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1.
Rev. cuba. ortop. traumatol ; 35(2): e392, 2021. ilus, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1341471

ABSTRACT

Introducción: Las infecciones de artroplastia total de cadera tienen una incidencia baja, pero cuando suceden generan un problema sanitario no solo para el paciente, sino también para el sistema de salud. Las mismas pueden generar dolor, disminución de la capacidad funcional, pobre calidad de vida, múltiples cirugías, y en ocasiones, la muerte. Objetivos: Evaluar la incidencia nacional de infecciones en las artroplastias primarias de cadera operadas por artrosis en el 2014 en Uruguay, y los factores de riesgo vinculados al paciente, medio ambiente y acto quirúrgico, incluido el abordaje quirúrgico. Métodos: Estudio observacional analítico de todos los pacientes operados por artrosis. Se selecciona una muestra aleatoria de 633 pacientes, representativa de las 1738 artroplastias realizadas en Uruguay durante el año 2014. Mediante entrevista telefónica y revisión de historias clínicas se identificaron los pacientes con infección profunda del sitio quirúrgico. Se estimó la incidencia de infección y se realizó un análisis uni- multivariado mediante regresión logística para identificar factores asociados a la infección periprotésica profunda. Resultados: Se presentaron 8 infecciones, con una incidencia de 1,21 por ciento (IC 95 por ciento 0,59 ­ 2,20) en la población general. Los factores asociados a la infección protésica con significancia estadística fueron: a) IMC ≥ 35, p= 0,006; b) procedencia de Montevideo 2,07 por ciento (1,03 ­ 4,11) p= 0,031; c) procedencia del subsector privado 1,47 por ciento (0,77 ­ 2,78) p= 0,009; d) centro quirúrgico donde se realizó la cirugía 4,3 % (1,6 ­ 10,9) p= 0,03, e) uso de cemento con antibiótico 1,59 por ciento (0,65 ­ 3,25) p= 0,034. Se presentó sospecha de infección en 6 de 8 pacientes, en los primeros 30 días postoperatorios; a 7 de 8 pacientes se les realizó limpieza quirúrgica y solo a 1 de 8 pacientes se le realizó la revisión protésica definitiva. Conclusiones: La incidencia de infección en cirugía protésica electiva de cadera por artrosis en el Registro Nacional de Uruguay, fue similar a lo publicado en la bibliografía. De las variables frecuentemente citadas como incidentales en esta complicación, solo el índice de masa corporal fue asociado en esta serie. Llaman la atención las asociaciones dependientes de la procedencia, nivel socioeconómico y centro quirúrgico. Los resultados respecto al uso de cemento con antibiótico deben ser evaluados en estudios futuros(AU)


Introduction: Total hip arthroplasty infections have a low incidence, but when they occur they generate health problems for the patient, and for the health system. They can cause pain, decreased functional capacity, poor quality of life, multiple surgeries, and sometimes death. Objectives: To evaluate the national incidence of infections in primary hip arthroplasties operated for osteoarthritis in 2014, and the risk factors related to the patient, the environment and the surgical act, including the surgical approach. Methods: Analytical observational study of all patients operated on for osteoarthritis. A random sample of 633 patients was selected, representative of 1738 arthroplasties performed in Uruguay in 2014. Through a telephone interview and review of medical records, patients with deep infection of the surgical site were identified. The incidence of infection was estimated and univariate and multivariate analysis was performed using logistic regression to identify factors associated with deep periprosthetic infection. Results: There were 8 infections, with an incidence of 1.21 percent (95 percent CI 0.59 - 2.20) in the general population. The statistically significant factors associated with prosthetic infection were: a) BMI ≥ 35, p = 0.006; b) origin of Montevideo 2.07 percent(1.03 - 4.11) p = 0.031; c) origin of the private subsector 1.47 percent (0.77 - 2.78) p = 0.009; d) surgical center where the surgery was performed 4.3 percent(1.6 - 10.9) p = 0.03, e) use of cement with antibiotic 1.59 percent(0.65 - 3.25) p = 0.034. Suspicion of infection was presented in 6 of 8 patients, in the first 30 postoperative days; 7 of 8 patients underwent surgical cleaning and only 1 of 8 patients underwent final prosthetic revision. Conclusions: The incidence of infection in elective prosthetic hip surgery for osteoarthritis in the Uruguayan National Registry was similar to that published in the literature. Body mass index was the only variable associated as incidental to this complication in this series, out of those frequently cited. The associations depending on the origin, socioeconomic level and surgical center are striking. The results regarding the use of cement with antibiotics should be evaluated in future studies(AU)


Subject(s)
Humans , Middle Aged , Aged , Aged, 80 and over , Osteoarthritis/etiology , Arthroplasty, Replacement, Hip , Infections/epidemiology , Retrospective Studies , Observational Study
2.
Arch. argent. pediatr ; 119(3): 202-207, Junio 2021. ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1222985

ABSTRACT

Se presenta una serie de casos de inmunodeficiencias primarias y se describen las variables asociadas a supervivencia en pacientes ≤ 16 años. Los diagnósticos fueron acordes a los criterios de la Unión Internacional de las Sociedades de Inmunología. Se realizó un análisis de supervivencia mediante curvas de Kaplan-Meier.Entre los años 2004 y 2019, se diagnosticaron 40 pacientes con inmunodeficiencias primarias. Las más frecuentes fueron inmunodeficiencias que afectaban la inmunidad celular y humoral, el 32,5 %, y deficiencias predominantemente de anticuerpos, el 32,5 %. La mediana de edad al inicio de los síntomas y al momento del diagnóstico fue de 3,01 y 10,4 meses, respectivamente. Fallecieron el 35 % y el riesgo fue mayor en pacientes con inmunodeficiencias que afectaban la inmunidad celular y humoral y en quienes presentaron manifestaciones clínicas y tuvieron el diagnóstico en los primeros seis meses de vida.


