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1.
In. Pradines Terra, Laura; García Parodi, Lucía; Bruno, Lorena; Filomeno Andriolo, Paola Antonella. La Unidad de Pie Diabético del Hospital Pasteur: modelo de atención y pautas de actuación: importancia del abordaje interdisciplinario. Montevideo, Cuadrado, 2023. p.227-249, ilus, tab.
Monography in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1418718
2.
Arq. ciências saúde UNIPAR ; 27(3): 1164-1172, 2023.
Article in Portuguese | LILACS | ID: biblio-1425449

ABSTRACT

O Lúpus Eritematoso Sistêmico (LES) é uma patologia crônica, de origem autoimune e inflamatória. As diversas manifestações clínicas existentes em pacientes acometidos pelo LES, sejam elas sistêmicas ou órgãos-alvo, possibilitam variados diagnósticos diferenciais. Dentre as manifestações clínicas que possibilitam estes diagnósticos está o acometimento cutâneo, com vasta variabilidade de apresentação. Da mesma forma, a sífilis também possui apresentação cutânea, tornando possível o diferencial de diagnóstico com outras patologias, inclusive o próprio LES. O presente estudo tem como objetivo relatar um caso de sífilis mimetizando lúpus eritematoso sistêmico, descrever o quadro clínico apresentado pelo paciente, bem como as ferramentas utilizadas para diagnóstico, e a posterior abordagem terapêutica. O caso relatado refere-se a um paciente de 29 anos, do sexo masculino, procedente de Campos Novos (SC), que apresentou um quadro clínico e laboratorial de lúpus-like induzido por uma infecção aguda de sífilis. A resolução completa de critérios inflamatórios de LES ocorreu após tratamento correto da doença infecciosa, com total melhora clínica e sorológica.


Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease. The various clinical manifestations in SLE patients, both systemic and in target organs, allow for various differential diagnoses. Among the clinical manifestations that aid in diagnosis are the cutaneous injuries, which have a wide range of presentations. Syphilis also has cutaneous manifestations, which aid in the differential diagnosis from other pathologies, including SLE. The present study aims to report a case of syphilis mimicking SLE, describe the clinical condition presented by the patient, the tools used for diagnosis, and the therapeutic approach. The case reported refers to a 29- year-old male patient from Campos Novos (SC), who showed a clinical and laboratory lupus-like condition induced by an acute syphilis infection. The full resolution of SLE inflammatory criteria occurred following appropriate treatment for the infectious disease, with complete clinical and serological improvement.


El lupus eritematoso sistémico (LES) es una enfermedad inflamatoria autoinmune crónica. Las diversas manifestaciones clínicas de los pacientes con LES, tanto sistémicas como en órganos diana, permiten realizar varios diagnósticos diferenciales. Entre las manifestaciones clínicas que ayudan al diagnóstico se encuentran las lesiones cutáneas, que tienen una amplia gama de presentaciones. La sífilis también tiene manifestaciones cutáneas, que ayudan al diagnóstico diferencial con otras patologías, incluido el LES. El presente estudio tiene como objetivo comunicar un caso de sífilis que simula un LES, describir el cuadro clínico presentado por la paciente, las herramientas utilizadas para el diagnóstico y el abordaje terapéutico. El caso relatado se refiere a un paciente masculino de 29 años, natural de Campos Novos (SC), que presentó un cuadro clínico y de laboratorio semejante al lupus, inducido por una infección aguda por sífilis. La resolución completa de los criterios inflamatorios del LES ocurrió tras el tratamiento adecuado de la enfermedad infecciosa, con mejoría clínica y serológica completa.


Subject(s)
Humans , Male , Adult , Syphilis/diagnosis , Syphilis/pathology , Syphilis/therapy , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/pathology , Lupus Erythematosus, Systemic/therapy , Skin Manifestations , Adaptation, Biological , Communicable Diseases/pathology , Communicable Diseases/therapy , Clinical Laboratory Techniques/methods , Case Reports as Topic , Infections/diagnosis
3.
Article in English | LILACS | ID: biblio-1410496

ABSTRACT

Background: many doubts about the infection of SARS-CoV-2 were raised, such as sexual transmission, sterility, and changes in fertility procedures; however, information is not clearly stated and organized. Purpose: to review and summarize scientific evidence on detection of SARS-CoV-2 in semen samples of Covid-19 patients. Methods:literature search in PubMed, Web of Science, Scopus, Medline and Embase databases, and followed Scoping Review protocol defined by Joanna Briggs Institute (JBI) after the guiding question "Is it possible to detect SARS-CoV-2 in the semen of adult patients with a confirmed diagnosis of Covid-19?" Results: 287 studies were identified, and, after discerning analysis, 9 studies published in the English language were selected. Three researchers analyzed the studies for SARS-CoV-2 presence in the seminal fluid, patients' severity, days since the onset of disease, diagnosis confirmation, semen collection method, viral analysis method, and sample numbers. Conclusions: it was not possible to find strong evidence to confirm the presence or absence of Covid-19 in the semen of adult patients. New studies on the subject should be better designed, taking into account the possible anatomical and functional conditions and changes of the male reproductive system during and after the infection by SARS-CoV-2 (AU)


Objetivo: Revisar e resumir as evidências científicas em pesquisas realizadas para detectar a presença de SARS-CoV-2 em amostras de sêmen de pacientes com COVID-19. Métodos: A pesquisa de literatura foi conduzida nas bases de dados PubMed, Web of Science, Scopus, Medline e Embase. Seguiu o protocolo de revisão de escopo definido por Joanna Briggs Institute (JBI) e baseou-se na pergunta norteadora "É possível detectar SARS-CoV-2 no sêmen de pacientes adultos com diagnóstico confirmado de Covid-19?". Resultados: 287 estudos foram identificados, 9 estudos publicados em língua inglesa foram selecionados após análise minuciosa. Três pesquisadores analisaram os estudos em busca de presença de SARS-CoV-2 no fluído seminal, gravidade do paciente, dias desde o início da doença, confirmação diagnóstica, método de coleta de sêmen, método de análise viral e número de amostras. Conclusões: Não foi possível identificar fortes evidências para confirmar a presença ou ausência de COVID-19 no sêmen de pacientes adultos. Novos estudos sobre o tema devem ser melhor projetados, levando-se em conta as possíveis condições anatômicas e funcionais e mudanças no sistema reprodutor masculino durante e após a infecção por SARS-CoV-2 (AU)


