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Bee venom is a natural toxin composed of several peptides. Massive envenoming causes severe local and systemic reactions. We report two cases of severe bee envenomation, of which one was fatal. We also describe clinical characteristics and immune markers. Both victims suffered from respiratory distress, renal failure, rhabdomyolysis, and shock. They required invasive mechanical ventilation, vasoactive drugs, and renal replacement therapy. Moreover, serum levels of chemokines, cytokines, and cell-free circulating nucleic acids demonstrated an intense inflammatory process. Massive envenoming produced systemic injury in the victims, with an uncontrolled inflammatory response, and a more significant chemotactic response in the fatal case.

This research was funded by MINAS GERAIS STATE RESEARCH SUPPORT FOUNDATION (FAPEMIG), grants numbers 65/10 and CDS-APQ-03266-13, and by NATIONAL COUNCIL FOR SCIENTIFIC AND TECHNOLOGICAL DEVELOPMENT (CNPQ) grants numbers 310174/2014-7 and 446796/2014-0. Federal University of Minas Gerais. Faculty of Medicine. Mycobacteria Research Laboratory. Belo Horizonte, MG, Brazil. Federal University of Minas Gerais. Faculty of Medicine. Mycobacteria Research Laboratory. Belo Horizonte, MG, Brazil. Federal University of Minas Gerais. Faculty of Medicine. Mycobacteria Research Laboratory. Belo Horizonte, MG, Brazil. Federal University of Minas Gerais. Faculty of Medicine. Mycobacteria Research Laboratory. Belo Horizonte, MG, Brazil. Federal University of Minas Gerais. Faculty of Pharmacy. Department of Social Pharmacy. Belo Horizonte, MG, Brazil. Federal University of Minas Gerais. Veterinary School. Department of Preventive Veterinary Medicine. Belo Horizonte, MG, Brazil. Federal University of Rio Grande. Faculty of Medicine. Laboratory of Mycobacteria. Rio Grande, RS, Brazil. Federal University of Rio Grande. Faculty of Medicine. Laboratory of Mycobacteria. Rio Grande, RS, Brazil. Federal University of Rio Grande. Faculty of Medicine. Laboratory of Mycobacteria. Rio Grande, RS, Brazil. Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. Tropical Medicine Foundation Dr. Heitor Vieira Dourado. Manaus, AM, Brazil. Tropical Medicine Foundation Dr. Heitor Vieira Dourado. Manaus, AM, Brazil. Federal University of Rio de Janeiro. Institute of Chest Diseases. Clementino Fraga Filho University Hospital. Rio de Janeiro, RJ, Brazil. Federal University of Rio de Janeiro. Institute of Chest Diseases. Clementino Fraga Filho University Hospital. Rio de Janeiro, RJ, Brazil. Federal University of Grande Dourados. Faculty of Health Sciences. Dourados, MS, Brazil / Oswaldo Cruz Foundation. Campo Grande, Mato Grosso do Sul, MS, Brazil. Adolfo Lutz Institute. Bacteriology Center. Tuberculosis and Mycobacteriosis Center. S?o Paulo, SP, Brazil. Adolfo Lutz Institute. Bacteriology Center. Tuberculosis and Mycobacteriosis Center. S?o Paulo, SP, Brazil. Adolfo Lutz Institute. Bacteriology Center. Tuberculosis and Mycobacteriosis Center. S?o Paulo, SP, Brazil. State Secretariat of Health of Rio Grande do Sul. State Center for Health Surveillance. Center for Scientific and Technological Development. Porto Alegre, RS, Brazil. State Secretariat of Health of Rio Grande do Sul. State Center for Health Surveillance. Center for Scientific and Technological Development. Porto Alegre, RS, Brazil. Oswaldo Cruz Foundation. National Institute of Infectology Evandro Chagas. Laboratory of Bacteriology and Bioassays of Rio de Janeiro. Rio de Janeiro, RJ, Brazil. Sergio Arouca National Public Health School. Professor H?lio Fraga Reference Center. Rio de Janeiro, RJ, Brazil. Sergio Arouca National Public Health School. Professor H?lio Fraga Reference Center. Rio de Janeiro, RJ, Brazil. Nova University of Lisbon. Institute of Hygiene and Tropical Medicine. Medical Microbiology Unit, Global Health and Tropical Medicine. Lisboa, Portugal. Nova University of Lisbon. Institute of Hygiene and Tropical Medicine. Medical Microbiology Unit, Global Health and Tropical Medicine. Lisboa, Portugal. Federal University of Rio de Janeiro. Faculty of Medicine. Tuberculosis Research Center. Rio de Janeiro, RJ, Brazil. Background: The Commercial Kit SIRE Nitratase? PlastLabor, is a drug susceptibility test kit used to detect Mycobacterium tuberculosis resistance to first-line TB treatment drugs. The present study aimed at evaluating its performance in a multicenter study. (2) Methods: To determine its accuracy, the proportion methods in Lowenstein Jensen medium or the BACTECTMMGITTM960 system was used as a gold standard. (3) Results: The study revealed that the respective accuracies of the kit with 190 M. tuberculosis clinical isolates, using the proportion methods in Lowenstein Jensen medium or BACTECTMMGITTM960 system as a gold standard, were 93.9% and 94.6%, 96.9% and 94.6%, 98.0% and 97.8%, and 98.0% and 98.9%, for streptomycin, isoniazid, rifampicin, and ethambutol, respectively. (4) Conclusion: Thus, the kit can rapidly screen resistance to streptomycin, isoniazid, rifampicin, and ethambutol. Additionally, it does not require sophisticated equipment; hence, it can be easily used in the laboratories of low and middle income countries.

