 percent), diabetes mellitus (35.2 percent) and ischemic heart disease (35.2 percent). Antibiotic biotherapy was the most common modality. In most cases an antibiotic therapy cycle was used, but it was often necessary to do two or more cycles of antibiotic treatment. Mortality showed a significant relationship with age and predominated in patients who were 60 or older and in patients with bronchopneumonia (40.3 percent). Conclusions: Health-care associated infections prevailed in an aging population, frequently associated with comorbidity, and mortality was mainly grouped in elderly patients with bronchopneumonia(AU)

Susceptibilidad antimicrobiana en muestras clínicas de pacientes con infecciones asociadas a la atención de salud / Antimicrobial susceptibility in clinical samples of patients with health care associated infections

Introducción: Las infecciones asociadas a la atención de salud (IAAS) son uno de los principales problemas que afecta a los pacientes en las unidades hospitalarias, tanto en países desarrollados como carentes de recursos. Objetivo: Identificar los tipos de IAAS reportadas, microorganismo causal y susceptibilidad antimicrobiana en el Servicio de Medicina Interna del Hospital Clínico-Quirúrgico "Manuel Fajardo". Material y método: Estudio descriptivo, retrospectivo y transversal de 105 pacientes con IAAS, quienes ingresaron en el Servicio de Medicina Interna del Hospital Clínico-Quirúrgico Manuel Fajardo, desde enero 2013 hasta diciembre 2015. Se analizaron distintas variables. Se utilizó la estadística descriptiva y se relacionó la información nacional e internacional con los resultados obtenidos. Resultados: Predominaron los pacientes con edad superior a los 60 años. El diagnóstico más común fue la bronconeumonía en 58 pacientes (55.2 por ciento). El principal microorganismo causal para la bronconeumonía, la traqueobronquitis y las úlceras de presión fue Pseudomona spp.; mientras que para la infección del tracto urinario y flebitis-celulitis y absceso fueron E. coli y S. aureus respectivamente. Pseudomona spp. y E. coli mostraron alta resistencia a las cefalosporinas de primera, segunda y tercera generaciones testadas y a otros tipos de antibióticos; sin embargo, para los aminoglucósidos y Cefepime la sensibilidad fue favorable. La susceptibilidad de S. aureus mostró resultados muy adversos, pues solo para la Amikacina y Vancomicina tuvo aceptable sensibilidad. Conclusiones: Las IAAS predominaron en una población envejecida y fueron ocasionadas por una diversidad de microorganismos, principalmente Pseudomona spp., E. coli y S. aureus, los cuales mostraron elevada resistencia antimicrobiana(AU)

Introduction: The health care associated infections (HCAI) are one of the major problems which affect the patients in the hospital units, both in developed countries and in countries with low resources. Objective: To identify what kind of HCAI were reported, causal microorganism and antimicrobial susceptibility in the Internal Medicine Service at the "Manuel Fajardo" clinical-surgical hospital. Material and method: Descriptive, retrospective and transversal study of 105 patients with HCAI, who were admitted in the Internal Medicine Service at the Manuel Fajardo clinical-surgical hospital, from January 2013 to December 2015. It was analyzed different variables. It was used descriptive statistics and it was related the national and international information with the obtained results. Results: It were predominated the patients with age over 60 years. The more common diagnosis was broncho-pneumonia in 58 patients (55.2 percent). The principal causal microorganism for broncho-pneumonia, the tracheo-bronchitis and the pressure ulcers was Pseudomona spp.; while for urinary tract infection and flebitis-cellulitis and abscess were E. coli and S. aureus respectively. Pseudomona spp. and E. coli showed high resistance to cephalosporins of the first, second and third generation tested and other kinds of antibiotics; however, for the amynoglucosides and for Cefepime the sensibility was favourable. The susceptibility of S. aureus showed very adverse results, because only for Amikacin and Vancomicin had acceptable sensibility. Conclusions: The HCAI predominated in an aged population and were caused by a diversity of microorganisms, principally Pseudomona spp., E. coli and S. aureus, which showed high antimicrobial resistance(AU)

Wound healing - A literature review

Abstract: Regeneration and tissue repair processes consist of a sequence of molecular and cellular events which occur after the onset of a tissue lesion in order to restore the damaged tissue. The exsudative, proliferative, and extracellular matrix remodeling phases are sequential events that occur through the integration of dynamic processes involving soluble mediators, blood cells, and parenchymal cells. Exsudative phenomena that take place after injury contribute to the development of tissue edema. The proliferative stage seeks to reduce the area of tissue injury by contracting myofibroblasts and fibroplasia. At this stage, angiogenesis and reepithelialization processes can still be observed. Endothelial cells are able to differentiate into mesenchymal components, and this difference appears to be finely orchestrated by a set of signaling proteins that have been studied in the literature. This pathway is known as Hedgehog. The purpose of this review is to describe the various cellular and molecular aspects involved in the skin healing process.

Logros en la competencia comunicativa a través de la utilización de la música en las clases de Inglés / Achievements in the communicative competence through the use of music in the English classes

Se realizó un estudio pre-experimental con la cantidad de 50 estudiantes de 2do año de la carrera de Medicina a los que se le aplicó un instrumento evaluativo para conocer los logros en la competencia comunicativa a través de la utilización de la música en las clases de Inglés. Ese instrumento fue aplicado antes y después de introducir las canciones y se obtuvo como resultado una elevación del nivel de asimilación y comprensión de conocimientos y habilidades que necesitan los estudiantes en el estudio de la Lengua Inglesa.

