Isolation of Salmonella enterica in opossum (Didelphis aurita and Didelphis albiventris) of the São Paulo State, Brazil

No Brasil, não há relato de estudos de Salmonella em gambás, sendo assim, este trabalho tem por objetivo determinar a frequência de isolamento de Salmonella enterica em gambás (D. aurita e D. albiventris) no Estado de São Paulo. No período de janeiro de 2005 a dezembro de 2006, foram necropsiados 106 D. aurita e 40 D. albiventris e colhidos fragmentos de intestinos delgado, grosso e suabe da cloaca. As amostras foram plaqueadas diretamente em ágar Mac Conkey, paralelamente suspendidas nos caldos Rappaport-Vassiliadis e Tetrationato e posteriormente plaqueados em ágar XLT4. As colônias sugestivas de Salmonella foram confirmadas através de provas bioquímicas e sorotipagem. Encontrou-se Salmonella enterica em 17,0% (18/106) dos D. aurita. Destes, 50% apresentaram positividade no intestino delgado (ID), 88,9% no intestino grosso (IG) e 66,7% na cloaca. Da espécie S. enterica, as subespécies encontradas foram: diarizonae (11,1%) houtenae e enterica (5,5% cada um); enquanto da subespécie S. enterica enterica os sorotipos foram Newport (83,3%), Typhimurium e Cerro (5,5% cada um). Nos D. albiventris, 17,5% (7/40) eram positivos, sendo que se encontraram 42,8% no ID, 85,7% no IG e 71,4% na cloaca. O sorotipo mais prevalente também foi Newport (71,4%), seguido por Typhimurium, Bareilly e Thompson (14,3% cada um). Através dos resultados obtidos neste estudo pode-se comprovar a presença de Salmonella enterica no trato intestinal de gambás no Brasil.In Brazil there is not report of Salmonella in opossum, so then, the objective of this study is to determine the isolation frequency of Salmonella enterica in opossum in São Paulo State, Brazil. From January 2005 to December 2006, 106 D. aurita and 40 D. albiventris were necropsied and samples from small and large intestine and cloacal swab were collected. These samples were submitted to direct plating in Mac Conkey agar and parallel suspension in Rappaport-Vassiliadis and Tetrationate broths with posterior streaking in XLT4 agar. The characterization of the isolates was done through biochemical tests and serotyping. Salmonella enterica was found in 17.0% (18/106) of the D. aurita; 50% presented the bacteria in the small intestine (SI), 88.9% in the large intestine (LI) and 66.7% in the cloaca. Of the S. enterica were found the subspecies: diarizonae (11.1%), enterica and houtenae (5.5% each); and the serotypes of the S. enterica enterica were Newport (83.3%), Typhimurium and Cerro (5.5% each). In the D. albiventris 17.5% (7/40) were positive; 42.8% in the SI, 85.7% in the LI and 71.4% in the cloaca. Newport (71.4%) was also the most frequent serotype and the second were Typhimurium, Bareilly and Thompson (14.3% each). The presence of Salmonella enterica in the intestines of opossums in Brazil was proved

Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project

Introduction: Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. Method: This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I)2006–2009; II)2010–2013; III)2014–2017. Survival analyses were run for 3-year survival in timeframes I-II. Results: Out of 14, 391 patients, 8871 (61.6%) received neoadjuvant treatment. Long-course chemo/radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy ± chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11 cm) increased over time (31.5%vs 34.5%vs 38.6%, p = 0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p = 0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3%and 5.5% (p = 0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59–0.87, Cochrane-Mantel-Haenszel P = 0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p < 0.0001), and cancer-specific survival (p < 0.0001). The survival benefit was smaller in upper third cancers. Conclusion: There was an increasing trend and a potential overuse of neoadjuvant treatment in cancer of the upper rectum. Most ypN0 patients received postoperative treatment. Involvement of CRM in lower third tumors was reduced after neoadjuvant treatment. Stage III and MRcN + benefited the most

International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990�2015: a systematic analysis for the Global Burden of Disease Study 2015

Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors�the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25 over the same period. All risks jointly evaluated in 2015 accounted for 57·8 (95 CI 56·6�58·8) of global deaths and 41·2 (39·8�42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million 192·7 million to 231·1 million global DALYs), smoking (148·6 million 134·2 million to 163·1 million), high fasting plasma glucose (143·1 million 125·1 million to 163·5 million), high BMI (120·1 million 83·8 million to 158·4 million), childhood undernutrition (113·3 million 103·9 million to 123·4 million), ambient particulate matter (103·1 million 90·8 million to 115·1 million), high total cholesterol (88·7 million 74·6 million to 105·7 million), household air pollution (85·6 million 66·7 million to 106·1 million), alcohol use (85·0 million 77·2 million to 93·0 million), and diets high in sodium (83·0 million 49·3 million to 127·5 million). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY licens

Eficacia de la utilización de estilos de aprendizaje en conjunto con mapas conceptuales y aprendizaje basado en la resolución de problemas para el aprendizaje de neuroanatomía Effectiveness of using learning styles in conjunction with conceptual maps based learning and problem solving for teaching neuroanatomy

