RESUMO
Observation on 32,448 salmonellosis patients was carried out. In 653 cases (2.01%) the complicated course of the disease was observed. It was caused by generalized disturbances in blood circulation, or shock, in 0.09% of cases, or by regional disturbances in blood circulation (myocardial infarction in 0.4%, acute disturbances in cerebral circulation in 0.4%, thrombosis of mesenterial vessels in 0.1% of cases). In addition, infectious complications developed in the form of pneumonia (0.5%) and acute renal insufficiency (0.6% of cases). Acute adrenal insufficiency, observed in the past, did not practically occur during the recent 20 years, having lost its importance due to the use of adequate therapy with polyionic crystalloid solutions.
Assuntos
Intoxicação Alimentar por Salmonella/complicações , Intoxicação Alimentar por Salmonella/diagnóstico , Doença Aguda , Injúria Renal Aguda/etiologia , Humanos , Moscou , Infarto do Miocárdio/etiologia , Pneumonia/etiologia , Síndrome do Desconforto Respiratório/etiologia , Trombose/etiologiaRESUMO
The nosoparasitic form of salmonellosis occurs not only in cases of the association of salmonellosis with infectious diseases, but also in noninfectious patients, mostly in oncological and hematological cases. The appearance of the nosoparasitic form of salmonellosis was observed in 9 patients; of these, 5 with leukosis, 2 with malignant tumors, 1 with erythremia and 1 with cytostatic disease. Concomitant Salmonella infection contributed to the aggravation of the main disease. In 6 out of 9 cases patients with the nosoparasitic form of salmonellosis remained in oncological and hematological hospitals, and no cases of hospital infection were registered. Immunodeficiency played an important role in the development of the nosoparasitic form of salmonellosis in these patients.
Assuntos
Infecções por Salmonella/diagnóstico , Adulto , Idoso , Doenças Autoimunes/complicações , Feminino , Humanos , Síndromes de Imunodeficiência/complicações , Leucemia/complicações , Pessoa de Meia-Idade , Neoplasias/complicações , Policitemia Vera/complicações , Salmonella/classificação , Infecções por Salmonella/etiologia , SorotipagemRESUMO
The study was made of lipopolysaccharide-binding activity of peripheral blood neutrophils (LBA) and content of albumin, prealbumin, transferrin, haptoglobin in patients with mild, moderate and severe course of acute dysentery and food poisoning. Uniformity of changes in the above parameters irrespectively of etiology of acute intestinal infections is discovered. Inhibition of LBA in acute disease, the pattern of acute-phase proteins time-course changes, i.e. reduced levels of albumin, prealbumin, transferrin and elevated ones of haptoglobin, more persistent and marked in severe course were registered.
Assuntos
Proteínas de Fase Aguda/análise , Disenteria Bacilar/sangue , Doenças Transmitidas por Alimentos/sangue , Gastroenterite/sangue , Lipopolissacarídeos/sangue , Neutrófilos/metabolismo , Doença Aguda , Biomarcadores/sangue , Feminino , Humanos , Masculino , Fatores de TempoRESUMO
Shock (hypovolemic and infectious-toxic) is a severe complication of acute intestinal infections. Of 35096 patients with acute intestinal infections (90.6% had food poisoning, 9.4% had salmonellosis), 24 (0.07%) patients developed hypovolemic, 26 (0.08%) infectious-toxic shock. Hypovolemic shock is based on decompensated dehydration, infectious-toxic one arises from generalized circulation disorders with severe affection of hemostasis. Hypovolemic shock was effectively managed with polyionic crystalloid solutions. In infectious-toxic shock hemodynamic and homeostatic defects should be corrected. In spite of intensive therapy, lethality in infectious-toxic shock in patients with acute intestinal infections reached 80.8%.
