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Search Results: 1 - 10 of 15110 matches for " Vera Clérigo "
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A Rare Case of Pulmonary Mucormycosis Successfully Treated with Dual Antifungal Agents and Surgery in a Patient with Uncontrolled Diabetes  [PDF]
Vera Clérigo, Lígia Fernandes, Tiago Abreu, Pedro Barradas
Open Journal of Respiratory Diseases (OJRD) , 2016, DOI: 10.4236/ojrd.2016.62005
Abstract: Pulmonary mucormycosis is an emergent and life-threatening invasive fungal infection underdiagnosed by clinicians due to unspecific clinical picture and lack of awareness. Although the acknowledgment of risk factors, clinical and radiological findings may increase early recognition, the definite diagnosis is challenging to establish and the ideal treatment has never been delineated. The authors describe a rare case of pulmonary mucormycosis that was successfully treated with dual antifungal treatment and surgery in a patient with uncontrolled diabetes. When last evaluated, he was asymptomatic with no evidence of relapse. To our knowledge this is a rare report of a successfully treated diabetic patient with pulmonary mucormycosis with L-AmB, triazole posaconazole and surgery with no evidence of recurrence. We highlight the importance of clinicians’ awareness to early diagnosis, combined antifungal treatment and adjuvant surgery as the greatest chance of cure of a rapidly progressive disease with high mortality and morbidity.
Impact of HIV Status, CD4 Count and Antiretroviral Treatment on Tuberculosis Treatment Outcomes in a Low-Burden Country  [PDF]
Vera Clérigo, Teresa Mourato, Concei??o Gomes, Ana Castro
Journal of Tuberculosis Research (JTR) , 2018, DOI: 10.4236/jtr.2018.64025
Abstract: Background: Few data is available in low-burden TB-HIV countries on TB treatment outcomes. We evaluated TB patients (pts) characteristics by HIV status and compared treatment outcomes in relation to HIV status, CD4 count and antiretroviral therapy (ART). Methods: We performed a retrospective analysis of 447 adult TB pts who registered and initiated treatment in our center from 2014 to 2015. Results: Pts were categorized as HIV-negative (n = 399, 89.3%), HIV-positive on ART (n = 42, 9.4%) and HIV-positive not on ART (n = 6, 1.3%). The proportion of pts with extended TB therapy was higher among HIV-positive pts (p = 0.03). Increased age was associated with higher death rates regarding treatment success (OR 1.08; 95% CI 1.01 - 1.17, p = 0.03). Statistically significant higher mortality was found among HIV-positive pts on ART (OR 9.93; 95% CI 1.36 - 72.37, p = 0.03) and HIV-positive pts not on ART (OR 397.00; 95% CI 44.27 to 3559.91, p ≤ 0.0001) compared to HIV-negative pts. When multivariate analyses were restricted to HIV-positive pts, being not on ART was associated with higher mortality (OR 40.0; 95% CI 4.37 - 365.78, p = 0.001). Conclusions: There was significant difference in death rates between HIV-positive and HIV-negative TB pts. HIV-positive pts not on ART had a significantly higher mortality.
A Rare Case of Diaphragmatic Mass: The Key to Diagnosis of a Lung Adenocarcinoma  [PDF]
Cláudia Rocha, Vera Clérigo, Lígia Fernandes, André Rodrigues, Dora Sargento, Glória Silva
Advances in Lung Cancer (ALC) , 2014, DOI: 10.4236/alc.2014.33009
Abstract: Lung cancer is a leading cause of death due to malignancy worldwide. Diaphragmatic metastasis secondary to primary lung cancer is rare. In the literature, only a few cases have been described as the majority of cases of diaphragmatic metastasis which are secondary to gastrointestinal neoplasia. The authors report a rare case of diaphragmmatic metastasis from a primary adenocarcinoma of the lung in a 76-year-old female patient with no history of active or passive smoking with progressive worsening fatigue, asthenia, malaise, and unquantified weight loss with three months of evolution, associated with pleuritic chest pain and edema of the lower limbs for fifteen days previous to hospital admission. Chest X-ray showed elevation of the right hemi-diaphragm and thoracic-abdominal-pelvic computed tomography revealed a complex multilobuled mass with neoformative characteristics intersecting the diaphragm and invading the dome liver and the right lung region. Biopsy of the mass was performed whose histological examination was consistent with moderately differentiated adenocarcinoma. Immunohistochemical examination was positive for cytokeratin 7 and negative forcytokeratin 20, suggesting primary lung tumor. A positron emission tomography was performed without uptake in other locations. Diagnosis of adenocarcinoma with diaphragmatic metastasis was then admitted and the patient started chemotherapy with carboplatin and gemcitabine. The patient died six months after the diagnosis. The authors also present a brief theoretical discussion based on the current and scarce literature on this rare entity.
