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Search Results: 1 - 10 of 56962 matches for " Rosemeri Maurici da;Teixeira "
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O escarro induzido no diagnóstico das doen?as pulmonares em pacientes positivos ao vírus da imunodeficiência humana
Silva, Rosemeri Maurici da;Teixeira, Paulo José Zimermann;Moreira, José da Silva;
Jornal Brasileiro de Pneumologia , 2004, DOI: 10.1590/S1806-37132004000500009
Abstract: background: induced sputum is widely used in assessing airway inflammation. however, its utility as a diagnostic tool in the diagnosis of lung disease in immunosuppressed patients merits further investigation. objectives: to determinate the diagnostic yield of sputum induction in the diagnosis of lung diseases in hiv-positive patients. method: subjects were selected from among hiv-positive patients older than 14 years who were evaluated at a reference hospital between january 2001 and september 2002. those with respiratory symptoms for 7 days or longer with normal or abnormal chest x-rays, as well as those without respiratory symptoms but with abnormal chest x-rays, were included. all subjects were submitted to clinical examination, radiologic evaluation, sputum induction and laboratory testing. subsequently, flexible fiberoptic bronchoscopy, bronchoalveolar lavage and transbronchial lung biopsy were performed. samples were processed for gram and ziehl-neelsen staining, quantitative culture for pyogenic bacteria, direct staining for fungi, culture for mycobacteria and fungi, silver stain for pneumocystis jiroveci, as well as for total and differential cellularity determination. results: a total of 54 patients were included. upon testing negative for any etiologic agent, 7 patients were excluded, resulting in a total of 54 patients studied. a total of 60 infectious agents were isolated. among the etiologic agents isolated, 46.7% were p. jiroveci, 33.5 were pyogenic bacteria and 16.7% were mycobacterium tuberculosis. sputum induction presented 57.5% sensitivity, 42.9% specificity, 87.1% predictive positive value, 13% predictive negative value and 55.6% overall accuracy. conclusions: in this population, sputum induction proved to be a technique that is safe and easily performed, with a good diagnostic yield.
The clinical utility of induced sputum for the diagnosis of bacterial community-acquired pneumonia in HIV-infected patients: a prospective cross-sectional study
Silva, Rosemeri Maurici da;Teixeira, Paulo José Zimermann;Moreira, José da Silva;
Brazilian Journal of Infectious Diseases , 2006, DOI: 10.1590/S1413-86702006000200004
Abstract: background: bacterial pneumonias have been overcoming pneumocytosis in frequency. controversy still remains about how to manage immunocompromised patients and those with lung diseases. sputum analysis is a noninvasive and simple method, and when interpreted according to specific criteria it may help with diagnosis. we conducted a study to evaluate sensitivity, specificity, positive and negative predicted values, and the accuracy of induced sputum (is) for bacterial community-acquired pneumonia diagnosis in hiv-positive patients. material and methods: this cross sectional study evaluated a diagnostic procedure in a reference hospital for hiv patients in florianópolis, sc, brazil. from january 1, 2001 to september 30, 2002, 547 hiv-positive patients were analyzed and 54 inpatients with pulmonary infection were selected. bronchoalveolar lavage (bal) and transbronchial lung biopsy (tblb) were considered the gold standards. gram stains and quantitative cultures of is and bal were obtained. the cut-offs for quantitative cultures were 106 cfu/ml for is and 104 cfu/ml for bal. results: the mean age was 35.7 years, 79.6% were males and 85.2% were caucasians. the mean lymphocyte count was 124.8/mm3. bacterial pneumonia was diagnosed in 20 patients. the most prevalent bacteria was streptococcus pneumoniae. considering is for the diagnosis of bacterial pneumonia, sensitivity was 60%, specificity 40%, the positive predictive value was 80%, negative predictive value 20% and accuracy 56%. conclusion: is with quantitative culture can be helpful for the diagnosis of bacterial pneumonia in hiv-positive patients.
A síndrome da imunodeficiência adquirida e o pulm?o
Jornal de Pneumologia , 2000, DOI: 10.1590/S0102-35862000000100009
Abstract: the greatest causes of morbidity and mortality in patients infected with human immunodeficiency virus are opportunistic infections and neoplastic diseases. most of them are lung diseases. its correct diagnosis and proper treatment improve the quality of life as well as the survival in this group of patients.
A síndrome da imunodeficiência adquirida e o pulm o
Jornal de Pneumologia , 2000,
Abstract: As maiores causas de morbimortalidade em pacientes infectados com o vírus da imunodeficiência humana s o as infec es oportunísticas e os processos neoplásicos. Grande parte dessas afec es apresenta-se como desordens pulmonares. Seu correto diagnóstico e tratamento adequado melhoram tanto a sobrevida como a qualidade de vida desse grupo de pacientes.
