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1.
Arch. argent. pediatr ; 122(3): e202310204, jun. 2024. tab, gráf
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1554934

RESUMEN

Introducción. El descenso de las coberturas de vacunación fue muy significativo en la última década. Los pediatras son una pieza fundamental para recuperar coberturas y aumentar la confianza en la vacunación. Objetivos. Describir la percepción de los pediatras acerca del conocimiento y prácticas sobre vacunas, e identificar barreras en el acceso. Métodos. Estudio analítico observacional, mediante encuesta en línea. Se incluyeron variables del perfil del profesional, capacitación y barreras en inmunizaciones. Resultados. Participaron 1696 pediatras (tasa de respuesta: 10,7 %), media de 50,4 años. El 78,7 % fueron mujeres. El 78,2 % contaba con ≥10 años de ejercicio profesional. El 78,4 % realizaba atención ambulatoria y el 56,0 % en el subsector privado. El 72,5 % realizó una capacitación en los últimos 2 años. Se manifestaron "capacitados" para transmitir a sus pacientes los beneficios de las vacunas: 97,2 %; objetivos de campañas: 87,7 %; contraindicaciones: 82,4 %; efectos adversos: 78,9 %; recupero de esquemas: 71,2 %; notificación de ESAVI: 59,5 %. La proporción fue estadísticamente superior, en todos los aspectos, en pediatras con ≥10 años de ejercicio y en aquellos con capacitación reciente (p ≤ 0,01). Barreras identificadas en el acceso a la vacunación: falsas contraindicaciones (62,3 %); falta temporaria de vacunas (46,4 %); motivos culturales (41,4 %); horario restringido del vacunatorio (40,6 %). Conclusiones. La percepción del grado de capacitación fue variable según el aspecto de la vacunación. Aquellos con mayor tiempo de ejercicio profesional y con actualización reciente se manifestaron con mayor grado de capacidad. Se identificaron múltiples barreras frecuentes asociadas al acceso en la vacunación.


Introduction. The decline in vaccination coverage has been very significant in the past decade. Pediatriciansplay a key role in catching-up coverage and increasing confidence in vaccination. Objectives. To describe pediatricians' perceptions of vaccine knowledge and practices and to identify barriers to access. Methods. Observational, analytical study using an online survey. Variables related to professional profile, training and barriers to vaccination were included. Results. A total of 1696 pediatricians participated (response rate: 10.7%). Their mean age was 50.4 years; 78.7% were women; 78.2% had ≥ 10 years of experience; 78.4% provided outpatient care and 56.0%, in the private subsector; and 72.5% received training in the past 2 years. Respondents described themselves as "trained" in convey the following aspects to their patients: benefits of vaccines: 97.2%; campaign objectives: 87.7%; contraindications: 82.4%; adverse effects: 78.9%; catchup vaccination: 71.2%; reporting of events supposedly attributable to vaccination or immunization: 59.5%. The proportion was statistically higher in all aspects, among pediatricians with ≥ 10 years of experience and those who received training recently (p ≤ 0.01). The barriers identified in access to vaccination were false contraindications (62.3%), temporary vaccine shortage (46.4%), cultural reasons (41.4%), and restricted vaccination center hours (40.6%). Conclusions. The perception of the level of training varied depending on the vaccination-related aspect. Pediatricians with more years of professional experience and those who received recent updates perceivedthemselves as more trained. Multiple barriers associated with access to vaccination were identified.


Asunto(s)
Humanos , Persona de Mediana Edad , Vacunas , Vacunación , Percepción , Argentina , Encuestas y Cuestionarios , Pediatras
2.
Arch. argent. pediatr ; 122(3): e202310063, jun. 2024. tab
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1555007

RESUMEN

El síndrome de Down, o trisomía 21, tiene una mortalidad mayor que la población general, debido principalmente a infecciones respiratorias. El objetivo de este trabajo es describir el compromiso inmunológico en una serie de casos de pacientes con síndrome de Down derivados a Inmunología por infecciones recurrentes o por hallazgo patológico de laboratorio, entre el 1 de junio de 2016 y el 31 de mayo de 2022. Se describe el compromiso de la inmunidad en 24 pacientes. Doce pacientes presentaron falla de respuesta a polisacáridos y recibieron quimioprofilaxis antibiótica y/o gammaglobulina sustitutiva. En 3 pacientes, se observó agammaglobulinemia con linfocitos B presentes y se indicó gammaglobulina sustitutiva. En 9 pacientes, se observó linfopenia T y en 1 paciente, compromiso inmune combinado.


