Prevalencia y otros índices epidemiológicos de trastornos de la conducta alimentaria en una muestra de estudiantes

Los trastornos de la conducta alimentaria englobando todos sus tipos puede llegar a abarcar hasta el 4% de la población de adolescentes y adultos jóvenes, siendo más comunes en el sexo femenino (10:1) y su edad de aparición más usual antes de los 20 años y estudiantes, en muchas ocasiones no cumplen los criterios específicos para cada enfermedad pero ya presentan indicios de alguna de ellas1,6. Debido a que son muchos los factores que pueden llevar al desarrollo de trastornos de la conducta alimentaria en la población, con mayor frecuencia en las mujeres de clase alta y educada y en las edades de la adolescencia tardía y adultez joven, según las fuentes de literatura internacional, además, puede presentar múltiples consecuencias psicológicas, sociales y fisiológicas, las cuales pueden tener una repercusión de por vida, dentro de éstas tenemos: depresión, alteraciones cognitivas, amenorrea, hipotiroidismo, alteraciones hidroelectrolíticas, caquexia, arritmias, bloqueos cardíacos, entre muchas otra

Autoimmunity in cystic fibrosis: significance and clinical implications

Anti-neutrophil cytoplasmic antibodies specific for bactericidal/permeability-increasing protein (BPI-ANCA) are frequently present in cystic fibrosis patients. These autoantibodies are believed to develop in response to infection and colonization by Pseudomonas aeruginosa. Development of BPI-ANCA has been shown to correlate with the severity of lung infection and poor prognosis in cystic fibrosis patients

An unusual mycobacterial infection

The frequency of atypical mycobacterial or nontuberculous mycobacterial (NTM) infections has increased during the last three decades with the emergence of HIV/AIDS and more use of immunosuppressive treatments. We present a case of pulmonary mycobacterial infection secondary to Mycobacterium kansasii in a patient with chronic obstructive pulmonary disease (COPD) and malnutrition. M. kansasii is a ubiquitous organism, most commonly found in the southern and central regions of the US. It can occur as a colonizer, but when it produces disease it usually involves the lung. The American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) have issued criteria to differentiate casual NTM isolation from true pulmonary NTM disease. Among the NTM infections, M. Kansasii is the pathogen which causes a clinical picture which most resembles pulmonary tuberculosis. It can produce a bronchiectasis, nodular lesions, and/or fibrocavitary infiltrates on x-rays. Treatment requires a rifampin based regimen, usually combined with isoniazid and ethambutol. If rifampin resistance is present, macrolides, quinolones, or sulfas are usually recommended

Aeromonas veronii septicemia in an immunocompetent patient

We present a 29-year-old healthy man who fell into an industrial auger, sustaining acrushed, open pelvic injury, multiple comminuted fractures of the right leg, and traumaticamputation of his left foot. Blood and wound cultures were positive for Aeromonasspp and vancomycin resistant Enterococcus. Treatment included cefepime, levofloxacin,daptomycin, and metronidazole. Aeromonas veronii is a Gram negative bacillus usuallyfound in fresh and brackish water in warm climates. It can cause severe skin andsoft tissue infections, typically after injured tissue is exposed to contaminated water.Aeromonas septicemia is uncommon and is usually associated with underlying diseases,such as malignancy, cirrhosis, diabetes, or immunosuppression. It rarely occurs in ahealthy host

