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1.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; Braz. J. Psychiatry (São Paulo, 1999, Impr.);36(4): 322-329, Oct-Dec/2014. graf
Artigo em Inglês | LILACS | ID: lil-730589

RESUMO

Objective: To evaluate the influence of environmental enrichment (EE) on memory, cytokines, and brain-derived neurotrophic factor (BDNF) in the brain of adult rats subjected to experimental pneumococcal meningitis during infancy. Methods: On postnatal day 11, the animals received either artificial cerebrospinal fluid (CSF) or Streptococcus pneumoniae suspension intracisternally at 1 × 106 CFU/mL and remained with their mothers until age 21 days. Animals were divided into the following groups: control, control + EE, meningitis, and meningitis + EE. EE began at 21 days and continued until 60 days of age (adulthood). EE consisted of a large cage with three floors, ramps, running wheels, and objects of different shapes and textures. At 60 days, animals were randomized and subjected to habituation to the open-field task and the step-down inhibitory avoidance task. After the tasks, the hippocampus and CSF were isolated for analysis. Results: The meningitis group showed no difference in performance between training and test sessions of the open-field task, suggesting habituation memory impairment; in the meningitis + EE group, performance was significantly different, showing preservation of habituation memory. In the step-down inhibitory avoidance task, there were no differences in behavior between training and test sessions in the meningitis group, showing aversive memory impairment; conversely, differences were observed in the meningitis + EE group, demonstrating aversive memory preservation. In the two meningitis groups, IL-4, IL-10, and BDNF levels were increased in the hippocampus, and BDNF levels in the CSF. Conclusions: The data presented suggest that EE, a non-invasive therapy, enables recovery from memory deficits caused by neonatal meningitis. .


Assuntos
Animais , Masculino , Fator Neurotrófico Derivado do Encéfalo/sangue , Transtornos Cognitivos/terapia , Citocinas/sangue , Exposição Ambiental , Transtornos da Memória/terapia , Meningite Pneumocócica/terapia , Encéfalo/fisiopatologia , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Neurogênese/fisiologia , Plasticidade Neuronal/fisiologia , Ratos Wistar , Recuperação de Função Fisiológica , Reprodutibilidade dos Testes , Resultado do Tratamento
2.
Braz J Psychiatry ; 36(4): 322-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25076170

RESUMO

OBJECTIVE: To evaluate the influence of environmental enrichment (EE) on memory, cytokines, and brain-derived neurotrophic factor (BDNF) in the brain of adult rats subjected to experimental pneumococcal meningitis during infancy. METHODS: On postnatal day 11, the animals received either artificial cerebrospinal fluid (CSF) or Streptococcus pneumoniae suspension intracisternally at 1 × 10(6) CFU/mL and remained with their mothers until age 21 days. Animals were divided into the following groups: control, control + EE, meningitis, and meningitis + EE. EE began at 21 days and continued until 60 days of age (adulthood). EE consisted of a large cage with three floors, ramps, running wheels, and objects of different shapes and textures. At 60 days, animals were randomized and subjected to habituation to the open-field task and the step-down inhibitory avoidance task. After the tasks, the hippocampus and CSF were isolated for analysis. RESULTS: The meningitis group showed no difference in performance between training and test sessions of the open-field task, suggesting habituation memory impairment; in the meningitis + EE group, performance was significantly different, showing preservation of habituation memory. In the step-down inhibitory avoidance task, there were no differences in behavior between training and test sessions in the meningitis group, showing aversive memory impairment; conversely, differences were observed in the meningitis + EE group, demonstrating aversive memory preservation. In the two meningitis groups, IL-4, IL-10, and BDNF levels were increased in the hippocampus, and BDNF levels in the CSF. CONCLUSIONS: The data presented suggest that EE, a non-invasive therapy, enables recovery from memory deficits caused by neonatal meningitis.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/sangue , Transtornos Cognitivos/terapia , Citocinas/sangue , Exposição Ambiental , Transtornos da Memória/terapia , Meningite Pneumocócica/terapia , Animais , Encéfalo/fisiopatologia , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Masculino , Neurogênese/fisiologia , Plasticidade Neuronal/fisiologia , Ratos Wistar , Recuperação de Função Fisiológica , Reprodutibilidade dos Testes , Resultado do Tratamento
3.
Biomedica ; 34(1): 92-101, 2014.
Artigo em Espanhol | MEDLINE | ID: mdl-24967862

