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OBJETIVE: this study was to determine the relationship between acute febrile illness and bacterial pathogens with zoonotic potential that cause emerging and re-emerging diseases in a central-eastern region of Peru. RESULTS: Out of the 279 samples analyzed, 23 (8.2%) tested positive for infection by Rickettsia spp., while a total of 15 (5.4%) tested positive for Leptospira spp. Women had a higher frequency of infection by Rickettsia spp., with 13 cases (53.3%), while men had a higher frequency of infection by Leptospira spp., with 10 cases (66.7%). The most frequently reported general symptom was headache, with 100.0% (n = 23) of patients with Rickettsia (+) and 86.7% (n = 13) of patients with Leptospira (+) experiencing it. Arthralgia was the second most frequent symptom, reported by 95.6% (n = 22) and 60% (n = 9) of patients with Rickettsia (+) and Leptospira (+), respectively. Myalgia was reported by 91.3% (n = 21) and 66.7% (n = 10) of patients with Rickettsia (+) and Leptospira (+), respectively. Retroocular pain, low back pain, and skin rash were also present, but less frequently. Among the positives, no manifestation of bleeding was recorded, although only one positive case for Leptospira spp. presented a decrease in the number of platelets.
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Leptospira , Leptospirosis , Infecciones por Rickettsia , Rickettsia , Humanos , Perú/epidemiología , Rickettsia/aislamiento & purificación , Femenino , Masculino , Leptospira/aislamiento & purificación , Leptospira/patogenicidad , Leptospirosis/epidemiología , Leptospirosis/microbiología , Leptospirosis/complicaciones , Leptospirosis/diagnóstico , Infecciones por Rickettsia/epidemiología , Infecciones por Rickettsia/microbiología , Infecciones por Rickettsia/diagnóstico , Adulto , Animales , Fiebre/microbiología , Zoonosis/microbiología , Zoonosis/diagnóstico , Zoonosis/epidemiología , Mialgia/microbiología , Mialgia/epidemiología , Persona de Mediana Edad , Adulto Joven , Adolescente , Cefalea/microbiología , Cefalea/etiología , Cefalea/epidemiología , Artralgia/microbiología , Artralgia/etiologíaRESUMEN
Introduction: Point-of-care ultrasound (POCUS) performed by emergency physicians (EP) has emerged as an effective alternative to radiology department ultrasounds for the diagnosis of lower extremity deep vein thrombosis (DVT). Systematic reviews suggested good sensitivity and specificity overall for EP-performed POCUS for DVT diagnosis, yet high levels of heterogeneity were reported. Methods: In this systematic review and meta-analysis, we aimed to provide the most up-to-date estimates of the accuracy of EP-performed POCUS for diagnosis of DVT and to explore potential correlations with test performance. We performed systematic searches in MEDLINE and Embase for original, primary data articles from January 2012-June 2021 comparing the efficacy of POCUS performed by EPs to the local standard. Quality Assessment of Diagnostic Accuracy Studies-2 for individual articles are reported. We obtained summary measures of sensitivity, specificity, and their corresponding 95% confidence intervals (CI) using bivariate mixed-effects regression models. We performed meta-regression, subgroup, and sensitivity analyses as planned in the protocol CRD42021268799 submitted to PROSPERO. Results: Fifteen publications fit the inclusion criteria, totaling 2,511 examinations. Pooled sensitivity and specificity were 90% (95% CI 82%-95%) and 95% (CI 91%-97%), respectively. Subgroup analyses by EP experience found significantly better accuracy for exams performed by EP specialists (93%, CI 88%-97%) vs trainees (77%, CI 60%-94%). Specificity for EP specialists (97%, CI 94%-99%) was higher than for trainees (87%, CI 76%-99%, P = 0.01). Three-point compression ultrasound (CUS) was more sensitive than two-point CUS but was only statistically significant when limited to EP specialists (92% vs 88%, P = 0.07, and 95% vs 88%, P = 0.02, respectively). Conclusion: Point-of-care ultrasound performed by emergency physicians is sensitive and specific for the diagnosis of suspected DVT when performed by trained attending EPs. Three-point compression ultrasound examination may be more sensitive than two-point CUS.
