Actualización en clínica y terapia de mordedura de serpiente (ofidismo)

This review on snake bites, seek to update the clinical epidemiology and therapy of frequent pathology in the Peruvian jungle and coast. Among the venomous snakes, the accident caused by the genus Bothrops stands out, in Peru the species B. atrox (jungle jar) is the cause in more than 90% of cases. Esta revisión sobre mordedura de serpiente (ofidismo), buscar actualizar la epidemiologia clínica y terapia de la patología frecuente en la selva y costa peruana. Entre las serpientes venenosas destaca el accidente producido por el género Bothrops, en el Perú la especie B. atrox (Jergón de la selva) es el causante en más del 90% de los casos.&nbsp

Influenza-Like Illness Sentinel Surveillance in Peru

BACKGROUND: Acute respiratory illnesses and influenza-like illnesses (ILI) are a significant source of morbidity and mortality worldwide. Despite the public health importance, little is known about the etiology of these acute respiratory illnesses in many regions of South America. In 2006, the Peruvian Ministry of Health (MoH) and the US Naval Medical Research Center Detachment (NMRCD) initiated a collaboration to characterize the viral agents associated with ILI and to describe the clinical and epidemiological presentation of the affected population. METHODOLOGY/PRINCIPAL FINDINGS: Patients with ILI (fever > or =38 degrees C and cough or sore throat) were evaluated in clinics and hospitals in 13 Peruvian cities representative of the four main regions of the country. Nasal and oropharyngeal swabs, as well as epidemiological and demographic data, were collected from each patient. During the two years of this study (June 2006 through May 2008), a total of 6,835 patients, with a median age of 13 years, were recruited from 31 clinics and hospitals; 6,308 were enrolled by regular passive surveillance and 527 were enrolled as part of outbreak investigations. At least one respiratory virus was isolated from the specimens of 2,688 (42.6%) patients, with etiologies varying by age and geographical region. Overall the most common viral agents isolated were influenza A virus (25.1%), influenza B virus (9.7%), parainfluenza viruses 1, 2, and 3, (HPIV-1,-2,-3; 3.2%), herpes simplex virus (HSV; 2.6%), and adenoviruses (1.8%). Genetic analyses of influenza virus isolates demonstrated that three lineages of influenza A H1N1, one lineage of influenza A H3N2, and two lineages of influenza B were circulating in Peru during the course of this study. CONCLUSIONS: To our knowledge this is the most comprehensive study to date of the etiologic agents associated with ILI in Peru. These results demonstrate that a wide range of respiratory pathogens are circulating in Peru and this fact needs to be considered by clinicians when treating patients reporting with ILI. Furthermore, these data have implications for influenza vaccine design and implementation in South America

Current situation of endemic mycosis in the Americas and the Caribbean: Proceedings of the first international meeting on endemic mycoses of the Americas (IMEMA)

Background: The Americas are home to biologically and clinically diverse endemic fungi, including Blastomyces, Coccidioides, Emergomyces, Histoplasma, Paracoccidioides and Sporothrix. In endemic areas with high risk of infection, these fungal pathogens represent an important public health problem. Objectives: This report aims to summarise the main findings of the regional analysis carried out on the status of the endemic mycoses of the Americas, done at the first International Meeting on Endemic Mycoses of the Americas (IMEMA). Methods: A regional analysis for the Americas was done, the 27 territories were grouped into nine regions. A SWOT analysis was done. Results: All territories reported availability of microscopy. Seventy percent of territories reported antibody testing, 67% of territories reported availability of Histoplasma antigen testing. None of the territories reported the use of (1–3)-β-d-glucan. Fifty two percent of territories reported the availability of PCR testing in reference centres (mostly for histoplasmosis). Most of the territories reported access to medications such as trimethoprim-sulfamethoxazole, itraconazole, voriconazole and amphotericin B (AMB) deoxycholate. Many countries had limited access to liposomal formulation of AMB and newer azoles, such as posaconazole and isavuconazole. Surveillance of these fungal diseases was minimal. Conclusions: A consensus emerged among meeting participants, this group concluded that endemic mycoses are neglected diseases, and due to their severity and lack of resources, the improvement of diagnosis, treatment and surveillance is needed.Fil: Caceres, Diego H.. Universidad Colegio Mayor de Nuestra Señora del Rosario; Colombia. Centers for Disease Control and Prevention; Estados UnidosFil: Echeverri Tirado, Laura C.. Universidad de Antioquia; ColombiaFil: Bonifaz, Alexandro. Hospital General de Mexico; MéxicoFil: Adenis, Antoine. Inserm; FranciaFil: Gomez, Beatriz L.. Universidad Colegio Mayor de Nuestra Señora del Rosario; ColombiaFil: Bnada Flores, Claudia Lizett. Universidad Peruana Cayetano Heredia; PerúFil: Canteros, Cristina Elena. Instituto Nacional de Enfermedades Infecciosas; ArgentinaFil: Santos, Daniel Wagner. Universidade Federal do Maranhao; BrasilFil: Arathoon, Eduardo. Asociación de Salud Integral; GuatemalaFil: Ramirez Soto, Elia. Centro Nacional de Enfermedades Tropicales; BoliviaFil: Queiroz-Telles, Flavio. Universidade Federal do Paraná; BrasilFil: Schwartz, Ilan S.. University of Alberta; CanadáFil: Zurita, Jeannete. Pontificia Universidad Católica del Ecuador; EcuadorFil: Serra Damasceno, Lisandra. Universidade Estadual do Ceará; BrasilFil: Garcia, Nataly. Sociedad Venezolana de Microbiología; VenezuelaFil: Fernandez, Norma B.. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Chincha, Omayra. Universidad Peruana Cayetano Heredia; PerúFil: Araujo, Patricia. Ministerio de Salud Pública y Bienestar Social; ParaguayFil: Rabagliati, Ricardo. No especifíca;Fil: Chiller, Tom. Centers for Disease Control and Prevention; Estados UnidosFil: Giusiano, Gustavo Emilio. Universidad Nacional del Nordeste. Instituto de Medicina Regional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; Argentin

