Clinical management handbook
Technical report
This manual aims to provide information about the methods for investigating outbreaks of hepatitis E, and measures for their prevention and control. In addition, the manual gives information about the causative agent – known as the hepatitis E virus (HEV) – its epidemiology..., clinical manifestations of the disease and diagnosis.
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Over 2 million children worldwide are living with HIV infection and 95% reside in sub-Saharan Africa with the majority infected through mother-to-child transmission. Infected children have a high mortality with 50% dying by 2 years of age. Their clinical presentation includes common childhood infect...ions, opportunistic infections and conditions associated with HIV/AIDS immune suppression.
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There are three sections in this e-learning module on radiation emergencies: Section One is an introduction about the basics of radiation. For instance, the difference between ionizing and non-ionizing radiation and the different ways to measure radiation. Section Two is about the health effects of ...acute exposure to radiation. For instance, the mechanisms by which ionizing radiation damages our cells and the clinical manifestations of acute exposure are introduced. Section Three discusses the measures in response to a radiation emergency. For instance, the principles of emergency department preparedness, the use of personal protective equipment and the procedures to decontamination are presented. Although this module is primarily for first responders to prepare for radiation emergencies, it is also suitable for the general public who are interested in knowing more about this topic. Healthcare professionals may also find this module useful in case they want to refresh their knowledge on radiation.
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El 31 de diciembrede 2019 las Autoridades de la República Popular China, comunicaron a la OMS varios casos de neumonía de etiología desconocida en Wuhan, una ciudad situada en la provincia china de Hubei. Una semana más tarde confirmaron que se trataba de un nuevo co...ronavirus que ha sido denominado SARS-CoV-2. Al igual que otros de la familia de los coronavirus, este virus causa diversas manifestaciones clínicas englobadas bajoel término COVID-19, que incluyen cuadros respiratorios que varían desde el resfriado común hastacuadros de neumonía grave con síndrome de distrés respiratorio, shock séptico y fallo multi-orgánico. La mayoría de los casos de COVID-19 notificados hasta el momento debutan con cuadros leves.Un punto de detección importante de casos de COVID-19es la urgencia hospitalaria. El triaje tiene como objetivo identificar y priorizar al paciente más grave. Al tratarse deuna enfermedad transmisiblese debenextremar las medidas deprecaución.
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Evidencias COVID-19 es un recurso que ofrece información relevante relacionada con la pandemia del coronavirus SARS-CoV-2 y la COVID-19.
Este recurso recoge una serie de documentos que sintetizan la información más relevante para dar respuesta a preguntas clínicas y temas prioritarios sobre l...a pandemia, en forma de revisiones de la literatura y evaluaciones críticas de estudios. Los documentos han sido elaborados por integrantes de la Red Cochrane Iberoamericana con la intención de sintetizar y actualizar el conocimiento disponible en relación con la COVID-19 y son compartidos con la intención de dar una respuesta colaborativa a la situación actual.
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The WHO COVID-19 Clinical management: living guidance contains the Organization’s most up-to-date recommendations for the clinical management of people with COVID-19. Providing guidance that is comprehensive and holistic for the optimal care of COVID-19 patients throughout their entire illness is ...important. The latest version of this living guideline is available in pdf format (via the ‘Download’ button) and via an online platform, and is updated regularly as new evidence emerges. No further updates to the previous existing recommendations were made in this latest version.
This updated (fifth) version contains 16 new recommendations for the rehabilitation of adults with post COVID-19 condition (see Chapter 24)
This updated (fourth) version contains three new recommendations regarding hospitalized patients with severe or critical COVID-19
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Ce document d'orientation est destiné aux cliniciens qui s'occupent de patients atteints de COVID-19 à toutes les phases de leur maladie (c'est-à-dire du dépistage à la sortie de l'hôpital). Cette mise à jour a été étendue pour répondre aux besoins des cliniciens de première ligne et fa...vorise une approche multidisciplinaire des soins aux patients atteints de COVID-19, y compris ceux qui présentent une maladie légère, modérée, grave et critique. Les sections suivantes sont entièrement nouvelles : parcours de soins COVID-19, traitement des infections aiguës et chroniques, gestion des manifestations neurologiques et mentales, maladies non transmissibles, réadaptation, soins palliatifs, principes éthiques et déclaration du décès ; les chapitres précédents ont également été considérablement étoffés.
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In the Region of the Americas, the leishmaniases are a group of diseases caused by various species of Leishmania, which cause a set of clinical syndromes in infected humans that can involve the skin, mucosa, and visceral organs. The spectrum of clinical disease is varied and depends on the interacti...on of several factors related to the parasite, the vector, and the host. Cutaneous leishmaniasis is the form most frequently reported in the Region and nearly 90% of cases present single or multiple localized lesions. Other cutaneous clinical forms, such as disseminated and diffuse cutaneous leishmaniasis, are more difficult to treat and relapses are common. The mucosal form is serious because it can cause disfigurement and severe disability if not diagnosed and treated early on. Visceral leishmaniasis is the most severe form, as it can cause death in up to 90% of untreated people.
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El presente protocolo es una actualización del emitido el 24 de abril 2020 y contiene las
siguientes modificaciones:
• Definición de caso: Las definiciones de caso sospechoso y confirmado son dinámicas y secundarias a la situación epidemiológica vigente. En este contexto el Ministerio de
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Salud de Nación ha modificado el criterio de caso sospechoso y de caso confirmado en pediatría. El Ministerio de Salud de Provincia de Buenos Aires acepta y adhiere a estos cambios.
• Manifestaciones clínicas: Se agregan manifestaciones clínicas en pediatría en base a la evidencia disponible y según la actualización realizada por el Ministerio de Salud de
Nación.
