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Background The coronavirus disease 2019 (COVID-19) pandemic has had a profound global impact, raising concerns about its long-term effects, particularly neurological complications. While studies have highlighted such complications in adults, there is a paucity of research focusing on children.

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Las parasitosis intestinales son infecciones que se pueden producir por la ingestión de quistes (u ooquistes) de protozoos, huevos, larvas de helmintos o por la penetración de larvas por vía transcutánea. Una de las bases principales para poder prevenirlas, es el cumplimiento de las medidas higiénicas básicas. La presente investigación tiene como finalidad determinar el nivel de conocimiento sobre las medidas preventivas de las parasitosis intestinales, en los padres de familia de la ciudadela Municipal de Portoviejo, Ecuador. Se realizó un estudio observacional, descriptivo, transversal y prospectivo, en el que se evaluaron 217 familias que desearon contribuir en el estudio y a las cuales, se les realizó una encuesta. En su mayoría, se encontró padres de familia con una edad de 39 a 49 años, con un grado de instrucción superior y de ocupación oficios del hogar; en cuanto al conocimiento sobre medidas preventivas de parasitosis intestinal, la mayoría de los padres mostraron un nivel de conocimiento “bueno”, según la clasificación aquí realizada. Concluyendo que los padres de familia de la Ciudadela Municipal, conoce sobre las normas de prevención contra parasitosis intestinales, lo cual debería contribuir a mejorar la calidad de vida de la población

El Reemplazo Articular total es un recurso terapeútlco valioso pero conlleva el riesgo de infectarse en el 1 % de los casos. Presentamos dos casos de prótesis Articulares Infectadas atendidos en el C.M.N entre 1990-1991. CASO 1 : MGA 68a, mujer, con coxartrosis IV, se le efectuó artroplastía con prótesis no-cementada. Desde P09 evidencia sígnos flogósicos, fiebre ondulante. Ex. Auxiliares: Hemograma:N Hemocultivos:Neg. Urocultivo:Neg. Rx. Torax:N. Rx Pelvis: Zonas osteolíticas en región del trocanter mayor que se propaga hacia canal medular. Cultivo de punción-aspiración de herida operatoria Pseudomona au. Tratamiento:Ciprofloxacina. Alta voluntaria. CASO 2 : AAL 78a, mujer, sometida a artroplastía en 1989 por coxartrosis IV derecha. Un año después inicia con dolor en coxoíemoral derecha,Cebrículas y flogósis en región trocantérea.Ex. Aux:Hemograma: N, Rx pelvis: erosiones y periostitis.Tratamiento inicial Cue remoción de prótesis, lavado y reimplante de la misma prótesis, 6 meses después desarrolla f'astula sometiéndosele a cura quirúrgica de osteomielitis e irrigación continua. Cultivo de secreción de lecho operatorio: Acinetobacter. Los casos descritos tuvieron diferentes mecanismos de infección de partes blandas que por contiguidad contaminó la prótesis y el segundo caso una infección a distancia con bacteremia y posterior colonización en prótesis.

Autoimmune hepatitis (AIH) is a complex condition with unclear origins, involving genetic susceptibility and environmental triggers that lead to immune system dysfunction. We report a case of a pregnant woman from a mosquito-borne disease-endemic area who presented jaundice, abdominal pain, and pruritus, complicated by acute liver failure. Immunological markers showed AIH triggered by dengue virus infection, which was confirmed by a positive IgM test. Treatment with supportive care followed by steroids and azathioprine resulted in favorable outcomes, averting the need for a liver transplant. Although AIH can be triggered by viruses, the role of dengue in its pathogenesis remains poorly understood. Regular clinical monitoring is vital for managing AIH, particularly during pregnancy, due to variable immune status and treatment responses. Further research is necessary to understand the link between dengue infection and AIH. Individualized treatment strategies are crucial, especially during pregnancy, in order to ensure favorable outcomes. [ABSTRACT FROM AUTHOR]

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Milk is understood to be the product that arises from the normal secretion of the mammary glands of mammals. Milk is a good culture medium for the growth of various microorganisms due to its water content, almost neutral pH, and a wide variety of nutrients such as lactose. As a derivative of milk, cheese is produced, which is obtained by maturing the milk curd and eliminating the whey. The purpose of this investigation was to determine the presence or absence of Staphylococcus sp. in fresh cheese sold in San Salvador. For this, ten samples were obtained from different points of sale, subsequently, they were taken to the INNOVET laboratory, where the Staphylococcus genus was isolated. For the typing of the aureus species, biochemical coagulase and catalase tests were performed. Of the ten samples obtained, 100% showed the presence of the genus to be investigated. A very important fact to mention was the presence of microbial E. coli in sample four; samples one, two, three and five presented for Proteus vulgaris, both bacteria found belong to Enterobacteriaceae. Unpasteurized dairy products contain a bacterial load, which can be harmful to some individuals. It is important to emphasize that the genera found in the samples are widely distributed in the environment, however, it is necessary to consider the contamination of products of animal origin either due to the contaminated dairy product, due to poor handling or due to both situations. [ABSTRACT FROM AUTHOR]

