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La resistencia a los antirretrovirales (ARV) es un problema de salud pública. Con el uso de inhibidores de la integrasa (INSTI) en pediatría, también comienzan a aparecer resistencias. El objetivo de esta comunicación es describir 3 casos con resistencia a los INSTI. Se describen 3 pacientes pediátricos con transmisión vertical del virus de la inmunodeficiencia humana (VIH). Iniciaron ARV de lactantes y preescolares, con mala adherencia al tratamiento, cursaron con diferentes planes secundarios a comorbilidades asociadas y fallas virológicas por resistencia. Los 3 casos clínicos describen la rápida aparición de resistencia frente a la falla virológica y el compromiso de los INSTI. La adherencia debe ser supervisada para detectar precozmente el aumento de la viremia. La falla virológica en un paciente tratado con raltegravir obliga a un rápido cambio de esquema ARV, ya que continuar utilizándolo podría favorecer nuevas mutaciones y resistencia a los INSTI de segunda generación.
Antiretroviral (ARV) drug resistance is a public health issue. Resistance has also been observed in the case of integrase strand transfer inhibitors (INSTIs) used in pediatrics. The objective of this article is to describe 3 cases of INSTI resistance. These are the cases of 3 children with vertically-transmitted human immunodeficiency virus (HIV). They were started on ARVs as infants and preschoolers, with poor treatment adherence, and had different management plans due to associated comorbidities and virological failure due to resistance. In the 3 cases, resistance developed rapidly as a result of virological failure and INSTI involvement. Treatment adherence should be monitored so that any increase in viremia can be detected early. Virological failure in a patient treated with raltegravir forces to a rapid change in ARV therapy because its continued use may favor new mutations and resistance to second-generation INSTIs.
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Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Infecciones por VIH/tratamiento farmacológico , VIH-1/genética , Inhibidores de Integrasa VIH/uso terapéutico , Inhibidores de Integrasa VIH/farmacología , Fármacos Anti-VIH/uso terapéutico , Uruguay , Raltegravir Potásico/uso terapéutico , Raltegravir Potásico/farmacología , MutaciónRESUMEN
RESUMEN Los hidrocistomas ecrinos son tumores benignos, únicos o múltiples. Se presentan con mayor frecuencia en la mediana edad y predominan en el sexo femenino. Se presenta un paciente con hidrocistomas ecrinos múltiples, masculino de 74 años.
ABSTRACT Eccrine hydrocystomas are benign tumors, which can be single or multiple. They occur most oftenly in middle aged patients or in the elderly, predominantly female. We present a case of multiple eccrine hydrocystomas, in a 74-year-old male patient.
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RESUMEN El sebaceoma es un tumor de las glándulas sebáceas. Vinculado a una posible alteración en la vía de señalización Wnt/beta-catenina. Se caracteriza clínicamente por ser una lesión exofítica, más comúnmente de aparición solitaria y amarillenta. Cuando en un mismo paciente los tumores son múltiples debemos descartar la presencia del síndrome de Muir-Torre, un trastorno asociado a la presencia de neoplasias malignas internas. En la histopatología, el diagnóstico diferencial se realizaprincipalmente con el adenoma sebáceo, teniendo en cuenta el porcentaje de células germinativas o inmaduras en los lóbulos. El tratamiento de elección es la extirpación quirúrgica, aunque también se puede emplear la electrodesecación, entre otros. Se decide reportar el caso de una paciente femenina con un tumor sebáceo de poca frecuencia, haciendo una revisión de las características clínicas e histopatológicas que nos ayuden a disminuir las dificultades en el diagnóstico.
ABSTRACT Sebaceoma is a rare sebaceous gland tumor, named by Troy and Ackerman in 1984. A possible alteration in the Wnt / beta-catenin signaling pathway has been linked to its etiology and would play an important role in genesis of some tumors, including sebaceous. It is clinically characterized by being an exophytic lesion, most commonly of a solitary, yellowish appearance, which appears in seborrheic areas, although the symptoms can be very heterogeneous. When tumors are multiple in the same patient, we must rule out the presence of Muir-Torre syndrome, an autosomal dominant disorder that is associated with the presence of internal malignancies. In Sebaceoma dermoscopy, an amorphous yellowish erythematous area is generally found, which suggests the sebaceous etiology of the lesion, but currently the definitive diagnosis can only be confirmed with histopathology. The differential diagnosis is made mainly with sebaceous adenoma, taking into account the percentage of germ cells or immature lobes, being less than 50% in sebaceous adenoma and more than 50% in sebaceoma, the latter also tends to be of greater size and depth. The treatment of choice is surgical removal, although electrodesiccation, cryotherapy, or curettage can also be used. It was decided to report the case of a female patient with an infrequent sebaceous tumor, making a review of the clinical and histopathological characteristics that help us decrease the difficulties in diagnosis.
