Detection Of Salmonella Spp. By Conventional Bacteriology And By Quantitative Polymerase-chain Reaction In Commercial Egg Structures

Conventional bacteriology techniques and quantitative polymerasechain reaction (qPCR) were applied to the eggshell, albumen, and yolk of washed and unwashed commercial white and brown eggs, to detect Salmonella spp. Pooled samples of eggshells, albumen, and yolk of white and brown eggs were collected at the poultry house and at the egg-storage room. Salmonella spp. was detected by conventional bacteriology in 5.4% (21/387) of analyzed samples and in 16% (68/387) by qPCR. In the 114 unwashed white eggs samples of eggshell, albumen and yolk, the bacterium was identified in 2.6% of the eggs (3/114) by conventional bacteriology and in 13.2% (15/114) by qPCR. In the 90 samples of washed eggs, 6.7% (6/90) were contaminated as detected by conventional bacteriology and 10.0% (9/90) by qPCR. In the 81 samples of unwashed brown eggs, Salmonella spp. was detected in 6.1% of the eggs (5/81) by conventional bacteriology and 27.2% (22/81) by qPCR. In the 102 samples of brown washed eggs, 6.9% (7/102) where positive by conventional bacteriology and 35.3% (16/102) by qPCR. All samples detected as positive by conventional bacteriology were also positive by qPCR. Salmonella Agona represented 18.2% (4/22) of identified serovars, Salmonella enterica subs. enterica O: 4.5 18.2% (4/22), Salmonella Schwarzengrund 18.2% (4/22), Salmonella Cerro 13.6% (3/22), Salmonella Anatum 13.6% (3/22), Salmonella Enteritidis 9.1% (2/22), Salmonella Johannesburg 4.5% (1/22), and Salmonella Corvallis 4.5% (1/22). The qPCR method provided better detection of Salmonella spp. in commercial eggs than conventional bacteriology. The conventional egg washing and disinfection procedures are not efficient to eliminate Salmonella. © 2016, Fundacao APINCO de Ciencia e Tecnologia Avicolas. All rights reserved.18111712

Avaliação do Risco de Desenvolvimento de Problemas Relacionados com Medicamentos em Pacientes de Baixa Renda Atendidos em uma Clínica-Escola

No posee resumen.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Cost Analysis Of Pharmaceutical Care Provided To Hiv-infected Patients: An Ambispective Controlled Study

