Mycobacterium abscessus subsp. bolletii keratitis: rare case reported in Brazil

In this report, we described a rare case of Mycobacterium abscessus subsp. bolletii keratitis in a young healthy male, in the absence of risk factors

Pulmonary functional assessment: longitudinal study after treatment of pulmonary tuberculosis

Even when treated adequately, pulmonary tuberculosis can lead to pulmonary sequelae. Patients treated for PTB between 2012 and 2016 answered a standardized questionnaire and underwent chest radiography and spirometry, measurement of absolute pulmonary volume, Diffusing Capacity for Carbon Monoxide (DLCO) and the 6-min walk test (6MWT) on two occasions: within the first year after the end of treatment (follow-up 1), and one and two years after follow-up 1 (follow-up 2). A total of 55 patients they underwent spirometry, 23 (41.82%) had obstructive ventilatory disorder (OVD) and eight (14.5%) had moderate OVD. In total, 29 patients underwent pulmonary function tests (PFTs) and 24 patients underwent the 6MWT on two occasions. The functional changes after PTB treatment appear not to have varied between one and two years of follow-up. There was a correlation between low FEV1 and low DLCO (p<0.001); low DLCO and low 6MWT (p<0.001) and radiographic abnormalities and low FEV1 (p=0.033). The most frequently observed change in spirometry was found in patients with OVD

Time elapsed between the first symptoms, diagnosis and treatment of oral cancer patients in Belo Horizonte, Brazil

Objective: One of the most important objectives of a public health service is early diagnosis of disease, which provides a better prognosis and reduction in treatment cost. We investigated the delay for diagnosis and treatment of oral cancer in a public hospital. Material and methods: One hundred eighty records of patients who attended for their first consultation in the department of head and neck surgery in a public hospital from Belo Horizonte?Brazil, between the period from 1 January 1999 to 31 December 2001 were analysed. The following variables were analyzed: gender, age, evolution time (ET), time elapsed from referral to hospital and first appointment (RT), time elapsed from first appointment and treatment (TT), total time elapsed from first noticing the lesion and starting treatment (TTE), sites and staging. Results: Results for males and females were, respectively: mean age = 57.9 and 60.8 years; ET= 169.4 and 215.4 days; RT = 27.9 and 40.6 days; TT = 40.9 and 44.9days; TTE = 207.9 and 263.8 days. No correlation was observed between age and TTE for either gender. Women presented the highest mean values for ET and TTE (p<0.01). Conclusion: It was concluded that public health policy should be developed to address the excessively long time lapsed between diagnosis and treatment as well as improve public health education programs to promote early oral cancer identification

Cuidados dietéticos e a dieta de poucos alimentos (few foods diets) como alternativa para o tratamento do Transtorno de Déficit de Atenção com Hiperatividade – TDAH

O Transtorno de Déficit de Atenção com Hiperatividade - TDAH, tem origem multifatorial e possui prevalência entre 5-6% na infância e 2-3% na fase adulta, havendo estudos que apontam eficácia da dietoterapia no combate a sua sintomatologia. Este trabalho busca promover reflexões a respeito dos cuidados dietéticos e dieta de poucos alimentos como intervenções aliadas ao tratamento de indivíduos com o TDAH, a partir da revisão narrativa de literatura, cuja seleção de literatura ocorreu utilizando as plataformas PubMed e Biblioteca Virtual em Saúde - BVS, com utilização dos seguintes descritores para buscas: (TDAH) AND (Nutrição, Dieta e Alimentação) para as buscas na BVS e (ADHD) AND (Diet, Food, and Nutrition) OR (few foods diets) para buscas na PubMed, cujas publicações tenham ocorrido nos últimos 5 anos (2018-2023). Ao longo do trabalho foram apresentadas discussões a respeito dos impactos dos alimentos ultraprocessados ao indivíduo com TDAH, a importância dos micronutrientes no tratamento do TDAH e a relação da dieta com poucos alimentos com o TDAH. Diante disso, a utilização da dieta de poucos alimentos, que considere a redução de alimentos ultraprocessados favorecendo a utilização de alimentos in natura e/ou minimamente processados a partir da orientação do profissional nutricionista, respeitando e promovendo a diminuição da eventual seletividade alimentar e déficit nutricional, emergem como ferramentas promissoras ao tratamento do TDAH. Cabendo, ainda, destacar o papel fundamental da atuação interprofissional para o bom andamento do tratamento e promoção de melhor qualidade de vida e saúde dos indivíduos com TDAH

