Complication of post-infectious bronchiolitis obliterans (Swyer-James syndrome).

Swyer-James syndrome is a complication of post-infectious bronchiolitis obliterans that causes inflammation and fibrosis of the bronchial walls. There are two types: asymptomatic, with most cases diagnosed in adults during routine radiological examinations; and symptomatic, most commonly found in children. Here, we report the case of a 6-year-old child with recurrent dyspnea since the age of 3, who showed signs and symptoms of bronchiolitis obliterans and radiological signs of bronchial wall thickening and air trapping. The clinical and radiological findings led to the diagnosis of Swyer-James syndrome. Treatment of this syndrome is intended to reduce the pulmonary lesions and improve the patient's quality of life.

Survey of infection in orthopedic postoperative and their causative agents: a prospective study.

OBJECTIVE: to evaluate the cases of wound infections in orthopedic postoperative period. METHODS: postoperative patients who developed infection during the period from November 2012 to November 2013 were studied. Secretions were collected during surgery using sterile swabs, and sent for microbiological analysis. RESULTS: during the period analyzed, 38 surgical procedures progressed to infection. The type of surgery presenting the largest number of infections was osteosynthesis, in 36 (94.7%) patients. Among the materials used, 18 (36%) surgeries that used external fixator were infected, and 17 (34%) using plate. The species of bacteria that caused the largest number of infections were Staphylococcus aureus, infecting 16 (43.9%) patients, followed by Acinetobacter baumannii, which infected four (10.5%) patients. Regarding the resistance profile of Gram-positive strains to antibiotics, 100% of Staphylococcus aureus strains were susceptible to vancomycin and 31.3%, to ceftriaxone. As for the Gram-negative bacteria, 100% of Acinetobacter baumannii strains were resistant to ceftriaxone, gentamicin and imipenem. CONCLUSION: infection control in the postoperative period is necessary, using antibiotics correctly and consciously, avoiding resistance of bacterial agents.

Complication of post-infectious bronchiolitis obliterans (Swyer-James syndrome) / Complicação de bronquiolite obliterante pós-infecciosa (Síndrome de Swyer-James-Macleod)

Summary Swyer-James syndrome is a complication of post-infectious bronchiolitis obliterans that causes inflammation and fibrosis of the bronchial walls. There are two types: asymptomatic, with most cases diagnosed in adults during routine radiological examinations; and symptomatic, most commonly found in children. Here, we report the case of a 6-year-old child with recurrent dyspnea since the age of 3, who showed signs and symptoms of bronchiolitis obliterans and radiological signs of bronchial wall thickening and air trapping. The clinical and radiological findings led to the diagnosis of Swyer-James syndrome. Treatment of this syndrome is intended to reduce the pulmonary lesions and improve the patient's quality of life.

Resumo A síndrome de Swyer-James-Macleod é uma complicação da bronquiolite pós-infecciosa, ocasionando inflamação e fibrose das paredes dos bronquíolos. Pode se manifestar de duas formas: assintomática, sendo a maioria diagnosticada na fase adulta, quando o paciente se submete a exames radiológicos de rotina, e a forma sintomática, que é mais encontrada em crianças. Relatamos um caso de uma criança de 6 anos de idade com crises de dispneia de repetição desde os 3 anos, apresentando sinais e sintomas de bronquiolite obliterante e sinais radiológicos de espessamento brônquico e aprisionamento aéreo. Por meio da clínica e achados radiológicos, foi feito o diagnóstico de síndrome de Swyer-James-Macleod. O tratamento dessa síndrome visa a reduzir as lesões pulmonares e a melhorar a qualidade de vida do paciente.