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RESUMEN La anetodermia primaria es una dermatosis de baja frecuencia, crónica, la cual se caracteriza por pérdida de fibras elásticas. En algunas ocasiones se ha observado en pacientes con enfermedades autoinmunes, entre ellas el lupus eritematoso sistémico (LES). Presentamos un caso de LES asociado a anetodermia, en una paciente de sexo femenino, de 19 años de edad.
ABSTRACT Primary anetoderma is an infrequent skin disease that has sometimes been observed in patients with autoimmune diseases such as systemic lupus erythematosus. We present a case of systemic lupus erythematosus associated with anetoderma, in a 19-year-oldfemale patient.
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Abstract Introduction: In high-volume trauma centers, especially in developing countries, penetrating cardiac box injuries are frequent. Although many aspects of penetrating chest injuries have been well established, video-assisted thoracoscopy is still finding its place in cardiac box trauma and algorithmic approaches are still lacking. The purpose of this manuscript is to provide a streamlined recommendation for penetrating cardiac box injury in stable patients. Methods: Literature review was carried out using PubMed/MEDLINE and Google Scholar databases to identify articles describing the characteristics and concepts of penetrating cardiac box trauma, including the characteristics of tamponade, cardiac ultrasound, indications and techniques of pericardial windows and, especially, the role of video-assisted thoracoscopy in stable patients. Results: Penetrating cardiac box injuries, whether by stab or gunshot wounds, require rapid surgical consultation. Unstable patients require immediate open surgery, however, determining which stable patients should be taken to thoracoscopic surgery is still controversial. Here, the classification of penetrating cardiac box injury used in Colombia is detailed, as well as the algorithmic approach to these types of trauma. Conclusion: Although open surgery is mandatory in unstable patients with penetrating cardiac box injuries, a more conservative and minimally invasive approach may be undertaken in stable patients. As rapid decision-making is critical in the trauma bay, surgeons working in high-volume trauma centers should expose themselves to thoracoscopy and always consider this possibility in the setting of penetrating cardiac box injuries in stable patients, always in the context of an experienced trauma team.
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Humanos , Traumatismos Torácicos , Heridas por Arma de Fuego , Heridas Penetrantes , Lesiones Cardíacas/cirugía , Lesiones Cardíacas/diagnóstico por imagen , Toracoscopía , Cirugía Torácica Asistida por VideoRESUMEN
RESUMEN Las mastocitosis e histiocitosis, son enfermedades que se caracterizan por la proliferación o activación descontrolada y posterior acumulación anormal de mastocitos e histiocitos respectivamente. De incidencia desconocida, talvez porque son subdiagnosticadas. Su patogenia aún es desconocida, si bien está relacionada con mutaciones en la vía del C-KIT para las mastocitosis y de origen viral o neoplásico en el caso de las histiocitosis. Ambas patologías suelen ser frecuentes en la infancia, incluso algunas son congénitas. El mastocitoma cutáneo único sería una forma benigna de mastocitosis y la histiocitosis de células de Langerhans es una forma de histiocitosis que en nuestro caso al afectar un solo órgano (la piel) tendría un buen pronóstico.
SUMMARY Mastocytosis and histiocytosis are diseases that are characterice by uncontrolled proliferation or activation and subsequent abnormal activation of mast cells and histiocytes respectively. Of unknown incidence, perhaps because they are underdiagnosed, their pathogenesis is still unknown although it is related to mutations in the C-KIT pathway for mastocytosis and of viral or neoplastic origin in the case of histiocytosis. Both pathologies are usually frequent in childhood, even some are congenital. The single cutaneous mastocytoma would be a benign form of mastocytosis and the histiocytosis of Langerhans cells is a form of histiocytosis that in our case affecting a single organ (the skin) will have a good prognosis.
