Brote de histoplasmosis en el contexto de la pandemia por COVID-19 / Histoplasmosis outbreak in the context of the COVID-19 pandemic

La histoplasmosis es una micosis profunda de distribución mundial causada por el Histoplasma capsulatum var. capsulatum. Se caracteriza por una variabilidad clínica que depende principalmente de la carga fúngica, del estado inmunológico del paciente y de la virulencia del germen. Se describe un brote de histoplasmosis pulmonar aguda en militares, producido en el contexto epidemiológico de la COVID-19. El episodio tuvo lugar a partir de actividad laboral en cuevas donde participaron cuatro militares, tres de los cuales desarrollaron síntomas y fueron admitidos en el Hospital Dr. Gustavo Aldereguía Lima de Cienfuegos en enero de 2022. La información fue obtenida a través de la entrevista médica y la historia clínica. Se evidenció que en el contexto epidemiológico de la pandemia por COVID-19 no se debe subestimar el diagnóstico de otras enfermedades respiratorias, incluidas las micosis endémicas(AU)

Histoplasmosis is a deep mycotic infection of worldwide distribution caused by Histoplasma capsulatum var. capsulatum. It is characterized by clinical variability that depends mainly on the fungal load, the patient's immune status and the virulence of the germ. We describe an outbreak of acute pulmonary histoplasmosis among military officers, which occurred in the epidemiological context of COVID-19. The episode occurred during work activities in caves in which four soldiers participated, three of whom developed symptoms and were admitted to the "Dr. Gustavo Aldereguía Lima" Hospital in Cienfuegos in January 2022. The information was obtained through medical interviews and clinical records. It was evidenced that in the epidemiological context of the COVID-19 pandemic, the diagnosis of other respiratory diseases, including endemic mycoses, should not be underestimated(AU)

Resultados terapêuticos da homeopatia em pacientes suspeitos ou confirmados de COVID-19: um estudo longitudinal prospectivo / Therapeutic results of homeopathy in suspected or confirmed COVID-19 patients: a longitudinal study

A infecção humana causada pelo vírus SARS-CoV-2 (COVID-19), diagnosticada como pneumonia de causa desconhecida originalmente na cidade de Wuhan (China), foi considerada como pandemia pela Organização Mundial da Saúde. Com a inexistência inicial de uma vacina para proteção dos sadios, foi adotada a estratégia de isolamento social e tratamento com medidas de suporte geral e/ou avançado. Neste contexto, coube investigar a contribuição da terapêutica homeopática no enfrentamento da doença, notadamente no alívio dos sintomas desconfortáveis por ela provocados em sua fase inicial, com acompanhamento e registro dos resultados obtidos pelos médicos homeopatas. MÉTODO: Este estudo coletou, durante o período de maio a setembro de 2020 (após aprovação pelo CEP), informações de pacientes diagnosticados com a doença, tratados por médicos homeopatas com medicamentos homeopáticos escolhidos de acordo com a sintomatologia apresentada pelo paciente. Foram avaliados os efeitos no estado de saúde do paciente, por meio de escores e escalas clínicas, bem como aspectos relacionados à segurança do medicamento, variação na duração da doença e medicamentos mais associados a eventuais sucessos terapêuticos. Questionário padronizado e específico para a COVID-19 foi elaborado e e aplicado para preenchimento dos médicos colaboradores do estudo durante o acompanhamento dos pacientes. Os dados foram armazenados em planilhas eletrônicas e analisados com técnicas estatísticas descritivas e inferenciais. Os pacientes selecionados eram colaboradores do Hospital Santo Antônio - Obras Sociais Irmã Dulce (OSID) e foram submetidos a uma avaliação preliminar presencial no ambulatório de Otorrinolaringologia deste hospital. As consultas homeopáticas foram realizadas por plataforma de Telemedicina para seguimento e acompanhamento do caso. Foram avaliados 116 colaboradores, com faixa etária que variou entre 21 e 66 anos, sendo a média de idade 38 anos; destes, 84 (72%) eram do gênero feminino e 32 (16%) gênero masculino; 53 pacientes (70% dos colaboradores atendidos) eram profissionais da saúde (médicos, enfermeiros e técnicos de enfermagem); 63 (30%) eram colaboradores de áreas administrativas ou técnicas; 50 pacientes tinham critérios para inclusão no grupo de risco (43%). Quanto ao resultado do RT-PCR: 58 pacientes (50%) tiveram RT-PCR detectado (confirmados); 58 pacientes (50%) tiveram RT-PCR não-detectado - destes, 18 pacientes (31%) apresentaram anosmia em sua evolução. Dos 116 pacientes do critério de inclusão, 77 estavam incluídos na síndrome clássica da COVID19. Destes 77 colaboradores, 3 não usaram o medicamento homeopático (N=74). Os medicamentos homeopáticos mais indicados foram: Arsenicum album (42%); Bryonia (24%), Phosphorus (15%); Gelsemium (15%); Pulsatilla (2%); outros (4%). O Score médio de sintomas antes do tratamento foi 12,27 e após o tratamento foi 0,52 (p < xxxxx). Dos 57 pacientes que tiveram anosmia, houve recuperação total em 43 (75%) dos casos no momento da reavaliação. O tempo médio decorrido entre o uso da medicação homeopática e a recuperação dos sintomas foi de 9 dias. Apenas 3 pacientes (3,9%) necessitaram de internamento hospitalar sem necessidade de intubação, sendo 2 deles pertencentes ao grupo de risco. apesar destes resultados serem parciais (pois ainda existem sujeitos da pesquisa ainda em fase de avaliação), os resultados sugerem que o tratamento homeopático promoveu o restabelecimento do quadro infeccioso sem necessidade de internamento em 97% dos pacientes. A anosmia teve recuperação completa em 75% dos pacientes. Arsenicum album, Bryonia e Phosphorus foram os medicamentos predominantemente eleitos para o tratamento, o que corrobora com outros estudos homeopáticos.

