RESUMO
BACKGROUND: Tuberculous meningitis (TBM) is the most severe form of Mycobacterium tuberculosis infection. Our aim was to analyze the epidemiology, clinical features, diagnostic approach, and outcome of tuberculous meningitis in childhood. METHODS: During a 25-y period (1984-2008), 43 children, aged 7 months to 13 y, were hospitalized in the Paediatric Department of the referral centre for infectious diseases in Thessaloniki, Greece with the diagnosis of TBM. The patients were classified according to the clinical findings on admission as per the UK Medical Research Council (MRC) staging: stage I, 16/43 (37.2%) children; stage II, 16/43 (37.2%); and stage III 11/43 (25.6%). RESULTS: Twenty-seven of the 43 patients were Greek (63%) and none had been BCG-vaccinated. A family history of tuberculosis was identified in 18 cases (42%). 35 patients (81%) had a positive tuberculin skin test. An extrameningeal site of infection was identified in 14 children (33%); pulmonary tuberculosis in 14/43 patients (5/13 miliary tuberculosis) and spondylitis in 1. All patients were treated with anti-tuberculous drugs and 36 (84%) also received corticosteroids. Complications during hospitalization (coma, seizures, cranial nerve palsy, hydrocephalus) presented in 26 patients (60%). Two patients died (5%) and 6 (14%) had permanent neurological sequelae. CONCLUSION: TBM, although rare, remains a disease with significant morbidity and mortality. Early clinical diagnosis and appropriate treatment initiation are important for the prognosis.
Assuntos
Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Meníngea , Adolescente , Criança , Pré-Escolar , Feminino , Grécia/epidemiologia , Humanos , Hidrocefalia , Lactente , Masculino , Prognóstico , Teste Tuberculínico , Tuberculose Meníngea/diagnóstico , Tuberculose Meníngea/tratamento farmacológico , Tuberculose Meníngea/epidemiologia , Tuberculose Meníngea/patologia , Tuberculose PulmonarRESUMO
Background: University students worldwide seem to have increased rates of smoking, alcohol abuse, binge drinking episodes and harmful consumption trends, raising a serious public health issue. The aim of the present study was to investigate university students' smoking habits and exposure to secondary smoke amid a financial crisis. Methods: The present descriptive, correlational analysis was conducted at the University of Peloponnese. Results: The average age of the sample (n=203) was 24.9 years (±7.6 years) with 36.0% of the participants (n=73) being postgraduate students. Some 51.2% (n=104) of the participants said they didn't smoke and 46.3% (n=94, p=0.003) reported no secondary smoke exposure during the past week at home. The majority of the remainder initiated smoking at age 16-17 (48.5%, n=48), and 64.6% (n=42) said the financial crisis did not lead them to change their smoking habits. Conclusions: The majority of students support smoking ban laws in enclosed public spaces, but also their replies highlighted poor implementation on behalf of the state and the authorities. The financial crisis did not appear to have affected student smoking habits.