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Elaborar recomendaciones basadas en la evidencia disponible y el consenso de expertos, para la gestión del riesgo del tratamiento biológico y los inhibidores de las JAK en pacientes con artritis reumatoide. Se identificaron preguntas clínicas de investigación relevantes para el objetivo del documento. Estas preguntas fueron reformuladas en formato PICO (paciente, intervención, comparación, outcome o desenlace) por un panel de expertos, seleccionados en base a su experiencia en el área. Se realizó una revisión sistemática de la evidencia, graduándose de acuerdo a los criterios GRADE (Grading of Recommendations Assessment, Development, and Evaluation). A continuación, se formularon las recomendaciones específicas. Se propusieron por el panel de expertos 6 preguntas PICO en base a su relevancia clínica y a la existencia de información reciente referentes al riesgo de aparición de infecciones graves, el riesgo de reactivación del virus de la hepatitis B, el riesgo de reactivación del virus varicela-zoster, el riesgo de aparición de cáncer de piel (melanoma y no melanoma) o hematológico, el riesgo de aparición de enfermedad tromboembólica y el riesgo de progresión del virus del papiloma humano. Se formularon un total de 29 recomendaciones, estructuradas por pregunta, basadas en la evidencia encontrada y el consenso de los expertos. Se presentan las recomendaciones SER sobre la gestión del riesgo del tratamiento con terapias biológicas e inhibidores de las JAK en la artritis reumatoide. To present recommendations based on the available evidence and the consensus of experts, for risk management of biological treatment and JAK inhibitors in patients with rheumatoid arthritis. Clinical research questions relevant to the purpose of the document were identified. These questions were reformulated in PICO format (patient, intervention, comparison, outcome) by a panel of experts, selected based on their experience in the area. A systematic review of the evidence was carried out, grading according to the GRADE criteria (Grading of Recommendations Assessment, Development, and Evaluation). Specific recommendations were then formulated. Six PICO questions were proposed by the panel of experts based on their clinical relevance and the existence of recent information regarding the risk of occurrence of serious infections, the risk of reactivation of the hepatitis B virus, the risk of reactivation of the virus varicella-zoster, the risk of appearance of skin (melanoma and non-melanoma) or hematological cancer, the risk of appearance of thromboembolic disease and the risk of progression of the human papilloma virus. A total of 29 recommendations were formulated, structured by question, based on the evidence found and the consensus of the experts. The SER recommendations on risk management of treatment with biologic therapies and JAK inhibitors in rheumatoid arthritis are presented. [ABSTRACT FROM AUTHOR]

Introducción: Las enfermedades cardiovasculares son el resultado de la interacción genética y ambiental que condiciona la integridad del corazón y los vasos sanguíneos. Los factores de riesgo incluyen infecciones. La respuesta inflamatoria contra el agente infeccioso es un desencadenante de las enfermedades cardiovasculares autoinmunes, debido a la similitud entre las proteínas del patógeno y los antígenos humanos, pues la respuesta inmunitaria puede presentar reactividad cruzada causada por mimetismo molecular. Métodos: Realizamos una búsqueda de patógenos involucrados en enfermedades cardíacas autoinmunes y de autoantígenos asociados a estas enfermedades en los buscadores Pubmed y Google Scholar. La identidad entre proteínas se realizó a través de alineamientos globales utilizando PSI-BLAST. Las estructuras 3D de las proteínas fue obtenida por Uniprot o NCBI y, si no se encontraban, las estructuras se modelaban por homología, utilizando el servidor Swiss Model. La predicción de los epítopes se realizó a través de Ellipro, y la Base de Datos de Epítopos Inmunológicos (IEDB). Además, se utilizó el programa PYMOL para la visualización de proteínas en 3D, y el posicionamiento de los epítopes en la estructura. Resultados: Diez proteínas cardiovasculares mostraron una identidad (30-88,24%) en sus secuencias de aminoácidos con antígenos de diez patógenos. Las proteínas de actina y las familias de proteínas de choque térmico (HSP, por sus siglas en inglés), presentaron niveles de identidad más altos con Trypanosoma Cruzi, Cryptococcus neoformans y Chlamydia trachomatis, 71,47%, 88,24% y 80,61%, respectivamente. Otros patógenos, como Streptococcus pyogenes, Bacillus sp, Magnetospirillum gryphiswaldense, Helicobacter pylori y Chlamydia pneumoniae, presentaron identidad moderada con un valor máximo del 65,79%. Conclusión: La actina humana y las HSP comparten un alto grado de conservación con epítopos de varios microorganismos, como bacterias, hongos y protozoos; lo que sugiere la imitación molecular y la reactividad cruzada como mecanismos para el desarrollo de la aterosclerosis, la enfermedad cardíaca reumática, la miocarditis y la enfermedad cardíaca de Chagas. Se necesitan trabajos in vitro e in vivo, que demuestren los resultados obtenidos en el análisis In Silico.

Las úlceras por presión, en especial las escaras sacras, han sido un desafío constante en la medicina desde hace décadas 1. Las complicaciones asociadas pueden ser graves, pasando de las infecciones locales, a la osteomielitis e incluso sepsis; su extensión al retroperitoneo es excepcional 2.

