Casos de parálisis flácida aguda reportados para descartar polio en la República Dominicana entre 2001 y 2017: revisión de sus factores etiopatológicos

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dc.creatorSantoni, Juan
dc.creatorGarib, Zacarias
dc.creatorMancebo García, Pablo
dc.creatorSantoni, Carlos
dc.creatorGrullón, Patricia
dc.creatorRodríguez, Antolina
dc.date2018-09-14
dc.date.accessioned2020-09-09T19:43:47Z
dc.date.available2020-09-09T19:43:47Z
dc.descriptionIntroduction:In 2001, after an 18 case Polio outbreak near Constanza, Public Health Ministry and Panamerican Health Organization agreed to review within 60 days, cases of Acute Flaccid Paralysis (AFP), supervised by neu­rology specialists. Both institutions published epidemic’s features while JRS/CJSW performed electromyogram. Methods: After culture, reports and neurological exa­mination, diagnosis of eleven categories was recorded. Sample included 188 male, 148 female. Results: Poliomyelitis cases (18) irregularly immunized cases were included; PNS Guillain-Barré syndromes (84) were most frequent AFP, 2 fatalities coincided with short, intervals between previous illness and GBS, one due to vaccination. (polio relates to membrane D55 vulnerability, GBS to protein mimicry, the rest to cytokines); transverse myelitis plus Acute disseminated encephalomyelitis (58) with immune pathology caused by initial infections like chicken pox; In CNS, encephalitis or meningitis (49) were identified by increased reflexes and spasticity rather than flaccidity; peripheral neuropathy, (23) with scarce glove/ stocking cases, more with mononeuropathy, important because of its asymmetry; myopathy (25) having known past Streptococcal event. Severe arthropaties were inclu­ded because functional weakness resembled Polio, plus 4 Sydenham’s chorea; enterovirus (16): a relatively new en­tity for AFP: found easily by positive stool identification; Vasculitis (11): a rarely diagnosed CVA. Cerebral tumors (10) found by CAT/MRI scanning, having 2 postopera­tive fatalities. Asymmetric weaknesses (15) casting doubt for motoneurone involvement, but none was showing stool confirmation of poliovirus. Normal Neurological examination in 24, without laboratory evidence to arrive at diagnosis. Three parents refused reviewing. Conclusion: Besides making sure absence of new cases of polio by examining all reported AFP cases. On reviewing its literature we have contributed in knowing its clinical variety and pathology.en-US
dc.descriptionIntroducción: Tras 18 casos de poliomielitis descubiertos al final del 2000, en Constanza, el Ministerio de Salud Pública (MSP) y la Organización Panamericana de la Salud (OPS), comparten la responsabilidad de revisar, a los 60 días, todos los casos de Parálisis Flácidas Agudas (PFA). Para examinarlos se nombra un comité de pro­fesores (Tolentino, Mendoza, Santoni). Las entidades comprometidas habían publicado las características clí­nico-epidemiológicas del brote, mientras que J.Santoni y C.Santoni Williams publican su electromiografía. Para este artículo se revisa la literatura de etiopatogenias en la PFA y polio. Métodos: Se citan 336 casos acompañados por encargados comunitarios, 188 varones, 148 hembras, edad promedio: 6.2 años. Se revisa: evolución, imágenes, analítica, cultivo viral en heces. Así mismo, diagnóstico y clasificación tras examen neurológico. Resultados: Casos de poliomielitis (18), de 1 a 13 años: todos vacunados irregularmente. Citamos patología de membrana CD155 y del cañón neuronal. Describimos los casos de PFA en orden descendente; síndromes de Guillain-Barré (84), 10 de ellos Miller-Fisher; evolución moderada, 2 fallecidos. Se atribuye a mímica proteica de oligosacáridos. Casos de FPA que involucran a las cito­kinas; mielitis y encefalomielitis diseminada agudas (58); encefalitis, meningitis, cerebelitis (49); polineuritis/mono­neuritis (23); miopatías relacionadas a Estreptococias (25) con sus 6 Coreas por mímica proteica anti-lysogangliosi­do GM1; procesos entero virales (16), vasculitis con ACV escasos (11), tumores (10). Finalmente, encontramos 15 con exámenes asimétricos sospechosos de motoneurona lesionada, pero todos con cultivos fecales de poliovirus negativos; y 24 exámenes neurológicos normales, pero sin causa. Aceptamos 3 inasistencias. Conclusión: Demostramos la ausencia de nuevos casos de polio y actualizamos la clasificación de las PFA. Revisando sus etiopatogenias las entendemos mejor.es-ES
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dc.identifierhttps://revistas.intec.edu.do/index.php/cisa/article/view/1275
dc.identifier10.22206/cysa.2018.v2i3.pp9-17
dc.identifier.urihttps://repositoriobiblioteca.intec.edu.do/handle/123456789/2719
dc.languagespa
dc.publisherIntituto Tecnológico de Santo Domingo (INTEC)es-ES
dc.relationhttps://revistas.intec.edu.do/index.php/cisa/article/view/1275/1638
dc.relationhttps://revistas.intec.edu.do/index.php/cisa/article/view/1275/1959
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dc.rightsDerechos de autor 2018 Ciencia y Saludes-ES
dc.rightshttps://creativecommons.org/licenses/by-nc-sa/4.0es-ES
dc.sourceScience and Health; Vol 2 No 3 (2018): Science and Health, september-december; 9-17en-US
dc.sourceCiencia y Salud; Vol. 2 Núm. 3 (2018): Ciencia y Salud, septiembre-diciembre; 9-17es-ES
dc.source2613-8824
dc.source2613-8816
dc.source10.22206/cysa.2018.v2i3
dc.subjectGuillain-Barré syndromeen-US
dc.subjectacute disseminatd encephalomyelitis,en-US
dc.subjectviral enteritisen-US
dc.subjectdermatomiositisen-US
dc.subjectcytokinesen-US
dc.subjectsíndrome de Guillain-Barrées-ES
dc.subjectencefalomielitis diseminada agudaes-ES
dc.subjectenteritis vitaleses-ES
dc.subjectdermatomiositis, citokinases-ES
dc.titleCases of acute flaccid paralysis reported to rule out poliomyelitis in the Dominican Republic from 2001 to 2017: review of their etiopathological factorsen-US
dc.titleCasos de parálisis flácida aguda reportados para descartar polio en la República Dominicana entre 2001 y 2017: revisión de sus factores etiopatológicoses-ES
dc.typeinfo:eu-repo/semantics/article
dc.typeinfo:eu-repo/semantics/publishedVersion
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