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Showing 1 - 200 of 1720 Journals sorted alphabetically
AAPS Journal     Hybrid Journal   (Followers: 20)
Achievements in the Life Sciences     Open Access   (Followers: 4)
ACS Synthetic Biology     Full-text available via subscription   (Followers: 21)
Acta Biologica Colombiana     Open Access   (Followers: 7)
Acta Biologica Hungarica     Full-text available via subscription   (Followers: 4)
Acta Biologica Sibirica     Open Access  
Acta Biomaterialia     Hybrid Journal   (Followers: 25)
Acta Biotheoretica     Hybrid Journal   (Followers: 5)
Acta Chiropterologica     Full-text available via subscription   (Followers: 6)
acta ethologica     Hybrid Journal   (Followers: 4)
Acta Limnologica Brasiliensia     Open Access   (Followers: 3)
Acta Médica Costarricense     Open Access   (Followers: 2)
Acta Musei Silesiae, Scientiae Naturales : The Journal of Silesian Museum in Opava     Open Access  
Acta Neurobiologiae Experimentalis     Open Access  
Acta Parasitologica     Hybrid Journal   (Followers: 9)
Acta Scientiarum. Biological Sciences     Open Access   (Followers: 2)
Acta Scientifica Naturalis     Open Access   (Followers: 2)
Actualidades Biológicas     Open Access   (Followers: 1)
Advanced Health Care Technologies     Open Access   (Followers: 4)
Advanced Studies in Biology     Open Access  
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Bioinformatics     Open Access   (Followers: 18)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4)
Advances in Biosensors and Bioelectronics     Open Access   (Followers: 6)
Advances in Cell Biology     Open Access   (Followers: 24)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Ecological Research     Full-text available via subscription   (Followers: 43)
Advances in Environmental Sciences - International Journal of the Bioflux Society     Open Access   (Followers: 21)
Advances in Enzyme Research     Open Access   (Followers: 9)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in High Energy Physics     Open Access   (Followers: 19)
Advances in Human Biology     Open Access   (Followers: 1)
Advances in Life Science and Technology     Open Access   (Followers: 14)
Advances in Life Sciences     Open Access   (Followers: 4)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3)
Advances in Regenerative Biology     Open Access   (Followers: 1)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Virus Research     Full-text available via subscription   (Followers: 5)
African Journal of Range & Forage Science     Hybrid Journal   (Followers: 6)
AFRREV STECH : An International Journal of Science and Technology     Open Access   (Followers: 1)
Ageing Research Reviews     Hybrid Journal   (Followers: 8)
Aging Cell     Open Access   (Followers: 11)
Agrokémia és Talajtan     Full-text available via subscription   (Followers: 2)
Agrokreatif Jurnal Ilmiah Pengabdian kepada Masyarakat     Open Access  
AJP Cell Physiology     Full-text available via subscription   (Followers: 13)
AJP Endocrinology and Metabolism     Full-text available via subscription   (Followers: 23)
AJP Lung Cellular and Molecular Physiology     Full-text available via subscription   (Followers: 3)
Al-Kauniyah : Jurnal Biologi     Open Access  
Alasbimn Journal     Open Access   (Followers: 1)
AMB Express     Open Access   (Followers: 1)
Ambix     Hybrid Journal   (Followers: 3)
American Biology Teacher     Full-text available via subscription   (Followers: 13)
American Fern Journal     Full-text available via subscription   (Followers: 1)
American Journal of Agricultural and Biological Sciences     Open Access   (Followers: 10)
American Journal of Bioethics     Hybrid Journal   (Followers: 10)
American Journal of Biostatistics     Open Access   (Followers: 9)
American Journal of Human Biology     Hybrid Journal   (Followers: 12)
American Journal of Medical and Biological Research     Open Access   (Followers: 6)
American Journal of Plant Sciences     Open Access   (Followers: 19)
American Journal of Primatology     Hybrid Journal   (Followers: 15)
American Malacological Bulletin     Full-text available via subscription   (Followers: 3)
American Naturalist     Full-text available via subscription   (Followers: 71)
Amphibia-Reptilia     Hybrid Journal   (Followers: 6)
Anaerobe     Hybrid Journal   (Followers: 4)
Analytical Methods     Full-text available via subscription   (Followers: 9)
Anatomical Science International     Hybrid Journal   (Followers: 2)
