Biomedica最新文献

Hepatitis due to Treponema pallidum is a rare entity and its diagnosis represents a clinical challenge. Treponema pallidum should be considered as a presumptive etiology in all patients with acute liver disease, when other frequent causes have been ruled out.We present the case of a young, immunocompetent patient with elevated values in his liver tests, a cholestatic pattern, and maculopapular lesions on his palms and soles. Given his clinical picture, diagnostic tests, and response to the antimicrobial therapy, a diagnosis of cholestasis due to secondary syphilis has been established. It is important to include secondary syphilis within the possible causes of acute liver disease.

Introduction: Cerebral venous thrombosis is an uncommon cause of cerebrovascular disease, which has been increasing worldwide. In Colombia, there are not enough recent studies that allow us to determine epidemiological characteristics of the disease in our population to identify more frequent risk factors and complications according to our living conditions.

Objetive: To describe clinical, demographic, and radiographic characteristics, and risk factors in a cohort of patients with cerebral venous thrombosis attended at two hospitals in Colombia.

Materials and methods: Retrospective descriptive study with patients treated in the hospitalization neurology service of two hospitals in Bogotá, Colombia from December 2018 to December 2020.

Results: Thirty-three patients were included. There was a higher incidence of cerebral venous thrombosis in women of childbearing age in the puerperium (n=7; 33.3%) and associated with autoimmune diseases (n=10; 30.3%). The most common initial symptom was headache (n=31; 93.9 %), followed by neurological focal signs (n=9; 27.2%) and seizures (n=8; 24.2%). Fifty-one percent (n=17) of the patients had a normal physical examination. Cerebral venous infarction occurred in 21.1 % (n=7), subarachnoid hemorrhage in 12.1 % (n=4), and intraparenchymal hematoma in 9 % (n=3) of all the patients. Sixty-point six percent (n=20) of the patients had a total independent Barthel functional scale. None of those died.

Conclusions: We found similar sociodemographic, clinical, and radiography characteristics to those reported in the world literature. Regarding the differences, deep cerebral venous circulation was higher than that described in previous studies but without complications increase or mortality.

Introduction: Inadequate prescription of antibiotics has been recognized as a public health problem by the World Health Organization. In this context, antibiotic stewardship programs have been implemented as a tool to mitigate its impact.

Objetive: To describe the changes in clinical outcomes after the implementation of an antibiotic stewardship program in a level IV hospital.

Materials and methods: We conducted a unique cohort study of patients hospitalized for infectious pathologies that were treated with antibiotics in an advanced medical facility. We collected the clinical history before the implementation of the antibiotic stewardship program (2013 to 2015) and then we compared it to the records from 2018 to 2019 collected after the implementation of the program. We evaluated changes in clinical outcomes such as overall mortality, and hospital stay, among others.

Results: We analyzed 1,066 patients: 266 from the preimplementation group and 800 from the post-implementation group. The average age was 59.2 years and 62% of the population was male. Statistically significant differences were found in overall mortality (29% vs 15%; p<0.001), mortality due to infectious causes (25% vs 9%; p<0.001), and average hospital stay (45 days vs 21 days; p<0.001); we also observed a tendency to decrease hospital readmission at 30 days for infectious causes (14% vs 10%; p=0.085).

Conclusions: The antibiotic stewardship program implemented was associated with a decrease in overall mortality and mortality due to infectious causes, as well as in average hospital stay. Our results evidenced the importance of interventions aimed at mitigating the impact of inadequate prescription of antibiotics.

Introduction: Massive open online courses provide the opportunity to train health professionals and researchers from Latin America in global health.

Objetives: To determine the global offer of massive open online courses in global health and the characteristics of their content.

Material and methods: We examined massive open online course platforms to compile the global health offerings. The search had no time restriction and was last conducted in November, 2021. The search strategy only included the descriptor “global health”. We obtained the characteristics of the courses, their content, and the global health domain covered. These data were analyzed using descriptive statistics, reporting absolute and relative frequencies.

Results: Our search strategy identified 4,724 massive open online courses. Of these, only 92 were related to global health. Most of these courses (n=44; 47.8%) were offered through Coursera. More than half (n=50; 54.4%) of the MOOCs were conducted by U.S.A. institutions and in English language (n=90; 97.8%). Most courses focused on “globalization of health and healthcare” (n=24; 26.1%), followed by the domains “capacity building” (n=16; 17.4%), “global burden of disease” and “social and environmental determinants of health” (n=15; 16.3%).

Conclusions: We found a high offer of massive open online courses on global health. These courses covered the global health competencies required for health professionals.

Introduction: Early introduction of fluids and water affects the duration of breastfeeding, the infant immune system, and possibly causes infants to consume less breast milk, which may, in turn, affect their nutritional and immune status.

Objective: This study was carried out to determine water consumption in 0-6-month-old infants and the factors affecting this consumption.

Materials and methods: A literature review was conducted in seven electronic databases (Medline, Web of Science, PubMed, ScienceDirect, Scopus, Cochrane Library, and TÜBITAK) for studies published until April 25, 2022, using the keywords: drinking water, infant, and breastfeeding.

Results: The systematic review included 13 studies. Five studies were crosssectional, three were descriptive and quasi-experimental, and the others were case-control and cohort studies. It was reported in the examined studies that 86.2% of the infants were around 6 weeks old, 44 % of the infants were 1 month old, 77% were 3 months old, 2.5% were 4 months old, and 2.5 to 85% of the infants were around 6 months old when they first consumed water. The prominent reasons for making the infants drink water are the thought that they need it and cultural reasons.

Conclusions: The exclusive breastfeeding of 0-6-month-old infants is the recommendation of reliable health authorities. Nurses play a key role in implementing this practice. In this systematic review, it was seen that families gave their infants water at varying rates in the 0-6-month period, and the factors affecting this situation were revealed. If nurses determine which factors affect families in terms of the early introduction of fluids, they could be able to plan the necessary education and interventions.

Introduction. The development of resistance to insecticides in Aedes aegypti represents a major threat to public health. Surveillance and monitoring of the behavior of bioefficacy and susceptibility of insecticides is of fundamental importance to prolong the useful life of insecticide molecules.Objective. To evaluate the bioefficacy and susceptibility of the insecticides deltamethrin and cyfluthrin in Aedes aegypti during the zika epidemic outbreak in Kuna Yala, Panama.Methods and materials. The bioefficacy and susceptibility of deltamethrin and cyfluthrin in Aedes aegypti Ustupo using WHO standardized bioassays during the Zika epidemic outbreak in Kuna Yala, Panama.Results. In the bioassays with Aedes aegypti Ustupo, possible resistance to deltamethrin and cyfluthrin was observed, with a mortality rate of 95,3% and 94%, respectively. The bioefficacy results with Aedes aegypti Ustupo registered low bioefficacy of deltamethrin and cyfluthrin with average percentages of mortality in the intradomicile of 75% and 31,1%, respectively, while in the peridomicile it was 63,7% and 26,1%, respectively.Conclusion. The results of this study represent a challenge that the National Aedes Control Program must face in order to care for and maintain the toxic effect of insecticides applied against Aedes populations. It is necessary for the National Aedes Control Program to establish a resistance management program to evaluate resistance and its distribution in order to guarantee the sustainability of anti-vector interventions against Aedes populations.