A case series of primary immunodeficiencies is presented and outcome measures associated with survival among patients ≤ 16 years old are described. Diagnoses were made based on the criteria by the International Union of Immunological Societies. Survival was analyzed using Kaplan-Meier curves.Between 2004 and 2019, 40 patients were diagnosed with primary immunodeficiencies. The most common were immunodeficiencies affecting humoral and cell-mediated immunity (32.5 %) and predominantly antibody deficiencies (32.5 %). The median age at the onset of symptoms and at the time of diagnosis was 3.01 and 10.4 months, respectively. Thirty-five percent of patients died, and the risk was higher among those with immunodeficiencies affecting humoral and cell-mediated immunity and those who developed clinical manifestations and were diagnosed in the first 6 months of life


Subject(s)
Humans , Male , Female , Child , Adolescent , Primary Immunodeficiency Diseases/epidemiology , Immunologic Deficiency Syndromes/epidemiology , Respiratory Tract Infections/epidemiology , Retrospective Studies , Severe Combined Immunodeficiency/epidemiology , Primary Immunodeficiency Diseases/diagnosis , Primary Immunodeficiency Diseases/therapy , Hospitals, Public , Immune System , Immunologic Deficiency Syndromes/diagnosis , Infections/epidemiology , Mexico
3.
Arq. ciências saúde UNIPAR ; 25(1): 53-59, jan-abr. 2021.
Article in Portuguese | LILACS | ID: biblio-1151416

ABSTRACT

O referido trabalho tem como objetivo analisar e avaliar a atual conjuntura das pesquisas científicas na busca da imunização eficaz contra a malária, destacando os principais mecanismos imunológicos e moleculares subjacentes à referida proteção, bem como, as perspectivas a curto e médio prazo. O presente estudo de revisão selecionou pesquisas nas bases de dados da Medical Literature Analysis and Retrieval System Online (Medline), National Library of Medicine (Pubmed), Scientific Electronic Library Online (SciELO), Web of Science e Scopus. Foram combinados os termos Malaria, Immunization, Vaccine and Epidemiology, com seus sinônimos remissivos e outros descritores associados, no período compreendido entre janeiro e julho de 2019. Como fator preponderante dos critérios de inclusão, foram selecionadas revisões sistemáticas com ou sem metanálise, publicadas nos últimos 5 anos, que discorressem detalhadamente sobre o tema, ou que apresentassem informações estatísticas ou históricas relevantes, relacionada ao tema. Como critérios de exclusão foram considerados: materiais literários e científicos, anteriores ao período de 2014 e que não apresentassem informações estatísticas ou histórica relevantes ao tema, ou que, não se adequassem à temática da pesquisa. Após a aplicação dos critérios de inclusão e exclusão, foi realizada a análise e seleção dos artigos. Dos 451 artigos identificados, 44 foram selecionados. As informações extraídas dos referidos trabalhos convergem no sentido de que a erradicação da malária é uma tarefa demasiadamente complexa, a qual não será alcançada com as vacinas atuais, havendo necessidade do desenvolvimento de ferramentas imunizadoras de maior eficácia. Apesar dos esforços, atualmente ainda não existe uma vacina eficaz na prevenção da infecção, mas vários estudos se encontram em andamento nessa vertente, tornando promissor o surgimento de uma vacina eficaz contra o parasita.


This study aims at analyzing and evaluating the current status of scientific research in the search for effective immunization against malaria, highlighting the key immunological and molecular mechanisms of such protection and the short- and medium-term perspectives. The search and selection of studies took place in the databases of the Medical Literature Analysis and Retrieval System Online (Medline); National Library of Medicine (Pubmed); Scientific Electronic Library Online (SciELO); Web of Science; and Scopus. The terms Malaria, Immunization, Vaccine, and Epidemiology were used, with their corresponding cross-referenced synonyms and other associated descriptors, including the period from January to July 2019. As a main factor in the inclusion criteria, systematic reviews with or without meta-analysis published in the last 5 years, presenting a detailed discourse about the topic, or relevant statistical or historical information related to the topic were selected. The following exclusion criteria were considered: literary and scientific materials, prior to 2014, and without statistical or historical information relevant to the theme, or which did not fit the research theme. After applying the inclusion and exclusion criteria, the articles were analyzed and selected. From a total of 451 identified articles, 44 were selected. The information extracted from the referred studies converge in the sense that malaria eradication is an overly complex task, which will not be achieved with the current vaccines, requiring the development of more effective immunizing tools. Despite all the efforts, there is no effective vaccine for preventing infection yet, but several studies are being developed in this area, making the emergence of an effective vaccine against the disease promising.


Subject(s)
Immunization , Malaria/immunology , Parasites , Protozoan Infections/prevention & control , Vaccines/immunology , Epidemiology/statistics & numerical data , Sporozoites/immunology , Infections/epidemiology
4.
Infectio ; 24(1): 15-19, ene.-mar. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1090538

ABSTRACT

Resumen Objetivo: estandarizar una qPCR para la determinación de T. pallidum en muestras de suero de pacientes con sífilis gestacional y congénita. Materiales y métodos: se optimizó una qPCR con sonda para la amplificación del gen TpN47 en muestras de suero, se evaluó la sensibilidad, especificidad y eficiencia analítica de la técnica. Se comparó con pruebas serológicas (VDRL y TPPA) y se calculó índice de concordancia Kappa. Resultados: la qPCR mostró un límite de detección de 0.113 femtogramos, especificidad analítica del 100% y fidelidad de 104%. Se evidenció correlación optima en la prueba, sugerida por un r2 de 0.99 y un valor p <0,0001 de la qPCR. Se observó acuerdo entre las pruebas serológicas y moleculares. Conclusiones: se desarrolló una herramienta molecular prometedora con buena sensibilidad, óptima especificidad analítica y gran potencial diagnóstico para la detección y hallazgo de T. pallidum subsp. pallidum, a través de la amplificación del gen TpN47 en muestras clínicas de pacientes con diagnóstico presuntivo de sífilis gestacional y congénita.


Abstract Objective: to evaluate a qPCR to detect T.pallidum in serum samples from patients with gestational and congenital syphilis. Methodology: qPCR with probe was optimized for the amplification of the TpN47 gene in serum samples, the sensitivity, specificity and analytical efficiency of the technique were evaluated. It was compared with the serological tests (VDRL and TPPA) and the Kappa concordance index was calculated. Results: the qPCR showed a detection limit of 0.113 femtograms, an analytical specificity of 100% and an accuracy of 104%. Optimal correlation was evidenced in the test, suggested by an r2 of 0.99 and a p value <0.0001 of the qPCR. An agreement was observed between serological and molecular tests. Conclusion: a promising molecular tool was developed with good sensitivity, excellent analytical specificity and great diagnostic potential for the detection and finding of T. pallidum subsp. pallidum, through the amplification of the TpN47 gene in serum from patients with gestational and congenital syphilis.