Down syndrome, or trisomy 21, has a higher mortality than the general population, mainly due to respiratory tract infections. The objective of this study was to describe immune compromise in a series of cases of patients with Down syndrome referred to the Pediatric Immunology Section due to recurrent infections or pathological laboratory findings between 6/1/2016 and 5/31/2022. Here we describe immune compromise in 24 patients. Twelve patients failed to develop a polysaccharide response and received antibiotic chemoprophylaxis, or gamma globulin replacement therapy. Three patientsdeveloped agammaglobulinemia with presence of B cells and gamma globulin replacement therapy was indicated. Nine patients had T-cell lymphopenia and 1 patient, combined immune compromise.


Asunto(s)
Humanos , Lactante , Preescolar , Niño , Adolescente , Infecciones del Sistema Respiratorio , Síndrome de Down/complicaciones , gammaglobulinas , Inmunoglobulinas Intravenosas/uso terapéutico , Antibacterianos/uso terapéutico
3.
Bol. latinoam. Caribe plantas med. aromát ; 23(3): 382-389, mayo 2024. ilus, tab, graf
Artículo en Inglés | LILACS | ID: biblio-1538151

RESUMEN

The extraction of geraniol from palmarosa oil using hydrotropic solvents was investigated. Palmarosa oil possesses an appealing rose aroma and properties like anti - inflammatory, antifungal, and antioxidant due to the presence of geraniol. The extraction of geraniol from palmarosa oil by using distillation methods like steam dis tillation and fractional distillation was a laborious process. So hydrotropes were tried for extraction. The geraniol yield and purity depend on parameters like concentration of hydrotrope, solvent volume ratio, and time period. Using the Box Benkhem Desig n (BBD), the extraction process was optimized. One of the major advantages of using hydrotropic solvents is that they were classified as green solvents, and recovery of solvents is also possible. To reduce the extraction time probe sonication is carried ou t. Different hydrotropic solvents with probe sonication are done on palmarosa oil by altering various process parameters to study the separation, yield, and purity.


Se investigó la extracción de geraniol del aceite de palmarosa utilizando solventes hidrotrópicos. El aceite de palmarosa posee un atractivo aroma a rosa y propiedades antiinflamatorias, antifúngicas y antioxidantes debido a la pr esencia de geraniol. La extracción de geraniol del aceite de palmarosa mediante métodos de destilación como la destilación por vapor y la destilación fraccionada ha sido un proceso laborioso. Por lo tanto, se probaron los hidrotropos para la extracción. El rendimiento y la pureza del geraniol dependen de parámetros como la concentración del hidrotropo, la relación de volumen del solvente y el período de tiempo. Se optimizó el proceso de extracción usando el diseño Box Benkhem (BBD). Una de las principales v entajas de usar solventes hidrotrópicos es que se clasifican como solventes verdes y también es posible recuperar los solventes. Para reducir el tiempo de extracción, se lleva a cabo una sonda de ultrasonido. Se realizan diferentes solventes hidrotropos co n sonda de ultrasonido en el aceite de palmarosa alterando varios parámetros del proceso para estudiar la separación, el rendimiento y la pureza.


Asunto(s)
Cymbopogon/química , Monoterpenos Acíclicos/farmacología , Monoterpenos Acíclicos/química , Aceites de Plantas/farmacología , Aceites de Plantas/química
4.
Arch. argent. pediatr ; 122(2): e202310049, abr. 2024. ilus
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1537747

RESUMEN

La tuberculosis es una enfermedad infectocontagiosa cuya forma de presentación más frecuente es la pulmonar; la afectación abdominal es poco frecuente, por lo que su diagnóstico continúa siendo un desafío. Las manifestaciones clínicas de la tuberculosis abdominal así como sus hallazgos en el examen físico suelen ser inespecíficos y, en muchas ocasiones, similares a los de otras patologías, por lo que es fundamental considerarla entre los diagnósticos diferenciales. Se presenta el caso clínico de un paciente de sexo masculino, de 15 años de edad, hospitalizado por un síndrome febril prolongado asociado a dolor abdominal, diarrea, sudoración nocturna y pérdida de peso


Tuberculosis is an infectious disease which most commonly compromises the respiratory system, whereas abdominal involvement is rare, thus its diagnosis is a challenge. The clinical manifestations of abdominal tuberculosis as well as its physical examination findings are usually non-specific and, frequently, similar to those of other diseases, so it is critical to consider abdominal tuberculosis among the differential diagnoses. Here we report the clinical case of a 15-year-old male patient hospitalized for a prolonged febrile syndrome associated with abdominal pain, diarrhea, night sweats, and weight loss.


