Intervención educativa sobre dengue en adultos / Educational Intervention on Dengue in Adults

Introducción: El dengue es una infección transmitida por mosquitos que en los últimos decenios se ha convertido en un importante problema de salud pública internacional. Objetivo: Evaluar la efectividad de una intervención educativa sobre dengue en adultos. Métodos: Se realizó un estudio cuasi-experimental de intervención educativa, antes y después, sobre dengue en adultos del consultorio 2 del policlínico Alex Urquiola, en el municipio Holguín, en el período comprendido de febrero a marzo de 2021. Tuvo 3 etapas: diagnóstico, intervención y evaluación. Resultados: Antes de la aplicación de la estrategia solo 80 pacientes poseían conocimientos sobre el dengue, después 130 pacientes adquirieron estos conocimientos. Solo 23 pacientes conocían la conducta a seguir ante la sospecha de dengue; después 126 pacientes se incluían. Solo 19 pacientes conocían las medidas de prevención del dengue (13,57 por ciento). Después de aplicada la estrategia educativa 135 pacientes (96,42 por ciento) tenían una adecuada percepción del riesgo. Conclusiones: Se evaluó la efectividad educativa, el nivel de conocimientos sobre el dengue, sus síntomas y signos, forma de transmisión, medidas de prevención y conducta a seguir, así como la percepción del riesgo por estos pacientes(AU)

Introduction: Dengue is a mosquito-borne infection that in recent decades has become a major international public health problem. Objective: To evaluate the effectiveness of an educational intervention on dengue in adults. Methods: A quasi-experimental study of educational intervention was carried out, before and after, on dengue in adults from doctor´s office 2 of Alex Urquiola community clinic, in Holguín municipality, from February to March 2021. It had 3 stages : diagnosis, intervention and evaluation. Results: Before the implementation of the strategy, only 80 patients had knowledge about dengue; after, 130 patients acquired this knowledge. Only 23 patients knew the behavior to follow in case of suspicion of dengue; then 126 patients were included. Only 19 patients knew about dengue prevention measures (13.57percent). After implementing the educational strategy, 135 patients (96.42percent) had an adequate perception of risk. Conclusions: The educational effectiveness, the level of knowledge about dengue, its symptoms and signs, mode of transmission, prevention measures and behavior to follow, as well as the perception of risk by these patients were evaluated(AU)

Mujer joven con nefritis lúpica y dengue / Young woman with lupus nephritis and dengue

Se reporta caso clínico de una mujer de 21 años con lupus eritematoso sistémico (LES) de diagnóstico reciente complicada con nefritis lúpica (NL) tratada en nuestro centro, con evolución favorable con inmunosupresores. Pero reingresa por dengue con signos de alarma del cual se recupera satisfactoriamente.

Clinical case of a 21 year old woman with complicated systemic lupus erythem atosus (SLE) recently diagnosed with lupus nephritis (LN) treated at our center, with favorable evolution immunosuppression reported. But readmitted because dengue of with warning signs, at present he is recovering satisfactorily

A Pilot Study to Evaluate the Effectiveness of Carica Papaya Leaf Extract in Increasing the Platelet Count in Cases of Dengue with Thrombocytopenia.

The pilot study was conducted to investigate the platelet increasing property of Carica papaya leaf extract (CPLE) in patients with dengue fever (DF). An open labeled randomized controlled trial was carried out at two centres of Bangalore metropolis on 30 subjects in patients with thrombocytopenia associated with dengue. The subjects were randomized into two groups, as control and intervention group. Both the groups were managed by the standard management guidelines for dengue except steroid administration. In addition to this, the intervention group received CPLE tablet three times daily for five days. All of them were followed daily with platelet monitoring. The results showed that CPLE had significant increase in the platelet count (p<0.003) over the therapy duration, in dengue fever patients, reiterating that it accelerates the increase in platelet count compared to the control group. There were few adverse events related to GI disturbance like nausea and vomiting which were similar in both groups. Thus this study concluded that Carica papaya leaf extract (CPLE) does significantly increase the platelet count in patients with thrombocytopenia associated with dengue with fewer side effects and good tolerability.