Subject(s)
Humans , Male , Female , Infant, Newborn , Adolescent , Adult , Syphilis, Congenital , Syphilis , Treponema pallidum , Molecular Diagnostic Techniques , Fetal Mortality , Infections/epidemiology
5.
Clinics ; 75: e1508, 2020. tab, graf
Article in English | LILACS | ID: biblio-1089596

ABSTRACT

OBJECTIVES: Evidence suggests that infection or inflammation is a major contributor to early spontaneous preterm birth (sPTB). Therefore, this study aimed to investigate the development and causes of maternal infection associated with maternal and neonatal outcomes in women with sPTB. METHODS: This was a secondary analysis of a multicenter cross-sectional study with a nested case-control component, the Brazilian Multicentre Study on Preterm Birth (EMIP), conducted from April 2011 to July 2012 in 20 Brazilian referral obstetric hospitals. Women with preterm birth (PTB) and their neonates were enrolled. In this analysis, 2,682 women undergoing spontaneous preterm labor and premature pre-labor rupture of membranes were included. Two groups were identified based on self-reports or prenatal or hospital records: women with at least one infection factor and women without any maternal infection (vulvovaginitis, urinary tract infection, or dental infection). A bivariate analysis was performed to identify potential individual risk factors for PTB. The odds ratios (ORs) with their respective 95% confidence intervals were calculated. RESULTS: The majority of women with sPTB fulfilled at least one criterion for the identification of maternal infection (65.9%), and more than half reported having urinary tract infection during pregnancy. Approximately 9.6% of women with PTB and maternal infection were classified as having periodontal infection only. Apart from the presence of a partner, which was more common among women with infectious diseases (p=0.026; OR, 1.28 [1.03-1.59]), other variables did not show any significant difference between groups. CONCLUSION: Maternal infection was highly prevalent in all cases of sPTBs, although it was not clearly associated with the type of PTB, gestational age, or any adverse neonatal outcomes.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Premature Birth/epidemiology , Infections/epidemiology , Urinary Tract Infections/epidemiology , Brazil/epidemiology , Population Surveillance , Cross-Sectional Studies , Risk Factors , Chorioamnionitis/epidemiology , Vaginosis, Bacterial/epidemiology
6.
J. bras. nefrol ; 41(4): 526-533, Out.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056617

ABSTRACT

ABSTRACT Introduction: Children with nephrotic syndrome are at increased risk of infections because of disease status itself and use of various immunosuppressive agents. In majority, infections trigger relapses requiring hospitalization with increased risk of morbidity and mortality. This study aimed to determine the incidence, spectrum, and risk factors for major infections in hospitalized children with nephrotic syndrome. Methods: All consecutive hospitalized children between 1-12 years of age with nephrotic syndrome were enrolled in the study. Children with acute nephritis, secondary nephrotic syndrome as well as those admitted for diagnostic renal biopsy and intravenous cyclophosphamide or rituximab infusion were excluded. Results: A total of 148 children with 162 admissions were enrolled. Incidence of major infections in hospitalized children with nephrotic syndrome was 43.8%. Peritonitis was the commonest infection (24%), followed by pneumonia (18%), urinary tract infection (15%), and cellulitis (14%), contributing with two thirds of major infections. Streptococcus pneumoniae (n = 9) was the predominant organism isolated in children with peritonitis and pneumonia. On logistic regression analysis, serum albumin < 1.5gm/dL was the only independent risk factor for all infections (OR 2.6; 95% CI, 1.2-6; p = 0.01), especially for peritonitis (OR 29; 95% CI, 3-270; p = 0.003). There were four deaths (2.5%) in our study, all due to sepsis and multiorgan failure. Conclusions: Infection remains an important cause of morbidity and mortality in children with nephrotic syndrome. As Pneumococcus was the most prevalent cause of infection in those children, attention should be paid to the pneumococcal immunization in children with nephrotic syndrome.


RESUMO Introdução: Crianças com síndrome nefrótica apresentam maior risco de infecções devido ao próprio status da doença e ao uso de vários agentes imunossupressores. Em grande parte, as infecções desencadeiam recidivas que exigem hospitalização, com risco aumentado de morbidade e mortalidade. Este estudo teve como objetivo determinar a incidência, o espectro e os fatores de risco para infecções graves em crianças hospitalizadas com síndrome nefrótica. Métodos: Todas as crianças hospitalizadas consecutivamente entre 1 e 12 anos de idade com síndrome nefrótica foram incluídas no estudo. Crianças com nefrite aguda, síndrome nefrótica secundária, bem como aquelas admitidas para biópsia renal diagnóstica e infusão intravenosa de ciclofosfamida ou rituximabe foram excluídas. Resultados: Foram cadastradas 148 crianças com 162 internações. A incidência de infecções graves em crianças hospitalizadas com síndrome nefrótica foi de 43,8%. A peritonite foi a infecção mais comum (24%), seguida por pneumonia (18%), infecção do trato urinário (15%) e celulite (14%), contribuindo com dois terços das principais infecções. Streptococcus pneumoniae (n = 9) foi o organismo predominantemente isolado em crianças com peritonite e pneumonia. Na análise de regressão logística, a albumina sérica < 1,5gm / dL foi o único fator de risco independente para todas as infecções (OR 2,6; 95% CI, 1,2-6; p = 0,01), especialmente para peritonite (OR 29; IC95% 3 -270, p = 0,003). Houve quatro mortes (2,5%) em nosso estudo, todas devido a sepse e falência de múltiplos órgãos. Conclusões: A infecção continua sendo uma importante causa de morbimortalidade em crianças com síndrome nefrótica. Como o Pneumococo foi a causa mais prevalente de infecção nessas crianças, deve-se atentar para a imunização pneumocócica em crianças com síndrome nefrótica.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Hospitalization/statistics & numerical data , Infections/mortality , Infections/epidemiology , Nephrotic Syndrome/complications , Peritonitis/blood , Cellulitis/complications , Cellulitis/microbiology , Cellulitis/epidemiology , Incidence , Albumins/analysis , Hospitalization/trends , Immunosuppressive Agents/adverse effects , India/epidemiology , Infections/etiology , Multiple Organ Failure/mortality , Multiple Organ Failure/epidemiology , Nephrotic Syndrome/diagnosis
7.
Ciênc. Saúde Colet ; 24(12): 4375-4384, dez. 2019. graf
Article in English | LILACS | ID: biblio-1055758

ABSTRACT

Abstract Fiscal austerity policies have been used as responses to economic crises and fiscal deficits in both developed and developing countries. While they vary in regard to their content, intensity and implementation, such models recommend reducing public expenses and social investments, retracting the public service and substituting the private sector in lieu of the State to provide certain services tied to social policies. The present article discusses the main effects of the recent economic crisis on public health based on an updated review with consideration for three dimensions: health risks, epidemiological profiles of different populations, and health policies. In Brazil, the combination of economic crisis and fiscal austerity policies is capable of producing a direr situation than those experienced in developed countries. The country is characterized by historically high levels of social inequality, an under-financed health sector, highly prevalent chronic degenerative diseases and persisting preventable infectious diseases. It is imperative to develop alternatives to mitigate the effects of the economic crisis taking into consideration not only the sustainability of public finance but also public well-being.


