Prevalencia de sífilis gestacional y congénita en el estado del Mato Grosso do Sul - Brasil, entre los años de 2010 y 2019

RESUMEN Esta investigación tuvo como objetivo informar la prevalencia de sífilis gestacional y congénita entre los años 2010 a 2019 en el estado de Mato Grosso do Sul, según datos de SINAN. Fue hecha una investigación documental y retrospectiva, con un enfoque cuantitativo. Se reportaron 8,791 casos de sífilis en mujeres embarazadas, el grupo de edad más afectado fue entre 20 y 29 años, con un total de 4,250 casos en este también con un mayor número de casos etnia parda. El diagnóstico de sífilis congénita se realizó con mayor frecuencia en una etapa reciente. Tanto las mujeres puerperales como sus parejas presentaron un tratamiento inadecuado. Con este estudio, fue posible observar un aumento en la sífilis gestacional y congénita a lo largo de los años estudiados, seguido de una caída, que puede denotar debilidades en la atención prenatal y la mujer embarazada, señalando que las mejoras son necesarias.

ABSTRACT This research aimed to report the prevalence of gestational and congenital syphilis between the years 2010 to 2019 in the state of Mato Grosso do Sul, based on data from SINAN. It was made a documentary and retrospective investigation, with a quantitative approach. 8,791 cases of syphilis were reported in pregnant women, the most affected age group was between 20 and 29 years old, with a total of 4,250 cases in this age group as also as with a greater number of cases for brown skin. The diagnosis of congenital syphilis was most often made at a recent stage. Both puerperal women and their partners presented inadequate treatment. In this study, it was possible to observe an increase in gestational and congenital syphilis over the years studied followed by a fall, which may denote weaknesses in prenatal care and the pregnant woman, pointing out that improvements are necessary.

Sífilis ocular como manifestación de neurolues: a propósito de un caso clínico / Ocular syphilis as a manifestation of neurolues: about a clinical case / Sífilis ocular como manifestação de neurolores: sobre um caso clínico

Resume: La sífilis ocular es una forma infrecuente de neurosífilis, que se puede presentar en cualquier estadio de la enfermedad. La presentación clínica puede ser heterogénea, siendo la forma más frecuente la uveítis. El diagnóstico se confirma con serología, debiéndose realizar estudio del líquido cefalorraquídeo para descartar compromiso meníngeo. Su detección y tratamiento precoz permiten la prevención de complicaciones neurológicas como la ceguera irreversible. Presentamos el caso clínico de un paciente que se presenta con panuveítis y diagnóstico serológico de sífilis presentando excelente respuesta al tratamiento instaurado.

Abstract. Ocular syphilis is an uncommon type of neurosyphilis, which can occur at any stage of the disease. The clinical presentation can be heterogeneous, with uveitis being the most frequent form. The diagnosis is confirmed with serology and a study of the cerebrospinal fluid should be performed to rule out meningeal involvement. Its diagnosis and early treatment allow the prevention of neurological complications such as irreversible blindness. We present a clinical case of a patient who presents with panuveitis and serological diagnosis of syphilis presenting an excellent response to treatment.

Resumo: A sífilis ocular é uma apresentação atípica do neurosífilis, que pode ocorrer em qualquer estágio da doença. A apresentação clínica pode ser heterogênea, sendo a uveíte a forma mais frequente. O diagnóstico é confirmado com sorologia e um estudo do líquido cefalorraquidiano deve ser realizado para descartar o compromisso meníngeo. Seu diagnóstico e tratamento precoce permitem prevenir complicações neurológicas como cegueira irreversível. Apresentamos um caso clínico de um paciente com panuveíte e diagnóstico sorológico de sífilis e excelente resposta ao tratamento.