Subject(s)
Humans , Semen , SARS-CoV-2 , Infections/diagnosis
4.
Acta bioquím. clín. latinoam ; 55(3): 347-355, jul. 2021. graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1374056

ABSTRACT

Resumen Las infecciones de las vías respiratorias inferiores se encuentran entre aquellas en las que el uso inadecuado de antimicrobianos es frecuente, por lo que es fundamental contar con una prueba diagnóstica rápida, sensible y específica. El sistema de FilmArray es un análisis de PCR múltiple con un panel de neumonía que incluye 26 microorganismos y 7 marcadores de resistencia antimicrobiana. Los objetivos de este estudio fueron: a) establecer la correlación entre los cultivos cuantitativos para agentes bacterianos de muestras de vías respiratorias inferiores (MRVB) y la detección fenotípica de mecanismos de resistencia con los correspondientes resultados de FilmArray; b) determinar el cambio terapéutico generado con el informe del resultado inmediato. Se incluyó un total de 194 MRVB correspondientes a 191 pacientes con neumonía y se documentaron 277 bacterias. FilmArray identificó 253/277 (91%) bacterias y 161/277 (58%) se aislaron del cultivo, 58 (23%) coincidieron con el mismo recuento, 116 (46,7%) dieron mayores recuentos con FilmArray y 72 (28,9%) fueron detectadas por este método pero el cultivo fue negativo. Se detectaron marcadores de resistencia antimicrobiana en 63 aislados, pero solo 28 fueron confirmados por métodos fenotípicos. Estos resultados podrían haber provocado cambios en el tratamiento antibiótico en el 74,6% (174/194). FilmArray es una herramienta útil para optimizar el tratamiento antimicrobiano en pacientes con neumonía.


Abstract Lower respiratory tract infections are among those in which the inappropriate use of antimicrobials is common, so it is essential to have a rapid, sensitive and specific diagnostic test. The FilmArray system is a multiplex PCR assay with a pneumonia panel that includes 26 microorganisms and 7 antibiotic resistance markers. The objectives of this study were: a) to establish the correlation between quantitative cultures for bacterial agents from lower respiratory tract samples (MRVB) and the phenotypic detection of resistance mechanisms with the corresponding results of FilmArray b) to determine the therapeutic change generated with the immediate result report. A total of 194 MRVB corresponding to 191 patients with pneumonia were included and 277 bacterial strains were documented. FilmArray identified 253/277 (91%) bacteria and 161/277 (58%) were isolated from culture, 58 (23%) matched the same count, 116 (46.7%) yielded higher counts with FilmArray, and 72 (28.9%) with negative culture were detected by this method. Antibiotic resistance markers were detected in 63 strains, but only 28 were confirmed by phenotypic methods. These results may cause changes in the antimicrobial treatment in 74.6% (174/194). FilmArray is a useful tool to optimize antimicrobial therapy in patients with pneumonia.


Resumo As infecções do trato respiratório inferior estão entre aquelas em que o uso inadequado de antimicrobianos é comum, por isso é essencial um teste diagnóstico rápido, sensível e específico. O sistema FilmArray é um ensaio de PCR multiplo com um painel de pneumonia que inclui 26 microrganismos e 7 marcadores de resistência antimicrobiana. Os objetivos deste estudo foram: a) estabelecer a correlação entre as culturas quantitativas de agentes bacterianos de amostras do trato respiratório inferior (MRVB) e a detecção fenotípica de mecanismos de resistência com os resultados correspondentes do FilmArray b) determinar a alteração terapêutica gerada com o relatório de resultado imediato. Um total de 194 MRVB correspondendo a 191 pacientes com pneumonia foram incluídos e 277 cepas bacterianas foram documentadas. FilmArray identificou 253/277 (91%) bactérias e 161/277 (58%) foram isoladas da cultura, 58 (23%) coincidiram com mesma contagem, 116 (46,7%) deram contagens mais altas com FilmArray e 72 (28,9%) foram detectados por este método, mas a cultura foi negativa. Marcadores de resistência antimicrobiana foram detectados em 63 cepas, mas apenas 28 foram confirmados por métodos fenotípicos. Esses resultados puderam causar alterações no tratamento antibiótico em 74,6% (174/194). FilmArray é uma ferramenta útil para otimizar a terapia antimicrobiana em pacientes com pneumonia..


Subject(s)
Pneumonia/diagnosis , Infections/diagnosis , Anti-Infective Agents/administration & dosage , Airway Resistance
5.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 58: e183270, 2021. mapas, graf, ilus, tab
Article in English | LILACS, VETINDEX | ID: biblio-1344760

ABSTRACT

Livestock rabies is endemic in Peru. Hence, its persistence and annual dissemination represent an important economic impact, especially for impoverished farming communities. The disease is mostly transmitted by the hematophagous bat Desmodus rotundus. The present study aimed to adapt an existing predictive model of the occurrence of livestock rabies to Peru, in which the risk of rabies transmission from bats to livestock was estimated using decision-tree models of receptivity and vulnerability. Official rabies surveillance data between 2010 and 2015 were used along with possible risk factors, such as livestock biomass, environmental changes, and geomorphological characteristics. Several scenarios were established to evaluate the prediction of the occurrence of livestock rabies cases by determining more than one cut-off point of the receptivity variables. During the study period, the precision of the model was estimated through the sensitivity (39.46%) and specificity (98.64%) by using confusion matrices. Targeting control efforts, especially in districts with a high estimated risk, could represent the prevention of a significant proportion of livestock rabies cases, which would optimize the human and economic resources of the Peruvian surveillance service. However, the quality of data produced by the surveillance should be improved not only to obtain higher model precision but also to allow the adequate planning of control actions.(AU)


Raiva de herbívoros é endêmica no Peru. Consequentemente, sua disseminação persistente e anual representa um importante impacto econômico, especialmente às comunidades rurais empobrecidas. A doença é principalmente transmitida pelo morcego hematófago Desmodus rotundus. Este estudo tem por objetivo adaptar um modelo preditivo pré-existente às ocorrências de raiva de herbívoros no Peru, no qual o risco de transmissão de morcegos para os herbívoros foi estimado por meio de árvores de cenários de receptividade e vulnerabilidade. Foram usados os dados oficiais de vigilância da raiva entre 2010 e 2015, assim como os possíveis fatores de risco, tais quais a biomassa de animais, alterações ambientais e características geomorfológicas. Diversos cenários foram criados para avaliar a predição da ocorrência da raiva por meio da determinação de diversos pontos de corte das variáveis de receptividade. Durante o período de estudo, a precisão do modelo foi estimada por meio da sensibilidade (39,46%) e especificidade (98,64%), utilizando matrizes de confusão. Focando em esforços de controle, especialmente em distritos com elevado risco estimado, seria possível prevenir uma proporção significativa dos focos, o que poderia otimizar os recursos humanos e econômicos do serviço oficial peruano. Entretanto, a qualidade dos dados produzidos pelo sistema de vigilância deveria ser melhorada não somente para obter maior precisão do modelo, mas também para possibilitar o melhor planejamento das ações de controle desta doença.(AU)


