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1.
Travel Med Infect Dis ; 52: 102516, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36581142

RESUMO

The current Monkeypox (MPXV) outbreak has put evidence the worrisome trend of an increased prevalence of other sexually transmitted infections (STDs) particularly in the group of Men who have sex with men (MSM). This phenomenon is illustrated through the case of a 24-year-old male living with HIV that after attending a party where potentially unprotected sex was performed developed a painful popular perianal rash. Laboratory examinations performed confirmed the presence of an acute MPXV infection and primary syphilis, receiving pain relief medication and antibiotics with a rapid control of both illnesses. As in many cases during this outbreak, his HIV status was well controlled and thus a further understanding of the sexual practices in the MSM should help design more adequate interventions to prevent the spread of this and other more conventional STIs.


Assuntos
Coinfecção , Infecções por HIV , Mpox , Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Sífilis , Masculino , Humanos , Adulto Jovem , Adulto , Sífilis/complicações , Sífilis/diagnóstico , Sífilis/tratamento farmacológico , Homossexualidade Masculina , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Coinfecção/epidemiologia , Equador , Infecções Sexualmente Transmissíveis/epidemiologia , Prevalência
3.
Cambios rev. méd ; 20(2): 60-66, 30 Diciembre 2021. ilus, tabs.
Artigo em Espanhol | LILACS | ID: biblio-1368319

RESUMO

INTRODUCCIÓN. La evaluación preoperatoria determina el estado de salud del paciente que será sometido a una intervención quirúrgica, minimiza su riesgo y optimiza los recursos humanos y materiales del escenario perioperatorio. OBJETIVO. Determinar el proceso de evaluación preoperatorio y su capacidad para prevenir eventos clínicos adversos durante el postoperatorio inmediato de pacientes adultos sometidos a un procedimiento quirúrgico no cardiaco. MATERIALES Y MÉTODOS. Estudio retrospectivo de corte transversal. Población de 6 250 adultos y muestra de 912 Historias Clínicas electrónicas de pacientes atendidos en el Hospital de Especialidades Carlos Andrade Marín, en el año 2017. Criterios de inclusión: pacientes mayores de 18 años, que se sometieron a una evaluación preoperatoria de manera ambulatoria y fueron operados de intervenciones no cardiacas hasta el mes de enero del 2019, o suspensión de cirugía por contraindicaciones determinadas en la cita médica. Criterios de exclusión: pacientes menores a 18 años, no intervenidos quirúrgicamente, hospitalizados por cualquier motivo entre la revisión y la cirugía, embarazadas e individuos con consulta preoperatoria fuera del hospital. Los programas informáticos utilizados para el registro de datos y su análisis fueron Microsoft Excel e International Business Machines Statistical Package for the Social Sciences. RESULTADOS. El 82,68% (754; 912) presentó un antecedente clínico y el 82,13% (749; 912) uno de tipo quirúrgico. Se reportó un 2,00% (18; 912) de complicaciones postoperatorias, y un caso de muerte pasadas las 72 horas postquirúrgicas. No se encontró correlación estadísticamente significativa p>0,05 entre las conclusiones clínicas del control preoperatorio y la ocurrencia de complicaciones en el postoperatorio. CONCLUSIÓN. Se evidenció que el proceso de evaluación preoperatoria fue realizado de manera sistemática a pacientes con características sociodemográficas y clínicas heterogéneas y no existió correlación estadística entre sus resultados y la presencia de complicaciones perioperatorias.


INTRODUCTION. The preoperative evaluation determines the health status of a patient that will undergo a surgical intervention, minimizes its risk, and optimizes the human and material resources of the perioperative scenario. OBJECTIVE. To determine the preoperative evaluation process and its ability to prevent adverse clinical events during the immediate postoperative period in adult patients undergoing a noncardiac surgical procedure. MATERIALS AND METHODS. This is a retrospective cross-sectional study. The sample of 912 medical records was calculated upon a population of 6 250 adults treated at the Carlos Andrade Marín Specialties Hospital in 2017. Inclusion criteria: patients over 18 years of age, who underwent a preoperative evaluation on an outpatient basis, and were operated on for non-cardiac interventions until January 2019, or suspension of surgery due to contraindications determined in the medical appointment. Exclusion criteria: patients under 18 years of age, not undergoing surgery, hospitalized for any reason between revision and surgery, pregnant women, and individuals with preoperative consultation outside the hospital. The computer programs used for data collection and analysis were Microsoft Excel and the International Business Machines Statistical Package for the Social Sciences. RESULTS. 82,68% (754; 912) had a previous clinical condition and 82,13% (749; 912) had a previous surgical intervention. 2,00% (18; 912) of postoperative complications were reported, and one case of death after 72 postoperative hours. No statistically significant correlation p>0,05 was found between the clinical conclusions of the preoperative control and the occurrence of postoperative complications. CONCLUSION. It was evidenced that the preoperative evaluation process was carried out systematically to patients with heterogeneous sociodemographic and clinical characteristics and there was no statistical correlation between its results and the presence of perioperative complications.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Complicações Pós-Operatórias/prevenção & controle , Período Pré-Operatório , Liberação de Cirurgia , Estudos Transversais , Estudos Retrospectivos , Medição de Risco
6.
Cambios rev. méd ; 17(1): 52-56, ene. - 2018. graf
Artigo em Espanhol | LILACS | ID: biblio-981100