Peritoneal dialysis associated peritonitis secondary to Mycobacterium fortuitum

We report a 23-year-old woman with systemic lupus erythematous, lupus nephritis(class IV), and end-stage renal disease on peritoneal dialysis who presented with abdominal pain, nausea, vomiting, and diarrhea for one week. A previous admission for peritonitis occurred one month earlier, and peritoneal fluid culture at that time was negative. She was discharged on three weeks of intraperitoneal cefepime and vancomycin. On the current admission, due to recurrent symptoms approximately two weeks after her antibiotics were discontinued, peritoneal fluid cultures were positive for Mycobacterium fortuitum. The peritoneal catheter was removed, and trimethoprim- sulfamethoxazoleand ciprofloxacin were initially recommended for six months. This was later changed to trimethoprim-sulfamethoxazole and amikacin based on new susceptibilities. M. fortuitum is a rapidly growing mycobacterial species (RGM) widely distributedin nature; tap water is the major reservoir. It can produce a wide range of infections inhumans, and outbreaks have been reported in hospitals from contaminated equipment. Immunosuppression and chronic lung disease have been described as predisposing factors for RGM infection. Peritoneal dialysis associated with M. fortuitum infection occurs very rarely; no guidelines exist for treatment recommendations

Disseminated Mycobacterium interjectum Infection with Bacteremia, Hepatic and Pulmonary Involvement Associated with a Long-Term Catheter Infection

We present a 49-year-old female with one year of intermittent fevers, chills, night sweats, and significant weight loss. Liver and lung biopsy showed evidence of a granulomatous process. Blood and liver biopsy cultures yielded growth of presumed Mycobacterium interjectum, thought to be related to a disseminated long-term central venous catheter infection. She successfully received one year of combined antimicrobial therapy after catheter removal without recurrence of disease. M. interjectum has been previously described as a cause of lymphadenitis in healthy children and associated with pulmonary disease in adults, although other localized infections have been reported. This is the first case described of a disseminated M. interjectum infection with bacteremia, hepatic and pulmonary involvement associated with a long-term catheter infection

Sobrevida en una cohorte con diagnóstico de tuberculosis en Colombia

7 páginasBackground: Tuberculosis is a chronic infectious pathology whose incidence is high in developing countries, however, information and studies that analyze mortality and long-term survival are limited. Methodology: retrospective cohort study, in patients with a diagnosis of tuberculosis older than 18 years, admission was consecutive until completing the study period. Survival and mortality were analyzed using the Kaplan-Meier estimator by the log Rank test. Results: 329 subjects were admitted, mortality at 30 days was 11.9% and at one year 24.6%, pulmonary tuberculosis was the most frequent type with 70.2%. Physical examination findings related to mortality were cachexia (p<0.001) and extremity edema (p<0.001). Overall survival was 87.2% at 30 days and 72.9% at one year. In patients with pulmonary tuberculosis, survival was 85.8% at 30 days and 72.8% at one year. Conclusion: The one-year survival rate in patients hospitalized for tuberculosis is low, advanced age, malnutrition, PaO2/FiO2 less than 300, c-reactive protein greater than 45 mg/dL, cerebrovascular disease and peripheral vascular disease were variables that were associated with higher mortalityIntroducción: La tuberculosis es una patología infecciosa crónica cuya incidencia es elevada en países en vía de desarrollo, sin embargo, es limitada la información y los estudios que analizan la mortalidad y sobrevida a largo plazo. Metodología: estudio de cohorte retrospectivo, en pacientes con diagnóstico de tuberculosis mayores de 18 años, el ingreso fue de manera consecutiva hasta completar el periodo de estudio. Se analizó la sobrevida y mortalidad a través del estimador Kaplan – Meier por la prueba de log Rank. Resultados: ingresaron 329 sujetos, la mortalidad a los 30 días fue de 11,9% y al año del 24,6%, la tuberculosis pulmonar fue el tipo más frecuente con en el 70,2%. Los hallazgos al examen físico relacionados con mortalidad fueron la caquexia (p<0,001) y el edema en extremidades (p<0,001). La sobrevida general fue del 87,2% a los 30 días y del 72,9% al año. En los pacientes con tuberculosis pulmonar la sobrevida fue del 85,8% a los 30 días y del 72,8% al año. Conclusión: La tasa de sobrevida a un año en pacientes hospitalizados por tuberculosis es baja, la edad avanzada, desnutrición, PaO2/FiO2 menor de 300, proteína c reactiva mayor de 45 mg/dL, enfermedad cerebrovascular y enfermedad vascular periférica fueron variables que se asociaron con una mayor mortalidad