Acta Medica Port
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Observational Study
Hospital-Acquired Pneumonia in a Multipurpose Intensive Care Unit: One-Year Prospective Study.
Hospital-acquired pneumonia continues to be a frequent complication in the intensive care unit and an important cause of admission in the intensive care unit. The aim of our study was to evaluate the demography, incidence, risk factors, causative bacterial pathogens and outcome of all episodes of Hospital-acquired pneumonia in our unit. ⋯ S. aureus was the predominant causative agent of nosocomial pneumonia. The most frequent risk factor identified for infection with multidrug-resistant organisms was previous treatment with antibiotics. Multidrug-resistant organisms were present in 45% of documented hospital-acquired pneumonias. In admitted patients with non-intensive care unit acquired pneumonia, the intensive care unit mortality rate was nearly five times higher compared to intensive care unit acquired pneumonia.
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Observational Study
Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre.
Ketogenic diet is a low carbohydrate diet, which can be used as a treatment for refractory childhood epilepsy. The first aim of this study was to evaluate its efficacy, in patients receiving ketogenic diet for at least three months, on epilepsy control, behaviour and awareness. The secondary aims were to evaluate the variation in the number of antiepileptic drugs, reasons for discontinuing the diet and adverse effects. ⋯ Beyond seizure control, patients experienced a marked improvement in behavior and awareness. It is necessary to develop strategies to increase the adherence of families to the diet.
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Case Reports
Passive Transfer of Hepatitis B Antibodies through Intravenous Immunoglobulin in a Neonate.
Passive transfer of antibodies secondary to intravenous immunoglobulin infusion is a rare but important side effect that can lead to the wrong diagnosis and therapeutic decisions. It has never been reported in a newborn. A male newborn, vaccinated against hepatitis B and diagnosed with dilated cardiomyopathy, presented positive hepatitis B core antibodies at 12 days of life. ⋯ Passive transfer of antibodies was confirmed at 44 days of age, after seroreversion of hepatitis B core antibodies. Passive transfer of antibodies after intravenous immunoglobulin infusion can lead to a misleading diagnosis if not recognized. In our patient it could have been especially harmful had it prevented heart transplant. Screening for hepatitis B should be performed at least 1 month after intravenous immunoglobulin infusion.
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Over the last few decades, behavioral changes in sexual practices have made oral transmission of traditional sexually transmissible infections increasingly recognized. Patients harboring a sexually transmissible infection may first present lesions on the oral cavity, as these may be visible and interfere with basic functions such as speech or swallowing. ⋯ Furthermore, examination of the oral cavity should is essential when evaluating any patient suspected of harboring a sexually transmissible infection. In this article, oral transmission of several viral and bacterial infections is reviewed, including human papillomavirus infection, genital herpes, syphilis and gonorrhea, among others.