Animal Cells and Systems     Hybrid Journal   (Followers: 4)
Annales de Limnologie - International Journal of Limnology     Hybrid Journal   (Followers: 1)
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale     Full-text available via subscription   (Followers: 3)
Annales Henri Poincaré     Hybrid Journal   (Followers: 3)
Annales UMCS, Biologia     Open Access   (Followers: 1)
Annals of Applied Biology     Hybrid Journal   (Followers: 7)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 18)
Annals of Human Biology     Hybrid Journal   (Followers: 4)
Annual Review of Biomedical Engineering     Full-text available via subscription   (Followers: 17)
Annual Review of Biophysics     Full-text available via subscription   (Followers: 25)
Annual Review of Cancer Biology     Full-text available via subscription   (Followers: 1)
Annual Review of Cell and Developmental Biology     Full-text available via subscription   (Followers: 38)
Annual Review of Food Science and Technology     Full-text available via subscription   (Followers: 15)
Annual Review of Genomics and Human Genetics     Full-text available via subscription   (Followers: 20)
Annual Review of Phytopathology     Full-text available via subscription   (Followers: 10)
Anthropological Review     Open Access   (Followers: 24)
Anti-Infective Agents     Hybrid Journal   (Followers: 3)
Antibiotics     Open Access   (Followers: 9)
Antioxidants     Open Access   (Followers: 4)
Antioxidants & Redox Signaling     Hybrid Journal   (Followers: 8)
Antonie van Leeuwenhoek     Hybrid Journal   (Followers: 5)
Anzeiger für Schädlingskunde     Hybrid Journal   (Followers: 1)
Apidologie     Hybrid Journal   (Followers: 4)
Apmis     Hybrid Journal   (Followers: 1)
APOPTOSIS     Hybrid Journal   (Followers: 8)
Applied Bionics and Biomechanics     Open Access   (Followers: 8)
Applied Vegetation Science     Full-text available via subscription   (Followers: 9)
Aquaculture Environment Interactions     Open Access   (Followers: 2)
Aquaculture International     Hybrid Journal   (Followers: 22)
Aquaculture Reports     Open Access   (Followers: 3)
Aquaculture, Aquarium, Conservation & Legislation - International Journal of the Bioflux Society     Open Access   (Followers: 6)
Aquatic Biology     Open Access   (Followers: 5)
Aquatic Ecology     Hybrid Journal   (Followers: 32)
Aquatic Ecosystem Health & Management     Hybrid Journal   (Followers: 14)
Aquatic Science and Technology     Open Access   (Followers: 3)
Aquatic Toxicology     Hybrid Journal   (Followers: 20)
Archaea     Open Access   (Followers: 3)
Archiv für Molluskenkunde: International Journal of Malacology     Full-text available via subscription   (Followers: 3)
Archives of Biomedical Sciences     Open Access   (Followers: 7)
Archives of Microbiology     Hybrid Journal   (Followers: 8)
Archives of Natural History     Hybrid Journal   (Followers: 8)
Archives of Oral Biology     Hybrid Journal   (Followers: 2)
Archives of Virology     Hybrid Journal   (Followers: 5)
Archivum Immunologiae et Therapiae Experimentalis     Hybrid Journal   (Followers: 2)
Arid Ecosystems     Hybrid Journal   (Followers: 3)
Arquivos do Instituto Biológico     Open Access   (Followers: 1)
Arquivos do Museu Dinâmico Interdisciplinar     Open Access  
Arthropod Structure & Development     Hybrid Journal   (Followers: 2)
Arthropods     Open Access   (Followers: 1)
Artificial DNA: PNA & XNA     Hybrid Journal   (Followers: 2)
Artificial Photosynthesis     Open Access   (Followers: 1)
Asian Bioethics Review     Full-text available via subscription   (Followers: 2)
Asian Journal of Biodiversity     Open Access   (Followers: 5)
Asian Journal of Biological Sciences     Open Access   (Followers: 3)
Asian Journal of Cell Biology     Open Access   (Followers: 6)
Asian Journal of Developmental Biology     Open Access   (Followers: 2)
Asian Journal of Medical and Biological Research     Open Access   (Followers: 2)
Asian Journal of Nematology     Open Access   (Followers: 3)
Asian Journal of Poultry Science     Open Access   (Followers: 4)
Australian Life Scientist     Full-text available via subscription   (Followers: 2)
Australian Mammalogy     Hybrid Journal   (Followers: 6)
Autophagy     Hybrid Journal   (Followers: 2)
Avian Biology Research     Full-text available via subscription   (Followers: 4)
Avian Conservation and Ecology     Open Access   (Followers: 12)
Bacteriology Journal     Open Access   (Followers: 2)