The human infection caused by the SARS-CoV-2 virus (COVID-19), originally diagnosed as pneumonia of unknown cause in the city of Wuhan (China), was considered a pandemic by the World Health Organization. With the initial lack of a vaccine to protect healthy people, the strategy relating to social isolation and treatment with general and/or advanced support measures was adopted. In this context, it was necessary to investigate the contribution of homeopathic therapy in coping with the disease, particularly in terms of relieving the uncomfortable symptoms caused by it in its initial phase, with monitoring and recording of the results obtained by homeopathic physicians. METHOD: This study collected information from patients diagnosed with the disease, treated by homeopathic physicians with homeopathic medications chosen according to the symptoms manifested by the patient, from May to September 2020 (after approval by the REC). The effects on the health conditions of patients were assessed using clinical scores and scales, as well as aspects related to the safety of the medication, variations in the duration of the disease and the medications most associated with any therapeutic successes. A standardized questionnaire specific to COVID-19 was drawn up and filled in by the physicians who collaborated in the study during patient monitoring. The data was stored in electronic spreadsheets and analyzed using descriptive and inferential statistical techniques. The selected patients were employees of Hospital Santo Antônio - Obras Sociais Irmã Dulce (OSID) and underwent a preliminary in-person assessment at the otolaryngology outpatient clinic of this hospital. The homeopathic consultations were carried out via a telemedicine platform to follow-up and monitor the case. A total of 116 employees were assessed, ranging in age from 21 to 66, with the average age being 38; of these, 84 (72%) were females and 32 (16%) males; 53 patients (70% of the employees cared for) were health care professionals (physicians, nurses and nursing technicians); 63 (30%) were employees from administrative or technical areas; 50 patients met the criteria for inclusion in the risk group (43%). As for the RT-PCR result: 58 patients (50%) had RT-PCR detected (confirmed); 58 patients (50%) had RT-PCR not detected - of these, 18 patients (31%) had anosmia during their evolution. Of the 116 patients who met the inclusion criteria, 77 were included in the classic COVID-19 syndrome. Of these 77 collaborators, 3 did not use homeopathic medication (N=74). The most indicated homeopathic medications were: Arsenicum album (42%); Bryonia (24%), Phosphorus (15%); Gelsemium (15%); Pulsatilla (2%); others (4%). The average symptom score before treatment was 12.27 and after treatment was 0.52 (p < xxxxx). Of the 57 patients who had anosmia, there was full recovery in 43 (75%) of the cases at the time of reassessment. The average time elapsed between the use of homeopathic medication and the recovery of symptoms was 9 days. Only 3 patients (3.9%) required hospitalization without the need for intubation, 2 of whom belonged to the risk group. Although these results are partial (as there are still research subjects in the evaluation phase), the results suggest that homeopathic treatment promoted the re-establishment of the infectious condition without the need for hospitalization in 97% of the patients. Anosmia recovered completely in 75% of the patients. Arsenicum album, Bryonia and Phosphorus were the drugs predominantly chosen for treatment, which corroborates other homeopathic studies.

Homeopatia em trombocitopenia canina: relato de caso / Homeopathy in canine thrombocytopenia: case report

Hemoparasitoses constituem-se de enfermidades cosmopolitas que são causadas por parasitos intracelulares obrigatórios de células sanguínea. Os mais frequentemente encontrados nos cães são a babesiose, erliquiose e anaplasmose. O tratamento consiste no uso de antibiótico do grupo das tetraciclinas, sendo a doxiciclina o medicamento mais indicado. O objetivo deste relato de caso é descrever o tratamento homeopático em um cão da raça shih-tzu, senil (8 anos de idade), cardiopata com trombocitopenia discreta secundário a hemoparasitose ­ ehrlichiose. O medicamento homeopático repertorizado foi Phosphorus 30 cH 3 glóbulos 2x ao dia por 3 dias. Foi administrado também a Calcarea Carbonica 6 cH 3 glóbulos 2x ao dia por 7 dias. Tal sucesso terapêutico foi atingido em 3 dias de tratamento, com melhora laboratorial da trombocitopenia e do quadro de dispnéia. Este estudo contribui com pesquisas existentes a caráter de novos tratamentos para a ehrlichiose canina.

Hemoparasitoses are cosmopolitan diseases that are caused by obligate intracellular parasites of blood cells. The most frequently found in dogs are babesiosis, ehrlichiosis and anaplasmosis. Treatment consists of the use of antibiotics from the tetracycline group, with doxycycline being the most indicated medication. The objective of this case report is to describe the homeopathic treatment in a dog of the shih-tzu breed, senile (8 years old), heart disease with mild thrombocytopenia secondary to hemoparasitosis - ehrlichiosis. The repertorized homeopathic medicine was Phosphorus 30 cH 3 globules 2x a day for 3 days. Calcarea Carbonica 6 cH 3 globules was also administered twice a day for 7 days. Such therapeutic success was achieved in 3 days of treatment, with laboratory improvement of thrombocytopenia and dyspnea. This study contributes to existing research on new treatments for canine ehrlichiosis.

Diferencias entre formas de contagio intra y extradomiciliaria en tres brotes epidémicos de COVID-19 en Santiago de Cuba / Differences between Forms of Intra- and Extra-Domiciliary Contagion in Three Epidemic Outbreaks of COVID-19 in Santiago de Cuba

Introducción: En la transmisión de la COVID-19 en Santiago de Cuba se distinguieron tres brotes epidémicos entre 2020 y 2021. Objetivo: Identificar las diferencias entre los contagios intra y extradomiciliarios en tres brotes epidémicos de COVID-19 en Santiago de Cuba entre marzo de 2020 y mayo de 2021. Métodos: Se realizó un estudio descriptivo transversal de los casos de COVID-19 del territorio y el período referidos, mediante las técnicas bivariadas habituales de la estadística y el análisis estadístico implicativo, con una muestra de 6408 que se eligió por muestreo aleatorio simple de la base de datos de casos confirmados. Resultados: El contagio extradomiciliario fue significativamente mayor que el intradomiciliario sin diferencias por sexo, pero sí según grupos de edades y municipios dentro y entre ambos grupos. Fue significativo el predominio de los adultos mayores en el contagio intradomiciliario y de los adultos jóvenes en el extradomiciliario. Primaron los sintomáticos en el intradomiciliario; y, los asintomáticos, en el extradomiciliario, sin diferencias significativas entre ambas formas. Los menores de 20 años de edad, adultos mayores, asintomáticos y el municipio Mella fueron las características que se asociaron con el contagio intradomiciliario, mientras, con el extradomiciliario, los adultos jóvenes sintomáticos. Conclusiones: Las formas de contagio intra y extradomiciliaria se modularon según la conducta de las personas y el aislamiento propio de cada grupo de edades. La extradomiciliaria predominó en edades intermedias de la vida, como expresión de la conducta mediada por su responsabilidad económica en el hogar, mientras las edades extremas, que permanecieron en casa por cumplir medidas de aislamiento, fueron más propensas a la intradomiciliaria(AU)

