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1.
Cambios rev. méd ; 20(1): 33-38, 30 junio 2021. tabs.
Artigo em Espanhol | LILACS | ID: biblio-1292774

RESUMO

INTRODUCCIÓN. El trastorno del espectro de neuromielitis óptica, enfermedad inflamatoria, desmielinizante, afecta al sistema nervioso central, frecuente en poblaciones no caucásicas como la ecuatoriana. El retraso en su diagnóstico y tratamiento provoca discapacidad que se puede prevenir. OBJETIVO. Determinar el perfil clínico y epidemiológico de los pacientes con diagnóstico de trastorno del espectro de neuromielitis óptica. MATERIALES Y MÉTODOS. Estudio descriptivo transversal. Población de 45 Historias Clínicas y una muestra de 41 de pacientes con diagnóstico de trastorno del espectro de neuromielitis óptica atendidos en la Unidad de Neurología del Hospital de Especialida-des Carlos Andrade Marín, período enero 2005 a diciembre 2019. Se realizó análisis univarial. Se aplicó el programa estadístico International Business Machines Statistical Package for the Social Sciences, versión 25. RESULTADOS. El 76,0% (31; 41) fueron mujeres. Datos promedios: edad 48,9 años; diagnóstico definitivo demoró 4,12 años, desde el inicio de los síntomas; tiempo de diagnóstico fue 3,17 años; 3,7 brotes en total; el 87,8% (36; 41) con un fenotipo recurrente. La media de duración de la enfermedad fue de 6,8 años. En el 70,7% (29; 41), se identificaron anticuerpos anti-AQP4 en suero mediante inmunofluorescencia directa, el 51,2% requirieron para la marcha apoyo uni o bilateral. El 43,9% (18; 41) debutó con neuritis óptica; el 31,7% (13; 41) presentaron mielitis como primer síntoma y el 24,4% (10; 41) la combinación de neuritis óptica y mielitis fueron los síntomas iniciales. CONCLUSIÓN. Se determinó el perfil clínico y epi-demiológico de los pacientes con diagnóstico de trastorno del espectro de neuromielitis óptica. Existió demora en el diagnóstico definitivo de los pacientes desde el inicio de los síntomas, lo que se tradujo en un aumento de la discapacidad.


INTRODUCTION. Neuromyelitis optica spectrum disorder, an inflammatory, demyelinating disease, affects the central nervous system, common in non-Caucasian popu-lations such as Ecuadorians. The delay in its diagnosis and treatment causes disabi-lity that can be prevented. OBJECTIVE. To determine the clinical and epidemiological profile of patients diagnosed with neuromyelitis optica spectrum disorder. MATERIALS AND METHODS. Cross-sectional descriptive study. Population of 45 Medical Records and a sample of 41 patients with a diagnosis of neuromyelitis optica spectrum disor-der seen at the Neurology Unit of the Carlos Andrade Marín Specialties Hospital, period from January 2005 to December 2019. Univariate analysis was performed. The statistical program International Business Machines Statistical Package for the Social Sciences, version 25 was used. RESULTS. 76,0% (31; 41) were women. Average data: age 48,9 years; definitive diagnosis took 4,12 years from the onset of symptoms; time to diagnosis was 3,17 years; 3,7 outbreaks in total; 87,8% (36; 41) with a recurrent phenotype. The average disease duration was 6,8 years. In 70,7% (29; 41), anti-AQP4 antibodies were identified in serum by direct immunofluorescence, 51,2% required uni- or bilateral su-pport for walking. Optic neuritis started in 43,9% (18; 41); 31,7% (13; 41) had myelitis as the first symptom and 24,4% (10; 41) the combination of optic neuritis and myelitis were the initial symptoms. CONCLUSION. The clinical and epidemiological profile of patients diagnosed with neuromyelitis optica spectrum disorder was determined. There was delay in the conclusive diagnosis of patients from the beginning of symptoms, which resulted in increased disability.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Doenças Autoimunes , Neurite Óptica , Neuromielite Óptica , Saúde da Pessoa com Deficiência , Mielite , Sistema Nervoso , Síndrome de Sjogren , Epidemiologia Descritiva , Técnica Direta de Fluorescência para Anticorpo , Doença de Hashimoto , Hipotireoidismo
2.
Rev. peru. med. exp. salud publica ; 38(1): 101-107, ene-mar 2021. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1280553

