Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 802.560
Filtrar
1.
Einstein (Sao Paulo) ; 18: eRC5063, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553357

RESUMO

A 65-year-old male with a history of urinary tract trauma requiring cystotomy and chronic bladder catheterization, presenting with chronic and uninvestigated changes in the color of the urine bag system, with no urine color change, and positive urine culture for Proteus mirabilis . These characteristics refer to the purple urine bag syndrome, a not weel-known condition, with a benign course in most cases, and associated with urinary tract infection in patients with chronic bladder catheterization. Although it is characterized by marked changes, it is underdiagnosed by healthcare professionals.


Assuntos
Infecções Relacionadas a Cateter/microbiologia , Coletores de Urina/efeitos adversos , Infecções Urinárias/microbiologia , Idoso , Infecções Relacionadas a Cateter/patologia , Humanos , Masculino , Proteus mirabilis/isolamento & purificação , Fatores de Risco , Síndrome , Infecções Urinárias/patologia , Urina/microbiologia
2.
Int Heart J ; 60(5): 1176-1183, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31564708

RESUMO

Recently, the potential role of gut microbiome (GM) in cardiovascular diseases has been revealed. Heart failure (HF) is one of the most prevalent cardiovascular diseases worldwide; however, whether GM dysbiosis participates in the development of HF remains largely unknown. This study aimed to investigate the specific changes in GM composition and function in isoproterenol (ISO)-induced HF in rats.The rats were divided into C (control), 4w-HF (ISO, 2.5 mg/kg/day for 4 weeks, intraperitoneally), and 2w-HF (ISO, 2.5 mg/kg/day for 2 weeks, intraperitoneally) groups. The cardiac structure and function in rats were assessed, and metagenomic analyses were then performed. Compared with the healthy control group, we found that the Shannon diversity index and microbial gene count in the 4w-HF and 2w-HF groups was drastically decreased. High-throughput sequencing showed that the three groups differed in intestinal bacterial community composition. Overgrowth of bacteria, such as Prevotella, was observed in the 4w-HF group, with reduced growth of bacteria, such as Roseburia, Lactobacillus, and Butyrivibrio, associated with healthy status compared with the C group on the genus level. Concomitant with the alteration of GM composition, underrepresentation of health-linked microbial function was observed in both the 4w-HF and 2w-HF groups compared with the C group.Iso-induced HF rats showed a significant decrease in the diversity and richness of the intestinal microbiome, with a downregulation of the key intestinal bacterial groups and overgrowth of bacteria considered to be involved in inflammatory responses as well as a decrease in health-linked microbial function. Our data indicated that altered GM may be a potential player in the pathogenesis and progression of HF.


Assuntos
Bactérias/classificação , Microbioma Gastrointestinal/efeitos dos fármacos , Insuficiência Cardíaca/microbiologia , Isoproterenol/efeitos adversos , Metagenômica/métodos , Animais , Bactérias/genética , Modelos Animais de Doenças , Ecocardiografia , Insuficiência Cardíaca/induzido quimicamente , Insuficiência Cardíaca/diagnóstico por imagem , Sequenciamento de Nucleotídeos em Larga Escala , Injeções Intraperitoneais , Isoproterenol/farmacologia , Masculino , Filogenia , Ratos , Análise de Sequência de DNA
3.
Medicine (Baltimore) ; 98(38): e17185, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567961

RESUMO

Infections caused by Panton-Valentine leukocidin-positive Staphylococcus aureus (PVL-SA) mostly present as recurrent skin abscesses and furunculosis. However, life-threatening infections (eg, necrotizing pneumonia, necrotizing fasciitis, and osteomyelitis) caused by PVL-SA have also been reported.We assessed the clinical phenotype, frequency, clinical implications (surgery, length of treatment in hospitals/intensive care units, and antibiotic treatments), and potential preventability of severe PVL-SA infections in children.Total, 75 children treated for PVL-SA infections in our in- and outpatient units from 2012 to 2017 were included in this retrospective study.Ten out of 75 children contracted severe infections (PVL-methicillin resistant S aureus n = 4) including necrotizing pneumonia (n = 4), necrotizing fasciitis (n = 2), pyomyositis (n = 2; including 1 patient who also had pneumonia), mastoiditis with cerebellitis (n = 1), preorbital cellulitis (n = 1), and recurrent deep furunculosis in an immunosuppressed patient (n = 1). Specific complications of PVL-SA infections were venous thrombosis (n = 2), sepsis (n = 5), respiratory failure (n = 5), and acute respiratory distress syndrome (n = 3). The median duration of hospital stay was 14 days (range 5-52 days). In 6 out of 10 patients a history suggestive for PVL-SA colonization in the patient or close family members before hospital admission was identified.PVL-SA causes severe to life-threatening infections requiring lengthy treatments in hospital in a substantial percentage of symptomatic PVL-SA colonized children. More than 50% of severe infections might be prevented by prompt testing for PVL-SA in individuals with a history of abscesses or furunculosis, followed by decolonization measures.


