Medicina
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Specific antibodies are produced after infection by SARS-CoV2. Currently, the understanding of antibody responses following infection with SARS-CoV-2 is limited including the magnitude, duration of responses and correlates of protective immunity following infection. Here we intended to characterize humoral immune response in a cohort of 55 hospitalized patients for COVID-19 and its relationship with different demographic and clinical parameters. ⋯ In chronic obstructive pulmonary disease patients, the IgM response is increased, while in immunocompromised and interstitial lung disease patients, IgM and IgG were lower, respectively. Those patients who required critical care, mechanical ventilation and those who died did not present significant differences in the magnitude of humoral response compared to those who had a less severe course. The methodology used adequately reflects the kinetics of antibodies.
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The aim of this study was to describe the long term prognosis of 34 patients with Takayasu arteritis and the results of surgical and endovascular treatment. A total of 5 central surgeries and 53 endovascular procedures were performed including 18 bypass surgeries (33.8%) and 35 angioplasties (66.2%). The median follow-up was 7.5 years, interquartile range [IQR] 2.6-12.5. ⋯ Surgery had higher mortality in patients with aortic and ascending aortic valve disease, combined coronary artery disease and carotid disease. In long term follow up Takayasu arteritis frequently requires revascularization and restenosis or new lesions are common. Surgical treatment had better results with less restenosis than angioplasty.
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In spite of the low frequency of COVID-19 associated bacterial coinfections, the rate of empiric antibiotic use varies between 70% and 90%. The primary objective of this study was to evaluate the impact of an antimicrobial stewardship program (ASP) on COVID-19 patients. The study design was an interrupted time series, assessing prevalence of antibiotic use, adequacy of treatment and antimicrobial consumption in adult patients hospitalized with COVID before the COVID-ASP implementation in June 2020, and on three subsequent periods (P2 in August 2020, P3 in October 2020 and P4 in June 2021). ⋯ Antimicrobial consumption by period in days of therapy (DOT)/1000 patient-day was 347.9 vs. 272.8 vs. 134.29 vs. 43.6 (p <0.001). We did not find any difference in intensive care unit transfer or mortality. COVID-ASP implementation was an effective strategy to reduce antimicrobial consumption and optimize antibiotic indications without affecting morbidity or mortality.
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Vaping is considered to be the inhalation of aerosols generated by heating liquids. There are devices freely marketed for vaping, with electronic cigarettes being the most common. These products are associated with the appearance of lung injury, either vaping-induced lung injury (VAPI), or lung injury associated with vaping and electronic cigarettes (EVALI). ⋯ The exact pathophysiology of vaping-induced lung injury is still unknown; dyspnea and cough are the most frequent symptoms. All patients have pathological radiological images. Respiratory support and systemic corticosteroids are the treatment of choice.
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Prosthetic joint infection is the most feared complication of implant surgeries. Its diagnosis continues to be a challenge since its clinical presentation is usually not very evident and overlapping. A high clinical suspicion is needed to make a timely diagnosis. This document represents an updated review of the existing evidence and recommendations, in order to provide a tool that allows professionals to follow a course of action based on current knowledge and available resources, according to the opinion of the members of the Commission of Osteoarticular Infections from the Argentinean Society of Infectious Diseases (SADI).