Posts filed under ‘Infecciones emergentes’

REVIEW – Human papillomavirus in 2019: An update on cervical cancer prevention and screening guidelines

Cleveland Clinic Journal of Medicine December 2019 V.86 N.12 P.173-178

ABSTRACT

The human papillomavirus (HPV) causes most cases of cervical cancer. Healthcare providers can help prevent this cancer by recommending HPV vaccination when appropriate, regularly screening women for cervical cancer, and following up on abnormal test results.

KEY POINTS

-Immunization against HPV can prevent up to 70% of HPV-related cervical cancer cases.

-Gardasil 9 is the only HPV vaccine currently available in the United States and is now approved for use in males and females between the ages of 9 and 45.

-In girls and boys younger than 15, a 2-dose schedule is recommended; patients ages 15 through 45 require 3 doses.

-Vaccine acceptance rates are highest when primary care providers announce that the vaccine is due rather than invite open-ended discussions.

-Regular cervical cancer screening is an important preventive tool and should be performed using the Papanicolaou (Pap) test, the high-risk HPV-only test, or the Pap-HPV cotest.

FULL TEXT

https://www.ccjm.org/content/86/3/173

PDF

https://www.ccjm.org/sites/default/files/additional-assets/PDFs/86_3_173.pdf

January 20, 2020 at 10:54 am

EDITORIAL – The return of measles—an unnecessary sequel

Cleveland Clinic Journal of Medicine December 2019 V.86 N.12 P.365-366

Concerns over fake news and alternative facts have permeated the fabric of our daily life. Trust in entrenched establishments seems to be at an all-time low. I grew up in the 1960s; I grew up with “don’t trust the man.” I grew up with the Vietnam War, Watergate, and the military-industrial complex, and I have read and heard enough since then to know that a good amount of our distrust was well founded. More recently, there has been increased public scrutiny of the “pharmaceutical-medical complex,” with concerns being raised in the media and by legislators regarding drug pricing, seemingly inappropriate physician prescribing of medications encouraged by drug manufacturers, and the overall costs of medical care. And yes, there is …

FULL TEXT

https://www.ccjm.org/content/86/6/365

PDF

https://www.ccjm.org/content/ccjom/86/6/365.full.pdf

January 20, 2020 at 10:52 am

Review – Measles: A dangerous vaccine-preventable disease returns

Cleveland Clinic Journal of Medicine December 2019 V.86 N.12 P.393-398

ABSTRACT

Although a safe and effective vaccine has been available for over 6 decades, vaccine hesitancy in the United States and social and political unrest globally have led to under-vaccination. As a result, in recent months, vaccine control of measles has been threatened with an alarming upswing in measles cases nationally and internationally. Here, we review the disease and its management in view of recent outbreaks.

KEY POINTS

-Measles is highly contagious and can have serious complications, including death.

-Measles vaccine is given in a 2-dose series. People who have received only 1 dose should receive either 1 or 2 more doses, depending on the situation, so that they are protected.

-The diagnosis of measles is straightforward when classic signs and symptoms are present—fever, cough, conjunctivitis, runny nose, and rash—especially after a known exposure or in the setting of outbreak. On the other hand, in partially vaccinated or immunosuppressed people, the illness presents atypically, and confirmation of diagnosis requires laboratory testing.

-Management is mostly supportive. Children—and probably also adults—should receive vitamin A.

-Since disease can be severe in the unvaccinated, immune globulin and vaccine are given to the normal host with an exposure and no history of vaccine or immunity.

FULL TEXT

https://www.ccjm.org/content/86/6/393

PDF

https://www.ccjm.org/sites/default/files/additional-assets/PDFs/86_6_393.pdf

January 20, 2020 at 10:50 am

Candida auris Isolates Resistant to Three Classes of Antifungal Medications — New York, 2019

MMWR. January 10, 2020 V.69 N.1 P.6-9.

Summary

What is already known about this topic?

Candida auris is an emerging yeast that is often drug-resistant.

What is added by this report?

