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1.
J Infect Dis ; 221(3): 356-366, 2020 01 14.
Artículo en Inglés | MEDLINE | ID: mdl-31314899

RESUMEN

BACKGROUND: The effect of neuraminidase inhibitor (NAI) treatment on length of stay (LoS) in patients hospitalized with influenza is unclear. METHODS: We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. Using mixed-effects negative binomial regression and adjusting for the propensity to receive NAI, antibiotic, and corticosteroid treatment, we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Patients with a LoS of <1 day and those who died while hospitalized were excluded. RESULTS: We analyzed data on 18 309 patients from 70 clinical centers. After adjustment, NAI treatment initiated at hospitalization was associated with a 19% reduction in the LoS among patients with clinically suspected or laboratory-confirmed influenza A(H1N1)pdm09 infection (IRR, 0.81; 95% CI, .78-.85), compared with later or no initiation of NAI treatment. Similar statistically significant associations were seen in all clinical subgroups. NAI treatment (at any time), compared with no NAI treatment, and NAI treatment initiated <2 days after symptom onset, compared with later or no initiation of NAI treatment, showed mixed patterns of association with the LoS. CONCLUSIONS: When patients hospitalized with influenza are treated with NAIs, treatment initiated on admission, regardless of time since symptom onset, is associated with a reduced LoS, compared with later or no initiation of treatment.


Asunto(s)
Antivirales/uso terapéutico , Inhibidores Enzimáticos/uso terapéutico , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/tratamiento farmacológico , Gripe Humana/epidemiología , Tiempo de Internación , Neuraminidasa/antagonistas & inhibidores , Pandemias , Adolescente , Corticoesteroides/uso terapéutico , Adulto , Anciano , Antibacterianos/uso terapéutico , Niño , Inhibidores Enzimáticos/farmacología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto Joven
2.
Cureus ; 16(3): e56434, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38638776

RESUMEN

Cushing's syndrome is a constellation of features occurring due to high blood cortisol levels. We report a case of a 47-year-old male with a history of recurrent olfactory neuroblastoma (ONB). He presented with bilateral lower limb weakness and anosmia and was found to have Cushing's syndrome due to high adrenocorticotropic hormone (ACTH) levels from an ectopic source, ONB in this case. Serum cortisol and ACTH levels declined after tumor removal.

3.
Cureus ; 15(8): e44093, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37753004

RESUMEN

Wernicke's encephalopathy (WE) is an acute neuropsychiatric emergency due to thiamine deficiency. This report includes a case of a young pregnant female in her second trimester (17th weeks) complaining of hyperemesis gravidarum, who, due to excessive vomiting, developed severe vitamin B1 deficiency, leading to WE and Korsakoff's psychosis. The typical triad of confusion, ocular signs, and ataxia is fundamental for the diagnosis of WE, yet not all cases present with the entire triad; however, our patient presented with all the symptoms. Replacement of thiamine, which is a crucial vitamin that plays an important role in the integrity of the nervous system, is the first step in the management of WE.

4.
Saudi Med J ; 29(1): 129-32, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18176688

RESUMEN

Nalidixic acid-resistant Salmonella typhi NARST infections increase minimal inhibitory concentrations of fluoroquinolones, due to chromosomal mutations in the gene encoding DNA gyrase, and can lead to a delayed treatment response. This in turn alters the course of the disease allowing for a protracted period of illness and the occurrence of complications. In this case report, we present a patient from the Indian sub-continent, who was diagnosed with NARST complicated by sub-intestinal obstruction, her diagnosis, treatment, and subsequent recovery.


Asunto(s)
Antiinfecciosos/uso terapéutico , Ciprofloxacina/uso terapéutico , Obstrucción Intestinal/microbiología , Linfadenitis Mesentérica/microbiología , Fiebre Tifoidea/tratamiento farmacológico , Adulto , Diagnóstico Diferencial , Farmacorresistencia Bacteriana , Femenino , Humanos , Obstrucción Intestinal/diagnóstico , Linfadenitis Mesentérica/diagnóstico , Ácido Nalidíxico/uso terapéutico , Salmonella typhi/efectos de los fármacos , Fiebre Tifoidea/diagnóstico
5.
Saudi Med J ; 28(10): 1593-6, 2007 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17914526

RESUMEN

Chronic granulomatous disease CGD is a condition of inability to deal with bacterial and fungal infections, due to defective respiratory burst in neutrophils leading to recurrent cutaneous and visceral infections. Usually a disease of childhood, but patients nowadays survive to adulthood, and diagnosis might be difficult if not considered. We describe a 20-year-old female with previously undiagnosed CGD, presenting with recurrent cutaneous and hepatic abscesses.


Asunto(s)
Enfermedad Granulomatosa Crónica/complicaciones , Enfermedad Granulomatosa Crónica/diagnóstico , Absceso Hepático/etiología , Adulto , Femenino , Humanos , Recurrencia
6.
Saudi Med J ; 28(10): 1597-9, 2007 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17914527

RESUMEN

Congenitally corrected transposition of the great arteries CCTGA is a rare congenital disease first described by Von Rokitansky in 1875. Transposition of the great arteries comprises 2.6 - 7.8% of all cases of congenital heart disease, and if uncorrected, is commonly fatal in the first year of life. Patients with corrected transposition of the great arteries without associated defects may remain undiagnosed until adult life. Symptoms occur rarely before the fourth and fifth decades, when rhythm disturbance, left atrioventricular valve regurgitation, and moderately impaired systemic ventricular function cause congestive cardiac failure. We report here a case of drug overdose with ischemic symptoms, and CCTGA without associated anomalies in a 40-year-old male.


Asunto(s)
Anfetamina/envenenamiento , Estimulantes del Sistema Nervioso Central/envenenamiento , Sobredosis de Droga/complicaciones , Isquemia Miocárdica/etiología , Transposición de los Grandes Vasos/complicaciones , Transposición de los Grandes Vasos/diagnóstico , Adulto , Humanos , Masculino
7.
Neurosciences (Riyadh) ; 12(4): 330-2, 2007 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21857556

RESUMEN

The spinal cord can be involved in a variety of disease processes. These can be congenital or acquired. An acute onset of symptoms usually allows a defined set of causes to be considered including trauma, ruptured vascular anomalies, demyelination, and myelitis. Intramedullary cavernous hemangioma of the spinal cord is a congenital or acquired vascular malformation, and one of the rare causes of hematomyelia. We present such a case, and discuss the symptoms, diagnosis, and suggested best treatment options based on a review of present day literature.

8.
Ann Thorac Med ; 12(4): 282-289, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29118862

RESUMEN

INTRODUCTION: Venous thromboembolism (VTE) during hospitalization is a serious and potentially fatal condition. Despite its effectiveness, evidence-based thromboprophylaxis is still underutilized in many countries including Saudi Arabia. OBJECTIVE OF THE STUDY: Our objectives were to determine how often hospital-acquired VTE patients received appropriate thromboprophylaxis, VTE-associated mortality, and the percentage of patients given anticoagulant therapy and adherence to it after discharged. METHODS: This study was conducted in seven major hospitals in Saudi Arabia. From July 1, 2009, till June 30, 2010, all recorded deep vein thrombosis (DVT) and pulmonary embolism (PE) cases were noted. Only patients with confirmed VTE diagnosis were included in the analysis. RESULTS: A total of 1241 confirmed VTE cases occurred during the 12-month period. Most (58.3%) of them were DVT only, 21.7% were PE, and 20% were both DVT and PE. 21.4% and 78.6% of confirmed VTE occurred in surgical and medical patients, respectively. Only 40.9% of VTE cases received appropriate prophylaxis (63.2% for surgical patients and 34.8% for medical patients; P < 0.001). The mortality rate was 14.3% which represented 1.6% of total hospital deaths. Mortality was 13.5% for surgical patients and 14.5% for medical patients (P > 0.05). Appropriate thromboprophylaxis was associated with 4.11% absolute risk reduction in mortality (95% confidence interval: 0.24%-7.97%). Most (89.4%) of the survived patients received anticoagulation therapy at discharge and 71.7% of them were adherent to it on follow-up. CONCLUSION: Thromboprophylaxis was underutilized in major Saudi hospitals denoting a gap between guideline and practice. This gap was more marked in medical than surgical patients. Hospital-acquired VTE was associated with significant mortality. Efforts to improve thromboprophylaxis utilization are warranted.

9.
Saudi Med J ; 27(5): 707-10, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16680265

RESUMEN

Staphylococcus aureus is the most common cause of endocarditis in intravenous drug users. The organism gains access by intravenous injection or from the direct invasion of skin at injection sites. Known for its aggressiveness, the right sided endocarditis that ensues can lead to complications such as pulmonary abscesses and even death. We report the unusual case of an intravenous drug abuser, who following the occurrence of extensive pulmonary abscesses, developed bilateral pneumothoraces within a few days.


