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J Glob Infect Dis ; 11(1): 47-49, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30814836


Spilled gallstones during laparoscopic cholecystectomy (LC) are common. Lost gallstones can lead to complications such as intra-abdominal abscesses, which can occur days, months, or even years after the procedure. Citrobacter koseri belongs to the family of Enterobacteriaceae. It is a low-virulence pathogen; however, it is linked to infections of the urinary tract and abdomen. We report the case of a 70-year-old diabetic male who presented with C. koseri- associated subhepatic abscess. Two years prior, he had emphysematous cholecystitis and liver abscess caused by C. koseri. During his LC, gallstones were spilled in the abdominal cavity and every effort was made to retrieve them. However, 2 years later, an aspiration of the subhepatic abscess revealed cholesterol fragments. We hypothesize that dislodged cholesterol gallstones and bile, contaminated with C. koseri, were the culprits for the appearance of the subhepatic abscess with the same organism 2 years after the LC.

Emerg Infect Dis ; 25(6): 1241-1243, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30844358


We report a case of infection with New York orthohantavirus in a woman who showed renal impairment and hemorrhage, complicated by hydrocephalus, in Long Island, New York, USA. Phylogenetic analysis showed that this virus was genetically similar to a New York orthohantavirus isolated in the same region during 1993.

Infecções por Hantavirus/diagnóstico , Infecções por Hantavirus/virologia , Hantavirus , Hidrocefalia/diagnóstico , Insuficiência Respiratória/diagnóstico , Biomarcadores , Feminino , Hantavirus/classificação , Hantavirus/genética , Hantavirus/imunologia , Hantavirus/isolamento & purificação , Infecções por Hantavirus/complicações , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Hidrocefalia/etiologia , Hemorragias Intracranianas/diagnóstico , Hemorragias Intracranianas/etiologia , Pessoa de Meia-Idade , RNA Viral , Insuficiência Respiratória/etiologia , Testes Sorológicos , Avaliação de Sintomas
Ticks Tick Borne Dis ; 10(2): 407-411, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30573383


In North America, Lyme disease (LD) is caused predominantly by the spirochete Borrelia burgdorferisensu stricto, and is transmitted by blacklegged ticks. Long Island, New York, is highly endemic for the disease. The C6 peptide (C6P) is currently used as a screening test for LD in our institution. Our objective was to examine how screening with C6P concorded with diagnosis of LD at the Veterans Affairs Medical Center, Northport, Long Island. A retrospective chart-review of 2558 C6P tests was performed during the period of 1/1/2010 to 12/31/2016. Patients were categorized by Lyme Disease (LD) or no LD groups. LD group was defined as having an erythema migrans (EM) rash, or ≥ 2 IgM bands or ≥ 5 IgG bands on immunoblot. Out of the 409 patients with positive or equivocal C6P, 181 patients with LD were based on presence of EM, or Western blot IgM and IgG test results; 228 did not have LD. The positive predictive value of C6P was 44.5%. EM was the most common presentation. In the LD group, history of tick bite (P: 0.0001), headache (P: 0.0036), joint swelling (P: 0.0086) and myalgias (P: 0.0005) were more likely to be present. Zip code mapping of our cases mirrored those previously reported in the Suffolk County Department of Health. In our review we encountered a significant number of false positive C6 assays. False positive C6P tests were ordered by primary care physicians (PCP) (37%) followed by neurologists (33%). A history of tick exposure and clinical findings of early Lyme disease such as headaches or joint aches were more likely to denote a true positive C6 peptide test. Rigorous education of physicians about Lyme disease and pitfalls of our available diagnostic tests are needed for their proper utilization.

Proteínas de Bactérias/sangue , Doença de Lyme/epidemiologia , Peptídeos/sangue , Veteranos , Idoso , Anticorpos Antibacterianos/sangue , Artralgia/etiologia , Borrelia , Doenças Endêmicas , Eritema Migrans Crônico/microbiologia , Reações Falso-Positivas , Feminino , Cefaleia/etiologia , Humanos , Immunoblotting , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Doença de Lyme/diagnóstico , Masculino , Pessoa de Meia-Idade , New York/epidemiologia , Estudos Retrospectivos , Picadas de Carrapatos/epidemiologia
J Glob Infect Dis ; 10(4): 226-227, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30581266


We report the case of a middle aged man, 43-pack-years active smoker, who upon radiographic screening for lung cancer found to have a non-spiculated lung nodule concerning for malignancy. Histologic evaluation of this lesion turned out to be a nodule due to Histoplasma capsulatum.

Prim Care ; 44(4): 599-607, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29132522


Nonalcoholic fatty liver disease (NAFLD) defines a condition of hepatic steatosis with or without hepatic injury. NAFLD is increasing in prevalence worldwide and presents a public health burden. Most patients are asymptomatic, although some present with fatigue and right upper quadrant pain. NAFLD is discovered incidentally when patients have elevated liver enzymes or fatty liver is seen on imaging modalities. Imaging studies can confirm fatty deposits in the liver, but needle biopsy is needed to determine degree of inflammation. The mainstay of treatment is weight loss and controlling diabetes and hyperlipidemia. Liver transplantation is considered when disease progresses to cirrhosis.

Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/terapia , Biópsia com Agulha de Grande Calibre , Diabetes Mellitus/epidemiologia , Humanos , Hiperlipidemias/epidemiologia , Testes de Função Hepática , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Atenção Primária à Saúde , Perda de Peso
Cancer Lett ; 310(1): 101-8, 2011 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-21775057


Variably-spliced prolactin receptors (PRLRs) and PRL are expressed by the ovarian cancer cell lines, TOV-112D, OV-90 and TOV-21G. Incubation in the PRLR antagonists, G129R- or S179D-PRL, or anti-PRL reduced cell number, indicating a functional autocrine PRL growth loop. Added PRL promoted, and the antagonists decreased, cell migration. When cells were stressed, added PRL decreased apoptosis and increased survival, and the antagonists had the opposite effect. Cells expressing higher long:short PRLR ratios had increased growth, survival and migration in response to PRL. Results suggest that PRLR antagonists may be therapeutically beneficial in ovarian cancer.

Movimento Celular/efeitos dos fármacos , Prolactina/farmacologia , Receptores da Prolactina/antagonistas & inibidores , Proteínas Recombinantes/farmacologia , Apoptose/genética , Western Blotting , Adesão Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Fragmentação do DNA/efeitos dos fármacos , Relação Dose-Resposta a Droga , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Microscopia Confocal , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/metabolismo , Neoplasias Ovarianas/patologia , Prolactina/genética , Prolactina/metabolismo , Isoformas de Proteínas/antagonistas & inibidores , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Receptores da Prolactina/genética , Receptores da Prolactina/metabolismo , Proteínas Recombinantes/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa