Revista Do Instituto De Medicina Tropical De Sao Paulo最新文献

The influence of sex on pyrazinamide and uric acid serum levels in Brazilian patients treated for pulmonary tuberculosis.

IF 1.5 4区医学

Revista Do Instituto De Medicina Tropical De Sao Paulo Pub Date : 2025-03-17 eCollection Date: 2025-01-01 DOI: 10.1590/S1678-9946202567018

Carlos Augusto Abreu Albério, Juan Gonzalo Bardalez Rivera, Alberto Camarão de Sousa, Luann Wendel Pereira de Sena, José Luiz Fernandes Vieira

{"title":"The influence of sex on pyrazinamide and uric acid serum levels in Brazilian patients treated for pulmonary tuberculosis.","authors":"Carlos Augusto Abreu Albério, Juan Gonzalo Bardalez Rivera, Alberto Camarão de Sousa, Luann Wendel Pereira de Sena, José Luiz Fernandes Vieira","doi":"10.1590/S1678-9946202567018","DOIUrl":"10.1590/S1678-9946202567018","url":null,"abstract":"Adverse reactions to antituberculosis drugs can lead to treatment abandonment, prolonging the burden of the disease. The role of sex in pyrazinamide exposure and uric acid metabolism raises questions about its influence on the rates of arthralgia and hyperuricemia in patients with tuberculosis. Given the limited evidence in the literature regarding sex-related differences in adverse reaction rates, this study compares serum levels of pyrazinamide and uric acid, as well as the rates of hyperuricemia and arthralgia, between male and female patients with pulmonary tuberculosis. Uric acid levels were measured using the spectrophotometric uricase method, and serum pyrazinamide levels were determined by high-performance liquid chromatography. A total of 88 patients were enrolled in the study. The mean weight, pyrazinamide dosage, and median uric acid levels were similar between sexes. However, the proportion of males with hyperuricemia was higher than that of females. Pyrazinamide maximum concentrations ranged from 10 to 98 µg/mL and were higher in females than in males. The overall rate of arthralgia was 25%, occurring primarily in male patients with hyperuricemia. Serum pyrazinamide levels were higher in patients with arthralgia compared to those without it. No significant correlations were found between drug levels and uric acid in either sex. In conclusion, sex influences pyrazinamide exposure and arthralgia and hyperuricemia rates. Close monitoring of uric acid levels may help improve adherence to tuberculosis therapy.","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e18"},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

ERRATUM.

IF 1.5 4区医学

Revista Do Instituto De Medicina Tropical De Sao Paulo Pub Date : 2025-03-17 eCollection Date: 2025-01-01 DOI: 10.1590/S1678-9946202567003err

引用次数: 0

A complex case of Nocardia keratitis: challenges in diagnosis and therapy.

IF 1.5 4区医学

Revista Do Instituto De Medicina Tropical De Sao Paulo Pub Date : 2025-03-17 eCollection Date: 2025-01-01 DOI: 10.1590/S1678-9946202567019

Maria Astrid Claudia, Ismi Zuhria

{"title":"A complex case of Nocardia keratitis: challenges in diagnosis and therapy.","authors":"Maria Astrid Claudia, Ismi Zuhria","doi":"10.1590/S1678-9946202567019","DOIUrl":"10.1590/S1678-9946202567019","url":null,"abstract":"Nocardia keratitis is a rare cause of microbial keratitis, primarily affecting patients in tropical and subtropical regions. Its diagnostic challenge arises from this keratitis uncommon presentation, which often mimics other infectious keratitis types, leading to delays in appropriate treatment. This case report aims to elucidate the complexities of diagnosing and managing Nocardia keratitis of a 41-year-old male who had a chronic, progressively worsening wreath-pattern corneal infiltrate and hypopyon following ocular trauma. Initial empirical treatments were ineffective. Diagnostic confirmation via corneal scraping culture enabled targeted antimicrobial therapy. Subconjunctival amikacin and topical tobramycin led to gradual improvement, though complications such as corneal scarring and neovascularization remained, indicating potential need for surgical intervention. This case emphasizes the importance of high clinical suspicion and precise laboratory diagnostics in managing rare cases of Nocardia keratitis. Establishing standardized treatment guidelines for rare ocular infections could improve clinical outcomes.","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e19"},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bartonellas: could they cause reproductive disorders in humans?

