Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 38.583
Filtrar
1.
San Salvador; MINSAL; ene, 06, 2023. 22 p. ilus, graf, tab, mapas.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1411601

RESUMO

Resumen de eventos de notificación hasta SE 52/2022. Alertas internacionales. Situación epidemiológica de dengue. Situación epidemiológica de zika y chikungunya. Infección respiratoria aguda. Neumonías. Vigilancia centinela de influenza y otros virus respiratorios. Vigilancia centinela de rotavirus. Enfermedad diarreica aguda


Summary of notification events up to SE 52/2022. International alerts. Epidemiological situation of dengue. Zika and chikungunya epidemiological situation. Acute respiratory infection. pneumonias. Sentinel surveillance of influenza and other respiratory viruses. Rotavirus sentinel surveillance. Acute diarrheal disease


Assuntos
Epidemiologia , Doenças Transmissíveis , Publicações Eletrônicas , Vírus , Notificação , El Salvador , Infecções
2.
Int J Mol Sci ; 24(2)2023 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-36675034

RESUMO

Insects rely only on their innate immune system to protect themselves from pathogens. Antimicrobial peptide (AMP) production is the main immune reaction in insects. In Drosophila melanogaster, the reaction is regulated mainly by the Toll and immune deficiency (IMD) pathways. Spaetzle proteins, activated by immune signals from upstream components, bind to Toll proteins, thus, activating the Toll pathway, which in turn, induces AMP genes. Previous studies have shown the difference in immune systems related to Toll and IMD pathways between D. melanogaster and Tribolium castaneum. In T. castaneum, nine Toll and seven spaetzle (spz) genes were identified. To extend our understanding of AMP production by T. castaneum, we conducted functional assays of Toll and spaetzle genes related to Toll-pathway-dependent AMP gene expression in T. castaneum under challenge with bacteria or budding yeast. The results revealed that Toll3 and Toll4 double-knockdown and spz7 knockdown strongly and moderately reduced the Toll-pathway-dependent expression of AMP genes, respectively. Moreover, Toll3 and Toll4 double-knockdown pupae more rapidly succumbed to entomopathogenic bacteria than the control pupae, but spz7 knockdown pupae did not. The results suggest that Toll3 and Toll4 play a large role in Toll-pathway-dependent immune reactions, whereas spz7 plays a small part.


Assuntos
Peptídeos Antimicrobianos , Imunidade Inata , Infecções , Tribolium , Animais , Besouros/genética , Besouros/imunologia , Besouros/microbiologia , Expressão Gênica , Tribolium/genética , Tribolium/imunologia , Tribolium/microbiologia , Peptídeos Antimicrobianos/genética , Peptídeos Antimicrobianos/imunologia , Imunidade Inata/imunologia , Infecções/imunologia , Infecções/microbiologia
3.
Med. oral patol. oral cir. bucal (Internet) ; 28(1): e56-e64, ene. 2023. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-EMG-520

RESUMO

Background: Point-of-care-ultrasound can be applied to preview a difficult airway, detect the presence of fluid collection, and soft-tissue edema, and guide the drainage location, although is rarely used. The purpose of this study is to validate a protocol for the assessment of these clinical features on patients with severe odontogenic infections.Material and methods: This was a single-group prospective cohort study (n=20) including patients with the diagnosis of deep-neck propagation of odontogenic infection. A transcervical linear high-frequency probe transducer (13-6 MHz) was used to scan the structures of the upper airway and the infectious collections. The drainage was guided by ultrasound and the patients were daily evaluated, according to the protocol. The data were extracted and the airway volume, midline deviation, and other important data such as length of hospital stay, dysphagia, voice alteration, raised floor of the mouth, dyspnea, and neck swelling were registered.Results: The ultrasound examination was correlated with multiple clinical findings, such as dyslalia (p=0,069), dysphagia (p=0,028), dyspnea (p=0,001), among others. This protocol has an advantage as it can be used at bedside evaluation, allowing the assessment of severe and unstable patients, and predicting the increase of the hospitalization time (p=0,019).Conclusions: This protocol is reliable for the assessment of the upper airway, even in an emergency, predicting not only the severity of the clinical features but aids in the determination of the length of the hospitalization time. (AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Odontologia/métodos , Infecções/diagnóstico por imagem , Ultrassonografia , Testes Imediatos , Estudos Prospectivos , Controle de Infecções Dentárias
4.
Forensic Sci Int ; 342: 111534, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36528011

