Caracterización del comportamiento clínico y de laboratorio de pacientes con sospecha de dengue / Characterization of clinical and laboratory behavior of patients with suspected dengue

RESUMEN Fundamento: el dengue es una enfermedad infecciosa muy extendida en varias regiones del planeta. Objetivo: caracterizar el comportamiento de algunos parámetros clínicos y de laboratorio de pacientes con sospecha de dengue. Métodos: se realizó un estudio analítico longitudinal prospectivo en el Hospital Clínico Quirúrgico Docente Amalia Simoni desde de junio de 2016 a junio de 2017. El universo estuvo compuesto por 151 pacientes de los cuales se seleccionó una muestra de forma probabilística aleatoria simple compuesta por 90 pacientes. Los datos se recogieron en un formulario y se procesaron en una base de datos creada con SPSS v23. Resultados: los resultados agrupados en forma de tablas, mostraron predominio de los pacientes del sexo masculino, los síntomas iniciales más frecuentes estuvieron dados por fiebre asociada a cefalea y artralgia. Conclusiones: entre los síntomas iniciales encontrados predominaron los pacientes que no presentaron signos de alarma de dengue, la aparición de estos signos se asoció de forma significativa a leucocitosis, hematocrito elevado y trombocitopenia.

ABSTRACT Background: dengue is an infectious disease widespread in several regions of the planet. Objective: to characterize the behavior of some clinical and laboratory parameters of patients with suspected dengue. Methods: a prospective longitudinal analytical study was carried out at the Amalia Simoni Teaching Surgical Clinical Hospital in the period from June 2016 to June 2017. The universe consisted of 151 patients from which a sample of simple probabilistic form composed of 90 patients was selected randomly. The data was collected in a form and processed in a database created with SPSS v23. Results: the results grouped in the form of tables, showed predominance of male patients, the most frequent initial symptoms were due to fever associated with headache and arthralgia. Conclusions: among the most frequent initial symptoms, patients with no signs of dengue alarm predominated, the appearance of these signs was significantly associated with leukocytosis, elevated hematocrit and thrombocytopenia.

Congenital syphilis in a philanthropic maternity of the state of Sergipe: still a challenge / Sífilis congênita em maternidade filantrópica do estado de Sergipe: ainda um desafio

Introduction: Syphilis is a bacterial disease whose main means of contamination are the transplacental and sexual pathways. Its high prevalence in pregnancy in Brazil makes it a national public health issue. Objective: To evaluate the positivity of the mandatory testing recommended by the Brazilian Ministry of Health (MoH) in children of VDRL-positive mothers, using data from a congenital syphilis clinic in a Philanthropic Maternity of Aracaju, Sergipe (SE). Methods: Observational, longitudinal and descriptive design, following the MoH' congenital syphilis elimination program protocol (2006). Live births of VDRL-positive mothers were included from January 2010 to December 2014. Data analysis was performed using SPSS v21.0. Results: A total of 428 newborns (NB) were evaluated; 395 long-bone r-rays were carried out, of which, 7.3% had radiological alterations. VDRL positivity was found in cerebrospinal fluid (2.7%) and in peripheral blood (70.3%). The ear testing was altered in 3.0% and the examination of the eye fundus altered in 2.5%. The chance of having bone changes was greater in those who were born weighing from 1 to 2.5 kg and in those who presented with syphilis symptoms. Cerebrospinal fluid positivity was higher in those who had bone changes, were symptomatic, and whose partners were not treated. Maternal treatment decreased the chance of bone changes in infants. Conclusion: The non-treponemal test, VDRL, in peripheral blood was the most significant in the identification of the vertical transmission, corresponding to 70.3% of the identified samples, suggesting that its use had a greater diagnostic sensitivity, being the long bones radiography, ear test, and eye fundus test complementary in screening children of VDRL-positive mothers. In addition, the outpatient follow-up was statistically significant (p<0.01) in reducing the patients' morbidity and mortality. This reinforces the importance of updating the guidelines for Congenital Syphilis management by the Ministry of Health, used in the institution at the time of the study, aiming to eradicate this disease that still persists despite almost seven decades of penicillin usage

