Clinical Usefulness of Streptococcus pneumoniae Urinary Antigen in Patients Hospitalized with Non-Nosocomial Pneumonia

Introduction : Community acquired pneumonia (CAP) is a major cause of hospital admissions and mortality in developed countries. Nevertheless, in about half of the cases a microbial etiology can`t be determined. The need to improve the diagnostic tools of this disease has led to the development of new techniques, such as Streptococcus pneumoniae urinary antigen. Objectives : To analyse the usefulness of the urinary antigen in determining the etiologic diagnosis of pneumonias and its influence in the antibiotherapy modification. Methods : Retrospective analysis of hospitalized patients in 2010 with CAP (n=226) and healthcare associated pneumonia (HCAP) [n=64] diagnosis whose urinary pneumococcal antigen has been analyzed. Results: Median age was significantly greater in HCAP. HCAP patients had more co-morbidities and higher severity scores. Twenty-one patients in the CAP group and 4 patients in the HCAP group had positive pneumococcal antigen. The sensibility of urinary antigen in determining pneumococcal pneumonias was 36% and the specificity 89%. Almost one quarter of the 25 patients with positive urinary antigen had appropriate reductions in antimicrobial spectra, which was not statistically significant when compared with the group with negative urinary antigen. There was a significant relation between a positive urinary antigen and pneumonia severity. Conclusions: Considering its high specificity, the urinary antigen is useful to confirm the presence of pneumococcal pneumonia. Potentially urinary antigen can help to avoid unnecessary treatments in hospitalized patients with CAP

Thermal restraint and fire resistance of columns

A proposal is made, based on the results of a series of tests and calculations, with the aim of being used as a simple method to correct the value of the critical temperature of steel columns free to elongate, in order to take into account the restraint effect of the structure to which they belong in a practical situation. To better illustrate the possible types of behaviour of heated steel columns with elastic restraint to the thermal elongation, and the reasons why the critical temperature of axially loaded slender steel columns with thermal restraint can sometimes be lower than the critical temperature of the same columns free to elongate, a simple model is presented and used in a qualitative analysis.http://www.sciencedirect.com/science/article/B6V37-46WW50B-1/1/139a30367738460772843d1279c4c32

STAPHYLOCOCCUS AUREUS RESISTENTE À METICILINA E ABCESSO HEPÁTICO Análise Retrospectiva de 117 Casos

Introdução: Os abcessos hepáticos constituem uma entidade clínica que coloca desafios no diagnóstico e tratamento, sendo em muito casos necessário um elevado índice de suspeição. A maioria dos abcessos hepáticos piogénicos são polimicrobianos. Os agentes entéricos facultativos e anaeróbios são os mais comuns. Na literatura revista, os abcessos hepáticos a Staphylococcus aureus constituem cerca de 7% dos abcessos hepáticos piogénicos. Esta infecção habitualmente resulta de disseminação hematogénea de microrganismos isolados em infecções à distância. Não existem séries publicadas sobre esta matéria, sendo que a informação disponível se restringe a case-reports. Objectivo e Métodos: Com o objectivo de aprofundar a fisiopatologia, diagnóstico e história natural dos abcessos hepáticos, nomeadamente por Staphylococcus Aureus resistente à meticilina (MRSA), realizou-se um estudo retrospectivo, fazendo a revisão do processo clínico dos doentes com o diagnóstico de abcesso hepático/piemia portal entre Janeiro de 2004 e Dezembro de 2009, num total de 117 doentes. Resultados: Clinicamente, a maior parte dos doentes tinha febre e dor abdominal. A esmagadora maioria dos doentes não dispensou TC abdominal no diagnóstico. Apenas 81,2% dos doentes realizaram algum tipo de colheita para microbiologia. O agente mais frequentemente isolado foi a Escherichia coli. O MRSA estava presente em 7,6% dos abcessos cujo pús foi processado. A terapêutica mais frequentemente seleccionada foi a drenagem percutânea associada a antibioterapia. Todos os MRSA isolados eram sensíveis ao trimetoprim-sulfametoxazol e vancomicina. O grupo de patologia subjacente mais frequentemente encontrada foi o das doenças das vias biliares, seguido dos pós-operatórios recentes. Na esmagadora maioria das infecções a MRSA, o grupo de patologia subjacente mais frequentemente encontrada foi o pós-operatório abdominal. A taxa de mortalidade global foi de 17,9%. No que respeita a abcessos a MRSA, faleceu 1 doente devido a complicações da doença de base. Conclusões: Estes dados confirmam que o MRSA é um patogénio importante em infecções hospitalares, incluindo as intra-abdominais. É de salientar a importância do pós-operatório abdominal como factor de risco para infecção por este agente, um dado pouco descrito na literatura revista. Estes achados acarretam implicações assinaláveis a nível terapêutico, investigacional e prognóstico