Candida auris ha sido reconocido como un agente patógeno multirresistente emergente con una carga significativa en la salud pública. Genera casos de infección invasiva y colonización debido a su persistencia en superficies inanimadas, su capacidad para colonizar fácilmente la piel de algunos pacientes y su alta transmisibilidad en el ambiente hospitalario. El primer reporte esporádico de esta especie fue en Asia en el 2009 cuando se realizó su aislamiento a partir del conducto auditivo de un paciente, y pronto le siguieron reportes en otras regiones del mundo. Sin embargo, no fue hasta 2015 que se conocieron las alertas epidemiológicas a nivel mundial debido a un aumento en el número de casos de infecciones causadas por C. auris en varios países. Colombia se sumó a la lista en 2016 luego de un aumento inusual en el número de aislamientos de C. haemulonii informados, que luego se confirmaron como C. auris. Desde que el Instituto Nacional de Salud junto con el Ministerio de Salud emitieron la Alerta Nacional en el 2016, el número de casos reportados superó los 2.000 en el 2022. Los aislamientos colombianos no han mostrado resistencia generalizada a los antifúngicos disponibles, contrario a lo reportado para cepas de C. auris en algunas regiones del mundo, por lo que los pacientes en Colombia aún cuentan con opciones terapéuticas para estas infecciones. No obstante, se ha observado un aumento en la resistencia al fluconazol.

Introducción: Las infecciones del tracto urinario (ITU) constituyen la infección más frecuente en los trasplantados renales (TR). El objetivo principal fue determinar las características clínicas y microbiológicas de las ITU que ocurren durante el primer año posterior al TR. Metodología: Estudio de cohorte retrospectivo, donde se incluyeron pacientes mayores 18 años que recibieron un TR entre 2009-2020 en dos hospitales de la ciudad de Córdoba. A través del registro en las historias clínicas se realizó seguimiento de los pacientes durante el primer año postrasplante y se analizaron los que presentaron al menos un episodio de ITU. Resultados: En el período de estudio, se realizaron 568 TR, de los cuales 207(36,4%) tuvieron al menos un episodio de ITU. En total hubo 419 episodios de ITU, 6(1,4%) episodios de ITU polimicrobianos, se identificaron un total de 426 microorganismos en total en los urocultivos. Del total de episodios 206(49,2%) ocurrieron entre los 31-180 días postrasplante. El principal agente etiológico fue E. coli con 225 aislamientos(52,8%) seguido de Klebsiella sp. con 94(22,1%). El 52,1% del total de episodios fueron causados por microorganismos multirresistentes (MMR). Entre los aislamientos de E. coli, 94(41,8%) fueron MMR. El principal factor de riesgo asociado a ITU por MMR fue el antecedente de ITUs recurrentes (RR=1,62; IC95%=1,29-2,02; p

