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1.
Health Qual Life Outcomes ; 15(1): 11, 2017 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-28100258

RESUMO

BACKGROUND: Herpes zoster (HZ) has a significant negative effect on the productive work life of individuals, and has been shown to be responsible for cases of absenteeism, presenteeism and decreased work effectiveness. The aim of this study was to evaluate health utility scores and associated predictors in an actively employed population of Herpes Zoster (HZ) patients with and without work time loss (WTL). METHODS: This was a pooled analysis of the prospective, observational MASTER cohort studies, conducted in 8 countries across North America, Latin America and Asia. A total of 428 HZ patients engaged in full or part time work were included. WTL, defined as missing ≥ 1 partial or full work day, and work effectiveness, reported on a scale of 0-100%, were evaluated with the Work and Productivity Questionnaire (WPQ). The Pearson product-moment correlation was used to assess the correlation between work effectiveness and HRQoL. Mixed models with repeated measures assessed the relationship between HZ-related WTL over a 6-month follow-up period, and HRQoL, as evaluated by the EQ-5D. Additional predictors of HRQoL were also identified. RESULTS: Overall, 57.7% of respondents reported WTL. Mean (SD) percent work effectiveness of patients in the WTL group was significantly lower compared to non-WTL (NWTL) patients at baseline [50.3 (31.6) vs. 71.4 (27.8); p < 0.001]. Patients in the WTL group also reported lower health utility scores at baseline and overall than their NWTL counterparts, with WTL identified as an independent negative predictor of both the EQ-5D summary scores and the EQ-5D VAS (p < 0.001). Decrease in work effectiveness was negatively associated with HRQoL overall (p < 0.001). Predictors of lower HRQoL were worst Zoster Brief Pain Inventory (ZBPI) pain score, the presence of HZ complications and country income (predictor of EQ-5D VAS only). CONCLUSIONS: HZ adversely impacts the work and productive life of actively employed individuals. In turn, HZ-related reductions in work effectiveness and work time are associated with a negative effect on HRQoL.


Assuntos
Absenteísmo , Herpes Zoster/epidemiologia , Tolerância ao Trabalho Programado , Adulto , Idoso , Ásia/epidemiologia , Estudos de Coortes , Avaliação da Deficiência , Eficiência , Feminino , Herpes Zoster/prevenção & controle , Humanos , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , América do Norte/epidemiologia , Dor/epidemiologia , Estudos Prospectivos , Estatísticas não Paramétricas
2.
Int J Infect Dis ; 34: 126-31, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25841633

RESUMO

OBJECTIVES: The most common complication of herpes zoster (HZ) is postherpetic neuralgia (PHN), a persistent pain that can substantially affect quality of life (QoL). This analysis aimed to evaluate predictors of PHN in HZ patients. METHODS: A pooled analysis of prospective cohort studies of HZ patients aged ≥ 50 years from North America (Canada), Latin America (Brazil, Mexico, and Argentina), and Asia (Taiwan, South Korea, and Thailand) was performed. Patients within 14 days of rash onset were included. The incidence of PHN was defined as a worst pain score of ≥ 3, persisting/appearing at >90 days after rash onset. Socio-demographics, HZ disease characteristics, treatment, pain-related interference with activities of daily living, and health-related QoL were assessed. RESULTS: Of 702 patients with HZ, 148 (21.1%) developed PHN. Similar risks of PHN were observed across geographic regions. On multivariate analysis, older age, greater severity of pain at rash onset, employment status, walking problems at enrollment, and pain interference affecting social relationships were significantly associated with the development of PHN. CONCLUSIONS: In addition to older age and severe acute pain, this study suggests that impaired physical and social functioning from acute zoster pain may play a role in the development of PHN in this prospective cohort study of HZ patients from North and Latin America and Asia.