RESUMO

RESUMEN Con el objetivo de determinar la frecuencia viral y las características clínico-epidemiológicas en los episodios de infección respiratoria aguda de pacientes del Instituto Nacional de Salud del Niño San Borja en Lima, se analizó la información de los episodios de pacientes que requirieron al menos una prueba de inmunofluorescencia directa desde el 1 de enero del 2017 al 31 de diciembre del 2018. Se identificaron 1153 episodios en 707 pacientes. La mediana de la edad fue de 1 año y el 55% fueron del sexo masculino. La frecuencia viral fue del 13,4%; el virus respiratorio sincitial se identificó en el 10,7% de los episodios. La frecuencia viral fue mayor en los menores de 1 año (16,2%); en aquellos con enfermedad congénita respiratoria (38,9%) y durante el otoño (24,2%). Los síntomas más comunes fueron tos (70,3%) y fiebre (53,4%); y los principales diagnósticos fueron neumonía viral (31,8%) y bronquiolitis (23,4%). Se concluye que la frecuencia viral respiratoria estuvo relacionada con la edad, estacionalidad y patología preexistente.


ABSTRACT The aim of the study was to determine the viral frequency and clinical-epidemiological characteristics in the episodes of acute respiratory infection in patients of the Instituto Nacional de Salud del Niño San Borja in Lima, the information of the episodes of patients who required at least one direct Immunofluorescence test from January 1, 2017 to December 31, 2018 was analyzed. 1153 episodes were identified in 707 patients. The median age was 1 year and 55% were male. The viral frequency was 13.4%; respiratory syncytial virus was identified in 10.7% of the episodies. The viral frequency was higher in children under 1 year of age (16.2%); in those with congenital disease respiratory (38.9%) and during the autumn (24.2%). The most common symptoms were cough (70.3%) and fever (53.4%); and the main diagnoses, viral pneumonia (31.8) and bronchiolitis (23.4%). It is concluded that the respiratory viral frequency was related to age, seasonality and pre-existing pathology.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Infecções Respiratórias , Vírus , Saúde da Criança , Infecções , Patologia , Pediatria , Peru , Pneumonia Viral , Bronquiolite , Técnica Direta de Fluorescência para Anticorpo
3.
Rev. peru. med. exp. salud publica ; 38(1): 101-107, ene-mar 2021. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1280586

RESUMO

RESUMEN Con el objetivo de determinar la frecuencia viral y las características clínico-epidemiológicas en los episodios de infección respiratoria aguda de pacientes del Instituto Nacional de Salud del Niño San Borja en Lima, se analizó la información de los episodios de pacientes que requirieron al menos una prueba de inmunofluorescencia directa desde el 1 de enero del 2017 al 31 de diciembre del 2018. Se identificaron 1153 episodios en 707 pacientes. La mediana de la edad fue de 1 año y el 55% fueron del sexo masculino. La frecuencia viral fue del 13,4%; el virus respiratorio sincitial se identificó en el 10,7% de los episodios. La frecuencia viral fue mayor en los menores de 1 año (16,2%); en aquellos con enfermedad congénita respiratoria (38,9%) y durante el otoño (24,2%). Los síntomas más comunes fueron tos (70,3%) y fiebre (53,4%); y los principales diagnósticos fueron neumonía viral (31,8%) y bronquiolitis (23,4%). Se concluye que la frecuencia viral respiratoria estuvo relacionada con la edad, estacionalidad y patología preexistente.


ABSTRACT The aim of the study was to determine the viral frequency and clinical-epidemiological characteristics in the episodes of acute respiratory infection in patients of the Instituto Nacional de Salud del Niño San Borja in Lima, the information of the episodes of patients who required at least one direct Immunofluorescence test from January 1, 2017 to December 31, 2018 was analyzed. 1153 episodes were identified in 707 patients. The median age was 1 year and 55% were male. The viral frequency was 13.4%; respiratory syncytial virus was identified in 10.7% of the episodies. The viral frequency was higher in children under 1 year of age (16.2%); in those with congenital disease respiratory (38.9%) and during the autumn (24.2%). The most common symptoms were cough (70.3%) and fever (53.4%); and the main diagnoses, viral pneumonia (31.8) and bronchiolitis (23.4%). It is concluded that the respiratory viral frequency was related to age, seasonality and pre-existing pathology.


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Infecções Respiratórias , Viroses , Pediatria , Vírus , Comorbidade , Estratégias de Saúde , Técnica Direta de Fluorescência para Anticorpo
5.
Rev. Hosp. Ital. B. Aires (2004) ; 40(4): 219-222, dic. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1145550

RESUMO

La erupción variceliforme de Kaposi es una infección cutánea diseminada, causada en la mayor parte de los casos por el virus Herpes simple tipo 1. Se suele presentar en pacientes con alteraciones preexistentes de la barrera cutánea, especialmente en niños con dermatitis atópica. Se comunica el caso de un paciente de 84 años, quien negaba enfermedades cutáneas previas, que consultó por lesiones dolorosas y pruriginosas, en la piel del tórax y el abdomen, de 3 semanas de evolución. Con sospecha de una enfermedad infecciosa viral, bacteriana, ampollar o neutrofílica, se realizó inmunofluorescencia directa para herpes, cultivo y biopsia de piel para estudio histológico. La inmunofluorescencia fue positiva para Herpes simple tipo 1 y el estudio histopatológico mostró cambios compatibles con infección herpética y enfermedad de Darier. La enfermedad de Darier es una genodermatosis infrecuente que se suele manifestar en la adolescencia. Si bien su diagnóstico en la ancianidad es excepcional, este caso ilustra que se debe considerar en todos los pacientes que presenten erupción variceliforme. (AU)


Kaposi's varicelliform rash is a disseminated cutaneous infection, caused by Herpes virus 1. It usually presents in patients with pre-existing skin barrier disorders, especially in children with atopic dermatitis. We report the case of an 84-year-old patient, who reported having no previous skin diseases, who consulted for painful, itchy, 3-week-old skin lesions. As we suspected viral, bacterial, bullous or neutrophilic disease, direct immunofluorescence, culture, and skin biopsy for histological study were performed. Immunofluorescence was positive for Herpes simplex type 1 and the histopathological study showed changes compatible with herpetic infection and Darier's disease. Darier's disease is a rare genodermatosis that usually manifests in adolescence. Although its diagnosis in old age is anecdotal, it should be considered in patients with a varicelliform rash. (AU)


Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Erupção Variceliforme de Kaposi/diagnóstico , Doença de Darier/diagnóstico , Aciclovir/administração & dosagem , Foscarnet/uso terapêutico , Herpesvirus Humano 1/patogenicidade , Técnica Direta de Fluorescência para Anticorpo , Herpes Simples/complicações , Erupção Variceliforme de Kaposi/etiologia , Erupção Variceliforme de Kaposi/patologia , Erupção Variceliforme de Kaposi/tratamento farmacológico , Doença de Darier/etiologia
6.
NOVA publ. cient ; 18(33): 21-33, ene.-jun. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1149446

RESUMO

Resumen Chlamydia trachomatis (C. trachomatis) es una bacteria Gram negativa inmóvil, caracterizada por ser un microorganismo intracelular obligado y por poseer un ciclo reproductivo en el que puede distinguirse una forma infecciosa extracelular metabólicamente inerte (cuerpo elemental - EB's), y una forma no infecciosa intracelular y activa (cuerpo reticulado - RB's). C trachomatis se caracteriza por causar infección en humanos, está relacionada con enfermedades de transmisión sexual e infecciones oculares; por lo que puede conllevar a secuelas de interés, si no se da un tratamiento oportuno. El objetivo de este estudio fue optimizar el modelo de infección de C. trachomatis en células HEp-2 con cuerpos elementales (EB's) de C. trachomatis serovar L2. Inicialmente, se establecieron las condiciones para el crecimiento adecuado de las células HEp-2 en tiempo y con una confluencia del 90%, para continuar con la optimización de un protocolo de infección. La infección fue confirmada a partir de la coloración con Giemsa permitiendo evaluar características morfológicas tanto de las células HEp-2 sin infectar e infectadas, y así mismo, de los cuerpos elementales de C. trachomatis. Finalmente, se corroboró la infección con la técnica de inmunofluorescencia directa que detecta la proteína de membrana MOMP de C. trachomatis. Tras los ensayos realizados se evidenció la presencia de cuerpos elementales próximos y dentro del citoplasma celular, así como células vacuoladas y daño celular causado por la infección.


