Bacterial meningitis in an urban area: etiologic study and prognostic factors

Objectives: The study of clinical features, diagnostic methods and prognostic factors of bacterial meningitis, in an urban area. Patients and Methods: All patients admitted between June 2001 and July 2004 in the emergency departments of a few hospitals, with the diagnosis of bacterial meningitis were included. CSFand blood cultures were performed in every case. Phenotypic characterization of strains of 5treptococcus pneumoniae and Neisseria meningitidis identified by culture were performed. In order to detect the three most common agents it was done a PCRassay in culture negative CSFsamples. Results: Bacterial meningitis was diagnosed in 201 patients. Etiologic definition was based on culture in 142 patients (70.6%), done by CSFPCRassay in 33 (16.4%) other patients and exclusively by latex agglutination test results in two cases. Thus, an etiologic diagnosis was established in 177 (88%) cases. Antigenic characterization showed a slight prevalence of N. meningitidis phenotype C:2b:P1; the 5. pneumoniae serotype characterization showed that 43.8% of identified serotypes are not included in any of the available vaccines. Eighteen patients died (8.9%). The statistic analysis found that factors associated with an adverse outcome were age older than 50 years (aR 7.07; IC 95% 1.1-27.4), the presence of comorbidities (aR 3.3; IC 95% 1.1-9.6) and the occurrence of systemic complications (aR 5.8; IC 95% 2.1-16.0). Conclusions: This epidemiologic pattern is similar to that found in other countries after the introduction of Haemophilus influenzae b conjugated vaccine. The association of culture and noncultural methods of diagnosis had a better performance in defining the etiology. Comparing to other series, in-patients mortality rate was lower (8.9%) than usually referred to, being considered unfavourable prognostic factors the age more than 50 years, the presence of comorbidities and of systemic complications

Histoplasmose pulmonar aguda e primeiro isolamento do Histoplasma capsulatum do solo do Rio Grande do Sul, Brasil

A case of acute pulmonary histoplasmosis, where the clinical histoiy and epidemiological data led to the identification of H. capsulatum natural source, is described. Specimens of spleen and liver, obtained after intraperitonial inoculation in mice, grew H. capsulatum in culture from the soil of rural area of General Câmara, by the first time in Rio Grande do Sul.Apresenta-se um caso de histoplasmose pulmonar aguda, onde a história clinica orientada levou a Identificação da fonte natural do Histoplasma capsulatum. O fungo foi obtido em cultivo a partir de fragmentos de baço e fígado de ratos inoculados intraperitonealmente com solo da zona rural de General Câmara, pela primeira vez no Rio Grande do Sul

Leiomioma da Uretra Feminina - Revisão da Literatura a Propósito de Caso Clínico

Oleiomioma da uretra é uma patologia rara, estando descritos cerca de uma centena de casos na literatura. São tumores benignos, constituídos por músculo liso e surgem mais frequentemente na idade fértil.Otratamento é cirúrgico com excisão da massa, existindo contudo possibilidade de recidiva local. Apresenta-seumcaso clínico de leiomioma da uretra e realizou-se revisão da literatura

Qualidade pós-colheita de Physalis sob temperatura ambiente e refrigeração.

A physalis (Physalis peruviana) é um pequeno fruto cujo cultivo vem se expandindo no Brasil. No entanto, informações a respeito do seu armazenamento ainda são escassas. Por isso, o objetivo deste trabalho foi avaliar a qualidade de physalis durante o armazenamento, sob temperaturas ambiente e refrigerada. A colheita foi realizada quando o cálice dos frutos apresentava coloração amarelo-esverdeada, sendo os frutos submetidos aos seguintes tratamentos: 1- armazenamento à temperatura de 20°C (± 0,5°C) e 2- armazenamento à temperatura de 4°C (± 0,5°C). Foram avaliados os teores de SS, AT, SS/AT, o pH, a firmeza, a cor e a perda de massa dos frutos, a cada dois dias, durante oito dias. Foi possível observar que o emprego da refrigeração promoveu a manutenção da firmeza, auxiliando também na prevenção da perda de massa fresca, do fruto e do cálice. O teor de sólidos solúveis (SS) reduziu-se significativamente, independentemente da temperatura de armazenamento dos frutos. Frutos armazenados sob refrigeração apresentaram teores superiores de acidez titulável (AT) e, consequentemente, menor relação SS/AT. Os resultados, obtidos neste estudo, permitiram concluir que as modificações que ocorrem em parâmetros considerados importantes para a qualidade de physalis , como pH, AT, SS/AT, firmeza e cor, durante o período de armazenamento de frutos, podem ser minimizados com o uso da refrigeração (4 °C)

Trajectories of Anxiety and Depression Symptoms over Five Years since Breast Cancer Diagnosis: Results of the NEON-BC Prospective Study

