Objetivos: Analisar achados clínicos, epidemiológicos, radiográficos e endoscópicos encontrados em indivíduos com tuberculose pulmonar apresentando-se sob forma pneumônica. Verificar a freqüência de utilização e o rendimento dos métodos empregados para a comprovação diagnóstica. Métodos: Foram revisados e analisados no período de janeiro de 2000 a dezembro de 2006 prontuários de 2828 pacientes consecutivamente atendidos e tratados em uma Unidade Sanitária de Porto Alegre - RS, que tiveram tuberculose como o principal diagnóstico, encontrando-se nesse grupo 59 casos (2,1%) com a apresentação pneumônica, presumivelmente ocorrendo por fístula gânglio-brônquica, todos microbiologicamente comprovados. Resultados: Dos 59 pacientes estudados, 42 (71,2%) tinham idade entre 20 e 50 anos; 53,0% eram homens, e 47,0% eram da raça negra. Os sintomas mais freqüentes foram tosse (100,0%), febre (88,0%), expectoração (81,0%), e emagrecimento (40,0%). Co-morbidades foram registradas em 60,% dos pacientes, sendo as mais freqüentes SIDA ou HIV+ (20,0%) e diabete mélito (15,0%). A localização da consolidação, ao radiograma de tórax, predominou nos lobos superiores (68,0%). A confirmação diagnóstica se deu principalmente pelo exame do escarro, positivo para BAAR em 41 pacientes (69,5%), seguindo-se o lavado broncoalveolar (LBA) em 10 (17,0%), e, em 8 pacientes (13,5%), foi necessária biópsia endoscópica, com estudo histo-bacteriológico do material obtido da lesão brônquica, a qual foi claramente visualizada em 3 casos. Conclusões: A pneumonia tuberculosa se apresentou sob forma de doença pulmonar infecciosa aguda, consolidativa, mais freqüentemente com tosse inicialmente improdutiva, seguida de febre e expectoração. Esteve freqüentemente associada com alguma co-morbidez, em especial a SIDA e, relativamente, com a raça negra. A comprovação de sua etiologia se fez principalmente pelo encontro do BAAR no escarro, ou então no LBA ou por biópsia da lesão do brônquio. / Objectives: To study clinical, epidemiological, radiographic and endoscopic features found in individuals with tuberculosis pneumonia. To verify the frequency of use of the different methods yielding the microbiological confirmation of the disease. Methods: Charts of 2828 tuberculosis patients who were included between january 2000 and december 2006 in a Public Heath Unity (Porto Alegre-Brazil) for treatment were reviewed. It was found in that group 59 confirmed cases (2.1%) of tuberculosis pneumonia, supposely occurring through the lymph node to bronchus fistula mechanism. Results: Of the 59 patients studied, 42 (71.2%) had age between 20 and 50 years old; 53.0% were male, and 47.0% of them were black. The more frequent symptoms were cough (100.0%), fever (88.0%), expectoration (81.0%) and weight loss (40.0%). Some co-morbidity was registered in 35 patients (60.0%), specially AIDS (20.0%), and diabetes (15.0%). On the chest x-ray the consolidation predominated in upper lobes (68.0%). The diagnostic confirmation was made mainly through the direct sputum examination, yielding the presence of acid-fast bacilli en 41 patients (69.0%). Bronchoscopy was performed in 18 patients (30.5%), with a positive bronchoalveolar lavage in 10 (17.0%), and in 8 (14,0%) by the histo-bacteriology of biopsy material from the bronchial lesion, clearly seen in tree cases. Conclusions: The tuberculosis pneumonia presented as an acute pulmonary infection disease, with alveolar consolidation, cough, fever and expectoration. It was more frequently associated to some co morbidity, specially AIDS, and also to non caucasian individuals. The etiologic confirmation was obtained mainly through the direct sputum examination for acid fast bacilli, or either by BAL or biopsy of the bronchial lesion.

<p>The F₁ part of F₀F₁-ATP synthase in the proteobacterium<em> Rhodobacter blasticus </em>contains five different proteins, but when the DNA was sequenced a sixth gene was found in the operon. The protein that corresponds to the sixth gene has been named Majastridin. When an amino acid BLAST search is performed with the Majastridin sequence, protein sequences have been found that are similar to Majastridin in other bacterial strains, and one of them is <em>Streptococcus pneumonia</em>. The hypothetical protein from <em>Streptococcus pneumonia</em> contains 242 amino acids and has a molecular weight around 30 kDa.</p><p> </p><p>In this work the Majastridin-like protein from <em>Streptococcus pneumonia</em> was expressed in <em>E. coli</em> cells and purified with nickel affinity chromatography and size exclusion chromatography. The result was verified with SDS-PAGE and western blot. The purified protein was then crystallized with the hanging drop method, where crystals were formed and optimization was made. The protein was also used to produce antibodies.</p>

Rationale: Lower respiratory tract infections (LRTI) are a common cause of morbidity and mortality in children. Swallowing problems are also common in children. Aspiration is one outcome of swallowing dysfunction that may be a contributing factor to LRTI. Methods: Retrospective review of children undergoing videofluoroscopic swallow study was done to identify the prevalence and correlates of aspiration and LRTI. Results: Aspiration prevalence was 36.6%. Significant factors on univariate analysis included: developmental delay, LRTI, pneumonia, digestive tract anomalies, indigenous heritage, cough and congestion. With logistic regression, congestion and LRTI correlated with aspiration. Prevalence of LRTI was 42%. Using univariate analysis pneumonia, aspiration and indigenous heritage were significant. With logistic regression, respiratory issues and indigenous heritage correlated with LRTI. Conclusion: The etiology of LRTI is complex and multifactoral. Understanding the relationship between all factors is imperative given that current interventions are invasive and the untreated outcome can be progressive lung injury.

