Medicina
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Invasive aspergillosis (IA) is a serious disease with high mortality. There are several risk factors and in-hospital outbreaks related with construction have been described. ⋯ Diagnosis is based on recognition of predisposing factors, clinical signs, imaging, direct examination, culture, histopathology, and biomarkers such as galactomannan. The drug of choice is voriconazole, but alternative therapies must be taken into account given the increasing presence of resistant isolates.
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Mortality of infective endocarditis (IE) in Argentina continues to be high. The aim objective was to describe the clinical characteristics and identify factors associated with in-hospital and long-term mortality in patients with native valve IE. ⋯ Mortality in IE was associated with the degree of previous comorbidity, with the presence of surgical indication criteria and, inversely, with the timely completion of surgical treatment.
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The objective was to evaluate the predictive value of the ROX index and describe the evolution of a population of patients admitted to intensive care for COVID-19 pneumonia who required high-flow oxygen therapy. ⋯ In patients with acute respiratory failure secondary to COVID-19 pneumonia treated with highflow oxygen therapy, the ROX index was a good predictor of success.
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Uncommon forms of syphilis exist, among which neurosyphilis, otosyphilis, and ocular syphilis are included. Neurosyphilis is the infection of the central nervous system caused by Treponema pallidum. The clinical manifestations of neurosyphilis are diverse and include early, late, and atypical forms. ⋯ Half of the patients presented bilateral sensorineural hearing loss; and also half of the patients had reactive VDRL in cerebrospinal fluid. All were treated with aqueous penicillin G, and in two of these cases, ceftriaxone was chosen to complete ambulatory treatment. One patient had an unfavorable outcome and died (case 1); another was lost in follow-up (case 4); one completely resolved his symptoms (case 2); and another one experienced symptom relapse six months after treatment (case 3).
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At the beginning of the SARS-CoV-2 pandemic, acute respiratory failure has been the most important cause of hospitalization in patients with COVID-19, being more severe in patients with comorbidities and risk factors. In these scenarios hypoxemia has been associated with increased mortality. Our objective was to identify parameters obtained from arterial blood gases (ABG) associated with mortality in patients with COVID-19 at hospital admission. ⋯ GSA generate a key contribution in understanding the pathophysiology of the COVID-19 patient: in the initial evaluation, monitoring and prognosis of this disease.