Prevalence of mycobacterium tuberculosis among professionals in a university hospital, Mato Grosso do Sul, 2004 / Prevalência da infecção tuberculosa entre profissionais de um hospital universitário / Existencia de la infección tuberculosis entre profesionales de un hospital universitario en Mato Grosso do Sur, 2004

Several studies have demonstrated an elevated prevalence amongst professionals of mycobacterium tuberculosis, both in the rate of infections and illness. This study was carried out in a School Hospital in Campo Grande, MS, Brazil, aiming to establish the prevalence of infection with Mycobacterium tuberculosis. The results of the analysis of 194 subjects showed an overall positivity for the tuberculin test of 38.7 percent. There was a correlation with smoking (p=0.01, RP=1. 72 (1.20-2.45- Yates's correction). The conclusion is that the establishment of a program of tuberculin screening jointly with the implementation of interventions is necessary in order to reduce the risk of nosocomial transmission.

Vários estudos têm demonstrado prevalência elevada de infecção tuberculosa, tanto quanto de adoecimento, entre os profissionais de saúde. Este estudo, realizado em um Hospital Universitário, situado na cidade de Campo Grande, MS, teve como objetivo conhecer a prevalência de infecção pelo Mycobacterium tuberculosis entre esses profissionais. Na análise de 194 indivíduos, encontrou-se prevalência global de positividade da prova tuberculínica de 38,7 por cento. Observou-se associação com o tabagismo (p 0,01, e RP 1,72 (1,20-2,45) - corrigido por Yates). Conclui-se que é necessário estabelecer um programa de triagem tuberculínica de rotina para acompanhamento de viragem tuberculínica, juntamente, com a instituição de intervenções para reduzir o risco de transmissão nosocomial.

Varios estudios han demostrado la alta prevalencia de infección tuberculosis, y también de la propia enfermedad, entre los profesionales de salud. Este estudio, realizado en un Hospital Universitario ubicado en la ciudad de Campo Grande-MS, tuvo como objetivo conocer la existencia de la infección causada por el Mycobacterium tuberculosis. En el análisis de 194 personas, fue encontrada la existencia de la prueba tuberculinilla del 38,7 por ciento. Fue observada una asociación con el tabaquismo (p 0,01, y RP 1,72 (1,20-2,45) corregido por yates). Concluimos que es necesario un programa de selección tuberculinilla de rutina para acompañar el viraje tuberculínico, junto a intervenciones para reducir el riesgo de transmisión nosocomial.

Prevalence of mycobacterium tuberculosis among professionals in a university hospital, Mato Grosso do Sul, 2004.

Several studies have demonstrated an elevated prevalence amongst professionals of mycobacterium tuberculosis, both in the rate of infections and illness. This study was carried out in a School Hospital in Campo Grande, MS, Brazil, aiming to establish the prevalence of infection with Mycobacterium tuberculosis. The results of the analysis of 194 subjects showed an overall positivity for the tuberculin test of 38.7%. There was a correlation with smoking (p=0.01, RP=1. 72 (1.20-2.45- Yates's correction). The conclusion is that the establishment of a program of tuberculin screening jointly with the implementation of interventions is necessary in order to reduce the risk of nosocomial transmission.

Neuroparacoccidioidomycosis: analysis of 13 cases observed in an endemic area in Brazil.

The epidemiological, clinical and laboratory features of 13 cases of neuroparacoccidioidomycosis (NPCM) were analysed. All patients were men, with a mean age of 41.6 years. The lungs were involved in 11 cases (84.6%) and only two cases had mycosis limited to the central nervous system. Co-morbidity was observed in four patients (malignant neoplasm in three and diabetes mellitus in one). The most frequent neurological manifestations were paresis (eight cases), headache (five cases) and gait disturbance (four cases). Neuroimaging diagnosis showed a predominance of multiple round lesions with ring enhancement following contrast medium injection. Lesions were seen in the brain hemispheres (nine cases), thalamus (nine cases), cerebellum (four cases), brainstem (four cases) and spinal cord (four cases). Most cases responded well to therapy. Lesions with enhancement following contrast medium injection persisted in four patients for a period of 6 months to 8 years. These findings emphasize the importance of considering NPCM in the differential diagnosis of brain and spinal cord lesions in endemic areas of paracoccidioidomycosis.

Paracoccidioidomycosis in patients with human immunodeficiency virus: review of 12 cases observed in an endemic region in Brazil.

OBJECTIVE: To study the clinical characteristics of 12 patients with paracoccidioidomycosis (PCM) and human immunodeficiency virus (HIV) infection. METHODS: The clinical manifestations, diagnosis, treatment, and outcome of PCM in 12 patients infected with HIV attended at a University Hospital of Mato Grosso do Sul, Brazil, were evaluated. RESULTS: All patients were men, mean age 36.1 years old, and 11 had a diagnosis other than PCM as the aids-defining illness. Lymph nodes were the organs most often involved (10 patients, 83.3%), followed by lung involvement, usually with an interstitial pattern (seven patients, 58.3%), papule-nodular skin lesions with central ulceration in six (50%) and ulcerated lesions of oral mucous membrane in five (41.6%) patients. Pleural involvement occurred in one patient who presented large pleural effusion beside a pathologic rib fracture caused by P. brasiliensis. Seven patients showed involvement in more than one extrapulmonary organ. In eight (66.6%) cases the diagnosis was established by direct microscopy of clinical specimens. All patients used trimethoprim-sulfamethoxazole and seven patients were also treated with amphotericin B. Eight patients died with progressive PCM manifestations. CONCLUSION: Our review demonstrates that PCM, an endemic systemic mycosis in Brazil, when associated with AIDS, behaves clinically as an opportunistic disease.

Aspectos clinico e funcional pulmonar da doença trofoblástica / Clinical and pulmonary functional aspects of trophoblastic disease

Os autores estudam nove pacientes portadoras da doença trofoblástica. Salientam os aspectos clínicos e de repercussão sistêmica do tumores, como emagrecimento, amenia, proteinúria, velocidade de hemossedimentação elevada.