RESUMO

INTRODUCTION: Streptococcus pneumoniae infection in adults is related to pneumonia, meningitis and bacteremia. Its care costs in adults are not well documented in Colombia and it has a greater impact in people over 45 years old. OBJECTIVES: The aims of this study were to analyze the associated costs of pneumonia, bacteremia and meningitis in invasive S. pneumoniae infection in Colombia among hospitalized adults and to estimate outpatient costs for community-acquired pneumonia. Additionally, we wanted to serve as a starting point for future economic evaluations. MATERIALS AND METHODS: We performed a direct cost study associated with S. pneumoniae outpatient community-acquired pneumonia, bacteremia and meningitis costs confirmed by cultures. A cohort of hospitalized adults treated between January 2010 and June 2011 in three third level hospitals in Bogotá was analyzed. We evaluated 107 records and 60 bills charged to the payer. The data were classified according to care and treatment costs. We performed an estimate of direct costs for community-acquired pneumonia for outpatient cases through Delphi methodology using expert clinicians. RESULTS: The average direct costs associated with pneumococcal disease were US$ 6,283, US$ 3,886, and US$ 4,768 for pneumonia, meningitis and bacteremia, respectively (exchange rate 1 US$ = Col$ 1,938.34; average variation between 2010 and 2011). Pneumonia cases were 70% men and 30% women; the distribution for meningitis was the same for both genders (50%); and for bacteremia we had 67% men and 33% women. Outpatient cost of community-acquired pneumonia was estimated at US$ 82.2 ( Col $ 159,280 ) in adults. For special cases, direct cost increased to US$ 142 ( Col $ 274,427). CONCLUSIONS: The management of S. pneumoniae infection in people over 45 years old represents a high cost due to the use of drugs and hospitalization, which has a direct impact on health resources. Prevention and early treatment for pneumonia can reduce the cost and the burden of the disease.


Assuntos
Bacteriemia/economia , Bacteriemia/terapia , Hospitalização , Meningite Pneumocócica/economia , Meningite Pneumocócica/terapia , Infecções Pneumocócicas/economia , Infecções Pneumocócicas/terapia , Pneumonia Pneumocócica/economia , Pneumonia Pneumocócica/terapia , Streptococcus pneumoniae , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Colômbia , Infecções Comunitárias Adquiridas/economia , Infecções Comunitárias Adquiridas/terapia , Efeitos Psicossociais da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
4.
Biomédica (Bogotá) ; Biomédica (Bogotá);34(1): 92-101, ene.-mar. 2014. graf, tab
Artigo em Espanhol | LILACS | ID: lil-708893

RESUMO

Introducción. Las infecciones por Streptococcus pneumoniae en adultos se relacionan con neumonía, meningitis y bacteriemia. El costo de la atención en personas adultas no está bien documentado en Colombia, pero puede ser significativo. Objetivo. Analizar los costos asociados con la neumonía adquirida en comunidad, meningitis y bacteriemia por S. pneumoniae en adultos hospitalizados en Colombia y estimar el costo de la atención ambulatoria de esta neumonía. Servir de base para futuras evaluaciones económicas. Materiales y métodos. Se realizó un estudio de costos directos asociados a neumonía adquirida en comunidad, meningitis y bacteriemia por S. pneumoniae confirmado por cultivos. Se tomó una muestra de conveniencia de adultos hospitalizados entre enero de 2010 y junio de 2011 en tres hospitales de tercer nivel de Bogotá. Se analizaron 107 registros y se obtuvieron 60 facturas cobradas al pagador. La información se clasificó por costos de atención y tratamiento. Para los casos ambulatorios de neumonía, el estimativo de costos se hizo utilizando metodología Delphi con expertos clínicos. Resultados. El promedio de los costos directos totales asociados con neumonía fue de Col$ 12´178.949, Col$ 7´533.187 para meningitis y Col$ 9´242.806 para bacteriemia. La neumonía se presentó en 70 % de los hombres y 30 % de las mujeres; la meningitis se distribuyó igual en ambos sexos (50 %) y la bacteriemia se presentó en 67 % de los hombres y 33 % de las mujeres. El costo por adulto de la atención ambulatoria de la neumonía adquirida en la comunidad se estimó en Col$ 106.174. Para casos especiales se incrementó a Col$ 164.695. Conclusión. La enfermedad neumocócica en adultos, especialmente mayores de 45 años, representa un alto costo por el empleo de medicamentos y la estancia hospitalaria, que causan un impacto en los recursos del sistema. La prevención y el tratamiento temprano de las neumonías pueden disminuir costos y reducir la carga de enfermedad.


Introduction: Streptococcus pneumoniae infection in adults is related to pneumonia, meningitis and bacteremia. Its care costs in adults are not well documented in Colombia and it has a greater impact in people over 45 years old. Objectives: The aims of this study were to analyze the associated costs of pneumonia, bacteremia and meningitis in invasive S. pneumoniae infection in Colombia among hospitalized adults and to estimate outpatient costs for community-acquired pneumonia. Additionally, we wanted to serve as a starting point for future economic evaluations. Materials and methods: We performed a direct cost study associated with S. pneumoniae outpatient community-acquired pneumonia, bacteremia and meningitis costs confirmed by cultures. A cohort of hospitalized adults treated between January 2010 and June 2011 in three third level hospitals in Bogotá was analyzed. We evaluated 107 records and 60 bills charged to the payer. The data were classified according to care and treatment costs. We performed an estimate of direct costs for community-acquired pneumonia for outpatient cases through Delphi methodology using expert clinicians. Results: The average direct costs associated with pneumococcal disease were US$ 6,283, US$ 3,886, and US$ 4,768 for pneumonia, meningitis and bacteremia, respectively (exchange rate 1 US$ = Col$ 1,938.34; average variation between 2010 and 2011). Pneumonia cases were 70% men and 30% women; the distribution for meningitis was the same for both genders (50%); and for bacteremia we had 67% men and 33% women. O utpatient cost of community-acquired pneumonia was estimated at US$ 82.2 ( Col $ 159,280 ) in adults. For special cases, direct cost increased to US$ 142 ( Col $ 274,427). Conclusions: The management of S. pneumoniae infection in people over 45 years old represents a high cost due to the use of drugs and hospitalization, which has a direct impact on health resources. Prevention and early treatment for pneumonia can reduce the cost and the burden of the disease.


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Bacteriemia/economia , Bacteriemia/terapia , Hospitalização , Meningite Pneumocócica/economia , Meningite Pneumocócica/terapia , Infecções Pneumocócicas/economia , Infecções Pneumocócicas/terapia , Pneumonia Pneumocócica/economia , Pneumonia Pneumocócica/terapia , Streptococcus pneumoniae , Colômbia , Efeitos Psicossociais da Doença , Infecções Comunitárias Adquiridas/economia , Infecções Comunitárias Adquiridas/terapia
5.
Salvador; s.n; 2013. 89 p. ilus, tab.
Tese em Português | LILACS | ID: biblio-1000908