Background: Studies have shown that pharmaceutical care can result in favorable clinical outcomes in human immunodeficiency virus (HIV)-infected patients, however, few studies have assessed the economic impact. The objective of this study was to evaluate the clinical and economic impact of pharmaceutical care of HIV-infected patients. Methods: A controlled ambispective study was conducted in Brazil from January 2009 to June 2012. Patients were allocated to either intervention or control group. The control group was followed according to standard care while the intervention group was also followed by a pharmacist at each physician appointment for one year. Effectiveness outcomes included CD4+ count, viral load, absence of co-infections and optimal immune response, and economic outcomes included expenses of physician and pharmaceutical appointments, laboratory tests, procedures, and hospitalizations, at six months and one year. Results: Intervention and control groups included 51 patients each. We observed significant decreases in total pharmacotherapy problems during the study. At six months, the intervention group contained higher percentages of patients without co-infections and of patients with CD4+ >500 cells/mm3. None of the differences between intervention and control group considering clinical outcomes and costs were statistically significant. However, at one year, the intervention group showed higher percentage of better clinical outcomes and generated lower spending (not to procedures). An additional health care system daily investment of US$1.45, 1.09, 2.13, 4.35, 1.09, and 0.87 would be required for each additional outcome of viral load <50 copies/ml, absence of co-infection, CD4+ >200, 350, and 500 cells/mm3, and optimal immune response, respectively. Conclusion: This work demonstrated that pharmaceutical care of HIV-infected patients, for a one-year period, was able to decrease the number of pharmacotherapy problems. However, the clinical outcomes and the costs did not have statistical difference but showed higher percentage of better clinical outcomes and lower costs for some items.231(2008) Secretária de Vigilância em Saúde, Programa Nacional de DST e Aids: Recomendações Para Terapia Anti-retroviral em Adultos Infectados Pelo HIV, , http://www.ensp.fiocruz.br/portal-ensp/judicializacao/pdfs/491.pdf, Brazil, Ministry of HealthDipiro, J., Talbert, R., Yees, G., Matzke, G., Wells, B., Posey, L., (2007) Pharmacotherapy: A Pathophysiologic Approach, , 6th edition. Rio de Janeiro: Mcgraw Hill Companie;Okie, S., Fighting HIV-Lessons from Brazil (2006) N Engl J Med, 354, pp. 1977-1981Ma, A., Chen, D.M., Chau, F.M., Saberi, P., Improving adherence and clinical outcomes through an HIV pharmacist's interventions (2010) AIDS Care, 22, pp. 1189-1194Carcelero, E., Tuset, M., Martin, M., De Lazzari, E., Codina, C., Miró, J., Gatell, J., Evaluation of antiretroviral-related errors and interventions by the clinical pharmacist in hospitalized HIV-infected patients (2011) HIV Med, 12, pp. 494-499Hirsch, J., Gonzales, M., Rosenquist, A., Miller, T., Gilmer, T., Best, B., Antiretroviral therapy adherence, medication use, and health care costs during 3 years of a community pharmacy medication therapy management program for Medi-Cal beneficiaries with HIV/AIDS (2011) J Manag Care Pharm, 17, pp. 213-223March, K., Mak, M.M., Louie, S.G., Effects of pharmacists' interventions on patient outcomes in an HIV primary care clinic (2007) Am J Heal Syst Pharm, 64, pp. 2574-2578Mocroft, A., Youle, M., Moore, A., Sabin, C.A., Madge, S., Lepri, A.C., Tyrer, M., Phillips, A.N., Reasons for modification and discontinuation of antiretrovirals: Results from a single treatment centre (2001) AIDS, 15, pp. 185-194Saberi, P., Dong, B.J., Johnson, M.O., Greenblatt, R.M., Cocohoba, J.M., The impact of HIV clinical pharmacists on HIV treatment outcomes: A systematic review (2012) Patient Prefer Adherence, 6, pp. 297-322Schumock, G.T., Butler, M.G., Meek, P.D., Vermeulen, L.C., Arondekar, B.V., Bauman, J.L., Evidence of the Economic Benefit of Clinical Pharmacy Services: 1996-2000 (2003) Pharmacotherapy, 23, pp. 113-132Bozek, P.S., Perdue, B.E., Bar-Din, M., Weidle, P.J., Effect of pharmacist interventions on medication use and cost in hospitalized patients with or without HIV infection (1998) Am J Health Syst Pharm, 55, pp. 1151-1155Engles-Horton, L.L., Skowronski, C., Mostashari, F., Altice, F.L., Clinical guidelines and pharmacist intervention program for HIV-infected patients requiring granulocyte colony-stimulating factor therapy (1999) Pharmacotherapy, 19, pp. 356-362Horberg, M., Hurley, L., Silverberg, M., Kinsman, C., Quesenberry, C., Effect of clinical pharmacists on utilization of and clinical response to antiretroviral therapy (2007) J Acquir Immune Defic Syndr, 44, pp. 531-539De Rijdt, T., Willems, L., Simoens, S., Economic effects of clinical pharmacy interventions: A literature review (2008) Am