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Id: 749791 LILACS-Express
Autor: Chou, Deng-Wei; Wu, Shu-Ling; Chung, Kuo-Mou; Han, Shu-Chen.
Título: Septic pulmonary embolism caused by a Klebsiella pneumoniae liver abscess: clinical characteristics, imaging findings, and clinical courses
Fonte: Clinics;70(6):407-407, 06/2015. tab, graf.
Idioma: en.
Resumo: OBJECTIVES: Septic pulmonary embolism caused by a Klebsiella (K.) pneumoniae liver abscess is rare but can cause considerable morbidity and mortality. However, clinical information regarding this condition is limited. This study was conducted to elucidate the full disease spectrum to improve its diagnosis and treatment. METHOD: We reviewed the clinical characteristics, imaging findings, and clinical courses of 14 patients diagnosed with septic pulmonary embolism caused by a K. pneumoniae liver abscess over a period of 9 years. RESULTS: The two most prevalent symptoms were fever and shortness of breath. Computed tomography findings included a feeding vessel sign (79%), nodules with or without cavities (79%), pleural effusions (71%), peripheral wedge-shaped opacities (64%), patchy ground-glass opacities (50%), air bronchograms within a nodule (36%), consolidations (21%), halo signs (14%), and lung abscesses (14%). Nine (64%) of the patients developed severe complications and required intensive care. According to follow-up chest radiography, the infiltrates and consolidations were resolved within two weeks, and the nodular opacities were resolved within one month. Two (14%) patients died of septic shock; one patient had metastatic meningitis, and the other had metastatic pericarditis. CONCLUSION: The clinical presentations ranged from insidious illness with fever and respiratory symptoms to respiratory failure and septic shock. A broad spectrum of imaging findings, ranging from nodules to multiple consolidations, was detected. Septic pulmonary embolism caused by a K. pneumoniae liver abscess combined with the metastatic infection of other vital organs confers a poor prognosis. .(AU)
Responsável: BR1.1 - BIREME


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Id: 749470 LILACS-Express
Autor: Rodríguez, Mabel Karina; Agudelo, Clara Inés; Duarte, Carolina.
Título: Aislamientos invasivos de Haemophilus influenzae en menores de 5 años: distribución de los serotipos y de la sensibilidad antimicrobiana, SIREVA II, Colombia 2002-2013 / Invasive Haemophilus influenzae isolates in children younger than 5 years: Distribution of serotypes and antimicrobial sensitivity, SIREVA II , Colombia 2002-2013
Fonte: Infectio;19(2):67-74, mar.-jun. 2015. graf, mapas, tab.
Idioma: es.
Resumo: Objetivo: Analizar del 2002 al 2013 los datos de la vigilancia de los serotipos y sensibilidad antimicrobiana de los aislamientos invasivos de Haemophilus influenzae ( H. influenzae ) en niños menores de 60 meses. Materiales y métodos: Se analizaron los datos demográficos, fuente y enfermedad asociada de los aislamientos invasivos de H. influenzae recibidos entre 2002 y 2013. Todos los aislamientos habían sido confirmados bacteriológicamente, tenían el dato del serotipo, el cual fue determinado por el método de aglutinación en lámina y PCR y los patrones de sensibilidad antimicrobiana por concentración inhibitoria mínima a ampicilina, SXT, cloranfenicol, cefuroxima y ceftriaxona. El análisis se realizó por periodos de 3 años. Resultados: Por enfermedad invasiva el 50,5% eran de pacientes con meningitis, 23,5% de neumonías, 19,5% de sepsis y bacteriemia, 2,0% de otros y 4,5% sin dato. Por procedencia se recibieron de Bogotá y Antioquia 55 aislamientos de cada uno, de Risaralda 24, de Valle 15, de Santander 11 y 40 de 14 departamentos. El serotipo predominante fue el Hib (40,5%), seguido de HiNT (38,0%), Hia (17,5%), Hid (2,0%), Hif (1,5%) y Hie (0,5%). Del total de los aislamientos, 12,0% eran resistentes a ampicilina; 16,5% a SXT; 1,0% a cloranfenicol y 0,5% a ceftriaxona. Todos los aislamientos fueron sensibles a cefuroxima y a rifampicina. Conclusiones: La vigilancia por el laboratorio es una vigilancia pasiva voluntaria pero, no obstante el número reducido de aislamientos, permite determinar que Hib continúa circulando en esta población y que hay otros serotipos de H. influenzae que causan enfermedad invasiva. Por tanto es necesario mantener y fortalecer la vigilancia de este patógeno.(AU)

