Ventilator associated pneumonia: comparison between quantitative and qualitative cultures of tracheal aspirates

INTRODUCTION: Deferred or inappropriate antibiotic treatment in ventilator-associated pneumonia (VAP) is associated with increased mortality, and clinical and radiological criteria are frequently employed to establish an early diagnosis. Culture results are used to confirm the clinical diagnosis and to adjust or sometimes withdraw antibiotic treatment. Tracheal aspirates have been shown to be useful for these purposes. Nonetheless, little is known about the usefulness of quantitative findings in tracheal secretions for diagnosing VAP. METHODS: To determine the value of quantification of bacterial colonies in tracheal aspirates for diagnosing VAP, we conducted a prospective follow-up study of 106 intensive care unit patients who were under ventilatory support. In total, the findings from 219 sequential weekly evaluations for VAP were examined. Clinical and radiological parameters were recorded and evaluated by three independent experts; a diagnosis of VAP required the agreement of at least two of the three experts. At the same time, cultures of tracheal aspirates were analyzed qualitatively and quantitatively (10(5 )colony-forming units [cfu]/ml and 10(6 )cfu/ml) RESULTS: Quantitative cultures of tracheal aspirates (10(5 )cfu/ml and 10(6 )cfu/ml) exhibited increased specificity (48% and 78%, respectively) over qualitative cultures (23%), but decreased sensitivity (26% and 65%, respectively) as compared with the qualitative findings (81%). Quantification did not improve the ability to predict a diagnosis of VAP. CONCLUSION: Quantitative cultures of tracheal aspirates in selected critically ill patients have decreased sensitivity when compared with qualitative results, and they should not replace the latter to confirm a clinical diagnosis of VAP or to adjust antimicrobial therapy

Polyphenols isolated from pomegranate juice (Punica granatum L.): Evaluation of physical-chemical properties by FTIR and quantification of total polyphenols and anthocyanins content / Isolamento de polifenóis do suco da romã (Punica granatum L.): Avaliação das propriedades físico-química por FTIR e quantificação do teor total de polifenóis e antocianinas

Pomegranate (Punica granatum L.) is a polyphenols source, such as anthocyanins, punicalagin, ellagitannins and tannins. Polyphenols are antioxidant compounds present in foods as cereals, fruits (peels, seeds and juice), vegetables, wine, and among others. Polyphenols are responsible to protect cells and to limit the risks of degenerative and tumoral diseases, as well as, to prevent cardiovascular diseases, neuronal diseases, and present important anti-inflammatory effects. The purpose of this study was to isolate polyphenols from pomegranate juice using solvents without heating. The solvents used were ultrapure water, ethanol, ethanol 70% and methanol. The samples were characterized by FTIR to evaluate the physical-chemical properties, the total polyphenols content was quantified by Folin-Ciocalteau method, using gallic acid as standard equivalent, and the total anthocyanins content was quantified by pH-differential method, using anthocyanins (cyanidin-3-glucoside) as standard equivalent. FTIR spectra showed the main characteristic groups of polyphenols, as hydroxyl group and stretching vibration of benzene rings. And the characteristic groups of solvents were CH2 ou CH3, hydroxyl, carboxyl e carbonyl group. For the quantification of total polyphenols and anthocyanins content, the best results were found to the pomegranate juice: ultrapure water samples. According to the data obtained it was possible to conclude, who the process employed was effective to isolate the polyphenols from pomegranate juice and the use of different types of solvent influenced in the achievement of these results. 

Polyphenols isolated from pomegranate juice (Punica granatum L.): Evaluation of physical-chemical properties by FTIR and quantification of total polyphenols and anthocyanins contente / Isolamento de polifenóis do suco da romã (Punica granatum L.): Avaliação das propriedades físico-química por FTIR e quantificação do teor total de polifenóis e antocianinas

Pomegranate (Punica granatum L.) is a polyphenols source, such as anthocyanins, punicalagin, ellagitannins and tannins. Polyphenols are antioxidant compounds present in foods as cereals, fruits (peels, seeds and juice), vegetables, wine, and among others. Polyphenols are responsible to protect cells and to limit the risks of degenerative and tumoral diseases, as well as, to prevent cardiovascular diseases, neuronal diseases, and present important anti-inflammatory effects. The purpose of this study was to isolate polyphenols from pomegranate juice using solvents without heating. The solvents used were ultrapure water, ethanol, ethanol 70% and methanol. The samples were characterized by FTIR to evaluate the physical-chemical properties, the total polyphenols content was quantified by Folin-Ciocalteau method, using gallic acid as standard equivalent, and the total anthocyanins content was quantified by pH-differential method, using anthocyanins (cyanidin-3-glucoside) as standard equivalent. FTIR spectra showed the main characteristic groups of polyphenols, as hydroxyl group and stretching vibration of benzene rings. And the characteristic groups of solvents were CH2 ou CH3, hydroxyl, carboxyl e carbonyl group. For the quantification of total polyphenols and anthocyanins content, the best results were found to the pomegranate juice: ultrapure water samples. According to the data obtained it was possible to conclude, who the process employed was effective to isolate the polyphenols from pomegranate juice and the use of different types of solvent influenced in the achievement of these results. 

