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1.
Rev. argent. salud publica ; 10(40): 44-47, 30 de septiembre 2019.
Artigo em Espanhol | LILACS, BINACIS, ARGMSAL | ID: biblio-1024943

RESUMO

El monitoreo de indicadores epidemiológicos es un elemento clave en el fortalecimiento de la respuesta al VIH. OBJETIVO: Se presenta un análisis epidemiológico de las tendencias en indicadores seleccionados en base a las notificaciones de infección reportadas a la Coordinación Salud Sexual, Sida e Infecciones de Transmisión Sexual, dependiente del Ministerio de Salud de la Ciudad Autónoma de Buenos Aires entre 2003 y 2017. MÉTODOS: En dicho análisis se incluyen datos sobre la distribución por sexo e índice de masculinidad, el acceso al diagnóstico de VIH, la distribución por edad al momento del diagnóstico, la cobertura de salud, las vías de transmisión, la tasa de mortalidad por sida, la vigilancia de la transmisión perinatal del VIH y la situación de niños, niñas y adolescentes con VIH. RESULTADOS: Los datos presentados reflejan un perfil metropolitano en el que predomina la transmisión sexual tanto en mujeres como en varones y ponen en evidencia algunas situaciones que precisan un abordaje específico y avalan la importancia de implementar estrategias de prevención diferenciadas de acuerdo a las necesidades de cada grupo poblacional. DISCUSIÓN: La forma en la que se presenta la información muestra una clara intencionalidad de fomentar la interacción entre la epidemiología y la toma de decisiones en salud, a sabiendas de que esa información constituye una herramienta fundamental para la definición y puesta en práctica de políticas públicas. Palabras clave: Epidemiología; VIH; Ciudad de Buenos Aires


Assuntos
Epidemiologia , HIV
4.
Rev. pediatr. electrón ; 13(2): 2-9, ago. 2016. tab
Artigo em Espanhol | LILACS | ID: biblio-869931

RESUMO

Objetivos: La participación de alumnos en estudios que evalúan el cumplimiento del programa de Inmunizaciones (PAI) y sus causales representa una experiencia relevante. La evaluación del cumplimiento del PAI permite proponer estrategias para aumentar coberturas.Métodos: Estudio observacional, analítico, transversal. Población: Neonatos a 11 años de edad, realizado en 6 hospitales de la CABA. Período: 1/06-31/12/2014. Participaron estudiantes del internado anual rotatorio capacitados sobre PAI,supervisados por docentes.Criterio de inclusión: Presentar el carné de vacunación, no tener condiciones que impidieran indicación del PAI.Resultados: Encuestas 531. Esquema incompleto o no recibió ninguna vacuna 25,7 por ciento. Se asociaron a incumplimiento las siguientes variables: Edad <1 año, edad materna <28 años, escasa educación materna, embarazo no controlado, ausencia de control de salud, internados, consulta porenfermedad. Análisis multivariado: falta de control de salud: RR 2,1(IC 95 por ciento:1,4-2,9).Como motivo de OPV predominó olvido (71,8 por ciento). Los alumnos refirieron útil su participación. Consideraron positivo aprender a investigar, contacto con pacientes y familiares, trabajar en equipo. Negativo: restó tiempo para estudiar.Conclusiones: Interactuar con la comunidad permitiría eliminar barreras que condicionan OPV. La comunicación es valiosa para lograr este objetivo. La participación supervisada de alumnos fue una experiencia innovadora, al introducirlos en la investigación clínica.


