Salud Integral y Comunitaria (Journal)
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Cholestasis gravidarum in women in the second and third trimester of gestation, clinical and specific pharmacological treatment and its benefits
Full text linkIntroduction: cholestasis gravidarum is a syndrome that usually occurs in pregnant women in the second or third trimester of pregnancy and ends in the puerperium. It is clinically characterized by the presence of predominantly nocturnal pruritus that is palmoplantar at first and then generalized. Alterations in liver function with or without jaundice and elevated serum bile acid levels, biochemical cholestasis is classified as mild to moderate in severity.This pathology does not have significant consequences for the mother, but it is associated with a high risk of affecting the newborn, such as premature delivery, fetal distress, fetal arrhythmias and intrauterine death. Objective: diagnostic methods and behaviors in their pharmacological treatments that provide the best results for those patients. Methods: systematic review with qualitative database from the PUBMED platform. The articles were downloaded from the PUBMED platform and Zotero was used to make the proper citations and references. In the investigation, the population will be composed of adult female patients who were admitted to any health care unit during the second and third trimesters. Results: the PUBMED database was used with the following MESH terms (cholestasis of pregnancy) that generated 2 597 results. 28 articles were analyzed in more depth, of which 12 articles were finally selected for the final analysis. Ursodeoxycholic acid (UDCA), a beta epimer of chenodeoxycholic acid, is a more polar bile acid than primary bile acids, with substantial choleretic and multiple other chemoprotective effects. The mechanism of action is not fully understood, but studies have shown that after treatment there is a reduction in total serum bile acids in both maternal and umbilical cord serum and a qualitative change in bile acid pool. serum. When compared to all controls, UDCA was also found to be associated with a decreased incidence of preterm birth, neonatal respiratory distress, and the number of neonatal intensive care unit admissions. Conclusion: the treatment of cholestasis gravidarum is the oral administration of ursodeoxycholic acid, it is effective and safe in the treatment of patients with cholestasis gravidarum
Covid-19 in pediatrics: A systematic review of the most frequent signs and symptons in the pediatric population
Full text linkIntroduction: coronavirus or Covid-19 is an infectious disease produced by SARS-CoV-2 that in 2019 generated a wave of infections throughout the world, where in March 2020 the World Health Organization (WHO) declared that the situation was no longer considered an epidemic but rather a pandemic, such a disease affected both adult and pediatric patients, but the disease in children has a much more benign behavior than that seen in adults, thus the number of articles published having focus on this group is much greater than that on children. Method: a systematic review of the literature available in different databases was carried out, focusing on PUBMED. Selecting those articles that were best related to the proposed topic. Results: non-specific symptoms such as fever, cough, diarrhea, sore throat are the most frequent and that when the patient presents atypical symptoms such as anosmia or ageusia, which are more frequent in adults, the probability of a positive diagnosis is greater. Even if the pathology is more benign, there is also the probability that these same patients present some complication, such as pediatric Multisystem Inflammatory Syndrome (SIM-p), which has a wide spectrum of manifestations and which, if not diagnosed and treated, leads the patient to death. Conclusion: according to published studies, the symptoms presented are very non-specific and not very serious, so it is not a pathology that frequently carries a risk to health, even though some cases have an evolution that can develop complications and very rarely to death
¿Vampirism or porphyria? Clarifying the enigma
Full text linkIntroduction: vampirism is the behavior of a person who acts like a vampire. Vampires are not real beings, but for two centuries there have been countless medical studies carried out to provide a causal and pathogenic response to the phenomenon. The exact disease that causes most of these vampiric alterations is porphyria.Objective: to describe the relationship between the classic signs and symptoms of the porphyric patient and the appearance and lifestyle of the mythical vampire.Method: a literature review was carried out during the period from August 1 to 20, 2023. Articles published in the last 5 years in Spanish and English were included and repeated or incomplete articles were excluded. The ScieELO, Medigraphic, and PubMed databases were reviewed. The search terms included Vampirism, Vampirism in Medicine, Porphyria, as well as their translation into English.Development: the association between vampirism and porphyria is probably the most famous. Erythropoietic congenital porphyria is the one associated with vampirism. It causes hypersensitivity to light and chronic hemolytic anemia. The similarities between the impressive description of the vampire\u27s anatomy and the physical appearance of porphyria sufferers are more than evident.Conclusions: many diseases have been proposed as an explanation for the appearance and behavior of this enigmatic character, with porphyria being the most accurate. Photosensitivity, pale skin, erythroderma and dark clothing are distinctive features of the “bloodsucking monsters” and are consistent with the clinical expression of the aforementioned disease