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1.
Washington; Organización Panamericana de la Salud; rev; Jan. 2022, 03. 158 p. tab.
Monography in English, Spanish | LILACS, BIGG | ID: biblio-1362814

ABSTRACT

En la actualidad, las guías basadas en la evidencia constituyen una de las herramientas más útiles para mejorar la salud pública y la práctica clínica. Su finalidad es formular intervenciones con sólidas pruebas de eficacia, evitar riesgos innecesarios, utilizar los recursos de forma eficiente, disminuir la variabilidad clínica y, en esencia, mejorar la salud y garantizar una atención de calidad, razón de ser de los sistemas y servicios de salud. Las presentes directrices se elaboraron siguiendo la metodología GRADE con el apoyo de un panel de expertos clínicos de distintos países, todos ellos convocados por la Organización Panamericana de la Salud. Por medio de la respuesta a doce preguntas clave sobre el diagnóstico clínico y el tratamiento del dengue, el chikunguña y el zika, se formulan recomendaciones basadas en evidencia para pacientes pediátricos, jóvenes, adultos, personas mayores y embarazadas expuestos a estas enfermedades o con sospecha o diagnóstico confirmado de infección. La finalidad de las directrices es evitar la progresión a las formas graves y a los eventos mortales que puedan causar. Las recomendaciones están dirigidas a profesionales de la salud, incluidos el personal médico general, residente y especialista; y los profesionales de enfermería, así como a estudiantes de medicina y enfermería, quienes de una u otra forma participan en la atención de pacientes con sospecha de dengue, chikunguña o zika. También se dirige a los administradores de las unidades de salud y a los equipos directivos de los programas nacionales de prevención y control de enfermedades arbovirales, quienes tienen la responsabilidad de facilitar el proceso de aplicación de estas directrices. Esperamos que esta publicación beneficie no solo al personal de salud, que dispondrá de información científica actualizada y de la mejor calidad posible, sino a los menores, los adultos, las embarazadas, las personas mayores y la población en general, quienes recibirán una mejor atención de salud prestada por personal médico debidamente capacitado.


Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduce clinical variability and, in essence, improve health and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.


Subject(s)
Humans , Male , Female , Pregnancy , Child , Adolescent , Adult , Middle Aged , Arbovirus Infections/diagnosis , Fluid Therapy/standards , Arbovirus Infections/drug therapy , Steroids/therapeutic use , Histamine Antagonists/therapeutic use
3.
Brasília; S.N; 23 jul. 2020.
Non-conventional in Portuguese | PIE, LILACS, BRISA, PIE | ID: biblio-1117682

ABSTRACT

O Informe Diário de Evidências é uma produção do Ministério da Saúde que tem como objetivo acompanhar diariamente as publicações científicas sobre tratamento farmacológico e vacinas para a COVID-19. Dessa forma, são realizadas buscas estruturadas em bases de dados biomédicas, referentes ao dia anterior desse informe. Não são incluídos estudos pré-clínicos (in vitro, in vivo, in silico). A frequência dos estudos é demonstrada de acordo com a sua classificação metodológica (revisões sistemáticas, ensaios clínicos randomizados, coortes, entre outros). Para cada estudo é apresentado um resumo com avaliação da qualidade metodológica. Essa avaliação tem por finalidade identificar o grau de certeza/confiança ou o risco de viés de cada estudo. Para tal, são utilizadas ferramentas já validadas e consagradas na literatura científica, na área de saúde baseada em evidências. Cabe ressaltar que o documento tem caráter informativo e não representa uma recomendação oficial do Ministério da Saúde sobre a temática. Foram encontrados 21 artigos e 8 protocolos.


Subject(s)
Pneumonia, Viral/drug therapy , Coronavirus Infections/drug therapy , Steroids/therapeutic use , Technology Assessment, Biomedical , BCG Vaccine/therapeutic use , Heparin/therapeutic use , Almitrine/therapeutic use , Cohort Studies , Adrenal Cortex Hormones/therapeutic use , Enoxaparin/therapeutic use , Azithromycin/therapeutic use , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Darunavir/therapeutic use , Betacoronavirus/drug effects , Ipilimumab/therapeutic use , Fondaparinux/therapeutic use , Nivolumab/therapeutic use , Histamine Antagonists/therapeutic use , Hydroxychloroquine/therapeutic use , Anticoagulants/therapeutic use
4.
Brasília; s.n; 8 maio 2020.
Non-conventional in Portuguese | PIE, LILACS, BRISA, PIE | ID: biblio-1097403

ABSTRACT

Essa é uma produção do Departamento de Ciência e Tecnologia (Decit) da Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde (SCTIE) do Ministério da Saúde (Decit/SCTIE/MS), que tem como missão promover a ciência e tecnologia e o uso de evidências científicas para a tomada de decisão do SUS, tendo como principal atribuição o incentivo ao desenvolvimento de pesquisas em saúde no Brasil, de modo a direcionar os investimentos realizados em pesquisa pelo Governo Federal às necessidades de saúde pública. Informar sobre as principais evidências científicas descritas na literatura internacional sobre tratamento farmacológico para a COVID-19. Além de resumir cada estudo identificado, o informe apresenta também uma avaliação da qualidade metodológica e a quantidade de artigos publicados, de acordo com a sua classificação metodológica (revisões sistemáticas, ensaios clínicos randomizados, entre outros). Foram encontrados 14 artigos e 13 protocolos.