Three chronically ill patients in New York were identified as having pan-resistant C. auris after receipt of antifungal medications. No transmission of the pan-resistant isolates was found in patient contacts or the facility environments.

What are the implications for public health practice?

Three years after the first identification of C. auris in New York, pan-resistant isolates remain rare. Continued surveillance for C. auris, prudent antifungal use, and susceptibility testing for all C. auris clinical isolates (especially after patients have been treated with antifungal drugs) are needed.

FULL TEXT

https://www.cdc.gov/mmwr/volumes/69/wr/mm6901a2.htm

PDF

https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6901a2-H.pdf

January 18, 2020 at 6:13 pm

Candida auris Isolates Resistant to Three Classes of Antifungal Medications — New York, 2019

Morbidity and Mortality Weekly Report (MMWR) (CDC) January 10, 2020 V.69 N.1 P-6-9

What is already known about this topic?

Candida auris is an emerging yeast that is often drug-resistant.

What is added by this report?

Three chronically ill patients in New York were identified as having pan-resistant C. auris after receipt of antifungal medications. No transmission of the pan-resistant isolates was found in patient contacts or the facility environments.

What are the implications for public health practice?

Three years after the first identification of C. auris in New York, pan-resistant isolates remain rare. Continued surveillance for C. auris, prudent antifungal use, and susceptibility testing for all C. auris clinical isolates (especially after patients have been treated with antifungal drugs) are needed.

Candida auris is a globally emerging yeast that causes outbreaks in health care settings and is often resistant to one or more classes of antifungal medications (1). Cases of C. auris with resistance to all three classes of commonly prescribed antifungal drugs (pan-resistance) have been reported in multiple countries (1). C. auris has been identified in the United States since 2016; the largest number (427 of 911 [47%]) of confirmed clinical cases reported as of October 31, 2019, have been reported in New York, where C. auris was first detected in July 2016 (1,2). As of June 28, 2019, a total of 801 patients with…..

FULL TEXT

https://www.cdc.gov/mmwr/volumes/69/wr/mm6901a2.htm?s_cid=mm6901a2_w&deliveryName=USCDC_921-DM16734

PDF

https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6901a2-H.pdf

January 9, 2020 at 3:22 pm

First reported case of Shewanella haliotis in the region of the Americas — New York, December 2018.

MMWR Morb Mortal Wkly Rep December 20, 2019 V.68 N.50 P.1168-1169

Liu D et al.

On December 18, 2018, a man aged 87 years was evaluated in a hospital emergency department in Flushing, New York, for right lower abdominal quadrant pain.

Evaluation included a computed tomography scan, which showed acute appendicitis with multiple abscesses measuring ≤3 cm.

The patient was admitted, a percutaneous drain was placed, and 5 mL of an opaque jelly-like substance was aspirated and sent for culture and testing for antimicrobial sensitivities…..

PDF

https://www.cdc.gov/mmwr/volumes/68/wr/pdfs/mm6850a5-H.pdf

January 9, 2020 at 9:00 am

SARAMPION – NUEVAS RECOMENDACIONES DE VACUNACIÓN PARA SU CONTROL.

ALERTA EPIDEMIOLÓGICA – 02 de enero de 2020 – SE 1

BROTE DE SARAMPIÓN EN CURSO

NUEVAS RECOMENDACIONES DE VACUNACIÓN PARA SU CONTROL.

Ante la continua detección de nuevos casos de sarampión en la Ciudad Autónoma de Buenos Aires (CABA) y municipios del área metropolitana de la provincia de Buenos Aires asociado a proximidad de las vacaciones de verano y la alta movilidad poblacional hacia zonas turística, con el consiguiente riesgo de diseminación de casos de sarampión en otras jurisdicciones, el Ministerio de Salud de la Nación, en consenso con las jurisdicciones y las comisiones asesoras, recomienda continuar con las medidas de contención de brote en curso y decide actualizar las indicaciones de vacunación a viajeros hacia zonas con circulación viral activa…..

PDF

https://www.argentina.gob.ar/sites/default/files/alerta_31-12-19_version_final.pdf

January 4, 2020 at 7:47 am

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