Bilateral Symmetrical Lissencephaly With Pachygyria: A Case Report

Background: Lissencephaly is a rare developmental disorder characterized by absence of cerebral convolutions.Pachygyria (broad gyri) or agyria (no gyri) are terms used to describe appearance of cerebral surface. Togetherthese associated conditions are a part of congenital cortical malformations and may result due to arrest ofbrain development before third or fourth month of gestation. Patients suffering from these conditions presentswith significant developmental delays which further depends on the degree of malformation. Results: We reporta case of bilateral symmetrical extensive lissencephaly with pachygyria. The major MRI findings during evaluationof our case were smooth gyral pattern with thickened cortex, thinning of periventricular white matter andprominent VR (Ventricular) spaces.Conclusion: These defects can be idiopathic, associated with chromosomal abnormalities LIS 1 (chromosome 17)or can be to environmental factors (prenatal drugs or intrauterine perfusion failures). In our case Chromosome17 defect was suspected as the parieto-occipital regions were more involved.

Resultados de un programa nacional de trasplante cardiaco pediátrico: fortalezas y debilidades / Results of a national program of pediatric heart transplantation: strengths and weakness

El trasplante cardiaco pediátrico es una terapia efectiva para tratar la insuficiencia cardiaca avanzada. Objetivos: Analizar los resultados inmediatos y a mediano plazo de niños enlistados para trasplante cardiaco. Pacientes y Método: Se analizó el registro de pacientes enlistados para trasplante, entre octubre de 2001 y julio de 2016, analizando datos demográficos, diagnósticos, status de enlistamiento, tiempo de espera, datos de donantes, uso de asistencia ventricular, complicaciones y mortalidad. Resultados: La serie abarca 30 pacientes con edad promedio de 9,4 años (1 mes a 15 años). El diagnóstico principal fue miocardiopatía dilatada en 24 pacientes (80%). El status de ingreso fue I (urgencia) en 19 casos y II (no urgencia) en 11. Fallecieron 10 en la lista de espera (33,3%) en un promedio de 52 días (13 a 139 días). Catorce pacientes fueron trasplantados (46.7%), con un tiempo de espera de 199,6 días (4 a 586 días). Requirieron asistencia ventricular 9 pacientes (30%). Todos recibieron inmunosupresión tri asociada. Un paciente falleció a los 16 días por falla primaria del injerto (7,1%). El seguimiento promedio fue de 43 meses (0,5 a 159 meses). Dos pacientes fallecieron alejadamente (55 y 82 meses) por rechazo secundario al abandono de tratamiento inmunosupresor. La supervivencia a 1 y 5 años fue 93% y 74%, respectivamente. Conclusiones: Nuestro programa ha trasplantado al 50% de los pacientes enlistados con buena supervivencia a mediano plazo. Una proporción significativa de pacientes se enlistó con carácter de urgencia y un 34.5% de los pacientes fallecieron en la lista de espera.

Pediatric heart transplantation is an effective therapy to treat advanced heart failure in children. Objectives: To analyze the immediate and mid-term results of pediatric patients listed for heart transplantation. Patients and Methods: Registration of patients admitted to our transplant protocol between October 2001 and July 2016 were reviewed, analyzing demographic data, diagnosis, status at the time of listing, waiting time until transplantation, donor data, use of ventricular assist device, hemodynamic data, complications and global mortality. Results: Thirthy patients where included with a mean age of 9.4 years (1 month to 15 years). The most frequent diagnosis was dilated cardiomyopathy in 24 patients (80%). The status was I (urgency) in 19 cases and II in 11 cases. Ten patients died on the waiting list (33.3%) at an average of 52 days (13-139 days). Fourteen were transplanted (46.7%), with a waiting time of 199.6 days (4-586 days). Nine patients required mechanical support (30%). All patients received triple association of immunosuppression. One patient died 16 days post transplant due to primary graft failure (7.1%). The average follow-up was 43 months (0.5-159 months). Two patients died later on (82 and 55 months), both due to secondary rejection because of voluntary cessation of immunosuppressive therapy. Survival at 1 and 5 years was 93% and 74%, respectively. Conclusions: Our program has successfully transplanted 50% of patients enrolled, with good medium-term survival. A significant proportion of patients were listed as a medical emergency and 34.5% died on the waiting list.

