Diagnóstico por estudio bacteriológico cuantitativo de la infección en la herida por quemadura / Diagnosis for quantitative bacteriological study of the infection in the injury by burn

RESUMEN Fundamento: los procesos infecciosos son una de las causas de morbilidad y mortalidad en pacientes quemados, por lo que el diagnóstico temprano de la infección a través del estudio bacteriológico cuantitativo representa un paso de avance para el tratamiento oportuno. Objetivo: determinar mediante el estudio bacteriológico cuantitativo de la herida por quemadura el diagnóstico de infección en pacientes quemados. Métodos: se realizó un estudio descriptivo, de corte transversal para determinar mediante el estudio bacteriológico cuantitativo de la herida por quemadura el diagnóstico de infección en los pacientes quemados ingresados en el servicio de Caumatología del Hospital Universitario Manuel Ascunce Domenech de la provincia Camagüey, desde septiembre de 2015 a noviembre de 2017. Se estudiaron 34 pacientes y se evaluaron las variables: edad, sexo, índice de gravedad, positividad o no de los estudios cualitativos y cuantitativos en relación con las manifestaciones clínicas de infección. Resultados: el sexo femenino fue el más representado con 70,59 % de casos, predominaron las edades entre 48-67 años, el 38,23 % de los lesionados estaban clasificados como muy grave, la colonización fue la predominante sobre la infección en el cultivo cuantitativo con un 26,47 %. En los pacientes con manifestaciones clínicas de infección, el cultivo bacteriológico cuantitativo fue positivo en 11 de ellos para un 32,35 %. Se encontró en el 44,12 % la presencia de gérmenes a una concentración de más de 105 gérmenes por gramo de tejido. Conclusiones: los factores determinantes en la aparición de infección en la herida por quemadura son la edad, la extensión y profundidad de las lesiones. Existió una correlación entre la positividad del estudio bacteriológico cuantitativo y la presencia de manifestaciones clínicas de infección en los pacientes. Se documentó mayor número de cultivos cuantitativos con resultados positivos y su correlación con la presencia de gérmenes en los cultivos cualitativos.

ABSTRACT Background: the infectious processes are one of the main causes of morbidity and mortality in the burned patients, which is why the early diagnosis of the infection through the bacteriological quantitative study represents a forward-motion step for the opportune treatment of these patients. Objective: to determine the diagnosis of infection in the burned patients by means of the bacteriological quantitative study of the injury by burn. Methods: a descriptive, cross-section study was carried out to determine by means of the bacteriological quantitative study of the injury by burn the diagnosis of infection in the burned patients entered in the service of Burn at Manuel Ascunce Domenech Universitary Hospital of the province Camagüey, from September 2015 to November 2017. 34 patients were studied in those who were evaluated the following variables: age, sex, severity rate, positivity or no of the qualitative and quantitative study relating to the clinical public demonstrations of infection. Results: in this study the feminine sex became represented by 70.59 %, predominating ages between 48- 67 years, the 38.23 % of injured persons were classified as very grave, and colonization was the predominant on the infection in the quantitative cultivation with a 26.47 %. In patients with clinical demonstrations of infection, the quantitative culture was positive in 11 of them for a 32.35 %. It was found in 44.12 % of patients, the presence from germs to a concentration of over 105 germen per gram of fabric. Conclusions: determining factors in the appearing of infection in the injury by burn were age, extension and depth of the injuries. There was a correlation between the positivity of the bacteriological quantitative study and the presence of clinical demonstrations of infection in these patients. Greater number of quantitative cultivations with positive results and their correlation with the presence of germs in the qualitative cultivations were documented.

Intervenciones de enfermería para la atención de mujeres y hombres con VIH / Nursing interventions for the care of women and men with HIV

Introducción. La infección por el virus de inmunodeficiencia humana (VIH) puede considerarse una enfermedad crónica. De acuerdo con ONUSIDA, en 2012 se estimó que 35.3 millones de personas vivían con VIH y se registraron 2.3 millones de nuevos casos, por tanto son considerables los efectos económicos de la estructura de la morbi-mortalidad de esta infección.Métodos. Con el descriptor “HIV infections” y el planteamiento de preguntas PICO, se realizó la búsqueda sistemática en: PUBMED, CUIDEN y algunos sitios web para la revisión de guías clínicas, revisiones sistemáticas, estudios observacionales entre otros, cuyas evidencias y recomendaciones con mayor gradación y fuerza respectivamente, dieran respuesta a la detección oportuna, adherencia al tratamiento, cuestiones psicosociales y el autocuidado de hombres y mujeres que viven con VIH. Se consideraron documentos en inglés, portugués y español publicados en el periodo 2009-2014.Resultados. Se utilizaron 30 documentos para la elaboración de esta guía. La evidencia científica destaca la importancia de la detección y tratamiento oportuna de la infección a través de pruebas rápidas, así como la valoración de factores que puedan inferir negativamente en la adherencia al tratamiento y por ende el abandono, la resistencia farmacológica y complicaciones que comprometan la integridad y la vida de las personas con VIH.Conclusiones. Son necesarias acciones que promuevan una cultura de corresponsabilidad y autocuidado para mejorar la calidad de vida de las personas que viven con VIH y su inclusión a todos los ámbitos de su vida y sociedad.

