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1.
Karla Maria Tamez-Torres Pedro Torres-Gonzalez Miguel E. Cervera-Hernandez Barbara Chavez-Mazari Corazon de Jesus Barrientos-Flores Miriam Bobadilla-del-Valle Alfredo Ponce-de-Leon Jose Sifuentes-Osornio 《The Brazilian journal of infectious diseases》2018,22(5)
Objectives
To determine the factors associated with Mycobacterium tuberculosis complex-positive blood culture.Methods
Case-control study. Sociodemographic, clinical and laboratory data were collected from 2000 to 2015.Results
We reviewed medical records of 533 patients with culture-proven tuberculosis, of whom 27.2% (145/533) had blood culture available. Patients with mycobacteremia presented more frequently with abdominal tuberculosis, body mass index <18 kg/m2, and had lower hemoglobin and albumin levels. No differences were observed regarding HIV status.Conclusions
Few studies have reported on the characteristics associated with Mycobacterium tuberculosis complex bacteremia, especially among Human Immunodeficiency Virus-negative patients. Out of 145 tuberculosis-infected patients with blood culture results available, 21 turned out positive. Anemia, hypoalbuminemia, and a body mass index < 18 kg/m2 were associated with mycobacteremia. 相似文献2.
Background
Food protein-induced allergic proctocolitis is a frequent cause of rectal bleeding in infants. Characteristics of infants with multiple food allergies have not been defined.Objective
This study aimed to identify characteristics of infants with proctocolitis and compare infants with single and multiple food allergies.Methods
A total of 132 infants with proctocolitis were evaluated retrospectively. All of the infants were diagnosed by a paediatric allergist and/or a paediatric gastroenterologist according to guidelines. Clinical features of the infants, as well as results of a complete blood count, skin prick test, specific immunoglobulin E, and stool examinations or colonoscopy were recorded.Results
Cow's milk (97.7%) was the most common allergen, followed by egg (22%). Forty-five (34.1%) infants had allergies to more than one food. Infants with multiple food allergies had a higher eosinophil count (613 ± 631.2 vs. 375 ± 291.9) and a higher frequency of positive specific IgE and/or positive skin prick test results than that of patients with a single food allergy. Most of the patients whose symptoms persisted after two years of age had multiple food allergies.Conclusions
There is no difference in clinical presentations between infants with single and multiple food allergies. However, infants with multiple food allergies have a high blood total eosinophil count and are more likely to have a positive skin prick test and/or positive specific IgE results. 相似文献3.
Valdirene Leão Carneiro Maria Teresita Bendicho Rosalina Guedes Santos Marilda Casela Eduardo M. Netto Scarlet Torres Moraes Mota Iza Cristina Araújo Pina Roberto Meyer Nascimento Songeli Menezes Freire Theolis Barbosa 《The Brazilian journal of infectious diseases》2018,22(3):202-207
Introduction
Latent tuberculosis infection diagnosis based on the release of interferon-gamma in cultures of peripheral blood cells stimulated with Mycobacterium tuberculosis antigens has replaced the tuberculin skin test in many countries with low tuberculosis prevalence. The IFN-γ production can be influenced by genetic polymorphisms, of which the IFNG + 874 (rs62559044) locus is the most studied. We investigated the possible influence of the IFNG + 874 A/T polymorphism on interferon-gamma test performance.Methods
Patients diagnosed with pulmonary tuberculosis (75), volunteers with positive tuberculin skin test (70) and healthy volunteers with negative tuberculin skin test and no history of contact with tuberculosis (57) were evaluated regarding the IFNG + 874 genotype and the IFN-γ levels in whole blood cultures performed using an interferon-gamma commercial kit (QuantiFERON-TB® Gold In-Tube).Results
IFN-γ production was not influenced by the IFNG + 874 genotype, regardless of antigen or mitogen-based stimulation, which suggests that other genes may influence IFN-γ production in response to mycobacteria. The IFNG + 874 polymorphism was found to exert no influence over QFT-IT test sensitivity in our study.Conclusions
The IFNG + 874 polymorphism was not shown to influence QuantiFERON-TB® Gold In-Tube test performance in an admixed population from northeastern Brazil. 相似文献4.