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Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Introducción. Según la Organización Mundial de la Salud, en instituciones de países en desarrollo las infecciones nosocomiales podrían superar el 25%; en Colombia, en 2012 estas representaban el 4.7% de las causas de muerte según Secretaría de Salud de Bogotá. El Ministerio de Salud señaló a Antioquia como el departamento con la tasa más alta en Infecciones Asociadas a la Atención en Salud (IAAS). Objetivo. Evaluar el nivel de conocimientos, actitudes y aptitudes en IAAS por parte del personal asistencial de un hospital de baja y uno de alta complejidad, en Antioquia. Metodología. Estudio descriptivo transversal, 66 participantes entre médicos, auxiliares de enfermería y enfermeros de urgencias y hospitalización. Intervalo de confianza del 90%. Criterios de inclusión: llevar mínimo tres meses trabajando en el hospital, en todos los tipos de contratación. Exclusión: no aceptar participación y personal asistencial con funciones administrativas. Se aplicó un instrumento con preguntas cerradas sobre los conocimientos, actitudes y aptitudes en IAAS. Resultados. Enfermería tuvo mayor nivel en conocimientos, auxiliares de enfermería en prácticas y los médicos tuvieron menor puntaje con un 24%. En actitud, el personal de ambos hospitales percibía las actividades asociadas a la atención en salud como importantes, pero rutinarias. Discusión. El componente de conocimientos representa el mayor problema para la población, más específicamente la temática sobre lavado de manos, los médicos presentaron mayor número de puntajes por debajo del 60%. Conclusiones. El estudio sugiere que los profesionales de ambos hospitales, independientemente de su profesión, poseen mejores bases prácticas que teóricas, la actitud no parece tener relación con las otras variables. Introduction. According to the World Health Organization, nosocomial infection rate in institutions from developing countries could exceed 25%; in Colombia, in 2012 these represented 4.7% of the causes of death according to the Health Secretariat of Bogotá The Ministry of Health has identified Antioquia as the department with the highest rate of Healthcare-Associated Infections (HAI). Objective. To assess the level of knowledge, attitudes and skills in HAIs by the healthcare staff of a low and a high complexity hospital in Antioquia. Methodology. Cross-sectional descriptive study, 66 participants thereof including physicians, nursing assistants and emergency and hospitalization nurses. 90% confidence interval. Inclusion criteria: at least three months working in the hospital, under all types of contracts. Exclusion: staff not accepting participation and assistance staff with administrative functions. An instrument with closed questions on knowledge, attitudes and skills in HAIs was applied. Results. Nursing staff had the highest level in knowledge, nursing assistants in practice and physicians had the lowest score with 24%. As for attitudes, staff at both hospitals identified the activities associated with health care as important, but routinary. Discussion. The knowledge component stands as the greatest issue for this population, more specifically the hand washing topic, with physicians recording the greater number of scores below 60%. Conclusions. The study suggests that practitioners in both hospitals, regardless of their professional duties, have a better practical than theoretical basis; attitude does not seem to be related to the other variables. Introdução. Segundo a Organização Mundial da Saúde, em instituições de países em desenvolvimento, as infecções nosocomiais podem ultrapassar 25%; na Colômbia, em 2012, representavam 4.7% das causas de morte, segundo o Ministério da Saúde de Bogotá. O Ministério da Saúde indicou Antioquia como o departamento com maior índice de Infecções Associadas à Atenção à Saúde (IAAS). Objetivo. Avaliar o nível de conhecimento, atitudes e aptidões em IAAS da equipe assistencial de um hospital de baixa complexidade e um hospital de alta complexidade, em Antioquia. Metodologia. Estudo descritivo transversal, com 66 participantes entre médicos, auxiliares de enfermagem e enfermeiros de emergência e internação. Intervalo de confiança de 90%. Critérios de inclusão: trabalhar no hospital há, no mínimo, três meses, em todos os tipos de vínculos. Exclusão: não aceitar participação e pessoal de saúde com funções administrativas. Foi aplicado um instrumento com questões fechadas sobre conhecimentos, atitudes e aptidões em IAAS. Resultados. A enfermagem apresentou maior nível de conhecimento, os auxiliares de enfermagem e os médicos obtiveram menor pontuação com 24%. Na atitude, os funcionários de ambos os hospitais perceberam as atividades associadas aos cuidados de saúde como importantes, mas rotineiras. Discussão. O componente conhecimento representa o maior problema para a população, mais especificamente a questão da lavagem das mãos, os médicos apresentaram o maior número de pontuações abaixo dos 60%. Conclusões. O estudo sugere que os profissionais de ambos os hospitais, independentemente da profissão, possuem melhores bases práticas do que teóricas; a atitude não parece estar relacionada com as demais variáveis.

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Resistencia antimicrobiana

La fiebre de origen desconocido (FOD) representa un desafío diagnóstico para lo médicos, ya que existen múltiples diagnósticos diferenciales entorno a ello y su enfoque se basa en las caracteristicas clínicas distintivas de cada patología. Estás pueden agruparse en enfermedades cuya etiología es de origen infeccioso, autoinflamatorias o autoinmunes, neoplasias malignas, e incluso en un gran porcentaje de los casos no se encuentra una causa aparente. Cada una de ellas está asociada con síntomas, signos clínicos y hallazgos de laboratorio característicos, que si bien no son específicos cuando se analiza de forma individual, pueden ser de utilidad para establecer un diagnóstico y así mismo elegir el tratamiento apropiado para el paciente. Las clasificaciones etiológicas siguen siendo las mismas desde 1991, sin embargo, la evaluación clínica inicial combinado con los avances tecnológicos actuales, han permitido tener un mejor rendimiento diagnóstico y un tratamiento oportuno. A continuación, revisaremos definiciones recientes, abordaje clínico guiado por fases, seguido de los nuevos avances en medicina nuclear y metagenómica, con sus respectivas ventajas y limitaciones.

Introduction. Blastocystis sp is a parasitic protozoan found in the intestinal tract of man and some animals, and it is estimated that it infects more than 1,000 million people in the world. In the national parasitism survey, it was reported with a prevalence of 52% in the northern Andean region. The aim of this study was to determine the genotypes of Blastocystis sp associated with different sources of transmission in rural areas of the department of Quindío. Materials and Methods. Forty-two coprological samples were obtained from children between 0 and 14 years of age, 17 from animal feces, 17 from food, 28 from inert surfaces, 15 from soil, 18 from household water and 3 from water sources. DNA extraction and PCR amplification were performed for Blastocystis sp using the SSADNr gene as target. The sequences were aligned with ClustalW and phylogenetic trees were performed with the program (MEGA11). Results. Of the 140 samples collected between coprological samples of children and environmental matrices, we found a prevalence of Blastocystis sp of 23.5% in food, 22.2% in the home network and 4.75% in the child population, there was no statistical evidence implying an association between the presence of this protozoan and sociodemographic variables. Subtype 2 was found associated with infant population and subtype 3 associated with environmental matrices (water and food) and infant population. Conclusions: We report the presence of Blastocystis sp in tomato and carrot, in the home network and infant population in a rural area of the department of Quindío where the associated subtypes were subtype 2 and 3. [ABSTRACT FROM AUTHOR]