• Criterio de Alta: Los criterios de alta para el manejo de casos son dinámicos y se
adecúan conforme con las actualizaciones de la evidencia disponible y las recomendaciones de la Organización Mundial de la Salud. En este marco, el Ministerio de Salud de Nación ha modificado el criterio de alta del aislamiento para un caso
confirmado de COVID-19 el 24 de junio. El Ministerio de Salud de Provincia de Buenos
Aires acepta y se adhiere a este cambio.
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Revista Médica del Hospital General de México, Vol. 81. Issue 3.Pages 154-164 (July - September 2018)
Chagas disease is a parasitic zoonosis caused by Trypanosoma cruzi, a protozoan whose transmission to humans is primarily vector-borne. It is estimated that 6–8 million people worldwide are inf...ected and that 65–100 million people are at risk of becoming infected. Its clinical spectrum is very broad. During the acute phase, non-specific manifestations develop that may go unnoticed. During the chronic phase, specific manifestations develop that are diagnosed late and increase the morbidity and mortality of those suffering from it.
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Leptospirosis is a perplexing conundrum for many. In the existing literature, the pathophysiological mechanisms pertaining to leptospirosis is still not understood in full. Considered as a neglected tropical zoonotic disease, leptospirosis is culminating as a serious problem worldwide, seemingly exi...sting as co-infections with various other unrelated diseases, including dengue and malaria. Misdiagnosis is also common as non-specific symptoms are documented extensively in the literature. This can easily lead to death, as the severe form of leptospirosis (Weil’s disease) manifests as a complex of systemic complications, especially renal failure. The virulence of Leptospira sp. is usually attributed to the outer membrane proteins, including LipL32. With an armament of virulence factors at their disposal, their ability to easily adhere, invade and replicate within cells calls for a swift refinement in research progress to establish their exact pathophysiological framework. As an effort to reconstitute the current knowledge on leptospirosis, the basis of leptospiral infection, including its risk factors, classification, morphology, transmission, pathogenesis, co-infections and clinical manifestations are highlighted in this review. The various diagnostic techniques are also outlined with emphasis on their respective pros and cons.
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As of 12 December 2022, over 645 million people worldwide have been diagnosed with COVID-19, with over 6.6 million deaths (4).
The Omicron variant, which emerged in late November 2021, and its subvariants, are now the dominant circulating viruses, contributing to the ongoing surge in several countr...ies (4). Vaccination has substantially reduced case numbers and hospitalizations in many countries,but limitations in global access to vaccines mean that many populations, including those in low- and middle-income countries, remain vulnerable. Even in vaccinated individuals, uncertainties remain about duration of protection and efficacy, and the degree of crossprotection with new variants.
There remains a need for more effective treatment and management for those affected by COVID-19. The pandemic – and the
explosion of both research and misinformation – has highlighted the need for trustworthy, accessible and regularly updated living
guidelines to place emerging findings into context and provide clear recommendations for clinical practice
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Leishmaniases are a group of diseases of zoonotic importance caused by over 20 species of protozoa of the genus Leishmania, in which domestic dogs are considered to be the main reservoir for the disease. However, the involvement of other vertebrates as reservoirs for these parasites has also been in...vestigated. Therefore, the objective of the present study was to carry out a systematic review with meta-analysis on occurrences of leishmaniasis in equids. The case reports described animals with cutaneous symptoms of leishmaniasis (papules, nodules, ulcers or crusts) that regressed spontaneously, located mainly on the head and limbs, from which three species of protozoa were identified in the lesions: Leishmania braziliensis, Leishmania infantum and Leishmania siamensis. In turn, the meta-analysis showed a combined prevalence of 25%, although with high heterogeneity among the studies, which was attributed to the use of different methods for diagnosing the disease. Leishmaniasis in equids is a benign disease but it should be included in the differential diagnosis of cutaneous diseases among these species. Seroepidemiological studies are important in investigating and monitoring suspected exposure of these hosts to the parasite, especially in endemic areas. However, there is also a need to standardize diagnostic methods.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog...nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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The WHO COVID-19 Clinical management: living guidance contains the most up-to-date recommendations for the clinical management of people with COVID-19. Providing guidance that is comprehensive and holistic for the optimal care of COVID-19 patients throughout their entire illness is important.
Two decades of epidemiological research shows that silent cerebrovascular disease is common and is associated with future risk for stroke and dementia. It is the most common incidental finding on brain scans. To summarize evidence on the diagnosis and management of silent cerebrovascular disease to ...prevent stroke, the Stroke Council of the American Heart Association convened a writing committee to evaluate existing evidence, to discuss clinical considerations, and to offer suggestions for future research on stroke prevention in patients with 3 cardinal manifestations of silent cerebrovascular disease: silent brain infarcts, magnetic resonance imaging white matter hyperintensities of presumed vascular origin, and cerebral microbleeds. The writing committee found strong evidence that silent cerebrovascular disease is a common problem of aging and that silent brain infarcts and white matter hyperintensities are associated with future symptomatic stroke risk independently of other vascular risk factors. In patients with cerebral microbleeds, there was evidence of a modestly increased risk of symptomatic intracranial hemorrhage in patients treated with thrombolysis for acute ischemic stroke but little prospective evidence on the risk of symptomatic hemorrhage in patients on anticoagulation. There were no randomized controlled trials targeted specifically to participants with silent cerebrovascular disease to prevent stroke. Primary stroke prevention is indicated in patients with silent brain infarcts, white matter hyperintensities, or microbleeds. Adoption of standard terms and definitions for silent cerebrovascular disease, as provided by prior American Heart Association/American Stroke Association statements and by a consensus group, may facilitate diagnosis and communication of findings from radiologists to clinicians.
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