Application of LIS management group in hospital software and hardware management / 医疗卫生装备

Objective To explore the application of LIS management group in hospital software and hardware management.Methods The objective,responsibilities and management procedure of hospital LIS management group were introduced,and its effects were studied in hospital software and hardware management.Results Hospital LIS management group optimized LIS management procedure,decreased fault rate and shortened the time for fault handling.Conclusion LIS management group promotes hospital digitalization and clinical laboratory department management.

Development of clinical laboratory vehicle for field rescue / 医疗卫生装备

Objective To develop a clinical laboratory vehicle with advantages in mobility,deployment,automation and informatization to meet the requirements of disaster relief.Methods Ford transit V348 ambulance was used as the base,which was equipped with routine blood analyzer,routine urine analyzer,biochemical analyzer and etc.The same instruments,agents and procedures were adopted as those in the clinical laboratory department of rear hospital,and LIS,air cleaning system and necessary auxiliary units were also involved in the modification.Results The clinical laboratory vehicle increased the working efficiency while decreased the errors.Conclusion The vehicle fulfills mobile medical support for military operations other than war such as disaster relief,and thus is worthy promoting practically.

Informatized management and optimization measures of clinical laboratory process / 医疗卫生装备

Objective To standardize the informatized management of clinical laboratory process,improve quality control and personnel supervision and enhance clinical laboratory efficiency.Methods The present situation of informatization in barcode automation,on-line data acquisition,expense management,statistical analysis,quality control and etc was analyzed,and the problems and measures were pointed out for clinical laboratory process optimization.Results The optimization measures included two-way communication mode,integration of LIS and LAS and etc.Conclusion Informatized management of clinical laboratory process and further automatic and intelligent management contribute to enhancing clinical laboratory examination efficiency,controlling examination cost and reducing biological pollution.

Establishment and application of intelligent nutritional diet analysis system in hospital / 医疗卫生装备

Objective To establish an intelligent nutritional diet analysis system in the hospital to guide and monitor the patient's diets and nutrition.Methods Individual health report and nutrition prescription were output intelligently through an intelligent nutritional diet knowledge-based system as well as the interfaces between the modules of electronic record interchange,intelligent nutrition analysis and diet management,and the modules were all interfaced with HIS and LIS respectively.Results The patient's diets and satisfaction were all enhanced by the system.Conclusion The system integrates computer technology into nutritional diet management to realize whole-course traceable closed-loop management.

Design and application of picture archiving and communication systems / 医疗卫生装备

Objective To develop a PACS covering the whole hospital.Methods Communication between PACS and the existing HIS was realized with Web technology,SOA,Oracle database and barcode technology.esults The electronic information from HIS contributed to real-time,automatic and one-to-one charging by PACS,and the examining results and images were returned to HIS to implement the integration of data set,application set and flow set,and statistical analysis was carried out on the examining results,then a set of PACS/RIS with complete functions came into being.Conclusion PACS/RIS simplifies the process for visiting a doctor,decreases waiting time,transmits data on the detection equipment in time and implements paperless image report.