Infective Endocarditis with Negative Cultures: A Defiant Diagnosis  [PDF]
Cláudia Rocha, Vera Clérigo, Lígia Fernandes, André Rodrigues, Dora Sargento, Glória Silva
Case Reports in Clinical Medicine (CRCM) , 2014, DOI: 10.4236/crcm.2014.38101
Abstract:

The diagnosis and management of blood culture-negative endocarditis constitute a real clinical challenge and a systemic approach is necessary for a successful outcome. The authors report a case of a female patient aged 26, with previous clinical history of valve disease and heart failure NYHA class II, with decompensation of co-morbidities associated with fever, productive cough, nonselective anorexia and unquantified weight loss with one month of evolution with negative blood cultures. Transesophageal echocardiography revealed the presence of severe pulmonary hypertension and mitral valve vegetations in the context of positive serology for Q fever. Herein, the authors report a case of blood culture-negative endocarditis and present a brief review on the management of this medical condition. We highlighted the diagnostic difficulties of blood culture-negative endocarditis and subacute clinical presentation, which sometimes present with fever of unknown origin and complaints of deterioration of cardiac function, thus creating a challenging differential diagnosis.

Gangrenous Cholecystitis with Atypical Presentation in an Elderly Diabetic Woman  [PDF]
Vera Clérigo, Cláudia Rocha, André Rodrigues, Lígia Fernandes, Dora Sargento, Glória Silva
Case Reports in Clinical Medicine (CRCM) , 2014, DOI: 10.4236/crcm.2014.39110
Abstract:

In elderly patients, numerous factors subsidize the diagnostic challenge and high incidence of complications in this specific population, taking gangrenous cholecystitis as a critical example. The aim of this work is to report an unusual case of gangrenous choleystitis in an elderly diabetic women and its atypical clinical presentation. A 79-year-old female patient came to our observation; her medical history showed nausea and vomiting of about 2 hours which rapidly ended with symptomatic therapy, without recurrence, and a 3-week history of intermittent fever associated with productive cough. No abdominal discomfort was declared. Physical examination of the abdomen was negative. Laboratory analysis revealed leukocytosis with the remaining criteria within the normal range. After 2 days, she started with a mildabdominal pain in the epigastric region that rapidly progressed to the right upper quadrant, right flank and right iliac fossa, without nausea, vomiting or fever. Abdominal computer tomography findings revealed thickness of the gall-bladder and important densification of the vascular bed. Acute cholecystitis was diagnosed. The patient was then submitted to a laparoscopic cholecystectomy under general anaesthesia with findings suggestive of gangrenous acute cholecystitis confirmed by histologic examination of the specimen. Delays in diagnosing acute cholecystitis in specific populations, such as elderly diabetics, result in a higher prevalence of morbidity and mortality due to potentially serious complications as gangrenous cholecystitis. Consequently, the diagnosis should be measured and investigated promptly in order to prevent poor outcomes.

Swimming Heart: A Pleural, Pulmonary and Pericardial Disseminated Thymoma  [PDF]
Lígia Fernandes, André Rodrigues, Vera Clérigo, Cláudia Rocha, Dora Sargento, Glória Silva
Open Journal of Clinical Diagnostics (OJCD) , 2014, DOI: 10.4236/ojcd.2014.44030
Abstract: Thymoma is the most common neoplasm of the anterior mediastinum and accounts for one quarter of all mediastinal tumours and half of all anterior mediastinal masses. Pericardial effusion may be present in approximately 20% of cases. This report presents a patient with a previously diagnosed thymoma without surgical indication and with poor response to chemotherapy and radiotherapy who had a pericardial effusion that likely resulted from the malignancy dissemination to pericardium.
