Partially Purification M Protein from Streptococcus Pyogens and Molecular Study of Some Virulence Factors

The current study was conducted to isolation one type of surface protein of Streptococcus pyogens this protein separated using partially purification method. Purifiction  process include precipitation of crude  M protein  one peak of this protein was appeared, the best precipitate rate was 30% . PCR assay were performed to identify the presence of some genes related to pathogenicity in bacteria responsible from Tonsillitis .Streptococcus pyogens represented the largest causative agent of inflammation of the tonsil so the study revealed the presence of certain gene in some isolate of bacteria, including the gene SpeB that gave large proportions in the study isolates 12 out of 37 at a rate of (32.4%). Keywords : S.pyogens , Tonsillitis , M protein ,PCR ,Spe

Perda da nacionalidade brasileira

O presente trabalho objetiva analisar a normativa constitucional sobre a perda da nacionalidade brasileira. Inicialmente, busca-se averiguar o conceito de voluntariedade na aquisição da nacionalidade estrangeira, que irá culminar com a perda da nacionalidade brasileira. Faz-se necessário, no desenvolvimento deste estudo, verificar a conformidade da ordem jurídica brasileira com três princípios fundamentais, que orientam o direito da nacionalidade: necessidade da nacionalidade, unidade da nacionalidade e possibilidade de mudança da nacionalidade. Em seguida, durante o estudo da perda da nacionalidade brasileira por atividade nociva ao interesse nacional, pretende-se compreender o conceito de atividade nociva, à luz da doutrina e da jurisprudência. Nesse contexto, através de uma análise dos textos constitucionais brasileiros anteriores, busca-se apresentar as hipóteses constitucionais de perda da nacionalidade brasileira por aquisição de outra e da perda da nacionalidade brasileira por atividade nociva ao interesse nacional. Serão realizadas também duas pesquisas, uma na Câmara dos Deputados e outra, no Ministério da Justiça

Aging Time Effects on the Mechanical Properties of Al 6061-T6 Alloy

This work investigates the influence of artificial aging and solution heat treatment on the hardness and tensile strength (mechanical properties) of Al 6061-T6 alloy. For this investigation, several aluminum 6061-T6 alloy specimens were prepared following the ASTM 176000 recommendations. The prepared specimens were heated for 1 hour at 500ºC before being water-quenched. The procedure for artificial aging was performed for 1, 2, 3, and 4 hours at 190ºC before being slowly cooled in air. Several mechanical and characterization studies were performed on the treated specimens, including an investigation on their microstructure, tensile strength, hardness, and X-ray diffraction pattern. From the results, the strength and hardness properties of the specimens were found to be generally improved, even as the best features were obtained after 2 hours of artificial aging

Hipertensão arterial sistêmica secundária

The prevalence of secondary systemic arterial hypertension (S-SAH) is 3% to 5%. Before investigating the secondary causes of SAH, the following should be excluded: ._ Inadequate measurement of arterial pressure (AP). ._ White-coat hypertension; ._ Inadequate treatment; ._ Treatment non-adherence; ._ Progression of lesions in hypertension target organs; ._ Presence of co-morbidities; ._ Interaction with prescription drugs. Table 1 lists the situations when the presence of S-SAH should be investigated. Next, the main causes of S-SAH will be discussed. [Author supplied abstract

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely