Alcina Ferreira

Infectious balanoposthitis: management, clinical and laboratory features

Background  Balanitis is defined as inflammation of the glans penis, often involving the prepuce (balanoposthitis). It is a common condition due to a wide variety of causes with infection being the most frequent and several microorganisms reported. The clinical aspect is often non specific. The management of balanoposthitis remains a clinical challenge.

Noninfectious balanitis in patients attending a sexually transmitted diseases clinic.

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Severe Tuberculosis Requiring Intensive Care: A Descriptive Analysis

Background. This study aims to describe the characteristics of tuberculosis (TB) patients requiring intensive care and to determine the in-hospital mortality and the associated predictive factors. Methods. Retrospective cohort study of all TB patients admitted to the ICU of the Infectious Diseases Department of Centro Hospitalar de São João (Porto, Portugal) between January 2007 and July 2014. Comorbid diagnoses, clinical features, radiological and laboratory investigations, and outcomes were reviewed. Univariate analysis was performed to identify risk factors for death. Results. We included 39 patients: median age was 52.0 years and 74.4% were male. Twenty-one patients (53.8%) died during hospital stay (15 in the ICU). The diagnosis of isolated pulmonary TB, a positive smear for acid-fast-bacilli and a positive PCR for Mycobacterium tuberculosis in patients of pulmonary disease, severe sepsis/septic shock, acute renal failure and Multiple Organ Dysfunction Syndrome on admission, the need for mechanical ventilation or vasopressor support, hospital acquired infection, use of adjunctive corticotherapy, smoking, and alcohol abuse were significantly associated with mortality (p < 0.05). Conclusion. This cohort of TB patients requiring intensive care presented a high mortality rate. Most risk factors for mortality were related to organ failure, but others could be attributed to delay in the diagnostic and therapeutic approach, important targets for intervention.

Hospital admissions and associated diagnosis of HIV patients in the HAART era

of results 318 patients (approximately 20% of the patients followed at the clinic) were admitted, accounting for 521 admissions; 47.6% of them HIV-related. 227 (43.6%) admissions were due to AIDS opportunistic infections, 33 (6.4%) to AIDS-defining or non-AIDS-defining cancers, and 220 (42.2%) were due to non-opportunistic infections. 35 (6.7%) of the admissions were new HIV diagnoses (two acute HIV infections) and 25 (71.4%) of these were AIDS-defining conditions. Hepatic disase accounted for 33 (6.4%) of the total causes of admissions. Eight (1.5%) admissions were HAART-related (toxicity/tolerability). 221 (69.5%) of the admitted patients had been lost to follow-up at the outpatient clinic for >6 months and 239 (75.1%) had no/poor adherence to their HAART regimens. 85.1% of the patients who were under HAART >6 months (n = 47), were virologically suppressed. Mean CD4 cell count of admitted patients was 156 ± 178 cells/ mm3.