Abstract Chlamydia trachomatis (C. Trachomatis) is a Gram negative unmoving bacterium, characterized by being an obligate intracellular microorganism and having a reproductive cycle in which a metabolically inactive extracellular infectious form (elementary body - EB's) can be distinguished from an intracellular active and non-infectious form (reticulated body - RB's). C trachomatis is characterized by causing infection in humans, is related to sexually transmitted diseases and eye infections, so it can lead to sequelae of interest if timely treatment is not given. The objective of this study was to optimize the infection model of C. trachomatis in HEp-2 cells with elementary bodies (EB's) of C. trachomatis serovar L2. Initially, the conditions for the adequate growth of HEp-2 cells were established in time and with a confluence of 90%, to continue with the optimization of an infection protocol. The infection was confirmed from the staining with Giemsa allowing to evaluate morphological characteristics of both uninfected and infected HEp-2 cells and also of the elementary bodies of C. trachomatis. Finally, the infection was corroborated with the direct immunofluorescence technique, that detects the C. trachomatis MOMP membrane protein. After the tests were performed, the presence of elementary bodies nearby and within the cellular cytoplasm was evidenced, as well as vacuolated cells and cellular damage caused by the infection.


Assuntos
Chlamydia trachomatis , Bactérias , Infecções Sexualmente Transmissíveis , Técnica Direta de Fluorescência para Anticorpo , Infecções
7.
Rev. Soc. Bras. Med. Trop ; 53: e20190402, 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1092199

RESUMO

Abstract In Brazil, rabies occurs mainly within an urban cycle, in which dogs and bats are reservoirs. This paper aims to report the occurrence of rabies in Callithrix sp. in Niterói, Rio de Janeiro, Brazil. In June 2019 a hybrid specimen was referred for diagnosis. The Direct Fluorescent Antibody, Mouse Inoculation, and Polymerase Chain Reaction tests were positive. A phylogenetic analysis was compatible with antigenic variant 3, characteristic of Desmodus rotundus. New studies should be undertaken to elucidate the real role of callitrichids in the urban rabies cycle.


Assuntos
Animais , Raiva/diagnóstico , Vírus da Raiva/genética , Callithrix/virologia , Filogenia , Vírus da Raiva/imunologia , População Urbana , Brasil , Reação em Cadeia da Polimerase , Técnica Direta de Fluorescência para Anticorpo
8.
Rev. bras. parasitol. vet ; 28(4): 790-796, Oct.-Dec. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1057980

RESUMO

Abstract The aim of this study was to investigate the occurrence of Leishmania spp. antibodies, and its association with feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV), in domestic cats from an area endemic for canine and human leishmaniasis in Rio Grande do Norte State, Brazil. Ninety-one cats were subjected to a complete clinical exam, and blood samples were collected. An epidemiological questionnaire was used to investigate the risk factors. IgG anti-Leishmania spp. antibodies were detected by immunofluorescence antibody test (IFAT), with a cut-off value of 1:40. Polymerase chain reaction (PCR) was performed to detect genetic material of Leishmania spp. in the blood samples. The presence of antibodies against FIV and antigens of FeLV was evaluated using an immunochromatographic test. Seropositivity for Leishmania spp., FIV, and FeLV was observed in 14/91 (15.38%), 26/91 (28.57%), and 3/91 (3.29%) cats, respectively. All samples gave negative results on PCR analysis. Based on these data, no significant statistical association was observed between seropositivity for Leishmania spp., and sex, age, presence of clinical signs, evaluated risk factors, and positivity for retroviruses. These findings demonstrated for the first time that cats from Mossoró, Rio Grande do Norte, are being exposed to this zoonosis and might be part of the epidemiological chain of transmission of visceral leishmaniasis.


Resumo O objetivo do presente estudo foi investigar a ocorrência de anticorpos contra Leishmania spp., e sua associação com o vírus da imunodeficiência felina (FIV) e o vírus da leucemia felina (FeLV), em felinos domésticos provenientes de uma área endêmica no estado do Rio Grande do Norte, para a leishmaniose visceral canina e humana. Noventa e um gatos foram submetidos a exame clínico completo e amostras de sangue foram coletadas. Um questionário epidemiológico foi feito para investigar fatores de risco. Anticorpos IgG anti-Leishmania spp. foram identificados por meio da imunofluorescência indireta (RIFI), adotando-se como ponto de corte a diluição de 1:40. A reação em cadeia da polimerase (PCR) foi executada visando detectar o material genético de Leishmania spp. a partir de amostras de sangue total. Para avaliar a presença de anticorpos contra o FIV e antígenos do FeLV foi utilizado um teste imunocromatográfico. Observou-se soropositividade em 14/91 (15,38%), 26/91 (28,57%) e 3/91 (3,29%) animais para Leishmania spp., FIV e FeLV, respectivamente. Nenhuma amostra foi positiva na PCR. Baseado nestes dados, não foi observada nenhuma associação estatística significativa entre a soropositividade para Leishmania spp. e gênero, idade, presença de sinais clínicos, fatores de risco avaliados e positividade para as retroviroses. Esses achados demonstram pela primeira vez que felinos da cidade Mossoró, Rio Grande do Norte, estão sendo expostos a esta zoonose, sugerindo que os mesmos podem estar participando da cadeia epidemiológica de transmissão da leishmaniose visceral.


