INDICE DE CONTENIDOS TÍTULO: Estudios biológicos e inmunológicos de aislamientos de Toxoplasma gondii provenientes de animales de zoológico en Argentina ………………………………………01
Our results indicate that estimation of time of infection on the basis of serologic results is improved by the simultaneous application of several tests, and correlates closely with the presence of clinical lymphadenitis.
A prospective observational study of central venous catheters (CVC) was carried out in order to determine if a CVC inserted near an open burn wound increases catheter infection risk in burned patients. The study was carried out during a 12-month period (1998-1999) at the Benaim Foundation's Burn Unit in Buenos Aires (C.E.P.A.Q.). Eighty-three CVCs were inserted in 20 burned patients during the study period. Twenty-six catheters were inserted near an open wound (NOW) and 57 far from an open wound (FOW). NOW CVCs were considered when 25 cm2 surrounding the catheter's insertion site overlapped the wound. Colonization rates were 84% (22/26 CVCs) in those inserted NOW and 47% (27/57 CVCs) in FOW (P = 0.001). Colonization relative risk of NOW-CVCs was 1.79 (95% confidence interval, 1.3-2.46). Bacteremia rates were 27% (7/26 CVCs) in CVCs inserted NOW and 6% (3/57 CVCs) in FOW (P = 0.004). Bacteremic risk of NOW-CVCs was 5.12 (95% confidence interval, 1.44-18.22). Colonization rates were higher and sooner in NOW-CVCs than in FOW-CVCs. We suggest that insertion of catheters near an open burn wound should be avoided and, if inevitable, should not be left in place for period exceeding 3 days.
Skin autograft is the most important definitive treatment for acute-deep burns. Wound infection is the most important cause of autograft loss. Prior clinical studies have not shown any significant difference in the autograft survival rate and the use of perioperative systemic antibiotics. Their study assesses the potential benefit of systemic antibiotics in this setting, especially when topical antibiotics or artificial skin products are not readily available. The authors designed a prospective, randomized study in a cohort of patients with acute burns to assess the hypothesis that the use of systemic antibiotic prophylaxis affects the rate of skin autograft survival. Enrolled patients could have more than one autograft procedure done. These patients were randomized for each surgical procedure. The outcome measurement was autograft survival rate between the two groups. From October 2001 to October 2006, 77 patients were enrolled with a mean age of 41.7 years (SD +/- 19.4) and a mean skin total burn body surface area of 21.8 (SD +/- 23). The experimental group had 44 autograft procedures with systemic antibiotics (AP) and the control group had 46 procedures without antibiotics (NP). The rate of autograft survival for the AP group was 97% and for the NP group was 87% (P < .01) There was a partial autograft loss in 10 procedures (23%) in the AP group and 23 procedures (50%) in the NP group (P < .01). Patients with acute deep burns treated with autografts may benefit from systemic perioperative antibiotics prophylaxis, as antibiotics seem to be associated with increase autograft survival rate. The risk of colonization in other parts of the body with multidrug resistant bacteria warrants further study.
This study estimated the number of HCWs with protective antibody levels 5 and 10 years after HBV vaccination. Kaplan-Meier probabilities of protective levels were 0.95 at 60 days after vaccination, 0.87 at 5 years, and 0.79 at 10 years. Those without protective levels displayed good response 7 and 30 days after a booster.
Congenital toxoplasmosis diagnosis in the newborn is a very important issue due to the need for early treatment to prevent future sequels. Aim To compare available methods at the institution for the diagnosis of congenital toxoplasmosis. Material and Methods In this study we have evaluated the different diagnostic tests used in 67 congenital exposed newborns, including serological tests, PCR, parasite isolation and molecular characterization. Results The ISAGA IgM and IgA tests showed sensitivity (Se) of 87 and 91%, respectively, and specificity (Sp) of 100%. When ISAGA IgM and IgA were performed simultaneously, the Se increased to 98% and the Sp was 100%. The presence of IgE contributed to the diagnosis when it was detected in the child's serum but not in maternal blood. In four congenital infected children the parasite was isolated and genotyped: one was genotype II and the other three were "atypical" genotypes. No parasite was isolated in children without congenital toxoplasmosis. Discussion Overall, serological tests showed a good diagnostic performance although in one case they were all negative and isolation was the only tool to identify the infection. We conclude that it is essential to use all diagnostic tests in every single exposed child, including if possible, molecular characterization due to its epidemiological implication.
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