Anxiety and depression symptoms are frequent among patients with breast cancer (BCa) and may last after initial treatments. We aimed to identify five-year trajectories of anxiety and depression symptoms among women with BCa. Neuro-oncological complications of BCa (NEON-BC) cohort included 506 patients admitted at the Portuguese Institute of Oncology of Porto in 2012, who were evaluated with the Hospital Anxiety and Depression Scale before cancer treatment and after one, three, and five years (7.9% attrition rate). Mixed-effect models were used to model anxiety and depression scores over time and model-based clustering to identify the different trajectories. Three trajectories of anxiety symptoms were identified: (1) high scores at baseline and increasing over time (21.7%); (2) consistently low scores over time (63.6%); (3) mid-range scores at baseline, decreasing over time (14.6%). Three trajectories were identified for depression symptoms: (1) high scores at baseline and increasing over time (21.1%); (2) mid-range scores at baseline, which decreased afterward (58.7%); (3) consistently low levels over time (20.2%). Age, education, baseline, and one-year anxiety/depression status predicted the worst five-year trajectories. These results show that assessing anxiety and depression symptoms before treatment and after one year may contribute to identifying the patients who could benefit the most from psychological support. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.This research was funded by the European Regional Development Funds (POCI-01-0145-FEDER016867) and Fundação para a Ciência e a Tecnologia (FCT), under the project “A five-year prospective cohort study on the neurological complications of breast cancer: frequency and impact in patient-reported outcomes” (PTDC/DTP-EPI/7183/2014), and by FCT under EPIUnit-Instituto de Saúde Pública da Universidade do Porto (UIDB/04750/2020) and Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (LA/P/0064/2020). NA receives funding from FCT under the project NeurodegCov19-Neurological Complications after COVID-19 (PTDC/SAU-EPI/6275/2020) and C.L., from FCT under the project NEON-PC: neuro-oncological complications of prostate cancer-longitudinal study of cognitive decline (POCI-01-0145-FEDER-032358, Ref. PTDC/SAU-EPI/32358/2017). Data management activities up to the first year of follow-up were supported by the Chair on Pain Medicine of the Faculty of Medicine, University of Porto, and the Grünenthal Foundation—Portugal

Prevalence and determinants of painful and painless neuropathy in type 1 diabetes mellitus

Aims: To evaluate (1) the prevalence of diabetic distal symmetrical sensory-motor polyneuropathy (DSPN) and painful DSPN among patients with type 1 diabetes mellitus (DM1) aged over 18 years and (2) the determinant factors of neuropathy and pain in those patients. Materials and Methods: An epidemiological, cross-sectional, observational study was performed; 330,386 people were included, and a total of 444 people were diagnosed with DM1. After exclusion of possible confounders, 360 patients were assessed for painless and painful DSPNs using neurological examination and questionnaires for neuropathy and pain. Odds ratio (OR) and confidence intervals (95% CI) were estimated using multinomial logistic regression models. The analysis was based on a framework with four conceptual levels that consider feasible pathways between several risk factors: (1) socio-demographic factors and diabetes duration, (2) patient habits, (3) co-morbidities, and (4) metabolic factors and disease complications. Results: The prevalence of DSPN and painful DSPN were 42.8 and 18.9%, respectively. Diabetes duration was positively associated with painful (OR = 1.107, 95% CI: 1.107-1.139) and painless DSPN (OR = 1.069, 95% CI: 1.043-1.096). Education level was negatively associated with painful DSPN (OR = 0.889, 95% CI: 0.826-0.957). Sex (female) was positively associated only with painless DSPN (OR = 1.769, 95% CI: 1.007-3.107). Being a current or former smoker was positively associated only with painless DSPN (OR = 1.940, 95% CI: 1.069-3.518). Hypertension was positively associated with painful DSPN (OR = 2.474, 95% CI: 1.110-5.512) and painless DSPN (OR = 2.565, 95% CI: 1.252-5.256). Glycated hemoglobin (HbA1c) was positively associated only with painless DSPN (OR = 1.193, 95% CI: 1.018-1.399). Conclusions: Diabetes duration and hypertension have a direct impact on the development of painful and painless DSPN. However, female sex and HbA1c have a direct effect only on the development of painless DSPN, and education level has an indirect effect on the development of painful DSPN. Therefore, it can be concluded that different etiological factors have different contributions to the development of neuropathy and pain.The authors received study funding from the Associação dos Amigos do Serviço de Endocrinologia do Hospital de S. João

Estudo de solos do município de Encruzilhada do Sul - RS.

bitstream/item/30598/1/Circular-45.pdf; bitstream/item/30600/1/aptidao-bmp-final.pdf; bitstream/item/30616/1/capacidade-bmp-final.pdf; bitstream/item/30623/1/relevo-bmp-final.pdf; bitstream/item/30634/1/vegetacao-bmp-final.pd