Pub Date : 2018-12-30DOI: 10.18004/IMT/201813210-20
N. González, Sara Amarilla, C. Zárate, D. Lovera, Silvio Apodaca, A. Arbo
Goals. To evaluate the impact of Obesity on Community Acquired Pneumonia (CAP) in the pediatric population that has passed the breastfeeding period. Population and methods. Study carried out in the Institute of Tropical Medicine (IMT) of Paraguay in which the cases with NAC in children and adolescents between 2 and 15 years, hospitalized between 2009 and 2013, will be analyzed. The diagnosis of NAC was based on the presence of Febrile respiratory symptomatology and condensation image in the thorax Rx. In each case the presence of fever, tachypnea, runs, chest pain, oxygen saturation (SatO2), laboratorial data (leukocytocyte and platelet count, hemoglobin, liver function), presence of pleural effusion, oxygen requirement (O2) are evaluated. supplementary, need for admission to intensive care unit (ICU), need for mechanical ventilation (ARM), days of hospitalization, and mortality. The weight in kilograms and the height in centimeters were measured. The body mass index was calculated with the formula of BMI = Weight / Size2. The nutritional status is based on the age and agreement of the charts of the World Health Organization (WHO) and the National Center for Health Statistics (NCHS) of the United States (year 2006). The groups of obese and eutrophic patients were compared. Results We analyzed 231 patients between 2 and 15 years old, of which 143 (62%) corresponded to children from 2 to 5 years old and 88 (38%) from 5 to 15 years old. Forty (17%) were obese and 160 (70%) were eutrophic. No difference was found in the presentation of fever (p = 0.9), runs (p = 0.06), chest pain (p = 1). Tachypnea showed a difference in favor of eutrophics (p <0.01). SatO2 <94% in the obese was higher (p <0.05). Regarding the labor data, the GPT values were higher in the obese patients (p <0.05) and the eutrophic ones are published more frequently in the pleural frame (p <0.01). No differences were found in the frequency of use of oxygen therapy (p = 0.7), admission to the ICU (p = 0.3), need for ARM (p = 1) and in the days of hospitalization between both groups. Similarly, there was no difference in mortality: 0/40 vs 4/160 (p = 0.58). Conclusion. The prevalence of obesity is higher than in official records. The clinical presentation and evolution of CAP in obese patients was not found to differ significantly from what is observed in eutrophic patients. However, obese patients with CAP have lower values of SatO2 on admission than eutrophic patients, as an expression of lower gas exchange. In addition, obesity has not been associated with differences in the leukocyte response and Hb levels compared with eutrophic patients, although it has been found higher values of GPT, probably related to liver involvement in obesity. Finally, the Diciembre 2018 Rev. Inst. Med. Trop 2018;13(2)10-21 10.18004/imt/201813210-21 12 length of hospital stay, the frequency of admission to the ICU and mortality were similar in both groups
{"title":"IMPACT OF OBESITY IN CHILDREN WITH ACQUIRED PNEUMONIA FROM THE COMMUNITY","authors":"N. González, Sara Amarilla, C. Zárate, D. Lovera, Silvio Apodaca, A. Arbo","doi":"10.18004/IMT/201813210-20","DOIUrl":"https://doi.org/10.18004/IMT/201813210-20","url":null,"abstract":"Goals. To evaluate the impact of Obesity on Community Acquired Pneumonia (CAP) in the pediatric population that has passed the breastfeeding period. Population and methods. Study carried out in the Institute of Tropical Medicine (IMT) of Paraguay in which the cases with NAC in children and adolescents between 2 and 15 years, hospitalized between 2009 and 2013, will be analyzed. The diagnosis of NAC was based on the presence of Febrile respiratory symptomatology and condensation image in the thorax Rx. In each case the presence of fever, tachypnea, runs, chest pain, oxygen saturation (SatO2), laboratorial data (leukocytocyte and platelet count, hemoglobin, liver function), presence of pleural effusion, oxygen requirement (O2) are evaluated. supplementary, need for admission to intensive care unit (ICU), need for mechanical ventilation (ARM), days of hospitalization, and mortality. The weight in kilograms and the height in centimeters were measured. The body mass index was calculated with the formula of BMI = Weight / Size2. The nutritional status is based on the age and agreement of the charts of the World Health Organization (WHO) and the National Center for Health Statistics (NCHS) of the United States (year 2006). The groups of obese and eutrophic patients were