Resumo Políticas de austeridade fiscal têm sido utilizadas como respostas à crise econômica e deficit fiscal tanto em países desenvolvidos como em desenvolvimento. Embora variem quanto ao conteúdo, intensidade e cronograma de implementação, tais modelos preconizam a redução do gasto público, promovendo também a diminuição do investimento social, a retração da máquina pública e a substituição do Estado pelo setor privado na provisão de determinados serviços vinculados a políticas sociais. Este artigo debate os principais efeitos da crise econômica recente sobre a saúde da população, tendo sido baseado em uma revisão atualizada, considerando-se três dimensões: riscos à saúde, perfil epidemiológico das populações e políticas de saúde. A crise econômica no Brasil, combinada com a política de austeridade fiscal, pode produzir um contexto mais grave do que o vivenciado pelos países desenvolvidos. O país apresenta altos níveis históricos de desigualdade social, subfinanciamento do setor saúde, alta prevalência de doenças crônico-degenerativas e persistência de doenças infeciosas evitáveis. É imperativo que se construam alternativas para se mitigar os efeitos da crise econômica, levando-se em conta não apenas a sustentabilidade das finanças públicas, mas também o bem-estar da população.


Subject(s)
Humans , Health Care Rationing/economics , Public Health/economics , Resource Allocation/economics , Developing Countries/economics , Economic Recession , Health Policy/economics , Research Support as Topic/economics , Socioeconomic Factors , Brazil/epidemiology , Poverty Areas , Developed Countries/economics , Chronic Disease/epidemiology , Communicable Diseases/epidemiology , Risk Factors , Mortality , Health Expenditures , Risk Assessment , Economics , Noncommunicable Diseases/epidemiology , Infections/epidemiology , Mental Disorders/etiology , Mental Disorders/psychology
8.
Rev. invest. clín ; 71(4): 275-282, Jul.-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1289696

ABSTRACT

Abstract Background Rituximab is a monoclonal antibody that increases the disease-free and overall survival of patients with non-Hodgkin lymphoma (NHL) CD20+. The objective of this study is to describe the prevalence and spectrum of infections in patients with NHL receiving rituximab-containing chemotherapy and the impact on survival. Materials and Methods From January 2011 to December 2012, all patients diagnosed with NHL who received at least one dose of rituximab were included. Results During the study period, 265 patients received rituximab; 108 (40.8%) males; the mean age was 60 ± 15 years. There were 177 infections in 85 patients, being the most common febrile neutropenia (n = 38; 21.5%) and mucosal barrier injury-related infections (n = 28; 15.8%). In 88 events (49%), there was a microbiologic diagnosis, being bacterial infection the most frequent (39.6%), but tuberculosis (TB) was developed in 4 cases (1.5%; incidence rate 721/100,000 person-year). During follow-up, 71 patients died (27%); in 35 cases, it was related to infection. There were no differences in follow-up between those who died due to infection versus those who died from another cause (p = 0.188). Multivariate analysis for mortality showed that age >60 years, failure to achieve a complete response, and development of an infectious complication increased the risk of death. Conclusions It is important to perform a screening test for TB in all patients who will receive rituximab and maintain a constant monitoring to detect an infectious process and begin treatment as soon as possible.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Lymphoma, Non-Hodgkin/drug therapy , Rituximab/administration & dosage , Antineoplastic Agents, Immunological/administration & dosage , Infections/epidemiology , Bacterial Infections/epidemiology , Tuberculosis/epidemiology , Lymphoma, Non-Hodgkin/mortality , Prevalence , Survival Rate , Retrospective Studies , Follow-Up Studies , Age Factors , Disease-Free Survival , Febrile Neutropenia/epidemiology , Infections/microbiology
10.
Infectio ; 22(3): 131-135, July-Sept. 2018. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-953980

ABSTRACT

Resumen Introducción: La infección por Strongyloides stercoralis constituye una de las enfermedades tropicales desatendidas en áreas endémicas como Perú, con una frecuencia global de 6,6%. Se puede diferenciar cuatro síndromes clínicos: agudo (SA), crónico (SC), hiperinfección (SH) y estrongiloidiasis diseminada (ED). Objetivo: Describir las características clínicas y epidemiológicas de los pacientes con diagnóstico de estrongiloidiasis. Material y métodos: Se estudió en forma retrospectiva 27 casos de pacientes con estrongioloidiasis atendidos en los meses de julio del 2014 a agosto del 2015 en el Hospital Regional Lambayeque, Perú. Resultados: Los pacientes tuvieron una mediana de edad de 41 años (rango intercuartílico: 2 a 84) y 74% (20/27) fueron varones. Se encontraron 10 casos (37,04%) de SC y 10 casos (37,04%) de SH. Del total, 63% presentaron eosinofilia, 85,2% anemia y 85,1% diarrea; 59,3% tuvo algún tipo de inmunocompromiso y 18,5% fallecieron. Conclusiones: La mayoría de pacientes con estrongiloidiasis de este estudio presentaron SC y SH, eosinofilia, anemia y algún tipo de inmunocompromiso. Asímismo, la alta frecuencia de estrongiloidiasis severa en pacientes con inmunocompromiso revela la necesidad de un tamizaje coproparasitológico con métodos específicos (Baerman y cultivo en agar) con el fin de detectar y tratar a tiempo la infección crónica previa.


Abstract Background: Strongyloides stercoralis infection is a neglected tropical disease in endemic areas such as Peru, with an overall frequency of 6.6%. Four clinical syndromes can be distinguished: acute (AS), chronic (CS), hyperinfection (HS) and disseminated strongyloidiasis (DS). Objective: To describe the clinical and epidemiological characteristics of patients diagnosed with strongyloidiasis. Material and methods: 27 clinical charts of patients with estrongioloidiasis admitted from July 2014 to August 2015 at the Hospital Regional Lambayeque, from Peru, were reviewed. Results: The median age was 41 years (Interquartile range: 2 to 84) and 74% (20/27) were males. There were 10 (37.04%) cases of CS and 10 cases (37.04%) of HS. Of the total, 63% presented eosinophilia, 85.2% anemia and 85.1% diarrhea; 59.3% were some type of immunocompromise and 18.5% died. Conclusions: The majority of patients with strongyloidiasis in this study presented CS and HS, eosinophilia, anemia, diarrhea and some type of immunocompromise. Also, the high frequency of severe strongyloidiasis in patients with immunocompromise reveals the need for a coproparasitological screening with specific methods (Baerman and agar culture) to detect and treat previously chronic infection.