Dapsone was discovered in 1908, it is a drug prescribed in inflammatory and infectious diseases. It is the first line treatment mainly in skin diseases with an accumulation of neutrophils and eosinophils. It is metabolized by two enzymatic pathways N-acetylation and N-hydroxylation. It has adverse haematological, skin, gastrointestinal, kidney and nervous system effects. [ABSTRACT FROM AUTHOR]

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Introduction. According to the World Health Organization, nosocomial infection rate in institutions from developing countries could exceed 25%; in Colombia, in 2012 these represented 4.7% of the causes of death according to the Health Secretariat of Bogotá The Ministry of Health has identified Antioquia as the department with the highest rate of Healthcare-Associated Infections (HAI). Objective. To assess the level of knowledge, attitudes and skills in HAIs by the healthcare staff of a low and a high complexity hospital in Antioquia. Methodology. Cross-sectional descriptive study, 66 participants thereof including physicians, nursing assistants and emergency and hospitalization nurses. 90% confidence interval. Inclusion criteria: at least three months working in the hospital, under all types of contracts. Exclusion: staff not accepting participation and assistance staff with administrative functions. An instrument with closed questions on knowledge, attitudes and skills in HAIs was applied. Results. Nursing staff had the highest level in knowledge, nursing assistants in practice and physicians had the lowest score with 24%. As for attitudes, staff at both hospitals identified the activities associated with health care as important, but routinary. Discussion. The knowledge component stands as the greatest issue for this population, more specifically the hand washing topic, with physicians recording the greater number of scores below 60%. Conclusions. The study suggests that practitioners in both hospitals, regardless of their professional duties, have a better practical than theoretical basis; attitude does not seem to be related to the other variables. [ABSTRACT FROM AUTHOR]

Introduction: In January 2019, the Community of Madrid’s Health Department published a guide about the use of antimicrobials in outpatient children. Taking this regional Guide as reference, this study was aimed at estimating the adequacy of the antimicrobial stewardship at discharge from a pediatric Emergency Department (ED). Secondarily, the differences in adequacy according to the diagnosis and the prescriber were studied, and the agreement between this Guide and the protocols of the ED was assessed. Material and methods: An observational, descriptive, retrospective study was conducted on patients under 16 years old, with a diagnosis included in the regional Guide who were discharged from a pediatric ED between March of 2018 and February of 2019. Prescription was considered adequate when the indication, the antibiotic and the posology (dosage, dosing interval, length of treatment and route of administration) were correct. Results: 165 out of 648 (25,5%) infectious diseases processes analyzed received antimicrobial treatment. In 23 processes treated with antimicrobial, the adequacy could not be evaluated due to the absence of data necessary to assess any aspect of posology. Therapy was considered appropriate in 550/625 processes (88.0%). When antimicrobial treatment was prescribed, 70/142 (49.3%) were appropriate and no statistically significant differences in adequacy were found between prescribers. Posology was the worst handled point of the prescription (26.3%). Tract urinary infection, conjunctivitis and otitis media were the pathologies with the lowest adecuacy (44.4%; 50.0% and 52.2%) and presented the highest discrepancy between the Guide and the center protocols (κ = 0.308; κ = 0.000; κ = 0.586). Conclusions: The adequacy of the management of infectious processes to the reference Guide in our pediatric ED was high, but it was below 50% when antimicrobial treatment was required. The degree of adequacy to the local protocols of the center was greater than to the regional Guide. This reveals a discrepancy between the 2 documents that should be analyzed and corrected according to the available scientific evidence. Resumen: Introducción: En enero del 2019 la Consejería de Sanidad de la Comunidad de Madrid publicó una guía acerca del uso de antimicrobianos en niños con tratamiento ambulatorio. El objetivo de este trabajo fue estimar la adecuación de la prescripción de antimicrobianos al alta desde el Servicio de Urgencias Pediátricas (SUP) en pacientes con enfermedades infecciosas, tomando como referencia esta guía regional. Secundariamente, se estudió la variación en la adecuación según el diagnóstico realizado y el facultativo prescriptor, y se valoró la concordancia entre dicha guía y los protocolos del centro. Material y métodos: Estudio observacional, descriptivo y retrospectivo en el que se incluyó a pacientes de 0-16 años con diagnóstico al alta del SUP incluido en la guía regional, entre marzo del 2018 y febrero del 2019. La prescripción se consideró adecuada cuando lo era la indicación, y en su caso, el fármaco elegido, la posología (dosis, intervalo y duración) y la vía de administración. Resultados: Se obtuvo una muestra de la que se analizaron 648 procesos infecciosos, siendo tratados con antimicrobianos 165 (25,5%). En 23 procesos no pudo evaluarse la adecuación a la guía por ausencia de algún dato posológico de la prescripción de antimicrobiano. El manejo terapéutico fue adecuado globalmente en 550/625 procesos (88,0%). En los procesos tratados con antimicrobiano, la adecuación fue de 70/142 (49,3%), sin encontrarse diferencias estadísticamente significativas entre facultativo prescriptor. El motivo de inadecuación más frecuente fue el error posológico (26,3%). Infección urinaria, conjuntivitis y otitis media aguda fueron las entidades clínicas con peor adherencia (el 44,4, el 50,0 y el 52,2% respectivamente) y en las que existió una mayor discrepancia entre guía y protocolos (κ = 0,308; κ = 0,000; κ = 0,586). Conclusiones: La adecuación a las guías de referencia del manejo de procesos infecciosos en el SUP de nuestro centro fue elevada, pero fue inferior al 50% cuando se precisó tratamiento antimicrobiano. El grado de adecuación a los protocolos del centro fue mayor que a la guía de la Comunidad de Madrid, revelando una discrepancia entre ambos que debería ser analizada y corregida de acuerdo con la evidencia científica disponible.