Evaluation of the commercial kit SIRE Nitratase for detecting resistant Mycobacterium tuberculosis in Brazil

This study was supported by the Minas Gerais State Research Support Foundation (FAPEMIG) protocol number 65/10 and the National Council for Scientific and Technological Development [Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)] protocol number 310174/2014-7-CNPQ.Universidade Federal de Minas Gerais. Faculdade de Medicina. Grupo de Pesquisa em Micobactérias. Belo Horizonte, MG, Brasil.Universidade Federal de Minas Gerais. Faculdade de Medicina Grupo de Pesquisa em Micobactérias. Belo Horizonte, MG, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Universidade Federal de Minas Gerais. Faculdade de Medicina Grupo de Pesquisa em Micobactérias. Belo Horizonte, MG, Brasil.Universidade Federal de Minas Gerais. Faculdade de Medicina Grupo de Pesquisa em Micobactérias. Belo Horizonte, MG, Brasil.Universidade Federal do Rio de Janeiro. Programa Acadêmico de Tuberculose. Rio de Janeiro, RJ, Brasil.Universidade Federal de Minas Gerais. Faculdade de Farmácia. Belo Horizonte, MG, Brasil.Universidade Federal de Minas Gerais. Consultoria e Apoio Técnico. Belo Horizonte, MG, Brasil.Introduction: This study aimed to evaluate a new commercial kit, Kit SIRE Nitratase-PlastLabor, for testing the drug susceptibility of clinical Mycobacterium tuberculosis isolates. Methods: The accuracy of the Kit SIRE Nitratase was evaluated by examining the susceptibility (streptomycin, isoniazid, rifampicin, and ethambutol) of 40 M. tuberculosis isolates, using the proportion method with Lowenstein-Jensen medium or the BACTEC MGIT 960 system. Results: The detection accuracy for streptomycin, isoniazid, rifampicin, and ethambutol was 95%, 97.5%, 100%, and 80%, respectively. Conclusions: The exceptional accuracy demonstrated by Kit SIRE Nitratase for isoniazid and rifampicin makes the kit an attractive option for screening M. tuberculosis strain resistance

Queimaduras: fisiopatologia das complicações sistêmicas e manejo clínico / Burns: pathophysiology of systemic complications and clinical management

INTRODUÇÃO: As queimaduras são danos nos tecidos orgânicos em virtude de traumas térmicos em consequência da exposição ou contato com o calor,  substâncias químicas, radiação ou atrito, a qual resulta em complicações físicas e psicológicas.(SBCP,2008). OBJETIVO: O objetivo geral deste artigo é revisar sobre o entendimento da fisiopatologia e manejo clínico das queimaduras, com o enfoque na abordagem clínica e sistêmica no primeiro atendimento dos pacientes queimados. MATERIAIS E MÉTODOS: A revisão foi realizada nos bancos de dados nacionais e internacionais, tais como Scielo e PubMed, com artigos publicados entre 2000 e 2020.  RESULTADOS: Após análise dos artigos, foi analisada as alterações metabólicas, sendo  seus principais sintomas e sinais clínicos: obstrução aguda das vias aéreas superiores, broncoespasmo, oclusão das pequenas vias aéreas, infecção, sepse, lesão térmicas, hiperemia restrita à área queimada, hipovolemia e choque sistêmico. Assim, a literatura demonstra que o manejo correto e precoce no primeiro atendimento ao paciente queimado proporciona melhor desfecho clínico, evitando complicações sistêmicas mais graves e sequelas. DISCUSSÃO: A fisiopatologia da lesão traumática causada pela queimadura configura- se pelo comprometimento da integridade funcional da pele, rompendo a homeostase hidroeletrolítica e afetando o controle da temperatura corporal, a flexibilidade e a lubrificação da superfície corpórea.Nesse sentido, é notório que a queimadura pode acarretar na necrose tecidual, além de danificar outros sistemas do organismo, principalmente o respiratório e o cardiovascular.   CONCLUSÃO: A queimadura é caracterizada como problema de ordem pública, na qual é fulcral intervenção precoce no tratamento das lesões térmicas na derme e no manejo das complicações sistêmicas que abrangem alterações metabólicas, respiratórias, cardiovasculares e infecciosas , podendo provocar sepse e complicações para o paciente queimado

