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1.
Cambios rev. méd ; 20(1): 21-25, 30 junio 2021. tabs.
Article in Spanish | LILACS | ID: biblio-1292703

ABSTRACT

INTRODUCCIÓN. La apendicitis aguda es una patología pediátrica quirúrgica que en su fase complicada requiere uso de antibióticos en el postoperatorio; encontrar la mejor opción como experiencia local, fue necesario. OBJETIVO. Comparar un esquema de antibioticoterapia triple vs un doble respecto a variables: demográficas, clínicas y de costos en pacientes pediátricos con apendicitis complicada. MATERIALES y MÉTODOS. Estudio analítico transversal. Población de 133 pacientes y una muestra de 93, operados por apendicitis complicada; 58 recibieron ampicilina + metronidazol + gentamicina y 35 ceftriaxona + metronidazol. Se comparó las variables: estadía hospitalaria, complicaciones y costo monetario de cada esquema. Se realizó en la Unidad de Cirugía Pediátrica del Hospital de Especialidades Carlos Andrade Marín, en el periodo enero de 2017 a octubre de 2018. Los datos fueron analizados con R-Studio 1.8.366 para Windows. RESULTADOS. No hubo diferencia estadística con respecto a: estadía hospitalaria (p=0,261); complicaciones como infección del sitio quirúrgico (p=0,196), re-intervención quirúrgica (p=0,653) y costo (p=0,059). CONCLUSIÓN. Se comparó el esquema de antibioticoterapia triple vs un doble, utilizados en apendicitis complicada en pediatría. No se encontró diferencias estadísticamente significativas en este reporte preliminar, con la diferencia de que con el esquema doble la frecuencia de administración fue menor y se evitó la exposición a los efectos colaterales de los aminoglicósidos.


INTRODUCTION. Acute appendicitis is a pediatric surgical pathology that in its complicated phase requires the use of antibiotics during the postoperative period; finding the best option as local experience was a must. OBJECTIVE. Compare a triple vs a double antibiotic therapy scheme respect demographic, clinical and cost variables in pediatric patients whit complicated apendicitis. MATERIALS AND METHODS. Cross-sectional analytical study. Population of 133 patients and sample of 93, with complicated appendicitis; 58 received ampicillin + metronidazole + gentamicin and 35 ceftriaxone + metronidazole. The following variables were compared; hospital stay, complications and monetary cost of each scheme. It was performed in the Pediatric Surgery Unit of the Hospital of Specialties Carlos Andrade Marin, during january 2017, through october 2018. The data were analyzed with R-Studio 1.8.366 for Windows. RESULTS. There was no statistical difference regarding hospital stay (p=0.261); complications such as surgical site infection (p=0.196), re-surgical intervention (p=0.653); nor cost (p=0.059). CONCLUSION. Triple vs. Double antibiotic therapy scheme used in complicated appendicitis in pediatrics was compared. No statistically significant differences were found in this preliminary report, how ever with the double scheme the frequency of administration was lower and exposure to side effects of aminoglycosides was avoided.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Appendicitis/complications , Gentamicins , Cephalexin , Ampicillin , Metronidazole , Anti-Bacterial Agents/therapeutic use , Pediatrics , Postoperative Complications , General Surgery , Cost-Benefit Analysis
2.
Infectio ; 25(2): 101-107, abr.-jun. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1250075

ABSTRACT

Resumen Objetivo: Estimar la resistencia del Staphylococcus aureus frente a diferentes antibióticos usados para el manejo ambulatorio de piodermias. Métodos: Se realizaron análisis descriptivos y de tendencias mediante modelos de regresión segmentada. Resultados: La mayor resistencia se presentó a la oxacilina, con mediana de 54,3% (RIQ: 43 - 58,8), seguido de eritromicina con el 20%, (RIQ: 15,4 - 26,5), clindami cina con el 14% (RIQ: 7,9 - 20), gentamicina con el 7,5% (RIQ: 0 -10), trimetoprima/sulfametoxazol (SXT) con el 5,5% (RIQ: 4 - 11), y ciprofloxacina con 2,1% (RIQ: 2 - 8.4). La tendencia de la resistencia del S. aureus a la oxacilina fue creciente con un cambio anual porcentual no significativo de (0,07) (IC 95%: -3,7; 3,9). Para eritromicina, clindamicina, ciprofloxacina, trimetoprima/sulfametoxazol, y gentamicina hubo decrecimiento. Conclusiones: La resistencia del S. aureus a oxacilina fue ligeramente creciente para el periodo 2010 al 2019 y francamente creciente en los últimos 3 años, superando en promedio a lo reportado a nivel país y Latinoamérica. Los antibióticos con menor resistencia fueron ciprofloxacina, SXT, clindamicina para uso sistémico, y ácido fusídico, mupirocina para manejo tópico y descolonización. Es pertinente articular la vigilancia del S. aureus en la atención ambulatoria a la red de vigilancia nacional.


Abstract Objective: To estimate the resistance trend of Staphylococcus aureus (S. aureus) against different antibiotics in a reference dermatology outpatient center in Colombia. Methods: Descriptive and trend analyzes were performed using segmented regression models for the period 2010 to 2019. Results: The greatest resistance was presented to oxacillin, with a median of 54.3% (RIQ: 43 - 58.8), followed by erythromycin with 20%, (RIQ: 15.4 - 26.5), then clindamycin with 14% (RIQ: 7.9 - 20), gentamicin with 7.5% (RIQ: 0 -10), trimethoprim / sulfamethoxazole (SXT) with 5.5% (RIQ: 4 - 11), and ciprofloxacin with 2.1% (RIQ: 2 - 8.4). The trend of S. aureus resistance to oxacillin from 2010 to 2019 was increasing with a non-significant Annual Percent Change (APC) of (0.07) (95% CI -3.7, 3.9). APC for erythromycin (-1.2) (95% CI: -11.3; 10), clindamycin (-1.7) (95% CI: 11; -12.9), ciprofloxacin (-25.4) (95% CI: -44.6; 0.5) and trimethoprim / sul famethoxazole (-20.7) (95% CI: -43.5; 11.2), were decreasing not significant. For gentamicin the trend was decreasing and significant (-44.2) (95% CI: -19.9; -61.1). Conclusions: The resistance of S. aureus to oxacillin exhibited a slightly increasing trend for the period 2010 to 2019 and increasing in the last 3 years, exceeding on average that reported at the country level and the world average. Antibiotics for outpatient management of skin and soft tissue pyoderma with less resistance were ciprofloxacin, SXT, clindamycin for systemic use, and fusidic acid, mupirocin for topical management and decolonization. It is important to articulate surveillance of S. aureus in outpatient care to the national surveillance network.


