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Search Results: 1 - 10 of 50675 matches for " Vandack;Silva "
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Schistosomal myeloradiculopathy due to Schistosoma mansoni: report on 23 cases
Nobre Vandack,Silva Luciana CS,Ribas Jo?o G,Rayes Abdunnabi
Memórias do Instituto Oswaldo Cruz , 2001,
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.
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.
Hepatosplenic schistosomiasis in field-based studies: a combined clinical and sonographic definition
Lambertucci, José Roberto;Cota, Gláucia Fernandes;Pinto-Silva, Rogério Augusto;Serufo, José Carlos;Gerspacher-Lara, Rogério;Drummond, Sandra Costa;Antunes, Carlos Maurício;Nobre, Vandack;Rayes, Abdunnabi;
Memórias do Instituto Oswaldo Cruz , 2001, DOI: 10.1590/S0074-02762001000900022
Abstract: a combined clinical and sonographic classification of hepatosplenic schistosomiasis mansoni to be used in field-based studies is proposed herein. seven hundred forty one individuals out of 892 (83%), living in an area endemic for schistosomiasis in brazil, have been ubmitted to clinical and ultrasound examinations. based on two stool examinations the overall prevalence for schistosomiasis in this area was 73%. abdominal palpation was performed with patients in dorsal decubit, during deep breath, by two experienced physicians and a portable ultrasound was used for the evaluation of liver fibrosis, portal collaterals and spleen size. four groups of individuals were identified using data obtained by abdominal palpation and ultrasound examination: (1) palpable spleen and intense periportal thickening in 9 individuals (1.2%); (2) spleen not palpable and intense periportal thickening in 15 (2%); (3) palpable spleen with light to moderate periportal thickening in 32 (4.3%), and (4) palpable spleen with a normal liver on ultrasound in 30 (4%). the definition of hepatosplenic schistosomiasis in field-based studies as the finding of schistosoma mansoni eggs in the stools in an individual with splenomegaly is not acceptable anymore. abdominal ultrasound should be combined with clinical examination to accurately identify hepatosplenics in endemic areas for schistosomiasis.
The behavior and diagnostic utility of procalcitonin and five other inflammatory molecules in critically ill patients with respiratory distress and suspected 2009 influenza a H1N1 infection
Paiva, Mariana Benevides Santos;Botoni, Fernando Ant?nio;Teixeira Jr., Ant?nio Lúcio;Miranda, Aline Silva de;Oliveira, Clara Rodrigues Alves de;Abrah?o, Jamila de Oliveira;Faria, Guilherme Marques;Nobre, Vandack;
Clinics , 2012, DOI: 10.6061/clinics/2012(04)05
Abstract: objectives: during the 2009 influenza a h1n1 pandemic, it became difficult to differentiate viral infections from other conditions in patients admitted to the intensive care unit. we sought to evaluate the behavior and diagnostic utility of procalcitonin, c-reactive protein and four other molecules in patients with suspected 2009 influenza a h1n1 infection. methods: the serum levels of procalcitonin, c-reactive protein, tumor necrosis factor α, interferon γ, interleukin 1β, and interleukin 10 were tested on admission and on days 3, 5, and 7 in 35 patients with suspected 2009 h1n1 infection who were admitted to two icus. results: twelve patients had confirmed 2009 influenza a h1n1 infections, 6 had seasonal influenza infections, and 17 patients had negative swabs. the procalcitonin levels at inclusion and on day 3, and the c-reactive protein levels on day 3 were higher among subjects with 2009 influenza a h1n1 infections. the baseline levels of interleukin 1b were higher among the 2009 influenza a h1n1 patients compared with the other groups. the c-reactive protein levels on days 3, 5, and 7 and procalcitonin on days 5 and 7 were greater in non-surviving patients. conclusion: higher levels of procalcitonin, c-reactive protein and interleukin-1β might occur in critically ill patients who had a 2009 h1n1 infection. neither procalcitonin nor crp were useful in discriminating severe 2009 h1n1 pneumonia. higher levels of crp and procalcitonin appeared to identify patients with worse outcomes.
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.
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.
Les es dermatológicas em pacientes infectados pelo vírus linfotrópico humano de células T do tipo 1 (HTLV-1)
Nobre Vandack,Guedes Ant?nio Carlos Martins,Proietti Fernando Augusto,Stanciolli Edel
Revista da Sociedade Brasileira de Medicina Tropical , 2005,
Abstract: O vírus linfotrópico humano de células T do tipo 1 (HTLV-1) é o primeiro retrovírus isolado do ser humano. Descreveu-se, em pouco tempo, o seu papel etiológico em algumas doen as, com destaque para a leucemia/linfoma de células T do adulto (ATLL), a mielopatia associada ao HTLV-1/paraparesia espástica tropical (HAM/TSP) e a uveíte associada ao HTLV-1 (HAU). Na década de 90, o HTLV-1 foi associado a eczema grave da infancia, conhecido como dermatite infecciosa (DI). Desde ent o, diversos outros tipos de les es cutaneas têm sido observados em pacientes infectados pelo HTLV-1, em especial, nos doentes de HAM/TSP ou de ATLL. Porém, mesmo portadores assintomáticos do vírus apresentam doen as dermatológicas. Excetuando-se a dermatite infecciosa, n o há les o da pele específica da infec o pelo HTLV-1. Aqui, os autores apresentam as principais les es dermatológicas descritas em pacientes infectados pelo HTLV-1, destacando o valor epidemiológico e clínico desses achados.
Respiratory failure due to opportunistic diseases in AIDS
Teixeira Júnior Ant?nio Lúcio,Nobre Vandack,Lambertucci José Roberto
Revista da Sociedade Brasileira de Medicina Tropical , 2002,
Abstract:
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