compared. Results We analyzed 231 patients between 2 and 15 years old, of which 143 (62%) corresponded to children from 2 to 5 years old and 88 (38%) from 5 to 15 years old. Forty (17%) were obese and 160 (70%) were eutrophic. No difference was found in the presentation of fever (p = 0.9), runs (p = 0.06), chest pain (p = 1). Tachypnea showed a difference in favor of eutrophics (p <0.01). SatO2 <94% in the obese was higher (p <0.05). Regarding the labor data, the GPT values were higher in the obese patients (p <0.05) and the eutrophic ones are published more frequently in the pleural frame (p <0.01). No differences were found in the frequency of use of oxygen therapy (p = 0.7), admission to the ICU (p = 0.3), need for ARM (p = 1) and in the days of hospitalization between both groups. Similarly, there was no difference in mortality: 0/40 vs 4/160 (p = 0.58). Conclusion. The prevalence of obesity is higher than in official records. The clinical presentation and evolution of CAP in obese patients was not found to differ significantly from what is observed in eutrophic patients. However, obese patients with CAP have lower values of SatO2 on admission than eutrophic patients, as an expression of lower gas exchange. In addition, obesity has not been associated with differences in the leukocyte response and Hb levels compared with eutrophic patients, although it has been found higher values of GPT, probably related to liver involvement in obesity. Finally, the Diciembre 2018 Rev. Inst. Med. Trop 2018;13(2)10-21 10.18004/imt/201813210-21 12 length of hospital stay, the frequency of admission to the ICU and mortality were similar in both groups","PeriodicalId":52959,"journal":{"name":"Revista del Instituto de Medicina Tropical","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47390182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-30DOI: 10.18004/imt/201813221-30
María Belén Vera-Sanabria, C. Rios-González
{"title":"CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF THE OPHIDIC ACCIDENTS OF A REGIONAL HOSPITAL OF PARAGUAY, 2010 TO 2016","authors":"María Belén Vera-Sanabria, C. Rios-González","doi":"10.18004/imt/201813221-30","DOIUrl":"https://doi.org/10.18004/imt/201813221-30","url":null,"abstract":"","PeriodicalId":52959,"journal":{"name":"Revista del Instituto de Medicina Tropical","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44155360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-30DOI: 10.18004/IMT/201813239-44
Máyda Pereira Vilela-Ferreira, Raphael Oliveira Ramos-Franco-Netto, Juliana de Almeida-Rodrigues Franco-Netto, J. González-Escobar, Berenice Moreira, Marcos Arturo Ferreira-Aguero
Currently, infections caused by HIV and HPV are considered a major public health problem worldwide. The objective was to analyze the impact of HIV and HPV on family, sexual and social life; To identify the diagnoses and to relate the viral and CD4 load and to evaluate the adherence to ART. A 52-year-old man with a diagnosis of HIV and HPV was able to identify the main multidisciplinary diagnoses according to NANDA, with a total of 11 diagnoses. It is suggested a more reflective look by the physician and his multidisciplinary team regarding public health, since it is not enough to treat the infected patient, it is necessary that the patient receive guidance about the health-disease process of the HIV patient with co-infection by the HPV in order to promote secondary prevention
{"title":"PATIENT WITH HIV AND CO-INFECTED BY HPV: A CASE STUDY","authors":"Máyda Pereira Vilela-Ferreira, Raphael Oliveira Ramos-Franco-Netto, Juliana de Almeida-Rodrigues Franco-Netto, J. González-Escobar, Berenice Moreira, Marcos Arturo Ferreira-Aguero","doi":"10.18004/IMT/201813239-44","DOIUrl":"https://doi.org/10.18004/IMT/201813239-44","url":null,"abstract":"Currently, infections caused by HIV and HPV are considered a major public health problem worldwide. The objective was to analyze the impact of HIV and HPV on family, sexual and social life; To identify the diagnoses and to relate the viral and CD4 load and to evaluate the adherence to ART. A 52-year-old man with a diagnosis of HIV and HPV was able to identify the main multidisciplinary diagnoses according to NANDA, with a total of 11 diagnoses. It is suggested a more reflective look by the physician and his multidisciplinary team regarding public health, since it is not enough to treat the infected patient, it is necessary that the patient receive guidance about the health-disease process of the HIV patient with co-infection by the HPV in order to promote secondary prevention","PeriodicalId":52959,"journal":{"name":"Revista del Instituto de Medicina Tropical","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47653581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.18004/imt/201813117-23
