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1.
Lancet Reg Health Am ; 2: 100049, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34642686

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic may have exacerbated existing socioeconomic inequalities in health. In Argentina, public hospitals serve the poorest uninsured segment of the population, while private hospitals serve patients with health insurance. This study aimed to assess whether socioeconomic inequalities in low birth weight (LBW) risk changed during the first wave of the COVID-19 pandemic. METHODS: This multicenter cross-sectional study included 15929 infants. A difference-in-difference (DID) analysis of socioeconomic inequalities between public and private hospitals in LBW risk in a pandemic cohort (March 20 to July 19, 2020) was compared with a prepandemic cohort (March 20 to July 19, 2019) by using medical records obtained from ten hospitals. Infants were categorized by weight as LBW < 2500 g, very low birth weight (VLBW) < 1500 g and extremely low birth weight (ELBW) < 1000 g. Log binomial regression was performed to estimate risk differences with an interaction term representing the DID estimator. Covariate-adjusted models included potential perinatal confounders. FINDINGS: Of the 8437 infants in the prepandemic cohort, 4887 (57•9%) were born in public hospitals. The pandemic cohort comprised 7492 infants, 4402 (58•7%) of whom were born in public hospitals. The DID estimators indicated no differences between public versus private hospitals for LBW risk (-1•8% [95% CI -3•6, 0•0]) and for ELBW risk (-0•1% [95% CI -0•6, 0•3]). Significant differences were found between public versus private hospitals in the DID estimators (-1•2% [95% CI, -2•1, -0•3]) for VLBW risk. The results were comparable in covariate-adjusted models. INTERPRETATION: In this study, we found evidence of decreased disparities between public and private hospitals in VLBW risk. Our findings suggest that measures that prioritize social spending to protect the most vulnerable pregnant women during the pandemic contributed to better birth outcomes. FUNDING: No funding was secured for this study.

3.
Rev. Ciênc. Méd. Biol. (Impr.) ; 16(2): 251-254, out 27, 2017. fig
Artigo em Português | LILACS | ID: biblio-1344055

RESUMO

Introdução: a tríade clássica composta por progressiva disfunção neurológica, associada à surdez, e alterações visuais, foi descrita inicialmente em 1979 por Susac et. al. Rara, entretanto, com grande potencial de destruição, a Síndrome de Susac (SS) sempre deve ser aventada por otorrinolaringologistas em casos de surdez súbita, principalmente quando associada a quadros de encefalopatia aguda. Se diagnosticada corretamente, tratada de forma agressiva, precoce e em período adequado aumenta substancialmente o sucesso na recuperação da doença, bem como na prevenção de sequelas. Objetivo: o presente manuscrito descreve o caso clínico de uma paciente jovem, do sexo feminino, com Síndrome de Susac. Metodologia: a história clínica do caso foi desenhada a partir de anamnese detalhada com a paciente portadora da síndrome, que também nos forneceu os resultados de seus exames laboratoriais, de imagens e audiométricos. Fundamentando o tema a dados disponíveis na literatura científica, foi redigido o manuscrito a seguir. Resultados: o presente caso descreve o relato de uma jovem com SS tendo como primeira hipótese a esclerose múltipla, entretanto somente após o aparecimento completo da tríade, se confirmou o diagnóstico adequado. Conclusão: é importante incluir a hipótese da SS no diagnóstico diferencial de esclerose múltipla em adultos jovens, principalmente se a clínica do paciente evolui de forma atípica. Sutis manifestações otorrinolaringológicas ou de retina nestes pacientes, são dados essenciais e devem chamar atenção para a Síndrome de Susac.


Introduction: the classic triad composed by progressive neurological dysfunction associated to deafness and visual changes was first described in 1979 by Susac et. al. Despite of being a rare disease, Susac's syndrome (SS) has a high destruction potential, and has to be evaluated otolaryngologist in sudden deafness case, manly when associated with acute encephalopathy. If occur a correctly diagnostic associated with an aggressive, premature and appropriated period of treatment, the success of disease's recovery increase substantially, as well as sequels prevention. Objective: The present manuscript describes the report of a young woman with Susac´s syndrome. Methodology: the clinical history of the case was described from the detailed anamnesis with the patient with the syndrome, who also provided the results of her laboratory, imaging and audiometric tests. Based on the data available in the scientific literature, the following manuscript was written. Results: the present case describes the report of a young woman with SS. She had multiple sclerosis as first diagnosis, though the right diagnosis had only been confirmed after the triad completely appeared. Conclusion: it is important to include the SS hypothesis in the differential diagnosis of multiple sclerosis in young adults, especially if the patient's clinic evolves atypically. Subtle otolaryngological or retinal manifestations in these patients are essential data and should call attention to the Susac Syndrome.


Assuntos
Humanos , Feminino , Adulto , Perda Auditiva Súbita , Diagnóstico Diferencial , Síndrome de Susac , Otorrinolaringologistas , Esclerose Múltipla , Relatos de Casos
4.
J Travel Med ; 14(6): 407-10, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17995537

RESUMO

We describe one case of eosinophilic meningitis (EM) in a traveler returning from Santo Domingo, presumably caused by Angiostrongylus cantonensis. Treatment with mebendazole and steroids was effective. The presence of persistent headache, fever, and eosinophilia in travelers who return from developing countries should alert clinicians to the possibility of EM.


Assuntos
Angiostrongylus cantonensis/isolamento & purificação , Eosinofilia/parasitologia , Meningite/parasitologia , Infecções por Strongylida/diagnóstico , Viagem , Adulto , Animais , Antinematódeos/uso terapêutico , Diagnóstico Diferencial , República Dominicana , Eosinofilia/diagnóstico , Eosinofilia/tratamento farmacológico , Glucocorticoides/uso terapêutico , Humanos , Itália , Masculino , Mebendazol/uso terapêutico , Meningite/diagnóstico , Meningite/tratamento farmacológico , Prednisolona/uso terapêutico , Infecções por Strongylida/tratamento farmacológico
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