Posts filed under ‘GUIDELINES’

LEPTOSPIROSIS – GUIA para el Equipo de Salud. Ministerio de Salud de la Nación Argentina – ABRIL 2014

INDICE

Pág 3. Información para el equipo de salud:

  1. Introducción
  2. Manifestaciones clínicas
  3. ¿Cuándo sospechar leptospirosis?
  4. ¿Cómo confirmar leptospirosis?
  5. ¿Cómo notificar el caso de leptospirosis?
  6. ¿Cómo se trata el paciente con leptospirosis?
  7. Flujograma de manejo de casos sospechosos de leptospirosis
  8. Diagnóstico diferencial
  9. ¿Qué hacer si se confirma?
  10. ¿Cómo se tratan los casos caninos de leptospirosis?
  11. Prevención de la leptospirosis 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 la leptospirosis en su área?

Pág 29. Información para la población

  1. ¿Qué es la leptospirosis?
  2. ¿Cómo se transmite la leptospirosis?
  3. ¿Cómo ingresa la bacteria?
  4. ¿Cuáles son los síntomas de la leptospirosis?
  5. ¿Qué hacer en caso de padecer de algunos de los síntomas mencionados antes?
  6. ¿Cuál es el tratamiento?

7 ¿Cómo afecta la enfermedad a los animales domésticos?

  1. ¿Qué podemos hacer para prevenir la leptospirosis?

Pág 35. Anexos

  1. Muestras clínicas para examen
  2. Notificación a través del Módulo SIVILA del SNVS
  3. Bioseguridad
  4. Laboratorios de la Red de leptospirosis
  5. Algoritmo de diagnóstico y notificación por laboratorio
  6. Ficha de notificación de casos de síndrome febril
  7. Ficha de notificación de caso leptospirosis canina

PDF

http://www.msal.gob.ar/images/stories/bes/graficos/0000000489cnt-guia-medica-leptospirosis.pdf

July 17, 2017 at 8:32 am

Aspergilosis. Formas clínicas y tratamiento

Enf Infecciosas & Microbiologia Clínica Abril 2012 V.30 N.4

Jesús Fortún, Yolanda Meije, Gema Fresco, Santiago Moreno.

Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España

Resumen

La aspergilosis invasiva junto con la aspergilosis crónica pulmonar y la aspergilosis broncopulmonar alérgica, constituyen las formas clínicas de aspergilosis.

Aunque el número de especies de Aspergillus spp. es muy numeroso, Aspergillus fumigatus-complex es el agente etiológico más frecuente, independientemente de la forma clínica y la afección de base del paciente.

El incremento de los diferentes tratamientos inmunosupresores y el mayor uso de corticoides en pacientes con enfermedad obstructiva crónica han condicionado un mayor protagonismo de la aspergilosis en los últimos años.

El uso de galactomanano y las pruebas de imagen complementan las limitaciones microbiológicas en el diagnóstico de estos pacientes. Voriconazol y anfotericina liposomal constituyen la base del tratamiento en todas las formas de aspergilosis, y posaconazol, itraconazol, caspofungina y otras equinocandinas son alternativas eficaces.

El pronóstico depende de la forma clínica y las características del huésped, pero es sombrío fundamentalmente en las formas invasivas diseminadas.

abstract

http://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-aspergilosis-formas-clinicas-tratamiento-S0213005X12000316

PDF (hacer CLIC en “DESCARGAR PDF”)

July 17, 2017 at 8:11 am

Profilaxis antibiótica en el paciente poli-traumatizado. Guías 2011 elaboradas por los Comités de Infectología Crítica y de Trauma de la Sociedad Argentina de Terapia Intensiva (SATI)

MEDICINA INTENSIVA – 2011 – 28 Nº 4

Rosa Reina,* Guillermo Ramos,** Carina Balasini,* Héctor Canales,** Wanda Cornistein,* Alberto Cremona,* Eleonora Cunto,* Mercedes Esteban,* Alberto Legarto,** Romina Lendaro,** Candela Llerena,* Monserrat Lloria,* Mónica Quinteros,** Juan Videla* * Comité de Infectología Crítica ** Comité de Trauma Sociedad Argentina de Terapia Intensiva Buenos Aires, Argentina

Resumen

Objetivo.