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Resumen 22. Las enfermedades ampollares de tipo penfigoide,se caracterizan por la presencia de ampollas de origen autoinmune.El Penfigoide gestacional(PG), es parte de este grupo de enfermedades y se define por la presencia de una erupción ampollar,intensamente pruriginosa de comienzo agudo, generalmente en el segundo trimestre del embarazo o posparto inmediato, en ocasiones puede haber compromiso fetal y asociarse con otras enfermedades de origen autoinmune.
Abstract 26. Pemphigoid-type bullous diseases are characterized by the presence of blisters of autoimmune origin.Gestational Pemphigoid (PG) is part of this group of diseases and is defined by the presence of an intensely pruritic bullous eruption of acute onset, usually in the second trimester of pregnancy or immediate postpartum period, there may be fetal compromise and associated with other diseases of autoimmune origin.
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RESUMEN La poroqueratosis es un trastorno de la queratinización, con herencia autosómica dominante en la mayoría de los casos, vinculada posiblemente a la presencia de un clon mutante de queratinocitos en expansión. Tiene diferentes formas clínicas: de Mibelli, actínica superficial diseminada, lineal, puntiforme, palmoplantar y facial atípica. El diagnóstico se confirma con la histología, presentándose típicamente la laminilla cornoide, que no es patognomónica de esta afección. En el tratamiento de esta patología se utilizan desde agentes tópicos como emolientes, 5-fluorouracilo, calcipotriol, imiquimod y retinoides como terapia sistémica. Otras opciones terapéuticas descritas son extirpación quirúrgica, criocirugía y dermoabrasión cuando se trata de formas localizadas o únicas. Se decide reportar el caso de una paciente femenina con poroqueratosis de afección exclusiva del área nasal por su rara frecuencia y escasos reportes sobre esta forma de presentación en la actualidad.
ABSTRACT Porokeratosis is a disorder of keratinization, with AD inheritance in most cases; possibly linked to the presence of a mutant clone of expanding keratinocytes, in addition to the overexpression of the p53 gene that could be related to an oncogenic potential. This disorder has also been associated with factors such as UVR, immunosuppression cases such as HIV +, liver or kidney failure, transplantation of organs that would act as triggers of this disease. It differs from other pathologies due to the presence of a peripheral hyperkeratotic ring which is usually asymptomatic in half of the patients. Clinically it can occur in different ways: porokeratosis de Mibelli, superficial actinic disseminated, linear, punctate, palmoplantar and atypical facial. Diagnosis is confirmed with histology, with the cornoid lamella typically present, which is not pathognomonic of this condition and consists of a parakeratotic keratinocyte column that extends from an invagination of the epidermis through the stratum corneum. The treatment to choose, will depend on the patient´s age; Size and location of the lesions, the aesthetic implications and the general condition of the affected person. They are used from topics such as emollients, 5-fluorouracil, calcipotriol, imiquimod. Retinoids are found as an option for systemic therapy. Another procedure considers surgical removal, cryosurgery and dermabrasion when dealing with localized or unique forms. We report a case of a 44-year-old female patient who presents with compatible dermatosis porokeratosis, affecting only the nasal area.
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Background/Purpose:Malaria is an established health challenge and a major cause of mortality and morbidity among under-five children in Nigeria. This community-based study was designed to assess the effect ofhealth education packages on the malaria control practices of mothers of under-five children in Ibeagwa Nike Enugu State.Methods:The study utilized a quasi-experimental study design with a sample size of 124 mothers that attended the infant welfare clinic at the community health center and those that received treatment of minor childhood illnesses for six months. A multistage random sampling technique was used in choosing the required samples. The instrument for the collection of data was a self-adapted and validated questionnaire. Reliability was assessed and yielded a Cronbach’s correlation coefficient of 0.823. Data generatedwere summarized using simple descriptive statistics of frequencies and percentages and analyzed using Fishers’ exact test and Chi-square. Results:Findings of the study showed that: the practice of malaria control practices was very low below 40% before health education intervention; malaria control practices increased significantly above 40% after the health education intervention; hindrances to the practice of malaria control measures reduced after the health education intervention; there is poor awareness of environmental hygiene as a method of malaria control measure before health education.Conclusion:Periodic health education on the importance of malaria control practices should be conducted in the community regularly, to promote control of malaria
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RESUMEN La Púrpura de Henoch - Schönlein (PHS) es una vasculitis leucocitoclástica, autolimitada que en la mayoría de los casos presenta manifestaciones cutáneas de purpura palpable acompañada de dolor articular, abdominal y alteración de la función renal. Reportamos un caso pediátrico de púrpura con ampollas de contenido hemorrágico variedad rara de presentación y difícil diagnóstico.