Avalia??o semiológica da palidez: concordancia entre observadores e compara??o com níveis séricos de hemoglobina
Silva, Rosemeri Maurici da;Machado, Carlos Alexandre;
Revista Brasileira de Hematologia e Hemoterapia , 2010, DOI: 10.1590/S1516-84842010000600007
Abstract: introduction: pallor is characterized by discoloring of the skin and mucous membranes due to a reduction in the amount of circulating hemoglobin. the objective of this study was to compare the degree of pallor, stratified using crosses, with hemoglobin levels and to evaluate the correlation between observers. method: from february to april 2009, an observational cross-sectional study was carried out of over 18-year-old individuals admitted to a hospital in the south of the state of santa catarina, for whom the measurement of hemoglobin levels had been requested. the degree of pallor (from absent to ++++/4) of the ocular mucosa of 96 patients was evaluated by two types of examiners (physicians and medical students). the kappa agreement index was used to assess the agreement between observers. results: all patients (45.8% male and 54.2% female) were caucasian with a mean age of 57.7 years. there were statistically significant differences on comparing the mean hemoglobin levels with pallor for the medical students but no significant differences were seen for the physicians. the kappa agreement index between the observers was low. this research demonstrates that the agreement between the observers was not good for the evaluation of pallor. the most reliable evaluation regarding the hemoglobin levels was by the physicians.
Manifesta??es clínicas, radiológicas e laboratoriais em indivíduos com tuberculose pulmonar: estudo comparativo entre indivíduos HIV positivos e HIV negativos internados em um hospital de referência
Besen, Aline;Staub, Guilherme J?nck;Silva, Rosemeri Maurici da;
Jornal Brasileiro de Pneumologia , 2011, DOI: 10.1590/S1806-37132011000600010
Abstract: objective: to compare clinical, radiological, and laboratory characteristics of individuals with pulmonary tuberculosis co-infected or not with hiv. methods: a cross-sectional study, in which signs and symptoms were assessed by anamnesis and physical examination in patients hospitalized with pulmonary tuberculosis. the results of sputum smear microscopy and culture for mycobacterium tuberculosis, as well as hemoglobin levels and cd4+ t-cell counts, were obtained from medical records, and chest x-ray reports were consulted. results: we included 50 pulmonary tuberculosis patients, who were divided into two groups (hiv-positive and hiv-negative; n = 25 per group). the mean age of the participants was 38.4 ± 10.5 years; 46 (92%) were males; and 27 (54%) were white. expectoration was presented by 21 (84%) and 13 (52%) of the patients in the hiv-negative and hiv-positive groups, respectively (p = 0.016). radiological findings of cavitation were present in 10 (43%) and 2 (10%) of the patients in the hiv-negative and hiv-positive groups, respectively (p = 0.016), whereas an interstitial pattern was observed in 18 (78%) and 8 (40%), respectively (p = 0.012). the mean hemoglobin level was 11.1 ± 2.9 g/dl and 9.3 ± 2.2 g/dl in the hiv-negative and hiv-positive groups, respectively (p = 0.015). conclusions: in our sample of tuberculosis patients, expectoration was less prevalent, hemoglobin levels were lower, and cavitation was less common, as was an interstitial pattern, among those co-infected with hiv than among those without hiv co-infection.
Induced sputum versus bronchoalveolar lavage in the diagnosis of pneumocystis jiroveci pneumonia in human immunodeficiency virus-positive patients
Silva, Rosemeri Maurici da;Bazzo, Maria Luiza;Borges, Alessandra Abel;
Brazilian Journal of Infectious Diseases , 2007, DOI: 10.1590/S1413-86702007000600005
Abstract: induced sputum is a useful technique for assessing airway inflammation, but its role in the diagnosis of lung disease in immunosuppressed patients needs further investigation. this study compared the use of induced sputum and bal in the diagnosis of pneumocystosis, in hiv patients. from january 1, 2001, to december 30, 2002, hiv-positive patients older than 14 were evaluated at a hospital in florianópolis, santa catarina, brazil. patients with respiratory symptoms for seven days or longer, with a normal or abnormal chest x-ray, and those without respiratory symptoms but with an abnormal chest x-ray, were included in the study. all patients were submitted to clinical, radiological and laboratory evaluation, after which induced sputum and bronchoscopy with bronchoalveolar lavage were carried out. the samples were subjected to the following techniques: gram and ziehl-neelsen staining, quantitative culture growth for pyogenic bacteria, direct staining for fungi, culture growth for mycobacteria and fungi, and grocott-gomori staining for pneumocystis jiroveci, as well as total and differential cell counts. the samples with p. jiroveci were selected, as well as the samples for which no etiologic agents were observed. forty-five patients with a mean age of 34.6, 38 male and 40 caucasian, comprised the subjects. interstitial infiltrate was the most frequent radiological pattern (53.3%). the induced sputum sensitivity was 58.8%, specificity 81.8%, predictive positive value 90.9%, predictive negative value 39.1% and accuracy 64.4%, for the diagnosis of pneumocystosis, compared with bal. based on these data, induced sputum is a useful technique for the diagnosis of pneumocystosis in hiv patients.