Asunto(s)
Antibacterianos/uso terapéutico , Endocarditis Bacteriana/etiología , Neumotórax/etiología , Infecciones Estafilocócicas/etiología , Staphylococcus aureus/aislamiento & purificación , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/tratamiento farmacológico , Humanos , Masculino , Neumotórax/diagnóstico , Neumotórax/terapia , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/tratamiento farmacológico
10.
Neurosciences (Riyadh) ; 11(3): 197-200, 2006 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-22266621

RESUMEN

Neurosyphilis is the infection of the central nervous system with treponema pallidum species, and true to its reputation as the old mimic, can present with a multitude of clinical scenarios, one of which is stroke in the young. Rare in developed countries, except for an at-risk population of drug abusers and HIV infected patients; it is still common in the rest of the world. We describe the case of a young Indian male, his presentation, diagnosis and treatment, and remarkable recovery on aqueous penicillin G therapy following his presentation with a stroke.

11.
Saudi Med J ; 26(11): 1800-2, 2005 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-16311669

RESUMEN

Hospitalized patients are in danger of deep venous thrombosis either due to a genetic tendency, immobilization or the underlying medical condition. Paradoxically heparin, the substance used to prevent this complication, can lead to thrombo-embolic phenomena, which can be life threatening. We report a case of heparin-induced thrombocytopenia, which caused a massive pulmonary embolism, and its management by administering a thrombolytic agent in a situation where bleeding seems inevitable.


Asunto(s)
Heparina de Bajo-Peso-Molecular/efectos adversos , Embolia Pulmonar/inducido químicamente , Trombocitopenia/inducido químicamente , Terapia Trombolítica/efectos adversos , Accidentes de Tránsito , Enfermedad Aguda , Estudios de Seguimiento , Heparina de Bajo-Peso-Molecular/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Traumatismo Múltiple/diagnóstico , Traumatismo Múltiple/terapia , Tomografía de Emisión de Positrones , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/tratamiento farmacológico , Medición de Riesgo , Trombocitopenia/complicaciones , Terapia Trombolítica/métodos , Resultado del Tratamiento
12.
Saudi Med J ; 26(1): 130-2, 2005 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-15756370

RESUMEN

Thrombolytic therapy is the modality of choice for the treatment of life threatening thrombosis in various vascular territories and nowadays, is used extensively in setting of acute myocardial infarction. There is, however, the omnipresent danger of serious bleeding inherently associated with the use of all thrombolytics which if it occurs in the brain, can lead to potentially serious neurological impairment and even death. In our report, we describe the successful surgical management of a streptokinase-induced intracranial hemorrhage. Timely neurosurgical intervention is advocated as the optimal approach for this particular side effect of thrombolytic agents.


Asunto(s)
Hemorragia Cerebral/inducido químicamente , Hemorragia Cerebral/cirugía , Fibrinolíticos/efectos adversos , Hematoma/inducido químicamente , Hematoma/cirugía , Infarto del Miocardio/tratamiento farmacológico , Estreptoquinasa/efectos adversos , Terapia Trombolítica/efectos adversos , Adulto , Humanos , Masculino
13.
Neurosciences (Riyadh) ; 10(1): 96-8, 2005 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22473196

RESUMEN

Thrombolytic therapy is the modality of choice for the treatment of life threatening thrombosis in various vascular territories and nowadays, is used extensively in the setting of acute myocardial infarction. There is, however, the omnipresent danger of serious bleeding inherently associated with the use of all thrombolytics which if it occurs in the brain, can lead to potentially serious neurological impairment and even death. In our report, we describe the successful surgical management of a streptokinase-induced intracranial hemorrhage. Timely neurosurgical intervention is advocated as the optimal approach for this particular side effect of thrombolytic agents.

14.
Neurosciences (Riyadh) ; 10(3): 226-9, 2005 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-22473264

RESUMEN

Neurocysticercosis is a disease endemic in pork breeding societies. It exhibits itself by the sudden development of seizures in an apparently healthy individual, a rather nonspecific symptom. In its own cultural circles, diagnosis is easy because of the higher incidence and prevalence of the ailment. However in cultures whose religion excludes the breeding of pork, such as Islamic countries, diagnosis depends on an often forgotten spiritual history, which we believe may have a place as the fourth epidemiologic criterion in the revised diagnostic criteria for neurocysticercosis.