J Health Syst Pharm, 65, pp. 1161-1172Areda, C.A., Bonizio, R.C., Freitas, O., Pharmacoeconomy : An indispensable tool for the rationalization of health costs (2011) Braz J Pharm Sci, 47, pp. 231-240Bavinger, C., Bendavid, E., Niehaus, K., Olshen, R.A., Olkin, I., Sundaram, V., Wein, N., Desai, M., Risk of cardiovascular disease from antiretroviral therapy for HIV : A systematic review (2013) PLoS One, 8, p. e59551Dube, M.P., Disorders of glucose metabolism in patients infected with human immunodeficiency virus (2000) Clin Infect Dis, 31, pp. 1467-1475Friis-Møller, N., Sabin, C.A., Weber, R., D'Arminio Monforte, A., El-Sadr, W.M., Reiss, P., Thiébaut, R., Lundgren, J.D., Combination antiretroviral therapy and the risk of myocardial infarction (2003) N Engl J Med, 349, pp. 1993-2003Crum-Cianflone, N., Roediger, M.P., Eberly, L., Headd, M., Marconi, V., Ganesan, A., Weintrob, A., Fraser, S., Infectious Disease Clinical Research Program HIV Working Group, Agan BK: Increasing rates of obesity among HIV-infected persons during the HIV epidemic (2010) PLoS One, 5, p. e10106Strand, L.M., Cipolle, R.J., Morley, P.C., Documenting the clinical pharmacists activities: Back to basics (1988) Drug Intell Clin Pharm, 22, pp. 63-67Pharmacy Workup Notes, , http://www.pharmacy.umn.edu/medmanagenotes/Molino, C.G.R.C., Carnevale, R.C., Rodrigues, A.T., Visacri, M.B., Moriel, P., Mazzola, P.G., Impact of pharmacist interventions on drug-related problems and laboratory markers in outpatients with human immunodeficiency virus infection (2014) Ther Clin Risk Manag, 10, pp. 631-639SGTAP - Sistema de Gerenciamento da Tabela de Procedimentos, Medicamentos e OPM Do SUS, , http://sigtap.datasus.gov.br/tabela-unificada/app/sec/inicio.jspRuiz, I., Olry, A., López, M.A., Prada, J.L., Causse, M., Prospective, randomized, two-arm controlled study to evaluate two interventions to improve adherence to antiretroviral therapy in Spain (2010) Enferm Infecc Microbiol Clin, 28, pp. 409-415Martin, S., Wolters, P., Calabrese, S., Toledo-Tamula, M.A., Wood, L.V., Roby, G., Elliott-Desorbo, D.K., The antiretroviral regimen complexity index. A novel method of quantifying regimen complexity (2007) J Acquir Immune Defic Syndr, 45, pp. 535-544Mok, S., Minson, Q., Drug-related problems in hospitalized patients with HIV infection (2008) Am J Health Syst Pharm, 65, pp. 55-59Rastegar, D., Knight, A., Monolakis, J., Antiretroviral medication errors among hospitalized patients with HIV infection (2006) Clin Infect Dis, 43, pp. 933-938Pastakia, S., Corbett, A., Raasch, R., Napravnik, S., Correll, T., Frequency of HIV-related medication errors and associated risk factors in hospitalized patients (2008) Ann Pharmacother, 42, pp. 491-497Misson, J., Clark, W., Kendall, M., Therapeutic advances: Protease inhibitors for the treatment of HIV-1 infection (1997) J Clin Pharm Ther, 22, pp. 109-117Osterberg, L., Blaschke, T., Adherence to medication (2005) N Engl J Med, 353, pp. 487-497Langford, S.E., Ananworanich, J., Cooper, D.A., Predictors of disease progression in HIV infection : A review (2007) Aids Res Ther, 4, pp. 1-14(2012), http://www.aids.gov.br/sites/default/files/anexos/publicacao/2011/50652/boletim_aids_2011_final_m_pdf_26659.pdf, Brazil, Ministry of Health, Secretaria de Vigilancia em Saúde, Departamento de DST Aids e Hepatites Virais: Boletim Epidemiológico - AIDS e DSTMcPherson-Baker, S., Malow, R.M., Penedo, F., Jones, D.L., Schneiderman, N., Klimas, N.G., Enhancing adherence to combination antiretroviral therapy in non-adherent HIV-positive men (2000) AIDS Care, 12, pp. 399-404Shen, J., Sun, Q., Zhou, X., Wei, Y., Qi, Y., Zhu, J., Yan, T., Pharmacist interventions on antibiotic use in inpatients with respiratory tract infections in a Chinese hospital (2011) Int J Clin Pharm, 33 (6), pp. 929-933Yen, Y.-H., Chen, H.-Y., Wuan-Jin, L., Lin, Y.-M., Shen, W.C., Cheng, K.-J., Clinical and economic impact of a pharmacist-managed I.V.-to-P.O. Conversion service for levofloxacin in Taiwan (2012) Int J Clin Pharmacol Ther, 50, pp. 136-141Brennan, T.A., Dollear, T.J., Hu, M., Matlin, O.S., Shrank, W.H., Choudhry, N.K., Grambley, W., An integrated pharmacy-based program improved medication prescription and adherence rates in diabetes patients (2012) Health Aff (Millwood), 31, pp. 120-129Lee, A.J., Boro, M.S., Knapp, K.K., Meier, J.L., Korman, N.E., Clinical and economic outcomes of pharmacist recommendations in a Veterans Affairs medical center (2002) Am J Health Syst Pharm, 59, pp. 2070-2077Janknegt, R., Van Der Meer, J.W.M., Sequential therapy with intravenous and oral cephalosporins (1994) J Antimicrob Chemother, 33, pp. 169-177Preços Máximos de Medicamentos Por Princípio Ativo Para Compras Públicas - Monodrogas/preços Fábrica (PF) e Preço Máximo de Venda Ao Governo (PMVG), , http://portal.anvisa.gov.br/wps/wcm/connect/de29e2004baf729293c5dbbc0f9d5b29/LISTA_CONFORMIDADE_GOV_2012-06-19.pdf?MOD=AJPERES, Accessed July 12, 2014

