Archive for February, 2013

Medidas preventivas para el control de las enfermedades respiratorias y de transmisión aérea – 2010 128 págs.

Manual Separ de Procedimientos

Sociedad Española de Neumología y Cirugía Torácica (SEPAR)

 

INDICE

Conceptos generales de prevención

Normas de aislamiento.

Medidas preventivas en los procedimientos diagnósticos y terapéuticos respiratorios.

Medidas preventivas de infecciones nosocomiales.

Medidas preventivas en situaciones específicas: Infecciones respiratorias víricas y gripe

Medidas preventivas en situaciones específicas: Tuberculosis

Medidas preventivas en situaciones específicas: Legionela

Medidas preventivas en situaciones específicas: Fibrosis Quística y Bronquiectasias

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PDF

http://www.ssibe.cat/documents/doc_1051.pdf#page=62

February 28, 2013 at 2:45 pm

Treatment failure of pharyngeal gonorrhoea with internationally recommended first-line ceftriaxone verified in Slovenia, September 2011.

Euro Surveill. 2012 Jun 21;17(25).

Unemo M, Golparian D, Potočnik M, Jeverica S.

Source

World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Swedish Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden. magnus.unemo@orebroll.se

Abstract

We describe the second case in Europe of verified treatment failure of pharyngeal gonorrhoea, caused by an internationally occurring multidrug-resistant gonococcal clone, with recommended first-line ceftriaxone 250 mg in Slovenia. This is of grave concern since ceftriaxone is last remaining option for empirical treatment. Increased awareness of ceftriaxone failures, more frequent test-of-cure, strict adherence to regularly updated treatment guidelines, and thorough verification/falsification of suspected treatment failures are essential globally. New effective treatment options are imperative.

PDF

http://www.eurosurveillance.org/images/dynamic/EE/V17N25/art20200.pdf

February 28, 2013 at 2:43 pm

The 2012 European guideline on the diagnosis and treatment of gonorrhoea in adults recommends dual antimicrobial therapy.

Euro Surveill. 2012 Nov 22;17(47).

Unemo M; European STI Guidelines Editorial Board.

PDF

http://www.eurosurveillance.org/images/dynamic/EE/V17N47/art20323.pdf

 

February 28, 2013 at 2:41 pm

Tackling multidrug-resistant gonorrhea: how should we prepare for the untreatable?

Expert Rev Anti Infect Ther. 2012 Aug;10(8):831-3.

Kidd S, Kirkcaldy R, Weinstock H, Bolan G.

PDF

http://www.expert-reviews.com/doi/pdfplus/10.1586/eri.12.69

February 28, 2013 at 2:40 pm

Update to CDC’s Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections.

MMWR Morb Mortal Wkly Rep. 2012 Aug 10;61(31):590-4.

Centers for Disease Control and Prevention (CDC).

Abstract

Gonorrhea is a major cause of serious reproductive complications in women and can facilitate human immunodeficiency virus (HIV) transmission. Effective treatment is a cornerstone of U.S. gonorrhea control efforts, but treatment of gonorrhea has been complicated by the ability of Neisseria gonorrhoeae to develop antimicrobial resistance. This report, using data from CDC’s Gonococcal Isolate Surveillance Project (GISP), describes laboratory evidence of declining cefixime susceptibility among urethral N. gonorrhoeae isolates collected in the United States during 2006-2011 and updates CDC’s current recommendations for treatment of gonorrhea. Based on GISP data, CDC recommends combination therapy with ceftriaxone 250 mg intramuscularly and either azithromycin 1 g orally as a single dose or doxycycline 100 mg orally twice daily for 7 days as the most reliably effective treatment for uncomplicated gonorrhea. CDC no longer recommends cefixime at any dose as a first-line regimen for treatment of gonococcal infections. If cefixime is used as an alternative agent, then the patient should return in 1 week for a test-of-cure at the site of infection.