Survey of infection in orthopedic postoperative and their causative agents: a prospective study / Avaliação de infecção no pós-operatório ortopédico e seus agentes causadores: estudo prospectivo

SummaryObjective:to evaluate the cases of wound infections in orthopedic postoperative period.Methods:postoperative patients who developed infection during the period from November 2012 to November 2013 were studied. Secretions were collected during surgery using sterile swabs, and sent for microbiological analysis.Results:during the period analyzed, 38 surgical procedures progressed to infection. The type of surgery presenting the largest number of infections was osteosynthesis, in 36 (94.7%) patients. Among the materials used, 18 (36%) surgeries that used external fixator were infected, and 17 (34%) using plate. The species of bacteria that caused the largest number of infections were Staphylococcus aureus, infecting 16 (43.9%) patients, followed by Acinetobacter baumannii, which infected four (10.5%) patients. Regarding the resistance profile of Gram-positive strains to antibiotics, 100% of Staphylococcus aureus strains were susceptible to vancomycin and 31.3%, to ceftriaxone. As for the Gram-negative bacteria, 100% of Acinetobacter baumannii strains were resistant to ceftriaxone, gentamicin and imipenem.Conclusion:infection control in the postoperative period is necessary, using antibiotics correctly and consciously, avoiding resistance of bacterial agents.

ResumoObjetivo:avaliar os casos de feridas infectadas em pós- -operatório ortopédico.Métodos:foram estudados pacientes de pós-operatório que evoluíram com processo infeccioso, durante o período de novembro de 2012 a novembro de 2013. Foi realizada coleta intraoperatória de secreções com o auxílio de swabs estéreis, e o material foi encaminhado para análise microbiológica.Resultados:durante o período analisado, 38 procedimentos cirúrgicos evoluíram para processo infeccioso. O tipo de cirurgia que apresentou o maior número de infecções foi a osteossíntese, em 36 (94,7%) pacientes. Em relação ao material utilizado, 18 (36%) cirurgias que empregaram fixador externo e 17 (34 %) que fizeram uso de placa se infectaram. A bactéria que causou o maior número de infecções foi a Staphylococcus aureus, acometendo 16 (43,9%) pacientes, seguida pela Acinetobacter baumannii, que acometeu 4 (10,5%) pacientes. Em relação ao perfil de resistência das cepas Gram-positivas aos antibióticos, 100% das cepas de Staphylococcus aureus foram sensíveis à vancomicina, e 31,3%, à ceftriaxona. Quanto às bactérias Gram-negativas, 100% das cepas de Acinetobacter baumannii apresentaram resistência a ceftriaxona, gentamicina e imipenem.Conclusão:o controle de infecções em pós-operatório se faz necessário, utilizando antibióticos de forma correta e consciente, evitando a resistência aos agentes bacterianos.

Hepatitis B in Rondônia (Western amazon region, Brazil): descriptive analysis and spatial distribution.

BACKGROUND: The Amazon is one of the regions who have the highest rates of infection by the hepatitis B virus in the world. Objectives This study aimed to evaluate the epidemiological data and spatial distribution of hepatitis B cases reported between 2002 and 2012 in the Brazilian State of Rondônia. METHODS: Social and clinical data of these individuals were studied through the Information System for Notifiable Diseases (SINAN), including the following variables: gender, age group, vaccination, contact with a known patient with HBV, exposure to risk factors, source of infection, and clinical status. RESULTS: There were 7,132 cases reported in Rondônia, with an average incidence rate of 42/100,000 inhabitants per year. The municipalities with the highest incidence rates were Monte Negro (187.6/100,000 inhabitants) and Ariquemes (157.2/100,000 inhabitants). The 20-39 year-old age group had the highest number of cases (n = 3,834), and 69.9% of patients were likely infected via sexual contact. Regarding the clinical disease status, most of the patients (80.7%) were in the chronic phase. CONCLUSIONS: There was a recent 402% increase in the diagnosis of hepatitis B, which is likely owing to the improvements in the public diagnostic system. This highlights the need for public policies to prevent and control the disease.