Bacteriophage     Full-text available via subscription   (Followers: 4)
Bangladesh Journal of Bioethics     Open Access  
Bangladesh Journal of Plant Taxonomy     Open Access  
Bangladesh Journal of Scientific Research     Open Access   (Followers: 2)
Berita Biologi     Open Access   (Followers: 1)
Between the Species     Open Access   (Followers: 1)
Bio Tribune Magazine     Hybrid Journal  
BIO Web of Conferences     Open Access  
BIO-Complexity     Open Access  
Bio-Grafía. Escritos sobre la Biología y su enseñanza     Open Access  
Bioanalytical Reviews     Hybrid Journal   (Followers: 2)
Biocatalysis and Biotransformation     Hybrid Journal   (Followers: 6)
Biochemistry and Cell Biology     Hybrid Journal   (Followers: 14)
Biochimie     Hybrid Journal   (Followers: 7)
BioControl     Hybrid Journal   (Followers: 5)
Biocontrol Science and Technology     Hybrid Journal   (Followers: 5)
Biodemography and Social Biology     Hybrid Journal   (Followers: 1)
Biodiversity : Research and Conservation     Open Access   (Followers: 27)
Biodiversity and Natural History     Open Access   (Followers: 5)
Biodiversity Data Journal     Open Access   (Followers: 3)
Biodiversity Informatics     Open Access  
Bioedukasi : Jurnal Pendidikan Biologi FKIP UM Metro     Open Access  
Bioeksperimen : Jurnal Penelitian Biologi     Open Access  
Bioelectrochemistry     Hybrid Journal   (Followers: 2)
Bioelectromagnetics     Hybrid Journal   (Followers: 1)
Bioenergy Research     Hybrid Journal   (Followers: 2)
Bioengineering and Bioscience     Open Access   (Followers: 1)
BioEssays     Hybrid Journal   (Followers: 10)
Bioethics     Hybrid Journal   (Followers: 14)
BioéthiqueOnline     Open Access  
Biofabrication     Hybrid Journal   (Followers: 3)
Biogeosciences (BG)     Open Access   (Followers: 10)
Biogeosciences Discussions (BGD)     Open Access   (Followers: 1)
Bioinformatics     Hybrid Journal   (Followers: 308)
Bioinformatics and Biology Insights     Open Access   (Followers: 15)
Bioinspiration & Biomimetics     Hybrid Journal   (Followers: 6)
Biointerphases     Open Access   (Followers: 1)
Biojournal of Science and Technology     Open Access  
Biologia     Hybrid Journal  
Biologia on-line : Revista de divulgació de la Facultat de Biologia     Open Access  
Biological Bulletin     Partially Free   (Followers: 5)
Biological Control     Hybrid Journal   (Followers: 4)
Biological Invasions     Hybrid Journal   (Followers: 16)
Biological Journal of the Linnean Society     Hybrid Journal   (Followers: 16)
Biological Letters     Open Access   (Followers: 4)
Biological Procedures Online     Open Access  
Biological Psychiatry     Hybrid Journal   (Followers: 42)
Biological Psychology     Hybrid Journal   (Followers: 6)
Biological Research     Open Access  
Biological Rhythm Research     Hybrid Journal   (Followers: 2)
Biological Theory     Hybrid Journal   (Followers: 1)
Biological Trace Element Research     Hybrid Journal  
Biologicals     Full-text available via subscription   (Followers: 9)
Biologics: Targets & Therapy     Open Access   (Followers: 1)
Biologie Aujourd'hui     Full-text available via subscription  
Biologie in Unserer Zeit (Biuz)     Hybrid Journal   (Followers: 42)
Biologija     Open Access  
Biology     Open Access   (Followers: 5)
Biology and Philosophy     Hybrid Journal   (Followers: 17)
Biology Bulletin     Hybrid Journal   (Followers: 1)
Biology Bulletin Reviews     Hybrid Journal  
Biology Direct     Open Access   (Followers: 7)

        1 2 3 4 5 6 7 8 | Last

Journal Cover Acta Médica Costarricense
  [2 followers]  Follow
  This is an Open Access Journal Open Access journal
   ISSN (Print) 0001-6002
   Published by SciELO Homepage  [713 journals]
  • (The return of measles)

  • (Role of endosymbiont bacteria Wolbachia in the control of vectorial
           diseases such as dengue, zika and chikunkunya)