Subject(s)
Animals , Rabies virus , Proportional Hazards Models , Chiroptera/virology , Infections/diagnosis
7.
Rev. chil. pediatr ; 91(4): 597-604, ago. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1138677

ABSTRACT

Resumen: Cada vez es más frecuente la atención médica en la Unidad de Cuidados Intensivos (UCI) de niños o adolescentes inmigrantes como también de aquellos nacidos en nuestro país con padres en tal condición. Esto ha ocasionado, en la actualidad, que el equipo de salud se deba enfrentar con problemas diagnósticos derivados del escaso conocimiento de condiciones genéticas propias de esta población y/o el desarrollo de diversas patologías infrecuentes en nuestro país, algunas resultantes de su condi ción sanitaria. En esta revisión se abordan diversos aspectos de la patología hematológica, infecciosa, parasitaria, respiratoria y cardiovascular, todos tópicos relevantes de conocer durante su estadía en la UCI. Es un deber del equipo de salud actualizarse sobre patologías de baja prevalencia en nuestro país, algunas de ellas muy poco conocidas hasta hace una década, pero que, actualmente, están cada vez más presentes en las UCI del sistema de salud público chileno.


Abstract: It is increasingly common to provide medical care in the Intensive Care Unit (ICU) for immigrant children and adolescents as well as those born in Chile with parents in such condition. Currently, this has caused that the health team has to face diverse infrequent pathologies in our country and/ or diagnostic problems derive from the poor knowledge of genetic conditions of this population, some resulting from their health conditions. This review addresses several aspects of hematological, infectious, parasitic, respiratory, and cardiovascular pathologies, all relevant topics to know during their stay in the ICU. It is a duty of the health team to be updated on pathologies of low prevalence in our country, some of them very little known until a decade ago, but which are currently increasingly present in the ICUs of the Chilean public health system.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Respiratory Tract Diseases/diagnosis , Respiratory Tract Diseases/ethnology , Respiratory Tract Diseases/therapy , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/ethnology , Cardiovascular Diseases/therapy , Critical Care/methods , Emigrants and Immigrants , Hematologic Diseases/diagnosis , Hematologic Diseases/ethnology , Hematologic Diseases/therapy , Infections/diagnosis , Infections/ethnology , Infections/therapy , Intensive Care Units , Chile/epidemiology , Prevalence
8.
Rev. medica electron ; 42(4): 2130-2139, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1139303

ABSTRACT

RESUMEN La pielonefritis enfisematosa se considerada una entidad clínica inusual. Constituye una infección necrotizante aguda, con formación de gas en el parénquima renal, sistema colector y/o espacio perirrenal. La población diabética es más propensa a este tipo de pielonefritis, pero se han descrito casos de pielonefritis enfisematosa recurrente en pacientes con obstrucción de la vía urinaria en ausencia de diabetes mellitus. Del 69 al 97 % de los casos, el germen implicado en la génesis de la enfermedad es la Escherichia coli, seguido por la klebsiella pneumoniae; responsable de una enfermedad con alto impacto en la morbimortalidad de los pacientes diabéticos. El conocer esta entidad clínica, permite realizar un diagnóstico precoz con el fin de establecer el tratamiento más adecuado que contribuya a una mejor sobrevida en el paciente. Los estudios tomográficos orientan en el diagnóstico, facilitan tener la opción de un tratamiento conservador y cuando lo requiera un correcto tratamiento invasivo, que debe ser individualizado según la posible causa que lo genera (AU).


ABSTRACT Emphysematous pyelonephritis is considered an unusual clinical entity. It is an acute necrotizing infection, with gas formation in the renal parenchyma, the collector system and/or perinephric space. Diabetic population is more prone to this kind of pyelonephritis, but cases of emphysematous pyelonephritis have been described in patients with urinary tract obstruction in absence of Diabetes mellitus. On 69 to 97 % of the cases, the germ implied in the disease genesis is Escherichia coli, followed by Klebsiella pneumonia, that are responsible for a disease having a high impact on the diabetic patients´ morbidity and mortality. Knowing this clinical entity allows arriving to a precocious diagnosis with the aim of establishing the most suitable treatment contributing to a better patients´ survival. Tomographic studies guide in the diagnosis, facilitate the option of a conserving treatment, and when it is required a correct invasive treatment individualized according to the possible cause generating it (AU).


Subject(s)
Humans , Male , Female , Pyelonephritis/diagnosis , Infections/diagnosis , Pyelonephritis/complications , Pyelonephritis/epidemiology , Signs and Symptoms , Therapeutics , Sepsis/diagnosis , Diabetes Mellitus/pathology
9.
Rev. argent. microbiol ; 52(2): 101-110, jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1155701

ABSTRACT

Resumen La aparición de secuenciadores masivos que permiten leer en paralelo de millones a miles de millones de secuencias o fragmentos del ADN (reads) ha revolucionado la microbiología, la cual ha pasado de un ámbito exclusivamente laboratorial a uno computacional, con la aplicación ineludible de la bioinformática. La posibilidad de efectuar estudios de la microbiota, el microbioma y el metagenoma de una muestra clínica de manera rápida y a un coste reducido permite avanzar más rápidamente en el diagnóstico de enfermedades, en el conocimiento de la taxonomía y la epidemiología de los agentes involucrados, así como de su virulencia. También posibilita la realización de estudios de genómica comparada y el descubrimiento de genes o variantes de interés, lo que puede llevar a que enfermedades tradicionalmente consideradas como de carácter no microbiano sean asociadas a la presencia de microrganismos. En esta revisión se aclara la terminología usada en este campo, y se describen las principales tecnologías de secuenciación y su utilidad en el análisis microbiano. Asimismo, se señalan diversos programas de código libre, pipelines de análisis, bases de datos y plataformas web que permiten que la bioinformática se integre exitosamente al ámbito de la microbiología clínica y al estudio de las enfermedades infecciosas.