Objective: To analyze 2002-2013 surveillance data on the serotypes and antimicrobial sensitivity of invasive Haemophilus influenzae ( H. influenzae ) isolates in children younger than 60 months. Materials and methods: We analyzed the demographic data, source and associated diseases ofinvasive HI isolates from cases recorded from 2002-2013. All isolates had been bacteriologically confirmed and had data on their serotype, which was determined by the slide agglutination method and polymerase chain reaction. The antimicrobial sensitivity patterns were determined by minimum inhibitory concentration of ampicillin, trimethoprim-sulfamethoxazole, chloramp-henicol, cefuroxime and ceftriaxone. The analysis was conducted in 3-year periods. Results: According to invasive disease, 50.5% of patients had meningitis, 23.5% had pneumonia,19.5% had sepsis and bacteremia, 2.0% had other diseases and 4.5% lacked data. By origin, 55 isolates each were received from Bogota and Antioquia, 24 were from Risaralda, 15 were from Valle, 11 were from Santander and 40 came from 14 departments. The predominant serotype was Hib (40.5%), followed by HiNT (38.0%), Hia (17.5%), Hid (2.0%), Hif (1.5%) and Hie (0.5%). Ofthe total isolates, 12.0% were resistant to ampicillin; 16.5% to trimethoprim-sulfamethoxazole,1.0% to chloramphenicol and 0.5% to ceftriaxone. All isolates were sensitive to cefuroxime andrifampicin. Conclusions: Laboratory surveillance is a voluntary passive surveillance; however, the low number of isolates helped determine that Hib continues to circulate in this population and that there are other H. influenzae serotypes that cause invasive disease. Therefore, surveillance of this pathogen needs to be maintained and reinforced.(AU)
Responsável: CO332 - Facultad de Medicina


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Id: 748982 LILACS-Express
Autor: Maia-de-Oliveira, Joao P.; Brasileiro, Lizie E.; Correia, Carlos E.; Machado-de-Sousa, João P.; Hallak, Jaime E..
Título: Psychotic syndrome secondary to meningioma treated with a low dose of olanzapine
Fonte: Rev. bras. psiquiatr;37(2):180-180, Apr-Jun/2015. graf.
Idioma: en.
Responsável: BR1.1 - BIREME


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Id: 748493
Autor: Herrera, Silvia Rejane Fontoura.
Título: Comparação entre duas técnicas cirúrgicas para correção intra-uterina de meningomielocele em feto de ovelha / Comparison between two surgical technique for prenatal correction of meningomyelocele in sheep.
Fonte: São Paulo; s.n; 2014. [94] p. ilus, tab, graf.
Idioma: pt.
Tese: Apresentada a Universidade de São Paulo. Faculdade de Medicina para obtenção do grau de Doutor.
Resumo: Introdução: A incidência de defeitos do tubo neural é de cerca de 1/1000 nascimentos. Na mielomenngocele, o tratamento intra-uterino utilizando a técnica neurocirúrgica clássica, apresenta melhor prognóstico neurológico, do que o tratamento pós natal, mas está associado a complicações maternas e fetais. Novas técnicas de correção estão sendo estudadas para diminuir a morbidade materna e fetal. Objetivo: Comparar os efeitos sobre a medula de duas técnicas cirúrgicas de correção intra-uterina de um defeito semelhante à mielomeningocele , em fetos de ovelha. Métodos: Em 15 fetos foi criado um defeito semelhante à mielomeningocele (laminectomia e excisão de dura-máter) no 90° dia de gestação. O tipo de correção foi randomizado. No grupo 1, o defeito foi corrigido usando a técnica neurocirúrgica clássica, com a sutura de três camadas (dura-máter, músculo e pele), realizada por um neurocirurgião. No grupo 2, um especialista em Medicina Fetal, utilizou uma técnica simplificada, colocando um fragmento de celulose Biosintética sobre a medula e suturando apenas a pele sobre a celulose. Próximo ao termo da gestação (132° dias), os fetos foram sacrificados para análise anatomopatológica. Resultados: Ocorreram 1 morte materna, 3 casos de trabalho de parto precoce e 4 tardios. Um total de 10 casos foram viáveis para avaliação anatomopatológica 10 casos, 6 no grupo 1 e 4 no grupo 2. No grupo 1, todos os casos mostraram aderência da medula à cicatriz (meningoadesão) e perda da arquitetura medular por destruição do funículo posterior e 5 de 6 casos apresentaram perda da visualização da substância cinzenta. No grupo 2, observamos em todos os casos, a formação de uma neoduramater, separando o tecido nervoso do músculo adjacente, sendo que o funículo posterior e a substância cinzenta estavam preservados. Conclusão: A técnica simplificada foi superior à técnica neurocirúrgica, com maior preservação da medula e evitando as aderências do tecido nervoso. Nossos...(AU)