    • Abstract: ResumenWolbachia es un género de bacterias perteneciente al orden Rickettsiales, que participa en diversas relaciones simbióticas con varios organismos, principalmente artrópodos y nematodos.Debido a su capacidad para inducir ciertos fenotipos reproductivos en sus hospederos, constituye un atractivo candidato para su uso como control biológico de plagas y vectores. Con el fin de proporcionar información sobre esta bacteria y sus posibles aplicaciones de control en la lucha contra el dengue y otras enfermedades transmitidas por vectores, se realizó una revisión utilizando las bases de datos de Pubmed y BINASS. Como metodología se incluyeron artículos en lengua inglesa, referentes a Wolbachia y su uso como control biológico, entre 2001 y 2017, hallados bajo las palabras clave: Wolbachia, control biológico, dengue, zika, chikungunya. Se puede resaltar que la aplicación de esta estrategia de control biológico en Costa Rica constituye un reto que involucraría el apoyo de autoridades políticas, trabajando en conjunto con los sectores académico y comunitario. Wolbachia is a genus of bacteria belonging to the order Rickettsiales that participates in diverse symbiotic relationships with several organisms, mainly arthropods and nematodes. Due to its ability to induce certain reproductive phenotypes in its hosts, it is an attractive candidate for its use as a biological agent to control of pests and vectors. In order to provide information on this bacterium and its potential control applications in the fight against dengue and other vector-borne diseases, a review was performed using Pubmed and BINASS databases. Articles in English referring to Wolbachia and its use as biological control between 2001 and 2017 where included in the search; and were found under the key words: Wolbachia, biological control, dengue, zika, chikungunya.It can be emphasized that the implementation of this biological control strategy in Costa Rica constitutes a challenge that would involve the support of the political authorities working along with the academic and community sector.
  • (Diagnosis in psychiatry: a theoretical and practical discussion for
           clinical assessment)

    • Abstract: ResumenEl artículo aborda las dificultades en el diagnóstico psiquiátrico por las características propias de estos trastornos que, junto con la definición de lo patológico desde la prescripción de lo moralmente aceptado y los conflictos de interés entre la psiquiatría y las compañías farmacéuticas, han llevado a cuestionar las categorías diagnósticas en este campo del saber. Se argumenta la necesidad de contar con categorías, aunque imperfectas, para el abordaje clínico inicial, para el disfrute de los derechos laborales y en atención médica, para la investigación en este campo y para la definición y asignación de recursos en políticas públicas basadas en evidencia. Se explica cómo el personal de salud debe evaluar la percepción subjetiva del padeciente acerca de su sintomatología, malestar y disfunción, aunado a una cuidadosa observación del comportamiento no verbal y paraverbal, para proponer un diagnóstico sindrómico presuntivo y el abordaje inicial. Los criterios diagnósticos del DSM o la CIE no se deben aplicar como un “checklist” que resulta en un diagnóstico final incuestionable.Por último, se hace un llamado a desestigmatizar las categorías psiquiátricas. Se ha demostrado que el temor a la estigmatización resultante del etiquetado en psiquiatría, contribuye a que las personas no busquen ayuda profesional para trastornos en los que el tratamiento psicoterapéutico y farmacológico mejoran el malestar, calidad de vida y funcionalidad. This article addresses the difficulties in psychiatric diagnoses together with the practical need for these labels. The characteristics of these disorders, the definition of what is considered pathological by morally prescribed standards and the conflicts of interest between psychiatry and pharmaceutical companies, have led to question the diagnostic categories in this field of knowledge. We argue that diagnostic categories are necessary, for the initial clinical approach; for access to medical care, disability and other legal rights; for research in this field; and for the definition and allocation of resources in evidence-based public policies. We discuss how clinical practitioners should assess the subjective perception of the sufferer of their symptoms, discomfort and dysfunction, together with a careful observation of non-verbal and para-verbal behavior, to propose a presumptive syndromic diagnosis and the initial approach. The diagnostic criteria of the DSM or ICD should not be applied as a “checklist” resulting in an unquestionable final diagnosis. Finally, we make a call to de-stigmatize the psychiatric categories. Fear of stigmatization resulting from psychiatric labels has been shown to contribute to sufferers not seeking professional help, for disorders in which psychotherapeutic and pharmacological treatment, improves symptomatology, quality of life and functionality.
