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el Lun Ago 15, 2011 2:22 pm
Recuerdo del primer mensaje :

ESPERO Q LES SIRVAN PARA PRACTICAR INGLES,, YA Q ESTE HACE LA DIFERENCIA CREANME!!!!! Very Happy Very Happy
Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico.

National Institute of Respiratory Diseases, Mexico City, Mexico. perezpad@gmail.com
Abstract
BACKGROUND:

In late March 2009, an outbreak of a respiratory illness later proved to be caused by novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in Mexico. We describe the clinical and epidemiologic characteristics of persons hospitalized for pneumonia at the national tertiary hospital for respiratory illnesses in Mexico City who had laboratory-confirmed S-OIV infection, also known as swine flu.
METHODS:

We used retrospective medical chart reviews to collect data on the hospitalized patients. S-OIV infection was confirmed in specimens with the use of a real-time reverse-transcriptase-polymerase-chain-reaction assay.
RESULTS:

From March 24 through April 24, 2009, a total of 18 cases of pneumonia and confirmed S-OIV infection were identified among 98 patients hospitalized for acute respiratory illness at the National Institute of Respiratory Diseases in Mexico City. More than half of the 18 case patients were between 13 and 47 years of age, and only 8 had preexisting medical conditions. For 16 of the 18 patients, this was the first hospitalization for their illness; the other 2 patients were referred from other hospitals. All patients had fever, cough, dyspnea or respiratory distress, increased serum lactate dehydrogenase levels, and bilateral patchy pneumonia. Other common findings were an increased creatine kinase level (in 62% of patients) and lymphopenia (in 61%). Twelve patients required mechanical ventilation, and seven died. Within 7 days after contact with the initial case patients, a mild or moderate influenza-like illness developed in 22 health care workers; they were treated with oseltamivir, and none were hospitalized.
CONCLUSIONS:

S-OIV infection can cause severe illness, the acute respiratory distress syndrome, and death in previously healthy persons who are young to middle-aged. None of the secondary infections among health care workers were severe.


In this study it is referred that there were hospitalized with pneumonia and S-OIV

a) 18 cases
b) 98 cases
c) 116 cases
d) 8 cases



The age groups described in the article shows that:

a) The risk of infection was in young to mature persons
b) Some medical personnel were infected with influenza A (H1N1) virus (S-OIV)
c) The patients were treated in different hospitals
d) The patients were included in a retrospective study



How many patients were referred for a first treatment of their condition?

a) 18
b) 2
c) 16
d) 98
Which were the most significant laboratory findings?

a) Increased serum lactate dehydrogenase levels
b) Elevated leucocyte count
c) Increased lymphocyte count
d) Diminished creatinine kinase


Most deaths occurred in patients who required:

a) Treatment of pnemonia
b) Mechanical ventilation
c) Treatment for secondary infections
d) Hopitalilzation






Comparative efficacy of inactivated and live attenuated influenza vaccines.
Monto AS, Ohmit SE, Petrie JG, Johnson E, Truscon R, Teich E, Rotthoff J, Boulton M, Victor JC.
Source

Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA. asmonto@umich.edu
Abstract
BACKGROUND:

The efficacy of influenza vaccines may vary from year to year, depending on a variety of factors, and may differ for inactivated and live attenuated vaccines.
METHODS:

We carried out a randomized, double-blind, placebo-controlled trial of licensed inactivated and live attenuated influenza vaccines in healthy adults during the 2007-2008 influenza season and estimated the absolute and relative efficacies of the two vaccines.
RESULTS:

A total of 1952 subjects were enrolled and received study vaccines in the fall of 2007. Influenza activity occurred from January through April 2008, with the circulation of influenza types A (H3N2) (about 90%) and B (about 9%). Absolute efficacy against both types of influenza, as measured by isolating the virus in culture, identifying it on real-time polymerase-chain-reaction assay, or both, was 68% (95% confidence interval [CI], 46 to 81) for the inactivated vaccine and 36% (95% CI, 0 to 59) for the live attenuated vaccine. In terms of relative efficacy, there was a 50% (95% CI, 20 to 69) reduction in laboratory-confirmed influenza among subjects who received inactivated vaccine as compared with those given live attenuated vaccine. The absolute efficacy against the influenza A virus was 72% (95% CI, 49 to 84) for the inactivated vaccine and 29% (95% CI, -14 to 55) for the live attenuated vaccine, with a relative efficacy of 60% (95% CI, 33 to 77) for the inactivated vaccine.
CONCLUSIONS:

In the 2007-2008 season, the inactivated vaccine was efficacious in preventing laboratory-confirmed symptomatic influenza A (predominately H3N2) in healthy adults. The live attenuated vaccine also prevented influenza illnesses but was less efficacious. (ClinicalTrials.gov number, NCT00538512.)