Introduction: The incidence of neural tube defects is about 1/1000 births. In myelomeninocele, the intrauterine treatment with the classical neurosurgical technique suggest better neurological prognosis for the fetus, than postnatal treatment, but it is associated with maternal and fetal complications. New correction techniques are being studied to decrease maternal and fetal morbidity. Objective: To compare the effects on the medulla of two surgical techniques for intrauterine correction of myelomeningocele-like defect in sheep. Methods: In 15 pregnant sheep a myelomeningocele -like defect (laminectomy and dural excision) was created in the lumbar region in 90o day gestation. The type of correction was randomized. In group 1 the defect was corrected using the classic neurosurgical technique of three layers suture (dura-mater, muscle and skin closure) performed by a neurosurgeon. In group 2, a fetal medicine specialist used a biosynthetic cellulose patch to protect the medulla and only the skin was sutured above it. Near term (132o day gestation) fetuses were sacrificed for pathological analysis. Results: One maternal death occurred, early preterm labour, and late preterm labour occurred in 3 and 4 cases, respectively. A total of 10 cases were available for pathological analysis, 6 in group 1 and 4 in group 2. In group 1, all the cases showed a adherence of the medulla to the scar (meningoneural adhesion) and a destruction of the normal architecture of nervous tissue, whithout view of posterior funiculus and in 5 of 6 cases without view of grey matter. In group 2, in all the cases were observed a formation of an organized tissue involving the cellulose patch, a neoduramater, separating the nervous tissue of adjacent muscle, preserving the posterior funicullus and grey matter. Conclusion: The simplified new technique was better than the classical neurosurgical technique. It preserved the nervous tissued and avoided the adherence of the medulla to the scar....(AU)
Descritores: Meningomielocele
Disrafismo Espinal
Terapias Fetais
Fetoscopia
Ovinos
Limites: Animais
Masculino
Feminino
Responsável: BR66.1 - Divisão de Biblioteca e Documentação


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Id: 748364 LILACS-Express
Autor: Saraiva, Maria das Graças Gomes; Santos, Eyde Cristianne Saraiva; Saraceni, Valéria; Rocha, Lívia Laura dos Santos; Monte, Rossicléia Lins; Albuquerque, Bernardino Cláudio de; Bastos, Michele de Souza; Santos, Marcelo Cordeiro dos; Monteiro, Wuelton Marcelo; Mourão, Maria Paula Gomes; Guerra, Marcus Vinitius de Farias; Lacerda, Marcus Vinícius Guimarães de.
Título: Epidemiology of infectious meningitis in the State of Amazonas, Brazil
Fonte: Rev. Soc. Bras. Med. Trop;48(supl.1):86-86, 05/2015. tab, graf.
Idioma: en.
Resumo: INTRODUCTION: In the State of Amazonas, particularly in the capital Manaus, meningitis has affected populations of different cultures and social strata over the years. Bacterial meningitis is caused by several different species and represents a major issue of public health importance. The present study reports the meningitis case numbers with different etiologies in Amazonas from January 1976 to December 2012. METHODS: Since the 1970s, the (currently named) Tropical Medicine Foundation of Doutor Heitor Vieira Dourado [Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD)] has remained a reference center in Amazonas for the treatment of meningitis through the diagnosis and notification of cases and the confirmation of such cases using specific laboratory tests. RESULTS: The foundation has achieved coverage of over 90% of the state medical records for many years. Between 1990 and 2012, meningitis cases caused by Haemophilus influenzae decreased with the introduction of the H. influenzae vaccine. Meningococcal disease previously had a higher frequency of serogroup B disease, but starting in 2008, the detection of serogroup C increased gradually and has outpaced the detection of serogroup B. Recently, surveillance has improved the etiological definition of viral meningitis at FMT-HVD, with enteroviruses, Epstein-Barr virus (EBV) and varicella zoster virus (VZV) prevailing in this group of pathogens. With the advent of acquired immunodeficiency syndrome (AIDS), cryptococcal meningitis has become an important disease in Amazonas. Additionally, infectious meningitis is an important burden in the State of Amazonas. CONCLUSIONS: Changes in the epidemiological profile for the different etiology-defined cases are the result of continuous epidemiological surveillance and laboratory capacity improvements and control measures, such as Haemophilus influenzae vaccination. .(AU)
Responsável: BR1.1 - BIREME