Asunto(s)
Humanos , Masculino , Adolescente , Tuberculosis Ganglionar/diagnóstico , Abdomen , Dolor Abdominal/etiología , Diagnóstico Diferencial , Diarrea
5.
Arch. argent. pediatr ; 122(2): e202310099, abr. 2024. tab, graf
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1537971

RESUMEN

El feocromocitoma y el paraganglioma son tumores neuroendocrinos secretores de catecolaminas. Los feocromocitomas se originan en la médula suprarrenal, mientras que los paragangliomas son extraadrenales. Se describe una serie de casos de niños con diagnóstico anatomopatológico de feocromocitoma o paraganglioma que consultaron en un hospital pediátrico de alta complejidad de Argentina. Se incluyeron 21 pacientes, 14 varones, con una mediana de edad de 11,4 años; 8 casos con feocromocitoma y 13 casos con paraganglioma. Se presentaron con hipertensión arterial 14/21. La mayoría de los paragangliomas tuvieron localización paraaórtica (9/13). Debido a que representan una causa potencialmente curable de hipertensión arterial, la sospecha clínica es muy importante. El diagnóstico temprano y la instauración de un tratamiento antihipertensivo adecuado, que permita afrontar la cirugía con normotensión arterial, aseguran la curación en la mayoría de los casos si la resección tumoral es completa.


Pheochromocytomas and paragangliomas are neuroendocrine tumors producing catecholamines. Pheochromocytomas occur in the adrenal medulla, while paragangliomas are those that occur outside the adrenal gland. Here we describe a case series of children with a pathological diagnosis of pheochromocytoma or paraganglioma who consulted at a tertiary care children's hospital in Argentina. A total of 21 patients (14 males) were included; their median age was 11.4 years; 8 children had pheochromocytoma and 13, paraganglioma. Arterial hypertension was observed in 14/21. Most paragangliomas were para-aortic (9/13). Since they are a potentially curable cause of hypertension, clinical suspicion is very important. An early diagnosis and the initiation of an adequate antihypertensive treatment, which allows the patient to undergo surgery with normal blood pressure, ensure a cure in most cases if tumor resection is complete.


Asunto(s)
Humanos , Niño , Paraganglioma/complicaciones , Paraganglioma/diagnóstico , Feocromocitoma/complicaciones , Feocromocitoma/diagnóstico , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/terapia , Hipertensión/diagnóstico , Argentina , Hospitales
6.
Rev. Asoc. Med. Bahía Blanca ; 34 (1), 2024;34(1): 16-23, 20240301.
Artículo en Español | LILACS, UNISALUD, BINACIS | ID: biblio-1554620

RESUMEN

Introducción: La adolescencia es la etapa clave en la adquisición de hábitos y conductas adictivas que perduran toda la vida. Existe un modelo de consumo juvenil de drogas, legales e ilegales, como forma de relación social, uso recreativo y realización personal. El policonsumo no debe ser visto como un rito de transición, sino como un problema de salud pública. Objetivos: Se estudió la prevalencia de consumo de sustancias adictivas y de medicamentos en 520 alumnos, entre 15 y 18 años, de Escuelas Públicas secundarias de la ciudad de Bahía Blanca. Asimismo, caracteriza el marco familiar, hábitos y costumbres de los estudiantes. Grupos estudiados: El 55% de los alumnos encuestados pertenece al sexo femenino y un 36% tiene doble escolaridad. Resultados: Los resultados indican que el 24% de los alumnos manifiesta fumar y un 85% tomar alcohol, de los cuales el 62% llegó a la borrachera. El 25% consume drogas, 96% corresponde a marihuana, 8% cocaína y 7% éxtasis. El 76% declara automedicarse y un 27% considera riesgosa esta práctica. El 84% convive con ambos padres y un 51% no posee materias desaprobadas. Un 35% de los jóvenes no realiza deporte, el 46% estudia otro idioma y un 39% tiene como hábito la lectura. El 25% de los alumnos que reconocen tener actividad sexual no utilizaron ningún método de protección. Conclusiones: Los resultados de la encuesta exponen la magnitud del problema y sumado a la baja edad de los estudiantes, derivan en múltiples consecuencias adversas. Este panorama constituye un desafío para el médico que, junto con la familia, docentes y especialistas, pueden actuar en aspectos preventivos, diagnósticos y terapéuticos.


Introduction: Adolescence is the key stage in the acquisition of habits and addictive behaviors that last a lifetime. There is a pattern of youth drug use, both legal and illegal, as a form of social interaction, recreational use and personal fulfilment. Polydrug use should not be seen as a rite of passage, but as a public health problem. Objetive: This paper studies the prevalence of substance and drug use in 520 students, aged 15-18, from public secondary schools in the city of Bahía Blanca. It also characterizes the family background, habits and customs of the students. Gropus: 55% of the students surveyed were female and 36% of them had double schooling. Results: The results indicate that 24% of the students report smoking and 85% drinking alcohol, of which 62% became drunk. 25% use drugs, 96% marijuana, 8% cocaine and 7% ecstasy. 76% declare that they self-medicate and 27% consider this practice risky. 84% live with both parents and 51% do not have failed subjects in the report card. 35% of those surveyed do not practice sport, 46% study another language and 39% have reading as a habit. 25% of students who admit to sexual activity did not use any method of protection. Conclusions: The results of the survey expose the magnitude of the pro- blem and, coupled with the low age of the students, lead to multiple adverse consequences. This panorama constitutes a challenge for the doctor who, together with the family, teachers and specialists, can act in preventive, diagnostic and therapeutic aspects.


