RESUMO
Zika virus (ZIKV) is an emerging mosquito-borne flavivirus transmitted mainly by Aedes species of mosquitos. Although the infection is usually mild and self-limiting, it is emerging as a public health challenge in tropical and subtropical countries owing to its unprecedented pathogenicity and increased risk for fetal malformations and neurological symptoms. Cutaneous manifestations as for other mosquito-borne viruses remain a hallmark of the disease. This article provides a detailed overview on ZIKV infection, including its varied cutaneous clinical manifestations and diagnostic aspects, and also provides detailed insights into its pathogenesis in human skin.
Assuntos
Exantema/etiologia , Dermatopatias/virologia , Pele/patologia , Infecção por Zika virus/complicações , Zika virus , Diagnóstico Diferencial , Febre/etiologia , Humanos , Infecção por Zika virus/patologiaRESUMO
Mediastinitis is a serious postoperative complication following pediatric cardiac surgery. The objective of this study is to evaluate the cost-effectiveness of surgical treatment for mediastinitis in Guatemala. All children who underwent a median sternotomy and developed postoperative mediastinitis between January 2004 and December 2005 were evaluated. Type of surgical treatment for mediastinitis, hospital outcome, and costs were analyzed. Eighteen (3.3%) of the 535 children who underwent a median sternotomy developed mediastinitis. Two patients underwent debridement of the infected tissues and delayed sternal closure, whereas 16 patients had debridement, primary chest closure, and continuous antibiotic irrigation of the mediastinum. All 11 patients who had the diagnosis of mediastinitis within 2 weeks after the operation survived. Three of the 7 patients (43%) who had delayed diagnosis died (p = 0.0003); all 3 had osteomyelitis (p = 0.0007). Primary closure with antibiotic irrigation was associated to a lower mortality rate and proved less expensive in comparison to delayed sternal closure (p = 0.003) mainly due to the shorter intensive care requirement. Debridement followed by primary closure of the chest and continuous antibiotic irrigation of the mediastinum seems to be a feasible and less expensive method to treat selected cases of postoperative mediastinitis in children.
Assuntos
Cardiopatias Congênitas/cirurgia , Mediastinite/cirurgia , Complicações Pós-Operatórias/cirurgia , Esterno/cirurgia , Criança , Pré-Escolar , Guatemala , Humanos , Lactente , Mediastinite/economia , Mediastinite/mortalidade , Osteomielite/economia , Osteomielite/mortalidade , Osteomielite/cirurgia , Complicações Pós-Operatórias/economia , Complicações Pós-Operatórias/mortalidade , Estudos Retrospectivos , Estatísticas não ParamétricasRESUMO
Se trata de una revisión retrospectiva de los traumatismos en menores de 18 años que ingresaron a la emergencia del Hospital de Emergencia del El Valle "Dr. Leopoldo Manrique Terrero". Con el diagnóstico de traumatismo abdominal puro, en el período comprendido entre enero de 1992 y diciembre de 1996. Durante ese lapso ingresaron 140 pacientes de los cuales 134 (95,72 por ciento) fueron de sexo masculino. El rango de edad más frecuente varió entre los 13 y 18 años con un 87,56 por ciento. El agente causal más frecuente fue herida por arma de fuego con un 74,28 por ciento. De los 140 pacientes a 126(90 por ciento) se le realizó laparotomía, de los cuales se complicaron 33 pacientes (26 por ciento) y tuvimos 10 defunciones que representaron el 7.1 por ciento