Lissencephaly:a case report and literature review / 临床儿科杂志

Objective To explore the clinical features of lissencephaly and the detection ofLISI gene.MethodsThe characteristic of clinical features, laboratory examination and gene detection in one case of lissencephaly was retrospectively analyzed. Meanwhile, the related literatures were reviewed.ResultsA 5-month-old female child diagnosed with epilepsy 20 days ago was hospitalized for convulsive seizure more than 30 times in 3 days. The manifestations were eyes staring, and turning upward, cyanosis of lips and face, froth at the mouth, extremities rigidity and loss of consciousness, and the symptoms can spontaneously remitted in 2-3 minutes. Laboratory examination showed that peripheral blood white cell count was 13.67×109/L, hemoglobin 108 g/L, red blood cell count 3.90×1012/L, lymphocyte 10.26×109/L; maocardial enzyme and hepatic and renal function were normal; blood ammonia was 23 μmol/L and lactic acid 2.11 mmol/L. Long-range video EEG showed highly arrhythmia, and frequent partial epilepsy, and sometimes secondary generalized epilepsy. Head MRI showed lissencephaly. The child was treated with oral administration of Keppra 27 mg/(kg·day), Topiramate 6.5 mg/(kg·day), currently no seizure. The detection ofLIS1 gene found that heterozygous mutation of c.232delG, which lead to protein shift mutation (p.E78NfsX25). No mutation was found in her parents.ConclusionsChild with lissencephaly may combine with epilepsy which may cause by mutation inLIS1 gene. And there was no information about point mutation of c.232delG inLIS1 gene being reported at home and abroad so far.

Issues on the automation and information of clinical laboratories / 中华医学科研管理杂志

This article describes the development,components and function of the laboratory automation system (LAS) and laboratory information system(LIS). And it also discusses the construction and application laboratory automation,and the operation of the automated laboratory information system.

New Spectrophotometric Methods for Simultaneous Determination of Amlodipine besylate and Lisinopril in Tablet Dosage Forms.

Two simple, accurate, precise, reproducible, requiring no prior separation and economical procedures for simultaneous estimation of Amlodipine besylate (AML) and Lisinopril (LIS) in tablet dosage form have been developed. First method is simultaneous equation method; in this method 360.0 nm and 248.0 nm were selected to measure the absorbance of drugs at both wavelengths. The second method is Q-value analysis based on measurement of absorptivity at 300.0 nm (as an iso-absorptive point) and 360.0 nm. AMD and LIS at maximum wavelength of AML, 360.0 nm and at isoabsorptive point 300.0 nm shows linearity in a concentration range of 5- 40 μg/mL. Recovery studies range from >99.82% for AMD and >98.09% for LIS in case of simultaneous equation method and >100% for AMD and >98.45% for LIS in case of Q-analysis method confirming the accuracy of the proposed method. The proposed methods are recommended for routine analysis since it is rapid, simple, accurate and also sensitive and specific (no heating and no organic solvent extraction is required).

The Clinical Efficacy of GOCA Scoring System in Patients with Acute Respiratory Distress Syndrome

To explore the following hypotheses: 1) Gas exchange, Organ failure, Cause, Associated disease (GOCA) score, which reflects both general health and the severity of lung injury, would be a better mortality predictor of acute respiratory distress syndrome (ARDS) than acute physiology and chronic health evaluation (APACHE II) or simplified acute physiology score (SAPS II), which are not specific to lung injury, and lung injury score (LIS) that focuses on the lung injury; 2) the performance of APACHE II and SAPS II will be improved when reinforced by LIS, we retrospectively analyzed ARDS patients (N=158) admitted to a medical intensive care unit for five years. The overall mortality of the ARDS patients was 53.2%. Calibrations for all models were good. The area under the curve of (AUC) of LIS (0.622) was significantly less than those of APACHE II (0.743) and SAPS II (0.753). The AUC of GOCA (0.703) was not better than those of APACHE II and SAPS II. The AUCs of APACHE II and SAPS II tended to further increase when reinforced by LIS. In conclusion, GOCA was not superior to APACHE II or SAPS II. The performance of the APACHE II or SAPS II tended to improve when combining a general scoring system with a scoring system that focused on the severity of lung injury.

