Subject(s)
Humans , Male , Middle Aged , Sexually Transmitted Diseases , Arthritis , Tobacco Use Disorder , Hypertension , Inpatients , Physical Examination , Communicable Diseases , MicrobiologySubject(s)
Humans , Female , Adult , Leprosy, Lepromatous/diagnosis , Leprosy, Lepromatous/drug therapy , Public Health , MycobacteriumSubject(s)
Autoimmune Diseases , COVID-19 , COVID-19 Vaccines , Humans , SARS-CoV-2 , Surveys and Questionnaires , VaccinationABSTRACT
Resumen Objetivo: Describir la epidemiología de la Leptospirosis en el departamento del Huila durante el período 2011 -2017. Materiales y métodos: Estudio descriptivo de corte transversal, retrospectivo. La población analizada fueron pacientes de los diferentes municipios del departamento del Huila que se reportaron como casos probables o confirmados de leptospirosis. Se estructuraron registros por cada año en bases de datos recopiladas por el área de epidemiología de la Secretaría de Salud del Huila, basadas en las fichas de notificación de vigilancia en salud pública para leptospirosis y generadas por cada Unidad Primaria Generadora de Datos (UPGD) ante la presencia del evento. Los datos fueron discriminados de acuerdo a las variables de interés para el estudio en una nueva base de datos en Excel; tabuladas con el programa estadístico R - Studio 3.3.3 y Epidat 4.2, para luego ser procesados con estadísticos descriptivos y finalmente ser expresados en porcentajes y en tasas de incidencia. Resultados: Se reportaron 268 casos, de los cuales 61 (23%) fueron confirmados por laboratorio y 207 (77%) sospechosos o probables. El 69% de los pacientes presentaron fiebre, mialgias y cefalea como síntomas representativos. El grupo etario más afectado tenía entre 27 y 59 años de edad (44%). La población se caracterizó por ser del área urbana (65%), con mayor frecuencia en hombres (72%). En relación a la ocupación laboral, se encontró mayor frecuencia en agricultores (20%) y en el personal de aseo (17%). Los factores de riesgo evidenciados fueron la presencia de animales domésticos en un 67% de los casos, así como la presencia de ratas en el hogar (51%) y el posible mal manejo del agua. Conclusiones: El incremento en el número de casos de Leptospirosis probablemente está asociado a la mala manipulación del agua y a la presencia de animales en el domicilio.
Abstract Objective: Describe the epidemiology of Leptospirosis in the department of Huila during the years 2011 to 2017. Materials and methods: This article is a descriptive, cross-sectional, retrospective study. The population analyzed were patients from the different municipalities of the department of Huila who were reported as probable or confirmed cases for leptospirosis, structuring records for each year in databases compiled by the epidemiology area of the department's health secretary, based on the public health surveillance notification sheets for leptospirosis, and generated by each Primary Data Generating Unit (UPGD) in the presence of the event; The data were discriminated according to the variables of interest for the study in a new database in Excel; tabulated with the statistical program R - Studio 3.3.3 and Epidat 4.2, to later be processed with descriptive statistics and finally expressed in percentages and incidence rates. Results: 268 cases were reported, which 61 (23%) were confirmed by laboratory and 207 (77%) suspicious or probable. 69% of the patients presented fever, myalgia and headache as representative symptoms. The most affected group range in ages from 27 and 59 (44%). The population was characterized for being part of the urban area (65%), and the cases were more frequent in men (72%). Regarding to employment, it was found that farmers (20%) and the cleaning staff (17%) were the most common cases. The risk factors identified were the presence of domestic animals in 67% of the cases, as well as the presence of rats at home (51%) and the possible poor water management. Conclusions: The increase in the number of cases of Leptospirosis is probably associated with the poor water management and the presence of animals at home.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Zoonoses , Risk Factors , Myalgia , Leptospirosis/epidemiology , Retrospective Studies , Colombia , Fever , Public Health Surveillance , Farmers , Headache , Animals, DomesticABSTRACT
No disponible
Subject(s)
Humans , Male , Chest Pain/diagnostic imaging , Chest Pain/etiology , Paracoccidioidomycosis/diagnostic imaging , Middle Aged , Radiography, Thoracic/methods , Paracoccidioidomycosis/drug therapy , Itraconazole/administration & dosageABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Plasmacytoma/diagnosis , Spinal Cord Neoplasms , Immunophenotyping/methods , Neoplasms, Plasma Cell , Erythema Nodosum , Syndecan-1Subject(s)
Multiple Myeloma/pathology , Plasmacytoma/pathology , Humans , Male , Middle Aged , Multiple Myeloma/complicationsABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Bacterial Infections/epidemiology , Bacterial Infections/prevention & control , Bacterial Infections , Central Nervous System/pathology , Central Nervous System , Brain Abscess , Glioblastoma , Tomography, Emission-Computed/methods , Tomography, Emission-Computed , Magnetic Resonance Imaging/methods , Diagnosis, Differential , Encephalitis , Meningitis, Bacterial , Cerebral Ventriculitis , Empyema , Mycobacterium tuberculosis/radiation effectsABSTRACT
INTRODUCTION: PCT has been consolidated as a key tool in the diagnosis of bacterial infections in general population. Few studies have been conducted to determine the applicability of this test in elderly patients. METHODS: Study of validity of PCT on elderly patients. Two groups were formed; the first group was formed by patients aged 75 years or older, under bacterial infection criteria and PCT on the initial Lab test. The second group was formed by patients aged 75 years or older with any noninfectious disease; these patients were asked PCT in the initial Lab test. Sensitivity, specificity, positive and negative likelihood ratio were calculated. RESULTS: 161 patients were included, 95 with probable bacterial infection and 66 without infection. Patients with probable bacterial infection criteria, 72% of them had PCT >0.5 ng/mL. Patients without infection, 8% of the patients had PCT >0.5 ng/mL. Sensitivity and specificity of PCT to bacterial infection with the cutoff value of 0.5 ng/mL was 72% and 92%, respectively. CONCLUSION: PCT can be used in elderly patients to diagnose bacterial infections because it has proved good sensitivity and high specificity.
