Population-based surveillance for invasive pneumococcal disease and pneumonia in infants and young children in Goiânia, Brazil

Background

Streptococcus pneumoniae is the leading cause of vaccine-preventable death in children <5 years of age globally. We determined incidence rates of invasive pneumococcal disease (IPD), clinical and chest X-ray-confirmed pneumonia (CXR + Pn), S. pneumoniae serotype distribution, and antimicrobial susceptibility in children in Goiânia, Brazil.

Methods

Prospective, population-based surveillance was conducted from May 2007 to May 2009 in children 28 days to <36 months of age presenting to all 33 pediatric healthcare services (outpatient departments, emergency rooms, hospitals) in Goiânia. Eligibility criteria were temperature ≥39.0 °C in the previous 24 h and/or clinical suspicion of pneumonia or IPD.

Results

14,509 subjects were enrolled. Median age was 14.0 months. S. pneumoniae was detected in 64 samples from 62 subjects: 58 (90.6%) blood; 4 (6.3%) cerebrospinal fluid; and 2 (3.1%) pleural fluid. Incidence rate of IPD (culture- and polymerase chain reaction-positive) for all children aged 28 days to <36 months was 57.5/100,000; overall incidence for culture-positive only was 54.9/100,000. Age stratification of culture-positive-only subjects found the highest rates were, 114.6/100,000 and 69.8/100,000, respectively, for the 6 months to <12 months and 12 months to <24 months age groups. The overall incidence of invasive pneumonia and pneumococcal meningitis was 37.2/100,000 and 5.3/100,000, respectively. The most common IPD serotypes were 14 (45.0%), 6B (13.3%), 18C (6.7%), and 23F (5.0%). Eight isolates (13.3%) were penicillin nonsusceptible. The cumulative percentages of serotypes included in 7-valent, 10-valent, and 13-valent pneumococcal conjugate vaccines were 78.3%, 80.0%, and 88.3%, respectively. The overall incidence of clinical pneumonia and CXR + Pn was, 9598/100,000 and 3428/100,000, respectively. CXR + Pn rates for hospitalized and non-hospitalized subjects were 1751/100,000 and 1677/100,000, respectively.

Conclusions

The burden of IPD and pneumonia is considerable in children in a large Brazilian city, and is seen in hospitalized as well as ambulatory subjects. Vaccination with pneumococcal conjugate vaccines has the potential to decrease this burden.     

Effects of different photobiomodulation dosimetries on temporomandibular dysfunction: a randomized,double-blind,placebo-controlled clinical trial

Changes involving temporomandibular joint, masticatory musculature, and associated structures characterize temporomandibular dysfunction (TMD). The analgesic and anti-inflammatory effect produced by photobiomodulation has contributed to pain relief and functional improvement. However, the parameters to be used have not yet been well established. The aim of this study is to compare the efficacy of three different photobiomodulation dosimetries in the treatment of patients with TMD. A randomized, double-blind, placebo-controlled clinical trial with 44 subjects divided into the groups 8 J/cm² (n?=?11), 60 J/cm² (n?=?11), 105 J/cm² (n?=?11), and control (n?=?11). Pain, symptom severity, and joint mobility were evaluated before and after a ten-session protocol of photobiomodulation with AlGaAs laser (830 nm), at a power density of 30 mW/cm². The mouth opening increased in the 8-J/cm² group from 10.49?±?4.68 to 15.40?±?6.43 degrees, and in the right protrusion from 9.80?±?4.2 to 12.56?±?5.40 degrees after the intervention protocol (p?<?0.05). All groups significantly decreased pain (p?<?0.05). 830-nm laser photobiomodulation was effective in reducing TMD pain and symptoms at all doses tested. Only the doses of 8 J/cm² were effective regarding maximal opening and protrusion of the mandible.     

Effects of methylprednisolone and ganglioside GM-1 on a spinal lesion: a functional analysis

OBJECTIVES: The pharmacological effects of methylprednisolone (MP) and ganglioside GM-1 on spinal injuries have been thoroughly investigated, but only a few studies have evaluated the interaction between these two drugs. METHODS: Twenty-four Wistar rats were subjected to contusive injury of the spinal cord produced by the NYU system. These animals were divided into four groups: group I was injected with MP; group II was injected with GM-1; group III was injected with MP together with GM-1; and group control received physiological serum. The animals were evaluated with regard to their recovery of locomotive function by means of the BBB test on the second, seventh and fourteenth days after receiving the contusive injury to the spinal cord. They were sacrificed on the fourteenth day. RESULTS: This study demonstrated that the MP and GM-1 groups presented functional results that were better than those of the control group, although the enhanced recovery of group II (GM-1) relative to the control group was not statistically significant (p>0.05). The most notable recovery of locomotive function was observed in the group that received MP alone (p<0.05). The group that received MP together with GM-1 presented results that were better than those of the control group (p<0.05). CONCLUSION: Administration of methylprednisolone alone or with GM-1 was shown to be effective for recovery of locomotive function. Combined administration of these drugs resulted in better outcomes than administration of methylprednisolone alone.     

Plasma–Saline Water Interaction: A Systematic Review

Plasma–liquid interaction research has developed substantially in recent years due, mostly, to the numerous applications of cold atmospheric plasma (CAP). Plasma–liquid interactions are influenced by the concentrations of the ionic species present in the liquid environment, and few studies have paid attention to saline water, which generally mediates the reactions in many plasma applications. Therefore, the present review aims to explore the main results and the influence of variables on the modification of properties of saline water by CAP sources following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The searches were carried out in the Scopus, Science Direct, and Web of Science databases, resulting in the inclusion of 37 studies. The main effects of the interaction between CAP and saline water are (i) the production of reactive oxygen and nitrogen species (RONS); (ii) the increase in conductivity and decrease in pH, directly proportional to the increase in discharge voltage; (iii) and the effective area of interaction and the shortest distance between electrode and solution. Other effects are the localized evaporation and crystallization of salts, which make the interaction between plasma and saline water a promising field in the development of technologies for desalination and improvement of liquid properties.     

Eyelid Swelling as the Only Manifestation of Ocular Sarcoidosis

Purpose: To describe a case of eyelid sarcoidosis without systemic manifestations with a three-year follow-up. Methods: A 73-year-old woman presented complaining of a one-year history of swelling and hyperemia in the right upper eyelid. To confirm the diagnosis, we performed an incisional biopsy of the eyelid. Results: Histopathological examination showed a non-caseating granulomatous process suggestive of sarcoidosis. After three years, the patient was asymptomatic and physical and laboratory examination showed no signs of systemic sarcoidosis. Conclusion: The histopathological exam was fundamental for the diagnosis.