Assuntos
Herpes Zoster/epidemiologia , Neuralgia Pós-Herpética/epidemiologia , Atividades Cotidianas , Idoso , Argentina/epidemiologia , Brasil/epidemiologia , Canadá/epidemiologia , Exantema/epidemiologia , Feminino , Humanos , Incidência , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Análise Multivariada , Medição da Dor , Estudos Prospectivos , Qualidade de Vida , República da Coreia/epidemiologia , Taiwan/epidemiologia , Tailândia/epidemiologia
3.
Salud Publica Mex ; 49(4): 249-55, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17710273

RESUMO

OBJECTIVE: The aim of this study was to determine the prevalence of asymptomatic nasopharyngeal carriage of Streptococcus pneumoniae, which is a major factor in the transmission of this bacterium. MATERIAL AND METHODS: Nasopharyngeal cultures were performed on children attending 32 day-care centers in 12 states in Mexico. RESULTS: Streptococcus pneumoniae was isolated from the nasopharynx of 829 out of 2,777(29.9%) subjects aged two months to six years. All children lived in urban areas and 80% spent more than six hours daily in a day-care center. Streptococcus pneumoniae serotypes most frequently identified were: 19F (23%), 6B (15.6%), 23F (11.2%) and 6A (14.9%). Thirty-six percent of the isolates were susceptible to penicillin. CONCLUSIONS: Serotype distribution suggests the possible benefits that could be obtained from the heptavalent pneumococcal conjugate vaccine.


Assuntos
Creches , Streptococcus pneumoniae/isolamento & purificação , Criança , Pré-Escolar , Interpretação Estatística de Dados , Humanos , Lactente , México , Testes de Sensibilidade Microbiana , Nasofaringe/microbiologia , Penicilinas/farmacologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/administração & dosagem , Sorotipagem , Streptococcus pneumoniae/efeitos dos fármacos , Fatores de Tempo , População Urbana
4.
Salud pública Méx ; 49(4): 249-255, jul.-ago. 2007. tab
Artigo em Inglês | LILACS | ID: lil-458837

RESUMO

OBJECTIVE: The aim of this study was to determine the prevalence of asymptomatic nasopharyngeal carriage of Streptococcus pneumoniae, which is a major factor in the transmission of this bacterium. MATERIAL AND METHODS: Nasopharyngeal cultures were performed on children attending 32 day-care centers in 12 states in Mexico. RESULTS: Streptococcus pneumoniae was isolated from the nasopharynx of 829 out of 2 777(29.9 percent) subjects aged two months to six years. All children lived in urban areas and 80 percent spent more than six hours daily in a day-care center. Streptococcus pneumoniae serotypes most frequently identified were: 19F (23 percent), 6B (15.6 percent), 23F (11.2 percent) and 6A (14.9 percent). Thirty-six percent of the isolates were susceptible to penicillin. CONCLUSIONS: Serotype distribution suggests the possible benefits that could be obtained from the heptavalent pneumococcal conjugate vaccine.


OBJETIVO: La intención de este estudio fue determinar la prevalencia de portadores nasofaríngeos asintomáticos de Streptococcus pneumoniae, el cual es el principal factor en la transmisión de esta bacteria. MATERIAL Y MÉTODOS: Los cultivos nasofaríngeos fueron realizados en niños que asisten a 32 estancias infantiles en 12 estados de México. RESULTADOS: Streptococcus pneumoniae fue aislado de la nasofaringe de 829 (29.9 por ciento) niños de los 2 777 incluidos en el estudio con un rango de edad de 2 meses a 6 años. Todos los niños vivían en áreas urbanas y 80 por ciento permanecían más de seis horas diarias en la estancia infantil. Los serotipos de Streptococcus pneumoniae más frecuentemente identificados fueron: 19F (23 por ciento), 6B (15.6 por ciento), 23F (11.2 por ciento) y 6 A (14.9 por ciento). Treinta y seis por ciento de los aislamientos fueron susceptibles a penicilina. CONCLUSIONES: La distribución de serotipos nos da una idea de los posibles beneficios que podrían obtenerse de la vacuna neumocóccica conjugada heptavalente.


Assuntos
Criança , Pré-Escolar , Humanos , Lactente , Creches , Streptococcus pneumoniae/isolamento & purificação , Interpretação Estatística de Dados , México , Testes de Sensibilidade Microbiana , Nasofaringe/microbiologia , Penicilinas/farmacologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/administração & dosagem , Sorotipagem , Streptococcus pneumoniae/efeitos dos fármacos , Fatores de Tempo , População Urbana
5.
Rev Iberoam Micol ; 22(2): 83-92, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16107165

