ABSTRACT
PURPOSE: The state of Veracruz, Mexico, is a well-recognized endemic region for Chagas disease, but congenital transmission has not been extensively studied. We estimated here the prevalence and the risk of congenital transmission of Trypanosoma cruzi in pregnant women from 27 municipalities of central Veracruz. METHODS: 528 sera from pregnant women were analyzed by ELISA and IFA assays for the detection of IgG antibodies against T. cruzi. RESULTS: The presence of anti-T. cruzi antibodies was identified in women from 17 municipalities, obtaining an overall seroprevalence of 17.0%. A higher seropositivity was observed in the municipalities of Orizaba (25.2%), Nogales (13.6%), and Río Blanco (10.5%). The results suggest that there is a high risk of congenital transmission of T. cruzi in the region. CONCLUSION: There are currently limited actions for the surveillance and control of congenital transmission of Chagas disease in Veracruz.
Subject(s)
Antibodies, Protozoan/blood , Chagas Disease/epidemiology , Chagas Disease/transmission , Infectious Disease Transmission, Vertical , Adolescent , Adult , Chagas Disease/congenital , Female , Humans , Immunoglobulin G/blood , Mexico/epidemiology , Pregnancy , Risk Factors , Seroepidemiologic Studies , Tertiary Care Centers , Trypanosoma cruzi , Young AdultABSTRACT
Introducción: La mortalidad neonatal es una de las prioridades de la salud pública, por lo que se debe revisar cómo la inestabilidad fisiológica del recién nacido después de un traslado contribuye al incremento de la mortalidad neonatal. El objetivo de este trabajo fue determinar si el índice de estabilidad fisiológica (TRIPS) en los recién nacidos trasladados a la Unidad de Cuidados Intensivos Neonatales de un hospital de segundo nivel sirve como factor predictivo de mortalidad neonatal temprana. Métodos: Se valoró el índice de estabilidad fisiológica de la escala de TRIPS para predecir la muerte neonatal en los primeros 7 días del ingreso de los pacientes. Resultados: Se encontró que la mortalidad neonatal a los 7 días del ingreso está relacionada con la puntuación de la calificación TRIPS. La puntuación de los sobrevivientes y las defunciones presentaron una diferencia significativa (p = 0.009). Para una puntuación de 16 se determinó una sensibilidad del 62% y una especificidad de 84%, con un área bajo la curva de 0.757. Conclusiones: La ponderación del índice de estabilidad fisiológica de TRIPS es un buen predictor de la mortalidad neonatal. Es importante establecer medidas para mejorar la estabilidad fisiológica de los recién nacidos antes, durante y después del traslado, con la finalidad de disminuir la mortalidad neonatal.
Background: Neonatal mortality is a public health priority. We review the physiological instability of the newborn after a transfer, which contributes to increased neonatal mortality. The objective of this work was to determine whether the Transport Risk Index of Physiologic Stability (TRIPS) in newborns transferred to the Neonatal Intensive Care Unit of a secondary hospital serves as a predictor of early neonatal mortality. Methods: We use the TRIPS to predict neonatal death in the first 7 days after patients' admission. Results: Neonatal mortality at 7 days after admission is related to the TRIPS rating. The score of the survivors and neonatal deaths show a significant difference (p: 0.009). For a score of 16, a sensitivity of 62% and a specificity of 84%; area under the curve of 0.757 was determined. Conclusions: Physiological index weighting using TRIPS is a good predictor of neonatal mortality. It is important to establish measures to improve physiological stability of the newborn before, during and after the transfer in order to reduce neonatal mortality.
ABSTRACT
BACKGROUND: Neonatal mortality is a public health priority. We review the physiological instability of the newborn after a transfer, which contributes to increased neonatal mortality. The objective of this work was to determine whether the Transport Risk Index of Physiologic Stability (TRIPS) in newborns transferred to the Neonatal Intensive Care Unit of a secondary hospital serves as a predictor of early neonatal mortality. METHODS: We use the TRIPS to predict neonatal death in the first 7 days after patients' admission. RESULTS: Neonatal mortality at 7 days after admission is related to the TRIPS rating. The score of the survivors and neonatal deaths show a significant difference (p: 0.009). For a score of 16, a sensitivity of 62% and a specificity of 84%; area under the curve of 0.757 was determined. CONCLUSIONS: Physiological index weighting using TRIPS is a good predictor of neonatal mortality. It is important to establish measures to improve physiological stability of the newborn before, during and after the transfer in order to reduce neonatal mortality.
ABSTRACT
Se presentan 2 casos clínicos que ejemplifican los mecanismos más frecuentes de intoxicación por salicilatos. Se revisan las principales alteraciones fisiopatológicas y manifestaciones clínicas. Se propone la ruta diagnóstica y el esquema de tratamiento adoptado por el servicio de Urgencias del I.N.P., basada en la evaluación clínica de la severidad. La intoxicación por salicilatos constituye una de las causas más frecuentes de intoxicación en los niños, con gran variabilidad en las manifestaciones clínicas, de difícil diagnóstico y que requiere de un alto grado de sospecha para un tratamiento temprano, debido a sus complicaciones potencialmente fatales