RESUMO

Nowadays, the diagnostic value of postmortem microbiological investigations is still a debated topic, but postmortem microbiology (PMM) remains a discipline with great forensic potential. To evaluate the usefulness and diagnostic-forensic value of postmortem microbiological cultures, it has been conducted a study on cadaveric material sampled during autopsy aiming to identify the correct cause of death. The study analyzed 45 cadavers subjected to judicial autopsy, divided into two groups based on the presence or absence of external or internal macroscopic autopsy signs suggesting infectious pathology. In the same cases, both the microbiological and conventional histological investigations have been simultaneously carried out. From the investigations, mono-bacterial, mono-fungal, mixed and negative cultures were observed. In mono-species microbiological growth, the histological epicrisis confirmed an infectious cause of death due to the presence of signs of acute infection with an aggressive infectious agent. In cases where growth was mixed, it was possible to distinguish between simple postmortal contamination and perimortem colonization. Finally, in some cases where the microbiology was negative, this has been essential in highlighting signs of a vital reaction to viral or parasitic infection. The joint and integrated evaluation of the laboratory results made it possible to correctly understand even those peculiar situations in which the PMM results alone would not have been significant. These methods, when combined, constitute an optimal forensic approach for the identification of the real cause of death and thus reduce the number of unsolved cases.


Assuntos
Infecções , Humanos , Medicina Legal , Autopsia/métodos , Cadáver , Patologia Legal
5.
J Pediatr Orthop B ; 32(1): 94-98, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35703242

RESUMO

Musculoskeletal infections, including septic arthritis, osteomyelitis, and soft tissue infections, are critical morbidity factors for children and adolescents. This study investigated the role of D-dimer levels for diagnosing childhood musculoskeletal infections. This single-center prospective study was initiated in April 2020 following approval from the local ethics committee. The study included 54 children, divided into the infection group ( n = 21), comprising patients who underwent surgical treatment for childhood musculoskeletal infections and had macroscopically visible purulent discharge during surgery, and the control group ( n = 33), comprising healthy children. In the infection group, the mean values of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), plasma D-dimer, and white blood cell (WBC) were 39.42 ± 27.00 mm/h, 101.50 ± 76.90 mg/l, 2.34 ± 2.59 mg/l, and 15.55 ± 6.86 × 10 9 /l, respectively. On comparison, the infection group showed higher levels of WBC, CRP, ESR, D-dimer, and neutrophil-to-lymphocyte ratio than the control group. When the D-dimer cutoff value of 0.43 mg/l was taken, it was observed that it had 95.2% sensitivity and 81.8% specificity. The area under curve (AUC) of the above-mentioned parameters calculated via receiver operating characteristic curves showed CRP levels as the optimum predictor of childhood musculoskeletal infections, followed by the ESR, plasma D-dimer, and WBC levels in descending order (AUC: 0.999, 0.997, 0.986, and 0.935, respectively). D-dimer is another test, which in combination with other conventional established tests (CRP and ESR) can be helpful in diagnosis of pediatric infection. We recommend the addition of D-Dimer to ESR, CRP, and WBC as a first-line investigation in cases with suspected pediatric musculoskeletal infections.


Assuntos
Infecções , Estudos Prospectivos , Adolescente , Criança , Humanos , Infecções/diagnóstico
7.
San Salvador; MINSAL; dic. 09, 2022. 23 p. ilus, graf, tab, mapas.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1402141

RESUMO

Resumen de eventos de notificación hasta SE 48/2022. Alertas internacionales. Situación epidemiológica de dengue. Situación epidemiológica de zika y chikungunya. Infección respiratoria aguda. Neumonías. Vigilancia centinela de influenza y otros virus respiratorios. Vigilancia centinela de rotavirus. Enfermedad diarreica aguda. Resumen Epidemiológico quemaduras por pólvora


Summary of notification events up to SE 48/2022. International alerts. Epidemiological situation of dengue. Zika and chikungunya epidemiological situation. Acute respiratory infection. pneumonias. Sentinel surveillance of influenza and other respiratory viruses. Rotavirus sentinel surveillance. Acute diarrheal disease. Epidemiological Summary Gunpowder Burns


Assuntos
Epidemiologia , Doenças Transmissíveis , Publicações Eletrônicas , Vírus , Notificação , El Salvador , Infecções
8.
San Salvador; MINSAL; dic. 08, 2022. 23 p. ilus, graf, tab, mapas.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1401768

