Severe COVID-19 in HIV/Leishmania infantum coinfected patient: a successfully managed case report.

BACKGROUND: Coronavirus disease 2019 originated in China and swiftly spread worldwide, posing a significant threat to public health. Caused by SARS-CoV-2, it manifests as a flu-like illness that can escalate to Acute Respiratory Distress Syndrome, potentially resulting in fatalities. In countries where HIV/Leishmania infantum is endemic, the occurrence of concurrent SARS-CoV-2/HIV/Leishmania infantum infections is a reality, prompting inquiries into appropriate clinical management. CASE PRESENTATION: We present the case of a 48-year-old woman who was hospitalized for 36 days across three different hospitals in the state of Pernambuco, Brazil. She was diagnosed with SARS-CoV-2/HIV/L. infantum coinfection. The patient exhibited severe COVID-19 symptoms, including fever, productive cough, and dyspnea. Throughout her hospitalization, she experienced oxygen saturation levels of ≤ 93%, along with fluctuations in blood pressure, respiratory rate, and heart rate. Her blood tests revealed lymphopenia, leukopenia, and neutropenia, while laboratory results indicated abnormal levels of d-dimer, AST, ALT, lactate dehydrogenase, ferritin, and C-reactive protein. A computed tomography scan revealed 75% involvement of the lung parenchyma with patchy ground-glass opacities. CONCLUSION: Against all odds, the patient was discharged. The leukopenia associated with HIV/L. infantum may have played a decisive role. Further studies are necessary to better understand diagnostic strategies and clinical management measures for HIV/L. infantum coinfected patients who are susceptible to SARS-CoV-2 infection.

Systematic Review of Survival Analysis in Leprosy Studies-Including the Following Outcomes: Relapse, Impairment of Nerve Function, Reactions and Physical Disability.

Leprosy is a public health problem in South American, African and Oceanian countries. National programs need to be evaluated, and the survival analysis model can aid in the construction of new indicators. The aim of this study was to assess the period of time until the outcomes of interest for patients with or exposed to leprosy by means of survival analysis surveys. This review researched articles using the databases of PubMed, Science Direct, Scopus, Scielo and BVS published in English and Portuguese. Twenty-eight articles from Brazil, India, Bangladesh, the Philippines and Indonesia were included. The Kaplan-Meier method, which derives the log-rank test, and Cox's proportional hazards regression, which obtains the hazard ratio, were applied. The mean follow-up until the following outcomes were: (I) leprosy (2.3 years) in the population who were exposed to it, (II) relapse (5.9 years), (III) clinical manifestations before, during and after treatment-nerve function impairment (5.2 years), leprosy reactions (4.9 years) and physical disability (8.3 years) in the population of patients with leprosy. Therefore, the use of survival analysis will enable the evaluation of national leprosy programs and assist in the decision-making process to face public health problems.

Triggering receptor expressed on myeloid cells-1 as pediatric sepsis biomarker.

OBJECTIVE: Triggering receptor expressed on myeloid cells-1 concentration can be used as a predictive, diagnostic, and prognostic marker in patients with sepsis. The objective of this study was to determine the validity of triggering receptor expressed on myeloid cells-1 levels as a biomarker of sepsis in pediatric patients. METHODS: This was an integrative literature review. PubMed, ScienceDirect, LILACS, MEDLINE, and VHL databases were searched for papers published between 2015 and 2020, using the keywords triggering receptor expressed on myeloid cells-1, sepsis, and child. RESULTS: The review included ten studies, of which four used triggering receptor expressed on myeloid cells-1 as a predictive biomarker; four, as a diagnostic biomarker; and two, as a prognostic biomarker. A total of 1,409 and 1,628 patients were included in primary and review studies, respectively. There was a predominance of significant results for the validity of triggering receptor expressed on myeloid cells-1 levels in the prediction, diagnosis, and prognosis of sepsis in pediatric patients. CONCLUSIONS: Triggering receptor expressed on myeloid cells-1 is a valid predictive, diagnostic, and prognostic biomarker of sepsis with good sensitivity and specificity in the pediatric population.