Assuntos
Toxinas Bacterianas/metabolismo , Exotoxinas/metabolismo , Leucocidinas/metabolismo , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/metabolismo , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Tempo de Internação , Masculino , Pneumonia Necrosante/microbiologia , Estudos Retrospectivos , Infecções dos Tecidos Moles/microbiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/patologia , Infecções Estafilocócicas/terapia
4.
Dis Aquat Organ ; 136(1): 3-36, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31575832

RESUMO

With over 10000 species of Amphipoda currently described, this order is one of the most diverse groups of freshwater and marine Crustacea. Members of this group are globally distributed, and many are keystone species and ecosystem engineers within their respective ecologies. As with most organisms, disease is a key factor that can alter population size, behaviour, survival, invasion potential and physiology of amphipod hosts. This review explores symbiont diversity and pathology in amphipods by coalescing a range of current and historical literature to provide the first full review of our understanding of amphipod disease. The review is broken into 2 parts. The first half explores amphipod microparasites, which include data pertaining to viruses, bacteria, fungi, oomycetes, microsporidians, dinoflagellates, myxozoans, ascetosporeans, mesomycetozoeans, apicomplexans and ciliophorans. The second half reports the metazoan macroparasites of Amphipoda, including rotifers, trematodes, acanthocephalans, nematodes, cestodes and parasitic Crustacea. In all cases we have endeavoured to provide a complete list of known species that cause disease in amphipods, while also exploring the effects of parasitism. Although our understanding of disease in amphipods requires greater research efforts to better define taxonomic diversity and host effects of amphipod symbionts, research to date has made huge progress in cataloguing and experimentally determining the effects of disease upon amphipods. For the future, we suggest a greater focus on developing model systems that use readily available amphipods and diseases, which can be comparable to the diseases in other Crustacea that are endangered, economically important or difficult to house.


Assuntos
Anfípodes/microbiologia , Anfípodes/parasitologia , Anfípodes/virologia , Parasitos , Animais , Modelos Animais de Doenças , Ecossistema
5.
Cent Eur J Public Health ; 27(3): 235-238, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31580560

RESUMO

OBJECTIVES: Lyme disease (Lyme borreliosis) is a transmissible infection, common in the temperate climate zones. It is caused by a group of spirochetal bacteria known as Borrelia burgdorferi sensu lato complex. The aim of the present work was to investigate the incidence rate of borreliosis in different regions of Bulgaria and to identify possible risk factors for its occurrence. METHODS: National and regional borreliosis incidence rates for 2009-2018 were obtained from the public database of the National Centre of Public Health and Analyses. Their association with some socio-demographic variables and the geographic location (south or north) of the regions was tested with Spearman's correlation analysis and simple linear regression. RESULTS: The mean annual incidence for the last 10 years (2009-2018) in Bulgaria was 6.9 (range 4.1-11.6) cases per 100,000 inhabitants. We found that the Lyme disease was highly fluctuating at regional level with incidence rates varied from 0.3 to 30.9 per 100,000 inhabitants. Several regions showed significantly higher endemicity for the disease. Socio-demographic factors were not found to be important for Lyme disease frequency while the geographic location in the north part of the country was a significant risk factor for it. CONCLUSIONS: Lyme disease is a serious health risk in Bulgaria especially in its northern part - regions on the north are the most vulnerable to a higher incidence of the disease.


Assuntos
Borrelia burgdorferi , Ixodes , Doença de Lyme , Animais , Bulgária , Estudos Epidemiológicos , Humanos , Incidência , Ixodes/microbiologia , Doença de Lyme/epidemiologia
6.
Cent Eur J Public Health ; 27(3): 245-250, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31580562