SUMARY Henoch-Schönlein purpura (HSP) is a self-limited a leukocytoclastic vasculitis, the most case have palpable purpura skin manifestations with arthralgia strong abdominal pain, and renal function compromise. We report a pediatric case of purpura with hemorrhagic blisters rare variety of presentation and difficult diagnosis.
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RESUMEN Presentamos un caso de neurofibromatosis segmentaria, en un paciente de sexo masculino de 60 años de edad. Los neurofibromas se localizaban en región cervical, los mismos eran asintomáticos, de 8 años de evolución.
ABSTRACT A case of segmental neurofibromatosis in a 60 years old male patient is presented along with a brief review of the literature. The patient had 8 years old neurofibromas, located in the cervical region; they were asymptomatic. No other alteration of type 1 neurofibromatosis was found.
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Humanos , Masculino , Persona de Mediana Edad , Neurofibromatosis 1/diagnóstico , Neurofibromatosis 1/patología , Neurofibromatosis 1/terapia , Neurofibroma/epidemiologíaRESUMEN
RESUMEN El granuloma anular (GA) es una dermatosis inflamatoria crónica de carácter benigno, asintomática y autolimitada. Aún permanece desconocida la fisiopatología de dicha entidad, pero se ha sugerido una base inmunológica. Dicha dermatosis se caracteriza, en su forma clásica, por presentar pápulas que confluyen formando placas, de periferia elevada y centro deprimido, endisposición anular. Las lesiones son de color piel normal, ligeramente eritematosas o violáceas. Se describen diversas formas clínicas. Los cuatro tipos más frecuentes son: GA localizado, GA generalizado, GA perforante y GA profundo, subcutáneo o nodular. La clínica por sí sola, habitualmente, no presenta ningún desafío diagnóstico, ya que suele ser característica en la mayoría de los casos, peroen el caso de las formas clínicas atípicas es necesaria la confirmación con un estudio histopatológico. Se presenta el caso de un paciente masculino de 41 años de edad con dermatosis compatible con una forma atípica de GA.
ABSTRACT Granuloma annulare is a benign cutaneous inflammatory disease. It is usually asymptomatic and self-limited. While the exact pathophysiology is unknown, it has been associated with a retarded hypersensitivity of type IV driven by the presence of unspecified antigens. Classical cutaneous lesions are characterized by the presence of papules coalescing to form annular plaques with a central clearing or a central depression.The clinical manifestations vary from a usual localized form to a generalized one, both with erythematous, violaceous or skin-colored lesions. Given that most cases present the classical form, they do not pose a diagnostic challenge. However, histopathological study is necessary in the case of atypical clinical presentations. A 41-year-old male presented with a 4-month dermatosis. The physical examination showed four 2cm erythematous plaques, slightly infiltrated in the right upper limb and three lesions of 1cm in the left upper limb with the same characteristics. Tactile, pain and thermal sensitivity was conserved. The patient only referred to an occasionally mild pruritus.
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El pseudoxantoma elástico o síndrome de Gröenblad-Strandberg, es una rara enfermedad multisistémica hereditaria, que se caracteriza por la mineralización ectópica de los tejidos conectivos y se manifiesta clínicamente mediante: lesiones cutáneas, oftalmológicas y vasculares. Está producido por mutaciones en el gen ABCC6 localizado en el cromosoma 16p13.1, que se expresa primariamente en el hígado, los riñones y en niveles muy bajos en los tejidos afectados clínicamente. Se han descrito más de 600 mutaciones, siendo p.R1141X y del23-29 las dos más frecuentes. Actualmente, no existe un tratamiento específico para el pseudoxantoma elástico, por lo que el diagnóstico precoz, el control multidisciplinario y las modificaciones en el estilo de vida, son importantes para disminuir su morbimortalidad. En este trabajo se presenta un caso de pseudoxantoma elástico, con compromiso cutáneo y ocular y se realiza una revisión de la literatura.