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Médicos , Trombosis de la Vena , Humanos , Sistemas de Atención de Punto , Servicio de Urgencia en Hospital , Ultrasonografía/métodos , Sensibilidad y Especificidad , Trombosis de la Vena/diagnóstico por imagenRESUMEN
Introducción: La medicina ancestral ha utilizado plantas con cualidades medicinales para prevenir y tratar enfermedades; aun cuando este tipo de investigaciones se han incrementado, son escasos los estudios con tubérculos andinos. Objetivo: Determinar la actividad biológica de extractos acuosos y etanólicos de los tubérculos andinos Tropaeolum tuberosum (mashua) y Ullucus tuberosus (melloco). Métodos: La investigación fue experimental y se desarrolló in vitro. La muestra estuvo constituida por 2 tubérculos andinos utilizados en la medicina ancestral. Se aplicaron técnicas de extracción en medio acuoso y etanólico. Los extractos fueron evaluados para determinar la actividad hemoaglutinante, anticoagulante y antimicrobiana con cepas ATCC. Resultados: Se demostró actividad hemoaglutinante en el extracto acuoso de T. tuberosum sobre eritrocitos A. Todos los extractos acuosos mostraron actividad anticoagulante, Tropaeolum tuberosum inhibió la actividad de la coagulación sanguínea (vía intrínseca) con un TTPa> 300 seg. Tanto los extractos acuosos y etanólicos exhibieron actividad antimicrobiana contra cepas ATCC, Tropaeolum tuberosum inhibió el crecimiento de Staphylococcus aureus 25923 con halos de 17 y 22 mm y Ullucus tuberosus (blanco) con halos de 10 y 30 mm, respectivamente. Los extractos acuosos de Tropaeolum tuberosum y Ullucus tuberosus (rojo) inhibieron el crecimiento de Candida tropicalis 66029 con halos de 27 y 12 mm y respectivamente. Conclusiones: Determinada la actividad biológica, se evidencia que los tubérculos andinos estudiados aglutinan eritrocitos humanos, específicamente eritrocitos del grupo A, así mismo, capacidad de inhibir las proteínas plasmáticas de la coagulación y de inhibir el crecimiento bacteriano y micótico de cepas ATTC.
Introduction: Ancestral medicine has used plants with medicinal qualities to prevent and treat diseases, even though this type of research has increased, studies with Andean tubers are scarce. Objective: To determine the biological activity of aqueous and ethanolic extracts of the Andean tubers Tropaeolum tuberosum (mashua) and Ullucus tuberosus (melloco). Methods: The research was experimental and was developed in vitro. The sample consisted of 2 Andean tubers used in ancestral medicine. Extraction techniques were applied in aqueous and ethanolic medium. The extracts were evaluated for hemagglutinating, anticoagulant and antimicrobial activity with ATCC strains. Results: Hemagglutinating activity was demonstrated in the aqueous extract of T. tuberosum on A erythrocyte. All aqueous extracts showed anticoagulant activity, Tropaeolum tuberosum inhibited blood coagulation activity (intrinsic pathway) with an aPTT>300 sec. Both aqueous and ethanolic extracts exhibited antimicrobial activity against ATCC strains, Tropaeolum tuberosum inhibited the growth of Staphylococcus aureus 25923 with halos of 17 and 22 mm and Ullucus tuberosus (white) with halos of 10 and 30 mm, respectively. The aqueous extracts of Tropaeolum tuberosum and Ullucus tuberosus (red) inhibited the growth of Candida tropicalis 66029 with halos of 27 and 12 mm, respectively. Conclusions: Once the biological activity was determined, it was evident that the Andean tubers studied agglutinated human erythrocytes, specifically group A erythrocytes, as well as the ability to inhibit plasma coagulation proteins and inhibit the bacterial and fungal growth of ATTC strains.