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Id: 747519 LILACS-Express
Autor: Assandri, Elizabeth; Amorín, Belén; Gesuele, Juan P; Algorta, Gabriela; Pírez, María Catalina.
Título: Enfermedad neumoccócica invasora en recién nacidos, antes y después de la vacunación universal con vacuna conjugada 7 y 13 valente en Uruguay / Pneumococcal invasive disease in newborns before and after 7-valent and 13-valent universal pneumococcal vaccination in Uruguay
Fonte: Rev. chil. infectol;32(2):167-174, abr. 2015. tab.
Idioma: es.
Resumo: Introduction: Streptococcus pneumoniae infections are not frequent in neonates, but presents high morbidity and mortality. In 2008, the 7-valent pneumococcal conjugate vaccine (PCV) was introduced in the childhood vaccination schedule and then replaced by 13-valent PCV in 2010. First dose is given at 2 months of age. Protection of neonates is expected with universal vaccination. Objective: To describe the clinical presentation, microbiology and outcome of neonates with pneumococcal invasive infections (PII) detected in two hospitals in Uruguay in 2001-2007 (pre-vaccination), 2008 (intervention) and 2009-2013 (post-vaccination). Methods: A descriptive, retrospective study was done at Pereira Rossell Hospital and Paysandú Hospital. All isolates of S. pneumoniae obtained from normally sterile fluids were included. Data were obtained from the clinical records and the microbiology laboratory. A statistical analysis with absolute frequencies, relative, rates and relative risk was performed. Results: 25 neonates were enrolled with diagnosis of: sepsis (n = 13), meningitis (n = 9), bacteremia (n = 1), pneumonia with empyema (n = 1) and pneumonia (n = 1). The incidence of PII in the prevaccination period was 19/25, with a rate of 0.30/1,000 births, compared to post-vaccination rate of 0.04/1,000. The relative risk was 5.9. 6/20 (30%) cases of death were reported (meningitis n = 3; sepsis n = 2; empyema n = 1). Most common serotypes were 5 and 1 (14/25) and 24/25 strains were susceptible to penicillin. Discussion: The symptoms were indistinguishable to infections caused by other pathogens. PII cases decreased and no deaths occurred in the post-vaccination period. No increase in non-vaccine serotypes was observed.(AU)