Assuntos
Humanos , Animais , Gatos , Cães , Anticorpos Antiprotozoários/sangue , Doenças do Gato/parasitologia , Leishmaniose/veterinária , Brasil/epidemiologia , Doenças do Gato/diagnóstico , Doenças do Gato/epidemiologia , Leishmaniose/diagnóstico , Leishmaniose/epidemiologia , Reação em Cadeia da Polimerase , Fatores de Risco , Vírus da Imunodeficiência Felina/imunologia , Vírus da Leucemia Felina/imunologia , Técnica Direta de Fluorescência para Anticorpo , Doenças Endêmicas
9.
An. bras. dermatol ; 94(6): 724-728, Nov.-Dec. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1054888

RESUMO

Abstract Eosinophilic spongiosis is a histological feature shared by some distinct inflammatory disorders, and is characterized by the presence of intraepidermal eosinophils associated with spongiosis. Most often, isolated eosinophilic spongiosis indicates the early stages of a subjacent autoimmune bullous dermatosis, such as the pemphigus group and bullous pemphigoid. Herein, the main causes of eosinophilic spongiosis are discussed, as well as the supplementary investigation needed to elucidate its etiology.


Assuntos
Humanos , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatopatias Vesiculobolhosas/patologia , Eosinofilia/diagnóstico , Eosinofilia/patologia , Técnica Direta de Fluorescência para Anticorpo , Diagnóstico Diferencial , Epiderme/patologia
10.
An. bras. dermatol ; 94(2): 224-226, Mar.-Apr. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1001141

RESUMO

Abstract Psoriasis has been associated with various autoimmune diseases, however, its relation to bullous diseases is infrequent. Of these, bullous pemphigoid appears as the main associated entity, even though both conditions differ considerably in demographic and clinical aspects. We report the case of a 42-year-old female patient, with long-standing psoriasis who consulted due to the exacerbation of psoriatic plaques associated with generalized bullous lesions on the skin and oral mucosa, with one-week duration. With clinical signs and histopathological findings compatible with bullous pemphigoid associated with psoriasis, we decided to treat her with methotrexate 10mg a week. The patient had an excellent response after two months of treatment.


Assuntos
Humanos , Adulto , Psoríase/tratamento farmacológico , Metotrexato/uso terapêutico , Penfigoide Bolhoso/tratamento farmacológico , Fármacos Dermatológicos/uso terapêutico , Psoríase/complicações , Psoríase/diagnóstico , Penfigoide Bolhoso/complicações , Penfigoide Bolhoso/diagnóstico , Resultado do Tratamento , Técnica Direta de Fluorescência para Anticorpo
11.
An. bras. dermatol ; 93(3): 435-437, May-June 2018. graf
Artigo em Inglês | LILACS | ID: biblio-949900

RESUMO

Abstract: Linear immunoglobulin A bullous dermatosis is a rare autoimmune disease that usually has an excellent prognosis in childhood; however, its control is more difficult in adults. It presents heterogeneous clinical manifestations and is frequently confused with other bullous diseases such as bullous pemphigoid and Duhring's dermatitis herpetiformis. Dermatologists' awareness of this disease contributes to early diagnosis and appropriate treatment. We thus report three cases of linear immunoglobulin A dermatosis in adults.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatose Linear Bolhosa por IgA/diagnóstico , Dermatopatias Vesiculobolhosas/patologia , Técnica Direta de Fluorescência para Anticorpo , Doenças Raras , Diagnóstico Precoce , Dermatose Linear Bolhosa por IgA/patologia
13.
An. bras. dermatol ; 92(5,supl.1): 37-39, 2017. graf
Artigo em Inglês | LILACS | ID: biblio-887065

RESUMO

Abstract: Bullous systemic lupus erythematosus (BSLE) is a rare autoimmune subepidermal blistering disease, with few cases described in childhood. It has different clinical-pathological features. We report a case of BSLE in a 10-year-old child with systemic lupus erythematosus, treated with prednisone and hydroxychloroquine. There was complete remission with dapsone, with no recurrence of skin lesions throughout one year of follow-up. We highlight the rarity and early age of occurrence.