RESUMO

O advento das vacinas pneumocócicas conjugadas veio contribuir de forma decisiva para a redução da incidência dos casos de doença invasiva por S. pneumoniae em vários países do mundo. Em contrapartida, tem-se verificado um aumento de casos decorrentes de sorotipos não vacinais, que escapam da vacina e reduzem o seu efeito a partir da expansão de clones pré-existentes com consequente substituição de sorotipos e/ou do fenômeno de troca capsular (capsular switching). No Brasil, a vacina conjugada 10-valente (PCV10) foi introduzida no calendário nacional de imunização a partir de 2010. Este estudo teve como objetivo caracterizar através de técnicas fenotípicas e moleculares os sorotipos não-vacinais (SNVT) de S.pneumoniae, isolados de pacientes com meningite nos períodos anterior (janeiro/2008 - junho/2010) e posterior (julho/2010 - dezembro/2012) à implementação da vacina pneumocócica conjugada 10-valente (PCV10), na cidade de Salvador, Bahia. Os isolados de S. pneumoniae foram identificados através de métodos microbiológicos clássicos e a determinação do tipo capsular foi realizada através da técnica de Multiplex-PCR e/ou reação de Quellung. A sensibilidade a oito antimicrobianos foi realizada através da técnica de microdiluição em caldo e a caracterização genotípica por intermédio das técnicas de PFGE e MLST...


The licensure and subsequent widespread use of pneumococcal conjugate vaccines have contributed for the reduction in the overall incidence of invasive pneumococcal disease worldwide. However, the emergence of Streptococcus pneumoniae nonvaccine serotypes (SNVT), which escape from the vaccine by the expansion of pre-existing clones following serotype replacement and/or by capsular switching is a matter of concern. In 2010, Brazil introduced the 10-valent conjugate pneumococcal vaccine (PCV10) into its routine National Immunization Program. Our aim was to characterize the phenotypic and genotypic profile of S. pneumoniae non-vacine serotypes (SNVT) isolated from patients with meningitis before (January 2008 – June 2010) and after (July 2010 – December 2012) the introduction of PCV10 in Salvador, Bahia. The pneumococcal isolates were identified by classical microbiological methods and submitted to capsular deduction by multiplex-PCR and/or Quellung reaction. The antimicrobial susceptibility was performed the broth microdilution method. The genotypic profile was assessed by PFGE and MLST...


Assuntos
Humanos , Meningite Pneumocócica/complicações , Meningite Pneumocócica/diagnóstico , Meningite Pneumocócica/epidemiologia , Meningite Pneumocócica/patologia , Meningite Pneumocócica/prevenção & controle , Meningite Pneumocócica/terapia , Meningite Pneumocócica/transmissão , Monitoramento Epidemiológico
6.
Arq Bras Cardiol ; 97(3): e50-2, 2011 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-22030703

RESUMO

In this report, we describe the case of a 64-year-old male patient, with no history of alcohol consumption, who presented the Osler's triad, which is the association of endocarditis, pneumonia, and meningitis caused by a single agent. This syndrome is called Austrian syndrome, when the infection is caused by Streptococcus pneumoniae. We discuss the clinical manifestations, the pathophysiology, and the therapeutic approach to this condition. Given the rarity of the condition and its high morbidity and mortality, the importance of an early diagnosis and an appropriate treatment to reduce the complications associated with this disease will be emphasized.


Assuntos
Endocardite Bacteriana/diagnóstico , Meningite Pneumocócica/diagnóstico , Infecções Estreptocócicas/diagnóstico , Streptococcus pneumoniae , Endocardite Bacteriana/terapia , Humanos , Masculino , Meningite Pneumocócica/terapia , Pessoa de Meia-Idade , Infecções Estreptocócicas/terapia , Streptococcus pneumoniae/isolamento & purificação , Síndrome
7.
Arq. bras. cardiol ; Arq. bras. cardiol;97(3): e50-e52, set. 2011. ilus
Artigo em Português | LILACS | ID: lil-601797

RESUMO

Neste relato, é descrito o caso de um paciente masculino, 64 anos, sem história de etilismo, que se apresentou com a Tríade de Osler, que consiste no desenvolvimento de endocardite, pneumonia e meningite, por um mesmo agente. A síndrome é denominada síndrome de Austrian, quando a infecção for por Streptococcus pneumoniae. Serão discutidas as manifestações clínicas, fisiopatológicas e a terapêutica mais adequada para esse quadro. Tendo em vista a raridade do caso e a elevada morbimortalidade, serão enfatizadas a importância do diagnóstico precoce e o tratamento adequado, visando reduzir as complicações inerentes a essa doença.