Subject(s)
Humans , Male , Adult , Middle Aged , Dermatology , Methicillin-Resistant Staphylococcus aureus , Staphylococcus aureus , Sulfamethoxazole , Gentamicins , Ciprofloxacin , Fusidic Acid , Anti-Bacterial Agents
3.
Femina ; 49(4): 237-245, 20210430. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1224090

ABSTRACT

Objetivo: Descrever o perfil epidemiológico e microbiológico das puérperas com diagnóstico de infecção após cesárea, caracterizando as infecções de sítio cirúrgico e o tratamento. Métodos: Coorte prospectiva de parturientes submetidas a parto cesáreo em maternidade pública de Manaus, Amazonas, Brasil, com diagnóstico de infecção de sítio cirúrgico, entre 1º de julho de 2019 e 30 de abril de 2020. Foram coletados dados epidemiológicos. Para a investigação do perfil microbiológico, foi realizada a identificação da cultura a partir da secreção da infecção do sítio cirúrgico e do antibiograma das culturas. Resultados: Um total de 81 pacientes foi diagnosticado com infecção de sítio cirúrgico durante o período de estudo. A taxa de infecção de sítio cirúrgico na maternidade em estudo foi de 6,0%. As pacientes possuíam baixa escolaridade e baixa renda mensal, com ocupações que requerem menor qualificação, sendo a maioria solteira. Entre as pacientes, 70,4% eram obesas e 28,4% apresentaram sobrepeso; 45,6% delas tiveram parto cesáreo de emergência e 29,6% não usaram antibióticos profiláticos. Staphylococcus aureus foi a cultura identificada mais frequentemente e apresentou resistência ao antibiótico mais prescrito: a gentamicina. Conclusão: A taxa de infecção do sítio cirúrgico foi alta durante o período do estudo. Ressaltamos a necessidade de um protocolo eficaz de identificação bacteriana e acompanhamento da puérpera. O conhecimento das características epidemiológicas e microbiológicas pode auxiliar no planejamento dos cuidados realizados pelas instituições de saúde para minimizar os casos de infecção de sítio cirúrgico e suas consequências.(AU)


Objective: To describe the epidemiological and microbiological profiles of puerperal women diagnosed with the infection after cesarean sections, characterizing the surgical site infections and treatment. Methods: Prospective cohort of parturients underwent cesarean delivery at a public maternity hospital in Manaus, Amazonas, Brazil, diagnosed with surgical site infection between July 1, 2019, and April 30, 2020. Epidemiological data were collected. To investigate the microbiological profile, both culture identification from surgical site infection secretion and antibiogram for the cultures were performed. Results: A total of 81 patients were confirmed to have surgical site infection during this study period; The surgical site infection rate in the maternity hospital under study was 6.0%. The patients presented a low level of education and monthly income, with occupations that require lower qualification, and most of them are single. Seventy point four percent of the patients were obese, and 28.4% were overweight. Forty-five point six percent of patients had an emergency cesarean delivery, and 29.6% did not use prophylactic antibiotics. Staphylococcus aureus was the most frequent culture identified from surgical site infection secretion and presented resistance to the most prescribed antibiotic, Gentamicin. Conclusion: The rate of surgical site infection was high during the study period. We highlight the need for an effective bacterial identification protocol and monitoring of puerperal women. Knowledge of epidemiological and microbiological characteristics can assist in the planning of care performed by the health institutions to minimize cases of surgical site infection and its consequences.(AU)


Subject(s)
Humans , Female , Pregnancy , Puerperal Infection/microbiology , Puerperal Infection/drug therapy , Puerperal Infection/epidemiology , Gentamicins/therapeutic use , Antibiotic Prophylaxis , Staphylococcus aureus , Brazil/epidemiology , Cesarean Section/adverse effects , Prospective Studies , Risk Factors , Drug Resistance, Bacterial
4.
Arq. bras. med. vet. zootec. (Online) ; 73(2): 302-310, Mar.-Apr. 2021. tab
Article in English | ID: biblio-1248934

ABSTRACT

Bovine clinical mastitis caused by Staphylococcus spp. is a serious and widespread disease in the world of dairy farming. Antimicrobial therapy is of fundamental importance in the prevention and treatment of infectious mastitis, but the indiscriminate use of antimicrobials acts as a determining factor for the spread of the disease. The present study evaluated the resistance profiles of 57 Staphylococcus spp. isolated from bovine clinical mastitis to beta-lactams and gentamicin, relating characteristics of phenotype (in vitro susceptibility tests) and genotype (detection and expression of genes encoding resistance - mecA, mecALGA251, blaZ, femA, femB, and aacA-aphD - using PCR and RT-PCR, respectively). One or more genes coding for resistance to different antimicrobials were detected in 50 Staphylococcus spp. isolates. The femA and femB genes were the most frequent (75.4% for both). The observed expression of the genes was as follows: blaZ (60%), femA (39.5%), aacA-aphD (50%), femB (32.6%), mecA (8.3%), and mecALGA251 (0%). Considering the relevance of the genus Staphylococcus to bovine mastitis, this study aimed to elucidate aspects regarding the genotypic and phenotypic profiles of these microorganisms so as to contribute to the development of effective strategies for mastitis control.(AU)


A mastite clínica bovina causada por Staphylococcus spp. é uma doença grave e generalizada no mundo da pecuária leiteira. A terapia antimicrobiana é de fundamental importância na prevenção e no tratamento da mastite infecciosa, mas o uso indiscriminado de antimicrobianos atua como fator determinante para a disseminação da doença. O presente estudo avaliou os perfis de resistência de 57 Staphylococcus spp. isolados de mastite clínica bovina em relação ao uso de betalactâmicos e gentamicina, relacionando características do fenótipo (testes de suscetibilidade in vitro) e genótipo (detecção e expressão de genes que codificam resistência - mecA, mecALGA251, blaZ, femA, femB, e aacA-aphD - usando PCR e RT-PCR, respectivamente). Um ou mais genes que codificam resistência a diferentes antimicrobianos foram detectados em 50 Staphylococcus spp. isolados. Os genes femA e femB foram os mais frequentes (75,4% para ambos). A expressão observada dos genes foi a seguinte: blaZ (60%), femA (39,5%), aacA-aphD (50%), femB (32,6%), mecA (8,3%) e mecALGA251 (0%). Considerando-se a relevância do gênero Staphylococcus para a mastite bovina, este estudo teve como objetivo elucidar aspectos referentes aos perfis genotípico e fenotípico desses microrganismos, a fim de contribuir para o desenvolvimento de estratégias eficazes para o controle da mastite.(AU)


Subject(s)
Staphylococcus/isolation & purification , Gene Expression/genetics , beta-Lactam Resistance/genetics , Drug Resistance, Bacterial/genetics , Mastitis, Bovine/microbiology , Gentamicins , Reverse Transcriptase Polymerase Chain Reaction
5.
Rev. Eugenio Espejo ; 15(1): 12-21, 20210102.
Article in Spanish | LILACS | ID: biblio-1145479

ABSTRACT

La elevada incidencia del Enterococcus faecalis en procedimientos odontológicos es un tópico de interés para el área de la salud, esta bacteria resiste a varios antimicrobianos y su proliferación aumenta debido a su baja susceptibilidad a sustancias de uso convencional como el hidróxido de calcio, convirtiéndose en una de las principales causas del fracaso de los tratamientos de conduc- to. La presente investigación evaluó la susceptibilidad in vitro del Enterococcus faecalis cepa ATCC-29212 frente a la combinación de sustancias y antibióticos con el hidróxido de calcio. Se utilizó la técnica de difusión en agar, inoculando el microorganismo en cajas de Petri con agar Cerebro Corazón (BHI), tratado con discos de papel filtro impregnados con 1µl de cada trata- miento por triplicado; T1 (Hidróxido de Calcio + propilenglicol), T2 (Hidróxido de Calcio + paramonoclorofenol), T3 (Hidróxido de Calcio + ampicilina gentamicina + propilenglicol), T4 (Hidróxido de Calcio + Solución Salina Fisiológica), Control positivo (medicamento comercial a base de Hidróxido de Calcio), se incubó a 35°C durante 24h, los halos formados alrededor de cada disco fueron medidos y comparados con la escala de Duraffourd y procesados mediante ANOVA de un factor. Se obtuvo una medida del halo de inhibición de 22,50±3,3 mm, con el trata- miento T3, siendo sumamente sensible. Concluyendo que este resultó el más efectivo en compa- ración el resto de la pruebas in vitro en comparación con el resto de los fármaco investigados.


