Characterization of Oral Enterobacteriaceae Prevalence and Resistance Profile in Chronic Kidney Disease Patients Undergoing Peritoneal Dialysis

Enterobacteriaceae; Insuficiència renal crónica; Diàlisi peritonealEnterobacteriaceae; Insuficiencia renal crónica; Diálisis peritonealEnterobacteriaceae; Chronic renal failure; Peritoneal dialysisChronic Kidney Disease (CKD) is a growing public-health concern worldwide. Patients exhibit compromised immunity and are more prone to infection than other populations. Therefore, oral colonization by clinically relevant members of the Enterobacteriaceae family, major agents of both nosocomial and dialysis-associated infections with frequent prevalence of antibiotic resistances, may constitute a serious risk. Thus, this study aimed to assess the occurrence of clinically relevant enterobacteria and their antibiotic resistance profiles in the oral cavity of CKD patients undergoing peritoneal dialysis (CKD-PD) and compare it to healthy controls. Saliva samples from all the participants were cultured on MacConkey Agar and evaluated regarding the levels of urea, ammonia, and pH. Bacterial isolates were identified and characterized for antibiotic resistance phenotype and genotype. The results showed that CKD-PD patients exhibited significantly higher salivary pH, urea, and ammonia levels than controls, that was accompanied by higher prevalence and diversity of oral enterobacteria. Out of all the species isolated, only the prevalence of Raoultella ornithinolytica varied significantly between groups, colonizing the oral cavity of approximately 30% of CKD-PD patients while absent from controls. Antibiotic resistance phenotyping revealed mostly putative intrinsic resistance phenotypes (to amoxicillin, ticarcillin, and cephalothin), and resistance to sulfamethoxazole (~43% of isolates) and streptomycin (~17%). However, all isolates were resistant to at least one of the antibiotics tested and multidrug resistance isolates were only found in CKD-PD group (31,6%). Mobile genetic elements and resistance genes were detected in isolates of the species Raoultella ornithinolytica, Klebsiella pneumoniae, Klebsiella oxytoca, Escherichia coli, and Enterobacter asburiae, mostly originated from CKD-PD patients. PD-related infection history revealed that Enterobacteriaceae were responsible for ~8% of peritonitis and ~ 16% of exit-site infections episodes in CKD-PD patients, although no association was found to oral enterobacteria colonization at the time of sampling. The results suggest that the CKD-induced alterations of the oral milieu might promote a dysbiosis of the commensal oral microbiome, namely the proliferation of clinically relevant Enterobacteriaceae potentially harboring acquired antibiotic resistance genes. This study highlights the importance of the oral cavity as a reservoir for pathobionts and antibiotic resistances in CKD patients undergoing peritoneal dialysis.This work is a result of the project POCI-01-0145-FEDER-029777, co-financed by Competitiveness and Internationalisation Operational Programme (POCI), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF) and through national funds by the FCT – Fundação para a Ciência e a Tecnologia. CC fellowship was supported by FCT/MCTES scholarship with the reference 2020.08540.BD. This work and CF were financially supported by FEDER through project “Assessing the risks associated with environmental antibiotic resistant bacteria: propagation and transmission to humans” (PTDC/CTA-AMB/28196/2017) – Programa Operacional Competitividade e Internacionalização, and by National Funds from FCT – Fundação para a Ciência e a Tecnologia and was hosted by CBQF through FCT project UIDB/50016/2020

As regiões de planejamento de Minas Gerais sob a ótica do desenvolvimento rural sustentável: uma abordagem teórico-metodológica

O estudo revelou uma tipologia dos municípios mineiros a partir de suas principais características sociais, econômicas e institucionais de desenvolvimento rural sustentável. Com esse fim, foram aplicados dois métodos estatísticos multivariados (componentes principais e classificação por cluster), utilizando 20 indicadores, divididos em seis dimensões, definidas pelo Ministério do Desenvolvimento Agrário, na forma de diretrizes para o desenvolvimento rural sustentável, são elas: Diversidades sociais e regionais; Direitos e qualidade de vida; Conhecimentos e saberes; Organização social e participação política; Organização econômica e mercados e Produção, consumo e sustentabilidade. Os indicadores foram selecionados a partir de diversas fontes de dados, para os 853 municípios do estado de Minas Gerais, e os resultados mostraram que é possível agrupar os municípios mineiros em quatro regiões relativamente homogêneas: municípios em condições muito favoráveis de desenvolvimento rural sustentável; municípios em condições favoráveis de desenvolvimento rural sustentável; municípios em condições pouco favoráveis de desenvolvimento rural sustentável e municípios em condições desfavoráveis de desenvolvimento rural sustentável

