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Search Results: 1 - 10 of 43 matches for " Abdunnabi;Serufo "
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Dengue: uma nova abordagem
Serufo José Carlos,Nobre Vandack,Rayes Abdunnabi,Marcial Tania Maria
Revista da Sociedade Brasileira de Medicina Tropical , 2000,
Abstract: Os conceitos de dengue clássico, com ou sem hemorragia, e de febre hemorrágica do dengue (FHD) que, pode cursar sem fen menos hemorrágicos, com ou sem síndrome do choque do dengue (SCD), s o revistos neste artigo. As defini es clássicas propostas, úteis em outros tempos, geram confus o e dificultam a tomada de decis es no momento do tratamento dos pacientes com as formas graves da doen a porque deixaram de incorporar novos conceitos e avan os terapêuticos. A classifica o do dengue proposta neste trabalho, e apresentada em fluxograma, incorpora os conceitos atuais de sepse, síndrome da resposta inflamatória sistêmica (SIRS) e síndrome da angústia respiratória do adulto (SARA). A nova classifica o serve de guia para orientar a conduta terapêutica inicial e aproxima o tratamento do dengue aos protocolos e rotinas já implantados nos diversos centros hospitalares de urgência, facilitando a atua o dos servi os de saúde em situa es de surtos epidêmicos.
Opportunistic infections in patients with aids admitted to an university hospital of the Southeast of Brazil
Nobre Vandack,Braga Emanuella,Rayes Abdunnabi,Serufo José Carlos
Revista do Instituto de Medicina Tropical de S?o Paulo , 2003,
Abstract: Opportunistic diseases in HIV-infected patients have changed since the introduction of highly active anti-retroviral therapy (HAART). This study aims at evaluating the frequency of associated diseases in patients with AIDS admitted to an university hospital of Brazil, before and after HAART. The medical records of 342 HIV-infected patients were reviewed and divided into two groups: group 1 comprised 247 patients before HAART and, group 2, 95 patients after HAART. The male-to-female rate dropped from 5:1 to 2:1for HIV infection. There was an increase in the prevalence of tuberculosis and toxoplasmosis, with a decrease in Kaposi's sarcoma, histoplasmosis and cryptococcosis. A reduction of in-hospital mortality (42.0% vs. 16.9%; p = 0.00002) has also occurred. An agreement between the main clinical diagnoses and autopsy findings was observed in 10 out of 20 cases (50%). Two patients with disseminated schistosomiasis and 2 with paracoccidioidomycosis are reported. Overall, except for cerebral toxoplasmosis, it has been noticed a smaller proportion of opportunistic conditions related to severe immunosuppression in the post HAART group. There was also a significant reduction in the in-hospital mortality, possibly reflecting improvement in the treatment of the HIV infection.
VISCERAL LARVA MIGRANS AND TROPICAL PYOMYOSITIS: A CASE REPORT
LAMBERTUCCI Roberto,RAYES Abdunnabi,SERUFO José Carlos,TEIXEIRA Daniela Moura
Revista do Instituto de Medicina Tropical de S?o Paulo , 1998,
Abstract: We report a case of tropical pyomyositis in a boy who presented with a severe febrile illness associated with diffuse erythema, and swelling in many areas of the body which revealed on operation extensive necrotic areas of various muscles that required repeated débridement. The patient gave a history of contact with dogs, and an ELISA test for Toxocara canis was positive. He also presented eosinophilia and high serum IgE levels. Staphylococcus aureus was the sole bacteria isolated from the muscles affected. We suggest that tropical pyomyositis may be caused by the presence of migrating larvae of this or other parasites in the muscles. The immunologic and structural alterations caused by the larvae, in the presence of concomitant bacteremia, would favour seeding of the bacteria and the development of pyomyositis.
Pyogenic abscesses and parasitic diseases
LAMBERTUCCI, José Roberto;RAYES, Abdunnabi Ahmed;SERUFO, José Carlos;NOBRE, Vandack;
Revista do Instituto de Medicina Tropical de S?o Paulo , 2001, DOI: 10.1590/S0036-46652001000200003
Abstract: parasitic diseases which during their course in the host switch the immune system from a t helper 1 to a t helper 2 response may be detrimental to the host, contributing to granuloma formation, eosinophilia, hyper-ige, and increased susceptibility to bacterial and fungal infections. patients and animals with acute schistosomiasis and hyper-ige in their serum develop pyogenic liver abscess in the presence of bacteremia caused by staphylococcus aureus. the salmonella-s. mansoni association has also been well documented. the association of tropical pyomyositis (pyogenic muscle abscess) and pyogenic liver abscess with toxocara infection has recently been described in the same context. in tropical countries that may be an interesting explanation for the great morbidity of bacterial diseases. if the association of parasitic infections and pyogenic abscesses and/or fungal diseases are confirmed, there will be a strong case in favor of universal treatment for parasitic diseases to prevent or decrease the morbidity of superinfection with bacteria and fungi.