Elaborar guías de profilaxis antibiótica (P-ATB) para pacientes politraumatizados.

Método.

Sistema GRADE para calidad y fuerza de la evidencia.

Resultados.

1) P-ATB prequirúrgica, desbridamiento amplio: 1-A.

2) Trauma de abdomen sin lesión de víscera hueca, con o sin packing: 2-D; con lesión de víscera hueca, con o sin packing, P-ATB hasta 24 h del posoperatorio: 1-A.

3) Trauma de cráneo: a) colocación de sensor de presión intracraneal: 2-D; b) fractura de base de cráneo: no administrar P-ATB: 1-A; c) fractura con hundimiento, por arma de fuego, con atricción de partes blandas o sin ella (la P-ATB no previene meningitis o absceso): 2-D.

4) Trauma maxilofacial: a) cerrado: con hemoseno o sin él, no administrar P-ATB: 1-A; b) penetrante (ruptura de senos, pérdida de piezas dentarias, con laceración de mucosa o sin ella): P-ATB por un día: 1-A; c) fractura mandibular: reducción cerrada/abierta: P-ATB posoperatoria: 2-D; d) cara sin fractura, lesión de partes blandas: 2-D; e) trauma ocular penetrante: PATB durante un día: 2-D.

5) Quemados: a) prevenir sepsis temprana e infección de herida: 1-C; b) quemados graves, de alto riesgo, en asistencia respiratoria mecánica: prevención de neumonía e infecciones intrahospitalarias: 2-B; c) quemadura <40%: curación simple, balneoterapia y resecciones de escaras: 1-C; d) procedimientos en quemaduras >40%, P-ATB perioperatoria para reducir la bacteriemia y la infección de la quemadura: 2-C; e) prevenir la pérdida de injertos de piel autóloga: 2-C.

6) Trauma de tórax: a) colocación de drenaje: 2-D; b) aspiración de contenido gástrico: no administrar P-ATB: 1-A.

7) Trauma pelviano-genitourinario abierto a vagina/recto y lesión de víscera hueca: P-ATB hasta 24 h del posoperatorio: 1-A.

8) Fractura expuesta de huesos largos: a) iniciar P-ATB rápidamente: 1-A; b) Gustillo I-II: suspender antibiótico a las 24 h del cierre de las heridas: 1-B; c) Gustillo III: continuar antibiótico por 72 h luego del trauma y 24 h después del cierre de las heridas: 1-B.

Conclusión.

Pocas indicaciones con fuerte nivel de evidencia para P-ATB

PDF

http://revista.sati.org.ar/index.php/MI/article/viewFile/285/239

July 17, 2017 at 8:03 am

Update of the Swiss guidelines on post-treatment Lyme disease syndrome.

Swiss Med Wkly. 2016 Dec 5;146:w14353.

Nemeth J1, Bernasconi E2, Heininger U3, Abbas M4, Nadal D5, Strahm C6, Erb S7, Zimmerli S8, Furrer H8, Delaloye J9, Kuntzer T10, Altpeter E11, Sturzenegger M12, Weber R1, For The Swiss Society For Infectious Diseases And The Swiss Society For Neurology.

Author information

1 Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland.

2 Division of Infectious Diseases, Regional Hospital Lugano, Switzerland.

3 Paediatric Infectious Diseases and Vaccinology, University of Basel Children’s Hospital, Basel, Switzerland.

4 Division of Infectious Diseases, Geneva University Hospital, Switzerland.

5 Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital Zürich, Switzerland.

6 Division of Infectious Diseases, Cantonal Hospital St. Gallen, Switzerland.

7 Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Switzerland.

8 Division of Infectious Diseases, University Hospital Bern, Switzerland.

9 Division of Infectious Diseases, University Hospital Lausanne (CHUV), Switzerland.

10 Service of Neurology, University Hospital Lausanne (CHUV), Switzerland.

11 Swiss Federal Office of Public Health, Bern, Switzerland.

12 Department of Neurology, Inselspital, University Hospital of Bern, Switzerland.

Abstract

Lyme borreliosis is caused by Borrelia burgdorferi sensu lato infection, which responds well to antibiotic therapy in the overwhelming majority of cases.