Subject(s)
Humans , Male , Middle Aged , Strongyloidiasis , Strongyloides stercoralis , Infections/epidemiology , Peru , Mass Screening , Eosinophilia , Neglected Diseases , Infections
11.
Rev. bras. enferm ; 70(4): 733-739, Jul.-Aug. 2017. tab, graf
Article in English | LILACS, BDENF | ID: biblio-898189

ABSTRACT

ABSTRACT Objective: to evaluate the clinical outcome of elderly patients admitted to intensive care units who had nosocomial infection, correlating the findings with sociodemographic and clinical variables. Method: descriptive research, performed with 308 elderly patients. The collection was made from medical records and covers the years 2012 to 2015. Uni-/bivariate analyses were performed. Results: a statistical association was found between the clinical outcome types and the variables age, length of stay, presence of previous comorbidities, main diagnosis, respiratory and urinary tract infections, use of central venous and indwelling urinary catheters, mechanical ventilation, and tracheostomy. The survival curve showed higher mortality among the elderly from the age of 80 on. Conclusion: the clinical outcome of the elderly who acquire infection in the intensive care unit is influenced by sociodemographic and clinical variables that increase mortality rates.


RESUMEN Objetivo: evaluar el desenlace clínico de ancianos que adquirieron infección intrahospitalaria durante internación en Unidades de Terapia Intensiva, correlacionando los hallazgos con variables sociodemográficas y clínicas. Método: investigación descriptiva, realizada con 308 pacientes ancianos. Datos recolectados de historias clínicas, considerando los años de 2012 a 2015. Se realizaron análisis uni/bivariados. Resultados: se registró asociación estadística entre los tipos de desenlace clínico y las variables: faja etaria, tiempo de internación, presencia de comorbilidades previas, diagnóstico principal, infección del tracto respiratorio y urinario, uso de catéteres vesicales de demora y venoso central, ventilación mecánica y traqueotomía. La curva de supervivencia evidenció mayor mortalidad entre ancianos a partir de los 80 años. Conclusión: el desenlace clínico de ancianos que adquieren infecciones en Unidades de Terapia Intensiva es influenciado por variables sociodemográficas y clínicas, que incrementan las tasas de mortalidad.


RESUMO Objetivo: avaliar o desfecho clínico de idosos que adquiriram infecção hospitalar hospitalizados em Unidades de Terapia Intensiva, correlacionando os achados com variáveis sociodemográficas e clinicas. Método: pesquisa descritiva, realizada com 308 pacientes idosos. A coleta deu-se em prontuários e contempla os anos de 2012 a 2015. Realizaram-se análises uni-/bivariadas. Resultados: registrou-se associação estatística entre os tipos de desfechos clínicos e as variáveis: faixa etária, tempo de internação, presença de comorbidades prévias, diagnóstico principal, infecção do trato respiratório e urinário, uso de cateteres vesical de demora e venoso central, ventilação mecânica e traqueostomia. A curva de sobrevivência evidenciou maior mortalidade entre idosos a partir de 80 anos. Conclusão: o desfecho clínico de idosos que adquirem infecção na Unidade de Terapia Intensiva é influenciado por variáveis sociodemográficas e clínicas, que incrementam as taxas de mortalidade.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Hospital Mortality , Patient Outcome Assessment , Infections/mortality , Intensive Care Units/statistics & numerical data , Iatrogenic Disease/epidemiology , Infections/epidemiology , Intensive Care Units/organization & administration , Middle Aged
12.
Rev.Fac.Med.Univ.Nac.Nordeste ; 37(3): 48-56, 2017.
Article in Spanish | LILACS | ID: biblio-1382248

ABSTRACT

Las infecciones asociadas a la atención de la salud son un problema de salud pública importante, debido a la frecuencia con que se producen, la morbilidad y mortalidad que provocan y la carga que imponen a los pacientes, al personal sanitario y a los sistemas de salud. El objetivo fue determinar la frecuencia y la tendencia de las infecciones asociadas al cuidado de la salud en áreas no críticas, durante el año 2016 en el Hospital Julio CPerrando. Se consideró infecciones asociadas al cuidado de la salud (IACS) a: "Toda infección que se inicia transcurridas las 48 hs de la admisión al hospital o dentro de los 30 días posteriores al alta"; y como infección del sitio quirúrgico a: "toda infección localizada en el sitio incisional que ocurre dentro de los 30 días posteriores a un procedimiento quirúrgico o hasta un año si hubiera implante de prótesis". Se realizó un estudio descriptivo, transversal, prospectivo. Se incluyó a todos los pacientes mayores de 14 años internados en este nosocomio que cumplan con la definición de caso. La recolección de datos se realizó diariamente y la información obtenida se registró en un formulario de confección propia. Se registraron un total de 429 infecciones, con una tasa de incidencia de 8,14 por 1000 pacientes internados por día en el año, con tendencia al descenso, siendo los servicios con mayor tasa los de Cirugía y Clínica


Summary: The infections asocciated with health care (HAI) are a major public health problem, due to the frecuency of they ocurrence, the morbidity and morbility they cause, and the burden they impose on patients, health personnel, and health systems. The aim was to determine the frecuency and trend of de infections asocciated with health care in non-critical areas of the Hospital Julio C Perrando during the year 2016. As infections associated with health care (HAI) were considered any infections that begin 48 hours from admission to the hospital or within 30 days afer discharge; and asa surgical site infection to: any infections localizated at the incisional site that's ocurrs within 30 days after a surgical procedure or up to year if the protesis was implanted. A cross-sectional descriptive study was designed. Included al patients older than 14 years of age who met the definition of a case. Data collection was performed daily and the information obtained was recorded on a self-made form. A total of 429 infections were registered, with an incidence rate of 8.14 per 1000 hospitalized patients/ day in the year, with a tendency to decline. Surgery and Clinic were the services with the highest rate. Palabras clave: infección hospitalaria; incidencia; tendencia


Subject(s)
Humans , Adolescent , Adult , Cross Infection/prevention & control , Incidence , Hospitals , Infections/epidemiology , Patients/statistics & numerical data , Morbidity/trends , Mortality/trends , Delivery of Health Care/trends
13.
In. Vieira, Joaquim Edson; Rios, Isabel Cristina; Takaoka, Flávio. Anestesia e bioética / Anesthesia and bioethics. São Paulo, Atheneu, 8; 2017. p.163-189.
Monography in Portuguese | LILACS | ID: biblio-847827
15.
Rev. cuba. ortop. traumatol ; 30(2): 0-0, jul.-dic. 2016. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-845069

ABSTRACT

Introducción: las infecciones vertebrales constituyen una afección de baja incidencia, pero con incremento importante en años recientes, el cual está en relación con una población más susceptible por diversas razones. A pesar de nuevos métodos para el diagnóstico, la demora constituye un importante problema. Propósito: revisar y discutir algunos temas actuales acerca de las infecciones vertebrales, la epidemiologia, etiología, fisiopatología, diagnóstico y tipos de tratamientos. Método: se seleccionó la literatura apropiada usando las bases de datos Pubmed, Hinari y Clinical Key. Resultados: la literatura muestra la importancia del correcto y rápido diagnóstico; determinar el agente causal es de primordial importancia para aplicar una adecuada terapia antimicrobiana. El tratamiento conservador produce, generalmente, buenos resultados y el quirúrgico está indicado en déficit o sepsis neurológicos, inestabilidad espinal y/o deformidad y fallo del tratamiento conservador. Se muestra algoritmo para diagnóstico y tratamiento. Conclusiones: aplicar una metodología correcta para el diagnóstico y tratamiento de las infecciones vertebrales, logra resultados satisfactorios(AU)