The high incidence of Enterococcus faecalis in dental procedures is a topic of interest for the health area. This bacterium resists various antimicrobials and its proliferation increases due to its low susceptibility to substances of conventional use such as calcium hydroxide, becoming a of the main causes of root canal failure. The present investigation evaluated the in vitro suscepti- bility of Enterococcus faecalis strain ATCC-29212 to the combination of substances and antibio - tics with calcium hydroxide. The agar diffusion technique was used, inoculating the microorga- nism in Petri dishes with Brain Heart agar (BHI), treated with filter paper disks impregnated with 1µl of each treatment in triplicate; T1 (Calcium Hydroxide + propylene glycol), T2 (Cal- cium Hydroxide + paramonochlorophenol), T3 (Calcium Hydroxide + ampicillin gentamicin + propylene glycol), T4 (Calcium Hydroxide + Physiological Saline Solution), Positive control (Hydroxide-based commercial medicine Calcium), incubated at 35 ° C for 24h, the halos formed around each disc were measured and compared with the Duraffourd scale and processed by one-factor ANOVA. A measure of the inhibition halo of 22.50 ± 3.3 mm was obtained with the T3 treatment, being extremely sensitive. It was concluded that this was the most effective in comparison with the rest of the in vitro tests of the rest of the investigated drugs.


Subject(s)
Calcium Hydroxide , Enterococcus faecalis , Ampicillin , Pharmaceutical Preparations , Gentamicins , Health
6.
Dent. press endod ; 10(3): 63-69, Sept-Dec.2020. Ilus
Article in English | LILACS | ID: biblio-1347990

ABSTRACT

Introdução: A insuficiência renal aguda (IRA) ocorre em cerca de 5% das hospitalizações e até 30% das internações em UTI, possuindo taxas de mortalidade entre 15% e 60%. Objetivo: O objetivo do presente trabalho foi analisar diferentes protocolos de indução da IRA em modelo animal, buscando a padronização do modelo para o estudo da relação bidirecional com a periodontite apical (PA). Métodos: Foram utilizados vinte e quatro ratos divididos em três grupos (n=8): G1) administração de gentamicina na dosagem de 80mg/Kg/dia durante cinco dias; G2) administração de gentamicina na dosagem de 100mg/kg/dia durante oito dias; e G3) administração de gentamicina na dosagem de 100mg/kg/dia durante dez dias. A PA foi induzida em todos os grupos por meio da exposição pulpar dos primeiros e segundos molares superiores e inferiores do lado direito. Após trinta dias da exposição pulpar, os animais foram eutanasiados; os rins, coletados para análise histológica em HE; e as maxilas e mandíbulas, removidas para análise radiográfica. Resultados: A presença da PA foi confirmada em todos os espécimes pelo exame radiográfico. O grupo G3 apresentou índice de mortalidade de 75%, enquanto G1 e G2 não apresentaram mortalidade. Histologicamente, o tecido renal do grupo G2 apresentou alterações teciduais, como dilatação e necrose tubular mais severa, quando comparado ao grupo G1 (p<0,05). Conclusão: Diante do alto índice de mortalidade observado em G3 e dos achados histológicos observados em G1 e G2, o protocolo indicado para o estudo da relação bidirecional com a periodontite apical é o de 100mg/kg/dia durante oito dias (AU).


Introduction: Acute Renal Failure (ARF) occurs in about 5% of hospitalizations and up to 30% of ICU admissions, with mortality rates between 15% and 60%. The objective of this study was to analyze different protocols for the induction of IRA in an animal model, seeking the standardization of the model for the study of bidirectional relationship with apical periodontitis (AP). Methods: Twenty-four rats were divided into three groups (n = 8): G1 - Administration of Gentamicin at a dose of 80mg/ kg/day for 5 days; G2 - Administration of Gentamicin at the dose of 100mg/kg/day for 8 days; G3 - Administration of Gentamicin at the dosage of 100mg/kg/day for 10 days. The AP was induced in all groups by means of pulp exposure of the first and second upper and lower molars from the right side. After 30 days, the animals were euthanized, the kidneys collected for histological analysis, and the jaws removed for radiographic analysis. Results: The presence of AP was confirmed in all specimens by radiographic examination. The G3 group had a mortality rate of 75% while G1 and G2 had no mortality. Histologically, the renal tissue of the G2 protocol presented tissue changes such as dilation and more severe tubular necrosis when compared to the G1 protocol (p <0.05). Conclusion: In view of the high mortality rate observed in G3 and the histological findings observed in G1 and G2, the indicated protocol is 100mg/kg/day for 8 days to study the bidirectional relationship with apical periodontitis (AU).


Subject(s)
Periapical Periodontitis , Reference Standards , Renal Insufficiency , Kidney/injuries , Gentamicins , Dosage
7.
Arq. bras. med. vet. zootec. (Online) ; 72(3): 827-835, May-June, 2020. ilus, tab
Article in Portuguese | ID: biblio-1129486

ABSTRACT

O colágeno é sintetizado e segregado no espaço extracelular e organizados em fibrilas estriadas de acordo com o tipo de tecido. Utilizaram-se 24 coelhos brancos da raça Nova Zelândia, com idade de 12 meses e com 3,0kg de peso corporal, para avaliar a porcentagem de colágeno das feridas cutâneas tratadas com plasma rico em plaquetas de equino e pomada contendo gentamicina, sulfanilamida, sulfadiazina, ureia e vitamina A. Os animais foram separados em quatro grupos de igual número e submetidos à remoção de pele na região das linhas médias dorsal torácica (feridas tratadas) e lombar (feridas controle). As feridas torácicas foram tratadas com plasma rico em plaqueta de equino e pomada contendo gentamicina, sulfanilamida, sulfadiazina, ureia e vitamina A, e as do grupo controle somente com a pomada. Dos animais do grupo I, foi coletado tecido cutâneo, para a avaliação histológica e a ultraestrutural, com três dias de pós-operatório; dos animais do grupo II, com sete dias; do grupo III, com 14 dias; e do grupo IV, com 21 dias. Decorrido o período de avaliação de cada grupo, foi coletado fragmento de pele para avaliação da porcentagem de colágeno, bem como do diâmetro e da densidade da fibrila de colágeno por microscopia eletrônica de transmissão. O tratamento com PRP de equino associado à aplicação tópica da pomada mostrou-se eficaz na maturação das fibrilas colágenas e na antecipação do processo cicatricial.(AU)