Introduction: The participation of students in research studies is a valuable teaching objective. Particularly evaluating implementation of the National immunization Program and their causal, allowing to propose strategies to increase coverage.Methods: An observational, analytical, crosssectional study. Population: Newborn to 11 years old, conducted in 6 hospitals of Buenos Aires city. Period: 1/06-31/12/2014. Pediatrics students belonging to the pediatric annualtraining in pediatrics, supervised by their teachers. Inclusion criteria: Presentation the vaccination card, have no conditions that would prevent indication of the vaccines.Results: 531 surveys were completed.Incomplete scheme, or no received vaccine 25.7 percent. The following variables were associated with non-compliance schedule: Age <1 year, maternal age <28 years, lowmaternal education, uncontrolled pregnancy, lack of health control, boarding, ambulatory consult for disease. Multivariate analysis: lackof control health: RR 2.1 (95 percent CI: 1.4-2.9).Family forgot vaccinate the child prevailed (71.8 percent). Students reported their participation useful. They considered positive learning how to research, contact with patients andfamilies, teamwork. As negative: Rest time to study.Conclusions: Interacting with the community enable barriers that condition not comply with the scheme. Communication is valuable to achieving this aim. Supervised student participation was an innovative experience to introduce in clinical research.


Assuntos
Humanos , Masculino , Recém-Nascido , Lactente , Pré-Escolar , Adulto , Educação Médica , Programas de Imunização , Avaliação de Programas e Projetos de Saúde , Estudantes de Medicina , Argentina , Coleta de Dados , Análise Multivariada , Estudo Observacional , Estudos Prospectivos
5.
Arch Argent Pediatr ; 112(6): e284, 2014 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-25522441
7.
Arch. argent. pediatr ; 112(6): e284, 2014 Dec.
Artigo em Espanhol | BINACIS | ID: bin-133369
8.
Rev. Soc. Boliv. Pediatr ; 52(1): 35-42, 2013. ilus
Artigo em Espanhol | LILACS-Express | ID: lil-738281

RESUMO

Introducción. En la Argentina, la pandemia de Influenza A pH1N1 de 2009 provocó cerca de 10 000 casos confirmados con alto impacto en pediatría. Objetivos. Describir las características clínico epidemiológicas y analizar los factores de riesgo de letalidad en niños hospitalizados con infección confirmada por pH1N1. Población y métodos. Se identificaron todas las fichas de casos sospechosos (según Ministerio de Salud) internados en 34 centros y se incluyeron todos los casos confirmados de 0-18 años desde el 1/4/09 al 31/8/09 en un estudio de cohorte retrospectivo. El diagnóstico viral se confirmó por método RT-PCR. Los datos se expresaron en porcentajes, media, mediana, desvío estándar e intervalo intercuartilo (IIC) según correspondiera; y como medida de asociación, Riesgo Relativo (RR), con Intervalo de Confianza 95% (IC95%). Se realizó regresión logística múltiple para determinar los predictores independientes. Resultados. Número total de casos sospechosos: 2367; se realizó PCR al 47,8% (n: 1131) siendo positivos para pH1N1 65,5% (n: 741/1131); 57,2% varones; 61,5% <24 meses, mediana de edad: 14 meses (IIC 6-46 meses); 45,1% con enfermedad subyacente; formas clínicas de presentación más frecuentes: neumonía 39,7% y bronquiolitis 25,8%; letalidad: 5,9% (44/741). Factores de riesgo de letalidad [RR (IC95%)]: enfermedad neurológica [5,00 (2,84-8,81)], enfermedad genética [3,67 (1,58-8,52)], desnutrición [3,07 (1,46-6,48)] y prematurez [2,28 (1,14-4,56)]. Predictor independiente de letalidad: enfermedad neurológica [3,84 (1,81-8,14)]. No se observó asociación significativa entre edad, enfermedad respiratoria crónica, inmunosupresión y coinfección viral con la letalidad. Conclusiones. Casi la mitad de los niños con infección por pH1N1 tenía enfermedad subyacente; la enfermedad neurológica fue un predictor independiente de letalidad.