Raphael Oliveira Ramos Franco Netto, Juliana de Almeida Rodrigues Franco Netto, N. Z. S. Junior, Sandra Silva, Marcos Arturo Ferreira-Aguero, Balbina Coronel-de Bobadilla, Angel Pifferrer
{"title":"Incidence of Non Prescribed Use of Methylphenidate among Medical Students","authors":"Raphael Oliveira Ramos Franco Netto, Juliana de Almeida Rodrigues Franco Netto, N. Z. S. Junior, Sandra Silva, Marcos Arturo Ferreira-Aguero, Balbina Coronel-de Bobadilla, Angel Pifferrer","doi":"10.18004/imt/201813117-23","DOIUrl":"https://doi.org/10.18004/imt/201813117-23","url":null,"abstract":"","PeriodicalId":52959,"journal":{"name":"Revista del Instituto de Medicina Tropical","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49603282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.18004/IMT/201813132-39
C. Rios-González, Ginno Alessandro De Benedictis-Serrano, Alfonzo David Chirino Caicedo
Introduction: In Latin America there are several arboviruses that affect populations and present similar symptoms, such as the Mayaro virus, which has not been studied extensively on the continent, having a high capacity to spread Objective: to determine the knowledge, attitudes and practices about the Mayaro in medical students from Latin America during the months of July to August 2017. Junio 2018 Rev. Inst. Med. Trop 2018;13(1)32-39 10.18004/imt/201813132-39 Material and methods: A cross-sectional, observational, cross-sectional, non-probabilistic study was conducted for convenience in medical students. Results: A total of 989 medical students aged 18-32 years were included in the study, of whom 58.24% (576) were male, were third year 33.47 (331), and 44, 08% of the participants were from Venezuela (446). The level of knowledge was 71.39% (706) low, 24.97% (247) considered that the public has the most important role in the control of Mayaro, and 39.23% (388) do not use repellents. Conclusion: The level of general knowledge was low, indecisive / doubtful attitudes and appropriate practices.
{"title":"Knowledge, attitudes and practices on medical students in Mayaro virus, 2017","authors":"C. Rios-González, Ginno Alessandro De Benedictis-Serrano, Alfonzo David Chirino Caicedo","doi":"10.18004/IMT/201813132-39","DOIUrl":"https://doi.org/10.18004/IMT/201813132-39","url":null,"abstract":"Introduction: In Latin America there are several arboviruses that affect populations and present similar symptoms, such as the Mayaro virus, which has not been studied extensively on the continent, having a high capacity to spread Objective: to determine the knowledge, attitudes and practices about the Mayaro in medical students from Latin America during the months of July to August 2017. Junio 2018 Rev. Inst. Med. Trop 2018;13(1)32-39 10.18004/imt/201813132-39 Material and methods: A cross-sectional, observational, cross-sectional, non-probabilistic study was conducted for convenience in medical students. Results: A total of 989 medical students aged 18-32 years were included in the study, of whom 58.24% (576) were male, were third year 33.47 (331), and 44, 08% of the participants were from Venezuela (446). The level of knowledge was 71.39% (706) low, 24.97% (247) considered that the public has the most important role in the control of Mayaro, and 39.23% (388) do not use repellents. Conclusion: The level of general knowledge was low, indecisive / doubtful attitudes and appropriate practices.","PeriodicalId":52959,"journal":{"name":"Revista del Instituto de Medicina Tropical","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46619470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.18004/IMT/201813124-31
Zunilda Garay, A. Vera, Nora Pitta, H. Bianco, C. Ayala, P. Almada, C. M. Cuellar
{"title":"Impact of Pneumonias Associated with Mechanical Ventilation in Mortality in an Adult Intensive Care Unit","authors":"Zunilda Garay, A. Vera, Nora Pitta, H. Bianco, C. Ayala, P. Almada, C. M. Cuellar","doi":"10.18004/IMT/201813124-31","DOIUrl":"https://doi.org/10.18004/IMT/201813124-31","url":null,"abstract":"","PeriodicalId":52959,"journal":{"name":"Revista del Instituto de Medicina Tropical","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42332826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.18004/IMT/201813140-53
Sara Amarilla, D. Lovera, C. M. Cuellar, S. Araya, C. Aranda, Gustavo Chamorro, A. Kawabata, O. Merlo, A. Arbo
