18 research outputs found
The water supply system as a potential source of fungal infection in paediatric haematopoietic stem cell units
Get PDFBackground: We conducted a prospective study to investigate the presence of microfungal contamination in the water supply system of the Oncology Paediatric Institute, São Paulo - Brazil after the occurrence of one invasive Fusarium solani infection in a patient after Haematopoietic Stem Cell Transplantation (HSCT). During a twelve-month period, we investigated the water supply system of the HSCT unit by monitoring a total of fourteen different collection sites.Methods: One litre of water was collected in each location, filtered through a 0.45 mu m membrane and cultured on SDA to detect the presence of filamentous fungi. Physicochemical analyses of samples were performed to evaluate the temperature, turbidity, pH, and the concentration of free residual chlorine.Results: Over the 12 months of the study, 164 samples were collected from the water supply system of the HSCT unit, and 139 of the samples tested positive for filamentous fungi (84.8%), generating a total of 2,362 colonies. Cladosporium spp., Penicillium spp., Purpureocillium spp. and Aspergillus spp. were ranked as the most commonly found genera of mould in the collected samples. of note, Fusarium solani complex isolates were obtained from 14 out of the 106 samples that were collected from tap water (mean of 20 CFU/L). There was a positive correlation between the total number of fungal CFU obtained in all cultures and both water turbidity and temperature parameters. Our findings emphasise the need for the establishment of strict measures to limit the exposure of high-risk patients to waterborne fungal propagules.Conclusions: We were able to isolate a wide variety of filamentous fungi from the water of the HSCT unit where several immunocompromised patients are assisted.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo, Dept Med, Disciplina Infectol, BR-04024002 São Paulo, BrazilUniv Austral Chile, Inst Clin Microbiol, Valdivia, ChileUniv Antofagasta, Antofagasta, ChileUniversidade Federal de São Paulo, Inst Oncol Pediat, GRAACC, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, Disciplina Infectol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Inst Oncol Pediat, GRAACC, BR-04023062 São Paulo, BrazilFAPESP: 2005/02138-3CNPq: 133621/2007-3CAPES: PNPD 2312/2011CNPq: 150368/2005-4Web of Scienc
Occurrence of Ascaridia galli and Heterakis gallinarum in Guinea Fowl (Numida meleagris) in the State of Rondônia, Brazil
Get PDFBackground: Parasitic diseases are among the problems that most affect birds. The Ascaridia spp. is one of the genera which is responsible for the main infections, and the Ascaridia. galli is the most frequent species found in birds. The Ascaridia spp. egg is oval and present a smooth shell which could be mistaken with the Heterakis gallinarum eggs, once they are the most frequent parasites in birds. Therefore, this case report describes the occurrence of Ascaridia galli and Heterakis gallinarum in a guinea fowl (Numida meleagris) feces and gut.Case: In January 2017, rain season in northern Brazil, a visit was performed to a free range avian breeding property in the municipality of São Miguel do Guaporé in the state of Rondônia, Brazilian Amazonian Region. The property breeds two chicken species: Gallus gallus domesticus and Numida meleagris as well as one quail species. The problem was related to the guinea fowl breeding which was composed by 50 adults and 45 young birds about two or three weeks old. All 45 young guinea fowl were presenting various clinical signs, which included: yellowish catarrhal diarrhea, isolation, loss of appetite, body weight, ruffled feathers, drooping wings and sternal prominence. All animals that presented the clinical signs as ruffled feathers, drooping wings and sternal prominence died on an average of 24 h and the mortality was of 65.9% (29/45). Subsequently, a three-week old bird corpse was necropsied, and it was observed that its intestines presented a large amount of endoparasites besides presenting thickening. As there were a lot of helminths, they were collected along with the intestinal content for examination. The parasitological examinations of the feces were performed by Willys Molay's technique. As a result of the fluctuation technique, were observed and identified large quantities of Heterakis gallinarum and Ascaridia galli eggs. The adult worms of H. gallinarum and A. galli were identified using dichotomous key.Discussion: Ascaridia galli and Heterakis gallinarum infection were reported in guinea fowl in a free