RESUMO

Resumen de eventos de notificación hasta SE 47/2022. Alertas internacionales. Situación epidemiológica de dengue. Situación epidemiológica de zika y chikungunya. Infección respiratoria aguda. Neumonías. Vigilancia centinela de influenza y otros virus respiratorios. Vigilancia centinela de rotavirus. Enfermedad diarreica aguda. Resumen Epidemiológico quemaduras por pólvora


Summary of notification events up to SE 47/2022. International alerts. Epidemiological situation of dengue. Zika and chikungunya epidemiological situation. Acute respiratory infection. pneumonias. Sentinel surveillance of influenza and other respiratory viruses. Rotavirus sentinel surveillance. Acute diarrheal disease. Epidemiological Summary Gunpowder Burns


Assuntos
Epidemiologia , Doenças Transmissíveis , Publicações Eletrônicas , Vírus , Notificação , El Salvador , Infecções
9.
J. Health Biol. Sci. (Online) ; 10(1): 1-7, 01/jan./2022. tab, ilus
Artigo em Inglês | LILACS | ID: biblio-1411691

RESUMO

Objective: This review determined and reports the prevalence of urinary tract infections and aetiological agents common in most sub-Saharan African countries. Methods: A literature search involved Springer, Hindawi, PubMed, Medcrave, Google Scholar, BioMed, and Elsevier databases to identify the urinary tract infection articles published between 2000 and 2021. Results: Of 111 articles obtained from databases, 22 met the qualities to be included in the study. Overall, the prevalence of UTI was 32.12% with Escherichia coli being the most commonly isolated bacteria accounting for 86.4%. Escherichia coli is found in the GIT thus, the proximity between the anus and urinary system makes the contamination easier. Conclusion: The findings of this study provide useful information for the effective intervention of urinary tract infections. Further, it is advised women wipe from front to back whenever they attend the call of nature and or during bathing.


Objetivo: Relatamos a prevalência de infecções do trato urinário e agentes etiológicos comuns na maioria dos países da África Subsaariana. Metodos: Uma pesquisa bibliográfica envolveu as bases de dados Springer, Hindawi, PubMed, Medcrave, Google Scholar, BioMed e Elsevier para identificar os artigos que abordavam infecção do trato urinário nos países da África Subsaariana, publicados entre 2000 e 2021. Resultados: Dos 111 artigos obtidos nas bases de dados, 22 atenderam aos criterios de inclusao e foram incluídos no estudo . No geral, a prevalência de UTI foi de 32,12%, sendo a Escherichia coli a bactéria mais comumente isolada, representando 86,4%. A Escherichia coli é encontrada no TGI, portanto, a proximidade entre o ânus e o sistema urinário facilita a contaminação. Conclusao: Os achados deste estudo fornecem informações úteis para a intervenção efetiva das infecções do trato urinário. Além disso, é aconselhável que as mulheres busquem fazer sua higiene intima sempre da parte da frente para trás.


Assuntos
Infecções Urinárias , Sistema Urinário , Prevalência , África ao Sul do Saara , PubMed , Infecções
10.
Rev. Odontol. Araçatuba (Impr.) ; 43(3): 48-53, set.-dez. 2022. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1381107

RESUMO

A ciência endodôntica possui um vasto conhecimento e com esse conhecimento os seus inúmeros questionamentos. Algumas teorias e conceitos mudam constantemente e trazem à tona contradições e divergências clínicas no âmbito biológico e prático. A patência foraminal é uma prática que permite que um instrumento de pequeno calibre ultrapasse o forame apical, com o intuito de limpar passivamente e prevenir o acúmulo de detritos e inibir a proliferação de microorganismos que podem causar infecções pós tratamento endodôntico. Essa prática gera discussão interna entre especialistas da área, mas as vantagens da técnica são inúmeras, principalmente no que diz respeito aos casos de polpa necrosada. Casos como esse não são solucionados com sucesso sem a utilização da patência apical. Por outro lado, existem contradições em relação aos casos em que a polpa está viva. Esse trabalho tem como objetivo analisar as vantagens e desvantagens da patência apical, bem como, se os benefícios excedem os possíveis danos que ela pode trazer(AU)