Asunto(s)
Abuso de Medicamentos , Automedicación , Salud del Estudiante , Trastornos Relacionados con Sustancias
8.
Rev. argent. radiol ; 88(1): 11-22, mar. 2024. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1550716

RESUMEN

Resumen La mamografía contrastada (CEDM, contrast-enhanced digital mammography) es una herramienta nueva que ha ido implementándose de forma creciente. Aparece como alternativa a la resonancia magnética (RM), y al igual que esta, tiene como principio el uso de contraste endovenoso para explorar la angiogénesis tumoral. Combina la imagen de mamografía convencional (Mx) con la técnica de sustracción con energía dual poscontraste, lo que resulta en un incremento en la detección de cáncer de mama, en un tiempo corto de estudio y a un bajo costo. Es un método prometedor en casos seleccionados y de fácil lectura, siendo útil principalmente en pacientes con diagnóstico de cáncer de mama para detectar lesiones adicionales y determinar el tamaño tumoral, ayudando en la planificación quirúrgica, así como también en la evaluación de la respuesta a la neoadyuvancia. También en el seguimiento de pacientes operadas, para caracterizar lesiones dudosas en Mx y ecografía, o como alternativa ante contraindicación de la RM. El objetivo de este trabajo es valorar la utilidad de la mamografía contrastada en la práctica diaria y determinar sus principales indicaciones. Repasamos con casos propios las utilidades y características del método.


Abstract Contrast-enhanced digital mammography (CEDM) is an emerging tool that has been increasingly implemented. It appears as an alternative to magnetic resonance imaging (MRI), using intravenous contrast to explore tumor angiogenesis. It combines conventional mammography (Mx) with post-contrast dual energy subtraction technique, resulting in increased detection of breast cancer, in a short study time and at a low cost. It is a promising method in selected cases and easy to read, being useful mainly in patients with breast cancer to detect additional lesions and determine the tumor size, that helps surgical planning, as well as in the evaluation of post-neoadjuvant chemotherapy response in the follow-up of patients treated with surgery, to address inconclusive findings in screening mammogram, or as an alternative when MRI is contraindicated. The purpose of this article is to assess the usefulness of contrasted mammography in daily practice and to determine its main indications. We review with our own cases the applications and characteristics of this method.

9.
Rev. argent. cir. plást ; 30(1): 41-47, 20240000. graf, fig
Artículo en Español | LILACS, BINACIS | ID: biblio-1551374

RESUMEN

El dolor crónico asociado a heridas de larga evolución en miembros inferiores constituye una situación de conflicto con características angustiantes que compromete seriamente la calidad de vida e interfiere en el proceso de reparación tisular, estableciendo un cuadro propio en el cual la herida se transforma en un componente más de esta compleja condición y no el motivo en sí de la consulta. Dadas las limitaciones y efectos negativos de las terapias usuales para el alivio del dolor crónico en heridas, se establece una apertura a nuevas propuestas adyuvantes. Motivo de ello es el propósito del presente trabajo, a través del uso de sevoflurano tópico para evaluar el incremento de la analgesia en una población con úlceras en miembro inferior de diverso origen etiológico.


Asunto(s)
Humanos , Masculino , Femenino , Calidad de Vida , Extremidad Inferior/lesiones , Dolor Crónico/terapia , Sevoflurano/uso terapéutico
10.
Int. j. morphol ; 42(1): 40-45, feb. 2024. ilus, tab
Artículo en Inglés | LILACS | ID: biblio-1528826

RESUMEN

SUMMARY: Angiogenesis, a process by which new blood vessels are generated from pre-existing ones, is significantly compromised in tumor development, given that due to the nutritional need of tumor cells, pro-angiogenic signals will be generated to promote this process and thus receive the oxygen and nutrients necessary for its development, in addition to being a key escape route for tumor spread. Although there is currently an increase in the number of studies of various anti-angiogenic therapies that help reduce tumor progression, it is necessary to conduct a review of existing studies of therapeutic alternatives to demonstrate their importance.


La angiogénesis, proceso por el cual se generan nuevos vasos sanguíneos a partir de otros preexistentes, se encuentra comprometida de forma importante en el desarrollo tumoral, dado que por necesidad nutritiva de las células tumorales se generarán señales pro angiogénicas para promover este proceso y así recibir el oxígeno y los nutrientes necesarios para su desarrollo, además de ser una ruta de escape clave para la diseminación tumoral. Si bien, actualmente existe un aumento en la cantidad de estudios de diversas terapias anti angiogénicas que ayudan a reducir el avance tumoral, es necesario realizar una revisión de los estudios existentes de alternativas terapéuticas para demostrar su importancia.


