Pyoderma Gangrenosum in an Infant

Pioderma gangrenoso é uma dermatose cutânea incomum, de patogênese desconhecida, incluída no grupo das dermatoses neutrofílicas. Caracteriza-se como ulceração não infecciosa, necrotizante e dolorosa da pele. Acomete preferencialmente adultos, sendo raro em crianças (menos de 4%) e com poucos casos relatados na literatura de acometimento na faixa etária <1 ano. O diagnóstico geralmente é baseado em evidências clínicas e confirmado com a exclusão das outras etiologias de lesões ulceradas cutâneas. Relatamos um caso de pioderma gangrenoso em uma lactente de 4 meses de idade, com lesões ulceradas múltiplas na região de nádegas, sem comprometimento sistêmico e com resposta satisfatória e efetiva ao tratamento com corticoterapia oral.Pyoderma gangrenosum is an uncommon cutaneous dermatosis of unknown pathogenesis, included in the group of neutrophilic dermatosis. It is characterized as noninfectious, necrotizing and painful cutaneous ulcers. It affects primarily adults and is rare in children (less than 4%) and with few cases reported in literature of involvement in the age group < 1 year. The diagnosis is usually based on clinical evidence and confirmed with the exclusion of others causes of skin ulcerated lesions. This report describes a case of pyoderma gangrenosum in a 4 months old infant presented with multiple cutaneous ulcers on her buttocks, without any systemic involvement and with rapid and effective response to oral corticosteroid

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Challenges of the integration of SUS: analysis of the Women´s Health Care Network in Recife

Made available in DSpace on 2015-05-19T13:30:29Z (GMT). No. of bitstreams: 2 422.pdf: 2236861 bytes, checksum: 2b76f9b82ef612b0c824dad4eb072a9a (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2011Fundação Oswaldo Cruz. Centro de Pesquisas Aggeu Magalhães. Recife, PE, BrasilNo Brasil, a Rede de Atenção à Saúde da Mulher do SUS tem apresentado dificuldades que vão desde obstáculos ao acesso, desarticulação entre os serviços de saúde, pouca resolubilidade da atenção, vazios assistenciais e baixo nível de resposta às necessidades das usuárias, tendo como conseqüência elevada morbi-mortalidade materna e perinatal. Diante disso, os gestores do SUS vêm discutindo medidas para melhorar tal situação. Uma das estratégias adotadas é a reorganização da atenção à saúde da mulher baseada na conformação de uma Rede Integrada de Serviços de Saúde/RISS, visando uma maior articulação entre os serviços, compondo assim sistemas regionais mais funcionais e resolutivos. Estudos apontam que esta conformação tem potencial para redução da mortalidade materna e perinatal, pois pode possibilitar uma assistência contínua e integrada, prevenindo, diagnosticando e tratando os eventos indesejáveis durante a gestação, visando ao bem-estar da gestante e de seu recém-nascido. As RISS são entendidas como arranjos organizativos de unidades funcionais de saúde/pontos de atenção, onde são desenvolvidos procedimentos de diferentes densidades tecnológicas, que através de sistemas logísticos, de apoio e de gestão, buscam garantir a integralidade do cuidado. Dada a importância da organização e gestão dessa rede integrada de cuidados no pré-natal para a redução da morbi-mortalidade materna e perinatal, este estudo teve como objetivo analisar os mecanismos de integração assistencial presentes na organização da Rede de Atenção à Saúde da Mulher, tendo como enfoque o cuidado pré-natal no Distrito Sanitário VI. Tratou-se de um estudo de caso, utilizando-se a análise documental, entrevistas semi-estruturadas e formulários aplicados, na perspectiva da triangulação de fontes de dados. Os resultados obtidos apontam que estão presentes alguns mecanismos de integração entre os níveis assistenciais percebidos por gestores e profissionais, o que indica a preocupação da gestão municipal com a garantia da atenção integral. As principais estratégias identificadas foram: implementação de mecanismos de gestão de rede e do cuidado, organização de fluxos de referência, ampliação da oferta de serviços básicos e implantação de regulação de consultas e exames. Contudo, ainda persistem problemas relativos a falta de vínculo entre os serviços de cuidado pré-natal e do parto, o que dificulta o acesso, a utilização dos serviços e a garantia do atendimento na atenção especializada e hospitalar, representando assim um obstáculo à integralidade do cuidad

Risks scenarios frameworks in the context of an oil refinery installation at Pernambuco State