Introduction. Infection with human immunodeficiency virus (HIV) can be considered a chronic disease. According to UNAIDS, in 2012 it was estimated that 35.3 million people were living with HIV and 2.3 million new cases are therefore considerable economic effects of the structure of morbidity and mortality of this infection were recorded.Methods. PUBMED, CUIDEN and some websites for review of clinical guidelines, systematic reviews, observational studies among others, whose findings and recommendations more gradation: the descriptor ""HIV infections"" and asking questions PICO, systematic search was conducted and strength respectively, would respond to early detection, treatment adherence, self-care and psychosocial issues of men and women living with HIV. documents in English, Portuguese and Spanish published in the period 2009-2014 were considered.Results. 30 documents for the development of this guide were used. The scientific evidence highlights the importance of early detection and treatment of infection through rapid testing and evaluation of factors that may adversely infer adherence to treatment and thus neglect, drug resistance and complications involving the integrity and the lives of people with HIV.Conclusions. They are necessary actions that promote a culture of responsibility and self-care to improve the quality of life of people living with HIV and their inclusion in all spheres of life and society.

Introdução. A infecção com o vírus da imunodeficiência humana (VIH) pode ser considerada uma doença crónica. De acordo com a UNAIDS, em 2012 estimava-se que 35,3 milhões de pessoas viviam com HIV e 2,3 milhões de novos casos são, portanto, os efeitos económicos consideráveis ​​da estrutura de morbidade e mortalidade desta infecção foram registrados.Métodos. PubMed, CUIDEN e alguns sites de revisão de diretrizes clínicas, revisões sistemáticas, estudos observacionais, entre outros, cujas conclusões e recomendações mais gradação: o descritor ""infecções por HIV"" e fazer perguntas PICO, busca sistemática foi conduzida e força, respectivamente, iria responder a detecção precoce, a adesão ao tratamento, auto-cuidado e questões psicossociais de homens e mulheres que vivem com o HIV. Foram considerados documentos em Inglês, Português e Espanhol publicados no período 2009-2014.Resultados. Foram utilizados 30 documentos para o desenvolvimento deste guia. A evidência científica destaca a importância da detecção e tratamento da infecção precoce através de testes rápidos e avaliação de fatores que podem inferir negativamente a adesão ao tratamento e, portanto, negligência, resistência aos medicamentos e complicações que envolvem o integridade e as vidas das pessoas com HIV.Conclusões. Eles são ações necessárias que promovam uma cultura de responsabilidade e auto-cuidado para melhorar a qualidade de vida das pessoas que vivem com o HIV e sua inclusão em todas as esferas da vida e da sociedade.

Procalcitonin: a new parameter for the prediction and assisting diagnosis of infection complications in severe multiple trauma patients / 第三军医大学学报

Objective To study the changes in tumor necrosis alpha(TNF ?), interleukin 6(IL 6), procalcitonin(PCT) and C reactive protein (CRP) levels and their values in the prediction and assisting diagnosis of infection complications in severe multiple trauma patients. Methods TNF ?, IL 6 and CRP were measured by enzyme linked immunosorbant assay(ELISA) and PCT was determined by immunoluminometric assay(ILMA) in serial samples of plasma from 34 patients with severe multiple trauma(ISS≥16) and compared with those of 11 normal control volunteers. Patients were divided into 2 groups(infection and non infection groups). The differences of the above parameters between groups were compared. In addition, all data were managed by receiver operating characteristic(ROC), and sensitivity, specificity, negative and positive predictive values for the diagnosis of infection complications were calculated. Results Plasma levels of TNF ?, IL 6, PCT and CRP in multiple trauma patients without infection complications were increased differently in the early posttrauma period. TNF ? and CRP levels in the early posttrauma period before infection were not significantly different from those in patients without infection complications, but they increased significantly following infection. However, during the whole observing period, plasma levels of PCT and IL 6 in the patients with infection complications were higher than those in patients without. The value of those parameters in assisting diagnosis of infection was evaluated. PCT was of the highest specificity and higher negative and positive predictive values. Conclusion All the parameters are of clinical value in infection diagnosis after severe multiple trauma. PCT is the best index for the prediction and assisting diagnosis of infection after multiple trauma.