Perfil laboratorial liquórico de pacientes com meningite atendidos em um hospital da região metropolitana de Porto Alegre/RS ­ Brasil / Cerebrospinal fluid laboratory profile of patients with meningitis attended to in a hospital in the metropolitan region of Porto Alegre/RS - Brazil

Introdução: Considerado um material nobre em laboratório clínico, o líquor (LCR) se assemelha a um ultrafiltrado de plasma e tem como principais funções o fornecimento de nutrientes essenciais ao cérebro e proteção mecânica. Os setores rotineiramente envolvidos na análise laboratorial do LCR são a bioquímica, a microbiologia e a citologia. Objetivo: Avaliar os principais agentes etiológicos associados à ocorrência de meningites e identificar as alterações laboratoriais mais prevalentes nas amostras liquóricas analisadas em laboratório de um hospital da região metropolitana de Porto Alegre. Métodos: Estudo transversal retrospectivo (01/2013 a 12/2017) em banco de dados. Resultados: Foi observada maior ocorrência de meningites bacterianas (35,53%), seguida por infecções virais (26,31%), fúngicas (25%) e parasitárias (13,16%). Os principais agentes infecciosos identificados foram Cryptococcus sp (n=18), Herpes Simples Vírus I e II (n=12), Toxoplasma gondii (n=10) e Streptococcus pneumoniae (n=9), e as principais alterações laboratoriais estiveram associadas à hiperproteinorraquia e à elevação no número de leucócitos. Nas meningites bacterianas, observaram-se hipoglicorraquia, hiperproteinorraquia e importante elevação de lactato desidrogenase (LDH); as fúngicas apresentaram discreta diminuição na glicorraquia e LDH moderadamente elevado, enquanto os agentes virais e parasitários apresentaram maior alteração na dosagem de proteínas (hiperproteinorraquia). Conclusão: Com perfil predominantemente masculino e adulto, a identificação de casos infecciosos na análise laboratorial liquórica representou 8,32% do total das análises, sendo as meningites bacterianas as mais prevalentes, podendo ser laboratorialmente reconhecidas por alterações bioquímicas e celulares. Os achados possibilitam o conhecimento epidemiológico e laboratorial, podendo embasar estudos posteriores.

Introduction: Considered a noble material in the clinical laboratory, CSF is similar to a plasma ultrafiltrate and its main functions are the supply of essential nutrients to the brain and mechanical protection. The sectors routinely involved in the laboratory analysis of CSF are biochemistry, microbiology and cytology. Objective: To evaluate the main etiological agents associated with the occurrence of meningitis and to identify the most prevalent alterations in CSF samples analyzed in the laboratory of a hospital in the metropolitan region of Porto Alegre. Methods: A retrospective cross-sectional study (01/2013 to 12/2017) in a database. Results: A higher occurrence of bacterial meningitis (35.53%) was observed, followed by viral (26.31%), fungal (25%) and parasitic (13.16%) infections. The main infectious agents identified were Cryptococcus sp (n=18), Herpes Simplex Virus I and II (n=12), Toxoplasma gondii (n=10) and Streptococcus pneumoniae (n=9) and the main laboratory alterations were associated with hyperproteinorrhachia and elevation in the number of leukocytes. In bacterial meningitis, hypoglycorrhachia, hyperproteinorrhachia and a significant increase in lactate dehydrogenase (LDH) relawere observed; fungal meningitis showed a slight decrease in glycorrhachia and moderately high LDH, while viral and parasitic agents showed greater change in protein level (hyperproteinorrhachia). Conclusion: With a predominantly male and adult profile, the identification of infectious cases in the CSF laboratory analysis represented 8.32% of the total analyses, with bacterial meningitis being the most prevalent, which can be recognized by biochemical and cellular alterations through laboratory testing. The findings allow for epidemiological and laboratory knowledge, which may support further studies.

Infectious-like Spread of an Agent Leading to Increased Medical Admissions and Deaths in Wigan (England), during 2011 and 2012.

Aims: To demonstrate infectious-like spread of an agent leading to a period of higher death and medical admissions in the Wigan local authority, part of the greater Manchester area of England, during 2011 and 2012. Study Design: Longitudinal study of deaths and hospital admissions. Place and Duration of Study: Deaths (all-cause mortality) for the resident population of Wigan from January 2006 to February 2014. Patients admitted to the Wigan Infirmary, a large acute hospital on the outskirts of Manchester, England, between 2008 and 2013. Methodology: Running twelve month totals for deaths and medical admissions were used to detect step-like increases in these factors. Additional analysis by age, length of stay and for clusters of persons living in over 40 small areas (called mid super output areas) containing approximately 5,000 population within Wigan and surrounds. Results: A step-like increase in total deaths can be seen for all-cause mortality in Wigan commencing around February of 2012. Medical admissions to the hospital also show a step-like increase at this point. Deaths and medical admissions remain high for around 15 months before beginning to abate. Infectious-like spread of medical admissions can be observed within 40 small area population groups in Wigan during the period January 2011 to April 2012. Certain medical conditions appear to be affected earlier than others, and the pattern of increased admissions show evidence of saw-tooth behavior with age, which is indicative of ‘antigenic original sin’ and which has also been demonstrated for deaths in England and Wales during 2012. Conclusion: The spread of a previously unidentified infectious agent is implicated in the synchronous increases in death (both in- and out-of-hospital) and in medical admissions (some of which result in death). This is not the first occurrence of an outbreak of this agent and urgent research is required to identify both the agent and clarify its mode of action which appears to be via immune modulation. The ubiquitous herpes virus, cytomegalovirus, which is known to have powerful immune modulating properties, may be involved.