Femoral shaft fracture: reproducibility of AO-ASIF and Winquist classifications

OBJECTIVE: To evaluate inter-observer reproducibility of AO / ASIF and Winquist-Hansen classifications for shaft fractures of the femur in adults. METHODS: 50 anterior-posterior and profilelateral radiographs were randomly selected, of adult patients awith diaphyseal fracture of the femur. The radiographs were analyzed by 5 observers-a member of the Brazilian Society of Orthopedic Trauma, a radiologist and 3 residents. To assess the concordance between these classifications, we used the statistical index Kappa (K). RESULTS: In all analyses, we observed a statistically significant correlation coefficient between observers (p <0.05) and according to the criteria of Landis and Koch, they were ranked them as good (values of 0.61 to 0.80) or very good (values above 0.80). CONCLUSION: The AO rating and Winquist present a high rate of concordance between observers for shaft fractures of the femur in adults.OBJETIVO: Avaliar a reprodutibilidade interobservadores das classificações AO/ASIF e de Winquist para as fraturas diafisárias do fêmur no adulto. MÉTODOS: foram selecionadas aleatoriamente 50 radiografias de pacientes adultos portadores de fratura diafisária do fêmur nas incidências em antero-posterior e perfil. As radiografias foram analisadas por 5 observadores, sendo um membro da Sociedade Brasileira de Trauma Ortopédico, um radiologista, um residente do terceiro ano de Ortopedia e Traumatologia, um do segundo e um do primeiro. Para avaliar a concordância interobservadores destas classificações, foi utilizado o índice estatístico Kappa (K). RESULTADOS: Em todas as análises, observou-se um coeficiente de concordância entre observadores estatisticamente significativo (valor p < 0,05) e classificado como bom (valores de 0,61 a 0,80) ou muito bom (valores acima de 0,80), segundo os critérios de Landis e Koch. CONCLUSÃO: As classificações AO e Winquist apresentam alto índice de concordância interobservadores para as fraturas diafisárias do fêmur no adulto.Universidade Federal de Minas Gerais Hospitais Felício Rocho e da Baleia Departamento do Aparelho LocomotorUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaHospital Felício Rocho Serviço de Ortopedia e TraumatologiaUniversidade Federal de Minas Gerais Departamento do Aparelho LocomotorUNIFESP, EPMSciEL

Avanços e desafios da ciência de recursos hídricos no Brasil: uma síntese comunitária do XXIII Simpósio Brasileiro de Recursos Hídricos

In this paper we synthesize the special sessions of the XXIII Brazilian Water Resources Symposium 2019 in order to understand the major advances and challenges in the water sciences in Brazil. We analyzed more than 250 papers and presentations of 16 special sessions covering topics of Climate Variability and Change, Disasters, Modeling, Large Scale Hydrology, Remote Sensing, Education, and Water Resources Management. This exercise highlighted the unique diversity of natural and human water features in Brazil, that offers a great opportunity for understanding coupled hydrological and societal systems. Most contributions were related to methods and the quantification of water phenomena, therefore, there is a clear necessity for fostering more research on phenomena comprehension. There is a vast network of co-authorship among institutions but mostly from academia and with some degree of regional fragmentation. The ABRhidro community now has the challenge to enhance its collaboration network, the culture of synthesis analysis, and to build a common agenda for water resources research. It is also time for us to be aligned with the international water science community and to use our experiences to actively contribute to the tackling of global water issues.Este artigo apresenta uma síntese das sessões especiais do XXIII Simpósio Brasileiro de Recursos Hídricos 2019, com o objetivo de compreender os principais avanços e desafios em recursos hídricos no Brasil. Foram analisados mais de 250 trabalhos e apresentações em 16 sessões especiais abrangendo temas como Variabilidade e Mudanças Climáticas, Desastres, Modelagem, Hidrologia de Grande Escala, Sensoriamento Remoto, Educação e Gestão de Recursos Hídricos. Esta avaliação destacou a diversidade única de atributos naturais e antrópicos dos recursos hídricos brasileiros, que oferece uma grande oportunidade para aprendizado sobre sistemas hidrológico e humano acoplados. A maioria das contribuições é relacionada a métodos e quantificação de fenômenos hídricos, existindo uma necessidade clara de incentivo a mais pesquisas em compreensão de fenômenos. Existe uma vasta rede de coautores, mas principalmente da academia e com certo grau de fragmentação regional. A comunidade da ABRhidro tem o desafio de aumentar a sua rede de colaboração, a cultura de análises de síntese, e construir uma agenda comum para a pesquisa em recursos hídricos. Também é o momento de alinhar esforços com a comunidade de recursos hídricos internacional, usando nossas experiências para contribuir ativamente na solução de questões relacionadas à água em nível global

Neuroplasticity in visual impairments

The visual acuity loss enables the brain to access new pathways in the quest to overcome the visual limitation and this is wellknown as neuroplasticity which have mechanisms to cortical reorganization. In this review, we related the evidences about the neuroplasticity as well as cortical anatomical differences and functional repercussions in visual impairments. We performed a systematic review of PUBMED database, without date or status publication restrictions. The findings demonstrate that the visual impairment produce a compensatory sensorial effect, in which non-visual areas are related to both cross (visual congenital) and multimodal (late blind) neuroplasticity

6ª Diretriz de monitorização ambulatorial da pressão arterial e 4ª diretriz de monitorização residencial da pressão arterial

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