Carbonation-Related Microstructural Changesin Long-Term Durability Concrete
Silva, Cláudio A. Rigo da;Reis, Rubens J. Pedrosa;Lameiras, Fernando Soares;Vasconcelos, Wander Luiz;
Materials Research , 2002, DOI: 10.1590/S1516-14392002000300012
Abstract: this paper discusses the effects of carbonation on the microstructure of portland cement concrete for long-term durability applications. a class c40 concrete (characteristic compression strength between 40 mpa and 44 mpa on the 28th day, according to brazilian standard nbr 8953) was chosen for the experimental study of the carbonation effects, from which test samples were molded for accelerated test under a 100%-co2 atmosphere after physical and mechanical characterization. it was observed that carbonation provoked a reduction of 5% to 12% of the concrete open porosity accessible to water. flexural strength values obtained after the carbonation tests revealed a decrease of 12% and 25% in relation to the values obtained before tests on the 28th and 91st days, respectively.
Avalia??o da resposta imune humoral frente a antígenos de Strongyloides venezuelensis
Rigo, Carla Rodrigues;Lescano, Susana Zevallos;Marchi, Cláudia Regina de;Amato Neto, Vicente;
Revista da Sociedade Brasileira de Medicina Tropical , 2008, DOI: 10.1590/S0037-86822008000600017
Abstract: strongyloidiasis affects 30 million people in 70 countries. this enteral parasitosis is usually diagnosed using parasitological tests based on hydrotropism or thermotropism of larvae eliminated in feces, but these tests have been shown to have low sensitivity. in this study, antigenic extracts were tested by means of elisa, immunoblotting and ifi, using filariform larvae of strongyloides venezuelensis, a parasite of rodents that shows cross-reactions with strongyloides stercoralis epitopes. sensitivity of 89, 85 and 57% for the elisa reaction and 100, 100 and 96% for immunoblotting with the sal, zwip and zw antigens, and specificity of 90, 60 and 81% for elisa and 96, 92 and 91% for immunoblotting with the same antigens, were found in these assays.
Effects of High Temperature on the Residual Performance of Portland Cement Concretes
Tolentino Evandro,Lameiras Fernando S.,Gomes Abdias M.,Silva Cláudio A. Rigo da
Materials Research , 2002,
Abstract: In this work we analyzed the "residual" performance of Portland cement concretes heat-treated at 600 °C after cooling down to room temperature. Concretes with characteristic compressive strength at 28 days of 45 MPa and of 60 MPa were studied. The heat-treatment was carried out without any imposed load. We measured the residual compressive strength and modulus of elasticity. The geometry of the structure was described by mercury intrusion porosimetry and nitrogen sorption tests. We observed a decrease of residual compressive strength and modulus of elasticity, with the raise of heat-treatment temperature, as a result of heat-induced material degradation. The results also indicated that the microstructural damage increased steadily with increasing temperature. Based on the results of this experimental work we concluded that residual mechanical properties of concrete are dependent of their original non heat-treated values.
Structural Evaluation and Performance of Portland Cement Concretes After Exposure to High Temperatures
Tolentino Evandro,Lameiras Fernando S.,Gomes Abdias M.,Silva Cláudio A. Rigo da
Materials Research , 2002,
Abstract: We evaluated the "residual" thermal conductivity of Portland cement concretes (with characteristic compressive strength at 28 days, f ck, of 20 MPa and 50 MPa) at room temperature after heat-treating at 180 °C, 300 °C and 600 °C. The description of the geometry of the structure was carried out using mercury intrusion porosimetry and nitrogen sorption. The results showed a decreasing tendency of residual thermal conductivity, which we attributed to heat-induced concrete degradation. Furthermore, the results from mercury intrusion porosimetry and nitrogen sorption tests showed that a coarser pore structure is produced with the raise of heat-treatment temperatures.
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