RESUMO
INTRODUCTION: The identification, diagnosis, follow-up, and treatment of patients with secondary progressive multiple sclerosis (SPMS) show significant differences between health care professionals in Argentina. AIM: To provide consensus recommendations on the management of patients with SPMS in Argentina to optimize patient care. DEVELOPMENT: A panel of expert neurologists from Argentina dedicated to the diagnosis and care of multiple sclerosis patients gathered during 2019 and 2020 to carry out a consensus recommendation on the diagnosis and treatment of SPMS patients in Argentina. To achieve consensus, the methodology of 'formal consensus-RAND/UCLA method' was used. Recommendations were established based on published evidence and the expert opinion. Recommendations focused on how to define SPMS and how to follow SPMS patients. CONCLUSION: The recommendations of this consensus guidelines attempt to optimize the care of SPMS patients in Argentina.
TITLE: Consenso sobre la identificación y seguimiento de la esclerosis múltiple secundaria progresiva en Argentina.Introducción. Existen diferencias significativas en el diagnóstico, la identificación y el seguimiento de pacientes con esclerosis múltiple secundaria progresiva (EMSP) entre los profesionales de la salud a cargo de su tratamiento. Objetivo. Proveer recomendaciones sobre el tratamiento de los pacientes con EMSP en Argentina con el fin de optimizar su cuidado. Desarrollo. Un grupo de neurólogos expertos en esclerosis múltiple de Argentina elaboró un consenso para el tratamiento de pacientes con EMSP en la región mediante metodología de ronda de encuestas a distancia y reuniones presenciales. Se establecieron 33 recomendaciones basadas en la evidencia publicada y en el criterio de los expertos que participaron. Las recomendaciones se enfocaron en el diagnóstico y el seguimiento de los pacientes con EMSP. Conclusión. Las recomendaciones establecidas en el presente consenso permitirían optimizar el cuidado y el seguimiento de los pacientes con EMSP en Argentina.
Assuntos
Esclerose Múltipla Crônica Progressiva/diagnóstico , Esclerose Múltipla Crônica Progressiva/terapia , Argentina , Humanos , Guias de Prática Clínica como AssuntoRESUMO
INTRODUCTION: Adult non tuberculous primary bacterial meningitis (PBM) represents an important cause of morbidity and mortality in hospitals. The shortage of studies based on the population in Latin America provided the motivation for this work. AIMS: To determine the incidence of PBM in the captive population of our hospital and carry out a descriptive analysis of the cases detected. PATIENTS AND METHODS: We performed an epidemiological study of the captive population (CP) of the hospital (an average of 85,200 patients in 11 years) and a retrospective descriptive examination of patients who had been admitted. The clinical histories of all patients over the age of 18 who had been admitted with PBM between 1 January 1988 and 31 December 1998 were studied. RESULTS AND CONCLUSIONS: A total number of 87 cases of primary bacterial meningitis were registered, of which 70 belonged to the CP. The overall gross rate of PBM incidence in the CP was 8.6/100,000 per year. The annual incidence rate, adjusted to the 1991 National Census on the Argentinean Population, was 5.4/100,000 per year, with a greater frequency between the ages of 70 and 79: 21/100,000 per year. Median age: 73 (lower quartile, 66; upper quartile, 78). Clinical manifestations included high temperatures (90%), consciousness disorders (87%), and a stiff neck (81%). The frequency with which it appeared remained constant over the 11 year period, without showing any seasonal variations. The most frequent etiological agent was pneumococcus (50%). No cases of PBM by Listeria were reported. Overall fatality during the stay in hospital was 23%, without any type of modification over the period we studied.