Registros intra-arteriais da pressão versus registros indiretos em função da largura do manguito

We compared intra-arterial to auscultation blood pressure values using correct (CCW) or standard (SCW) cuff widths. Intra-arterial values were obtained from the radial artery using a digital monitor. Measurements were simultaneously made by two observers: one recorded intra-arterial values, while the other registered values by auscultation (brachial artery). Systolic intra-arterial pressure (mmHg) values were 125.04 vs. 119.75 (CCW), and 124.84 vs 116.39 (SCW). Diastolic pressure values were 68.72 vs. 73.26 (CCW), and 68.63 vs. 70,56 (SCW). Auscultation underestimated systolic pressure, particularly when SCW was used, whereas it overestimated diastolic pressure, when CCW was used. Auscultation using CCW yielded higher agreement of systolic pressure values and lower agreement of diastolic pressure values as compared to intra-arterial blood pressure measurementsComparamos valores de la presión intraarterial y auscultatoria, usando manguito rotador correcto (MLC) y patrón (MLP). Se obtuvo el valor intaarterial por punción radial y monitoreo digital. Dos observadores tomaron simultáneamente la medidas: unoregistró los valores intraarteriales, otro los auscultados (arteria braquial). La presión sistólica intraarterial (mmHg) fue de 125,04 comparada a 119,75 (MLC) y 124,84 comparada a 116,39 (MLP). La presión diastólica fue de 68,72 comparada a s 73,26 (MLC) y de 68,63 comparada as 70,56 (MLP). El método auscultatorio subestimó la presión sistólica, especialmente con el uso de MLP, y sobreestimó la diastólica, especialmente con el MLC. El MLC permitió mayor concordancia en la presión sistólica y menor en la diastólicaComparamos valores de pressão intrarteriais e auscultatórios, usando manguitos correto (MLC) e padrão(MLP). Obteve-se o valor intrarterial por punção radial e monitor digital. A medida foi feita simultaneamente por dois observadores: um registrou os valores intrarteriais, outro os auscultados (artéria braquial). A pressão sistólica intrarterial, em mmHg, foi 125,04 versus (vs) 119,75 (MLC) e 124,84 vs 116,39 (MLP). A pressão diastólica foi 68,72 vs 73,26 (MLC) e 68,63 vs 70,56 (MLP). O método auscultatório subestimou a pressão sistólica, especialmente com MLP, e superestimou a diastólica, especialmente com MLC. O MLC possibilitou maior concordância na pressão sistólica e menor na diastólic

Intra-arterial versus auscultation blood pressure values as a function of cuff width

Comparamos valores de pressão intrarteriais e auscultatórios, usando manguitos correto (MLC) e pa drão (MLP). Obteve-se o valor intrarterial por punção radial e monitor digital. A medida foi feita simultaneamen te por dois observadores: um registrou os valores intrarteriais, outro os auscultados (artéria braquial). A pres são sistólica intrarterial, em mmHg, foi 125,04 versus (vs) 119,75 (MLC) e 124,84 vs 116,39 (MLP). A pressão dias tólica foi 68,72 vs 73,26 (MLC) e 68,63 vs 70,56 (MLP). O método auscultatório subestimou a pressão sistólica, es pecialmente com MLP, e superestimou a diastólica, especialmente com MLC. O MLC possibilitou maior concor dância na pressão sistólica e menor na diastólica.Comparamos valores de la presión intraarterial y auscultatoria, usando manguito rotador correcto (MLC) y patrón (MLP). Se obtuvo el valor intaarterial por punción radial y monitoreo digital. Dos observado res tomaron simultáneamente la medidas: unoregistró los valores intraarteriales, otro los auscultados (arteria braquial). La presión sistólica intraarterial (mmHg) fue de 125,04 comparada a 119,75 (MLC) y 124,84 com parada a 116,39 (MLP). La presión diastólica fue de 68,72 comparada a s 73,26 (MLC) y de 68,63 comparada as 70,56 (MLP). El método auscultatorio subestimó la presión sistólica, especialmente con el uso de MLP, y so breestimó la diastólica, especialmente con el MLC. El MLC permitió mayor concordancia en la presión sis tólica y menor en la diastólicaWe compared intra-arterial to auscultation blood pressure values using correct (CCW) or standard (SCW) cuff widths. Intra-arterial values were obtained from the radial artery using a digital monitor. Measurements were simultaneously made by two observers: one recorded intra-arterial values, while the other registered values by auscultation (brachial artery). Systolic intra-arterial pressure (mmHg) values were 125.04 vs. 119.75 (CCW), and 124.84 vs 116.39 (SCW). Diastolic pressure values were 68.72 vs. 73.26 (CCW), and 68.63 vs. 70,56 (SCW). Aus cultation underestimated systolic pressure, particularly when SCW was used, whereas it overestimated diastolic pressure, when CCW was used. Auscultation using CCW yielded higher agreement of systolic pressure values and lower agreement of diastolic pressure values as compared to intra-arterial blood pressure measurements

