The Gastrointestinal Tract Is Pinpointed as a Reservoir of Candida albicans, Candida parapsilosis, and Candida tropicalis Genotypes Found in Blood and Intra-Abdominal Samples.

BACKGROUND: Candida spp., as part of the microbiota, can colonise the gastrointestinal tract. We hypothesised that genotyping Candida spp. isolates from the gastrointestinal tract could help spot genotypes able to cause invasive infections. MATERIALS/METHODS: A total of 816 isolates of C. albicans (n = 595), C. parapsilosis (n = 118), and C. tropicalis (n = 103) from rectal swabs (n = 754 patients) were studied. Genotyping was conducted using species-specific microsatellite markers. Rectal swab genotypes were compared with previously studied blood (n = 814) and intra-abdominal (n = 202) genotypes. RESULTS: A total of 36/754 patients had the same Candida spp. isolated from blood cultures, intra-abdominal samples, or both; these patients had candidemia (n = 18), intra-abdominal candidiasis (n = 11), both clinical forms (n = 1), and non-significant isolation (n = 6). Genotypes matching the rectal swab and their blood cultures (84.2%) or their intra-abdominal samples (92.3%) were found in most of the significant patients. We detected 656 genotypes from rectal swabs, 88.4% of which were singletons and 11.6% were clusters. Of these 656 rectal swab genotypes, 94 (14.3%) were also detected in blood cultures and 34 (5.2%) in intra-abdominal samples. Of the rectal swab clusters, 62.7% were previously defined as a widespread genotype. CONCLUSIONS: Our study pinpoints the gastrointestinal tract as a potential reservoir of potentially invasive Candida spp. genotypes.

Prevalence rates of chronic kidney disease and its association with cardiometabolic factors and cardiovascular diseases. SIMETAP-CKD study. / Tasas de prevalencia de enfermedad renal crónica y su asociación con factores cardiometabólicos y enfermedades cardiovasculares. Estudio SIMETAP-ERC.

INTRODUCTION: Chronic kidney disease (CKD) is a major health problem that contributes to the development of cardiovascular disorders such as heart failure and arteriosclerotic cardiovascular disease (ACVD). The aims of this study were to determine the prevalence of CKD and to assess its association with ACVD and cardiometabolic risk factors. METHODS: Cross-sectional observational study conducted in primary care setting. Population-based random sample: 6,588 people between 18 and 102 years old (response rate: 66%). Crude and sex- and age-adjusted prevalence rates of CKD according to KDIGO were determined by assessing albuminuria and estimated glomerular filtration rate according to CKD-EPI, and their associations with cardiometabolic factors and ACVD were determined. RESULTS: The crude prevalence of CKD was 11.48% (95%CI: 10.72-12.27%), without significant difference between men (11.64% [95%CI: 10.49-12.86%]) and women (11.35% [95%CI: 10.34-12.41%]). The age- and sex-adjusted prevalence rate of CKD was 9.16% (men: 8.61%; women: 9.69%). The prevalence of low estimated glomerular filtration rate (<60mL/min/1.73m2) and albuminuria (≥30mg/g) were 7.95% (95%CI: 7.30-8.61) and 5.98% (95%CI: 5.41-6.55), respectively. Hypertension, diabetes, prediabetes, increased waist-to-height ratio, heart failure, atrial fibrillation, and ACVD were independently associated with CKD (P<.001). Very high cardiovascular risk according to SCORE was found in 77.51% (95%CI: 74.54-80.49) of the population with CKD. CONCLUSIONS: The adjusted prevalence of CKD was 9.2% (low estimated glomerular filtration rate: 8.0%; albuminuria: 6.0%). Most of the patients with CKD had very high cardiovascular risk. Hypertension, diabetes, prediabetes, increased waist-to-height ratio and ACVD were independently associated with CKD.

Gastrointestinal tract Candida spp colonization shows mostly a monoclonal pattern: an intra-patient pilot study.

Gastrointestinal tract Candida genotypes may associate with isolates later causing infections. We genotyped Candida spp isolates (n = 200 individual colonies) from rectal swabs to assess whether gastrointestinal gut colonization is caused by a single genotype (monoclonal pattern) or a combination of them (polyclonal pattern). C. glabrata showed a sheer monoclonal pattern. C. parapsilosis and C. tropicalis showed a monoclonal pattern involving the presence of either exclusively identical genotypes or a combination of clonally-related genotypes; in the latter case, a dominant genotype was always found. C. albicans showed mostly a polyclonal pattern involving a combination of dominant clonally-related genotypes and unrelated genotypes. LAY SUMMARY: We genotyped C. albicans, C. parapsilosis, C. tropicalis, and C. glabrata isolates prospectively from rectal swabs to study the gastrointestinal colonization pattern in the patients. Gastrointestinal tract colonization is mostly monoclonal and commonly dominated by one genotype.