Carola Saure Carolina Caminiti Julieta Weglinski Fernanda de Castro Perez Soledad Monges 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(2):81-85
Introduction
Duchenne muscular dystrophy (DMD) is a severe muscular disease characterized by progressive loss of functional muscle mass followed by changes in body composition.Aim
To describe body composition, resting energy expenditure (REE), and metabolic disorders in DMD patients followed-up at a tertiary care center. To analyze the association with type of steroid and ambulatory status, and to compare obese DMD patients with patients with multifactorial obesity.Population and methods
A prospective, observational, cross-sectional study was conducted. Anthropometric measurements were taken, evaluating body composition with bioelectrical impedance analysis (BIA), REE with indirect calorimetry, and biochemical parameters in all DMD patients seen between June 2013 and April 2014.Results
63 boys between 5.4 and 18.7 years of age were evaluated. Diagnosis of obesity ranged from 28% measuring body mass indexZ-score (BMIZ-score) to 70% using percentage of fat mass (%FM). Patients who had lost gait had a significantly higher %FM than those in whom gait was preserved (72% vs 46%, p < 0.05).Insulin resistance was present in 29% associated with BMI Z-score and waist circumference and 40% had dyslipidemia associated with %FM, both of which were steroid independent. In obese DMD patients REE was lower than predicted and also lower than controls, and persist when dividing the patients into ambulators and non-ambulators.Conclusions
A high prevalence of obesity was observed. BMI-Z-score underestimates the degree of FM. No correlation was found between steroid type and body composition or metabolic disorders. No differences were found in REE between ambulators and non-ambulators. Obese DMD patients have a lower REE than controls. 相似文献5.
6.
Detection of high biliary and fecal viral loads in patients with chronic hepatitis C virus infection
Hugo Monrroy Jenniffer Angulo Karla Pino Pilar Labbé Juan Francisco Miquel Marcelo López-Lastra Alejandro Soza 《Gastroenterologia y hepatologia》2017,40(5):339-347
Background
The life cycle of the hepatitis C virus (HCV) is closely associated with lipid metabolism. Recently, NPC1L1 (a cholesterol transporter) has been reported to function as an HCV receptor. This receptor is expressed in the hepatocyte canalicular membrane and in the intestine; serving as a key transporter for the cholesterol enterohepatic cycle.Objectives
We hypothesized that HCV might have a similar cycle, so we aimed to study the presence of HCV in bile and stools of infected patients.Materials and methods
Blood, feces, and duodenal bile samples were collected from patients infected with HCV. The biliary viral load was normalized to the bile salt concentration of each sample and the presence of HCV core protein was also evaluated. A total of 12 patients were recruited. HCV RNA was detected in the bile from ten patients.Results
The mean viral load was 2.5 log10 IU/60 mg bile salt. In the stool samples, HCV RNA was detected in ten patients (mean concentration 2.7 log10 IU/g of feces).Conclusions
HCV RNA is readily detectable and is present at relatively high concentrations in the bile and stool samples of infected patients. This may be relevant as a source of infection in men who have sex with men. Biliary HCV secretion may perhaps play a role in the persistence of viral infection via an enterohepatic cycle of the virus or intrahepatic spread. 相似文献7.
Per Lundberg Rune Andersson Elizabeth S. Machado Tomaz Pinheiro da Costa Cristina Barroso Hofer 《The Brazilian journal of infectious diseases》2018,22(5):412-417
Background
Perinatally HIV-infected children are surviving into adulthood, and getting pregnant. There is a scarcity of information on health and pregnancy outcomes in these women.Aim
To evaluate characteristics related to HIV disease and pregnancy outcomes in perinatally infected women, and to compare these women with a group of youth with behaviorally acquired HIV-infection, at a reference hospital in Rio de Janeiro, Brazil.Methods
A cohort study. Epidemiological, clinical, and laboratory data were compared between perinatally (PHIV) and behaviorally HIV-infected (BHIV) pregnant youth with the primary aim to study pregnancy outcomes in the PHIV group and compare with outcomes to BHIV group.Results
Thirty-two pregnancies occurred in PHIV group, and 595 in BHIV group. A total of seven (22%) PHIV women and 64 (11%) BHIV women had a premature delivery (p = 0.04), however, when adjusting for younger age at pregnancy, and antiretroviral therapy initiation in 1st trimester of pregnancy (OR = 18.66, 95%CI = 5.52–63.14), the difference was no longer significant. No cases of mother-to-child HIV transmission (MTCT) were observed in the PHIV group while there was a 2% MTCT rate in BHIV group.Conclusion
Pregnancy among PHIV was as safe as among BHIV. The differences between those groups were probably related to treatment and prolonged care in the first group. 相似文献8.
9.