Introdução: A sífilis é uma doença bacteriana que tem como principais meios de contaminação a via transplacentária e a sexual. Sua alta prevalência na gestação no Brasil a torna um problema de saúde pública. Objetivo: Avaliar a positividade dos exames preconizados pelo Ministério da Saúde (MS) em filhos de mães Venereal Disease Research Laboratory (VDRL) positivo, mediante dados do ambulatório de sífilis congênita numa maternidade filantrópica de Aracaju (SE). Métodos: Design observacional, longitudinal e descritivo, seguindo o protocolo do programa de eliminação de sífilis congênita do MS de 2006. Foram incluídos nascidos vivos de mães VDRL positivo, no período de janeiro de 2010 a dezembro de 2014. Na análise de dados, utilizou-se o software SPSS® versão 21.0. Resultados: Foram avaliados 428 recém-nascidos (RN); 395 realizaram radiografia de ossos longos, dos quais 7,3% tinham alterações radiológicas. O VDRL foi positivo no liquor em 2,7% e no sangue periférico em 70,3% deles. O teste da orelhinha e o exame de fundo de olho foram alterados em 3,0 e 2,5%, respectivamente. A chance de ter alterações ósseas foi maior naqueles que nasceram com peso entre 1 e 2,5 kg e naqueles que apresentaram sintomas de sífilis. A positividade do liquor foi maior naqueles que tinham alterações ósseas, eram sintomáticos e cujos parceiros não foram tratados. O tratamento materno diminuiu a chance de alterações ósseas nos bebês. Conclusão: O teste não treponêmico, o VDRL, em sangue periférico foi o mais significativo na identificação da transmissão vertical, correspondendo a 70,3% das amostras identificadas, sugerindo-se que sua utilização teve maior sensibilidade diagnóstica, tendo a radiografia de ossos longos, o teste da orelhinha e o exame de fundo de olho um papel complementar no rastreio dos filhos de mães VDRL positivo. Além disso, o acompanhamento ambulatorial dos pacientes foi estatisticamente significativo (p<0,01) para redução de morbimortalidade dos pacientes avaliados. Isso reforça a importância da manutenção das guidelines para manejo de sífilis congênita do MS, utilizadas na instituição na época do estudo, objetivando erradicar essa doença que ainda persiste apesar de quase sete décadas do uso da penicilina

Referentes teóricos sobre la retinopatía de la prematuridad y sus criterios de pesquisa / Theoretical framework on retinopathy of prematurity and research criteria

Fundamento: La retinopatía de la prematuridad es una microangiopatía vasoproliferativa que se desencadena en los niños pretérminos y con factores de riesgo para su desarrollo. Puede avanzar, de no ser detectada y tratada, hacia la discapacidad visual e incluso la ceguera, de ahí la importancia de su pesquisaje. Se realizó una revisión sistemática sobre este tema relativamente joven en la oftalmología, en la base de datos Medline, que involucrara la última década, por ser esta la etapa en que Cuba ha desarrollado el trabajo de pesquisaje y tratamiento de la enfermedad. Objetivo: Actualizar los conocimientos acerca de la retinopatía de la prematuridad y sus criterios de pesquisa. Desarrollo: En el mundo se han realizado estudios multicéntricos para su mejor comprensión y manejo; y se han unificado criterios para su clasificación, siendo los principales factores de riesgo a los que se asocia la baja edad gestacional al nacimiento, el bajo peso extremo, el empleo de ventilación y oxígeno, entre otros. Existen varios tratamientos para evitar la ceguera por retinopatía de la prematuridad, siendo el láser el más utilizado actualmente, combinándose en muchos casos con terapéuticas novedosas como la vitrectomía y los antiangiogénicos. En cuanto a los criterios de pesquisa no existe uniformidad en el mundo, pero Cuba cuenta con un Protocolo Nacional para su manejo, que garantiza su diagnóstico oportuno y un tratamiento inmediato. Conclusiones: La retinopatía de la prematuridad es una enfermedad oftalmológica que constituye prioridad en Cuba, existiendo en el país un protocolo nacional para su manejo y así evitar el daño visual que puede ocasionar.

