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Search Results: 1 - 10 of 5398 matches for " Marcus Conde "
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Tratamento intermitente para TB e resistência Intermittent treatment for TB and resistance
Marcus Barreto Conde
Jornal Brasileiro de Pneumologia , 2009, DOI: 10.1590/s1806-37132009000600001
Abstract:
Tuberculose pleural
Seiscento, Márcia;Conde, Marcus Barreto;Dalcolmo, Margareth Maria Pretti;
Jornal Brasileiro de Pneumologia , 2006, DOI: 10.1590/S1806-37132006000900003
Abstract: tuberculous pleural effusion is a common manifestation of the primary form of the disease or consequence of the reactivation of a latent infection due to the m. tuberculosis. advances in the laboratory methods have contributed to better diagnose and understand the pathophysiology of the effusion secondary to tuberculosis. however, although a predominant lymphocytic pleural effusion is suspicious of tuberculosis, a diagnostic routine shall be instituted to orient treatment and prevent undesirable sequels.
Vital capacity and inspiratory capacity as additional parameters to evaluate bronchodilator response in asthmatic patients: a cross sectional study
Karen S Azevedo, Ronir R Luiz, Patricia RM Rocco, Marcus B Conde
BMC Pulmonary Medicine , 2012, DOI: 10.1186/1471-2466-12-49
Abstract: The aim of this study was to evaluate the usefulness of vital capacity (VC) and inspiratory capacity (IC) to evaluate bronchodilator response in asthma patients with persistent airflow obstruction. The 43 asthma patients enrolled in the study were stratified into moderate or severe airflow obstruction groups based on baseline FEV1. All patients performed a 6-minute walk test before and after the bronchodilator (BD). A bipolar visual analogue scale post-BD was performed to assess clinical effect. The correlation between VC and IC and clinical response, determined by visual analogue scale (VAS) and 6-minute walk test (6MWT), was investigated.Patients in the severe group presented: 1) greater bronchodilator response in VC (48% vs 15%, p?=?0.02), 2) a significant correlation between VC variation and the reduction in air trapping (Rs?=?0.70; p?<?0.01), 3) a significant agreement between VC and VAS score (kappa?=?0.57; p?<?0.01). There was no correlation between IC and the reduction in air trapping or clinical data.VC may be a useful additional parameter to evaluate bronchodilator response in asthma patients with severe airflow obstruction.Asthma is a serious worldwide health issue, but its clinical manifestations can be controlled with appropriate treatment [1]. Currently, a positive bronchodilator response is established based on an increase?≥?12% and 200 ml in forced vital capacity (FVC) and/or forced expiratory volume in one second (FEV1) compared with baseline values following administration of bronchodilators [2]. However, in clinical practice, patients with moderate or severe asthma may refer clinical improvement after bronchodilator use despite a negative bronchodilator test. In patients with chronic obstructive pulmonary disease (COPD), in whom the bronchodilator test is frequently negative, vital capacity (VC) and inspiratory capacity (IC) variation are used as complementary tools in order to evaluate bronchodilator response [3-6]. COPD patients have a persisten
Humoral response to HspX and GlcB to previous and recent infection by Mycobacterium tuberculosis
Marcelo Rabahi, Ana Junqueira-Kipnis, Michelle dos Reis, Walter Oelemann, Marcus Conde
BMC Infectious Diseases , 2007, DOI: 10.1186/1471-2334-7-148
Abstract: Four hundred and thirty seven HCW were screened and classified into three different groups according to tuberculin skin test (TST) status: uninfected, previous LTBI and recent LTBI. ELISA test were performed to determine the humoral immune response to HspX and GlcB.The levels of IgG and IgM against the HspX and GlcB antigens were the same among HCW with recent and previous LTBI, as well as among non infected HCW. However, the IgM levels to HspX was significantly higher among HCW with recent LTBI (OD = 1.52 ± 0.40) than among the uninfected (OD = 1.09 ± 0.50) or subjects with previous LTBI (OD = 0.96 ± 0.51) (p < 0.001).IgG and IgM humoral responses to GlcB antigens were similar amongst all studied groups; nevertheless IgM levels against HspX were higher among the recent LTBI/HCW.Tuberculosis (TB) remains one of the world's major public health problems. The World Health Organization (WHO) estimated 8.9 million of new cases of TB in 2004 and that