Enfermedades infecciosas y microbiología clínica
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Enferm. Infecc. Microbiol. Clin. · Oct 2012
Review[Candidemia and invasive candidiasis in the adult: clinical forms and treatment].
Invasive candidiasis is progressively increasing in frequency as a complication of the hospitalised adult patient. The availability of new antifungal drugs with lower toxicity and high efficacy has increased the complexity of managing of these infections. ⋯ Finding of a balance between the best benefit for the patient with the less costs is, nowadays, one of the main objectives of the current recommendations for the management of invasive candidiasis. In this review, the recommendations for the management of candidemia and other forms of invasive candidiasis (esophagitis, peritonitis, ocular, cardiovascular and osteoarticular candidiasis, central nervous system and urinary tract candidiasis, and chronic disseminated candidiasis) are analysed.
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Enferm. Infecc. Microbiol. Clin. · Oct 2012
ReviewInfluenza A(H1N1)pdm09-related pneumonia and other complications.
Influenza A(H1N1)pdm09 virus infection was associated with significant morbidity, mainly among children and young adults. The majority of patients had self-limited mild-to-moderate uncomplicated disease. However, some patients developed severe illness and some died. ⋯ In experimentally infected animals, the level of pulmonary replication of the influenza A(H1N1)pdm09 virus was higher than that of seasonal influenza viruses. Pathological studies in autopsy specimens indicated that the influenza A(H1N1)pdm09 virus mainly targeted the lower respiratory tract, resulting in diffuse alveolar damage (edema, hyaline membranes, inflammation, and fibrosis), manifested clinically by severe acute respiratory distress syndrome with refractory hypoxemia. Influenza A(H1N1)pdm09-related pneumonia and other complications were associated with increased morbidity and mortality among hospitalized patients.
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Enferm. Infecc. Microbiol. Clin. · Oct 2012
ReviewAntiviral treatment and vaccination for influenza A(H1N1)pdm09 virus: lessons learned from the pandemic.
The influenza pandemic that was declared by the World Health Organization in June 2009 created a new scenario for the use of influenza antivirals and vaccination. The new strain, influenza A(H1N1)pdm09, was resistant to amantadine and rimantadine, and the most frequently used antiviral was oseltamivir. Randomized studies were not performed comparing neuraminidase inhibitors with placebo. ⋯ A safe and effective vaccine to prevent disease from this new influenza strain was available in developed countries soon after the pandemic began; thus, the rate of adverse effects was comparable to that of seasonal influenza vaccines. The main barrier to its use was the concern of target populations about its necessity and safety. Therefore, the challenges for future pandemics will be to increase the population coverage of the vaccine in developed countries and to make it affordable for developing countries.
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On August 2010, the World Health Organization declared the end to the 2009 A(H1N1) pandemic. However, influenza A(H1N1)pdm09 continues to circulate as a seasonal virus. Different viruses have predominated in different parts of the world. ⋯ In addition, delays in oseltamivir administration, higher ages and comorbidities and low vaccination rates in patients with influenza A(H1N1)pdm09 infection were found during the first postpandemic season. Therefore, physicians should carefully consider the pandemic virus as a possible causative agent in patients with influenza-like illnesses admitted to emergency departments. In addition, surveillance systems and vaccination campaigns should continue after the pandemic period.
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Enferm. Infecc. Microbiol. Clin. · Oct 2012
[Clinico-epidemiological characteristics of HIV-positive immigrants: study of 371 cases].
The number of HIV-positive immigrants have increased in Spain in the last few years, and now represent a significant proportion of the epidemic. Our objective is to describe the clinico-epidemiological characteristics of HIV-positive immigrants seen in a specialist unit in Madrid. ⋯ Immigrants represent a significant proportion of new HIV-positive patients. It is a very heterogeneous group according to their clinical and epidemiological characteristics.