Endodontic science has vast knowledge and with this knowledge its countless questions. Some theories and concepts are constantly changing and bring to light clinical contradictions and divergences in the biological and practical scope. Foraminal patency is a practice that allows a small-caliber instrument to go beyond the apical foramen, in order to passively clean and prevent the accumulation of debris in the region and inhibit the proliferation of microorganisms that can cause infections after endodontic treatment. This practice generates internal discussion among specialists in the field, but the advantages of the technique are numerous, especially with regard to cases of necrotic pulp. Cases like this are not successfully resolved without the use of apical patency. On the other hand, there are contradictions regarding the cases where the pulp is alive. This work aims to analyze the advantages and disadvantages of apical patency, as well as whether the benefits exceed the harm it can bring(AU)


Assuntos
Humanos , Masculino , Adulto , Tratamento do Canal Radicular , Ápice Dentário , Preparo de Canal Radicular , Infecções
11.
Mult Scler Relat Disord ; 68: 104400, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36544307

RESUMO

BACKGROUND: B-cell depleting medications are effective disease-modifying therapies for multiple sclerosis. Prior studies have demonstrated that use of these medication is associated with infections and immunologic changes. Limited data suggest that infectious adverse effects may be more common with long-term use. We aimed to investigate rates of infections and laboratory abnormalities in a real-world cohort of patients treated with long term B-cell depletion and identify clinical factors associated with these outcomes. METHODS: In this retrospective, single-center observational study, patients with MS and other autoimmune neurologic disorders treated with rituximab or ocrelizumab for ≥2 years were identified. Linear regression analyses identified factors associated with increased risk of minor and severe infections. Rates of total and severe infections were compared between the first two years of treatment and years three and beyond. RESULTS: 291 patients, treated with rituximab or ocrelizumab for an average of 46 months, were included. Total infections and infections requiring hospitalization occurred at rates of 25.0 and 3.03 per 100 person-years, respectively. Female gender and current or former smoking status were associated with a higher rate of total infections. Hypogammaglobulinemia and higher BMI were associated with increased risk of hospitalization. Rates of total and serious infections were higher in years three and beyond compared to the first two years. CONCLUSIONS: Infections in patients with MS treated with long-term B-cell depletion may be more common with longer duration of therapy. This study provides additional information to help personalize care.


Assuntos
Doenças Autoimunes do Sistema Nervoso , Infecções , Esclerose Múltipla , Humanos , Feminino , Rituximab/efeitos adversos , Estudos Retrospectivos , Esclerose Múltipla/tratamento farmacológico , Doenças Autoimunes do Sistema Nervoso/tratamento farmacológico , Doenças Autoimunes do Sistema Nervoso/epidemiologia , Doenças Autoimunes do Sistema Nervoso/complicações , Infecções/epidemiologia , Infecções/etiologia
12.
San Salvador; MINSAL; dic. 21, 2022. 23 p. ilus, graf, tab, mapas.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1410712

RESUMO

Resumen de eventos de notificación hasta SE 49/2022. Alertas internacionales. Situación epidemiológica de dengue. Situación epidemiológica de zika y chikungunya. Infección respiratoria aguda. Neumonías. Vigilancia centinela de influenza y otros virus respiratorios. Vigilancia centinela de rotavirus. Enfermedad diarreica aguda. Resumen Epidemiológico quemaduras por pólvora


Summary of notification events up to SE 49/2022. International alerts. Epidemiological situation of dengue. Zika and chikungunya epidemiological situation. Acute respiratory infection. pneumonias. Sentinel surveillance of influenza and other respiratory viruses. Rotavirus sentinel surveillance. Acute diarrheal disease. Epidemiological Summary Gunpowder Burns


Assuntos
Epidemiologia , Doenças Transmissíveis , Publicações Eletrônicas , Vírus , Notificação , El Salvador , Infecções
13.
San Salvador; MINSAL; dic. 24, 2022. 23 p. ilus, graf, tab, mapas.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1411366

RESUMO

Resumen de eventos de notificación hasta SE 50/2022. Alertas internacionales. Situación epidemiológica de dengue. Situación epidemiológica de zika y chikungunya. Infección respiratoria aguda. Neumonías. Vigilancia centinela de influenza y otros virus respiratorios. Vigilancia centinela de rotavirus. Enfermedad diarreica aguda. Resumen Epidemiológico quemaduras por pólvora


Summary of notification events up to SE 50/2022. International alerts. Epidemiological situation of dengue. Zika and chikungunya epidemiological situation. Acute respiratory infection. pneumonias. Sentinel surveillance of influenza and other respiratory viruses. Rotavirus sentinel surveillance. Acute diarrheal disease. Epidemiological Summary Gunpowder Burns