In this report, we describe the case of a 64-year-old male patient, with no history of alcohol consumption, who presented the Osler's triad, which is the association of endocarditis, pneumonia, and meningitis caused by a single agent. This syndrome is called Austrian syndrome, when the infection is caused by Streptococcus pneumoniae. We discuss the clinical manifestations, the pathophysiology, and the therapeutic approach to this condition. Given the rarity of the condition and its high morbidity and mortality, the importance of an early diagnosis and an appropriate treatment to reduce the complications associated with this disease will be emphasized.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Endocardite Bacteriana/diagnóstico , Meningite Pneumocócica/diagnóstico , Streptococcus pneumoniae , Infecções Estreptocócicas/diagnóstico , Endocardite Bacteriana/terapia , Meningite Pneumocócica/terapia , Síndrome , Infecções Estreptocócicas/terapia , Streptococcus pneumoniae/isolamento & purificação
9.
Kasmera ; 34(2): 114-118, jul.-dic. 2006. tab
Artigo em Espanhol | LILACS | ID: lil-503773

RESUMO

La meningitis bacteriana aguda por S. pneumoniae en adultos presenta elevada tasa de morbimortalidad. Los cortiocosteroides no son usados de forma rutinaria aquí la terapia complementaria con dexametasona se administró a 6 pacientes que recibieron penicilina sódica y cloranfenicol. Los resultados sugieren que mejora la evolución clínica. Se recomienda continuar el estudio con más pacientes.


Assuntos
Humanos , Terapia Biológica , Cloranfenicol , Dexametasona/administração & dosagem , Dexametasona/uso terapêutico , Meningite Pneumocócica/terapia , Bacteriologia , Medicina , Venezuela
10.
Pediatria (Säo Paulo) ; 16(1): 44-50, jan.-mar. 1994. ilus, tab
Artigo em Português | LILACS | ID: lil-159073

RESUMO

Sao analisados 19 casos de meningite pneumococica internados na Unidade de Infectologia do ICR do HC-FMUSP, durante o periode de janeiro de 1980 a agosto de 1992. Houve predominio do sexo masculino sobre o feminino na proporcao de 2,1: 1,0 e de criancas abaixo de um ano de idade (63,1 por cento). Dos sinais clinicos, a febre foi o mais frequente, seguida por vomitos e sinais de acometimento do sistema nervoso central...


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Meningite Pneumocócica/mortalidade , Sinais e Sintomas , Dexametasona/uso terapêutico , Meningite Pneumocócica/complicações , Meningite Pneumocócica/líquido cefalorraquidiano , Meningite Pneumocócica/terapia
11.
ACM arq. catarin. med ; 19(3): 185-8, jul.-set. 1990. tab
Artigo em Português | LILACS | ID: lil-152413

RESUMO

Estudou-se 67 casos de meningite pneumococcica no Hospital Infantil Joana de Gusmao, em Florianopolis, Santa Catarina, no periodo de janeiro de 1980 a dezembro de 1989. Obteve-se um indice de letalidade geral de 26,86 por cento. Foram analisados os seguintes fatores prognosticos: idade, presenca de coma, convulsoes, pleocitose discreta no LCR, septicemia, hemiparesia, hipoglicorraquia, leucopenia e hiperproteinorraquia. Evidenciou-se correlacao estatisticamente relevante em relacao ao obito para os fatores coma, pleocitose discreta e hipoglicorraquia, em ordem decrescente de importancia, quando aplicada analise de regressao multipla.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Meningite Pneumocócica/complicações , Meningite Pneumocócica/mortalidade , Meningite Pneumocócica/patologia , Meningites Bacterianas/complicações , Meningites Bacterianas/mortalidade , Meningites Bacterianas/patologia , Meningite Pneumocócica/tratamento farmacológico , Meningite Pneumocócica/terapia , Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/terapia , Prognóstico
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