RESUMO
Clinical manifestations of Giardia duodenalis infection vary from asymptomatic infection to chronic diarrhoea. We study the correlation between the presence of symptoms and the G. duodenalis genotype in 108 patients with giardiasis. Patient age ranged from 2 to 72 years old. We found a correlation between assemblage AII and symptomatic infections, and between assemblage B and asymptomatic infections in the overall patient group and in patients less than five years of age. Nevertheless, if only patients of more than five years of age were considered, no statistically significant relationship between assemblage and symptomatic or asymptomatic Giardia infections was found. In these patients, host factors may affect the presence of clinical manifestations more than Giardia assemblage.
Assuntos
Giardia lamblia/genética , Giardíase/parasitologia , Adolescente , Adulto , Fatores Etários , Idoso , Animais , Criança , Pré-Escolar , Disenteria/parasitologia , Fezes/parasitologia , Gastroenterite/parasitologia , Genótipo , Giardia lamblia/isolamento & purificação , Giardíase/patologia , Humanos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase/métodos , Polimorfismo de Fragmento de Restrição/genética , Fatores de VirulênciaRESUMO
Forty-six Yersinia enterocolitica O:3 clinical isolates resistant to nalidixic acid were studied. The use of molecular typing techniques, other indicators of resistance patterns, the plasmid profile, and the presence of genes that encode aminoglycoside-modifying enzyme production suggested to us a clonal dissemination of the studied strains.
Assuntos
Anti-Infecciosos/farmacologia , Farmacorresistência Bacteriana , Ácido Nalidíxico/farmacologia , Yersiniose/epidemiologia , Yersinia enterocolitica/efeitos dos fármacos , Farmacorresistência Bacteriana/genética , Humanos , Testes de Sensibilidade Microbiana , Nucleotidiltransferases/genética , Plasmídeos/genética , Yersiniose/microbiologia , Yersinia enterocolitica/genéticaRESUMO
The study presented here examined the efficacy of a commercially available qualitative immunochromatographic assay for detecting Cryptosporidium oocysts in stool samples. A total of 75 samples were tested, including 50 positive for Cryptosporidium spp. by acid-fast stain, 20 positive for other parasites ( Blastocystis hominis, Endolimax nana, Entamoeba coli, Giardia lamblia, Ascaris lumbricoides, Strongyloides stercoralis and Trichuris trichiura), and five negative samples. The observed sensitivity was 98%, while specificity was 100%; the detection threshold was near 1000 oocysts/ml. Correctly diagnosed positive samples included Cryptosporidium parvum genotypes 1 and 2, whereas the single false-negative sample corresponded to a Cryptosporidium meleagridis infection.
Assuntos
Criptosporidiose/diagnóstico , Cryptosporidium parvum/isolamento & purificação , Fezes/microbiologia , Testes Imunológicos/normas , Oocistos/isolamento & purificação , Animais , Criptosporidiose/imunologia , Cryptosporidium parvum/imunologia , Humanos , Testes Imunológicos/métodos , Oocistos/imunologia , Sensibilidade e EspecificidadeRESUMO
Patients about to undergo surgery are often taking drugs that alter hemostasis and affect anesthesia, particularly when neuroaxial techniques are used for subarachnoid or epidural anesthesia. The aim of this paper is to provide safety guidelines for regional anesthesia in patients receiving hemostasis-altering drugs, in order to reduce the risk of bleeding. We offer a detailed discussion of patients treated with inhibitors of platelet aggregation (emphasizing that such treatment alone is not a contraindication for neuroaxial blockade although certainly guidelines must be followed), unfractionated heparin (anesthesia should be started at least 4 hours after administration of this drug or 30 minutes before, provided pulmonary arterial pressure is normal), low molecular weight heparin (which should be administered 12 hours before or 12 hours after the anesthetic technique), and oral anticoagulants (provision of regional anesthesia depends mainly on International Normalized Ratio monitoring). We also stress that removal of catheters should follow criteria similar to those listed above, that the risk of complications due to bleeding increases considerably in association with these drugs, and that adequate neurological monitoring is essential during postoperative recovery. Overall, the final decision to use regional anesthesia in patients receiving drugs that alter hemostasis must be made on an individual basis after assessment of benefit and risk.