Association between migraine and aura, migrainous infarction and cortical laminar necrosis: a literature review/ Associação entre enxaqueca e aura, enxaqueca por enfarte e necrose laminar cortical: uma revisão bibliográfica

Introduction: Migraine infarction is one of the rare complications of migraine with aura, characterized by the persistence of aura symptoms for more than sixty minutes, associated with ischemic brain damage in the appropriate territory, demonstrated by neuroimaging examination. In spite of several cases reported in the literature correlate cerebral infarction with migraine, it is still unclear which magnetic resonance (MRI) pattern is associated with this condition. Cortical laminar necrosis (CLN) is a type of cortical infarction characterized by selective and late necrosis, especially in the third layer of the cerebral cortex, a region where there is greater vulnerability to metabolic stress. On MRI, CLN is characterized by an increase in cortical signal intensity on T1-weighted images with a typical curvaceous gyriform distribution. The goal of this study was to demonstrate, throughout a literature review, a possible association between migraine with aura, migraine infarction and cortical laminar necrosis without neuroimaging examination.Methods: A systematic research was performed in databases at the PubMed and Embase in February 2021. The search terms used for 'Migraine' or 'Migraine with aura' or 'Migrainous Infarction' combined with 'Cortical Laminar Necrosis', using their respective variations of the according as MeSH and Emtree. It was articles published in English, in pair reviewed journals, during any period and submitted to studies relevant to clinical questions, which revealed cases of Laminar Cortical Necrosis associated with migraine, were included. Studies that do not attempt the criteria, was excluded.Results and Discussion: The search for selected databases resulted in 24 articles. Excluding 14 articles were not chosen because they are not CLN, and 1 article published in conference abstracts that we did not choose for this review. Finally, 8 original studies were selected and critically analyzed in this review. There was a prevalence in hundred percent of the cases analyzed with migraine with aura (Table 1), and all of them manifested additional neurological symptoms. In two cases, the etiology was of familiar legacy of genetic origin, which consisted of a familial hemiplegic migraine. MR was performed days after the begining of symptoms, ranging from the 3rd to the 30th day. In all cases, was observed unilateral cortical hypersignal on axial T1-evaluation. Unilateral T1-evaluation cortical hyperintensity with Gadoliun and FLAIR was also identified in most of the cases. Less commonly, alterations to the DWI and ADC sequences are seen. Conclusion: Despite being a rare manifestation, this review demonstrates that CLN can be recognized as an attribute associated with migraine with aura, spread the spectrum of neuroimaging acts correlated with migraine. Our goal was narrow the boundaries between neurovascular disease on imaging and a migraine with aura, helping neurologists to recognize this association. Before this scene of high predominance of migraines, further studies are needed to elucidate its relationship with CLN, as its pathophysiology and group of patients with risk factors, who may benefit from prophylactic treatment

New evidence about the “dark side” of social cohesion in promoting binge drinking among adolescents