However, despite adequate antibiotic treatment some patients report persisting symptoms which are commonly summarised as post-treatment Lyme disease syndrome (PTLDS). In 2005, the Swiss Society of Infectious Diseases published a case definition for PTLDS.

We aimed to review the scientific literature with a special emphasis on the last 10 years, questioning whether the definitions from 2005 are still valid in the light of current knowledge.

Furthermore, we describe the clinical history of infection with Borrelia burgdorferi sensu lato, the estimated prevalence of PTLDS, the possible pathogenesis of PTLDS, and treatment options with an emphasis on clinical studies. In summary, we were unable to find a scientific reason for modification of the PTLDS definitions published in 2005.

Thus, the diagnostic criteria remain unchanged, namely documented clinical and laboratory evidence of previous infection with B. burgdorferi, a completed course of appropriate antibiotic therapy, symptoms including fatigue, arthralgia, myalgia, cognitive dysfunction or radicular pain persisting for >6 months, a plausible timely association between documented B. burgdorferi infection and onset of symptoms (i.e., persistent or recurrent symptoms that began within 6 months of completion of a recommended antibiotic therapy for early or late Lyme borreliosis), and exclusion of other somatic or psychiatric causes of symptoms.

The main therapeutic options remain cognitive behavioural therapy and low-impact aerobic exercise programmes. Growing and unequivocal evidence confirms that prolonged or repeated antibiotic therapy for PTLDS is not beneficial, but potentially harmful and therefore contraindicated.

The Guidelines of the Swiss Society of Infectious Diseases offer an evidence based, diagnostic and therapeutic framework for physicians caring for patients suffering from presumptive PTLDS in Switzerland.

FULL TEXT

https://smw.ch/article/doi/smw.2016.14353

July 15, 2017 at 2:11 pm

SOMANZ guidelines for the investigation and management sepsis in pregnancy.

Aust N Z J Obstet Gynaecol. July 3, 2017    

Bowyer L1, Robinson HL2, Barrett H3, Crozier TM4, Giles M5,6, Idel I7, Lowe S8, Lust K9, Marnoch CA10, Morton MR11, Said J12,13, Wong M14, Makris A15,16.

Author information

1 Maternal Fetal Medicine, Royal Hospital for Women, Sydney, New South Wales, Australia.

2 Department of Medicine, Ipswich Hospital, Ipswich, Queensland, Australia.

3 Department of Obstetric Medicine, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia.

4 Intensive Care, Monash Medical Health, Melbourne, Victoria, Australia.

5 Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia.

6 Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.

7 Department of Nephrology, Eastern Health, Melbourne, Victoria, Australia.

8 Royal Hospital for Women, Sydney, New South Wales, Australia.

9 Department of Obstetrics and Gynaecology, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia.

10 Auckland District Health Board, Auckland, New Zealand.

11 Women’s and Babies Division, Women’s and Children’s Hospital, North Adelaide, South Australia, Australia.

12 Department of Maternal Fetal Medicine, Sunshine Hospital, Melbourne, Victoria, Australia.

13 Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.

14 Department of Anaesthesia, Royal Women’s Hospital, Melbourne, Victoria, Australia.

15 Department of Nephrology, Liverpool Hospital, Liverpool, New South Wales, Australia.

16 Department of Medicine, Western Sydney University, Sydney, New South Wales, Australia.

Abstract

SOMANZ (Society of Obstetric Medicine Australia and New Zealand) has written a guideline to provide evidence-based guidance for the investigation and care of women with sepsis in pregnancy or the postpartum period.

The guideline is evidence-based and incorporates recent changes in the definition of sepsis. The etiology, investigation and treatment of bacterial, viral and non-infective causes of sepsis are discussed.

Obstetric considerations relevant to anaesthetic and intensive care treatment in sepsis are also addressed. A multi-disciplinary group of clinicians with experience in all aspects of the care of pregnant women have contributed to the development of the guidelines.