RESUMO

We have conducted a longitudinal study over a 3-year period to address the point prevalence, microbiological characteristics and antifungal susceptibility patterns of yeast isolates colonizing or infecting the oral cavities of 111 HIV-infected (51 adults, 60 children) and 201 non HIV-infected (109 adults, 92 children) Mexican persons. Regarding the epidemiology of oral candidiasis, Candida albicans was the most frequent species isolated. Seventy-one out of 85 isolates from colonized persons were C. albicans (83.5%), 27 isolates of them were from HIV-infected children and 44 from non HIV-infected patients. Sixty-two isolates belonged to serotype A which was the most prevalent serotype of C. albicans. Non-albicans species (Candida glabrata, Candida tropicalis and Candida parapsilosis, and Saccharomyces cerevisiae) were isolated from 16.5% of colonized patients and from 38.5% patients with candidiasis or Candida-related lesions. There were nine episodes of infection or colonization by at least 2 different yeast species. In the case of HIV/AIDS patients, it was determined that yeast carriage was not associated with the number of CD4+ cells or the viral load, but HAART reduced the prevalence of oral candidiasis. Overall, most patients harbored strains in vitro susceptible to fluconazole, however 10.8% of the yeasts were resistant to one or more azole antifungal agents and 29% were intermediate susceptible to them. On the contrary, 5-fluorocytosine was very active against all isolates tested, and amphotericin B was active against 97.9% of them.


Assuntos
Candida/isolamento & purificação , Candidíase Bucal/epidemiologia , Infecções por HIV/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Contagem de Linfócito CD4 , Candida/classificação , Candida/efeitos dos fármacos , Candida albicans/efeitos dos fármacos , Candida albicans/isolamento & purificação , Candida glabrata/efeitos dos fármacos , Candida glabrata/isolamento & purificação , Candida tropicalis/efeitos dos fármacos , Candida tropicalis/isolamento & purificação , Candidíase Bucal/tratamento farmacológico , Candidíase Bucal/microbiologia , Criança , Pré-Escolar , Comorbidade , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Lactente , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Mucosa Bucal/microbiologia , Prevalência , Saccharomyces cerevisiae/efeitos dos fármacos , Saccharomyces cerevisiae/isolamento & purificação , Carga Viral
6.
J Clin Microbiol ; 43(8): 4159-62, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16081965

RESUMO

Oral yeast carriage was studied in 312 Mexican subjects. Candida albicans was the most frequent species, but other Candida spp. were isolated from 16.5 to 38.5% of patients. Colonization did not correlate with CD4+ number or viral load, but highly active antiretroviral therapy reduced the frequency of candidiasis. Most isolates were susceptible to fluconazole, but 10.8% were resistant to one or more azoles.


Assuntos
Candida/isolamento & purificação , Infecções por HIV/microbiologia , Boca/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Antirretroviral de Alta Atividade , Candida/efeitos dos fármacos , Farmacorresistência Fúngica , Fluconazol/farmacologia , Infecções por HIV/tratamento farmacológico , Humanos , Pessoa de Meia-Idade
7.
AIDS Res Hum Retroviruses ; 21(6): 537-44, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15989458

RESUMO

Recently, we developed an immunoglobulin G (IgG)-capture BED-enzyme immunoassay (BED-CEIA) to identify recent HIV-1 infections. We estimated HIV-1 incidence among inner-city pregnant women in Atlanta, Georgia (1991-1998) using this assay. The annual cumulative incidence was estimated at 2.4/1000 (95% CI = 2.0-2.9). Incidence declined from 3.1/1000 in 1991-1994 to 1.4/1000 in 1995-1998 (risk ratio = 2.3, 95% CI = 1.5-3.4). Women with recent HIV-1 infection more often reported a previous negative antibody test (p = 0.018) and sexual relations with men other than the father during the past year (p = 0.046). Fewer seroconverters in 1995-1998 used crack cocaine than in the earlier time period. A high but declining HIV-1 incidence was found among inner-city pregnant women in Atlanta.