Assuntos
Doenças Transmitidas por Alimentos/diagnóstico , Enteropatias/diagnóstico , Infecções por Salmonella/diagnóstico , Choque Séptico/diagnóstico , Choque/diagnóstico , Doença Aguda , Adulto , Idoso , Terapia Combinada , Cuidados Críticos , Coagulação Intravascular Disseminada/diagnóstico , Coagulação Intravascular Disseminada/etiologia , Coagulação Intravascular Disseminada/terapia , Feminino , Doenças Transmitidas por Alimentos/complicações , Doenças Transmitidas por Alimentos/terapia , Humanos , Enteropatias/complicações , Enteropatias/terapia , Masculino , Pessoa de Meia-Idade , Infecções por Salmonella/complicações , Infecções por Salmonella/terapia , Choque/etiologia , Choque/terapia , Choque Séptico/etiologia , Choque Séptico/terapiaRESUMO
During the follow-up of 32,448 patients with food poisoning and salmonellosis complications occurred in 665 (2.01%). Among them were general circulation disorders (shock), myocardial infarction, acute cerebral vascular accidents, mesenterial thromboembolism, pneumonia, acute renal failure (0.09, 0.4, 0.4, 0.1, 0.5 and 0.6% of patients, respectively). Complications of food poisoning and salmonellosis caused lethal outcomes in 0.03% of cases. For the last 15 years acute adrenal insufficiency in patients with food poisoning and salmonellosis has not been reported.
Assuntos
Doenças Transmitidas por Alimentos/complicações , Intoxicação Alimentar por Salmonella/complicações , HumanosRESUMO
Some data on the specific features of the clinical course of acute enteric infections (AKI) and hypertensive disease (HD) are presented. The data indicate that the pathogenetic mechanisms of these diseases often act on the same points and in some cases in the same direction. 32,448 AEI patients were placed under observation, among them 29,398 patients with alimentary toxicoinfections and 3,050 patients with salmonellosis. Of these 1,483 patients had HD of stages II and III. In 266 patients of this group hypertensive crises of types I and II developed. In 128 AEI patients acute disturbances in cerebral blood circulation were observed. In 67.2% of cases these patients were found to have HD in their medical history. The treatment of patients with the combination of AEI and HD included rehydration with polyionic crystalloid solutions and the administration of hypotensive preparations.
Assuntos
Hipertensão/diagnóstico , Enteropatias/diagnóstico , Doença Aguda , Adulto , Transtornos Cerebrovasculares/diagnóstico , Transtornos Cerebrovasculares/etiologia , Transtornos Cerebrovasculares/terapia , Terapia Combinada , Diarreia/diagnóstico , Diarreia/etiologia , Diarreia/terapia , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/etiologia , Doenças Transmitidas por Alimentos/terapia , Humanos , Hipertensão/etiologia , Hipertensão/terapia , Enteropatias/etiologia , Enteropatias/terapia , Pessoa de Meia-Idade , Infecções por Salmonella/diagnóstico , Infecções por Salmonella/etiologia , Infecções por Salmonella/terapiaRESUMO
The complicated and combined course of alimentary toxicoinfections are practically the main causes of all the lethal outcomes in these diseases. In this work the data on the recent progress in the rehydration therapy of acute enteric infections are presented. The authors established that combined forms constituted 15.3% and complicated ones constituted 2% of alimentary toxicoinfections. The results of the treatment of alimentary toxicoinfections combined with ischemic heart disease, hypertension and chronic alcoholism, as well as complicated by shock and pneumonia, are presented. The general principles of treatment in combined and complicated cases are the maintenance of the usual (under given conditions) volume of liquid for rehydration with the limitation of the rate of its introduction.
Assuntos
Intoxicação Alimentar por Salmonella/terapia , Doença Aguda , Alcoolismo/terapia , Terapia Combinada , Hidratação/métodos , Lavagem Gástrica , Humanos , Hipertensão/terapia , Isquemia Miocárdica/terapia , Pneumonia/etiologia , Pneumonia/terapia , Intoxicação Alimentar por Salmonella/complicações , Intoxicação Alimentar por Salmonella/etiologia , Choque Séptico/etiologia , Choque Séptico/terapiaRESUMO
An adult woman with catarrhal measles developed idiopathic ketosis. The contributing factors were: diet noncompliance (taking meat rich in fat), emotional stress and fatigue, acute infection (measles).
