Influência de corantes na estabilidade oxidativa de amostras de biodiesel

The feasibility of using the dyequinizarin (QNZ) on the oxidative stability of soybean biodiesel samples was studied in this work. The paper presents parameters indicative of the oxidation of biodiesel under thermal degradation through measurements of its acid value, peroxide and conjugated dienes and trienes. The study aimed to evaluate the behavior/performance antioxidant of the dyequinizarin (QNZ) along with the antioxidant tert – butylhydroquinone (TBHQ) at the concentration of 5mg L-1, iea possible synergism between these two substances. The samples were characterized by physicochemical analyzes and spectrophotometric UV/Vis(200-400 nm). The analysis of the acid number and peroxide were consistent with the absorbance at 232and 270nm, for in both analyzes were detected increase in the oxidation of biodiesel samples throughout storage period and/or thermal degradation.  A viabilidade do uso da dyequinizarina (QNZ) na estabilidade oxidativa de amostras de biodiesel de soja foi estudada neste trabalho. O trabalho apresenta parâmetros indicativos da oxidação do biodiesel sob degradação térmica através de medidas de seu valor ácido, peróxido e dienos e trienos conjugados. O estudo teve como objetivo avaliar o antioxidante comportamento / desempenho da corantequinizarina (QNZ) juntamente com o antioxidante terc - butil-hidroquinona (TBHQ) na concentração de 5mg L-1, um possível sinergismo entre essas duas substâncias. As amostras foram caracterizadas por análises físico-químicas e UV / Vis espectrofotométricas (200-400 nm). As análises do número de ácido e peróxido foram consistentes com a absorvância a 232 e 270 nm, pois em ambas as análises foi detectado aumento na oxidação das amostras de biodiesel durante o período de armazenamento e / ou degradação térmica

Risk factors for the acquisition of imipenem-resistant Acinetobacter baumannii in a burn unit: An appraisal of the effect of colonization pressure

Imipenem-resistant Acinetobacter baumannii (IRAB) is a major threat for critically ill patients, including those admitted to burn units. Recent studies have suggested that colonization pressure (the proportion of patients or patient-days harbouring the pathogen of interest) is an important driver of the risk for acquisition of multidrug-resistant organisms. With that in mind, we conducted a cohort study, enrolling 208 patients admitted to a burn unit from November 2008 through December 2009. The outcome of interest was the acquisition of IRAB. In addition to the usual risk factors, we assessed the impact of colonization pressure. The number of wound excisions (odds ratio (OR) 12.06, 95% confidence interval (CI) 2.82-51.64) and the number of antimicrobials used (OR 22.82, 95% CI 5.15-101.19) were significant risk factors for the outcome of interest. On the other hand, colonization pressure (measured for whole time of exposure or up to the last 14, 7, or 3 days) was not associated with the risk for IRAB acquisition

Predictors of adherence to influenza vaccination for healthcare workers from a teaching hospital: a study in the prepandemic era

