RESUMO
PURPOSE: Community-acquired pneumonia is common among patients with coexisting illnesses and it can be the initial manifestation of these comorbid diseases. The objectives of our study were to evaluate the frequency of this association and to analyze whether certain characteristics could predict the presence of unknown comorbid conditions. SUBJECTS AND METHODS: Over a 5-year period, we prospectively studied 660 consecutive patients with community-acquired pneumonia seen at our institution. In a subgroup of these patients, diagnosis of previously unknown comorbid conditions was established during follow-up. Characteristics of these patients were compared with data from the remaining sample of patients. RESULTS: Prior underlying diseases were present in 298 (45%) patients. One or more new comorbid conditions were found in 41 (6%), of which diabetes (14 cases), malignancies (12 cases), chronic obstructive pulmonary disease (8 cases), and human immunodeficiency virus (HIV) infection (5 cases) were the most common. In the comparative study, a bacterial etiology, positive blood cultures, and hospitalization were more frequently found (P < 0.05) in patients with new comorbid conditions than atypical microorganisms or viruses, negative blood cultures, or outpatient care. CONCLUSION: In the initial diagnostic workup of patients with community-acquired pneumonia, the possibility of unknown comorbid conditions should be carefully evaluated.
Assuntos
Infecções Comunitárias Adquiridas/complicações , Comorbidade , Pneumonia/complicações , Infecções Comunitárias Adquiridas/microbiologia , Complicações do Diabetes , Feminino , Seguimentos , Infecções por HIV/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Pneumonia/microbiologia , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/complicaçõesRESUMO
Se realizó un estudio transversal descriptivo en 50 pacientes con el diagnóstico de desprendimiento de la retina (DR) en el período de 1996 hasta septiembre del 2001, vistos en el hospital provincial Manuel Ascunce Domenech. Se analiza el momento en que se diagnosticó el desprendimiento de la retina y la importancia del diagnóstico precoz. Además, valoramos sus características físicas, extensión, número de desgarros y presencia de proliferación vítreo retinal (PVR) y la técnica quirúrgica a utilizar. Como complicación más frecuente aparece el desprendimiento de la retina recidivado (DRR) (12 %), seguido de la diplopia y expulsión del implante (4 %). Antes de la cirugía tuvimos 86 % de los pacientes con visión no útil y después de aplicada la retina se logró un 38 % de visión útil. Se concluyó que los desprendimientos de la retina constituyen urgencias médicas para mejores resultados.
A descriptive cross- sectional study was performed in 50 patients with the diagnosis of retinal detachment (RD) within the period from 1996 to september 2001 assisted at Manuel Ascunce D provincial hospital. It was analyzed at the time of RD diagnosis and the importance of its early diagnosis; also we assess its physical characteristics, extension, number of lacerations and presence of vitreo - retinal proliferation (V.R.P) and the surgical technique to be used. As the most frequent complication, the recurrent RD (12 %) appears, followed by dipoplia and graft expulsion (4 %). Before surgery we had 86 % of patients with useful vision and after the retinal application. It was achieved 38 % of useful vision. Concluding, RDs constitute medical emergencies for better results.