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1.
Front Pediatr ; 11: 1167871, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37274824

RESUMEN

Introduction: Multisystem inflammatory syndrome in children associated with coronavirus disease 2019 (MIS-C), a novel hyperinflammatory condition secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is associated with severe outcomes such as coronary artery aneurysm and death. Methods: This multicenter, retrospective, observational cohort study including eight centers in Mexico, aimed to describe the clinical characteristics and outcomes of patients with MIS-C. Patient data were evaluated using latent class analysis (LCA) to categorize patients into three phenotypes: toxic shock syndrome-like (TSSL)-MIS-C, Kawasaki disease-like (KDL)-MIS-C, and nonspecific MIS-C (NS-MIS-C). Risk factors for adverse outcomes were estimated using multilevel mixed-effects logistic regression. Results: The study included 239 patients with MIS-C, including 61 (26%), 70 (29%), and 108 (45%) patients in the TSSL-MIS-C, KDL-MIS-C, and NS-MIS-C groups, respectively. Fifty-four percent of the patients were admitted to the intensive care unit, and 42%, 78%, and 41% received intravenous immunoglobulin, systemic glucocorticoids, and anticoagulants, respectively. Coronary artery dilatation and aneurysms were found in 5.7% and 13.2% of the patients in whom coronary artery diameter was measured, respectively. Any cause in-hospital mortality was 5.4%. Hospitalization after ten days of symptoms was associated with coronary artery abnormalities (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.2-2.0). Age ≥10 years (OR: 5.6, 95% CI: 1.4-2.04), severe underlying condition (OR: 9.3, 95% CI: 2.8-31.0), platelet count <150,000 /mm3 (OR: 4.2, 95% CI: 1.2-14.7), international normalized ratio >1.2 (OR: 3.8, 95% CI: 1.05-13.9), and serum ferritin concentration >1,500 mg/dl at admission (OR: 52, 95% CI: 5.9-463) were risk factors for death. Discussion: Mortality in patients with MIS-C was higher than reported in other series, probably because of a high rate of cases with serious underlying diseases.

2.
Rev. enfermedades infecc. ped ; 11(48): 256-9, abr.-jun. 1999. tab
Artículo en Español | LILACS | ID: lil-254635

RESUMEN

La resistencia de M. tuberculosis a los fármacos es un problema de salud a nivel mundial. Se han implementado programas de control cuyos objetivo incluyen la detección de casos y un tratamiento acortado y estandarizado. Se revisan los factores de riesgo de presentar fármaco-resistencia al tratamiento contra la tuberculosis y los mecanismos de resistencia, así como la vigilancia epidemiológica, que junto con recomendaciones específicas es fundamental para el éxito de los programas


Asunto(s)
Humanos , Salud Global , Factores de Riesgo , Tuberculosis Resistente a Múltiples Medicamentos , Tuberculosis/terapia
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