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1.
Recurso na Internet em Inglês, Espanhol | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-47017

RESUMO

Los esfuerzos para garantizar que los países de America Latina y el Caribe estén preparados para llevar a cabo el diagnóstico de laboratorio para detectar la nueva enfermedad por el coronavirus 2019 (COVID-19) han continuado esta semana con una capacitación en la Ciudad de México, organizada por la Organización Panamericana de la Salud (OPS) y el Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE) de la Secretaría de Salud de México.


Assuntos
Infecções por Coronavirus/diagnóstico , Capacitação Profissional , Vírus da SARS , Américas/epidemiologia
2.
Recurso na Internet em Inglês, Espanhol | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-47018

RESUMO

Expertos de la Fundación Oswaldo Cruz (Fiocruz), el Ministerio de Salud de Brasil y la Organización Panamericana de la Salud (OPS) realizaron este 6 y 7 de febrero, una capacitación para representantes de nueve países de las Américas sobre diagnóstico de laboratorio del nuevo coronavirus (2019-nCoV)


Assuntos
Capacitação Profissional , Coronavirus , Síndrome Respiratória Aguda Grave/diagnóstico
3.
Recurso na Internet em Inglês, Espanhol | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-47019

RESUMO

En una serie de actividades de cooperación técnica, expertos de la OPS en laboratorio, epidemiología, manejo clínico, prevención y control de infecciones, y otras áreas, están apoyando a funcionarios de salud pública en los países.


Assuntos
Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/prevenção & controle , Capacitação Profissional , Coronavirus/patogenicidade , América Latina/epidemiologia
4.
Recurso na Internet em Espanhol | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46990

RESUMO

Los coronavirus son una familia de virus que causan enfermedades que van desde el resfriado común hasta enfermedades respiratorias más graves, circulan entre humanos y animales. A veces, los coronavirus que infectan a los animales pueden evolucionar, transmitirse a las personas y convertirse en una nueva cepa de coronavirus capaz de provocar enfermedades en los seres humanos, tal y como sucedió con el Síndrome Respiratorio Agudo Severo (SARS), en Asia en febrero de 2003 y, el Síndrome Respiratorio de Oriente Medio (MERS-CoV), que fue detectado por primera vez en Arabia Saudita en 2012.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/diagnóstico , Doença Relacionada a Viagens , Controle Sanitário de Viajantes , Infecções por Coronavirus/transmissão
5.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46978

RESUMO

Você sabe o que é hanseníase? Muitas pessoas não sabem. Por isso, o mês de janeiro ganhou o título de ‘Janeiro Roxo’


Assuntos
Hanseníase , Hanseníase/diagnóstico
9.
Emergencias (Sant Vicenç dels Horts) ; 32(1): 9-18, feb. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-ET2-3431

RESUMO

Objetivos. Analizar qué características clínicas y del ECG de la primera valoración de pacientes con dolor torácico no traumático (DNT) se asocian con una clasificación inicial de sospecha de síndrome coronario agudo (SCA) y con el diagnóstico final de SCA, e identificar cuáles resultan sobre o infravaloradas durante la clasificación inicial. Método. Se incluyeron las consultas consecutivas por DTNT en una unidad de dolor torácico durante 10 años (2008-2017) en las que se disponía de los diagnósticos inicial de sospecha (SCA/no SCA) y final de alta de urgencias (SCA/no SCA). Se incluyeron 33 variables independientes (2 demográficas, 5 comorbilidad cardiovascular, 22 dolor torácico, 4 datos ECG). Se calcularon las odds ratio (OR) para la clasificación (inicial y final) como SCA para cada variable independiente, crudas y ajustadas en modelos globales que incluían todas ellas. En estos modelos ajustados se comparó si las OR para la clasificación inicial y final como SCA eran significativamente diferentes. Resultados. Se incluyeron 34.552 visitas. Las 33 variables analizadas mostraron asociación significativa para la clasificación inicial y final del DTNT como SCA, y en muchos casos esta asociación se mantuvo en el modelo ajustado. Diecinueve variables mostraron OR significativamente diferentes para la sospecha inicial de SCA que para el diagnóstico final de SCA: 10 sobrestimaban la asociación final y 9 la subestimaban. Conclusión. Los datos clínicos iniciales clásicamente utilizados para sospechar SCA pacientes con DTNT en urgencias identifican todos ellos individualmente a pacientes con riesgo incrementado de ser clasificado inicial y finalmente como SCA; sin embargo, algunos de ellos sobreestiman y otros subestiman inicialmente el riesgo final. Los urgenciólogos debieran sensibilizarse más con estos datos subestimados


