Archive for March 20, 2016

Brucelosis – Guía para Equipo de Salud – NOV 2013

Ministerio de Salud de la Nación Argentina – 58 págs.

 

Contenido:

 

Pág 3. Información para el equipo de salud

  1. Introducción
  2. Manifestaciones clínicas en animales
  3. Manifestaciones clínicas en el humano
  4. Exámenes complementarios
  5. ¿Cuándo sospechar brucelosis?
  6. ¿Cómo se confirma la brucelosis?
  7. ¿Cómo notificar el caso de brucelosis?
  8. ¿Cómo se trata el paciente con brucelosis?
  9. Diagnóstico Diferencial
  10. ¿Qué hacer si se confirma?
  11. ¿Cómo se tratan los casos caninos de brucelosis?
  12. ¿Qué hacer cuando hay un caso canino de brucelosis en un hogar?
  13. Prevención de la infección por Brucella en la familia y la comunidad

 

Pág 25. Recomendaciones para la organización de las actividades en el Equipo de Salud

  1. ¿Qué pueden Ud. y su equipo de salud hacer para contribuir al control de las infecciones por Brucella en su área?

 

Pág 29. Información para la población

  1. ¿Qué es la brucelosis?
  2. ¿Qué animales pueden trasmitir brucelosis a las personas?
  3. ¿Cómo se transmite?
  4. ¿Cuáles son los síntomas?
  5. ¿Cuál es el tratamiento para la brucelosis?
  6. ¿Existe la vacuna para la brucelosis?
  7. ¿Cómo se puede disminuir el riesgo de enfermar?

 

Pág 37. Anexos

  1. Vigilancia de brucelosis por laboratorio
  2. Medidas preventivas de trabajadores de laboratorios
  3. Bioterrorismo
  4. Procedimiento ante una emergencia
  5. Red Nacional de Brucelosis

 

PDF

http://www.msal.gob.ar/images/stories/bes/graficos/0000000304cnt-guia-medica-brucelosis.pdf

 

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March 20, 2016 at 7:45 pm

Polymerase chain reaction-based assays for the diagnosis of human brucellosis.

Ann Clin Microbiol Antimicrob. 2014 Aug 1;13:31.

Wang Y, Wang Z, Zhang Y, Bai L, Zhao Y, Liu C, Ma A, Yu H.

Abstract

Polymerase chain reaction (PCR) is an in vitro technique for the nucleic acid amplification, which is commonly used to diagnose infectious diseases.

The use of PCR for pathogens detection, genotyping and quantification has some advantages, such as high sensitivity, high specificity, reproducibility and technical ease. Brucellosis is a common zoonosis caused by Brucella spp., which still remains as a major health problem in many developing countries around the world.

The direct culture and immunohistochemistry can be used for detecting infection with Brucella spp. However, PCR has the potential to address limitations of these methods. PCR are now one of the most useful assays for the diagnosis in human brucellosis.

The aim of this review was to summarize the main PCR techniques and their applications for diagnosis and follow-up of patients with brucellosis.

Moreover, advantages or limitation of the different PCR methods as well as the evaluation of PCR results for treatment and follow-up of human brucellosis were also discussed.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236518/pdf/s12941-014-0031-7.pdf

March 20, 2016 at 7:43 pm

Impact of treatment with biologic DMARDs on the risk of sepsis or mortality after serious infection in patients with rheumatoid arthritis.

Ann Rheum Dis. 2015 Nov 13. pii: annrheumdis-2015-207838.

Richter A1, Listing J1, Schneider M2, Klopsch T3, Kapelle A4, Kaufmann J5, Zink A6, Strangfeld A1.

Author information

1Department of Epidemiology, German Rheumatism Research Centre, Berlin, Germany.

2Scientific Advisory Board Düsseldorf, Duesseldorf, Germany.

3Neubrandenburg, Germany.

4Hoyerswerda, Germany.

5Ludwigsfelde, Germany.

6Department of Epidemiology, German Rheumatism Research Centre, Berlin, Germany Charité University Medicine Berlin.

Abstract

OBJECTIVE:

This observational cohort study investigated the impact of biological (b) disease-modifying antirheumatic drugs (DMARDs) on the outcomes of serious infections (SIs) in patients with rheumatoid arthritis.

METHODS:

We investigated outcomes of SIs observed in 947 patients enrolled in the German biologics register RABBIT(Rheumatoid arthritis: observation of biologic therapy). Outcomes were (1) recovery without complication, (2) sepsis following SI (≤30 days), and (3) death after SI without known sepsis (≤90 days). We applied a multinomial generalised estimating equation model for longitudinal data to evaluate the risks of sepsis and death simultaneously.

RESULTS:

Sepsis within 30 days after SI was reported in 135 out of 947 patients, 85 of these had a fatal outcome. Fifty-three patients died within 90 days after SI without known sepsis. The adjusted risk of developing sepsis increased with age and was higher in patients with chronic renal disease. Compared with conventional synthetic (cs)DMARDs, the risk was significantly lower when patients were exposed to bDMARDs at the time of SI (OR: 0.56, 95% CI 0.38 to 0.81). Risk factors of fatal SI were higher age, use of glucocorticoids at higher doses and heart failure. Patients treated with bDMARDs and those with better physical function had a significantly lower mortality risk.

CONCLUSIONS:

These results suggest a beneficial effect of bDMARDs on the risk of sepsis after SI and the risk of a fatal outcome. Successful immunosuppression may prevent an unregulated host response to SI, that is, the escalation to sepsis. Further investigation is needed to validate these results.

PDF

http://ard.bmj.com/content/early/2015/11/13/annrheumdis-2015-207838.full.pdf+html

March 20, 2016 at 7:40 pm


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