Chagas disease is caused by the protozoan Trypanosoma cruzi. Although it is commonly transmitted by an insect vector in continental Latin-America, in recent decades, due migration, has been diagnosed in other countries such Spain, the European country with a largest immigrant population of Latin American. For a long time, the patient remains asymptomatic, but some years after this stage, the symptoms can be serious (dilated cardiomyopathy, megacolon, megaesophagus). In addition, detection in pregnant women has a high priority because of the route of vertical transmission. Several specific guidelines about Chagas disease has been developed on the Banks of blood, maternal hospitals, HIV co-infection, organ transplant. But due to the detection of lack of information to primary care professionals, we consider to will be useful this document written and agreed to by family phisicians, pediatricians and specialists in International Health.
Consensus document for the detection and management of Chagas disease in Primary Health Care in non-endemic areas La tripanosomiasis americana o enfermedad de Chagas es una enfermedad infecciosa endémica en América Latina continental, causada por el protozoo Trypanosomacruzi. En las últimas décadas, debido a los movimientos poblacionales, se ha expandido más allá de las zonas endémicas, siendo España el país europeo con más inmigrantes latinoamericanos. Durante años puede permanecer asintomática, pero cuando se manifiesta clínicamente puede ser grave (miocardiopatía dilatada, megacolon, megaesófago). Así como, debido a su transmisión vertical, la detección en embarazadas es una alta prioridad. Se han elaborado guías de detección de Trypanosomacruzi en circunstancias específicas (bancos de sangre, maternidades, coinfección con VIH, trasplante de órganos); pero detectamos falta de información dirigida a los profesionales de atención primaria. Para facilitar la detección y manejo de esta enfermedad se consideró la necesidad de realizar este documento, redactado y consensuado por médicos de familia, pediatras de Atención Primaria y especialistas en Salud Internacional. Chagas disease is caused by the protozoan Trypanosoma cruzi. Although it is commonly transmitted by an insect vector in continental Latin-America, in recent decades, due migration, it has been diagnosed in other countries such as Spain, the European country with a largest immigrant population of Latin Americans. For a long time, the patient remains asymptomatic, but some years after this stage, the symptoms can be serious (dilated cardiomyopathy, megacolon, megaesophagus). In addition, detection in pregnant women has a high priority because of the route of vertical transmission. Several specific guidelines about Chagas disease have been developed (blood banks, maternal hospitals, HIV co-infection, organ transplant). But lack of information to primary care professionals has been detected. We consider this document written and agreed by family physicians, pediatricians and specialists in International Health will be useful.
Chagas disease is an endemic disease that in recent decades has ceased to be a rural disease to become mainly an urban disease, becoming a public health problem because it is a life-threatening disease and because 70 million people are at risk of infection. This disease, which has cardiac involvement in its chronic phase, can often be silent and asymptomatic, because of this the establishment of early markers in this type of patients is of great interest. To achieve this goal this study proposes the use of the permutation entropy (PE) which has been shown satisfactory results in the analysis of hearth rhythm and the differentiation between healthy people and people who suffered of congestive heart failure, also known as heart failure. This study analyzes three groups: 83 volunteers (Control), 102 patients with positive serology and no cardiac involvement diagnosed by conventional non-invasive methods (CH1) and 107 patients with positive serology and mild to moderate incipient heart failure (CH2). The used data comes from the 24-hour ECG record, the RR intervals from each of the three groups are shown in 288 frames of 5 minutes. The analysis performed shows significant differences between the three groups, with 90% to 100% specificity and sensitivity, making this study a promising precedent for the development of a low-cost, non-invasive method for detecting possible heart failure in asymptomatic patients.
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