Assuntos
Humanos , Feminino , Criança , Vesícula/patologia , Lúpus Eritematoso Sistêmico/patologia , Membrana Basal/patologia , Biópsia , Vesícula/tratamento farmacológico , Técnica Direta de Fluorescência para Anticorpo , Doenças Raras/patologia , Doenças Raras/diagnóstico por imagem , Lúpus Eritematoso Sistêmico/tratamento farmacológico
14.
An. bras. dermatol ; 92(5,supl.1): 145-147, 2017. graf
Artigo em Inglês | LILACS | ID: biblio-887071

RESUMO

Abstract Pemphigus herpetiformis is an autoimmune bullous disease, that combines clinical features of dermatitis herpetiformis and linear IgA bullous dermatosis and immunological characteristics of pemphigus, which makes this disease peculiar and this diagnosis rarely suspected in the first evaluation of the patient. The reported case is of a patient with clinically bullous disease similar to dermatitis herpetiformis, whose multiple biopsies were inconclusive, and only after direct immunofluorescence with a pemphigus pattern (intraepidermal intercellular pattern) the confirmation of the diagnosis was possible.


Assuntos
Humanos , Feminino , Adulto , Dermatite Herpetiforme/patologia , Pênfigo/patologia , Técnica Direta de Fluorescência para Anticorpo/métodos , Biópsia , Eritema/patologia
15.
An. bras. dermatol ; 92(5,supl.1): 14-16, 2017. graf
Artigo em Inglês | LILACS | ID: biblio-887093

RESUMO

Abstract: Epidermolysis bullosa acquisita is a severe autoimmune subepidermal bullous disease. In this report, we described for the first time a patient with epidermolysis bullosa acquisita who developed acute renal failure. There is a possibility that epidermolysis bullosa acquisita and acute renal failure's pathogenesis shared some common autoimmune pathways. Moreover, acute blood volume reduction may be another cause of prerenal kidney failure. Further studies are needed to verify our hypothesis.


Assuntos
Humanos , Masculino , Idoso , Epidermólise Bolhosa Adquirida/complicações , Epidermólise Bolhosa Adquirida/patologia , Injúria Renal Aguda/etiologia , Pele/patologia , Biópsia , Epidermólise Bolhosa Adquirida/tratamento farmacológico , Resultado do Tratamento , Técnica Direta de Fluorescência para Anticorpo , Injúria Renal Aguda/tratamento farmacológico
16.
Rev. pediatr. electrón ; 14(1): 50-54, 2017. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-968203

RESUMO

Las infecciones respiratorias agudas bajas (IRAB) son la principal causa de hospitalización en lactantes, y una de las principales causas de muerte de niños entre un mes y 4 años. Constituyen un problema de salud pública durante los meses de otoño e invierno, con una sobredemanda de atención en los servicios de urgencia y requerimiento de camas en los distintos centros hospitalarios, guardando este fenómeno directa relación con la epidemia del virus respiratorio sincicial (VRS), el principal agente etiológicoi-ii. En los últimos años se han implementado una serie de medidas que han permitido desarrollar un mejor manejo de las IRAB, como el uso de nuevos esquemas de vacunación, la disminución del uso irracional de antibióticos, la implementación de salas IRA en atención primaria para el manejo de las infecciones respiratoriasiii, uso de protocolos actualizados para manejo de patología respiratoriaiv, aumento del recurso humano durante la campaña de invierno en los servicios públicos de salud, y avances en infraestructura. Los virus son la principal causa de IRAB, siendo el VRS el más frecuente, seguido por rinovirus, virus influenza, parainfluenza, metapneumovirus, y adenovirus. Éste último, hasta hace algunos años era la segunda causa viral de IRAB, importante agente en infecciones asociadas a la atención en salud y causa de secuelas respiratorias en muchos casosv-vi. Esto pone de manifiesto la importancia de determinar la etiología de las IRAB en pacientes hospitalizados, más cuando la clínica e imagenología no permiten diferenciarlos. Conocer la etiología condicionará medidas terapéuticas a tomar, necesidad de aislamiento, y seguimiento de casos especiales. Esto cobra particular importancia en los lactantes, quienes por presentar un menor desarrollo de la vía respiratoria e inmadurez inmunológica, tienen las más altas tasas de hospitalización y padecen los cuadros más gravesvii. De acuerdo a datos del Departamento de Estadísticas e Información de Salud (DEIS) del año 2011, las infecciones respiratorias fueron la principal causa de egresos hospitalarios de niños y adolescentes en el país con un 21,7% del total. Específicamente en el Hospital Roberto del Rio la situación fue similar, correspondiendo a un 33,3% de las altas. En el siguiente reporte se describen las características de las infecciones respiratorias agudas bajas de niños y adolescentes egresados del Hospital Roberto del Río a lo largo del año 2016.


