High-resolution computed tomography findings in young infants with cystic fibrosis detected by newborn screening

OBJECTIVE: High-resolution computed tomography (HRCT) allows the early detection of pathological changes in the lung structure, and reproducible scoring systems can be used to quantify chest computed tomography (CT) findings in patients with cystic fibrosis (CF). The aim of the study was to describe early HRCT findings according to a validated scoring system in infants with CF diagnosed by newborn screening (NBS). METHODS: This cross-sectional study included infants with CF diagnosed by NBS who were born between January 2013 and January 2017 and who underwent HRCT scanning within the first year after diagnosis when they were clinically stable. The CT scans were evaluated using the modified Bhalla score. RESULTS: Thirty-two subjects underwent HRCT scanning. The mean total-modified Bhalla score was 3.6±2.1, and 93.8% of the scans were abnormal. Pseudomonas aeruginosa airway colonization was associated with increased modified Bhalla score values. Bronchial wall thickening was the most common feature (90.6%), followed by bronchial collapse/consolidation (59.4%), mosaic attenuation/perfusion (50%), bronchiectasis (37.5%) and mucus plugging (15.6%). Bronchial wall thickening was diffuse in most of the patients. CONCLUSION: A substantial proportion of infants diagnosed with CF after detection by NBS already showed evidence of lung disease. P. aeruginosa colonization was associated with increased Bhalla scores, highlighting the importance of this CF pathogen in early structural lung disease. The presence of bronchial wall thickening at such a young age may reflect the presence of airway inflammatory processes. The detection and quantification of structural abnormalities with the modified Bhalla score may aid in the identification of lung disease before it is clinically apparent

Methicillin-resistant Staphylococcus aureus in cystic fibrosis patients: do we need to care? A cohort study

ABSTRACT CONTEXT AND OBJECTIVE: The prevalence of a variety of potentially pathogenic microorganisms in cystic fibrosis patients, such as methicillin-resistant Staphylococcus aureus (MRSA), has increased over the past decade. Given the increasing prevalence of MRSA and the few data available in the literature, better understanding of the clinical repercussions of colonization by this bacterium in cystic fibrosis patients becomes essential. This study aimed to evaluate the repercussions of chronic colonization by MRSA in cystic fibrosis patients. DESIGN AND SETTING: Retrospective cohort study from January 2004 to December 2013 in a cystic fibrosis reference center. METHODS: Each patient with cystic fibrosis was evaluated for nutritional status (body mass index, BMI, and BMI percentile), pulmonary function and tomographic abnormalities (modified Bhalla scores) at the time of chronic colonization by MRSA or methicillin-susceptible Staphylococcus aureus (MSSA) and throughout the study period. RESULTS: Twenty pairs of patients were included. There were no significant differences between the groups regarding nutritional characteristics. Spirometric data showed a trend towards greater obstruction of the airways in patients with MRSA. Patients with MRSA presented greater structural damage to their lungs, demonstrated not only by the total Bhalla score but also by its parameters individually. CONCLUSIONS: Patients colonized by MRSA presented greater functional and structural respiratory impairment at the time of chronic colonization. Disease progression was also faster in patients chronically colonized by MRSA than in those with MSSA. This was shown through comparisons that avoided possible confounding variables

Ergonomic risk: social representations of dental students

Objective: To learn the social representations of ergonomic risk prepared ​​by dental students. Methodology: This exploratory study, subsidized the Theory of Social Representations, with 64 dental students of an educational institution, by means of interviews. The data were processed in Alceste4.8 and lexical analysis done by the descending hierarchical classification. Results: In two categories: knowledge about exposure to ergonomic risk end attitude of students on preventing and treating injuries caused by repetitive motion. For students, the ergonomic risk is related to the attitude in the dental office. Conclusion: Prevention of ergonomic risk for dental students has not been incorporated as a set of necessary measures for their health and the patients, to prevent ergonomic hazards that can result in harm to the patient caused by work-related musculoskeletal disorder, which is reflected in a lower quality practice

Mastopatia linfocítica simulando neoplasia de mama: relato de caso

Made available in DSpace on 2015-06-08T14:06:19Z (GMT). No. of bitstreams: 2 Mastopatia linfocítica simulando neoplasia de mama relato de caso.pdf: 170548 bytes, checksum: b71cdfd746063d465b1911f3b6f3d55d (MD5) license.txt: 1914 bytes, checksum: 7d48279ffeed55da8dfe2f8e81f3b81f (MD5) Previous issue date: 2014Instituto de Pós-Graduação Médica Carlos Chagas. Rio de Janeiro, RJ, Brasil.Universidade Católica do Rio de Janeiro. Rio de Janeiro, RJ, Brasil. / Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Setor de Mastologia e do Ambulatório de Ginecologia. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Serviço de Radiologia. Rio de Janeiro, RJ, Brasil.Instituto de Pós-Graduação Médica Carlos Chagas. Rio de Janeiro, RJ, Brasil.A mastopatia linfocítica acomete mulheres jovens e de meia idade e está frequentemente associada a doenças autoimunes. Seu diagnóstico é feito associando achados clínicos (espessamento ou nódulo mamário endurecido), radiológicos (aumento da densidade mamária, nódulo e calcificações), ultrassonográficos (nódulo com sombra acústica posterior), histopatológicos (fibrose e infiltrado linfo-cítico) e imuno-histoquímicos. É uma entidade benigna que pode simular carcinoma. Neste artigo, relata-se um caso de paciente com mastopatia linfocítica.Lymphocytic mastopathy affects both young and middle-aged women and is frequently associated with autoimmune diseases. Diagnosis is done by associating clinical (breast tissue thickening or hardened breast lump), radiological (increased breast density, presence of mass and calcifications), sonographic (nodule with posterior acoustic shadowing), histopathological (fibrosis and lymphocytic infiltrate) and immunohistochemical findings. Lymphocytic mastopathy is a benign entity that may mimic carcinoma. The authors report the case of a patient with lymphocytic mastopathy

Urological assessment in 22 consecutive patients with confirmed Congenital Zika Syndrome.

<p>Urological assessment in 22 consecutive patients with confirmed Congenital Zika Syndrome.</p

Urodynamic parameters measured in 22 consecutive patients with Congenital Zika Syndrome and microcephaly.

<p>Urodynamic parameters measured in 22 consecutive patients with Congenital Zika Syndrome and microcephaly.</p

Urodynamic studies found on CZS patients.

<p>Urodynamic studies showing three different scenarios of overactive bladder found on CZS patients, all with high-risk urodynamic indicators known to cause progressive urinary system damage. A (case 1): Bladder behavior is normal at the beginning but a series of uninhibited detrusor contractions raises the bladder pressure during 2/3 of the filing phase. B (case 2): A very high and sustained inhibited detrusor contraction and a concomitant increased sphincter activity (detrusor-sphincter dyssynergia) raises the intravesical pressure up to 100 cm H₂0. The leak point pressure is equally dangerously high (110 cm H₂0). C (case 3): The repeated inhibited detrusor contractions starting at the very beginning of the filing phase, always followed by leak, severely reduces the bladder capacity.</p