Rationale: Lower respiratory tract infections (LRTI) are a common cause of morbidity and mortality in children. Swallowing problems are also common in children. Aspiration is one outcome of swallowing dysfunction that may be a contributing factor to LRTI. Methods: Retrospective review of children undergoing videofluoroscopic swallow study was done to identify the prevalence and correlates of aspiration and LRTI. Results: Aspiration prevalence was 36.6%. Significant factors on univariate analysis included: developmental delay, LRTI, pneumonia, digestive tract anomalies, indigenous heritage, cough and congestion. With logistic regression, congestion and LRTI correlated with aspiration. Prevalence of LRTI was 42%. Using univariate analysis pneumonia, aspiration and indigenous heritage were significant. With logistic regression, respiratory issues and indigenous heritage correlated with LRTI. Conclusion: The etiology of LRTI is complex and multifactoral. Understanding the relationship between all factors is imperative given that current interventions are invasive and the untreated outcome can be progressive lung injury.

No description available.

No description available.

Thesis (M.P.H.M.)--Mahidol University, 2000.

Thesis (M.S.)--Ball State University, 2008. / Title from PDF t.p. (viewed on Sept. 01, 2009). Research paper (M.S.), 3 hrs. Includes bibliographical references (p. [80-82])

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OBJETIVO: Determinar a freqüência da pneumonia adquirida na comunidade (PAC) por pneumococo, através do teste de detecção de antígeno urinário para Streptococcus pneumoniae em adultos imunocompetentes hospitalizados. Avaliar rendimento de exame de escarro e hemoculturas, bem como descrever aspectos clínicos, radiológicos, epidemiológicos e prognósticos associados à PAC. MÉTODOS: Durante um período de 17 meses, foram estudados, prospectivamente, 30 pacientes consecutivos com diagnóstico de PAC. RESULTADOS: Dezessete (57%) pacientes eram homens, a idade média foi de 49 anos, 14 (48,3%) apresentavam comorbidades, 17 (57%) pertenciam às classes IV e V de Fine e 11 (36,7%) pacientes foram admitidos em unidade de terapia intensiva (UTI). Um agente etiológico foi identificado em 19 dos 30 casos (63%). O Streptococcus pneumoniae foi identificado em 14 casos(47%) e representou 74% dos diagnósticos etiológicos obtidos. O teste imunocromatográfico de membrana (BINAX NOW) identificou S. pneumoniae em 11 dos 30 casos (36,7%), e foi positivo em 33% dos casos de etiologia desconhecida através de métodos convencionais de escarro e hemoculturas. O uso de antimicrobianos previamente à admissão hospitalar ocorreu em 31% dos casos e foi significativamente associado com etiologia desconhecida. Teste imunocromatográfico de membrana não foi afetado pelo uso de antibióticos previamente à admissão hospitalar e pacientes com teste positivo tiveram maior tempo de permanência hospitalar. CONCLUSÕES: Em nosso estudo, o teste de detecção de antígenos urinários para S. pneumoniae (BINAX NOW) demonstrou ser um instrumento diagnóstico útil na avaliação de pacientes com pneumonia adquirida na comunidade causada por penumococo. / PURPOSE: The aim of this study was to determine the frequency of pneumococcal community-acquired pneumonia by using the Binax NOW Streptococcus pneumoniae urinary antigen test in immunocompetents adults patients admitted to the hospital. To evaluate the performance of sputum and blood cultures to determine the pneumococcal etiology. To describe the clinical, epidemiological, radiological and prognostic features. METHODS: During a 17-month period, all consecutive patients with clinical and radiological diagnosis of CAP were prospectively enrolled in the study. RESULTS: The study group consisted of 30 patients (17 males and 13 females). The mean age of the patients was 49 years; most patients had underlying diseases (14 patients, 48,3%), 17 (57%) patients belonged to IV and V Fine Index, and 11 (36,7%) patients were admitted to intensive care unit (ICU). An etiologic agent was identified in 19 cases (63%). Streptococcus pneumoniae was identified in 14 patients (47%) and was accounts for 74% of cases where an etiologic diagnosis was made. The immunochromatographic test (BINAX NOW) was positive in 11 patients (36,7%) and recognized 33% of the cases in whom no pathogen was identified by conventional methods. Prior antimicrobial treatment was observed in 31% of cases, and was significantly associated with unknown etiology. In contrast, BINAX NOW antigen assay performance was not affected by prior antibiotic therapy. Patients with a positive immunochromatographic test were significantly associated with most prolongated hospital stay. CONCLUSIONS: In our study, urinary antigen test for detection of Streptococcus pneumoniae (BINAX NOW), proved to be a useful diagnostic tool in the evaluation of the patients with pneumococcal community-acquired pneumonia.