Prevalence of prediabetes and association with cardiometabolic and renal factors. SIMETAP-PRED study. / Prevalencia de prediabetes y asociación con factores cardiometabólicos y renales. Estudio SIMETAP-PRED.

INTRODUCTION: Prediabetes is a major public health problem. The aims of the SIMETAP-PRED study were to determine the prevalence rates of prediabetes according to two diagnostic criteria, and to compare the association of cardiometabolic and renal risk factors between populations with and without prediabetes. METHODS: Cross-sectional observational study conducted in Primary Care. Based random sample: 6,588 study subjects (response rate: 66%). Two diagnostic criteria for prediabetes were used: 1) prediabetes according to the Spanish Diabetes Society (PRED-SDS): Fasting plasma glucose (FPG) 110-125mg/dL or HbA1c 6.0% -6.4%; 2) prediabetes according to the American Diabetes Association (PRED-ADA): FPG 100-125mg/dL or HbA1c 5.7%-6.4%. The crude and sex- and age-adjusted prevalence rates, and cardiometabolic and renal variables associated with prediabetes were assessed. RESULTS: The crude prevalence rates of PRED-SDS and PRED-ADA were 7.9% (95% CI 7.3-8.6%), and 22.0% (95% CI 21.0-23.0%) respectively, their age-adjusted prevalence rates were 6.6% and 19.1 respectively. The high or very high cardiovascular risk of the PRED-SDS or PRED-ADA populations were 68.6% (95%CI 64.5-72.6%) and 61.7% (95%CI 59.1-64.1%) respectively. Hypertension, hypertriglyceridemia, overweight, obesity, and increased waist-to-height ratio were independently associated with PRED-SDS. In addition to these factors, low glomerular filtration rate and hypercholesterolemia were also independently associated with PRED-ADA. CONCLUSIONS: The prevalence of PRED-ADA triples that of PRED-SDS. Two thirds of the population with prediabetes had a high cardiovascular risk. Several cardiometabolic and renal risk factors were associated with prediabetes. Compared to the SDS criteria, the ADA criteria make the diagnosis of prediabetes easier.

Antifungal Susceptibility Testing Identifies the Abdominal Cavity as a Source of Candida glabrata-Resistant Isolates.

To identify unrecognized niches of resistant Candida isolates and compartmentalization, we retrospectively studied the antifungal susceptibility of 1,103 Candida spp. isolates from blood cultures, nonblood sterile samples, and nonsterile samples. Antifungal susceptibility was assessed by EUCAST E.Def 7.3.2; sequencing and genotyping of the fks1-2 and erg11 genes were carried out for non-wild-type isolates. Resistance compartmentalization (presence of resistant and susceptible isogenic isolates in different anatomical sites of a given patient) was studied. Clinical charts of patients carrying non-wild-type isolates were reviewed. Most isolates (63%) were Candida albicans, regardless the clinical source; Candida glabrata (27%) was the second most frequently found species in abdominal cavity samples. Fluconazole and echinocandin resistance rates were 1.5 and 1.3%, respectively, and were highest in C. glabrata. We found 22 genotypes among non-wild-type isolates, none of them widespread across the hospital. Fluconazole/echinocandin resistance rates of isolates from the abdominal cavity (3.2%/3.2%) tended to be higher than those from blood cultures (0.7%/1.3%). Overall, 15 patients with different forms of candidiasis were infected by resistant isolates, 80% of whom had received antifungals before or at the time of isolate collection; resistance compartmentalization was found in six patients, mainly due to C. glabrata. The highest antifungal resistance rate was detected in isolates from the abdominal cavity, mostly C. glabrata. Resistance was not caused by the spread of resistant clones but because of antifungal treatment. Resistance compartmentalization illustrates how resistance might be overlooked if susceptibility testing is restricted to bloodstream isolates.

In vitro activity of ibrexafungerp and comparators against Candida albicans genotypes from vaginal samples and blood cultures.

