ABSTRACT
El dengue es un problema creciente para la salud pública mundial. En Argentina, los casos se han ido incrementado en los últimos años. La vacuna Dengvaxia (CYD-TDV) fue aprobada por la Agencia Nacional de Medicamentos, Alimentos y Tecnología (ANMAT) en 2017, y actualmente está indicada para personas entre los 9 y 45 años de edad que residan enzonas endémicas. A partir de la consulta de una paciente sobre la posibilidad de vacunarse contra el dengue, la autora se plantea la pertinencia de su indicación, teniendo en cuenta la eficacia y seguridad de la vacuna. Luego de una búsqueda rápida se encontró evidencia que señala que la vacuna contra el dengue CYD-TDV mostró poca eficacia en comparación con otras vacunas disponibles en el mercado, siendo más segura y eficaz en personas que ya han sido infectadas anteriormente por el virus del dengue (sujetos seropositivos). En cambio, se observó un aumento del riesgo de dengue grave en los infectados por vez primera tras la vacunación (sujetos seronegativos). Se concluye que la estrategia recomendada consiste en vacunar únicamente a las personas que hayan tenido infección por dengue con anterioridad, consistiendo en una buena práctica la toma de decisiones compartidas con cada paciente. (AU)
Dengue is a growing problem for global public health. In Argentina, cases have been increasing in recent years. The Dengvaxia vaccine (CYD-TDV) was approved by the National Agency for Medicines, Food and Technology in 2017, and it is currently indicated for people between 9 and 45 years of age who reside in endemic areas. Based on the consultation of a patient about the possibility of being vaccinated against dengue, the author considers the relevance of its indication, taking into account the efficacy and safety of the vaccine. After a quick search, evidence was found that indicates that the CYD-TDV dengue vaccine showed little efficacy compared to other vaccines available on the market, being safer and more effective in people who have already been previously infected by the dengue virus (seropositive subjects). In contrast, an increased risk of severe dengue was observed in those infected for the first time after vaccination (seronegative subjects). It is concluded that the recommended strategy consists of vaccinating only people who have had dengue infection before, making shared decisions with each patient a good practice. (AU)
Subject(s)
Humans , Female , Adult , Dengue/immunology , Dengue Vaccines/pharmacology , Patient Participation , Meta-Analysis as Topic , Public Health , Severe Dengue/etiology , Dengue/prevention & control , Dengue Virus/classification , Dengue Vaccines/adverse effects , Dengue Vaccines/immunology , Systematic Reviews as Topic , Decision Making, SharedSubject(s)
Humans , Male , Female , Middle Aged , Respiratory Tract Infections/drug therapy , Cough/drug therapy , Anti-Bacterial Agents/therapeutic use , Drug Prescriptions , Respiratory Tract Infections/diagnosis , Practice Patterns, Physicians'/statistics & numerical data , Prospective Studies , Treatment Outcome , Cough/diagnosis , Observational Studies as Topic , General Practice , United Kingdom , Anti-Bacterial Agents/adverse effectsSubject(s)
Humans , Male , Aged , Aged, 80 and over , Apathy , Alzheimer Disease/drug therapy , Central Nervous System Stimulants/therapeutic use , Methylphenidate/therapeutic use , Veterans/psychology , Severity of Illness Index , Activities of Daily Living , Randomized Controlled Trials as Topic , Double-Blind Method , Prospective Studies , Caregivers , Cognition , Depression/psychology , Independent Living , Alzheimer Disease/physiopathology , Alzheimer Disease/psychology , Mental Status and Dementia TestsABSTRACT
A partir de una viñeta clínica, la autora describe los resultados de dos revisiones sistemáticas que evaluaron la eficacia y la seguridad de la pregabalina para el alivio del dolor en pacientes con fibromialgia. (AU)
Based on a clinical vignette, the author describes the results of two systematic reviews that evaluated the efficacy and safety of pregabalin for pain relief in patients with fibromyalgia. (AU)