15.
Ann Thorac Med ; 10(1): 3-15, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25593601

RESUMEN

The diagnosis of deep venous thrombosis (DVT) may be challenging due to the inaccuracy of clinical assessment and diversity of diagnostic tests. On one hand, missed diagnosis may result in life-threatening conditions. On the other hand, unnecessary treatment may lead to serious complications. As a result of an initiative of the Ministry of Health of the Kingdom of Saudi Arabia (KSA), an expert panel led by the Saudi Association for Venous Thrombo-Embolism (SAVTE; a subsidiary of the Saudi Thoracic Society) with the methodological support of the McMaster University Working Group, produced this clinical practice guideline to assist healthcare providers in evidence-based clinical decision-making for the diagnosis of a suspected first DVT of the lower extremity. Twenty-four questions were identified and corresponding recommendations were made following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. These recommendations included assessing the clinical probability of DVT using Wells criteria before requesting any test and undergoing a sequential diagnostic evaluation, mainly using highly sensitive D-dimer by enzyme-linked immunosorbent assay (ELISA) and compression ultrasound. Although venography is the reference standard test for the diagnosis of DVT, its use was not recommended.

16.
Saudi Med J ; 23(1): 99-103, 2002 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11938375

RESUMEN

Infectious endocarditis is a potentially lethal inflammation of the hearts' inner lining invaded by microorganisms. The mortality from this illness increases as the number of infective organisms rises to 2, due to involvement of the left side of the heart. These microorganisms usually arise from the patient's own flora but can be acquired from the environment. Fever and heart murmurs are the principal clinical manifestations followed by a plethora of peripheral signs due to dissemination of microorganisms via the bloodstream. Echocardiographic imaging and sensitive culture techniques form the cornerstone of diagnosis. We report a patient with rheumatic heart disease who had combined brucella melitensis and streptococcus viridans endocarditis complicated by heart failure and an aortic root abscess. He was diagnosed on the basis of a history of prolonged fever and occupational risk as a shepherd, the presence of heart murmurs, positive blood cultures and echocardiographic evidence of aortic vegetations. He had an excellent response to intravenous antibiotic therapy combined with aortic valve replacement, which nowadays is regarded as the safest therapeutic approach for aortic valve endocarditis.


Asunto(s)
Brucella melitensis/aislamiento & purificación , Brucelosis/diagnóstico , Endocarditis Bacteriana/microbiología , Endocarditis Bacteriana/terapia , Infecciones Estreptocócicas/diagnóstico , Streptococcus/clasificación , Antibacterianos , Brucelosis/complicaciones , Brucelosis/terapia , Cateterismo Cardíaco , Terapia Combinada , Quimioterapia Combinada/administración & dosificación , Ecocardiografía Transesofágica , Endocarditis Bacteriana/diagnóstico por imagen , Estudios de Seguimiento , Prótesis Valvulares Cardíacas , Humanos , Masculino , Persona de Mediana Edad , Arabia Saudita , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/terapia , Resultado del Tratamiento
17.
Saudi Med J ; 23(12): 1532-6, 2002 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-12518208

RESUMEN

Traumatic fat embolism syndrome occurs most often following fractures of long bones sustained in road traffic accidents and is a common cause of medical consultation from the orthopedic surgery department. The sub-clinical presentation is subtle and expresses itself by the presence of hypoxemia, while the full clinical syndrome compromises respiratory insufficiency, an altered consciousness and a characteristic petechial rash. Recognition is simple once the patient is viewed in the context of his or her clinical setting. Diagnosis is aided further by the presence of hematological and biochemical abnormalities including anemia, thrombocytopenia, an elevated erythrocyte sedimentation rate and fat macroglobulinemia. Imaging by chest radiograph, computed tomography or magnetic resonance of the brain is used to confirm the extent of the respective organ involvement and to exclude alternative pathologies. The release of free fatty acids into the circulation and their subsequent effects is the key pathological event. Treatment is based on supportive care and high-dose corticosteroid therapy. We report a patient with traumatic fat embolism syndrome who developed the syndromes classical symptoms and signs following fracture of the long bones of his left lower leg. Admission to an intensive care unit, mechanical ventilatory support with positive end-expiratory pressure and corticosteroid therapy lead to his improvement and allowed eventual open reduction and internal fixation and discharge of our patient. Modern therapy offers a relatively good prognosis for patients with traumatic fat embolism syndrome; the optimal dose and timing of corticosteroid therapy in prophylaxis and treatment however, remain the subject of intense debate.


