Abstract Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.

RESUMO Objetivo: Avaliar a adesão ao tratamento de paracoccidioidomicose. Métodos: Estudo conduzido com 188 pacientes com paracoccidioidomicose atendidos em um hospital terciário na Região Centro-Oeste do Brasil, de 2000 a 2010, para avaliar adesão ao tratamento. Foram considerados aderentes pacientes que tiveram o seguinte critério: retiraram os medicamentos na farmácia e autorrelataram a utilização de, no mínimo, 80% de dispensação dos antifúngicos prescritos na última consulta. Resultados: A maioria dos pacientes era homem (95,7%), tinha a forma crônica da doença (94,2%) e foi tratada com sulfametoxazol/trimetropim (86,2%). Apenas 44,6% dos pacientes aderiram ao tratamento. A maior perda de seguimento foi observada nos primeiros 4 meses de tratamento (p < 0,02). Adesão ao tratamento foi maior em pacientes com do que sem envolvimento pulmonar (RC: 2,986; IC95% 1,351-6,6599) e maior para os pacientes com do que sem tuberculose associada (RC 2,763; IC95% 1,004-7,604). Conclusões: A adesão ao tratamento da paracoccidioidomicose foi baixa e os primeiros 4 meses constituíram o período com maior evasão. Pacientes com envolvimento paracocidióidico pulmonar ou tuberculose associada revelaram maior adesão ao tratamento da paracoccidioidomicose.

ABSTRACT Objective: To evaluate the treatment compliance of patients with paracoccidioidomycosis. Methods: We studied 188 patients with paracoccidioidomycosis admitted to a tertiary referral hospital in the Central-West Region of Brazil from 2000 to 2010, to assess their compliance to treatment. In order to be considered compliant, patients needed to present two established criteria: (1) receive medicines from the pharmacy, and (2) achieve a self-reported utilization of at least 80% of the dispensed antifungal compounds prescribed since their previous appointment. Results: Most patients were male (95.7%), had the chronic form of the disease (94.2%), and were treated with cotrimoxazole (86.2%). Only 44.6% of patients were treatment compliant. The highest loss to follow-up was observed in the first 4 months of treatment (p < 0.02). Treatment compliance was higher for patients with than for those without pulmonary involvement (OR: 2.986; 95%CI 1.351-6.599), and higher for patients with than without tuberculosis as co-morbidity (OR: 2.763; 95%CI 1.004-7.604). Conclusions: Compliance to paracoccidioidomycosis treatment was low, and the period with the highest loss to follow-up corresponds to the first four months. Pulmonary paracoccidioidal involvement or tuberculosis comorbidity predicts a higher compliance to paracoccidioidomycosis therapy.

Com o objetivo de avaliar o comportamento da paracoccidioidomicose nas últimas três décadas, dados clínicos e epidemiológicos de 595 pacientes atendidos dentre 1980 a 2009 no Hospital da Universidade Federal de Mato Grosso do Sul foram estudados. Sexo, faixa etária, forma clínica, associação com tuberculose ou AIDS e mortalidade foram comparados por década em que a doença foi diagnosticada. Observou-se, nas três décadas do estudo, uma redução do percentual de mulheres, de pacientes do grupo de 20 a 39 anos, assim como de casos com a forma aguda/subaguda. Estas alterações estão intimamente relacionadas e podem ser analisadas simultaneamente. Houve aumento de casos de coinfecção com AIDS da primeira para segunda década, coincidindo com o surgimento da epidemia, e manteve-se estável durante a década seguinte. Não houve alteração da taxa de coinfecção com tuberculose, que no geral foi de 6,9% o que reforça a importância desta comorbidade. A taxa geral de mortalidade foi de 6,7% e também não variou entre as décadas estudadas. A manutenção da taxa de óbitos chama a atenção para a relevância dessa doença negligenciada.

With the objective to evaluate the behavior of paracoccidioidomycosis in the last three decades, clinical and epidemiological data of 595 patients admitted to clinical services of the Federal University of Mato Grosso do Sul from 1980 to 2009 were investigated. Gender, age distribution, clinical form, comorbidity with tuberculosis or AIDS, and mortality were compared by decades of clinical admission. It was shown that during the three decades there was a decrease in women percentage, and the same manner occurred a reduction in participants in the age group of 20 to 39 years. Moreover, the acute/subacute forms have been diminished in the period. These fluctuations are closely related and can be simultaneously analyzed. Increased AIDS co-infection prevalence from the first to the second decade was also revealed, coinciding with the appearance of the retroviral epidemic and stabilizing during the third decade. No change in the tuberculosis co-infection rate was observed (overall = 6.9%). It reinforces the importance of this co-morbidity. The overall mortality rate remained steady at 6.7%, not varying significantly from one decade to another. The persistent mortality rate calls attention to the importance of this neglected disease.

OBJETIVO: Avaliar in vitro o efeito antibacteriano do laser diodo com comprimento de onda de 650nn, associado a substancia fotossensível azul de toluidina sobre as bactérias de ulceras cutâneas infectadas. MÉTODOS: Foram coletadas amostras através de um swab com meio de transporte, de material infectado de úlceras cutâneas. Os materiais foram inoculadas em meios de cultura contendo ágar sangue azida para o crescimento de bactérias gram-positivas e agar Mac Conkey para as gram-negativas, e incubadas por 48 horas. Os resultados obtidos da contagem das unidades formadoras de colônias foram relacionados e submetidos a analise estatística adotando como nível de significância p > ou = 0.05. RESULTADOS: Os resultados da análise de variância ANOVA para a media geral foi p= 0,0215 e para o post hoc test teste t. TBO x Controle p=0,0186, TBO + Laser x Controle p=0,0039. CONCLUSÃO: Houve redução, significativa das unidades formadoras de colônias quando submetidas à terapia fotodinâmica.

PURPOSE: To evaluate in vitro the antibacterial effect of diode laser light of wavelength 650 nm, in association with the photosensitive substance toluidine blue, on the bacteria in infected skin ulcers. METHODS: Samples were collected by means of swabs containing a medium for transporting infected material from skin ulcers. The material was inoculated into culturing medium containing azide blood agar for the growth of Gram-positive bacteria, and MacConkey agar for Gram-negative bacteria, and incubated for 48 hours. The results obtained from counting the colony-forming units were correlated and subjected to statistical analysis, adopting the significance level of p > or = 0.05. RESULTS: From analysis of variance (ANOVA), the result for the general mean was p = 0.0215. Using the t test with post-hoc test, the result for TBO vs. Control was p = 0.0186, and for TBO + Laser vs. Control it was p = 0.0039. CONCLUSION: There was a significant reduction in colony-forming units when the cultures were subjected to photodynamic therapy.