  • (Open pancreatic necrosectomy morbility and mortality)

    • Abstract: ResumenJustificación y objetivo:la necrosectomía pancreática abierta es un procedimiento quirúrgico usado en la pancreatitis aguda necrotizante infectada, con una mortalidad variable entre el 6% y el 80%, y una morbilidad que supera el 50% de los casos. En Costa Rica no existen estudios acerca de esta cirugía, por lo cual se hizo uno retrospectivo, observacional, de casos controles, con el objetivo de conocer los resultados quirúrgicos en nuestro centro hospitalario y compararlos con la estadística mundial, para intentar identificar patrones que modifiquen la mortalidad.Métodos:estudio observacional, descriptivo y retrospectivo de casos y controles. Se analizaron todos los pacientes sometidos a necrosectomía pancreática abierta en el hospital “Dr. R. A. Calderón Guardia”, desde el 1 de enero de 2006 al 30 junio de 2014. Se definió como caso todo paciente que falleció posterior a una necrosectomía pancreática por pancreatitis necrotizante, y como control, todo paciente que sobrevivió posterior al diagnóstico y cirugía.Resultados:en el período 2006 - 2014 se analizaron 28 casos. La edad promedio de población fue de 47,7 años; 17 hombres y 11 mujeres; pancreatitis agudas severas en el 89,3% de casos, teniendo como principales causas: colelitiasis e ingesta etílica. Indicaciones quirúrgicas utilizadas: colección pancreática o peripancreática infectada y necrosis pancreática; momento quirúrgico promedio de 17,3 días; abordaje por línea media con necrosectomía y empaque más abdomen abierto mayormente usado. En promedio: 6,3 intervenciones quirúrgicas por paciente, con estancias medias en UCI y hospitalaria, de 26,6 y 47,5 días. Complicaciones frecuentes: fístula pancreática enel 53,6% de los casos, abscesos postoperatorios en el 53,6% también, y mortalidad del 35,7%. En cuanto a la mortalidad, se encontró que la perforación intestinal fue la principal condición de riesgo para fallecimiento, y la fístula pancreática, un factor protector.Conclusión:en el hospital del estudio, la necrosectomía pancreática abierta es un procedimiento de alta morbimortalidad. Background and aim:Open pancreatic necrosectomy is a surgical procedure used in infected acute necrotizing pancreatitis with a mortality that varies between studies from 6% to 80% and a morbidity that exceeds 50% of the cases. In Costa Rica there are no studies related to this surgery so a retrospective, observational and control study was done with the objective of knowing the surgical results in our center and comparing it with the world statistics and to identify patterns that modify mortality.Methods:Observational, descriptive and retrospective case-control study. All patients undergoing open pancreatic necrosectomy at the “Dr. R. A. Calderón Guardia” from January 1, 2006 to June 30, 2014 were reviewed. All patients who died after a pancreatic necrosectomy for necrotizing pancreatitis were defined as cases, and as a controls, all patients who survived after diagnosis and surgery.Results:In the period 2006 to 2014 in our tertiary center Hospital Calderón Guardia 28 cases were obtained, with the following results: average age of 47.7 years, 17 men and 11 women, severe acute pancreatitis was found in 89.3% of cases with cholelithiasis and alcohol ingestion as the main causes. Surgical indications were pancreatic and/or peripancreatic infected collection and pancreatic necrosis, surgical time average of 17.3 days, midline approach with necrosectomy and packing, plus open abdomen mostly used. On average, 6.3 surgeries per patient were made, with mean days in ICU and hospital stay of 26.6 and 47.5 days each. Most frequent pancreatic complications were pancreatic fistula in 53.6% of cases, postoperative abscesses in 53.6%, and mortality of 35.7%. Regarding mortality it was found that intestinal perforation was a risk factor fordeath and pancreatic fistula a protective factor.Conclusion:at the study hospital open pancreatic necrosectomy is a high morbidity and mortality procedure.
