Escarlatina estafilocócica como complicación de quemadura por contacto

El Staphylococcus aureus causa una variedad de infecciones localizadas e invasivas supurativas y 3 síndromes mediados por toxinas: Síndrome de choque tóxico estafilocócico (STSS, por sus siglas en ingles), síndrome de piel escaldada estafilocócica (SSSS) e intoxicación alimentaria1. La escarlatina estafilocócica está relacionada con las toxinas del STSS y SSSS. De hecho, se pudieron describir dos síndromes diferentes cada uno relacionado a un tipo de toxina que eran formas atenuadas de estas entidades. El curso de esta patología generalmente es autolimitado, pero puede evolucionar rápidamente a enfermedad severa que ponga en peligro la vida. Un entendimiento de este conjunto de patologías nos permite abordar al paciente de una manera oportuna, manteniendo la vigilancia y en caso de ser necesario intervenir para evitar el advenimiento del STSS que puede desembocar en falla orgánica múltiple e incluso la muerte. Esta revisión se trata de un caso atendido en la unidad de quemados del Hospital del Niño Dr. José Renán Esquivel (HDNJRE) en el mes de mayo del 2023 con quemadura por contacto complicada con escarlatina estafilocócica. (provisto por Infomedic International)

Staphylococcus aureus causes a variety of localized and invasive suppurative infections and 3 toxin-mediated syndromes: staphylococcal toxic shock syndrome (STSS), staphylococcal scalded skin syndrome (SSSS) and food poisoning1 . Staphylococcal scarlet fever is related to STSS and SSSS toxins. In fact, two different syndromes each related to a type of toxin could be described which were attenuated forms of these entities. The course of this pathology is usually self-limiting, but can rapidly progress to severe life-threatening disease. An understanding of this set of pathologies allows us to approach the patient in a timely manner, maintaining vigilance and if necessary intervening to prevent the advent of STSS that can lead to multiple organ failure and even death. This review is about a case treated at the burn unit of the Hospital del Niño Dr. José Renán Esquivel (HDNJRE) in May 2023 with contact burn complicated by staphylococcal scarlet fever. (provided by Infomedic International)

Differences in physical activity volume and intensity between Unified and non-Unified Special Olympics football training: An observational pilot study.

BACKGROUND: The participation of people with intellectual disabilities in Special Olympics sports and training opportunities offers numerous benefits for health and inclusion. However, little is known about the impact of such training on physical activity behaviour. Here, we evaluate the differences in physical activity volume and intensity of Special Olympics athletes between Unified and non-Unified football training. METHOD: Accelerometer data of 12 male athletes from eight standardised training sessions (four Unified, four non-Unified) were analysed. RESULTS: While there was no statistically significant difference for the main part of the training, athletes showed higher levels of physical activity intensity (MVPA: Mdiff = 11.74%; 95% CI = 5.50-17.97) and volume (average acceleration ENMO: Mdiff = 112.82 mg; 95% CI = 24.73-200.90) in a Unified compared to non-Unified endurance-related exercise task. CONCLUSION: Understanding physical activity participation in different training types can help to design and implement future training programmes.

Quemaduras severas asociadas a lesión por inhalación

La lesión por inhalación es uno de los factores de riesgo que más contribuye a la mortalidad de pacientes quemados. La mortalidad asociada a la inhalación de humo es de 48 al 76%, se ha determinado que la mortalidad asociada con las quemaduras aumenta aproximadamente en 20% al combinarse con lesión por inhalación. En Panamá, específicamente en el Hospital del Niño Doctor José Renán Esquivel (HDNJRE), en los últimos 20 años han ocurrido 181 lesiones por inhalación, con una mortalidad asociada del 1.1%. Por esto la importancia de la detección temprana y manejo agresivo de esta patología. Presentamos el caso clínico de un paciente de 9 años quien sufre quemadura térmica por gasolina de un 25.5% y lesión por inhalación referido a nuestra unidad. (provisto por Infomedic International)

Inhalation injury is one of the risk factors that most contributes to the mortality of burned patients. Mortality associated with smoke inhalation ranges from 48 to 76%, and it has been determined that the mortality associated with burns increases by approximately 20% when combined with inhalation injury. In Panama, specifically in Hospital del Niño, in the last 20 years, 181 inhalation injuries have occurred, with an associated mortality of 1.1%. Therefore, the importance of early detection and aggressive management of this pathology. We present the clinical case of a 9-year-old patient who suffered a 25.5% gasoline thermal burn and inhalation injury referred to our unit. (provided by Infomedic International)

Case Report: First Confirmed Case of Coinfection of SARS-CoV-2 With Choclo orthohantavirus.