Assuntos
Anticorpos Anti-HIV/sangue , Infecções por HIV/epidemiologia , HIV-1/imunologia , Imunoglobulina G/sangue , Complicações Infecciosas na Gravidez/epidemiologia , População Urbana , Adolescente , Adulto , Feminino , Georgia/epidemiologia , Infecções por HIV/virologia , Soroprevalência de HIV , Humanos , Técnicas Imunoenzimáticas/métodos , Incidência , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/virologia
8.
Semin Pediatr Infect Dis ; 16(2): 84-92, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15825139

RESUMO

Acute respiratory infections are the main cause of morbidity worldwide, and pneumonia represents one of the main causes of death in children younger than the age of 5 years in developing countries. Several risk factors for acquiring respiratory infections in developing countries, such as poverty, restricted family income, low parental education level, low birth weight, malnutrition, and lack of breastfeeding, have been described. Another important factor in recent years that has aggravated the problem of acute respiratory infections in developing countries is the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pandemic. In developing countries, identifying the etiology is difficult and World Health Organization recommends making the diagnosis of pneumonia based on clinical parameters. The diagnosis and suitable treatment administered by primary healthcare workers, particularly in rural areas, is part of the strategy to prevent mortality. Finally, it is important that industrialized countries support the economic growth of the developing countries to improve their healthcare system and to ensure that performed research studies will give benefits to their populations.


Assuntos
Países em Desenvolvimento , Infecções Respiratórias/epidemiologia , Pré-Escolar , Controle de Doenças Transmissíveis , Surtos de Doenças , Saúde Global , Infecções por HIV/epidemiologia , Humanos , Imunização , Lactente , Mortalidade , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/prevenção & controle , Fatores de Risco , Fatores Socioeconômicos
10.
Pediatr Neurol ; 31(2): 130-2, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15301834

RESUMO

A 12-year-old female diagnosed with human immunodeficiency virus infection at age 1 was admitted to our hospital with complaints of headache, left hemiparesis, and blurry vision. On admission, her CD4+ count was 97 cells/mm(3) (13%) and her viral load 44,783 ribonucleic acid copies/mL. Treatment had been initiated 3 months before admission with lopinavir/ritonavir, lamivudine, and stavudine. A computed tomographic scan and magnetic resonance imaging of the head revealed an aneurysm of the right middle cerebral artery. A head angiographic scan was consistent with intracranial arteritis. Six months after the initiation of antiretroviral therapy, her CD4+ cell count was 226 cells/mm(3) (16%) and her viral load was undetectable (less than 50 copies ribonucleic acid/mL). Magnetic resonance angiography of the head performed 15 months after the diagnosis demonstrated resolution of the aneurysm and the intracranial arteritis. This case highlights the association of human immunodeficiency virus infection with the occurrence of intracerebral aneurysms in the context of human immunodeficiency virus-vasculopathy, as well as its improvement with highly active antiretroviral therapy.


Assuntos
Infecções por HIV/diagnóstico , Aneurisma Intracraniano/diagnóstico , Criança , Feminino , Infecções por HIV/complicações , Humanos , Aneurisma Intracraniano/complicações , Angiografia por Ressonância Magnética/métodos
11.
Pediatr Infect Dis J ; 23(5): 470-2, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15131477

RESUMO

Mucormycosis (zygomycosis) normally occurs among individuals with predisposing factors such as prematurity, use of broad spectrum antibiotics, metabolic acidosis or advanced stages of immunosuppression. There have been reports of sporadic cases of cutaneous mucormycosis related to predisposing skin lesions and contact with contaminated material such as adhesive bandages and tongue depressors placed close to intravenous catheter insertion sites. We report successful treatment of a case of Absidia corymbifera infection with the combination of amphotericin B and surgical debridement of the affected area.


Assuntos
Absidia , Dermatomicoses/tratamento farmacológico , Dermatomicoses/cirurgia , Doenças do Prematuro/tratamento farmacológico , Doenças do Prematuro/cirurgia , Absidia/efeitos dos fármacos , Absidia/isolamento & purificação , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Desbridamento/métodos , Dermatomicoses/microbiologia , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/microbiologia , Mucormicose/tratamento farmacológico , Mucormicose/microbiologia , Mucormicose/cirurgia , Resultado do Tratamento
12.
Gac Med Mex ; 140(1): 59-69, 2004.
Artigo em Espanhol | MEDLINE | ID: mdl-15022888

RESUMO

Introduction of new antiretroviral agents and development of new prophylaxis schedules against opportunistic microorganisms have allowed increase in survival as well as better quality of life in HIV-infected patients. These new treatment schedules have changed the epidemiology of opportunistic infections that previous to use of highly active antiretroviral therapy (HAART), formerly occurred with high frequency in HIV-infected children. Specifically, pneumonia due to Pneumocystis carinii formerly occurred in 12 to 80% of these patients and was associated with high mortality. Currently, with use of combined antiretroviral therapy (ART) and prophylactic treatments important reduction of PCP has been observed. However, despite these benefits ART is not yet available for many patients from several developing countries who are at risk for opportunistic infections, mainly due to Pneumocystis carinii, which can affect life expectancy. Therefore, the purpose of this paper was a review of epidemiologic, clinical, and therapeutic characteristics of P. carinii pneumonia in HIV-infected children.


