Over the past several years, the epidemiological profile of dengue has been changing progressively and is currently characterized by an increase in the number of cases in children under 15 years of age. This study was aimed at comparing the clinical and laboratory features between adults and children with dengue; therefore, we performed a cross-sectional analysis of 5686 individuals with laboratory-confirmed dengue who sought treatment at a healthcare facility in Rio de Janeiro, Brazil from 2010 to 2011. A multivariate analysis indicated that myalgia (OR=2.58; CI 95%=2.08-3.18), retro-orbital pain (OR=1.36; CI 95%=1.15-1.62), nausea (OR=1.92; CI 95%=1.60-2.30), and arthralgia (OR=3.64; CI 95%=2.72-4.89) were the most frequent clinical symptoms in adults, whereas vomiting (OR=0.52; CI 95%=0.43-0.61) and skin rash (OR=0.46; CI 95%=0.25-0.85) were the most prevalent symptoms in children. Adults exhibited a higher hemoconcentration (OR=3.04; CI 95%=2.53-3.65), thrombocytopenia (OR=2.17; CI 95%=1.80-2.60), increased erythrocyte sedimentation rate (OR=1.81; CI 95%=1.53-2.14), and increased ALT (OR=3.13; CI 95%=2.44-4.02) than did children. In addition, adults exhibited a higher frequency of the severe forms of the disease (OR=1.74; CI 95%=1.12-2.72) and hospitalization (OR=2.21; CI 95%=1.59-3.06) relative to children. Based on these results, this study demonstrated significant differences in the clinical and laboratory presentations and disease severity between adults and children affected by dengue.
ObjectiveTo evaluate by magnetic resonance imaging changes in bone marrow of patients
undergoing treatment for type I Gaucher’s disease.Materials and MethodsDescriptive, cross-sectional study of Gaucher’s disease patients submitted to 3 T
magnetic resonance imaging of femurs and lumbar spine. The images were blindly
reviewed and the findings were classified according to the semiquantitative bone
marrow burden (BMB) scoring system.ResultsAll of the seven evaluated patients (three men and four women) presented signs of
bone marrow infiltration. Osteonecrosis of the femoral head was found in three
patients, Erlenmeyer flask deformity in five, and no patient had vertebral body
collapse. The mean BMB score was 11, ranging from 9 to 14.ConclusionMagnetic resonance imaging is currently the method of choice for assessing bone
involvement in Gaucher’s disease in adults due to its high sensitivity to detect
both focal and diffuse bone marrow changes, and the BMB score is a simplified
method for semiquantitative analysis, without depending on advanced sequences or
sophisticated hardware, allowing for the classification of the disease extent and
assisting in the treatment monitoring.
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