Introduction: In the transmission of COVID-19 in Santiago de Cuba province, three epidemic outbreaks were observed between 2020 and 2021. Objective: To identify the differences between intra- and extra-domiciliary infections in three epidemic outbreaks of COVID-19 in Santiago de Cuba between March 2020 and May 2021. Methods: A cross-sectional descriptive study of COVID-19 cases in the territory and period above mentioned was carried out, using the usual bivariate techniques of statistics and implicative statistical analysis, to a sample of 6408 cass that was chosen by simple random sampling from the database of confirmed cases. Results: Extra-domiciliary contagion was significantly higher than intra-domiciliary contagion without differences by sex, but according to age groups and municipalities within and between both groups. The predominance of older adults in intra-domiciliary contagion and of young adults in extra-domiciliary contagion was significant. Symptomatic patients prevailed in the intra-domiciliary; and, the asymptomatic, in the extra-domiciliary, without significant differences between both forms. Children under 20 years of age, older adults, asymptomatic and Mella municipality were the characteristics that were associated with intra-domiciliary contagion, while, with the extra-domiciliary were related symptomatic young adults. Conclusions: The forms of intra- and extra-domiciliary contagion were modulated according to the behavior of the people and the isolation of each age group. Extra-domiciliary predominated in intermediate ages of life, as an expression of the behavior mediated by their economic responsibility at home, while extreme ages, who remained at home to comply with isolation measures, were more prone to intra-domiciliary contagion(AU)

Tratamento homeopático e prevenção da Covid-19: protocolo de pesquisa clínica para avaliar a eficácia e a segurança do medicamento do gênio epidêmico / Homeopathic treatment and prevention of Covid-19: clinical research protocol to evaluate the effectiveness and safety of the epidemic genius medicine

Além da reconhecida aplicação nas doenças crônicas, a homeopatia individualizada também pode atuar de forma resolutiva ou complementar nos casos agudos, incluindo as doenças epidêmicas. No entanto, para atingir esse intento, apresenta uma metodologia semiológica e terapêutica específica que deve ser seguida e respeitada, com o risco de não apresentar a eficácia e a segurança desejada. No caso das doenças epidêmicas, que pela virulência dos seus agentes provoca um quadro sintomatológico comum na maioria dos indivíduos suscetíveis, o medicamento homeopático individualizado (medicamento homeopático do gênio epidêmico) deve apresentar semelhança com o conjunto de sinais e sintomas característicos dos pacientes acometidos nos diferentes estágios de cada surto epidêmico. Estudos evidenciam a eficácia e a segurança desta prática terapêutica e/ou profilática em diversas epidemias do passado. Assim sendo, após o levantamento dos possíveis medicamentos homeopáticos individualizados do gênio epidêmico de cada epidemia, sua aplicação terapêutica e/ou profilática em larga escala deve ser sustentada por ensaios clínicos prévios que demonstrem sua eficácia e segurança, em consonância com os aspectos éticos e bioéticos da pesquisa envolvendo seres humanos. Cumprindo essas premissas da boa prática clínica, elaboramos, em março de 2020, esse protocolo de pesquisa para investigar, em ensaio clínico randomizado, duplo-cego e placebo-controlado, a eficácia e a segurança de possíveis medicamentos homeopáticos individualizados do gênio epidêmico da COVID-19. Caso a eficácia e a segurança se confirmem, e tão somente nessa condição, o medicamento poderá ser utilizado de forma generalizada e coletiva no tratamento e na prevenção da atual epidemia. Com esse intuito, encaminhamos este projeto a médicos, pesquisadores e gestores de diversos hospitais públicos e privados, solicitando uma oportunidade para aplicar essa proposta em pacientes internados em enfermarias e/ou centros de terapia intensiva destinadas ao tratamento da COVID-19.

In addition to the recognized application in chronic diseases, individualized homeopathy can also act in a resolutive or complementary way in acute cases, including epidemic diseases. However, to achieve this intent, it presents a specific semiologic and therapeutic methodology that must be followed and respected, with the risk of not presenting the desired efficacy and safety. In the case of epidemic diseases, which due to the virulence of their agents causes a common symptomatological picture in most susceptible individuals, the individualized homeopathic medicine (homeopathic medicine of the epidemic genius) should present similarity with the set of characteristic symptoms and signs of the patients affected in the different stages of each epidemic outbreak. Studies show the efficacy and safety of this therapeutic and/or prophylactic practice in several epidemics of the past. Therefore, after the survey of possible individualized homeopathic medicine from the epidemic genius of each epidemic, its therapeutic and/or large-scale prophylactic application should be supported by previous clinical trials that demonstrate its effectiveness and safety, in line with the ethical and bioethical aspects of research involving human beings. Fulfilling these premises of good clinical practice, we developed, in March 2020, this research protocol to investigate, in a randomized, double-blind and placebo-controlled clinical trial, the effectiveness and safety of possible individualized homeopathic medicines of epidemic genius of COVID-19. If effectiveness and safety are confirmed, and only in this condition, the medicine may be used in a generalized and collective manner in the treatment and prevention of the current epidemic. To this end, we refer this project to physicians, researchers and managers of several public and private hospitals, requesting an opportunity to apply this proposal to patients hospitalized in wards and/or intensive care units for the treatment of COVID-19.

Análise sintomatológica de adultos com Covid-19: uma abordagem homeopática / Symptomatic analysis of adults with Covid-19: a homeopathic approach

A doença pelo novo coronavírus (SARS-CoV-2), denominada COVID-19, apresentou rápida disseminação nos cinco continentes, e tem causado graves implicações sanitárias e socioeconômicas nos países afetados. Embora a maioria das pessoas afetadas apresente doença leve, pacientes vulneráveis podem ter pneumonia intersticial com complicações graves ou até mesmo fatais. O objetivo do presente estudo quali-quantitativo foi coletar e analisar, numa perspectiva homeopática, os sintomas da COVID-19, bem como identificar os medicamentos homeopáticos mais similares ao quadro sintomático da doença (identificação do gênio epidêmico). Foram entrevistados, por médicos homeopatas, 46 indivíduos provenientes de quatro regiões brasileiras (Fortaleza, Campo Grande, Florianópolis e São Paulo). Observou-se um padrão consistente de sintomas entre os diferentes centros, com pouca diferença quanto à frequência e intensidade nos sintomas. A análise da totalidade sintomática da amostra, com auxílio de diferentes técnicas repertoriais, identificou Arsenicum album, Phosphorus e Bryonia alba como medicamentos homeopáticos mais similares aos quadros clínicos nesta epidemia de COVID-19. Estes resultados podem fornecer informações subsidiárias aos estudos de intervenção que avaliam a efetividade e eficácia da Homeopatia na prevenção e tratamento da COVID-19.

