A Gangrena de Fournier é uma infecção polimicrobiana ocasionada por microrganismos aeróbios e anaeróbios, que determinam uma fasciíte necrosante rápida e progressiva, comprometendo principalmente a região do períneo e a região genital. Embora qualquer um possa ser acometido pela doença, são afetadas com mais frequência pessoas com algum déficit de imunidade, observa-se também maior prevalência no sexo masculino. Caracteriza-se por ser uma doença de rápida podendo evoluir para Sepse e, se não tratada em tempo hábil poderá progredir para falência múltipla orgânica e até mesmo óbito. O diagnóstico precoce facilita um tratamento eficaz. São medidas de tratamento o desbridamento químico e cirúrgico, antibioticoterapia de amplo espectro e a oxigenoterapia hiperbárica.
Balance disorders have been poorly investigated and somewhat neglected in people infected with the human immunodeficiency virus, especially in children, whose have intrinsic and extrinsic risk factors that may compromise the balance. To evaluate the foot plantar pressures and the balance in children with acquired immunodeficiency. We recruited 53 children aged between 6 and 15 years: 33 healthy children, and 20 children with positive serology for the human immunodeficiency virus. A physical examination included anthropometric, reflexes, tactile sensitivity of the foot and orthopedic evaluation. We also collected data of them using Pediatric Equilibrium Scale, baropodometry, and stabilometry. We considered significance level of 0.05 for statistics. Both groups were aged-, sex-matched and similar body mass index and scores of the Pediatric Equilibrium Scale. Three infected children had altered tactile sensitivity, and none had orthopedic or reflex alteration. Infected children had higher mean plantar pressure in the hindfoot than of the control group (p = 0.02). There was higher maximum plantar pressure in the hindfoot of the infected children than of the controls (p = 0.04). Controls had lower maximum plantar pressure in the forefoot than the infected children (p = 0.04). Infected children had larger displacement of the center of pressure (p = 0.006), larger mean velocity of displacement (p = 0.006), and longer duration between successive peaks of displacement than the controls (p = 0.02). Children living with the human immunodeficiency virus discharges great plantar pressures in the hindfoot and to present balance disturbances in the absence of neurological symptomatology.
A Gangrena de Fournier é uma infecção polimicrobiana ocasionada por microrganismos aeróbios e anaeróbios, que determinam uma fasciíte necrosante rápida e progressiva, comprometendo principalmente a região do períneo e a região genital. Embora qualquer um possa ser acometido pela doença, são afetadas com mais frequência pessoas com algum déficit de imunidade, observa-se também maior prevalência no sexo masculino. Caracteriza-se por ser uma doença de rápida podendo evoluir para Sepse e, se não tratada em tempo hábil poderá progredir para falência múltipla orgânica e até mesmo óbito. O diagnóstico precoce facilita um tratamento eficaz. São medidas de tratamento o desbridamento químico e cirúrgico, antibioticoterapia de amplo espectro e a oxigenoterapia hiperbárica.
Background In Portugal, there are no published data on the health-related consequences of prescription drug misuse, which is therefore a public health issue of unknown dimension in our country. Poison control centres and other pharmacoepidemiological sources can be part of a surveillance system for monitoring medicine's use and misuse. Methods Retrospective observational study of intentional exposures to opioid analgesics, antiepileptics, antidepressants, anxiolytics, hypnotics and sedatives reported to the Portuguese Poison Information Centre (CIAV) between 2014 and 2018. Variables studied were demographic characteristics of individuals, geographic distribution of calls, co-exposure to alcohol or illicit drugs, call origin, case evaluation and guidance. Results CIAV received 24624 calls reporting 34203 intentional exposures to any medicine, 31169 (91.1%) of which involving one of the studied psychoactive medicines and 20906 exposures having emergency room advice or effective hospitalisation. The most frequently involved medicines were benzodiazepines (62.0%) - alprazolam (15.4%) and diazepam (12.0%) - with trazodone ranking fifth (6.0%). Combination with non-medicinal products was seen in 2169 calls (9.4%), 2052 (94.6%) of which with alcohol. Conclusions There is female predominance in the poisonings reported involving any of the medicines studied. Benzodiazepines and antidepressants are the top classes reported. The rate of intentional exposures to psychoactive medicines is higher in Coimbra district, whose significant university student population requires further analysis of data. To adjust for the variability in the level of medicines' use in the population, work is undergoing to include rates of intentional poisonings in patients prescribed the studied medicines. To better characterise the potential consequences of misuse of psychoactive prescription drugs in Portugal, additional data on deaths involving these medicines will also be included in the project. Key messages First published Portuguese data on prescription drug poisoning reported to CIAV. First Portuguese project to analyse prescription drug poisoning, forensic and hospitalisation data.
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