800x600 Background: The incidence of invasive mycoses is increasing worldwide. Polymerase Chain Reaction (PCR)-based methods have been used as alternatives to conventional microscopy and culture with the additional benefit of greater accuracy. The aim of this study was to evaluate the usefulness of PCR amplification of ITS5-NL4 and subsequent analysis of products by Restriction Fragment Length Polymorphism (PCR-RFLP) as a routine tool to detect and identify fungi involved in invasive mycoses in a healthcare center in the North of Brazil. PCR-RFLP was applied to identification of 10 reference strains and 90 cultures of agents of invasive mycoses. In addition, the new approach was applied to detect fungal agents in 120 biological samples (blood, cerebrospinal fluid and bone marrow) from patients with suspicion of systemic mycoses. PCR-RFLP results were compared with the ones obtained with conventional methods (culture, microscopy, and biochemical testing). Results: The assay carried out with the reference strains ( Candida albicans, Candida parapsilosis, Candida tropicalis, Candida krusei, Candida guilliermondii, Cryptococcus neoformans, Cryptococcus gattii and Histoplasma capsulatum ) demonstrated that the RFLP profiles were correctly predicted by the in silico investigation and allowed unequivocal identification of all chosen reference strains. The investigated PCR-RFLP also identified correctly 90 cultures of agents of invasive mycoses 2.5 times faster than the conventional assays. By using this assays in the routine of diagnosis of invasive mycosis it was observed that the PCR was found to be highly accurate with 100% and the RFLP profiles allowed identification of the etiological agents: C. neoformans (n = 3) and C. gattii (n = 1) in CSF samples, H. capsulatum (n = 1) in bone marrow and C. albicans (n = 2) in blood cultures. The detection and identification by PCR-RFLP were found to be between two to ten times faster than the conventional assays. Conclusion: The results demonstrated that PCR-RFLP is a valuable tool for the identification of invasive mycoses that can be implemented in hospital laboratories, allowing for a high number of analyses per day. Normal 0 21 false false false ES X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif";}

Introdução - A tuberculose (TB) é um grave problema de saúde no Brasil e no mundo, atingindo principalmente países em desenvolvimento. Com o surgimento de novas tecnologias que simulam uma conversação humana, surge a possibilidade de avaliarmos o uso de um agente conversacional aplicados em diversos cenários, este trabalho propôs avaliar a utilização de um agente conversacional durante o tratamento da tuberculose. Objetivo - Desenvolver um agente conversacional para acompanhar o paciente durante o tratamento de tuberculose, visando aumentar o engajamento e o sucesso do paciente no tratamento da doença. Métodos - A etapa de levantamento de requisitos foi realizada através da aplicação de questionários a agentes de saúde que participam da aplicação da estratégia DOTS para o tratamento de tuberculose no município de Ribeirão Preto. Os dados coletados foram organizados em mapas onde pudemos observar as principais características que a aplicação deveria conter, e a matriz dos principais assuntos de interesse dos pacientes em tratamento da tuberculose. Como ferramenta para o desenvolvimento da aplicação foi utilizada o DialogFlow, especializada em criação de agentes conversacionais. Resultados - Foram analisados três principais cenários de implantação para o uso da ferramenta desenvolvida: No tratamento de tuberculose pulmonar, no tratamento de casos de Infecção Latente de Tuberculose e no cenário de educação em saúde. Nestas análises pudemos observar que a tecnologia de agentes conversacionais aplicadas a extensão de cuidados ao paciente, fornecendo acesso a informações em saúde para profissionais de saúde como para toda população, se mostrou bastante promissora. Conclusões - A análise da inserção desta tecnologia apresentou uma diversidade de aplicações diferentes e aponta um ganho significativo no que diz respeito a atenção a população e pacientes em tratamento de tuberculose. Introduction - Tuberculosis (TB) is a serious health problem in Brazil and in the world, affecting mainly developing countries. With the emergence of new technologies that simulate a human conversation, the possibility arises to evaluate the use of a conversational agent applied in different scenarios, this work proposed to evaluate the use of a conversational agent during the treatment of tuberculosis. Objective - To develop a conversational agent to accompany the patient during the treatment of tuberculosis, aiming to increase the patient\'s engagement and success in the treatment of the disease. Methods - The requirements survey stage was carried out through the application of questionnaires to health agents who participate in the application of the DOTS strategy for the treatment of tuberculosis in the city of Ribeirão Preto. The collected data were organized in maps where we could observe the main characteristics that the application should contain, and the matrix of the main subjects of interest to patients in the treatment of tuberculosis. As a tool for the development of the application, DialogFlow was used, specialized in the creation of conversational agents. Results - Three main implantation scenarios for the use of the developed tool were analyzed: In the treatment of pulmonary tuberculosis, in the treatment of cases of Latent Tuberculosis Infection and in the health education scenario. In these analyzes we could observe that the technology of conversational agents applied to the extension of patient care, providing access to health information for health professionals and for the entire population, has shown itself to be very promising. Conclusions - The analysis of the insertion of this technology presented a diversity of different applications and points out a significant gain about the attention to the population and patients undergoing treatment for tuberculosis.