Dengue: uma nova abordagem
Serufo, José Carlos;Nobre, Vandack;Rayes, Abdunnabi;Marcial, Tania Maria;Lambertucci, José Roberto;
Revista da Sociedade Brasileira de Medicina Tropical , 2000, DOI: 10.1590/S0037-86822000000500008
Abstract: previous definition of classic dengue, with or without bleeding, and of dengue hemorrhagic fever (dhf) that may evolve without bleeding and with or without dengue shock syndrome (dss) are reviewed here. the classical approach to the diagnosis and treatment of dengue, although useful in the past, nowadays breeds confusion and adds a burden to the physician's task of decision-making regarding the treatment of patients with severe forms of the disease. the classification of dengue proposed in this paper, and summarized in a diagram, incorporates new concepts about sepsis, systemic inflammatory response syndrome (sirs), and acute respiratory distress syndrome (ards). this new approach, in our view, is a useful guide to initial evaluation and treatment of the disease. it also approximates the dengue syndrome to other protocols and medical procedures routinely used in intensive care units, making it easier to be followed by the health personnel working in areas subject to epidemic bursts.
Pyogenic abscesses and parasitic diseases
LAMBERTUCCI José Roberto,RAYES Abdunnabi Ahmed,SERUFO José Carlos,NOBRE Vandack
Revista do Instituto de Medicina Tropical de S?o Paulo , 2001,
Abstract: Parasitic diseases which during their course in the host switch the immune system from a T helper 1 to a T helper 2 response may be detrimental to the host, contributing to granuloma formation, eosinophilia, hyper-IgE, and increased susceptibility to bacterial and fungal infections. Patients and animals with acute schistosomiasis and hyper-IgE in their serum develop pyogenic liver abscess in the presence of bacteremia caused by Staphylococcus aureus. The Salmonella-S. mansoni association has also been well documented. The association of tropical pyomyositis (pyogenic muscle abscess) and pyogenic liver abscess with Toxocara infection has recently been described in the same context. In tropical countries that may be an interesting explanation for the great morbidity of bacterial diseases. If the association of parasitic infections and pyogenic abscesses and/or fungal diseases are confirmed, there will be a strong case in favor of universal treatment for parasitic diseases to prevent or decrease the morbidity of superinfection with bacteria and fungi.
Splenic palpation for the evaluation of morbidity due to schistosomiasis mansoni
Gerspacher-Lara Rogério,Pinto-Silva Rogério A,Serufo José Carlos,Rayes Abdunnabi AM
Memórias do Instituto Oswaldo Cruz , 1998,
Abstract: This study was undertaken to determine the accuracy of splenic palpation for the diagnosis of splenomegaly, and to determine whether the frequency of individuals with a palpable spleen in an endemic area can be considered as an index of morbidity of schistosomiasis. For the clinical diagnosis of splenomegaly, two criteria have been tested: (A) presence of a palpable spleen and (B) presence of a palpable spleen whose border could be felt more than 4 cm below the costal margin. In an area of high prevalence of the disease (66.3%) 285 individuals aged 18 years or more have been submitted to abdominal ultrasonography and physical examination. Splenomegaly was defined as a splenic length greater than 120 mm by ultrasound and the sensitivity, specificity, positive and negative predictive values of criterion A were 72.2%, 90.5%, 35.1% and 97.8%. The values for criterion B were 27.8%, 98%, 50% and 95%, respectively. In an non endemic area, 517 individuals were submitted to the same protocol and 22 individuals had a palpable spleen, but no patient fulfilled criterion B for splenomegaly, and only one met the ultrasonographic criterion for splenomegaly. The authors concluded that abdominal palpation is a poor method for the diagnosis of splenomegaly.