Lower respiratory tract infections (LRTI) are the main cause of outpatient visits during cold months and hospitalization in infants. Through an observational, descriptive study, we analyzed the medical attentions at the Emergency Department (ED) and the hospitalizations occurred during 2016 in Hospital Roberto del Río. We included demographic variables, date of admission, diagnosis at discharge, etiologic agent and requirement of intensive care unit. Respiratory infections were the main cause of outpatient visits to the ED, being 21.7%. They are also the major cause of hospital discharge (1,856 cases, 23.8% of total). 61% of hospitalized cases were male, ant the mail affected group was those under 2 years of age (74.4%). In 93% of cases with detected etiological agent, a virus was found, 57, 9% being respiratory syncytial virus. Sixty nine percent of admission occurred during June and September and 15, 2% patients were admitted to the intensive care unit. We hope the current data helps policy maker in further years.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Alta do Paciente/estatística & dados numéricos , Infecções Respiratórias/epidemiologia , Hospitais Pediátricos/estatística & dados numéricos , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/microbiologia , Estações do Ano , Comorbidade , Chile/epidemiologia , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Distribuição por Idade , Técnica Direta de Fluorescência para Anticorpo , Serviço Hospitalar de Emergência/estatística & dados numéricos
17.
Rev. pediatr. electrón ; 14(1): 55-58, 2017. graf
Artigo em Espanhol | LILACS | ID: biblio-968882

RESUMO

En los meses de invierno, las enfermedades respiratorias representan la primera causa de hospitalización en hospitales pediátricos. La mayoría de estas enfermedades son causadas por virus, dentro de los cuales se encuentra el adenovirus (AdV), el cual puede generar infecciones diseminadas graves, secuelantes e incluso letales y se caracteriza por tener una rápida transmisión entre pacientes, generando brotes intrahospitalarios. Se identificó a 54 pacientes hospitalizados con infección por adenovirus en el periodo de marzo-julio del 2016 con una edad promedio de 18,3 meses, de los cuales 23 casos fueron infecciones asociadas a la atención de salud (IIAS) y 2 tuvieron desenlace fatal. Los casos de IIAS, se asociaron a una mayor tasa de hospitalización prolongada (p= <0.01), ingreso a UPC (p= <0.01) y uso de ventilación mecánica (p= <0.01). No se encontró asociación entre la presencia de antecedentes mórbidos con el desarrollo de IIAS. Las IIAS por adenovirus se asocia a una hospitalización prolongada, ingreso de unidades de alta complejidad y necesidad de uso de ventilación mecánica. Dado que el adenovirus se transmite a través de contactos directo, aerosoles y fómites, las medidas básicas de precaución de contacto y de aislamiento permiten reducir los contagios nosocomiales, recayendo la responsabilidad en todo el equipo de salud a cargo.


Respiratorio deseases are frequent in winter times. being the main cause of hospital admissions. Viral infecciones are the main etiology, and adenovirus infección clould lead to severe disease, with cross infections. We identified 54 patients admitted to the Roberto del Río Childrens hospital in 2016, with a mean age of 18,3 months old; 23 cases where nosocomial infection, and 2 were fatal. Hospital acquired adenovirus infection were associated to long hospital stay (p= <0.01), intensive care admission (p= <0.01) and ventilatory support (p= <0.01). We did not find previous illness conditions. Adenovirus hospital acquired infection is associated with longer hospital stay and dead. Adenovirus is transmitted with direct contact, aerosols and fomites, therefore basic contact precautions are important.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Infecções por Adenoviridae/epidemiologia , Isolamento de Pacientes , Respiração Artificial/efeitos adversos , Estações do Ano , Fatores de Tempo , Chile/epidemiologia , Reação em Cadeia da Polimerase , Infecção Hospitalar/epidemiologia , Infecções por Adenoviridae/diagnóstico , Técnica Direta de Fluorescência para Anticorpo , Hospitalização
18.
Rev. chil. enferm. respir ; 32(4): 224-232, dic. 2016. graf, tab
Artigo em Espanhol | LILACS | ID: biblio-844386

