Caracterización epidemiológica de pacientes con sospecha de atopía, evaluados mediante Prick test: IX Región (2007-2009) / Epidemiological characterization of patients with suspicion of atopy, evaluated through Prick test: IX Region (2007-2009)

Las enfermedades alérgicas constituyen una importante causa de morbilidad en la población general. OBJETIVO: Describir la distribución de la sensibilización para AI y AA mediante Prick test (PT), en una población seleccionada de pacientes de la Región de la Araucanía con sospecha clínica de atopía, según sexo, edad, etnia y estación del año durante los años 2007 al 2009. PACIENTES Y MÉTODO: Estudio de corte transversal, en un muestreo no probabilístico por conveniencia de 3055 pacientes, derivados para estudio mediante PT, al Centro de Diagnóstico y Tratamiento de Enfermedades Respiratorias desde Enero 2007 a Diciembre 2009. El PT se realizó con técnica estandarizada para AI y/o AA. Los datos fueron ingresados en el programa Microsoft Excel y analizados con el programa Stata 10.0. RESULTADOS: De un total de 3055 pacientes, 53,9 por ciento son mujeres, 4,8 por ciento son de etnia mapuche. El promedio de edad 20,7+/-19,13 años con un rango de 1 a 93 años. Del total de pacientes, 45,2 por ciento presentaron sensibilización para AI, 2,3 por ciento para AA y un 21 por ciento para ambos. CONCLUSIONES: En la población estudiada, se observó mayor sensibilización al polvo de habitación. Destaca la sensibilización a Dermatofagoide pteronyssinus en la población masculina, presentando una diferencia estadísticamente significativa con respecto a la población femenina.

The allergic diseases constitute an important reason of morbidity in the general population. AIM: Describe the distribution of the sensitization for AI and AA through Prick test (PT), in a selected population of patients from the Araucanía Region with clinical suspicion of atopy, according to sex, age, ethnic group and season of the year, during the years 2007 to 2009. PATIENTS AND METHODS: Transversal cut study, in a non-probability sample of 3055 patients, derived for study through PT to the Center of Diagnosis and Treatment of Respiratory Diseases from January 2007 to December 2009. The PT was realized by standardized technique for AI and / or AA. The information was ingresed by the program Microsoft Excel and analyzed by the program Stata 10.0. RESULTS: Of a total of 3055 patients, 53,9 percent are women, 4,8 percent are Mapuche. The average of age 20,7 +/-19,13years with a range from 1 to 93 years. Of the total of patients, 45,2 percent presented sensitization for AI, 2,3 percent for AA and 21 percent for both. CONCLUSIONS: In the population studied, we observed increased sensitization to house dust. Stresses the Dermatophagoides pteronyssinus sensitization in the male population, showing a statistically significant difference compared to the female population.

[Management of community acquired pneumonia in adults following clinical guidelines at a rural hospital]. / Evaluación y manejo del adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad, en un hospital de baja complejidad, basado en la Guía Clínica Chilena.

BACKGROUND: A National Consensus Guideline published in 2005 established the basis for the diagnostic, severity assessment and treatment of community acquired pneumonia (CAP) in the adult population. The compliance with pneumonia clinical guidelines has been associated to a reduction in hospital stay healthcare-related costs, morbidity and mortality. AIM: To describe the management and outcome of non-severe CAP in hospitalized adult patients treated in a rural hospital, based on the national clinical guidelines. PATIENTS AND METHODS: Ninety six patients aged 74 +/- 13 years (50 males) hospitalized with non-severe pneumonia (group 3) at a community-based primary care center between January 1, 2006, and March 31, 2007, were evaluated. RESULTS: Eighty percent of patients had concomitant diseases such as hypertension in 49%, diabetes in 23% and chronic obstructive pulmonary disease in 18%. All were treated with a third generation cephalosporin (ceftriaxone 1-2 g/day TV) as empirical therapy. Only 9% of patients also received a macrolide. Early switch to oral antimicrobial therapy was successful in two third of cases. Mean hospital length of stay was 5.0 +/- 2.5 days, and 30-day mortality was 6.3%. CONCLUSIONS: Following the recommendations of the national clinical guidelines, most of these patients had a favorable response to monotherapy with a beta-lactam antimicrobial. Early switch therapy to oral antibiotic was effective and safe, reducing significantly hospital length of stay as compared to previous national clinical studies.

Evaluación y manejo del adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad, en un hospital de baja complejidad, basado en la Guía Clínica Chilena / Management of community acquired pneumonia in adults following clinical guidelines at a rural hospital

Background: A National Consensus Guideline published in 2005 established the basis for the diagnostic, severity assessment and treatment of community acquired pneumonia (CAP) in the adult population. The compliance with pneumonia clinical guidelines has been associated to a reduction in hospital stay healthcare-related costs, morbidity and mortality. Aim To describe the management and outcome of non-severe CAP in hospitalized adult patients treated in a rural hospital, based on the national clinical guidelines. Patients and methods: Ninety six patients aged 74 ± 13 years (50 males) hospitalized with non-severe pneumonia (group 3) at a community-based primary care center between January 1, 2006, and March 31, 2007, were evaluated. Results: Eighty percent of patients had concomitant diseases such as hypertension in 49 percent, diabetes in 23 percent and chronic obstructive pulmonary disease in 18 percent. All were treated with a third generation cephalosporin (ceftriaxone 1-2 g/day TV) as empirical therapy. Only 9 percent of patients also received a macrolide. Early switch to oral antimicrobial therapy was successful in two third of cases. Mean hospital length of stay was 5.0 ± 2.5 days, and 30-day mortality was 6.3 percent. Conclusions: Following the recommendations of the national clinical guidelines, most of these patients had a favorable response to monotherapy with a B-lactam antimicrobial. Early switch therapy to oral antibiotic was effective and safe, reducing significantly hospital length of stay as compared to previous national clinical studies.