Submitted by Kamylla Nascimento ([email protected]) on 2018-06-11T13:42:57Z No. of bitstreams: 1 Framework dos cenários de risco no contexto da implantação.pdf: 63609 bytes, checksum: c7dd35fe4f28897e912d699d50aedd5b (MD5)Approved for entry into archive by Kamylla Nascimento ([email protected]) on 2018-06-12T12:38:15Z (GMT) No. of bitstreams: 1 Framework dos cenários de risco no contexto da implantação.pdf: 63609 bytes, checksum: c7dd35fe4f28897e912d699d50aedd5b (MD5)Made available in DSpace on 2018-06-12T12:38:15Z (GMT). No. of bitstreams: 1 Framework dos cenários de risco no contexto da implantação.pdf: 63609 bytes, checksum: c7dd35fe4f28897e912d699d50aedd5b (MD5) Previous issue date: 2009Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.A magnitude dos problemas socioambientais relacionados à urbanização, industrialização e esgotamento de recursos naturais tem impacto crescente sobre a saúde e o ambiente. Paradoxalmente, os padrões de consumo demandam a ampliação da produção industrial, baseada na exploração de recursos não renováveis, cujos riscos tecnológicos, particularmente os da indústria petroquímica, impõem dificuldades reais às medidas de controle e vigilância à saúde. O refino de petróleo é uma atividade potencialmente danosa ao ambiente e à saúde humana, particularmente aos trabalhadores. Esse estudo objetivou caracterizar os cenários de risco para a saúde ambiental decorrentes da instalação de uma refinaria de petróleo na Região Metropolitana de Recife (Pernambuco). Com base em dados secundários e referências da literatura, construiu-se uma matriz de reprodução social para contextualizar os problemas nas dimensões biológica, da consciência e conduta, econômica, política e ecológica, permitindo presumir riscos, com vista a subsidiar o desenvolvimento e a organização das ações de vigilância em saúde no Estado, articuladas intersetorialmente, com participação social, capazes de intervir sobre os riscos e evitar o adoecimento dos trabalhadores e da população nesse território.The magnitude of the environmental and social problems due to urbanization, industrialization and exhaustion of natural resources has shown an increase in the impact on health and environment. Paradoxically, the consumption patterns demand for the expansion in the industrial production based on the exploitation of the non-renewable resources, which technological risks, especially from the petrochemical industry, have put difficulties on the risk control and health surveillance. The petroleum refining is an activity potentially damageable to the environment and human health, particularly to workers. The main objective of this study was to characterize the scenarios of risk to environmental health due to an oil refinery installation in the Metropolitan Region of Recife (Pernambuco). Based on secondary data and literature review, a Social Reproduction Matrix was made contextualizing the problems in the biological, consciousness and conduct, economic, policy and ecological dimensions, enabling to presume the risks to support the health surveillance development and organization in the state, with intersectoriality, social participation, and able to intervene on risks and prevent diseases among the workers and people in the territory

Diagnóstico de Dioctophyma renale em um cão na baixada santista através da ultrassonografia abdominal

O Dioctophyma renale é um helminto que habita preferenci-almente o rim direito do hospedeiro definitivo, mas descrito também em tecidos pe-ri-renais, ureteres, bexiga, uretra, bolsa escrotal, tecido subcutâneo inguinal, útero, ovários, linfonodos mesentéricos, glândula mamária, cavidade torácica, pericárdio, cavidade abdominal, estômago e fígado. Por apresentar comportamento destrutivo progressivo, pode levar à perda total do órgão afetado. Os sintomas são por muitas vezes, inespecíficos, variando de acordo com a região afetada, e muitas vezes po-dem ser inexistentes. Sua incidência está relacionada ao acesso a ambientes aquáti-cos e hábitos alimentares do animal, como por exemplo, ingestão de peixe ou rã cruas. Objetivou-se com esse trabalho, relatar um caso de Dioctophyma renale em um cão habitado na cidade de Santos, área não endêmica do parasito, a fim de aler-tar a população, incluindo os médicos veterinários, da possibilidade de investigação e riscos desta doença. O paciente relatado é uma cadela, sem raça definida, de apro-ximadamente 3 anos, que começou a apresentar prostração e hematúria progressiva observados em consulta clínica. Foi solicitado hemograma e ultrassonografia abdo-minal, sendo este último exame o qual identificou o nematoide no interior do rim di-reito. A nefrectomia foi realizada no dia seguinte ao diagnóstico e atualmente o pa-ciente passa bem

Insights into the proteomic profile and gene expression of Lutzomyia longipalpis-derived lulo cell line

Lutzomyia longipalpis-derived cell line (Lulo), has been suggested as a model for studies of interaction between sand flies and Leishmania. Here, we present data of proteomic and gene expression analyses of Lulo cell related to interactions with L. (V.) braziliensis. Lulo cell protein extracts were analysed through a combination of two-dimensional gel electrophoresis and mass spectrometry and resulting spots were further investigated in silico to identify proteins, using Mascot search, and, afterwards, resulting sequences were applied for analysis with VectorBase. Sixty-four spots were identified showing similarities to other proteins registered in the databases and could be classified according to their biological function, such as ion-binding proteins (23 %), proteases (14 %), cytoskeletal proteins (11 %) and interactive membrane proteins (9.5 %). Effects of interaction with L. (V.) braziliensis with the expression of three genes (enolase, tubulin, and vacuolar transport protein) were observed after an 8-hour timeframe and compared to culture without parasites, and demonstrated the impact of parasite interaction with the expression of the following genes: LLOJ000219 (1.69-fold), LLOJ000326 (1.43-fold) and LLOJ006663 (2.41-fold). This set of results adds relevant information regarding the usefulness of the Lulo cell line for studies with Leishmania parasites that indicate variations of protein expression

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data