IF 1.5 4区医学

Revista Do Instituto De Medicina Tropical De Sao Paulo Pub Date : 2025-03-03 eCollection Date: 2025-01-01 DOI: 10.1590/S1678-9946202567015

Rafaela de Paula Silva, Marina Rovani Drummond, Paulo Eduardo Neves Ferreira Velho

引用次数: 0

Central sterile supply departament management on hospital-associated infections: a systematic review and meta-analysis.

IF 1.5 4区医学

Revista Do Instituto De Medicina Tropical De Sao Paulo Pub Date : 2025-03-03 eCollection Date: 2025-01-01 DOI: 10.1590/S1678-9946202567016

Jing Shuai, Maoyu Liu, Jialing Hou, Yu Chen, Jun Jiang, Jing Yu, Liang Yin

{"title":"Central sterile supply departament management on hospital-associated infections: a systematic review and meta-analysis.","authors":"Jing Shuai, Maoyu Liu, Jialing Hou, Yu Chen, Jun Jiang, Jing Yu, Liang Yin","doi":"10.1590/S1678-9946202567016","DOIUrl":"10.1590/S1678-9946202567016","url":null,"abstract":"Hospital-associated infections (HAIs) pose significant risks in clinical settings, and sterile supply centers management plays a crucial role in infection control. This systematic review and meta-analysis aimed to evaluate the impact of supply center management on the incidence of HAIs and adverse events. The systematic review encompassed studies that compared supply center management protocols with standard care. The PRISMA guidelines were followed to search seven databases for relevant studies. The meta-analysis calculated pooled odds ratios (OR) for HAIs and adverse events, and heterogeneity was assessed using Tau2, Chi-squared, and I2 statistics. Eight studies were included in the final analysis, each assessing intervention efficacy. The results revealed a significant reduction in HAIs (pooled OR=0.3; 95%CI [0.19; 0.49]). Adverse events were also significantly reduced (pooled OR=0.15; 95%CI [0.09; 0.25]). Heterogeneity was low for both HAIs (Tau2=0.00; I2=0%) and adverse events (Tau2=0.04; I2=19%), which indicated a consistent effect across the studies. Sterile supply center management significantly reduced the incidence of HAIs and adverse events. This suggests these interventions are effective in improving clinical outcomes and could be a vital component of infection control strategies in healthcare facilities.","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e16"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalent zoonoses in Sao Paulo State, Brazil: the role of bats and molecular diagnosis.

IF 1.5 4区医学

Revista Do Instituto De Medicina Tropical De Sao Paulo Pub Date : 2025-03-03 eCollection Date: 2025-01-01 DOI: 10.1590/S1678-9946202567017

Danilo Alves de França, Helio Langoni

引用次数: 0

Eradicating latent tuberculosis: use of interferon gamma release assay and isoniazid/rifapentine in people living with HIV/AIDS.