Infecciones intrahospitalarias asociadas a dispositivos invasivos en unidades de cuidados intensivos de un hospital nacional de Lima, Perú

Con el objetivo de describir la incidencia de infecciones intrahospitalarias asociadas a dispositivos invasivos en unidades de cuidados intensivos (UCI) del Hospital Nacional Cayetano Heredia se realizó un estudio observacional retrospectivo utilizando datos de la Oficina de Epidemiología y Salud Ambiental durante los años 2010 al 2012. Se notificó un total de 222 infecciones intrahospitalarias, la UCI de Medicina tuvo la incidencia por 1000 días de uso del dispositivo más alta para neumonía asociada a ventilador mecánico (28,6); infección del torrente sanguíneo asociado a catéter venoso central (11,9), e infección del tracto urinario asociado a catéter (8,1). Los principales agentes infecciosos aislados fueron Pseudomona sp. (32,3%) en la UCI de emergencia, Staphylococcus coagulasa negativo(36%) en la UCI de medicina y Candida sp (69,2%) en la UCI de cirugía. Las tasas de infecciones asociadas a dispositivos invasivos se reportaron altas semejantes a otros hospitales nacionales con limitados recursos e infraestructur

Infecciones intrahospitalarias asociadas a dispositivos invasivos en unidades de cuidados intensivos de un hospital nacional de Lima, Perú

Con el objetivo de describir la incidencia de infecciones intrahospitalarias asociadas a dispositivos invasivos en unidades de cuidados intensivos (UCI) del Hospital Nacional Cayetano Heredia se realizó un estudio observacional retrospectivo utilizando datos de la Oficina de Epidemiología y Salud Ambiental durante los años 2010 al 2012. Se notificó un total de 222 infecciones intrahospitalarias, la UCI de Medicina tuvo la incidencia por 1000 días de uso del dispositivo más alta para neumonía asociada a ventilador mecánico (28,6); infección del torrente sanguíneo asociado a catéter venoso central (11,9), e infección del tracto urinario asociado a catéter (8,1). Los principales agentes infecciosos aislados fueron Pseudomona sp. (32,3%) en la UCI de emergencia, Staphylococcus coagulasa negativo(36%) en la UCI de medicina y Candida sp (69,2%) en la UCI de cirugía. Las tasas de infecciones asociadas a dispositivos invasivos se reportaron altas semejantes a otros hospitales nacionales con limitados recursos e infraestructur

Spread of community-associated methicillin-resistant Staphylococcus aureus to Peru.

LETTERSCOPUS: le.jinfo:eu-repo/semantics/publishe

Enfermedad hidatídica diseminada con localización mediastinal como causa de síndrome de vena cava superior

Hydatidic illness is a frequent parasitic zoonosis in our country whose more frequent localization is the liver and the lungs. However other many sites have been described, depending their symptoms on the cyst’s size, localization and effect on next structures, being sometimes its evolution fatal. This is a 52 year-old female patient admitted at emergency room for dysfunction of sensory and neurological focalization. She had a previous history of surgery many years ago by abdominal tumor. We found a collateral circulation on right hemithorax and facial and arms edema at exam. The cerebral CT howed extensive left parietal parenchymal hemorrhage. Thoracoabdominal CT revealed multiple cystic masses of diverse sizes in the mediastinum, lungs, liver and other places. The patient’s evolution was torpid, the neurological compromise didn’t improve in spite of the treatment against the intracranial hypertension (EH), being also added a nosocomial pneumonia. The patient died after several days. Necropsy revealed presence of cystic lesions in mediastinum, heart’s great vessels, pericardium, lungs, liver, spleen and mentum, as well as intra and extraparenchymal hemorrhages of hypertensive cause in brain, not being cystic lesions in central nervous system. We concluded that it was disseminated hydatidic illness, cysts in the mediastinum caused compression of the heart’s great vessels, causing a superior cave vein syndrome. ( Rev Med Hered 2001; 12: 142-149