Introduction: vertebral infections are a disease of low incidence, but with significant increase in recent years. This increase is related to a more susceptible population due to various reasons. Despite the new methods for diagnosis, its delay is a major problem. Objective: review and discuss some current issues about the spine infections, epidemiology, etiology, pathophysiology, diagnosis and types of treatment. Method: select the appropriate literature using PubMed database, Hinari and Clinical Key. Results: the literature shows the importance of correct and rapid diagnosis, which determine the causal agent, is primordial to implement appropriate antimicrobial therapy. Conservative treatment generally produces good results and surgery is indicated in neurological deficit or sepsis, spinal instability and / or deformity and failure of conservative treatment. Diagnostic and treatment algorithm is shown. Conclusions: applying correct methodology for the diagnosis and treatment of spinal infection, satisfactory results are achieved(AU)


Introduction: les infections vertébrales sont des affections à faible incidence, mais d'un récent accroissement important. Cette augmentation est associée à une population plus sensible pour des raisons diverses. Malgré les nouvelles méthodes diagnostiques, le retard constitue un problème important. Objectif: le but de cette étude est d'examiner et discuter des questions actuelles sur les infections vertébrales, leur épidémiologie, leur étiologie, leur physiopathologie, leur diagnostic, et les types de traitement. Méthode: on a sélectionné une littérature appropriée au moyen des bases de données de PubMed, Hinari et Clinical Key. Résultats: la littérature montre l'importance d'un diagnostic correct et précoce; la définition de l'agent causal est d'une importance essentielle pour appliquer une adéquate thérapie antimicrobienne. En général, le traitement conservateur a de bons résultats, mais le traitement chirurgical est indiqué en cas de déficit ou sepsis neurologiques, d'instabilité et/ou déformation rachidienne, et d'échec du traitement conservateur. Un algorithme est présenté pour le diagnostic et le traitement. Conclusions: l'application d'une correcte méthodologie pour le diagnostic et le traitement des infections vertébrales assure des résultats satisfaisants(AU)


Subject(s)
Humans , Spine/physiopathology , Spine/diagnostic imaging , Discitis/epidemiology , Infections/epidemiology , Spondylitis , Biopsy , Anti-Infective Agents/therapeutic use
16.
Rev. bras. ter. intensiva ; 28(2): 141-146, tab
Article in Portuguese | LILACS | ID: lil-787734

ABSTRACT

RESUMO Objetivo: Comparar a evolução clínica da hemorragia subaracnóidea perimesencefálica com a da hemorragia subaracnóidea não perimesencefálica. Métodos: Estudo retrospectivo, que incluiu pacientes portadores de hemorragia subaracnóidea sem causa conhecida em um hospital terciário localizado na região norte de Portugal. Os dados epidemiológicos, clínicos e de imagem foram analisados estatisticamente, levando em conta a divisão dos pacientes em duas categorias: hemorragia subaracnóidea perimesencefálica e hemorragia subaracnóidea não perimesencefálica. Resultados: Cumpriram os critérios de inclusão 62 pacientes, 46,8% deles com hemorragia subaracnóidea perimesencefálica e 53,2% com hemorragia subaracnóidea não perimesencefálica. As caraterísticas demográficas, assim como os antecedentes clínicos, foram similares entre os grupos. As complicações foram observadas mais comumente no grupo com hemorragia subaracnóidea não perimesencefálica, sendo que 84,8% desses pacientes tiveram, no mínimo, uma complicação, comparados a 48,3% dos pacientes com hemorragia subaracnóidea perimesencefálica. Vasoespasmo, infecções e hidrocefalia foram as complicações mais comuns - todas observadas mais frequentemente nos pacientes com hemorragia subaracnóidea não perimesencefálica. Dois pacientes vieram a falecer, ambos com hemorragia subaracnóidea não perimesencefálica. A mediana do tempo de permanência no hospital foi maior nos pacientes com hemorragia subaracnóidea não perimesencefálica (21 dias, em comparação aos 14 dias observados nos pacientes com hemorragia subaracnóidea perimesencefálica). Não se observaram recidivas de sangramento durante o acompanhamento (tempo médio de 15 ± 10,3 meses). Conclusão: As hemorragias subaracnóideas perimesencefálica e não perimesencefálica tiveram formas diferentes de evolução clínica, principalmente no que se referiu à taxa de complicações e ao tempo mediano de permanência no hospital. Assim, a abordagem dessas duas formas de hemorragia subaracnóidea deve ser distinta, tanto em busca de melhorar o tratamento dos pacientes quanto para obter um melhor aproveitamento dos recursos de saúde.


ABSTRACT Objective: To compare the clinical evolution of perimesencephalic subarachnoid hemorrhage and non-perimesencephalic subarachnoid hemorrhage. Methods: The study was conducted retrospectively in a tertiary hospital center in the north region of Portugal. Included patients had no identifiable cause for subarachnoid hemorrhage. Several epidemiologic, clinical and imaging aspects were statistically analyzed, taking into account the differences in perimesencephalic subarachnoid hemorrhage and non-perimesencephalic subarachnoid hemorrhage. Results: Sixty-two patients met the inclusion criteria (46.8% - perimesencephalic subarachnoid hemorrhage; 53.2% - non-perimesencephalic subarachnoid hemorrhage). Demographic and clinical background characteristics were similar in both groups. Complications were more frequent in patients with non-perimesencephalic subarachnoid hemorrhage - 84.8% of the patients had at least one complication versus 48.3% in perimesencephalic subarachnoid hemorrhage. Vasospasm, infection and hydrocephaly were the most common complications (each was detected more frequently in the non-perimesencephalic subarachnoid hemorrhage group than in perimesencephalic subarachnoid hemorrhage group). Two patients died, both had a non-perimesencephalic subarachnoid hemorrhage. The median inpatient time was longer in the non-perimesencephalic subarachnoid hemorrhage group (21 versus 14 days). No incidents of rebleeding were reported during the follow-up period (mean time of 15 ± 10.3 months). Conclusion: Perimesencephalic subarachnoid hemorrhage and non-perimesencephalic subarachnoid hemorrhage are two different entities that have different clinical outcomes, namely in terms of complication rate and median inpatient time. The management of these patients should respect this difference to improve treatment and optimize health care resources.


