RESUMO
We describe three cases of community-acquired necrotizing pneumonia which were caused by Panton-Valentine leucocidin-producing strains of Staphylococcus aureus (one of them methicillin sensitive). All cases were successfully treated without any sequelae for the patients due to the prompt initiation of adequate antimicrobial therapy. High suspicion toward this fatal pathogen was the key to the successful outcome of the patients.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Toxinas Bacterianas/biossíntese , Exotoxinas/biossíntese , Leucocidinas/biossíntese , Pneumonia Estafilocócica/diagnóstico , Staphylococcus aureus/metabolismo , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/patologia , Necrose/microbiologia , Necrose/patologia , Pneumonia Estafilocócica/microbiologia , Pneumonia Estafilocócica/patologia , Índice de Gravidade de DoençaRESUMO
<p><b>AIM</b>To investigate the effect of substituting beta-blockers with nebivolol on the erectile function of patients suffering from essential hypertension.</p><p><b>METHODS</b>Forty-four young and middle-aged men (31-65 years) with essential hypertension visited our outpatient clinic and took beta-blocker treatment (atenolol, metoprolol or bisoprolol) for more than 6 months. All the patients completed a questionnaire regarding erectile function (International Index for Erectile Function). Patients were then switched to an equipotent dose of nebivolol for 3 months and, at the end of this time period, filled out the same questionnaire.</p><p><b>RESULTS</b>Twenty-nine out of the 44 (65.9%) patients who took beta-blockers (atenolol, metoprolol or bisoprolol) had exhibited erectile dysfunction (ED). Their systolic and diastolic blood pressure did not change significantly with the treatment switch. In 20 out of these 29 (69%) patients, a significant improvement in the erectile function score was exhibited after 3 months of nebivolol administration, and in 11 of these 20 patients, erectile function was normalized.</p><p><b>CONCLUSION</b>Nebivolol seems to have a beneficial effect on ED (possibly due to increased nitric oxide availability); however, further prospective, randomized, placebo-controlled studies are needed to confirm the beneficial effects of nebivolol.</p>