Política industrial, crecimiento económico e inserción internacional: comparación de países seleccionados

El debate actual sobre las políticas industriales ya no se centra en determinar si las políticas industriales son necesarias, sino en la mejor manera de implementar dichas políticas y en las lecciones que se pueden aprender (y transferir) a partir de las experiencias de industrialización exitosas. Por lo tanto, la propuesta de este artículo consiste en analizar el impacto de diferentes configuraciones de políticas industriales en el crecimiento y la inserción internacional de nueve economías de América Latina. Dicho impacto se determina mediante el análisis de modelos autorregresivos integrados de media móvil (ARIMA) y de intervención para el período 1966-2014. Los resultados indican que las intervenciones analizadas no modificaron significativamente el comportamiento de las series estudiadas, excepto las series de crecimiento económico. Para las demás variables, las intervenciones fueron bastante puntuales y no se verificó ningún patrón de comportamiento en función de los períodos de intervención analizados

Industrial policy, economic growth and international engagement: a comparison of selected countries

The current debate on industrial policies is no longer focused on whether such policies are necessary, but on how best to implement them and on the lessons that can be learned (and transferred) from successful industrialization experiences. Accordingly, the aim of this paper is to analyse the impact of different configurations of industrial policies on the growth and international engagement of nine Latin American economies. This impact is measured by analysing autoregressive integrated moving average (ARIMA) models and intervention models for 1966–2014. The results show that the interventions analysed did not significantly modify the behaviour of the time series studied, except in the case of the economic growth series. For the other variables, the interventions were quite self-contained, and it was impossible to identify any behavioural pattern associated with the intervention periods analysed

Reflexões Acerca da Assistência à Saúde de Pessoas que Vivem com o HIV em Contexto de Restrição Orçamentária no Brasil

