Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Sporotrichosis is a subacute-chronic fungal infection caused by dimorphic fungi of the Sporothrix schenckii Complex. It is more common in tropical areas. The prevalence in Argentina is estimated between 0.01 and 0.02%. In half of the patients it manifests as lymphocutaneous sporotrichosis, which occurs after inoculation of the fungus into the skin after minor trauma. The initial lesion is a papule or nodule that occurs with the appearance of an ascending chain of mobile, painless and erythematous subcutaneous nodules. The diagnosis is made from mycological culture. The antifungal of choice is itraconazole and the prognosis is usually favorable. We present the case of a healthy 4-year-old girl who consulted for subacute axillary lymphadenopathy without response to multiple antimicrobial regimens, arriving at the diagnosis of lymphocutaneous sporotrichosis from the culture of a lymph node biopsy sample.

Background: Voriconazole is the antifungal of choice for the treatment of invasive aspergillosis (IA). Plasma concentrations (PCs) ≥1mg / mL have been associated with better therapeutic results which have not always been achieved during treatment in immunocompromised children. In the necessity to initiate early and effective therapy for the infection, it is relevant to establish the voriconazole administration regimen that is associated with optimal PCs in this population. Aim: To compare the PC and safety of intravenous (IV) voriconazole, dosed BID and TID in immunocompromised children with indication of antifungal treatment. Method: Retrospective observational study since January 2015 until July 2018 in a highly complex pediatric hospital in Santiago of Chile, in patients aged 0 to 17 years who received treatment with IV voriconazole. Those with renal replacement therapy, liver failure and / or renal failure were excluded. Trough CPs were compared between a group with BID dosing regimen versus another group with TID administration. Adverse reactions were evaluated in both groups. Results: 137 trough CPs were obtained in 76 children, with a median age of 9 years (0-17 years) in the BID group and 9 years (0-16) in the TID group with a median weight of 27 kg (6-83 kg) and 28kg (9.3-60 kg), respectively. Patients <12 years old exposed to TID dosages are 4.65 times (OR: 4.65, 95% CI 1.93-11.2) more likely to have PC ≥1mg / mL compared to BID administration (P = 0.001). Eight adverse reactions were reported, mainly photophobia, with no significant difference found between the BID and TID groups. Conclusion: TID dosages are associated with a greater probability of obtaining adequate exposure to voriconazole in patients <12 years old compared to BID dosages, with a low frequency of adverse reactions.

Introducción: La enfermedad COVID-19, además de presentar síntomas respiratorios, puede afectar otros órganos como la piel.Al momento, se han descrito 5 variantes clínicas de manifestaciones cutáneas por COVID-19. Pocos reportes abordan el tema de la gravedad de las dermatosis cutáneas de COVID-19 y el pronóstico.Objetivo: describir patrones clínicos e histológicos de dermatosis en pacientes con COVID-19. Materiales y métodos: es una cohorte para pacientes del IMSS-T1 en León, Guanajuato, México, entre septiembre 2020 y enero 2021. Identificamos pacientes con dermatosis asociada a COVID-19 desde su ingreso hospitalario y aquellos que la desarrollaron durante su estancia. Se les invitó a participar para evaluación clínica y toma de biopsia que fueron descritas por un patólogo experto. Resultados: La frecuencia de las dermatosis por COVID-19 fue del 15.7%. Los que desarrollaron las lesiones durante su estancia hospitalaria presentaron mayor morbi-mortalidad (p=0.001). Las lesiones vaso-oclusivas fueron las más diagnosticadas, y asociadas con mayor mortalidad (p=0.003). Histológicamente el hallazgo más común fue trombosis superficial y profunda (58%).Conclusiones: Los pacientes que desarrollaron las lesiones durante su hospitalización y aquellos con lesiones vaso-oclusivas tuvieron la mayor morbi-mortalidad. Las lesiones vaso-oclusivas pueden ser un factor de mal pronóstico en pacientes con COVID-19.

Background: Metaxenic and zoonotic diseases are one of the ten national priorities for health research in Peru 2019-2023. Of these, the cases reported by loxoscelism have been increasing progressively. Aim: To determine the factors associated with the knowledge and preventive measures of Loxosceles laeta bite in the population of the ENAPRES in Peru 2017-2019. Methods: Observational, cross-sectional, analytical and retrospective study, based on information from ENAPRES. Results: A total sample of 285,354 people was analyzed. Of these, those aged 60 or over (PRa=1,48; 95%CI: 1,45-1,51), those from the coast (PRa=1,37; 95%CI: 1,33-1,40), women (PRa=1,12; 95%CI: 1,11-1,13), with primary or secondary (PRa=1,12; 95%CI: 1,09-1,15), with inadequate housing [ceiling (PRa=1,07; 95%CI: 1,05-1,10), floor (PRa=1,02; 95%CI: 1,00-1,04)] were associated with higher possibility of having more knowledge about L. laeta bite. On the other hand, those aged 60 or over (PRa=1,49; 95%CI: 1,46-1,52), those from the coast (PRa=1,39; 95%CI: 1,35-1,43), with non-university higher education (PRa=1,19; 95%CI: 1,15-1,22), women (PRa=1,13; 95%CI: 1,12-1,14) and with inadequate housing ceilings (PRa=1,07; 95%CI 1,05-1,10) were associated with a greater possibility of taking adequate preventive measures. In both, an association was found between disposing of organic waste on the street or on public roads (RPa=0.97; 95%CI: 0.96-0.99) Conclusions: It were found factors associated with knowledge and preventive for L. laeta bite.

