RESUMO
BACKGROUND: Cardiac hemangiomas are very uncommon benign primary tumors. They are usually located preferentially in the right atrium and their location in the interatrial septum is extremely rare. CASE PRESENTATION: We report the case of a 41-year-old patient who was admitted due to a stroke. The transthoracic echocardiogram revealed a large mass in the right atrium adhered to the interatrial septum. Suspecting an atrial myxoma, surgical intervention was performed confirming that the mass extended within the thickness of the interatrial septum, protruding into the right atrial cavity. The histologic report confirmed a hemangioma. CONCLUSIONS: Cardiac hemangiomas are rare primary tumors and are usually misdiagnosed as other cardiac tumors. Histopathological examination is essential for a definitive diagnosis.
Assuntos
Septo Interatrial , Ecocardiografia , Neoplasias Cardíacas , Hemangioma , Adulto , Humanos , Septo Interatrial/diagnóstico por imagem , Septo Interatrial/cirurgia , Septo Interatrial/patologia , Diagnóstico Diferencial , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Neoplasias Cardíacas/cirurgia , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Hemangioma/diagnóstico , Hemangioma/cirurgia , Hemangioma/diagnóstico por imagemRESUMO
OBJECTIVE: Traveler's diarrhea (TD) is the most frequent disease among people from industrialized countries who travel to less developed ones, especially sub-Saharan Africa, Southern Asia and South America. The most common bacteria causing TD is enterotoxigenic Escherichia coli (ETEC). The WC/rBS cholera vaccine (Dukoral) has been shown to induce cross-protection against ETEC by means of the B subunit of the cholera toxin. The aim of the study was to evaluate the effectiveness of the WC/rBS cholera vaccine in preventing TD. METHODS: Between May 1 and September 30 (2007), people seeking pre-travel advice in ten Spanish international vaccination centers were included in a prospective cohort study of travelers to cholera risk countries. The incidence rates of TD were adjusted for variables whose frequencies were statistically different (entry point 0.10) between the vaccinated and non-vaccinated cohorts. FINDINGS: The vaccinated cohort (n = 544 travelers) included people vaccinated with the WC/rBS cholera vaccine, and the non-vaccinated cohort (n = 530 travelers) by people not vaccinated. The cumulative incidence rate of TD was 1.69 in vaccinated and 2.14 in non-vaccinated subjects. The adjusted relative risk of TD in vaccinated travelers was 0.72 (95% CI: 0.58-0.88) and the adjusted vaccination effectiveness was 28% (95% CI: 12-42). CONCLUSIONS: The WC/rBS cholera vaccine prevents TD in 2 out of 7 travelers (preventive fraction: 28%). The number needed to vaccinate (NNV) to prevent 1 case of TD is 10.
Assuntos
Vacinas contra Cólera/administração & dosagem , Vacinas contra Cólera/imunologia , Diarreia/epidemiologia , Diarreia/prevenção & controle , Viagem , Administração Oral , Adolescente , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Espanha , Resultado do Tratamento , Adulto JovemRESUMO
INTRODUCTION: Streptococcus agalactiae is a well-recognized pathogen in the obstetric population and is a cause of invasive infection in adults with underlying diseases. Nevertheless, the role of S. agalactiae in urinary tract infections in the adult non-pregnant population treated in outpatient health care centers has been less extensively studied. METHODS: The clinical significance of S. agalactiae isolation in urine samples from health care center patients was studied in five areas of Spain over a period of six months. The study protocol included the collection of personal, epidemiological and clinical data. A total of 85 patients were studied; 79 were women (17 pregnant) and 6 men. RESULTS: Pyuria was found in 72.9% of the cases. A total of 26.4% (n = 18) of non-pregnant women and all the men had some type of chronic underlying disease and 35.3% (n = 24) had urinary disease. Among the pregnant women, 53% had asymptomatic bacteriuria and 35.3% had vaginal and/or urethral colonization. Among the group of men and non-pregnant women, the most frequent entity was non-complicated cystitis, seen in 66.1% (45 of 68) of cases, followed by complicated infection in 19.1% and asymptomatic bacteriuria in 11.8%. Of the 45 patients with non-complicated cystitis, 35 (77.7%) were over 40 years old and 19 (42.2%) were over 60 years old. CONCLUSIONS: Among the population of non-pregnant adults treated in outpatient health care centers, S. agalactiae isolation from urine was found mainly in women over 40 years old and was the cause of non-complicated urinary tract infection in more than half of cases.
Assuntos
Instituições de Assistência Ambulatorial/estatística & dados numéricos , Bacteriúria/microbiologia , Piúria/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/isolamento & purificação , Uretra/microbiologia , Vagina/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bacteriúria/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/microbiologia , Piúria/epidemiologia , Espanha/epidemiologia , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/urinaRESUMO
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