Posts filed under ‘GUIDELINES’

2011 GUIA MEXICANA – SARCOMA de KAPOSI en pacientes HIV positivos – Guía Práctica Clínica

2011 GUIA MEXICANA – SARCOMA de KAPOSI en pacientes HIV positivos – Guía Práctica Clínica 55p

 Preguntas a responder por esta guía

  1. ¿Cuáles son los factores de riesgo para desarrollar sarcoma de Kaposi?
  2. ¿Qué estudios se deben solicitar al tener sospecha de sarcoma de Kaposi?
  3. ¿Cuál es la tipificación del sarcoma de Kaposi, para toma de decisión de tratamiento?
  4. De acuerdo a la clasificación de riesgo, ¿cuál es la mejor alternativa terapéutica?
  5. ¿Cuál es el papel de la terapia antirretroviral?
  6. ¿Cuál es el beneficio de inicio de terapia sistémica con quimioterapia en pacientes de bajo riesgo?
  7. ¿Cuál es el mejor esquema de tratamiento sistémico con quimioterapia en pacientes con sarcoma de Kaposi de alto riesgo?
  1. ¿Cuáles son las indicaciones de radioterapia en esta neoplasia?
  2. ¿Qué papel tiene el interferón en el manejo del sarcoma de Kaposi?
  3. ¿Cuáles son los criterios para decidir la referencia al tercer nivel?
  4. De los pacientes que requirieron atención en tercer nivel, ¿cuáles son los criterios para su contra referencia a segundo nivel?

http://www.imss.gob.mx/sites/all/statics/guiasclinicas/462GER.pdf

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July 1, 2019 at 11:14 am

Pyoderma gangrenosum – a guide to diagnosis and management.

Clin Med (Lond). May 2019 V.19 N.3 P.224-228.       

George C1, Deroide F2, Rustin M2.

1 Royal Free Hospital, London, UK cgeorge2@nhs.net.

2 Royal Free Hospital, London, UK.

Abstract

Pyoderma gangrenosum (PG) is a reactive non-infectious inflammatory dermatosis falling under the spectrum of the neutrophilic dermatoses.

There are several subtypes, with ‘classical PG’ as the most common form in approximately 85% cases. This presents as an extremely painful erythematous lesion which rapidly progresses to a blistered or necrotic ulcer.

There is often a ragged undermined edge with a violaceous/erythematous border. The lower legs are most frequently affected although PG can present at any body site.

Other subtypes include bullous, vegetative, pustular, peristomal and superficial granulomatous variants.

The differential diagnosis includes all other causes of cutaneous ulceration as there are no definitive laboratory or histopathological criteria for PG.

Underlying systemic conditions are found in up to 50% of cases and thus clinicians should investigate thoroughly for such conditions once a diagnosis of PG has been made.

Treatment of PG remains largely anecdotal, with no national or international guidelines, and is selected according to severity and rate of progression.

Despite being a well-recognised condition, there is often a failure to make an early diagnosis of PG.

This diagnosis should be actively considered when assessing ulcers, as prompt treatment may avoid the complications of prolonged systemic therapy, delayed wound healing and scarring.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542232/pdf/clinmed-19-3-224.pdf

June 27, 2019 at 8:18 am

2018 European guideline on the organization of a consultation for sexually transmitted infections

Journal of The European Academy of Dermatology and Venereology

New in the 2018 guidelines

This is an update of the 2012 IUSTI guideline. In this new version, we have expanded the sections on sexual history taking to include PEP and PrEP use, intimate partner and gender‐based violence, chemsex, swinging and psychosexual problems. We highlight the potential for the use of technology in the context of sexual health to facilitate sexual history taking and partner notification. We have explained the principle of safeguarding young and other vulnerable people who may present to services.

This guideline is primarily aimed at services provided in mainstream clinic/office environments, but increasingly many countries are seeing an era of rapid transition of sexual health services in which satellite clinics and online service provision are centre stage. Services are moving away from the main hospitals/clinics into smaller peripheral sites and various non‐traditional or outreach type settings such as saunas, brothels, bars, clubs, educational facilities, prisons and gay pride events. The advantage of such services is that it might allow hard‐to‐reach groups to be engaged with clinical services.1 We need a cohesive, multiagency approach to addressing the challenges associated with this style of service provision, if we are to harness the potential for decentralization of sexual health services while safeguarding the most vulnerable and remaining true to the founding principles of sexual health care….

FULL TEXT

https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.15577

PDF

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jdv.15577

June 17, 2019 at 10:39 am

Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America

Clinical Infectious Diseases May 15, 2019 V.68 N.10 P.1611-1615

IDSA GUIDELINES

Asymptomatic bacteriuria (ASB) is a common finding in many populations, including healthy women and persons with underlying urologic abnormalities. The 2005 guideline from the Infectious Diseases Society of America recommended that ASB should be screened for and treated only in pregnant women or in an individual prior to undergoing invasive urologic procedures. Treatment was not recommended for healthy women; older women or men; or persons with diabetes, indwelling catheters, or spinal cord injury. The guideline did not address children and some adult populations, including patients with neutropenia, solid organ transplants, and nonurologic surgery. In the years since the publication of the guideline, further information relevant to ASB has become available. In addition, antimicrobial treatment of ASB has been recognized as an important contributor to inappropriate antimicrobial use, which promotes emergence of antimicrobial resistance. The current guideline updates the recommendations of the 2005 guideline, includes new recommendations for populations not previously addressed, and, where relevant, addresses the interpretation of nonlocalizing clinical symptoms in populations with a high prevalence of ASB.