range chicken breeding property in the municipality of São Miguel do Guaporé in the state of Rondônia, Brazilian Amazonian Region. Ascaridia galli and Heterakis gallinarum eggs have already been identified in free-range chickens (Gallus gallus domesticus) by flotation techniques, as Willys Mollay and Faust and they are the main species of helminths housed by chickens. However, these parasites are not commonly reported in guinea fowl worldwide, especially in the Numida meleagris species. Regarding necropsy, intestinal wall thickening is generally a common finding which has been reported in chickens, however it is not commonly reported in guinea fowl. Additionally, the presence of clinical signs of nematode parasitosis frequently occurs in birds with high parasitic load. In this report, we believe that the guinea fowls births on the rain season was one of the factors to the high parasites incidence found, since both nematodes species are frequently identified in the rain seasons. Additionally, the management adopted by the breeder, using concomitantly the same nursery for guinea fowl and chicken, added up to inadequate sanitary management, seems to have directly influenced the contamination and recontamination of the different brood litter of guinea fowls. It is concluded that guinea fowl (Numida meleagris) located in the state of Rondônia were affected by high amounts of Ascaridia galli and Heterakis gallinarum and caused high mortality in the young specimens and consequently causing economic losses to the proprietary
A influência da síndrome de ovários policísticos e síndrome metabólica na escolha do tipo de parto: revisão de literatura
Get PDFIntroduction: Polycystic Ovary Syndrome (PCOS) and Metabolic Syndrome (MS) are interconnected through various physiological pathways, and their coexistence may have significant implications, especially during pregnancy and the childbirth process. During pregnancy, women with PCOS and MS may face an increased risk of obstetric complications. Regarding the impact on childbirth, PCOS and MS can influence the choice of the type of delivery.
Methodology: This work constitutes a literature review, following the systematization with the five pillars described below. 1) Problem statement: "What is the influence of PCOS and MS on the choice of the type of delivery?". 2) Relevant studies were identified using the PUBMED platform with the descriptors "Metabolic Syndrome, Polycystic Ovary Syndrome, Parturition, Pregnancy," PUBMED all in accordance with MESH. 3) Initially, 11 studies were selected; 4 were discarded after a thorough reading as they did not contribute to the problem statement. 4) Data extraction was performed using a text editing program. 5) Experts were consulted.
Results: The studies revealed that PCOS and MS are associated with a clinically significant increase in the risk of complications during pregnancy compared to control groups. Additionally, there is a 3 to 4 times higher likelihood of developing pregnancy-induced hypertension and preeclampsia, a threefold increase in the risk of gestational diabetes, and a twofold likelihood of premature birth. The elevated obstetric risk for women with PCOS is reflected in a higher rate of spontaneous abortion. Moreover, it was observed that, compared to the general population, PCOS and MS are more associated with cesarean delivery.
Conclusion: Cesarean delivery is predominant in patients with PCOS and MS. Furthermore, there is a higher risk of developing pregnancy-induced hypertension, preeclampsia, and premature birth.Introdução: A síndrome dos ovários policísticos (SOP) e a síndrome metabólica (SM) estão interligadas por várias vias físicas, e sua coexistência pode ter implicações significativas, especialmente durante a gravidez e no processo de parto. Durante a gravidez, as mulheres SOP e SM podem enfrentar um risco aumentado de complicações obstétricas. Quanto ao impacto no parto, a SOP e a SM podem influenciar a escolha do tipo de parto
Metodologia: Este trabalho trata-se de uma revisão de literatura, de acordo com a sistematização com os 5 pilares descritos a seguir. 1) Questão problema: “Qual a influência da SOP e SM na escolha do tipo de parto?”. 2) Estudos relevantes foram identificados utilizando na plataforma PUBMED os descritores “Metabolic Syndrome, Polycystic Ovary Syndrome, Parturition, Pregnancy”, na PUBMED, todos de acordo com MESH. 3) 11 estudos foram selecionados inicialmente, 4 foram descartados mediante leitura completa por não contribuir com a questão problema. 4) A extração de dados foi realizada em um programa de edição de texto. 5) Especialistas foram consultados.