RESUMO

OBJECTIVES: Urinary tract infections (UTIs) are common problems in women, and important reason for visiting primary care physicians, resulting in substantial financial burden to community. The aim of this study was to determine the resistance rates of E. coli to commonly prescribed antimicrobial drugs for community-acquired UTIs in women and to establish the association between age and resistance to antibiotics among isolates of E. coli from urine. METHODS: The study was designed as a retrospective cross-sectional study during the 5-years period. It was conducted on a sample of urinary tract isolates of E. coli taken from women with community-acquired UTIs. After prevalence of E. coli resistance to antibiotics was established, the analysis of risk factors for emergence of resistance was conducted. RESULTS: There were 10,734 isolates of E. coli, comprising 70.62% of all samples analyzed. E. coli was the most frequently resistant to ampicillin (54.68%), followed by trimethoprim-sulphamethoxazole (37.46%), first and second generation cephalosporins (cephalexin and cefaclor) (29.53% both), and ciprofloxacin (23.80%). Less than 50% of E. coli isolates was sensitive to all three tested antibiotics, and nearly 13% acquired triple-resistance. Prevalence of isolates resistant to two or three agents was higher in the subgroup of women older than 65 years. CONCLUSIONS: Empirical choice of antimicrobial agent for community-acquired non-complicated UTIs in women should be individualized on the basis of the patient's age, prevalence of resistance in the local community, and compliance history of the patient.


Assuntos
Anti-Infecciosos , Infecções por Escherichia coli , Escherichia coli/química , Infecções Urinárias , Estudos Transversais , Farmacorresistência Bacteriana , Escherichia coli/isolamento & purificação , Feminino , Humanos , Estudos Retrospectivos , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia
7.
Medicine (Baltimore) ; 98(38): e17215, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567977

RESUMO

The aim of the study is to explore whether monocyte-to-lymphocyte ratio (MLR) provides predictive value of the severity in patients with Klebsiella pneumonia infection (KPI).Patients in a tertiary medical center with Klebsiella pneumonia infection from 2014 to 2017 were recruited in this study. Patients with Klebsiella pneumonia infection were stratified into two groups based on the National Early Warning Score (NEWS). MLR was calculated by dividing monocytes count by lymphocytes count obtained from routine blood examination. The area under the curve (AUC) values was determined using the receiver-operating characteristic (ROC) curve. The correlation between the variables was tested with Pearson or Spearman correlation analysis. Ordinal logistic regression analysis was used to assess the relationship between MLR and the severity of Klebsiella pneumonia infection.One hundred fifty-two patients were finally enrolled for analysis. Among those, 43 (28.29%) cases had severe KPI. MLR was found to be an independent risk factor of the serious Klebsiella pneumonia infection (OR: 23.74, 95% CI: 5.41-104.11, P < .001). Besides, MLR was positively correlated with NEWS score (r = 0.57, P < .001). In the receiver-operating characteristic (ROC) curve analysis, MLR, with an optimal cut-off value of 0.665, predicted the severe coronary lesion with a sensitivity of 79.4% and specificity of 84.4%.MLR was an independent predictor of the severe Klebsiella pneumonia infection. Compared with neutrophil-to-lymphocyte ratio (NLR), MLR has a better performance to evaluate the severity of Klebsiella pneumonia infection.


Assuntos
Infecções por Klebsiella/diagnóstico , Klebsiella pneumoniae , Contagem de Leucócitos , Contagem de Linfócitos , Monócitos , Pneumonia Bacteriana/diagnóstico , Idoso , Feminino , Humanos , Infecções por Klebsiella/sangue , Infecções por Klebsiella/microbiologia , Masculino , Pneumonia Bacteriana/sangue , Pneumonia Bacteriana/microbiologia , Curva ROC , Fatores de Risco , Índice de Gravidade de Doença
8.
Water Sci Technol ; 80(3): 551-562, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31596266

RESUMO

Exposure to antibiotics, biocides, chemical preservatives, and heavy metals in different settings such as wastewater treatment plants (WWTPs) may apply selective pressure resulting in the enrichment of multiple resistant, co- and cross-resistant strains of bacteria. The purpose of this study was to identify and characterize potentially pathogenic triclosan (TCS) - and/or, chloroxylenol (PCMX) tolerant bacteria from sewage and river water in the North-West, Potchefstroom, South Africa. Several potential pathogens were identified, with Aeromonas isolates being most abundant. Clonal relationships between Aeromonas isolates found at various sampling points were elucidated using ERIC-PCR. Selected isolates were characterized for their minimum inhibitory concentrations against the biocides, as well as antibiotic resistance profiles, followed by an evaluation of synergistic and antagonistic interactions between various antimicrobials. Isolates were also screened for the presence of extracellular enzymes associated with virulence. High-performance liquid chromatography revealed the presence of both biocides in the wastewater, but fingerprinting methods did not reveal whether the WWTP is the source from which these organisms enter the environment. Isolates exhibited various levels of resistance to antimicrobials as well as several occurrences of synergy and antagonisms between the biocides and select antibiotics. Several isolates had a very high potential for virulence but further study is required to identify the specific virulence and resistance genes associated with the isolates in question.