Subject(s)
Humans , Pneumonia, Viral/drug therapy , Coronavirus Infections/drug therapy , Betacoronavirus/drug effects , Technology Assessment, Biomedical , Ivermectin/therapeutic use , Methylprednisolone/therapeutic use , Prednisolone/therapeutic use , Vaccines/therapeutic use , Chloroquine/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Drug Combinations , Oseltamivir/therapeutic use , Glucocorticoids/therapeutic use , Histamine Antagonists/therapeutic use , Hydroxychloroquine/therapeutic use , Metformin/therapeutic use
5.
Brasília; s.n; 19 maio 2020.
Non-conventional in Portuguese | PIE, LILACS, BRISA, PIE | ID: biblio-1097389

ABSTRACT

O Informe Diário de Evidências é uma produção do Ministério da Saúde que tem como objetivo acompanhar diariamente as publicações científicas sobre tratamento farmacológico e vacinas para a COVID-19. Dessa forma, são realizadas buscas estruturadas em bases de dados biomédicas, referente ao dia anterior desse informe. Não são incluídos estudos pré-clínicos (in vitro, in vivo, in silico). A frequência dos estudos é demonstrada de acordo com a sua classificação metodológica (revisões sistemáticas, ensaios clínicos randomizados, coortes, entre outros). Para cada estudo é apresentado um resumo com avaliação da qualidade metodológica. Essa avaliação tem por finalidade identificar o grau de certeza/confiança ou o risco de viés de cada estudo. Para tal, são utilizadas ferramentas já validadas e consagradas na literatura científica, na área de saúde baseada em evidências. Cabe ressaltar que o documento tem caráter informativo e não representa uma recomendação oficial do Ministério da Saúde sobre a temática. Foram encontrados 19 artigos e 17 protocolos.


Subject(s)
Humans , Pneumonia, Viral/drug therapy , Coronavirus Infections/drug therapy , Disease Progression , Betacoronavirus/drug effects , Steroids/therapeutic use , Methylprednisolone/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Ritonavir/therapeutic use , Leukotriene Antagonists/therapeutic use , Drug Combinations , Lopinavir/therapeutic use , Histamine Antagonists/therapeutic use , Hydroxychloroquine/therapeutic use , Anticoagulants/therapeutic use
6.
Einstein (Säo Paulo) ; 18: eAO5175, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133773

ABSTRACT

ABSTRACT Objective To evaluate the positivity of challenge tests of patients suspected of chronic inducible urticaria and the response to treatment. Methods A retrospective study of electronic medical records of patients suspected of chronic inducible urticaria. All patients were submitted to challenge tests with triggering stimuli, according to the clinical history and, subsequently, the response to drug treatment was evaluated. Results A total of 191 patients with suspected chronic inducible urticaria were included. It was confirmed in 118 patients and 122 positive tests (4 patients with 2 different positive tests). Most had dermographic urticaria (70.3%), followed by cholinergic urticaria (17.8%). Regarding treatment, 28% responded to antihistamine in licensed doses, 34.7% with increased doses, 9.3% responded to the addition of another medication. The concomitance of chronic inducible urticaria and chronic spontaneous urticaria was found in 35.3% of patients, being more frequent in females, with longer time to control symptoms and higher frequency of cholinergic urticaria. Conclusion The confirmation of chronic inducible urticaria in patients with this suspicion, after challenge tests, was high. There was a good response to antihistamine. In the concomitance of chronic spontaneous urticaria, longer time to control symptoms and higher frequency of cholinergic urticaria were observed.


