International Medical Publisher Journals (iMedPub)
Not a member yet
352 research outputs found
Sort by
Video laryngoscopy as a device for removal of foreign body in the laryngopharynx
Get PDFBackground: Foreign bodies in the hypo pharynx unusually present needle stick nature, and not tend to perforate the mucosa. The most common in this region are described EC spines of fish, but a wide variety of objects have been found. In this case were rice husk (oryza sativa). The following case report describe the foreign body removing with devices usually used for intubation.Case report: a female patient, 28 years old, admitted to the emergency HRC with complaints of pain and irritation in the throat (herringbone). Was referred for endoscopy diagnosis of foreign body in the oesophagus and submitted to EDA under general anesthesia without visualizing abnormalities.  Conclusions: video laryngoscopy devices can be used to remove most foreign body in the hypo pharynx after several attempts by other techniques
Prácticas sexuales y uso del preservativo en adolescentes escolarizados de MedellÃn, 2014
Get PDFIntroducción: La adolescencia es un periodo de grandes cambios fÃsicos, psicológicos, emocionales y sociales que incrementan el riesgo sexual.Objetivo: Estimar la prevalencia de prácticas sexuales de riesgo y su asociación con el uso del preservativo en adolescentes escolarizados en instituciones públicas de MedellÃn.Material y métodos: Estudio de prevalencia en 3.453 adolescentes seleccionados aleatoriamente. Se empleó fuente primaria de información. Los análisis se basaron en proporciones, intervalos de confianza, Prueba Z, Chi cuadrado, t Student, razones de prevalencia y regresión logÃstica.Resultados: 39,7% fueron hombres, 50,7% de estrato socioeconómico bajo; la principal fuente de información en sexualidad fue internet, 42,6% viven en familias nucleares. El 54,6% ha iniciado su vida sexual, con edad media de inicio de 14 años. La proporción de adolescentes que han tenido relaciones sexuales fue estadÃsticamente mayor en hombres, de adolescencia tardÃa, provenientes de familias monoparentales y en quienes buscan información sobre salud sexual en internet o amigos. La frecuencia de uso del condón fue 66,3%; 58,7% lo utilizan de forma incorrecta y sólo 38,3% lo usa en todas sus relaciones sexuales.Conclusión: El elevado riesgo sexual, la elevada frecuencia de mitos sobre el condón y la identificación de grupos de mayor vulnerabilidad sexual, constituyen resultados de gran utilidad para formular, implementar o evaluar las polÃticas públicas relacionadas con la adolescencia y la salud sexual y reproductiva
Antibiotic resistant bacteria in terrestrial and aquatic environments: A review
Get PDFAntibiotic resistant bacteria have become increasingly widespread in environment and their prevalence is a serious problem for health. The rise and spread of this resistance is primarily due to overuse of antibiotics in clinical therapeutics and as growth promoters for livestock. Overuse undermines the usefulness of antibiotics by giving a selective advantage to microbes that are resistant. The problem has been exacerbated by the emergence of bacteria that are resistant to multiple antibiotics, and by the ability of these resistance determinants to spread horizontally between different bacteria via horizontal gene transfer. Such transfer can, for example, take place in the guts of farm animals, which can become reservoirs of multiple antibiotic resistant bacteria (MARB). Antibiotics and MARB enter the environment via wastewater, especially from hospitals and pharmaceutical plants, and through agricultural runoff, leading to contamination of surface and ground water. This is a serious problem in arid regions such as Oman where wastewater is recycled for irrigation and recharging aquifers. Even treatment with chlorine does not completely remove bacteria from wastewater or prevent their re-growth in downstream distribution systems. MARB can reach humans via contaminated food and drinking water, or directly from the environment. Agricultural runoff and sewage, either treated or untreated, are also the main sources of antibiotic resistant bacteria in coastal sea water. It is necessary to use antibiotics more prudently in medicine, treat wastewater more effectively, eliminate the discharge of untreated waste into the environment, and curtail the profligate use of antibiotics as growth promoters for livestock.Â
Diagnosing congenital toxoplasmosis: where are we? A systematic review