Asunto(s)
Humanos , Inhibidores de la Angiogénesis/uso terapéutico , Celecoxib/uso terapéutico , Neoplasias/tratamiento farmacológico , Neovascularización Patológica/tratamiento farmacológico , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Inhibidores de la Ciclooxigenasa 2 , Neoplasias/patología , Antineoplásicos/uso terapéutico
11.
Braz. j. med. biol. res ; 57: e12829, fev.2024. graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1534064

RESUMEN

This study was conducted to evaluate how sterubin affects rotenone-induced Parkinson's disease (PD) in rats. A total of 24 rats were distributed into 4 equal groups: normal saline control and rotenone control were administered saline or rotenone (ROT), respectively, orally; sterubin 10 received ROT + sterubin 10 mg/kg po; and sterubin alone was administered to the test group (10 mg/kg). Rats of the normal saline and sterubin alone groups received sunflower oil injection (sc) daily, 1 h after receiving the treatments cited above, while rats of the other groups received rotenone injection (0.5 mg/kg, sc). The treatment was continued over the course of 28 days daily. On the 29th day, catalepsy and akinesia were assessed. The rats were then euthanized, and the brain was extracted for estimation of endogenous antioxidants (MDA: malondialdehyde, GSH: reduced glutathione, CAT: catalase, SOD: superoxide dismutase), nitrative (nitrite) stress markers, neuroinflammatory cytokines, and neurotransmitter levels and their metabolites (3,4-dihydroxyphenylacetic acid (DOPAC), dopamine (DA), norepinephrine (NE), serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), and homovanillic acid (HVA)). Akinesia and catatonia caused by ROT reduced the levels of endogenous antioxidants (GSH, CAT, and SOD), elevated the MDA level, and altered the levels of nitrites, neurotransmitters, and their metabolites. Sterubin restored the neurobehavioral deficits, oxidative stress, and metabolites of altered neurotransmitters caused by ROT. Results demonstrated the anti-Parkinson's activities of sterubin in ROT-treated rats.

12.
Arch. argent. pediatr ; 122(1): e202302992, feb. 2024. tab
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1525290

RESUMEN

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.


Asunto(s)
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 , Mutación
13.
Arch. argent. pediatr ; 122(1): e202202934, feb. 2024. tab, ilus
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1525294

RESUMEN

La pileflebitis es definida como la trombosis supurativa de la vena porta como complicación de infecciones abdominales. En pediatría, la etiología más frecuente es la apendicitis, generalmente de diagnóstico tardío, que se presenta como sepsis, con una elevada mortalidad. Para el diagnóstico son necesarios métodos de diagnóstico por imágenes; los más utilizados son la ecografía Doppler y la angiotomografía. El tratamiento se basa en la intervención quirúrgica, la antibioticoterapia y la anticoagulación. Esta última tiene indicación controvertida, pero podría mejorar el pronóstico y disminuir la morbimortalidad. Se presenta un caso clínico de pileflebitis secundaria a sepsis por Escherichia coli con punto de partida en una apendicitis aguda, en un paciente pediátrico que evoluciona a la transformación cavernomatosa de la vena porta. Es de importancia conocer el manejo de esta entidad, ya que, una vez superado el cuadro inicial, requerirá un minucioso seguimiento por la posibilidad de evolucionar a la insuficiencia hepática.


Pylephlebitis is defined as suppurative thrombosis of the portal vein as a complication of abdominal infections. In pediatrics, the most frequent etiology is appendicitis, generally of late diagnosis, presenting as sepsis, with a high mortality rate. Imaging methods are necessary for diagnosis; the most common are the Doppler ultrasound and computed tomography angiography. Treatment is based on surgery, antibiotic therapy, and anticoagulation. The indication for the latter is controversial, but it may improve prognosis and decrease morbidity and mortality. Here we describe a clinical case of pylephlebitis secondary to Escherichia coli sepsis, which started as acute appendicitis in a pediatric patient who progressed to cavernomatous transformation of the portal vein. It is important to know the management of this disease because, once the initial symptoms are overcome, it will require close follow-up due to a potential progression to liver failure.