Collagen is synthesized and secreted into the extracellular space and organized into striated fibrils according to the tissue type. This study evaluated the concentration of collagen in rabbit skin wounds treated with equine platelet-rich plasma (PRP) and ointment containing gentamicin, sulfanilamide, sulfadiazine, urea, and vitamin A. Twenty-four New Zealand white rabbits aged 2 to 12 months and weighing 3.0kg were included. The animals were allocated equally into four groups and the skin was removed from the thoracic dorsal midline (treated wound) and lumbar (control wound) regions. The thoracic wounds were treated with equine PRP and ointment containing gentamicin, sulfanilamide, sulfadiazine, urea, and vitamin A, and the control group was treated with the ointment alone. For histological and ultrastructural assessment, cutaneous tissue was collected on postoperative days 3 (group I), 7 (group II), 14 (group III), and 21 (group IV). After the evaluation period, in each group, a skin fragment was collected for analysis of the collagen concentration, as well as the collagen fibril diameter and density by transmission electron microscopy. The results indicated that treatment with equine PRP combined with topical application of the ointment was effective in facilitating the maturation of collagen fibrils and the wound healing process.(AU)


Subject(s)
Animals , Rabbits , Wound Healing/physiology , Wounds and Injuries/rehabilitation , Wounds and Injuries/veterinary , Collagen/ultrastructure , Platelet-Rich Plasma , Sulfadiazine/administration & dosage , Sulfanilamides/administration & dosage , Urea/administration & dosage , Vitamin A/administration & dosage , Gentamicins/administration & dosage , Horses
8.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 57(2): e166204, mai. 2020. ilus, graf
Article in English | ID: biblio-1122176

ABSTRACT

Medical management of abdominal abscesses in horses requires prolonged antibiotic therapy and presents varied success rates. A 6-year-old male horse with a history of colic and multiple abdominal punctures to relieve gas was attended. At admission, tachycardia, tachypnea, hyperthermia, mucosal congestion, dehydration, and rigid gait were observed. The association of physical examination, laboratory and ultrasonographic findings allowed the diagnoses of peritonitis and abdominal abscess. Supporting treatment plus broad spectrum antibiotic therapy was performed: daily intraperitoneal ceftriaxone (25 mg/kg, 7 days); daily intravenous gentamicin (6.6 mg/kg, 7 days); per os metronidazole three times a day (15 mg/kg 12 days), followed by the same dose twice a day (15 mg/kg 33 days), totaling 45 days of treatment. Plasma fibrinogen and ultrasonographic examination were the most effective tools to evaluate abscess evolution. There was normalization of the physical examination 24 h after beginning the treatment, consecutive regression of the nucleated cell count in the peritoneal fluid, and regression of plasma fibrinogen and size of the abscess. On the 10th treatment day, the animal was discharged from the hospital, maintaining oral therapy with metronidazole every 12 h (15 mg / kg). When the animal returned on the 30th day, an abscess size regression was observed. However, there was no resolution, and therapy with metronidazole was maintained. On the 45th day of treatment, a new hospital evaluation was performed, where the abscess resolved, and metronidazole was suspended. It is highlighted that the therapeutic association used in the treatment of abdominal infection and abscess resulted in a rapid clinical response.(AU)


O tratamento conservativo dos abscessos abdominais em equinos requer antibioticoterapia prolongada e apresenta variadas taxas de sucesso. Foi atendido um cavalo de seis anos de idade, com histórico de cólica e múltiplas punções abdominais por agulha para esvaziamento de gás. Na admissão, foram observados taquicardia, taquipnéia, hipertermia, congestão mucosa, desidratação e marcha rígida. A associação do exame físico, achados laboratoriais e ultrassonográficos permitiu o diagnóstico de peritonite e abscesso abdominal. Foi realizado tratamento suporte e antibioticoterapia de amplo espectro: ceftriaxona intraperitoneal diária (25 mg/kg, 7 dias); gentamicina intravenosa diária (6,6 mg/kg, 7 dias); metronidazol oral três vezes ao dia (15 mg/kg, 12 dias), seguido de mesma dose duas vezes ao dia, por mais 33 dias, totalizando 45 dias de tratamento. O fibrinogênio plasmático e o exame ultrassonográfico foram os recursos mais eficazes para a avaliação da evolução do abscesso. Após 24 horas do início do tratamento foi constatada a normalização do exame fisico, regressão progressiva da contagem de células nucleadas no líquido peritoneal, do fibrinogênio plasmático e do tamanho do abscesso. No 10° dia de tratamento o animal recebeu alta hospitalar, mantendo-se a terapia oral com metronidazol a cada 12 horas (15 mg/Kg). Em retorno, ao 30° dia, observou-se regressão do tamanho do abscesso, entretanto, não houve resolução, tendo sido mantida a terapia com metronidazol. No 45º dia de tratamento, realizou-se nova avaliação hospitalar, onde foi observada a resolução do abscesso e a admnistração do metronidazol foi suspensa. Destaca-se, que a associação terapêutica utilizada no tratamento de infecção abdominal e abscesso resultou em rápida resposta clínica.(AU)


Subject(s)
Animals , Peritonitis/veterinary , Ceftriaxone/administration & dosage , Gentamicins/administration & dosage , Abdominal Abscess/veterinary , Horses , Metronidazole/administration & dosage , Ultrasonics , Fibrinogen , Injections, Intraperitoneal/veterinary
9.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(1): 54-62, mar. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1099202

ABSTRACT

La vestibulopatía bilateral es poco frecuente, se caracteriza principalmente por inestabilidad al caminar o al estar de pie, visión borrosa inducida por el movimiento u oscilopsia al caminar o al realizar movimientos rápidos de la cabeza o del cuerpo, empeoramiento de la estabilidad en la oscuridad o terrenos irregulares, reducción de los síntomas al estar en condiciones estáticas, ganancia del reflejo vestíbulo-ocular angular reducida de forma bilateral, entre otros. Existen múltiples causas. Dentro de las causas identificables, se describen principalmente medicamentos ototóxicos, meningitis y enfermedad de Ménière. Se presenta el caso de una paciente de 64 años diagnosticada con vestibulopatía bilateral posterior a tratamiento intramuscular con gentamicina por sobreinfección bacteriana cutánea de las manos. La evaluación vestibular complementada con videonistagmografía y prueba de impulso cefálico asistida por video confirman el diagnóstico y se inicia tratamiento con rehabilitación vestibular enfocada en promover la compensación central a través de estrategias de sustitución principalmente; además de habituación y adaptación vestibular, favoreciendo la estabilización de la mirada, mantención del equilibrio, control postural, marcha y reducción de los síntomas.


