950 resultados para Patient Knowledge


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A chronic infection (10 years) by Lagochilascaris minor is described in a woman from the amazon region of Colombia. This is the third case of infection by this parasite that has been described so far in Colombia, and only the first one in a person coming from the Colombian Amazon region.

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A case of sporotrichosis in a woman presenting 63 cutaneous lesions distributed all over the tegument is related. The patient had both humoral (Immunoglobulins) and cellular (Lymphocytes subpopulations) immunity within normal limits, but was under treatment with steroid during a long time (Prednisone 10 mg daily for 2 years), due to a sciatic pain. In addition a review of the Brazilian literature on this type of lesions was carried out and commented.

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We report the detection of specific IgA antibodies and the determination of IgG avidity in sequential serum samples from a patient exhibiting significant levels of Toxoplasma-specific IgM antibodies for seven years after the onset of the clinical symptoms of toxoplasmosis. IgM antibodies were detected by an indirect immunofluorescence test and by three commercial enzyme-linked immunosorbent assays (ELISA). Anti-T. gondii IgA was quantified by the a-capture ELISA technique using a commercial kit. As defined by the manufacturer of the IgA ELISA test used, most patients with acute toxoplasmosis have antibody levels > 40 arbitrary units per ml (AU/mL). At this cut-off level, the patient still had a positive ELISA result (45 AU/mL) in a serum sample taken one year after the beginning of clinical manifestations. The IgG avidity-ELISA test was performed with the Falcon assay screening test (F.A.S.T.®) - ELISA system. Avidity indices compatible with a recent Toxoplasma infection were found only in serum samples taken during the first 5 months after the onset of the clinical symptoms of toxoplasmosis. These results show that the interpretation of positive IgM results as indicative of recently acquired toxoplasmosis requires additional laboratory confirmation either by other tests or by the demonstration of a significant rise in the antibody titers in sequential serum samples.

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Mycobacterium tuberculosis was isolated from a central venous catheter in a non-immunosuppressed patient with systemic tuberculosis. This case report represents a very uncommon form of isolation of Mycobacterium tuberculosis. A total improvement was obtained after treatment.

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A case of peritonitis due to Scedosporium apiospermum in a boy undergoing continuous ambulatory peritoneal dialysis is reported. The finding of suggestive tissual form of the fungus in the effluent hastened the diagnosis of the infection.

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Despite the abundant literature in knowledge management, few empirical studies have explored knowledge management in connection with international assignees. This phenomenon has a special relevance in the Portuguese context, since (a) there are no empirical studies concerning this issue that involves international Portuguese companies; (b) the national business reality is incipient as far as internationalisation is concerned, and; (c) the organisational and national culture presents characteristics that are distinctive from the most highly studied contexts (e.g., Asia, USA, Scandinavian countries, Spain, France, The Netherlands, Germany, England and Russia). We examine the role of expatriates in transfer and knowledge sharing within the Portuguese companies with operations abroad. We focus specifically on expatriates’ role on knowledge sharing connected to international Portuguese companies and our findings take into account organizational representatives’ and expatriates’ perspectives. Using a comparative case study approach, we examine how three main dimensions influence the role of expatriates in knowledge sharing among headquarters and their subsidiaries (types of international assignment, reasons for using expatriation and international assignment characteristics). Data were collected using semi‐structured interviews to 30 Portuguese repatriates and 14 organizational representatives from seven Portuguese companies. The findings suggest that the reasons that lead Portuguese companies to expatriating employees are connected to: (1) business expansion needs; (2) control of international operations and; (3) transfer and knowledge sharing. Our study also shows that Portuguese companies use international assignments in order to positively respond to the increasingly decaying domestic market in the economic areas in which they operate. Evidence also reveals that expatriation is seen as a strategy to fulfill main organizational objectives through their expatriates (e.g., business internationalization, improvement of the coordination and control level of the units/subsidiaries abroad, replication of aspects of the home base, development and incorporation of new organizational techniques and processes). We also conclude that Portuguese companies have developed an International Human Resources Management strategy, based on an ethnocentric approach, typically associated with companies in early stages of internationalization, i.e., the authority and decision making are centered in the home base. Expatriates have a central role in transmitting culture and technical knowledge from company’s headquarters to the company’s branches. Based on the findings, the article will discuss in detail the main theoretical and managerial implications. Suggestions for further research will also be presented.

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The current economic crisis has rushed even more the economists’ concerns to identify new directions for the sustainable development of the society. In this context, the human capital is crystallised as the key variable of the creative economy and of the knowledge-based society. As such, we have directed the research underlying this paper to identifying the most eloquent indicators of human capital to meet the demands of the knowledge-based society and sustainable development as well as towards achieving a comprehensive analysis of the human capital in the EU countries, respectively of a comparative analysis: Romania - Portugal. To carry out this paper, the methodology used is based on the interdisciplinary triangulation involving approaches from the perspective of human resource management, economy and economic statistics. The research techniques used consist of the content analysis and investigation of secondary data of international organisations accredited in the field of this research, such as: the United Nation Development Programme - Human Development Reports, World Bank - World Development Reports, International Labour Organisation, Eurostat, European Commission’s Eurobarometer surveys and reports on human capital. The research results emphasise both similarities and differences between the two countries under the comparative analysis and the main directions in which one has to invest for the development of human capital.