The disease caused by the new coronavirus (SARS-CoV-2), denominated COVID-19, has spread rapidly across five continents, and has been causing serious health and socioeconomic implications for the affected countries. Although most affected individuals have mild illness, vulnerable patients can have interstitial pneumonia with serious or even fatal complications. The objective of the present qualitative and quantitative study was to collect and analyze, under a homeopathic perspective, the symptoms of COVID-19, as well as to identify the homeopathic remedies most similar to the symptomatic picture of the disease (epidemic genius method). Forty-six individuals from four Brazilian regions (Fortaleza, Campo Grande, Florianópolis and São Paulo) were interviewed by homeopathic physicians. There was a consistent pattern of symptoms between the different centers, with little difference in frequency and intensity of symptoms. The symptomatic analysis of the entire sample, with the aid of different repertoire techniques, indicated the homeopathic remedies Arsenicum album, Phosphorus and Bryonia alba as the epidemic genius for this COVID-19 epidemic. Our results may provide support information for the intervention experiments assessing the effectiveness of Homeopathy in the prevention and treatment of COVID-19.

Estudo preliminar para avaliação de sintomas e medicamentos prevalentes do "gênio epidêmico" da pandemia de Covid-19 no Brasil / Preliminary study for evaluation of prevalent symptoms and medicines of Covid-19 epidemic genius in Brazil

A Organização Mundial da Saúde (OMS) reconheceu a Covid-19 como uma nova doença infectocontagiosa em 12/01/2020, que logo tornou-se pandêmica. A Homeopatia historicamente apresenta bons resultados no tratamento de doenças epidêmicas, desde quando seu criador, Samuel Hahnemann, obteve êxito no tratamento, controle e profilaxia de uma epidemia de escarlatina no ano de 1799. O objetivo desse trabalho era o estudo retrospectivo de sintomas comuns da doença na sua primeira fase, buscando um grupo de sintomas característicos que indicassem os possíveis medicamentos do "gênio epidêmico". Para isso, utilizamos a metologia desenvolvida por Hahnemann e James Tyler Kent para o entendimento dos sintomas comuns da doença. Foram utilizados relatos de casos de 27 pacientes com Covid-19 confirmados laboratorialmente enviados por médicos homeopatas em diversas regiões do Brasil. Os sintomas mais característicos encontrados foram: fraqueza intensa, febre baixa, tosse seca, sudorese profusa noturna, cefaleia incaracterística e ageusia/anosmia. Utilizando-se de várias técnicas de repertorização desses sintomas, chegou-se ao grupo de cinco medicamentos possíveis para o tratamento da doença: Arsenicum album, Bryonia alba, China officinalis, Chininum arsenicosum e Phosphorus.

The World Health Organization (WHO) recognized Covid-19 as a new infectious disease on 12th January of 2020, which soon became a pandemic. Homeopathy historically presents good results in the treatment of epidemic diseases, since the time when its creator, Samuel Hahnemann, was successful in the treatment, control and prophylaxis of a scarlet fever epidemic in the year of 1799. The objective of this work was the retrospective study of common symptoms of disease in its first phase, looking for a group of characteristic symptoms that would indicate the possible remedies of the "epidemic genius". For this, we used the methodology developed by Hahnemann and James Tyler Kent to understand the common symptoms of the disease. Case reports of 27 patients with laboratory-confirmed Covid-19 sent by homeopathic physicians in different regions of Brazil were used. The most characteristic symptoms found were: intense weakness, low fever, dry cough, profuse night sweats, uncharacteristic headache and ageusia/anosmia. Using various techniques for repertorizing these symptoms, a group of five possible drugs for the treatment of the disease was reached: Arsenicum album, Bryonia alba, China officinalis, Chininum arsenicosum and Phosphorus.

Protocolo de pesquisa clínica para avaliar a eficácia e a segurança de medicamento homeopático individualizado no tratamento e na prevenção da epidemia de COVID-19 / Clinical research protocol to evaluate the efficacy and safety of individualized homeopathic medicine in the treatment and prevention of the COVID-19 epidemic

Além da reconhecida aplicação nas doenças crônicas, a homeopatia individualizada também pode atuar de forma resolutiva ou complementar nos casos agudos, incluindo as doenças epidêmicas. No entanto, para atingir esse intento, apresenta uma metodologia semiológica e terapêutica específica que deve ser seguida e respeitada, com o risco de não apresentar a eficácia e a segurança desejada. No caso das doenças epidêmicas, que pela virulência dos seus agentes provoca um quadro sintomatológico comum na maioria dos indivíduos suscetíveis, o medicamento homeopático individualizado (medicamento homeopático do gênio epidêmico) deve apresentar semelhança com o conjunto de sinais e sintomas característicos dos pacientes acometidos nos diferentes estágios de cada surto epidêmico. Estudos evidenciam a eficácia e a segurança desta prática profilática e/ou terapêutica em diversas epidemias do passado. Assim sendo, após o levantamento dos possíveis medicamentos homeopáticos individualizados do gênio epidêmico de cada epidemia, sua aplicação profilática e/ou terapêutica em larga escala deve ser sustentada por ensaios clínicos prévios que demonstrem sua eficácia e segurança, em consonância com os aspectos éticos e bioéticos da pesquisa envolvendo seres humanos. Cumprindo essas premissas da boa prática clínica, elaboramos o atual protocolo com o objetivo de investigar, em ensaio clínico randomizado, duplo-cego e placebo-controlado, a eficácia e a segurança de possíveis medicamentos homeopáticos individualizados do gênio epidêmico da COVID-19, em tratamento adjuvante e complementar de pacientes acometidos pela doença. Caso a a eficácia e a segurança se confirme, e tão somente, o(s) medicamento(s) poderão ser utilizado de forma generalizada e coletiva no tratamento e na prevenção da atual epidemia. (AU)

In addition to the recognized application in chronic diseases, individualized homeopathy can also act in a resolutive or complementary way in acute cases, including epidemic diseases. However, to achieve this intent, it presents a specific semiological and therapeutic methodology that must be followed and respected, with the risk of not presenting the desired efficacy and safety. In the case of epidemic diseases, which due to the virulence of their agents causes a common symptomatological picture in most susceptible individuals, the individualized homeopathic medicine (homeopathic medicine of the epidemic genius) should present similarity with the set of characteristic symptoms and signs of the patients affected in the different stages of each epidemic outbreak. Studies show the efficacy and safety of this prophylactic and/or therapeutic practice in several epidemics of the past. Therefore, after the survey of possible homeopathic drugs individualized from the epidemic genius of each epidemic, its prophylactic and/or large-scale therapeutic application should be supported by previous clinical trials that demonstrate its efficacy and safety, in line with the ethical and bioethical aspects of research involving human beings. Fulfilling these premises of good clinical practice, we developed the current protocol with the objective of investigating, in a randomized, double-blind and placebo-controlled clinical trial, the efficacy and safety of possible individualized homeopathic drugs of epidemic genius of COVID-19, in adjuvant and complementary treatment of patients affected by the disease. If efficacy and safety are confirmed, and only in this condition, the medicine may be used in a generalized and collective manner in the treatment and prevention of the current epidemic. (AU)