Objectives. To analyze clinical data and electrocardiographic (ECG) findings obtained during the initial evaluation of patients with nontraumatic chest pain (NTCP). To explore associations between these findings and the initial and final diagnoses of acute coronary syndrome (ACS). To assess which variables initially over- or underestimate risk ACS. Methods. Consecutive patients with NTCP attended in a chest pain unit during the 10-year period of 2008–2017 were included if the suspected and discharge diagnoses of interest (ACS or non-ACS) had been recorded. Thirtythree independent variables (demographic, 2; cardiovascular, 5; chest pain, 22; ECG, 4). We included all variables in models to calculate crude and adjusted odds ratios (ORs) between each independent variable and the initial and final diagnoses. The adjusted ORs were compared to determine whether the initial and final diagnoses of ACS differed significantly in relation to the variables. Results. A total of 34 552 patient visits were attended. The ORs for the 33 variables were significantly associated with initial and final NTCP classification as ACS or non-ACS, and in many cases the association was confirmed by the adjusted ORs. The adjusted ORs for 19 variables were significantly different in their relation to the initial and final diagnoses of ACS: 10 overpredicted the probability of the diagnosis and 9 underpredicted it. Conclusions. The variables traditionally used to warn of ACS in emergency patients with NTCP identify individuals likely to be initially and finally diagnosed with ACS. However, some of these variables overestimate or underestimate the risk of a final ACS diagnosis. Emergency medicine physicians should be aware of variables associated with underestimation of risk


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Análise de Dados , Ficha Clínica , Eletrocardiografia/estatística & dados numéricos , Dor no Peito/epidemiologia , Síndrome Coronariana Aguda/diagnóstico , Indicadores Básicos de Saúde , Razão de Chances , Modelos Logísticos , Análise Multivariada
10.
Emergencias (Sant Vicenç dels Horts) ; 32(1): 19-25, feb. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-ET2-3432

RESUMO

Objetivo. La correcta identificación en el primer contacto médico de los pacientes con un síndrome coronario agudo (SCA) es esencial. No existe ninguna escala predictiva para el diagnóstico de SCA en los centros de coordinación de emergencias (CCE) que facilite la toma de decisiones al equipo médico. El objetivo primario es construir y validar una escala de estas características. Método. Estudio prospectivo, observacional, unicéntrico, realizado durante 1 año (2016). Se incluyeron los pacientes que consultaron telefónicamente por dolor torácico no traumático en un CCE. Los pacientes incluidos se repartieron en las muestras de derivación y validación de forma aleatoria. La escala predictiva –escala SCARE– se construyó mediante regresión logística, la discriminación y calibración del modelo se realizó con el cálculo del área bajo la curva (ABC) de la característica operativa del receptor y el test de Hosmer-Lemeshow. Resultado. La muestra de derivación incluyó 902 pacientes y 7 de las variables recogidas se relacionaron con un diagnóstico final de SCA: sexo masculino, edad, tabaquismo, dolor torácico de características típicas, primer episodio de dolor torácico, diaforesis y la intuición del médico que realizó la entrevista telefónica. La utilización de la escala desarrollada en los 465 pacientes de la muestra de validación obtuvo un ABC de 0,81 (intervalo de confianza al 95% 0,76-0,87) y el test de Hosmer-Lemeshow fue de 5,18 (p = 0,74). Conclusión. La escala SCARE mostró una correcta discriminación y calibración. Es necesaria una validación externa multicéntrica antes de implementar su uso en los CCE


Background and objective. Correctly identifying patients with acute coronary syndrome (ACS) on first contact is essential, yet emergency dispatchers currently lack a risk scale that can help predict an ACS diagnosis. Our main aim was to develop and validate such a risk scale. Methods. Prospective, observational single-center study in 2016 (January 1 to December 31). We included patients who called our emergency dispatch center to report nontraumatic chest pain. Included patients were randomly assigned to a development or a validation sample. The predictive SCARE scale was built with logistic regression analysis. Discrimination and calibration were analyzed by calculating the area under the receiver operating characteristic curve; calibration was assessed with the Hosmer-Lemeshow test. Results. The development sample included 902 patients. The regression model identified 7 variables associated with a final diagnosis of ACS: male sex, age, smoking, typical pain characteristics, first episode of chest pain, diaphoresis, and physician intuition (the teledispatcher’s suspicion). When we applied the scale in the validation sample of 465 patients the area under the curve was 0.81 (95% CI, 0.76-0.87). The Hosmer-Lemeshow statistic was 5.18 (P=.74). Conclusions. The SCARE scale had good discrimination and calibration properties. The scale should be further validated in an external sample from a multicenter study before it is implemented by emergency dispatch centers


