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Perdigão Neto LV, Machado AS, da Silva RG, de Souza RBC, Coutinho SM, Comello F, Porto APM, Lima DS, di Gioia TSR, Castro Lima VAC, Farias LABG, Macedo MRF, Noguera SLV, Dos Anjos SN, Tonheiro CMMP, Cocentino BCB, Costa SF, Oliveira MSD. Case Report: Successful Treatment of Recurrent Urinary Tract Infection Due to Extensively Drug-Resistant Klebsiella Pneumoniae in a Kidney Transplant Recipient Using Chloramphenicol. Transplant Proc 2023; 55:654-659. [PMID: 36934054 DOI: 10.1016/j.transproceed.2023.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/19/2023] [Indexed: 03/17/2023]
Abstract
Effective therapies for multidrug-resistant (MDR) microorganisms, especially Gram-negative bacteria, are becoming rare. Also, solid-organ transplant recipients are at high risk of MDR Gram-negative bacilli infection. Urinary tract infections are the most frequent bacterial infections in kidney transplant recipients and are an important cause of mortality after renal transplantation. We describe a case of complicated urinary tract infection in a kidney transplant patient due to extensively drug-resistant (XDR) K. pneumoniae treated successfully with a regimen comprising a combination of chloramphenicol and ertapenem. We do not recommend chloramphenicol as a first-line choice for treating complicated urinary tract infections. Still, we believe it is an alternative for infections caused by MDR and/or XDR pathogens in renal transplant patients, as other options are nephrotoxic.
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Affiliation(s)
- Lauro Vieira Perdigão Neto
- Hospital Paulistano, São Paulo, Brazil; Department of Infectious Diseases of Hospital das Clínicas and Laboratório de Investigação Médica - LIM 49, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | | | | | | | | | | | - Luis Arthur Brasil Gadelha Farias
- Department of Infectious Diseases of Hospital das Clínicas and Laboratório de Investigação Médica - LIM 49, University of São Paulo, São Paulo, Brazil.
| | - Mariana Rolim Fernandes Macedo
- Department of Infectious Diseases of Hospital das Clínicas and Laboratório de Investigação Médica - LIM 49, University of São Paulo, São Paulo, Brazil
| | - Saidy Liceth Vasconez Noguera
- Department of Infectious Diseases of Hospital das Clínicas and Laboratório de Investigação Médica - LIM 49, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Silvia Figueiredo Costa
- Department of Infectious Diseases of Hospital das Clínicas and Laboratório de Investigação Médica - LIM 49, University of São Paulo, São Paulo, Brazil
| | - Maura Salaroli de Oliveira
- Hospital Paulistano, São Paulo, Brazil; Department of Infectious Diseases of Hospital das Clínicas and Laboratório de Investigação Médica - LIM 49, University of São Paulo, São Paulo, Brazil
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Uchôa LRA, Luna LP, Farias LABG, Lima DLN, de Araujo Coimbra PP. Internal auditory canal hypoplasia associated with bilateral vestibulocochlear nerve aplasia and deviant facial nerve course: A case report and MRI findings. J Radiol Case Rep 2021; 15:17-23. [PMID: 34276875 DOI: 10.3941/jrcr.v15i5.3912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The evaluation of internal auditory canals and cochlea has gained significant importance due to the increasing number of cochlear implantations worldwide. This region's anatomical study is essential for cochlear implant surgery using magnetic resonance imaging as the method of choice. We report a case of a 6-year-old male patient diagnosed with a rare bilateral malformation of the internal auditory canals associated with an aberrant course of the facial nerve and vestibulocochlear nerve aplasia. This report raises the importance of identifying this rare malformation for appropriate management and reinforces awareness of possible complications.
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Affiliation(s)
| | - Licia Pacheco Luna
- Radiology Department, Fortaleza General Hospital (HGF), Fortaleza, Ceará, Brazil
- Department of Radiology, Division of Neuroradiology, Johns Hopkins Hospital, Baltimore, USA
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Cavalcante Meneses G, Andrade de Carvalho Gomes PE, Studart Galdino G, Bezerra da Silva Junior G, Coelho Lopes N, Costa Martins AM, Brasil Gadelha Farias LA, De Francesco Daher E. MO157HYPONATREMIA AND DISEASE SEVERITY IN LEPTOSPIROSIS. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab092.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Hyponatremia is associated with severe complication in tropical diseases and may be associated with higher mortality. The aim of this study was to investigate the association between hyponatremia and disease severity in patients with leptospirosis.
Method
This is a retrospective study including patients with confirmed diagnosis of leptospirosis admitted to three reference hospitals in Fortaleza, northeast Brazil, in the period from 1985 to 2018. Demographic, clinical and laboratory data were analyzed, and the incidence of unfavorable outcomes were investigated: acute kidney injury (AKI) – defined according to KDIGO criteria, hemodialysis need and death. Patients were divided in groups according to the levels of sodium at hospital admission (< or ≥135mEq/L). Statistical analysis was done with the SPSS program version 23.0.