FULL TEXT

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a3.htm

PDF (see pag. 590)

http://www.cdc.gov/mmwr/pdf/wk/mm6131.pdf

February 28, 2013 at 2:39 pm

Biomarkers in community-acquired pneumonia: A state-of-the-art review.

Clinics (Sao Paulo). 2012 Nov;67(11):1321-5.

Seligman R, Ramos-Lima LF, Oliveira Vdo A, Sanvicente C, Pacheco EF, Dalla Rosa K.

Source

Departamento de Medicina Interna, Hospital de ClÃ-nicas de Porto Alegre (HCPA), Faculdade de Medicina, Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Abstract

Community-acquired pneumonia (CAP) exhibits mortality rates, between 20% and 50% in severe cases. Biomarkers are useful tools for searching for antibiotic therapy modifications and for CAP diagnosis, prognosis and follow-up treatment. This non-systematic state-of-the-art review presents the biological and clinical features of biomarkers in CAP patients, including procalcitonin, C-reactive protein, copeptin, pro-ANP (atrial natriuretic peptide), adrenomedullin, cortisol and D-dimers.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488993/pdf/cln-67-11-1321.pdf

February 24, 2013 at 9:06 pm

Treatment of liver hydatidosis: how to treat an asymptomatic carrier?

World J Gastroenterol. 2010 Sep 7;16(33):4123-9.

Frider B, Larrieu E.

Bernardo Frider, Department of Medicine-Hepatology, Argerich Hospital, University of Buenos Aires, Maimonides University, Salguero 2601, 1425 Buenos Aires, Argentina

Edmundo Larrieu, Department of Zoonosis, Ministry of Health of Rio Negro Province, Laprida 240, 8500 Viedma, Argentina; University of La Pampa, Calle 5 y 116, 6360 General Pico, Argentina

Abstract

Liver hydatidosis is the most common clinical presentation of cystic echinococcosis (CE). Ultrasonographic mass surveys have demonstrated the true prevalence, including the asymptomatic characteristic of the majority of cases, providing new insight into the natural history of the disease. This raises the question of whether to treat or not to treat these patients, due to the high and unsuspected prevalence of CE. The high rate of liver/lung frequencies of cyst localization, the autopsy findings, and the involution of cysts demonstrated in long time follow-up of asymptomatic carriers contribute to this discussion. The decision to treat an asymptomatic patient by surgery, albendazole, or puncture aspiration injection and re-aspiration or to wait and watch, is based on conflicting reports in the literature, the lack of complications in untreated patients over time, and the spontaneous disappearance and involution of cysts. All these points contribute to difficulties of individual clinical decisions. The patients should be informed of the reasons and the risks of watchful/waiting without treatment, the possibility of complications, and the risks of the other options. As more information on the natural history of liver hydatidosis is acquired, selection of the best treatment will be come easier. Without this knowledge it would be very difficult to establish definitive rules of treatment. At present, it is possible to manage these patients over time and to wait for the best moment for treatment. Follow-up studies must be conducted to achieve this objective.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2932914/pdf/WJG-16-4123.pdf

February 24, 2013 at 9:03 pm

Guidelines for treatment of cystic and alveolar echinococcosis in humans. WHO Informal Working Group on Echinococcosis.

Bull World Health Organ. 1996;74(3):231-42.