Introduction. In Argentina, pandemic influenza pH1N1 caused nearly 10,000 confirmed cases with high impact in pediatrics. Objectives. To describe clinical and epidemiological characteristics and analyse the risk factor of lethality in children hospitalized with infection pH1N1 confirmed by PCR Population and methods. We identified all suspected cases (according to Ministry of health) in 34 centers and we included all the confirmed cases of 0-18 years from 1/4/09 to 31/8/09 in a retrospective cohort study. The viral diagnosis was confirmed by RT-PCR method. Data are expres sed in percentages, average, median, standard deviation, and range (IQR) as appropriate; and as a measure of association, relative risk (RR), with 95% confidence interval (95%CI). Multiple logistic regression was conducted to determine the independent risk predictors. Results. Total number of suspected cases were: 2367; PCR was performed to 47.8% (n: 1131) being positive for pH1N1 65.5% (n: 741/1131); 57.2% males; 61.5% <24 months, median age: 14 months (IQR 6-46 months); 45.1% with underlying disease; more frequent clinical pictures were: pneumonia (39,7%) and bronchiolitis 25.8%; Case-fatality rate: 5.9% (44/741). Mortality risk factors were [RR (95%CI)]: neurological disease [5.00 (2.84-8.81)], genetic disease [3.67 (1.58-8.52)], malnutrition [3,07 (1.46-6.48)] and prematurity [2.28 (1.14-4.56)]. Independent mortality predictor: neurological disease [3.84(1.81-8.14)]. No significant association between age, chronic respiratory disease, immunosuppression and viral co-infection with lethality was observed. Conclusions. Almost half of children with pH1N1 infection had underlying disease; the neurological condition was a separate CFR predictor.

12.
Arch Argent Pediatr ; 109(3): 198-203, 2011 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-21660384

RESUMO

INTRODUCTION: In Argentina, pandemic influenza pH1N1 caused nearly 10,000 confirmed cases with high impact in pediatrics. OBJECTIVES: To describe clinical and epidemiological characteristics and analyse the risk factor of lethality in children hospitalized with infection pH1N1 confirmed by PCR. POPULATION AND METHODS: We identifed all suspected cases (according to Ministry of health) in 34 centers and we included all the confirmed cases of 0-18 years from 1/4/09 to 31/8/09 in a retrospective cohort study. The viral diagnosis was confirmed by RT-PCR method. Data are expressed in percentages, average, median, standard deviation, and range (IQR) as appropriate; and as a measure of association, relative risk (RR), with 95% confidence interval (95%CI). Multiple logistic regression was conducted to determine the independent risk predictors. RESULTS: Total number of suspected cases were: 2367; PCR was performed to 47.8% (n: 1131) being positive for pH1N1 65.5% (n: 741/1131); 57.2% males; 61.5% <24 months, median age: 14 months (IQR 6-46 months); 45.1% with underlying disease; more frequent clinical pictures were: pneumonia (39,7%) and bronchiolitis 25.8%; Case-fatality rate: 5.9% (44/741). Mortality risk factors were [RR (95%CI)]: neurological disease [5.00 (2.84-8.81)], genetic disease [3.67 (1.58-8.52)], malnutrition [3,07 (1.46-6.48)] and prematurity [2.28 (1.14-4.56)]. Independent mortality predictor: neurological disease [3.84 (1.81-8.14)]. No significant association between age, chronic respiratory disease, immunosuppression and viral co-infection with lethality was observed. CONCLUSIONS: Almost half of children with pH1N1 infection had underlying disease; the neurological condition was a separate CFR predictor.


Assuntos
Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Pandemias , Adolescente , Argentina , Criança , Criança Hospitalizada , Pré-Escolar , Feminino , Humanos , Lactente , Influenza Humana/mortalidade , Masculino , Estudos Retrospectivos , Fatores de Risco
13.
Arch. argent. pediatr ; 109(3): 198-203, jun. 2011. ilus
Artigo em Espanhol | LILACS | ID: lil-602388