Assuntos
Epidemiologia , Doenças Transmissíveis , Publicações Eletrônicas , Vírus , Notificação , El Salvador , Infecções
14.
J. Health Biol. Sci. (Online) ; 10(1): 1-5, 01/jan./2022.
Artigo em Inglês | LILACS | ID: biblio-1411517

RESUMO

Objective: Understand whether the collection site (toothless or toothless) influences the frequency of bacteria in the oral cavity. It was performed as an observational, prospective, and cross-sectional study. Methods: Clinical samples of the oral surfaces of the teeth and/or cheek mucosa were collected in the oral cavity of 37 patients who underwent elective cardiac surgery in the preoperative period from May to July 2019. The clinical samples collected were subjected to identification of colonies and antimicrobial sensitivity tests. Results: It was observed that regardless of whether the collection site is toothless or toothless, the microbial profile, socio-demographic variables, comorbidities, and risk factors do not statistically influence the choice of the collection site. Conclusions: there wasn't statistical difference between the strains found at the collection sites. Practical Implications: the result found is relevant for other researchers that will work with oral cavity collections since the chosen collection site will not influence the frequency of strains found.


Objetivo: Compreender se o local de coleta (com dentes ou desdentado) influencia na frequência de bactérias na cavidade oral. Foi realizado como um estudo observacional, prospectivo e transversal. Métodos: Amostras clínicas das superfícies orais dos dentes e/ou mucosa jugal foram coletadas na cavidade oral de 37 pacientes submetidos à cirurgia cardíaca eletiva no período pré-operatório de maio a julho de 2019. As amostras clínicas coletadas foram submetidas à identificação de colônias e testes antimicrobianos de sensibilidade. Resultados: Observou-se que independente do local de coleta ser dentado ou desdentado, o perfil microbiano, variáveis sociodemográficas, comorbidades e fatores de risco não influenciam estatisticamente na escolha do local de coleta. Conclusões: Não houve diferença estatística entre as cepas encontradas nos locais de coleta. O resultado encontrado é relevante para outros pesquisadores que trabalharão com coletas de cavidade oral, pois o local de coleta escolhido não influenciará na frequência de cepas encontradas.


Assuntos
Placa Dentária , Boca , Bactérias , Dente , Saúde Bucal , Biofilmes , Infecções
15.
An. Fac. Cienc. Méd. (Asunción) ; 55(3): 105-109, 20221115.
Artigo em Espanhol | LILACS | ID: biblio-1401560

RESUMO

Introducción: Las infecciones de las vías urinarias constituyen una de las patologías infecciosas más frecuentes tanto en la comunidad como en el ámbito hospitalario En el medio hospitalario se ha observado una alta frecuencia de infecciones asociadas a hongos oportunistas, en su mayoría corresponden a especies de Candida spp. Sin embargo, se aíslan otras especies como Trichosporon, donde predomina la especie asahii, en casos de pacientes inmunodeprimidos o con tratamiento previo de antibioticoterapia. Presentación de Casos Clínicos: Se presentan 2 casos donde se aisló en urocultivos Trichosporon asahii. En ambos casos los pacientes presentaron factores de riesgo y síntomas inespecíficos. Conclusión: La presencia de hongos de forma persistente en el tracto urinario es considerada clínicamente significativa. El tratamiento de la funguria debe basarse en el análisis del paciente, de su estado general y de sus factores de riesgo. Para el tratamiento, se observó que el efecto de los triazoles, fueron los más efectivos en el tratamiento de la infección por T. asahii.


Introduction: Urinary tract infections are one of the most frequent infectious pathologies both in the community and in the hospital setting. In the hospital environment, a high frequency of infections associated with opportunistic fungi has been observed, most of which correspond to species of Candida spp. However, other species such as Trichosporon are isolated, where the asahii species predominates (6,7). Presentation of Clinical Cases: Two cases are presented where Trichosporon asahii was isolated in urine cultures. In both cases, the patients presented risk factors and nonspecific symptoms. Conclusion: The persistent presence of fungi in the urinary tract is considered clinically significant (9,10). The treatment of funguria should be based on the analysis of the patient, his general condition and his risk factors (10). For treatment, it was observed that the effect of triazoles was the most effective in the treatment of T. asahii infection (8)


Assuntos
Infecções Urinárias , Trichosporon , Infecções
16.
An. Fac. Cienc. Méd. (Asunción) ; 55(3): 133-137, 20221115.
Artigo em Espanhol | LILACS | ID: biblio-1401571

