Revisión de sepsis obstétrica [Obstetrics sepsis review article]

<p>La sepsis es una de las principales causas de mortalidad y morbilidad materna a nivel mundial, con una incidencia de 240-300 casos por cada 100 000 habitantes. La clave en el manejo de esta patología está en la identificación temprana de los signos y síntomas sugestivos de sepsis. Este concepto ha variado de manera significativa durante la última década con la creación de nuevas herramientas, que han permitido la captación oportuna de una mayor proporción de pacientes, además de estrategias terapéuticas con lo que se ha logrado mejorar el resultado de los pacientes; sin embargo, hasta el momento no hay una prueba diagnóstica específica. A pesar de todos los avances ocurridos en el diagnóstico y tratamiento de la sepsis en el paciente adulto, no existe un concepto definido para “Sepsis obstétrica” o Sepsis en el embarazo, dado que las pacientes en estado de gravidez representan un grupo poblacional con consideraciones específicas propias del embarazo, que se deben tomar en cuenta para realizar un diagnóstico y tratamiento oportuno.</p><p> </p><p>ABSTRACT</p><p>Sepsis is one of the main causes of maternal mortality and morbidity worldwide, representing 8.3% of maternal deaths in Latin America. The key in the management of this pathology is in the early identification of the signs and symptoms suggestive of sepsis. This concept has changed significantly in the last decade with the creation of new tools, which have allowed the timely recruitment of a greater proportion of patients, in addition to therapeutic strategies, thereby improving patient outcomes; however until the moment there is no specific diagnostic test. Despite all the advances that have occurred in the diagnosis and treatment of sepsis in the adult patient, there is no defined concept for “Obstetric Sepsis” or Sepsis in pregnancy, since pregnant patients represent a population group with diagnosis specific to pregnancy, which must be taken into account to make a proper diagnosis and treatment.<br /><br /></p>

Management of Resistant Cyclic Vomiting Syndrome With a New Empiric Treatment in the Prophylaxis Period: A Case Report and Review of Literature

Introduction: Cyclic Vomiting Syndrome (CVS) is an idiopathic disorder, identified by recurrent stereotypic episodes of severe nausea and vomiting and intervals of normal health between episodes. There is no specific diagnostic test for CVS, and clinical features are relied on for diagnosis. Many medications have been used to treat CVS, such as antiemetic, anti-migraine, and sedative medications. Nevertheless, treatment is difficult in some resistant cases. Case Presentation: We report a child with frequent and intensive vomiting episodes after an asymptomatic 2-year period. The patient was unresponsive to many medications but was successfully treated with chlorpromazine and then controlled using olanzapine, followed by aripiprazole. We also performed a brief literature review related to this case report in international databases. Conclusions: Since CVS management has remained challenging to the clinician in the severe and resistant patients, the empiric treatment of CVS is recommended.

A Powerful LAMP Weapon against the Threat of the Quarantine Plant Pathogen Curtobacterium flaccumfaciens pv. flaccumfaciens

Curtobacterium flaccumfaciens pv. flaccumfaciens (Cff) is a Gram-positive phytopathogenic bacterium attacking leguminous crops and causing systemic diseases such as the bacterial wilt of beans and bacterial spot of soybeans. Since the early 20th century, Cff is reported to be present in North America, where it still causes high economic losses. Currently, Cff is an emerging plant pathogen, rapidly spreading worldwide and occurring in many bean-producing countries. Infected seeds are the main dissemination pathway for Cff, both over short and long distances. Cff remains viable in the seeds for long times, even in field conditions. According to the most recent EU legislation, Cff is included among the quarantine pests not known to occur in the Union territory, and for which the phytosanitary inspection consists mainly of the visual examination of imported bean seeds. The seedborne nature of Cff combined with the globalization of trades urgently call for the implementation of a highly specific diagnostic test for Cff, to be routinely and easily used at the official ports of entry and into the fields. This paper reports the development of a LAMP (Loop-Mediated Isothermal Amplification) specific for Cff, that allows the detection of Cff in infected seeds, both by fluorescence and visual monitoring, after 30 min of reaction and with a detection limit at around 4 fg/μL of pure Cff genomic DNA.

Paraquat poisoning: a case report

Paraquat (1, r-dimethyl-4, 4’-bipyridium dichloride) is a commonly used herbicide in Asia. In spite of its wide availability, poisoning due to this herbicide is uncommon. An ingested dose of more than 10 ml is known to cause irreversible lung injury. Due to lack of any specific diagnostic test or specific clinical signs, diagnosis is often difficult without identifying the compound from history. Poisoning with high doses is associated with poor prognosis. As there is no specific antidote, treatment is aggressive decontamination and supportive management. However, in high doses, cases are often fatal.

SARS-CoV-2 A Relation with Other Acute Respiratory Tract Infectious (ARTI) Diseases: A Short Communication

The short study implicates few basic similarities of COVID-19 such as diseases origination, symptoms, diagnosis with other relatable viral diseases viz SARS-CoV, common Flu, pneumonia etc. In the present situation, other viral diseases are frequently chaotic and misled with COVID-19 disease because of few clinical features similarities in signs and symptoms and also due to lack of specific diagnostic test. To avoid unnecessary suspects, quarantines of false positive results and to prevent the spread of COVID-19 diseases, the scientific technical research field are highly encourage to implement an efficient, rapid and sophisticated superior test for early stages of infection detection. It will be significantly convenient for physician, laboratory technicians and most importantly the common population facing a psychological disturbance.

An Unbiased Immunization Strategy Results in the Identification of Enolase as a Potential Marker for Nanobody-Based Detection of Trypanosoma evansi

Trypanosoma evansi is a widely spread parasite that causes the debilitating disease “surra” in several types of ungulates. This severely challenges livestock rearing and heavily weighs on the socio-economic development in the affected areas, which include countries on five continents. Active case finding requires a sensitive and specific diagnostic test. In this paper, we describe the application of an unbiased immunization strategy to identify potential biomarkers for Nanobody (Nb)-based detection of T. evansi infections. Alpaca immunization with soluble lysates from different T. evansi strains followed by panning against T. evansi secretome resulted in the selection of a single Nb (Nb11). By combining Nb11-mediated immuno-capturing with mass spectrometry, the T. evansi target antigen was identified as the glycolytic enzyme enolase. Four additional anti-enolase binders were subsequently generated by immunizing another alpaca with the recombinant target enzyme. Together with Nb11, these binders were evaluated for their potential use in a heterologous sandwich detection format. Three Nb pairs were identified as candidates for the further development of an antigen-based assay for Nb-mediated diagnosis of T. evansi infection.

Dermatomyositis Presented with Facial Rash in a 40 Years Old Lady in Bangladesh: A Case Report

Dermatomyositis is overly simplified as inflammatory myopathy with characteristic rashes. Understanding dermatomyositis is challenging because firstly presentation may be non-specific, vague and delayed. Secondly there is no specific diagnostic test or universally acceptable diagnostic criteria. Therefore, to missed or delayed diagnosis results in failure to treatment. A forty year old lady with facial rash and generalized weakness was diagnosed with dermatomyositis on the basis of generalized weakness, typical facial rash with very high CK and eletrophysiological study. Steroid treatment initially improved her symptoms. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 191-193

Diagnostic test assessment on protist misconception

One of the fatal problems emerge in educational practice is misconception as it is related to the students’ understanding. Consequently, these must be detected at the beginning of learning process. This research was conducted to construct and develop the specific diagnostic test to detect the misconception in protist material. The instrument consisted of, Evidence and Proof (EP), Structure Communication Grid (SCG), and essay. The instruments were analyzed to determine the validity, reliability, discriminatory power, and difficulty levels. As many as 351 students of grade X, XI, and XII were selected as the samples. The samples selected from three Public High Schools and three Private High Schools in Klaten Regency using stratified random sampling. The results showed that 93.10% of the columnar (EP) items, 100% of the SCG items, and 100% of the essay questions were valid; in which the all instruments were reliable. Based on discriminatory power analysis, of the three instruments developed, there was more than 50% of the items were classified as fair level. Whereas, the difficulty level of the instruments were balance. In general, the instruments can be accepted and used after revisions. These diagnostic test instruments can also be developed for another topic.

Angiotensin-Converting Enzyme Inhibitor-Induced Gastrointestinal Angioedema: The First Danish Case Report

Angiotensin-converting enzyme inhibitors (ACEI) are widely used to treat hypertension and congestive heart failure. A rare side effect of ACEI therapy is angioedema, which in very rare cases may present as gastrointestinal angioedema (GA). A 45-year-old female presented with suddenly occurring diffuse abdominal pain. Imaging studies revealed small bowel wall edema. The patient had been on ACEI therapy for the last 6 months. The therapy was withdrawn, and the patient recovered quickly. There is no specific diagnostic test to confirm ACEI-induced GA, but symptoms usually regress completely after therapy discontinuation. An early diagnosis of ACEI-induced GA is important to avoid invasive diagnostic investigations and even laparotomy.

Identification of Entamoeba histolytica and E. dispar infection in Maceió, Alagoas State, northeast Brazil

Introduction: A cross-sectional study was carried out to assess the prevalence of E. histolytica and E. dispar by examining stool samples obtained from 1,003 students of public schools in Maceió, Alagoas, Brazil. Methodology: All stool samples were processed using the spontaneous sedimentation technique and examined microscopically for the presence of Entamoeba species. In order to distinguish infections caused by E. histolytica, fecal samples presenting cysts of Entamoeba were subjected to specific enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). Results: The analysis of the fecal specimens by microscopy identified 6.4% (64/1,003) students positive for E. histolytica/E. dispar/E. moshkovskii cysts. The prevalence of E. histolytica detected by ELISA was 3.0% (30/1,003) and by PCR 2.8% (28/1,003), but the difference is not statistically significant (p > 0.05). The prevalence of E. dispar in schoolchildren was 5.0% (50/1,003). Mixed infections with E. histolytica and E. dispar were also detected by PCR. Even though immunological and molecular methods have shown similar results for identification of E. histolytica, ELISA is advantageous over the PCR since it is relatively cheaper and easier to perform. Conclusions: Our study demonstrated the occurrence of E. histolytica in Maceió and highlights the need to introduce a specific diagnostic test to detect amoebiasis cases in public laboratories.