Pharmacological screening of methanolic extract of Ixora species

Objective:To investigate the antimicrobial activity of methanolic extracts of different parts of Ixora species. Methods:Antimicrobial activity was carried out using disc diffusion assay against fungi, gram-positive and gram-negative bacteria. Results:All methanolic extracts of different parts of Ixora species showed a broad-spectrum of antibacterial and antiyeast activities, which inhibited the growth of at least one bacterium or yeast. There was no remarkable difference between different Ixora species observed in this study. Conclusions:The significant antimicrobial activity shown by this Ixora species suggests its potential against infections caused by pathogens. The extract may be developed as an antimicrobial agent.

Pharmacological screening of methanolic extract of Ixora species

<p><b>OBJECTIVE</b>To investigate the antimicrobial activity of methanolic extracts of different parts of Ixora species.</p><p><b>METHODS</b>Antimicrobial activity was carried out using disc diffusion assay against fungi, gram-positive and gram-negative bacteria.</p><p><b>RESULTS</b>All methanolic extracts of different parts of Ixora species showed a broad-spectrum of antibacterial and antiyeast activities, which inhibited the growth of at least one bacterium or yeast. There was no remarkable difference between different Ixora species observed in this study.</p><p><b>CONCLUSIONS</b>The significant antimicrobial activity shown by this Ixora species suggests its potential against infections caused by pathogens. The extract may be developed as an antimicrobial agent.</p>

Effects of Coincident Infection on Treatment Response and Coronary Artery Lesion Outcome in Children with Kawasaki Disease / 实用儿科临床杂志

Objective To explore the effects of coincident infection on treatment response and coronary artery lesion (CAL) outcome in children with Kawasaki disease(KD).Methods A retrospective study of 141 children diagnosed on KD between Jul.2005 and Dec.2006 were performed.Standardized clinical assessments,laboratory examinations microbiology test results plus treatment regimens were reviewed.CAL were visualized by using echocardiography.Infectious agents positive (INF+) and negative (INF-) groups were identified,and clinical assessments,laboratory and treatment data were analyzed.Results 1.Concurrent infections:41%(58/141) of children had one of above confirmed infection at KD diagnosis.2.Treatment response:the presence of infection did not alter the response to treatment with intravenous immunoglobulin (IVIG),with resolution of fever within 72 h in 85% (120/141) children after 1 dose of IVIG (2 g/kg) together with aspirin administration regardless of present or absent infection.3.CAL outcome:in total,56.0% (79/141) of children developed CAL at the time of diagnosis,involving dilatation (91.1%,72/79 cases) and aneurysm (8.9%,7/79 cases),and no giant aneurysm was found.Most CAL were recovered within 1 year after treatment.Incidence of aneurysm in INF+ group was significantly higher than that in INF-group (P=0.019).Conclusions Coincident infection would not affect on the clinical assessment,laboratory test results and treatment response to IVIG in children with KD,but would result in higher risk of serious CAL.Therefore,children with infection at diagnosis on KD will not only accept active treatment in acute phase,but also insist on convalescent care and follow-up visit.

Analysis of prescriptions for anti-infectious agents for tumor patients / 中华医院管理杂志

Objective To find out about the use of anti-infectious agents by tumor outpatients of the hospital. Methods A survey was conducted on 1 011 prescriptions for anti-infectious agents written out in the hospital from October to December of 2003 and an analysis was made of the structure and rationality of their use by means of drug utilization studies. Results The utilization rate of anti-infectious agents was 8.35% , accounting for 1.09% of the total sum of money for the prescriptions. The kinds of anti-infectious agents used were mostly cephalosporins and quinolones. The utilization rate of agents of compatibility was 4.44%. The drug utilization index of some chemicals was close to 1.00, accounting for about 44.44% . Conclusion There is no widespread abuse of anti-infectious agents by the outpatients of the hospital and the utilization rates of anti-infectious agents and agents of compatibility are low. Still, there are some problems in the use and compatibility of certain agents and the rationality of their use is to be questioned. The use of anti-infectious agents should be planned in a scientific way and in line with the economic condition of the patients.

A study on the anti-inflammatory effects of nonsteroidal antiinflammatory ophthalmic solutions / 眼科

The topical effects of nonsteroidal anti-inflammatory agents, diclofenac, ketoprofen and naproxen, on reducing ocular inflammation were studied by aqueous paracentesis in rabbit eyes. In the aqueous humor, the inhibition rate of protein,the centration was 76.98% by diclofenac, 61.71% by ketoprofen and 20.83% by naproxen. The inhibition effect of ketoprofen on miosis is strongeer than that of placebo solution (vehicle) ; ketoprofen has significant difference at any examination time statistically (p