RESUMO

La tuberculosis (TB) cutánea es una forma rara de tuberculosis extrapulmonar y puede tener diversas manifestaciones clínicas. La afectación cutánea puede producirse como resultado de inoculación exógena, diseminación contigua desde un foco de infección, o mediante la propagación hematógena desde un foco distante 1. Las formas multibacilares de localización cutánea siguen siendo, con mucho, las más comunes en los niños 2. La tuberculosis cutánea representa sólo el 1-2% de las formas extrapulmonares de TB. Se clasifica en varias variantes, y la escrofulodermia es una forma de tuberculosis endógena. Afecta a personas de todas las edades, sin embargo, los niños, los adolescentes y los ancianos se ven muy afectados, debido a la incapacidad inmunológica para contener la infección por micobacterias. La escrofulodermia puede presentarse de forma aislada o coexistir con formas pulmonares y diseminadas de TB. Se presenta como nódulos eritematosos que se fistulizan y descargan material caseoso y purulento 3. Los exámenes patológicos revelan abscesos, necrosis y granulomas de tipo tuberculoide (3). La correlación clínica, biológica, patológica y, a veces, la progresión con el tratamiento antibacilar son la clave del diagnóstico 2


Cutaneous tuberculosis (TB) is a rare form of extrapulmonary tuberculosis that can have diverse clinical manifestations. Cutaneous involvement may occur as a result of exogenous inoculation, contiguous dissemination from a focus of infection, or by hematogenous spread from a distant focus (1). Multibacillary forms of cutaneous localization remain by far the most common in children (2). Children and the elderly are greatly affected due to immunological inability to contain the mycobacterial infection. Scrofuloderma can occur in isolation or coexist with pulmonary and disseminated forms of TB. It presents with erythematous nodules that fistulize and discharge caseous and purulent material (3). Anatomopathological examinations reveal abscesses, necrosis and tuberculoid granulomas (3). Clinical, biological, pathological correlation and sometimes progression with antibacillary treatment are the key to diagnosis (2)


Assuntos
Tuberculose , Pediatria , Tuberculose Cutânea , Infecções , Mycobacterium
17.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 40(10): 539-545, dic. 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-212837

RESUMO

Background: Infections related to non-surgical manipulation of the biliary tract (NSMBT) are common events despite periprocedural antibiotic prophylaxis (PAP). Since June 2017, our local protocol has indicated a 24-h regimen of intravenous piperacillin–tazobactam for this purpose. Objective: We aimed to describe the incidence and characteristics of NSMBT-related paediatric infections, define risk factors for their development, and analyse adherence to our PAP protocol. Materials and methods: Epidemiological, clinical, and microbiological data were collected in consecutive NSMBT procedures performed in paediatric patients (<18 years) in our centre (2010–2019). Results: 113 procedures in 37 patients, median age 4 years (IQR 1–8), were included. Main underlying diseases were biliary atresia (32%) and cancer (14%). Sixty-eight percent had undergone liver transplant and 70% hepaticojejunostomy. In 44 procedures (39%), the intervention was performed during the course of infection and previously prescribed antibiotic treatment was maintained. In the other 69, PAP was specifically indicated for NSMBT; antibiotic adequacy increased from 35% to 100% after June 2017. In total, 32 NSMBT-related infections (28%) occurred, mainly in the first 24h post-procedure (72%); no deaths happened. Causative pathogens were Gram-negative rods (64%), Gram-positive cocci (28%), and Candida spp. (8%). Main related risk factors were hepaticojejunostomy, biliary obstruction, and liver transplant. Conclusions: NSMBT in children entails a significant infection risk, even under antibiotic prophylaxis, being hepaticojejunostomy the main risk factor. Infectious complications mainly occurred immediately after the procedure. After establishing a PAP protocol, 100% of interventions received appropriate prophylaxis, decreasing antibiotic exposure time and potentially, the length of hospital stay.(AU)