Introduction: Meningococcal disease has been and continues to be an important cause of morbidity and mortality around the world. Objectives: To analyze the clinical and epidemiological characteristics of patients with invasive meningococcal infection hospitalized in a reference hospital center. Materials and methods: A descriptive, observational and retrospective study based in the review of clinical records of patients admitted between 2005 and 2018 in the Institute of Tropical Medicine in whom Neisseria meningitidis was isolated o detected by PCR in blood or CSF. Results: Forty-four patients with invasive meningococcal disease were recruited during the period studied (3 ± 2 cases/year). The cases predominated in the age group <5 years (36% of all cases), with similar gender distribution. Forty-six patients (59%) had meningitis and 18 (41%) meningococcemia, 12 of them (27%) with concomitant meningitis. Forty-three percent of the patients required admission to the ICU. The lethality was 20.5% (9/44), higher in patients with meningococcemia, although without statistical significance (p = 0.16). The presence of shock (p<0.01), the ICU requirement (p=0.001), leukopenia <5000, leukocytes/mm3 (p <0.01), leukocytosis>15000/mm3 (p=0.03), thrombocytopenia<150000/mm3 (p=0.01) and the presence of <100 leukocytes field in CSF (p = 0.02) were factors associated with higher mortality. No association was found between severity and serotypes. When all the years of the study was analyzed, serogroup B was the predominant (50%); however, in the last 3 years all isolates (n = 14) corresponded to serogroups C (n = 10, 71%) and W135 (n = 4, 29%). Conclusion: Meningococcal disease presents a stable pattern of endemicity in Paraguay, with a recent increase in cases of serogroup C and W135 Currently the serogroup C constitues more than 70% of the cases. The presence of shock, leukocytosis>15,000/mm3, leukopenia <5000 / mm3, and thrombocytopenia were associated with increased mortality.
{"title":"Epidemiology, clinical and prognostic factors of Invasive Meningococcal Disease in a reference center in Paraguay. 2005 to 2018","authors":"Sara Amarilla, D. Lovera, C. M. Cuellar, S. Araya, C. Aranda, Gustavo Chamorro, A. Kawabata, O. Merlo, A. Arbo","doi":"10.18004/IMT/201813140-53","DOIUrl":"https://doi.org/10.18004/IMT/201813140-53","url":null,"abstract":"Introduction: Meningococcal disease has been and continues to be an important cause of morbidity and mortality around the world. Objectives: To analyze the clinical and epidemiological characteristics of patients with invasive meningococcal infection hospitalized in a reference hospital center. Materials and methods: A descriptive, observational and retrospective study based in the review of clinical records of patients admitted between 2005 and 2018 in the Institute of Tropical Medicine in whom Neisseria meningitidis was isolated o detected by PCR in blood or CSF. Results: Forty-four patients with invasive meningococcal disease were recruited during the period studied (3 ± 2 cases/year). The cases predominated in the age group <5 years (36% of all cases), with similar gender distribution. Forty-six patients (59%) had meningitis and 18 (41%) meningococcemia, 12 of them (27%) with concomitant meningitis. Forty-three percent of the patients required admission to the ICU. The lethality was 20.5% (9/44), higher in patients with meningococcemia, although without statistical significance (p = 0.16). The presence of shock (p<0.01), the ICU requirement (p=0.001), leukopenia <5000, leukocytes/mm3 (p <0.01), leukocytosis>15000/mm3 (p=0.03), thrombocytopenia<150000/mm3 (p=0.01) and the presence of <100 leukocytes field in CSF (p = 0.02) were factors associated with higher mortality. No association was found between severity and serotypes. When all the years of the study was analyzed, serogroup B was the predominant (50%); however, in the last 3 years all isolates (n = 14) corresponded to serogroups C (n = 10, 71%) and W135 (n = 4, 29%). Conclusion: Meningococcal disease presents a stable pattern of endemicity in Paraguay, with a recent increase in cases of serogroup C and W135 Currently the serogroup C constitues more than 70% of the cases. The presence of shock, leukocytosis>15,000/mm3, leukopenia <5000 / mm3, and thrombocytopenia were associated with increased mortality.","PeriodicalId":52959,"journal":{"name":"Revista del Instituto de Medicina Tropical","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48685216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.18004/IMT/20181314-16
L. Flores, D. Narváez, A. Armoa
