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1.
Medicina (B Aires) ; 80(3): 229-240, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32442937

RESUMO

The Argentine Society of Infectious Diseases and other scientific societies have updated these recommendations based on data on urinary tract infections in adults obtained from a prospective multicenter study conducted in Argentina during 2016-2017. Asymptomatic bacteriuria should be treated only in pregnant women, who should also be systematically investigated; the antibiotics of choice are nitrofurantoin, amoxicillin, clavulanic/amoxicillin, cephalexin and trimethoprim-sulfamethoxazole. In procedures involving injury to the urinary tract with bleeding, it is recommended to request urine culture and, in the presence of bacteriuria, antimicrobial treatment according to sensitivity should be prescribed from immediately before up to 24 hours after the intervention. In women, cystitis can be treated with nitrofurantoin, cephalexin or fosfomycin, while trimethoprim-sulfamethoxazole and fluoroquinolones are not recommended; pyelonephritis can be treated with ciprofloxacin, cefixime or cephalexin in ambulatory women or ceftriaxone, cefazolin or amikacin in those who are hospitalized. In men, urinary tract infections are always considered complicated; nitrofurantoin or cephalexin are recommended for 7 days, alternatively fosfomycin should be given in a single dose. In men, ciprofloxacin, ceftriaxone or cefixime are suggested for pyelonephritis on ambulatory treatment whereas ceftriaxone or amikacin are recommended for hospitalized patients. Acute bacterial prostatitis can be treated with ceftriaxone or gentamicin. Fluoroquinolones were the choice treatment for chronic bacterial prostatitis until recently; they are no longer recommended due to the increasing resistance and recent concerns regarding the safety of these drugs; alternative antibiotics such as fosfomycin are to be considered.


Assuntos
Anti-Infecciosos Urinários/uso terapêutico , Consenso , Infecções Urinárias/tratamento farmacológico , Argentina , Cistite/diagnóstico , Cistite/tratamento farmacológico , Feminino , Humanos , Masculino , Gravidez , Estudos Prospectivos , Prostatite/diagnóstico , Prostatite/tratamento farmacológico , Pielonefrite/diagnóstico , Pielonefrite/tratamento farmacológico , Infecções Urinárias/diagnóstico
2.
Medicina (B Aires) ; 80(3): 241-247, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32442938

RESUMO

The second part of the Inter-Society Argentine Consensus on Urinary Tract Infection (UTI) includes the analysis of special situations. In patients with urinary catheter, urine culture should be requested only in the presence of UTI symptomatology, before instrumentation of the urinary tract, or as a post-transplant control. The antibiotics recommended for empirical treatment in patients without risk factors are third-generation cephalosporins or aminoglycosides. UTIs associated with stones are always considered complicated. In case of obstruction with urosepsis, an emergency drainage should be performed via a percutaneous nefrostomy or ureteral stenting. In patients with stents or ureteral prostheses, such as double J catheters, empirical treatment should be based on epidemiology, prior antibiotics, and clinical status. Before the extracorporeal lithotripsy procedure, bacteriuria should be investigated and antibiotic prophylaxis should be administered in case of positive result, according to the antibiogram. First generation cephalosporins or aminoglycosides are valid alternatives. The use of antibiotic prophylaxis with first-generation cephalosporins or aminoglycosides before percutaneous nephrolithotomy is recommended. Transrectal prostatic biopsy can be associated with infectious complications, such as UTI or acute prostatitis, mainly due to Escherichia coli or other enterobacteria. In patients without risk factors for multiresistant bacteria and negative urine culture, prophylaxis with intravenous amikacin or ceftriaxone is recommended. In patients with positive urine culture, prophylaxis will be performed according to the antibiogram, from 24 hours before to 24 hours post-procedure. For the targeted treatment of post-transrectal biopsy prostatitis, carbapenems for 3-4 weeks are the treatment of choice.