Resultado: Os estudos revelaram que a SOP e SM estão associadas a um aumento clinicamente significativo no risco de complicações durante a gravidez, em comparação com os grupos de controle. Além disso, há uma probabilidade de 3 a 4 vezes maior de desenvolver hipertensão causada pela gravidez e pré-eclâmpsia, um aumento de 3 vezes sem risco de diabetes gestacional e uma probabilidade duas vezes maior de parto prematuro. O risco obstétrico elevado para mulheres com SOP se reflete em uma maior taxa de aborto espontâneo. Diante disso, observou-se que em relação a população em geral, SOP e SM associam-se mais com o parto cesariano.
Conclusão: O parto cesariano é predominante em pacientes com SOP e SM. Além disso, há maior risco de desenvolver hipertensão causada pela gravidez, pré-eclâmpsia e parto prematuro
O impacto da ultrassonografia no atendimento multidisciplinar na UTI
Get PDFIntroduction: The introduction of ultrasound in the Intensive Care Unit (ICU) represents a significant milestone, fostering substantial advancements in multidisciplinary practice and positively influencing the management of various critical conditions. The application of pulmonary ultrasound, in particular, emerges as a versatile and essential tool, directly impacting the quality of care provided.
Methodology: A bibliographic search was conducted on the PUBMED platform, utilizing specific Mesh descriptors: Ultrasonography, Intensive Care Units, Patient Care Team. The search period spanned from 2013 to 2021, encompassing a total of 33 articles.
Results: The application of ultrasound in the ICU has proven to be an extremely relevant tool for multidisciplinary care. Pulmonary ultrasound, when employed by intensivists, not only provides a precise assessment of the mentioned conditions but also plays a fundamental role in rapid decision-making and treatment optimization.
Conclusion: Ultrasound emerges as a transformative tool in the ICU, shaping multidisciplinary practice and ushering in an era of more advanced and patient-centered intensive care. Its crucial role in swift decision-making and treatment optimization reinforces its position as an indispensable element in the toolkit of healthcare professionals in both the present and future ICU settings.Introdução: A introdução da ultrassonografia na Unidade de Terapia Intensiva (UTI) representa um marco significativo, promovendo avanços substanciais na prática multidisciplinar e influenciando positivamente o manejo de diversas condições críticas. A aplicação da ultrassonografia pulmonar, em particular, surge como uma ferramenta versátil e essencial, impactando diretamente a qualidade do atendimento prestado.
Metodologia: A pesquisa bibliográfica foi conduzida na plataforma PUBMED, utilizando descritores Mesh específicos: Ultrasonography, Intensive Care Units, Patient Care Team. O período de busca abrangeu os anos de 2013 a 2021, totalizando 33 artigos.
Resultado: Aplicação da ultrassonografia na UTI tem se mostrado uma ferramenta de extrema relevância para o atendimento multidisciplinar. A ultrassonografia pulmonar, quando utilizada pelos intensivistas, não apenas oferece uma avaliação precisa das condições mencionadas, mas também desempenha um papel fundamental na rápida tomada de decisões e na otimização do tratamento.
Conclusão: A ultrassonografia emerge como uma ferramenta transformadora na UTI, moldando a prática multidisciplinar e promovendo uma era de cuidados intensivos mais avançados e centrados no paciente. Seu papel crucial na rápida tomada de decisões e na otimização do tratamento reforça sua posição como um elemento indispensável na caixa de ferramentas dos profissionais de saúde nas UTIs do presente e do futuro
The water supply system as a potential source of fungal infection in paediatric haematopoietic stem cell units
Full text linkEfeito Agudo da Pressao Positiva Continua sobre a Pressao de Pulso na Insuficiencia Cardiaca Cronica
No full textFundamento: Pacientes com insuficiência cardíaca (IC) apresentam disfunção ventricular esquerda e redução da pressão arterial média (PAM). O aumento do estímulo adrenérgico causa vasoconstrição e resistência dos vasos, mantendo a PAM, enquanto aumenta a resistência vascular periférica e a rigidez dos vasos condutores. O aumento da pressão de pulso (PP) reflete a complexa interação do coração com os sistemas arteriais e venosos. O aumento da PP é um importante marcador de risco em pacientes com insuficiência cardíaca crônica (ICC). A ventilação não invasiva (VNI) tem sido utilizada para IC aguda descompensada para melhorar a congestão e a ventilação pelos efeitos respiratórios e hemodinâmicos. No entanto, nenhum desses estudos relatou o efeito da VNI na PP. Objetivo: O objetivo deste estudo foi determinar os efeitos agudos da VNI com CPAP (pressão positiva contínua nas vias aéreas) sobre a PP em pacientes ambulatoriais com