Chikungunya: educación y prevención como pilares fundamentales para enfermedad sin cura / Chikungunya: education and prevention as fundamental support for disease without cure

Chikungunya virus is an alphavirus, member of the Togaviridae family, first discovered in Africa in 1952. Since then it caused sporadic outbreaks in Africa and Asia, but since 2000, outbreaks had been more frequent, being identified in Europe, America and the Caribbean. Chikungunya virus can cause chronic and incapacitating arthralgia, with an important morbidity, being considered as a relevant re-emerging public health problem. This review intends to update our knowledge in epidemiology, transmission, pathogenesis, treatment and vaccination strategies of Chikungunya virus. (AU)

Pie diabético / Diabetic foot

The prevalence of diabetes has increased considerably, constituting a global epidemic today. Many of these patients will develop chronic complications of diabetes, including diabetic foot, which aggravates the patient’s clinical condition, decreases the quality of life and has a great socioeconomic impact. The most important action to reduce the morbidity and mortality associated with this pathology is the prevention of this complication, performing a propermetabolic management and serial control of the patient, educating about self-care of the feet. Once diabetic foot ulcer is present, the cornerstones of treatment are debridement of the wound, management of any infection, revascularization procedures when indicated, and discharge of the ulcer, all of the above in order to avoid amputation. This article intends tomake a review about the epidemiology, pathophysiology, classification, diagnosis, prevention and management of diabetic foot oriented to the primary care doctor.

Virus Zika: epidemiología, manifestaciones clínicas y prevención / Zika virus: epidemiology, clinical manifestations and prevention

Zika virus is an arbovirus that was first discovered in Africa in 1947. Until some time ago, it was an unnoticed emergent virus, due to its low epidemiological impact and its mild flu-like symptoms. However, from 2007 on, Zika virus started to propagate throughout the world and was first locally transmitted in America in 2015. Since then, autochthonous cases of Zika infection have been reported on 33 countries of the Americas. The most relevant impact of the Zika virus outspread is its supposed link to the increase in birth defects and microcephaly in newborns in regions with high Zika virus infection incidence during the past two years. Therefore, the World Health Organization declared Zika virus a public health emergency of international concern. This review describes Zika virus epidemiology, transmission mechanisms and pathogeny, such as its clinical presentation, adverse fetal outcomes, diagnosis, treatment and current recommendations for transmission prevention.