Browsing by Author "Coelho, F"
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- Os dias iniciais da infecção pelo vírus da gripe pandémica (H1N1) 2009 na região centro de PortugalPublication . Duque, V; Cordeiro, E; Mota, V; Morais, C; Rodrigues, F; Coelho, F; Saraiva da Cunha, JG; Meliço-Silvestre, ABACKGROUND: The first case of pandemic (H1N1) 2009 virus infection was diagnosed in the central region of Portugal on June 16, 2009, in a woman infected in Canada. METHODS: The aim of our study was, first to characterize the clinical and epidemiologic aspects of all the patients with clinical manifestations included in the definition of case for investigation with samples submitted to diagnosis of the pandemic (H1N1) 2009 virus infection, in the central region of Portugal; second to assess the precision of the case definition of case for investigation considered in the study according to the presence or the absence of fever at the moment of clinical observation. We reviewed the medical records of all the patients presenting with Influenza like-illness classified as case for investigation and the first cases of patients infected with the new pandemic (H1N1) 2009 virus, diagnosed in the central region of Portugal during the pandemic period between June and August, 2009, were analyzed. Real-time reverse-transcriptase polymerase-chain-reaction (RT-PCR) testing was used to confirm the pandemic (H1N1) 2009 virus infection. Data collection was performed on a standardized paper format in agreement with the General Health Directorate. Results and discussion: Pandemic (H1N1) 2009 virus infection was confirmed in 255 patients. Overall, median age was 23 years and 42.7 % were included in the category of 20 to 29 years. Confirmed infection in patients with less than 2 years or greater than 50 years was a rare event. The first cases were imported from Europe, namely France, Spain and England. On a second phase, pandemic (H1N1) 2009 virus infection was acquired in the south of Portugal (Algarve), before de diagnosis of the first domestic case. The incidence rate for pandemic (H1N1) 2009 virus infection was 10.7 per 100,000 persons and was different according to the district. It was higher in the district of Coimbra and Guarda were the main roads connecting to Europe are. The median calculated incubation period for the for pandemic (H1N1) 2009 virus infection was 2 days. The length of the clinical manifestations until the patients look for medical observation had a median time of 2 days. All the cases were of mild to moderate severity. No deaths were observed. CONCLUSIONS: The early days of pandemic (H1N1) 2009 virus infection was mild in our region. Most affected patients were young adults, with the extreme categories ages of life being spared. Early detection and diagnosis, combined with stringent isolation and treatment procedures could have slowed the spread of the infection in our region.
- Leishmaniose visceral e infecção por vírus da imunodeficiência humana na era da terapêutica anti-retrovírica de alta eficáciaPublication . Marques, N; Cabral, S; Sá, R; Coelho, F; Oliveira, J; Saraiva da Cunha, JG; Meliço-Silvestre, AVisceral Leishmaniasis is an endemic infection in Portugal, as well as in other Mediterranean basin countries, where it has become a frequent complication of HIV infection. There are several studies published about Leishmania/HIV co-infection, however some particularities of its epidemiology, pathogenesis and especially of its treatment and prophylaxis remain unclear and undefined. The authors review some aspects of this co-infection, particularly epidemiology, clinical classic manifestations and laboratory features, diagnosis, treatment, prophylaxis and prevention and report the casuistic of the Infectious Diseases Department of the University Hospital of Coimbra during the last ten years (1996-2006) in the HAART (<>) era. Visceral Leishmaniasis behaves as an opportunistic infection in HIV-infected patients and should be considered as an AIDS-defining disease. Nowadays and according to World Health Organization, VL is the second most important protozoan disease and one of the most neglected; therefore the establishment of treatment and prophylaxis guidelines is urgent.
- Spondylodiscitis associated with recurrent Serratia bacteremia due to a transjugular intrahepatic portosystemic shunt (TIPS): a case reportPublication . Marques, N; Sá, R; Coelho, F; Saraiva da Cunha, JG; Meliço-Silvestre, AWe report a case of spondylodiscitis caused by multiresistant Serratia marcescens in a cirrhotic patient who had several Serratia bacteremias after the placement of a transjugular intrahepatic portosystemic shunt (TIPS) device. We concluded that an endovascular stent that can not be removed makes management of recurrent bacteremia difficult. Furthermore, back pain due to bacteremia is indicative of spondylodiscitis. Serratia marcescens can be an aggressive pathogen, causing spinal infection.