Assuntos
Desinfetantes , Eliminação de Resíduos Líquidos , Águas Residuárias/microbiologia , Antibacterianos , Farmacorresistência Bacteriana/genética , Testes de Sensibilidade Microbiana , Rios , Esgotos , África do Sul
9.
Medicine (Baltimore) ; 98(39): e16976, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574796

RESUMO

RATIONALE: Halitosis is an unpleasant odor that emanates from the mouth. Studies show halitosis returns in a week, after treatment with PDT. Probably, bacteria living in the periodontal sulcus could recolonize the dorsum of the tongue. Until nowadays, there are no study in adult population that associates halitosis and periodontal treatment with follow-up evaluation. The aim of this randomized, controlled, single-blinded clinical trial is to treat oral halitosis in healthy adults with photodynamic therapy (PDT), associated with periodontal treatment and follow them up for 3 months. PATIENT CONCERNS:: the concerns assessments will be done over the study using anamnesis interviews and specific questionnaire. DIAGNOSES:: halitosis will be evaluated by OralChroma. INTERVENTIONS: The participants (n = 40) with halitosis will be randomized into 2 groups: G1-treatment with PDT (n = 20) or G2-cleaning of the tongue with a tongue scraper (n = 20). OUTCOMES: Halitosis will be evaluated by measuring volatile sulfur compounds using gas chromatography. After the treatments, a second evaluation will be performed, along with a microbiological analysis (RT-PCR) for the identification of the bacteria T. denticola. The assessment of halitosis and the microbiological analysis will be repeated. After that, patients will receive periodontal treatment. The participants will return after 1 week and 3 months for an additional evaluation. Quality of life will be measured by Oral Health Impact Profile questionnaire (OHIP-14). LESSONS: This protocol will determine the effectiveness of phototherapy regarding the reduction of halitosis in adults. clinicaltrials.gov NCT03996915. ETHICS AND DISSEMINATION: This protocol received approval from the Human Research Ethics Committee of Universidade Nove de Julho (certificate number: 3.257.104). The data will be published in a peer-reviewed periodical.


Assuntos
Halitose/tratamento farmacológico , Doenças Periodontais/terapia , Fotoquimioterapia , Cromatografia Gasosa , Seguimentos , Halitose/etiologia , Halitose/microbiologia , Humanos , Pessoa de Meia-Idade , Higiene Bucal , Doenças Periodontais/complicações , Doenças Periodontais/microbiologia , Fármacos Fotossensibilizantes/uso terapêutico , Recidiva , Método Simples-Cego , Resultado do Tratamento , Treponema denticola/isolamento & purificação
10.
Medicine (Baltimore) ; 98(39): e17339, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574872

RESUMO

INTRODUCTION: During the past decade, the rate of carbapenem resistance among Enterobacteriaceae, mostly in Escherichia coli and Klebsiella pneumoniae, has significantly increased worldwide. It is a great challenge for the choice of drug treatment especially in children.Tigecycline is the first drug in the glycylcycline class of antibiotics. For children, the China Food and Drug Administration and US Food and Drug Administration postulated that tigecycline is not recommended. It must be used only as salvage therapy for life-threatening infections in critically ill children who have no alternative treatment options. PATIENT CONCERNS: A male pediatric case of 4.5 months was blood stream infection after liver transplantation. The blood cultures obtained grew Gram-negative rods, which reportedly grew a strain of extended-spectrum ß-lactamase and carbapenemases-producing Escherichia coli within 10 hours. All bacterial isolates were found to be resistant to all antimicrobial agents except aminoglycosides and tigecycline. DIAGNOSES: Complicated intra-abdominal infection, central line-associated blood stream infection. INTERVENTIONS: The blood stream infection with carbapenem-resistant Escherichia coli after liver transplantation was cured by tigecycline. OUTCOMES: The patient's condition continued to improve, then transferred to general ward. CONCLUSION: The following report, to our knowledge, is the youngest liver transplantation patient who used tigecycline treatment around the world. It provides reference and experience for the use of tigecycline in infants with severe infections.


