RESUMO
For better management of patients with febrile neutropenia, our study investigated the epidemiologic, microbiologic, and clinical characteristics of adult inpatients with febrile neutropenia and their mortality-associated factors. To this end, we carried out a prospective, observational, multicenter study in 28 Argentinian hospitals between 2007 and 2012. We included 515 episodes of febrile neutropenia from 346 patients, median age 49 years. Neutropenia followed chemotherapy in 77% of cases, half of the cases due to hematological malignancies. Most episodes were classified as high-risk according to MASCC criteria, and 53.6% of patients were already hospitalized at the onset of febrile neutropenia. Bloodstream infections were detected in 14% episodes; whereas an infectious source of fever was identified in 80% of cases. Mortality rate achieved to 14.95%. The binary regression analysis showed that persistence of fever at day 7, or neutropenia at day 14, dehydration and tachycardia at the onset of febrile neutropenia as well as prior infections were significantly associated with mortality. In addition to expanding our current knowledge on the features of adult patients with febrile neutropenia, present findings provide useful information for better management of them in Argentina, given the appropriate representativeness of centers participating in the study.
Assuntos
Neutropenia Febril/epidemiologia , Neutropenia Febril/microbiologia , Neutropenia Febril/mortalidade , Adulto , Antibacterianos/uso terapêutico , Argentina/epidemiologia , Feminino , Febre/complicações , Neoplasias Hematológicas/complicações , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de RiscoRESUMO
La fiebre Hemorrágica Argentina es una enfermedad viral aguda grave, de carácter sistémico, con duración de una a dos semanas, con cuadros clínicos de gravedad variable. Su agente transmisor es el virus Junín cuyo reservorio natural es el llamado ratón maicero y su zona endémica de distribución comprende sur de la provincia de Santa Fe, Córdoba, Noroeste de Buenos Aires y La Pampa, en Argentina. La primera medida preventiva para la enfermedad es la vacuna llamada Candid 1. Se realizó una encuesta poblacional para dimensionar en la zona de Venado Tuerto y localidades vecinas el alcance de la vacunación y estimar el conocimiento de la existencia de dicha vacuna, que no es de aplicación obligatoria.
Population survey on vaccination against Argentine Hemorrhagic fever in endemic area in the Province of Santa Fe. Argentine Hemorrhagic Fever is a serious systemic, acute viral disease, with a duration of one or two weeks and of variable gravity. Its transmitting agent is Junín Virus, whose natural reservoir is the corn mouse. Its endemic zone is the south of the province of Santa Fe, Cordoba, northwest of Buenos Aires and La Pampa; in Argentina. The first preventive measure for the disease is the vaccine called Candid 1. A population survey was carried out to measure the extent of vaccination and the knowledge of the vaccine, that is not of compulsory application.
Assuntos
Humanos , Doenças Endêmicas/prevenção & controle , Febre Hemorrágica Americana/prevenção & controle , Vírus Junin , Inquéritos Epidemiológicos , Saúde Pública , Vacinas , Viroses/prevenção & controleRESUMO
El síndrome TAR (Thrombocytopenia with Absent Radius) es una patología congénita autosómica recesiva infrecuente, caracterizada por trombocitopenia con aplasia de radio bilateral. Incluye malformaciones esqueléticas, renales, hematológicas y cardíacas. Su base genética todavía no está clara. Presentamos el caso de una paciente sin diagnóstico previo de síndrome TAR que llega a la consulta, tras haber sido evaluada por varios profesionales médicos, para el diagnóstico y el tratamiento de trastornos hematológicos, que finalmente estuvieron asociados a su síndrome congénito. (AU)
Thrombocytopenia with Absent Radius (TAR) is a rare autosomic recessive disease characterized by thrombocytopenia and bilateral radial aplasia, which includes skeletal, hematologic, renal and cardiac abnormalities. The genetics bases of this syndrome remain unclear. We report here a patient without a previous diagnosis of TAR syndrome who was seen in the clinic, after being evaluated by several medical professionals for diagnosis and treatment of blood disorders, which eventually were associated with the congenital syndrome. (AU)