Browsing by Author "Lecour, Henrique"
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- 25 Anos de Sida: história de uma pandemia: em memória de José Luís ChampalimaudPublication . Castro, R. Sarmento e; Lecour, HenriqueTwenty five years after the report of the first cases of HIV/AIDS we can consider that the evolution of this pandemic registered several successes but also significant failures. During the first 15 years of the pandemic, etiologic agent was identified, diagnostic tests were developed and the first antiretrovirals were available. During this period we could verify that the use of zidovudine had a prophylactic effect on the vertical transmission and that some drugs could prevent several opportunistic infections. However, the morbidity and the mortality associated to the infection continued to be very significant and AIDS was considered a fatal disease. Only in 1996 with the development of HAART (highly active antiretroviral therapy) AIDS became a chronic disease. The use of protease inhibitors and, later, of non-nucleoside reverse transcriptase inhibitors, the development of resistance assays and the capacity to quantify the viral load and of dosing the plasmatic concentration of the antiretrovirals, were important tools to change the course of this infection. Nevertheless, in 2007, HIV continues to resist to the efforts to find a cure or a vaccine and HIV continues to spread particularly in the poorest countries of the World and infected until now 65 millions of persons of which 25 millions died.
- Bacterial meningitis in an urban area: etiologic study and prognostic factorsPublication . Santos, L. C.; Simões, J.; Severo, M.; Vazquez, J.; Lecour, HenriqueObjectives: The study of clinical features, diagnostic methods and prognostic factors of bacterial meningitis, in an urban area. Patients and Methods: All patients admitted between June 2001 and July 2004 in the emergency departments of a few hospitals, with the diagnosis of bacterial meningitis were included. CSFand blood cultures were performed in every case. Phenotypic characterization of strains of 5treptococcus pneumoniae and Neisseria meningitidis identified by culture were performed. In order to detect the three most common agents it was done a PCRassay in culture negative CSFsamples. Results: Bacterial meningitis was diagnosed in 201 patients. Etiologic definition was based on culture in 142 patients (70.6%), done by CSFPCRassay in 33 (16.4%) other patients and exclusively by latex agglutination test results in two cases. Thus, an etiologic diagnosis was established in 177 (88%) cases. Antigenic characterization showed a slight prevalence of N. meningitidis phenotype C:2b:P1; the 5. pneumoniae serotype characterization showed that 43.8% of identified serotypes are not included in any of the available vaccines. Eighteen patients died (8.9%). The statistic analysis found that factors associated with an adverse outcome were age older than 50 years (aR 7.07; IC 95% 1.1-27.4), the presence of comorbidities (aR 3.3; IC 95% 1.1-9.6) and the occurrence of systemic complications (aR 5.8; IC 95% 2.1-16.0). Conclusions: This epidemiologic pattern is similar to that found in other countries after the introduction of Haemophilus influenzae b conjugated vaccine. The association of culture and noncultural methods of diagnosis had a better performance in defining the etiology. Comparing to other series, in-patients mortality rate was lower (8.9%) than usually referred to, being considered unfavourable prognostic factors the age more than 50 years, the presence of comorbidities and of systemic complications.
- EditorialPublication . Lecour, Henrique; Monteiro, Luís
- Emergência da patologia infecciosaPublication . Lecour, Henrique
- Epidemiologia: prevalência em PortugalPublication . Lecour, Henrique; Santos, Maria de Lurdes
- Infecção em cuidados de saúde: perspectiva actualPublication . Lecour, HenriqueApós uma breve resenha sobre a história da infecção nosocomial e sobre seu conceito actual, é chamada atenção para a relevância que a infecção associada à prestação de cuidados de saúde actualmente assume, mostrando-se a sua prevalência em países ocidentais, de elevado nível de desenvolvimento, onde a infecção nosocomial mostra valores preocupantes, com graves consequências sociais e económicas, pelo aumento da morbilidade e da mortalidade que condiciona, e naturalmente maior sofrimento humano. A instituição de normas de prevenção adequadas e o seu cumprimento estrito podem reduzir a taxa de infecção nosocomial, cujo âmbito é hoje mais vasto, pois abrange toda a infecção que resulte da prestação de cuidados de saúde, qualquer que seja o local em que sejam praticados. Referem-se o tipo de infecções mais comuns, bem como os factores que podem propiciar a sua ocorrência. De igual modo se realça a crescente eclosão das resistências microbianas e as normas que devem ser seguidas na prescrição de antibióticos. É chamada a atenção para a importância das funções que competem às Comissões de Controlo da Infecção, pilar fulcral nessa luta. A situação vivida em Portugal e a análise dos vários inquéritos realizados pela Direcção Geral da Saúde são também focadas.
- A medicina portuguesa em 1958Publication . Lecour, Henrique
- Novas e velhas doenças infecciosas: seus factores condicionantesPublication . Lecour, Henrique
- A patologia infecciosa: da clássica à emergentePublication . Lecour, Henrique
- Toscana vírus meningitis in Portugal: 2002-2005Publication . Santos, L.; Simões, J.; Costa, R.; Martins, S.; Lecour, HenriqueToscana virus infection is endemic in Italy, but has also been documented in other Mediterranean countries. Our aim was to investigate the occurrence of Toscana virus (TOSV) meningitis in children and young adults in a metropolitan area in the north of Portugal. Cerebrospinal fluid samples from 308 patients with the diagnosis of meningitis and with negative bacterial culture were tested for enteroviruses and herpesviruseses by reverse transcription PCR. Those samples that proved negative for enterovirus and herpesvirus were tested for Toscana virus with a commercial reverse transcription nested PCR assay. In total, we investigated 106 samples, collected between May and September during the four-year period between 2002 and 2005 from patients younger than 30 years old. Toscana virus was the cause of meningitis in six (5.6%) of the cases, three children and three young adults. All had a benign course and self-limited disease. Since a first case report of TOSV infection 1985 and another in 1996, both in foreign tourists, these six cases of Toscana virus meningitis are, to our knowledge, the first diagnosed in Portuguese inhabitants, and they underline the need for more studies on the prevalence of this virus in Portugal.