Exploring the staphylococcus aureus in patients infected of the tertiary-care university hospital: results of the retrospective cohort study

Objective: To establish a baseline of knowledge regarding about inappropriate therapy, virulence and resistance in a cohort of patients infected with S. aureus. Methods: Retrospective cohort study in tertiary-care university hospital was employed to evaluate the risk factors and the impact of inappropriate therapy among patients with Staphylococcus aureus infections, resistance and virulence. To assess the presence of the genes was performed PCR. Results: Patients with MRSA were older and hospitalized 17 days longer than those with MSSA infection, which were in ICU with a bloodstream infection. 50.0% received inadequate antibiotic therapy and we found virulence factors associated with MRSA (mecA, LukS, fnbB and clfA genes). Conclusion: These data show that surveillance studies related to Staphylococcus aureus infections remain essential to identify resistance and inform policy on resistance

Erratum to: The study of cardiovascular risk in adolescents – ERICA: rationale, design and sample characteristics of a national survey examining cardiovascular risk factor profile in Brazilian adolescents

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Feasibility of virtual therapy in rehabilitation of Parkinsons disease patients: pilot study

Introduction: Among Parkinsons disease (PD) motor disabilities, postural and balance alterations are important parameters to physical therapists who need to choose specific, targeted therapies for their patients. Among many therapy options, virtual therapy is studied as to whether it can be a viable rehabilitation method. Objective: To verify the applicability of virtual rehabilitation in PD patients for the improvement of their balance and quality of life. Material and methods: Six volunteers, diagnosed to be in Stages II and III of PD (Hoehn and Yahr Scale), were recruited for this study. Patients (65 ± 13 years old) participated in activities involving Wii Fit, for a total of twelve interventions, twice per week. Clinical and qualitative methods were used for the data collection for the initial and final evaluations: Borgs Scale, Berg Functional Balance Scale, Time Up and Go, anterior and lateral functional reach and Nottinghams Scale were performed during the study. Penguin Slide, Ski Slalom, Soccer Heading and Table Tilt were the Wii games selected as a form of virtual therapy. Results: The collected data were analyzed using the Wilcoxon test. Motor skill, functional capacities and quality of life were analyzed as variables of the patients balance. Statistically significant differences were found in the following tests: Borgs Scale (p = 0.0464), Berg Functional Balance Scale (p = 0.0277), lateral functional reach to the right (p = 0.0431*) and lateral functional reach to the left (p = 0.0277). Conclusion: It is believed that exercises with virtual reality therapy can be a useful tool to improve the balance in PD patients

Feasibility of virtual therapy in rehabilitation of Parkinson's disease patients: pilot study

INTRODUCTION: Among Parkinson's disease (PD) motor disabilities, postural and balance alterations are important parameters to physical therapists who need to choose specific, targeted therapies for their patients. Among many therapy options, virtual therapy is studied as to whether it can be a viable rehabilitation method. OBJECTIVE: To verify the applicability of virtual rehabilitation in PD patients for the improvement of their balance and quality of life. MATERIAL AND METHODS: Six volunteers, diagnosed to be in Stages II and III of PD (Hoehn and Yahr Scale), were recruited for this study. Patients (65 ± 13 years old) participated in activities involving Wii Fit, for a total of twelve interventions, twice per week. Clinical and qualitative methods were used for the data collection for the initial and final evaluations: Borg's Scale, Berg Functional Balance Scale, Time Up and Go, anterior and lateral functional reach and Nottingham's Scale were performed during the study. Penguin Slide, Ski Slalom, Soccer Heading and Table Tilt were the Wii games selected as a form of virtual therapy. RESULTS: The collected data were analyzed using the Wilcoxon test. Motor skill, functional capacities and quality of life were analyzed as variables of the patients' balance. Statistically significant differences were found in the following tests: Borg's Scale (p = 0.0464), Berg Functional Balance Scale (p = 0.0277), lateral functional reach to the right (p = 0.0431*) and lateral functional reach to the left (p = 0.0277). CONCLUSION: It is believed that exercises with virtual reality therapy can be a useful tool to improve the balance in PD patients

Projeto de modernização de uma linha produtiva com base nas técnicas de orçamento de capital e análise de investimentos.

RESUMOEstudo de caso realizado em uma empresa do ramo industrial para avaliar a viabilidade de modernização da linha produtiva. Analisam-se dados referentes à produtividade e custos da Empresa tendo como dados da análise as informações fornecidas pelos responsáveis e os dados da nova máquina. Aplicam-se técnicas de orçamento e análise de investimentos com os dados obtidos. Apresenta-se o estudo de viabilidade da implantação da modernização da linha produtiva.Palavras-chave: Análise de investimentos. Técnicas de orçamento de capital.  Indicadores de retorno.  Indicadores de risco.ABSTRACTCase study made in a industrial company to examine the viability of modernization of the productive processes. The data given by the owners were analysed taken into account the productivity and costs of the company and the new machine. To the proposed is applied budgetary techniques and investment analysis.Key-words: Investment analysis.  Capital budgetary techniques.  Address performance. Risk indicators. 

Clinical and Molecular Epidemiology of Multidrug-Resistant P. aeruginosa Carrying aac(6')-Ib-cr, qnrS1 and blaSPM Genes in Brazil.

We described a comprehensive analysis of the molecular epidemiology of multidrug-resistant (MDR) P. aeruginosa. Molecular analysis included typing by Pulsed Field Gel Electrophoresis, identification of genes of interest through PCR-based assays and sequencing of target genes. Case-control study was conducted to better understand the prognostic of patients and the impact of inappropriate therapy in patients with bacteremia, as well as the risk factors of MDR infections. We observed a high rate of MDR isolates (40.7%), and 51.0% of them was independently associated with inappropriate antibiotic therapy. Bacteremia was detected in 66.9% of patients, and prolonged hospital stay was expressive in those resistant to fluoroquinolone. Plasmid-mediated quinolone resistance genes (PMQR), qnrS1 and aac(6')Ib-cr, were detected in two different nosocomial isolates (5.3%), and the aac(6')-Ib7 variant was detected at a high frequency (87.5%) in those negative to PMQR. The presence of mutations in gyrA and parC genes was observed in 100% and 85% of selected isolates, respectively. Isolates harboring PMQR genes or mutations in gyrA and parC were not closely related, except in those containing SPM (São Paulo metallo-β-lactamase) clone. In addition, there is no study published in Brazil to date reporting the presence of Pseudomonas aeruginosa isolates harboring both qnrS1 and aac(6')Ib-cr genes, with alarming frequency of patients with inappropriate therapy

<i>Pseudomonas aeruginosa</i> antimicrobial resistance and sensitivity profiles to the main antimicrobials of isolates from 242 episodes of hospital infections.

<p><i>Pseudomonas aeruginosa</i> antimicrobial resistance and sensitivity profiles to the main antimicrobials of isolates from 242 episodes of hospital infections.</p