RESUMO Objetivo Avaliar a positividade dos testes de provocação de pacientes com suspeita de urticária crônica induzida e sua resposta ao tratamento. Métodos Estudo retrospectivo de prontuários eletrônicos de pacientes com suspeita de urticária crônica induzida. Todos os pacientes foram submetidos aos testes de provocação com estímulos desencadeantes, conforme história clínica e, posteriormente, foi avaliada a resposta ao tratamento medicamentoso. Resultados Foram incluídos 191 pacientes com suspeita de urticária crônica induzida, a qual foi confirmada em 118 pacientes e 122 testes positivos (4 pacientes com 2 testes positivos diferentes). A maioria apresentava urticária dermográfica (70,3%), seguida de urticária colinérgica (17,8%). Em relação ao tratamento, 28% responderam ao anti-histamínico em doses licenciadas, 34,7% em doses aumentadas e 9,3% responderam à adição de outro medicamento. A concomitância de urticária crônica induzida com urticária crônica espontânea foi encontrada em 35,3% dos pacientes, sendo mais frequente no sexo feminino, com tempo mais prolongado para controle dos sintomas e maior frequência de urticária colinérgica. Conclusão A confirmação de urticária crônica induzida nos pacientes com suspeita da doença foi elevada. Houve boa resposta ao anti-histamínico. Na concomitância com urticária crônica espontânea, observou-se maior tempo para o controle dos sintomas e maior frequência de urticária colinérgica.


Subject(s)
Humans , Female , Chronic Urticaria/diagnosis , Chronic Urticaria/drug therapy , Histamine Antagonists/therapeutic use , Chronic Disease , Retrospective Studies
7.
Int. arch. otorhinolaryngol. (Impr.) ; 23(3): 325-330, July-Sept. 2019. tab
Article in English | LILACS | ID: biblio-1040031

ABSTRACT

Abstract Introduction Oral antihistamines and intranasal corticosteroids have been shown to be effective and safe for the treatment of allergic rhinitis; however, the evidence suggests a level of superiority of corticosteroids, so they should be preferred over the former. Objective To know the prescription profile of two second generation antihistamines (cetirizine and levocetirizine) and two nasal corticosteroids (mometasone and furoateciclesonide) in a cohort of patients with allergic rhinitis, and to compare the clinical outcomes obtained. Methods A cohort study was carried including patients with allergic rhinitis treated with cetirizine, levocetirizine, mometasone furoate or ciclesonide. The improvement was evaluated with the total nasal symptoms score (TNSS). This scale yields results between 0 and 12. Zero indicates absence of symptoms. Results A total of 314 patients completed 12 weeks of follow-up. Seventy-five percent were treated with antihistamines, 20% with corticosteroids, and 5% with a combination of the above. The TNSS median for corticosteroid was 2.5 points; for antihistamines, its was 5 points, and for combination, it was 4 points. We found differences between corticosteroids and antihistamines. Conclusion The prescription percentage of second generation oral antihistamines is higher than that of intranasal corticosteroids. However, patients with allergic rhinitis treated with the second option obtained better control of symptoms.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Adrenal Cortex Hormones/therapeutic use , Rhinitis, Allergic/drug therapy , Histamine Antagonists/therapeutic use , Drug Prescriptions , Administration, Intranasal , Cohort Studies , Treatment Outcome , Cetirizine/therapeutic use , Adrenal Cortex Hormones/administration & dosage , Colombia , Mometasone Furoate/therapeutic use
9.
Rev. Soc. Bras. Med. Trop ; 52: e20190055, 2019. graf
Article in English | LILACS | ID: biblio-1013312

ABSTRACT

Abstract Snakebites by aglyphous or opisthoglyphous snakes are common in Brazil. We report a case of snakebite by the opisthoglyphous Erythrolamprus aesculapii. The victim presented with pain, edema, and bleeding at the bite site, along with erythema, similar to a Bothrops envenomation. In this type of snakebite, if the snake is not brought to the hospital, the victim may receive unnecessary serum therapy, with the risk of adverse reactions to the antivenom. The possibility of reducing after-effects with anti-inflammatory drugs and early antibiotic therapy for secondary infection need to be further investigated, preferably in multicenter studies, while observing good clinical practice.


Subject(s)
Humans , Animals , Male , Young Adult , Snake Bites/complications , Snake Venoms/poisoning , Colubridae , Hand Injuries/etiology , Snake Bites/drug therapy , Brazil , Betamethasone/therapeutic use , Accidents, Occupational , Hand Injuries/drug therapy , Histamine Antagonists/therapeutic use
10.
Article in English | LILACS | ID: biblio-894169

ABSTRACT

Antivenoms or antitoxins have been effectively used for more than a century. During this time, these products have always proven to be highly effective in the treatment of infections and envenomations. However, antivenoms did not exhibit good safety results in their initial applications. After many improvements, antivenoms have substantially better safety profiles but still have some side effects. Due to the occurrence of adverse reactions, the practice of using premedication with the intent to decrease side effects has become accepted or mandatory in many countries. The drugs used for premedication belong to the histamine H1 antagonist, glucocorticoid and catecholamine groups. Currently, this practice is being questioned due to low or controversial efficacies in clinical assays. In this article, we discuss the causes of adverse reactions, the mechanisms of drugs that block the undesired effects and the results obtained in clinical trials. Although these three families of drugs could have positive effects on reducing adverse reactions, only adrenaline has demonstrated positive results in clinical assays.(AU)