Assuntos
Anti-Infecciosos Urinários/uso terapêutico , Consenso , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/etiologia , Argentina , Feminino , Humanos , Litotripsia/efeitos adversos , Masculino , Nefrolitíase/complicações , Nefrolitotomia Percutânea/efeitos adversos , Prostatite/tratamento farmacológico , Prostatite/etiologia , Fatores de Risco , Stents/efeitos adversos , Cateteres Urinários/efeitos adversos
3.
Medicina (B Aires) ; 77(1): 24-30, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-28140307

RESUMO

Herpes zoster (HZ) is caused by reactivation of the varicella zoster virus. Its main risk factor is increasing age and comorbidities. There are limited data on the characteristics of HZ in South America, especially in the elderly. We analyzed epidemiological and clinical characteristics of 340 patients over 60 years assisted for HZ, between June 2013 and May 2014. The average age was 74 years (60-100), 62% (210) had thoracic location; 75% (255) of the initial consultations were held in guards; 68% (143) had pain and vesicles, and 4% (14) only pain at baseline. Pain persisted after finishing the episode in 41% (139). The diagnosis was made between 1 and 3 days from the beginning of the episode in 53% (180 patients). Average number of visits per episode was 3.6 (1-24). Antiviral treatment was supplied to 91% (309); however it was inadequate in dose or time in 49.1% (167 cases). Pain treatment was indicated in 66% (224). Most frequently used drugs (alone or in combination) were non-steroidal painkillers (43%, 146), pregabalin (30%, 102), opiates (24%, 82), and steroids (12%, 41); 9% (31) presented comorbidities; 27% (126) experienced pain after the ending of the episode, with an average duration of 138.7 days. In general, diagnosis was done late, making it difficult to use antivirals correctly. The presence of pain was more frequent than reported in other publications, however there are few data in this age group.


Assuntos
Herpes Zoster , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Antivirais/uso terapêutico , Argentina , Feminino , Herpes Zoster/complicações , Herpes Zoster/tratamento farmacológico , Herpes Zoster/patologia , Hospitais Comunitários , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neuralgia/etiologia , Estudos Retrospectivos , Fatores de Risco
4.
Medicina (B.Aires) ; 77(1): 24-30, feb. 2017. graf, tab
Artigo em Espanhol | LILACS-Express | ID: biblio-841628

RESUMO

El herpes zoster (HZ) se produce por reactivación del virus varicela zoster. Sus principales factores de riesgo son edad avanzada y presencia de comorbilidades (diabetes, inmunodepresión). Existen escasos datos de HZ en Sudamérica, y especialmente en adultos mayores. Analizamos retrospectivamente las características epidemiológicas y clínicas de 340 pacientes mayores de 60 años atendidos por HZ, entre junio 2013 y mayo 2014. La edad promedio de consulta fue de 74 años (60-100), localización torácica 210 (62%); el 75% (255) de las consultas iniciales se realizaron en guardias. El 68%, 143, presentaron dolor y vesículas, y 4% (14) solo dolor al inicio; el dolor persistió luego de finalizar el episodio en el 41% (139) de los pacientes. El diagnóstico se realizó entre 1 y 3 días de iniciado el cuadro en el 53% (180). El promedio de consultas por episodio fue de 3.6 (1-24). Tratamiento antiviral se indicó en 91% (309) de los pacientes [en 49% (167) fue inadecuado en tiempo o dosis], y tratamiento para el dolor en el 66% (224) de los casos: drogas más usadas (solas o en combinación) AINES (43%, 146), pregabalina (30%, 102), opiáceos (24%, 82), y corticoides (12%, 41). Solo el 9% (31) presentó comorbilidades y el 27% (126) dolor post episodio (duración promedio: 138.7 días). El diagnóstico fue tardío, dificultando el uso correcto de antivirales. El dolor post episodio fue más frecuente que en la literatura consultada; sin embargo, son pocos los datos en este grupo etario.