El virus del Zika y determinantes sociales en un área de salud de Santiago de Cuba / Zika virus and social determinants in a health area from Santiago de Cuba

El zika es una enfermedad transmitida por el mosquito del género Aedes, identificada por vez primera en Uganda. Entre los síntomas más comunes figuran: fiebre, artralgias, sarpullido, conjuntivitis no purulenta, cefalea, mialgias y dolor ocular. Se realizó un estudio descriptivo y transversal durante 2017 de las 204 viviendas de la manzana 1204 del Policlínico Docente 30 de Noviembre de Santiago de Cuba, con el objetivo de identificar los determinantes sociales del estado de salud de la población durante el brote de trasmisión de zika. La técnica utilizada para la recolección de los datos fue la observación y como variable se analizaron los determinantes del estado de salud de la población. Se observó que el nuevo brote de zika en la manzana estudiada, surgió bajo la influencia de dichos determinantes. Se concluyó que la biología humana, el estilo de vida, el medio ambiente y la organización de los servicios de salud, influyeron directamente en la aparición de esta enfermedad.

Zika is a disease transmitted by the mosquito from Aedes gender, identified for the first time in Uganda. Among the most common symptoms there are: fever, artralgias, heat rash, non-purulent conjunctivitis, migraine, myalgias and ocular pain. A descriptive and cross-sectional study was carried out during 2017, of the 204 houses of the block 1204 from 30 de noviembre Teaching Polyclinic in Santiago de Cuba, with the objective of identifying the social determinants of the population health state during the zika outbreak transmission. The technique used for the gathering data was observation and as variable the determinant of the health state of the population were analyzed. It was observed that the new zika outbreak in the studied block, emerged under the influence of these determinants. It is concluded that the human biology, lifestyle, environment and the organization of the health services, influenced directly in the emergence of this disease.

Outbreak communication challenges when misinformation spreads on social media / Desafios da comunicação de surtos epidêmicos quando a desinformação se espalha nas redes sociais / Desafíos en la comunicación de brotes epidémicos cuando se difunde información errónea en las redes sociales

This commentary analyses the implications of social media misinformation for global health risk communication. We define misinformation, describe the pathways through which it can adversely affect responses to risk communication efforts, highlight vulnerabilities in existing interventions and present an agenda for further research to understand and address this problem.

Este artigo analisa as implicações da desinformação nas mídias sociais para a comunicação global de riscos à saúde. Definimos desinformação, descrevemos os caminhos pelos quais ela pode afetar negativamente as respostas aos esforços de comunicação de risco, destacamos as vulnerabilidades nas intervenções existentes e apresentamos uma agenda para futuras pesquisas para entender e abordar esse problema.

Este artículo analiza las implicaciones de la desinformación en las redes sociales para la comunicación de riesgos de salud global. Definimos información errónea, describimos los caminos por los cuales puede afectar de manera adversa las respuestas a los esfuerzos de comunicación de riesgos, resaltamos las vulnerabilidades en las intervenciones existentes y presentamos una agenda para futuras investigaciones para comprender y abordar este problema.

Meningitis aséptica en pacientes con parotiditis viral durante un brote epidémico / Aseptic meningitis associated to mumps during an epidemic outbreak

Resumen Comunicamos dos casos de meningitis aséptica asociadas a parotiditis viral en mujeres de edad mediana, una de ellas embarazada. Ambas se presentaron pocos días después del aumento de volumen parotídeo, con cefalea, fiebre y signos meníngeos, pleocitosis de predominio mononuclear en el LCR y resultados negativos para otras causas. La parotiditis fue confirmada por serología IgG e IgM positiva. Las pacientes tuvieron una evolución favorable con desaparición total de sus síntomas. Ambos casos ocurrieron durante un brote regional de parotiditis. La meningitis aséptica es una complicación frecuente de las parotiditis. Su diagnóstico puede lograrse por el aumento de volumen glandular precedente, la pleocitosis de predominio mononuclear en el LCR y una serología IgM e IgG positiva o detección genómica por RPC en muestra urinaria o salival. Esta complicación es más probable que sea observada durante brotes de parotiditis viral.

We report two cases of acute aseptic meningitis associated to mumps in middle-aged women, one pregnant. Both presented shortly after parotid gland enlargement. Neurological complications were suspected by headache, fever and meningeal signs and confirmed by CSF findings (mononuclear predominant pleocytosis) with negative results for alternative causes. Mumps were confirmed by positive IgM and IgG serology. Both patients were discharged with a favorable evolution and complete disappearance of symptoms. Cases were concurrent with a regional mumps outbreak. Conclusions: Aseptic meningitis is a rare mumps-associated neurological complication. Its diagnostic can be achieved by precedent parotid enlargement, mononuclear pleocytosis in the CSF and positive IgM and IgG serology or viral detection by PCR in urine or salivary samples. This complication would be more probably observed during mumps outbreaks.

Experiência de Macaé/RJ com homeopatia e dengue, 2007-2012 / Homeopathy and dengue: Macaé, Rio de Janeiro, Brazil, 2007-2012

No Brasil, a primeira epidemia documentada clínica e laboratorialmente foi em 1981-1982 e desde então vem ocorrendo no Brasil de maneira continuada, intercalando-se com a ocorrência de epidemias, geralmente associadas com a introdução de novos sorotipos. Em Macaé, RJ, ocorreram epidemias em 2002, 2007 e 2010. A Secretaria Municipal de Saúde de Macaé vem implementando mecanismos para o efetivo enfrentamento da dengue através de uma política de saúde baseada na intersetorialidade e a partir de 2007 se agregou ao plano de contingência a utilização de medicamento homeopático. No presente artigo são apresentados os resultados da aplicação profilática de medicamentos homeopáticos, assim como os critérios de escolha dos mesmos entre os anos 2007 e 2012. A utilização da homeopatia foi implantada facilmente, com um custo de financiamento condizente às condições socioeconômicas e culturais do país e contou com grande adesão da população...

The first documented dengue epidemic took place in Brazil in 1981-1982; from that time onwards dengue became endemic, with periodic epidemic outbreaks associated with the introduction of new serotypes. In Macaé, Rio de Janeiro, epidemic outbreaks occurred in 2002, 2007 and 2010. The Municipal Health Secretary consequently established an ongoing multi-sector policy for control of dengue, which began to include homeopathy starting 2007. The present article analyzes the results of prophylactic application of homeopathic medicines and the criteria to choose them from 2007 to 2012. Homeopathy was easily implemented, with low cost and was massively accepted by the local population...