Assuntos
Anestesia Epidural/métodos , Anestesia Local/métodos , Raquianestesia/métodos , Anticoagulantes/uso terapêutico , Coagulação Sanguínea/efeitos dos fármacos , Inibidores da Agregação Plaquetária/uso terapêutico , Guias de Prática Clínica como Assunto , Administração Oral , Anestesia Epidural/normas , Anestesia Local/normas , Raquianestesia/normas , Heparina/uso terapêutico , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , EspanhaRESUMO
No disponible
Assuntos
Humanos , Hemostasia , Anestesia por Condução , Perda Sanguínea Cirúrgica/prevenção & controle , Anestesia por Condução/métodos , Inibidores da Agregação Plaquetária , Inibidores da Agregação Plaquetária/farmacologia , Heparina de Baixo Peso Molecular , Heparina de Baixo Peso Molecular/farmacologia , Anticoagulantes/administração & dosagem , Anticoagulantes , Anticoagulantes/farmacologia , Anti-Inflamatórios não Esteroides , Anti-Inflamatórios não Esteroides/farmacologia , Complicações Intraoperatórias/prevenção & controleRESUMO
No es infrecuente que los pacientes que van a ser intervenidos quirúrgicamente estén tratados con fármacos que alteran la hemostasia, cuyas implicaciones afectan a la actuación del anestesiólogo, sobre todo cuando están indicadas las técnicas neuroaxiales para la realización de una anestesia subaracnoidea o epidural.El objetivo de este documento es ofrecer unas recomendaciones de seguridad sobre cómo realizar las técnicas regionales anestésicas en los pacientes con alteraciones farmacológicas de la hemostasia, para minimizar el riesgo de complicaciones hemorrágicas.Para ello se analiza de manera pormenorizada a los pacientes tratados con antiagregantes plaquetarios (se recalca que la terapia antiagregante aislada no contraindica la realización de un bloqueo neuroaxial, si bien es aconsejable mantener unas recomendaciones generales), heparina no fraccionada (la técnica debe posponerse al menos 4 h o realizarse 30 min antes de su administración, contando siempre con un TPTA normal), heparina de bajo peso molecular (administración del fármaco 12 h antes o 12 h después de la técnica anestésica) y anticoagulantes orales (la realización de una anestesia regional depende, sobre todo, del resultado de la monitorización del INR). Del mismo modo se destaca que para la retirada de los catéteres se deben seguir recomendaciones similares a las citadas, que el riesgo de complicaciones hemorrágicas en los casos de asociación de fármacos se incrementa considerablemente y que es imprescindible una monitorización neurológica adecuada en el período postoperatorio inmediato.Con todo, la decisión final de la realización de una técnica anestésica regional en estos pacientes debe ser individualizada, después de la valoración particular de la relación beneficio/riesgo en cada uno de ellos (AU)
No disponible
Assuntos
Humanos , Guias de Prática Clínica como Assunto , Espanha , Inibidores da Agregação Plaquetária , Coagulação Sanguínea , Anticoagulantes , Administração Oral , Anestesia Local , Raquianestesia , Anestesia Epidural , Heparina de Baixo Peso Molecular , HeparinaRESUMO
OBJECTIVES: We report on a patient with an increase in testicular size that had been initially diagnosed as neoplasm. METHODS: The ultrasound and histological findings, the atypical clinical features and possible causes are analyzed. RESULTS: Segmental infarction with diffuse testicular atrophy. CONCLUSION: Infarction of testis may atypically present as a testicular mass that may lead us to suspect a testicular neoplasm since the age of presentation of both types of lesions are similar.
Assuntos
Infarto/diagnóstico , Escroto , Neoplasias Testiculares/diagnóstico , Testículo/irrigação sanguínea , Adolescente , Diagnóstico Diferencial , Humanos , MasculinoRESUMO
Ureteral iatrogenic lesions occur with variable frequency in the different types of surgery, mainly in uncomplicated abdominal hysterectomy. This paper contributes 29 patients (2 male and 27 female) with several types of lesions, secondary to gynaecological, intestinal and vascular surgery. The series produced 16 cases of clamping, 6 ureterovaginal fistulae, 6 ureteral sections (5 total and 1 partial) and 1 ureterouterine fistula. The terminal ureter was the most frequently damaged. The diagnostic and therapeutical methods used in this type of lesions are analyzed.
Assuntos
Doença Iatrogênica , Complicações Intraoperatórias , Ureter/lesões , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/cirurgia , Masculino , Pessoa de Meia-IdadeRESUMO
Ureteral iatrogenic lesions occur with variable frequency in the different types of surgery, mainly in uncomplicated abdominal hysterectomy. This paper contributes 29 patients (2 male and 27 female) with several types of lesions, secondary to gynaecological, intestinal and vascular surgery. The series produced 16 cases of clamping, 6 ureterovaginal fistulae, 6 ureteral sections (5 total and 1 partial) and 1 ureterouterine fistula. The terminal ureter was the most frequently damaged. The diagnostic and therapeutical methods used in this type of lesions are analyzed.