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a major international public health concern. The World Health Organization (WHO) declared the pandemic of coronavirus disease 2019 (COVID-19) on March 11, 2020. In Panama, the first SARS-CoV-2 infection was confirmed on March 9, 2020, and the first fatal case associated to COVID-19 was reported on March 10. This report presents the case of a 44-year-old female who arrived at the hospital with a respiratory failure, five days after the first fatal COVID-19 case, and who was living in a region where hantavirus pulmonary syndrome cases caused by Choclo orthohantavirus (CHOV), are prevalent. Thus, the clinical personnel set a differential diagnosis to determine a respiratory disease caused by the endemic CHOV or the new pandemic SARS-CoV-2. This case investigation describes the first coinfection by SARS-CoV-2 and CHOV worldwide. PCR detected both viruses during early stages of the disease and the genomic sequences were obtained. The presence of antibodies was determined during the patient's hospitalization. After 23 days at the intensive care unit, the patient survived with no sequelae, and antibodies against CHOV and SARS-CoV-2 were still detectable 12 months after the disease. The detection of the coinfection in this patient highlights the importance, during a pandemic, of complementing the testing and diagnosis of the emergent agent, SARS-CoV-2, with other common endemic respiratory pathogens and other zoonotic pathogens, like CHOV, in regions where they are of public health concern.

Absolute Accelerometer-Based Intensity Prescription Compared to Physiological Variables in Pregnant and Nonpregnant Women.

Estimation of the intensity of physical activity (PA) based on absolute accelerometer cut points (Cp) likely over- or underestimates intensity for a specific individual. The purpose of this study was to investigate the relationship between absolute moderate intensity Cp and the first ventilatory threshold (VT1). A group of 24 pregnant and 15 nonpregnant women who performed a submaximal incremental walking test with measures of ventilatory parameters and accelerations from three different accelerometers on the wrist (ActiGraph wGT3X-BT, GENEActiv, Axivity AX3) and one on the hip (Actigraph wGT3X-BT) were analyzed. Cp were determined corresponding to 3 metabolic equivalents of task (MET), using the conventional MET definition (Cp3.5) (3.5 mL/kg×min) and individual resting metabolic rate (Cpind). The ventilatory equivalent (VE/VO2) was used to determine VT1. Accelerations at VT1 were significantly higher (p < 0.01) compared to Cp3.5 and Cpind in both groups. Cp3.5 and Cpind were significantly different in nonpregnant (p < 0.01) but not in pregnant women. Walking speed at VT1 (5.7 ± 0.5/6.2 ± 0.8 km/h) was significantly lower (p < 0.01) in pregnant compared to nonpregnant women and correspondent to 3.8 ± 0.7/4.9 ± 1.4 conventional METs. Intensity at absolute Cp was lower compared to the intensity at VT1 independent of the device or placement in pregnant and nonpregnant women. Therefore, we recommend individually tailored cut points such as the VT1 to better assess the effect of the intensity of PA.

Prevalence Estimates for Pharmacological Neuroenhancement in Austrian University Students: Its Relation to Health-Related Risk Attitude and the Framing Effect of Caffeine Tablets.

Background: Pharmacological neuroenhancement (PN) is defined as the use of illicit or prescription drugs by healthy individuals for cognitive-enhancing purposes. The present study aimed (i) to investigate whether including caffeine tablets in the definition of PN within a questionnaire increases the PN prevalence estimate (framing effect), (ii) to investigate whether the health-related risk attitude is increased in students who use PN. Materials and methods: Two versions of a paper-and-pencil questionnaire (first version included caffeine tablets in the definition of PN, the second excluded caffeine tablets) were distributed among university students at the University of Graz, Austria. The unrelated question model (UQM) was used to estimate the 12-month PN prevalence and the German version of the 30-item Domain-Specific Risk-Taking (DOSPERT) scale to assess the health-related risk attitude. Moreover, large-sample z-tests (α = 0.05) were performed for comparing the PN prevalence estimates of two groups. Results: Two thousand four hundred and eighty-nine questionnaires were distributed and 2,284 (91.8%) questionnaires were included in analysis. The overall PN prevalence estimate for all students was 11.9%. One-tailed large-sample z-tests revealed that the PN estimate for students with higher health-related risk attitude was significantly higher compared to students with lower health-related risk attitude (15.6 vs. 8.5%; z = 2.65, p = 0.004). Furthermore, when caffeine tablets were included into the example of PN, the prevalence estimate of PN was significantly higher compared to the version without caffeine tablets (14.9 vs. 9.0%; z = 2.20, p = 0.014). Discussion: This study revealed that the PN prevalence estimate increases when caffeine tablets are included in the definition of PN. Therefore, future studies investigating the prevalence of, and predictors for, PN should be performed and interpreted with respect to potential framing effects. This study further revealed that the PN prevalence estimate is increased in students with a higher health-related risk attitude compared to students with a lower one. Therefore, future education and prevention programs addressing PN in the collective of students should not only inform about potential side effects of its use but also address the limited effects on cognition and potential alternatives of PN.