Asunto(s)
Humanos , Niño , Apendicitis/diagnóstico , Tromboflebitis/diagnóstico , Tromboflebitis/etiología , Tromboflebitis/tratamiento farmacológico , Sepsis/etiología , Hepatopatías , Vena Porta , Antibacterianos/uso terapéutico
15.
Arq. bras. cardiol ; 121(1): e20230179, jan. 2024. tab, graf
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1533735

RESUMEN

Resumo Fundamento: O prolongamento do intervalo PQ, geralmente associado a um atraso na condução atrioventricular, pode estar relacionado a alterações na propagação do impulso intraventricular. Objetivo: Avaliar, por meio do mapeamento do potencial de superfície corporal (BSPM), o processo de despolarização ventricular em atletas com intervalos PQ prolongados em repouso e após o exercício. Métodos: O estudo incluiu 7 esquiadores cross-country com intervalo PQ superior a 200 ms (grupo PQ Prolongado) e 7 com intervalo PQ inferior a 200 ms (grupo PQ Normal). O BSPM de 64 derivações unipolares do tronco foi realizado antes (Pré-Ex) e após o teste ergométrico de bicicleta (Pós-Ex). Mapas equipotenciais da superfície corporal foram analisados durante a despolarização ventricular. O nível de significância foi de 5%. Resultados: Comparado com atletas com PQ Normal, o primeiro e o segundo períodos de posição estável dos potenciais cardíacos na superfície do tronco foram mais longos, e a formação da distribuição de potencial "sela" ocorreu mais tarde, no Pré-Ex, nos atletas com PQ Prolongado. No Pós-Ex, o grupo PQ Prolongado apresentou um encurtamento do primeiro e segundo períodos de distribuições de potencial estáveis e uma diminuição no tempo de aparecimento do fenômeno "sela" em relação ao Pré-Ex (para valores próximos aos do Normal -Grupo PQ). Além disso, no Pós-Ex, a primeira inversão das distribuições de potencial e a duração total da despolarização ventricular em atletas com PQ Prolongado diminuíram em comparação com o Pré-Ex e com valores semelhantes em atletas com PQ Normal. Em comparação com atletas com PQ Normal, a segunda inversão foi mais longa no Pré-Ex e Pós-Ex em atletas com PQ Prolongado. Conclusão: Atletas com PQ prolongado apresentaram diferenças significativas nas características temporais do BSPM durante a despolarização ventricular, tanto em repouso quanto após o exercício, em comparação com atletas com PQ normal.


Abstract Background: Prolongation of the PQ interval, generally associated with an atrioventricular conduction delay, may be related to changes in intraventricular impulse spreading. Objective: To assess, using body surface potential mapping (BSPM), the process of ventricular depolarization in athletes with prolonged PQ intervals at rest and after exercise. Methods: The study included 7 cross-country skiers with a PQ interval of more than 200 ms (Prolonged-PQ group) and 7 with a PQ interval of less than 200 ms (Normal-PQ group). The BSPM from 64 unipolar torso leads was performed before (Pre-Ex) and after the bicycle exercise test (Post-Ex). Body surface equipotential maps were analyzed during ventricular depolarization. The significance level was 5%. Results: Compared to Normal-PQ athletes, the first and second periods of the stable position of cardiac potentials on the torso surface were longer, and the formation of the "saddle" potential distribution occurred later, at Pre-Ex, in Prolonged-PQ athletes. At Post-Ex, the Prolonged-PQ group showed a shortening of the first and second periods of stable potential distributions and a decrease in appearance time of the "saddle" phenomenon relative to Pre-Ex (to the values near to those of the Normal-PQ group). Additionally, at Post-Ex, the first inversion of potential distributions and the total duration of ventricular depolarization in Prolonged-PQ athletes decreased compared to Pre-Ex and with similar values in Normal-PQ athletes. Compared to Normal-PQ athletes, the second inversion was longer at Pre-Ex and Post-Ex in Prolonged-PQ athletes. Conclusion: Prolonged-PQ athletes had significant differences in the temporal characteristics of BSPM during ventricular depolarization both at rest and after exercise as compared to Normal-PQ athletes.

16.
Ibom Medical Journal ; 17(1): 62-67, 2024. figures, tables
Artículo en Inglés | AIM | ID: biblio-1525511

RESUMEN

Background:Human immunodeficiency virus/ Acquired immunodeficiency syndrome (HIV/AIDS), has remained a disease of public health concern, with the largest burden being found in sub Saharan Africa. The advent of anti-retroviral therapy (ART) has significantly reduced the mortality of the disease, thereby transforming it to a chronic disorder, with significant co-morbid psychiatric sequalae.Objectives:To determine the prevalence and pattern of psychiatric morbidity among PLWHAattending Aminu Kano Teaching Hospital, Kano.Materials and methods:This was a cross sectional study of adult patients with HIV/AIDS attending outpatient clinic at the S.S. Wali Virology Centre of Aminu Kano Teaching Hospital who gave informed consent. Systematic random sampling technique was used.Patients aged 18years and above who had been on ARVdrugs for at least one year were included, while those who had a medical emergency and needed immediate attention were excluded.Socio demographic characteristics were obtained using a socio-demographic questionnaire and psychiatric morbidity was assessed with the MINI International Neuropsychiatry Interview.Results:Atotal of 420 participants were recruited in the study with a male to female ratio of 1:1.5 and mean age of 40.4±10.0 years. The prevalence of a psychiatric disorder was 22.1% out of whom 5.0% had more than one psychiatric diagnosis. Major depression was the most common (11%) psychiatric disorder. Generalized Anxiety disorder, substance abuse, post-traumatic stress disorder and alcohol abuse accounted for 7.6%, 5.5%, 2.4% and 1.7% of psychiatric disorders respectively.Conclusion:Psychiatric disorders are common in PLWHA, with major depression being the commonest.