Subject(s)
Humans , Animals , Premedication/trends , Snake Bites/therapy , Hydrocortisone/therapeutic use , Antivenins/adverse effects , Epinephrine/therapeutic use , Histamine Antagonists/therapeutic use , Antivenins/therapeutic use
11.
Rev. Hosp. Ital. B. Aires (2004) ; 37(4): 157-159, dic. 2017. ilus
Article in Spanish | LILACS | ID: biblio-1096381

ABSTRACT

El eritema polimorfo solar es la fotodermatosis más frecuente y suele aparecer en primavera con la primera exposición intensa al sol. Sus manifestaciones cutáneas son variadas y el diagnóstico se basa en la clínica junto al antecedente de exposición solar. En los casos leves, la fotoprotección suele ser suficiente para el control de la enfermedad, pero en formas más graves se requieren otras terapéuticas, como corticoides, antihistamínicos, o fototerapia, que genera una "fotoadaptación" de las áreas de piel afectadas. Presentamos un caso típico de erupción polimorfa solar que respondió de forma adecuada a medidas de fotoprotección. (AU)


The polymorphic solar eruption is the most frequent photodermatosis, and usually appears in spring with the first intense exposure to the sun. It has multiple cutaneous manifestations, and its diagnosis is based on the clinic and the antecedent of solar exposition. In mild cases, photoprotection is usually enough to control the disease, but in more severe forms, other therapies are required, such as corticosteroids, antihistamines, or phototherapy to generate a "photo-adaptation" of the affected skin areas. We present a typical case of polymorphic solar eruption that responded adequately to photoprotection measurements. (AU)


Subject(s)
Humans , Female , Adult , Photosensitivity Disorders/diagnosis , Sunlight/adverse effects , Erythema/diagnosis , Phototherapy , Photosensitivity Disorders/immunology , Photosensitivity Disorders/pathology , Quality of Life , Seasons , Sunscreening Agents/therapeutic use , Azathioprine/therapeutic use , Thalidomide/therapeutic use , Ultraviolet Rays/adverse effects , Ultraviolet Therapy , Adrenal Cortex Hormones/therapeutic use , Cholecalciferol/therapeutic use , Erythema/etiology , Erythema/immunology , Erythema/pathology , Histamine Antagonists/therapeutic use , Antimalarials/therapeutic use
12.
Rev. gaúch. enferm ; 38(1): e65111, 2017. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-845223

ABSTRACT

RESUMO Objetivo Determinar a prevalência e os fatores associados à automedicação entre estudantes de enfermagem. Método Estudo transversal realizado com 116 estudantes de enfermagem de uma universidade pública do Estado do Amazonas – Brasil, no período de março a abril de 2014. Utilizou-se questionário constituído por variáveis socioeconômicas e de consumo de medicamentos. Foi realizada a análise bivariada e a regressão logística – nível de significância de 5%. Resultados A prevalência de automedicação foi de 76,0%, motivada especialmente pela percepção de que o problema de saúde não requeria visita ao médico (46,6%). Metade dos estudantes relataram queixas álgicas. Os grupos farmacológicos mais consumidos foram anti-inflamatórios não esteroides (63,2%) e antibióticos (11,1%). O desconhecimento das implicações negativas da prática da automedicação foi associado à automedicação (OR=6,0). Conclusão A alta prevalência de automedicação, além de poder levar a reações adversas retrata também o uso irracional de medicamentos pelos estudantes, especialmente, quando considerado o papel destes futuros profissionais na segurança do paciente.


RESUMEN Objetivo Determinar la prevalencia y los factores asociados con la automedicación entre estudiantes de enfermería. Métodos Estudio transversal con 116 estudiantes de enfermería de una universidad pública en Amazonas - Brasil, en el período de marzo y abril del 2014. Se utilizó un cuestionario que consta de los niveles socioeconómicos y el consumo de drogas. Se realizó un análisis bivariante y regresión logística -nivel de significación del 5%. Resultados La prevalencia de la automedicación fue de un 76,0%, motivada especialmente por la constatación de que el problema de salud requiere no visitar al médico (46,6%). La mitad de los estudiantes reportaron quejas de dolor. Los grupos de fármacos más consumidos fueron los antiinflamatorios no esteroide (63,2%) y antibióticos (11,1%). Ignorar las implicaciones negativas de la práctica de la automedicación se asoció con la automedicación (OR = 6,0). Conclusión La alta prevalencia de la automedicación, pueden dar lugar a reacciones adversas, retrata el uso irracional de los medicamentos por los estudiantes, especialmente teniendo en cuenta el papel de estos futuros profesionales de la seguridad del paciente.