Chloroquine use improves dengue-related symptoms

Dengue is the most important arboviral disease in the world. As chloroquine, an antimalarial agent, has shown some antiviral effects, this study evaluated its effect in patients with dengue. A randomised, double-blind study was performed by administering chloroquine or placebo for three days to 129 patients with dengue-related symptoms. Of these patients, 37 were confirmed as having dengue and completed the study; in total, 19 dengue patients received chloroquine and 18 received placebo. There was no significant difference in the duration of the disease or the degree and days of fever. However, 12 patients (63%) with confirmed dengue reported a substantial decrease in pain intensity and a great improvement in their ability to perform daily activities (p = 0.0004) while on the medication and the symptoms returned immediately after these patients stopped taking the medication. The same effect was not observed in patients with diseases other than dengue. Therefore, this study shows that patients with dengue treated with chloroquine had an improvement in their quality of life and were able to resume their daily activities. However, as chloroquine did not alter the duration of the disease or the intensity and days of fever, further studies are necessary to confirm the clinical effects and to assess the side effects of chloroquine in dengue patients.

Tratamiento del dengue durante su etapa aguda: revisión sistemática de la literatura / Treatment of acute phase of dengue fever: a systematic review

El dengue es la enfermedad ocasionada por un arbovirus de mayor incidencia en el mundo y su impacto económico sobre la productividad de los países afectados es muy importante. Sin embargo, hasta el momento no existe una terapia específica para la enfermedad y hay muy pocos estudios sobre el tema. Esta revisión pretende recopilar los resultados de los trabajos originales que existen en la literatura sobre las intervenciones utilizadas en humanos para el tratamiento del dengue durante la etapa aguda de la enfermedad. Se abordaron los siguientes temas: reemplazo de líquidos, antipiréticos, tratamiento de las hemorragias, tratamiento de la trombocitopenia, uso de corticoides y otras medidas terapéuticas.

Effects of dengue virus infection on peripheral blood cells of mice exposed to hexavalent chromium with drinking water.

BACKGROUND & OBJECTIVE: The occupational and non-occupational exposure to hexavalent chromium Cr (VI) is common. The effect of chromium compromises the immune response of the host. Dengue virus (DV) infection causes various changes in the peripheral blood cells. It is, therefore, possible that the chromium toxicity may affect the disease process during DV infection. The present study aims to study the effects of dengue virus infection on peripheral blood cells of mice fed Cr (VI) with drinking water. METHODS: One group of mice was given ad libitum drinking water containing Cr (VI) and the other group used as the normal control mice was given plain water to drink. At the 3, 6 and 9 wk of Cr (VI) drinking, a set of mice from each group was inoculated intracerebrally (ic) with DV and studied at the 4th and 8th day post inoculation. RESULTS: It was observed that Cr (VI) drinking led to reduction in lymphocytes, haemoglobin and the haematocrit values while the granulocyte, monocyte and platelet counts were increased. On the other hand, most of the parameters were decreased following inoculation of normal mice with DV. In Cr (VI)-fed mice the effects of DV infection were minimal. The most significant finding of these experiments was that the reduction in platelet counts following inoculation with DV was markedly less in Cr (VI)-fed mice than that in DV-inoculated normal control mice. INTERPRETATION & CONCLUSION: Cr(VI) compounds have been declared as a potent occupational carcinogen. On the contrary, Cr(III) salts such as chromium polynicotinate, chromium chloride and chromium picolinate, are used as micronutrients and nutritional supplements, and have been shown to exhibit health benefits in animals and humans. Whether therapeutic doses of chromium (III) compounds may be able to prevent the DV-induced fall in platelet counts, needs to be investigated.