Bilateral vestibulopathy is infrequent, and it is characterized mostly by unstable walking or when standing, blurred vision induced by movement, or oscillopsia when walking or performing fast movements; worsening of the stability in darkness or uneven ground, but with lack of symptoms in static conditions. Other symptoms may include bilateral reduction of the oculo-vestibular reflex. Among the identifiable causes, there is the use of ototoxic medication, meningitis, Ménière's disease, although it can be idiopathic or have a neurological cause. We hereby describe the case of a 64-year-old woman, diagnosed with bilateral vestibulopathy secondary to intramuscular treatment with gentamicin due to a bacterial hand infection. Vestibular assessment was complemented with video-nystagmography and video head impulse test which confirmed the diagnosis, and therapy was started with vestibular rehabilitation focused on promoting central compensation mainly, through substitution strategies. Also, habituation exercise and vestibular adaptation strategies were used, thus promoting sight stabilization, balance maintenance, postural control, walking, and reduction of the symptoms.


Subject(s)
Humans , Female , Middle Aged , Gentamicins/adverse effects , Bilateral Vestibulopathy/chemically induced , Bilateral Vestibulopathy/rehabilitation , Anti-Bacterial Agents/adverse effects , Audiometry , Superinfection , Electronystagmography , Head Impulse Test , Bilateral Vestibulopathy/diagnosis , Bilateral Vestibulopathy/physiopathology
10.
J. coloproctol. (Rio J., Impr.) ; 40(1): 8-11, Jan.-Mar. 2020.
Article in English | LILACS | ID: biblio-1090847

ABSTRACT

Abstract Introduction Peritoneal antibiotic or normal saline lavage is seen to be beneficial in order to reduce the pain or infection risk through laparoscopic surgeries. It can also be applied for laparoscopic colectomy surgeries. In this study, we have compared the effects of antibiotic solution lavage (gentamycin-clindamycin) with normal saline lavage in patients undergoing laparoscopic colectomy surgery. Method In this double-blind Randomized Controlled Trial (RCT), 40 patients undergoing laparoscopic colectomy surgery were divided into antibiotic and normal saline lavage groups (20 patients in each group). Post-operational pain, need for painkiller, white blood cells count, C-reactive protein level, duration of hospitalization and wound infection were compared in 30 days between the groups. Results Antibiotic lavage group had significantly less pain than the normal saline group (p < 0.05) through 3, 6, 12 and 24 h after surgery. C-reactive protein level, white blood cells count, painkiller use, and hospitalization duration were significantly lower in antibiotic group. However, there was no difference regarding wound or intra-abdominal infection between the both groups. Conclusion Using gentamicin-clindamycin peritonea lavage helps patients undergoing laparoscopic colectomy surgery in pain reduction, need for painkillers and hospitalization duration.


Resumo Introdução A lavagem peritoneal com antibiótico ou com soro fisiológico normal é benéfica para reduzir o risco de dor ou de infecção durante cirurgias laparoscópicas, além de poder ser aplicada também em colectomias laparoscópicas. Neste estudo, comparamos os efeitos da lavagem com solução antibiótica (gentamicina-clindamicina) e da lavagem com solução salina normal em pacientes submetidos à colectomia laparoscópica. Método Neste Ensaio Clínico Randomizado (ECR), controlado e duplo-cego, 40 pacientes submetidos à colectomia laparoscópica foram divididos em dois grupos (20 pacientes em cada grupo) para receberem antibiótico ou solução salina normal. Dor pós-operatória, necessidade de analgésico, contagem de leucócitos, nível de proteína C-reativa, tempo de internação e infecção da ferida foram comparados entre os grupos em 30 dias. Resultados De forma significativa, o Grupo Antibiótico apresentou menos dor que o Grupo Salina Normal (p < 0,05) em 3, 6, 12 e 24 horas após a cirurgia. O nível de proteína C-reativa, a contagem de leucócitos, o uso de analgésicos e o tempo de internação foram significativamente menores no Grupo Antibiótico. Porém, não houve diferença em relação à infecção da ferida ou intra-abdominal entre os dois grupos. Conclusão O uso da lavagem peritoneal com gentamicina-clindamicina ajuda a reduzir a dor, a necessidade de analgésicos e o tempo de internação de pacientes submetidos à colectomia laparoscópica.


Subject(s)
Humans , Pain, Postoperative/drug therapy , Surgical Wound Infection/drug therapy , Peritoneal Lavage , Laparoscopy , Colectomy/methods , Anti-Bacterial Agents/therapeutic use , Clindamycin/therapeutic use , Gentamicins/therapeutic use , Double-Blind Method , Saline Solution/therapeutic use , Length of Stay
11.
Pesqui. vet. bras ; 40(2): 129-133, Feb. 2020. tab
Article in English | ID: biblio-1098445

ABSTRACT

Enterococcus are recognized worldwide as significant nosocomial agents that have been continuously envolving to adapt to different niches and acquire resistance to several antibiotic classes. Vancomycin and gentamicin-resistant strains of E. faecalis and E. faecium have been associated with nosocomial human infections. Some epidemiological studies suggest the participation of pets as reservoirs of vancomycin and gentamicin-resistant Enterococcus strains. However, the role of companion birds as reservoirs of these strains has been poorly studied. In this study, 126 psittacine birds were evaluated and 26.9% carried Enterococcus spp., including the species E. faecalis, E. faecium, E. hirae, E. phoeniculicola, E. gallinarum and E. casseliflavus. The antibiotic resistance profile showed four high-level gentamicin-resistance (HLGR) strains. In addition, two strains presented intermediate levels of vancomycin resistance. Resistant strains were isolated from fecal and oropharynx samples of sick and clinically healthy birds, suggesting that psittacine birds may act as reservoirs of HLGR Enterococcus spp. However, sick birds appear to be more implicated in the enterococci transmission than healthy birds.(AU)


Enterococcus são reconhecidos mundialmente como significantes agentes nosocomiais, que têm continuamente se adaptado a diferentes nichos e adquirido resistência a várias classes de antibióticos. Cepas de E. faecalis e E. faecium vancomicina e gantamicina-resistentes têm sido associadas a infecções nosocomiais em humanos. Alguns estudos epidemiológicos sugerem a participação de aves como reservatórios de cepas de Enterococcus vancomicina e gentamicina-resistentes. Entretanto, a relação das aves de companhia como reservatórios destas cepas tem sido pouco estudada. Neste estudo, 126 psitacídeos foram avaliados, e 26,9% destes eram portadores de Enterococcus spp., incluindo as espécies E. faecalis, E. faecium, E. hirae, E. phoeniculicola, E. gallinarum e E. casseliflavus. O perfil de resistência antibiótica mostrou quatro cepas com alto nível de resistência a gentamicina (ANRG). Além de duas cepas com nível intermediário de resistência a vancomicina. As cepas resistentes foram isoladas de amostras fecais e de orofaringe de aves doentes e clinicamente saudáveis, sugerindo que psitacídeos podem estar atuando como reservatórios para Enterococcus spp. com ANRG. Contudo, Aves doentes parecem estar mais relacionadas à transmissão de enterococcus, do que aves saudáveis.(AU)