La enfermedad de Chagas es una zoonosis producida por la infección del Trypanosoma cruzi (T. cruzi) (1), cuya principal vía de transmisión es vectorial (2). Esta enfermedad se caracteriza por ser una infección crónica que puede ocasionar daños cardiacos, digestivos y neurológicos irreversibles (3). En el departamento del Putumayo, de acuerdo con los datos del Sistema de Vigilancia Epidemiológica (SIVIGILA), entre el año 2015 y el 2020, se han notificado 19 casos de Chagas crónico y 4 casos de Chagas agudos (4). Por este motivo resulta de gran interés compartir con los lectores de la revista MedUNAB la actualización de la distribución geográfica de los triatominos, vectores de la enfermedad de Chagas, y establecer el riesgo epidemiológico que representan para la población Putumayense, donde hay hallazgos de gran importancia porque se identifican especies en municipios y localidades donde antes no se conocían. Chagas Disease is a zoonotic disease produced by infection with Trypanosoma cruzi (T. cruzi) (1), whose main route of transmission is vectorial (2). This disease is characterized by being a chronic infection that can cause irreversible cardiac, digestive, and neurological damage (3). In the department of Putumayo, according to data from the epidemiological surveillance system (SIVIGILA, for the Spanish original), between 2015 and 2020, 19 chronic cases and 4 acute cases of Chagas were reported (4). For this reason, it is important to share with the readers of the MedUNAB journal the update to the geographical distribution of triatomines, vectors of Chagas Disease, and to establish the epidemiological risk that they represent for the population of Putumayo, where there are findings of great importance as species are identified in municipalities and localities where they were not previously found.

Introducción: Los catéteres venosos centrales (CVC) son de gran utilidad para el diagnóstico y tratamiento en varias enfermedades; las infecciones asociadas al mismo es una de las complicaciones más frecuentes. Objetivo: Describir las características de las infecciones asociadas al uso de catéter venoso central en el servicio de pediatría del Hospital Central del Instituto de Previsión Social de abril del 2020 a abril de 2021. Metodología: Estudio observacional, descriptivo, retrospectivo de corte transversal de pacientes del servicio de pediatría del Hospital Central de IPS que requirieron la colocación de catéter venoso central entre abril de 2020 a abril del 2021. Las variables analizadas fueron la edad, sexo, comorbilidades, sitio de inserción, intervalo de tiempo hasta la infección y gérmenes aislados. Los datos se analizaron en SPSS v.23, utilizando estadística descriptiva. Resultados: Se incluyeron 198 pacientes con CVC (edad media: 64,3 ± 58,8 meses), 53% de sexo masculino (n=105), 41,4% con patologías quirúrgicas (n=82), 26,8% hematoncológicas (n=53), infecciosas 21,7% (n=43). La frecuencia de infecciones asociadas fue del 16,2 % (n=32), el tiempo para las infecciones fue 11,5 ± 3,3 días, los gérmenes asociados fueron el Staphylococcus coagulasa negativo (n=9) y Klebsiella pneumoniae (n=6). El 12 % (4/32) de los pacientes presentó bacteremia concomitante con aislamiento en hemocultivos del mismo gérmen encontrado en el CVC, los cuales fueron en mayor frecuencia Staphylococcus aureus. Conclusión: Las infecciones asociadas a CVC se presentaron en alrededor de la cuarta parte de los pacientes. El germen responsable con más frecuencia fue el S. coagulasa negativo.

Introducción: el síndrome de orina púrpura es una presentación clínica poco frecuente en el ámbito de urgencias, caracterizado por coloración anormal de la orina secundaria a una reacción química de algunos patógenos que producen infección de vías urinarias, siendo más frecuente en pacientes con múltiples comorbilidades y diferentes factores de riesgo. Objetivo: el objetivo de este manuscrito es presentar el caso de un paciente con síntomas atípicos de infección de vías urinarias. Presentación del caso: varón de 88 años de edad, con antecedente de diabetes mellitus no insulino-requiriente, con hiperplasia prostática benigna que ingresó al servicio de urgencias por síntomas irritativos urinarios asociados a uso de sonda vesical, con orina de coloración violeta en bolsa recolectora. El urocultivo reportó la presencia de Proteus vulgaris multisensible, por lo que se decidió dar manejo con cefepima de 1 gr cada ocho horas, con lo cual se obtuvo una adecuada evolución clínica. Discusión y conclusión: el síndrome de la bolsa de orina púrpura es una presentación clínica atípica, pero muy llamativa de la infección urinaria. Esta se genera como resultado de la conversión del triptófano en la dieta en indoxil sulfato que, una vez se elimina por la orina, se transforma en índigo (color violeta) e indirrubina (color rojo), dando este aspecto clínico.

