Significance of atypical pathogens among community-acquired pneumonia adult patients admitted to hospital in Kuwait

The aim of this study is to determine the microbial etiology and severity of community-acquired pneumonia [CAP] in Kuwait. The severity of consecutive adult CAP cases admitted to 3 hospitals over a 1-year period was classified according to the Pneumonia Outcome Research Team [PORT] severity index. The microbial etiology was determined using st and ard methods for bacteria and serological tests for atypical and viral pathogens. The study population was 124 of the 135 admissions; 63 female, 61 male; mean age 41.3 +/- 18 years. The severity class distribution was: class 131%, class II 37%, class III 17%, class IV 13%, and class V 2%. Etiological agents were identified from 44 patients [35%], with one pathogen in 31 [25%], two in 9 [7%], and three or more in 4 [3%]. The most common pathogens identified were: Mycoplasma pneumoniae in 14 patients [11%], Legionella pneumophila in 10 [8%], Chlamydia pneumoniae in 8 [6%], influenza B virus in 8 [6%], influenza A virus in 5 [4%], Haemophilus influenzae in 4 [3%], Streptococcus pneumoniae in 3 [2%], Staphylococcusaureus in 3 [2%], gram-negative enterobacteria in 5 [4%], Moraxella catarrhalis in 2 [2%], and viruses in 4 [3%]. The yields from laboratory tests were 48% for paired serology, 20% from adequate sputum sample, and 3% from blood culture. Our study shows that a large percentage of mild CAP cases are admitted to hospitals in Kuwait, Atypical pathogens have a significant role in the etiology of CAP. There is overtreatment of CAP with a combination treatment consisting mainly of third-generation chephalosporins and macrolides

Diagnóstico definitivo das cáries proximais do esmalte pelo uso da separaçao temporária dos dentes posteriores / Diagnostic approximal enamel caries by temporary separation of the posterior teeth

Sao discutidos os meios usuais de diagnóstico da cárie proximal incipiente de dentes posteriores e é enfatizada a necessidade de, em caso de dúvida, aplicar a separaçao temporária dos dentes, a fim de pemitir o diagnóstico defintivo da presença ou nao da cavidade, bem como, a indicaçao correta de tratamento. Foram selecionadas algumas técnicas de separaçao temporária dos dentes posteiores