La création du Système Unifié de Santé (SUS) a représenté une grande avancée dans la lutte contre l'épidémie de VIH/SIDA. Cependant, avec le gouvernement actuel en place, basé sur une politique néolibérale qui privilégie l'adoption de mesures d'austérité économique, au détriment de l'investissement dans les politiques de protection sociale, on observe l'aggravation de sa précarité et sa déconstruction. L'épidémie de VIH/SIDA, à son tour, a des liens étroits avec les inégalités socio-économiques et culturelles et historiques, ce qui corrobore une incidence plus élevée chez les personnes à forte vulnérabilité socio-économique, dépendantes de l'aide de l'État. Dans cet essai, nous chercherons à analyser le thème à la lumière des études Biopolitiques, initiées par Michel Foucault afin de réfléchir sur l'impact des restrictions budgétaires, sur la pérennité des soins de santé pour les Personnes Vivant avec le VIH, ainsi que sur les Stratégies. Dans cette perspective, nous soulevons l'urgence d'une articulation politique de la population en défense de la pérennité du SUS, afin de garantir sa pérennité et les programmes en cours, comme le programme VIH/SIDA. Nous pensons que ce n'est qu'à travers l'articulation de la société civile, en partenariat avec les acteurs situés dans les instances décisionnelles politiques et en faveur de la pérennité du SUS, qu'il sera possible de maintenir le droit universel et inaliénable à la santé, décrit dans la loi fédérale Constitution.The creation of the Unified Health System (SUS) represented a great advance in the fight against the HIV/AIDS epidemic. However, with the current government, based on a neoliberal policy that prioritizes the adoption of economic austerity measures, to the detriment of investment in social welfare policies, we have seen the worsening of its precariousness and deconstruction. The HIV/AIDS epidemic, in turn, has strong connections with socioeconomic and historical-cultural inequalities, which corroborates a higher incidence in individuals with high socioeconomic vulnerability, dependent on State assistance. In this essay, we will seek to analyze the theme in the light of Biopolitics studies, initiated by Michel Foucault, in order to reflect on the impact of budget restrictions, on the sustainability of health care for People Living with HIV, as well as current public policies. In this perspective, we raise the urgent need for political articulation of the population in defense of the sustainability of the SUS, in order to guarantee its permanence and existing programs, such as the HIV/AIDS program. We believe that only through the articulation of civil society, in partnership with actors located in decision-making political instances and in favor of SUS sustainability, will it be possible to maintain the universal and inalienable right to health, described in the Federal Constitution.A criação do Sistema Único de Saúde (SUS), representou grande avanço no combate à epidemia de HIV/AIDS. Porém, com a vigência do atual governo, pautado em uma política neoliberal que prioriza a adoção de medidas de austeridade econômica, em detrimento do investimento em políticas de bem-estar social, observamos o agravamento de sua precarização e desconstrução. À epidemia de HIV/AIDS, por sua vez, tem fortes conexões com as desigualdades socioeconômicas e histórico-culturais, que corrobora maior incidência em indivíduos com alta vulnerabilidade socioeconômica, dependentes da assistência do Estado. Neste ensaio, buscaremos analisar o tema sob a luz dos estudos de Biopolítica, iniciados por Michel Foucault a fim de refletir sobre o impacto das restrições orçamentárias, sobre a sustentabilidade da assistência à saúde de Pessoas Vivendo com HIV, assim como das políticas públicas vigentes. Nesta ótica, suscitamos a urgência da articulação política da população em defesa da sustentabilidade do SUS, de modo sua garantir permanência e dos programas vigentes, como o programa de HIV/AIDS. Acreditamos que somente através da articulação da sociedade civil, em parceria com atores situados em instâncias políticas decisórias e em prol da sustentabilidade do SUS, será possível manter o direito universal e inalienável à saúde, descrito na Constituição Federal.La creación del Sistema Único de Salud (SUS) representó un gran avance en la lucha contra la epidemia del VIH/SIDA. Sin embargo, con el actual gobierno vigente, basado en una política neoliberal que prioriza la adopción de medidas de austeridad económica, en detrimento de la inversión en políticas de bienestar social, se observa el recrudecimiento de su precariedad y deconstrucción. La epidemia de VIH/SIDA, a su vez, tiene fuertes conexiones con las desigualdades socioeconómicas y cultural-históricas, lo que corrobora una mayor incidencia en individuos con alta vulnerabilidad socioeconómica, dependientes de asistencia estatal. En este ensayo, buscaremos analizar el tema a la luz de los estudios de Biopolítica, iniciados por Michel Foucault con el fin de reflexionar sobre el impacto de las restricciones presupuestarias, en la sostenibilidad de la atención a la salud de las Personas que Viven con VIH, así como en la actualidad pública políticas En esta perspectiva, planteamos la urgencia de la articulación política de la población en defensa de la sostenibilidad del SUS, para garantizar su permanencia y los programas vigentes, como el de VIH/SIDA. Creemos que sólo a través de la articulación de la sociedad civil, en sociedad con los actores ubicados en los órganos de decisión política y en favor de la sostenibilidad del SUS, será posible mantener el derecho universal e inalienable a la salud, descrito en la Ley Federal Constitución

Effects of intellectual property rights on innovation and economic activity: A non-linear perspective from Latin America

This work was financed by the Coordenação ao de Aperfeiçoamento de Pessoal de Nivel Superior – Brasil (CAPES) – Finance Code 001 and supported by National Council for Scientific and Technological Development – CNPq (Proc. 152,060/2022–7).Acknowledgements: The authors sincerely thank the Editor Mario Pianta and anonymous referees for all comments and constructive suggestions, which significantly contributed to improving the quality of the manuscript. We would like to register our sincere thanks to Miss Maribel Guerrero for her helpful suggestions in a firsthand view of our research. The authors are also grateful for the many helpful comments at the Academy of International Business – AIB LAC 2023 Conference hosted at ESPM in São Paulo, Brazil.Intellectual property rights (IPRs) have a significant impact on facilitating the economic endeavors of countries. Nevertheless, there exists notable disparity among studies concerning the implications of IPRs within developing countries. Therefore, this study examines how stronger IPRs affect economic activity and moderate two important knowledge channels, domestic and foreign innovation activity. Using a sample of 18 Latin American countries from 2007 to 2018, we employed the Driscoll-Kraay robust standard errors, two-stage least squares (2SLS), and Generalized Method of Moments (GMM) to examine the effects of IPRs. Results confirm an inverted U-shaped relationship between IPRs and economic activity. Hence, the majority of Latin countries continue to vary in the factors of production that suport robust IPRs. Conversely, robust IPRs effectively improve the relation between domestic innovation and economic activity. Similarly, this influence holds true for foreign innovation as well. Based on this evidence, the research suggests implementing an optimal IPR policy.info:eu-repo/semantics/publishedVersio