Asunto(s)
Infecciones por VIH , Síndrome de Inmunodeficiencia Adquirida
17.
Ibom Medical Journal ; 17(1): 68-74, 2024. figures, tables
Artículo en Inglés | AIM | ID: biblio-1525514

RESUMEN

Background:Moderate acute malnutrition (MAM) is a leading cause of childhood morbidity and mortality globally. The morbidity pattern of underfives with this condition is yet to be described. Objective: To describe the morbidity pattern of underfives with MAM.Method: Across sectional study was conducted in two Primary Health Centres in Uruan Local Government Area of Akwa Ibom State. Caregivers'brought children aged 6- 59 months to the health facilities following community mobilization. Eligible children were recruited into the study after obtaining parental consent. Avalidated proforma was used to obtain the biodata and symptoms of common illnesses in the children. Ageneral physical examination, anthropometric measurements and systemic examination were performed. Results: Atotal of 162 children were recruited into the study. Their mean (±SD) age was 20.4 ± 13.0 months. Over 70% of them were 6 - 23 months of age. Their mean (±SD) length/height was 77.3 ± 29.6 cm, mean (±SD) weight was 8.3 ± 3.4 kg and mean (±SD) mid upper arm circumference was 12.4 ± 4.5 cm. The main symptoms noted in the children were; fever 99 (61.1%), cough 84 (51.9%), weight loss 81 (50.0%), diarrhoea 40 (24.7%) and vomiting 40 (24.7%) while pallor 77 (47.5%), lymphadenopathy 56 (34.6%), hair changes 49 (30.2%), skin changes 27 (16.6%) were the main signs in them.Conclusion: The main symptomatology of underfives with MAM were fever, cough and weight loss


Asunto(s)
Desnutrición Aguda Severa
18.
Ibom Medical Journal ; 17(1): 29-41, 2024. figures, tables
Artículo en Inglés | AIM | ID: biblio-1525618

RESUMEN

Background: Brain Fag Syndrome (BFS) is a culture-bound syndrome characterized by cognitive and somatic symptoms, commonly reported among African students. This study aimed to determine the prevalence of BFS among Nigerian university students and examine its associated factors. Methods: A cross-sectional survey was conducted among undergraduate students from a university in the northwest region of Nigeria. The study utilized a self-administered questionnaire to collect data on socio-demographic characteristics, stimulant use, course of study, and academic performance. The presence of BFS was assessed using standardized diagnostic criteria. Results:The study included a total of 625 participants, in their young adulthood. The prevalence of BFS among Nigerian university students was found to be 62.7%. The majority of affected students were aged 20-30, male, and from the Hausa ethnic group. No significant association was found between stimulant use and BFS. However, there was a significant relationship between the course of study and the occurrence of BFS. Academic performance (CGPA) showed a weak negative association with BFS. Other socio-demographic factors such as age, gender, ethnicity, relationship status, birth position, type of home, and family income did not predict the occurrence of BFS. Conclusion: The high prevalence highlights the need for attention to mental health issues among this population. The results emphasize the importance of considering the course of study and academic performance when studying BFS. Further research is warranted to explore the underlying mechanisms and develop effective interventions for students affected by BFS.


Asunto(s)
Humanos , Masculino , Femenino , Trastornos Psicofisiológicos , Trastornos del Sueño-Vigilia , Salud Mental , Trastornos del Conocimiento , Rendimiento Académico
19.
Health sci. dis ; 25(2 suppl 1): 42-47, 2024. tables, figures
Artículo en Francés | AIM | ID: biblio-1526872

RESUMEN

Introduction. La fréquence, la présentation et le devenir de cardiomyopathie du peripartum (CMPP) varient considérablement dans le monde. Au Niger, les données sont inexistantes d'où le but de notre étude qui était de préciser les aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs de la cardiomyopathie du peripartum (CMPP). Méthodologie. Il s'agit d'une étude rétrospective concernant les patientes hospitalisées pour CMPPau pôle de Cardiologie de l'Hôpital National de Niamey du 01/01/2019 au 31/12/2019. Les facteurs de risque et les aspects épidémiologiques, cliniques, paracliniques, diagnostiques, thérapeutiques et évolutifs ont été étudiés. Résultats. La prévalence hospitalière de la CMPP était de 3,83%. L'âge moyen était de 27,4 ans (extrêmes de 16 et 45 ans). La multiparité a été rapportée chez 79 % des patientes contre 21% qui étaient primipares. La dyspnée était le signe le signe fonctionnel rapporté chez toutes les patientes. Les anomalies échocardiographiques les plus fréquentes étaient l'HVG (75%) et L'HAG (45,83%). L'hypocinésie était diffuse dans 100% des cas. L'altération de la fraction d'éjection du ventricule du ventricule gauche (FEVG) était moyenne dans 50%. Toutes les patientes ont ont eu comme traitement des bétabloquants, des diurétiques et des IEC. L'évolution a été favorable dans 87,5 % des cas. Les principaux facteurs pronostiques péjoratifs étaient la multiparité (79%) une fraction d'éjection du ventricule inférieure à (FEVG)