Introducción: Streptococcus pneumoniae infrecuentemente produce infecciones en recién nacidos (RN), presentando elevada morbi-mortalidad. En Uruguay, en 2008 se incorporó al calendario de inmunizaciones infantil la vacuna conjugada neumocóccica (VCN) 7 valente, (sustituída por VCN13 en 2010). La vacunación comienza a los dos meses de vida. Se espera que la vacunación universal tenga impacto en la protección de RN. Objetivo: Describir la presentación clínica, microbiología y evolución de RN con enfermedad neumocóccica invasora (ENI), identificados en dos hospitales de Uruguay, años 2001-2007 (pre-vacunación), 2008 (intervención) y 2009-2013 (post-vacunación). Material y Métodos: Estudio descriptivo, retrospectivo. Lugar: Hospital Pereira Rossell y Hospital Paysandú. Se incluyeron todos los aislados de S. pneumoniae a partir de líquidos normalmente estériles. Fuente de datos: laboratorios de bacteriología e historias clínicas. Análisis estadístico: frecuencias absolutas, relativas, tasas y riesgo relativo. Resultados: RN con ENI: 25, sepsis (n: 13), meningitis (n: 9), bacteriemia (n: 1), neumonía con empiema (n: 1), neumonía (n: 1). Incidencia de ENI en el período pre-vacunación 19/25, tasa 0,30/1.000 nacimientos; tasa post-vacunación: 0,04/1.000. Riesgo relativo 5,9. Fallecimientos: 6/20 (30%): meningitis (n: 3), sepsis (n: 2), empiema (n: 1). Los serotipos más frecuentes fueron: 5 y 1 (14/25). Susceptibles a penicilina: 24/25. Discusión: Los síntomas fueron indistinguibles de infecciones causadas por otros patógenos. Disminuyeron los casos de ENI y no ocurrieron fallecimientos en el período post-vacunación. No aumentaron los serotipos no vacunales.(AU)
Responsável: CL1.1 - Biblioteca Central


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Id: 747150 LILACS-Express
Autor: Marcolini, Thomas Ribeiro; Safraider, Maryane Cristine; Socher, Jan Alessandro; Lucena, Guilherme Olinto.
Título: Differential Diagnosis and Treatment of Isolated Pathologies of the Sphenoid Sinus: Retrospective Study of 46 Cases
Fonte: Int. arch. otorhinolaryngol. (Impr.);19(2):129-129, Apr-Jun/2015. graf.
Idioma: en.
Resumo: Introduction Isolated disease of the sphenoid is rare and has often been overlooked due to its remote location and difficult access. Objective A retrospective study of the main causes of isolated sphenoid sinus diseases with discussion of the most appropriate methods of diagnosis and treatment. Methods A total of 46 cases of isolated sphenoid disease treated between January 2008 and December 2013 were evaluated by objective ear, nose, and throat examination and video endoscopy, computed tomography of the paranasal sinuses, and, in some cases, magnetic resonance imaging. In each case, we decided between drug and/or endoscopic treatment. Results We identified 12 cases of isolated sphenoiditis (26.1% ), 3 cases of fungal sphenoiditis (6.5% ), 3 cases of sphenochoanal polyps (6.5% ), 22 cases of mucocele (47.8% ), 2 cases of cerebrospinal fluid leak (4.3% ), and 1 case each of meningoencephalocele (2.1% ), inverted papilloma (2.1% ), fibrous dysplasia (2.1% ), and squamous cell carcinoma (2.1% ). Conclusion A prevalence of inflammatory and infectious diseases was found, and endoscopic surgery for the sphenoid sinus approach is effective in treating various diseases of the isolated sphenoid, whether complicated or not. .(AU)
Responsável: BR1.1 - BIREME