OBJECTIVES: Emergence of azole resistance may contribute to recurrences of vulvovaginal candidiasis. Thus, new drugs are needed to improve the therapeutic options. We studied the in vitro activity of ibrexafungerp and comparators against Candida albicans isolates from vaginal samples and blood cultures. Furthermore, isolates were genotyped to study compartmentalization of genotypes and the relationship between genotype and antifungal susceptibility. METHODS: Candida albicans unique patient isolates (n = 144) from patients with clinical suspicion of vulvovaginal candidiasis (n = 72 isolates) and from patients with candidaemia (n = 72) were studied. Antifungal susceptibility to amphotericin B, fluconazole, voriconazole, posaconazole, isavuconazole, clotrimazole, miconazole, micafungin, anidulafungin and ibrexafungerp was tested (EUCAST 7.3.2). Mutations in the erg11 gene were analysed and isolates genotyped. RESULTS: Ibrexafungerp showed high activity (MICs from 0.03 mg/L to 0.25 mg/L) against the isolates, including those with reduced azole susceptibility, and regardless of their clinical source. Fluconazole resistance rate was 7% (n = 5/72) and 1.4% (n = 1/72) in vaginal and blood isolates, respectively. Some amino acid substitutions in the Erg11 protein were observed exclusively in phenotypically fluconazole non-wild type. Population structure analysis suggested two genotype populations, one mostly involving isolates from blood samples (66.3%) and the mostly from vaginal samples (69.8%). The latter group hosted all fluconazole non-wild-type isolates. DISCUSSION: Ibrexafungerp shows good in vitro activity against Candida albicans from vaginal samples including phenotypically fluconazole non-wild-type isolates. Furthermore, we found a certain population structure where some genotypes show reduced susceptibility to fluconazole.

Related cardiometabolic factors and prevalence of low HDL-cholesterol levels and atherogenic dyslipidemia. SIMETAP-AD study. / Factores cardiometabólicos asociados y prevalencia de concentraciones bajas de colesterol HDL y de dislipidemia aterogénica. Estudio SIMETAP-DA.

AIM: To determine the crude and sex- and age-adjusted prevalence rates of atherogenic dyslipidemia (AD) and low HDL-cholesterol levels (low-HDLc), and to assess their associations with cardiovascular risk factors, chronic kidney disease, cardiovascular and cardiometabolic diseases. METHODS: Population-based cross-sectional study conducted in Primary Care, with randomly selected adult subjects. The AD was considered if the patients had hypertriglyceridemia (triglycerides≥150mg/dL) and low-HDLc (<40mg/dL [men];<50mg/dL [women]). Crude and sex- and age-adjusted prevalence rates were determined, and univariate and multivariate analysis were performed to assess related cardiometabolic factors. RESULTS: Study population with 6,588 adults (55.9% women) with mean age 55.1 (±17.5) years. The mean HDLc levels were 49.2 (±12.6) mg/dL in men and 59.2 (±14.7) mg/dL in women. The crude prevalence rates of low-HDLc and AD were 30.8% (95%CI: 29.7-31.9), and 14.3% (95%CI: 13.5-15.2), respectively. The adjusted prevalence rates of low-HDLc were 28.0% in men and 31.0% in women, and AD were 16.4% in men and 10.6% in women. Seventy-three percent of the population with AD had high or very high cardiovascular risk. The independent factors associated with low HDLc or with AD were diabetes, smoking, abdominal obesity, and obesity. The major factors associated with low HDLc and AD were hypertriglyceridemia and diabetes, respectively. CONCLUSIONS: Almost a third of the adult population had low HDL-C and half of them met AD criteria. Cardiometabolic factors were associated with low HDL-C and AD, highlighting hypertriglyceridemia with low HDLc, and DM with AD.

Colonization of the nasal airways by Staphylococcus aureus on admission to a major heart surgery operating room: A real-world experience.

INTRODUCTION: Nasal swab culture is used to identify Staphylococcus aureus colonization, as this is a major risk factor for surgical site infection (SSI) in patients who are going to undergo major heart surgery (MHS). We determined nasal carriage of S. aureus in patients undergoing MHS by comparing the yield of a conventional culture with that of a rapid molecular test (Xpert® SA Nasal Complete, Cepheid). METHODS: From July 2015 to April 2017, all patients who were to undergo MHS were invited to participate in the study. We obtained two nasal cultures from each patient just before entering the operating room, independently of a previous test for the determination of nasal colonization by this microorganism performed before surgery. One swab was used for conventional culture in the microbiology laboratory, and the other was used for the rapid molecular test. We defined nasal colonization as the presence of a positive culture for S. aureus using either of the two techniques. All patients were followed up until hospital discharge or death. RESULTS: Overall, 57 out of 200 patients (28.5%) were colonized by S. aureus at the time of surgery. Thirty-three patients had both conventional culture- and PCR-positive results. Twenty-four patients had a negative culture and a positive PCR test. Only twenty-one percent (12/57) of colonized patients had undergone an attempt to decolonise before the surgical intervention. CONCLUSION: A significant proportion of patients undergoing MHS are colonized by S. aureus in the nostrils on entering the operating room. New strategies to prevent SSI by this microorganism are needed. Rapid molecular tests immediately before MHS, followed by immediate decolonisation, must be evaluated. Trial Registration Clinical Trials.gov NCT02640001.