Antecedentes: Las infecciones relacionadas con la manipulación no quirúrgica de las vías biliares (MNQVB) son acontecimientos frecuentes, a pesar de la profilaxis antibiótica periprocedimiento (PAP). Desde junio de 2017, nuestro protocolo local indica una pauta de 24 h de piperacilina/tazobactam por vía intravenosa para este fin. Objetivo: El objetivo era describir la incidencia y las características de las infecciones pediátricas relacionadas con la MNQVB, definir los factores de riesgo para su desarrollo y analizar el cumplimiento de nuestro protocolo de PAP. Materiales y métodos: Se recogieron datos epidemiológicos, clínicos y microbiológicos en procedimientos consecutivos de MNQVB realizados en pacientes pediátricos (< 18 años) en nuestro centro (2010-2019). Resultados: Se incluyeron 113 procedimientos en 37 pacientes, con una mediana de edad de 4 años (RIC 1-8). Las principales enfermedades subyacentes fueron atresia biliar (32%) y cáncer (14%). El 68% se había sometido a un trasplante de hígado y el 70% a una hepaticoyeyunostomía. En 44 procedimientos (39%), la intervención se realizó durante el transcurso de la infección y se mantuvo el tratamiento antibiótico recetado previamente. En los otros 69, la PAP estaba indicada específicamente para la MNQVB; la eficacia de los antibióticos aumentó del 35 al 100% después de junio de 2017. En total, se produjeron 32 infecciones relacionadas con la MNQVB (28%), principalmente en las primeras 24 h posteriores al procedimiento (72%); no se produjo ninguna muerte. Los patógenos causantes fueron bacilos gramnegativos (64%), cocos grampositivos (28%) y Candida spp. (8%). Los principales factores de riesgo relacionados fueron la hepaticoyeyunostomía, la obstrucción biliar y el trasplante de hígado.(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Infecções/complicações , Controle de Infecções , Antibioticoprofilaxia , Ductos Biliares , Transplante de Fígado , Colangite , Microbiologia , Doenças Transmissíveis
18.
Gastroenterol. hepatol. (Ed. impr.) ; 45(10): 767-779, dic. 2022. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-211877

RESUMO

Objetivos: Analizar la evolución analítica, clínica y de la fibrosis en pacientes F3-F4 curados con antivirales de acción directa (AAD). Pacientes y métodos: Estudio unicéntrico, observacional y prospectivo. Se incluyeron todos los pacientes con hepatitisC F3-F4 curados con AAD del 1 de noviembre de 2014 al 31 de agosto de 2019. Se realizó una visita basal (VB) y a las 12semanas (12s), 1, 2, 3 y 4años tras finalizar el tratamiento. Se recogieron variables demográficas, analíticas, medición no invasiva de la fibrosis, marcadores indirectos de hipertensión portal, presencia de varices esofágicas, descompensaciones de la cirrosis y hepatocarcinoma. Resultados: Se trataron 169 pacientes: 123 (72,8%) hombres, edad 57,5±12 años; 117 (69,2%) presentaban cirrosis, 99 (84,6%) ChildA. El 96,4% consiguieron respuesta virológica sostenida (RVS). La mediana de seguimiento fue de 46,14 (2,89-62,55) meses. Durante el seguimiento se observó precozmente un aumento significativo de plaquetas (155×103/μl [VB]; 163×103/μl [12s]), colesterol (158mg/dl [VB]; 179mg/dl [12s]) y albúmina (4,16g/dl [VB]; 4,34g/dl [12s]), y un descenso significativo de GPT (82UI/l [VB]; 23UI/l [12s]), GOT (69UI/l [VB]; 26UI/l [12s]), GGT (118UI/l [VB]; 48UI/l [12s]), y bilirrubina (0,9mg/dl [VB]; 0,7mg/dl [12s]). La fibrosis disminuyó, también inicialmente, tanto con métodos serológicos como Fibroscan (19,9KPa [VB]; 14,8KPa [12s]); p<0,05). El 8,1% de los pacientes con cirrosis compensada presentaron alguna descompensación. El 4,5% desarrollaron varices esofágicas. Nueve (5,52%) pacientes presentaron hepatocarcinoma de novo; seis (3,68%) lo presentaban basalmente, y el 40% sufrieron recidiva. Durante el seguimiento la mortalidad fue del 9,2%. Conclusiones: Existe mejoría de los parámetros analíticos y de la fibrosis hepática medida por métodos no invasivos en los pacientes F3-F4 curados con AAD.(AU)