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Id: 747004 LILACS-Express
Autor: Montiel-Blanco, Johnny D.; Lázaro-Ignacio, Edgar J.; Granados-Alzamora, Viviana C.; Muñoz-Huerta, Pamela R.; Caro-Kahn, Inés; Flores-Bravo, Julio C.; Castillo-Barrientos, Hernán Del; Timaná, Nicolás Ramos; Koc-Gonzales, Daniel G..
Título: Meningoencefalitis tuberculosa en niños: Experiencia en el Instituto Nacional de Salud del Niño de Lima, 2009 - 2013 / Meningial Tuberculosis in children: Experience in the Instituto Nacional de Salud del Niño from Lima, 2009-2013
Fonte: Rev. neuropsiquiatr;78(1):14-21, ene. 2015. ilus, graf, tab.
Idioma: es.
Resumo: Objetivos: Describir las características epidemiológicas, clínicas, de laboratorio y neuroimagen en los niños diagnosticados de meningoencefalitis tuberculosa (MEC TBC) en el Instituto Nacional de Salud del Niño de Lima - Perú. Material y métodos: Estudio retrospectivo y descriptivo de una serie de casos entre enero del 2009 a setiembre del 2013. Resultados: Se seleccionaron 31 casos con diagnóstico de MEC TBC, con una frecuencia de 7,4 casos por año, edad promedio de 7,3 años, la relación varón/ mujer fue 1,2. Los características más frecuentes fueron la desnutrición, el contacto TBC y la TBC pulmonar. Los síntomas más frecuentes fueron la fiebre, vómitos, y somnolencia. El trastorno de la conciencia y el síndrome meníngeo fueron los síndromes neurológicos más comunes. La mayoría ingresaron en estadio II (83,9 %) y egresaron con secuelas mayores (51,6%). Los hallazgos en el líquido cefalorraquídeo (LCR) fueron pleocitosis promedio de 275,6 células /mm3 y mediana de 184 células/mm3 (rango entre 15-1364 células/mm3), el Bacilo de Koch fue aislado por cultivo en el 19,5% de los casos. Los hallazgos más frecuentes de neuroimagen fueron la hidrocefalia (58%), infarto ygranuloma. Seis pacientes con hidrocefaliarequirieron derivación ventricular. Cinco de los pacientes desarrollaron reacción paradójica. La letalidad fue 12,9%.Conclusiones: La incidencia hospitalaria de MEC TBC fue 7,4 casos por año, la mayoría ingresó en estadio IIy egresó con secuelas mayores, en la neuro imagen la hidrocefalia fue el hallazgo más observado, la letalidad fue 12,9%.(AU)

Objectives: To describe clinical, epidemiological, laboratory and neuro imaging characteristics of children with Meningeal Tuberculosis (MEC TBC) at the Instituto Nacional de Salud del Niño, in Lima, Peru. Methods: Retrospective, descriptive case series from January 2009 to September 2013. Results: 31 cases with MEC TBC were included, with a frequency of 7.4 cases per year. The average age was7.3 years and boy/girl rate was 1.2. The more frequent characteristics were the malnutrition, a positive TBC contact and pulmonary TBC. The most common clinical findings were fever, vomits, altered consciousness and meningeal signs. Most cases were in the II clinical state of the disease (83.9%) and the majority evolved with severe complications (51.6%). The cerebrospinal fluid (CSF) findings showed an average 275.6 cells/mm3 cells and median of 184 cells/mm3 (15-1364 cells/mm3). The Koch bacillus was identified in 19.5 % of the CSF culture. The more frequent imaging findings were hydrocephalus (58%), cerebral infarct and granuloma. Six children with hydrocephalus needed a cerebral peritoneal shunt and five children evolved with a paradoxical reaction. The mortality was 12.9%. Conclusions: The hospital incidence was 7.4 cases per year, most of them came in stage II of the disease and left with major sequela, the hydrocephalus was the most frequent imaging finding and the mortality was 12.9%.(AU)
Responsável: PE1.1 - DUGIC - Dirección Universitária de Gestión de la Información Científica


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Id: 746698
Autor: Orati, Juliane Agustini; Amorim, Alessandro; Tardivo, Marcia Terezinha; Simão, Corrado Jose Guerzoni; Araújo, Daniela Sica Silva de; Castro, Nathália Antônio Monteiro.
Título: Aerococcus viridans como agente etiológico de endocardite em valva nativa / Aerococcus viridans as etiological agent in native valve endocarditis
Fonte: Rev. bras. cardiol. (Impr.);27(4):286-288, jul.-ago. 2014. ilus.
Idioma: pt.
Resumo: Aerococcus viridans é um patógeno humano incomum e endocardite por este agente na literatura é rara. Relata-se o caso de paciente feminina, 56 anos,hospitalizada devido a quadro de picos febris que, após investigação, foi diagnosticada através dos critérios clínicos de Duke, com endocardite em valva nativa. Foi evidenciado através das hemoculturas o crescimento de A. viridans, sendo o primeiro casoreportado no Brasil. Há relatos desse agente também em infecções urinárias, bacteremia, meningite e artrite séptica. No presente caso, a paciente teve melhorresposta clínica após o início da ampicilina, confirmando alguns artigos que orientam o tratamento com penicilinas.(AU)