Assuntos
Infecções por HIV/complicações , Infecções Oportunistas/complicações , Pneumocystis carinii , Pneumonia por Pneumocystis/complicações , Algoritmos , Criança , Humanos , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/epidemiologia , Infecções Oportunistas/microbiologia , Infecções Oportunistas/terapia , Pneumonia por Pneumocystis/diagnóstico , Pneumonia por Pneumocystis/epidemiologia , Pneumonia por Pneumocystis/microbiologia , Pneumonia por Pneumocystis/terapia , Taxa de Sobrevida
13.
Gac. méd. Méx ; 140(1): 59-69, ene.-feb. 2004. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-632143

RESUMO

La introducción de nuevos agentes antirretrovirales y el desarrollo de nuevos esquemas de profilaxis antimicrobiana contra agentes oportunistas, ha conducido a una mejor calidad de vida en los pacientes infectados por el virus de la inmunodeficiencia humana (VIH). Estos nuevos esquemas de tratamiento han cambiado la epidemiología de las infecciones oportunistas que, previo al uso de terapia antirretroviral (AR V) altamente activa, se presentaban con una elevada frecuencia en los niños infectados por el VIH. Específicamente, la neumonía por Pneumocystis carinii (PCP) ocurría en 12 al 40% de estos pacientes y estaba asociada con una elevada mortalidad. Actualmente, el uso de la terapia antirretroviral combinada y la administración de esquemas de profilaxis han resultado en una disminución importante en los casos de PCP. Sin embargo, en países en vías de desarrollo como el nuestro, la terapia altamente activa y la administración de estas profilaxis no están al alcance de todos los pacientes, por lo se encuentran en alto riesgo de presentar infecciones oportunistas, sobre todo producidas por Pneumocystis carinii, las cuales pueden acortar y afectar notablemente su supervivencia. El propósito de este articulo es hacer una revisión de la neumonía debida al Pneumocystis carinii, con especial énfasis, en las características epidemiológicas, clínicas y terapéuticas de la enfermedad en niños con VIH/SIDA.


Introduction of new antiretroviral agents and development of new prophylaxis schedules against opportunistic microorganisms have allowed increase in survival as well as better quality of life in HIV-infected patients. These new treatment schedules have changed the epidemiology of opportunistic infections that previous to use of highly active antiretroviral therapy (HAART), fomerly occurred with high frequency in HIV-infected children. Specifically, pneumonia due to Pneumocystis carinii formerly occurred in 12 to 80% of these patients and was associated with high mortality. Currently, with use of combined antiretroviral therapy (ART) and prophylactic treatments important reduction of PCP has been observed. However, despite these benefits ART is not yet available for many patients from several developing countries who are at risk for opportunistic infections, mainly due to Pneumocystis carinii. which can affect life expectancy. Therefore, the purpose of this paper was a review of epidemiologic, clinical, and therapeutic characteristics of P. carinii pneumonia in HIV-infected children.


Assuntos
Criança , Humanos , Infecções por HIV/complicações , Infecções Oportunistas/complicações , Pneumocystis carinii , Pneumonia por Pneumocystis/complicações , Algoritmos , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/epidemiologia , Infecções Oportunistas/microbiologia , Infecções Oportunistas/terapia , Pneumonia por Pneumocystis/diagnóstico , Pneumonia por Pneumocystis/epidemiologia , Pneumonia por Pneumocystis/microbiologia , Pneumonia por Pneumocystis/terapia , Taxa de Sobrevida
14.
Am J Infect Control ; 31(5): 302-8, 2003 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12888767