Subject(s)
Animals , Parrots/microbiology , Disease Reservoirs/veterinary , Gentamicins , Vancomycin Resistance , Drug Resistance, Bacterial , Pets/microbiology , Enterococcus/isolation & purification
12.
Cienc. tecnol. salud ; 7(2): 196-204, 2020. il 27 c
Article in Spanish | LILACS, LIGCSA, DIGIUSAC | ID: biblio-1348153

ABSTRACT

Salmonellosis is a relevant public health threat worldwide. Reptiles are commonly involved in human cases. A microbiological survey was conducted from August to October 2018 to isolate Salmonella bacteria and de-termine if they were resistant to regularly used antibiotics in eight species of pet turtles (Kinosternon acutum sp., K. leucostomum, K. scorpioides, Rhinoclemmys areolata sp., R. pulcherrima, Staurotypus salvinii sp., Trachemys scripta and T. venusta) in Guatemala city, San Lucas Sacatepéquez and Antigua Guatemala. Cloacal swabs were taken from 63 turtles and cultivated in the Microbiology Laboratory at the Veterinary Medicine and Animal Hus-bandry Faculty, University of San Carlos of Guatemala, in Guatemala City. Three samples were positive to the presence of Salmonella sp. One of these isolates (from Trachemys scripta) was resistant to gentamicin, penicillin and amikacin, other isolate (from T. scripta) was partially resistant to amoxicilin + clavulanic acid and penicillin, and other (from T. venusta) to penicillin. These findings highlight the need for better biosecurity practices and show the capacity of bacteria to develop survival strategies that involve resistance to harmful substances like antibiotics.


La salmonelosis es una importante enfermedad zoonótica considerada una amenaza a la salud pública a nivel mundial. Los reptiles están comúnmente involucrados en la transmisión animal-humano. Con el objetivo de determinar la presencia de Salmonella y determinar su resistencia a antibióticos de uso común, se realizó un estudio exploratorio en ocho especies de tortugas (Kinosternon acutum sp., K. leucostomum, K. scorpioides, Rhinoclem-mys areolata sp., R. pulcherrima, Staurotypus salvinii sp., Trachemys scripta y T. venusta) en Guatemala y en San Lucas Sacatepéquez. Se tomaron hisopados cloacales de 63 especímenes y se cultivaron en el Laboratorio de Microbiología de la Facultad de Medicina Veterinaria y Zootecnia de la Universidad de San Carlos de Guatemala. Tres muestras fueron positivas a la presencia de Salmonella sp. Uno de los aislados (de Trachemys scripta) fue resistente a gentamicina, penicilina y amikacina, otro aislado (de T. scripta) fue parcialmente resistente a amoxicilina + ácido clavulánico y a penicilina y un tercer aislado (de T. venusta) a penicilina. Estos hallazgos resaltan la necesidad de mejores prácticas de bioseguridad y muestran la capacidad de las bacterias para desarrollar estrategias de sobrevivencia que involucran la resistencia a sustancias que les son nocivas, como los antibióticos.


Subject(s)
Salmonella/drug effects , Turtles/parasitology , Anti-Bacterial Agents/analysis , Penicillins/adverse effects , Amikacin/adverse effects , Gentamicins/adverse effects , Pets/microbiology
13.
Clinics ; 75: e1622, 2020. tab, graf
Article in English | LILACS | ID: biblio-1142786

ABSTRACT

OBJECTIVES: To investigate the effects of an intratympanic injection of dexamethasone combined with gentamicin on the expression level of serum P0 protein antibodies in patients with Meniere's disease (MD). METHODS: A total of 136 patients with MD treated in our hospital were enrolled in this study. Among them, 68 patients were treated with an intratympanic injection of dexamethasone combined with gentamicin (observation group). Another 68 patients were treated with gentamicin alone (control group). RESULTS: After treatment, the expression levels of IgG and IgM in the two groups significantly decreased (p<0.05); the levels in the observation group were significantly lower than those in the control group (p<0.05). The incidences of vertigo, tinnitus, and gait instability in the observation group were significantly lower than those in the control group (p<0.05). Vestibular symptom index (VSI) scores in the observation group were significantly lower than those in the control group (p<0.05). We observed no significant difference between the two groups in the number of vertigo attacks 6 months after treatment (p>0.05). CONCLUSION: For patients with MD, dexamethasone combined with gentamicin can reduce the incidence of vertigo, tinnitus, and gait instability, but it has no effect on the efficacy or number of vertigo attacks 6 months after treatment. Therefore, the levels of myelin P0 protein antibodies after treatment can be used as predictors of vertigo at 6 months after treatment.


Subject(s)
Humans , Myelin P0 Protein , Meniere Disease/drug therapy , Dexamethasone/therapeutic use , Gentamicins/therapeutic use , Treatment Outcome , Injection, Intratympanic , Anti-Bacterial Agents/therapeutic use
14.
Braz. arch. biol. technol ; 63: e20200131, 2020. tab, graf
Article in English | LILACS | ID: biblio-1132247

ABSTRACT

Abstract Gallic acid (GA), as a strong antioxidant, was selected in this study to investigate its possible nephroprotective effects against gentamicin (GM)-induced nephrotoxicity. Twenty-four rats were separated into three groups (n=8): group 1 (control group) received saline (0.5 mL/day), group 2 (GM group) received GM (100 mg/kg/day), and group 3 (treated group) received GM (100 mg/kg/day) and GA (100mg/kg/day). All treatments were performed intraperitoneally for 12 days. After 12 days, the rats were euthanized, and kidneys were removed immediately. For serum preparation, blood samples were collected before killing. Kidney paraffin sections were prepared from one of the kidneys and stained by the periodic acid-Schiff process. GA significantly decreased GM-induced renal histopathological injuries, including tubular necrosis, tubular cast, and leucocyte infiltration compared with the GM group. Additionally, GA significantly improved proteinuria, serum levels of urea and creatinine, and serum activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) compared with nephrotoxic animals. Furthermore, GA caused a significant improvement in the levels of cholesterol (Chol), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and cardiac risk ratios 1 and 2 in comparison with nephrotoxic animals. GA administration was observed to significantly improve the levels of lipid peroxidation, nitric oxide (NO), and glutathione (GSH) compared with the GM group. Finally, the activities and gene expression levels of catalase (CAT) and glutathione peroxidase (GPX) significantly increased following GA administration compared with the GM group. Our results indicated that GA has potential protective effects against GM nephrotoxicity by reducing oxidative stress in rats.