HEPATITIS B IN RONDÔNIA (WESTERN AMAZON REGION, BRAZIL): descriptive analysis and spatial distribution / Hepatite B em Rondônia (região da Amazônia Ocidental, Brasil): análise descritiva e distribuição espacial

Background The Amazon is one of the regions who have the highest rates of infection by the hepatitis B virus in the world. Objectives This study aimed to evaluate the epidemiological data and spatial distribution of hepatitis B cases reported between 2002 and 2012 in the Brazilian State of Rondônia. Methods Social and clinical data of these individuals were studied through the Information System for Notifiable Diseases (SINAN), including the following variables: gender, age group, vaccination, contact with a known patient with HBV, exposure to risk factors, source of infection, and clinical status. Results There were 7,132 cases reported in Rondônia, with an average incidence rate of 42/100,000 inhabitants per year. The municipalities with the highest incidence rates were Monte Negro (187.6/100,000 inhabitants) and Ariquemes (157.2/100,000 inhabitants). The 20-39 year-old age group had the highest number of cases (n = 3,834), and 69.9% of patients were likely infected via sexual contact. Regarding the clinical disease status, most of the patients (80.7%) were in the chronic phase. Conclusions There was a recent 402% increase in the diagnosis of hepatitis B, which is likely owing to the improvements in the public diagnostic system. This highlights the need for public policies to prevent and control the disease. .

Contexto A Amazônia é uma das regiões que possui as maiores taxas de infecção pelo vírus da hepatite B do mundo. Objetivos Esse estudo teve como objetivo avaliar dados epidemiológicos e a distribuição espacial dos casos de hepatite B notificados no Estado de Rondônia no período de 2002 a 2012. Métodos Foram estudados dados clínicos e sociais desses indivíduos através do Sistema de Informação de Agravos de Notificação (SINAN). Foram analisadas as seguintes variáveis: gênero, faixa etária, vacinação, contato com paciente sabidamente portador do vírus hepatite B, exposição do paciente aos fatores de risco, fonte de infecção e forma clínica. Resultados Foram notificados 7.132 casos, tendo uma incidência de 42/100.000 habitantes por ano. Os municípios que apresentaram as maiores taxas de incidência foram Monte Negro, 187,6/100.000 habitantes e Ariquemes, 157,2/100.000 habitantes. A faixa etária com maior número de casos foi de 20-39 anos (n=3.834), sendo que 69,9% dos pacientes se infectaram provavelmente por via sexual. Em relação à forma clínica da doença, a maioria dos pacientes (80,7%) se encontra na fase crônica. Conclusão Houve um aumento do diagnóstico do vírus da hepatite B da ordem de 402% nos últimos anos, seguramente pela melhora no sistema de diagnóstico da doença, sendo necessário uma maior atenção das políticas públicas de prevenção e controle da doença em função de sua elevada prevalência. .

Occurrence and ppatial distribution of hepatitis c in a western Brazilian amazon sttee / Ocorrência e distribuição espacial da hepatite C em Estado da Amazônia Ocidental Brasileira

Context Hepatitis C causes a major impact on public health due to the high prevalence in the population. Objectives Evaluate the epidemiological data of hepatitis C in the State of Rondônia, Brazil. Methods Data from hepatitis C were analyzed during the period 2002 to 2012, assigned by the Agency for Sanitary Vigilance of the State of Rondônia. The variables studied were: year of diagnosis, gender, age, associated disease, exposure to risk factors and clinical presentation. Results Eight hundred fifty-nine cases were reported during the study period. Of this total, 542 (63.1%) cases were male. In relation to age group, the one with the highest number of cases was between 40-59 years (54%), followed by 20-39 years (33.5%). In relation to sexually transmitted diseases (STDs) association, 1.8% of patients had HIV and 2.1% other type of sexually transmitted disease. About exposure to risk factors, 288 (28.1%) individuals were exposed to a surgical procedure. Was also analyzed the clinical form of the disease, 9.9% are in acute disease and 91.1% in the chronic phase. Conclusions In the State of Rondônia, hepatitis C had a mean annual incidence of 5.1 cases/100,000 inhabitants, similar to the national rate. .

