RESUMEN
The use of invasive techniques, such as intravascular catheter insertion, and the formation of biofilms in several devices by methicillin-resistant Staphylococcus aureus (MRSA) have contributed to the increased number of septic patients, morbidity and mortality. This study aimed to evaluate the virulence of strains through catheter colonization and identification of microbial biofilm, as well as pathological changes on the colonized skin. An experimental biofilm formation model utilized catheter fragments implanted subcutaneously in 25 Swiss mice. The technique consisted of inoculating a catheter fragment on the back of each animal, followed by intradermal inoculation of 50 µl of bacterial suspension at 1.0 × 107 colony forming units/ml. After 96 h, catheters were removed for macroscopic analysis and evaluated through culture. Local skin fragments were also extracted for histopathology analysis. Staphylococcus aureus can adhere to catheters, colonize and form biofilms. The high amount of viable bacterial cells colonizing catheters and virulence factors can lead to severe infections of skin and adjacent tissues. [Int Microbiol 19(4): 199-207 (2016)].
Asunto(s)
Toxinas Bacterianas/biosíntesis , Biopelículas/crecimiento & desarrollo , Infecciones Relacionadas con Catéteres/microbiología , Exotoxinas/biosíntesis , Leucocidinas/biosíntesis , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/crecimiento & desarrollo , Animales , Humanos , Masculino , Staphylococcus aureus Resistente a Meticilina/crecimiento & desarrollo , Staphylococcus aureus Resistente a Meticilina/patogenicidad , Ratones , Staphylococcus aureus/patogenicidadRESUMEN
OBJECTIVE: To present the long-term follow-up of children hospitalised for severe rheumatic carditis who were treated with corticosteroids. METHODS: This is a retrospective analysis of the outcome of 242 patients with severe rheumatic carditis after discharge from two public hospitals in Niteroi, Brazil. We followed up 118 patients for 4 years or more, with an average of 7.7 years. They were treated with antibiotics to accomplish bacterial eradication and either intravenous methylprednisolone - 40 cases - or oral prednisone - 78 patients - to treat carditis. They were followed up in outpatient clinic. RESULTS: Cardiac failure was categorised as classes III and IV according to the New York Heart Association classification. In the intravenous corticosteroid group, 21 cases (52.5%) had isolated mitral valve regurgitation, 12 (30%) had mitral plus aortic involvement, and seven (17.5%) had aortic lesion only. In the oral prednisone group, 45 (58%) had mitral valve regurgitation only, 27 (34%) had mitral plus aortic involvement, and six (8%) had aortic lesion only. A total of 28 children were in their first disease attack, of whom 19 (68%) had a rupture of chordae tendineae. A total of 58 patients (49%) sustained recurrence of carditis because of neglected secondary prophylaxis. In all, 19 cases (16%) underwent cardiac surgery - valve replacement or valvuloplasty. In 33% of the cases, the outcome was favourable - asymptomatic at follow-up. The overall mortality rate was 6.8%. CONCLUSION: Many critically ill patients who complied with secondary prophylaxis were left with minor injuries, whereas those who neglected it or abandoned it had serious sequelae. The rate of abandonment and loss to follow-up was very high. Many cases (49%) were re-hospitalised because of carditis recurrence.
Asunto(s)
Cumplimiento de la Medicación/estadística & datos numéricos , Prednisona/uso terapéutico , Cardiopatía Reumática/tratamiento farmacológico , Adolescente , Brasil , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Masculino , Recurrencia , Estudios Retrospectivos , Cardiopatía Reumática/complicaciones , Cardiopatía Reumática/mortalidad , Tasa de SupervivenciaRESUMEN
Caffeine-induced Ca2+ transients (CICTs) in rabbit nodose ganglion neurons (NGNs) are produced by two distinct mechanisms: release from intracellular stores via ryanodine receptors and Ca2+ influx across the plasma membrane, due to activation of an unknown receptor. In isolated rat NGNs, we used single-cell microfluorimetry to measure changes in intracellular Ca2+ and to test whether TRPV1 receptors underlie the Ca2+ influx pathway. Caffeine (10 mM) evoked CICTs in all NGNs tested (n = 47) averaging 365 +/- 32 nM. CICTs were partially dependent upon a Ca2+ influx pathway that ranged between 33% and 98% of the total Ca2+ transient. Application of two selective TRPV1 antagonists significantly attenuated CICTs. The peak average amplitudes of CICTs in Ca2+-free Locke solution and Ca2+-free Locke solution with IRTX or with BCTC were not significantly different from one another (n = 5 and 7, respectively). These observations suggest that caffeine can induce Ca2+ influx by activating TRPV1 channels.