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Síndrome Coronariana Aguda/diagnóstico , Serviços Médicos de Emergência/métodos , Técnicas de Apoio para a Decisão , Dor no Peito/diagnóstico , Estudos Prospectivos , Valor Preditivo dos Testes , Telefone/estatística & dados numéricos , Modelos Logísticos , Intuição , Inquéritos e Questionários
11.
Emergencias (Sant Vicenç dels Horts) ; 32(1): 40-44, feb. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-ET2-3435

RESUMO

Objetivo. Determinar el impacto pronóstico de la enfermedad pulmonar obstructiva crónica (EPOC) en los pacientes diagnosticados de enfermedad tromboembólica venosa (ETV) en servicios de urgencias (SU) españoles. Método. Análisis secundario del registro ESPHERIA que incluyó pacientes consecutivos con ETV sintomática en 53 SU. Resultados. Se incluyeron 801 pacientes de los que 71 (9%) tenían EPOC, siendo la tromboembolia pulmonar la forma de presentación más frecuente de ETV en este subgrupo de pacientes (77,5% vs 47,1%, p < 0,001). Los pacientes con EPOC tuvieron con más frecuencia disfunción de ventrículo derecho en la angiotomografía pulmonar (18,2% vs 13,1%; p < 0,001) y necesidad de soporte ventilatorio (7% vs 0,5%; p < 0,001). Los pacientes con ETV y EPOC tuvieron mayor incidencia de reingreso o mortalidad en el seguimiento a 180 días [HR 1,52 (IC 95% 1,00-2,29; p = 0,048)], comparados con los pacientes con ETV sin EPOC. Conclusiones. La EPOC tiene impacto pronóstico en los pacientes diagnosticados de ETV en SU españoles, en términos de mortalidad y reingreso hospitalario


Objective. To determine the impact of chronic obstructive pulmonary disease (COPD) on prognosis in patients diagnosed with venous thromboembolic disease (VTED) in Spanish emergency departments. Methods. Secondary analysis of data from the ESPHERIA (Spanish acronym for Risk Profile of Patients VTED Attended in Spanish Emergency Departments) registry. Results. A total of 801 patients, 71 (9%) with COPD, were included. Pulmonary thromboembolism was recorded in 77.%% of the patients with COPD (vs in 47.1% of patients without COPD; P<.001). Patients with COPD had evidence of right ventricular dysfunction on computed tomography angiography more often than other VTED patients (18.2% vs 13.1%; P<.001) and more often required ventilatory support (7% vs 0.5%; P<.001). VTED patients with COPD also had a higher rate of readmission or mortality at 180 days (hazard ratio, 1.52; 95% CI, 1.00-2.29; P = .048)] than patients without COPD. Conclusions. COPD affects the prognosis of patients diagnosed with VTED in Spanish emergency departments as evidenced by hospital readmission and mortality


Assuntos
Humanos , Masculino , Idoso , Doença Pulmonar Obstrutiva Crônica/complicações , Tromboembolia Venosa , Tromboembolia Venosa/complicações , Prognóstico , Serviços Médicos de Emergência , Estudos de Coortes , Intervalos de Confiança , Readmissão do Paciente , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Análise Multivariada
13.
Washington; OPS; 01/02/2020. 5 p.
Não convencional em Inglês, Espanhol | LILACS | ID: biblio-1049524

RESUMO

En las directrices de laboratorio para la detección y diagnóstico de la infección con el nuevo coronovirus 2019 la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS) recomienda a los Estados Miembros garantizar su identificación oportuna, el envío de las muestras a laboratorios nacionales y de referencia y la implementación del protocolo de detección molecular para 2019-nCoV, según la capacidad del laboratorio.


Assuntos
Humanos , Infecções por Coronavirus/diagnóstico , Betacoronavirus/isolamento & purificação , Técnicas de Diagnóstico Molecular , Reação em Cadeia da Polimerase em Tempo Real
14.
Adv Neurobiol ; 24: 3-42, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32006355

RESUMO

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder generally manifesting in the first few years of life and tending to persist into adolescence and adulthood. It is characterized by deficits in communication and social interaction and restricted, repetitive patterns of behavior, interests, and activities. It is a disorder with multifactorial etiology. In this chapter, we will focus on the most important and common epidemiological studies, pathogenesis, screening, and diagnostic tools along with an explication of genetic testing in ASD.


