RESUMO
RESUMEN Durante la emergencia sanitaria debida al SARS-CoV-2 y ante la ausencia de una terapéutica específica surgieron tratamientos sin evidencia científica, conllevando a un contexto de infodemia sobre el uso de dióxido de cloro y derivados del cloro, cuyas medidas de elaboración, distribución y administración no son reguladas, exponiendo a un gran número de personas a dicho producto pudiendo llevar a contextos de intoxicación y muerte. En este escenario el artículo presentado tiene el objetivo de brindar al personal de salud, un enfoque de tratamiento integral del paciente intoxicado por estos productos a nivel prehospitalario, que consiste en realizar un protocolo donde se valore el escenario de la exposición del paciente (uso de equipo de protección personal, triaje, descontaminación, entre otros), se realice la evaluación primaria y una evaluación secundaria (revaloración continua del paciente) y a nivel hospitalario (evaluación sistemática del paciente, identificación de la vía de exposición y aplicación de uso de antídoto en escenarios específicos); así como medidas de prevención tanto para el personal de salud como para la población general.
ABSTRACT During the sanitary emergency due to SARS-CoV-2, and considering the absence of specific therapy against this condition, many therapy approaches with no underlying scientific evidence appeared, leading to infodemics with many publications about the use of chloride dioxide and chlorine derivatives, without any regulation on manufacturing, distribution, and administration of such products; and so many people developed multiple symptoms, leading to intoxication and death. In this context, this paper aims to offer healthcare personnel, a comprehensive pre-hospital therapy approach for patients affected by the aforementioned compounds. The idea is to perform a protocol where the scenario for patients' exposure is determined (use of personal protective equipment, triage, decontamination, and the like), primary and secondary assessments are to be performed (continuously reassessing the affected patient). Later, hospital management is to be performed (systematic patient's assessment, identifying the exposure route and use of an antidote when necessary for specific cases); and establishing prevention measures for both healthcare personnel and the general population.
RESUMO
BACKGROUND: Onychoscopy is a technique that uses a dermatoscope for the evaluation of specific features of different skin conditions that are not visible to the naked eye. There are few studies establishing parameters for the diagnosis of onychomycosis based on onychoscopy. Determining the sensitivity and specificity of a potentially new diagnostic test for onychomycosis requires an evaluation study of this new diagnostic test, as there are limited studies reporting onychoscopy results. AIM: To determine the sensitivity, specificity, positive predictive value and negative predictive value of onychoscopy findings in a Colombian population with onychomycosis. METHODS: We assessed outpatients with a diagnosis of toenail onychomycosis confirmed by potassium hydroxide preparation or fungal culture. Onychoscopy was performed using a dermatoscope, and digital images collected using a smartphone. RESULTS: The onychoscopy findings were: longitudinal striae, distal spiked pattern, distal irregular termination, linear edge and ruins aspect, while some patients were confirmed as having traumatic onycholysis. A statistically significant association was found between the clinical symptoms of onychomycosis and both the clinical feature of dyschromia and the onychoscopy feature of longitudinal striae. CONCLUSION: We suggest that this technique is an alternative method that should be used in patients with onychopathies because it has the potential to differentiate onychomycosis from traumatic onycholysis and another nail involvement.
Assuntos
Dermoscopia , Onicomicose/diagnóstico por imagem , Colômbia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Unhas/diagnóstico por imagem , Unhas/lesões , Onicomicose/microbiologia , Onicomicose/patologia , Valor Preditivo dos TestesRESUMO
BACKGROUND: In dental examining rooms, children experience diagnostic and therapeutic pain related to dental procedures that may be associated with anxiety. Therefore, the main objective of the present study was to evaluate anxiety and pain levels related to dental procedures in children. METHODS: Children in a Mexican pediatric dental clinic rated their dental anxiety using the Modified Dental Anxiety Scale (MDAS), the Children's Fear Survey Schedule Dental Subscale (CFSS-DS) and a 100-mm Visual Analogue Scale (VAS). Pain was evaluated with the VAS. RESULTS: A total of 437 children with a mean age of 9.8 (±2.2) years were evaluated. Four hundred eighty-one dental procedures were completed. The averages in the MDAS and the CFSS-DS were 8.5 (±3.4) and 22.7 (±7.6), respectively. Of all dental procedures, 275 (57.2 %) were rated as stressful prior to their realization, 222 (46.2 %) were stressful during their realization and 175 (36.4 %) were rated as painful. Overall, 12.6 % of the painful events were rated as severe, 25.1 % were rated as moderate, and 62.3 % were rated as slight. CONCLUSION: This study provides data on common procedures performed in dental clinics that cause pain and anxiety in children and young adolescents. Dentistry must consider the best non-pharmacological and pharmacological interventions to reduce dental anxiety and pain.