Asunto(s)
Cafeína/farmacología , Señalización del Calcio/efectos de los fármacos , Estimulantes del Sistema Nervioso Central/farmacología , Células Receptoras Sensoriales/efectos de los fármacos , Animales , Masculino , Ratas , Ratas Sprague-Dawley , Células Receptoras Sensoriales/metabolismo , Canales Catiónicos TRPV/antagonistas & inhibidores , Canales Catiónicos TRPV/metabolismoRESUMEN
Objetivo: Relatar um caso de apendicite aguda em recém -nascido prematuro. Método: Análise retrospectiva da bibliografia médica pesquisada nos bancos de dados Medline e Lilasc e laudo da anatomia patológica. Relato do caso: Recém-nascido prematuro, branco de 34 semanas de idade gestacional, pesando 1.750g ao nascer, e apresentando Apgar 4 e 8 no 1§ e 5§ minutos de vida, respectivamente. O exame físico era normal até o 9§ de vida, quando desenvolveu quadro sugestivo de abdome agudo por possível enterocolite necrotizante com perfeição, sendo submetido à laparotomia exploradora onde estabeleceu-se o diagnóstico de apendicite aguda. Conclusão: Apendicite aguda deverá fazer parte do diagnóstico diferencial nos casos de abdome agudo no neonato, principalmente quando se suspeita de enterocolite necrotizante com perfuração especialmente quando fatores predisponentes não estão presentes
Asunto(s)
Humanos , Masculino , Recién Nacido , ApendicitisRESUMEN
Apesar do arsenal terapêutico e dosrecursos diagnósticos, é inegável o aumento da incidência das DST, aí incluída a sífilis, também entre crianças. Este trabalho determina a ocorrência da sífilis adquirida entre as crianças atendidas no Setor de DST/UFF entre 1987 e 1996; descreve os achados clínicos e laboratoriais destas crianças, investiga a ocorrência de abuso sexual e procura divulgar a importåncia do reconhecimento precoce e tratamento desta patologia. Para atingir os objetivos, é feita a revisäo dos arquivos do DST/UFF, com descriçäo dos pacientes atendidos com esta patologia. Foi feita revisäo bibliográfica de 25 anos do Index Medicus, bem como através de bancos de dados da Internet. Somente 3 pacientes foram atendidos neste período, tendo como sintomas mais frequêntes o condiloma plano, seguindo-se as adenomegalias inguinais. A literatura relatou ainda o registro de cancro e os pacientes assintomáticos como frequentes. A sorologia positiva para sífilis e a suposiçäo de abuso sexual foram observados na totalidade dos pacientes
Asunto(s)
Masculino , Femenino , Humanos , Niño , Adolescente , Preescolar , Abuso Sexual Infantil/diagnóstico , Sífilis/diagnóstico , Sífilis/terapia , Serodiagnóstico de la Sífilis/métodos , Enfermedades Bacterianas de Transmisión Sexual/diagnósticoRESUMEN
PURPOSE: To describe the cardiac findings in children with AIDS, the follow-up with treatment and the correlation between clinical and pathological features. METHODS: We studied prospectively 25 children with clinical-laboratorial diagnosis of AIDS, ages between 3 months and 11 years, even those without cardiac symptoms. We classified the signs of AIDS following that of CDC-Atlanta 1994. Eight children died and it was done necropsy in six with macro and microscopic examinations. RESULTS: Fifteen cases had already complications of AIDS and were classified as C2 and C3, 5 as B2, 3 B1 and 2 as A1. Beside the symptoms related to the disease and infections we found signs of congestive heart failure III and IV (NYHA) in 5 children, pericardial effusion in 5, (one of them had cardiac tamponade). In the electrocardiogram (EKG), 8 children had repolarization abnormalities. In 1st echocardiogram (ECHO) we found some features of dilated myocardiopathy in 8 (6 were asymptomatic) 5 of those had pericardial effusion, one child had huge amount of pericardial liquid and also increased measures of intraventricular septum and posterior wall of left ventricle by ECHO and confirmed by necropsy examination. All cases of diagnosis of myocardiopathy received treatment with captopril and 4 also received furosemide and digoxina. Even under oral treatment three of them had deterioration of heart failure but after combined anti-retroviral drugs they showed better cardiac functions. From the six necropsied cases, two had increased heart weight without myocarditis, one had toxoplasma pancarditis and other one had fibrocalcic vasculopathy. CONCLUSION: We found several assymptomatic cases already with decreased ventricular function. Some worsened of heart failure even under apropriate treatment and showed better cardiac index after combined anti-retroviral drugs.
Asunto(s)
Humanos , Lactante , Preescolar , Niño , Cardiopatías , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Estudios Prospectivos , Cardiopatías , Síndrome de Inmunodeficiencia Adquirida/diagnósticoRESUMEN
Os autores descrevem e discutem o caso de um lactente internado no HUAP, portador de Epidermólise Bolhosa e infecçäo por Citomegalovírus.