La isoprofilaxis no es homeoprofilaxis ni inmunización homeopática, si no inmunización isopática, y no se fundamenta en el modelo epistemológico Homeopático: respuesta a Golden (parte 2 de 2) / The isoprophylaxis is not homeoprophylaxis or homeopathic immunization, if not isopathic immunization, and not based on the homeopathic epistemological model response to Golden (part 2 of 2)

Existen opiniones controversiales dentro de la Homeopatía en relación con la inmunizacióntradicional, las cuales señalan que ésta puede producir efectos adversos en algún porcentaje de la población que la recibe, e incluso agravar enfermedades crónicas, por lo que se ha propuesto una vacunación con preparados de elementos bacterianos llevados a dinamizaciones homeopáticas en un esquema de vacunación isoprofiláctica que podría sustituir a la vacunación tradicional. En esta publicación, el doctor Teixeira realiza un análisis de este tipo de propuestas, señalando las ventajas y desventajas de las mismas. Desde su propio enfoque analiza también las opiniones que tienen varios organismos internacionales al respecto, y afirma que nada se compara en protección y seguridad a una prescripción homeopática individualizada que siga las premisas epistemológicas de este método.Del mismo modo, el autor establece que, mientras no se tengan estudios clínicos de alta calidad metodológica que demuestren la seguridad y eficacia de una isoprofilaxis, ésta no podrá sustituir a los esquemas de vacunación tradicional...

There are controversial opinions within homeopathy regarding traditional immunization, which refer that this may cause side effects in some percentage of the population receiving it, and may even aggravate some chronic diseases, this has led to propose a vaccination with bacterial elements homeopathically prepared in an isprophylactic vaccination scheme that could replace the traditional vaccination.In this paper, Dr. Texeira performs an analysis of such proposals, showing their advantages and disadvantages. From his own approach he also analyzes the opinions of several international organizations, he says that nothing compares in safety and security as an individualized homeopathic prescription guided by the homeopathic epistemological premises. In the same way, the author states that as long as clinical studies of high methodological quality demonstrating the safety and effectiveness of a isoprofilaxis, don’t exist, this type of prophylaxis cannot replace the traditional vaccination schedules...

La isoprofilaxis no es homeoprofilaxisni inmunización homeopática, sino inmunización isopática, y no se fundamenta en el modelo epistemológico homeopático: respuesta a Golden (parte 1 de 2) / The isoprophylaxis is not homeoprophylaxis homeopathic immunization, but allopathic immunization, and not based on the homeopathic epistemological model response to Golden (part 1 of 2)

La Homeopatía puede utilizarse para la prevención de enfermedades epidémicas (homeoprofilaxis) siempre que los medicamentos sean escogidos individualmente, de acuerdo al ‘principio de semejanza sintomática’ y a la totalidad de los síntomas característicos de una epidemia dada (remedio del ‘genio epidémico’), como demuestran un gran número de ejemplos en la literatura. El uso de nosodes para prevención de epidemias (isoprofilaxis), es decir, escogidos en función del ‘principio de identidad etiológica’, con total omisión de la individualización sintomática y los estudios patogenésicos, no tiene fundamento en el modelo epistemológico homeopático. Hasta que no se disponga de evidencias científicas confiables que atestigüen su eficacia y seguridad, no es posible indicar el remplazo de las vacunas tradicionales por una ‘inmunización isopática’, pues representaría una contravención de los principios bioéticos de ‘beneficencia’ y ‘no-maleficencia’. Aunque es cierto que muchos homeópatas indican sistemáticamente tal remplazo, éste es criticado por instituciones homeopáticas de todo el mundo. En este artículo, discuto más extensamente aspectos epistemológicos, éticos y científicos de estas modalidades de profilaxis que abordé someramente en una revisión anterior...

Homeopathy might be employed for the prevention of epidemic diseases (homeoprophylaxis) provided remedies are selected on an individual basis in compliance with the ‘principle of symptom-based ilitude’ and according to the totality of symptoms peculiar to a given epidemic (remedy of the ‘epidemic genius’ or ‘genus epidemicus’), as countless examples in literature. The use of nosodes for the revention of epidemic diseases (isoprophylaxis), i.e., selected based on the ‘principle of etiological identity’ with full neglect of symptom-based individualization and pathogenetic trials, is not supported by the homeopathic epistemological model. As long as there are no reliable scientific evidences attesting to its efficacy and safety, ‘isopathic immunization’ might not be indicated as a regular placement of classical immunization, as it would mean a transgression of the bioethical principles of ‘beneficence’ and ‘non-maleficence’. Although many homeopathic practitioners systematically indicate that practice, it is condemned by homeopathic institutions worldwide. In this article, I elaborate on epistemological, ethical and scientific features of these disparate approaches to prophylaxis, which I had summarily addressed in a previous review...

Un brote epidémico de endocarditis por Pseudomonas aeruginosa secundario a angiografía coronaria / An outbreak of Pseudomonas aeruginosa infective endocarditis subsequent to coronary angiography

Objectives: To describe an endocarditis outbreak affecting three patients due to Pseudomonas aeruginosa infection post coronary angiography performed in the Cardiovascular Surgery and Cardiology Medical Center of a private hospital. Methods: After recognition of an infection cluster within a onemonth period, the outbreak was reported to Antalya Department of Health and a broad investigation was initiated in order to determine the most probable cause and/or source of nosocomial pseudomonal endocarditis. Patient data were obtained by medical record review as well as interviews with patients or their next of kin. Thirty-six surveillance samples for P. aeruginosa were collected from various locations within the coronary angiography unit. The outbreak research team reviewed the private hospital's Cardiovascular Surgery and Cardiology Medical Center's infection control procedures. The epidemiology of P. aeruginosa was studied through analysis of phenotypic markers, including antimicrobial sensitivity profiles. Results: The infection control audit revealed multiple breaches of infection control procedures. Only 1/36 environmental samples yielded, which was isolated from a radio-opaque solution within an angiography injector pump. P. aeruginosa from the radio-opaque solution had an identical antimicrobial susceptibility pattern to the strain isolated from patients. Both samples were susceptible to all antipseudomonal agents. This outbreak could have been successfully controlled by instituting combined infection control measures. Conclusions: This outbreak emphasizes the important of adherence to infection control standards and practices for cardiac catheterization, as well as the need for closer collaboration between the Infection Control Committee and coronary angiography personnel.