Evaluation of molecular techniques to visceral leishmaniasis detection in asymptomatic patients: a systematic review.

INTRODUCTION: Visceral leishmaniasis (VL) is a systemic and neglected parasitic disease. Its main symptoms are fever, splenomegaly with or without hepatomegaly, and anemia, however, most individuals remain asymptomatic. Due to the lack of a gold standard and the limitations of current diagnostic techniques, where parasitology is ethically unfeasible for individuals without symptoms and serological tests do not differentiate between past and present disease, molecular methodologies are the most suitable. AREAS COVERED: We performed a systematic review analyzing the molecular techniques based on PCR used, so far, to detect asymptomatic cases of VL in humans. Structured searches were carried out on PubMed, LILACS, Scopus, and Web of Science databases without time and language restrictions. Two reviewers evaluated the studies, performed data extraction, and quality assessment by assigning scores. EXPERT OPINION: qPCR using RNA targets can be used in the diagnosis of asymptomatic cases of human VL, due to its characteristics. We recommend further studies to analyze the methodology, mainly observing the use of different rRNA targets. Therefore, we hope that this technique contributed to the construction of public policies that address the diagnosis and handling of asymptomatic patients.

O Protocolo de Manchester como ferramenta de melhora dos serviços de emergência / The Manchester Protocol as a tool for improving emergency services / El Protocolo de Manchester como herramienta para mejora de los servicios de emergencia

Objetivo: Descrever os benefícios do uso do Protocolo de Manchester em serviços hospitalares de emergência percebidos pelos enfermeiros classificadores. Método: Trata-se de um estudo transversal descritivo-exploratório de abordagem quantitativa, realizado com enfermeiros da unidade de emergência de um hospital de alta complexidade da cidade do Recife/PE Resultados: Verificou-se que 80% dos entrevistados perceberam benefícios para o paciente e para a melhoria da rotina do serviço, dos quais 90% verificaram redução no tempo de espera para atendimento, 70% apontaram redução na mortalidade após a implementação da classificação de risco e melhora na satisfação do usuário (40%) e na relação profissional/paciente (20%). Conclusão: Foi evidenciado que os profissionais conhecem e afirmam que o Protocolo de Manchester tem um grande impacto, quando se trata de benefícios e melhor mecanismo de gerenciamento, além da diminuição do risco de agravamento à saúde dos pacientes (AU).

Objective: To describe the benefits of using the Manchester Protocol in emergency hospital services perceived by classifying nurses. Method: This is a cross-sectional descriptive-exploratory study with a quantitative approach, carried out with nurses in the emergency unit of a highly complex hospital in the city of Recife / PE Results: It was found that 80% of the interviewees perceived benefits for the patient and for the improvement of the service routine, of which 90% found a reduction in the waiting time for care, 70% indicated a reduction in mortality after the implementation of the risk classification and improvement in user satisfaction (40%) and in the professional / patient (20%). Conclusion: It was evidenced that the professionals know and affirm that the Manchester Protocol has a great impact, when it comes to benefits and a better management mechanism, in addition to decreasing the risk of worsening the health of patients (AU).

Objetivo: Describir los beneficios de utilizar el Protocolo de Manchester en los servicios hospitalarios de emergencia percibidos por la clasificación de enfermeras. Método: Este es un estudio descriptivo-exploratorio de corte transversal con un enfoque cuantitativo, realizado con enfermeras en la unidad de emergencia de un hospital altamente complejo en la ciudad de Recife / PE Resultados: Se encontró que el 80% de los entrevistados percibieron beneficios para el paciente y para la mejora de la rutina del servicio, de los cuales el 90% encontró una reducción en el tiempo de espera para la atención, el 70% indicó una reducción en la mortalidad después de la implementación de la clasificación de riesgos y la mejora en la satisfacción del usuario (40%) y en el paciente (20%). Conclusión: se evidenció que los profesionales saben y afirman que el Protocolo de Manchester tiene un gran impacto, en lo que respecta a los beneficios y un mejor mecanismo de gestión, además de disminuir el riesgo de empeorar la salud de los pacientes (AU).