Assuntos
Antibacterianos/uso terapêutico , Enterobacteriáceas Resistentes a Carbapenêmicos , Infecções por Enterobacteriaceae/tratamento farmacológico , Infecções por Escherichia coli/tratamento farmacológico , Complicações Pós-Operatórias/tratamento farmacológico , Tigeciclina/uso terapêutico , Infecções por Enterobacteriaceae/microbiologia , Infecções por Escherichia coli/microbiologia , Humanos , Lactente , Transplante de Fígado/efeitos adversos , Masculino , Complicações Pós-Operatórias/microbiologia
11.
Medicine (Baltimore) ; 98(39): e17355, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574879

RESUMO

BACKGROUND: Molar incisor hypomineralization (MIH) is a change in the formation of dental enamel of systemic origin that affects at least one of the first 4 permanent molars and usually affects incisors. During the eruption, the affected surfaces tend to fracture, exposing the dentin, which causes excessive sensitivity in addition to making the region very susceptible to the appearance of carious lesions. The objective of this research will be to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) in permanent teeth with severe and sensitive MIH. METHODS: The methodology will be based on the selection of patients from 6 to 12 years of age with permanent molar teeth, randomly divided in 2 groups. The selected teeth should have MIH on the occlusal surface, indicated for clinical restorative treatment. In Group 1, aPDT will be applied for the treatment of infected dentin. Afterward, the teeth will be restored with high viscosity glass ionomer cement. In Group 2, the removal of the softened dentin around the side walls of the cavity with sharp dentine curettes and posterior restoration with high viscosity glass ionomer cement will be performed. All patients will have clinical and radiographic follow-up with a time interval of 6 and 12 months. The data obtained will be submitted to descriptive statistical analysis to evaluate the association of categorical variables. Chi-square test and Fisher exact test will be applied, to analyze the correlation between the continuous variables, Pearson correlation test will be applied. For the analysis of dentin density in the scanned radiographic images and the microbiological results for colony-forming units, ANOVA and Kruskal-Wallis will be applied. DISCUSSION: Often in the presence of severe MIH, the presence of dentin sensitivity is also associated with caries lesion, making it even more necessary to respect the principles of minimal intervention. TRIAL REGISTRATION: NCT03904641.


Assuntos
Anti-Infecciosos/uso terapêutico , Hipoplasia do Esmalte Dentário/tratamento farmacológico , Fotoquimioterapia/métodos , Criança , Hipoplasia do Esmalte Dentário/microbiologia , Dentina , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Resultado do Tratamento
12.
Medicine (Baltimore) ; 98(39): e17362, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574882

RESUMO

RATIONALE: Klebsiella pneumoniae infection can induce multiple invasive abscesses, and the invasive infection is severe and life-threatening. PATIENT CONCERNS: A 69-year-old previously healthy Chinese male presented with fever, chill, backache, and ocular pain. DIAGNOSIS: The blood culture results indicated Klebsiella pneumoniae of the K1 serotype. Multiple invasive abscesses in liver, lung, eye, soft tissue, and central nervous system were identified by imaging examination. Subsequently, the patient experienced right ocular pain accompanied by visual disturbance. Tyndall sign was strongly positive, and lens opacity was observed by the ophthalmologist. INTERVENTIONS: Full-dose and long-term treatment with meropenem was performed. Intraventricular injection of glass and anterior chamber puncture with antibiotics were performed twice. The patient also underwent an evacuation of the brain abscess. OUTCOMES: The patient's headache and lumbar backache were relieved, his ophthalmodynia disappeared, and his vision recovered after nearly 3 months of treatment. LESSONS: Imaging examination is very important for severe Klebsiella pneumoniae infection. The choice of antibiotics is complex, and the antimicrobial regimen should be adjusted according to the assessment of illness and the therapeutic effect. Surgical intervention must be considered for patients with multiple invasive abscesses.


Assuntos
Abscesso/microbiologia , Antibacterianos/uso terapêutico , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae , Meropeném/uso terapêutico , Idoso , Humanos , Masculino
13.
Medicine (Baltimore) ; 98(39): e17365, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574884

RESUMO

RATIONALE: Periorbital cellulitis or an orbital abscess caused by acute sinusitis is a serious acute infectious disease. If not treated in time, serious complications may occur. PATIENT CONCERNS: A 16-year-old girl with a history of right-sided proptosis, periorbital swelling, chemosis, hypophasis, restricted ocular movement in the upward direction, and diminution of vision was referred to our institution. The clinic, computed tomography (CT) and magnetic resonance imaging (MRI) examination indicate right orbital abscess in the upper quadrant and sinusitis. DIAGNOSES: She was diagnosed with orbital abscess, acute sinusitis. INTERVENTIONS: She underwent medical management, transnasal endoscopic surgery and then ultrasound-guided fine needle aspiration (FNA) and catheter drainage. OUTCOMES: She was completely cured without any complications or sequelae. LESSONS: Performance of surgical drainage in a timely manner and administration of effective antibiotic treatment according to bacterial culture can reduce the complications of orbital abscesses. Ultrasound-guided FNA and catheter drainage is a safe, simple, and effective method for the treatment of orbital abscess.