Introducción. La utilización combinada de estilos de aprendizaje en conjunto con mapas conceptuales y el empleo de aprendizaje basado en la resolución de problemas (EMCRP) es una nueva estrategia educativa. Objetivo. Evaluar la eficacia de la utilización del método EMCRP en la adquisición de aprendizaje significativo de neuroanatomía, comparado con el método usual de aprendizaje en estudiantes de fisioterapia, que cursaron la asignatura morfofisiología general en la Universidad Industrial de Santander (UIS) entre los años 2004 y 2007. Sujetos y métodos. Se utilizó un diseño experimental con participantes aleatorizados asignados a dos grupos con una relación 1 a 1. En el grupo intervenido se empleó el método EMCRP y en el control el método tradicional de enseñanza. Después de un año se evaluó la adquisición de aprendizaje significativo para determinar el rendimiento del método EMCRP. Resultados. Se estudiaron 55 estudiantes. La edad media fue de 23 años y la razón mujer-hombre fue de 3 a 1. Al evaluar a los estudiantes después de un año de la intervención, 15 del grupo intervenido reprobaron el examen frente a 26 del grupo control (55 frente a 92%; p = 0,002). Se determinó una reducción del riesgo absoluto de 0,37 (intervalo de confianza al 95% = 0,16-0,56) y número necesario para tratar de 2,7 (intervalo de confianza al 95% = 1,7-6,3). Conclusión. La adquisición de un aprendizaje significativo fue mayor en el grupo intervenido, evidenciado por una menor proporción de suspendidos importante en comparación con el grupo control, con un número de estudiantes bajo a intervenir para que se produzcan resultados favorables.Introduction. The use of learning styles combined with concept maps and the use of learning based on the resolution of problems (LSCMLRP) are a new educational strategy. Aim. To evaluate the effectiveness of the method LSCMLRP in the acquisition of significant learning of neuroanatomy, compared with the usual method of learning in physiotherapy students. These students, attended the subject general morphofisiology in the Industrial University of Santander (UIS) between the years 2004 and 2007. Subjects and methods. A controlled clinical test was carried out to determine the performance of the LSCMLRP. The students were randomized and assigned to two groups with a 1:1 relation. In the treated group the LSCMLRP method was used and in the control the lecture method. Subsequent to a period of 1 year the acquisition of significant learning was evaluated. Results. 55 students were studied. The average age was of 23 years and the ratio woman: man was of 3:1. When evaluating the students after 1 year of the intervention 15 students of the treated group failed the examination compared to 26 students of the control group control (55% versus 92%, p = 0.002). The calculated absolute risk reduction of 0.37 (CI 95% = 0.16-0.56) and NNT 2,7 (CI 95% = 1.7-6.3). Conclusion. The acquisition of significant learning was greater in the treated group, demonstrated by a significant minor proportion of exam failures compared to the control group, and with a low student to intervene in order to produce favorable outcomes

Eficacia de la utilización de estilos de aprendizaje en conjunto con mapas conceptuales y aprendizaje basado en la resolución de problemas para el aprendizaje de neuroanatomía

Introducción. La utilización combinada de estilos de aprendizaje en conjunto con mapas conceptuales y el empleo de aprendizaje basado en la resolución de problemas (EMCRP) es una nueva estrategia educativa. Objetivo. Evaluar la eficacia de la utilización del método EMCRP en la adquisición de aprendizaje significativo de neuroanatomía, comparado con el método usual de aprendizaje en estudiantes de fisioterapia, que cursaron la asignatura morfofisiología general en la Universidad Industrial de Santander (UIS) entre los años 2004 y 2007. Sujetos y métodos. Se utilizó un diseño experimental con participantes aleatorizados asignados a dos grupos con una relación 1 a 1. En el grupo intervenido se empleó el método EMCRP y en el control el método tradicional de enseñanza. Después de un año se evaluó la adquisición de aprendizaje significativo para determinar el rendimiento del método EMCRP. Resultados. Se estudiaron 55 estudiantes. La edad media fue de 23 años y la razón mujer-hombre fue de 3 a 1. Al evaluar a los estudiantes después de un año de la intervención, 15 del grupo intervenido reprobaron el examen frente a 26 del grupo control (55 frente a 92%; p = 0,002). Se determinó una reducción del riesgo absoluto de 0,37 (intervalo de confianza al 95% = 0,16-0,56) y número necesario para tratar de 2,7 (intervalo de confianza al 95% = 1,7-6,3). Conclusión. La adquisición de un aprendizaje significativo fue mayor en el grupo intervenido, evidenciado por una menor proporción de suspendidos importante en comparación con el grupo control, con un número de estudiantes bajo a intervenir para que se produzcan resultados favorables

Characterization of Enterobacteriaceae Isolates Obtained from a Tertiary Care Hospital in Mexico, Which Produces Extended-Spectrum ?-Lactamase

The thermal behavior of hydrogels synthesized by solution polymerization between acrylamide, acrylic acid and diglycidyl acrylate (DGA) as a crosslinking agent was investigated. The structure of the hydrogel can be tightly controlled with the reaction temperature. This method produces a new type of hydrogels, which exhibit well defined structures at various scales of length simultaneously. These multi-structured hydrogels are hydrophilic, elastic, water insoluble, and soft polymers with an anisotropic optical response. The structure was observed by scanning electron microscopy (SEM), polarized light microscopy (PLM) and macroscopic visualization (CCD camera). In addition, structural transitions in the hydrogels were monitored by temperature modulated differential scanning calorimetry (TMDSC). Severe heating tests in an adiabatic oven were performed to analyze decomposition of the material. Fourier transform infrared (FTIR) spectroscopy was used to qualitatively analyze the hydrogels samples exposed to a sudden thermal treatment. " 2006 Springer-Verlag.",,,,,,"10.1007/s10973-005-7449-2",,,"http://hdl.handle.net/20.500.12104/40002","http://www.scopus.com/inward/record.url?eid=2-s2.0-33750033015&partnerID=40&md5=365b7afcc2cb2b00df95c29422d13675",,,,,,"2",,"Journal of Thermal Analysis and Calorimetry",,"51