RESUMO

BACKGROUND: Pediatric surgical site infection (SSI) rates in the United States range from 2.5% to 4.4%. There is little data regarding their risk factors among children. We quantified SSI rates and identified risk factors of SSI in a tertiary care pediatric teaching hospital in Mexico City. METHODS: All neurosurgical, cardiovascular, and general surgical patients who underwent operation between Aug 1, 1998, and Jan 31, 1999, were followed-up daily during hospitalization. On postoperative day 30, a full review of microbiology reports and medical records was performed. Univariate and multivariate analyses were done to identify risk factors. RESULTS: Four hundred twenty-eight of 530 children completed follow-up. The overall SSI rate was 18.7%. Forty percent of SSI were superficial incisional, 21% were deep incisional, and 39% were organ/space infections. For clean, clean-contaminated, contaminated, and dirty procedures, SSI infection rates were 12.4%, 24.4%, 14.3%, and 32.4%, respectively. Open drains (OR = 2.3; 95% CI = 1.3-4.2; P <.005) and surgery that lasted 90 or more minutes (OR = 2.9; 95% CI = 1.6-5.1; P <.001) were associated with infection. CONCLUSIONS: Our rates are greater than comparable reported data among children. Duration of surgery and use of open drains were associated with SSI.


Assuntos
Hospitais Pediátricos/estatística & dados numéricos , Vigilância de Evento Sentinela , Infecção da Ferida Cirúrgica/epidemiologia , Pré-Escolar , Infecção Hospitalar/epidemiologia , Feminino , Hospitais Pediátricos/normas , Hospitais de Ensino/normas , Hospitais de Ensino/estatística & dados numéricos , Hospitais Urbanos/normas , Hospitais Urbanos/estatística & dados numéricos , Humanos , Lactente , Masculino , México/epidemiologia , Estudos Prospectivos , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Infecção da Ferida Cirúrgica/prevenção & controle
15.
AIDS Patient Care STDS ; 16(4): 151-6, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12015869

RESUMO

It has been proposed that HIV-related oral lesions (HIV-ROL) have a significant diagnostic and prognostic value for human immunodeficiency virus (HIV) infection in adult patients. However, in HIV-infected children, the relation between HIV-ROL and immune and virologic status is not well established. The principal objective of this paper is to assess the prevalence of HIV-related oral lesions (HIV-ROL) in Mexican HIV-infected children in relation to their immunologic status, viral load, and gender. Forty-eight HIV-infected children from Immunodeficiency Clinic, Child's Hospital of México, México City, were examined for oral pathology. The data obtained from medical records were: name, gender, age, route of infection, CD4 lymphocytes cells count/mL, HIV-1-RNA level of copies/mL (viral load), and type and time of treatment. The prevalence of HIV-ROL was 29.2%. Oral candidosis was the most prevalent oral lesion (20.8%) followed by periodontal and gingival disease (4.2%), herpes simplex (2.1%), and parotid enlargement (2.1%). There was no association between the prevalence of HIV-ROL and gender, immunological status, or viral load. The most frequent clinical form of oral candidosis was erythematous candidosis (12.5%, N = 6). Our results do not suggest a direct relationship between prevalence of HIV-ROL, severe immunodepression, and/or viral load > 100000 copies in this population.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Candidíase Bucal/epidemiologia , Infecções por HIV/transmissão , Transmissão Vertical de Doenças Infecciosas , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Contagem de Linfócito CD4 , Candidíase Bucal/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , México/epidemiologia , Prevalência , Distribuição por Sexo , Carga Viral
16.
Bol. méd. Hosp. Infant. Méx ; 57(8): 423-31, ago. 2000. tab
Artigo em Espanhol | LILACS | ID: lil-286264

