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Search Results: 1 - 10 of 713 matches for " Nobre Vandack "
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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.
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:
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.
Schistosomiasis mansoni is asssociated with pyogenic liver abscesses in the state of Minas Gerais, Brazil
Teixeira Rosangela,Pfeilsticker Francis Jardim,Santa Cecília Giovanna DC,Nobre Vandack
Memórias do Instituto Oswaldo Cruz , 2001,
Abstract: The association between pyogenic liver abscesses and schistosomiasis has been confirmed by clinical and experimental studies. In this retrospective study of 78 patients with pyogenic liver abscesses the association with schistosomiasis has been investigated. Pyodermitis, a known focus of bacteremia, was observed in 19 patients (24%). Blood eosinophilia was observed in 30 patients (39%). Staphylococcus aureus was cultured from abscesses in 17 out of 38 patients (45%). Forty-one out of 57 patients (53%) had stool examination. Schistosoma mansoni was the main parasite identified. Eggs of S. mansoni were also identified in liver biopsies in 7 out of 19 patients who did the exam. The large number of young patients with liver abscesses described here is different from what has been observed in developed countries. This clinical study provide support for the concept that granulomas of S. mansoni in the liver are foci for colonization with S. aureus, which in presence of staphylococcal bacteremia can form liver abscesses.
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.
FEVER OF UNDETERMINED ORIGIN IN PATIENTS WITH THE ACQUIRED IMMUNODEFICIENCY SYNDROME IN BRAZIL: REPORT ON 55 CASES
LAMBERTUCCI, J. Roberto;RAYES, Abdunnabi A.M.;NUNES, Frank;LANDAZURI-PALACIOS, Jairo Enrique;NOBRE, Vandack;
Revista do Instituto de Medicina Tropical de S?o Paulo , 1999, DOI: 10.1590/S0036-46651999000100006
Abstract: the medical records of patients with aids admitted to a general hospital in brazil from 1989 to 1997 were reviewed retrospectively with the aim at defining the frequency and etiology of fever of undetermined origin (fuo) in hiv-infected patients of a tropical country and to evaluate the usefulness of the main diagnostic procedures. 188 (58.4%) out of 322 patients reported fever at admission to hospital and 55 (17.1%) had fuo. those with fuo had a mean cd4+ cell count of 98/ml. a cause of fever was identified for 45 patients (81.8%). tuberculosis (32.7%), pneumocystis carinii pneumonia (10.9%), and mycobacterium avium complex (9.1%) were the most frequent diagnoses. other infectious diseases are also of note, such as cryptococcal meningitis (5.5%), sinusitis (3.6%), salmonella-s. mansoni association (3.6%), disseminated histoplasmosis (3.6%), neurosyphilis (1.8%), and isosporiasis (1.8%). four patients had non-hodgkin's lymphoma (7.3%). we conclude that an initial aggressive diagnostic approach should be always considered because biopsies (lymph node, liver and bone marrow) produced the highest yield in the diagnosis of fuo and the majority of the diagnosed diseases are treatable. the association of diseases is common and have contributed to delay the final diagnosis of fuo in most cases. in our study area the routine request of hemocultures for salmonella infection and the investigation of cryptococcal antigen in the serum should be considered.
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