The primary objective of this study is to estimate the efficacy of two types of vaccines taking into account:

a) History of individual hypersensitivity to other vaccines component
b) The age and health status of elegibility
c) Randomization of vaccines
d) The study was performed from January throughout April


When do the vaccines under research were administered?

a) In the autumn season
b) When viruses A and B were present
c) The study was carried out in Massachusetts
d) The authors concern was about the f identification of the real-time polymerase-chain-reaction assay


How was determined the absolute efficacy in opposition of type A virus?

a) When the viruses were circulating during the influenza activity
b) When influenza virus A was 95 per cent CI
c) When the cultured virus was separated in culture
d) By the results of both vaccines



The conclusion of the study was as follows:

a) When one vaccine was effective and the other not as much as the other
b) That the efficacy of the vaccines were administered during the influenza season
c) The efficacy improved only in healthy male patients
d) The efficacy of influenza vaccines may vary from year to year, depending on a variety of factors



EXITO!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Very Happy Very Happy



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el Mar Ago 16, 2011 12:08 pm
Significa que esto es muy buena idea Dr. Fer, no alucine, no es nada malo... es un icono de un foquito encendido Smile
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el Mar Ago 16, 2011 12:17 pm
esque con eso de q volteaste bandera....... ya no se sabe!!! tongue tongue
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el Mar Ago 16, 2011 12:19 pm
Clinical prognostic factors in multiple sclerosis: a natural history review.
Degenhardt A, Ramagopalan SV, Scalfari A, Ebers GC.
Source

Department of Clinical Neurology, University of Oxford, Oxford, UK.
Abstract

This Review summarizes the natural history studies on multiple sclerosis (MS) that have evaluated prognostic factors. Reassessment of prognostic factors is warranted, as our ability to offer patients a reliable prognosis is limited, yet we rely on this knowledge to appropriately design clinical trials and interpret their results. The selection criteria for studies to review included a geographical referral base, duration of at least 9 years, prospective design, and populations of at least 100 patients with MS. For all forms of MS combined, negative prognostic factors included progressive disease, and disability at 2 and 5 years. In relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) combined, negative prognostic factors were the onset of progression, a higher relapse rate, greater disability in the first 5 years, a shorter interval to the second relapse, and the involvement of more systems. Additional negative factors include a shorter time to progression in SPMS and a faster rate of disability in the first 2 and 5 years in primary progressive MS (PPMS). Onset of progression, relapse rate and disability in the initial 5 years could be fruitful therapeutic targets; however, longer-term clinical trials will be required to justify these end points

What do the authors offer in this paper?

a) Adequately select patients for clinical trials
b) Design clinical trials and interpret their results
c) Use a specific inclussion judgement
d) Long follow up



What could be a productive intervention in the first years?

a) Beginning of evolution, relapse rate and disability
b) Monitoring of treatment
c) Reassessment of prognostic factors
d) Control disability


What does 2 and 5 years mean in this part of the paper?

a) Geographical referral
b) Clinical markers
c) Relapsing remitting MS
d) Negative prognostic factors

What iniciated the onset of progression of RRMS and SPMS ?

a) Atrial fibrillation
b) Negative prognostic factors
c) Justification of end points
d) The age of patients




RESP:
1:B
2:A
3:D
4:B

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el Miér Ago 17, 2011 12:04 pm
OBJECTIVE:

Cerebrospinal fluid (CSF) metastasis is the most difficult type of retinoblastoma metastasis to cure, even with bone marrow transplant. Most metastatic retinoblastoma cells express P-glycoprotein causing multidrug resistance (MDR). P-glycoprotein-rich blood vessels form blood-brain and blood-eye barriers, inhibit drug entry into central nervous system (CNS) and eyes. High-dose craniospinal radiation is too morbid for treatment of young children. To cure CSF metastasis without radiation, we designed an intensive multimodality chemotherapy regimen.
METHOD:

After left eye enucleation, a 4-month-old boy with bilateral International Intraocular Retinoblastoma Classification Group E eyes and CSF metastasis was treated with 7-cycle high-dose carboplatin and etoposide, standard-dose vincristine, and high-dose/short-infusion cyclosporine to inhibit P-glycoprotein. Intraventricular drugs, non-substrate of P-glycoprotein (cytarabine), or less susceptible to MDR (topotecan), contributed to treatment of the metastasis. On achieving complete response, he was consolidated with supralethal-dosage carboplatin, etoposide, and cyclophosphamide, and his bone marrow rescued with autologous cord blood stem cells.
RESULTS:

Following 1-cycle systemic chemotherapy and 2-dose intraventricular chemotherapy, the CSF metastasis cleared. The right eye tumor regressed completely. The patient remains in remission 8.3 years after diagnosis and 7.8 years post-transplant.
CONCLUSION:

Intensive multimodality chemotherapy can cure CSF metastasis in retinoblastoma without incurring extreme morbidity from craniospinal radiation.