Subject(s)
Humans , Male , Female , Adult , Aged , Subarachnoid Hemorrhage/physiopathology , Vasospasm, Intracranial/etiology , Hydrocephalus/etiology , Infections/etiology , Portugal , Subarachnoid Hemorrhage/complications , Time Factors , Retrospective Studies , Follow-Up Studies , Vasospasm, Intracranial/epidemiology , Tertiary Care Centers , Hydrocephalus/epidemiology , Infections/epidemiology , Length of Stay , Middle Aged
17.
Infectio ; 20(1): 9-16, ene.-mar. 2016. tab
Article in Spanish | LILACS, COLNAL | ID: lil-770880

ABSTRACT

Introducción: La prevalencia y mortalidad de la infección VIH/sida sigue siendo alta en Colombia, más aún cuando en nuestro sistema el acceso a los programas y terapia antirretroviral es limitado. Objetivo: Describir y analizar las características clínicas, epidemiológicas y sociodemográficas de pacientes hospitalizados con infección por VIH/sida. Metodología: Estudio descriptivo retrospectivo. Resultados: Se incluyeron 159 pacientes, con una edad promedio de 47 ± 13 años, 83% hombres. El 35% tenían antecedentes de promiscuidad sexual, el 27,6% eran homosexuales y el 20% tenían historia de tuberculosis. Al ingreso, un 66% tenía diagnóstico de sida, un 24% recuento de CD4 ≥ 200 cél/mm ³ y un 62% recibía tratamiento antirretroviral. Los principales síntomas al ingreso fueron gastrointestinales (50,3%), neurológicos (40,9%) y respiratorios (30%). En un 33,3% se documentaron infecciones oportunistas, siendo las principales: tuberculosis (37%), histoplasmosis (17%) y criptococosis (9,7%). En un 16,9% se diagnosticaron neoplasias; las más importantes fueron neoplasias de órgano sólido (6,9%), enfermedad linfoproliferativa (5,6%), enfermedad mieloproliferativa (2,5%) y sarcoma de Kaposi (1,8%). La estancia promedio fue de 12 ± 16 días; un 12,5% requirieron atención en UCI, y de estos, un 65% fueron sometidos a ventilación mecánica. La letalidad fue del 13,8%, y la mortalidad atribuible al VIH/sida, del 77,2%. Conclusiones: Las características de nuestra muestra son similares a las reportadas en otras series; difieren en el tipo de infecciones oportunistas y la alta letalidad y mortalidad atribuible a la infección VIH/sida. Las principales causas de hospitalización son infecciones oportunistas, seguidas de enfermedad neoplásica y quirúrgica. Mycobacterium tuberculosis es la infección oportunista más frecuente.


Introduction: The prevalence and mortality of HIV/AIDS infection still high in Colombia, due to a lack of access to HIV programmes and the limited coverage of antiretroviral therapy. Objective: To describe and analyse clinical, epidemiological and socio-demographic features of inpatients with HIV/AIDS infection. Methodology: Descriptive retrospective study. Results: A total of 159 patients were included; the average age was 47 ± 13 years and 83% were men. 35% had a history of sexual promiscuity, 27.6% were men who had sex with men and 20% had a history of tuberculosis. At admission, 66.6% had AIDS, 24% had CD4 ≥ 200 cells/mm ³ and 62% were taking antiretroviral therapy. The most common symptoms at admission were gastrointestinal (50.3%), neurological (40.9%) and respiratory (30%). In 33.3%, opportunistic infections were documented and the most frequent were: tuberculosis (37%), histoplasmosis (17%) and cryptococcosis (9.7%). Some 16.9% of patients had cancer, including 6.91% with a solid organ neoplasm, lymphoproliferative disease (5.6%), myeloproliferative disease (2.5%) and Kaposi's sarcoma (1.8%). The average length of hospitalisation was 12 ± 16 days; some 12.5% required ICU care and 65% required mechanical ventilation. Lethality was 13.8% and attributable mortality to HIV/AIDS infection was 77.2%. Conclusions: The characteristics of our population are similar to those described in other studies; however a high lethality and attributable mortality to HIV/AIDS infection were found. The most frequent causes of hospitalisation were opportunistic infections followed by neoplasms. Mycobacterium tuberculosis was the most common opportunistic infection.


Subject(s)
Humans , Male , Adolescent , Opportunistic Infections , Acquired Immunodeficiency Syndrome , HIV , Infections/epidemiology , Colombia , Histoplasmosis , Hospitals, University , Mycobacterium tuberculosis , Neoplasms
18.
S. Afr. med. j. (Online) ; 106(5): 489-493, 2016.
Article in English | AIM | ID: biblio-1271095

ABSTRACT

BACKGROUND:Hospital-acquired infections (HAIs) are a significant although unquantified burden in South Africa. Lack of adequate surveillance compounds this problem.OBJECTIVE:To report on the establishment and outcomes of a unit-specific surveillance system for hospital-acquired infections; based on international standards; in a private academic hospital. METHODS: Active unit-specific surveillance of device-associated infections (DAIs) was introduced over a 2-year period. The surveillance system was based on the US National Healthcare Safety Network (NHSN) utilising standardised definitions. Analysis of DAI rates and device utilisation was done according to Centers for Disease Control and Prevention methods. Comparative analysis using study-derived annualised data and existing NHSN data was done.RESULTS:Surveillance results of DAI rates showed significant reductions in intensive care unit-related ventilator-associated pneumonia (42%) and central line-associated bloodstream infections (100%) over a 3-year period. Substantial variations in DAI rates and utilisation ratios between wards highlight the importance of unit-specific surveillance.CONCLUSIONS:Active surveillance requires a significant investment in resources and is a sustained operational challenge; although equally significant benefits are derived from a better understanding of HAIs with more targeted interventions and efficient use of resources. A robust surveillance system is an essential component of any healthcare infection prevention and control programme and is a prerequisite to contextualising the HAI burden of hospitals


Subject(s)
Infection Control , Infections/epidemiology , Sentinel Surveillance
19.
Rev. bras. ginecol. obstet ; 37(9): 421-427, set. 2015. tab, ilus
Article in Portuguese | LILACS | ID: lil-758095