RESUMO

Introducción. En la Argentina, la pandemia de InfluenzaA pH1N1 de 2009 provocó cerca de 10 000 casos confirmados con alto impacto en pediatría. Objetivos. Describir las características clínico epidemiológicas y analizar los factores de riesgo de letalidad en niños hospitalizados con infección confirmada por pH1N1.Población y métodos. Se identificaron todas las fichas de casos sospechosos (según Ministerio de Salud) internados en 34 centros y se incluyeron todos los casos confirmados de 0-18 años desde el 1/4/09 al 31/8/09 en un estudio de cohorte retrospectivo. El diagnóstico viral se confirmó por método RT-PCR. Los datos se expresaron en porcentajes, media, mediana, desvío estándare intervalo intercuartilo (IIC) según correspondiera; y como medida de asociación, Riesgo Relativo (RR), con Intervalo de Confianza 95 por ciento(IC95 por ciento). Se realizó regresión logística múltiple para determinar los predictores independientes. Resultados. Número total de casos sospechosos: 2367; se realizó PCR al 47,8 por ciento (n: 1131) siendo positivos para pH1N1 65,5 por ciento (n: 741/1131); 57,2 por cientovarones; 61,5 por ciento <24 meses, mediana de edad: 14 meses (IIC 6-46 meses); 45,1 por ciento con enfermedad subyacente; formas clínicas de presentación más frecuentes: neumonía 39,7 por ciento y bronquiolitis 25,8 por ciento; letalidad: 5,9 por ciento (44/741).Factores de riesgo de letalidad [RR (IC95 por ciento)]: enfermedad neurológica [5,00 (2,84-8,81)], enfermedad genética [3,67 (1,58-8,52)], desnutrición [3,07 (1,46-6,48)] y prematurez [2,28 (1,14-4,56)]. Predictor independiente de letalidad: enfermedad neurológica [3,84 (1,81-8,14)]. No se observó asociación significativa entre edad,enfermedad respiratoria crónica, inmunosupresión y coinfección viral con la letalidad. Conclusiones. Casi la mitad de los niños con infección por pH1N1 tenía enfermedad subyacente; la enfermedad neurológica fue un predictor independiente de letalidad.


Introduction. In Argentina, pandemic influenza pH1N1 caused nearly 10,000 confirmed cases with high impact in pediatrics. Objectives. To describe clinical and epidemiological characteristics and analyse the risk factor of lethality in children hospitalized with infectionpH1N1 confirmed by PCR Population and methods. We identified all suspectedcases (according to Ministry of health)in 34 centers and we included all the confirmed cases of 0-18 years from 1/4/09 to 31/8/09 in a retrospective cohort study. The viral diagnosis was confirmed by RT-PCR method. Data are expressed in percentages, average, median, standard deviation, and range (IQR) as appropriate; and as a measure of association, relative risk (RR), with 95% confidence interval (95%CI). Multiple logistic regression was conducted to determine the independent risk predictors. Results. Total number of suspected cases were: 2367; PCR was performed to 47.8% (n: 1131) beingpositive for pH1N1 65.5% (n:741/1131); 57.2% males; 61.5% <24 months, median age: 14 months(IQR 6-46 months); 45.1% with underlying disease; more frequent clinical pictures were: pneumonia (39,7%) and bronchiolitis 25.8%; Case-fatality rate: 5.9% (44/741). Mortality risk factors were [RR (95%CI)]: neurological disease [5.00 (2.84-8.81)], genetic disease [3.67 (1.58-8.52)], malnutrition [3,07 (1.46-6.48)] and prematurity [2.28 (1.14-4.56)]. Independent mortality predictor:neurological disease [3.84 (1.81-8.14)].No significant association between age, chronic respiratory disease, immunosuppression and viral co-infection with lethality was observed.Conclusions. Almost half of children with pH1N1 infection had underlying disease; the neurological condition was a separate CFR predictor.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Epidemiologia , Vírus da Influenza A Subtipo H1N1 , Doenças Respiratórias , Fatores de Risco
14.
N Engl J Med ; 362(1): 45-55, 2010 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-20032320