Healthy bread as an alternative to traditional bread

Today, bread is part of the culture and eating habits of most people and can be considered one of the most consumed foods in the world. The bread is made from a simple mixture of flour, water, salt and yeast, and it is an extremely versatile food and with a very good digestibility. Since it was first produced for thousands of years, it has undergone changes both in terms of production methods and in terms of its constitution, thus giving place nowadays to a wide variety of breads available on the market. The objectives of this study were to compare the sensory and nutritionally attributes of a special healthier bread, ―Pão São‖, which is a recent product in the Portuguese market. Nutritionally this type of bread turned out to be a food with high nutritional value, with a low salt content (0.4%, about half of traditional bread), and being a good source of omega-3 (0.67%), fibre and protein when compared with the traditional bread. These differences are mainly due to the wide variety of raw materials selected to the preparation of this bread, including the mixture of flour (wheat flour type 150 and 65 and rye flour type 70), oatmeal, sunflower and linseed seeds, soy, fish oil extracts rich in omega 3, malt and milk protein. From the results of the sensory analysis, conducted by a panel of 40 untrained tasters aged 7 to 63 years, it was found that the traditional breads from the region closest to the marketing of healthy bread were preferred by the tasters, especially for their wood and bread flavour, as well as elasticity. The healthy bread was evaluated as a denser bread, with a more intense fermented flavour. With this work it was concluded that the healthy bread is a nutritious and healthy bread, being currently recommended by the Portuguese Foundation of Cardiology. However from the sensory point of view, consumers still slighly prefer the traditional bread

Pão são, uma alternativa ao pão tradicional

Hoje em dia o pão faz parte da cultura e dos hábitos alimentares da maioria dos povos, podendo considerar-se um dos alimentos mais consumidos do mundo. O pão é feito a partir de uma mistura simples de farinha, água, sal e fermento, sendo um alimento extremamente versátil e com uma enorme digestibilidade [1]. Desde que foi produzido pela primeira vez há milhares de anos, foi sofrendo evoluções quer ao nível dos métodos de produção, quer ao nível da sua constituição encontrando-se nos dias de hoje uma grande diversidade de pães no mercado. Os objectivos deste trabalho foram comparar nutricionalmente e sensorialmente um pão classificado como especial, o Pão São, um produto recente no mercado Português. Nutricionalmente o Pão São revelou ser um pão com elevado valor nutricional, apresentando um baixo teor de sal (0.4%, cerca de metade do pão tradicional), sendo uma boa fonte de ómega 3 (0.67%), fibras e proteínas quando comparado com o pão tradicional. Estas diferenças devem-se sobretudo à grande variedade de matérias-primas seleccionadas na elaboração do Pão São, nomeadamente a mistura de farinhas (farinhas de trigo tipo 65 e 150 e farinha de centeio tipo 70), flocos de aveia, sementes de girassol e linhaça, soja, extractos de óleo de peixe rico em ómega 3, malte e proteína de leite. Dos resultados obtidos da análise sensorial, realizada por um painel de 40 provadores não treinados com idades compreendidas entre os 7 e os 63 anos, verificou-se que os pães tradicionais da região de comercialização mais próxima do Pão São foram os preferidos pelos provadores, destacando-se pelo seu sabor a lenha e a pão, e pela sua elasticidade. O Pão São foi avaliado como um pão mais denso, apresentando um sabor mais intenso a fermentado. Com a realização deste trabalho foi possível concluir que o Pão São é um pão nutritivo e saudável, sendo actualmente recomendado pela Fundação Portuguesa de Cardiologia. No entanto sobre o ponto de sensorial o consumidor aprecia e prefere o pão tradicional

