Osteomyelitis after septic trochanteric bursitis - clinical case

We report the clinical case of a 76 years-old woman with a subacute trochanteric inflammatory pain with low-grade fever and laboratory markers of acute inflammation, associated with the ultrasonographic evidence of bursitis and radiologic evidence of femoral erosions, that resolved after intravenous antibiotherapy. Although rare, the infectious etiology should be considered in patients with clinical manifestations of bursitis and signs of systemic involvement.     

The value of tubular enzymes for early detection of acute kidney injury after liver transplantation: an observational study

Tubular enzymes (TE) are early markers of acute kidney injury (AKI), but their value for liver transplant (LT) recipients is unknown. We sought to evaluate the usefulness of TE to predict AKI after LT. We enrolled Thirty-nine adult patients without AKI who had been admitted to the Intensive Care Unit (ICU). AKI was diagnosed according to the Acute Kidney Injury Network criteria. Of these patients, 23 had received orthotopic LT and 16 controls had been admitted for other conditions. Urinary lactate dehydrogenase (LDH), alkaline phosphatase (AF) and γ-gutamyl transpeptidase (γ-GT) measured on days 1 and 3 of the ICU stay were normalized to urinary creatinine concentrations. AKI was diagnosed in 14 patients: 8 in the LT group and 6 in the control group. In the LT group, on the first day of the patients' stay in the ICU, urinary LDH (P = .032), AF (P = .022), and γ-GT (P = .002) were significantly higher among those who developed AKI; these elevations preceded those of serum creatinine. In forward receiver-operating characteristic (ROC) plot analysis, the areas under the ROC curves were 0.8, 0.86, and 0.92 for LDH, AF, and γ-GT, respectively. We concluded that TE determined early after LT are a helpful predictors of AKI.     

A combined strategy to improve the control of Schistosoma mansoni in areas of low prevalence in Brazil

Results of stool examinations for infections with Schistosoma mansoni among schoolchildren, living in a village of Minas Gerais State, Brazil, were used as an indicator to identify schistosomiasis-positive individuals within the entire population. This new approach is based on dividing the community into schoolchildren, members of households of schistosomiasis-positive and -negative schoolchildren, and members of households without schoolchildren. Each subgroup was evaluated comparing different sampling efforts with the predetermined "gold standard" to find the best relationship between detection rate and sampling effort. Consequently these results were combined, and a proposal for a new strategy, valid for an entire community, was elaborated. This alternative approach during the screening process permits to treat a similar proportion of positives as detected with 6 Kato-Katz slides of 3 stool samples, with 3-fold reduced sampling effort, enhancing the efficiency of schistosomiasis control programs in low-endemic areas.     

Living with the person who has Alzheimer's disease: perspectives of family caregiver

The present study aimed at describing and analyzing the fliving of the patient with Alzheimer's Disease under the perspective of the caregiver relative. It was used a qualitative approach. The data was collected by semi-structured interviews with eleven caregiver relatives of patients with Alzheimer's disease. The data was analyzed by the method of content analysis, thematic modality. In the results, the obtained reports were categorized like: the familiarity with the symptomatology and the familiarity with the limitations. It was considered that the Alzheimer's Disease is a familiar disease and, therefore, it is necessary a singular approach of the nurse who must to assume an educator and researcher role, and must to involve himself directly on the invested assistance.     

Crohn's supraglottitis – The presenting feature of otherwise asymptomatic systemic disease

We present the unique case of a 15 year old boy with upper airway obstruction found to have Crohn's disease in the absence of gastrointestinal symptoms. Laryngeal manifestations of Crohn's disease are extremely rare. Only 11 cases have been reported in the literature, of which only one is in a child. Laryngeal Crohn's disease usually occurs accompanied by gastrointestinal symptoms or in patients with a prior diagnosis of Crohn's disease. The literature on the clinical features and management of laryngeal Crohn's is discussed along with a summary of the reported otolaryngological manifestations and associations with Crohn's disease.     

Clinical,biochemical and molecular findings of 24 Brazilian patients with glutaric acidemia type 1: 4 novel mutations in the GCDH gene

Metabolic Brain Disease - Glutaric aciduria type 1 (GA-1) is a rare but treatable inherited disease caused by deficiency of glutaryl-CoA dehydrogenase activity due to GCDH gene mutations. In this...