ICC. Métodos: Seguindo um protocolo randomizado, duplo-cego, cruzado e controlado com placebo, 23 pacientes com ICC (17 homens, 60 ± 11 anos, IMC 29 ± 5 kg/cm2, classes II e III da NYHA) foram submetidos à CPAP via máscara nasal durante 30 minutos na posição reclinada. A pressão da máscara foi de 6 cmH2O, enquanto o placebo foi fixado em 0-1 cmH2O. PP e outras variáveis hemodinâmicas não invasivas foram avaliadas antes, durante e depois do placebo e do modo CPAP. Resultados: A CPAP diminuiu a frequência cardíaca de repouso (pré: 72 ± 9; pós 5 min: 67 ± 10 bpm , p < 0,01) e PAM (CPAP: 87 ± 11; controle 96 ± 11 mmHg , p < 0,05 pós 5 min). A CPAP diminuiu a PP (CPAP: 47 ± 20 pré para 38 ± 19 mmHg pós; controle: 42 ± 12 mmHg, pré para 41 ± 18 pós p < 0,05 pós 5 min). Conclusão: A VNI com CPAP diminuiu a pressão de pulso em pacientes com ICC estável. Ensaios clínicos futuros devem investigar se esse efeito está associado com melhora no desfecho clínico
Occurrence of Ascaridia galli and Heterakis gallinarum in Guinea Fowl (Numida meleagris) in the State of Rondônia, Brazil
No full textBackground: Parasitic diseases are among the problems that most affect birds. The Ascaridia spp. is one of the genera which is responsible for the main infections, and the Ascaridia. galli is the most frequent species found in birds. The Ascaridia spp. egg is oval and present a smooth shell which could be mistaken with the Heterakis gallinarum eggs, once they are the most frequent parasites in birds. Therefore, this case report describes the occurrence of Ascaridia galli and Heterakis gallinarum in a guinea fowl (Numida meleagris) feces and gut.Case: In January 2017, rain season in northern Brazil, a visit was performed to a free range avian breeding property in the municipality of São Miguel do Guaporé in the state of Rondônia, Brazilian Amazonian Region. The property breeds two chicken species: Gallus gallus domesticus and Numida meleagris as well as one quail species. The problem was related to the guinea fowl breeding which was composed by 50 adults and 45 young birds about two or three weeks old. All 45 young guinea fowl were presenting various clinical signs, which included: yellowish catarrhal diarrhea, isolation, loss of appetite, body weight, ruffled feathers, drooping wings and sternal prominence. All animals that presented the clinical signs as ruffled feathers, drooping wings and sternal prominence died on an average of 24 h and the mortality was of 65.9% (29/45). Subsequently, a three-week old bird corpse was necropsied, and it was observed that its intestines presented a large amount of endoparasites besides presenting thickening. As there were a lot of helminths, they were collected along with the intestinal content for examination. The parasitological examinations of the feces were performed by Willys Molay's technique. As a result of the fluctuation technique, were observed and identified large quantities of Heterakis gallinarum and Ascaridia galli eggs. The adult worms of H. gallinarum and A. galli were identified using dichotomous key.Discussion: Ascaridia galli and Heterakis gallinarum infection were reported in guinea fowl in a free range chicken breeding property in the municipality of São Miguel do Guaporé in the state of Rondônia, Brazilian Amazonian Region. Ascaridia galli and Heterakis gallinarum eggs have already been identified in free-range chickens (Gallus gallus domesticus) by flotation techniques, as Willys Mollay and Faust and they are the main species of helminths housed by chickens. However, these parasites are not commonly reported in guinea fowl worldwide, especially in the Numida meleagris species. Regarding necropsy, intestinal wall thickening is generally a common finding which has been reported in chickens, however it is not commonly reported in guinea fowl. Additionally, the presence of clinical signs of nematode parasitosis frequently occurs in birds with high parasitic load. In this report, we believe that the guinea fowls births on the rain season was one of the factors to the high parasites incidence found, since both nematodes species are frequently identified in the rain seasons. Additionally, the management adopted by the breeder, using concomitantly the same nursery for guinea fowl and chicken, added up to inadequate sanitary management, seems to have directly influenced the contamination and recontamination of the different brood litter of guinea fowls. It is concluded that guinea fowl (Numida meleagris) located in the state of Rondônia were affected by high amounts of Ascaridia galli and Heterakis gallinarum and caused high mortality in the young specimens and consequently causing economic losses to the proprietary
Brazilian version of the Personal Report of Communication Apprehension: Cross-cultural adaptation and psychometric evaluation among healthcare students.