Catarina Meng Carolina Belino Luciano Pereira Ana Pinho Susana Sampaio Isabel Tavares Manuela Bustorff António Sarmento Manuel Pestana 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2018,38(5):545-550
Background
Hepatitis B virus (HBV) reactivation in kidney transplant recipients (KTR) involves important morbidity and mortality. Despite being more common in patients who are HBsAg-positive, it may occur in patients with clinically resolved infection (HBsAg-negative and anti-HBc-positive), in whom the presence of the protective anti-HB antibody is thought to decrease the risk of reactivation. Data regarding reactivation rates in this population are scarce.Objective
To retrospectively evaluate the risk of HBV reactivation in KTR with previously resolved infection.Material and methods
Retrospective cohort study including patients who underwent a kidney transplant between January 1994 and December 2014 with resolved HBV infection at the time of transplantation (anti-HBc seropositivity without detectable HBsAg, with or without anti-HB-positive antibodies and normal liver enzymes).Results
Out of 966 patients, 95 patients with evidence of resolved HBV infection were analyzed, of which 86 had a titer of anti-HBs >10 mIU/ml. Mean follow-up time was 93 months; 12 patients had lost anti-HBs. Two patients showed evidence of reactivation. Risk factors associated with loss of anti-HBs were elderly age (>60) and occurrence of acute graft rejection (p < 0.05).Conclusion
The risk of HBV reactivation in KTR with previously resolved infection is not negligible at 2%. Elderly age and acute rejection were associated with loss of anti-HBs, and these patients may benefit from closer monitoring of HBV DNA levels. Routine serology and/or HBV viral load monitoring in HBsAg-negative, anti-HBc-positive patients is recommended and should be emphasized in these patients. 相似文献10.
11.
F. Javier García-Fernández José Luis Ibáñez Criado Aurelio Quesada Dorador 《Revista espa?ola de cardiología》2018,71(11):941-951
Introduction and objectives
This report describes the findings of the 2017 Spanish Catheter Ablation Registry.Methods
Data collection was retrospective. A standardized questionnaire was completed by each of the participating centers.Results
A total of 15 284 ablation procedures were performed by 98 institutions (the highest number of ablations and institutions historically reported in this registry), with a mean of 156 ± 126 and a median of 136 procedures per center. For the first time, the most frequently treated ablation target was atrial fibrillation (n = 3457; 22.6%), followed by cavotricuspid isthmus (n = 3449; 22.5%) and atrioventricular nodal re-entrant tachycardia (n = 3429; 22.4%). The overall success rate was 87%. The rate of major complications was 2.6%, and the mortality rate was 0.09%. The percentage of procedures performed without fluoroscopic support increased to 6% of all ablations, and 2.3% of all ablations were performed in pediatric patients.Conclusions
The Spanish Ablation Catheter Registry systematically and uninterruptedly collects data on the ablation procedures performed in Spain, revealing that both the number of ablations and the number of centers performing them has progressively increased, while maintaining a high success rate and a low percentage of complications. 相似文献12.
Aim
To review the effectiveness and safety of switching from an originator anti-TNF (Remicade®) to a biosimilar (CT-P13) in patients with inflammatory bowel disease (IBD).Methods
Electronic and manual search up to September 2017.Results
We identified 24 studies evaluating switching between Remicade® and CT-P13 in 1326 patients. Disease control (no worsening after switching) was confirmed in most of the patients (weighted mean, 88%; 95% CI = 86–89%). No unexpected adverse effects were reported in any of the studies.Conclusion
The risks of switching from Remicade® to a biosimilar seem to be purely theoretical and are not supported by the (still limited) real-world clinical practice experience. On the contrary, a steadily increasing number of publications have shown that there seem to be no safety or efficacy concerns about switching. Therefore, switching from originator to biosimilar infliximab in patients with IBD may be considered acceptable. 相似文献13.
Alessandra M. Mantovani Cristina E.P.T. Fregonesi Mariana R. Palma Fernanda E. Ribeiro Rômulo A. Fernandes Diego G.D. Christofaro 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2017,11(1):47-50
Individuals with diabetes develop lower extremity amputation for several reasons. Investigations into pathways to the development of complications are important both for treatment and prevention.
Aim
To evaluate the relationship between amputation and risk factors in people with diabetes mellitus.Materials and method
All participants included in this study (n = 165) were recruited from the Diabetic Foot Program, developed in a Brazilian University, over seven years (2007–2014) and all information for this study was extracted from their clinical records.Results
The prevalence of amputation in patients with diabetes with four risk factors was up to 20% higher when compared to those with only one risk factor. The main predictive risk factors for amputation in this population were the presence of an ulcer and smoking.Conclusion
The risk factors for amputation can be predicted for people with diabetes mellitus and, in the present study, the main factors were the presence of an ulcer and the smoking habit. 相似文献14.