Impacto de programa fisioterapêutico no desempenho funcional da criança com doença de Charcot-Marie-Tooth tipo 2: estudo de caso

This case study aimed at verifying the influence of a physical therapy program on the functional performance of a child with diagnosis of Charcot-Marie-Tooth) disease type 2. The 6 year-old male child presented low and upper limbs affected at both motor and sensitive levels. Before and after the program, the subject was assessed by means of the Pediatric Evaluation Disability Inventory (PEDI), designed for children between 6 months through 7.5 years old. PEDI is divided into three parts – functional skills (involving selfcare, mobility and social function), caregiver assistance, and environment modification – and only the first part was used in this study. Drawing on the difficulties detected at the first evaluation, a physical therapy program was designed, based on the neurodevelopmental concept. The program lasted two months, with two 50-minute sessions per week (a total of 15 sessions). At the post-program evaluation, self-care score raised from 20.8 to 26.7, and mobility scare, from 40 to 54,9, specially in transference and going up and downstairs skills. Thus, the therapy program was effective in improving the subject's functional performance.O estudo visou verificar a influência de um programa fisioterapêutico nodesempenho funcional de uma criança com diagnóstico de Charcot-Marie-Tooth tipo 2. O participante (sexo masculino, 6 anos) apresentava comprometimento motor e sensitivo em membros superiores e inferiores. Antes e após o programa, o participante foi avaliado pelo Pediatric Evaluation Disability Inventory (PEDI), questionário que avalia o desempenho funcional de crianças na faixa de 6 meses a 7 anos e meio. O PEDI divide-se em três partes: habilidades funcionais (envolvendoautocuidado, mobilidade e função social), assistência do cuidador e modificações do ambiente; este estudo limitou-se à parte de habilidades funcionais. A partir das dificuldades detectadas na avaliação inicial, elaborou-se um programa de intervenção fisioterapêutica com base no conceito neuroevolutivo Bobath. O programa foi aplicado por 2 meses, sendo realizadas 2 sessões semanais de 50 minutos cada, totalizando 15 sessões. Na avaliação após a aplicação do programa, aumentou o escore normativo no PEDI, nas áreas de autocuidado (de 20,8 para 26,7) e mobilidade (de 40 para 54,9), especialmente nas habilidades de transferência, subir e descer escadas. Portanto, o programa de intervenção fisioterapêutica mostrou-se eficaz, promovendo melhora no desempenho funcional da criança

Presence of Bartonella spp. in domestic cats from a state park in Rio de Janeiro, Brazil

Submitted by Sandra Infurna ([email protected]) on 2019-02-10T17:04:06Z No. of bitstreams: 1 elbareginaS_lemos_etal_IOC_2018.pdf: 488698 bytes, checksum: d9d816bea43126ebce0a39af3a3bc040 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2019-02-10T17:12:03Z (GMT) No. of bitstreams: 1 elbareginaS_lemos_etal_IOC_2018.pdf: 488698 bytes, checksum: d9d816bea43126ebce0a39af3a3bc040 (MD5)Made available in DSpace on 2019-02-10T17:12:03Z (GMT). No. of bitstreams: 1 elbareginaS_lemos_etal_IOC_2018.pdf: 488698 bytes, checksum: d9d816bea43126ebce0a39af3a3bc040 (MD5) Previous issue date: 2018Universidade Federal Fluminense. Faculdade de Veterinária. Programa de Pós-Graduação em Medicina Veterinária. Clínica e Reprodução Animal. Niterói, RJ, Brasil.Universidade Federal Fluminense. Faculdade de Veterinária. Departamento de Patologia e Clínica Veterinária. Niterói, RJ, Brasil.Universidade Federal Fluminense. Faculdade de Veterinária. Programa de Pós-Graduação em Medicina Veterinária (Clínica e Reprodução Animal). Niterói, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hantaviroses e Rickettsioses. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz Mato Grosso do Sul. Campo Grande, MS, Brasil.Universidade Federal Fluminense. Faculdade de Veterinária. Departamento de Patologia e Clínica Veterinária. Niterói, RJ, Brasil