This is an executive summary of the guidelines.

abstract

http://onlinelibrary.wiley.com/doi/10.1111/ajo.12646/abstract

PDF

http://onlinelibrary.wiley.com/doi/10.1111/ajo.12646/epdf

July 11, 2017 at 3:42 pm

European consensus-based (S2k) Guideline on the Management of Herpes Zoster – guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV), Part 2: TREATMENT.

J Eur Acad Dermatol Venereol. January 2017 V.31 N.1 P.20-29.                        

Werner RN1, Nikkels AF2, Marinović B3, Schäfer M4, Czarnecka-Operacz M5, Agius AM6, Bata-Csörgő Z7, Breuer J8, Girolomoni G9, Gross GE10, Langan S11, Lapid-Gortzak R12, Lesser TH13, Pleyer U14, Sellner J15, Verjans GM16, Wutzler P17, Dressler C1, Erdmann R1, Rosumeck S1, Nast A1.

Author information

1 Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine in Dermatology (dEBM), Charité – Universitätsmedizin Berlin, Berlin, Germany.

2 Department of Dermatology, University Medical Center of Liège, Liège, Belgium.

3 Department of Dermatology and Venereology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.

4 Department of Anesthesiology, Charité – Universitätsmedizin Berlin, Berlin, Germany.

5 Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland.

6 Department of Otorhinolaryngology, The Medical School, University of Malta, Msida, Malta.

7 Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary.

8 Division of Infection and Immunity, University College London, London, United Kingdom.

9 Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy.

10 Department of Dermatology and Venerology, Universitätsklinik Rostock, Rostock, Germany.

11 Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.

12 Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

13 Department of Otolaryngology, University Hospital Aintree NHS Foundation Trust, Liverpool, UK.

14 Department of Ophthalmology, Charité – Universitätsmedizin Berlin, Berlin, Germany.

15 Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.

16 Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands.

17 Department of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany.

Abstract

Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact the quality of life of affected patients. Different therapeutic approaches to treat acute HZ are available.

The aim of this European project was the elaboration of a consensus-based guideline on the management of patients who present with HZ, considering different patient populations and different localizations.

This interdisciplinary guideline aims at an improvement of the outcomes of the acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction in the incidence of postherpetic neuralgia (PHN) and other complications.

The guideline development followed a structured and pre-defined process, considering the quality criteria for guidelines development as suggested by the AGREE II instrument.

The steering group was responsible for the planning and the organization of the guideline development process (Division of Evidence-Based Medicine, dEBM).

The expert panel was nominated by virtue of clinical expertise and/or scientific experience and included experts from the fields of dermatology, virology/infectiology, ophthalmology, otolaryngology, neurology and anaesthesiology.

Recommendations for clinical practice were formally consented during the consensus conference, explicitly considering different relevant aspects.

The guideline was approved by the commissioning societies after an extensive internal and external review process. In this second part of the guideline, therapeutic interventions have been evaluated.

The expert panel formally consented recommendations for the treatment of patients with HZ (antiviral medication, pain management, local therapy), considering various clinical situations.

Users of the guideline must carefully check whether the recommendations are appropriate for the context of intended application.

In the setting of an international guideline, it is generally important to consider different national approaches and legal circumstances with regard to the regulatory approval, availability and reimbursement of diagnostic and therapeutic interventions.

PDF

http://onlinelibrary.wiley.com/doi/10.1111/jdv.13957/epdf

 

June 28, 2017 at 8:53 am

2016-11 European consensus – Guideline on the Management of H Zoster – guided by the EDF in cooperation with the EADV, Part 1: DIAGNOSIS

Authors

R.N. Werner, A.F. Nikkels, B. Marinović, M. Schäfer, M. Czarnecka-Operacz, A.M. Agius, Z. Bata-Csörgő, J. Breuer, G. Girolomoni, G.E. Gross, S. Langan, R. Lapid-Gortzak, T.H. Lesser, U. Pleyer, J. Sellner, G.M. Verjans, P. Wutzler, C. Dressler, R. Erdmann, S. Rosumeck, A. Nast

PDF

http://onlinelibrary.wiley.com/doi/10.1111/jdv.13995/full

http://onlinelibrary.wiley.com/doi/10.1111/jdv.13995/epdf

June 28, 2017 at 8:51 am

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