Assuntos
Sarampo/complicações , Doença Aguda , Adulto , Feminino , Humanos , Cetose/diagnóstico , Cetose/etiologia , Sarampo/diagnósticoRESUMO
153 chronic alcoholics were given treatment against food poisoning. 55 of them developed withdrawal syndrome, 98 had alcoholic psychosis including 88 with delirium tremens. The acute intestinal infection in these alcoholics was managed with rehydration using polyionic crystalloid solutions under controlled diuresis. Previous relief of central excitation contributed much to a positive treatment outcome.
Assuntos
Alcoolismo/complicações , Enteropatias/etiologia , Doença Aguda , Alcoolismo/terapia , Terapia Combinada , Etanol/efeitos adversos , Feminino , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/etiologia , Doenças Transmitidas por Alimentos/terapia , Humanos , Enteropatias/diagnóstico , Enteropatias/terapia , Masculino , Psicoses Alcoólicas/complicações , Psicoses Alcoólicas/terapia , Síndrome de Abstinência a Substâncias/complicações , Síndrome de Abstinência a Substâncias/terapiaRESUMO
The authors observed 32448 cases of alimentary toxoinfection (AT), 96.8% of which were females. Acute surgical abdominal conditions arose in 3.6% of them: appendicitis, cholecystitis, pancreatitis. Aggravation of chronic diseases occurred in 11.6% of the patients, hypertension and cholelithiasis being most frequent. 119 patients developed myocardial infarction, 266 hypertension crisis. The occurrence of acute and chronic diseases were analyzed in relation to common pathogenetic features, role of infection, intoxication, microcirculatory disturbances and hemostatic impairment. AT are suggested as risk factors of certain diseases likely to deteriorate prognosis.
Assuntos
Doenças Transmitidas por Alimentos/epidemiologia , Doença Aguda , Doença Crônica , Erros de Diagnóstico , Feminino , Doenças Transmitidas por Alimentos/complicações , Doenças Transmitidas por Alimentos/diagnóstico , Humanos , Masculino , Moscou/epidemiologia , Fatores de Risco , Fatores de TempoRESUMO
Comprehensive analysis of the incidence of acute enteric infections (AEI) in Moscow over the period of 1985-1990 was made. The analysis demonstrated serious drawbacks in the diagnosis of a number of AEI, including alimentary toxicoinfections, salmonellosis, dysentery, typhoid-paratyphoid diseases, Yersinia and Escherichia infections, and in rendering timely medical care of the patients at the prehospitalization stage. The analysis also revealed that in all AEI the outpatient and inpatient diagnosis still did not coincide in too many cases, and the diagnostic errors in recognition of surgical diseases in infectious patients were too frequent. This analysis also showed an increase in the number of cases of untimely hospitalization of AEI patients, which was the cause of severe and prolonged course of diseases and lethal outcomes. To improve the work at the prehospitalization stage, the following recommendations were made: to improve professional skills of medical personnel at all levels; to introduce differentiated hospitalization of AEI patients, with due consideration of the severity of the case and concomitant diseases and the patient's age; to organize hospital-type treatment at home, as well as to promote insurance medicine.
Assuntos
Doenças Transmissíveis/diagnóstico , Primeiros Socorros/normas , Enteropatias/diagnóstico , Qualidade da Assistência à Saúde/tendências , Doença Aguda , Doenças Transmissíveis/epidemiologia , Diagnóstico Diferencial , Erros de Diagnóstico , Primeiros Socorros/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Humanos , Enteropatias/epidemiologia , Moscou/epidemiologia , Prevalência , Qualidade da Assistência à Saúde/estatística & dados numéricosRESUMO
Literature data and original experience are reviewed on the treatment of alimentary toxoinfections complicated with acute renal failure (ARF). Out of 192 patients prerenal ARF was recorded in 74.5%, renal in 25.5% of the cases. ARF resulted from hemodynamic disturbances, salt and water loss, intoxication. ARF clinical symptoms were poor, the patients developed decompensated metabolic acidosis and hyperazotemia. Pathological and histological evidence is available for 17 patients with "shock kidney". They died of infective toxic shock. The treatment of ARF complicating acute alimentary toxoinfections in 98.9% made a success if implied polyion crystalloid solutions. Hemodialysis was demanded in 1.1% of the cases.