Subject(s)
Animals , Male , Rats , Gentamicins/adverse effects , Oxidative Stress/drug effects , Gallic Acid/therapeutic use , Kidney Diseases/drug therapy , Anti-Bacterial Agents/adverse effects , Antioxidants/therapeutic use , Biomarkers , Cholesterol , Rats, Wistar , Disease Models, Animal , Gallic Acid/chemistry , Kidney Diseases/chemically induced , Kidney Diseases/pathology , Lipoproteins, HDL , Lipoproteins, LDL
15.
Article in Korean | WPRIM | ID: wpr-816603

ABSTRACT

BACKGROUND: The emergence of multidrug-resistant Acinetobacter baumannii as a nosocomial pathogen is one of the major public health problems. The aim of this study was to evaluate the role of an efflux pump gene adeJ for the multidrug resistance of A. baumannii clinical isolates.METHODS: Two groups (MDRAB and SAB) of A. baumannii clinical isolates were studied. The SAB group consisted of strains that did not meet the criteria of MDRAB and were susceptible to more categories of antibiotics than MDRAB. Antimicrobial susceptibility results obtained by VITEKII system were used in data analysis and bacterial group allocation. We performed real-time reverse transcription PCR to determine relative expression of adeJ. We compared relative expression of adeJ in comparison groups by considering two viewpoints: i) MDRAB and SAB groups and ii) susceptible and non-susceptible groups for each antibiotic used in this study.RESULTS: The mean value of relative expression of adeJ of MDRAB and SAB groups was 1.4 and 0.92, respectively, and showed significant difference (P=0.002). The mean values of relative expression of adeJ of susceptible and non-susceptible groups to the antibiotics cefepime, ceftazidime, ciprofloxacin, imipenem, meropenem, tigecycline, piperacillin/tazobactam, ticarcillin/clavulanic acid, trimethoprim/sulfamethoxazole, piperacillin, and gentamicin showed statistically significant differences.CONCLUSION: The overexpression of adeIJK might contribute to the multi-drug resistance in A. baumannii clinical isolates. Further, the overexpression of adeIJK might be one of the factors contributing to the resistance to numerous antibiotics.


Subject(s)
Acinetobacter baumannii , Acinetobacter , Anti-Bacterial Agents , Ceftazidime , Ciprofloxacin , Drug Resistance, Multiple , Gentamicins , Imipenem , Piperacillin , Polymerase Chain Reaction , Public Health , Reverse Transcription , Statistics as Topic
16.
Chinese Journal of Biotechnology ; (12): 2459-2466, 2020.
Article in Chinese | WPRIM | ID: wpr-878502

ABSTRACT

Salmonella enterica serovar Enteritidis (SE) is one of the most important zoonotic pathogens that cause enteritis and systemic infection in animals and human. Understanding invasive capacities of SE isolates is of vital importance to elucidate pathogenesis of Salmonella infection. To improve the throughput capacity and repeatability of classical gentamicin protection assay (GPA), a modified PGA was developed by taking high-throughput advantage of 96-well cell plates and multichannel pipettes. In addition, drop plate technique rather than spread plate method was applied in the modified GPA protocol for bacterial enumeration. The modified GPA protocol was evaluated by phenotyping intracellular replication of a high virulent and a low virulent SE isolates, JL228 and LN248, in a phagocytic cell line RAW264.7. The protocol was then applied in invasive phenotype determination of 16 SE strains to non-phagocytes (HT-29) and the intracellular replication of 43 SE strains to phagocytes (RAW264.7). Significant lower intra-group and inter-group coefficient of variations of the modified GPA was observed, implying good repeatability and reproducibility over traditional protocol. Further, replication phenotypes were also correlated with those from direct observation by confocal microscopy. Collectively, the improved GPA protocol had advantages of high throughput capacity, good repeatability and reliability, it was also noticed that the protocol also represented a fast and labor-saving alternative scheme for the invasive phenotype determination of Salmonella Enteritidis, and providing reliable phenotype profiles for Salmonella-host interplay interpretation.


Subject(s)
Animals , Gentamicins/pharmacology , Humans , Phenotype , Reproducibility of Results , Salmonella Infections, Animal , Salmonella enteritidis
17.
An. Facultad Med. (Univ. Repúb. Urug., En línea) ; 6(2): 58-65, dic. 2019. ilus, tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1088703

ABSTRACT

La luxación erecta expuesta de hombro es una asociación lesional de muy baja frecuencia en la edad pediátrica. Son más frecuentes las lesiones fisarias y epifisarias que las luxaciones y lesiones ligamentarias. Esto es debido a la presencia de un tejido óseo con gran poder de deformidad elástica y un periostio grueso. Presentamos un caso clínico de un paciente de 11 años de edad que sufrió una luxación erecta expuesta de hombro derecho, producto de una caída de 1 metro y medio de altura. El tratamiento consistió en una limpieza quirúrgica de urgencia, reducción gleno humeral y antibioticoterapia empírica, penicinila 400.000 UI/kg/día fraccionado cada 6 hs y gentamicina 3mg/Kg/día fraccionada cada 8 h por 10 días, inmovilización por 3 semanas con cabestrillo seguido de rehabilitación, y un follow up de 2 años al final del cual el paciente no presento secuelas funcionales en la articulación glenohumeral derecha.


The exposed erect dislocation of the shoulder is a very low frequency lesion association in the pediatric age. The physical and epiphyseal lesions are more frequent than the dislocations and ligament injuries. This is due to the presence of a bone tissue with great elastic deformity power and a thick periosteum. We present a clinical case of an 11-year-old patient who suffered an exposed erect dislocation of the right shoulder, due to a fall of 1 meter and a half high. The treatment consisted of emergency surgical cleaning, humeral gleno reduction and empirical antibiotic therapy, penicinila 400,000 IU/kg/day divided every 6 hours and gentamicin 3mg/Kg/day divided every 8 hours for 10 days, immobilization for 3 weeks with a sling followed by rehabilitation, and a follow-up of 2 years at the end of which the patient did not present functional sequelae in the right glenohumeral joint.


A luxação ereta exposta do ombro é uma associação de lesão de freqüência muito baixa na idade pediátrica. As lesões físicas e epifisárias são mais freqüentes que as luxações e lesões ligamentares. Isto é devido à presença de um tecido ósseo com grande poder de deformidade elástica e um periósteo espesso. Apresentamos um caso clínico de um paciente de 11 anos de idade que sofreu uma luxação ereta exposta do ombro direito, devido a uma queda de 1 metro e meio de altura. O tratamento consistiu em limpeza cirúrgica de emergência, redução de gleno umeral e antibioticoterapia empírica, penicinila 400.000 UI / kg / dia dividida a cada 6 horas e gentamicina 3mg / Kg / dia dividida a cada 8 horas por 10 dias, imobilização por 3 semanas com tipóia seguida de reabilitação e seguimento de 2 anos no final dos quais o paciente não apresentava sequela funcional na articulação glenoumeral direita.