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A 26 year-old female was admitted with abdominal pain, fever and weight loss. The clinical and laboratory investigations led to the diagnosis of paracoccidioidomycosis. Gallium-67 whole body images correlated well with the clinical course of the disease and with the patient's prognosis.

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This case report describes the findings of a 18 year-old black male from Bahia, a Northeastern state in Brazil, with the sickle cell trait, who developed bilateral hyphema and vitreous hemorrhage with blindness in the course of leptospirosis. The patient started to complain of blurred vision four days after the start of fever and muscular pain and approximately twelve hours after the introduction of penicillin. The severity of the leptospirosis in conjunction with sickle cell trait was considered to be the most likely explanation for this ocular complication.

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An epizootic outbreak of rabies occurred in 1995 in Ribeirão Preto, SP, with 58 cases of animal rabies (54 dogs, 3 cats and 1 bat) confirmed by the Pasteur Institute of São Paulo, and one human death. The need to provide care to a large number of people for the application of equine rabies immune globulin (ERIG) prevented the execution of the skin sensitivity test (SST) and often also the execution of desensitization, procedures routinely used up to that time at the Emergency Unit of the University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo (EU-UHFMRP-USP), a reference hospital for the application of heterologous sera. In view of our positive experience of several years with the abolition of SST and of the use of premedication before the application of antivenom sera, we used a similar schedule for ERIG application. Of the 1489 victims of animal bites, 1054 (71%) received ERIG; no patient was submitted to SST and all received intravenously anti-histamines (anti-H1 + anti-H2) and corticosteroids before the procedure. The patients were kept under observation for 60 to 180 minutes and no adverse reaction was observed. On the basis of these results, since December 1995 ERIG application has been decentralized in Ribeirão Preto and has become the responsibility of the Emergency Unit of the University Hospital and the Central Basic Health Unit, where the same routine is used. Since then, 4216 patients have received ERIG (1818 at the Basic Health Unit and 2398 at the EU-UHFMRP), with no problems. The ideal would be the routine use of human rabies immune globulin (HRIG) in public health programs, but this is problematic, because of their high cost. However, while this does not occur, the use of SST is no longer justified at the time of application of ERIG, in view of the clinical evidence of low predictive value and low sensitivity of SST involving the application of heterologous sera. It is very important to point out that a negative SST result may lead the health team to a feeling of false safety that no adverse reaction will occur, but this is not true for the anaphylactoid reactions. The decision to use premedication, which is based on knowledge about anaphylaxis and on the pharmacology of the medication used, is left to the judgment of health professionals, who should always be prepared for eventual untoward events.

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The transition process between information and knowledge is faster and so the inputs that influence social and political practises. The dissemination of information is now determinant in terms of territorial competitiveness and both public and private sector take large benefits when the data-information- knowledge value chain repeats itself trough space and time. Mankind depends nowadays on the creation and diffusion of good and reliable information. Speed is also important and the greater the speed, the faster the opportunities for global markets. Information must be an input for knowledge and obviously for decision. So, the power of information is unquestionable. This paper focuses on concepts like information, knowledge and other, more geographical and tries to explain how territories change from real to virtual. Knowledge society appears on an evolutional context in which information dissemination is wider and technological potential overwrites traditional notions of Geography. To understand the mutations over the territories, the causes and the consequences emerges the Geography of the Knowledge Society, a new discipline inside Geography with a special concern about modern society and socio-economical developing models.

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Chapter in Merrill, Barbara (ed.) (2009) Learning to Change? The Role of Identity and Learning Careers in Adult Education. Hamburg: Peter Lang Publishers. URL: http://www.peterlang.com/ index.cfm?vID=58279&vLang=E&vHR=1&vUR=2&vUUR=1

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The current article reports the case of a 19-month-old-girl, from the state of Minas Gerais, Brazil, with visceral leishmaniasis, by Leishmania (Viannia) braziliensis, and Human Immunodeficiency Virus (HIV) co-infection. The child's mother and father, aged 22 and 27 years old, respectively, were both HIV positive. The child was admitted to the General Pediatric Center, in Belo Horizonte, presenting high fever, fatigue, weight loss and enlargement of liver and spleen. Indirect immunofluorescent test revealed a titer of 1:320 for Leishmania. Such result was confirmed by the presence of amastigotes in bone marrow aspirate samples and culture of promastigote forms. Parasites were identified as being Leishmania (Viannia) braziliensis through PCR, using a L. braziliensis complex primer and a generic primer, followed by hibridization. Specific leishmaniasis therapy (GlucantimeÒ antimonial) was intravenously administered.