Assuntos
Transtorno do Espectro Autista , Adolescente , Adulto , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/genética , Criança , Humanos
15.
Adv Neurobiol ; 24: 43-81, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32006356

RESUMO

Autism spectrum disorder (ASD) is a highly heritable, heterogeneous, and complex pervasive neurodevelopmental disorder (PND) characterized by distinctive abnormalities of human cognitive functions, social interaction, and speech development.Nowadays, several genetic changes including chromosome abnormalities, genetic variations, transcriptional epigenetics, and noncoding RNA have been identified in ASD. However, the association between these genetic modifications and ASDs has not been confirmed yet.The aim of this review is to summarize the key findings in ASD from genetic viewpoint that have been identified from the last few decades of genetic and molecular research.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/genética , Pesquisa Biomédica/tendências , Epigênese Genética , Humanos , Técnicas de Diagnóstico Molecular
18.
Zhonghua Zhong Liu Za Zhi ; 42(1): 37-43, 2020 Jan 23.
Artigo em Chinês | MEDLINE | ID: mdl-32023767

RESUMO

Objective: To investigate the molecular genetic and clinicopathologic characteristics, immunophenotypes, diagnostic and differential diagnostic features of myxoid angiomatoid fibrous histiocytoma (MAFH). Methods: Three cases of MAFH were collected from the archives of Zhejiang Provincial People's Hospital between January 2015 to August 2018. The clinical and radiologic features, histomorphology, immunohistochemistry, molecular genetics and prognosis were analyzed. Results: Patients consisted of 2 women and 1 man aged 37 years, 46 years, and 57 years, respectively. The clinical manifestations of 3 patients were presented as a painless, slowly-enlarged mass with a duration ranging of 2 weeks, 2 months and 50 years. These tumors were located at the deep somatic soft tissue of extremities or limbs (right hip, left forearm, left wrist, respectively) and 2 were preoperatively considered as ganglion cyst or giant cell tumor of tendon sheath by imaging examinations. The diameter of circumscribed mass lesion was ranged from 3.0 to 7.5 cm, which exhibited a gray white to tan and gelatinous cut surface. Extensive hemorrhage and cystic changes were observed in 2 cases. Under low magnification, all tumors showed a dense fibrous pseudo-capsule with a peritumoral lymphoplasmacytic cuff and a multi-nodular growth pattern. Blood-filled cystic spaces were observed in 2 tumors. The myxoid stroma occupied 60.0%, 80.0% and 90.0% area of the entire tumor, respectively. Within the myxoid areas, tumor cells were oval to stellate and arranged in cord-like, microcystic and reticular growth patterns. Transitions of myxoid tumor components to more solid areas with typical histology of angiomatoid fibrous histiocytoma (AFH) were observed at least focally in all the three cases. The tumor cells exhibited minimal atypia and scarce mitoses (1 to 2/50 HPF) without necrosis, and prominently focal intracytoplasmic vacuoles were identified in one case. The results of immunohistochemistry staining showed that, 2/3 cases focally expressed desmin, 2/3 focally expressed epithelial membrane antigen (EMA), and 1/3 focally expressed CD99. The positive index of Ki67 was approximately 1% to 5%. Fluorescence in situ hybridization analysis showed that EWSR1 gene rearrangement occurred in all of the three cases. During the period of follow-up, one case showed local recurrence at 15 months, one case showed postoperative recurrence at 24 months, and the recurrent tumor slowly grew for 120 months until the second resection, without recurrence at the following 2 months. The left case showed a disease-free survival at 32 months. Conclusions: MAFH is a rare subtype of AFH with a low-grade behavior and may lead to diagnostic confusions. Carefully searching for the typical AFH histomorphology and combining with EWSR1 gene rearrangement test can help to distinguish MAFH from other mimickers.