RESUMO

Introducción. La infección del virus de la inmunodeficiencia humana (VIH) está caracterizada por una disminución progresiva de los CD4 hasta su total depleción. A las manifestaciones orales se les ha atribuido un importante valor diagnóstico y pronóstico para la enfermedad; sin embargo, la prevalencia de lesiones orales asociadas con el síndrome de inmunodeficiencia adquirida (LOAS) en pacientes pediátricos no está bien establecida. El objetivo del presente trabajo de investigación fue determinar la prevalencia de LOAS y su correlación clínica, inmunológica y viral en pacientes pediátricos VIH/SIDA. Material y métodos. Para este propósito fueron revisados 42 pacientes pediátricos (26 del sexo femenino y 16 del masculino) de la Clínica de Inmunodeficiencia del Hospital Infantil de México Federico Gómez. Resultados. La prevalencia encontrada de lesiones orales asociadas a SIDA fue de 38.1 por ciento, de éstas, la que se presentó con mayor frecuencia fue la candidiosis en la cual se incluyó de acuerdo a su presentación clínica en: candidiosis eritematosa (19 por ciento), candidiosis pseudomembranosa (11.9 por ciento) y queilitis angular (7.1 por ciento); el crecimiento parotídeo 4.7 por ciento, la xerostomía se observó en 7.1 por ciento, gingivitis y periodontitis asociada a VIH 4.7 por ciento, herpes labial en 2.4 por ciento y depapilación lingual 2.4 por ciento. Conclusiones. No se observó relación entre las lesiones bucales con la cantidad de CD4 ni tampoco con la carga viral; sin embargo, sí se encontró relación entre la clasificación clínica y la prevalencia de lesiones bucales. Se debe estudiar más ampliamente la utilidad de LAOS como marcadores pronósticos del SIDA en pacientes pediátricos.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Candidíase Bucal/imunologia , Boca/lesões , Síndrome da Imunodeficiência Adquirida/imunologia , Queilite , Gengivite , HIV/imunologia , México/epidemiologia , Mucosa Bucal/lesões
17.
Bol. méd. Hosp. Infant. Méx ; 57(4): 195-199, abr. 2000. tab
Artigo em Espanhol | LILACS | ID: lil-280477

RESUMO

Introducción. La neumonía nosocomial constituye la mayor causa de mortalidad en pacientes pediátricos. Objetivo: identificar los principales factores de riesgo para el desarrollo de neumonía nosocomial en pacientes pediátricos en un hospital pediátrico de tercer nivel.Material y métodos. Se realizó un estudio de casos y controles pareado por edad, tiempo de hospitalización y servicio clínico. Se seleccionaron 3 controles por cada caso con un total de 72 casos y 216 controles con edades de recién nacidos hasta 18 años. Se incluyeron todos los pacientes con diagnóstico de neumonía nosocomial de acuerdo a los criterios de la Norma Oficial Mexicana. El análisis estadístico se realizó con cálculo de razón de momios y para determinar la significancia estadística se usó la prueba chi cuadrada.Resultados. Los factores de riesgo encontrados estadísticamente significativos (P<0.05) fueron: inmunocompromiso, desnutrición, catéter venoso central, ventilación mecánica y el estar en una Unidad de Cuidados Intensivos (P<0.001). La mortalidad asociada fue de 37.5 por ciento en el grupo con neumonía nosocomial comparado a 9.30 por ciento en el grupo control (P<0.001).Conclusiones. El presente estudio confirma la identificación de factores de riesgo en niños similares a los encontrados en adultos. Esta información es de utilidad para desarrollar programas específicos de prevención.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Adolescente , Fatores de Risco , Infecção Hospitalar/etiologia , Pneumonia/etiologia , Mortalidade Hospitalar , Criança Hospitalizada
18.
Bol. méd. Hosp. Infant. Méx ; 56(6): 340-52, jun. 1999. tab, graf, ilus
Artigo em Espanhol | LILACS | ID: lil-266240

RESUMO

Esta revisión tiene el propósito de describir los conceptos actuales de profilaxis antimicrobiana en cirugía y discutir los principios de su uso racional en la prevención de infecciones del sitio quirúrgico. Se revisan las evidencias clínicas y experimentales de esta práctica publicada sen los últimos 30 años. Se abordan las infecciones del sitio quirúrgico como padecimientos nosocomiales potencialmente prevenibles, cuya frecuencia global reportada en la población infantil varía, según la institución, entre 2.5 y 21 por ciento. Se describen y discuten, además, las indicaciones, contraindicaciones y riesgo de la profilaxis amtibiótica. Se hacen consideraciones respecto a las áreas del conocimiento quirúrgico infantil en las que es importante efectuar investigaciones clínicas que permita sustentar un uso racional de los antibióticos con fines preventivos. La evidencia actual sugiere esquemas de un solo fármaco, en dosis única alta preoperatoria e intravenosa tanto en cirugías limpias-contaminada como en algunas limpias