Abstract Massive parallel sequencing (High-Throughput Sequencing [HTS]) allows to read millions or billions of DNA sequences or fragments (reads) in parallel and is revolutionizing microbiology research, moving from laboratory methods to computed-assisted analyses, with the compelling use of Bioinformatics. The time and cost reduction in studies on the microbiota, microbiome and metagenome, allows to rapidly progress in diagnosis, taxonomy, epidemiology, comparative genomics, virulence, discovery of genes or variants of interest and the association of microorganisms with traditionally considered non-microbial diseases. In this review, the terminology, the sequencing technologies and their applications are described for microbial analysis using open-source bioinformatics software, analysis pipelines, databases and web platforms that allow a user-friendly bioinformatics approach affordable by the clinical microbiologist and infectious disease practitioners.


Subject(s)
Humans , Microbiological Techniques/methods , Computational Biology , High-Throughput Nucleotide Sequencing , Infections/diagnosis , Microbiota , Infections/microbiology
10.
Acta bioquím. clín. latinoam ; 54(2): 165-171, jun. 2020. tab
Article in Spanish | LILACS | ID: biblio-1130591

ABSTRACT

Se evaluó la implementación del método de PCR múltiple FilmArrayTM (Biofire Diagnostics, LLC, EE.UU.) en 21 niños con infección respiratoria aguda baja, 3 con meningoencefalitis, y un caso de sepsis. Se registraron el tiempo de demora hasta obtener el resultado y adecuar el tratamiento, los días de internación, los patógenos detectados y el costo de la incorporación de esta metodología. En los niños estudiados con FilmArrayTM el resultado estuvo disponible a los 90 minutos desde la toma de la muestra. Se detectaron patógenos no demostrados por los métodos disponibles, como Rhinovirus, además de diagnosticar coinfección viral; el tiempo promedio de estadía resultó 5 días. Se estimó reducir un 40% el costo global de internación. La implementación de FilmArrayTM resultó sencilla y se pudo incorporar a la sistemática de trabajo. Si bien esta experiencia incluyó un bajo número de pacientes, aportó información que demuestra el potencial de esta metodología para un mejor manejo del paciente crítico.


The implementation of multiple PCR FilmArrayTM (Biofire Diagnostics, LLC, USA) for 21 children with low acute respiratory infection, 3 with meningoencephalitis, and 1 case of sepsis was evaluated. Delay time until the result was obtained and the treatment adapted, hospitalization days, pathogens detected and the cost of incorporating this methodology were all recorded. In the children studied with FilmArrayTM the result was available 90 minutes after the sample was taken. Pathogens were not demonstrated by the available methods, such as Rhinovirus, apart from diagnosing viral coinfection, the average length of stay was 5 days. It was estimated to reduce the overall cost of hospitalization by 40%. The implementation of FilmArrayTM was simple and could be incorporated into the work system. Although this experience included a low number of patients, it provided information that demonstrates the potential of this methodology for better management of the critical patient.


Foi avaliada a implementação do método de PCR múltiplo FilmArrayTM (Biofire Diagnostics, LLC, EUA) em 21 crianças com infecção respiratória aguda baixa, 3 com meningoencefalite e um caso de sepse. O tempo de atraso foi registrado até a obtenção do resultado e a adaptação do tratamento, dias de internação, patógenos detectados e o custo da incorporação dessa metodologia. Nas crianças estudadas com o FilmArrayTM, o resultado ficou disponível 90 minutos após a coleta da amostra; foram detectados os patógenos não demonstrados pelos métodos disponíveis, como o Rinovírus, além de diagnosticar a coinfecção viral; o tempo médio de permanência foi de 5 dias. Foi estimado reduzir o custo total da hospitalização em 40%. A implementação do FilmArrayTM foi simples e pôde ser incorporada à sistemática de trabalho. Embora essa experiência tenha incluído um número de pacientes baixo, forneceu informações que demonstram o potencial dessa metodologia para um melhor gerenciamento do paciente crítico.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Rhinovirus , Bacterial Infections/complications , Polymerase Chain Reaction/methods , Infections/diagnosis , Meningoencephalitis , Pediatrics/methods , Therapeutics , Polymerase Chain Reaction , Costs and Cost Analysis , Methodology as a Subject , Hospitalization , Infections , Length of Stay , Methods
11.
Prensa méd. argent ; 106(3): 156-164, 20200000. graf, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1368842

ABSTRACT

ANTECEDENTES: La afectación de los espacios cervicales como resultado de focos infecciosos cervicofaciales son eventos infrecuentes, pero potencialmente mortales. La causa más frecuente de infecciones profundas del cuello son el resultado de la infección odontogénica (IO). Estas afectan a individuos de todas las edades y pueden presentar distintos grados de severidad. Son diagnosticadas con examen físico, estudios por imágenes, Ecografía o Tomografía Computada (TC). Debe realizarse siempre el drenaje quirúrgico de forma clásica o percutánea según el caso de las colecciones en forma precoz. OBJETIVO: Analizar la eficacia clínica del tratamiento percutáneo y el drenaje quirúrgico en abscesos odontogenos MATERIALES Y MÉTODOS: Se llevo a cabo un trabajo transversal de enero de 2015 a diciembre de 2019. Se realizo revisión de historias clínicas en la sección de Cirugía de Cabeza y Cuello de nuestro Hospital de todos los pacientes que requirieron internación y fueron sometidos a drenaje quirúrgico y/o percutáneo por la presencia de absceso cervical de origen odontogeno. RESULTADOS: Fueron analizados 174 pacientes. Edad promedio 36 +/- 2 años. Solo al 37% se les realizo drenaje quirúrgico abierto. Al resto se realizó punciones percutáneas en forma seriada. El 25 % presento algún signo de compromiso de vía aérea (escala de severidad 3), y solo 2 pacientes con mediastinitis que requirieron drenaje urgente. Se realizo la exodoncia a todas los pacientes durante la internación. DISCUSION: Las infecciones cervicofaciales representan un tipo de infección potencialmente fatal si no se inicia rápidamente un tratamiento eficaz. La causa principal son IO que se manifiestan como flemones o abscesos. Las caries dentales suelen ser el origen. Debe establecerse la terapéutica antibiótica empírica en forma precoz y corticoides con bajas dosis cuando hay edema y/o trismus. A estos pacientes se les realiza tratamiento antibiótico (ampicilina sulbactam), acompañado de tratamiento quirúrgico (drenaje percutáneo o drenaje quirúrgico). La complicación más temida, es la progresión de la infección al mediastino (mediastinitis descendente) y / o Angina de Ludwig. CONCLUSIONES: No está protocolizado a quienes se les debe realizar tratamiento quirúrgico o tratamiento percutáneo. El drenaje quirúrgico abierto parece ser la primera opción frente al compromiso de vía aérea o colecciones no pasibles de drenaje percutáneo. Para el resto de los pacientes, que son la mayoría, las punciones percutáneas guidas con ecografía y en forma seriada son la mejor opción