Objetivos: Describir un brote de endocarditis por Pseudomonas aeruginosa que afectó a tres pacientes tras habérseles efectuado una coronariografía en el Centro Médico de Cardiología y de Cirugía Cardiovascular (CMC-CCV) de un hospital privado. Métodos: Después de reconocer la aparición de un brote en un periodo de un mes, este hecho fue comunicado al Departamento de Salud de Antalya, iniciándose una exhaustiva investigación para precisar la más probable causa y/o fuente de las endocarditis nosocomiales. Se extrajo de los registros médicos los datos clínicos de los pacientes y se efectuaron entrevistas a los pacientes o sus familiares. Se extrajo 36 muestras medioambientales de vigilancia en busca de P. aeruginosa de diversos sitios dentro de la unidad de coronariografía. Un team que investigó el brote revisó los procedimientos en uso para la prevención de infecciones en el CMC-CCV. Se estudió la epidemiología de la P. aeruginosa mediante análisis de su fenotipos, incluyendo el perfil de susceptibilidad in vitro a antimicrobianos. Resultados: La auditoria comprobó el quiebre de diversas normas de control de infecciones. Sólo 1/36 de las muestras ambientales arrojó el cultivo de P. aeruginosa, a partir de una solución de medio radio-opaco dentro de una bomba inyectora empleada en las angiografías. Los aislados de P. aeruginosa desde la solución del medio radio-opaco tenían idéntico patrón de susceptibilidad antimicrobiana que las cepas recuperadas de los pacientes. Ambos tipos de muestras eran susceptibles a todos los antimicrobianos con actividad anti-pseudomonas. El brote pudo evitarse si se hubieran instaurado una serie de medidas de control de infecciones. Conclusiones: Este brote enfatiza la importancia de adherir a los estándares y prácticas de control de infecciones para la cateterización cardiaca, así como la necesidad de una estrecha colaboración entre el Comité de Control de Infecciones y el personal involucrado en el procedimiento de coronariografía.

Antimicrobial activity and bioautographic study of antistaphylococcal components from Caesalpinia pyramidalis Tull

The antimicrobial activity of dry methanol and ethyl acetate extracts for the leaves, bark of the stem, peel of the root, flower, fruit and seed of Caesalpinia pyramidalis Tull. (catingueira) was performed against seventeen isolates of Staphylococcus aureus MRSA multiresistant strains, which included two isolates of S. aureus MSSA and two ATCC strains. The antimicrobial activity was tested by the agar diffusion method and the Minimum Inhibitory Concentration (MIC) was determined. The dry methanol extract of the root showed good antimicrobial activity with a MIC of less than 0.5 mg.mL-1. The dry ethyl acetate extracts exhibited lower antimicrobial activity, which might be explained by solubility problems and less diffusion in the agar medium. Results of the bioautographies also confirmed inhibition halos corresponding to the active substances present in the leaves, as well as in the flower of C. pyramidalis. The phytochemical study of the leaves, bark of the stem, peel of the root, flower and fruit of extracts from C. pyramidalis confirmed the presence of a number of known antimicrobial agents including ursolic acid, quercetin, catechin, ellagic acid, sitosterol, flavonoids, proanthocyanidins and gallic acid.

A determinação da atividade antimicrobiana dos extratos metanólicos e em acetato de etila da folha, casca do caule, casca da raiz, flor, fruto e semente de Caesalpinia pyramidalis Tull. foi realizada frente a dezessete isolados de Staphylococcus aureus MRSA multirresistentes, dois isolados de S. aureus MSSA e duas cepas padrão, pelas técnicas de poço/difusão em ágar e determinação das CMI pelo método de diluição em agar/multiinoculador de Stears. O extrato metanólico de casca da raiz indicou uma boa atividade, com CMI inferior a 0.5 mg.mL-1. Os extratos secos por extração em acetato de etila apresentaram menor atividade que se poderia explicar por problemas de solubilidade e menor difusão no meio de cultura em ágar. Resultados das bioautografias confirmaram zonas de inibição correspondente às substâncias ativas presente na folha, como também na flor da C. pyramidalis. No estudo fitoquímico das folhas, casca da caule, casca da raiz, flor e fruto dos extratos de C. pyramidalis evidenciou-se a presença de vários constituintes com reconhecida atividade antimicrobiana, entre estes o ácido ursólico, quercetina, catequina, ácido elágico, sitosterol, flavonóides, proantocianidinas e ácido gálico. Entre todos os metabólitos citados, somente o ultimo não observamos, por CCD, na casca da raiz de C. pyramidalis.

Enfrentamiento a eventos epidémicos de transmisión vectorial: paludismo y dengue / Facing epidemic events of vector transmission: malaria and dengue

El libro titulado Enfrentamiento a eventos epidémicos de transmisión vectorial: paludismo y dengue deviene un referente necesario cuando se aborde lo relacionado con fenómenos de ese tipo en cualquier momento y lugar.

The book entitled Facing epidemic events of vector transmission: malaria and dengue becomes a reference material necessary when approaching topics related to phenomena of this type at any moment and place.

Dengue: aspectos epidemiológicos e o primeiro surto ocorrido na região do Médio Solimões, Coari, Estado do Amazonas, no período de 2008 a 2009 / Dengue: epidemiological aspects and the first outbreak in the Middle Solimões Region of Coari in the State of Amazonas from 2008 to 2009

INTRODUÇÃO: A dengue é uma das doenças infecciosas mais frequentes no Brasil e um dos principais problemas de saúde pública no mundo, principalmente em regiões tropicais e subtropicais, com 2,5 a 3 bilhões de pessoas expostas ao risco de serem infectadas atualmente. Deste modo, o presente estudo teve como objetivo demonstrar as características epidemiológicas dos indivíduos acometidos por dengue, sua prevalência e seu processo epidêmico na região do Médio Solimões, Coari, Amazonas, no período de 2008 e 2009. MÉTODOS: Os dados epidemiológicos foram obtidos na Vigilância Epidemiológica da Secretaria Municipal de Saúde da Cidade de Coari-AM. As variáveis analisadas foram: mês da notificação, casos confirmados, gênero (sexo), faixa etária e bairro de residência. RESULTADOS: No total, foram notificados 1.003 casos (635 em 2008 e 368 em 2009), sendo diagnosticados 639 casos positivos. Destes, ± 54% acometerem indivíduos do sexo feminino e ± 46% do sexo masculino. As faixas etárias mais acometidas foram às observadas entre 10-49 anos; quanto à distribuição espacial, observamos o acometimento de indivíduos de bairros próximos a igarapés, lagos e com processo recente e desordenado de habitação. CONCLUSÕES: Deste modo, conclui-se que, durante o período estudado, houve um surto epidêmico de dengue na Cidade de Coari, AM. Entretanto, deve-se considerar que uma epidemia de dengue anterior pode ter ocorrido em Coari, sem que tenha tido o devido diagnóstico etiológico, ou que houveram pessoas com infecção passada que se deslocaram para a capital do Amazonas (Manaus), onde os vírus circulam desde 1998.