A pre-experimental study was conducted with 50 students from the second year of the Medicine career. We applied and evaluated an instrument to know the level of knowledge acquired by them when introducing the music in the English lessons. That instrument was applied before and after introducing the different exercises, obtaining as results an elevation of the level of assimilation and comprehension of knowledge that the students need in the study of the English language.

Desarrollo de habilidades lingüísticas en estudiantes de 1er año de la carrera de Medicina / Development of linguistics’ skills in 1st year students of Medicine career

Se realizó un estudio pre-experimental con la cantidad de 40 estudiantes de 1er año de la carrera de Medicina a los que se le aplicó un instrumento evaluativo para conocer el nivel de conocimientos adquirido por ellos al integrar las 4 habilidades lingüísticas en la comprensión del idioma Inglés. Ese instrumento fue aplicado antes y después de integrar las 4 habilidades básicas obteniendo como resultados una elevación del nivel de asimilación y comprensión de conocimientos y habilidades que necesitan los estudiantes en el estudio de la Lengua Inglesa.

A pre-experimental study was done with a quantity of 40 students from 1st year of Medicine career to those we applied an evaluated instrument to the level of knowledge acquired by them when integrating the four basic abilities to the comprehension of English subject. That instrument was applied before and after integrating the four basic abilities obtaining as results an elevation of the level of assimilation and comprehension of knowledge that needed the students in the study of the English language.

Detection of Leishmania braziliensis in human paraffin-embedded tissues from Tucumán, Argentina by polymerase chain reaction

American cutaneous leishmaniasis (ACL) is an endemic disease in Northern Argentina. We applied the polymerase chain reaction (PCR) followed by a hybridization labelled probe to 21 paraffin embedded human skin biopsies, already analyzed histologically, from leishmaniasis endemic areas in the province of Tucumán, Argentina. We used primers previously designed to detect a Leishmania-specific 120-base-pair fragment of kinetoplast DNA minicircle, other two primer pairs that amplify kDNA minicircles belonging to the L. braziliensis and L. mexicana complexes respectively, and specific oligonucleotide primers to detect L. (V.) braziliensis which amplify the sequence of the ribosomal protein L-14 of this species. The PCR-hybridization showed a sensitivity of 90.5 percent when compared to the histopathology test which was 61.9 percent. Five of the total samples analyzed were positive for the L. braziliensis complex whilst none was positive for the L. mexicana complex. The specific primers for L. (V.) braziliensis detected the parasite in four samples. These results are consistent with those reported for close endemic areas and demonstrate that the causative agent of human leishmaniasis in the analyzed cases was L. (V.) braziliensis. PCR should be used as a diagnostic tool for tegumentary leishmaniasis, especially in the mucosal form, and as a valuable technique for the identification of the Leishmania species that causes the disease in certain areas.

Immunohistologic appraisal of infiltating cells in skin biopsies from young patients clinically suspected of having various forms of leprosy

FUNDAMENTOS - Na hanseníase, existem poucas informaçäes imunológicas sobre os tipos celulares nas lesöes iniciais de pacientes jovens. MAERIAL E MÉTODOS - Biópsias da pele obtidas de 28 pacientes jovens näo clinicamente suspeitos de hanseníase foram utilizadas para estudar os fenótipos de superfície produzidos pelas células inflamatórias, demonstrados pela imunohistoquímica usando-se os anticorpos monoclonais LCA;HAM-56;Pan-B;Pan-T;CD4;CD8;Leu7, e os policlonais anti proteína S-100 e anti BCG. Uma análise semiquantitativa das células coradas foi feita. RESULTADOS - Em 24 casos, o diagnóstico histopatológico de Hanseníase pôde ser feito: nove de forma indeterminada (IND); cinco da forma tuberculóide (TT); seis da forma dimorfa tuberculóide (BT) e quatro da forma virchowiana (LL). Todos os casos foram positivos para LCA. No grupo LL as células mais conspícuas foram os macrófagos, seguidos pelos linfócitos T. A subpopulaçäo TCD8 foi mais frequente que TCD4. No grupo BT as células T eram predominantes, com as CD4 discretamente mais frequentes que CD8, seguidas dos macrófagos. No grupo TT as células T também predominavam e dentre estas as CD4 eram as mais conspícuas. Os macrófagos eram as segundas células mais frequentes. O grupo IND foi heterogêneo. As células T foram as mais frequentes com células CD4 e CD8 mostrando mesma frequência que os macrófagos. DISCUSSÄO - Este estudo confirmou que as células T säo as mais frequentes nos grupos TT/BT, existindo maior número destas células nestes casos que no grupo LL, indicando reatividade imunológica consoante com a presença e atividade de células T. Além disso, anticorpos contra subpopulaçöes de células T mostraram nos casos TT/BT mais células CD4 positivas e nos casos LL mais células CD8 positivas proliferaram. As formas IND mostraram gradaçäo na composiçäo dos infiltrados. Nossos resultados demonstram que lesöes cutâneas em pacientes jovens com a forma indeterminada inicial da Hanseníase e com várias formas definidas diferem em relaçäo às células inflamatórias