RESUMO

Introducción. Existe poca información disponible sobre disfunción tiroidea en pacientes con esclerosis múltiple (EM), la mayoría proviene de estudios enfocados en la influencia del interferón b-1 (IFNb) en el hipotiroidismo. Objetivo. El objetivo del presente estudio es analizar el comportamiento epidemiológico del hipotiroidismo en un grupo de pacientes con esclerosis múltiple. Material y métodos. Estudio observacional, descriptivo, transversal, en pacientes con esclerosis múltiple atendidos en consulta externa del Hospital de Especialidades Carlos Andrade Marín entre septiembre del 2013 y octubre del 2015, a quienes se les diagnosticó disfunción tiroidea. Resultados. Se incluyeron 81 pacientes con esclerosis múltiple de los cuales el 17,2% (n=14) tuvieron hipotiroidismo clínico y subclínico confirmado. De este grupo, un paciente fue de sexo masculino y 13 del femenino. El promedio de edad fue 40±13,5 años. En los pacientes con comorbilidad esclerosis múltiple-hipotiroidismo, se encontró 78,5% (n=63) la variedad Remitente Recurrente y en 21% (n=17) la variedad progresiva. Se evidenció comorbilidad diabetes mellitus tipo 2 en pacientes con hipotiroidismo y esclerosis múltiple en un 24% (n=4). Cabe mencionar que entre los pacientes con comorbilidad de esclerosis múltiple e hipotiroidismo, el 14% (n=2) presentaron una tercera enfermedad autoinmune como lupus eritematoso sistémico. Conclusiones. La prevalencia encontrada de hipotiroidismo en pacientes con esclerosis múltiple en esta serie fue similar a la reportada en estudios internacionales. Sin embargo, no podemos asegurar si es similar a la de población ecuatoriana en general, ya que no existen estudios que precisen la prevalencia de hipotiroidismo en Ecuador, aunque esta se estima alrededor del 15 a 20%.


Introduction. There is little information available regarding thyroid dysfunction in patients with Multiple Sclerosis (MS). Most information on this matter comes from studies focused on the influence of Interferon b-1 in hypothyroidism. Objective. The goal of this study was to analyze the epidemiology of hypothyroidism in a group of MS patients. Materials and methods. Observational, descriptive, cross-sectional study carried out on Multiple Sclerosis (MS) patients of the external care area of the Carlos Andrade Marín Specialties Hospital between September 2013 and October 2015, who had been diagnosed with thyroid dysfunctions. Results. Eighty-one MS patients were included in the study, and 17.2% (n=14) of them had confirmed clinical and subclinical hypothyroidism. Out of these, 7.1% (n=l) was male and 92% (n=13) were females, with an age range of M=40, SD-=13.55. In patients with MS-hypothyroidism comorbidity, 78.5% (n=63) had a relapsing-remitting variety, and 21% (n=17) a progressive variety. A Diabetes Mellitus Type 2 comorbidity was evident in hypothyroidism and MS patients; 14% (n=4) were diagnosed with a third autoimmune disease, such as systemic lupus erythematosus. Conclusions. The prevalence of hypothyroidism found in MS patients within this study was similar to the prevalence reported in international studies. However, we cannot be certain whether or not this value was similar to the overall Ecuadorian population, since there are no studies that pinpoint the exact prevalence of hypothyroidism in Ecuador, although this rate is estimated to be within a range of 15 to 20%.


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Doenças da Glândula Tireoide , Hipotireoidismo , Esclerose Múltipla , Diabetes Mellitus , Lúpus Eritematoso Sistêmico
7.
INSPILIP ; 1(1): 1-11, ene.-jun 2017.
Artigo em Espanhol | LILACS | ID: biblio-987626

RESUMO

La leptospirosis en fase ictérica o enfermedad de Weil es una vasculitis zoonótica endémica de la Costa ecuatoriana. Sin embargo, la pancreatitis aguda como parte de esta entidad es una complicación rara vez documentada. En este reporte de caso se presenta a un adulto varón de 63 años con signos de falla multiorgánica y amilasa con rápido ascenso inicial. La leptospirosis no fue tomada como primera opción diagnóstica. El paciente fue tratado debido a un cuadro de SDRA como un shock séptico de foco pulmonar, con falla renal aguda que requirió hemodiálisis, permaneciendo en UCI con antibioticoterapia empírica. El objetivo de este caso es remarcar que la leptospirosis debe siempre estar considerada en el diagnóstico diferencial de ictericia y pancreatitis, sobre todo en nuestro medio.


The icteric presentation of Leptospirosis, also known as Weil's disease, is a zoonotic vasculitis endemic to Ecuador's coastal region. However, reports of pancreatic affection due to this entity are rarely documented. We chose to present the case of a 63 years old male with signs of catastrophic organic failure, associated with a rapid increase in serum amylase concentrations. Due to this presentation, Leptospirosis was not held as the primary culprit of the disease, and was treated at the ICU as septic shock of pulmonary origin with ARDS associated with acute kidney injury that required hemodialysis. Thus this case aims to highlight the importance of Leptospirosis as an important differential diagnosis in any patient hailing from a tropical region with jaundice and pancreatitis.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Vasculite , Doença de Weil , Amilases , Leptospirose , Insuficiência de Múltiplos Órgãos , Pacientes , Vigilância Sanitária
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