INCIDENCE OF DIARRHEA BY Clostridium difficile IN HEMATOLOGIC PATIENTS AND HEMATOPOIETIC STEM CELL TRANSPLANTATION PATIENTS: RISK FACTORS FOR SEVERE FORMS AND DEATH

We describe the rate of incidence of Clostridium difficile-associated diarrhea (CDAD) in hematologic and patients undergone stem cell transplant (HSCT) at HC-FMUSP, from January 2007 to June 2011, using two denominators 1,000 patient and 1,000 days of neutropenia and the risk factors associated with the severe form of the disease and death. The ELISA method (Ridascreen-Biopharm, Germany) for the detections of toxins A/B was used to identify C. difficile. A multivariate analysis was performed to evaluate potential factors associated with severe CDAD and death within 14 days after the diagnosis of CDAD, using multiple logistic regression. Sixty-six episodes were identified in 64 patients among 439 patients with diarrhea during the study period. CDA rate of incidence varied from 0.78 to 5.45 per 1,000 days of neutropenia and from 0.65 to 5.45 per 1,000 patient-days. The most common underlying disease was acute myeloid leukemia 30/64 (44%), 32/64 (46%) patients were neutropenic, 31/64 (45%) undergone allogeneic HSCT, 61/64 (88%) had previously used antibiotics and 9/64 (13%) have severe CDAD. Most of the patients (89%) received treatment with oral metronidazole and 19/64 (26%) died. The independent risk factors associated with death were the severe form of CDAD, and use of linezolid

Iatrogenia a importância do diagnóstico clínico miopatia induzida por clofibrate

Os autores descrevem o caso de uma enferma que apresentou síndrome polimio-site símile durante tratamento de hipercolesterolemia com clofibrate. Com ia suspensão da medicação, os sinais e sintomas de acometimento muscular desapareceram por completo. Os autores chamam a atenção para a importância das miopatias iatrogênicas no diagnóstico diferencial de pacientes com doenças do sistema neuromuscular

Doença do neurônio motor: avaliação metabólica

Com base nos escassos dados da literatura médica internacional, os autores estudam os níveis séricos e urinários de cálcio e fósforo, bem como a existência de possíveis anormalidades na coluna vertebral de 30 enfermos com o diagnóstico de doença do neurônio motor. Os autores postulam a participação de múltiplos fatores na etitfpatogenia da doença, fazendo menção aos aspectos tóxicos e metabólicos