Implicaciones del marco teórico de lo imaginario en la psicología social / Implications of the theoretical framework of the imaginary on social psychology

En el presente estudio abordaremos dos de las principales concepciones sobre los mecanismos implicados en la construcción significativa del mundo. Hablamos de la Teoría de las Representaciones Sociales (TRS), formulada desde la psicología, y del marco teórico de lo imaginario, formulado principalmente desde la antropología y la filosofía. Procederemos exponiendo, primero, la TRS y, posteriormente, los acercamientos al marco teórico de lo imaginario desde diferentes disciplinas, para señalar las aportaciones que ofrece este último a la psicología social, aportaciones éstas que complementan las de la TRS. Así, este estudio tiene como objetivos realizar un análisis teórico de la TRS y del marco teórico de lo imaginario y especificar las contribuciones e implicaciones del marco teórico de lo imaginario a la psicología social (y, más concretamente, a la psicología cultural) de modo a observar cómo el concepto de imaginario social incluye y trasciende al de representación social(RS). Consideraremos las implicaciones ontológicas, epistemológicas, metodológicas y para la salud de la utilización del marco teórico de lo imaginario en la psicología cultural. En este sentido, propondremos la adopción de dicho concepto por la psicología, considerando que el mismo es fundamental por su capacidad explicativa, comprensiva, interpretativa y crítica.

This study aims at two of the main ideas about the mechanisms involved in the meaningful construction of the world. Even though they are multidisciplinary, these two perspectives are fundamentally born from two different disciplines: the Social Representation Theory (TRS), based on psychology, and the Theoretical Framework of the Imaginary, mainly based on Anthropology and Philosophy. The study will address TRS firstly and, subsequently, the approaches to Theoretical Framework of the Imaginary from different disciplines, in order to identify the contributions offered by the latter to Social Psychology that complement those of TRS. Thereby, this study aims at delivering a theoretical analysis of the TRS and of the Theoretical Framework of the Imaginary and at specifying the contributions and implications of the Theory of the Imaginary to Social Psychology (and, specifically, to Cultural Psychology) in order to see how the social imaginary concept includes and transcends the social representation (RS) concept. The ontological, epistemological, methodological and health implications of using the Theoretical Framework of the Imaginary in cultural psychology will be considered. In this regard, this concept adoption by psychology will be proposed, since it is essential for its explanatory abilities, understanding, interpretation and criticism.

Proceso de evaluación para la incorporación de tecnologías en salud por instituciones gubernamentales en países que tienen un sistema universal de salud como Inglaterra, Brasil y Canadá, en una perspectiva comparada / Evaluation process for incorporating health technologies by government institutions in countries with universal health care system like England, Brazil and Canada, in a comparative perspective

Los procesos de Incorporación de Tecnologías en Salud son procesos complejos que involucran varias disciplinas y actores dentro de una organización y los sistemas de salud han seguido diferentes modelos en sus procesos y sub procesos considerando para su evaluación la revisión sistemática, meta análisis, modelos económicos y/o el impacto presupuestario, con la participación o no de las partes interesadas y/o de las personas usuarias y cuidadores. Algunos países han tenido mayores o menores éxitos en la incorporación de las tecnologías; teniendo en cuenta que la relación entre el avance tecnológico y el gasto sanitario es importante para la sostenibilidad del sistema de salud a corto y largo plazo. Objetivo: Describir el proceso de evaluación para la incorporación de tecnologías en salud por instituciones gubernamentales en países que tienen un sistema universal de salud como Inglaterra, Brasil y Canadá, en una perspectiva comparada Diseño: Estudio descriptivo y analítico con un abordaje comparativo donde se realiza una revisión sistematizada y profunda de documentos y artículos publicados de tres instituciones gubernamentales como NICE, CADTH y CONITEC de los países Inglaterra, Canadá y Brasil respectivamente. Resultados: Los tres países financian a sus agencias y comisiones con recursos del estado, que le da sostenibilidad económica y además NICE cuenta con reglamento obligatorio que le da independencia. La experiencia en la estructuración de la ETS es muy importante como NICE y CADTH. El proceso metodológico está definido y es transparente sobretodo en NICE...