Ramya Kateel Alfred J. Augustine Shivananda Prabhu Sheetal Ullal Manohar Pai Prabha Adhikari 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(1):27-30
Aim
To evaluate the clinical and microbiological profile of diabetic foot ulcer patients admitted to a tertiary care hospital.Methodology
This study recruited 120 diabetic foot ulcer patients of all grade. Their medical records were evaluated retrospectively.Results
We found that median age of patient was 60(52, 67.75) years. 68.3% of patients were males. Median duration of diabetes mellitus was 15(10, 20) years. Mean HbA1C and fasting glucose was 10.3 ± 2.3 and 167.6 ± 52.42 respectively. Neuropathy (35%) and peripheral vascular disease (23.3%) was major micro vascular and macro vascular complication associated. Different locations of ulcers were toe (23.3%), sole (20%), dorsum (18.3%), shin (16.6%), heel (13.3%), and ankle (8.3%). Bacterial infection was seen in 81.66% patients out of which 23.3% had poly microbial infection.Conclusion
Diabetic foot ulcer patient had poor blood glucose control with elevated HbA1C and fasting blood glucose level. Neuropathy and peripheral vascular disease, hypertension were major complications. Staphylococcus aureus, Pseudomonas aeruginosa were common infecting bacteria. 相似文献15.
Roberto Alonso Felipe Pérez-García Paula López-Roa Luis Alcalá Pilar Rodeño Emilio Bouza 《Enfermedades infecciosas y microbiología clínica》2018,36(3):175-178
Introduction
Detection of hepatitis C virus (HCV) RNA and the HCV core antigen assay (HCV-Ag) are reliable techniques for the diagnosis of active and chronic HCV infection. Our aim was to evaluate the HCV-Ag assay as an alternative to quantification of HVC RNA.Methods
A comparison was made of the sensitivity and specificity of an HCV-Ag assay (204 serum samples) with those of a PCR assay, and the correlation between the two techniques was determined.Results
The sensitivity and specificity of HCV-Ag was 76.6% and 100%, respectively. Both assays were extremely well correlated (Pearson coefficient = 0.951). The formula (Log CV = 1.15*Log Ag + 2.26) was obtained to calculate the viral load by PCR from HCV-Ag values. HCV-Ag was unable to detect viral loads below 5000 IU/mL.Conclusion
Although the HCV-Ag assay was less sensitive than the PCR assay, the correlation between both assays was excellent. HCV-Ag can be useful as a first step in the diagnosis of acute or chronic HCV infection and in emergency situations. 相似文献16.
M. Urrutia-Pereira L.P. Mocellin R.B. de Oliveira L. Simon L. Lessa D. Solé 《Allergologia et immunopathologia》2018,46(5):421-430
Introduction
Allergic diseases have become an increasingly common reality in the last years, extending beyond the family context.Objective
Assessing the level of knowledge on asthma, food allergies and anaphylaxis of asthmatic children's parents/caregivers (PC), elementary school teachers (EST) and university students (US) in Uruguaiana, RS, Brazil.Method
577 individuals (PC – N = 111; EST – N = 177; US – N = 299) took part in the study, answering the Newcastle Asthma Knowledge Questionnaire (validated for Portuguese) and another questionnaire on Food Allergy (FA) and anaphylaxis.Results
Although PC have asthmatic children, their asthma knowledge level was average, slightly above that of EST and EU. The lack of knowledge on passive smoking, use of medications and their side effects should be highlighted. US have shown to be better informed about FA and anaphylaxis. However, even though a significant proportion of respondents know the most common symptoms of FA and anaphylaxis, few named subcutaneous adrenaline as the drug of choice for treating anaphylaxis. Although a significant number of respondents know about the possibility of anaphylactic reactions happening at school or in activities outside the school, we were surprised by the absence of conditions in schools to provide emergency care to such students.Conclusion
Despite the high prevalence of allergic diseases in childhood, asthmatic children's parents/caregivers, elementary school teachers and university students have inadequate levels of knowledge to monitor these patients. 相似文献17.