Assessment of Renal Functions and Lesions in Dogs with Serological Diagnosis of Canine Visceral Leishmaniasis

Background: Visceral leishmaniasis is a complex vector-borne disease caused by the protozoan Leishmania infantum. In urban centers of South America, where this zoonotic cycle occurs, dogs seem to be the main reservoirs and infection sources. Animals with canine visceral leishmaniasis (CVL) may have a wide clinical spectrum, and dogs are usually classified as asymptomatic, oligosymptomatic, and symptomatic. Several organs are affected in canine CVL, and renal involvement is often a determining factor in dog prognosis. Nevertheless, serum markers are slow to indicate loss of renal function. The aim of this studywas to evaluate kidney impairment in dogs diagnosed with CVL.Material, Methods & Results: Blood and urine samples were collected from 45 dogs from Barra Mansa-RJ, and used for urinalysis, urine protein/creatinine (UPC) ratio, and serum concentrations of urea and creatinine. The animals were classified as symptomatic (42.2%), oligosymptomatic (37.8%), and asymptomatic (20.0%). Some alterations were found in the urine samples; pale-yellow color in 17.8%, low specific gravity in 6.7%, turbidity in 51.1%, proteinuria in 80%, occult blood in 46.7%, bilirubin in 8.89%, and glucose in 6.7% of the samples. According to the UPC ratio, 60% of dogs were proteinuric, and UPC > 2.0 was high in symptomatic dogs. Azotemia was observed only in three dogs with CVL.Discussion: The majority of dogs presented one or more symptoms of CVL, as expected in an endemic area from Brazil. Pale-yellow urine was observed in some samples, and this change, when accompanied by the decreased urine specific gravity in dogs with CVL, suggests some degree of kidney disease. The presence of epithelial and red blood cells, leukocytes, bacteria, suspended mucus, and phosphate crystals that precipitate in alkaline urines could be associated, to some degree, with the urine turbidity found in the present study. The alkaline urine identified in some dogs could be related to the animals’ diet, but renal tubular acidosis (RTA) is another possible cause when referring to animals with CVL. The abnormal presence of bilirubin and glycosuria can be justified by liver damage and glomerular and tubular damage, respectively. Occult blood was found in the urine of almost half of the tested dogs, which occurred because of the presence of red blood cells in the urine sediment and hematuria in some animals, could be caused by tubular and glomerular lesions. The presence of granular and hyaline casts found in the samples reinforce the possibility of tubular injury. We found different levels of proteinuria; it was an important result, possibly caused by immune complex deposition in addition to tubular disease. Most tested dogs, including animals without clinical manifestation, were classified as proteinuric or borderline proteinuric, showing that the renal disease could be the only clinical manifestation of CVL and that it could progress from slight proteinuria to end-stage renal disease, resulting in chronic renal failure, which is the main cause of death. The UPC ratio > 2.0 was significantly the more frequent finding in this study, mainly in symptomatic dogs. This result indicates a glomerular disease in these animals, reinforcing that the progression of renal disease follows the clinical progression of CVL. A few serum samples showed increased urea and creatinine levels, proving that azotemia is an uncommon finding in CVL-infected dogs. In conclusion, urinalysis helped in the early identification of renal injury in CVL-infected dogs, highlighting elements that reinforce the presence of tubular or glomerular lesions, or both, even in non-azotemic dogs. The high frequency of symptomatic dogs with UPC ratio > 2.0 suggests a relationship between the progression of renal disease and the clinical progression of CVL