965 resultados para rheumatic fever


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Objective: to identify patterns in the spatial and temporal distribution of cases of dengue fever occurring in the city of Cruzeiro, state of Sao Paulo (SP).Methods: an ecological and exploratory study was undertaken using spatial analysis tools and data from dengue cases obtained on the SinanNet. The analysis was carried out by area, using the IBGE census sector as a unit. The months of March to June 2006 and 2011 were assessed, revealing progress of the disease. TerraView 3.3.1 was used to calculate the Global Moran's I, month to month, and the Kernel estimator.Results: in the year 2006, 691 cases of dengue fever (rate of 864.2 cases/100,000 inhabitants) were georeferenced; and the Moran's I and p-values were significant in the months of April and May (TM = 0.28; p = 0.01; I-M = 0.20; p = 0.01) with higher densities in the central, north, northeast and south regions. In the year 2011, 654 cases of dengue fever (rate of 886.8 cases/100,000 inhabitants) were georeferenced; and the Moran's I and p-values were significant in the months of April and May (I, = 0.28; p = 0.01; I-M = 0.16; p = 0.05) with densities in the same regions as 2006. The Global Moran's I is a global measure of spatial autocorrelation, which indicates the degree of spatial association in the set of information from the product in relation to the average. The I varies between -1 and +1 and can be attributed to a level of significance (p-value). The positive value points to a positive or direct spatial autocorrelation.Conclusion: we were able to identify patterns in the spatial and temporal distribution of dengue cases occurring in the city of Cruzeiro, SP, and locate the census sectors where the outbreak began and how it evolved.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Describe the clinical and laboratory profile, follow-up, and outcome of a series of cases of acute viral myositis. A retrospective analysis of suspected cases under observation in the emergency department was performed, including outpatient follow-up with the recording of respiratory infection and musculoskeletal symptoms, measurement of muscle enzymes, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), transaminases (AST and ALT), blood count, C-reactive protein, and erythrocyte sedimentation rate in the acute phase and during follow-up until normalization. Between 2000 and 2009, 42 suspected cases were identified and 35 (27 boys) were included. The median age was 7 years and the diagnosis was reported in 89% in the first emergency visit. The observed respiratory symptoms were cough (31%), rhinorrhea (23%), and fever (63%), with a mean duration of 4.3 days. Musculoskeletal symptoms were localized pain in the calves (80%), limited ambulation (57%), gait abnormality (40%), and muscle weakness in the lower limbs (71%), with a mean duration of 3.6 days. There was significant increase in CPK enzymes (5507±9180U/L), LDH (827±598U/L), and AST (199±245U/L), with a tendency to leukopenia (4590±1420) leukocytes/mm(3). The complete recovery of laboratory parameters was observed in 30 days (median), and laboratory and clinical recurrence was documented in one case after 10 months. Typical symptoms with increased muscle enzymes after diagnosis of influenza and self-limited course of the disease were the clues to the diagnosis. The increase in muscle enzymes indicate transient myotropic activity related to seasonal influenza, which should be considered, regardless of the viral identification, possibly associated with influenza virus or other respiratory viruses.

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To establish guidelines based on cientific evidences for the management of cryopyrin associated periodic syndromes. The Guideline was prepared from 4 clinical questions that were structured through Pico (Patient, Intervention or indicator, Comparison and Outcome), to search in key primary scientific information databases. After defining the potential studies to support the recommendations, these were graduated considering their strength of evidence and grade of recommendation. 1215 articles were retrieved and evaluated by title and abstract; from these, 42 articles were selected to support the recommendations. 1. The diagnosis of Caps is based on clinical history and clinical manifestations, and later confirmed by genetic study. Caps may manifest itself in three phenotypes: FCAS (mild form), MWS (intermediate form) and Cinca (severe form). Neurological, ophthalmic, otorhinolaryngological and radiological assessments may be highly valuable in distinguishing between syndromes; 2. The genetic diagnosis with NLRP3 gene analysis must be conducted in suspected cases of Caps, i.e., individuals presenting before 20 years of age, recurrent episodes of inflammation expressed by a mild fever and urticaria; 3. Laboratory abnormalities include leukocytosis and elevated serum levels of inflammatory proteins; 4. Targeted therapies directed against interleukin-1 lead to rapid remission of symptoms in most patients. However, there are important limitations on the long-term safety. None of the three anti-IL-1β inhibitors prevents progression of bone lesions.