Asunto(s)
Embolia Grasa/etiología , Peroné/lesiones , Fracturas de la Tibia/complicaciones , Adulto , Embolia Grasa/diagnóstico , Embolia Grasa/terapia , Humanos , Masculino , Síndrome
18.
Neurosciences (Riyadh) ; 8(1): 60-4, 2003 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23648990

RESUMEN

Traumatic fat embolism syndrome occurs most often following fractures of long bones sustained in road traffic accidents and is a common cause of medical consultation from the orthopedic surgery department. The sub-clinical presentation is subtle and expresses itself by the presence of hypoxemia, while the full clinical syndrome compromises respiratory insufficiency, an altered consciousness and a characteristic petechial rash. Recognition is simple once the patient is viewed in the context of his or her clinical setting. Diagnosis is aided further by the presence of hematological and biochemical abnormalities including anemia, thrombocytopenia, an elevated erythrocyte sedimentation rate and fat macroglobulinemia. Imaging by chest radiograph, computed tomography or magnetic resonance of the brain is used to confirm the extent of the respective organ involvement and to exclude alternative pathologies. The release of free fatty acids into the circulation and their subsequent effects is the key pathological event. Treatment is based on supportive care and high-dose corticosteroid therapy. We report a patient with traumatic fat embolism syndrome who developed the syndrome`s classical symptoms and signs following fracture of the long bones of his left lower leg. Admission to an intensive care unit, mechanical ventilatory support with positive end-expiratory pressure and corticosteroid therapy lead to his improvement and allowed eventual open reduction and internal fixation and discharge of our patient. Modern therapy offers a relatively good prognosis for patients with traumatic fat embolism syndrome; the optimal dose and timing of corticosteroid therapy in prophylaxis and treatment however, remain the subject of intense debate.

19.
JMM Case Rep ; 1(4): e003269, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28663810

RESUMEN

INTRODUCTION: Gastrointestinal basidiobolomycosis (GIB) is an emerging fungal infection with a few cases reported worldwide. It is caused by Basidiobolus ranarum, which does not usually invade blood vessels and rarely disseminates. CASE PRESENTATION: We present a rare case of GIB with hepatic dissemination in a 12-year-old Yemeni boy living in southwestern Saudi Arabia. The initial provisional diagnosis was intestinal lymphoma, and a right hemicolectomy was carried out, but histopathological assessment ruled out lymphoma and suggested intestinal tuberculosis. Two weeks after starting antituberculous medications, the patient was referred to our hospital because of fever and right upper abdominal discomfort. There was leukocytosis with marked eosinophilia, and a liver biopsy showed evidence of B. ranarum infection. A second opinion by histopathological examination of resected tissues diagnosed colonic basidiobolomycosis. The patient was treated successfully with itraconazole. CONCLUSION: GIB is an emerging disease in southwestern Saudi Arabia and should be considered in a patient with an abdominal mass and eosinophilia coming from this region. Persistent elevation of leukocytes and eosinophils after surgical resection of the affected tissue could be used as a predictor of fungal dissemination. Further research is needed for a better understanding of GIB.

20.
Lancet Respir Med ; 2(5): 395-404, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24815805

RESUMEN

BACKGROUND: Neuraminidase inhibitors were widely used during the 2009-10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. METHODS: We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. FINDINGS: We included data for 29,234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70-0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41-0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37-0·67; p<0·0001). These associations with reduced mortality risk were less pronounced and not significant in children. There was an increase in the mortality hazard rate with each day's delay in initiation of treatment up to day 5 as compared with treatment initiated within 2 days of symptom onset (adjusted hazard ratio [HR 1·23] [95% CI 1·18-1·28]; p<0·0001 for the increasing HR with each day's delay). INTERPRETATION: We advocate early instigation of neuraminidase inhibitor treatment in adults admitted to hospital with suspected or proven influenza infection. FUNDING: F Hoffmann-La Roche.


Asunto(s)
Antivirales/uso terapéutico , Inhibidores Enzimáticos/uso terapéutico , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/tratamiento farmacológico , Neuraminidasa/antagonistas & inhibidores , Oseltamivir/uso terapéutico , Pandemias , Zanamivir/uso terapéutico , Adolescente , Adulto , Niño , Femenino , Hospitalización , Humanos , Gripe Humana/mortalidad , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Resultado del Tratamiento , Adulto Joven
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