Assuntos
Abscesso/cirurgia , Drenagem/métodos , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Doenças Orbitárias/cirurgia , Sinusite/cirurgia , Abscesso/microbiologia , Doença Aguda , Adolescente , Cateteres , Drenagem/instrumentação , Feminino , Humanos , Doenças Orbitárias/microbiologia , Sinusite/microbiologia
14.
Medicine (Baltimore) ; 98(39): e17378, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574888

RESUMO

RATIONALE: Pulmonary tuberculosis and lung adenocarcinoma are highly prevalent pulmonary diseases associated with high mortality. However, the coexistence of lung cancer and pulmonary tuberculosis is rare. Further, the morphological features of lung cancer with coexisting pulmonary tuberculosis are similar to that of lung cancer without pulmonary tuberculosis, even though the lesion is predominantly cavity. For these reasons, the diagnosis in patients with coexisting lung cancer and pulmonary tuberculosis could be delayed until the advanced stage, and therefore, prognosis in these patients is worse compared with that of lung cancer patients without coexisting pulmonary tuberculosis. Therefore, early diagnosis of the condition is essential for initiating timely and suitable treatment. PATIENT CONCERNS: A 67-year-old man was detected abnormal finding on chest CT performed outside the hospital during health screening without significant symptom. DIAGNOSES: Chest CT revealed a 3.2, irregular, enhancing cavitary mass in right lower lobe of lung and PET-CT revealed significant uptake of 18 FDG by the cavitary mass, which was suggestive of lung cancer. Pathology results confirmed a diagnosis of coexisting lung adenocarcinoma and tuberculosis. INTERVENTIONS AND OUTCOME: The patient underwent a right lower lobectomy. No significant complications occurred in a 24 month post-surgery follow-up period LESSONS:: Although rare, the coexistence of lung adenocarcinoma and tuberculosis within a single lesion can occur. Therefore, early diagnosis of such a lesion is essential to improve the prognosis in affected patients.


Assuntos
Adenocarcinoma de Pulmão/microbiologia , Neoplasias Pulmonares/microbiologia , Tuberculose Pulmonar/microbiologia , Idoso , Humanos , Pulmão/microbiologia , Masculino , Tuberculose Pulmonar/complicações
15.
Altern Ther Health Med ; 25(5): 30-38, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31550680

RESUMO

Context: Small intestinal bacterial overgrowth (SIBO) has gained popularity on the internet in addition to certain clinical and research circles. This interest has expanded awareness of important new dietary, nutraceutical, and pharmaceutical treatments in addition to laboratory evaluation assessment options. Concomitantly, there appears a loss of parsimony regarding how to use these tools resulting in an untenable degree of testing and treatment for this condition. Objectives: A balanced review of the data regarding SIBO testing, treatment, and management with the goal of establishing non-biased best practices. Design: Non-systematic review. Results: The results for the review fall into two categories. Ineffective Action: Treat only SIBO labs; Treat for SIBO if no symptoms are exhibited; Recommending eating or avoiding foods because they might be good or bad for SIBO; Recommending treatments that are non-validated. Effective Action: Use SIBO breath results, in addition to history and current symptoms, to determine the best treatment; Find foods that work for patients based on dietary elimination and reintroduction; Apply validated treatment for SIBO and IBS in a logical 'step-up' like treatment approach. Conclusions: Testing and treating for SIBO can offer patients clinically significant relief. However, these tests and treatments must be applied with circumspection to prevent over-testing, over-treatment, squandering resources, or creating a fear around certain foods.


Assuntos
Infecções Bacterianas/diagnóstico , Enteropatias/microbiologia , Intestino Delgado/microbiologia , Síndrome do Intestino Irritável/microbiologia , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Testes Respiratórios , Dietoterapia , Fármacos Gastrointestinais , Humanos , Enteropatias/diagnóstico , Enteropatias/terapia
16.
Semin Vasc Surg ; 32(1-2): 68-72, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540659

RESUMO

The management of infection involving the abdominal aorta requires clinical decisions based on patient factors and the nature of the infectious process. Any infection occurring after endovascular aortic aneurysm repair or open aortic replacement grafting should be treated promptly with appropriate systemic antibiotic therapy. Once a vascular prosthesis becomes infected, surgical treatment is necessary. There should be a low threshold for graft excision and extra-anatomic bypass in the presence of fistula or abscess cavity, when feasible entire graft should be excised. In selected patients, graft excision with in situ aorta reconstruction is an appropriate option using an autogenous femoral vein, cryopreserved allograft, or a prosthetic graft impregnated with antibiotic. The replaced in situ aortic graft should be covered with an omental pedicle. For primary aortic graft infections, endovascular treatment may act as a bridge to more definitive treatment; or, in the absence of gross retroperitoneal infections, endovascular grafting alone with prolonged systemic antibiotic therapy is a viable option, particularly in patients not fit for open surgical procedures.