FULL TEXT

https://academic.oup.com/cid/article/68/10/1611/5481760

PDF (CLIC en PDF)

May 5, 2019 at 12:04 pm

Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza.

Clinical Infectious Diseases March 5, 2019 V.68 N.6 P.e1-e47.   

Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza.

Uyeki TM1, Bernstein HH2, Bradley JS3,4, Englund JA5, File TM6, Fry AM1, Gravenstein S7, Hayden FG8, Harper SA9, Hirshon JM10, Ison MG11, Johnston BL12, Knight SL13, McGeer A14, Riley LE15, Wolfe CR16, Alexander PE17,18, Pavia AT19.

Abstract

These clinical practice guidelines are an update of the guidelines published by the Infectious Diseases Society of America (IDSA) in 2009, prior to the 2009 H1N1 influenza pandemic. This document addresses new information regarding diagnostic testing, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal influenza. It is intended for use by primary care clinicians, obstetricians, emergency medicine providers, hospitalists, laboratorians, and infectious disease specialists, as well as other clinicians managing patients with suspected or laboratory-confirmed influenza. The guidelines consider the care of children and adults, including special populations such as pregnant and postpartum women and immunocompromised patients.

Published by Oxford University Press for the Infectious Diseases Society of America 2018.

FULL TEXT

https://academic.oup.com/cid/article/68/6/e1/5251935

PDF (CLIC en PDF)

May 1, 2019 at 6:23 pm

RECOMENDACIONES PARA LA PREVENCIÓN DE INFECCIONES ASOCIADAS A ARTOPLASTIA ELECTIVA EN ADULTOS

Medicina (Buenos Aires). 2017 V.77 N.2 P.143-157

JUAN CARLOS CHULUYÁN1*, ANDREA VILA2*, ANA LAURA CHATTÁS3*, MARCELO MONTERO3*, CLAUDIA PENSOTTI4*+, CLAUDIA TOSELLO5*, MARISA SÁNCHEZ6*, CECILIA VERA OCAMPO7*, GUILLERMINA KREMER8*, RODOLFO QUIRÓS8*, GUILLERMO A. BENCHETRIT9*,CAROLINA FERNANDA PÉREZ10*, ANA LAURA TERUSI11*, FRANCISCO NACINOVICH12*

1 Grupo de Trabajo Infectología, Hospital General de Agudos Dr. T. Álvarez,

2 Servicio de Infectología, Hospital Italiano de Mendoza,

3 Hospital General de Agudos Dr. Pirovano,

4 Clínica Monte Grande,

5 Hospital de Clínicas José de San Martín, UBA,

6 Hospital Italiano de Buenos Aires,

7 Sanatorio Dupuytren,

8 Hospital Universitario Austral,

9 Instituto de Investigaciones Médicas A. Lanari, UBA,

10 Policlínico del Docente-Centro Médico Huésped,

11 Instituto César Milstein,

12 Instituto Cardiovascular de Buenos Aires, Centros Médicos Dr. Stamboulian, Argentina

Las infecciones del sitio quirúrgico que complican las cirugías ortopédicas con implante prolongan la estadía hospitalaria y aumentan tanto el riesgo de readmisión como el costo de la internación y la mortalidad. Las presentes recomendaciones están dirigidas a:

(i) optimizar el cumplimiento de normas y la incorporación de hábitos en cada una de las fases de la cirugía, detectando factores de riesgo para infecciones del sitio quirúrgico potencialmente corregibles o modificables; y

(ii) adecuar la profilaxis antibiótica preoperatoria y el cuidado intra y postoperatorio.

PDF

http://www.medicinabuenosaires.com/PMID/28463223.pdf

April 13, 2019 at 12:39 pm

Executive summary: Diagnosis and Management of Prosthetic Joint Infection: clinical practice Guidelines by the Infectious Diseases Society of America (IDSA).

Clinical Infectious Diseases January 2013 V.56 N.1 P.1-10   doi: 10.1093/cid/cis966.

Osmon DR, Berbari EF, Berendt AR, et al.

These guidelines are intended for use by infectious disease specialists, orthopedists, and other healthcare professionals who care for patients with prosthetic joint infection (PJI). They include evidence-based and opinion-based recommendations for the diagnosis and management of patients with PJI treated with debridement and retention of the prosthesis, resection arthroplasty with or without subsequent staged reimplantation, 1-stage reimplantation, and amputation.

FULL TEXT

https://academic.oup.com/cid/article/56/1/1/419472

PDF (HACER CLIC en PDF)

 

Clinical Infectious Diseases January 2013 V.6 N.1 P.e1-e25   doi: 10.1093/cid/cis803.

Diagnosis and Management of Prosthetic Joint Infection: clinical practice Guidelines by the Infectious Diseases Society of America (IDSA).

Osmon DR, Berbari EF, Berendt AR, et al.

These guidelines are intended for use by infectious disease specialists, orthopedists, and other healthcare professionals who care for patients with prosthetic joint infection (PJI). They include evidence-based and opinion-based recommendations for the diagnosis and management of patients with PJI treated with debridement and retention of the prosthesis, resection arthroplasty with or without subsequent staged reimplantation, 1-stage reimplantation, and amputation.

FULL TEXT

https://academic.oup.com/cid/article/56/1/e1/415705

PDF (HACER CLIC en PDF)

March 30, 2019 at 5:17 pm

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