RESUMO
Se presenta el caso de un paciente varón de seis años de edad, con síndrome hemofagocítico secundario a infección por virus de Epstein-Barr. El paciente inició el cuadro con fiebre, hepatoesplenomegalia, falla hepática, trastornos de la coagulación, ferritina, triglicéridos y disminución de todas las líneas celulares hematológicas. El aspirado de médula ósea evidenció la presencia de citofagocitosis, por lo que inició tratamiento específico según protocolo HLH 2004, respondiendo favorablemente luego de cuatro semanas. Actualmente, el paciente continúa sus controles por la especialidad sin recaída de enfermedad, con adecuado desarrollo y crecimiento. En nuestro país, son escasos los reportes de síndrome hemofagocítico; sin embargo, puede resultar una patología más frecuente de la que estimamos por lo que, es importante reportar estos casos y más aún el éxito del tratamiento a fin de continuar mejorando su manejo y reporte.
We present the case of a six-year old male patient who presented with hemophagocytic syndrome secondary to Epstein Barr virus infection. The patient had fever, hepatosplenomegaly, liver failure, coagulation, ferritin, and triglyceride disorders, as well as a significant reduction of all blood cell populations. Bone marrow aspirate revealed the presence of autophagocytosis, so specific therapy according to the HLH 2004 protocol was started, and the patient satisfactorily responded after four weeks. Nowadays the patient still attends his control appointments, no relapse has been detected, and both his development and growth are adequate. Few reports on hemophagocytic syndrome have been published in Peru; however, this condition may be more frequent than previously thought. Therefore, it is important to report such cases, particularly successful experiences, aiming to improve management of this condition.
RESUMO
Objetivo: Determinar la relación entre el estado nutricional y los grados de ausentismo laboral. Materiales y métodos: El diseño del estudio fue de tipo transversal. Se recolectó la información a través de las historias clínicas tras el examen médico ocupacional y el registro de las ausencias durante todo el año 2013. Se utilizó estadística descriptiva para el cálculo de la frecuencia y regresión logística para la obtención de los factores asociados. Resultados: Ingresaron 545 trabajadores. Al incrementarse la edad se incrementan las frecuencias de sobrepeso y obesidad. Las complicaciones asociadas al incremento de peso: hipertensión arterial (48,8%), diabetes mellitus tipo 2 (57,1%), dislipidemia (54,5%) y los trastornos musculo esqueléticos (61,9%) se presentan con mayor frecuencia en los trabajadores con sobrepeso, el valor de 28 kg/m2 tuvo la mayor significancia estadística para explicar la relación entre el índice de masa corporal (IMC) incrementado y grados de ausentismo (p=0,01). Conclusiones: El sobre peso está relacionado con mayores índices de ausentismo, específicamente al de mediano plazo. Un IMC de 28 kg/m2 se asocia a un incremento significativo del ausentismo, y los trastornos osteomusculares son los modifican de manera sustancial la relación entre ausentismo e incremento de peso
Objective: To determine the relationship between nutritional status and the levels of absenteeism in the workplace. Materials and methods: This was a cross-sectional study. The information was collected from the medical records after the occupational medical check-up and by reviewing all absences in the workplace during 2013. Descriptive statistics were used for calculating the rates and logistic regression for obtaining the associated factors. Results: Five hundred and forty-five workers were included in the study. The rates of being overweight and obese increased with age. Complications associated with weight gain were: high blood pressure (48.8%), type 2 diabetes (57.1%), dyslipidemia (54.5%) and skeletal muscle disorders (61.9%), which occur more often in overweight workers. The value of 28 Kg/ m2 had the highest statistical significance for explaining the relationship between an increased BMI and the rates of absenteeism in the workplace (p= 0.01). Conclusions: Being overweight is linked to higher rates of absenteeism, specifically in the medium term. A 28- Kg/m2 BMI is associated with a significant increase in absenteeism in the workplace, and musculoskeletal disorders substantially modify the relationship between absenteeism and weight gain
RESUMO
The frequency of the Beijing genotype of Mycobacterium tuberculosis as a cause of tuberculosis (TB) in South America was determined by analyzing genotypes of strains isolated from patients that had been diagnosed with the disease between 1997 and 2003 in seven countries of the subcontinent. In total, 19 of the 1,202 (1.6 percent) TB cases carried Beijing isolates, including 11 of the 185 patients from Peru (5.9 percent), five of the 512 patients from Argentina (1.0 percent), two of the 252 Brazilian cases (0.8 percent), one of the 166 patients from Paraguay (0.6 percent) and none of the samples obtained from Chile (35), Colombia (36) and Ecuador (16). Except for two patients that were East Asian immigrants, all cases with Beijing strains were native South Americans. No association was found between carrying a strain with the Beijing genotype and having drug or multi-drug resistant disease. Our data show that presently transmission of M. tuberculosis strains of the Beijing genotype is not frequent in Latin America. In addition, the lack of association of drug resistant TB and infection with M. tuberculosis of the Beijing genotype observed presently demands efforts to define better the contribution of the virulence and lack of response to treatment to the growing spread of Beijing strains observed in other parts of the world.