One of the routes of transmission of the HIV virus is blood through sharps accidents; health workers who are exposed to needle stick injuries that contain HIV-infected blood have a 0.23% risk of being infected. The objective of this study is to characterize the biological hazard accidents and the use of occupational post-exposure prophylaxis in health workers, who consulted in the National Program to Fight AIDS from January to December 2013. Material and Method: Observational, descriptive, cross-sectional design. 66 tokens were included for this study. The variables analyzed were: age, sex, origin, occupation or workplace, time of accident, occupational exposure, health worker, source patient, type of work accident or accident classification according to risk, type of exposure, indication of postprophylaxis exposure, side effects of antiretroviral drugs. Results: 85% were women and 15% were men. The mean age was 33.1 ± 8.9 (20-62) years. Health Workers more exposed were the nursing staff in 36.6%; followed by cleaners 24.24%, and medical personnel 18.8%. The accident was classified as mild in 62.1% and as severe in 37.8%. The type of exposure, in 65.1% was type 1 (punctures, cut with needles grooved or hollow, scalpel), the patient source was known in 54.5% of cases. Among the known source patients, 62% with serology positive for HIV, 77% started Prophylaxis Post Exposure. Only 6% completed the treatment schedule. Among those who completed PPE, one of them presented side effects (dizziness, nausea and facial erythema). Conclusion: Universal precaution is the first line of defense to prevent occupational exposure. Assuming that all patients are potentially infected is the only way to optimize measures to prevent the transmission of this pathology, with assurance of controls and measures to complete prophylaxis if necessary.
{"title":"Characterization of the accidents of biological risk and use of prophylaxis in health workers by occupational exposure, that consulted in the National Program of Fight against AIDS from January to December of the year 2013","authors":"L. Flores, D. Narváez, A. Armoa","doi":"10.18004/IMT/20181314-16","DOIUrl":"https://doi.org/10.18004/IMT/20181314-16","url":null,"abstract":"One of the routes of transmission of the HIV virus is blood through sharps accidents; health workers who are exposed to needle stick injuries that contain HIV-infected blood have a 0.23% risk of being infected. The objective of this study is to characterize the biological hazard accidents and the use of occupational post-exposure prophylaxis in health workers, who consulted in the National Program to Fight AIDS from January to December 2013. Material and Method: Observational, descriptive, cross-sectional design. 66 tokens were included for this study. The variables analyzed were: age, sex, origin, occupation or workplace, time of accident, occupational exposure, health worker, source patient, type of work accident or accident classification according to risk, type of exposure, indication of postprophylaxis exposure, side effects of antiretroviral drugs. Results: 85% were women and 15% were men. The mean age was 33.1 ± 8.9 (20-62) years. Health Workers more exposed were the nursing staff in 36.6%; followed by cleaners 24.24%, and medical personnel 18.8%. The accident was classified as mild in 62.1% and as severe in 37.8%. The type of exposure, in 65.1% was type 1 (punctures, cut with needles grooved or hollow, scalpel), the patient source was known in 54.5% of cases. Among the known source patients, 62% with serology positive for HIV, 77% started Prophylaxis Post Exposure. Only 6% completed the treatment schedule. Among those who completed PPE, one of them presented side effects (dizziness, nausea and facial erythema). Conclusion: Universal precaution is the first line of defense to prevent occupational exposure. Assuming that all patients are potentially infected is the only way to optimize measures to prevent the transmission of this pathology, with assurance of controls and measures to complete prophylaxis if necessary.","PeriodicalId":52959,"journal":{"name":"Revista del Instituto de Medicina Tropical","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46627812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ventilator-associated pneumonia: a problem of intensive care units","authors":"A. Arbo","doi":"10.18004/IMT/20181311-3","DOIUrl":"https://doi.org/10.18004/IMT/20181311-3","url":null,"abstract":"","PeriodicalId":52959,"journal":{"name":"Revista del Instituto de Medicina Tropical","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48709267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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