How Can Galectin-3 as a Biomarker of Fibrosis Improve Atrial Fibrillation Diagnosis and Prognosis?

Galectin-3 (Gal-3) is a biomarker of fibrosis that has been associated with atrial remodeling. Acknowledging the presence of a biomarker in patients with atrial fibrillation (AF) can allow for a better clinical treatment. The aim of this study was to assess the association of Gal-3 with atrial fibrosis in patients with AF. This is a systematic review study. From the total number of studies analyzed, 12 demonstrated a relation between atrial fibrosis and Gal-3 in patients with AF and presented statistically significant association values. We conclude that Gal-3 is associated with atrial fibrosis in patients with AF in all types, as well as after the arrhythmia treatment by ablation.

Loop-mediated isothermal amplification methods for diagnosis of visceral leishmaniasis (kala-azar) - a systematic review.

Introduction: Visceral leishmaniasis (VL) is a life-threatening infection remaining as one of the most neglected tropical diseases around the world. Despite scientific advances, an accurate diagnosis of VL remains a challenge. Loop-mediated isothermal amplification (LAMP) has emerged as a promising diagnostic tool with the possibility of becoming a point-of-care test to guide VL diagnosis and treatment.Areas covered: We conducted a systematic review assessing LAMP systems for diagnosing VL from 2000 to 2019. We performed structured searches in PubMed, LILACS, Scopus, and Web of Science without language restriction. Two reviewers screened articles, completed the data extraction and assessment of the risk of bias. A qualitative summary of the included studies was performed.Expert opinion: LAMP could be used as a screening test for VL diagnosis, so tissue aspiration could be performed only for those who are LAMP negative. We recommend more studies about the performance of the Loopamp™ Leishmania Detection kit and the Brazilian LAMP assay. Thus, we expect in the future the constitution of an international consortium to share experiences, projects, and other LAMP approaches mainly among researchers and institutions located within VL endemic countries.

Avaliação da dor pós-operatória sob a ótica do enfermeiro / Evaluation of postoperative pain under the nurse's point of view

Objetivo: identificar a forma utilizada pelos enfermeiros para avaliar e controlar a dor aguda em pacientes submetidos à cirurgia geral. Método: trata-se de um estudo qualitativo, descritivo e exploratório, realizado em um hospital público, com enfermeiros dos setores da sala de recuperação pós-anestésica e da clínica cirúrgica, cujos dados foram analisados pela técnica do Discurso do Sujeito Coletivo. Resultados: os enfermeiros em estudo não fazem uso de nenhum instrumento padronizado para avaliar e mensurar a dor pós-operatória e seu controle é realizado, basicamente, pela administração de medicamentos prescritos. Conclusão: os enfermeiros necessitam de capacitação prévia, bem como existe a necessidade de implementar um modelo de avaliação que seja utilizado para o controle mais efetivo da dor.(AU)

Vigilância pós-alta em cirurgia geral: assistência de enfermagem sistematizada como ferramenta no controle de infecções / Surveillance after discharge in general surgery: systematic nursing care as a tool in infection control

Objetivos: descrever o comportamento da infecção de sítio cirúrgico em pacientes submetidos à cirurgiageral e propor um protocolo de assistência de enfermagem perioperatória. Método: estudo transversaldescritivo, no qual foram analisados 96 pacientes submetidos à cirurgia geral e atendidos no ambulatório deegressos de um hospital universitário de Recife-PE. Para a coleta de dados foi utilizado um formulário. Oprograma Epi Info 3.5 foi utilizado para análise estatística descritiva. O estudo foi aprovado pelo Comitê deÉtica e Pesquisa, Protocolo n. 101/11. Resultados: houve predominância da faixa etária de 40 a 49 anos, dosexo feminino (62,5%). A prevalência de infecção de sítio cirúrgico foi de 6,3%, com predomínio de infecçõessuperficiais. Não houve informação sobre orientações de enfermagem no período pós-operatório em 89,7% dosprontuários. Conclusão: os dados demonstraram divergências na conduta de enfermagem no períodoperioperatório.