Results
A total of 319 patients were included. Hyponatremia was found in 163 cases (51%) at hospital admission. Patients’ mean age was 37±15 years, and 84% were male. The group with hyponatremia had higher frequency of some symptoms and signs, such as disorientation (8.1% vs 1.3%, p=0.047) and jaundice (76% vs 54%, p<0.001). Higher levels of urea (130±80 vs 94±34mg/dL, p<0.001) and creatinine (4.3±2.7 vs 3.0±2.6mg/dL, p<0.001) were observed at hospital admission, as well as maximum levels of bilirubins, in the group with hyponatremia (p<0,05). Median lower levels of platelets during hospital stay were observed in the group of hyponatremia (45 [26 – 110] vs 73 [42 – 157] x103/µL p=0.001). A higher frequency of complications was also observed in the group with hyponatremia: hemodialysis need (38% vs 20%, p<0.001) and AKI stage 3 (71% vs 46%, p=0.002). There was no difference regarding mortality rate between the two groups (14.1% vs 10.1%, p=0.281).
Conclusion
Hyponatremia in patients with leptospirosis, at hospital admission, is associated with worse prognosis and can be an important parameter to guide clinical care in this group of patients.
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Affiliation(s)
| | | | | | - Geraldo Bezerra da Silva Junior
- University of Fortaleza, School of Medicine, Post-Graduation Programs in Public Health and Medical Sciences, Fortaleza, Brazil
| | - Nicole Coelho Lopes
- Federal University of Ceará, Medical Sciences Post-Graduate Program, Fortaleza, Brazil
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Sombra IS, Vasconcelo MMLM, Cost LFLD, Araujo ALMVD, Lima LVA, Farias LABG, Silva FJCD, Arruda EAG, Silva TDMJ, Medeiros MS. SIMPLICAÇÃO COM TERAPIA DUPLA LAMIVUDINA/DOLUTEGRAVIR EM PACIENTES HIV COM SUPRESSÃO VIROLÓGICA NA VIDA REAL (ESTUDO LAMDO). Braz J Infect Dis 2021. [DOI: 10.1016/j.bjid.2020.101056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Vasconcelo MMLM, Aquino BP, Lima LVA, Farias LABG, Silva FJCD, Oliveira CALD, Moreira ALG, Tavor LGF, Lima DGL, Medeiros MS. ESTUDO DE EFICÁCIA TERAPÊUTICA NA SUPRESSÃO VIROLÓGICA DA TERAPIA DUPLA COM DOLUTEGRAVIR/DARUNAVIR‐R NA VIDA REAL. Braz J Infect Dis 2021. [DOI: 10.1016/j.bjid.2020.101057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Farias LABG, Teixeira MJ, Pires Neto RDJ. Palpebral myiasis due Cochliomyia macellaria in an alcoholic patient. Rev Soc Bras Med Trop 2020; 54:e20200168. [PMID: 33206878 PMCID: PMC7670750 DOI: 10.1590/0037-8682-0168-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/14/2020] [Indexed: 11/21/2022] Open
Affiliation(s)
- Luis Arthur Brasil Gadelha Farias
- Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza, CE, Brasil.,Secretaria de Saúde do Estado do Ceará, Hospital São José de Doenças Infecciosas, Fortaleza, CE, Brasil
| | - Maria Jânia Teixeira
- Universidade Federal do Ceará, Departamento de Parasitologia Médica, Fortaleza, CE, Brasil
| | - Roberto da Justa Pires Neto
- Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza, CE, Brasil.,Secretaria de Saúde do Estado do Ceará, Hospital São José de Doenças Infecciosas, Fortaleza, CE, Brasil
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Lemos DRQ, D’Angelo SM, Farias LABG, Almeida MM, Gomes RG, Pinto GP, Cavalcante JN, Feijão LX, Cardoso ARP, Lima TBR, Linhares PMC, Mello LP, Coelho TM, Cavalcanti LPDG. Health system collapse 45 days after the detection of COVID-19 in Ceará, Northeast Brazil: a preliminary analysis. Rev Soc Bras Med Trop 2020; 53:e20200354. [PMID: 32638888 PMCID: PMC7341828 DOI: 10.1590/0037-8682-0354-2020] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION COVID-19 emerged in late 2019 and quickly became a serious public health problem worldwide. This study aim to describe the epidemiological course of cases and deaths due to COVID-19 and their impact on hospital bed occupancy rates in the first 45 days of the epidemic in the state of Ceará, Northeastern Brazil. METHODS The study used an ecological design with data gathered from multiple government and health care sources. Data were analyzed using Epi Info software. RESULTS The first cases were confirmed on March 15, 2020. After 45 days, 37,268 cases reported in 85.9% of Ceará's municipalities, with 1,019 deaths. Laboratory test positivity reached 84.8% at the end of April, a period in which more than 700 daily tests were processed. The average age of cases was 67 (<1 - 101) years, most occurred in a hospital environment (91.9%), and 58% required hospitalization in an ICU bed. The average time between the onset of symptoms and death was 18 (1 - 56) days. Patients who died in the hospital had spent an average of six (0 - 40) days hospitalized. Across Ceará, the bed occupancy rate reached 71.3% in the wards and 80.5% in the ICU. CONCLUSIONS The first 45 days of the COVID-19 epidemic in Ceará revealed a large number of cases and deaths, spreading initially among the population with a high socioeconomic status. Despite the efforts by the health services and social isolation measures the health system still collapsed.