Carolina Schlindwein Mariano Ferreira Maria Cristina Abrão Aued Perin Maria Isabel de Moraes-Pinto Raquel Maria Simão-Gurge Ana Lucia Goulart Lily Yin Weckx Amélia Miyashiro Nunes dos Santos 《The Brazilian journal of infectious diseases》2018,22(1):41-46
Introduction
Immune response to vaccination in infants born prematurely may be lower than in infants born at full-term. Some clinical factors might be associated with humoral immune response.Objectives
The objectives of this study were to compare the immune response to measles and varicella vaccination in infants born prematurely with those born at full-term and to analyze factors associated with measles and varicella antibody levels.Methods
Prospective study including two groups of infants aged 12 months. One group of infants born prematurely with birth-weight <1500 g and who were in follow-up at the outpatient clinic for preterm infants at the institution and other group of infants born at full-term. Infants with malformations, primary immunodeficiency diseases, born to HIV-positive mothers or who had received plasma or immunoglobulin transfusions five months before or three weeks after vaccination were excluded. Plasma antibodies were measured by ELISA and factors associated with antibody levels were assessed by linear regression.Results
Sixty-five premature and 56 full-term infants were included. The percentage of immune individuals after vaccination against measles (100% vs. 100%) and varicella (92.5% vs. 93.2%) were similar in both groups, as well as the antibody levels against measles (2.393 vs. 2.412 UI/mL; p = 0.970) and varicella (0.551 vs. 0.399 UI/mL; p = 0.114). Use of antenatal corticosteroids decreased measles antibody levels whereas breastfeeding for more than six months increased varicella antibody levels.Conclusions
Humoral responses to measles and varicella were similar between infants born prematurely and full-term infants. Measles antibody levels were negatively associated with antenatal corticosteroid use; varicella antibodies were positively associated with prolonged breastfeeding. 相似文献18.
Filipa Aguiar Gabriela Fernandes Henrique Queiroga José Carlos Machado Luís Cirnes Conceição Souto Moura Venceslau Hespanhol 《Archivos de bronconeumología》2018,54(1):10-17
Background
Patients with activating somatic mutations in the Epidermal Growth Factor Receptor (EGFR) have better clinical outcomes when treated with Tyrosine Kinase Inhibitors (TKI) over chemotherapy. However, the impact of the use of TKIs on overall survival outside clinical trials is not well established.Objective
To characterize and analyze the overall survival of a Caucasian population with NSCLC and EGFR mutations.Methods
A retrospective cohort analysis of patients with NSCLC screened for EGFR mutations (exons 18–21) between October 2009 and July 2013 was conducted. Clinical and pathological characteristics, mutational EGFR status, treatment and overall survival were evaluated.Results
From the 285 patients which performed screening for EGFR mutations, 54 (18.9%) had mutations, 25 (46.3%) of which in exon 19 and 20 of which (37.0%) in exon 21. The occurrence of mutations was associated with female sex and non-smoking habits (both, P < .001). The median survival of the global population was 12.0 months, with a better overall survival in mutated than non-mutated patients (20.0 vs 11.0 months, respectively; P = .007).Conclusion
These data contribute for a better knowledge of our lung cancer population concerning the mutational status and clinical outcomes, confirming a better overall survival for the patients with EGFR TKI sensible mutations. 相似文献19.
Background
Adherence to pharmacotherapy reduces symptoms of asthma and rhinitis, however, little is known of its impact on school performance.Objective
To evaluate the impact of pharmacotherapy in absenteeism and school performance in a child population.Methods
A cross-sectional study, carried out in eight schools. All participants and their parents were given a questionnaire assessing parameters related to respiratory diseases and pharmacotherapy. Data on school performance was obtained from the academic history of each child who participated in the study. Adherence to pharmacotherapy was classified as a correct use of therapy for more than five days per week.Results
1109 children agreed to participate. Students were divided into two groups: symptomatic (36%) and asymptomatic (63%). The symptomatic group had a higher frequency of school absenteeism (1 vs. 3.1 days/year/patient p < 0.01) and lower academic performance (failed: 20% vs. 33% p < 0.01). After dividing the symptomatic group between adherents and non-adherents to the pharmacotherapy, the group of adherents had a similar school performance to the asymptomatic group and it was significantly different from the no-adherent group.Conclusion
Respiratory symptoms are associated with poor school performance and with an increase in school absenteeism, but adherence to pharmacotherapy can reduce these negative impacts in children. 相似文献20.
Andrii Dudnyk Svitlana Blyzniuk Oleksandr Pavel’chuk Olena Zakharchenko Dmytro Butov Sergiі Zaіkov 《The Indian journal of tuberculosis》2018,65(1):63-69
Tuberculosis (TB) may have a similar spirometry findings as a chronic obstructive pulmonary disease but the prevalence of TB-induced airflow obstruction (AO) is still unknown.