Archive for March 13, 2013

Neumonía adquirida en la comunidad. Nueva normativa de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR)

Arch de Bronconeumolog 2010; 46 :543-58

Rosario Menéndeza; Antoni Torresb; Javier Aspac; Alberto Capelasteguid; Cristina Prate; Felipe Rodríguez de Castrof

a Servicio de Neumología, Hospital Universitario La Fe, Valencia, CIBERES, España

b Servicio de Neumología, Hospital Clinic, Barcelona, CIBERES, IDIBAPS, Universitat de Barcelona, GRQ, España

c Servicio de Neumología, Hospital de La Princesa, Madrid, España

d Servicio de Neumología, Hospital de Galdakao, Galdakao, España

e Servicio de Microbiología, Hospital Germans Trias i Pujol, Badalona, Barcelona, España

f Servicio de Neumología, Hospital Dr. Negrín, Las Palmas de Gran Canaria, CIBERES España

Esta nueva actualización de las recomendaciones de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) ha sido elaborada con el propósito de ampliar el conocimiento de la neumonía adquirida en la comunidad (NAC) en sus aspectos epidemiológicos, diagnósticos, terapéuticos y preventivos, presentando información sistematizada y reciente basada en la evidencia científica actual.

Para la elaboración de dichas recomendaciones, los autores han diferenciado 6 secciones: epidemiología, evaluación de la gravedad y escalas pronósticas, diagnóstico microbiológico, tratamiento antimicrobiano, NAC que no responde al tratamiento y prevención. Como en documentos anteriores, las recomendaciones atañen a las NAC que se presentan en personas inmunocompetentes y adultas, es decir de 18 o más años de edad.

Las infecciones que afectan a diversas subpoblaciones de sujetos con otras características (p. ej., niños, pacientes con cáncer u otros estados de inmunodepresión, pacientes institucionalizados, etc.) requieren una consideración diferente no contemplada en el marco de la presente normativa….

PDF

http://www.archbronconeumol.org/watermark/ctl_servlet?_f=10&pident_articulo=13156293&pident_usuario=0&pident_revista=6&fichero=6v46n10a13156293pdf001.pdf&ty=66&accion=L&origen=abn&web=www.archbronconeumol.org&lan=es

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March 13, 2013 at 2:05 pm

Acute systemic histoplasmosis associated with chorioretinitis in an immunocompetent adolescent.

Digit J Ophthalmol. 2011;17(3):31-5.

Fowler B, Shen C, Mastellone J, Chaum E.

Source

Department of Ophthalmology, Hamilton Eye Institute, Memphis Medical Center, Memphis, Tennessee.

Abstract

Histoplasmosis is an endemic, systemic mycosis caused by the dimorphic fungus Histoplasma capsulatum. A minority of patients develop asymptomatic chorioretinitis known as presumed ocular histoplasmosis syndrome (POHS), which is typically associated with chorioretinal scarring and peripapillary atrophy and occasionally with choroidal neovascularization secondary to maculopathy. We report a case of acute severe bilateral chorioretinitis associated with disseminated H. capsulatum in an immunocompetent adolescent boy living in an endemic area. The chorioretinitis did not respond to systemic antifungal therapy, but both his systemic illness and ocular lesions resolved with the addition of systemic steroids

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3516160/pdf/djo-17-31.pdf

March 13, 2013 at 2:03 pm

Interim guidance for clinicians considering the use of preexposure prophylaxis for the prevention of HIV infection in heterosexually active adults.

MMWR Morb Mortal Wkly Rep. 2012 Aug 10;61(31):586-9.

Centers for Disease Control and Prevention (CDC).

Abstract

In the United States, an estimated 48,100 new human immunodeficiency virus (HIV) infections occurred in 2009. Of these, 27% were in heterosexual men and women who did not inject drugs, and 64% were in men who have sex with men (MSM), including 3% in MSM who inject drugs. In January 2011, following publication of evidence of safety and efficacy of daily oral tenofovir disoproxil fumarate 300 mg (TDF)/emtricitabine 200 mg (FTC) (Truvada, Gilead Sciences) as antiretroviral preexposure prophylaxis (PrEP) to reduce the risk for HIV acquisition among MSM in the iPrEx trial, CDC issued interim guidance to make available information and important initial cautions on the use of PrEP in this population. Those recommendations remain valid for MSM, including MSM who also have sex with women. Since January 2011, data from studies of PrEP among heterosexual men and women have become available, and on July 16, 2012, the Food and Drug Administration (FDA) approved a label indication for reduction of risk for sexual acquisition of HIV infection among adults, including both heterosexuals and MSM. This interim guidance includes consideration of the new information and addresses pregnancy and safety issues for heterosexually active adults at very high risk for sexual HIV acquisition that were not discussed in the previous interim guidance for the use of PrEP in MSM.

FULL TEXT

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a2.htm

PDF (SEE PAGE 586)

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

 

March 13, 2013 at 2:01 pm

Sunlight Exposure and Cutaneous Human Papillomavirus Seroreactivity in Basal Cell and Squamous Cell Carcinomas of the Skin

J Infect Dis. August 1, 2012  V.206 N.3  P.399-406.

Michelle R. Iannacone1, Wei Wang2, Heather G. Stockwell2, Kathleen O’Rourke2, Anna R. Giuliano1, Vernon K. Sondak3, Jane L. Messina3,4,5,6, Richard G. Roetzheim7, Basil S. Cherpelis5,6, Neil A. Fenske4,5,6, Kristina M. Michael8, Tim Waterboer8, Michael Pawlita8 and Dana E. Rollison1

1Department of Cancer Epidemiology

3Cutaneous Oncology Program, Moffitt Cancer Center

2Department of Epidemiology and Biostatistics, College of Public Health

4Department of Pathology and Cell Biology

5Department of Dermatology

6Department of Cutaneous Surgery

7Department of Family Medicine, College of Medicine, University of South Florida, Tampa, Florida

8Infection and Cancer Program, German Cancer Research Center, Heidelberg, Germany

Background

Ultraviolet radiation exposure may interact synergistically with cutaneous human papillomavirus (HPV) infection in the development of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin.

Methods

To investigate differences in the risk of sunlight-associated BCC and SCC by cutaneous genus-specific HPV serostatus, a case-control study was conducted among 204 BCC and 156 SCC cases who were recruited from a university dermatology clinic and 297 controls who had no history of cancer and screened negative for current skin cancer. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between measures of sunlight exposure and BCC/SCC, stratified by genus-specific HPV serostatus, with adjustment for age and sex.

Results

Sunburn due to cutaneous sensitivity to sunlight exposure (P = .006) and poor tanning ability (P = .003) were associated with a higher seroprevalence for genus beta HPV types. Poor or no tanning ability was more strongly associated with SCC among individuals who were seropositive for antibodies to cutaneous HPV types in genera alpha (OR, 15.60; 95% CI, 5.40–45.1; P = .01 for interaction) and beta (OR, 6.86; 95% CI, 3.68–12.80; P = .001 for interaction), compared with individuals who were seronegative for these HPV types.

Conclusions

Seropositivity for HPV types in genera alpha or beta increased the risk of SCC associated with poor tanning ability.

FULL TEXT

http://jid.oxfordjournals.org/content/206/3/399.full

PDF

http://jid.oxfordjournals.org/content/206/3/399.full.pdf+html

March 13, 2013 at 1:59 pm


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