Assuntos
Injúria Renal Aguda/etiologia , Doenças Transmitidas por Alimentos/complicações , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/fisiopatologia , Idoso , Feminino , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/fisiopatologia , Hemodinâmica , Humanos , Rim/fisiopatologiaRESUMO
The authors followed up 215 patients with acute cholecystitis who were hospitalized with an erroneous diagnosis of food poisoning and 346 food poisoning patients who developed acute cholecystitis in the course of the disease mentioned. Symptoms for differential diagnosis of acute cholecystitis and food poisoning were considered.
Assuntos
Colecistite/diagnóstico , Doenças Transmitidas por Alimentos/diagnóstico , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Erros de Diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Diabetes Mellitus/diagnóstico , Doenças Transmitidas por Alimentos/diagnóstico , Doença Aguda , Adulto , Terapia Combinada , Complicações do Diabetes , Diabetes Mellitus/terapia , Feminino , Hidratação/métodos , Doenças Transmitidas por Alimentos/terapia , Gastroenterite/diagnóstico , Gastroenterite/terapia , Humanos , Pessoa de Meia-IdadeRESUMO
The authors criticize the nosological principle of the diagnosis of toxic infections and believe that in a vast majority of cases such diagnosis must be based on syndromes. The only exceptions are cases of mass outbreaks and hospital infections. The definition of alimentary toxic infection is given, the difficulties of their clinical diagnosis and the ways to overcome these difficulties are indicated.
Assuntos
Doenças Transmitidas por Alimentos/diagnóstico , Diagnóstico Diferencial , Erros de Diagnóstico , Doenças Transmitidas por Alimentos/etiologia , Humanos , Enteropatias/diagnóstico , Enteropatias/etiologia , SíndromeRESUMO
Therapeutic effectiveness of an oral rehydration solution of the second generation Super-ORS based on rice and salt has been tried in 28 patients with food poisoning. Administration of the solution produced a marked clinical effect superior to that of the first generation solutions Glucosalan, Citroglucosalan, Rehydron.
Assuntos
Diarreia/terapia , Hidratação/métodos , Gastroenterite/terapia , Oryza , Soluções para Reidratação/administração & dosagem , Intoxicação Alimentar por Salmonella/terapia , Cloreto de Sódio/administração & dosagem , Doença Aguda , Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Salmonella enteritidisAssuntos
Disenteria Bacilar/diagnóstico , Primeiros Socorros/normas , Enteropatias/diagnóstico , Qualidade da Assistência à Saúde , Intoxicação Alimentar por Salmonella/diagnóstico , Doença Aguda , Adulto , Terapia Combinada , Disenteria Bacilar/terapia , Humanos , Enteropatias/terapia , Intoxicação Alimentar por Salmonella/terapia , U.R.S.S.RESUMO
The efficacy of the solutions of oral rehydration salts (ORS) of the first and second generations was estimated in the treatment of patients with acute intestinal infections. 150 patients with food toxicoinfections were examined. Two groups of the patients received the solutions of ORS of the first generation (glucosalan and citroglucosalan) and one group were given the second generation ORS solution based on the rice and salt, manufactured by Galactina (Switzerland). The clinical cases were analyzed. Some biochemical parameters that characterize certain aspects of homeostasis and bioenergetics were explored. The authors emphasize a greater effectiveness of the second generation solutions of ORS producing not only detoxification and rehydration but also serving as a food.