ABSTRACT

OBJETIVOS: Avaliar a prevalência de toxoplasmose, rubéola, citomegalovirose, hepatites B e C e sífilis (Torchs) em uma coorte de gestantes, bem como identificar os fatores sociodemográficos, clínicos e laboratoriais.MÉTODOS: Entre 1998 e 2013, foram atendidas 1.573 gestantes com sorologia positiva para o HIV em área metropolitana do Brasil, das quais 704 (44,8%) foram submetidas a algum dos testes sorológicos. Gestantes Torchs positivas (Gtp) foram consideradas aquelas com resultado positivo para uma dessas infecções, e gestantes Torchs negativas (Gtn) aquelas com resultados negativos para todas elas. As variáveis maternas investigadas foram: idade, estado civil, escolaridade, momento e forma de contágio da infeccção pelo HIV, contagem de linfócitos TCD4+, carga viral plasmática do HIV próxima ao parto e uso de terapia antirretroviral durante a gestação. As variáveis neonatais investigadas foram ocorrência de: transmissão vertical, prematuridade, baixo peso ao nascimento, complicações fetais, aborto e óbito fetal. Foram utilizadas razões de chance com intervalo de confiança de 95% para quantificar a associação entre as variáveis maternas e neonatais e a presença de Torchs.RESULTADOS: Entre as 704 gestantes, 70 (9,9%; IC95% 7,8-12,4) tinham alguma sorologia positiva para Torchs. Foram encontradas taxas: 1,5% (10/685) para a toxoplasmose; 1,3% (8/618) para rubéola; 1,3% (8/597) para citomegalovirose; 0,9% (6/653) para hepatite B e 3,7% (20/545) para hepatite C; e 3,8% (25/664) para sífilis. A transmissão vertical do HIV entre as gestantes Gtp foi 4,6% e de 1,2% entre as Gtn. As variáveis associadas à presença de Torchs na análise univariada foram: uso de terapia antirretroviral, transmissão vertical do HIV, baixo peso ao nascimento e complicações fetais.CONCLUSÃO: A prevalência das Torchs mostrou-se elevada para algumas infecções. Conclui-se que é importante manter o rastreamento de Torchs na gravidez, especialmente nas gestantes HIV positivas, para que se possa estabelecer diagnóstico e tratamento, e/ou medidas preventivas para evitar a transmissão materno-fetal.


PURPOSE: To evaluate the prevalence of toxoplasmosis, rubella, cytomegalovirus, hepatitis B&C and syphilis (Torchs) in a cohort pregnant women and to identify the sociodemographic, clinical and laboratory factors.METHODS: A total of 1,573 HIV-infected pregnant women from a Brazilian metropolitan region were studied between 1998 and 2013. The results of serological tests were available for 704 (44.8%) pregnant women. Pregnant women were considered to be Torchs positive (Gtp) when they had positive results for at least one of these infections, and to be Torchs negative (Gtn) when they had negative results for all of them. Maternal covariables were: age, marital status, educational level, time and mode of infection, CD4 lymphocyte count, viral load at delivery, and use of antiretroviral therapy (ARV). Neonatal covariables were: HIV infection, prematurity, low birth weight, neonatal complications, abortion and neonatal death. Odds ratios with 95% confidence interval were used to quantify the association between maternal and neonatal variables and the presence of Torchs.RESULTS: Among 704 pregnant women, 70 (9.9%; 95%CI 7.8-12.4) had positive serological tests for any Torchs factor. The individual prevalence rates were: 1.5% (10/685) for toxoplasmosis; 1.3% (8/618) for rubella; 1.3% (8/597) for cytomegalovirus; 0.9% (6/653) for hepatitis B and 3.7% (20/545) for hepatitis C; and 3.8% (25/664) for syphilis. The HIV Vertical HIV transmission was 4.6% among Gtp pregnant women and 1.2% among Gtn women. Antiretroviral therapy (ARV), vertical transmission, low birth weight and neonatal complications were significantly associated with Torchs positivity in univariate analysis.CONCLUSIONS: The Torchs prevalence found in the study was high for some infections. These findings emphasize the need to promote serological Torchs screening for all pregnant women, especially HIV-infected women, so that an early diagnosis can be made and treatment interventions can be implemented to prevent vertical HIV transmission.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Fetal Diseases/epidemiology , HIV Seropositivity , Infections/congenital , Infections/epidemiology , Infectious Disease Transmission, Vertical , Pregnancy Complications, Infectious , Brazil/epidemiology , Fetal Diseases/microbiology , Fetal Diseases/parasitology , Infant, Low Birth Weight , Prevalence , Urban Health
20.
Rev. Esc. Enferm. USP ; 49(3): 502-507, Jun/2015. tab, graf
Article in English | LILACS, BDENF | ID: lil-749030

ABSTRACT

OBJECTIVE To verify if the type of donor is a risk factor for infection in kidney transplant recipients. METHODS Systematic Review of Literature with Meta-analysis with searches conducted in the databases MEDLINE, LILACS, Embase, Cochrane, Web of Science, SciELO and CINAHL. RESULTS We selected 198 studies and included four observational studies describing infections among patients distinguishing the type of donor. Through meta-analysis, it was shown that in patients undergoing deceased donor transplant, the outcome infection was 2.65 higher, than those who received an organ from a living donor. CONCLUSION The study showed that deceased kidney donor recipients are at an increased risk for developing infections and so the need for establishing and enforcing protocols from proper management of ischemic time to the prevention and control of infection in this population emerges. .


OBJETIVO Verificar si el tipo de donante es factor de riesgo para infección en los pacientes trasplantados renales. MÉTODO Revisión Sistemática de la Literatura con Metanálisis llevado a cabo en las bases de datos MEDLINE, LILACS, Embase, Cochrane, Web of Science, SciELO y CINAHL. RESULTADOS Se seleccionaron 198 artículos y se incluyeron cuatro estudios observacionales que describieron las infecciones presentadas entre los pacientes, distinguiéndose el tipo de donante. Mediante el metanálisis, se evidenció que en pacientes sometidos a trasplante de donante fallecido, el resultado infección fue 2,65 mayor, con relación a quienes reciben el órgano de donante vivo. CONCLUSIÓN El estudio permitió verificar que receptores de riñón de donante fallecido presentan mayor riesgo para el desarrollo de infecciones y que emerge la necesidad de establecimiento y cumplimiento de protocolos desde el manejo adecuado del tiempo de isquemia hasta la prevención y el control de infección en esa población. .


OBJETIVO Verificar se o tipo de doador é fator de risco para infecção nos pacientes transplantados renais. MÉTODO Revisão Sistemática da Literatura com Metanálise realizada nas bases de dados MEDLINE, LILACS, Embase, Cochrane, Web of Science, SciELO e CINAHL. RESULTADOS Foram selecionados 198 artigos e incluídos quatro estudos observacionais que descreveram as infecções apresentadas entre os pacientes distinguindo o tipo de doador. Através da metanálise, foi evidenciado que em pacientes submetidos a transplante de doador falecido, o desfecho infecção foi 2,65 maior, em relação aos que recebem o órgão de doador vivo. CONCLUSÃO O estudo permitiu verificar que receptores de rim de doador falecido apresentam maior risco para o desenvolvimento de infecções e que emerge a necessidade de estabelecimento e cumprimento de protocolos desde o manejo adequado do tempo de isquemia à prevenção e controle de infecção nesta população. .


Subject(s)
Humans , Infections/epidemiology , Kidney Transplantation , Living Donors , Postoperative Complications/epidemiology , Cadaver , Prevalence
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