Bartonella and Coxiella infective endocarditis in Brazil: molecular evidence from excised valves from a cardiac surgery referral center in Rio de Janeiro, Brazil, 1998 to 2009

SummaryPCR was used to detect Coxiella burnetii and Bartonella spp in heart valves obtained during the period 1998–2009 from patients operated on for blood culture-negative endocarditis in a cardiac surgery hospital in Brazil. Of the 51 valves tested, 10 were PCR-positive; two were positive for Bartonella and one for C. burnetii

Secondary infections in a cohort of patients with COVID-19 admitted to an intensive care unit: impact of gram-negative bacterial resistance

Some studies have shown that secondary infections during the COVID-19 pandemic may have contributed to the high mortality. Our objective was to identify the frequency, types and etiology of bacterial infections in patients with COVID-19 admitted to an intensive care unit (ICU) and to evaluate the results of ICU stay, duration of mechanical ventilation (MV) and in-hospital mortality. It was a single-center study with a retrospective cohort of patients admitted consecutively to the ICU for more than 48 h between March and May 2020. Comparisons of groups with and without ICU- acquired infection were performed. A total of 191 patients with laboratory-confirmed COVID-19 were included and 57 patients had 97 secondary infectious events. The most frequent agents were Acinetobacter baumannii (28.9%), Pseudomonas aeruginosa (22.7%) and Klebsiella pneumoniae (14.4%); multi-drug resistance was present in 96% of A. baumannii and in 57% of K. pneumoniae. The most prevalent infection was ventilator-associated pneumonia in 57.9% of patients with bacterial infections, or 17.3% of all COVID-19 patients admitted to the ICU, followed by tracheobronchitis (26.3%). Patients with secondary infections had a longer ICU stay (40.0 vs. 17 days; p < 0.001), as well as a longer duration of MV (24.0 vs 9.0 days; p= 0.003). There were 68 (35.6%) deaths overall, of which 27 (39.7%) patients had bacterial infections. Among the 123 survivors, 30 (24.4%) had a secondary infections (OR 2.041; 95% CI 1.080 - 3.859). A high incidence of secondary infections, mainly caused by gram-negative bacteria has been observed. Secondary infections were associated with longer ICU stay, MV use and higher mortality

Tratamento em massa para controle das helmintíases intestinais em área endêmica na Amazônia Brasileira