Processes of Incorporation of Health Technologies are complex and involve multiple disciplines and stakeholders within an organization. Health systems have followed different models in their processes and sub processes for evaluation considering the systematic review, meta-analysis, models economic and/or fiscal impact, or involving stakeholders and/or the users and carers. Some countries have been more or less successful in incorporating technologies; considering the relationship between technological progress and health expenditures is important for the sustainability of the health system in the short and long term.Objective: Describe the evaluation process for the incorporation of health technologies by government institutions in countries with universal health care system like England, Brazil and Canada, in a comparative perspectiveDesign: A descriptive and analytical study with a comparative approach where a systematic and thorough review of documents and articles published in three government institutions such as NICE, CADTH and CONITEC countries England, Canada and Brazil respectively performed.Results: The three countries finance their resource agencies and commissions of the state, which gives economic sustainability and well NICE has mandatory regulations that gives independence. Experience in structuring the ETS is very important as NICE and CADTH. The methodology is defined and transparent especially in NICE. Economic evaluations are performed in the three entities depends on the technology. Citizen participation in Brazil is still in the process of further. Most technologies are evaluated pharmaceuticals and 62 per cent is new...

Temporalities in evaluation of training courses: standards and restrictions practiced by human resources professionals.

OBJECTIVE: This paper aims to decode the activity of Human Resources (HR) professionals responsible for evaluating continuing vocational training. It is based on the understanding of the different "time frames" involved in the development of the evaluation process as well as the reasons that justify the options for different implementation methods in the world of work. METHODS: Document analysis of the training evaluation process implemented in two companies and comparison of the results obtained in the evaluation of a specific training session using two different evaluation methods. RESULTS: In both cases the companies largely adopted the Kirkpatrick's model to evaluate training, although they hardly exceed the evaluation level reaction to training. One of the two companies offered the opportunity to carry out an evaluation procedure inspired in an alternative model that confirms that different evaluation methods lead to different analysis produced by the trainees regarding the process they have experienced. CONCLUSIONS: The choice for a specific training evaluation model usually depends on administration "time frames" and options and it usually entails a consensus that considers training evaluation as the fulfillment of previously determined standard procedures. Nevertheless, the use of alternative evaluation methods, as a complement to that already in use, may be the right way to revisit the questions which originated the training course and rethink not only its original design but also the working conditions associated to it.

Directiva sobre patentes del Instituto Nacional de Salud / Patent directive of the Instituto Nacional de Salud

La publicación describe los procedimientos para la protección de la titularidad y explotación de la propiedad intelectual, normados en todos los aspectos relacionados con los derechos derivados de propiedad intelectual que resulten de actividades desarrolladas por los investigadores o el personal administrativo bajo relación laboral con el Instituto Nacional de Salud

Directiva de auspicios del Instituto Nacional de Salud / Directive auspices of the National Institute of Health

La publicación describe los mecanismos de autorización de auspicios que otorga el Instituto Nacional de Salud para la realización de actividades científico-tecnológicas, relacionadas con la salud, por terceros o en forma conjunta con la institución. Es de aplicación obligatoria por los funcionarios y personal del Instituto Nacional de Salud, asimismo, es de aplicación por todas aquellas instituciones y organizaciones públicas y privadas de nivel nacional e internacional que soliciten el auspicio del Instituto Nacional de Salud

Bloodstream infections: evolution and trends in the microbiology workload, incidence, and etiology, 1985-2006.