Herpes zoster (HZ) is caused by reactivation of the varicella zoster virus. Its main risk factor is increasing age and comorbidities. There are limited data on the characteristics of HZ in South America, especially in the elderly. We analyzed epidemiological and clinical characteristics of 340 patients over 60 years assisted for HZ, between June 2013 and May 2014. The average age was 74 years (60-100), 62% (210) had thoracic location; 75% (255) of the initial consultations were held in guards; 68% (143) had pain and vesicles, and 4% (14) only pain at baseline. Pain persisted after finishing the episode in 41% (139). The diagnosis was made between 1 and 3 days from the beginning of the episode in 53% (180 patients). Average number of visits per episode was 3.6 (1-24). Antiviral treatment was supplied to 91% (309); however it was inadequate in dose or time in 49.1% (167 cases). Pain treatment was indicated in 66% (224). Most frequently used drugs (alone or in combination) were non-steroidal painkillers (43%, 146), pregabalin (30%, 102), opiates (24%, 82), and steroids (12%, 41); 9% (31) presented comorbidities; 27% (126) experienced pain after the ending of the episode, with an average duration of 138.7 days. In general, diagnosis was done late, making it difficult to use antivirals correctly. The presence of pain was more frequent than reported in other publications, however there are few data in this age group.

5.
J Nurs Care Qual ; 30(4): E17-25, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26035705

RESUMO

We evaluated the impact of the International Nosocomial Infection Control Consortium multidimensional approach to hand hygiene in 11 intensive care units in 4 cities in Argentina and analyzed predictors of poor hand hygiene compliance. We had a baseline period and a follow-up period. We observed 21 100 hand hygiene opportunities. Hand hygiene compliance increased from 28.3% to 64.8% (P = .0001). Males versus females (56.8% vs 66.4%; P < .001) and physicians versus nurses (46.6% vs 67.8%; P < .001) were significantly associated with poor hand hygiene compliance.


Assuntos
Fidelidade a Diretrizes , Higiene das Mãos/normas , Unidades de Terapia Intensiva , Argentina , Infecção Hospitalar/prevenção & controle , Feminino , Pessoal de Saúde/educação , Pessoal de Saúde/normas , Humanos , Controle de Infecções/normas , Masculino , Estudos Prospectivos , Melhoria de Qualidade , Fatores Sexuais
6.
Buenos Aires; Sociedad Argentina de Medicina; 2000. 307 p. ilus, tab, graf. (68779).
Monografia em Espanhol | BINACIS | ID: bin-68779
8.
Avellaneda; Sociedad Argentina de Medicina; 1996. 389 p. ilus, tab, graf. (68778).
Monografia em Espanhol | BINACIS | ID: bin-68778
9.
Medicina [B.Aires] ; 56(4): 397-402, 1996. ilus
Artigo em Espanhol | BINACIS | ID: bin-21404

RESUMO

Se describe un caso de sarcoma de Kaposi (SK) pulmonar en ausencia de lesiones cutaneomucosas observado en un paciente con SIDA, a su vez varón heterosexual de 30 años de edad y con antecedentes de drogadicción por vía intravenosa. Tanto la radiografia como la tomografía computarizada de tórax mostraron un patrón nodular difuso en ambos pulmones, mientras que la endoscopía no revelaba lesiones endobronquiales. El examen citológico de muestra obtenida por punción pulmonar transtorácica fue compatible con SK pulmonar primario, que es neoplasia excepcional en varones heterosexuales drogadependientes con SIDA. Al año de establecido el diagnóstico de SK, el paciente falleció por insuficiencia respiratoria. (AU)


Assuntos
Humanos , Masculino , Adulto , Sarcoma de Kaposi/diagnóstico , Neoplasias Pulmonares/diagnóstico , Síndrome de Imunodeficiência Adquirida , Transtornos Relacionados ao Uso de Substâncias , Sarcoma de Kaposi/patologia , Sarcoma de Kaposi/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/diagnóstico por imagem
10.
Medicina (B.Aires) ; 56(4): 397-402, 1996. ilus
Artigo em Espanhol | LILACS | ID: lil-186263

RESUMO

Se describe un caso de sarcoma de Kaposi (SK) pulmonar en ausencia de lesiones cutaneomucosas observado en un paciente con SIDA, a su vez varón heterosexual de 30 años de edad y con antecedentes de drogadicción por vía intravenosa. Tanto la radiografia como la tomografía computarizada de tórax mostraron un patrón nodular difuso en ambos pulmones, mientras que la endoscopía no revelaba lesiones endobronquiales. El examen citológico de muestra obtenida por punción pulmonar transtorácica fue compatible con SK pulmonar primario, que es neoplasia excepcional en varones heterosexuales drogadependientes con SIDA. Al año de establecido el diagnóstico de SK, el paciente falleció por insuficiencia respiratoria.