Background: The involvement of cervical spaces as a result of cervical infectious focuses are rare but life-threatening events. The most common cause of deep neck infections is the result of dental infection (DI). These affect individuals of all ages and may have varying degrees of severity. They are diagnosed with physical examination, imaging, ultrasound or computed tomography (CT). Surgical drainage should always be performed in a classic or percutaneous method early. Objective: To analyze the clinical efficacy of percutaneous treatment and surgical drainage in dental abscess Materials and methods: Cross-sectional study was carried out from January 2015 to December 2019. Medical records were reviewed in the Head and Neck Surgery Section of our Hospital of all patients who required hospitalization and were subjected to surgical and/or percutaneous drainage due to the presence of cervical abscess of dental origin. Results: 174 patients were analyzed. Average age was 36 +/- 2 years old. Only 37% were performed open surgical drainage. The rest of them were percutaneous drainage. 25% showed any signs of airway engagement (severity scale 3). Only 2 patients had mediastinitis who required urgent drainage. Exodontics was performed on all patients during hospitalization Discussion: Cervical infections represent a potentially fatal type of infection if effective treatment is not initiated quickly. The main cause is DI that manifest as phlegmons or abscesses. Tooth decay is usually the source. Empirical antibiotic therapy should be established early and low-dose corticosteroids should be established when there is edema and/or trismus. These patients are treated with antibiotics (ampicillin sulbactam), accompanied by surgical treatment (percutaneous drainage or surgical drainage). The most feared complication is the progression of infection to the mediastinum (descending mediastinitis) and/or Ludwig's Angina. Conclusions: Surgical or percutaneous treatment are not protocolized. Open surgical drainage seems to be the first choice over airway compromise or non-passable collections of percutaneous drainage. For the rest of the patients, who are the majority, guided percutaneous drainage with ultrasound and serial form are the best option


Subject(s)
Humans , Adult , Middle Aged , Periapical Abscess/surgery , Tomography , Cellulitis , Drainage , Oral Surgical Procedures , Early Diagnosis , Abscess/therapy , Infections/diagnosis
12.
Rev. Soc. Bras. Clín. Méd ; 18(2): 87-90, abril/jun 2020.
Article in Portuguese | LILACS | ID: biblio-1361367

ABSTRACT

A doença de Still do adulto é uma rara condição inflamatória, cujo diagnóstico é um desafio, por se tratar de diagnóstico de exclusão, após vasta investigação. Manifesta-se com febre alta diária, amigdalite não supurativa, artrite, rash evanescente, leucocitose e hiperferritinemia. O presente caso demonstra a doença de Still do adulto e sua vasta investigação, motivando a realização de revisão bibliográfica sobre inovações na fisiopatologia, no diagnóstico e no tratamento.


Adult onset Still's disease is a rare inflammatory condition, the diagnosis of which is a challenge, because it is a diagnosis of exclusion, and demands extensive investigation. It manifests with high daily fever, nonsuppurative tonsillitis, arthritis, evanescent rash, leukocytosis, and hyperferritinemia. The present case de­monstrates adult-onset Still's disease and its extensive inves­tigation, motivating literature review on innovations of its pathophysiology, diagnosis, and treatment.


Subject(s)
Humans , Female , Adult , Young Adult , Still's Disease, Adult-Onset/diagnosis , Aspartate Aminotransferases/blood , Rheumatoid Factor/blood , Splenomegaly , Blood Sedimentation , C-Reactive Protein/analysis , Pharyngitis , Rheumatic Diseases/diagnosis , Still's Disease, Adult-Onset/drug therapy , Adrenal Cortex Hormones/therapeutic use , Arthralgia , Antirheumatic Agents/therapeutic use , Rare Diseases/diagnosis , Diagnosis, Differential , Alanine Transaminase/blood , Exanthema , Fever , Hyperferritinemia/blood , Infections/diagnosis , Leukocytosis/blood , Neoplasms/diagnosis
13.
Ribeirão Preto; s.n; 2020. 106 p. tab.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1426878

ABSTRACT

A higienização das mãos é amplamente aceita como uma estratégia-chave na prevenção e controle de infecções, e representa a ação mais importante a ser tomada para reduzir danos evitáveis relacionados à disseminação de microrganismos. Os cuidadores em geral são pessoas leigas, que permanecem no hospital acompanhando e auxiliando no cuidado, portanto, desempenham papel essencial durante o processo de internação dos pacientes. Uma série de fatores podem influenciar a adesão da higienização das mãos dessa população, e diante desse contexto, propôs-se uma revisão sistemática com o objetivo de sintetizar os fatores que influenciam a higienização das mãos dos cuidadores acompanhantes. A estratégia de busca foi construída com base na estratégia PICO, sendo utilizados descritores controlados e seus sinônimos, de acordo com a pergunta da revisão: "Quais fatores influenciam na adesão da higienização das mãos de cuidadores acompanhantes de pacientes hospitalizados?". As buscas foram realizadas nas bases de dados: Cinahl, Cochrane Library, Embase, Lilacs, PubMed, Scopus e Web of Science. Para consulta da literatura cinzenta utilizou-se a Biblioteca Digital Brasileira de Teses e Dissertações, Google Acadêmico e Open Gray, sem aplicação de filtros. Destaca-se que todas as etapas foram realizadas por dois revisores independentes e, no caso de divergências, um terceiro revisor foi consultado. Foram identificados 1564 documentos, sendo 478 duplicados, por conseguinte, 1086 registros foram analisados por meio da leitura de título e resumo. Desses, 66 foram pré-selecionados para leitura na íntegra, dos quais 57 foram excluídos por terem sido realizados com outras populações (n=11), não abordarem a intervenção de interesse (n=3), apresentarem os resultados de cuidadores e outras populações de maneira generalizada (n=11), objetivos que não estão relacionados à temática de interesse (n=6), estudos que não eram originais e/ou de abordagem qualitativa (n=23), desfecho de interesse não avaliado (n=1) ou por não terem sido localizados (n=2). Os nove estudos que atenderam aos critérios de elegibilidade foram sintetizados e apresentados na análise qualitativa. A avaliação do risco de viés utilizou as ferramentas apropriadas do Joanna Briggs Institute (JBI) para estudos randomizados, para estudos de intervenção sem aleatorização e grupo controle. Nos estudos observacionais utilizou-se a ferramenta Axis. A maior parte das evidências sintetizadas são oriundas de estudos observacionais (n=5) e fornecem importantes elementos para prática. Dentre os estudos primários incluídos nessa revisão, sete apresentaram baixo risco de viés, e dois, risco de viés moderado. Devido a heterogeneidade clínica e metodológica entre os estudos primários incluídos a análise quantitativa (metánalise) não foi realizada. Em suma, dois estudos forneceram evidências sobre a disponibilização de recursos para higienização das mãos aos cuidadores acompanhantes como um fator que pode estar fortemente relacionado a adesão a prática, entretanto, disponibilidade de recursos isoladamente não garante a adesão. Evidências acerca da importância do planejamento de abordagens personalizadas e fornecimento de instruções claras e simplificadas, especificas a população de cuidadores acompanhantes foram identificadas em quatro estudos, visto que a compreensão das orientações constitui um importante fator de melhora na adesão a higienização das mãos. Por fim, todos os estudos incluídos nesta revisão sinalizam para o fato de que a união de diferentes fatores e de maneira constante obtém resultados melhores e mais duradouros.