Get PDFPurpose: Compile information on laboratory methods for diagnosis of congenital toxoplasmosis, considering the tests conducted since the gestational stage until the child period. Methods:A systematic review of 01.01.2006 to 31.12.2013 was held by VHL (Virtual Health Library). The search was performed with the descriptors ''toxoplasmosis†and “diagnosis. The selected articles were indexed in MEDLINE. The information pertinent to the study was selected, categorized and analyzed. Of the 186 articles found, 41 met the eligibility criteria. Results: Laboratory tests are based on the presence of antibodies IgM and IgG anti-Toxoplasma gondii, in this sense it is important to correctly interpret serology, because the detection of specific antibodies is often delayed by the presence of maternal IgG or late production of specific antibodies in newborns. Molecular techniques (PCR) have emerged as alternative due to its higher sensitivity and specificity in diagnosing instruments, given the ability to detect parasite DNA and non-dependence of the immune response of the patient, such as serological tests.Conclusions: The need for early treatment of congenital toxoplasmosis in order to avoid sequelae justifies the search for more sensitive and specific laboratory tests in early detection of the parasite. Theintegration among the different levels of care in the public health system is essential for obtaining effective control of toxoplasmosis in pregnant women.Â
The Cystic Mesothelioma: case report
Get PDFIntroduction: the cystic mesothelioma of the peritoneum (MCP) is a rare disease, with few reported cases. The first description was made by Smith and Mennemeyer in 1979. It is an intra-abdominal tumor that occurs most frequently in women of reproductive age. Objective: To describe the case of Mesothelioma Cystic the peritoneum due to rarity of this tumor, the similarity of their symptomatic presentation with other diseases, the lack of specific symptoms and characteristics of imaging and its diagnosis difficult, based on postoperative histological findings. Case report: A 45 years old and female, presented abdominal pain in the right upper quadrant lasting 6 months. During investigation was evidenced in computerized tomography a massive hypodense formation, net multiseptada. Its surgical hysterectomy for uterine perforation history. Forwards for surgery with macroscopic findings of retroperitoneal cystic lesion, complex and voluminous suggestive of Mesothelioma Cystic peritoneal. Conclusion: This tumor is known for its local recurrence, and surgery was the only effective treatment
Intra-Hepatic Cholangiocarcinoma Treated with GEMOX + Cetuximab Protocol
Get PDFNew studies show a possible benefit of combining Gemcitabine, Oxaliplatin and Cetuximab for the treatment of intrahepatic tumors. However, there is currently no consensus on this in the literature. Hence, this article contributes to the debate by presenting a case of cholangiocarcinoma(biliary tract cancer), treated with a modified Gemcitabine, Oxaliplatin and Cetuximab protocol, which evolved to a considerable regression of the tumor and a complete radiologic response assessed by PET-CT Scan. The case report is of a female adult, who presented with a cholangiocarcinoma extending to hepatic segments V and VIII which met the unresectability criteria. She was submitted to chemotherapy,consisting of a combination of Gemcitabine, Oxaliplatin and Cetuximab for a prolonged period,followed by a maintenance interval of Cetuximabmonotherapy. After the 8th cycle, the patient presented better hepatic biomarker levels; after 12months of treatment, she presented a PET-CT scan showing complete radiologic response; after 15 months of treatment, an MRI scanshowed a reduced and resectable tumor. Our case report suggests use of theGemcitabine + Oxaliplatin(GEMOX) plus Cetuximab protocol as a neoadjuvant settingfor patients with unresectable cholangiocarcinoma submitted to the GEMOX protocol, presenting a progressing disease. Additionally, our case report confirms the GEMOX plus Cetuximab protocol can be modified according to clinical response so patients can obtain maximum therapeutic gain despite minor or adverse reactions
Osteocondritis disecante: A propósito de un caso
Get PDF La OCD es una patologÃa tÃpica a tener en cuenta dentro del diagnostico diferencial del dolor de rodilla del niño y adolescente para evitar un posible retraso diagnóstico que conlleve su evolución hacia la limitación funcional, la inestabilidad articular, el dolor crónico o el desarrollo precoz de osteoartrosis. El tratamiento incluye opciones conservadoras o quirúrgicas en función de la edad, del tamaño y de la inestabilidad de la lesión condral. Â