Influence of Brick Walls on the Temperature Distribution in Steel Columns in Fire

This paper reports on a study of steel columns embedded in walls in fire. Several fire resistance tests were carried out at the Laboratory of Testing Materials and Structures of the University of Coimbra, in Portugal. The temperatures registered in several points of the experimental models are compared with those obtained in numerical simulations carried out with the SUPERTEMPCALC finite element program.

Left-sided infective endocarditis: analysis of in-hospital and medium-term outcome and predictors of mortality

Abstract Introduction: Despite diagnostic and therapeutic advances, infective endocarditis (IE) remains a challenging and potentially lethal disease. The prognosis of IE remains poor; in the last 30 years, its incidence and mortality have only been marginally reduced. Early identification of high-risk patients can change the course of the disease and improve outcomes. Objectives and methods: To describe and investigate predictors of mortality during hospital stay and in the six months after discharge in a cohort of left-sided IE patients in two tertiary centers. All patients diagnosed with IE (ICD9 code 133) were registered in a uniform database. Results: One hundred and forty-seven consecutive case patients with left-sided IE were included in this study. Thirty-five patients (23.8%) died during hospital stay. The variables significantly associated with increased mortality in univariate analysis were Charlson index ≥5, use of immunosuppressants, sepsis (severe sepsis and/or septic shock), cardiogenic shock and inappropriate use of antibiotic therapy. Conversely, surgical therapy and hospital length of stay ≥30 days were significantly associated with lower mortality. In multivariate analysis the most important predictors of in-hospital mortality were sepsis (severe and/or shock), use of immunosuppressants and inappropriate use of antibiotic therapy. There was a significant relation between the use of immunosuppressants and the occurrence of sepsis. The presence of significant valve disease after IE significantly increased the risk of heart failure. Conclusions: Our results may help to identify IE patients at increased risk for in-hospital mortality and medium-term disability. These findings can help to identify candidates for earlier and more aggressive management

Fatigue Evaluation through Machine Learning and a Global Fatigue Descriptor

Research in physiology and sports science has shown that fatigue, a complex psychophysiological phenomenon, has a relevant impact in performance and in the correct functioning of our motricity system, potentially being a cause of damage to the human organism. Fatigue can be seen as a subjective or objective phenomenon. Subjective fatigue corresponds to a mental and cognitive event, while fatigue referred as objective is a physical phenomenon. Despite the fact that subjective fatigue is often undervalued, only a physically and mentally healthy athlete is able to achieve top performance in a discipline. )erefore, we argue that physical training programs should address the preventive assessment of both subjective and objective fatigue mechanisms in order to minimize the risk of injuries. In this context, our paper presents a machine-learning system capable of extracting individual fatigue descriptors (IFDs) from electromyographic (EMG) and heart rate variability (HRV) measurements. Our novel approach, using two types of biosignals so that a global (mental and physical) fatigue assessment is taken into account, reflects the onset of fatigue by implementing a combination of a dimensionless (0-1) global fatigue descriptor (GFD) and a support vector machine (SVM) classifier. )e system, based on 9 main combined features, achieves fatigue regime classification performances of 0.82 ± 0.24, ensuring a successful preventive assessment when dangerous fatigue levels are reached. Training data were acquired in a constant work rate test (executed by 14 subjects using a cycloergometry device), where the variable under study (fatigue) gradually increased until the volunteer reached an objective exhaustion state

Designing whey protein-based architectures under application of moderate electric fields

info:eu-repo/semantics/publishedVersio