Introduction. The frequency, presentation and outcome of peripartum cardiomyopathy (PCM) vary considerably throughout the world. In Niger, data are non-existent, hence the aim of our study, which was to clarify the epidemiological, diagnostic, therapeutic and evolutionary aspects of peripartum cardiomyopathy (PPCM). Methodology. This is a retrospective study concerning patients hospitalized for CMPPat the Cardiology pole of the National Hospital of Niamey from 01/01/2019 to 31/12/2019. Risk factors and epidemiological, clinical, paraclinical, diagnostic, therapeutic and evolutionary aspects were studied. Results. The hospital prevalence of CMPP was 3.83%. The mean age was 27.4 years (extremes 16 and 45 years). Multiparity was reported in 79% of patients versus 21% who were primiparous. Dyspnea was the functional sign reported in all patients. The most frequent echocardiographic abnormalities were LVH (75%) and GAH (45.83%). Hypokinesia was diffuse in 100% of cases. Impaired left ventricular ejection fraction (LVEF) was moderate in 50%. All patients were treated with beta-blockers, diuretics and ACE inhibitors. Progression was favorable in 87.5% of cases. The main pejorative prognostic factors were multiparity (79%) lower ventricular ejection fraction (LVEF)


Asunto(s)
Humanos , Femenino , Periodo Periparto , Cardiomiopatías , Epidemiología , Diagnóstico
20.
Afr. J. Clin. Exp. Microbiol ; 25(1): 28-37, 2024. figures, tables
Artículo en Inglés | AIM | ID: biblio-1532983

RESUMEN

Background: Globally, 296 million people were infected by hepatitis B in 2019, with 1.1 million deaths. Africa is one of the endemic regions. Good knowledge and awareness of hepatitis B remain pivotal to the biosafety of medical students. This study sought to determine the levels of knowledge and awareness of hepatitis B among students of Pamo University of Medical Sciences (PUMS), Port Harcourt, Nigeria, and the predicting factors associated with this knowledge and awareness. The is with the aim of providing recommendations for improving and sustaining biosafety levels for medical and other health-related students of the University. Methodology: The study was a descriptive cross-sectional design conducted amongst 528 randomly selected medical students of PUMS, Port Harcourt, Nigeria. Structured questionnaires were interviewer-administered to collect socio-demographic information and participants' responses to questions on knowledge and awareness of hepatitis B. Data were analysed using SPSS version 26.0 and relationships of socio-demographic characteristics and predictive factors with knowledge and awareness of hepatitis B were tested using binary logistic regression analysis with p value for statistical significance set at <0.05. Results: A total of 528 students participated in the study, 202 (38.3%) males and 326 (61.7%) females. Most participants (296, 56.1%) were between 15-19 years of age with mean age of 19 ±2.43 years. The mean (±SD) of participants responses with good knowledge of hepatitis B was 249±121.5 while for good awareness, it was 181±88.3. The percentage average for good knowledge and good awareness was 47.2% and 34.2% respectively, with positive correlation between knowledge and awareness of hepatitis B (r=0.720, p<0.0001). Age was significantly associated with participants percentage average knowledge (OR=0.77, 95% CI 0.70-0.84, p<0.0001) and awareness of hepatitis B (OR=0.84, 95%CI 0.78-0.90, p=0.004). No other factor was significantly associated with knowledge and awareness of hepatitis B except Ijaw tribe (OR=0.4, 95%CI 0.24-0.66, p=0.034) and attendance of Federal Government College (OR=0.4, 95% CI 0.24-0.68, p=0.046). Conclusion: The percentage average good knowledge of 47.2% and awareness of 34.2% for hepatitis B in this study are low, although most participants in the study were between the ages of 15-19 years and in their first and second year of study. This gives room for improvement in knowledge and awareness of hepatitis B with progression in age and year of training. Good knowledge and awareness of hepatitis B are central to the biosafety of medical students. It is recommended that the National Universities Commission (NUC) and the Medical and Dental Council of Nigeria (MDCN) review the current medical school curriculum to increase the teaching of medical and health-related students that will impact more on knowledge and awareness of infectious diseases and infection prevention and control.


Asunto(s)
Masculino , Femenino , Facultades de Medicina , Concienciación , Hepatitis B , Universidades , Conocimiento
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