Pseudoxanthoma elasticum, also known as Groënblad-Strandberg syndrome, is a rare multi-system heritable disorder characterized by ectopic mineralization of connective tissues with clinical manifestations in the skin, eyes and vascular system. It is caused by mutations in the ABCC6 gene located in chromosome 16p13.1, which is expressed primarily in the liver and the kidney, and at very low level in tissues clinically affected. Over 600 distinct mutations have been identified so far, pR1141X and del23-29 are the most common ones. To date, there is no specific treatment for pseudoxanthoma elasticum, therefore early diagnosis, multidisciplinary control and lifestyle adjustments are very important to reduce its morbidity and mortality. A case of pseudoxanthoma elasticum in a patient with cutaneous and ocular involvement is presented along with a review of the available literature.
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This study aimed at characterizing the phenotypic and toxigenic status of circulating strains of cholera during outbreaks in Nigeria, employing molecular typing techniques. Two hundred and one samples of rectal swabs, stool, vomitus, water (from the well, borehole, sachet, stream, and tap) and disinfectants (sodium hypochlorite) were collected from three states in the country. The samples were inoculated on thiosulphate-citrate bile salt-sucrose (TCBS), Cary-Blair transport medium and smeared on glass slides for direct examination. The Vibrio cholerae isolates were serotyped, biotyped, and characterized using PCR of the cytotoxin gene A (ctxA), wbeO1, and wbfO139 gene primer. Of the 201 samples screened, 96 were positive for V. cholerae O1 (48%), with 69 (72%) positive for ctxA gene. The results from this study showed that the circulating strains of cholera in Nigeria were of Ogawa serotype, also observed in other outbreaks in Nigeria (1991, 1992, and 1996). However, the strains were of the Classical biotype and were mainly (72%) ctxA gene-positive. This current investigation has confirmed the production of cholera toxin by the circulating strains, and this could be harnessed for possible cholera vaccine production in Nigeria.
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El mastocitoma solitario es la segunda en frecuencia, de las variantes de las mastocitosis, caracterizada por una proliferación de los mastocitos tisulares que afecta únicamente a la piel, comúnmente congénita o de aparición en las primeras semanas de vida, con etiología aún desconocida y buen pronóstico, ya que tiene una resolución espontánea en la adolescencia. Presentamos el caso de un paciente quien desde su nacimiento, presentaba una placa en antebrazo derecho, con signo de Darier negativo y asintomatomática. Con los datos clínicos y los antecedentes personales se realiza biopsia de piel, mediante la que confirmamos el diagnóstico de mastocitoma solitario.
Solitary mastocytoma is the second most frequent disease within mastocytosis. It is characterized by a hyperplasia of the mastocitos tissue that affects only the skin. It is usually congenital though it can also appear in the first weeks of life, with unknown etiology; it has a good prognosis due to its spontaneous resolution in the adolescence. This paper presents case of a patient who, from birth, has had some plaque in his right forearm, with negative and asymptomatic Darier's sign. The skin biopsy has been performed with clinical data and personal history, thus confirming the diagnosis of solitary mastocytoma.
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The 2010 cholera outbreak in northern Nigeria affected over 40,000 people, with a case fatality rate [CFR] of >/= 3.75%. We assessed the emergency response of health care workers [HCWs] involved in case management. This was a cross-sectional study with data collected through a self-administered questionnaire. Data entry and analysis were performed using Epi info software. A total of 56 HCWs were interviewed. The mean age was 31 years [SD +/- 8.16 years]. The majority of the HCWs [80%; n = 45] were aged 18-39 years. Most were community health extension workers [60%], and 3.6% [n = 2] were medical doctors. Many of the HCWs had less than 2 years of work experience [42%]. Additionally, 82% of the respondents had <1 week of cholera emergency response training, and 50% of the HCWs managed >20 suspected cases of cholera per day. Although 78% of HCWs reported the practice of universal safety precautions, 32% [n = 18] knew HCWs who developed symptoms of cholera during the epidemic, most of which was believed to be hospital acquired [78%]. We also found that 77% [n = 43] of HCWs had no access to the required emergency response supplies. Inadequate training, a lack of qualified HCWs and a limited supply of emergency response kits were reported. Therefore, the government and stakeholders should address the gaps noted to adequately control and prevent future epidemics