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Affiliation(s)
| | - Sarah Mendes D’Angelo
- Secretaria de Saúde do Estado do Ceará, Fortaleza, CE, Brasil
- Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza, CE, Brasil
| | - Luis Arthur Brasil Gadelha Farias
- Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza, CE, Brasil
- Hospital São José de Doenças Infecciosas, Fortaleza, CE, Brasil
| | - Magda Moura Almeida
- Secretaria de Saúde do Estado do Ceará, Fortaleza, CE, Brasil
- Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza, CE, Brasil
| | | | | | | | | | | | | | - Pâmela Maria Costa Linhares
- Secretaria de Saúde do Estado do Ceará, Fortaleza, CE, Brasil
- Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza, CE, Brasil
| | | | - Tania Mara Coelho
- Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza, CE, Brasil
- Hospital São José de Doenças Infecciosas, Fortaleza, CE, Brasil
| | - Luciano Pamplona de Góes Cavalcanti
- Centro Universitário Christus, Faculdade de Medicina, Fortaleza, CE, Brasil
- Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza, CE, Brasil
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Farias LABG, Pessoa Colares M, De Almeida Barreto FK, Pamplona de Góes Cavalcanti L. O papel da atenção primária no combate ao Covid-19. Rev Bras Med Fam Comunidade 2020. [DOI: 10.5712/rbmfc15(42)2455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
A doença do novo Coronavírus (Covid-19) é causada pelo SARS-CoV-2 e representa o agente causador de uma doença potencialmente fatal que tem se revelado um problema de saúde pública global. A pandemia causada pelo Covid-19 tem causado prejuízos severos nos sistemas de saúde em diversos países. Diante do grande número de pessoas infectadas e da ausência de tratamento específico, várias nações têm enfrentado superlotação em seus hospitais. Com a confirmação de casos desta doença no Brasil, várias ações têm sido tomadas por gestores públicos e privados, tanto a nível hospitalar quanto em nível de atenção primária, a fim de minimizar os impactos para o Sistema Único de Saúde (SUS). O presente artigo apresenta uma breve análise do papel da atenção primária na luta contra o Covid-19 em âmbito nacional, além do impacto em saúde pública e das futuras perspectivas. Com base no grande número de pessoas infectadas no mundo e a experiência de diversos sistemas de saúde, torna-se imperativo a adaptação e adequação do SUS na condução de mecanismos de resposta para pandemia, sendo a atenção primária peça fundamental neste processo
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Borges RC, Farias LABG, Andrade RPOM, Costa EBGD, Sousa ARDD, Aires MAP. Necrólise epidérmica tóxica secundária ao uso de hidroxicloroquina em paciente com Chikungunya: relato de caso. Rev Fac Ciênc Méd Sorocaba 2019. [DOI: 10.23925/1984-4840.2019v21i1a9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Necrólise epidérmica tóxica (NET) é uma síndrome dermatológica de hipersensibilidade farmacológica. A associação com o uso de hidroxicloroquina é extremamente rara; relatamos o caso de paciente do sexo feminino, 48 anos, obesa, que após quadro de Chikungunya evoluiu com persistência das dores articulares e foi tratada com hidroxicloroquina, apresentando lesões eritemato-bolhosas-descamativas compatíveis com NET, após 22 dias de uso da medicação. A paciente evoluiu com remissão completa do quadro após um mês de terapia de suporte e antibioticoterapia para infecção secundária.
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Farias LABG, Bezerra KRF, Albuquerque MMDS, Pires Neto RDJ, Accioly Filho JW. Association between vitiligo lesions and acute chikungunya infection: is there a causal relationship? Rev Soc Bras Med Trop 2019; 52:e20190238. [DOI: 10.1590/0037-8682-0238-2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/18/2019] [Indexed: 11/21/2022] Open
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Farias LABG, Correia JNF, do Nascimento BHL, Machado LI, Feitosa HN. Wernicke encephalopathy associated with hyperemesis gravidarum: A case report and literature review. Trop J Obstet Gynaecol 2019. [DOI: 10.4103/tjog.tjog_98_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Farias LABG, Ferragut JM, Pires Neto RDJ. Encephalitis and transverse myelitis in dengue and chikungunya coinfection. Rev Soc Bras Med Trop 2018; 51:403. [PMID: 29972580 DOI: 10.1590/0037-8682-0259-2017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 08/25/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - Roberto da Justa Pires Neto
- Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.,Hospital São José de Doenças Infecciosas, Secretaria de Saúde do Estado do Ceará, Fortaleza, CE, Brasil
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Farias LABG. Estudantes de medicina e ação comunitária: estamos no caminho certo? Rev Bras Med Fam Comunidade 2017. [DOI: 10.5712/rbmfc12(39)1640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Trata-se de carta ao editor que questiona o comportamento do estudante de medicina frente à ação comunitária e seu impacto na sociedade.
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