Abstract

Summarized in this article are recent experiences in the treatment of human cystic echinococcosis (CE) and alveolar echinococcosis (AE) of the liver caused by the metacestode stages of Echinococcus granulosus and E. multilocularis, respectively. For CE, surgery remains the first choice for treatment with the potential to remove totally the parasite and completely cure the patient. However, chemotherapy with benzimidazole compounds (albendazole or mebendazole) and the recently developed PAIR procedure (puncture-aspiration-injection-re-aspiration) with concomitant chemotherapy offer further options for treatment of CE cases. Chemotherapy is not yet satisfactory: cure can be expected in about 30% of patients and improvement in 30-50%, after 12 months’ follow-up. AE is generally a severe disease, with over 90% mortality in untreated patients. Radical surgery is recommended in all operable cases but has to be followed by chemotherapy for at least 2 years. Inoperable cases and patients who have undergone nonradical resection or liver transplantation require continuous chemotherapy for many years. Long-term chemotherapy may significantly prolong survival, even for inoperable patients with severe AE. Liver transplantation may be indicated as a life-saving measure for patients with severe liver dysfunction, but is associated with a relatively high risk of proliferation of intraoperatively undetected parasite remnants. Details of indications, contraindications, treatment schedules and other aspects are discussed.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2486920/pdf/bullwho00401-0005.pdf

February 24, 2013 at 9:02 pm

In vitro activity and microbiological efficacy of tedizolid (TR-700) against Gram-positive clinical isolates from a phase 2 study of oral tedizolid phosphate (TR-701) in patients with complicated skin and skin structure infections.

Antimicrob Agents Chemother. 2012 Sep;56(9):4608-13.

Prokocimer P, Bien P, Deanda C, Pillar CM, Bartizal K.

Source

Trius Therapeutics, Inc., San Diego, California, USA.

Abstract

Tedizolid (TR-700, formerly torezolid) is the active moiety of the prodrug tedizolid phosphate (TR-701), a next-generation oxazolidinone, with high potency against Gram-positive species, including methicillin-resistant Staphylococcus aureus (MRSA). A recently completed randomized, double-blind phase 2 trial evaluated 200, 300, or 400 mg of oral tedizolid phosphate once daily for 5 to 7 days in patients with complicated skin and skin structure infections. This report examines the in vitro activity of tedizolid and Zyvox (linezolid) against Gram-positive pathogens isolated at baseline and describes the microbiological and clinical efficacy of tedizolid. Of 196 isolates tested, 81.6% were S. aureus, and of these, 76% were MRSA. The MIC(50) and MIC(90) of tedizolid against both methicillin-susceptible S. aureus (MSSA) and MRSA were 0.25 μg/ml, compared with a MIC(50) of 1 μg/ml and MIC(90) of 2 μg/ml for linezolid. For coagulase-negative staphylococci (n = 7), viridans group streptococci (n = 15), and beta-hemolytic streptococci (n = 3), the MICs ranged from 0.03 to 0.25 μg/ml for tedizolid and from 0.12 to 1 μg/ml for linezolid. The microbiological eradication rates at the test-of-cure visit (7 to 14 days posttreatment) in the microbiologically evaluable population (n = 133) were similar in all treatment groups, with overall eradication rates of 97.7% for all pathogens, 97.9% for MRSA, and 95.7% for MSSA. The clinical cure rates for MRSA and MSSA infections were 96.9% and 95.7%, respectively, across all dose groups. This study confirms the potent in vitro activity of tedizolid against pathogenic Gram-positive cocci, including MRSA, and its 4-fold-greater potency in comparison with linezolid. All dosages of tedizolid phosphate showed excellent microbiological and clinical efficacy against MRSA and MSSA.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3421864/pdf/zac4608.pdf

 

 

February 22, 2013 at 8:43 am

Lesions in the Oral Cavity

N Engl J of Medic Feb.21, 2013 V.368

IMAGES IN CLINICAL MEDICINE

Jose Narciso Rosa Assunção, D.D.S., Ms.C., and Gustavo Davi Rabelo, D.D.S., Ph.D.

University of São Paulo, São Paulo, Brazil

A 59-year-old man presented with multiple painful ulcers in the oral cavity that had developed over the course of a week. He also noted difficulty swallowing and speaking. Physical examination revealed …

FULL TEXT

http://www.nejm.org/doi/full/10.1056/NEJMicm1205661?query=TOC

PDF

http://www.nejm.org/doi/pdf/10.1056/NEJMicm1205661

 

 

February 22, 2013 at 8:42 am

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