Worldwide prevalence and distribution of acquired AmpC-β-lactamases in Enterobacteriaceae lacking inducible AmpC

Introduction: Acquired AmpC beta-lactamases (qAmpC) which confer resistance to cephamycins and reduced susceptibility to extended-spectrum cephalosporins and β-lactamase inhibitors have increasingly been recognized as an emerging problem worldwide. qAmpCs enzymes are grouped according to the DNA sequence similarity with natural chromosomal AmpCs of some Enterobacteriaceae species, namely C. freundii (CMY-2-like, LAT-1, CFE-1), Enterobacter spp. (ACT-1-like, MIR-1-like), M. morgannii (DHA-1-like) and H. alvei (ACC-1-like), and with Aeromonas spp. (CMY-1-like, FOX-1-like, MOX-1-like). Isolates harbouring qAmpCs are usually multirresistant, and inappropriate empirical therapy is associated with high mortality ratios in invasive infections. Objectives: Estimate the worldwide prevalence and distribution of qAmpC types. Methods: We conducted a literature review on pertinent articles published between 2000 and 2011 on qAmpC detection and prevalence in Enterobacteriaceae lacking inducible AmpC [E. coli (EC), K. pneumoniae (KP), K. oxytoca (KO), P. mirabilis (PM) and Salmonella spp. (SM)] isolated from human infections. Estimated relative frequencies were calculated for qAmpC types detected in each country with relevant articles. Results: A total of 26 relevant studies from 21 countries on qAmpC epidemiology were retrieved, comprising 216648 isolates (182573 EC, 18858 KP, 8117 SM, 2340 PM, and 2278 KO). qAmpCs were detected in all but one study from Brazil, being the worldwide overall prevalence 0.55% (1194/216648, or 5.5 qAmpC producers per 1000 isolates). Countries with higher prevalence were China (4%), South Korea (3.5%), Portugal (3%) and Poland (3%), and the lowest were observed in Brazil (0%), Japan (0.08%), Switzerland (0.16%) and Belgium (0.16%). The overall species specific prevalence was 4.1%, 3.5%, 1.4%, 0.5% and 0.2% in SM, PM, KP, KO, and EC respectively. China presented the higher prevalence for KP (7%) and KO (3%), Thailand for EC (2%), while for PM and SM it was Poland (20.5%) and Mexico (7.7%), respectively. Globally, the main qAmpC variants detected were CMY-2 (53.1%), DHA-1 (30.6%) and CMY-2-like (11.7%). CMY-2 was predominantly present in EC, PM and SM isolates while DHA-1 was detected mostly among KP and KO. In countries like South Korea, China, and Portugal DHA-1 is the dominant variant, while in North America, Norway, Danmark, Tailand, Japan, Algeria and Spain is CMY-2. Conclusion: Although qAmpC prevalence is globally low, the results suggest that it is rising. This study also demonstrates that CMY-2 is the most prevalent qAmpC followed by DHA-1. Future studies are needed in order to monitor the spread of this emerging resistance mechanism

Indicadores de maus-tratos a pessoas idosas na cidade de Braga : estudo preliminar

Objectivo: Recolher em condições seguras alguns indicadores de maus-tratos físicos, psicológicos, financeiros e de negligência, numa amostra sectorial da população idosa da cidade de Braga Participantes: 82 pessoas, 18 das quais do sexo masculino e 64 do sexo masculino, com idades entre os 63 e os 88 anos que frequentam um de três centros de dia que seleccionamos na cidade de Braga Instrumentos: Questions to Elicit Elder Abuse (Carney, Kahan & Paris, 2003), traduzido pelos autores deste estudo. Resultados: Os resultados indicam a presença de indicadores de maus-tratos num número muito significativo de participantes, sobretudo indicadores de negligência e de abuso emocional; a variável estudada mais associada à presença de indicadores de maus-tratos foi a percepção do estado de saúde. Contudo o género e a idade também aparecem significativamente associados ao fenómeno. Discussão: Os dados obtidos sugerem a importância de se estender a outros locais nacionais e de se usar outras metodologias para investigar o abuso a pessoas idosas. Dos dados obtidos, parecem estar em maior risco de abuso as pessoas com mais idade, o género feminino e pessoas com percepção de má saúde. Obviamente que importará conhecer mais sobre as condições de ocorrência do abuso, substanciando-o, recolhendo e explorando episódios de maus-tratos, para que o estudo neste domínio seja não só um conjunto de descrições de ocorrências onde se cruzam necessariamente certas variáveis mas, também, uma tarefa de compreensão do comportamento humano

Prehospital therapeutic hypothermia in recovered cardiac arrest victims

INTRODUÇÃO A Hipotermia terapêutica consiste no arrefecimento corporal induzido com o objetivo de manter uma temperatura central de 33ºC, com a finalidade de reverter e ou prevenir os mecanismos responsáveis pela lesão neurológica de reperfusão após recuperação de circulação espontânea. Existe alguma evidência de que a hipotermia terapêutica melhora a sobrevivência e o resultado neurológico após paragem cardíaca ocorrida no préhospitalar, contudo a sua utilização não é ainda consensual em vítimas com recuperação de circulação espontânea. OBJETIVO Determinar a eficácia da Hipotermia Terapêutica induzida no Pré-Hospitalar na melhoria da sobrevivência e dos resultados neurológicos das vítimas que sofreram paragem cardíaca extrahospitalar. MÉTODOS Foi realizada uma revisão sistemática da literatura sobre estudos que avaliavam a eficácia da aplicação de hipotermia terapêutica nas vítimas de paragem cardíaca no contexto de pré-hospitalar. Cinco RCT’s, envolvendo 759 participantes, sendo 378 do grupo de hipotermia pré-hospitalar e 381 do grupo controlo. RESULTADOS A análise dos estudos revelou que existem diferenças significativas na diminuição da temperatura na admissão hospitalar quando utilizada a HTPH comparativamente à normotermia ou hipotermia terapêutica hospitalar (HTH) (IV=-1,16; IC 95%= -1,40-0,92; p<0,00001). Contudo não são observadas diferenças significativas no que se refere à sobrevivência (RR=0,97; IC 95%=0,79-1,19; p=0,76) e outcomes neurológicos favoráveis (RR=0,98; IC 95%=0,79-1,20; p=0,83). CONCLUSÕES A hipotermia terapêutica no pré-hospitalar não tem influência na sobrevivência e nos outcomes neurológicos favoráveis no momento da alta, mas apresenta benefício com relevância clinica nos valores da temperatura no momento da admissão hospitalar, pelo que se infere serem necessários mais estudos para aferir da eficácia desta medida terapêutica.info:eu-repo/semantics/publishedVersio

Optimized cross-slot flow geometry for microfluidic extension rheometry

A precision-machined cross-slot flow geometry with a shape that has been optimized by numerical simulation of the fluid kinematics is fabricated and used to measure the extensional viscosity of a dilute polymer solution. Full-field birefringence microscopy is used to monitor the evolution and growth of macromolecular anisotropy along the stagnation point streamline, and we observe the formation of a strong and uniform birefringent strand when the dimensionless flow strength exceeds a critical Weissenberg number Wicrit 0:5. Birefringence and bulk pressure drop measurements provide self consistent estimates of the planar extensional viscosity of the fluid over a wide range of deformation rates (26 s1 "_ 435 s1) and are also in close agreement with numerical simulations performed by using a finitely extensible nonlinear elastic dumbbell model

Primary lymphomas of the female genital tract: imaging findings

Primary lymphomas of the female genital tract are extremely rare, and a definitive diagnosis requires correlation of the clinical, radiological, and pathological findings. Unlike nonlymphomatous malignant tumors, the treatment of lymphoma is typically nonsurgical, thus raising the possibility of lymphoma in the differential diagnosis of a pelvic mass, a radiologist can significantly change the approach to the disease. Although some imaging findings may appear nonspecific, others may suggest the possibility of lymphoma, such as the presence of one or more solid, well-defined, homogeneous masses without necrosis despite a large size or the presence of diffuse infiltration leading to organomegaly with architectural preservation. Additionally, pelvic lymphadenopathy may be evident. In this pictorial essay, we discuss the radiological appearances of gynecological primary lymphomas, grouped by organ, in ultrasonography, computed tomography, and magnetic resonance imaging

Eligibility for Special Education Services: Six Years of the ICF-CY Implementation

The debate around students? eligibility for special education services remains actual due to its preponderance for determining the resources allocation and services distribution (Burke & Ruedel, 2008; Hollenweger, 2008). This is also the case of Portugal that in 2008 enacted a special education law, which prescribed a new approach for defining the target group for special education services based on the use of the International Classification of Functioning, Disability and Health, version for children and youth, ICF-CY (2007), as a common language and framework to guide the assessment and eligibility determination processes. Special education services were defined for students with: "significant limitations in terms of activity and participation in one or more areas of life, due to structural and functional permanent changes resulting in continued difficulties in communication, learning, mobility, autonomy, interpersonal relationships and social participation" (Paragraph 1 of Article 1st, Chapter I). In line with this definition, DL 3/2008 introduced the principle that documentation of functioning profiles of students ? reflecting the ICF terminology and framework ? should base eligibility determination

Translation, Adaptation and Validation of the Portuguese Version of Children’s Assessment of Participation and Enjoyment / Preferences for Activities of Children (CAPE / PAC)

This study aimed to translate, adapt linguistically and culturally, and validate the Portuguese version of the Children’s Assessment of Participation and Enjoyment/Preferences for Activities of Children (CAPE/PAC). CAPE/PAC is a tool that measures the participation of children and youth with and without disabilities in leisure activities, considering behavioral, contextual and affective aspects. The Portuguese version resulted from a process of translation, back-translation, analysis by experts and pilot application to obtain evidence of content validity. The instrument was administered with 361 children − 306 without disabilities and 55 with disabilities – from five school clusters in the district of Porto, aged 6 to 18 years old. Data were analyzed for internal consistency – to determine the degree of homogeneity of the instrument’s items – as well as for the standardization of the participation of children and youth with and without disabilities, and their comparison with evidence from studies evaluating similar constructs. The results revealed that the Portuguese version of CAPE/PAC exhibits emerging evidence of reliability and validity.info:eu-repo/semantics/publishedVersio

Rheology of vitreous humour and pharmacological substitutes used in the treatment of vitreoretinal pathologies

Vitreoretinal pathologies are the second leading cause of blindness worldwide. They can be caused by age-related changes in vitreous humour (VH) or as a consequence of some diseases that lead to rheological, biochemical and structural rearrangements. So far, the most effective treatment for these diseases is the injection of a VH substitute in the vitreous cavity. These substances can be used intra- operatively to push a detached retina into its normal position, to restore the volume of the vitreous cavity, and to help surgeons in membrane dissection. The major vitreous substitutes commercially available are silicone oils and perfluorocarbon liquids, but currently there is little information about the rheological properties of these fluids, that are intimately linked to their functionality. The aim of this work is to compare the rheological properties of the VH and five commercial vitreous substitutes currently used in vitreoretinal surgeries. Six fluids were analysed: VH extracted from New Zealand white rabbit specimen, three silicone oils (RS-Oil1000 and RS-Oil5000, Alchimia and Siluron 2000, Fluoron), two perfluorocarbon liquids (HPF8 and HPF10, Alchimia) and a mixture of silicone oil with perfluorocarbon (Densiron68, Fluoron). Extensional measurements were performed with a capillary break-up extensional rheometer (Haake CaBER1, ThermoElectron) and an in-house extensional rheometer. The steady shear and small amplitude oscillatory shear measurements (SAOS) were performed with a hybrid rheometer (DHR-2, TA Instruments). Our results show that VH substitutes used for same purpose exhibit significantly different rheological properties between them and when compared with the VH. Vitreous humour shows viscoelastic behaviour and all the pharmacological fluids tested display a Newtonian-like behaviour in steady shear flow with viscosities varying from 0.49 mPa s to 4.57 Pa s, at 37°C

O bronze final na península de Lisboa: o caso do Cabeço de Alcainça na transição entre o 2º e o 1º milénio A.C.

Tese de mestrado, Arqueologia, Universidade de Lisboa, Faculdade de Letras, 2013A região da Península de Lisboa (Portugal),integra a área da Ribeira de Cheleiros, onde se localiza o sítio do Cabeço de Alcainça. A área providencia um conjunto de dados arqueológicos relativos às ocupações humanas durante a transição entre o 2º e o 1º milénio a.C. na área, verificando-se que a malha de povoamento congrega povoados de habitat em altura, abertos e ocupações ocasionais (depósitos). A prospecção do sítio e o presente estudo, permitiram aferir a ocupação humana deste povoado de altura durante o Bronze Final, a julgar pelo espólio cerâmico, lítico e metálico, além das estruturas arqueológicas identificadas. O sítio apresenta-se como um dos raros povoados de altura que fornece elementos-chave na aferição de momentos ocupacionais concretos (escala local) no Bronze Final numa escala Península de Lisboa (escala regional).ABSTRACT: The Peninsula region of Lisbon (Portugal), includes the area of the Ribeira de Cheleiros, where is located the site of the Cabeço Alcainça. The area provides a set of archaeological data relating to human occupation during the transition between the 2nd and 1st millennium BC in the area, verifying that the mesh congregates villages of habitat in height, open and occasional occupations (deposits). The exploration of the site and the present study allowed assessing human occupation of this site in height during the Late Bronze Age, judging by the spoils ceramic, lithic and metallic, besides the archaeological structures identified. The site presents itself as one of the few archaeological sites in height, that provides key elements in measuring local occupational moments (local scale) in the Late Bronze Peninsula of Lisbon (regional scale)

Estudio de comportamiento básico en mecanizado del torno JASHÖNE-M-215-260-E

En este Trabajo de Fin de Grado se procede a analizar el torno JASHONE M- 215-260-E situado en la sede Francisco Mendizábal. Para ello se realiza el mecanizado de un número de piezas iguales y del mismo material. Para dicha fabricación se pone especial cuidado en el proceso seguido por el operario, aunque en todo momento será el proceso que él sigue de forma habitual, de tal forma que el estudio sea lo más fiel a la realidad posible. Posteriormente se procederá a la medición y análisis de los datos obtenidos. El objetivo de este trabajo es conocer el funcionamiento actual de la máquina, sus limitaciones y las aplicaciones en las que es aceptable su uso, así como las posibles modificaciones a realizar sobre la máquina para la corrección de errores.Departamento de Ciencias de los Materiales e Ingeniería Metalúrgica, Expresión Gráfica en la Ingeniería, Ingeniería Cartográfica, Geodesia y Fotogrametría, Ingeniería Mecánica e Ingeniería de los Procesos de FabricaciónGrado en Ingeniería Mecánic