Asunto(s)
Enfermedades Autoinmunes del Sistema Nervioso/etiología , Betacoronavirus , Infecciones por Coronavirus/complicaciones , Trastornos Neurológicos de la Marcha/etiología , Pandemias , Neumonía Viral/complicaciones , Temblor/etiología , Corticoesteroides/uso terapéutico , Anciano , Albuterol/uso terapéutico , Antibacterianos/uso terapéutico , Enfermedades Autoinmunes del Sistema Nervioso/tratamiento farmacológico , Betacoronavirus/aislamiento & purificación , COVID-19 , Prueba de COVID-19 , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Quimioterapia Combinada , Humanos , Hidroxicloroquina/uso terapéutico , Linfohistiocitosis Hemofagocítica/tratamiento farmacológico , Linfohistiocitosis Hemofagocítica/etiología , Masculino , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , SARS-CoV-2RESUMEN
The incidence of community-acquired pneumonia (CAP) ranges from 2-15 cases / 1,000 inhabitants / year, being higher in those older than 65 years and in patients with high co-morbidity. Around 75% of all CAP diagnosed are treated in the Emergency Department (ED). The CAP represents the main cause for sepsis and septic shock in ED, and the most frequent cause of death and admission to the Intensive Care Unit (ICU) due to infectious disease. Overall mortality is 10-14% according to age and associated risk factors. Forty to 60% of CAP will require hospital admission, including observation units (with very variable ranges from 22-65% according to centers, seasonal of the year and patients´ characteristics). Between the admissions, 2-10% will be in the ICU. All of previously mentioned reflects the importance of the CAP in the ED, as well as the "impact of the emergency care on the patient with CAP", as it is the establishment where the initial, but key decisions, are made and could condition the outcome of the illness. It is known the great variability among physicians in the diagnostic and therapeutic management of CAP, which is one of the reasons that explains the great differences in the admission rates, achievement of the microbiological diagnosis, request for complementary studies, the choice of antimicrobial treatment, or the diversity of applied care. In this sense, the implementation of clinical practice guidelines with the use of the severity scores and the new tools available, such as biomarkers, can improve patient care with CAP in ED. Therefore, a multidisciplinary group of emergency professionals and specialists involved in the care process of CAP has designed a guideline with several recommendations for decisions-making during the key moments in patients with CAP attended in the ED.
Asunto(s)
Infecciones Comunitarias Adquiridas/terapia , Servicios Médicos de Urgencia/normas , Servicio de Urgencia en Hospital , Neumonía/terapia , Adolescente , Adulto , Anciano , Antibacterianos/uso terapéutico , Niño , Preescolar , Infecciones Comunitarias Adquiridas/etiología , Infecciones Comunitarias Adquiridas/microbiología , Femenino , Guías como Asunto , Mortalidad Hospitalaria , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Neumonía/etiología , Neumonía/microbiología , PronósticoRESUMEN
No disponible
Asunto(s)
Medicina Interna/educación , Educación Médica/tendencias , Medicina/tendenciasRESUMEN
AIMS: There are multiple drugs options in the treatment of Paroxysmal Supraventricular Tachycardia (PST) after inefficacious vagal stimulus. In this study we compare two of these treatments: verapamil versus adenosin triphosphate (ATP). METHODS: Fifty patients with PST were randomly treated with either Verapamil (5 to 10 mg) or ATP (5 to 20 mg). The basal features of each group, and the efficacy and safety of the two drugs were compared. Verapamil failures were treated with ATP and vice versa. RESULTS: The characteristics of both groups of treatment were similar. 86% of PST episodes were resolved with Verapamil use, versus 83% after ATP administration. Finally all patients were successfully treated with these drugs. No adverse effects were observed with Verapamil, whereas these effects were frequent with ATP use, but in any case requiring specific intervention. CONCLUSIONS: Both Verapamil and aTP are an equally safe and effective treatment of PST, but transient and minor side effects are frequent after ATP administration.