Respuesta exitosa del manejo con dapsona de un caso de lupus bulloso en un paciente con lupus eritematoso sistémico juvenil
Get PDFEl lupus ampulloso es una manifestación dermatológica infrecuente. Su aparición en población pediátrica es aún más rara. Presentamos el caso de una paciente que desarrolló esta manifestación en el curso de un lupus eritematoso sistémico con afectación fundamentalmente articular. Las lesiones cutáneas se circunscribieron a zonas de fotoexposición y no se asociaron a otras manifestaciones sistémicas de la enfermedad. La paciente fue tratada con Dapsona presentando mejorÃa clÃnica a corto plazo
Antifungal susceptibility, risk factors and treatment outcomes of patients with candidemia at a university hospital in Saudi Arabia
Get PDFBackground: Candidemia is a major cause of morbidity and mortality in hospitalized patients. The spectrum of candidemia has been changed especially among critically ill patients due to emergence of non-albicans Candida (NAC) species. The increasing use of azole agents is suggested to be responsible for this epidemiological shift. NAC species are of special concern because of their high drug-resistance and increasing prevalence.The aim of this study was to detect antifungal-susceptibility patterns, treatment outcomes and associated risk factors in patients with candidemia who were admitted to King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia (KSA) .Methods: This work represents a cross sectional study done in the Clinical and Microbiology Laboratory at KAUH, during the periodfrom March 2012 till February 2014 on a total of 141 patients with candidemia. They were 31(22%) Saudi and 110(87%) non-Saudi patients with age ranged from 1 day - 102 years. Blood cultures were collected for suspected cases of candidemia, followed by subculture on SDA. Identifiation was done by VITEK MS (MALDI-TOF MS), and confimation of Candida isolates and antifungal-susceptibility testing were performed by using VITEK ®2 system.Results: C.albicans isolates accounted for 39.7%, followed by C. tropicalis (21.3%), C. galabrata (18.4%) and C. parapsiliosis (14.9%). Additionally, C. dublinsis, C. krusei and C. famata were representing 2.1%, 2.1% and 1.4%, respectively. All Candida isolates were 100% susceptible to amphotericin B. The best susceptibility to flconazole was detected among each C. dubliensis and C. famata (100%). All C. krusei isolates were resistant to flconazole, while they were susceptible  to other antifungal agents. All isolates were susceptible to flcytosine,except C. albicans and C. dubliensis which were susceptible 92.9%and 66.7%, respectively. All isolates were susceptible to itraconazol,except C. albicans and C. tropicalis which were susceptible 94.6% and 96.7%, respectively. The percentage of deceased patients with candidemia was signifiantly higher than the survivors among age group >64 years, particularly those who were mechanically ventilated and those understeroid therapy. The percentage of deceased patients was signifiantly higher than survivors among those admitted to adult ICUs (73.78%vs 26.23%) .Conclusion: This study shows an epidemiological shift to higher NAC species isolation rates, with 100% susceptibility to amphotericin B in all isolates either C. albicans or NAC species, and 100% susceptibility to flconazole among C. dubliensis and C. famata. Patients aged > 64 years, admission to adult ICUs, mechanical ventilation and steroid therapy were signifiant risk factors for increased mortality due to candidemia
Variation of Peak Expiratory Flow Rate with Body Mass Index in Medical Students of Karachi, Pakistan
Get PDFOBJECTIVE: The primary aim of our study was to assess the variation of PEFR with BMI in normal medical students of Karachi, PakistanDESIGN: Cross-sectional studySetting: Medical students of Karachi Medical and Dental CollegeParticipants: 138 non-smoker healthy medical students composed of 111 females and 27 males. VARIABLE PARAMETERS: They include mean age, body height and body weight and PEFR. They were marked separately for each genderRESULTS: The mean BMI in females was found out to be 18.54±2.10 corresponding with that of mean PEFR value 431.62±56.62 whereas in males the mean BMI was 25.07±2.96 corresponding with that of mean PEFR value 533.70±23.22. Also there is a statistically significant variation in PEFR with an increase in BMI.CONCLUSION: The study concludes that PEFR is affected positively by variation in BMI. Also young males have more BMI and PEFR values than their young female counterparts. A large sample size with accurate peak flow meter is required along with ethnic consideration of the study population for better and accurate result