Contexto A hepatite C causa um grande impacto na saúde pública, devido à alta prevalência na população. Objetivos Avaliar os dados epidemiológicos da hepatite C no Estado de Rondônia, Brasil. Métodos Foram analisados os dados da hepatite C durante o período 2002 a 2012, cedidos pela Agência de Vigilância Sanitária do Estado de Rondônia. As variáveis estudadas foram: ano de diagnóstico, gênero, faixa etária, agravo associado, exposição a fatores de risco e forma clínica. Resultados Foram notificados 859 casos durante o período analisado. Desse total, 542 (63,1%) casos são do gênero masculino. Em relação à faixa etária, a que obteve o maior número de casos foi entre 40-59 anos (54%), seguida de 20-39 anos (33,5%). Em relação às doenças sexualmente transmissíveis associadas, 1,8% dos pacientes tinham HIV e 2,1% outro tipo de doença sexualmente transmissível. Sobre exposição a fatores de risco, 288 (28,1%) indivíduos foram expostos a algum procedimento cirúrgico. Também foi analisada a forma clínica da doença, sendo que 9,9% estão na aguda da doença e 91,1% na fase crônica. Conclusões No Estado de Rondônia, a hepatite C teve incidência média anual de 5,1 casos/100.000 habitantes, semelhante à taxa nacional. .

Hanseníase em Rondônia: incidência e características dos casos notificados, 2001 a 2012 / Leprosy in Rondonia: incidence and characteristics of reported cases, 2001-2012

Objetivo: descrever a incidência da hanseníase e as características dos casos notificados no estado de Rondônia, Brasil. Métodos: foi realizado estudo descritivo com dados do Sistema de Informação de Agravos de Notificação (Sinan) referentes ao período de 2001 a 2012; foi calculada a incidência por 100 mil habitantes e a distribuição percentual dos casos segundo variáveis de interesse. Resultados: no período de 2001 a 2012, foram notificados 15.648 casos de hanseníase, com média de 1.304 casos ao ano; a maior incidência foi observada no ano de 2003 (106,5/100 mil habitantes); a maior parte dos casos ocorreu entre homens (57,1 por cento); a forma clínica predominante foi a dimorfa (42,2 por cento); 46,6 por cento dos casos eram paucibacilares e 53,4 por cento multibacilares; e 6,6 por cento dos indivíduos notificados apresentavam grau II de incapacidade física. Conclusão: a ocorrência de hanseníase em Rondônia ainda é elevada, sendo o estado considerado hiperendêmico.

Objective: to describe the incidence of leprosy and characteristics of reported cases in the state of Rondônia, Brazil. Methods: a descriptive study was conducted using Notifiable Disease Information System data for the period 2001-2012. Incidence was calculated per 100,000 inhabitants and case distribution percentage was calculated according to variables of interest. Results: 15,648 leprosy cases were reported between 2001-2012, with an average of 1,304 cases per year. Highest incidence occurred in 2003 (106.5/100.000 inhabitants). Males were the most affected (57.1 per cent). The most common clinical presentation was borderline (42.2 per cent). 46.6 per cent of cases were paucibacillary and 53.4 per cent multibacillary. 6.6 per cent of individuals had grade 2 disability. Conclusion: the number of cases is still high in Rondônia and it is considered to be a hyperendemic state.

Paracoccidioidomycosis in a western Brazilian Amazon State: clinical-epidemiologic profile and spatial distribution of the disease.

INTRODUCTION: Paracoccidioidomycosis (PCM) is a systemic infection caused by the fungus Paracoccidioides brasiliensis. PCM is considered one of the most important systemic mycoses in Latin America. METHODS: This is a clinical, epidemiological, retrospective, quantitative study of PCM cases in patients attending the National Health Service in the State of Rondônia in 1997-2012. The examined variables included sex, age group, year of diagnosis, education level, profession, place of residence, diagnostic test, prior treatment, medication used, comorbidities and case progress. RESULTS: During the study period, 2,163 PCM cases were registered in Rondônia, and the mean annual incidence was 9.4/100,000 people. The municipalities with the highest rates were located in the southeastern region of Rondônia, and the towns of Pimenteiras do Oeste and Espigão do Oeste had the highest rates in the state, which were 39.1/100,000 and 37.4/100,000 people, respectively. Among all cases, 90.2% and 9.8% were observed in men and women, respectively, and most cases (58.2%) were observed in patients aged between 40 and 59 years. Itraconazole was used to treat 91.6% (1,771) of cases, followed by sulfamethoxazole in combination with trimethoprim (4.4% [85] of cases). One hundred thirty-one (6%) patients died. CONCLUSIONS: The State of Rondônia has a high incidence of PCM, and the municipalities in the southeastern region of the state were found to have the highest incidence rates of this disease. Our findings suggest that Rondônia is the state in the northern region with the highest mortality rate for PCM.