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Antibacterianos/administração & dosagem , Esquema de Medicação , Ensaio Clínico , Infecção da Ferida Cirúrgica/prevenção & controle , Pediatria , Cuidados Pré-Operatórios , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Fatores de Risco , Condutas Terapêuticas Homeopáticas
19.
Salud pública Méx ; 41(supl.1): S18-S25, 1999. mapas, tab
Artigo em Espanhol | LILACS | ID: lil-276472

RESUMO

Objetivo. Determinar la prevalencia de infecciones nosocomiales, los factores de riesgo, su microbiología, la prevalencia de uso de antibióticos y la mortalidad asociada en niños hospitalizados. Material y métodos. Se realizó un estudio transversal en 21 hospitales públicos que atienden a niños. Se incluyeron pacientes desde recién nacidos hasta de 17 años de edad. Los riesgos ajustados se estimaron mediante regresión logística múltiple. Resultados. En I 183 niños estudiados se identificaron 116 pacientes con infección nosocomial, con una prevalencia de 9.8 por ciento (IC 95 por ciento 8.1-11.6). Los sitios de infección más frecuentes fueron: neumonía (25 por ciento), sepsis/bacteriemia (19 por ciento) e infección del tracto urinario (5 por ciento). El principal microorganismo identificado en hemocultivo fue Klebsiella pneumoniae (31 por ciento). La prevalencia de uso de antibióticos fue de 49 por ciento con una variación de entre 3 y 83 por ciento. Mediante regresión logística múltiple se encontraron cuatro factores independientemente asociados con el desarrollo de infección nosocomial: exposición a catéteres intravenosos (RM 3.3, IC 95 por ciento 1.9-5.9), alimentación parenteral (RM 2.1, IC 95 por ciento 1.0-4.5), ventilación mecánica (RM 2.3, IC 95 por ciento 1.2-4.1) y ser recién nacido de bajo peso (RM 2.6, IC 95 por ciento 1.0-6.8). La mortalidad general fue de 4.8 por ciento; sin embargo, el riesgo de morir en pacientes con infección nosocomial fue del doble comparado con los no infectados (RM 2.6, IC 95 por ciento 1.3-5.1). Conclusiones. Esta evaluación rápida, usando una metodología estándar, ha permitido caracterizar la epidemiología de las infecciones nosocomiales en niños. Los resultados dieron lugar a programas preventivos dirigidos específicamente al cuidado de catéteres intravasculares y al uso de ventilación asistida, a fin de reducir la ocurrencia de sepsis/bacteriemia y neumonías, infecciones nosocomiales de alta prevalencia y mortalidad


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , México/epidemiologia , Inquéritos Epidemiológicos , Hospitais Pediátricos/tendências , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/etiologia , Prevalência , Inquéritos de Morbidade , Mortalidade/tendências , Sepse/prevenção & controle , Sepse/epidemiologia , Criança Hospitalizada
20.
Bol. méd. Hosp. Infant. Méx ; 55(6): 341-7, jun. 1998. tab
Artigo em Espanhol | LILACS | ID: lil-232865

RESUMO

Mientras que existen estudios donde se reporta que de 3 al 12 por ciento de los catéteres intravasculares cursan con complicaciones infecciosas hay estimaciones que indican que se colocan 75,000 catéteres anuales en niños hospitalizados en México. Esto podría representar una estimación entre 2,500 a 15,000 infecciones relacionadas a catéteres. Estas infecciones pueden presentarse en 5 formas: 1) infección del sitio de inserción, 2) infección del túnel del catéter, 3) sepsis relacionada al catéter, 4) bacteriemia nosocomial primaria y 5) colonización de la punta del catéter. Los principales microorganismos aislados con Staphylacoccus coagulasa negativa y Staphylococcus aureus, pero están emergiendo otras bacterias como: bacilos gramnegativos y Candida sp. Los factores de riesgo para la ocurrencia de estas infecciones incluyen: características del propio microorganismo condición inmunológica del hospedero, la piel, el material del cual están hechos los catéteres y el tiempo de permanencia. Este trabajo tiene como propósito revisar aspectos diagnósticos, de tratamiento y prevención de estas infecciones


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Anfotericina B/uso terapêutico , Bacteriemia/etiologia , Cateterismo/efeitos adversos , Incidência , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/etiologia , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/etiologia , Infecções Estafilocócicas/prevenção & controle , Controle de Infecções , Vancomicina/uso terapêutico
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