  • Measuring the burden of herpes zoster disease in Costa Rica

    • Abstract: Background: Herpes zoster is a distressing illness that significantly reduces patients’ quality of life. However, Costa Rican data regarding the clinical burden of herpes zoster and associated health care resource utilization is limited. This study aimed to assess the zoster-associated burden evaluating pain, impact on quality of life and health care resource utilization in a Costa Rican sample.Methods:Herpes zoster patients recruited in Costa Rica at a private geriatric practice were enrolled at various time points during a zoster episode and were actively followed over 6 months. Outcomes including zoster-associated pain, quality of life and health care resource utilization were assessed via patient self-reported questionnaires.Results: 50 zoster patients were included [68.0% female, mean (SD) age = 69.5 (10.8) years]. Zoster-associated pain decreased over time while quality of life improved though without full base recovery. The highest health care resource utilization included doctor’s office (98.0%), emergency room (60.0%) and specialists (60.0%) visits. Sixteen (32.0%) patients were hospitalized [mean (SD)= 4.3 (4.1) days].Conclusion: Similar to other Latin American countries, high herpes zoster burden was observed in a private geriatric practice in Costa Rica, supporting the need for early intervention and preventive strategies, one of such could be the implementation of a HZ vaccination program.ResumenJustificación: El herpes zoster es una enfermedad estresante que reduce significativamente la calidad de vida de los pacientes. Sin embargo, datos relativos a la carga clínica de herpes zoster y la utilización de recursos de salud son limitados en Costa Rica. El objetivo de este estudio fue evaluar la carga asociada al herpes zoster evaluando dolor, impacto sobre la calidad de vida y utilización de recursos de salud en una muestra costarricense.Métodos:Pacientes con herpes zoster fueron reclutados en una práctica geriátrica privada en diferentes etapas de un episodio de zoster y fueron activamente seguidos durante 6 meses. Se evaluaron los resultados en el paciente, incluyendo el dolor asociado a zoster, calidad de vida y utilización de recursos de salud mediante cuestionarios autoadministrados.Resultados: Se incluyeron 50 pacientes con herpes zoster [68,0% mujeres, media de edad (SD) = 69.5 (10.8) años]. El dolor asociado a zoster disminuyó con el tiempo mientras que calidad de vida mejoró, aunque sin plena recuperación comparado con la calidad de vida inicial. La utilización de recursos de salud más alta fue visitas al consultorio (98.0%), visitas a sala de urgencias (60.0%) y visitas a especialistas (60.0%). Dieciséis pacientes (32.0%) fueron hospitalizados [media (SD) = 4.3 (4.1) días].Conclusión: Similar a otros países de América Latina, se observó una alta carga de enfermedad debido a herpes zoster en una práctica privada geriátrica en Costa Rica, lo cual respalda la necesidad de la intervención temprana y uso de estrategias preventivas, una de las cuales podría ser la implementación de un programa de vacunación a herpes zoster.
  • (Pre-assessment of pharmacological immunosuppression in Rheumatology)

    • Abstract: ResumenEn los últimos 15 años se han desarrollado terapias y esquemas terapéuticos para inducir la remisión a la gran mayoría de enfermedades reumatológicas. La mejoría clínica lograda se consigue a expensas de una inmunosupresión más agresiva y específica, lo que conlleva un aumento en el riesgo de infecciones. La principal causa de muerte de las enfermedades autoinmunes, en los primeros 5 años de evolución, es la infección secundaria a la inmunosupresión. El objetivo del presente trabajo fue elaborar un documento de consenso con el afán de reducir este riesgo, basado en la mejor evidencia médica disponible, utilizando los recursos disponibles en el hospital para disminuir la morbimortalidad de los pacientes que reciben estas terapias. Contar con un documento de consenso permitirá minimizar los efectos secundarios y mejorar la acción terapéutica, con mayores oportunidades de remisión y una más adecuada utilización del recurso institucional. In the last 15 years therapies and therapeutic schemes have been developed to induce remission to the vast majority of rheumatologic diseases. The clinical improvement achieved is at the cost of a more aggressive and specific immunosuppression, which leads to an increase in the risk of infections. The main cause of death of autoimmune diseases in the first 5 years of evolution is infection secondary to immunosuppression. The objective of the present study was to develop a consensus document with the aim of reducing this risk of infection, based on the best available medical evidence, using the resources available in our hospital to reduce the morbidity and mortality of patients receiving these therapies. Having a consensus document will allow us to minimize side effects and improve therapeutic action with greater opportunities for referral and better utilization of institutional resources.
  • (Persistence of the omphalomesenteric duct)

    • Abstract: ResumenLa persistencia del conducto onfalomesentérico y del uraco constituyen las malformaciones congénitas más frecuentes de la región umbilical. Un fracaso en la regresión del conducto onfalomesentérico determina el origen de un amplio espectro de anomalías relacionadas con la pared abdominal, entre ellas la persistencia del conductoonfalomesentérico.Se presenta el caso de un paciente de 10 años de edad con persistencia completa y permeable del conducto onfalomesentérico; lo inusual fue su presentación con un cuadro de abdomen agudo, motivo por el cual se diagnosticó inicialmente como apendicitis aguda. Se recalca la importancia de este tipo de casos por sus múltiples manifestaciones clínicas y las complicaciones que conlleva. The persistence of the omphalomesenteric duct and the urachus are the most frequent congenital malformations of the umbilical region. A failure in the regression of the omphalomesenteric duct determines the origin of a wide spectrum of abnormalities related to the abdominal wall, including the persistence of the omphalomesenteric duct.We present the case of a 10-year-old patient with complete and permeable persistence of the omphalomesenteric duct, what makes the case unusual is its presentation with acute abdomen, reason for which it was initially diagnosed as acute appendicitis. The importance of this type of case is emphasized by its multiple clinical manifestations and the complications that it entails
  • (Septic Shock by Burkholderia pseudomallei )

    • Abstract: ResumenLa melioidosis es una enfermedad endémica del sureste de Asia y el norte de Australia causada por un bacilo Gram negativo llamado Burkholderia pseudomallei. En AméricaLatina se han reportado casos esporádicos en múltiples países y en Costa Rica se han documentado hasta el momento dos casos. Se presenta el caso de una femenina de 17 años que ingresó al centro médico con fiebre, expectoración purulenta, dolor lumbar, disnea, taquicardia, aumento de marcadores de fase aguda y linfopenia, además de una radiografía de tórax que evidenció un infiltrado circunscrito con broncograma aéreo a nivel del lóbulo superior derecho. A las 48 horas de internamiento desarrolló una insuficiencia respiratoria severa y falla circulatoria. Los cultivos de sangre, secreción bronquial y líquido pleural analizados fueron reportados positivos por el agente Burkholderia pseudomallei. Melioidosis is an endemic disease in Southeast Asia and northern Australia caused by a Gram-negative bacillus called Burkholderia pseudomallei. In Latin America sporadic cases have been reported in multiple countries and in Costa Rica two cases have been documented so far. We present the case of a 17 year old female who entered the medical center with fever, purulent sputum, low back pain, dyspnoea, tachycardia, increased acute phase markers and lymphopenia, as well as a chest x-ray that documented a bronchial circumscribed infiltrate airway at the right upper lobe level. At 48 hours of hospitalization, she developed severe respiratory and circulatory failure. The blood cultures, bronchial secretion and pleural fluid analyzed were reported positive by the agent Burkholderia pseudomallei.