Introduction: Even before the 2009 pandemics, influenza in healthcare workers (HCW) was a known threat to patient safety, while Influenza vaccine coverage in the same group was generally low. Identification of predictors for HCW adherence to Influenza vaccination has challenged infection control committees. Methods: Our group conducted a cross-sectional survey in December 2007, interviewing 125 HCWs from a teaching hospital to identify adherence predictors for Influenza vaccination. The outcomes of interest were: A - adherence to the 2007 vaccination campaign; B - adherence to at least three yearly campaigns in the past five years. Demographic and professional data were assessed through univariate and multivariate analysis. Results: of the HCWs interviewed, 43.2% were vaccinated against Influenza in 2007. However, only 34.3% of HCWs working in healthcare for more than five years had adhered to at least three of the last five vaccination campaigns. Multivariate analysis showed that working in a pediatric unit (OR = 7.35, 95% I = 1.90-28.44, p = 0.004) and number of years in the job (OR = 1.32, 95%CI = 1.00-1.74, p = 0.049) were significant predictors of adherence to the 2007 campaign. Physicians returned the worst outcome performances in A (OR = 0.40, 95%CI = 0.16-0.97, p = 0.04) and B (OR = 0.17, 95%CI = 0.05-0.60, p = 0.006). Conclusions: Strategies to improve adherence to Influenza vaccination should focus on physicians and newly-recruited HCWs. New studies are required to assess the impact of the recent Influenza A pandemics on HCW-directed immunization policies.INTRODUÇÃO: Mesmo antes da pandemia de 2009, o acometimento de profissionais da área da saúde (PAS) pela influenza já era uma ameaça conhecida para pacientes internados. A cobertura vacinal desse grupo era geralmente baixa. A identificação de preditores de adesão de PAS à vacinação contra influenza é um desafio para Comissões de Controle de Infecção. MÉTODOS: Realizou-se estudo transversal em Dezembro de 2007, entrevistando 125 PAS de um hospital de ensino para identificar preditores de adesão à vacinação contra influenza. Os desfechos de interesse foram: A - adesão à campanha de 2007; B - adesão a pelo menos três campanhas nos últimos cinco anos. Dados demográficos e profissionais foram analisados em modelos univariados e multivariados. RESULTADOS: Dos entrevistados, 43,2% haviam sido vacinados em 2007. No entanto, apenas 34,3% daqueles trabalhando há mais de cinco anos aderiram a três ou mais campanhas nesse período. Análise multivariada demonstrou que trabalhar em enfermaria pediátrica (OR = 7.35, 95% CI = 1.90-28.44, p = 0,004) e o número de anos no emprego (OR = 1.32, 95% CI = 1.00-1.74, p = 0.049) foram preditores significantes de adesão em 2007. Médicos tiveram má performance nos desfechos A (OR = 0,40, 95% CI = 0.16-0.97, p = 0,04) e B (OR = 0,17, 95% CI = 0,05-0,60, p = 0,006). CONCLUSÕES: Estratégias para aumentar adesão à vacinação contra influenza devem priorizar médicos e PAS admitidos recentemente ao emprego. Novos estudos são necessários para abordar o impacto da recente pandemia de influenza sobre as políticas de vacinação para PAS

Epidemiology of healthcare-associated infections among patients from a hemodialysis unit in southeastern Brazil

Patients submitted to hemodialysis are at a high risk for healthcare-associated infections (HAI). Presently there are scarce data to allow benchmarking of HAI rates in developing countries. Also, most studies focus only on bloodstream infections (BSI) or local access infections (LAI). Our study aimed to provide a wide overview of HAI epidemiology in a hemodialysis unit in southeastern Brazil. We present data from prospective surveillance carried out from March 2010 through May 2012. Rates were compared (mid-p exact test) and temporally analyzed in Shewhart control charts for Poisson distributions. The overall incidence of BSI was 1.12 per 1000 access-days. The rate was higher for patients performing dialysis through central venous catheters (CVC), either temporary (RR = 13.35, 95% CI = 6.68-26.95) or permanent (RR = 2.10, 95% CI = 1.09-4.13), as compared to those with arteriovenous fistula. Control charts identified a BSI outbreak caused by Pseudomonas aeruginosa in April 2010. LAI incidence was 3.80 per 1000 access-days. Incidence rates for other HAI (per 1000 patients-day) were as follows: upper respiratory infections, 1.72; pneumonia, 1.35; urinary tract infections, 1.25; skin/soft tissues infections, 0.93. The data point out to the usefulness of applying methods commonly used in hospital-based surveillance for hemodialysis units

Anorectal hemangioma - differential diagnosis of anal bleeding

ABSTRACT Anorectal hemangioma is one of the rarest causes of lower gastrointestinal bleeding, but is often neglected and confused in the differential diagnosis. The clinical examination is a turning point for a correct diagnosis and management of patients, thus avoiding unnecessary procedures. The treatment of choice for this condition is surgical and intraoperative bleeding is the main complication of this therapy. The present case reports a 25-year old patient with a history of bleeding from the age of 13, being diagnosed with anorectal hemangioma, and surgically treated with resection of the affected segment and with wound synthesis by marsupialization, with a good progression postoperatively

Predictive factors of post-discharge surgical site infections among patients from a teaching hospital