Perfil da aids em indivíduos acima de 50 anos na região amazônica / Aids profile in individuals over 50 years old in the Amazon region

O número de indivíduos acima de 50 anos no Brasil vem aumentando nos últimos anos, juntamente com a quantidade de casos de aids que atinge esta população. Esses indivíduos sofrem vários problemas sociais de familiares e dos profissionais da saúde após o diagnóstico da doença, pois estes ainda consideram o idoso um ser assexuado. Assim, o presente estudo teve como objetivo estudar os dados de aids em indivíduos com 50 anos ou mais no município de Porto Velho-RO. Os dados foram coletados na AGEVISA/RO com base nos dados epidemiológicos dos sistemas de informação de agravo de notificação Sinan NET e SinanW. As variáveis analisadas foram: faixa etária, gênero, modo de transmissão, ano de diagnóstico e evolução do caso. Foram notificados 1.668 casos de aids na faixa etária entre 14 e 81 anos, dos quais 15% (251) correspondiam a indivíduos acima de 50 anos, sendo 69,4% (175) homens e 30,4% (76) mulheres. O modo de transmissão do vírus mais comum foi relação sexual exclusiva com mulheres (144 casos) e o modo de transmissão com menor número de casos foi por transfusão sanguínea, com um caso. Na evolução dos casos, 191 pacientes estavam em tratamento e 54 foram a óbito. Houve aumento do número de indivíduos acima de 50 anos com aids na última década no município de Porto Velho-RO.

The number of individuals over 50 years in Brazil has increased in recent years along with the number of AIDS cases in this population. These individuals suffer from various social problems with family and health professionals after diagnosis, because these still consider the elder an asexual being. Thus, this study aimed to assess data on AIDS in individuals aged 50 or older in the city of Porto Velho, state of Rondonia, Brazil. Data were collected in AGEVISA / RO based on epidemiological data of information systems Sinan NET and SinanW. The variables analyzed were: age, gender, mode of transmission, year of diagnosis and outcome. Were reported 1,668 AIDS cases in the age group between 14 and 81 years, of which 15% (251) were individuals over 50 years, and 69.4% (175) were men and 30.4% (76) women. The most common mode of transmission of the virus was exclusive sexual relationship with women (144 cases) and transmission mode with a smaller number of cases by blood transfusion was having an affair. In the course of the disease, 191 patients were treated and 54 died. There was an increase in the number of individuals older than 50 years with AIDS in the last decade in the city of Porto Velho-RO.

Paracoccidioidomycosis in a western Brazilian Amazon State: Clinical-epidemiologic profile and spatial distribution of the disease

Introduction: Paracoccidioidomycosis (PCM) is a systemic infection caused by the fungus Paracoccidioides brasiliensis. PCM is considered one of the most important systemic mycoses in Latin America. Methods: This is a clinical, epidemiological, retrospective, quantitative study of PCM cases in patients attending the National Health Service in the State of Rondônia in 1997-2012. The examined variables included sex, age group, year of diagnosis, education level, profession, place of residence, diagnostic test, prior treatment, medication used, comorbidities and case progress. Results: During the study period, 2,163 PCM cases were registered in Rondônia, and the mean annual incidence was 9.4/100,000 people. The municipalities with the highest rates were located in the southeastern region of Rondônia, and the towns of Pimenteiras do Oeste and Espigão do Oeste had the highest rates in the state, which were 39.1/100,000 and 37.4/100,000 people, respectively. Among all cases, 90.2% and 9.8% were observed in men and women, respectively, and most cases (58.2%) were observed in patients aged between 40 and 59 years. Itraconazole was used to treat 91.6% (1,771) of cases, followed by sulfamethoxazole in combination with trimethoprim (4.4% [85] of cases). One hundred thirty-one (6%) patients died. Conclusions: The State of Rondônia has a high incidence of PCM, and the municipalities in the southeastern region of the state were found to have the highest incidence rates of this disease. Our findings suggest that Rondônia is the state in the northern region with the highest mortality rate for PCM. .