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Objective: LGBTQ+ health research guides can strengthen the LGBTQ+ community through connecting people to quality health services and information, and previous studies have recommended that health sciences libraries create and maintain these guides. Little evidence exists, though, on how these guides are used and how well they meet the needs of LGBTQ+ users. Using retrospective data retrieved from multiple LGBTQ+ health research guides, we examined the categories of LGBTQ+ health information most used, as well as how often guides were accessed. Based on these results, we hope to find patterns which can lead to best practices for libraries. Methods: Five North American academic health sciences libraries contributed select usage data from their LGBTQ+ health research guides, covering a three-year period (July 2018-June 2021). Data was analyzed in two ways. Firstly, the 20 most-clicked resources from each guide were categorized through open coding, to assess if certain information resource categories were more popular among guide users, allowing for inference of user needs. A time-series analysis was also conducted for two sites, using the Classical Seasonal Decomposition by Moving Averages method, to provide deeper insights into the data. Results: Open coding data showed consumer health information resources were used more often than other health resource categories. Resources from more locally based organizations and those with provider and services information were heavily used, indicating that users may be looking for information connecting to local health services and providers. The time series analysis allowed the potential positive effect of guide promotion to be showcased in ways that would not have been clear from the raw data. Conclusion: This study shows that people are accessing LGBTQ+ consumer health information through academic library research guides, with a preference for local information. Guide usage appears to be positively driven by outreach within one's institution and to the greater community. Locating external partners may increase guide impact and provide important links to local resources and services.
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Bibliotecas Médicas , Minorías Sexuales y de Género , Humanos , Estudios Retrospectivos , Proyectos de InvestigaciónRESUMEN
Purpose: HIV screening is a critical step in the HIV care continuum to lowering incidence and achieving viral load suppression among at-risk populations. Few studies assess factors associated with HIV screening among transgender individuals living in the southeast region of the United States. This study was conducted to determine factors that influence HIV screening among transgender individuals in South Florida. Methods: During Fall 2016, 68 participants were recruited to complete a questionnaire as part of a pilot pre-exposure prophylaxis study. Correlations were examined between sociodemographic factors, HIV risk, and access to and engagement in care. Significant correlations were entered into one logistic regression model to estimate predictors of HIV screening and knowledge of HIV status. Results: Almost half (48.5%) of the respondents were Latinx, 38.2% Black, 10.3% non-Latinx White, and 3% other. Seventy-eight percent reported access and routine engagement in care within the past year, 25% had not screened for HIV in the past year, and of those who knew their status, 16.7% reported living with HIV. Regression analysis revealed that participants with routine engagement in care were twice as likely to screen for HIV (p=0.02). Unstable housing was associated with no HIV screening in the past year (p=0.05). Conclusion: Stable housing is linked to engagement in routine care that can increase the likelihood of an at-risk transgender individual screening for HIV. Further research is needed to develop interventions to improve engagement in care among transgender individuals who do not have adequate housing or access to care.
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BACKGROUND: Although lasers have been the criterion standard for tattoo removal, selecting the best modality can be challenging because of the varying efficacies and adverse effects. OBJECTIVE: To evaluate all lasers used to remove tattoos and assess their efficacies and adverse effects. METHODS: Our systematic review searched PubMed, MEDLINE, Embase, Scopus, CINAHL, Cochrane Central Register of Trials, and ClinicalTrials.gov for all laser treatments. The outcomes measured included laser parameters, treatment methods, patient and tattoo characteristics, clearance rate, and adverse effect rate. The quality of the included articles was appraised by using specific assessment tools and given a high, moderate, or low risk of bias. RESULTS: Our search led to 3037 studies, with 36 being included in the systematic review (7 randomized controlled trials, 2 nonrandomized controlled trials, and 27 case series). Although quality-switched neodymium-doped yttrium-aluminum-garnet lasers are safe and effective, picosecond lasers have shown superiority with blue, green, and yellow tattoo pigments. Both are safe and effective for black tattoos. LIMITATIONS: Variability among studies. CONCLUSIONS: Picosecond lasers show superiority when treating blue, green, and yellow tattoos. The R20 and R0 novel techniques can effectively reduce treatment time. Further randomized controlled trials are required to make a more definitive recommendation.
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Terapia por Láser , Láseres de Estado Sólido , Tatuaje , Humanos , Terapia por Láser/efectos adversos , Terapia por Láser/métodos , Láseres de Estado Sólido/efectos adversosRESUMEN
OBJECTIVES: Current literature recommends online research guides as an easy and effective tool to promote LGBTQ+ health information to both health care providers and the public. This cross-sectional study was designed to determine how extensive LGBTQ+ health guides are among hospital and academic libraries and which features are most prevalent. METHODS: In order to locate LGBTQ+ health guides for content analysis, we searched for guides on the websites of libraries belonging to the Association of Academic Health Sciences Libraries (AAHSL) and the Canadian Association of Research Libraries (CARL). Additionally, we searched the Springshare interface for LibGuides with the word "health" and either "LGBT" or "transgender." Content analysis was performed to identify major characteristics of the located guides, including target audience and the information type provided. RESULTS: LGBTQ+ research guides were identified for 74 libraries. Of these, 5 were hospital libraries, and the rest were academic libraries. Of 158 AAHSL member libraries, 48 (30.4%) had LGBTQ+ guides on their websites. Nearly all guides (95.9%) provided general LGBTQ+ health information, and a large majority (87.8%) also had information resources for transgender health. Smaller percentages of guides contained information on HIV/AIDS (48.6%) and women's health (16.2%). CONCLUSIONS: Even though literature recommends creating LGBTQ+ health guides, most health sciences libraries are missing an opportunity by not developing and maintaining these guides. Further research may be needed to determine the usage and usefulness of existing guides and to better identify barriers preventing libraries from creating guides.