The objective of the present study was to estimate the prevalence of soil-transmitted helminthiasis and evaluate the sanitary conditions and the role of a mass treatment campaign for control of these infections in Santa Isabel do Rio Negro. A cross-sectional survey was carried out in 2002, to obtain data related to the sanitary conditions of the population and fecal samples for parasitological examination in 308 individuals, followed by a mass treatment with albendazole or mebendazole with coverage of 83% of the city population in 2003. A new survey was carried out in 2004, involving 214 individuals, for comparison of the prevalences of intestinal parasitosis before and after the mass treatment. The prevalences of ascariasis, trichuriasis and hookworm infection were 48%; 27% and 21% respectively in 2002. There was a significant decrease for the frequency of infections by Ascaris lumbricoides (p < 0.05; OR / 95% CI = 0.44 / 0.30 - 0.65), Trichuris trichiura (p < 0.05; OR / 95% CI = 0.37 / 0.22 - 0.62), hookworm (p < 0.05; OR / 95% CI = 0.03 / 0.01 - 0.15) and helminth poliparasitism (p < 0.05; OR / 95% CI = 0.16 / 0.08 - 0.32). It was also noticed a decrease of prevalence of infection by Entamoeba histolytica / dispar (p < 0.05; OR / 95% CI = 0.30 / 0.19 - 0.49) and non-pathogenic amoebas. It was inferred that a mass treatment can contribute to the control of soil-transmitted helminthiasis as a practicable short-dated measure. However, governmental plans for public health, education and urban infrastructure are essential for the sustained reduction of prevalences of those infections.O presente trabalho objetivou avaliar a prevalência e o papel de um tratamento em massa das helmintíases intestinais em Santa Isabel do Rio Negro, Estado do Amazonas, Brasil. Foi realizado em 2002 um estudo seccional, incluindo inquérito copro-parasitológico, objetivando a obtenção das prevalências das parasitoses intestinais e dados sobre as condições sanitárias do local, estudando-se uma amostra de 308 indivíduos. Em 2003 foi realizada intervenção para tratamento em massa das helmintíases intestinais com administração de albendazol (ou mebendazol para crianças entre 12 e 24 meses) na sede do município, alcançando-se 83% de cobertura. Novo inquérito copro-parasitológico foi realizado em 2004, para comparação das prevalências antes a após o tratamento. As prevalências das infecções por Ascaris lumbricoides, Trichuris trichiura e ancilostomídeos foram 48%, 27% e 21%, respectivamente em 2002. Em 2004 observou-se redução significativa das infecções por Ascaris lumbricoides (p < 0,05; OR / 95% IC = 0,44 / 0,30 - 0,65), Trichuris trichiura (p < 0,05; OR / 95% IC = 0,37 / 0,22 - 0,62), ancilostomídeos (p < 0,05; OR / 95% IC = 0,03 / 0,01 - 0,15) e poliparasitismo por helmintos intestinais (p < 0,05; OR / 95% IC = 0,16 / 0,08 - 0,32). Foi também observada redução da prevalência de infecção por Entamoeba histolytica/dispar (p < 0,05; OR / 95% CI = 0,30 / 0,19 - 0,49). Concluiu-se que o tratamento em massa pode auxiliar o controle das helmintíases intestinais, porém ações governamentais em infraestrutura urbana e educação são essenciais para uma redução sustentada das prevalências destas infecções