RESUMO

Objective: To assess the performance of multiplex-PCR for diagnosis of respiratory viruses in parallel with direct fluorescence assay (DFA). We assessed the performance and co-infection diagnosis of molecular respiratory panel PCR (MRP-PCR) and DFA in hospitalized and outpatients. Results: 8535 samples were included, 1792 tested by MRP-PCR (46.9% positive) and 6743 by DFA (35.1% positive). MRP-PCR diagnosed co-infection in 21.3% and DFA in 1.8% of the samples. Rhinovirus was the most common virus in any age group. In 210 patients both tests were done; 100 were positive by MRP-PCR and 18 by DFA. Positive concordance value was 6.2%. 85 samples were positive only by MRP-PCR and in 42 of them only novel respiratory viruses were identified. Performance of MRP-PCR was statistically significant compared DFA for traditional respiratory viruses. Discussion: Multiplex PCR has shown better sensitivity, may expand the etiologic spectrum of respiratory infections and detect a higher number of co-infections.


Objetivo: Evaluar la contribución del panel respiratorio molecular por reacción en cadena de la polimerasa-multiplex (PRM-RPC) en paralelo a la de inmunofluorescencia directa (IFD) al diagnóstico de infecciones respiratorias. Analizamos y comparamos el rendimiento y diagnóstico de co-infección de PRM-RPC con IFD en pacientes hospitalizados y ambulatorios. Resultados: Se analizaron 8535 muestras; 1792 por PRM-RPC (46,9% positivas) y 6743 por IFD (35,1% positivas). La co-infección fue 21,3% por PRM-RCP y 1,8% por IFD. El virus más frecuente fue rinovirus a toda edad. Se analizaron 210 pacientes por ambos métodos; resultaron positivas 100 por PRM-RPC y 18 por IFD, concordancia positiva de 6,2%. 85 muestras fueron solo positivas por PRM-RPC, 42 diagnosticaron nuevos virus respiratorios. El rendimiento de PRM-RPC fue significativamente mayor que el de IFD para virus respiratorios tradicionalmente diagnosticados. Conclusiones: La RCP-multiplex tiene mejor sensibilidad, podría expandir el espectro etiológico de infecciones respiratorias y detectar un mayor número de co-infecciones comparado a IFD.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Técnica Direta de Fluorescência para Anticorpo , Reação em Cadeia da Polimerase Multiplex , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/microbiologia , Doença Aguda , Distribuição por Idade , Técnicas de Diagnóstico Molecular , Infecções Respiratórias/virologia , Estações do Ano
19.
An. bras. dermatol ; 91(5,supl.1): 35-38, Sept.-Oct. 2016. tab, graf
Artigo em Inglês | LILACS | ID: biblio-837920

RESUMO

Abstract Linear IgA dermatosis is a rare subepidermal autoimmune blistering disease characterized by linear deposition of IgA along the basement membrane zone. In the last three decades, many different drugs have been associated with the drug-induced form of the disease, especially vancomycin. We report a case of vancomycin-induced linear IgA disease mimicking toxic epidermal necrolysis. The aim of this work is to emphasize the need to include this differential diagnosis in cases of epidermal detachment and to review the literature on the subject and this specific clinical presentation.


Assuntos
Humanos , Masculino , Idoso , Vancomicina/efeitos adversos , Síndrome de Stevens-Johnson/patologia , Dermatose Linear Bolhosa por IgA/induzido quimicamente , Dermatose Linear Bolhosa por IgA/patologia , Antibacterianos/efeitos adversos , Biópsia , Dermatopatias Vesiculobolhosas/induzido quimicamente , Dermatopatias Vesiculobolhosas/patologia , Técnica Direta de Fluorescência para Anticorpo , Diagnóstico Diferencial , Epiderme/patologia
20.
An. bras. dermatol ; 91(5,supl.1): 32-34, Sept.-Oct. 2016. graf
Artigo em Inglês | LILACS | ID: biblio-837941

RESUMO

Abstract Childhood linear immunoglobulin A dermatosis is a rare autoimmune vesiculobullous disease. It results in linear deposition of autoantibodies (immunoglobulin A) against antigens in the basal membrane zone, leading to subepidermal cleavage. Additional depositions of immunoglobulin G and complement-3 might occur. It is still debated whether concomitant findings of immunoglobulins A and G should be considered a subtype of this dermatosis or a new entity. Further studies are needed to recognize this clinical variant.


Assuntos
Humanos , Masculino , Criança , Pele/patologia , Dermatose Linear Bolhosa por IgA/patologia , Membrana Basal/patologia , Biópsia , Dermatopatias Vesiculobolhosas/patologia , Técnica Direta de Fluorescência para Anticorpo , Eritema/patologia
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