Effect of Blood Ordering and Input with using the Blood Information Sharing System (BISS) of the Korean RedCross / 대한수혈학회지

BACKGROUND: Generally, a hospital blood bank orders blood components from the Korean RedCross with using a telephone. Persons in a blood bank are required to do lots of work and labor, and spend much time during handling, processing and storage of blood components, and this is irrespective of simple procedure. To improve blood bank work, we used the BISS at the Korean RedCross with using the internet. METHODS: The orders for the blood components were saved on an excel file with using BISS. After we got the blood components, we classified and counted the blood components and interfaced the data of the excel file to blood bank laboratory information system (LIS), and these components were stored at the proper sites. We compared the blood bank work before and after introducing the BISS. RESULTS: Using BISS saved 154.3 hour and it increased 5,607 irregular antibody screening tests per year. It also prevented bar code reading errors and reduced the workers' personal stress. CONCLUSION: The input process of blood and the blood bank work were effectively improved after introducing the BISS. Key words:

Discussion of Application about Design and Function of Laboratory Information System in Hospital / 医疗卫生装备

Objective To introduce the aim,design principles,function and characteristic of LIS. Methods Through functionalized design of module,this net management system is created by composed application,sampling,check,count,verify,auditing,issuance,quality control,query,consume control as an entirety. Results The accurate test data,the timeliness report and the query convenience were increased. Conclusion The LIS can provide exact and quick medical service for patients.

Application and Research of Clinical Laboratory Information Management System / 医疗卫生装备

Objective The application of laboratory information system (LIS) increases extensively. The objective is to expatiate how to widen the application of LIS so that it can be seamlessly combined with HIS, and play a greater role in quality control of clinical laboratory. Methods A consummate and compact working process was designed. A bidirectional communication from equipment to client was established. Module modes and prefect security systems were set up. Results With the existing HIS network environment, corresponding bar codes were generated through the examination applications from the doctor's workstation. At the same time, patients' basic information and test information were generated based on the bar code. In this way, the seamless combination of LIS and HIS were achieved. The switch of the functional module was simple, efficient and easy to maintain. The internet version Kaspersky antivirus software was used in the area of security. Database were backed up automatically and regularly. Authority was strictly defined for operators in different level. Conclusion Through the current application in our section, LIS has already been an essential part in the process to become a modern hospital.

Study on Network Architecture Method for Medical Laboratory Information System / 医疗卫生装备

Objective To fully realize laboratory information sharing, giving full play of automation and intellectualization of laboratory devices and improving the management level and work efficiency. Methods A new network architecture method was adopted. The laboratory devices were connected by joining TS into the master network. A computer installing interface management program was used as device server. All laboratory instruments were managed by the interface management program. Results The new LIS realized the total inosculation of LIS and HIS and the connection method of different communication modes on many serial communication devices. Conclusion The method strengthens the system's network integration. The maintenance costs and PC resources are saved.

Quality control in Clinical Chemistry by "The Multi-Item Univariate Delta Check Method": The Multi-Item Univariate Delta Check Method / 대한의료정보학회지

Difficulties in calculation that hindered the practice of the delta check in the past is now no longer a problem thanks to the development of computers. But, high false positive rates, which creates heavy burden of checking-work load, are still a problem in the practice of the delta check. We propose a new approach to the reduction of false positive rates, naming our method "the multi-item univariate delta check (MIUDC) method". By the multi-item univariate delta check method, we mean a method in which univariate delta checks are performed on multiple items and specimens with the positive univariate delta check in at least k items receive a detailed investigation. Using data collected in the Department of Clinical Pathology at Korea University Guro Hospital via the Korea University Laboratory Information System, our research found that if we put specimens with positive univariate delta check in at least four test items (k=4) under a detailed investigation, check-out volumes will be light and efficiency will be high. As for test items deserving of more interest, total cholesterol, albumin, and total protein are appropriate because the false positive rate associated with them in the MIUDC was zero in a simulation study.

LIS design and research of security based on web technology / 医疗卫生装备

Functional requirement of LIS analyzed, this paper discusses the application of web technology to it. The choice of application server and security control and management are emphasized on, and then corresponding solutions are provided.

Operating principle and structure of automatic system in laboratory / 医疗卫生装备

This article introduces the principle and the structure of streamline testing based on the newly developed laboratory automation system in our hospital.An overview of the functions and the technical structure of each module within streamline testing are provided.The streamline procedure and the information transmission between modules are also briefly described.