Subject(s)
Humans , Male , Child , Shoulder Dislocation/surgery , Shoulder Dislocation/rehabilitation , Shoulder Dislocation/diagnostic imaging , Fractures, Open/surgery , Fractures, Open/rehabilitation , Fractures, Open/diagnostic imaging , Penicillins/administration & dosage , Shoulder Dislocation/drug therapy , Restraint, Physical , Gentamicins/administration & dosage , Follow-Up Studies , Exercise Therapy , Closed Fracture Reduction , Anti-Bacterial Agents/administration & dosage
18.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(3): 290-298, set. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058699

ABSTRACT

RESUMEN Introducción: La gentamicina transtimpánica se utiliza en el manejo de pacientes con vértigo crónico refractario al manejo médico. Objetivo: Describir y analizar las características clínicas, epidemiológicas, y resultados de pacientes sometidos a tratamiento con gentamicina transtimpánica en el Hospital Clínico de la Universidad de Chile. Material y método: Estudio retrospectivo, descriptivo, incluyendo los pacientes con patología otorrinolaringológica que hayan recibido gentamicina transtimpánica entre los años 2008 y 2018. Se analizaron variables epidemiológicas, clínicas, y función vestibular. Resultados: La serie está constituida por diez pacientes, con una edad promedio de 52,4 años; siete mujeres y tres hombres. El diagnóstico fue en su mayoría enfermedad de Ménière (7 pacientes). El número promedio de inyecciones de gentamicina fue de 2,8. En el período de seguimiento (rango 1-96 meses), se logró mejoría del vértigo en la mayoría de los pacientes (8 de 10). Conclusión: El tratamiento con inyecciones de gentamicina transtimpánica es una opción importante para aliviar la sintomatología de pacientes con vértigo crónico intratable. Debe indicarse en casos seleccionados, y siempre realizar un estudio auditivo y vestibular completo antes y después del tratamiento con gentamicina.


ABSTRACT Introduction: Transtympanic gentamicin is used for treatment of patients with chronic vertigo refractory to medical management. Aim: To describe and analyze the clinical outcome of patients whom underwent treatment with transtympanic gentamicin at the Clinical Hospital Universidad de Chile. Material and method: Retrospective and descriptive study including patients with otolaryngologist disease whom underwent treatment with transtympanic gentamicin between 2008 and 2018. Epidemiological, clinical variables and vestibular function were analyzed. Results: The serie consists of ten patients, 7 men and 3 women, with an average age of 52,4 years. The most frequent diagnosis was Ménière disease (7 patients). The average number of gentamicin injections was 2,8. The follow up varies from 1 to 96 months, presenting improvement of vertigo in the majority of the cases (8 of 10 patients). Conclusion: The treatment with transtympanic injections of gentamicin is a relevant option to decrease symptoms in patients with chronic intractable vertigo. It should be indicated in selected patients. Prior and posterior the treatment, patients must be studied with a complete evaluation of the auditory and vestibular function.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Gentamicins/therapeutic use , Vertigo/drug therapy , Meniere Disease/drug therapy , Tympanic Membrane , Vestibular Function Tests , Gentamicins/administration & dosage , Retrospective Studies , Follow-Up Studies , Treatment Outcome
19.
Rev. chil. nutr ; 46(3): 303-307, jun. 2019. graf
Article in Spanish | LILACS | ID: biblio-1003708

ABSTRACT

RESUMEN El objetivo del estudio fue determinar el efecto nefroprotector del extracto de camu camu en un modelo de nefrotoxicidad inducida por la gentamicina. Estudio de tipo experimental formado por 50 ratas Sprague Dawley que se dividieron aleatoriamente en cinco grupos de estudio: Al grupo control se le administró la solución salina, al grupo gentamicina se le indujo la nefrotoxicidad y a los grupos experimentales 1, 2 y 3 se les protegió con el extracto alcohólico de camu camu a diferentes dosis. La actividad nefroprotectora se evaluó por la cuantificación de la creatinina sérica, el peso y análisis histopatológico de los riñones. Los resultados evidenciaron una disminución significativa del nivel de creatinina en los grupos protegidos con el extracto alcohólico de camu camu con respecto al grupo gentamicina (p<0,05). Los grupos que recibieron camu camu presentaron un aumento gradual del peso de los riñones en una relación directa a la dosis del extracto (p<0,05). El análisis histológico evidenció pérdida epitelial, infiltrado inflamatorio intenso y congestión vascular en el grupo gentamicina, mientras que los grupos que recibieron camu camu con el extracto disminuyeron la gravedad del daño. Se concluye que el extracto de camu camu presentó una actividad nefroprotectora significativa en un modelo de nefrotoxicidad inducida por gentamicina.


ABSTRACT The aim of the study was to determine the nephroprotective effect of camu camu extract on a gentamicin-induced nephrotoxicity model. The study design was experimental using 50 Sprague Dawley rats randomly allocated into 1 of 5 five groups: a control group that was administered a saline solution, a gentamicin group in which nephrotoxicity was induced and experimental groups 1, 2 and 3 that were provided different doses of Camu Camu alcoholic extract. Nephroprotective activity was evaluated via quantification of seric creatinine, histopathological analysis and weighing of the kidneys. Results showed a significant decrease in creatinine levels between the group administered camu camu alcoholic extract and the gentamicin group (p<0.05). Groups who received camu camu presented a gradual increase in kidneys weight which corresponded directly to the extract dose (p<0.05). The histopathological analysis showed epithelial loss, intense inflammatory infiltrate and vascular congestion in the gentamicin group, while the groups who received the extract had a lower level of damage. Camu Camu extract provided a significant nephroprotective activity on a gentamicin-induced nephrotoxicity model.


Subject(s)
Animals , Ascorbic Acid , Rats , Plant Extracts , Gentamicins , Nephrology , Epidemiology, Experimental
20.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 17(1): 16-24, abr. 2019. tab
Article in Spanish | LILACS, BDNPAR | ID: biblio-1007865

ABSTRACT

Las úlceras corneales de origen infeccioso son una emergencia oftalmológica que amenaza la visión y la integridad estructural del ojo, causando ceguera en 1,5 a 2 millones de casos al año por lo que requiere tratamiento inmediato. El objetivo fue determinar el patrón epidemiológico, factores de riesgo y efectividad del tratamiento en pacientes con úlcera corneal en la Fundación Visión en el periodo 2015-2017. Estudio de cohorte prospectivo donde se evaluó 53 pacientes con úlcera corneal de causa infecciosa que consultaron en la Fundación Visión en el periodo 2015-2017, y tuvieron un seguimiento mínimo de 4 meses. Se encontró un predominio del sexo masculino (69,8%), edad 45-65 años (49,1%), casados (54,7%), de condición socioeconómica baja (56,6%), agricultores (26,4%), con antecedente de traumatismo corneal (69,8%) o uso de lentes de contacto (17%). El agente etiológico fue bacteriano en el 49,1% y micótico en el 37,7%; para los de origen bacteriano el tratamiento más empleado fueron colirios fortificados de Cefazolina + Gentamicina y Natamicina/Fluconazol en caso de ser micótico. La evolución fue favorable en 90,9% y 80,0% de los bacterianos y micóticos, respectivamente. Los grupos de riesgo detectados fueron pacientes varones, agricultores, de condición socioeconómica baja, con antecedente de traumatismo corneal o uso de lentes de contacto. La efectividad del tratamiento utilizado fue mayor al 80%, siendo en su mayoría patógenos bacterianos(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Corneal Ulcer/drug therapy , Corneal Ulcer/epidemiology , Gentamicins/therapeutic use , Visual Acuity , Fluconazole/therapeutic use , Cefazolin/therapeutic use , Corneal Ulcer/microbiology , Natamycin/therapeutic use , Prospective Studies , Risk Factors , Treatment Outcome , Keratitis/complications , Anti-Bacterial Agents/therapeutic use , Antifungal Agents/therapeutic use
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