one third of the world's population is infected by Mycobacterium tuberculosis (M. tb) [1,2]. Although the identification and cure of active, infectious cases of pulmonary TB is the most cost-effective public health measure for the control of the disease, the detection and treatment of individuals with latent TB infection (LTBI) may also provide an important role in the fight against the TB epidemic [2]. Different studies have demonstrated that among subjects with recent LTBI, the risk for developing active TB in the first year of follow up was 8 times higher than in the subsequent seven years and that 82% of TB cases developed active disease within 2 years of infection [3,4]. The most common test used to determine if a person has been infected by M. tb is the tuberculin skin test (TST). Although of low cost and relatively simple to administer, the TST suffers from a number of well-documented performance and logistical problems, such as the need for individuals to return for test reading, the variability and subjectivity in te
Pesquisa de IgA contra o antígeno recombinante HspX de Mycobacterium tuberculosis no diagnóstico de tuberculose pleural
Limongi, Loanda Carvalho Sant' Ana;Olival, Liliane;Conde, Marcus Barreto;Junqueira-Kipnis, Ana Paula;
Jornal Brasileiro de Pneumologia , 2011, DOI: 10.1590/S1806-37132011000300005
Abstract: objective: to evaluate the accuracy of determining specific iga to hspx recombinant antigen in pleural fluid and serum samples for the diagnosis of pleural tuberculosis in patients with pleural effusion. methods: this was a cross-sectional study. serum and pleural fluid samples of patients with pleural effusion and suspected of having pleural tuberculosis were tested with indirect elisa in order to determine the optical density of specific iga to hspx. results: we evaluated serum and pleural fluid samples from 132 patients: 97 diagnosed with pleural tuberculosis (study group) and 35 diagnosed with pleural effusion due to other causes (control group). the determination of iga in pleural fluid satisfactorily discriminated between pleural tuberculosis patients and control patients. the sensitivity of the test in pleural fluid and in serum was 69% and 30%, respectively, whereas the specificity was 83% and 84%, respectively. conclusions: our data suggest that this test can be used in the diagnosis of pleural tuberculosis. further studies, involving larger patient samples and different epidemiological scenarios, are warranted
Prevalência de resistência primária em pacientes com tuberculose pulmonar sem fatores de risco conhecidos para resistência primária
Bastos, Giselle Mota;Cezar, Michelle Cailleaux;Mello, Fernanda Carvalho de Queiroz;Conde, Marcus Barreto;
Jornal Brasileiro de Pneumologia , 2012, DOI: 10.1590/S1806-37132012000600008
Abstract: objective: to estimate the prevalence of primary resistance to the drugs in the basic treatment regimen for tuberculosis in treatment-na?ve patients with pulmonary tuberculosis and no known risk factors for such resistance, as well as to identify factors potentially associated with drug resistance. methods: this was an exploratory cross-sectional study. we analyzed the medical records of the subjects enrolled in two clinical trials of treatments for drug-susceptible tuberculosis between november 1, 2004 and march 31, 2011 at the prof. newton bethlem outpatient clinic of the federal university of rio de janeiro thoracic diseases institute, located in the city of rio de janeiro, brazil. the inclusion criteria were being > 18 years of age, testing positive for afb in the first sputum sample, having a positive culture for mycobacterium tuberculosis, having undergone drug susceptibility testing, and being treatment-na?ve. patients with a history of imprisonment or hospitalization were excluded, as were those who had been in contact with drug-resistant tuberculosis patients. results: we included 209 patients. the overall prevalence of primary drug resistance was 16.3%. the overall prevalence of resistance to isoniazid and streptomycin was, respectively, 9.6% and 9.1%, compared with 5.8% and 6.8% for single-drug resistance to isoniazid and streptomycin, respectively. the prevalence of resistance to two or more drugs was 3.8%, and the prevalence of multidrug resistance was 0.5%. no statistically significant associations were found between the variables studied and drug susceptibility testing results. conclusions: in this sample, the prevalence of primary drug resistance was high despite the absence of known risk factors.