Introduction Surgical site infections (SSIs) often manifest after patients are discharged and are missed by hospital-based surveillance. Methods We conducted a case-reference study nested in a prospective cohort of patients from six surgical specialties in a teaching hospital. The factors related to SSI were compared for cases identified during the hospital stay and after discharge. Results Among 3,427 patients, 222 (6.4%) acquired an SSI. In 138 of these patients, the onset of the SSI occurred after discharge. Neurological surgery and the use of steroids were independently associated with a greater likelihood of SSI diagnosis during the hospital stay. Conclusions Our results support the idea of a specialty-based strategy for post-discharge SSI surveillance

Correlation of clinical data and the Alvarado's Score as predictors of acute appendicitis

Objective: To correlate the patient's clinical data and the Alvarado's Score as predictors of acute appendicitis. Methods: This is an observational, descriptive and prospective study performed at a public urgency and emergency hospital in the city of Fortaleza, Ceará, between July and December 2016, with 34 patients undergoing open appendectomy with ages between 18 and 70 years. Statistical analysis was performed using the SPSS program. Results: The following statistical correlations were performed: number of days with abdominal pain until the operative event and degree of inflammation according to a macroscopic analysis of the appendix, Alvarado's Score and number of days with abdominal pain until the operative event, Alvarado's Score and degree of inflammation according to a macroscopic analysis of the appendix, number of days with abdominal pain until the operative event, and number of days of hospitalization in the postoperative period, degree of inflammation according to amacroscopic analysis of the appendix, number of days of hospitalization in the postoperative period and Alvarado's Score, and number of days of hospitalization in the postoperative period; the first five correlations were statistically significant (p < 0.05). Conclusion: The use of this Alvarado's Score in health services emerges as a tool for the diagnosis of acute appendicitis. Resumo: Objetivo: correlacionar os dados clínicos do paciente e a pontuação do Escore de Alvarado como preditores da apendicite aguda. Métodos: Estudo observacional, descritivo e prospectivo realizado em um hospital secundário de urgência e emergência da rede pública na cidade de Fortaleza-Ceará, entre julho a dezembro de 2016, com 34 pacientes submetidos à apendicectomia por via aberta com idade entre 18 e 70 anos. A análise estatística foi realizada utilizando o programa SPSS. Resultados: Foram realizadas as seguintes correlações estatísticas: número de dias com dor abdominal até o ato operatório e grau de inflamação segundo análise macroscópica do apêndice, Escore de Alvarado e número de dias com dor abdominal até o ato operatório, Escore de Alvarado e grau de inflamação segundo análise macroscópica do apêndice, número de dias com dor abdominal até o ato operatório e número de dias de internação no pós operatório, grau de inflamação segundo análise macroscópica do apêndice e número de dias de internação no pós operatório e Escore de Alvarado e número de dias de internação no pós-operatório, sendo as cinco primeiras estatisticamente significantes (p < 0,05). Conclusão: O uso desta escala nos serviços de saúde emerge como uma possibilidade de ferramenta para auxiliar o diagnóstico de apendicite aguda. Keywords: Appendicitis, Appendectomy, Diagnosis, Palavras-chave: Apendicite, Apendicectomia, Diagnóstic

A Study on the Epidemiological-Molecular Role of <i>Staphylococcus aureus</i> Strains in the Development of Ventilator-Associated Pneumonia in a Tertiary Hospital in Brazil

This study aimed to explore the molecular epidemiology of Staphylococcus aureus isolated from patients on mechanical ventilation and the participation of virulence factors in the development of ventilator-associated pneumonia (VAP). A prospective cohort study was conducted on patients under mechanical ventilation, with periodic visits for the collection of tracheal aspirates and clinical data. The S. aureus isolates were analyzed regarding resistance profile, virulence, expression of protein A and alpha-toxin using Western blot, clonal profile using PFGE, sequence type using MLST, and characterization and quantification of phenol-soluble modulins. Among the 270 patients in the study, 51 S. aureus strains were isolated from 47 patients. The incidence density of S. aureus and MRSA VAP was 2.35/1000 and 1.96/1000 ventilator days, respectively; of these, 45% (n = 5) were resistant to oxacillin, with 100% (n = 5) harboring SCCmec types II and IV. The most frequent among the tested virulence factors were icaA, hla, and hld. The clonal profile showed a predominance of sequence types originating from the community. Risk factors for VAP were the presence of solid tumors and the sea gene. In conclusion, patient-related risk factors, together with microbiological factors, are involved in the development of S. aureus VAP, which is caused by the patient’s own strains