INTRODUCTION: Dengue is one of the most prevalent infectious diseases in Brazil and is a major public health problem worldwide. It is most prevalent in tropical and subtropical regions with 2.5 to 3 billion people at risk of becoming infected. Thus, this study sought to demonstrate the epidemiological characteristics of individuals affected by dengue, its prevalence and its epidemic process in the Middle Solimões region of Coari in the state of Amazonas between 2008 and 2009. METHODS: Epidemiological data were obtained through epidemiological monitoring by the Municipal Health Facility of the city of Coari, AM. The variables analyzed were the month of notification, the number of confirmed cases, the cases' genders, the cases' ages and their neighborhoods of residence. RESULTS: In total, 1,003 cases were reported (635 in 2008 and 368 in 2009), and 639 cases were diagnosed as positive. Of these, +54% involved female subjects, and +46% were male. The majority of the affected individuals were between 10 and 49 years of age, and the spatial distribution was concentrated in neighborhoods near streams, lakes and areas in which housing had recently been disrupted. Conclusions: We concluded that, during the period studied, there was an outbreak of dengue in the City of Coari, AM. However, it is possible that a dengue epidemic may have occurred earlier in Coari without proper diagnosis or follow-up and that previously infected individuals may have traveled to the capital of Amazonas (Manaus), where the virus has circulated since 1998.

Molecular epidemiology of dengue in Jamaica: dengue virus genotypes in Jamaica, 2007 / Epidemiología del dengue en Jamaica: genotipos del virus del dengue en Jamaica, 2007

The genotypes of dengue viruses (DENV) isolated from patients with dengue in Jamaica during 2007 were determined using DNA sequencing and phylogenetic analysis of the C-prM gene junction. The 17 DENV analysed included strains of DENV serotypes 1 (DENV-1, n = 3), DENV-2 (n = 7) and DENV-4 (n = 7). All strains of DENV-1 were classified as genotype III, while 1 of 7 strains of DENV-2 belonged to the Asian American/Asian genotype, genotype I/ III (Jamaica genotype), 2 were genotype V, the American genotype and 4 strains clustered with reference strains belonging to genotype IV. The 6 DENV-4 strains from Jamaica and the control strain clustered together in a separate clade from Caribbean/ American reference strains, which belong to genotype II and Asian strains, classified as genotypes I and III. There has been little evolution in the DENV-1 strains circulating in Jamaica over the years and this might reduce the risk of outbreaks due to this serotype. In contrast, the high genetic diversity in strains of DENV-2 viruses in circulation, the presence of more recently introduced genotypes and a new clade of DENV-4 might contribute to the epidemic potential of these DENV serotypes. These preliminary data clearly indicate the need to maintain laboratory surveillance, and other control measures against hyperendemicity of dengue in Jamaica.

Los genotipos de los virus del dengue (DENV) aislados de pacientes con dengue en Jamaica durante 2007, fueron determinados usando secuenciación de ADN y análisis filogenético de la unión del gen C-prM . Los 17 DENV analizados incluyeron cepas de serotipos de DENV 1 (DENV-1, n = 3), DENV-2 (n = 7) y DENV-4 (n = 7). Todas las cepas de DENV-1 fueron clasificadas como genotipo III, mientras que 1 de 7 cepas de DENV-2 pertenecían al genotipo asiático americano/asiático, genotipo I/ III (genotipo de Jamaica), 2 fueron genotipo V, el genotipo americano y 4 cepas agrupadas con cepas de referencia pertenecientes al genotipo IV. Las 6 cepas DENV-4 de Jamaica y la cepa de control se agruparon en un clado aparte de cepas de referencia caribeña/americana, que pertenecen al genotipo II, y las cepas asiáticas, clasificadas como genotipos I y III. Ha habido poca evolución en las cepas DENV-1 que han estado circulando en Jamaica a través de todos estos años, y esto podría reducir el riesgo de brotes a causa de este serotipo. En contraste con ello, la alta diversidad genética de las cepas de los virus DENV-2 en circulación, la presencia de más genotipos introducidos recientemente, y un nuevo clado de DENV-4 podrían contribuir al potencial epidémico de estos serotipos de DENV. Estos datos preliminares indican claramente la necesidad de mantener la vigilancia de laboratorio, y otras medidas de control contra el carácter hyperendémico del dengue en Jamaica.

Sarcoma de kaposi: clasificación y evaluación en Zimbabwe / Kaposi's sarcoma: classification and evaluation in Zimbabwe

Se realizó estudio prospectivo longitudinal con los pacientes diagnosticados de sarcoma de Kaposi (SK), quienes fueron atendidos en la consulta especializada para esa entidad en el hospital Parirenyatwa de Harare, Zimbabwe entre 2005 y 2006, a los que se les recogieron variables como edad, sexo, resultado de biopsia de piel, prueba de VIH, tiempo de detección de la enfermedad y estadios en que se encontraban. Se encontró que el sexo más afectado fue el masculino con 63,5 por ciento de los pacientes, 87,9 por ciento tenían menos de 16 meses de detección de la enfermedad. 93 por ciento de los pacientes se encontraban en los estadios 3 y 4 de la enfermedad, 95,3 por ciento de los pacientes se clasificaron como SK epidémico y endémico solo 2,6 por ciento; la relación masculino: femenino fue de 8:1 en el SK endémico. 77,1 por ciento de los pacientes con SK epidémico tenían entre 25 y 44 años y 59 por ciento de los endémicos tenían más de 55 años(AU)

A prospective and longitudinal study was done among the patients diagnosed of suffering Kaposi's Sarcoma (KS). They were treated in specialized consultation for this disease in Parirenyatwa Hospital of Harare, Zimbabwe between 2005 and 2006. To whom were collected different variables such as age, sex, skin biopsy result, HIV test, time of detection and stages of this disease. Finding that sex more affected was masculine with 63,5 percent of patients, 87,9 percent of patients had a time of detection were less than 16 months, 93 percent of patients were found between 3 and 4 stage of this disease, 95,3 percent were classified as epidemic KS and 2,6 percent endemic KS, ratio male-female was 8:1 in endemic KS and 77,17 percent of patients with epidemic KS were between 25 and 44 years and 59 percent of endemic KS were more then 55 years(AU)