Endocardite Infecciosa: Ainda uma Doença Mortal

Short Editorial related to the article: Risk Factors for In-Hospital Mortality in Infective Endocarditis./ Minieditorial referente ao artigo: Fatores de Risco para Mortalidade Hospitalar na Endocardite Infecciosa.Submitted by Fábio Marques ([email protected]) on 2020-03-16T13:59:37Z No. of bitstreams: 2 ve_Cristiane_Lamas_INI_2020.pdf: 156352 bytes, checksum: c0412442e4e355954368c35ced384792 (MD5) ve_Cristiane_Lamas_INI_2020_portuguese.pdf: 167724 bytes, checksum: 32872e15ac183b97def2086136666c6e (MD5)Approved for entry into archive by Regina Costa ([email protected]) on 2020-03-18T18:44:15Z (GMT) No. of bitstreams: 2 ve_Cristiane_Lamas_INI_2020.pdf: 156352 bytes, checksum: c0412442e4e355954368c35ced384792 (MD5) ve_Cristiane_Lamas_INI_2020_portuguese.pdf: 167724 bytes, checksum: 32872e15ac183b97def2086136666c6e (MD5)Made available in DSpace on 2020-03-18T18:44:15Z (GMT). No. of bitstreams: 2 ve_Cristiane_Lamas_INI_2020.pdf: 156352 bytes, checksum: c0412442e4e355954368c35ced384792 (MD5) ve_Cristiane_Lamas_INI_2020_portuguese.pdf: 167724 bytes, checksum: 32872e15ac183b97def2086136666c6e (MD5) Previous issue date: 2020Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Centro Hospitalar. Rio de Janeiro, RJ, Brasil./ Department of Critical Care, Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, Brasil./ Coordenação de Ensino e Pesquisa, Instituto Nacional de Cardiologia./ Universidade do Grande Rio. Rio de Janeiro, RJ, BrasilA importante questão da mortalidade intra-hospitalar em endocardite infecciosa (EI) é discutida por Marques et al., A mortalidade intra-hospitalar na coorte International Collaboration in Endocarditis (ICE) (2000-2005) foi de 18%, semelhante à taxa de 17% na grande coorte europeia publicada recentemente, inaceitavelmente altas, considerando que a maioria dos pacientes incluídos era de países desenvolvidos e registros voluntários.The important issue of in-hospital mortality in infective endocarditis (IE) is discussed by Marques et al. In-hospital mortality in the International Collaboration in Endocarditis (ICE) cohort (2000-2005) was 18%, similar to the 17% in the large European cohort recently published, both unacceptably high, considering that most patients included were from developed countries and voluntary registries

tabel hospitalization per episode

We prepared a database in Access 2003 (Microsoft Corporation) for insertion of data collected. Later these data were transported to a table Excel (Microsoft Corporation) l. The patient-related variables were: age, sex, comorbidities (diabetes, hypertension, rheumatic fever, cancer, HIV and others), allergies, type of microorganism responsible for IE, type of valve at the beginning of the episode, presence of pacemaker or device as internal defibrillator, history of EI, source of acquisition of IE, echocardiographic data (evidence of vegetation, perforation, abscess and fistula), clinical data, date of commencement of treatment, total days planned for the end of treatment, antibiotics, indication for surgery and patient's fate

Data from: Adverse events related to intravenous antibiotic therapy: a prospective observational study in the treatment of infective endocarditis

Objective: The goal of this prospective observational present study was to identify adverse events (AEs) related to the use of intravenous access sites for infective endocarditis (IE) treatment in a tertiary care hospital that can occur during patient care that cannot be attributed to the underlying disease and may result in lengthening of hospital stay or death. Design: This is an observational, analytical and prospective study on AEs resulting from the use of intravenous access sites in patients under antimicrobial treatment for IE. Patients enrolled in the International Collaboration on Endocarditis (ICE) study had their peripheral, short term central catheters (CVC) and peripherally inserted central catheters (PICC) monitored for AEs. Setting: Tertiary care hospital for cardiac surgery in Rio de Janeiro, Brazil. Patients: Patients over 18 years of age, hospitalized in 2009 and 2010 with definite criteria for IE by the modified Duke criteria were included. Main outcome measures: Adverse events related to intravenous catheters: erythema and infiltration, fever, obstruction, externalization and blood stream infection. Results: Thirty-seven episodes of IE in 35 patients were studied. Mean age was 44.32 ± 15.2 years; 22 (63%) were male. 253 vascular catheters were studied, 148 peripheral, 85 CVC (21 of which for haemodialysis) and 20 PICC. The most frequent AEs were “erythema” and “infiltration” for peripheral catheters, “fever” for CVCs, and “obstruction” and “externalization” for PICCs. The number of catheter-days was 360 for peripheral catheters, 1.156 for CVC and 420 for PICC. Kaplan Meier curves for CVC and PICC showed statistical difference for obstruction (p<0.001) in PICCs. More bacteraemia occurred in CVC compared to PICC. Conclusion: The choice of intravenous access sites is critical in the treatment of IE. Close observation for adverse events and stricter implementation of infection control measures and better manipulation of catheters are suggested