Manual DE MALA RAZA (Spanish Edition)

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Undoubtedly, there may be other solutions for Caballo de mala raza y de poca alzada. If you discover one of these, please send it to us, and we'll add it to our database of clues and answers, so others can benefit from your research. Welcome to Dan Word. We use third party cookies for analytics and personalized ads. SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field. Resultados: Las bacterias aerobias aisladas fueron Moraxella sp. The aim of the study was to clarify the bacterial etiologic diagnosis in infants with CAP..

Methods: A prospective, cross-sectional and descriptive study in patients 6 months to 2 years 11 months of age with CAP with poor outcome was conducted.

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Patients were admitted to the Pediatric Pneumology Service and underwent bronchoscopy with bronchoalveolar lavage BAL , taking appropriate measures during the procedure to limit the risk of contamination.. Results: Aerobic bacteria isolated were Moraxella sp.

Conclusions: In contrast to other reports, we found Moraxella sp. Pneumonia is a major cause of morbimortality in childhood. Its treatment consumes significant health and economic resources within hospitals as well as outside the hospital. Peak incidence occurs in children aged years and is especially prevalent during the winter season. Pneumonia is defined as inflammation of the lung tissue due to an infectious agent that stimulates the inflammatory response, resulting in lung injury. This response causes migration of neutrophils, release of inflammatory mediators and oxidative enzymes, with plasma leakage and surfactant loss, which result in the absence of air and freezing of the organ known as consolidation.

The causative organisms may be bacteria, viruses, fungi or parasites. However, the high mortality rate of pneumonia is attributed, in most part, to bacterial etiological agents as well as to the lack of prompt and appropriate access to treatment..

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Community-acquired pneumonia CAP is an acute infection of the pulmonary parenchyma that affects an immuno-competent patient exposed to a microorganism outside the hospital. Effective antimicrobial therapy depends on the identification of the etiologic agent. It is therefore necessary to obtain the appropriate material for bacteriological diagnosis, including Gram stain and culture. Use of bronchoscopy and bronchoalveolar lavage BAL reduces contamination in obtaining samples. BAL is the method used to obtain a representative sample of fluid and secretions from the lower respiratory tract LRT , which will be useful for cytological and microbiological diagnosis of lung diseases, particularly in pediatric patients.

Enriched culture media will also be used for the nutritional requirements demanded by bacterial growth.. Most CAP in children is of viral etiology.

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However, the possible existence of bacterial infections often conditions the prescription of antibiotic treatment. It should be noted that the radiologic patterns described in different etiological forms do not have absolute validity. Although the existence of alveolar infiltration is characteristic of bacterial pneumonia, it can also be observed in those cases caused by viruses.. In Mexico there are few studies of the bacterial etiology of CAP in children. During the first 3 years of life the virus is clearly highlighted. Streptococcus pneumoniae and Haemophilus influenza should also be considered..

The greatest diagnostic difficulty lies in identifying the etiological agent. This fact is related to the problems that present in obtaining suitable samples for biological cultivation. This study was performed to appropriately identify the bacterial etiology in these patients.. Written informed consent of parents or guardians was obtained prior to participation in the study.

Study procedures were in compliance with the standards of the Institutional Committee for Responsible Human Experimentation and according to the World Medical Association and Declaration of Helsinki.

Sampling procedure. Bronchoscopy and BAL were performed using a standardized protocol. A pediatric bronchoscope was inserted orally to avoid nasal contamination.

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Breathing aliquots of saline solution 0. BAL first fraction was discarded. All patients were sedated with i. Intracutaneous monitoring was conducted to assess oxygen saturation and heart rate, and supplemental oxygen was administered as necessary during the procedure. BAL samples were processed using standard techniques. Infants admitted with diagnosis of CAP were managed with antibiotic schemes.

Statistical analysis. Seventeen infants who met the inclusion criteria were included. CAP diagnosis was based on clinical criteria.

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Duration was days. Fever occurred in Hospitalizations for LRT were reported as occasions Table 1. It is worth mentioning that BAL complications were not presented.. Samples studied were appropriate. All bacterial isolates were pure cultures. Moraxella sp. Unfortunately, accurate identification of M.

The presence of acute otitis media AOM was associated with Moraxella sp. The age group affected by Moraxella sp. This study addressed a group of 17 newborns with CAP who required hospitalization and determined the bacterial etiology of infection.. Isolated aerobic bacteria mainly were Moraxella sp. Risk of contamination in BAL samples was limited significantly because various technical measures were taken to avoid contamination by secretions from the URT.

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  6. The problem of poorly immunized children is still present in a country where the vaccine is compulsory and free. This failure at the primary level of care determines the need to maintain an active surveillance of the occurrence of preventable diseases such as those caused by type B H.

    The presence of AOM was found associated with Moraxella sp. Undoubtedly, it is the most frequent and severe infection caused by M. With regard of the identification of M. Other authors have reported the same dificulty. Most studies use combinations of conventional serological and microbiological methods e. Many of these methods have only been used in research applications and are not always reliable or readily available to clinicians. Consequently, data on the role of M. LRT infections caused by M.

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    Therefore, involvement of Moraxella sp. This suggests that pediatric CAP could be reduced by considering Moraxella sp. Pneumonia causes more deaths worldwide than any other infectious disease. Although it can be cured with antibiotics, patients can die if timely, appropriate and adequate treatment is not initiated. Therefore, pulmonologists have long tried to find a sensitive, specific and safe method for obtaining from patients the pathogens causing LRT infections. BAL allows half of the microbiological diagnoses in cases with minimal complication rates.

    It is important to keep in mind that in experienced hands this technique provides much clinical information.. It is a commensal microorganism closely related to the S. Homologous recombination has been observed among these species.