RESUMO

BACKGROUND: While the Northern Hemisphere experiences the effects of the 2009 pandemic influenza A (H1N1) virus, data from the recent influenza season in the Southern Hemisphere can provide important information on the burden of disease in children. METHODS: We conducted a retrospective case series involving children with acute infection of the lower respiratory tract or fever in whom 2009 H1N1 influenza was diagnosed on reverse-transcriptase polymerase-chain-reaction assay and who were admitted to one of six pediatric hospitals serving a catchment area of 1.2 million children. We compared rates of admission and death with those among age-matched children who had been infected with seasonal influenza strains in previous years. RESULTS: Between May and July 2009, a total of 251 children were hospitalized with 2009 H1N1 influenza. Rates of hospitalization were double those for seasonal influenza in 2008. Of the children who were hospitalized, 47 (19%) were admitted to an intensive care unit, 42 (17%) required mechanical ventilation, and 13 (5%) died. The overall rate of death was 1.1 per 100,000 children, as compared with 0.1 per 100,000 children for seasonal influenza in 2007. (No pediatric deaths associated with seasonal influenza were reported in 2008.) Most deaths were caused by refractory hypoxemia in infants under 1 year of age (death rate, 7.6 per 100,000). CONCLUSIONS: Pandemic 2009 H1N1 influenza was associated with pediatric death rates that were 10 times the rates for seasonal influenza in previous years.


Assuntos
Surtos de Doenças , Hospitalização/estatística & dados numéricos , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Adolescente , Distribuição por Idade , Argentina/epidemiologia , Criança , Pré-Escolar , Comorbidade , Feminino , Humanos , Hipóxia/etiologia , Hipóxia/mortalidade , Lactente , Recém-Nascido , Influenza Humana/classificação , Influenza Humana/complicações , Influenza Humana/mortalidade , Masculino , Pneumonia Bacteriana/epidemiologia , Pneumonia Bacteriana/etiologia , Índice de Gravidade de Doença , Staphylococcus/isolamento & purificação , Streptococcus pneumoniae/isolamento & purificação
15.
Arch Argent Pediatr ; 106(2): 147-50, 2008 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-18661041

RESUMO

Congenital tuberculosis is a severe rapidly progressive disease which differs from neonatal tuberculosis because patients present tuberculous lesions during their first weeks of life, primary hepatic complex or hepatic caseous granulomas, confirmation of tuberculosis in placenta or in maternal genital tract (uterus or adnexa), and exclusion of birth channel or postnatal exposure. We report a case of a 20 days newborn baby admitted to the neonatal unit with fever, hepatoesplenomegaly, abdominal distension and respiratory symptoms. Abdominal echography showed ascitis, diffuse hepatomegaly and splenomegaly, focal hipoecoical spleen images and portal lymphadenopathy. Thorax X-ray with micronodular infiltrates. Maternal pneumonia with pleural effusion was reported during pregnancy. Empirical treatment was initiated with 4 antituberculous drugs: isoniazid, rifampicin, pyrazinamide and ethambutol suspecting tuberculosis. She died the next day. M. tuberculosis was obtained in a gastric lavage culture, blood cultures and post mortem spleen puncture.


Assuntos
Tuberculose/congênito , Evolução Fatal , Feminino , Humanos , Recém-Nascido , Tuberculose/diagnóstico
16.
Arch. argent. pediatr ; 106(2): 147-150, abr.2008. ilus
Artigo em Espanhol | LILACS | ID: lil-482401

RESUMO

La tuberculosis congénita es una forma clínica grave, rápidamente progresiva, que se diferencia de la forma neonatal por aparición de la lesión en las primeras semanas de vida, presencia de complejo primario hepático o granulomas caseosos,confirmación de tuberculosis en la placenta o tracto genital la madre (útero o anexos) y exclusión de exposición en el canal de parto o post-natal por contacto con foco tuberculoso incluyendoal personal hospitalario. Comunicamos un caso de un recién nacido de 20 días ingresó a neonatología por síndrome febril sin foco evidente evolucionó con hepatoesplenomegalia, distensión abdominal y dificultad respiratoria. Ecografía abdominal con ascitis, hepatoesplenomegalia difusa, imágenes hipoecoicas en bazoadenopatías adyacentes al tronco celíaco y en hilio hepático.de tórax con infiltrado micronodulillar. Antecedente materno de neumonía con derrame durante el embarazo. Ante la sospecha de tuberculosis congénita comenzó tratamiento empírico con 4 drogas: isoniacida, rifampicina, pirazinamida y etambutol. Fallece al día siguiente. Se recibió posteriormente desarrollo de M. tuberculosis en cultivo de lavado gástrico, hemocultivoy punción esplénica