Las infecciones parasitarias provocan una enorme carga de enfermedad y constituyen un problema presente para la salud pública. La categoría de enfermedad emergente o reemergente se ve influenciada por fenómenos que se presentan en un mundo actual interconectado producto de la globalización, el desplazamiento de las personas, el comercio, la urbanización descoordinada y el cambio climático, influyen de manera muy importante en la transmisión de estas enfermedades.En este artículo se revisan los aspectos relacionados con las redes integradas de servicios de salud (RISS) para entregar acceso a tratamientos farmacológicos a pacientes con diagnóstico de difilobotriasis (infección por Cestoda, Pseudophyllidea), implementado por la dirección de servicio de salud Valdivia (SSV), en colaboración con el hospital San José de Osorno, centros de atención primaria y centros privados de la Región de los Ríos. Adicionalmente incluye un análisis descriptivo de los casos presentados de los últimos tres años 2019,2020 y parte del 2021.

Background: The COVID-19 pandemic that emerged in Wuhan, China at the end of 2019, spread rapidly around the world with almost 600 million cases and 6.3 million deaths today. The most affected were health workers with at least three times the risk of contracting the disease than the general community. Most studies on seroprevalence in health workers focus on hospital care establishments and what happens in Primary Health Care (PHC) has not been investigated with the same intensity.Aim: To determine the prevalence of SARS-CoV-2 using IgG antibodies in primary health care personnel in La Pintana commune, risk factors and clinical characteristics, prior to vaccination in Chile.Methods: A cross-sectional design carried out in November 2020. Sociodemographic and clinical data were collected through face-to-face interviews, after providing informed consent. Specific IgG was determined by ELISA using N and S proteins. The differences between positive and negative subjects were studied using bivariate analysis and multivariate models, controlling for potential confounding variables. The study was approved by the Universidad del Desarrollo Scientific Ethics Committee.Results: 463 employees (51.4%) participated, finding a prevalence of 21.8%. The risk factors found were younger age, being a physician and having been in close contact with a case. 22% were asymptomatic. Among those with anosmia/ageusia, the probability of IgG+ was greater than 70%. Antibody titers increase with severity.Conclusions: Prevalence found in primary health care personnel is consistent with previous evidence. Younger age and medical profession are associated with a higher risk of illness.

Introducción: El tétanos es un problema de salud pública, el cual afecta a todos los grupos etáreos y la mortalidad incrementa cuando los programas de inmunización son de baja cobertura. Esta enfermedad es causada por la toxina del Clostridium tetani el cual ingresa al organismo vía heridas contaminadas por cuerpos extraños. La clínica más frecuente del tétanos es del tipo generalizado y se caracteriza por la contracción tónica de músculos esqueléticos, espasmos musculares intensos, dolorosos, e hiperactividad autonómica. Objetivo: Describir el caso clínico de tétanos generalizado en un paciente pediátrico. Caso clínico: Se analiza el caso de un menor de 13 años con inmunizaciones incompletas el cual 14 días después de hacerse una herida en mano derecha evoluciona con dolor muscular y contracciones generalizadas. El tratamiento brindado fue penicilina G sódica, metronidazol e inmunoglobulina humana. Conclusión: El tétanos sigue siendo un problema de salud pública con alta mortalidad y presencia en países en vías de desarrollo, es importante tanto el manejo hospitalario como preventivo mediante los programas de inmunización.

This article reconstructs the main arguments against vaccination that circulated in Chile during the late nineteenth and early twentieth centuries. For this purpose, we will study the figure of Alfredo Helsby Hazell, who was the primary opponent of vaccination in Chile and published several writings in which he developed and disseminated his ideas. We observe that Helsby argued his rejection of vaccination from the defence of hygienism and distrust of the scientific explanations that began to spread from the germ theory. This was articulated with the defence of health as a private sphere of action, criticizing the intervention of the State in such matters.

Neutropenic enterocolitis (NEC) is a heterogeneous disease of the gastrointestinal tract with systemic response, that corresponds to a severe and life-threatening clinical condition in immunocompromised patients, especially in childhood cancer. The pathologic features are poorly understood, although its multifactorial cause of NEC is well established and it is associated with the cytotoxic effects of the chemotherapy agents used and recognized by the classic triad of fever, neutropenia, and abdominal pain, secondary to gastrointestinal injuries that alters mucosal permeability and helps intramural bacterial invasion. ECN is truly a clinical challenge that requires an early diagnosis and a multidisciplinary approach including basic laboratory and imagological tests in high complexity centers. We present a current review, adding epidemiological aspects, risks factors, diagnostic support elements, therapeutic considerations, and preventive measures in order to provide knowledge of this disease and help to reduce morbidity and mortality associated with it.

Con el objetivo de determinar si existe correlación entre los casos de varicela notificados en Perú y las búsquedas sobre varicela realizadas en Google a nivel nacional y por regiones se realizaron análisis de correlación de Spearman para las semanas epidemiológicas del 2016 al 2019, así como antes y después de la introducción de la vacuna para varicela en el Perú. A nivel nacional se encontró una alta correlación antes del inicio de la vacunación (Rho 0,779, p=0,001) y moderada durante el periodo de vacunación (Rho 0,441, p=0,001), algunas regiones tuvieron una correlación baja o muy baja y dejaron de ser estadísticamente significativas luego de la introducción de la vacuna en el Perú. En conclusión, el cambio en la estacionalidad de la varicela durante el periodo de vacunación tuvo además un impacto en las búsquedas que realiza la población en Google.