Assuntos
Aneurisma Infectado/cirurgia , Antibacterianos/uso terapêutico , Aorta Abdominal/cirurgia , Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular/efeitos adversos , Prótese Vascular/efeitos adversos , Remoção de Dispositivo/métodos , Procedimentos Endovasculares , Infecções Relacionadas à Prótese/cirurgia , Aneurisma Infectado/diagnóstico por imagem , Aneurisma Infectado/microbiologia , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/microbiologia , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/microbiologia , Implante de Prótese Vascular/instrumentação , Medicina Baseada em Evidências , Humanos , Infecções Relacionadas à Prótese/diagnóstico por imagem , Infecções Relacionadas à Prótese/microbiologia , Reoperação , Fatores de Risco , Resultado do Tratamento
17.
Semin Vasc Surg ; 32(1-2): 73-80, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540660

RESUMO

The use of autologous femoral veins for in situ reconstruction of the aortoiliac segment is an effective technique to treat native aorta or prosthetic graft infections. The indications, technical details, and outcomes of this procedure are detailed. Graft infection involving the aortic segment, while rare, remains one of the most challenging vascular surgery conditions to treat. The original technique of "neo-aortoiliac surgery" with in situ autologous vein grafts has evolved over the past 25 years and remains a worthwhile alternative for the treatment of aortic graft infections, with lower mortality rates compared with other extra-anatomic or in situ surgical options. Acceptance of this surgical option is due to low graft re-infection rates, rare graft disruption, and low long-term aneurysmal degeneration. Excision of the femoral veins is associated with acceptable rates of lower limb edema. The use of an autologous femoral vein graft can be considered the standard of care in selected patients for the management of aortic graft infections. Optimal management of patients with aortic graft infections requires consideration of all potential therapeutic options because no single modality can be used, and individualizing treatment according to the clinical condition will yield the best patient outcomes.


Assuntos
Aneurisma Infectado/cirurgia , Aorta/cirurgia , Aneurisma Aórtico/cirurgia , Implante de Prótese Vascular/efeitos adversos , Prótese Vascular/efeitos adversos , Veia Femoral/transplante , Infecções Relacionadas à Prótese/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Aneurisma Infectado/diagnóstico por imagem , Aneurisma Infectado/microbiologia , Aorta/diagnóstico por imagem , Aorta/microbiologia , Aneurisma Aórtico/diagnóstico por imagem , Aneurisma Aórtico/microbiologia , Implante de Prótese Vascular/instrumentação , Tomada de Decisão Clínica , Remoção de Dispositivo , Humanos , Seleção de Pacientes , Infecções Relacionadas à Prótese/diagnóstico por imagem , Infecções Relacionadas à Prótese/microbiologia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Reoperação , Fatores de Risco , Resultado do Tratamento
18.
Semin Vasc Surg ; 32(1-2): 81-87, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540661

RESUMO

Aortic graft infection remains one of the most complex clinical challenges faced by vascular specialists, and is often associated with significant patient morbidity and mortality regardless of the approach used for management. The cryopreserved aortic allograft is now a commonly used in situ aortic replacement in the management of graft infection, and is preferred over rifampin-soaked prosthetic grafts. In the review, we summarize the indications for cryopreserved aortic allograft usage, as well as operative technique, clinical results, and alternative treatments. We propose the use of a novel term tertiary aortic fistula, to distinguish aortic fistulae in the setting of aortic endograft infection, a clinical entity whose natural history and best management are currently being characterized.