What is the purpose of the authors?

a) Avoid mutation of chromosome 13
b) Relate association with pinealoblastoma
c) Use of chemical agents
d) Discard retinopathy of prematurity


Among treatments, which is very offensive

a) Cryotherapy
b) Surgery
c) External bean radiotherapy
d) Craniospinal radiation



Which was the treatment employed after eye enucleation?

a) Gentamycin, etoposide, vincristine
b) Cefalosporine, carboplatin
c) Apoptotic drugs
d) Carboplatin, etoposide, vincristine and cyclosporine



What was the outcome after one cycle of chemotherapy?

a) The patient had an eye implant
b) The patient was in resolution
c) The patient had a relapse
d) The patient died




What happen after the patient reacted to pharmacological treatment?

a) The patient was strengthen with the treatment
b) He was also treated with radiation
c) The patient showed multidrug resistance
d) The patient had severe pain


RESP
1:C
2:D
3:D
4:B
5:A Very Happy




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el Vie Ago 19, 2011 7:09 pm
Immunosuppressive disorders and risk of anal squamous cell carcinoma: a nationwide cohort study in Denmark, 1978-2005.
Sunesen KG, Nørgaard M, Thorlacius-Ussing O, Laurberg S.
Source

Department of Colorectal Surgery P, Aarhus Hospital, Aarhus University Hospital, Aarhus, Denmark. k.sunesen@rn.dk
Abstract

Compromised immune function may increase the risk of anal squamous cell carcinoma (SCC). We examined the risk of anal SCC in patients with HIV infection and other chronic disorders associated with immunosuppression. A population-based cohort study was conducted using the Danish National Patient Registry and the Danish Cancer Registry (DCR). We identified all patients with a first-time hospital contact or procedure for HIV infection, solid organ transplantation or autoimmune disease or a first-time record of haematologic malignancy in the DCR, 1978-2005, and followed these for a subsequent anal SCC, starting follow-up 1 year after diagnosis of the index disease. Standardised incidence ratios (SIRs) were computed as the ratio of observed to expected numbers of anal SCCs, based on national age-, sex- and period-specific rates. Among 4,488 patients with HIV, we observed 21 anal SCCs with 0.3 expected (SIR: 81.1 (95% confidence interval (CI): 51.6-121.9)). Risk of anal SCC was markedly increased among 5,113 solid organ recipients (SIR: 14.4 (CI: 7.0-26.4)) and 30,165 patients with haematologic malignancies (SIR: 2.3 (CI: 1.1-4.2)) but only moderately increased among 242,114 patients with autoimmune diseases (SIR: 1.3 (CI: 1.0-1.6)). SIRs varied according to type of autoimmune disease and were high in patients with Crohn's disease (SIR: 3.1 (CI: 1.2-6.4)), psoriasis (SIR: 3.1 (CI: 1.8-5.1)), polyarteritis nodosa (SIR: 8.8 (CI: 1.5-29.0)) and Wegener's granulomatosis (SIR: 12.4 (CI: 2.1-40.Cool). In conclusion, we found HIV infection, solid organ transplantation, haematologic malignancies and a range of specific autoimmune diseases strongly associated with increased risk of anal SCC.

The purpose of our research is to consider the hazard of immune function in...

a) Polyarthritis
b) Chronic disorders
c) The United States
d) Anal squamous cell carcinoma


Which method did the authors used for SIRs?

a) Identification of patients hospitalized for the first time
b) Computarized the proportion of anal SCCs
c) Analysis of records of hematologic malignancy
d) Analysis of autoinmune disease


Which type of patients had elevated chance of anal squamous cell carcinoma?

a) Patients with an elevated incidence ratio
b) Patients with hematologic malignancies
c) Patients with solid organs
d) Patients with psoriasis



Due to the increased chance in developing anal SCC, the authors infere that

a) SCC varied according to type of autoinmune disease
b) The chances were higher in first time hospitalization patients
c) The risk was related with a number od conditions and distinguishing diseases
d) In patients with HIV


RESP
1.D
2.B
3.C
4.C



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el Vie Ago 19, 2011 8:25 pm
de donde los sacas fer?

_________________
Miembro 4º x del Club de Fans de la Dra. Koko
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el Vie Ago 19, 2011 8:31 pm
del simulador!!!
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el Vie Ago 19, 2011 11:50 pm
Dra koko puede borrar ese coment porfa!!!
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el Sáb Ago 20, 2011 12:10 am
Listo... Very Happy
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el Sáb Ago 20, 2011 3:46 pm
GRADIASHHHHH!! Smile
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