ABSTRACT Objective To determine the prevalence of self-medication and associated factors among nursing students. Method This is a cross-sectional study with 116 nursing students from the public university in the state of Amazonas, Brazil, from March to April 2014. Data were collected using a questionnaire with socioeconomic and medicine use variables. The data were subjected to bivariate analysis and logistic regression at a significance level of 5%. Results The prevalence of self-medication was 76.0%, chiefly motivated by the belief that the health condition did not require a medical appointment (46.6%). Half of the students reported pain-related complaints. The most commonly used pharmacological groups were non-steroidal anti-inflammatory drugs (63.2%) and antibiotics (11.1%). Lack of awareness of the negative implications of self-medication was associated with self-medication (OR = 6.0). Conclusion The high prevalence of self-medication that may lead to adverse reactions reveals the students’ irrational use of medicines, especially considering the role of these future professionals in patient safety.


Subject(s)
Humans , Male , Female , Self Medication/statistics & numerical data , Self Medication/adverse effects , Socioeconomic Factors , Students, Nursing/statistics & numerical data , Vitamins/therapeutic use , Biological Products/therapeutic use , Brazil , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Cross-Sectional Studies , Surveys and Questionnaires , Contraceptive Agents/therapeutic use , Drug Utilization , Nonprescription Drugs/therapeutic use , Histamine Antagonists/therapeutic use , Anti-Bacterial Agents/therapeutic use
13.
Rev. chil. dermatol ; 33(4): 97-100, 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-965664

ABSTRACT

La Telangiectasia Macular Eruptiva Perstans (TMEP), forma infrecuente de mastocitosis cutánea consiste en la proliferación anormal de mastocitos en dermis papilar sin participación de otros órganos. Afecta mayormente a adultos, con algunos informes en niños. Típicamente, las lesiones de TMEP son máculas eritematosas con finas telangiectasias, distribuidas principalmente en tronco y extremidades superiores con un patrón simétrico, puede presentar afectación sistémica o asociarse con neoplasias linfoproliferativas. Se presentan dos casos de TMEP en una mujer de 32 años cuyo inicio coincidió con su primera gestación y el de una mujer de 55 años, ambas sin síntomas sistémicos, se discute la presentación clínica, histopatología y tratamiento.


Macular telangiectasia eruptiva perstans (TMEP), an uncommon form of cutaneous mastocytosis, consists in the abnormal proliferation of mast cells in the papillary dermis without the participation of other organs. It affects almost exclusively adults, with some reports in children. Typically, TMEP lesions are erythematous macules with fine telangiectasias, distributed mainly in the trunk and upper limbs with a symmetrical pattern, may present systemic involvement or be associated with lymphoproliferative neoplasms. We present two cases of TMEP in a 32-year-old woman whose onset coincided with her first pregnancy and that of a 55-yearold woman, both without systemic symptoms, whose clinical presentation, histopathology and treatment are discussed.


Subject(s)
Humans , Female , Adult , Middle Aged , Telangiectasis/diagnosis , Telangiectasis/pathology , Mastocytosis/pathology , Mastocytosis, Cutaneous/diagnosis , Telangiectasis/drug therapy , Mastocytosis, Cutaneous/drug therapy , Histamine Antagonists/therapeutic use
14.
Rev. chil. dermatol ; 33(3): 97-99, 2017. ilus
Article in Spanish | LILACS | ID: biblio-965165

ABSTRACT

El eritema flagelado es una erupción cutánea poco frecuente con múltiples causas, dentro de las cuales se encuentra la ingesta de hongos shiitake crudos o semicrudos. Se postula que es secundario a una reacción de hipersensibilidad Th-1 producida por el lentinan, un polisacárido termolábil de la pared celular del hongo. En años recientes ha aumentado su incidencia en el mundo occidental debido a la creciente popularidad de la comida asiática, en la que los hongos shiitake son un ingrediente muy utilizado. El cuadro clínico se caracteriza por la aparición de lesiones eritematosas lineales pruriginosas principalmente en tronco y extremidades, de curso autolimitado. El diagnóstico es principalmente clínico, basado en el antecedente de ingesta reciente de hongos shiitake y el rash característico y el tratamiento es sintomático con antihistamínicos y corticoides tópicos u orales. A continuación, presentamos un caso de eritema flagelado en una mujer joven, secundario a ingesta de hongos shiitake, que se resolvió completamente en 2 semanas.