Cuando supimos la noticia y después, mientras nos enterábamos de los primeros casos fuera de China, y luego los alarmantes reportes desde Europa y USA, nunca imaginamos la magnitud que tendría la actual pandemia por el virus SARS-CoV-2 en nuestro país y a nivel mundial, en nuestros hospitales, y en nuestras vidas (Huang et al., 2020). Como nunca, nos enfrentábamos a un enemigo agresivo y letal, aún desconocido en su comportamiento, y del que también podíamos ser víctimas al estar en la primera línea de la defensa.

Se considera miasis a toda enfermedad que tiene como agente etiológico el estado larvario de diversos tipos de díptero. Esta afección se desarrolla predominantemente en regiones tropicales y subtropicales. En lo fundamental, su diagnóstico se basa en hallazgos clínicos y epidemiológicos. El tratamiento depende de la gravedad de la infección y en ocasiones, los casos complicados requieren tratamiento quirúrgico. Se presenta el caso de un paciente masculino, de 68 años de edad, con antecedentes de etilismo crónico y diabetes mellitus, quien acudió a consulta por presentar herida en miembro inferior izquierdo, la cual nunca fue suturada y empeoró progresivamente, a pesar de la automedicación con amoxicilina. Con el empleo de anestesia general endovenosa se realizó toilette de la cavidad y se visualizó la presencia de larvas de moscas. Se extrajo un total de 18 larvas. Presentó evolución clínica y quirúrgica favorable. La miasis, a pesar de ser una enfermedad poco frecuente en el territorio, debe ser tenida en cuenta ante cuadros de heridas infectadas en pacientes con factores de riesgo.

Intra-hospital infections are those that are acquired in the process of care or hospital stay, are frequent and are associated with certain parameters in patients and in the intervention processes; These can be avoided by taking preventive measures in patient care procedures. The general objective of this article was to analyze the risk factors for hospital infections and preventive measures by nursing staff. To do this, a bibliographic review of primary and secondary sources was carried out, which was complemented with an observational study where real data were obtained by applying the survey technique to a population of 73 nurses from Hospital Doctor Rodríguez Zambrano ( HRZ) of the City of Manta, the descriptive and analytical method was used to process the information obtained. Among the results of the statistical analysis of the surveys, it was possible to quantify the most relevant risk factors that were from highest to lowest for patients: stay longer than 7 days (25%), use of probe devices, tubes, among others (22%); and comorbidities (16%); For the nursing staff, the following stood out: non-compliance with aseptic techniques (47%), blood and fluid handling (19%) and poor waste management (15%). As a conclusion, insufficient knowledge on the subject could be evidenced in the nursing staff, as well as non-compliance with biosafety standards. [ABSTRACT FROM AUTHOR]

Objective: The late 2019 COVID-19 outbreak has put the health systems of many countries to the limit of their capacity. The most affected European countries are, so far, Italy and Spain. In both countries (and others), the authorities decreed a lockdown, with local specificities. The objective of this work is to evaluate the impact of the measures undertaken in Spain to deal with the pandemic. Method: We estimated the number of cases and the impact of lockdown on the reproducibility number based on the hospitalization reports up to April 15th 2020. Results: The estimated number of cases shows a sharp increase until the lockdown, followed by a slowing down and then a decrease after full quarantine was implemented. Differences in the basic reproduction ratio are also significant, dropping from 5.89 (95% confidence interval [95%CI]: 5.46-7.09) before the lockdown to 0.48 (95%CI: 0.15-1.17) afterwards. Conclusions: Handling a pandemic like COVID-19 is complex and requires quick decision making. The large differences found in the speed of propagation of the disease show us that being able to implement interventions at the earliest stage is crucial to minimise the impact of a potential infectious threat. Our work also stresses the importance of reliable up to date epidemiological data in order to accurately assess the impact of Public Health policies on viral outbreak. Resumen: Objetivo: El brote de COVID-19 a finales de 2019 ha puesto los sistemas de salud de muchos países al límite de su capacidad. Los países europeos más afectados son, hasta ahora, Italia y España. En ambos (y en otros países), las autoridades decretaron un confinamiento, con especificidades locales. El objetivo de este trabajo es evaluar el impacto de las medidas adoptadas en España para hacer frente a la pandemia. Método: Estimamos el número de casos y el impacto del confinamiento en el número básico de reproducción según los informes de hospitalización hasta el 15 de abril de 2020. Resultados: El número estimado de casos muestra un fuerte aumento hasta el bloqueo, seguido de una desaceleración y luego una disminución tras la implementación del confinamiento total. Las diferencias en el número básico de reproducción también son muy significativas, cayendo de 5,89 (intervalo de confianza del 95% [IC95%]: 5,46-7,09) antes del bloqueo a 0,48 (IC95%: 0,15-1,17) después. Conclusiones: Gestionar una pandemia como la de COVID-19 es muy complejo y requiere una rápida toma de decisiones. Las grandes diferencias encontradas en la velocidad de propagación de la enfermedad muestran que poder implementar intervenciones en la etapa más temprana es crucial para minimizar el impacto de una potencial amenaza. Nuestro trabajo también indica la importancia de contar con datos epidemiológicos actualizados y confiables para evaluar con precisión el impacto de las políticas de salud pública en la pandemia.