IF 1.5 4区医学

Revista Do Instituto De Medicina Tropical De Sao Paulo Pub Date : 2025-03-03 eCollection Date: 2025-01-01 DOI: 10.1590/S1678-9946202567014

Mariana Amélia Monteiro, Carlos Fernando Apoliano, José Eduardo Rodrigues Martins, Noemia Orii Sunada, Víctor Ângelo Folgosi, Najara Ataíde de Lima Nascimento, Erica Chimara, Ana Paula Rocha Veiga, Luisa de Oliveira Pereira, Luisa Caracik de Camargo Andrade, Larissa Tiberto, Maurício Domingues Ferreira, Luiz Augusto Marcondes Fonseca, Alberto José da Silva Duarte, Denise Arakaki-Sanchez, Marisa Ailin Hong, Jorge Casseb

{"title":"Eradicating latent tuberculosis: use of interferon gamma release assay and isoniazid/rifapentine in people living with HIV/AIDS.","authors":"Mariana Amélia Monteiro, Carlos Fernando Apoliano, José Eduardo Rodrigues Martins, Noemia Orii Sunada, Víctor Ângelo Folgosi, Najara Ataíde de Lima Nascimento, Erica Chimara, Ana Paula Rocha Veiga, Luisa de Oliveira Pereira, Luisa Caracik de Camargo Andrade, Larissa Tiberto, Maurício Domingues Ferreira, Luiz Augusto Marcondes Fonseca, Alberto José da Silva Duarte, Denise Arakaki-Sanchez, Marisa Ailin Hong, Jorge Casseb","doi":"10.1590/S1678-9946202567014","DOIUrl":"10.1590/S1678-9946202567014","url":null,"abstract":"Tuberculosis (TB) is the most common comorbidity in people living with HIV/AIDS (PLWH), including those under antiretroviral treatment. PLWH are 28 times more likely to develop TB in Brazil, the leading cause of HIV-related deaths globally, with approximately 161,000 reported deaths worldwide in 2023. Early diagnosis of latent tuberculosis infection (LTBI) and prophylactic therapy can reduce TB cases, prevent disease progression, and decrease transmission in high-risk populations. This study assessed the prevalence of LTBI in PLWH using the interferon-gamma release assay (IGRA) and the impact of the 3HP regimen (isoniazid [INH]/rifapentine [RPT]) as prophylactic treatment. Blood samples from 335 PLWH (78% of the 427 in the cohort) were tested for IGRA; 50 PLWH (15%) tested positive and were treated with 3HP. Treatment included 900 mg of INH and 900 mg of RPT in 12 weekly doses according to the Brazilian health guidelines. No specific risk factors, including nadir CD4+T count, age, gender, or antiretroviral therapy (ART), were more frequently observed in the PLWH with LTBI compared to the PLWH without LTBI. All PLWH with LTBI received treatment and no cases of active TB were observed. Our findings highlight the need for wider LTBI screening and treatment among PLWH in the latent phase, emphasizing more stringent approaches for implementing 3HP prophylaxis.","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e14"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating the effects of evidence-based nursing on length of hospital stay, duration of mechanical ventilation, symptom relief, and complication rates in children with severe adenoviral pneumonia: a prospective randomized controlled trial.

IF 1.5 4区医学

Revista Do Instituto De Medicina Tropical De Sao Paulo Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI: 10.1590/S1678-9946202567013