Flagellate erythema is a rare skin eruption with many causes, including the ingestion of raw or undercooked shiitake mushrooms. It is thought to be a Th-1 hypersensitivity reaction produced by lentinan, a thermolabile polysaccharide found in the cell wall of the mushroom. In recent years, there has been an increase in the number of cases due to the growing popularity of Asian cuisine, in which shiitake mushrooms are a central ingredient. The clinical presentation is characterized by the appearance of linear, erythematous, pruritic lesions mostly on the trunk and extremities, of self-limited course. Diagnosis is mainly clinical, based on the history of recent shiitake mushroom ingestion and the characteristic rash, and treatment is symptomatic, with antihistamines and topical or systemic steroids. In this report, we present a case of flagellate erythema in a young woman, that appeared after the ingestion of shiitake mushrooms, and resolved completely after 2 weeks.


Subject(s)
Humans , Female , Adult , Mushroom Poisoning/diagnosis , Mushroom Poisoning/etiology , Shiitake Mushrooms , Erythema/diagnosis , Erythema/etiology , Mushroom Poisoning/drug therapy , Erythema/drug therapy , Histamine Antagonists/therapeutic use
15.
Evid. actual. práct. ambul ; 20(3): 82-83, 2017.
Article in Spanish | LILACS | ID: biblio-1100501

ABSTRACT

La inmunoterapia alérgeno específica (ITA) consiste en la administración de cantidades crecientes del alérgeno al cual el paciente es sensible con el propósito de modular la respuesta inmune a ese alérgeno, y se propone como una opción terapéutica en pacientes con rinitis alérgica. A partir de una viñeta clinica de un paciente con esta patología, el médico de familia que lo asiste se pregunta si la ITA podría disminuir la intensidad y duración de los síntomas y su eficacia perdurar a largo plazo. Después de realizar una búsqueda bibliografica, resumir y evaluar la bibliografía encontrada, se concluye que dicha terapia podría reducir la severidad de los síntomas, la frecuencia de uso de medicación de rescate, y sostener su eficacia clínica luego de la interrupción del tratamiento. Sin embargo, sus riesgos, sus costos, los inconvenientes en el regimen de aplicación y la dificultad para determinar cuando finalizar la inmunoterapia; sumados a la heterogeneidad de estudios incluidos en las revisiones sistemáticas que evalúan su eficacia, hacen imprescindible que el paciente y su médico discutan en forma conjunta las ventajas y desventajas de su utilización. (AU)


Allergen- specific immunotherapy involves the administration of increasing amounts of the allergen to which the patient is sensi-tive for the purpose of modulating the immune response to that allergen, and it is proposed as an optional treatment in patients with allergic rhinitis. From a clinical vignette with a patient with this condition, a family physician wonders if the specific allergen immunotherapy may diminish the intensity and duration of symptoms and whether its efficacy will be long lasting. After search-ing, summarizing and evaluating the retrieved literature it is concluded that such therapy could reduce the severity of symptoms and the utilized rescue medication. It also maintained its clinical efficacy after discontinuation of treatment. However, risks, costs, disadvantages of its implementation and the difficulty in determining when to finish immunotherapy; coupled with the heterogene-ity of studies included in the systematic reviews assessing its effectiveness makes it essential that the patient and doctor discuss jointly its use. (AU)


Subject(s)
Humans , Male , Female , Adult , Young Adult , Asthma/drug therapy , Desensitization, Immunologic/adverse effects , Rhinitis, Allergic/drug therapy , Quality of Life , Signs and Symptoms , Desensitization, Immunologic/instrumentation , Evidence-Based Medicine , Treatment Adherence and Compliance , Histamine Antagonists/administration & dosage , Histamine Antagonists/therapeutic use
16.
Rev. cuba. enferm ; 32(1): 76-86, ene.-mar. 2016. tab
Article in Spanish | LILACS, BDENF | ID: lil-797715

ABSTRACT

Introducción: el empleo de las aguas con fines curativos, se remonta a épocas tempranas en la evolución del hombre. Objetivo: determinar el efecto terapéutico de aguas mineromedicinales en el tratamiento de gingivoestomatitis herpética aguda. Métodos: estudio analítico cuasiexperimental, en el Policlínico Gilberto Marquetty, Candelaria, Artemisa, en el periodo de octubre de 2011 a octubre de 2012, con un universo de 110 niños de 1 a 14 años diagnosticados con gingivoestomatítis herpética aguda. Por muestreo aleatorio simple se dividieron en dos grupos, Grupo 1 (Control) 55 pacientes, se aplicó tratamiento convencional con antihistamínico y analgésicos, prescripto por el facultativo. Grupo 2 (Estudio): 55 pacientes, se aplicó tratamiento con aguas mineromedicinales. Las variables estudiadas fueron edad, sexo, zona de residencia, síntomas colaterales, zonas anatómicas afectadas y evolución. Se consideró favorable cuando curó o mejoró y desfavorable cuando siguió igual o empeoró. La información se obtuvo por examen físico evolutivo al tercer, quinto y décimo día de tratamiento, evaluando sintomatología y cuadro clínico. Para el análisis de la información se utilizó distribución de frecuencias absolutas y porcentaje. Resultados: evolución satisfactoria, en menos días de tratamiento y con ausencia de reacciones adversas en los pacientes tratados con aguas mineromedicinales; el 50,90 por ciento de niños al tercer día de tratamiento estaban curados y el 96,36 por ciento, al décimo día. Conclusiones: las aguas mineromedicinales del manantial El Templado de San Diego de los Baños tiene efectos terapéuticos favorables en el tratamiento de las gingivoestomatitis herpética aguda en niños; se logró una evolución clínica favorable en menor tiempo que en el tratamiento convencional(AU)