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Bibliotecas Médicas , Personas Transgénero , Canadá , Estudios Transversales , Femenino , Humanos , Encuestas y CuestionariosRESUMEN
In 2009, the Herbert Wertheim College of Medicine at Florida International University opened its doors. From the start, its medical library sought student feedback by administering a survey to each class. The responses found that students use online resources far more than the facility, that the hours are mostly adequate, and that most students prefer a combination of print and electronic textbooks. By analyzing the data, the library determined students' preferences for space, services, and resources and how those preferences have changed over time. This data will inform future decisions about the library's collection, services, and facility.
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Bibliotecas Médicas , Medicina , Estudiantes de Medicina , Humanos , Encuestas de Bibliotecas , UniversidadesRESUMEN
BACKGROUND: The majority of the transgender female population in South Florida are Latina and Black, and are at greatest risk for acquiring HIV, yet there is limited research focused on South Florida transgender women of color. The study objective was to describe the disparities among racial/ethnic minority transgender women regarding HIV screening, pre exposure prophylaxis (PrEP) knowledge and PrEP utilization. METHODS: Sixty transgender women, recruited from South Florida community-based organizations, completed a questionnaire on HIV prevention and PrEP awareness and use. Univariate statistics were generated to describe sexual risk behavior, PrEP awareness and use, and HIV screening by race/ethnicity. RESULTS: Of the 60 participants, 50.0% were Latina, 35.0% African American/non-Hispanic Black (AA/NHB), 11.7% white and 3.3% other race/ethnicity. 75.0% reported being screened for HIV in the last 12 months, 15.3% of the participants reported living with HIV (PLWH), while 18.6% reported an unknown status. Compared to Latinas, AA/NHB demonstrated more risk (≥2 sexual partners: 76.2% vs 53.3%; transactional sex: 47.6% vs. 26.7%; unprotected receptive anal sex: 42.9% v. 26.7%), and more engagement in routine care (81.0% vs. 76.7%) at least once a year. PrEP knowledge was 76.7% among Latinas, 71.4% among whites, 47.6% among Blacks, and 50.0% among other race/ethnicity. 65.0% of participants knew about PrEP. Of the 8.2% with current or previous PrEP use, none were AA/NHB. CONCLUSION: Findings suggest that education and public health campaigns in South Florida that promote HIV prevention should focus on increasing awareness and utilization of PrEP among racial/ethnic minority transgender, particularly among AA/NHB transgender women who are most at risk and had the lowest knowledge and use of PrEP.