Quality of sputum in the performance of polymerase chain reaction for diagnosis of pulmonary tuberculosis
Silva, Rosemeri Maurici da;Bazzo, Maria Luiza;Chagas, Mariana;
Brazilian Journal of Infectious Diseases , 2010, DOI: 10.1590/S1413-86702010000100022
Abstract: setting: faster alternative techniques are required to improve the diagnosis and control of pulmonary tuberculosis. objective: to evaluate the sample quality in the performance of pcr for diagnosis of pulmonary tuberculosis. method: during one year, sputum samples were collected from 72 pulmonary tuberculosis patients and 12 non-tuberculosis controls, which were admitted to the nereu ramos hospital, florianópolis city, brazil. the samples were subjected to ziehl-neelsen-stained sputum smear microscopy and lowestein-jensen medium culture, which were defined as gold standard tests for mycobacteria, and polymerase chain reaction (pcr). those samples that presented more than 40% of viable cells and less than 25% of epithelial cells were defined as high quality samples. results: pcr showed sensitivity of 55.6%, specificity of 41.7%, positive predictive value of 85.1%, negative predictive value of 13.5%, and accuracy of 53.6%. high quality samples showed sensitivity of 72.4%, specificity of 50%, positive predictive value of 91.3%, negative predictive value of 20%, and accuracy of 69.7%. low quality samples showed sensitivity of 44.2%, specificity of 37.5%, positive predictive value of 79.2%, negative predictive value of 11.1%, and accuracy of 43.1%. conclusion: use of high quality samples improved significantly the pcr performance, especially on their sensitivity and positive predictive values.
Diagnosis of the pulmonary tuberculosis by polymerase chain reaction: a comparative study between HIV - positive and - negative individuals
Silva, Rosemeri Maurici da;Machado, Tairone;Bazzo, Maria Luiza;
Brazilian Journal of Microbiology , 2012, DOI: 10.1590/S1517-83822012000100030
Abstract: this study was performed to assess the efficiency of polymerase chain reaction (pcr) directly from sputum for the diagnosis of pulmonary tuberculosis by comparison between hiv-positive and hiv-negative individuals. sputum samples were collected from hospitalized patients admitted with a clinical diagnosis of pulmonary tuberculosis, and subjected to smear microscopy, culture on lj medium and detection of m. tuberculosis by pcr. sensitivity, specificity, and predictive values (positive and negative) were calculated using smear and/or culture at day 42 as the gold standard, by comparing the yield in hiv-positive and hiv-negative individuals. regardless of serostatus, the technique's yield had 62% sensitivity, 70% specificity, 79% positive predictive value, 50% negative predictive value, and 65% accuracy. hiv-negative had 64% sensitivity, 74% specificity, 75% positive predictive value, 63% negative predictive value, and 68% accuracy. hiv-positive had 59% sensitivity, 33% specificity, 87% positive predictive value, 10% negative predictive value, and 56% accuracy. the pcr showed a higher yield in hiv-negative individuals compared to hiv-positive individuals.
Altera??es radiográficas em pacientes com a co-infec??o vírus da imunodeficiência humana/tuberculose: rela??o com a contagem de células TCD4+
Silva, Rosemeri Maurici da;Rosa, Lígia da;Lemos, Renata Nunes;
Jornal Brasileiro de Pneumologia , 2006, DOI: 10.1590/S1806-37132006000300009
Abstract: objective: to look for correlations between radiological patterns and cd4+ t cell counts in patients coinfected with tuberculosis and human immunodeficiency virus. methods: patients included were selected from among those presenting human immunodeficiency virus/tuberculosis coinfection and admitted to the nereu ramos hospital, located in florianópolis, brazil, between january of 2000 and december of 2003. results: a total of 87 patients were included. the mean age was 34 ± 8 years, and 6.8% were non-caucasian. the mean cd4+ t cell count was 220.2 cells/mm3 (median, 144 cells/mm3), and 56.4% of the patients presented less than 200 cells/mm3. we identified the following radiographic patterns and related them to the cd4+ t cell counts: the alveolar pattern in 50.6% of the cases (56.8% cd4+ t cells < 200); the interstitial pattern in 32.2% (53.6% cd4+ t cells < 200); pleural effusion in 24.1% (47.6% cd4+ t cells < 200); cavitation in 24.1% (57.1% cd4+ t cells < 200); enlarged mediastinal or hilar lymph nodes in 11.5% (90% cd4+ t cells < 200); and a normal pattern in 11.5% (60% cd4+ t cells < 200). the mean cd4+ t cell counts for the radiologic patterns isolated were as follows: 235.2/mm3 (alveolar consolidation); 208.8/mm3 (interstitial); 243.3/mm3 (pleural effusion); 265/mm3 (cavitation); 115.1/mm3 (enlarged mediastinal or hilar lymph nodes) (p < 0.05); and 205.5/mm3 (presenting no radiological alterations). as noted, mediastinal/hilar lymph node enlargement was the only pattern that correlated with the degree of cell-mediated immunity in a statistically significant way. conclusion: with the exception of mediastinal/hilar lymph node enlargement, the radiographic patterns were randomly distributed in relation to the cd4+ t cell counts.
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