RESUMO
OBJECTIVES: Up to 20% of HIV-related focal brain lesion (FBL) diagnoses cannot be determined without invasive procedures. In such cases, brain biopsy is an important step in the evaluation algorithm. The aims of this study were to describe the clinical outcomes of patients with FBL, the proportion of diagnoses confirmed by brain biopsies and their aetiologies, and to analyse the proportion of patients in whom the biopsy motivated a change in therapeutic management. METHODS: A retrospective cohort study was performed. The data from clinical records of patients with HIV-related FBL admitted between January 2005 and December 2015 were reviewed. RESULTS: A total of 137 patients were included in the study. The median age was 39 years [interquartile range (IQR) 33-44.5 years]. The median CD4 count was 54 cells/µL (IQR 21-124 cells/µL). Cerebral brain biopsy was performed in 21.16% of patients (29 of 137); 68.9% of these individuals (20 of 29) were diagnosed by histology, with results of central nervous system (CNS) lymphoma in 20.6% (six of 29), progressive multifocal leucoencephalopathy in 6.8% (two of 29), toxoplasmosis in 6.8% (two of 29), tuberculoma in 6.8% (two of 29), and other diagnoses in 27.6% (eight of 29). In nine patients, the histology was nonspecific. In 75.8% of patients (22 of 29), the result of the biopsy led to a change in the therapeutic management. We did not observe higher rates of mortality related to the procedure. Overall mortality at 30 and 90 days was similar in patients who were and were not biopsied. CONCLUSIONS: In this retrospective cohort study, cerebral biopsy was associated with significant adjustments in therapeutic management for a high percentage of patients.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Biópsia/métodos , Encefalopatias/diagnóstico , Encéfalo/patologia , Infecções por HIV/complicações , Histocitoquímica/métodos , Linfoma Relacionado a AIDS/diagnóstico , Adulto , Feminino , Humanos , Masculino , Estudos RetrospectivosRESUMO
his experiment was carried out in a 104 m2 poultry house located between the geographical coordinates 25°45'00" south latitude and 53°03'25" west longitude and an average altitude of 550 m, from September to November, 2008. The chickens were placed in 12 pens measuring 2 m2 each at a stocking density of 12 chickens m-2. This study aimed at evaluating the effect of two different initial weights (chick weight on first day of experiment) and two types of litter material on broiler production parameters, litter humidity, as well as on breast and footpad lesions. A total of 240 female Cobb® chickens, derived from the same flock of breeders, was distributed in a completely randomized experimental design with a 2 (initial weight) by 2 (litter material) factorial arrangement with three replicates per treatment. Initial weights were classified as light (34.40 - 35.22 g) or heavy (39.29 - 41.30 g), whereas wood shavings and sawdust were used as litter material. Data were analyzed by ANOVA and means were compared by Tukey's test at 95% confidence level. Initial weight significantly influenced bird performance, as chickens with heavy initial weight presented higher feed intake and body weight. Type of litter did not have any effect on breast injuries and litter humidity. However, the wood shavings litter significantly influenced footpad lesions.
Assuntos
Animais , Galinhas , Peso Corporal , Ferimentos e Lesões , Indústria Agropecuária/métodos , Tamanho Corporal/genéticaRESUMO
his experiment was carried out in a 104 m2 poultry house located between the geographical coordinates 25°45'00" south latitude and 53°03'25" west longitude and an average altitude of 550 m, from September to November, 2008. The chickens were placed in 12 pens measuring 2 m2 each at a stocking density of 12 chickens m-2. This study aimed at evaluating the effect of two different initial weights (chick weight on first day of experiment) and two types of litter material on broiler production parameters, litter humidity, as well as on breast and footpad lesions. A total of 240 female Cobb® chickens, derived from the same flock of breeders, was distributed in a completely randomized experimental design with a 2 (initial weight) by 2 (litter material) factorial arrangement with three replicates per treatment. Initial weights were classified as light (34.40 - 35.22 g) or heavy (39.29 - 41.30 g), whereas wood shavings and sawdust were used as litter material. Data were analyzed by ANOVA and means were compared by Tukey's test at 95% confidence level. Initial weight significantly influenced bird performance, as chickens with heavy initial weight presented higher feed intake and body weight. Type of litter did not have any effect on breast injuries and litter humidity. However, the wood shavings litter significantly influenced footpad lesions.(AU)
Assuntos
Animais , Peso Corporal , Galinhas , Indústria Agropecuária/métodos , Ferimentos e Lesões , Tamanho Corporal/genéticaRESUMO
Las infecciones por Mycoplasma pneumoniae presentan complicaciones del sistema nervioso de distinto tipo, que si bien son infrecuentes pueden ser graves; habitualmente tienen evolución favorable pero pueden dejar secuelas permanentes. Se presenta una paciente adulta joven con una meningoencefalitis aguda que no dejó secuelas como complicación de una infección respiratoria baja. El diagnóstico se efectuó por detección de anticuerpos específicos. (AU)
Assuntos
Adulto , Humanos , Feminino , Pneumonia por Mycoplasma/patologia , Mycoplasma pneumoniae/isolamento & purificação , Meningoencefalite/patologia , Pneumonia por Mycoplasma/complicações , Pneumonia por Mycoplasma/classificação , Meningoencefalite/microbiologia , Meningoencefalite/classificação , Reação em Cadeia da Polimerase , Imageamento por Ressonância Magnética , Eletroencefalografia , Herpes Simples/classificação , Doença AgudaRESUMO
Las infecciones por Mycoplasma pneumoniae presentan complicaciones del sistema nervioso de distinto tipo, que si bien son infrecuentes pueden ser graves; habitualmente tienen evolución favorable pero pueden dejar secuelas permanentes. Se presenta una paciente adulta joven con una meningoencefalitis aguda que no dejó secuelas como complicación de una infección respiratoria baja. El diagnóstico se efectuó por detección de anticuerpos específicos.