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Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Profilaxis Pre-Exposición , Grupos Raciales/estadística & datos numéricos , Personas Transgénero , Adolescente , Adulto , Femenino , Florida/epidemiología , Infecciones por VIH/epidemiología , Humanos , Tamizaje Masivo/estadística & datos numéricos , Asunción de Riesgos , Trabajo Sexual/estadística & datos numéricos , Parejas Sexuales , Encuestas y Cuestionarios , Adulto JovenRESUMEN
No disponible
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Humanos , Masculino , Anciano , Leishmaniasis Cutánea/diagnóstico , Meglumina/uso terapéutico , Crioterapia , Leishmaniasis Cutánea/tratamiento farmacológico , Leishmania/patogenicidadAsunto(s)
Leishmaniasis Cutánea/patología , Piel/patología , Anciano , Biopsia , Humanos , MasculinoRESUMEN
No disponible
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Humanos , Masculino , Anciano de 80 o más Años , Leucemia Mielomonocítica Aguda/diagnóstico , Eritema/etiología , BiopsiaRESUMEN
No disponible
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Adulto , Humanos , Micosis Fungoide/diagnóstico , Neoplasias Cutáneas/diagnóstico , Micosis Fungoide/patología , Neoplasias Cutáneas/patología , Dorso/patología , BiopsiaAsunto(s)
Mejilla/patología , Oído Externo/patología , Lepra Multibacilar/diagnóstico , Mycobacterium leprae/aislamiento & purificación , Piel/patología , Biopsia , Brasil , Mejilla/microbiología , Oído Externo/microbiología , Femenino , Granuloma/microbiología , Granuloma/patología , Humanos , Leprostáticos/uso terapéutico , Lepra Multibacilar/tratamiento farmacológico , Lepra Multibacilar/microbiología , Lepra Multibacilar/patología , Persona de Mediana Edad , Piel/microbiología , EspañaRESUMEN
Mujer latinoamericana de 50 años que acudió a la consulta por lesiones pruriginosas de reciente aparición en los brazos y muslos. En la exploración observamos múltiples pápulas planas en las extremidades, así como máculas hipopigmentadas en el tronco que, según refería la paciente, comenzaron a aparecer en la infancia. Se realizó el estudio histológico de ambos tipos de lesiones en el que se apreciaron en las capas altas de la epidermis unos queratinocitos aumentados de tamaño con citoplasma de color azul pálido. Se han descrito más de 20 tipos de virus del papiloma humano (VPH) asociados a epidermodisplasia verruciforme (EV) (VPH-EV). Aunque antes se pensaba que estos eran específicos de la EV, gracias a nuevas técnicas de biología molecular, se han aislado secuencias de VPH-EV en enfermedades cutáneas con hiperproliferación epidérmica tanto benignas como malignas en población inmunocompetente
We present the case of a 50-year-old Latin American woman who consulted her physician because of recent pruritic lesions on her arms and thighs. During the examination, we observed multiple flat papules on the limbs, as well as hypopigmented macules on the trunk which, according to the patient, began to appear during childhood. A histological study was performed on both types of lesions, and showed some enlarged keratinocytes with light blue cytoplasm in the upper layers of the epidermis. More than 20 types of HPV associated with EV (HPV-EV) have been described. Although it was previously thought that these were specific to EV, new molecular biology techniques have made it possible to isolate HPV-EV sequences in skin diseases, both benign and malignant, with epidermal hyperproliferation in the immunocompetent population
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Femenino , Persona de Mediana Edad , Humanos , Epidermodisplasia Verruciforme/diagnóstico , Epidermodisplasia Verruciforme/terapia , Queratinocitos/citología , Queratinocitos/patología , Papillomaviridae/patogenicidad , Epidermodisplasia Verruciforme/complicaciones , Queratinocitos , Papiloma/complicaciones , Papiloma/diagnóstico , Verrugas/complicaciones , Verrugas/diagnóstico , Epidermodisplasia Verruciforme/etiología , Epidermodisplasia Verruciforme/patologíaRESUMEN
We present the case of a 50-year-old Latin American woman who consulted her physician because of recent pruritic lesions on her arms and thighs. During the examination, we observed multiple flat papules on the limbs, as well as hypopigmented macules on the trunk which, according to the patient, began to appear during childhood. A histological study was performed on both types of lesions, and showed some enlarged keratinocytes with light blue cytoplasm in the upper layers of the epidermis. More than 20 types of HPV associated with EV (HPV-EV) have been described. Although it was previously thought that these were specific to EV, new molecular biology techniques have made it possible to isolate HPV-EV sequences in skin diseases, both benign and malignant, with epidermal hyperproliferation in the immunocompetent population.
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Epidermodisplasia Verruciforme/patología , Femenino , Humanos , Persona de Mediana EdadRESUMEN
La pérdida de la corona clínica cuya extensión se ubica subgingival o infraósea, representa para el odontólogo un problema al momento de restaurar un diente, por lo cual se pueden utilizar técnicas variadas para facilitar la restauración definitiva. Entre éstas se encuentra la erupción forzada, lograda mediante la ayuda de procedimientos ortodóncicos, desde pequeñas secciones de arco hasta el manejo integral de un tratamiento ortodóntico completo. El presente artículo muestra el manejo ortodóncico a través de la técnica de doble arco de un premolar superior el cual perdió la corona clínica, para luego ser restaurado de manera definitiva con un perno artificial colado y una corona de porcelana fundida sobre metal.