RESUMO
AIMS: To estimate the number of patients that have access to treatment of hepatitis C with direct-acting antivirals in Argentina and evaluate the factors associated with the lack of access. MATERIALS AND METHODS: A cross-sectional cohort study was conducted that included all the consecutive prescriptions of direct-acting antivirals issued at health centers that participated in the ECHOTM telemedicine project directed by the Hospital Italiano de Buenos Aires, within the time frame of January 2016 and February 2017. RESULTS: A total of 143 treatment prescriptions were included and overall access was 70% (95% CI 62-77%). The only independent factor associated with a lack of treatment access was coverage by a public healthcare system (OR 4.98 [95% CI 2.05- 12.09]). CONCLUSION: Patients with hepatitis C that were covered by a public healthcare system had a 4 times higher chance of not having access to treatment with direct-acting antivirals than patients covered by other healthcare systems (private insurance or the social welfare system).
Assuntos
Antivirais/uso terapêutico , Países em Desenvolvimento , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Hepatite C Crônica/tratamento farmacológico , Argentina , Estudos Transversais , HumanosRESUMO
INTRODUCTION: Stroke awareness by lay people in general is poor. It has been estimated that only as much as one third of patients with acute stroke reach emergency medical services within two hours of onset of their symptoms. We aimed to assess perception of and attitude towards a person with an acute stroke by professionals working in mobile unit of emergency medical service in the city of Campinas, Brazil. MATERIAL AND METHODS: The study was conducted during VII Stroke Workshop of Campinas in November 2007. We used an anonymous self-report questionnaire with a clinical case of an acute stroke with duration of 50 minutes. We asked two open-ended questions to gauge perception and attitude. RESULTS: One-hundred forty-nine of 205 (73%) participants answered the questionnaire; 49% were women, average age of 37 years (range 21-59). Ninety (60%) were professionals allied to medicine (nurses, health auxiliary, dentists), six (4%) were physicians, and 53 (36%) were other professionals (secretary, driver). In regard to perception, 142 of 149 (95%) had a correct perception of stroke. In regard to attitude, in general, the basic support measures have been pointed out, but only one (0.5%) mentioned an issue of time less than 3 hours for thrombolysis, four (2%) mentioned the possibility of thrombolysis, and 12 (8%) requested computed tomographic examination. DISCUSSION: It appears that professionals allied to medicine can diagnosis stroke of anterior circulation; however, they do not have thrombolytic therapy in mind, and this should be considered the default treatment for all patients with stroke within the "therapeutic window."
Assuntos
Atitude do Pessoal de Saúde , Serviços Médicos de Emergência , Acidente Vascular Cerebral/terapia , Adulto , Brasil , Estudos Transversais , Coleta de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Acidente Vascular Cerebral/diagnóstico , Inquéritos e Questionários , População Urbana , Adulto JovemRESUMO
Toddler-age nodulocystic acne is a rare disorder for which the etiology remains unknown. We report 2 cases and discuss the safety and efficacy of oral isotretinoin therapy. Oral isotretinoin is safe and effective in treating this condition but requires close monitoring.
Assuntos
Acne Vulgar/fisiopatologia , Acne Vulgar/tratamento farmacológico , Pré-Escolar , Feminino , Glucocorticoides/uso terapêutico , Humanos , Lactente , Isotretinoína/uso terapêutico , Ceratolíticos/uso terapêutico , Prednisolona/uso terapêuticoAssuntos
Acne Vulgar , Acne Vulgar/classificação , Acne Vulgar/diagnóstico , Idade de Início , Criança , Feminino , Humanos , PrognósticoRESUMO
The purpose of this study was to determine the role of the house dust mite. Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df), in allergic diseases on the island of St. Lucia. Dust samples were taken from living quarters of patients and hospital volunteers. The level of Df antigen in these living quarters was measured by RAST inhibition. All samples showed Df antigen within a large range of values. Prick tests were done to house dust mite and molds on 91 patients with suspected allergic disease with 63 (69%) reacting to at least one antigen. Of these, 56 (88.9%) reacted to one or both mites. House dust mite is a major allergen in St. Lucia.
Assuntos
Alérgenos/análise , Poeira/análise , Ácaros/imunologia , Adolescente , Adulto , Alérgenos/efeitos adversos , Animais , Antígenos de Dermatophagoides , Asma/epidemiologia , Asma/etiologia , Asma/microbiologia , Criança , Pré-Escolar , Poeira/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Rinite Alérgica Perene/epidemiologia , Rinite Alérgica Perene/etiologia , Rinite Alérgica Perene/microbiologia , Testes Cutâneos , Índias Ocidentais/epidemiologiaRESUMO
Four infants are described with kwashiorkor that was unassociated with poverty or infection as predisposing factors of their disease. The condition followed various dietary regimens deficient in protein of five weeks to seven months in duration. Features of this "sugar-bady" form of kwashiorkor included a low level of physician awareness of malnutrition as a diagnostic consideration, growth retardation, edema, muscle wasting, mental changes, and mild lymphocytosis. Initially, recovery was associated with rapid loss of weight and anemia and subsequently with weight gain and return to good health.