Hand hygiene is widely accepted as a key strategy in the prevention and control of infections and represents a more important action for the prevention of preventable damage related to the spread of microorganisms. Caregivers in general are lay people, who remain in the hospital to accompany and assist in care, therefore, they play an essential role during the process of hospitalization of patients. A number of factors can influence adherence to hand hygiene in this population, and in this context, propose a systematic review in order to synthesize the factors that influence hand hygiene of accompanying caregivers. A search strategy was created based on the PICO strategy, being used to describe controls and their synonyms, according to a review question: "What factors influence the adherence and hand hygiene of doctors accompanying hospitalized patients?". As searches were carried out in the databases: Cinahl, Cochrane Library, Embase, Lilacs, PubMed, Scopus and Web of Science. To consult gray literature, use the Brazillian Digital Library of Theses and Dissertations, Google Scholar and Open Gray, without applying filters. It is worth noting that all the steps were carried out by two independent reviewers and, in case of disagreements, a third reviewer was consulted. 1564 documents were created, of which 478 were duplicated, therefore, 1086 records were analyzed by reading the title and summary. Of these, 66 were pre-selected for reading in full, of which 57 were excluded for having been executed with other threats (n = 11), did not address an intervention of interest (n = 3), exhibited the results of four and other situations in a generalized way (n = 11), objectives that are not related to the topic of interest (n = 6), studies that were not original and / or of a qualitative approach (n = 23), unevaluated outcome of interest (n = 1 ) or because they were not found (n = 2). Thus, nine studies met the eligibility criteria, were synthesized and presented in the qualitative analysis. The risk of bias assessment used the appropriate Joanna Briggs Institute (JBI) tools for randomized studies and for intervention studies without randomization and control group and for observational studies, the Axis tool was used. Most of the synthesized evidence comes from observational studies (n = 5) and provides important elements for practice. Among the primary studies included in this review, seven had a low risk of bias, and two had a moderate risk of bias. Due to the clinical and methodological heterogeneity among the included primary studies, quantitative analysis (meta-analysis) was not performed. In summary, two studies provided evidence on the availability of resources for hand hygiene to accompanying caregivers as a factor that can be strongly related to adherence to the practice, however, availability of resources alone does not guarantee adherence. Evidence about the importance of planning personalized approaches and providing clear and simplified instructions, specific to the population of accompanying caregivers, was identified in four studies, since understanding the guidelines is an important factor in improving adherence to hand hygiene. Finally, all the studies included in this review signal the fact that the union of different factors and in a constant manner obtains better and more lasting results.


Subject(s)
Humans , Female , Pregnancy , Adult , Hand Disinfection , Infection Control/methods , Caregivers , Hand Hygiene , Infections/diagnosis
15.
Rev. Asoc. Argent. Ortop. Traumatol ; 84(4): 420-426, dic. 2019.
Article in Spanish | LILACS, BINACIS | ID: biblio-1057066

ABSTRACT

La acupuntura es una técnica de origen chino que surge hace aproximadamente 2000 años. Es una modalidad terapéutica que ha cobrado gran importancia en el mundo occidental para el tratamiento de diversos cuadros, incluida la lumbalgia. Comunicamos el caso de un hombre de 74 años de edad, que consulta por reagudización de la lumbalgia crónica, luego de un tratamiento alternativo, a quien se le diagnostica una complicación infecciosa. Si bien, en manos experimentadas e instruidas, es una técnica con relativamente escasas complicaciones, se han publicado diversos reportes que describen complicaciones, en su mayoría, menores y asociadas a una técnica estéril insuficiente o a falta de conocimiento por parte del acupunturista. El auge de estas técnicas alternativas puso el foco en las medidas de seguridad, por lo cual entes, como la Organización Mundial de la Salud han creado guías para su correcto uso. Conocer las posibles complicaciones facilita el diagnóstico temprano y el tratamiento. Se analiza la presentación clínica y se realiza una revisión bibliográfica del cuadro. Nivel de Evidencia: IV


Acupuncture originated in China approximately 2000 years ago and is a growing treatment modality worldwide. Patients resort to acupuncture for a variety of conditions, including lower back pain. We discuss the case of a 74-year-old man who received acupuncture to treat lower back pain, after which the pain increased. An infection was detected and treated. Despite the fact that acupuncture can be considered generally safe if performed by well-trained practitioners, literature from around the world reports all kinds of complications, most of which are minor and usually a result of an inappropriate technique. The popularity of this alternative treatment has driven some organizations, such as World Health Organization (WHO) to draft guidelines about its safety. Being aware of possible complications allows for an early diagnosis and treatment. On this paper, we discuss the aforementioned case and include a review of the related literature. Level of Evidence: IV


Subject(s)
Aged , Acupuncture Therapy/adverse effects , Low Back Pain/complications , Low Back Pain/therapy , Infections/diagnosis
16.
Infectio ; 23(3): 266-270, jul.-sept. 2019. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1002161

ABSTRACT

Introducción: Poco se sabe acerca de la presencia del VPH en la mucosa oral en población sana y cuales son los factores de riesgo que pueden llevar al virus a una infección persistente que conduzca al desarrollo de un carcinoma. Objetivos: En el presente estudio la detección del VPH se realizó en muestras de ADN obtenidas de la mucosa oral de 76 mujeres sanas. Métodos: El VPH se detectó mediante la técnica de PCR anidada para el gen viral L1. La genotipificación se realizó mediante la secuenciación directa del fragmento del gen L1 amplificado por el método de Sanger, seguido de un análisis de porcentajes de identidad. Resultados: El porcentaje de detección de VPH fue de 6.6 por ciento. Los genotipos virales identificados fueron HPV-11, HPV-43 y HPV-72, todos clasificados de bajo riesgo oncológico. Además, se observó que el no uso del condón en este grupo de edad se asoció significativamente con la presencia de VPH en la mucosa oral (p = 0.037). Conclusión: En la presente investigación exploratoria se evidencio una mayor detección de VPH en la mucosa oral de mujeres sanas y su presencia se asocia con una vida sexual activa sin una protección adecuada contra su transmisión.