Congenital tuberculosis is a severe rapidly progressive disease which differs from neonatal tuberculosis because patients present tuberculous lesions during their first weeks of life, primary hepatic complex or hepatic caseous granulomas, confirmation of tuberculosis in placenta or in maternal genital tract (uterus or adnexa), and exclusion of birth channel or postnatal exposure. We report a case of a 20 days newborn baby admitted to the neonatal unit with fever, hepatoesplenomegaly, abdominal distension and respiratory symptoms. Abdominal echography showed ascitis, diffuse hepatomegaly and splenomegaly, focal hipoecoical spleen images and portal lymphadenopathy. Thorax X-ray with micronodular infiltrates. Maternal pneumonia with pleural effusion was reported during pregnancy. Empirical treatment was initiated with 4 antituberculous drugs: isoniazid, rifampicin, pyrazinamide and ethambutol suspecting tuberculosis. She died the next day. M. tuberculosis was obtained in a gastric lavage culture, blood cultures and post mortem spleen puncture.


Assuntos
Recém-Nascido , Hepatomegalia , Mycobacterium tuberculosis , Tuberculose/congênito , Tuberculose/diagnóstico
17.
Arch. argent. pediatr ; 106(2): 147-150, abr.2008. ilus
Artigo em Espanhol | BINACIS | ID: bin-122261

RESUMO

La tuberculosis congénita es una forma clínica grave, rápidamente progresiva, que se diferencia de la forma neonatal por aparición de la lesión en las primeras semanas de vida, presencia de complejo primario hepático o granulomas caseosos,confirmación de tuberculosis en la placenta o tracto genital la madre (útero o anexos) y exclusión de exposición en el canal de parto o post-natal por contacto con foco tuberculoso incluyendoal personal hospitalario. Comunicamos un caso de un recién nacido de 20 días ingresó a neonatología por síndrome febril sin foco evidente evolucionó con hepatoesplenomegalia, distensión abdominal y dificultad respiratoria. Ecografía abdominal con ascitis, hepatoesplenomegalia difusa, imágenes hipoecoicas en bazoadenopatías adyacentes al tronco celíaco y en hilio hepático.de tórax con infiltrado micronodulillar. Antecedente materno de neumonía con derrame durante el embarazo. Ante la sospecha de tuberculosis congénita comenzó tratamiento empírico con 4 drogas: isoniacida, rifampicina, pirazinamida y etambutol. Fallece al día siguiente. Se recibió posteriormente desarrollo de M. tuberculosis en cultivo de lavado gástrico, hemocultivoy punción esplénica (AU)


Congenital tuberculosis is a severe rapidly progressive disease which differs from neonatal tuberculosis because patients present tuberculous lesions during their first weeks of life, primary hepatic complex or hepatic caseous granulomas, confirmation of tuberculosis in placenta or in maternal genital tract (uterus or adnexa), and exclusion of birth channel or postnatal exposure. We report a case of a 20 days newborn baby admitted to the neonatal unit with fever, hepatoesplenomegaly, abdominal distension and respiratory symptoms. Abdominal echography showed ascitis, diffuse hepatomegaly and splenomegaly, focal hipoecoical spleen images and portal lymphadenopathy. Thorax X-ray with micronodular infiltrates. Maternal pneumonia with pleural effusion was reported during pregnancy. Empirical treatment was initiated with 4 antituberculous drugs: isoniazid, rifampicin, pyrazinamide and ethambutol suspecting tuberculosis. She died the next day. M. tuberculosis was obtained in a gastric lavage culture, blood cultures and post mortem spleen puncture.(AU)


Assuntos
Recém-Nascido , Tuberculose/congênito , Tuberculose/diagnóstico , Mycobacterium tuberculosis , Hepatomegalia
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