História, memória e memorialistica

História, memória e memorialistic

Comparação entre quatro métodos usuais de identificação de espécies de Candida

Infection by Candidaspp. is associated with high mortality rates, especially when treatment is not appropriate and/or not immediate. Therefore, it is necessary to correctly identify the genus and species of Candida. The aim of this study was to compare the identification of 89 samples of Candidaspp. by the manual methods germ tube test, auxanogram and chromogenic medium in relation to the ID 32C automated method. The concordances between the methods in ascending order, measured by the Kappa index were: ID 32C with CHROMagar Candida(κ = 0.38), ID 32C with auxanogram (κ = 0.59) and ID 32C with germ tube (κ = 0.9). One of the species identified in this study was C. tropicalis,which demonstrated a sensitivity of 46.2%, a specificity of 95.2%, PPV of 80%, NPV of 81.1%, and an accuracy of 80.9% in tests performed with CHROMagar Candida;and a sensitivity of 76.9%, a specificity of 96.8%, PPV of 90.9%, NPV of 91%, and an accuracy of 91% in the auxanogram tests. Therefore, it is necessary to know the advantages and limitations of methods to choose the best combination between them for a fast and correct identification of Candidaspecies.A infecção por Candidaspp. está associada com alta mortalidade, principalmente quando o tratamento não é adequado, nem imediato. Assim, a correta identificação do gênero e espécie é necessária. O objetivo deste trabalho foi comparar 89 amostras de Candidaspp. pelos métodos manuais prova do tubo germinativo, auxanograma e CHROMagar em relação ao método automatizado ID 32C. As concordâncias entre os métodos em ordem crescente, medidas pelo coeficiente de Kappa, foram: ID 32C com CHROMagar Candida(κ = 0,38), ID 32C com auxanograma (κ = 0,59) e ID 32C com tubo germinativo (κ = 0,9). Uma das espécies identificadas neste trabalho foi a C. tropicalis, que demonstrou uma sensibilidade de 46,2%, especificidade de 95,2%, VPP de 80%, VPN de 81,1% e acurácia de 80,9% nos testes com CHROMagar Candidae uma sensibilidade de 76,9%, especificidade de 96,8%, VPP de 90,9%, VPN de 91% e acurácia de 91% nos testes de auxanograma. Portanto, o conhecimento das vantagens e limitações dos métodos é necessário para a escolha da melhor combinação entre os mesmos visando uma rápida e correta identificação das espécies de Candida

Evaluation of sound pressure levels in a pediatric intensive care unit

This study objectives were to measure the sound pressure levels found in the pediatric intensive care unit in a federal institution of Rio de Janeiro; to verify differences in noise levels during the morning and afternoon; to confront the sound pressure levels found against acceptable levels according to national and international noise organizations; to count the quantity of alarms triggered by each type of medical care equipment selected (multiparameter monitor, mechanical ventilator and infusion pump); to verify the relevance in the scientific world about pediatric intensive care unit noise through bibliometrics and to address the trinomial care technology - noise - implications on care. It’s an observational, exploratory, quantitative study, organized in three steps: Parameter collection and decibel meter calibration - data were based on the study by Salú, et al (2015) ; Data collection: 40 hours of discontinued observation (8am to 16pm) on different days for a period two months using two decibel meters; Data processing: An Excel spreadsheet was created for the database and data analysis was performed with the help of Microsoft Office Excel 2010 and Program R, organized into graphs and tables. 61% of the alarms corresponded to the mechanical ventilator; Bed E had the lowest standard deviation (SD = 2.945) and the highest median (69.5dBA). Even by removing the E bed from the analysis, there is a significant difference (p <0.001) between sound pressure levels. The median of the afternoon (28.2dBA); and morning (26.1dBA). Mechanical fan and monitor generated higher sounds; the pediatric intensive care unit has considerably exceeded that recommended by national and international noise organizations; afternoon generated higher sounds than morning. Keywords: Noise Meters; Noise; Intensive care; Pediatric

Liver abscess in a patient with fever of undetermined origin- case report

Abscesso hepático é o tipo mais comum de abscesso visceral. Sua prevalência é estimada em 2,3 casos por 100.000 pessoas anualmente e é maior entre homens do que mulheres. O abscesso hepático pode vir acompanhado por sinais e sintomas comuns a outras doenças como febre, emagrecimento e dor no hipocôndrio direito. Dessa forma, o diagnóstico essencialmente clínico é difícil de ser estabelecido. O artigo objetiva discutir o abscesso hepático em paciente com febre de origem indeterminada (FOI), através do relato de caso de um paciente de 43 anos que, dentre outros sintomas, apresentava tosse. O quadro clínico associado a aspectos epidemiológicos, levantaram a suspeita inicial de afecções respiratórias, o que postergou o diagnóstico de abscesso hepático.Liver abscess is the most common type of visceral abscess. The prevalence is estimated at 2.3 cases per 100,000 people annually and is higher among men than women. Liver abscess may be accompanied by signs and symptoms common to other diseases such as fever, weight loss and pain in the right hypochondrium. Thus, the essentially clinical diagnosis is difficult to establish. The article aims to discuss liver abscess in a patient with fever of unknown cause, through the case report of a 43-year-old patient who, among other symptoms, had cough. The clinical condition associated with epidemiological aspects raised the initial suspicion of respiratory disorders, which delayed the diagnosis of liver abscess

TLR9 activation dampens the early inflammatory response to paracoccidioides brasiliensis, Impacting host survival

Background: Paracoccidioides brasiliensis causes paracoccidioidomycosis, one of the most prevalent systemic mycosis in Latin America. Thus, understanding the characteristics of the protective immune response to P. brasiliensis is of interest, as it may reveal targets for disease control. The initiation of the immune response relies on the activation of pattern recognition receptors, among which are TLRs. Both TLR2 and TLR4 have been implicated in the recognition of P. brasiliensis and regulation of the immune response. However, the role of TLR9 during the infection by this fungus remains unclear.J.F. Menino was supported by a grant from Fundacao para a Ciencia e Tecnologia (FCT), Portugal (SFRH/BD/33446/2008). This work was supported by a grant from FCT (PTDC/BIA-MIC/108309/2008). M. Saraiva is a Ciencia 2007 fellow and M. Sturme is a Ciencia 2008 fellow. We would also like to thank FAPESP (Fundacao para Amparo a Pesquisa do Estado de Sao Paulo) and CNPq (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico) for financial support. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript