Background: Malaria remains a health problem in the Amazon and since 2005 the state of Acre has high incidence of malaria. Treatment with Coartem® for cases of falciparum malaria was introduced in Acre in August 2012. In Brazil, there is still no published study on the effectiveness of Coartem in endemic areas. Methods: This study was conducted in Mâncio Lima, Acre, in the western Brazilian Amazon region. All malaria cases notified in Mâncio Lima between August 01st, 2012 and October 31st, 2013 were revised. The therapeutic response to Coartem in Mâncio Lima, Acre, was evaluated. A recurrence of falciparum malaria was defined as a malaria case occurring in the same patient in a maximum interval of 40 days between the day treatments was started and the day the next diagnosis was made. Results: All malaria cases (7,171) notified between August 2012 and July 2013 were revised. About 23.72% (n = 1,701) were falciparum malaria. There were six cases of recurrent falciparum malaria that can be classified as treatment failure. All cases had low parasitemia. The minimum and maximum interval between the first and the recurrent malaria episode was 17 days and 33 days. Age range was 9 to 50 years. Two patients were from rural areas, while all others were from riverine areas. Conclusion: Possible failure to Coartem treatment was identified, however causes are not clear. Further studies are needed.
A leishmaniose tegumentar americana (LTA) é uma doença com elevada incidência no Norte brasileiro, onde o estado do Acre destaca-se com maior coeficiente de detecção. Nesse cenário, o objetivo do presente estudo foi descrever as características clínico epidemiológicas da LTA de pacientes atendidos no Serviço de Atendimento Especializado em Rio Branco, Acre. Trata-se de um estudo de caráter quantitativo, descritivo, do tipo coorte retrospectiva, em que foram analisados os prontuários médicos dos referidos pacientes. Foram identificados 279 prontuários médicos, que incluíram indivíduos entre 1 e 84 anos, sendo 69,9% do sexo masculino e 81,7% moradores de área urbana. O padrão clínico correspondeu a lesões cutâneas (62,7%), únicas (78,1%), com diagnóstico laboratorial mais frequente (70,3%) e tratamento realizado com antimoniato de meglumina em 72,0%. Apesar das limitações encontradas no uso de dados secundários, foi possível identificar o perfil epidemiológico e a conduta clínica estabelecida nos casos referenciados neste estado e, dessa forma, traçar um panorama do cenário assistencial que auxilie a saúde pública amazônica. Palavras-chave: Leishmaniose. Doenças Negligenciadas. Epidemiologia.
Os avanços na área da saúde possibilitaram o aumento da expectativa de vida e influenciaram na prevalência das doenças que acometem as pessoas idosas. Entre essas, têm-se as síndromes demenciais, como doença de Alzheimer, que deterioram a qualidade de vida não só do indivíduo acometido como dos familiares que o cercam. Atrelado a clínica do paciente existem testes cognitivos que auxiliam no diagnóstico, entre eles o Teste do Desenho do Relógio (TDR). O objetivo deste estudo é avaliar o emprego do TDR em idosos com e sem demência, antes e após tratamento homeopático, no município de Rio Branco, Acre. Consiste em um estudo observacional longitudinal do tipo coorte, realizado com pessoas idosas em acompanhamento por queixas cognitivas ou motoras no Hospital do Idoso da Fundação Hospitalar do Acre, com aplicação do TDR entre agosto de 2019 e maio de 2021. Conclui-se que na população de estudo acreana o teste tem grande influência da escolaridade e dificulta seu emprego como ferramenta diagnóstica para demência, além de também ter seus resultados confundidos pela renda e idade. Palavras-chave: Demências. Teste do desenho do relógio. Escolaridade.
No abstract
Context: Septic Cavernous Sinus Thrombosis (CST) is a rare and potentially lethal illness that clinicians still occasionally see. We describe the evolution of a 6 months old infant patient who had a history of delayed vaccination and acquired a Pneumococcal Meningitis, leading to septic CTS. Case report: The patient was admitted with the complaint of constant crying and vomiting. The physical exam noticed: bulging of the bregmatic fontanelle, Glasgow Coma Score = 11, and bad general state. The clinical picture had begun one week before the hospitalization, but the fever had started just three days before. The vaccine neglection plus some pathological signs of meningeal infection guided the clinical thinking to meningitis, later confirmed by the lumbar puncture. Some days later, the patient presented paralysis of the third pair of cranial nerves, conducing to the inability to open the eyes, mydriatic non-photo reagent pupils, and bilateral swelling. A magnetic resonance confirmed thrombosis of traverse sinus along with the transition to the sigmoid one. Bilateral ptosis and exotropia were noticed. Antibiotic therapy resulted in progressive eye-opening and recurrence of photo reagent reflexes. The prognosis was great, pointed by the normotension and normal amplitude of the bregmatic fontanelle. Conclusion: The elimination of the meningeal infection focus was extremely important, since the pathophysiology of CST came from phlebitis of the cavernous sinuses, with consequent thrombus formation from the endothelial lesion. In addition, it is worth mentioning the omission of vaccination, which was concessive to the case.
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