Assuntos
Humanos , Masculino , Adulto , Síndrome de Imunodeficiência Adquirida , Neoplasias Pulmonares/diagnóstico , Sarcoma de Kaposi/diagnóstico , Transtornos Relacionados ao Uso de Substâncias , Neoplasias Pulmonares , Neoplasias Pulmonares/patologia , Sarcoma de Kaposi , Sarcoma de Kaposi/patologia
11.
Medicina (B.Aires) ; 55(4): 334-6, 1995.
Artigo em Espanhol | LILACS | ID: lil-161636

RESUMO

Here we report a case of HIV infection in a lesbian lacking other risk factors. She had sought advice for asthenia and unexplained weight loss. The physical examination disclosed oropharyngeal candidiasis and generalized lymphoadenopathies. The patient defined herself as an active sexual partner and denied having any heterosexual intercourse whatsoever. Particle agglutination test proved positive for anti-HIV, as well as two consecutive ELISA assays, confirmed by Western blot. Since there was no history of blood transfusions or intravenous drug addiction, it may be concluded that HIV transmission was most likely due to female homosexual practices.


Assuntos
Humanos , Feminino , Adulto , Homossexualidade Feminina , Síndrome de Imunodeficiência Adquirida/transmissão , Argentina , Western Blotting , Ensaio de Imunoadsorção Enzimática , Soropositividade para HIV/diagnóstico , Síndrome de Imunodeficiência Adquirida/diagnóstico , Sorodiagnóstico da AIDS/métodos
12.
Avellaneda; Sociedad Argentina de Medicina; 1995. 334 p. ilus, tab, graf. (68777).
Monografia em Espanhol | BINACIS | ID: bin-68777
13.
Medicina [B.Aires] ; 55(4): 334-6, 1995.
Artigo em Espanhol | BINACIS | ID: bin-23055

RESUMO

Here we report a case of HIV infection in a lesbian lacking other risk factors. She had sought advice for asthenia and unexplained weight loss. The physical examination disclosed oropharyngeal candidiasis and generalized lymphoadenopathies. The patient defined herself as an active sexual partner and denied having any heterosexual intercourse whatsoever. Particle agglutination test proved positive for anti-HIV, as well as two consecutive ELISA assays, confirmed by Western blot. Since there was no history of blood transfusions or intravenous drug addiction, it may be concluded that HIV transmission was most likely due to female homosexual practices.(AU)


Assuntos
Humanos , Feminino , Adulto , Síndrome de Imunodeficiência Adquirida/transmissão , Homossexualidade Feminina , Síndrome de Imunodeficiência Adquirida/diagnóstico , Sorodiagnóstico da AIDS/métodos , Soropositividade para HIV/diagnóstico , Ensaio de Imunoadsorção Enzimática , Western Blotting , Argentina
14.
Lanús; Sociedad Argentina de Medicina; 1994. 306 p. ilus, tab, graf. (68776).
Monografia em Espanhol | BINACIS | ID: bin-68776
15.
Lanús; el Congreso; 1993. 429 p. ilus, tab, graf. (68775).
Monografia em Espanhol | BINACIS | ID: bin-68775
16.
Buenos Aires; Organismo Oficial del Congreso Nacional de Medicina; 1993. 429 p. (66896).
Monografia em Espanhol | BINACIS | ID: bin-66896
17.
Quilmes; el Congreso; 1992. 262 p. ilus, tab, graf. (68774).
Monografia em Espanhol | BINACIS | ID: bin-68774
18.
Quilmes; Organismo Oficial del Congreso Nacional de Medicina; 1992. 262 p. ilus, Tab. (66895).
Monografia em Espanhol | BINACIS | ID: bin-66895
19.
Buenos Aires; Sociedad Argentina de Medicina; 1995. 334 p. (78689).
Monografia em Espanhol | BINACIS | ID: bin-78689
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