Information available on bloodstream infection (BSI) is usually restricted to short periods of time, certain clinical backgrounds, or specific pathogens, or is just outdated. We conducted the current prospective study of patients with BSI in a 1750-bed teaching hospital to evaluate workload trends and the incidence and etiology of BSI in a general hospital during the last 22 years, including the acquired immunodeficiency syndrome (AIDS) era. The main outcome measures were laboratory workload, trends in incidence per 1000 admissions and per 100,000 population of different microorganisms, and the impact of the human immunodeficiency virus (HIV) epidemic in the period 1985-2006.From 1985 to 2006 we had 27,419 episodes of significant BSI (22,626 patients). BSI incidence evolved from 16.0 episodes to 31.2/1000 admissions showing an annual increase of 0.83 episodes/1000 admissions (95% confidence interval, 0.61-1.05; p < 0.0001). The evolution of the incidence per 1000 admissions and per 100,000 population of different groups of microorganisms was as follows: Gram positives 8.2 to 15.7/1000 admissions and 66.8 to 138.3/100,000 population; Gram negatives 7.8 to 16.2/1000 admissions and 63.5 to 141.9/100,000 population; anaerobes 0.5 to 1.3/1000 admissions and 4.1 to 11.7/100,000 population; and fungi 0.2 to 1.5/1000 admissions and 1.7 to 12.5/100,000 population. All those differences were statistically significant. We observed the emergence of multiresistant Gram-positive and Gram-negative microorganisms. At least 2484 episodes of BSI (9.1%) occurred in 1822 patients infected with HIV. The incidence of BSI in HIV-infected patients increased from 1985 and reached a peak in 1995 (17.6% of BSI). Since 1995, the decrease was continuous, and in 2006 only 3.9% of all BSI episodes occurred in HIV-positive patients in our institution. We conclude that the BSI workload has increased in modern microbiology laboratories. Gram-positive pathogens have overtaken other etiologic agents of BSI. Our observation shows the remarkable escalation of some resistant pathogens, and the rise and relative fall of BSI in patients with HIV.

Desarrollo de la identidad / Identity development

El presente módulo trata sobre la dimensión personal, en el sentido que el desarrollo de la identidad facilita interiorizar el derecho a la salud y fomentar el desarrollo de sentimientos de aceptación y aprecio hacia si mismo y el grupo de pares.

Evaluation of direct E-test on lower respiratory tract samples: a rapid and accurate procedure for antimicrobial susceptibility testing.

We compared the direct E-test susceptibility testing (DET) on respiratory samples with a standard microbroth dilution method (MBD) after quantitative cultures. A total of 152 samples from intensive care unit patients were processed by DET onto Mueller-Hinton agar. Oxacillin, piperacillin/tazobactam, cefepime, imipenem, ciprofloxacin, and amikacin were the antimicrobials evaluated. Cultures were 102 monomicrobials and 50 polymicrobials. Overall, 93.8% of the isolates were recovered by the DET. Among the 772 microorganism-antibiotic combinations evaluated, there was a total agreement with the MBD in 96.1%. There were 8 very major errors (1.03%), 15 major (1.94%), and 7 minor (0.91%). All discrepancies but one corresponded to polymicrobial cultures, and most occurred with cefepime (8 cases, 7.07%) and imipenem (7 cases, 6.18%). Readings of DET were easy to interpret and improved with transmitted light. DET on respiratory samples is a rapid technique that provides susceptibility results in 18 to 24 h comparable with these obtained by MBD.

La tuberculosis: Introducción / Tuberculosis: Introduction

El presente módulo trata acerca de la historia de la tuberculosis (TB)y de la manera en que está afectando a la población, tanto a nivel mundial como en el Perú. Asimismo, explica cómo se propaga la TB de persona a persona (transmisión) y cómo se desarrolla en el organismo la enfermedad de la TB (patogénesis). Además, deberá conocer sobre la transmisión, patogénesis y el tratamiento de la TB. Como trabajador de salud, deberá comprender estos conceptos, de manera que los pueda poner en conocimiento a los pacientes que atiende

Detección de casos de TB / TB detection of cases of

La presente publicación describe sobre la detección de casos, una de las actividades más importantes para controlar la tuberculosis, ya que a través de ella podrá conocer quién o quiénes han desarrollado la enfermedad y, por lo tanto, saber con qué pacientes iniciar el tratamiento antituberculosis para cortar la cadena epidemiológica de transmisión de la enfermedad y recuperar la salud de las personas afectadas

Tratamiento de Personas con TB / People with TB Treatment

El presente módulo describe cómo tratar a las personas con TB y TB MDR. Para tratar a las personas con TB es necesario identificar el tipo de paciente (nuevo o antes tratado), identificar qué características o condiciones tiene e indicar el esquema de tratamiento que le corresponde. El personal de salud tiene que conocer los medicamentos antituberculosis que el paciente toma y cómo manejará los efectos adversos que puedan ocasionar. Además, tiene que saber administrar el tratamiento y monitorizar el progreso del paciente a través de exámenes de control, para saber si el paciente se está curando o si es necesario tomar otra acción