Baseline characteristics and risk factors for ulcer, amputation and severe neuropathy in diabetic foot at risk: the brazupa study

CNPQ – CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOStudies on diabetic foot and its complications involving a significant and representative sample of patients in South American countries are scarce. The main objective of this study was to acquire clinical and epidemiological data on a large cohort of diabetic patients from 19 centers from Brazil and focus on factors that could be associated with the risk of ulcer and amputation. Methods: This study presents cross sectional, Baseline results of the BRAZUPA Study. A total of 1455 patients were included. Parameters recorded included age, gender, ethnicity, diabetes and comorbidity-related records, previous ulcer or amputation, clinical symptomatic score, foot classification and microvascular complications. Results: Patients with ulcer had longer disease duration (17.2 +/- 9.9 vs. 13.2 +/- 9.4 years; p < 0.001), and poorer glycemic control (HbA1c 9.23 +/- 2.03 vs. 8.35 +/- 1.99; p < 0.001). Independent risk factors for ulcer were male gender (OR 1.71; 95 % CI 1.2-3.7), smoking (OR 1.78; 95 % CI 1.09-2.89), neuroischemic foot (OR 20.34; 95 % CI 9.31-44.38), region of origin (higher risk for those from developed regions, OR 2.39; 95 % CI 1.47-3.87), presence of retinopathy (OR 1.68; 95 % CI 1.08-2.62) and absence of vibratory sensation (OR 7.95; 95 % CI 4.65-13.59). Risk factors for amputation were male gender (OR 2.12; 95 % CI 1.2-3.73), type 2 diabetes (OR 3.33; 95 % CI 1.01-11.1), foot at risk classification (higher risk for ischemic foot, OR 19.63; 95 % CI 3.43-112.5), hypertension (lower risk, OR 0.3; 95 % CI 0.14-0.63), region of origin (South/Southeast, OR 2.2; 95 % CI 1.1-4.42), previous history of ulcer (OR 9.66; 95 % CI 4.67-19.98) and altered vibratory sensation (OR 3.46; 95 % CI 1.64-7.33). There was no association between either outcome and ethnicity. Conclusions: Ulcer and amputation rates were high. Age at presentation was low and patients with ulcer presented a higher prevalence of neuropathy compared to ischemic foot at risk. Ischemic disease was more associated with amputations. Ethnical differences were not of great importance in a miscegenated population825CNPQ – CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOCNPQ – CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOsem informaçã

An acidic model pro-peptide affects the secondary structure, membrane interactions and antimicrobial activity of a crotalicidin fragment

In order to study how acidic pro-peptides inhibit the antimicrobial activity of antimicrobial peptides, we introduce a simple model system, consisting of a 19 amino-acid long antimicrobial peptide, and an N-terminally attached, 10 amino-acid long acidic model pro-peptide. The antimicrobial peptide is a fragment of the crotalicidin peptide, a member of the cathelidin family, from rattlesnake venom. The model pro-peptide is a deca (glutamic acid). Attachment of the model pro-peptide only leads to a moderately large reduction in the binding to- and induced leakage of model liposomes, while the antimicrobial activity of the crotalicidin fragment is completely inhibited by attaching the model pro-peptide. Attaching the pro-peptide induces a conformational change to a more helical conformation, while there are no signs of intra- or intermolecular peptide complexation. We conclude that inhibition of antimicrobial activity by the model pro-peptide might be related to a conformational change induced by the pro-peptide domain, and that additional effects beyond induced changes in membrane activity must also be involved.</p

Diet of two syntopic species of Crenuchidae (Ostariophysi: Characiformes) in an Amazonian rocky stream

Abstract This study assessed the diet of two poorly known syntopic fish species of the family Crenuchidae, Characidium aff. declivirostre and Leptocharacidium omospilus, in a Presidente Figueiredo´ rocky stream, Amazonas, Brazil. The stomach contents were analyzed and their Frequency of Occurrence (FO %) and Relative Volume (Vol %) were combined in a Feeding Index (IAi). We examined 20 individuals of C. aff. declivirostre and 23 of L. omospilus. The Morisita-Horn Index was used to estimate the overlap between the diets of these species. Immature insects were the most valuable items consumed by both fish species. The diet of C. aff. declivirostre was mainly composed of larvae and pupae of Chironomidae, while L. omospilus predominantly consumed larvae of Hydroptilidae, Hydropyschidae and Pyralidae. Thus, both species were classified as autochthonous insectivorous. Characidium aff. declivirostre was considered a more specialized species, probably reflecting lower feeding plasticity or the use of more restricted microhabitats compared to L. omospilus. When the food items were analyzed at the family taxonomic level, the diet overlap between these species was considered moderate (Morisita-Horn Index = 0.4). However, a more thorough analysis, at the genus level, indicates a very low diet overlap. Therefore, we conclude that the feeding segregation between C. aff. declivirostre and L. omospilus may favor their co-existence, despite their high phylogenetic closeness