RÉSUMÉ
Several studies conducted all over the world have reported that the influenza virus is associated with great morbidity and mortality rates. In this study, we analyzed the incidence of the influenza virus between 2000 and 2003 in Curitiba. We studied 1621 samples obtained from outpatients and hospitalized patients of both sexes and all ages. The study was conducted at the local primary care health units (outpatients) and at the tertiary care unit (hospitalized) of the General Hospital of the Federal University in the state of Paraná, Brazil. Nasopharyngeal aspirates and, eventually, bronchoalveolar lavage were assayed for the presence of viral antigens, either by indirect immunofluorescence or cell culture. Of the samples studied, 135 (8.3 percent) were positive for influenza virus, and of those, 103 (76.3 percent) were positive for type A and 32 (23.7 percent) for type B. Additionally, positive samples were analyzed by reverse transcription followed by polymerase chain reaction and subtypes H1 and H3 were identified from this group. A high incidence of positive samples was observed mainly in the months with lower temperatures. Furthermore, outpatients showed a higher incidence of influenza viruses than hospitalized patients.
Sujet(s)
Femelle , Humains , Mâle , Antigènes viraux/sang , Grippe humaine/épidémiologie , Alphainfluenzavirus/immunologie , Betainfluenzavirus/immunologie , Brésil/épidémiologie , Liquide de lavage bronchoalvéolaire/virologie , Techniques de culture cellulaire , Technique d'immunofluorescence indirecte , Incidence , Grippe humaine/diagnostic , Grippe humaine/virologie , Alphainfluenzavirus/génétique , Betainfluenzavirus/génétique , Liquide de lavage nasal/virologie , Surveillance de la population , RT-PCR , SaisonsRÉSUMÉ
A 400mg dose twice-a-day oral acyclovir prophylaxis regimen was evaluated in 50 allogenic transplant recipients. Twenty (40 percent) patients experienced 24 episodes of herpes simplex virus (HSV) shedding; 17 (70.8 percent) occurring during prophylaxis. Thirteen of such episodes were asymptomatic and, in three, it was difficult to differentiate severe mucositis from viral lesions. In the remaining one, HSV pneumonia was suspected after a bronchoalveolar lavage (BAL) procedure performed in an attempt to early detection of cytomegalovirus (CMV). All cases responded to acyclovir therapy or dose adjustment suggesting that acyclovir resistance did not account for the occurrence of infection in our patients. These data demonstrated that oral acyclovir prophylaxis, 400mg dose twice-a-day, was inadequate to suppress viral shedding. The bronchoalveolar lavage procedure in a patient with HSV shedding could precipitate HSV spread to the lungs and the occurrence of pneumonia.
Sujet(s)
Humains , Aciclovir/usage thérapeutique , Transplantation de moelle osseuse , Herpès/traitement médicamenteux , Herpès/prévention et contrôle , Simplexvirus/immunologie , Conditionnement pour greffe , Aciclovir/analogues et dérivés , Administration par voie orale , Test ELISA , Liquide de lavage bronchoalvéolaire/virologie , Études prospectives , Transplantation homologueRÉSUMÉ
A frequência do comprometimento pulmonar em pacientes com doença neurológica associada ao primeiro vírus linfotrópico humano de células T(HTLV-I) tem sido demonstrado por vários autores na Africa, Asia e América Latina. Com o objetivo de estudar o envolvimento pulmonar em pacientes com mielopatia por HTLV-I (HAM) estudamos o lavado bronco-alveolar (LBA) de pacientes com HAM e 13 pacientes com mielopatias de outras etiologias. A contagem diferencial das células do LBA de pacientes com HAM demonstrou percentual de Linfócitos maior que 20 em 18 (82 por cento) dos pacientes enquanto aqueles com mielopatias de outra natureza mostraram linfocitose no LBA em apenas 2 (15 por cento). Concluímos que o pulmao se constitui em importante órgao para a patogênese de HAM.