Aims: To analyze laboratory parameters, clinical and fibrosis evolution in F3-F4 patients cured with direct-acting antivirals (DAA). Patients and methods: Unicenteric, observational and prospective study. All F3–F4 hepatitis C patients cured with DAA from 01/11/2014 to 31/08/2019 were included. A basal visit (BV) was performed and at 12 weeks (12w), 1, 2, 3 and 4 years after treatment. Demographic and laboratory variables, fibrosis measured by non-invasive tests, indirect markers of portal hypertension, the presence of esophageal varices, cirrhosis decompensation and hepatoceullar carcinoma were collected. Results: 169 patients were treated: 123 (72.8%) men, age 57.5±12 years; 117 (69.2%) with cirrhosis, 99 (84.6%) ChildA. 96,4% achieved SVR. The study was conducted for a median follow-up of 46.14 (2.89-62.55) months. It was observed a significant increase in platelets [155×103/μL (BV); 163×103/μL (12w)], cholesterol [158mg/dL (BV); 179mg/dL (12w)] and albumin [4.16g/dL (BV); 4.34g/dL (12w)] and a significant decrease in ALT [82UI/L (BV); 23UI/L (12w], AST [69UI/L (BV); 26UI/L (12w)], GGT [118UI/L (BV); 48UI/L (12w)] and bilirrubin [0.9mg/dL (BV); 0.7mg/dL (12w)]. Fibrosis also improved early in follow-up, both by serological methods and Fibroscan [19.9kPa (BV); 14.8kPa (12w; P<.05]. 8.1% of compensated cirrhosis patients had some decompensation. 4.5% developed esophageal varices. Nine patients (5.52%) had de novo hepatocellular carcinoma; 6 (3.68%) had hepatoceullar carcinoma in BV and 40% had a recurrence. During follow-up mortality was 9.2%. Conclusions: There is an improvement in laboratory parameters and fibrosis measured by non-invasive methods in F3-F4 patients cured with DAA. However, the risk of decompensation and the incidence/recurrence of hepatocellular carcinoma still remain, so there is a need to follow these patients.(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Infecções , Hepatite C , Fibrose , Evolução Clínica , Antivirais , Resposta Viral Sustentada , Carcinoma Hepatocelular , Estudos Prospectivos , Gastroenterologia , Gastroenteropatias
19.
Gastroenterol. hepatol. (Ed. impr.) ; 45(10): 805-818, dic. 2022. tab
Artigo em Espanhol, Português | IBECS | ID: ibc-211885

RESUMO

Los pacientes con enfermedad inflamatoria intestinal (EII) pueden requerir diferentes tratamientos inmunosupresores a lo largo del curso de su enfermedad. Por ello, es fundamental evaluar el estado de inmunización en el momento del diagnóstico o, si no es posible, siempre antes de iniciar un tratamiento inmunosupresor, y administrar las vacunas apropiadas. El objetivo del presente documento es establecer unas recomendaciones claras y concisas sobre la vacunación en pacientes con EII en diferentes escenarios de práctica clínica, incluyendo situaciones especiales como la vacunación en la edad pediátrica, el embarazo, la lactancia o en viajes al extranjero. Se presentan las diferencias entre vacunas inactivadas y atenuadas, los diferentes grados de inmunosupresión y su relación con las pautas de administración de las diferentes vacunas (tanto obligatorias como opcionales) recomendadas a los pacientes con EII. En el documento, se establecen 17 recomendaciones basadas en la evidencia científica disponible y opinión de expertos. En la elaboración de estas recomendaciones del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa ha participado un equipo multidisciplinar con amplia experiencia en EII y vacunación formado por especialistas de gastroenterología, pediatría, enfermería y farmacia.(AU)


Patients with inflammatory bowel disease (IBD) may require different immunosuppressive treatments throughout their illness. It is essential to assess the immunization status of patients at diagnosis or, if this is not possible, at least before the beginning of immunosuppressive therapy and, subsequently, administering the appropriate vaccines. Therefore, the aim of this work is to establish clear and concise recommendations on vaccination in patients with IBD in the different settings of our clinical practice including vaccination in children, during pregnancy, breastfeeding or on trips. This consensus document emphasises the differences between inactivated and attenuated vaccines and the different degrees of immunosuppression and correlates them with the administration of both mandatory and optional vaccines recommended to our patients with IBD. Finally, as a summary, 17 recommendations are established based on the available scientific evidence and expert opinion. A multidisciplinary team with extensive experience in IBD and vaccination, made up of specialists in gastroenterology, paediatrics, nursing and pharmacy, has participated in the preparation of these recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis.


Assuntos
Humanos , Doença de Crohn , Colite Ulcerativa , Pacientes , Programas de Rastreamento , Prevenção de Doenças , Infecções , Doenças Inflamatórias Intestinais , Gastroenterologia , Gastroenteropatias
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...