Predictive value of the acid fast smear for detection of Mycobacterium tuberculosis in respiratory specimens in a Reference Center of HIV/Aids in Rio de Janeiro, Brazil
Conde, Marcus B;Figueira, Cesar M;Moraes, Renata;Fonseca, Leila S;DeRiemer, Kathy;Kritski, Afranio L;
Memórias do Instituto Oswaldo Cruz , 1999, DOI: 10.1590/S0074-02761999000600014
Abstract: in order to evaluate the predictive value of acid fast bacilii (afb) smear for the diagnosis of mycobacterium tuberculosis in respiratory specimens in a setting with a high prevalence of aids and an unknown prevalence of nontuberculous mycobacteria (ntm), we retrospectively examined specimens cultured for mycobacteria between 1 september 1993 and 30 september 1994 and medical records of patients with positive culture in a general hospital, aids reference in rio de janeiro, brazil. seventy three per cent (1517/2077) of samples were respiratory specimens and mycobacteria were recovered from 20.6% (313/1517) of these. m. tuberculosis was identified in 94.2% (295/313) and ntm in 5.8% (18/313). the yield of positive afb smear and of positive culture was 6.1% (93/1517) and 20.6% (313/1517), respectively. the positive predictive value (ppv) of afb for m. tuberculosis was 98.4% in expectorated sputum and 96.4% in bronchoalveolar lavage. forty four percent (130/295) of specimens with positive culture for m. tuberculosis and 66.7% (12/18) for ntm were from patients hiv positive. the conclusion was that in our study population, the ppv of afb for m. tuberculosis in respiratory specimens was high and the prevalence of ntm was low despite the high prevalence of hiv positive.
Tuberculosis and HIV: Renewed Challenge
Kritski Afranio L,Lapa e Silva José Roberto,Conde Marcus B
Memórias do Instituto Oswaldo Cruz , 1998,
Abstract:
Predictive value of the acid fast smear for detection of Mycobacterium tuberculosis in respiratory specimens in a Reference Center of HIV/Aids in Rio de Janeiro, Brazil
Conde Marcus B,Figueira Cesar M,Moraes Renata,Fonseca Leila S
Memórias do Instituto Oswaldo Cruz , 1999,
Abstract: In order to evaluate the predictive value of acid fast bacilii (AFB) smear for the diagnosis of Mycobacterium tuberculosis in respiratory specimens in a setting with a high prevalence of Aids and an unknown prevalence of nontuberculous mycobacteria (NTM), we retrospectively examined specimens cultured for mycobacteria between 1 September 1993 and 30 September 1994 and medical records of patients with positive culture in a General Hospital, Aids reference in Rio de Janeiro, Brazil. Seventy three per cent (1517/2077) of samples were respiratory specimens and mycobacteria were recovered from 20.6% (313/1517) of these. M. tuberculosis was identified in 94.2% (295/313) and NTM in 5.8% (18/313). The yield of positive AFB smear and of positive culture was 6.1% (93/1517) and 20.6% (313/1517), respectively. The positive predictive value (PPV) of AFB for M. tuberculosis was 98.4% in expectorated sputum and 96.4% in bronchoalveolar lavage. Forty four percent (130/295) of specimens with positive culture for M. tuberculosis and 66.7% (12/18) for NTM were from patients HIV positive. The conclusion was that in our study population, the PPV of AFB for M. tuberculosis in respiratory specimens was high and the prevalence of NTM was low despite the high prevalence of HIV positive.
Tempo entre o início dos sintomas e o tratamento de tuberculose pulmonar em um município com elevada incidência da doen?a
Maior, Marina de Loureiro;Guerra, Renata Leborato;Cailleaux-Cezar, Michelle;Golub, Jonathan Eric;Conde, Marcus Barreto;
Jornal Brasileiro de Pneumologia , 2012, DOI: 10.1590/S1806-37132012000200009
Abstract: objective: to estimate the time elapsed between the onset of symptoms and the initiation of treatment of pulmonary tuberculosis among treatment-na?ve patients with positive results in sputum smear microscopy, and to evaluate the variables associated with delays in diagnosis and in treatment initiation. methods: this was a descriptive exploratory study involving 199 treatment-na?ve tuberculosis patients > 12 years of age with afb-positive sputum smear microscopy results between 2006 and 2008. at their first (treatment initiation) visit to a primary health care clinic in the city of nova igua?u, brazil, the patients were interviewed and their ancillary test results were reviewed. results: the medians (and respective interquartile ranges) of the time from symptom onset to the initiation of treatment of pulmonary tuberculosis, from symptom onset to seeking medical attention, from entry into care to diagnosis, and from entry into care to treatment initiation, in weeks, were 11 (6-24), 8 (4-20), 2 (1-8), and 1 (1-1), respectively. the variables gender, age, level of education, previous use of antibiotics, hiv status, site of first medical visit, and radiological extent of tuberculosis showed no associations with the time from entry into care to diagnosis and to treatment initiation. the main reason for the delay in seeking medical attention reported by the patients was their inability to recognize their symptoms as indicators of a disease. conclusions: among the patients studied, there was an unacceptably long delay between the onset of symptoms and the initiation of tuberculosis treatment.
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