Subject(s)
Bacterial Infections/blood , Calcitonin/blood , Aged , Aged, 80 and over , Bacterial Infections/diagnosis , Biomarkers , Comorbidity , Diabetes Mellitus/epidemiology , Female , Humans , Likelihood Functions , Male , Nervous System Diseases/epidemiology , Predictive Value of Tests , Prospective Studies , Renal Insufficiency, Chronic/epidemiology , Retrospective Studies , Sensitivity and Specificity , Sepsis/bloodABSTRACT
INTRODUCCIÓN: El tratamiento antirretroviral de alta eficacia ha incrementado la expectativa de vida en los pacientes con infección por el virus de inmunodeficiencia humana (VIH), lo que ha traído consigo un aumento de comorbilidades propias del envejecimiento de la población, como es el caso de la enfermedad pulmonar obstructiva crónica (EPOC). Todo esto conlleva la necesidad de utilizar un mayor número de medicamentos y un aumento en el riesgo de interacciones farmacológicas con los antirretrovirales, especialmente con los inhibidores de la proteasa. MÉTODOS: Describimos un caso de insuficiencia suprarrenal iatrogénica por interacción entre ritonavir y fluticasona inhalada en un paciente diagnosticado de infección por VIH y EPOC. Posteriormente realizamos una revisión de casos clínicos publicados en adultos en la literatura médica (Medline) hasta diciembre del 2012. RESULTADOS: En el periodo estudiado se identificaron 34 casos, con una media de edad de 48 años. La dosis promedio de ritonavir fue de 187 mg/día, mientras que la de fluticasona fue de 866 μg/día. El promedio de tiempo de la interacción entre el ritonavir y la fluticasona fue de 8 meses. En el 85% de los casos se retiró la fluticasona una vez hecho el diagnóstico de insuficiencia suprarrenal/síndrome de Cushing. El 90% de los pacientes presentó una resolución completa del cuadro clínico con la modificación del tratamiento. CONCLUSIÓN: En los pacientes en tratamiento antirretroviral con un inhibidor de la proteasa potenciado con ritonavir en los que sea preciso el uso de corticoides inhalados, la beclometasona sería la mejor opción terapéutica
INTRODUCTION: Highly effective antiretroviral treatment has improved the life expectancy of human immunodeficiency virus (HIV) infected patients, but has led to an increase in the comorbidities related to aging, such as the chronic obstructive pulmonary disease (COPD). All this implies the need for a greater number of drugs and an increasing risk of drugs interactions with antiretroviral treatment, particularly protease inhibitors. METHODS: We report a case of iatrogenic adrenal insufficiency interaction secondary to ritonavir and inhaled fluticasone in an HIV-infected patient with COPD. A review was made of the cases reported in adults in the medical literature (Medline) up to December 2012. RESULTS: A total of 34 cases were reported. The mean age was 48 years. The mean dose of ritonavir was 187 mg/day, while the fluticasone dose was 866 μg/day. The average time of the interaction between ritonavir and fluticasone was 8 months. In 85% of cases fluticasone was discontinued at the time of diagnosis of adrenal insufficiency/Cushing syndrome. Almost all (90%) patients had a complete resolution of the symptoms after changing the treatment. CONCLUSION: HIV-infected patients on antiretroviral therapy with protease inhibitor boosted with ritonavir which requires the use of inhaled corticosteroids, beclomethasone would be the best treatment option
Subject(s)
Humans , Female , Middle Aged , Adrenal Insufficiency/microbiology , Ritonavir/therapeutic use , Cushing Syndrome/complications , Cushing Syndrome/microbiology , Drug Interactions , Hydrocortisone/therapeutic use , Ritonavir/metabolism , Administration, Inhalation , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/microbiology , Pulmonary Disease, Chronic Obstructive/prevention & controlABSTRACT
INTRODUCTION: Highly effective antiretroviral treatment has improved the life expectancy of human immunodeficiency virus (HIV) infected patients, but has led to an increase in the comorbidities related to aging, such as the chronic obstructive pulmonary disease (COPD). All this implies the need for a greater number of drugs and an increasing risk of drugs interactions with antiretroviral treatment, particularly protease inhibitors. METHODS: We report a case of iatrogenic adrenal insufficiency interaction secondary to ritonavir and inhaled fluticasone in an HIV-infected patient with COPD. A review was made of the cases reported in adults in the medical literature (Medline) up to December 2012. RESULTS: A total of 34 cases were reported. The mean age was 4 years. The mean dose of ritonavir was 187 mg/day, while the fluticasone dose was 866 µg/day. The average time of the interaction between ritonavir and fluticasone was 8 months. In 85% of cases fluticasone was discontinued at the time of diagnosis of adrenal insufficiency/Cushing syndrome. Almost all (90%) patients had a complete resolution of the symptoms after changing the treatment. CONCLUSION: HIV-infected patients on antiretroviral therapy with protease inhibitor boosted with ritonavir which requires the use of inhaled corticosteroids, beclomethasone would be the best treatment option.
