RESUMO
We studied microorganisms associated with infant diarrhea in a group of 256 children admitted to a public pediatric hospital in Montevideo, Uruguay. Diagnostic procedures were updated to optimize detection of potential pathogens, which were found in 63.8% of cases, and to be able to define their characteristics down to molecular or antigenic type. Coinfection with two or more agents was detected in more than one-third of positive studies. Escherichia coli enteric virotypes, especially enteropathogenic E. coli (EPEC), were shown to be prevalent. Rotavirus, Cryptosporidium, Campylobacter (mainly Campylobacter jejuni), and Shigella flexneri were also often identified. Enterotoxigenic E. coli, Salmonella, and Giardia lamblia were sporadically recognized. Unusual findings included two enteroinvasive E. coli strains, one Shigella dysenteriae 2 isolate, and a non-O:1 Vibrio cholerae culture. EPEC bacteria and S. flexneri (but not Salmonella) showed unusually frequent antimicrobial resistance, especially towards beta-lactam antibiotics, which is the subject of ongoing work.
Assuntos
Cryptosporidium/isolamento & purificação , Diarreia/etiologia , Giardia lamblia/isolamento & purificação , Bactérias Gram-Negativas/isolamento & purificação , Rotavirus/isolamento & purificação , Animais , Antibacterianos/farmacologia , Criptosporidiose/parasitologia , Cryptosporidium/classificação , Giardia lamblia/classificação , Giardíase/parasitologia , Bactérias Gram-Negativas/classificação , Bactérias Gram-Negativas/efeitos dos fármacos , Infecções por Bactérias Gram-Negativas/microbiologia , Humanos , Lactente , Testes de Sensibilidade Microbiana , Rotavirus/classificação , Infecções por Rotavirus/virologia , UruguaiRESUMO
OBJECTIVE: The purpose of the study was to assess the effectiveness of cerebral protection devices during carotid artery angioplasty and stent placement. METHODS: Between September 1998 and September 1999, carotid angioplasty and stenting were performed in 46 patients with symptomatic (39.1%) or asymptomatic (60.9%) severe carotid artery stenosis. Wallstents were used in all patients with selective predilatation. Cerebral protection devices were used in 25 of these patients. Primary end points were perioperative neurologic complications and mortality. Data were collected prospectively. RESULTS: The overall combined end point of all neurologic deficits and death rate was 4.34%. Two neurologic events (one transient ischemic attack and one minor stroke) occurred in the unprotected group (9.53%) versus none in the group with cerebral protection. This difference is not statistically significant. The mortality rate was 0% for both groups. On an intention to treat basis, the overall technical success rate for carotid angioplasty was 97.8%, and for placement of cerebral protection devices it was 100%. An important number of particles of different sizes were captured in all cases in which cerebral protection devices were used. CONCLUSION: Experience has shown that cerebral protection during carotid angioplasty and stenting is technically feasible and appears to be effective in preventing procedure-related neurologic complications. Further investigation is warranted.
Assuntos
Angioplastia com Balão/instrumentação , Estenose das Carótidas/terapia , Ataque Isquêmico Transitório/prevenção & controle , Stents , Acidente Vascular Cerebral/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Angioplastia com Balão/efeitos adversos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Pesquisa , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler TranscranianaRESUMO
Eight-seven patients with severe tinnitus were studied. All patients underwent a complete audiological examination and tinnitus evaluation (pitch-matching, loudness, post-masking effect, masking curves, etc.). Most of the patients with a positive residual inhibition test had Feldman type I and III masking curves.
Assuntos
Transtornos da Audição/diagnóstico , Zumbido/diagnóstico , Audiometria de Tons Puros , Feminino , Humanos , Masculino , Índice de Gravidade de DoençaRESUMO
A study was made of a noninvasive functional test of mucociliary clearance using micronized indigo blue colorant, which is insoluble in airway secretions. Transport time to the nasopharynx was measured optically with an endoscope. This method was more objective and less irritating than others tested by other authors. Measurements were made in each subject using different endoscopes. The results were highly suggestive of a difference in nasal mucociliary clearance time between healthy and unhealthy subjects. This may mean that chronic inflammation, atrophic rhitis, dyskinesia, and other diseases lead to malfunction of the nasal mucociliary system.