Schistosomal myeloradiculopathy due to Schistosoma mansoni: report on 23 cases
Nobre, Vandack;Silva, Luciana CS;Ribas, Jo?o G;Rayes, Abdunnabi;Serufo, JC;Lana-Peixoto, MA;Marinho, Rosana FZ;Lambertucci, JR;
Memórias do Instituto Oswaldo Cruz , 2001, DOI: 10.1590/S0074-02762001000900020
Abstract: schistosoma mansoni infection is likely to be responsible for a significant proportion of cases of myelopathy occurring in areas where schistosomiasis is endemic. the aim of this study is to describe the clinical, laboratory and therapeutic data of 23 patients with schistosomal myeloradiculopathy. the medical records of 23 patients with schistosomal myelopathy admitted to two general hospitals of belo horizonte (mg), in brazil, from 1995 to 1999, were reviewed retrospectively. seventeen patients were male (74%). the mean age for the whole group was 27 years. lower limb weakness and associated lumbar and/or lower limb pain were reported by 20 patients (87%), and 16 (70%) were unable to walk. all individuals presented urinary retention and 19 (83%) complained of intestinal dysfunction. the treatment was based on the association of antischistosomal drugs and corticosteroids. five patients (22%) presented a full response to treatment, 13 (57%) partial response without functional limitations and 4 (17%) partial improvement with limitations or no response. three out of the 4 patients who stopped steroids before 45 days of treatment developed recurrence of the symptoms and signs of myelopathy. our cases demonstrate the severe presentation of the disease and the data disclosed here suggest that treatment with steroids should be kept for months after clinical improvement.
Splenic palpation for the evaluation of morbidity due to schistosomiasis mansoni
Gerspacher-Lara, Rogério;Pinto-Silva, Rogério A;Serufo, José Carlos;Rayes, Abdunnabi AM;Drummond, Sandra C;Lambertucci, José Roberto;
Memórias do Instituto Oswaldo Cruz , 1998, DOI: 10.1590/S0074-02761998000700045
Abstract: this study was undertaken to determine the accuracy of splenic palpation for the diagnosis of splenomegaly, and to determine whether the frequency of individuals with a palpable spleen in an endemic area can be considered as an index of morbidity of schistosomiasis. for the clinical diagnosis of splenomegaly, two criteria have been tested: (a) presence of a palpable spleen and (b) presence of a palpable spleen whose border could be felt more than 4 cm below the costal margin. in an area of high prevalence of the disease (66.3%) 285 individuals aged 18 years or more have been submitted to abdominal ultrasonography and physical examination. splenomegaly was defined as a splenic length greater than 120 mm by ultrasound and the sensitivity, specificity, positive and negative predictive values of criterion a were 72.2%, 90.5%, 35.1% and 97.8%. the values for criterion b were 27.8%, 98%, 50% and 95%, respectively. in an non endemic area, 517 individuals were submitted to the same protocol and 22 individuals had a palpable spleen, but no patient fulfilled criterion b for splenomegaly, and only one met the ultrasonographic criterion for splenomegaly. the authors concluded that abdominal palpation is a poor method for the diagnosis of splenomegaly.
Opportunistic infections in patients with aids admitted to an university hospital of the Southeast of Brazil
Nobre, Vandack;Braga, Emanuella;Rayes, Abdunnabi;Serufo, José Carlos;Godoy, Pérsio;Nunes, Nívea;Antunes, Carlos Maurício;Lambertucci, José Roberto;
Revista do Instituto de Medicina Tropical de S?o Paulo , 2003, DOI: 10.1590/S0036-46652003000200003
Abstract: opportunistic diseases in hiv-infected patients have changed since the introduction of highly active anti-retroviral therapy (haart). this study aims at evaluating the frequency of associated diseases in patients with aids admitted to an university hospital of brazil, before and after haart. the medical records of 342 hiv-infected patients were reviewed and divided into two groups: group 1 comprised 247 patients before haart and, group 2, 95 patients after haart. the male-to-female rate dropped from 5:1 to 2:1for hiv infection. there was an increase in the prevalence of tuberculosis and toxoplasmosis, with a decrease in kaposi's sarcoma, histoplasmosis and cryptococcosis. a reduction of in-hospital mortality (42.0% vs. 16.9%; p = 0.00002) has also occurred. an agreement between the main clinical diagnoses and autopsy findings was observed in 10 out of 20 cases (50%). two patients with disseminated schistosomiasis and 2 with paracoccidioidomycosis are reported. overall, except for cerebral toxoplasmosis, it has been noticed a smaller proportion of opportunistic conditions related to severe immunosuppression in the post haart group. there was also a significant reduction in the in-hospital mortality, possibly reflecting improvement in the treatment of the hiv infection.
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