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jueves, diciembre 24, 2015
Plasmodium vivax cerebral malaria complicated with venous sinus thrombosis in Colombia.
Por: Dr.Pinzón Miguel Alejandro, Dr. Pineda JC, Dr. Rosso F, Dr Shinchi M, Dr Bonilla-Abadía F.
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Complicated malaria is usually due to Plasmodium falciparum. Nevertheless, Plasmodium vivax is infrequently related with life-threatening complications. Few cases have been reported of severe Plasmodium vivax infection, and most of them from Southeast Asia and India. We report the first case of cerebral malaria due to Plasmodium vivax in Latin America, complicated with sagittal sinus thrombosis and confirmed by a molecular method. Ver texto completo
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"Strongyloides Pneumonia"
Strongyloides Pneumonia
32-year-old man presented to the emergency department with a 5-day history of dry cough, progressive dyspnea, nausea, and diarrhea. He gave no history of fever or other significant symptoms. The patient had human immunodeficiency virus (HIV) infection but was intermittently adherent to therapy. On examination, he appeared acutely ill, dehydrated, and cachectic. Vital signs showed a blood pressure of 100/60 mmHg, pulse 120/min, respiratory rate 49/min, and oxygen saturation 56% on room air, which improved to 92% with 50% oxygen by mask. Chest auscultation revealed occasional bilateral crackles. Liver was enlarged (span, 14 cm) but not tender. The remainder of the exam was normal. Ver texto completo
Authors’ addresses: Juan Carlos Catan˜ o and Miguel Alejandro Pinzo´ n, Infectious Diseases Section, Internal Medicine Department, University of Antioquia Medical School, Medellı´n, Antioquia, Colombia, E-mails: kataju@hotmail.com and alejandropinzon01@yahoo.es.
** Dr. Miguel Alejandro Pinzón. Socio fundador y socio activo de la Fundación Alejandria.
Differences in the Clinical Outcome of Osteomyelitis by Treating Specialty: Orthopedics or Infectology
Differences in the Clinical Outcome of Osteomyelitis by Treating Specialty: Orthopedics or Infectology
Por:
Carolina Arias Arias ,Maria Carolina Tamayo Betancur ,Miguel Alejandro Pinzón ,
Osteomyelitis is a heterogeneous infection with regard to etiology and treatment, and currently no single management protocol exists. Management of the condition is typically an interdisciplinary approach between orthopedics and infectious disease; however, the orthopedist is often the person who manages treatment. The aim of the study was to determine differences in the outcome of osteomyelitis according to its treating specialty and to identify factors associated with the recurrence of the disease. An ambispective cohort study of 129 patients with osteomyelitis was conducted and the proportions for qualitative variables and central tendency and dispersion measures for quantitative variables were calculated; the latter were tested for normality using the Shapiro-Wilk test. A bivariate analysis was conducted with measures of association based on the chi square test and crude relative risk. A logistic regression model was applied and statistical significance was set at p < 0.05, including the model of relevant clinical variables that fit the Hosmer-Lemeshow test. We found that 70% of patients were treated either by orthopedics or infectious disease. Patients who were treated by an orthopedist alone presented a greater risk of relapse or reinfection (RR = 4.6; 95% CI 2.3;8.9). Risk factors of osteomyelitis recurrence as determined in the regression model included the following: age of 57 years or older (RR = 1.3; 95% 0.3;5.2), long bones (RR = 1.9; 95% CI 0.5;7.1), fracture (RR = 5.0; 95% CI 0.4;51.4), monotherapy (RR = 3.0; 95% CI 0.6;14.5), receiving less than 4 weeks of antibiotics (RR = 1.5; 95% CI 0.2;10.1), inadequate treatment (RR = 3.1; 95% CI 0.4;20.1), and receiving orthopedics treatment (RR = 5.5; 95% CI 1.6;18.2). Most patients evaluated jointly by orthopedics and infectious disease received adequate treatment for osteomyelitis and had fewer relapses. Ver Texto original
Por:
Carolina Arias Arias ,Maria Carolina Tamayo Betancur ,Miguel Alejandro Pinzón ,
- Published: December 17, 2015
- DOI: 10.1371/journal.pone.0144736
Osteomyelitis is a heterogeneous infection with regard to etiology and treatment, and currently no single management protocol exists. Management of the condition is typically an interdisciplinary approach between orthopedics and infectious disease; however, the orthopedist is often the person who manages treatment. The aim of the study was to determine differences in the outcome of osteomyelitis according to its treating specialty and to identify factors associated with the recurrence of the disease. An ambispective cohort study of 129 patients with osteomyelitis was conducted and the proportions for qualitative variables and central tendency and dispersion measures for quantitative variables were calculated; the latter were tested for normality using the Shapiro-Wilk test. A bivariate analysis was conducted with measures of association based on the chi square test and crude relative risk. A logistic regression model was applied and statistical significance was set at p < 0.05, including the model of relevant clinical variables that fit the Hosmer-Lemeshow test. We found that 70% of patients were treated either by orthopedics or infectious disease. Patients who were treated by an orthopedist alone presented a greater risk of relapse or reinfection (RR = 4.6; 95% CI 2.3;8.9). Risk factors of osteomyelitis recurrence as determined in the regression model included the following: age of 57 years or older (RR = 1.3; 95% 0.3;5.2), long bones (RR = 1.9; 95% CI 0.5;7.1), fracture (RR = 5.0; 95% CI 0.4;51.4), monotherapy (RR = 3.0; 95% CI 0.6;14.5), receiving less than 4 weeks of antibiotics (RR = 1.5; 95% CI 0.2;10.1), inadequate treatment (RR = 3.1; 95% CI 0.4;20.1), and receiving orthopedics treatment (RR = 5.5; 95% CI 1.6;18.2). Most patients evaluated jointly by orthopedics and infectious disease received adequate treatment for osteomyelitis and had fewer relapses. Ver Texto original
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