Introduction: The use of needles with therapeutic aims dates back to early ages in humankind evolution. Objective: To determine the therapeutic effect of medicinal mineral needles in the treatment of acute herpetic gingivostomatitis. Methods: Quasi-experimental analytical study, in Gilberto Marquetty Polyclinic of Candelaria, Artemisa Province, from October 2011 to October 2012, with a target group of 110 children at ages 1-14 years diagnosed with acute herpetic gingivostomatitis. By random sampling, they were divided into two groups: 1 (control group, 55 patients), to which conventional treatment with antihistaminic and analgesics, prescribed by the doctor; 2 (study group, 55 patients), to which treatment was applied with medicinal mineral needles. The variables studied were age, sex, dwelling area, side symptoms, affected anatomical areas and natural history. It was considered favorable when healed or ameliorated; and unfavorable when remained the same or worsened. The information was obtained by followed-up physical examination after three, four and five days of treatment, evaluating symptoms and clinical frame. For information analysis, distribution of absolute frequencies and percentages were used. Results: Satisfactory natural history, in less than ten days of treatment and without side effects in patients treated with medicinal mineral needles. 50.90 percent of children were healed after three days of treatment and 96.36 percent after ten days. Conclusions: medicinal mineral needles from El Templado springs of San Diego de los Baños have favorable therapeutic effects in the treatment of acute herpetic gingivostomatitis in less time than the conventional treatments(AU)


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Stomatitis, Herpetic/diagnosis , Therapeutics/adverse effects , Balneology/methods , Analgesics/therapeutic use , Stomatitis, Herpetic/therapy , Histamine Antagonists/therapeutic use
17.
Gut and Liver ; : 152-155, 2016.
Article in English | WPRIM | ID: wpr-111604

ABSTRACT

Noncardiac chest pain (NCCP) is one of the most common esophageal symptoms and lacks a clearly defined mechanism. The most common cause of NCCP is gastroesophageal reflux disease (GERD). One of the accepted mechanisms of NCCP in a patient without GERD has been altered visceral sensitivity. Mast cells may play a role in visceral hypersensitivity in irritable bowel syndrome. In this case, a patient with NCCP and dysphagia who was unresponsive to proton pump inhibitor treatment had an increased esophageal mast cell infiltration and responded to 14 days of antihistamine and antileukotriene treatment. We suggest that there may be a relationship between esophageal symptoms such as NCCP and esophageal mast cell infiltration.


Subject(s)
Adult , Chest Pain/etiology , Esophageal Diseases/complications , Esophagus/cytology , Female , Histamine Antagonists/therapeutic use , Humans , Leukotriene Antagonists/therapeutic use , Mast Cells/metabolism , Mastocytosis/complications
18.
An. bras. dermatol ; 90(1): 74-89, Jan-Feb/2015. tab, graf
Article in English | LILACS | ID: lil-735743

ABSTRACT

Chronic urticaria has been explored in several investigative aspects in the new millennium, either as to its pathogenesis, its stand as an autoimmune or auto-reactive disease, the correlation with HLA-linked genetic factors, especially with class II or its interrelation with the coagulation and fibrinolysis systems. New second-generation antihistamines, which act as good symptomatic drugs, emerged and were commercialized over the last decade. Old and new drugs that may interfere with the pathophysiology of the disease, such as cyclosporine and omalizumab have been developed and used as treatments. The purpose of this article is to describe the current state of knowledge on aspects of chronic urticaria such as, pathophysiology, diagnosis and the current therapeutic approach proposed in the literature.