Assuntos
Aorta/cirurgia , Implante de Prótese Vascular/efeitos adversos , Prótese Vascular/efeitos adversos , Vasos Sanguíneos/transplante , Criopreservação , Infecções Relacionadas à Prótese/cirurgia , Aloenxertos , Aorta/diagnóstico por imagem , Aorta/microbiologia , Implante de Prótese Vascular/instrumentação , Remoção de Dispositivo , Humanos , Infecções Relacionadas à Prótese/diagnóstico por imagem , Infecções Relacionadas à Prótese/microbiologia , Reoperação , Fatores de Risco , Resultado do Tratamento
19.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 285-290, 2019 Jul 26.
Artigo em Chinês | MEDLINE | ID: mdl-31544408

RESUMO

OBJECTIVE: To investigate the pathogenicity of Pneumocystis and its association with the development of chronic obstructive pulmonary disease (COPD). METHODS: The rat model of Pneumocystis pneumonia (PCP) was induced by intraperitoneal injection with dexamethasone, which was confirmed by pathogenic detection. The pathologic changes of rat lung specimens were examined using conventional HE staining, and the expression of inflammatory cells were detected by flow cytometry in bron-choalveolar lavage fluid (BALF) and splenic tissues of the rat model of PCP. In addition, the serum levels of matrix metalloproteinase 8 (MMP-8) and MMP-9 were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS: Fusion and atrophy of alveolar spaces and hyperplasia of lung tissue were seen in the lung specimens of the rat model of PCP, and foam-like alveolar exudates and infiltration of inflammation cells were observed in the alveolar space, while severe infections exhibited consolidation of lung, which was similar to pathological features of COPD. The counts of CD8+ T lymphocytes (t = -7.920 and -12.514, P < 0.01), macrophages (t = -7.651 and -14.590, P < 0.01) and granulocytes (t = -10.310 and -16.578, P < 0.01) significantly increased and the counts of CD4+ T lymphocytes (t = 6.427 and 18.579, P < 0.01) significantly reduced in the BALF and splenic specimens of the rats with PCP relative to those without PCP. In addition, higher serum MMP-8 (t = -8.689, P < 0.01) and MMP-9 levels (t = -7.041, P < 0.01) were measured in rats with PCP than in those without PCP. CONCLUSIONS: Pneumocystis infection may be associated with the development and progression of COPD.


Assuntos
Pneumocystis , Pneumonia por Pneumocystis , Doença Pulmonar Obstrutiva Crônica/etiologia , Animais , Líquido da Lavagem Broncoalveolar/microbiologia , Modelos Animais de Doenças , Pulmão/microbiologia , Pneumocystis/patogenicidade , Pneumonia por Pneumocystis/complicações , Pneumonia por Pneumocystis/microbiologia , Doença Pulmonar Obstrutiva Crônica/microbiologia , Ratos , Virulência
20.
Vet Parasitol ; 273: 97-104, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31473450

RESUMO

This study aimed to investigate the presence of the natural transovarial transmission of tick-borne pathogens in unfed larvae obtained from engorged female ticks from domestic animals in Turkey. Larvae (n = 4530, 151 pools) obtained from 75 engorged female ticks and female carcasses were screened for the presence of certain tick-borne pathogens by PCR. The presence of transovarial transmission of Babesia occultans was detected in Hyalomma marginatum and Hy. excavatum, while Ba. ovis in Rhipicephalus bursa. Theileria annulata was detected only in Hy. excavatum and Rh. turanicus female carcasses, but not in their examined progenies. Additionally, Rickettsia aeschlimannii and Rickettsia raoultii were detected in Hy. marginatum and Dermacentor marginatus females, respectively, and all their examined larvae. Besides, Ri. slovaca was detected in a De. marginatus female carcass and its one of two examined larvae pools. The presence of mixed Ba. occultans and Ri. aeschlimannii infection was also determined in an Hy. marginatum female and its larvae. This is the first demonstration of transovarial transmission of Ba. occultans in naturally infected Hy. excavatum. These data suggested that Hy. excavatum may act as vector in the natural cycle of Ba. occultans.


Assuntos
Infecções Bacterianas/veterinária , Infecções Protozoárias em Animais/transmissão , Doenças Transmitidas por Carrapatos/veterinária , Carrapatos/microbiologia , Carrapatos/parasitologia , Animais , Animais Domésticos/microbiologia , Animais Domésticos/parasitologia , Infecções Bacterianas/microbiologia , Infecções Bacterianas/transmissão , DNA Bacteriano/genética , DNA de Protozoário/genética , Feminino , Larva/microbiologia , Larva/parasitologia , Ovário/microbiologia , Ovário/parasitologia , Reação em Cadeia da Polimerase , Infecções Protozoárias em Animais/parasitologia , Doenças Transmitidas por Carrapatos/microbiologia , Doenças Transmitidas por Carrapatos/parasitologia , Doenças Transmitidas por Carrapatos/transmissão , Turquia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA