Evaluation of conjunctival flora in patients with tear film dysfunction

PURPOSE: To evaluate conjunctival microbiota in eyes with tear film dysfunction and its modification after punctal occlusion with silicone plug. METHODS: Non comparative interventional case series study to evaluate 68 eyes of 41 patients with tear film dysfunction, from 2002 to 2007, followed in Federal University of São Paulo. Samples for culture were all obtained from conjunctival swabs and inoculated in Brain heart infusion broth (BHI broth). Twenty two patients that undergone punctal plug occlusion repeated culture procedure one month after plug insertion. RESULTS: 47 of the 68 eyes evaluated had positive culture in their samples. Nine different types of bacteria were identified: Coagulase negative Staphylococcus in 66,66%, Staphylococcus aureus, in 13,72%, Corynebacterium sp, in 5,86%, Enterobacter aerogenes, in 3,92%, Streptococcus hemolítico do grupo viridans, in 1,96%, Serratia sp, in 1,96%, Alcaligenes xylosoxidans spp, in 1,96%, Corynebacterium xerosis, in 1,96%, and Proteus mirabilis in 1,96%. Coagulase negative Staphylococcus (CNS) was the most frequently isolated microorganism before and after punctal occlusion. CNS sensibility to Oxacilin before plug insertion was 87,50%, and after, 73,68%. CONCLUSION: Microbiota found in eyes with tear film dysfunction seems to be similar to that found in normal eyes. CNS resistance to oxacilin was slightly higher after silicone plug insertion.OBJETIVO: Avaliar a microbiota conjuntival em olhos com disfunção do filme lacrimal, e a modificação desta microbiota após a colocação de plug de silicone no canalículo inferior. MÉTODOS: Série de casos intervencionais não comparativos para avaliar 68 olhos de 41 pacientes com disfunção do filme lacrimal, durante o período de 2002 a 2007, na Universidade Federal de São Paulo (UNIFESP). Todos os pacientes foram submetidos à colheita de amostras de raspado conjuntival de fundo-de-saco inferior para cultivo em Brain heart infusion broth. Os vinte e dois pacientes submetidos à colocação de plug de silicone repetiram a colheita de raspado conjuntival um mês após o procedimento. RESULTADOS: Dos 68 olhos avaliados, 47 apresentaram crescimento bacteriano nas amostras colhidas. Nove diferentes espécies de bactérias foram identificadas: Staphylococcus coagulase negativa em 66,66%, Staphylococcus aureus em 13,72%, Corynebacterium sp em 5,86%, Enterobacter aerogenes em 3,92%, Streptococcus hemolítico do grupo viridans em 1,96%, Serratia sp em 1,96%, Alcaligenes xylosoxidans spp em 1,96%, Corynebacterium xerosis em 1,96%, e Proteus mirabilis em 1,96%. Staphylococcus coagulase negativa (SCN) foi o microrganismo mais frequentemente isolado tanto antes quanto após o plug de silicone. A sensibilidade do SCN à Oxacilina antes da colocação do plug era de 87,50%, e, após, de 73,68%. CONCLUSÃO: A microbiota em olhos com disfunção do filme lacrimal é bastante semelhante à encontrada em olhos normais. A resistência de SCN à Oxacilina foi um pouco maior após o implante do plug de silicone.Universidade Federal de São Paulo (UNIFESP) Departamento de OftalmologiaUniversidade Federal de São Paulo (UNIFESP) Laboratório de Microbiologia Departamento de OftalmologiaUNIFESP, Depto. de OftalmologiaUNIFESP, Laboratório de Microbiologia Depto. de OftalmologiaSciEL

Diabetes e sua descompensação crônica: um relato de experiência

Diabetic Ketoacidosis (DAC) is a complication that needs to be understood so that its warning signs are identified by health professionals and so that control measures can be taken, thus avoiding such a problem, so the aim was to understand the decompensation metabolic pathway that promotes CAD in patients with DM. This is an experience report elaborated from the analysis of intervention data and clinical evolution of a health service user who presented CAD due to decompensated DM and died even after the medical procedures. DKA is a hyperglycemic emergency that requires prompt medical intervention. In this sense, early diagnosis and treatment of DM is important because it prevents it from evolving to CAD. However, the study presented shows the opposite, since the patient was unaware that she had DM, so she did not undergo any treatment and died due to complications from DM.A Cetoacidose Diabética (CAD) é uma complicação que necessita ser compreendida para que seus sinais de alerta sejam identificados por profissionais de saúde e para que medidas de controle possam ser tomadas, evitando assim, tal problema, por isso, objetivou-se compreender a descompensação metabólica que promove a CAD em pacientes com DM. Trata-se de um relato de experiência elaborado a partir da análise dos dados de intervenção e evolução clínica de usuário de serviço de saúde que apresentou CAD por conta da DM descompensada e faleceu mesmo após as condutas médicas. A CAD é uma emergência hiperglicêmica que necessita de intervenção médica rápida. Nesse sentido, o diagnóstico precoce e tratamento da DM é importante pois impede que evolua para CAD. No entanto, o estudo apresentado mostra o oposto, visto que a paciente desconhecia que era portadora de DM, por conta disso não fez nenhum tratamento e faleceu em razão das complicações da DM

Description of a Prospective 17DD Yellow Fever Vaccine Cohort in Recife, Brazil

From September 2005 to March 2007, 238 individuals being vaccinated for the first time with the yellow fever (YF) -17DD vaccine were enrolled in a cohort established in Recife, Brazil. A prospective study indicated that, after immunization, anti-YF immunoglobulin M (IgM) and anti-YF IgG were present in 70.6% (IgM) and 98.3% (IgG) of the vaccinated subjects. All vaccinees developed protective immunity, which was detected by the plaque reduction neutralization test (PRNT) with a geometric mean titer of 892. Of the 238 individuals, 86.6% had IgG antibodies to dengue virus; however, the presence of anti-dengue IgG did not interfere significantly with the development of anti-YF neutralizing antibodies. In a separate retrospective study of individuals immunized with the 17DD vaccine, the PRNT values at 5 and 10 years post-vaccination remained positive but showed a significant decrease in neutralization titer (25% with PRNT titers < 100 after 5 years and 35% after 10 years)

Pharmacologic management of pain in patients with Chikungunya: a guideline

Abstract From the arrival of Chikungunya virus in the Americas in 2013 until March 2016, approximately two million cases of the disease have been reported. In Brazil, the virus was identified in 2014 and thousands of people have been affected. The disease has high attack rates, infecting 50% of a population within a few months. Approximately 50% of infected people develop chronic symptoms lasting for months or years. Joint involvement is the main clinical manifestation of Chikungunya. It is characterized by swelling and intense pain that is poorly responsive to analgesics, both in the acute and chronic phase of the disease. This significantly compromises quality of life and may have immeasurable psychosocial and economic repercussions, constituting therefore, a serious public health problem requiring a targeted approach. Physicians are often not familiar with how to approach the management of pain, frequently prescribing limited analgesics, such as dipyrone, in sub-therapeutic doses. In addition, there are few published studies or guidelines on the approach to the treatment of pain in patients with Chikungunya. Some groups of specialists from different fields have thus developed a protocol for the pharmacologic treatment of Chikungunya-associated acute and chronic joint pain; this will be presented in this review

Relações entre profissionais de saúde e usuários durante as práticas em saúde Relationships between health professionals and users throughout health care practices

Apresenta-se uma revisão integrativa sobre estudos que abordam as relações entre profissionais de saúde e usuários durante as práticas em saúde. Objetivou-se identificar os aspectos pesquisados no cotidiano dos serviços acerca dessas relações. A coleta foi realizada nas bases Lilacs e Pubmed segundo os descritores: acolhimento; relações profissional-família; relações profissional-paciente; humanização da assistência; e a palavra 'vínculo' associada ao descritor Sistema Único de Saúde. Selecionaram-se 290 estudos publicados entre 1990 e 2010. Por meio da análise temática, foram criados cinco núcleos de sentido: a relevância da confiança na relação profissional-usuário; sentimentos e sentidos na prática do cuidado; a importância da comunicação nos serviços de saúde; modo de organização das práticas em saúde; e (des)colonialismo. Identificou-se que as relações estabelecidas nas práticas de saúde têm uma dimensão transformadora. No entanto, permanece o desafio de humanizar os serviços de saúde. A enfermagem se destaca na produção do conhecimento nessa temática.<br>This article presents an integrative review about studies that address the relationships between health professionals and users in health care practices. It aimed to identify aspects that were researched on the daily life of the services concerning such relationships. Data were collected from the Lilacs and Pubmed databases based on these descriptors: user embracement; professionalfamily relations; professionalpatient relations; humanization of the care; and the bonding word associated to the Single Health System descriptor. Two hundred and ninety studies, published from 1990 to 2010, were selected. Through thematic analyses, five meaning cores were created: the relevance of the confidence in the professionaluser relationship; feelings and senses in the health care practice; the importance of communications in health care services; ways to organize health care practices and (de)colonialism. It was found that relationships established in health care practices have a transformative dimension. However, the challenge to humanize health care services remains. Nursing stands out in the production of knowledge on such theme

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data