Subject(s)
Adult , Female , Humans , Male , Urticaria/drug therapy , Urticaria/pathology , Adrenal Cortex Hormones/therapeutic use , Anti-Allergic Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Chronic Disease , Histamine Antagonists/therapeutic use , Skin Tests , Urticaria/classification , Urticaria/etiology
19.
Article in Portuguese | LILACS | ID: lil-724263

ABSTRACT

A gastrenterite eosinofílica é uma doença rara com apresentação heterogênea caracterizada pela presença de intenso infiltrado de eosinófilos em um ou em múltiplos segmentos do trato gastrin- testinal. Foi realizada revisão da literatura com ênfase em diag- nóstico, diagnóstico diferencial e tratamento, com o objetivo de divulgá-la entre a comunidade médica e viabilizar diagnóstico e tratamento precoces dessa entidade clínica, a fim de evitar complicações.(AU)


Eosinophilic gastroenteritis is a rare disease with heterogeneous presentation characterized by intense eosinophilic infiltration in one or multiple segments of the gastrointestinal tract. This review of the literature emphasized diagnosis, differential diagnosis and treatment in order to disseminate this clinical entity among the medical community and facilitate early diagnosis and treatment in order to avoid complications.(AU)


Subject(s)
Humans , Eosinophilia/pathology , Gastroenteritis/diagnosis , Adrenal Cortex Hormones/therapeutic use , Leukotriene Antagonists/therapeutic use , Diagnosis, Differential , Eosinophilia/drug therapy , Gastroenteritis/drug therapy , Histamine Antagonists/therapeutic use , Muscle, Smooth/pathology
20.
Medicina (B.Aires) ; 74(supl.1): 1-53, ago. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-734416

ABSTRACT

Se actualiza el diagnóstico de la urticaria crónica (UC) y los conceptos, definiciones y sugerencias basados en la evidencia para su tratamiento. La urticaria ocurre en al menos 20% de la población en algún momento de la vida. Su etiología difiere en la forma aguda (menos de 6 semanas), y en la crónica. No es posible pronosticar si las formas agudas evolucionarán a UC, ya que todas son agudas al comienzo. La UC ocurre como espontánea (UCE) o inducible (UCI). El diagnóstico es sencillo, pero incluye un minucioso estudio para descartar diagnósticos diferenciales; para UCI son útiles las pruebas de provocación en la caracterización y manejo. Los estudios complementarios se deben limitar y orientar según sospecha clínica. El tratamiento se divide en tres enfoques: evitación, eliminación o tratamiento del estímulo desencadenante o de la causa, y tratamiento farmacológico. Recientemente éste se modificó, con empleo de antihistamínicos de segunda generación como primera línea y aumento de dosis de antihistamínicos H1 no sedantes, hasta 4 veces, como segunda línea. Los antihistamínicos son fundamentales para tratar la UC; sin embargo, un 40% de los pacientes no logra un buen control pese al aumento de dosis y requiere otro medicamento adicional. La evidencia más reciente considera que un grupo de fármacos puede utilizarse como tercera línea en estos casos, para mejorar la calidad de vida y limitar la toxicidad por el uso frecuente o crónico de esteroides sistémicos. Se recomiendan para esta tercera línea solo 3 fármacos: omalizumab, ciclosporina A o antileucotrienos.


This interdisciplinary paper summarizes the news in the diagnosis and treatment of chronic urticaria (CU), and provides concepts, definitions and evidence-based suggestions for its management. Urticaria occurs in at least 20% of the population at some point in their lives. Acute urticaria (less than 6 weeks' duration), differs from CU in its etiology, but the onset of this disease is always acute. CU may occur as spontaneous (SCU) or induced (ICU). The diagnosis is simple, although a careful evaluation is necessary for differential diagnosis. ICU´s diagnosis is mainly clinical, even if provocation tests can be useful. Supplementary studies should be limited and based on the clinical suspicion. Treatment may be divided into three approaches: avoidance, elimination or treatment of the cause, and pharmacological treatment. Recently treatment has been modified with the use of second-generation antihistamines as first-line and increased doses of nonsedating H1 antihistamines, up to 4 times, as second line. Antihistamines are essential to treat CU; however, 40% of patients do not achieve good control despite increased doses and require additional treatment. The most recent evidence indicates a group of drugs to be used as third line in these cases, to improve quality of life and to limit toxicity from frequent or chronic use of systemic steroids. Only 3 drugs are recommended as third line: omalizumab, cyclosporin A or anti-leukotrienes.


Subject(s)
Humans , Anti-Allergic Agents/therapeutic use , Histamine Antagonists/therapeutic use , Urticaria/diagnosis , Urticaria/drug therapy , Urticaria/etiology , Algorithms , Argentina , Angioedema/drug therapy , Angioedema/pathology , Antibodies, Anti-Idiotypic/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Autoimmune Diseases/complications , Chronic Disease , Clinical Trials as Topic , Cyclosporine/therapeutic use , Diagnosis, Differential , Evidence-Based Medicine/economics , Immunoglobulin E/metabolism , Leukotriene Antagonists/therapeutic use , Omalizumab , Quality of Life , Urticaria/classification , Urticaria/complications , Urticaria/physiopathology
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