Background: The retinopathy of the prematurity is a vasoproliferative microangiopathy that is unchained in preterm children and with factors of risk for its development. It can advance, of not being detected and treated, toward the visual handicap and even the blindness, of there the importance of their inquire criteria. It was carried out a systematic revision on this relatively young topic in ophthalmology, in the database Medline that involved the last decade, to be this the stage in that Cuba has developed the inquire criteria work and treatment of the illness. Objective: To upgrade the knowledge about the retinopathy of the prematurity and its investigation approaches. Development: In the world there have been carried out multicentre studies for its best understanding and handling; and it have become unified approaches for its classification, being the main factors of risk to those that associates the low gestational age at birth, the extreme low weight, the ventilation and oxygen employment, among others. Several treatments exist to avoid the blindness for retinopathy of the prematurity, being the laser the more used at the moment, combining in many cases with therapeutic novel as the vitrectomy and the angiogenic. As for the investigation approaches uniformity doesn't exist in the world, but Cuba has a National Protocol for its handling that guarantees its opportune diagnosis and an immediate treatment. Conclusions: The retinopathy of the prematurity is an ophthalmologic illness that constitutes priority in Cuba, existing in the country a national protocol for its handling and this way to avoid the visual damage that can cause.

Adoption of Donor Screening Policy in a Tissue Bank at a Tertiary Hospital / 대한수혈학회지

BACKGROUND: Tissues for transplantation can save lives or restore essential functions. According to national policies and regulations, access to suitable transplantation, as well as the level of safety, quality, efficacy of donation, and transplantation of tissues, differ significantly between countries. We reviewed a few guidelines on tissue banking from the aspect of screening tests. In addition, four-year experience with screening panels for donated bones and donors at a tertiary hospital is introduced. METHODS: Seven national and international guidelines for screening tests for donors and donated tissues were reviewed. At our institution, screening tests for donation involve two steps. At retrieval, the first screening panel, including ABO/Rh typing, unexpected antibody screening, VDRL, HBsAg, anti-HBs, anti-HBc IgM, anti-HCV, anti-HIV, and microbiological cultures was performed. The second screening panel, including the same tests, except culture studies, was performed after 90 days. From 2008 to 2011, a total of 245 retrievals of bone tissue were performed and the screening panel results were analyzed. RESULTS: Mandatory screening serologic tests for living donors can differ according to local law or regulation and/or screening for endemic diseases. At our institution, among 245 donated bones for a period of four years, 61 bone tissues were discarded due to noncompliance for the second screening (n=32), contamination or no culture study results (n=9), abnormal serologic test results (n=8), and so on. CONCLUSION: Donor screening policies for tissue banking are various according to national laws or endemic disease status. Second screening tests with consideration of the window period should be adopted.

The analysis of playsical examination for 74 624 senior high school graduate students / 中华健康管理学杂志

Objective To investigate and analyze the constitution and health condition of senior high school graduate students,and to find methods to improve and promote teenagers' health.Methods Seventy-four thousand six hundred and twenty-four senior high school students graduated from the vear 2003 to 2007 were taken the health examination according to common university and college recruitment examination standard by special medical personnel.The whole data were statistically analyzed.Results The data showed that there were 30 cases of acute viral hepatitis,41 cases of infiltrative pulmonary tuberculosis,5 cases of congenital heart diseases,the rate of hepatitis B virus(HBV)infection was 9.0%(6959/74 624),nearsightedness 82.0%(61 082/74 624);and that the rate of purely qualification,unqualified quantity and specialty limit rate(contain Single disease accumulated) for registering was 14.0%,72 cases and 93.0%(69 593/74 624) respectively.Conclusion The constitution of senior high school graduate students was unsatisfactory.