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Laboratory diagnosis of Chlamydia and vaginitis in sexually active females has been limited by unavailability of a sequential method/rapid technique for simple diagnosis. Six hundred (600) adult females from hotel/brothel; Sexually Transmitted Infections (STIs) Clinic; Obstetrics/Gynaecology Clinic; Family Planning Clinic and Healthy controls were investigated for Chlamydia; Candida; trichomoniasis and bacterial vaginosis (BV). This was done using microscopy: wet mount; stained vaginal secretion and stained smear after culture. Results showed that there were 72infections in the female groups. The brothel and STI group had infection in the range (70-86). Chlamydial infection was highest in the STI group while Candida infection was highest in the healthy (control) females. Bacterial vaginosis was distributed in all groups. As p-value increased; f-value increased indicating constant co-infection of Candida and BV in Chlamydia positive females. Microscopy by direct detection from sample and stained smear after culture were in the range: 56-86. Direct microscopy for BV was 78.5and stained smear after culture; 57.1. Sensitivity and specificity of the techniques showed that detection of Chlamydia was less sensitive by direct microscopy of sample but sensitivity and specificity of stained smear after culture were high. Immunoassay (32.2) was also less sensitive. Sensitivity and specificity of wet mount microscopy for Candida; Trichomoniasis and BV were in the range 62.5 - 80and 62.5-97.8respectively. Wet mount has high sensitivity and specificity for detecting agents of vaginitis and may be useful for routine use and for diagnosis where disease is absent; thus; making identification more cost effective
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Chlamydia/diagnóstico , Microscopía , Vaginitis/diagnósticoRESUMEN
Introducción: el control del asma se logra a través de un adecuado plan de educación, control ambiental y tratamiento preventivo de la inflamación. Objetivo: valorar el conocimiento de asma en padres de niños asmáticos. Método: estudio descriptivo transversal en padres de niños asistidos en el Centro Hospitalario Pereira Rossell. Se realizó un cuestionario de conocimientos sobre el asma enfermedad en padres de niños con historia clínica evolutiva de asma. Los padres cuyos hijos presentaban diagnóstico de asma en el momento de realizar el cuestionario se designaron como grupo A y quienes no lo presentaban como grupo B. Los datos se procesaron con el software estadístico SPSS 14.0. Resultados: se entrevistaron 75 padres, de los cuales presentaban diagnóstico de asma 32 niños (42,7). El 100% de los encuestados presentó bajo conocimiento. Con respecto al dominio de conocimiento vinculado al conocimiento de mitos y creencias de la enfermedad el conocimiento fue también bajo. En relación al dominio de conocimiento vinculado al conocimiento de la enfermedad se obtuvo alto conocimiento en los padres del grupo A, con una puntuación media estadísticamente significativa con respecto al grupo B (p< 0,05). En el área de conocimiento vinculado a la realización de deportes y el tabaquismo el nivel de conocimiento fue bajo en toda la población de estudio. Conclusiones: los niveles de conocimiento de los padres en esta muestra no son suficientes para lograr que los niños presenten un asma controlada.
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Humanos , Preescolar , Niño , Adolescente , Asma/prevención & control , Educación en Salud , Padres/educación , Conocimientos, Actitudes y Práctica en SaludRESUMEN
Staphylococcus aureus infections are growing problems worldwide with important implications in hospitals. The organism is normally present in the nasal vestibule of about 35 percent of apparently healthy individuals and its carriage varies between different ethnic and age groups. Staphylococcal nasal carriage among health workers is particularly important to establish new clones and track origin of infections during outbreak situations. To determine the carriage rate and compare the pulsed field gel patterns of the strains, nasal swabs were collected from 185 medical students in a teaching hospital in Lagos, Nigeria. Isolates of S. aureus were tested for heamolysin production, methicillin sensitivity and Pulsed Field Gel Electrophoresis (PFGE) was performed. The results showed S.aureus nasal carrier rate of 14 percent with significant rate among males compared to females. All the isolates produced heamolysin. Antibiotic susceptibility pattern revealed that majority of the isolates was susceptible. Five strains (19 percent) harboured resistant determinants to penicillin and tetracycline. None of the strains was resistant to methicillin. 44 percent of the isolates typed by PFGE had type B, the most predominant pulsotype. PFGE A clone exhibited a single resistance phenotype suggesting a strong clonal relationship that could punctual an outbreak in the hospital. The results speculate that nasal carriage among medical personnel could be a function of various risk factors. Personal hygiene and behaviour may however be the means to reducing colonization and spread of S.aureus in our hospitals.