Adolescence is characterized by heightened susceptibility to peer influence, which makes adolescents vulnerable to initiating or maintaining risky habits such as heavy drinking. The aim of the study was to investigate the association of social capital with longitudinal changes in the frequency of binge drinking among adolescents at public and private high schools in the city of Diamantina, Brazil. This longitudinal study used two waves of data collected when the adolescents were 12 and 13 years old. At the baseline assessment in 2013 a classroom survey was carried out with a representative sample of 588 students. In 2014, a follow-up survey was carried out with the same adolescents when they were aged 13 years. The Alcohol Use Disorder Identification Test-C (AUDIT C) was employed for the evaluation of alcohol intake. Our predictor variables included sociodemographic and economic characteristics (gender, type of school, mother's education, family income) and Social Capital. For evaluation of social capital, we used the Social Capital Questionnaire for Adolescent Students (SCQ-AS). Descriptive and bivariate analyzes were performed (p <0.05). The log-binomial model was used to calculate prevalence ratios (PR) and 95% confidence intervals. The two-tailed p value was set at <0.05. The prevalence of binge drinking in 2013 was 23.1% and in 2014 the prevalence had risen to 30.1%. Gender (PR 1.48; 95% CI 0.87–2.52) and socioeconomic status (type of school and mother’s education) were not associated with the increase in the frequency of binge drinking. However, higher social capital was significantly associated with an increase in binge drinking by students. Adolescents who reported that they had an increase in social cohesion in the community/neighborhood subscale were 3.4 times more likely (95%CI 1.96–6.10) to binge drink themselves. Our results provide new evidence about the “dark side” of social cohesion in promoting binge drinking among adolescents

Nontuberculous mycobacteria in patients of a specialty hospital

The incidence and clinical characteristics of NTM diseases in Brazil remain relatively unknown. The present study describes the diagnosis of NTM isolates, the clinical presentation and treatment outcomes. We analyzed NTM isolates in patients of a tertiary hospital in the Southeast region of Brazil, from January 2008 to July 2019. The ATS/IDSA criteria for diagnosis and treatment of these patients was applied. Mycobacterium kansasii were identified in 13/113 (11.5%) patients. In 59/113 (52.2%) patients who met the ATS criteria for disease, 29/59 (49.1%) received treatment, and 22/29 (75.8%) were cured. The major species identified was M. kansasii. The most frequent symptoms among the treated patients were dyspnea and cough, and the proportion of cured patients was high

O uso indiscriminado de antibióticos nas infecções respiratórias agudas infantis na atenção primária

Os problemas de atenção primária à saúde em crianças, geralmente, envolvem infecções respiratórias agudas. Nesse viés, a antibioticoterapia é frequentemente usada para essas infecções. Desse modo, a resistência aos antibióticos é um problema crescente devido ao uso indiscriminado de antimicrobianos. Esta revisão objetiva identificar na literatura as causas e consequências da prescrição indiscriminada de antimicrobianos em IRAs causadas por vírus. Métodos: Trata-se de uma revisão integrativa da literatura. A busca na literatura foi realizada nas seguintes bases de dados: SciELO, ScienceDirect e PubMed. Resultado e Discussão: Nesta revisão, foram selecionados 12 artigos, no período compreendido entre 2017 e fevereiro de 2023. Da leitura e análise das publicações, ascenderam três núcleos temáticos: principais causas relacionadas à prescrição de antibioticoterapia para tratamento de infecções respiratórias agudas na atenção primária, consequências do uso indiscriminado de antibióticos e métodos de prevenção para o uso inadequado de antibióticos. Considerações finais: Infere-se que o uso indiscriminado de antibióticos nas IRAs decorre da falta de determinação da etiologia envolvida, do desconhecimento acerca do fármaco e seu uso, bem como a sua banalização. Nesse sentido, faz-se necessário políticas públicas de conscientização medicamentosa, bem como disponibilização de métodos diagnósticos nos centros de saúde