Aerococcus viridans is an uncommon human pathogen and reports of endocarditis caused by this agent arerare in the literature. This clinical case study describes a 56 year-old female patient admitted to hospital forspiking fevers. After investigation, this was diagnosed as native valve endocarditis, based on the Duke clinicalcriteria and confirmed through the growth of A. viridans in blood cultures, making this the first reported case in Brazil. There are also reports of thisagent in urinary tract infections, bacteremia, meningitis and septic arthritis. In this case, the patient had a better clinical response after starting on ampicillin, confirmed by some articles that recommend treatment withpenicillins.(AU)
Descritores: Endocardite/etiologia
Endocardite/fisiopatologia
Aerococcus/virologia
Valva Mitral/cirurgia
-Diagnóstico Diferencial
Bactérias/virologia
Ampicilina/uso terapêutico
Limites: Humanos
Feminino
Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: BR44.1 - Serviço de Biblioteca, Documentação Científica e Didática Prof. Dr. Luiz Venere Décourt
BR44.1


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Id: 746338
Autor: Menezes, Sandra Maria Marques Vidal de.
Título: Avaliação da implementação da vigilância epidemiológica das meningites no município de Porto Velho / Evaluation of the implementation of surveillance of meningitis in the city of Porto Velho.
Fonte: Rio de Janeiro; s.n; 2014. 126 p. mapas, tab, graf.
Idioma: pt.
Tese: Apresentada a Escola Nacional de Saúde Pública Sergio Arouca para obtenção do grau de Mestre.
Resumo: O estudo teve como objetivo avaliar a implementação da vigilância epidemiológica dasmeningites em Porto Velho/RO, utilizando uma adaptação da metodologia do CDC, quepossibilitou uma avaliação com enfoque na qualidade do programa. A implementação foiavaliada sob a dimensão da qualidade com foco no processo e uso na melhoria dos serviços,considerando os fatores contextuais, vistos através de fatores determinantes e condicionantesenvolvidos com a produção da meningite. Para análise da implementação, foi considerada adimensão da conformidade e as sub-dimensões: disponibilidade/adequação técnico-científica,sensibilidade e valor preditivo, de forma a contemplar os efeitos dos contextos externo eorganizacional que podem ter interferido na avaliação da implementação. Na análise dadimensão objetiva da qualidade dos serviços de saúde, a categoria qualidade foi explorada nocomponente específico do cuidado médico através da adequação técnico-científica. Destacousea dimensão da conformidade com abordagem qualitativa e quantitativa, como base deevidências do uso de normas, procedendo a uma avaliação da qualidade formal do programa.Quanto à dimensão subjetiva da qualidade, verificou-se experiências vivenciais dos atoressociais, bem como a utilização de instrumentos semiestruturados na coleta de dados tipoquestionário e checklist, o que permitiu a realização de um estudo de caso, com análisesimbricadas, utilizando-se o modelo teórico da avaliação (MTA)...(AU)

The study aimed to evaluate the implementation of epidemiological surveillance of meningitisin Porto Velho/RO, using an adaptation of the CDC's methodology, which enabled anassessment with a focus on program quality. The implementation was evaluated under thedimension of quality in the process and focus on improving services, considering thecontextual factors, as seen through the factors and conditions involved with the production ofmeningitis. For analysis of implementation was considered the extent of conformity and subdimensions:availability / suitability scientific knowledge, sensitivity and positive predictivevalue in order to include the effects of external and organizational contexts that may haveinterfered with the evaluation. In analyzing the objective dimension of quality of healthservices, the quality category was explored in a specific component of medical care throughscientific and technical adequacy. It was underscored the dimension of conformity withqualitative and quantitative approach based on evidence of use of standards, carrying out aformal evaluation of the quality of the program. As the subjective dimension of quality, therewere life experiences of social actors, as well as the use of instruments in the semi-structuredquestionnaire collecting data type and checklist, which allowed for a case study, withoverlapping analysis, using the theoretical model of assessment (TMA)...(AU)
Descritores: Vigilância Epidemiológica
Meningite/prevenção & controle
Avaliação de Programas e Projetos de Saúde
Qualidade da Assistência à Saúde
Avaliação
Limites: Humanos
Tipo de Publ: Estudos de Avaliação
Responsável: BR526.1 - Biblioteca de Saúde Pública



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