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Sepsis after Administering an Intramuscular Iron Injection in the Arm of an Elder Patient with Multiple Comorbidities: A Case Report

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Journal of Biosciences and Medicines 2023年第5期11卷 158-165页

作者： Michele Paula dos Santos Taís Michele Werle Mariana Martins Dantas Santos carolina Boeira Soares Carlos Augusto Treviso Italo Trois Maestri Stella Duarte Pinto carolina hack alves Laura Gomes Boabaid de Barros Maria Eduarda Perobelli Buzetto Guilherme Boeira Soares Gabriel Lorentz Trein Aline Porto Bárbara Adelmann de Lima Fernanda Bercht Merten Luane Pereira Gomes Rafaela Siviero Caron-Lienert Miriam Viviane Baron School of Medicine Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil Course of Medicine Lutheran University of Brazil (ULBRA) Canoas Brazil School of Medicine and Health Sciences Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil Interdisciplinary Institute of Science and Health Education Porto Alegre Brazil

Background: Skin reactions and musculoskeletal injuries caused by intramuscular injection are an increased risk for skin and soft tissue infections and may culminate in sepsis. Objective: To describe the history of an elderly patient who developed a lesion in her right arm after home administration of intramuscular iron injection in this arm and its outcome. Methods: This is a case report of a patient who participated in a study in an intensive care unit. Results: This study describes a 65-year-old patient with multiple comorbidities who was admitted to the hospital complaining of pain for two months and difficulty in moving her right shoulder associated with skin and soft tissue infections in her right arm after intramuscular iron administration by a relative for the treatment of multifactorial anemia and refractory melena. The patient worsened her general condition and was transferred to the intensive care unit. Despite the therapy instituted, the patient developed sepsis of cutaneous origin, multiple organ dysfunction, and death. Conclusions: The administration of intramuscular medication requires the participation of qualified professionals, such as nurses, mainly within the scope of the Brazilian public health system which commonly comprises patients in a context of vulnerability.

关键词： Critical Care Education Continuing Injectables Septicemia Soft Tissue Infections Suppuration

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Pulmonary Tuberculosis Associated with Socioeconomic Vulnerability and Ineffective Support Network: Case Report

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Journal of Biosciences and Medicines 2023年第5期11卷 151-157页

作者： Michele Paula dos Santos Gabriela Di Lorenzo Garcia Scherer carolina hack alves Italo Trois Maestri carolina Boeira Soares Carlos Augusto Treviso Stella Duarte Pinto Ana Paula Wagner Steinmetz Laura Gomes Boabaid de Barros Maria Eduarda Perobelli Buzetto Gabriel Lorentz Trein Guilherme Boeira Soares Aline Porto Brendda Pereira Gomes Fernanda Bercht Merten Luane Pereira Gomes Bárbara Adelmann de Lima Rafaela Siviero Caron-Lienert Miriam Viviane Baron School of Medicine Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil Course of Medicine Lutheran University of Brazil (ULBRA) Canoas Brazil School of Health and Life Sciences Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil Interdisciplinary Institute of Science and Health Education Porto Alegre Brazil

Tuberculosis is one of the 10 leading causes of death in the world. Its symptoms include fever, malaise, weakness, weight loss, chest pain, cough, expectoration, shortness of breath and sepsis, which is its most frequent complication. Due to these symptoms, many patients with tuberculosis require admission to the Intensive Care Unit, where they usually are placed on mechanical ventilation. Tuberculosis is more prevalent in the population in situations of social and economic vulnerability. The main factors that interfere with adherence to treatment and the prognosis of these patients are the patient’s support network and their socioeconomic status. We present the following report of a long-time smoker patient, with chronic kidney disease and previous treatment for tuberculosis, who was brought to the emergency room due to lowering of the sensorium, and was immediately placed on mechanical ventilation. The tests suggested sepsis with a respiratory focus, so a search for Alcohol-Acid-Resistant Bacillus was carried out, with a positive result. The patient was transferred to the Intensive Care Unit due to tachycardia and acute respiratory failure. The patient was a smoker with a high tobacco load, chronic kidney disease, in addition to precarious economic, educational and self-care conditions. This report shows that patients with tuberculosis and its complications can be stabilized through known pharmacological treatment. However, the most effective measure to interrupt the transmission of the disease remains the early diagnosis and the provision of adequate treatment, with guidelines aimed at the cessation of harmful habits, such as smoking.

关键词： Smoking Kidney Disease Sepsis Respiratory Failure

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Human enamel thickness and ENAM polymorphism

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International Journal of Oral Science 2016年第2期8卷 93-97页

作者： Diane M Daubert Joanna L Kelley Yuriy G Udod carolina Habor Chris G Kleist Ilona K Furman Igor N Tikonov Willie J Swanson Frank A Roberts Department of Periodontics University of Washington Center for Reproductive Biology and School of Biological Sciences Washington State University Department of Oral and Maxillofacial Surgery University of Texas Southwestern Medical Center Department of Genome Sciences University of Washington

The tooth enamel development gene, enamelin （ENAM）, showed evidence of positive selection during a genome-wide scan of human and primate DNA for signs of adaptive evolution. The current study examined the hypothesis that a single-nucleotide polymorphism （SNP） C14625T （rs7671281） in the ENAM gene identified in the genome-wide scan is associated with a change in enamel phenotype. African Americans were selected as the target population, as they have been reported to have a target SNP frequency of approximately 50%, whereas non-Africans are predicted to have a 96% SNP frequency. Digital radiographs and DNA samples from 244 teeth in 133 subjects were analysed, and enamel thickness was assessed in relation to SNP status, controlling for age, sex, tooth number and crown length. Crown length was found to increase with molar number, and females were found to have thicker enamel. Teeth with larger crowns also had thicker enamel, and older subjects had thinner enamel. Linear regression and generalized estimating equations were used to investigate the relationship between enamel thickness of the mandibular molars and ENAM SNP status; enamel in subjects with the derived allele was significantly thinner （P= 0.040） when the results were controlled for sex, age, tooth number and crown length. The derived allele demonstrated a recessive effect on the phenotype. The data indicate that thinner dental enamel is associated with the derived ENAM genotype. This is the first direct evidence of a dental gene implicated in human adaptive evolution as having a phenotypic effect on an oral structure.

关键词： enamel genetics polymorphisms tooth development

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