Occurrence and spatial distribution of hepatitis C in a Western Brazilian Amazon state.

CONTEXT: Hepatitis C causes a major impact on public health due to the high prevalence in the population. OBJECTIVES: Evaluate the epidemiological data of hepatitis C in the State of Rondônia, Brazil. METHODS: Data from hepatitis C were analyzed during the period 2002 to 2012, assigned by the Agency for Sanitary Vigilance of the State of Rondônia. The variables studied were: year of diagnosis, gender, age, associated disease, exposure to risk factors and clinical presentation. RESULTS: Eight hundred fifty-nine cases were reported during the study period. Of this total, 542 (63.1%) cases were male. In relation to age group, the one with the highest number of cases was between 40-59 years (54%), followed by 20-39 years (33.5%). In relation to sexually transmitted diseases (STDs) association, 1.8% of patients had HIV and 2.1% other type of sexually transmitted disease. About exposure to risk factors, 288 (28.1%) individuals were exposed to a surgical procedure. Was also analyzed the clinical form of the disease, 9.9% are in acute disease and 91.1% in the chronic phase. CONCLUSIONS: In the State of Rondônia, hepatitis C had a mean annual incidence of 5.1 cases/100,000 inhabitants, similar to the national rate.

Delta hepatitis in Rondônia: epidemiological analysis from 1999 to 2012 / Hepatite Delta em Rondônia: análise epidemiológica de 1999 a 2012

O vírus da hepatite Delta (VHD) é considerado um importante causador de doença hepática grave. Objetivo: Este estudo objetivou realizar uma análise epidemiológica dos casos diagnosticados em Rondônia. Métodos: Foi feito um estudo retrospectivo de 1999 a 2012, por meio de dados cedidos pela Agência Estadual de Vigilância em Saúde de Rondônia (AGEVISA RO). As variáveis analisadas foram: ano de diagnóstico, gênero, faixa etária, contato com paciente sabidamente portador do vírus da hepatite B (VHB), cor, vacinação, exposição aos fatores de risco, mecanismo de infecção e forma clínica. Resultados: Foram notificados 149 casos da doença, tendo uma incidência média de 0,7 casos/100.000 habitantes/ano; destes, 62,4% são do gênero masculino e 5,3% são gestantes. A faixa etária mais comum foi entre 20 e 39 anos. Sobre a vacinação da hepatite B, a mioria não tomou nenhuma dose da vacina. A forma mais comum de aquisição do vírus foi a sexual (71,8%), estando a grande maioria dos pacientes na fase crônica de doença (95,9%). Conclusão: A população acometida pelo vírus constituiu-se, principalmente, de homens na faixa etária sexualmente ativa, tendo como principal meio de transmissão a relação sexual. Observou-se baixa aderência da população acometida à vacinação; com isso, medidas de educação e conscientização da populaçãose fazem necessárias.

Hepatitis Delta virus (HDV) is considered an important cause of severe liver disease. Objective: This study aimed at an epidemiological analysis of cases diagnosed in Rondônia. Methods: A retrospective study from 1999 to 2012 was done through data provided by the State Agency of Health Surveillance of Rondônia (AGEVISA-RO). The variables analyzed were: year of diagnosis, gender, age, contact with patients known to have hepatitis B virus (HBV), ethnicity, caccination, exposure to risk factors, mechanism of infection and clinical manifestation. Results: 149 cases have been reported, with an average incidence of 0.7 cases per 100.000 inhabitants/year; 62,4% of these were males and 5,3%, females. The most common agre group was between 20 and 39 years. About hepatitis B vaccination, the majority took no vaccine dose. The most common route of transmission was sexual (71.8%), and most patients were in the chronic phase of the disease (95.9%). Conclusion: The population affected by the virus is mainly composed of men in the sexually active age group, with sexual intercourse as the main mode of transmission. Low adherence to vaccination by the population affected was observed; thereby, measures of education and public awareness are needed.