Shali Wu, Sha Zhu, Hui Wen, Tuhong Yang, Yazi Liu, Ying Peng

{"title":"Evaluating the effects of evidence-based nursing on length of hospital stay, duration of mechanical ventilation, symptom relief, and complication rates in children with severe adenoviral pneumonia: a prospective randomized controlled trial.","authors":"Shali Wu, Sha Zhu, Hui Wen, Tuhong Yang, Yazi Liu, Ying Peng","doi":"10.1590/S1678-9946202567013","DOIUrl":"10.1590/S1678-9946202567013","url":null,"abstract":"We conducted a prospective randomized controlled trial to evaluate the effect of evidence-based nursing care on length of hospital stay, duration of mechanical ventilation, symptom relief, and complication rates among mechanically ventilated children with severe adenovirus pneumonia. A total of 257 children admitted to Hunan Provincial People's Hospital in Changsha from February 2018 to December 2021 were enrolled. Two patients withdrew from the study, resulting in 124 cases in the conventional care group and 131 cases in the evidence-based care group. Primary outcomes included time to resolution of signs and symptoms, length of hospital stay, complication rates. Secondary outcomes were blood biomarker levels and successful weaning results. The evidence-based care group demonstrated significantly higher overall efficiency than the conventional care group (98.47% vs. 95.97%, p<0.05). Additionally, the evidence-based care group demonstrated quicker resolution of cough, sputum, pulmonary rales, and fever, shorter hospital stays, and reduced need for mechanical ventilation (p < 0.05). The evidence-based care group had a significantly lower complication rate than the conventional care group (9.16% vs. 25.00%, p < 0.05). Post-care blood biomarker analysis showed decreased levels of leukocytes, calcitonin, and C-reactive protein in the evidence-based care group compared to the conventional care group (p<0.05). Evidence-based nursing interventions can improve outcomes for children with adenovirus pneumonia by reducing comorbidities, improving blood gas levels, reducing inflammatory responses, and improving the weaning success rate of mechanically ventilated children with severe adenoviral pneumonia.","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e13"},"PeriodicalIF":1.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors associated with tuberculosis deaths during hospitalization in Midwest Brazil.

IF 1.5 4区医学

Revista Do Instituto De Medicina Tropical De Sao Paulo Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI: 10.1590/S1678-9946202567011

Ademar Rodrigues de Oliveira Junior, Cláudia Elizabeth Volpe-Chaves, Mara Luci Gonçalves Galiz Lacerda, Alexandre Albuquerque Bertucci, Bruna Abdul Ahad Saad, Caroline Tieppo Flores de Oliveira, James Venturini, Sandra Maria do Valle Leone de Oliveira, Anamaria Mello Miranda Paniago

{"title":"Factors associated with tuberculosis deaths during hospitalization in Midwest Brazil.","authors":"Ademar Rodrigues de Oliveira Junior, Cláudia Elizabeth Volpe-Chaves, Mara Luci Gonçalves Galiz Lacerda, Alexandre Albuquerque Bertucci, Bruna Abdul Ahad Saad, Caroline Tieppo Flores de Oliveira, James Venturini, Sandra Maria do Valle Leone de Oliveira, Anamaria Mello Miranda Paniago","doi":"10.1590/S1678-9946202567011","DOIUrl":"10.1590/S1678-9946202567011","url":null,"abstract":"Tuberculosis (TB) is a treatable disease and one of the leading causes of death worldwide, notably affecting people living with the human immunodeficiency virus. The COVID-2019 pandemic worsened TB outcomes, particularly in high-burden countries such as Brazil. Accurate data on the mortality of hospitalized patients is limited. This study aimed to evaluate clinical and epidemiological characteristics and identify mortality risk factors among all hospitalized patients with TB at a tertiary hospital in Midwest Brazil from 2017 to 2019. The median age of the 154 patients included in the study was 48 years (interquartile range: 38-59 years), and the majority were male (74.68%). The main comorbidities were diabetes mellitus and chronic obstructive pulmonary disease; 44 patients (28.57%) were admitted to the intensive care unit (ICU). The mortality rate was 33.12%, and the leading cause of death was septic shock, followed by respiratory failure due to TB. The main factors associated with death were age (p=0.001), central nervous system TB (p=0.026), reduced consciousness (p<0.001), ICU admission (p<0.001), mechanical ventilation (p<0.001), use of vasoactive drugs (VAD) (p<0.001), and duration of VAD use (p=0.038). A high rate of inpatient deaths was observed, reflecting the severity of TB and the challenges in its clinical management. It is imperative to implement strategies to reduce the mortality rate.","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"67 ","pages":"e11"},"PeriodicalIF":1.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An unusual cause of unilateral epistaxis: a leech in the nose.

IF 1.5 4区医学

Revista Do Instituto De Medicina Tropical De Sao Paulo Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI: 10.1590/S1678-9946202567012

Murat Yaşar, Fatma Atalay

引用次数: 0