Outbreak of toxoplasmosis in the city of Santa Maria, Brazil

Introduction: In the first months of 2018, there was an increase in the number of cases of fever possibly related to Toxoplasmosis in the city of Santa Maria, Brazil, reaching significant values. Toxoplasmosis is an autoimmune acute infection usually asymptomatic in 80-90% of immunocompetent adults. In this outbreak, attention is drawn to the intensity of the symptoms presented, which were observed in more than 70% of the cases. Objective: To report the cases of the outbreak of toxoplasmosis in the city of Santa Maria, Brazil. Methods: Cross-sectional study. Data were collected from bulletins published by the Municipal Health Department of Santa Maria, Rio Grande do Sul, Brazil. Results: The outbreak of toxoplasmosis in Santa Maria was confirmed on April 19, 2018. Until June 14, 2018, 510 cases were confirmed. According to the most recent bulletin released by the State Health Department on June 8, 2018, 441 occurrences are people residing in Santa Maria, five are residents of the districts and seven cases are patients residing in neighboring counties. In a bulletin published on May 25, 2018, 1,116 cases were reported to state epidemiological surveillance by the end of May. Of these, 766 cases were still suspected (fever, headache and/or myalgia accompanied by lymphadenopathy, weakness, arthralgia or change in vision. In the other 460 cases, there was laboratory confirmation for acute toxoplasmosis, of which 35 were pregnant, with two fetal deaths (36 and 28 weeks) and two abortions. There are also 212 cases still pending laboratory confirmation, of which 133 were pregnant women, 1 was a spontaneously aborted fetus and 17 were children . Tests carried out on the water supplying the city so far have resulted negative for toxoplasmosis. Conclusion: The results of this research show that the current outbreak of toxoplasmosis in the city of Santa Maria, Brazil, is the largest reported in the world

Man vs. machine : predicting hospital bed demand

Background: The recent literature reports promising results from using intelligent systems to support decision making in healthcare operations. Using these systems may lead to improved diagnostic and treatment protocols and to predict hospital bed demand. Predicting hospital bed demand in emergency department (ED) attendances could help resource allocation and reduce pressure on busy hospitals. However, there is still limited knowledge on whether intelligent systems can operate as fully autonomous, user-independent systems. Objective: Compare the performance of a computer-based algorithm and humans in predicting hospital bed demand (admissions and discharges) based on the initial SOAP (Subjective, Objective, Assessment, Plan) records of the ED. Methods: This was a retrospective cohort study that compared the performance of humans and machines in predicting hospital bed demand from an ED. It considered electronic medical records (EMR) of 9030 patients (230 used as a testing set, and hence evaluated both by humans and by an algorithm, and 8800 used as a training set exclusively by the algorithm) who visited the ED of a tertiary care and teaching public hospital located in Porto Alegre, Brazil between January and December 2014. The machine role was played by Support Vector Machine Classifier and the human prediction was performed by four ED physicians. Predictions were compared in terms of sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUROC). Results: All graders achieved similar accuracies. The accuracy by AUROC for the testing set was 0.82 [95% confidence interval (CI) of 0.77–0.87], 0.80 (95% CI: 0.75–0.85), 0.76 (95% CI: 0.71–0.81) for novice physicians, machine, experienced physicians, respectively. Processing time per test EMR was 0.00812±0.0009 seconds. In contrast, novice physicians took on average 156.80 seconds per test EMR, while experienced physicians took on average 56.40 seconds per test EMR. Conclusions: Our data indicated that the system could predict patient admission or discharge states with 80% accuracy, which was similar the performance of novice and experienced physicians. These results suggested that the algorithm could operate as an autonomous and independent system to complete this task

Outbreak of toxoplasmosis in the city of Santa Maria, Brazil

Introduction: In the first months of 2018, there was an increase in the number of cases of fever possibly related to Toxoplasmosis in the city of Santa Maria, Brazil, reaching significant values. Toxoplasmosis is an autoimmune acute infection usually asymptomatic in 80-90% of immunocompetent adults. In this outbreak, attention is drawn to the intensity of the symptoms presented, which were observed in more than 70% of the cases. Objective: To report the cases of the outbreak of toxoplasmosis in the city of Santa Maria, Brazil. Methods: Cross-sectional study. Data were collected from bulletins published by the Municipal Health Department of Santa Maria, Rio Grande do Sul, Brazil. Results: The outbreak of toxoplasmosis in Santa Maria was confirmed on April 19, 2018. Until June 14, 2018, 510 cases were confirmed. According to the most recent bulletin released by the State Health Department on June 8, 2018, 441 occurrences are people residing in Santa Maria, five are residents of the districts and seven cases are patients residing in neighboring counties. In a bulletin published on May 25, 2018, 1,116 cases were reported to state epidemiological surveillance by the end of May. Of these, 766 cases were still suspected (fever, headache and/or myalgia accompanied by lymphadenopathy, weakness, arthralgia or change in vision. In the other 460 cases, there was laboratory confirmation for acute toxoplasmosis, of which 35 were pregnant, with two fetal deaths (36 and 28 weeks) and two abortions. There are also 212 cases still pending laboratory confirmation, of which 133 were pregnant women, 1 was a spontaneously aborted fetus and 17 were children . Tests carried out on the water supplying the city so far have resulted negative for toxoplasmosis. Conclusion: The results of this research show that the current outbreak of toxoplasmosis in the city of Santa Maria, Brazil, is the largest reported in the world

Review of the literature : sepsis and neutrophil Cd64

Sepsis is a systemic inflammatory response against suspected or documented infection. In an infectious process, inflammation is triggered activating leukocytes, mainly neutrophils. CD64 is a surface antigen weakly expressed on non-activated mature neutrophils. When neutrophil CD64 is strongly expressed on neutrophils, it means neutrophils were activated, thus suggesting the presence of bacterial infection or acute fungal infection. A large number of biological substances has been investigated as candidate biomarkers and/or mediators of sepsis. Recent studies have focused on the investigation of neutrophil CD64 as a possible biomarker for the diagnosis of sepsis