Assuntos
Histiocitoma Fibroso Benigno , Adulto , Feminino , Rearranjo Gênico , Histiocitoma Fibroso Benigno/diagnóstico , Histiocitoma Fibroso Benigno/genética , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Masculino , Recidiva Local de Neoplasia
19.
Zhonghua Zhong Liu Za Zhi ; 42(1): 70-73, 2020 Jan 23.
Artigo em Chinês | MEDLINE | ID: mdl-32023773

RESUMO

Objective: To assess the clinical value of neutrophil-to-lymphocyte ratio (NLR) in predicting anastomotic leak of postoperative rectal cancer patients. Methods: The clinical data of 787 rectal cancer patients who underwent anterior resection from January 2014 to December 2017 in Affiliated Tumor Hospital of Zhengzhou University were collected. The postoperative numbers of white blood cell (WBS) on postoperative day (POD)1, 3 and 5 were detected, and the NLR was calculated. The relationship of NLR and the incidence of anastomotic leak was analyzed, and the area under the receiver-operating characteristic (ROC) curves was calculated. The accuracy of postoperative NLR in predicting the incidence of anastomotic leak was evaluated. Results: WBC counts of patients with leak on POD1, POD3 and POD5 were 13.2×10(9)/L, 9.1×10(9)/L and 8.9×10(9)/L, respectively, while those of patients without leak were 12.9×10(9)/L, 9.0×10(9)/L and 8.8×10(9)/L. The WBC count was not significantly different between patients with or without leak (P>0.05). The average NLR values of patients with or without leak were 13.3 and 11.6 on POD1, 10.9 and 7.6 on POD3, 9.3 and 5.3 on POD5, respectively. The NLR values of patients with leak on POD3 and POD5 were significantly higher than those of patients without leak (P<0.05). The cutoff value of NLR on POD3 was 8.6, the sensitivity and specificity of detecting the leakage was 73.2% and 75.6%, respectively, and the area under curve (AUC) was 0.744. The cutoff value of NLR on POD5 was 5.5, the sensitivity and specificity was 69.6% and 75.5%, the AUC was 0.726. The multivariate analysis result showed that NLR >8.6 was an independent factor for anastomotic leak prediction. Conclusion: Postoperative NLR on day 3 is useful in predicting anastomotic leak and can decrease the incidence of complication in rectal cancer patients who underwent anterior resection.


Assuntos
Fístula Anastomótica , Linfócitos , Neutrófilos , Neoplasias Retais , Fístula Anastomótica/diagnóstico , Humanos , Curva ROC , Neoplasias Retais/cirurgia , Estudos Retrospectivos
20.
Medicine (Baltimore) ; 99(6): e18978, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028407

RESUMO

RATIONALE: AA amyloidosis (AA) is caused by a wide variety of inflammatory states, but is infrequently associated with Castleman disease (CD). CD describes a heterogeneous group of hematologic disorders that share characteristic lymph node histopathology. CD can present with a solitary enlarged lymph node (unicentric CD, UCD) or with multicentric lymphadenopathy (MCD), constitutional symptoms, cytopenias, and multiple organ dysfunction due to an interleukin-6 driven cytokine storm. PATIENT CONCERNS: We are reporting a case of a 26-year-old woman with no significant past medical history who presented with a 3-month history of fatigue and an unintentional 20-pound weight loss. DIAGNOSIS: A CT-scan of the abdomen and pelvis revealed hepatosplenomegaly and a mesenteric mass. Congo Red staining from a liver biopsy showed apple-green birefringence and serum markers were suggestive of an inflammatory process. Post-excision examination of the resected mass revealed a reactive lymph node with follicular hyperplasia with kappa and lambda stains showing polyclonal plasmacytosis consistent with CD. INTERVENTIONS: The patient underwent surgery to remove the affected lymph node. OUTCOMES: IL-6, anemia, leukocytosis, and thrombocytosis resolved or normalized 2 weeks after resection; creatinine normalized 9 months postsurgery. Twenty two months post-surgery her IFN-γ normalized, her fatigue resolved, her proteinuria was reduced by >90% and she had returned to her baseline weight. LESSONS: Our case and literature review suggest that patients presenting with UCD or MCD along with organ failure should prompt consideration of concurrent AA amyloidosis.


Assuntos
Amiloidose/etiologia , Hiperplasia do Linfonodo Gigante/complicações , Doenças Peritoneais/etiologia , Adulto , Amiloidose/sangue , Amiloidose/diagnóstico , Amiloidose/diagnóstico por imagem , Hiperplasia do Linfonodo Gigante/sangue , Hiperplasia do Linfonodo Gigante/diagnóstico , Fadiga/etiologia , Feminino , Humanos , Doenças Peritoneais/sangue , Doenças Peritoneais/diagnóstico , Doenças Peritoneais/diagnóstico por imagem , Proteína Amiloide A Sérica/análise , Tomografia Computadorizada por Raios X , Perda de Peso
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