Objective: The aim of this paper was to analyse the association of demographic, clinical and pharmacological risk factors with the presence of SARS-COV-2 virus infection, as well as to know the variables related to mortality from COVID-19 in nursing home (NH) residents. Design: Retrospective case–control study. The study variables of those residents who acquired the infection (case) were compared with those of the residents who did not acquire it (control). A subgroup analysis was carried out to study those variables related to mortality. Site: Nursing homes in the region of Guipúzcoa (Spain). Participants and interventions: 4 NHs with outbreaks of SARS-CoV-2 between March and December 2020 participated in the study. The infectivity and, secondary, mortality was studied, as well as demographic, clinical and pharmacological variables associated with them. Data were collected from the computerised clinical records. Main measurements: Infection and mortality rate. Risk factors associated with infection and mortality. Results: 436 residents were studied (median age 87 years (IQR 11)), 173 acquired SARS-CoV-2 (39.7%). People with dementia and Global Deterioration Scale ≥6 were less likely to be infected by SARS-CoV-2 virus [OR = 0.65 (95% CI 0.43–0.97; p

OBJECTIVE: To know the incidence of enteric pathogens detection with the use of the FilmArray GI panel, at the laboratory of Hospital Ángeles Pedregal, Mexico City. MATERIALS AND METHODS: Retrospect, cross-sectional and descriptive study done from August 22nd, 2018 to July 9th, 2020 (98.1 weeks), with stool samples evaluated with the FilmArray GI panel. RESULTS: There were included 907 samples from two patient groups (outpatient and hospitalized). Of the total samples, 37.6% (341/907) were negative to the detection of pathogens. The age group in which the highest number of evidences was found was between 61 and 90 years, accounting for 35.7% (324/907) of the population studied; 62.4% (566/907) reported detection of one or more pathogens of the same sample; being identified: 79% bacteria, 13% viruses and 8% parasites. CONCLUSIONS: After the population analysis, a high number of positive cases stand out for a microorganisms and the identification of multiple enteric pathogens. This type of tool has allowed timely and adequate treatment of the patients, the cost is similar to that of specific tests for each pathogen. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Ciencias Médicas de Pinar del Río is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article titled "Kluyveromyces marxianus (Candida kefyr)" presents information about the yeast Candida kefyr, whose teleomorph is currently known as Kluyveromyces marxianus. This yeast can be found in various natural habitats, such as fermented dairy products, kefir grains, and wastewater from sugar industries. Although it is mainly associated with cases of candidemia, it has also been reported in cases of invasive candidiasis and other infections in immunocompromised patients. Colonies of this yeast can be white, cream-colored, or pink, and they can be identified through amplification of the ITS1 and ITS2 genes. Most antifungals are effective against this species, although some strains with resistance to amphotericin B have been described. [Extracted from the article]

Introduction: in order to limit the contagion of COVID-19, home confinement and the application of sanitary measures were necessary, which had an effect in the emergency services. Objective: to analyze the impact of the COVID-19 pandemic in the frequency of patient care in a pediatric emergency department. Material and methods: retrospective study in a private hospital in Mexico, in which two periods were analyzed: pre-pandemic (2019-2020) and during the first year of the COVID-19 pandemic (2020-2021). In these two periods, the frequency of emergency medical consultations provided to children and adolescents was compared. The information is broken down by month and by type of illness: infectious, noninfectious, and due to accidents. Results: in the pre-pandemic period, 5,905 consultations were provided, and 2,384 during the pandemic (59.6% reduction), without differences with respect to age group and sex. When analyzing according to the month, it was observed that, compared to December 2019, in December 2020 there was the greatest reduction (70% decrease). Consultations for infectious causes were reduced by 74.4%, non-infectious ones by 25.3%, and accidents by 51.4%. Consultations for real urgency decreased by 64.5%, while felt urgency decreased by 55.2%. Conclusions: COVID-19 pandemic decreased emergency care consultations for pediatric patients, particularly due to infectious diseases. [ABSTRACT FROM AUTHOR]

Introduction: the aim of this study was to analyze the prognosis related to complications in the post-surgical period of patients with complicated appendicitis. Material and methods: retrospective study over a period of three years. Pediatric patients with complicated appendicitis, who underwent appendectomy by open technique or by laparoscopy, were included. Results: 109 patients were studied, aged from three to 16 years; there was a higher proportion of male patients (65.1%). Twenty-three (21.1%) post-surgical complications were identified; 10 corresponded to infection in the surgical site, six to intra-abdominal abscess, five to paralytic ileus, and two patients with perforation. Conclusions: in pediatric patients with complicated appendicitis, the incidence of postoperative complications is about 20%; surgical site infection is the most common complication. [ABSTRACT FROM AUTHOR]