Introduction: Little is known about the presence of HPV in the oral mucosa in the healthy population and what risk factors can lead the virus to a persistent infection that leads to the development of a carcinoma. Objectives: In the present study, HPV detection was performed on DNA samples obtained from the oral mucosa of 76 healthy women, and the presence of the virus was associated with the sexual behavior of the participants. Methods: HPV was detected by the nested PCR technique for the viral gene L1. Genotyping was performed by direct sequencing of the L1 gene fragment amplified by the Sanger method, followed by an analysis of identity percentages. Results: The percentage of detection of HPV was 6.6 percent. The viral genotypes identified were HPV-11, HPV-43 and HPV-72, all classified as low oncological risk. In addition, it was observed that the lack of condom usage in this age group was significantly associated with the presence of HPV in the oral mucosa (p = 0.037). Conclusion: In the present exploratory research the detection of HPV in the oral mucosa of healthy women is evidenced, and its presence is associated with an active sexual life without adequate protection against its transmission.


Subject(s)
Humans , Female , Adult , Papillomaviridae , Alphapapillomavirus , Mouth Mucosa/virology , Sexual Behavior , Carcinoma , Condoms , Colombia , Infections/diagnosis
17.
Rev. biol. trop ; 67(1): 321-336, Jan.-Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-1041913

ABSTRACT

Abstract Phytoplasmas (class Mollicutes) are causal agents of plant diseases with an economic impact on crops or threatening local biodiversity. A survey was conducted from 2012 to 2016 on infected Catharanthus roseus plants that exhibited symptoms reminiscent of phytoplasma infection throughout Costa Rica. A total of 73 plants were collected exhibiting symptoms such as virescence, phyllody, axillary proliferation, little leaf, leaf malformation, chlorosis, or yellowing. All samples were tested by nested PCR using phytoplasma universal and specific primer pairs. Phytoplasma infection was detected in 52 (71.2 %) of the plants collected. Phytoplasmas of six subgroups belonging to 16Sr groups I, III, IX, XIII and XV were identified based on sequencing and in silico RFLP analyses. 'Candidatus Phytoplasma asteris' (16SrI) was the predominant group among the positive samples (n = 30) showing variety of symptoms and wide distribution from sea level to ca. 1 400 m.a.s.l. in six of the seven Costa Rican provinces. Group 16SrIII was the second most abundant (14 samples); and the remaining three groups were seldom found in C. roseus (8 samples). Moreover, group 16SrXIII phytoplasma was detected for the first time in the country. To the best of our knowledge, this is the first report of natural infection of C. roseus with phytoplasma subgroups 16SrI-B, 16SrI-P, 16SrIII-F, 16SrIX-F, 16SrXIII-A, and 16SrXV-B in Costa Rica and Central America.


Resumen Los fitoplasmas (clase Mollicutes) son agentes causales de enfermedades de plantas que provocan pérdidas económicas o amenazan la biodiversidad local. Una recolecta de plantas de Catharanthus roseus que mostraban síntomas de posible infección con fitoplasmas se realizó en diferentes lugares de Costa Rica desde 2012 a 2016. Un total de 73 plantas fueron recolectadas con síntomas tales como viriscencia, filodia, brotación axilar múltiple, reducción foliar, deformación foliar, clorosis, y amarillamiento. Todas las muestras fueron evaluadas mediante PCR anidado usando los pares de imprimadores universales y específicos para fitoplasmas. Infección por fitoplasmas se detectó en 52 (71.2 %) de las muestras. Fitoplasmas de seis subgrupos dentro de los grupos 16Sr I, III, IX, XIII y XV fueron identificados basados en secuenciación del ADN y análisis de polimorfismos de restricción (RFLP) in silico. El grupo predominante encontrado en las muestras positivas (n = 30) fue el 16SrI ('CandidatusPhytoplasma asteris'), éste mostró variedad de síntomas y amplia distribución desde el nivel del mar hasta casi los 1 400 m.s.n.m. en seis de las siete provincias de Costa Rica. El grupo 16SrIII fue el segundo más abundante (14 muestras); y los restantes tres grupos se encontraron en pocas muestras de C. roseus (8 muestras). Además, fitoplasmas del grupo 16SrXIII se detectaron por primera vez en el país. De acuerdo a nuestro conocimiento, este es el primer informe de infección natural de C. roseus con fitoplasmas de los subgrupos 16SrI-B, 16SrI-P, 16SrIII-F, 16SrIX-F, 16SrXIII-A y 16SrXV-B en Costa Rica y Centroamérica.


Subject(s)
RNA, Ribosomal, 16S/analysis , Polymerase Chain Reaction/instrumentation , Vinca , Biodiversity , Infections/diagnosis
18.
Bol. méd. Hosp. Infant. Méx ; 75(2): 79-88, mar.-abr. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-951294

ABSTRACT

Resumen Las biopelículas son comunidades de microorganismos que crecen agregados y rodeados por una matriz extracelular que ellos mismos producen, la cual favorece la adhesión covalente sobre superficies inertes y vivas; además, les ayuda a desarrollar alta tolerancia a las moléculas con actividad antimicrobiana. Por otra parte, las biopelículas se asocian con infecciones crónicas y persistentes que impactan de manera negativa en distintas áreas médicas. Además, generan altos costos a los sistemas de salud y a los pacientes cada año, porque son difíciles de tratar con antimicrobianos convencionales; adicionalmente, generan altas tasas de morbilidad y mortalidad. El objetivo de esta revisión es presentar información extensa y actualizada sobre el origen, la biosíntesis y la fisiopatología de las biopelículas, así como sobre su relación con infecciones crónicas, el diagnóstico, los tratamientos antimicrobianos actuales con actividad antibiopelícula y las perspectivas sobre la búsqueda de nuevos tratamientos. Estos últimos aún representan una importante área de investigación.