  • (Massive spontaneous bleeding)

    • Abstract: ResumenSe reporta el caso de un paciente que presentó de manera espontánea diátesis hemorrágica, sin tener causa alguna aparente que lo justificase. Tal diátesis hemorrágica forja un amplio apartado de posibilidades diagnósticas en cuanto a trastornos de la coagulación del adulto se refiere, en el contexto de un paciente conocido sano que nunca ha presentado episodios de sangrado mayor y debuta con hemorragias de forma masiva. Entre las muchas posibilidades diagnósticas se encuentra una poco conocida: la hemofilia adquirida. La hemofilia adquirida es un trastorno infrecuente de la hemostasia, caracterizado por la presencia de inhibidores adquiridos de los factores de la coagulación, en el plasma del paciente enfermo. Los inhibidores adquiridos son anticuerpos que a su vez podrían ser de tipo aloanticuerpos o autoanticuerpos. Los aloanticuerpos se desarrollan en pacientes deficitarios per se de factores de la coagulación, en respuesta a la terapia de sustitución de factores, lo que complica su tratamiento. Por su parte, los autoanticuerpos se desarrollan en sujetos sin defectos previos; son anticuerpos específicos contra un factor de la coagulación, afectando o no su función, alterando una o varias etapas de las vías de la coagulación. El caso que aquí se presenta es de un paciente masculino de 58 años, quien se presentó con sangrado espontáneo masivo y a quien se diagnosticó hemofilia adquirida por la presencia de autoanticuerpo específico del factor VIII. A patient that presented with spontaneous hemorrhagic diathesis, with no apparent cause is presented. Hemorrhagic diathesis presents a wide range of diagnosis possibilities as of coagulation disorders are referred, in the context of a healthy patient with no previous major bleeding episodes and that debuts with massive hemorrhages. Acquired hemophilia, a little known disease, is one that must be considered.Acquired hemophilia is an uncommon hemostasis disorder characterized by the presence of acquired inhibitors of coagulation factors in the plasma of the sick patient. These acquired inhibitors, are antibodies that could be alloantibodies or autoantibodies. Alloantibodies are developed in patients who have coagulation factor deficiency, in response to factor replacement therapy, thus complicating treatment.On the other hand, autoantibodies are developed in people without previous defects and are specific against a factor of coagulation, affecting or not their function, obstructing one or several stages of the coagulation pathways. We report a case of acquired hemophilia due to an autoantibody against factor VIII in a 58 years old male patient with spontaneous massive bleeding.
  • (Migration of fragmented percutaneous catheter in pediatric patient)

    • Abstract: ResumenLos pacientes hemato-oncológicos pediátricos son una población usualmente expuesta a catéteres percutáneos, debido a los tratamientos quimioterapéuticos de larga duración. Entre las complicaciones raras se encuentra la migración de fragmentos del catéter. A pesar de que se reportan diferentes técnicas quirúrgicas para remover los fragmentos, en algunas ocasiones el riesgo de remoción supera el beneficio del paciente. En este artículo se reporta el caso de una niña de 6 años, con diagnóstico de leucemia linfocítica aguda, en quien se produjo migración de un fragmento del catéter percutáneo. La paciente cursó asintomática y se manejó conservadoramente. En la actualidad tiene 1 año y 5 meses desde el diagnóstico de la migración del catéter y se encuentra sin clínica alguna. The pediatric hemato-oncological patients are usually exposed to have intravenous percutaneous catheters because of their long-term chemotherapy treatment. One of the unusual complications of the percutaneous catheters is to fragment and one of the fragments to migrate. Although, there are different surgical techniques for the removal of the fragments, sometimes the risk is larger than the benefit for the patient. This article reports the case of a 6 year old pediatric patient with acute lymphoblastic leukemia who suffered the migration of a fragment of a percutaneous device, that was treated conservatively without any complication. At the moment, the patient has 1 year and 5 months from her diagnosis of catheter migration and is completely asymptomatic.
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
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