Overview of some biomedical research projects in tropical medicine conducted at the Institute Venezolano de Investigaciones Cientificas

The Instituto Venezolano de Investigaciones Cientificas (IVIC) is a government-funded multidisciplinary academic institution dedicated to research, development and technology in many areas of knowledge. Biomedical projects and publications comprise about 40 percent of the total at IVIC. In this article, we present an overview of some selected research and development projects conducted at IVIC which we believe contain new and important aspects related to malaria, ancylostomiasis, dengue fever, leishmaniasis and tuberculosis. Other projects considered of interest in the general area of tropical medicine are briefly described. This article was prepared as a small contribution to honor and commemorate the centenary of the Instituto Oswaldo Cruz

Diagnóstico y manejo del dengue / fiebre hemorrágica dengue / síndrome de choque dengue / Diagnosis and treatment of dengue, hemorrhagic fever, and dengue shock syndrome

El Dengue es una enfermedad febril aguda en la que se observa 2 o más de las siguientes manifestaciones: dolor de cabeza, dolor retroorbital, mialgias, artralgias, erupción, manifestaciones hemorrágicas, presencia en lugar y tiempo de otros casos confirmados de dengue. Los signos de alarma son: dolor abdominal interno y continuo, vómitos persistentes, inquietud o letardia, súbito descenso de la fiebre, hipotermia, postración o desmayo. El tratamiento ambulatorio requiere de rehidratación oral, medios físicos o acetaminofen. En los casos que se requiere hospitalización se debe iniciar con líquidos por vía intravenosa, si no hay mejoría debe incrementarse la terapia intravenosa y además colocar al paciente con oxigenos. Cuando hay mejoría se reduce la terapia intravenosa para quitarla completamente a las 24 y/o 48 horas. La mejoría se manifiesta en: ausencia de fiebre mayor de 24 horas sin antipiréticos, recuperación del apetito, eliminación urinaria adecuada, hematocrito estable, ausencia de sufrimiento respiratorio

Protection against marked plasma leakage in dengue haemorrhagic fever by infusion of carbazochrome sodium sulfonate (AC-17).

Patients diagnosed clinically as having grade II dengue haemorrhagic fever, and confirmed serologically to have been recently infected by dengue virus were randomly assigned to two groups, to assess suppression of plasma leakage by intravenous administration of carbazochrome sodium sulfonate(AC-17). The double-blind prospective study over three successive epidemic periods included 39 patients in the placebo group, and 38 in the AC-17 group. The effects of the administration were evaluated with respect to pleural effusion of the chest X-ray films. A clear difference between the two groups was found in the numbers of patients with pleural effusion and severity of the pleural effusion thus the administration of AC-17 may be useful in eliminating the risk factors of severe bleeding and shock in dengue haemorrhagic fever.

Hemodynamic response to high-dose methyl prednisolone and mannitol in severe dengue-shock patients unresponsive to fluid replacement.

Nine children; 4 males and 5 females, aged ranging from 2 1/2 to 13 years presented with signs and symptoms of poor tissue perfusion associated with dengue shock syndrome. All these 9 patients were subjected to the therapeutic trial of high dose methyl prednisolone (MP; 9/9) and mannitol (M; 6/9) after their failure to the saline and plasma replacement. Following the high dose MP and M, a significant increment in the effective circulatory blood volume as reflected by the sustained increment in CVP, widening of PP and declining in PR as well as improvement in clinical tissue perfusion were established in 7 of these nine patients so treated.

Dipyridamole in the treatment of dengue haemorrhagic fever.

Clinical studies in the treatment of 54 children suffering from DHF with a combination of dipyridamole and ASA as an adjuvant of our standard therapy consisted of fluid, electrolytes, blood, plasma and plasma expanders were evaluated. Heparin was administered in cases of DIC. It appeared that dipyridamole and ASA did not change the mortality significantly, but it prevented the progress of the severity of the disease from grade I and II to grade III and IV.

Hydrocortisone in the management of dengue shock syndrome.

A total of 98 patients with dengue shock syndrome admitted into Children's Hospital from February 1973 to February 1974 were randomly selected into 2 groups. A double blind controlled trial of the efficacy of pharmacologic doses of hydrocortisone hemisuccinate was carried out. The 2 groups were confirmed to be completely matched by age, sex and severity of the disease. Nine deaths occurred out of 48 cases in the steroid group (Case Fatality Rate 18.75%) and 22 deaths out of 50 cases in the non-steroid group (Case Fatality Rate 44%), the difference being statistically significant. No significant difference was detected in fluid requirements and other morbidity pattern.