Abstract Biofilms are communities of microorganisms that grow aggregated and surrounded by an extracellular matrix, which they produce and favors them to adhere covalently to inert and living surfaces; it also helps them to develop high tolerance to molecules with antimicrobial activity. Moreover, biofilms are associated with chronic and persistent infections, which negatively impact different medical areas since they generate high costs to health care systems and patients every year because they are difficult to treat with conventional antimicrobial drugs. Additionally, they generate high rates of morbidity and mortality. The objective of this review was to present extensive and up-to-date information on the origin, biosynthesis, and pathophysiology of biofilms. Also, its relationship with chronic infections, diagnosis, current antimicrobial treatments with antibiotic activity, and perspectives on the search for new treatments, since the latter still represent an important area of research.


Subject(s)
Humans , Biofilms/drug effects , Infections/drug therapy , Anti-Infective Agents/pharmacology , Chronic Disease , Health Care Costs , Biofilms/growth & development , Drug Development/methods , Infections/diagnosis , Infections/microbiology
19.
Actual. SIDA. infectol ; 25(96): 47-53, 20170000. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1355130

ABSTRACT

Objetivos: Analizar las características de la población y determinar frecuente de infección por VIH. Método: Se realizó un estudio analítico descriptivo de corte transversal mediante análisis retrospectivo de los datos reportados en dos cohortes de seguimiento de pacientes de dos hospitales de la región oeste del Conurbano de Buenos Aires.Resultados: Analizamos las HC de 211 pacientes. Sexo femenino 108 (51,2 %), masculino 102 (48,3 %) y transgénero 1 (0,5 %). El modo primario de trans-misión se describió como heterosexual en el 89 % de los pacientes. El recuento de CD4 fue menor a 200 cel/ml en 60,2 % de los pacientes y menor a 350 cel/ml en el 77 %. Al momento de diagnóstico de infección presentaban un evento marcador de sida 65 pacientes (30 %) y se hallaban sintomáticos 86 (40,8 %). Ser de sexo masculino (OR 3,1 IC95 % 1,7-5,6), presentar edad de 45 años o superior (OR 4.0 IC95 % 2,1-7,8), y estar desempleado o con empleo informal (OR 3,3 IC95 % 1,8-5,9) se asociaron estadísticamente a EA tanto en el análisis bivariado como en el multivariado mientras que haber ingresado al nivel secundario de educación se asoció con baja posibilidad sólo en el bivariado. Conclusiones: Observamos una elevada frecuencia de EA en la población estudiada caracterizada como asociada desde el punto de vista estadístico al sexo masculino, la falta de empleo y la edad superior a los 45 años. La situación de los hombres referidos asi-mismo como heterosexuales debería ser especialmente estudiada


Objectives: To analyze characteristics of the population and determine frequency and possible associated factors with advanced disease (AD) at the time of diagnosis of HIV infection.Method: A cross-sectional descriptive study was carried out. Retrospective analysis of the reported data in two patient follow-up cohorts of two hospitals of the western region of Buenos Aires.Results: We analyzed HCs from 211 patients. Female gender 108 (51.2%), male 102 (48.3%) and transgender 1 (0.5%). The primary mode of transmission was described as heterosexual in 89% of patients. The CD4 count was less than 200 cells / ml in 60.2% of patients and less than 350 cells / ml in 77%. At the time of diagnosis of infection, 65 patients (30%) had an AIDS event and were symptomatic 86 (40.8%). Male sex (OR 3.1 IC95% 1.7-5.6), age of 45 years or above (OR 4.0 IC95% 2.1-7.8), and to be unemployed or with informal employment (OR 3.3 IC95% 1.8-5.9) were statistically associated to EA in both the bivariate and multivariate analyzes, while have begun the secondary level of education was associated with a low probability only in the bivariate. Conclusions: We observed a high frequency of AD in the studied population. characterized as statistically associated to male sex, lack of employment and age above 45 years. The situation of men referred as heterosexual should be specially evaluated


Subject(s)
Humans , Middle Aged , Aged , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective Studies , Cohort Studies , HIV Testing , Infections/diagnosis
20.
Rev. peru. med. exp. salud publica ; 34(2): 316-322, abr.-jun. 2017. tab, graf
Article in Spanish | LILACS, LIPECS | ID: biblio-902926

ABSTRACT

RESUMEN Varias de las enfermedades agudas con etiología infecciosa (viral, bacteriana o parasitaria) cursan inicialmente con un síndrome que puede ser febril, febril ictérico, febril hemorrágico, febril con manifestaciones respiratorias, febril con compromisio neurológico, febril con erupciones dérmicas, febril anémico, o pueden ocurrir muertes de pacientes febriles sin un diagnóstico definido, con algunas variantes según el nicho ecológico-social en el que se dan; es importante el enfoque sindrómico, para luego tipificar el caso o el brote y así tener un diagnóstico adecuado y oportuno que permita orientar tanto el manejo individual como las medidas de prevención y control en la población, aun cuando haya limitaciones para el diagnóstico de todos los casos. En este artículo se describe el enfoque sindrómico, los síndromes de importancia en salud pública (colectiva) y su abordaje, todo ello es importante por su presentación en brotes que vienen ocurriendo en los variados nichos ecológicos de nuestro país, exacerbados por el cambio climático.


ABSTRACT Several of the acute diseases with infectious etiology (viral, bacterial or parasitic) initially start with a syndrome which can be febrile, febrile icteric, febrile hemorrhagic, febrile with respiratory manifestations, febrile with neurological impairment, febrile with dermal eruptions, febrile anemic, diarrheal, necrotic cutaneous ulcer, or deaths of febrile patients may occur without a defined diagnosis, with some variants according to the ecological-social niche in which they occur; the syndromic approach is important, to quickly classify the case or the outbreak and thus have an appropriate and timely diagnosis that allows to orient both the individual management and the prevention and control measures in the population, even if there are limitations for the diagnosis of all the cases. This article describes the syndromic approach, the syndromes of importance in public health (collective) and their approach, all this is important because of its presentation in outbreaks that are occurring in the various ecological niches of our country, exacerbated by climate change.


Subject(s)
Humans , Sentinel Surveillance , Infections/diagnosis , Infections/therapy , Acute Disease , Emergencies , Fever/etiology , Infections/complications
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