No full textIntroductionCommunication apprehension (CA) refers to an individual's level of fear or anxiety toward either real or anticipated communication with another person or persons. The Personal Report of Communication Apprehension (PRCA-24) is the most widely used measure of CA, even among healthcare students.ObjectiveThis study aimed to undertake a cross-cultural adaptation of this scale, translate it into Brazilian Portuguese, and examine its psychometric properties among healthcare students.MethodsThe translation and cross-cultural adaptation procedures were undertaken with the objective of establishing compatibility between the original and translated scales. The content validity of the scale was established based on the feedback of a multidisciplinary expert committee. Its psychometric properties were evaluated using a convenience sample of 616 healthcare students. Its construct validity was examined using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Its internal consistency was examined by computing Cronbach's alpha and McDonald's omega coefficients. Its criterion validity was examined against the Interpersonal Communication Competence Scale (ICCS).ResultsThe adapted scale demonstrated acceptable content validity. EFA showed that it was undergirded by one dimension, and this observation was confirmed by the results of CFA. The scale demonstrated excellent internal consistency. Its convergent validity was examined by conducting correlation analysis, and scores on the adapted PRCA-24 were negatively correlated with scores on the ICCS.ConclusionThe Brazilian version of the PRCA-24 has satisfactory psychometric properties and is, therefore, suitable for use with Brazilian healthcare students. It can be used to assess their communication needs for the purpose of designing tailored training programs
Sumário de atualização da II Diretriz Brasileira de Insuficiência Cardíaca Aguda 2009/2011
Get PDFNos últimos dois anos, observamos diversas modificações na abordagem diagnóstica e terapêutica dos pacientes com Insuficiência Cardíaca aguda (IC aguda), o que nos motivou quanto à necessidade da realização de um sumário de atualização da II Diretriz Brasileira de Insuficiência Cardíaca Aguda de 2009. Na avaliação diagnóstica, o fluxograma diagnóstico foi simplificado e foi fortalecido o papel da avaliação clínica e ecocardiograma. Na avaliação clínico-hemodinâmica admissional, o ecocardiograma hemodinâmico ganhou destaque no auxilio da definição dessa condição no paciente com IC aguda na sala de emergência. Na avaliação prognóstica, os biomarcadores tiveram seu papel mais bem estabelecido, e a síndrome cardiorrenal teve seus critérios e valor prognóstico mais bem definidos. Os fluxogramas de abordagem terapêutica foram revistos, tornando-se mais simples e objetivos. Dentre os avanços na terapêutica medicamentosa destacam-se a segurança e a importância da manutenção ou introdução dos betabloqueadores na terapêutica admissional. A anticoagulação, de acordo com as novas evidências, ganha um espectro maior de indicações. O edema agudo de pulmão tem bem estabelecido os seus modelos hemodinâmicos de apresentação com suas distintas formas de abordagens terapêuticas, com novos níveis de indicação e evidência. No tratamento cirúrgico da IC aguda, a revascularização miocárdica, a abordagem das lesões mecânicas e o transplante cardíaco foram revistos e atualizados. Este sumário de atualização fortalece a II Diretriz Brasileira de Insuficiência Cardíaca Aguda por mantê-la atualizada e rejuvenescida. Todos os clínicos cardiologistas que lidam com pacientes com IC aguda encontrarão na diretriz e em seu sumário de atualização importantes instrumentos no auxílio da prática clínica para o melhor diagnóstico e tratamento de seus pacientes
