COMPARAÇÃO MICROBIOLÓGICA ENTRE MEMBRANAS AMNIÓTICAS HUMANAS COLETADAS EM PARTOS VAGINAIS E CESARIANAS – PROJETO PILOTO

Objective: The amniotic membrane, a thin membrane, may be used as a temporary cover on deep burns. The objective of this study is to identify the differences regarding bacterial contamination between membranes of vaginal and cesarean deliveries, as well as to assess the possibility of the clinical use of stored membranes.Methods: Twelve membranes were obtained from women submitted to vaginal and cesarean deliveries at the Obstetric Center of Hospital de Clínicas de Porto Alegre. Each amniotic membrane was stored in five different flasks containing a physiological solution. Samples were obtained from these flasks for analysis on days 1, 7, 14, 21 and 28. These samples were tested for bacterial contamination, analyzing its relation to time of storage and type of delivery. This is a pilot study with a transversal design.Results: The comparison between types of delivery yielded a relative risk of contamination in vaginal delivery (RR) of 2.67 (95% CI: 1.09-6.52) and no significance (P = 0.08). No contamination was found on day 1 flasks.Conclusion: All membranes derived from vaginal deliveries ended up showing bacterial contamination during the storage period, which lead to a theoretical unavailability for its use on Amniotic Membrane Banks.Objetivo: A membrana amniótica, uma membrana fina, pode ser utilizada como cobertura temporária em queimaduras profundas. O objetivo deste estudo é o de verificar as possíveis diferenças quanto à contaminação bacteriana entre as membranas de partos cesáreo e vaginal, assim como avaliar a viabilidade ou não do uso clínico-cirúrgico da membrana armazenada.Métodos: Foram coletadas 12 membranas amnióticas de mulheres submetidas a parto cesáreo e vaginal no Centro Obstétrico do HCPA. Cada membrana amniótica foi armazenada em cinco frascos diferentes contendo soro fisiológico, dos quais foram obtidas amostras para análise no momento da coleta e nos dias 7, 14, 21 e 28. Essas amostras foram testadas quanto à contaminação bacteriana, analisando sua relação com o tempo de armazenamento e com o tipo de parto realizado. O estudo é um piloto e tem um delineamento transversal. Resultados: A comparação entre os tipos de parto mostrou um risco relativo (RR) de 2,67 de contaminação no parto vaginal em relação à cesariana (IC de 95%: 1,09 a 6,52), P = 0,08. Não foi verificada contaminação em nenhum dos frascos no momento da coleta. Conclusão: Todas as membranas coletadas de parto vaginal apresentaram crescimento bacteriano no processo de estocagem, levando à sua inviabilidade teórica para uso em Bancos de Membrana Amniótica

Consenso em criptococose - 2008

Univ Sao Paulo, Fac Med, Div Clin Mol Infecciosas, Hosp Clin, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Dept Med, Sao Paulo, BrazilUniv Estadual Campinas, Hosp Clin, Inst Infectol Emilio Ribas, Campinas, SP, BrazilFundacao Oswaldo Cruz, Dept Microbiol Immunol & Parasitol, Inst Pesquisa Clin Evandro Chagas, Rio De Janeiro, BrazilUniv Fed Parana, Fac Med, Dept Saude Comunitaria, BR-80060000 Curitiba, Parana, BrazilUniv Fed Rio Grande do Sul, Fac Med, Dept Clin Med, Porto Alegre, RS, BrazilUniv Estadual Campinas, Fac Ciencias Med, Dept Clin Med, Sao Paulo, BrazilInst Doencas Trop Natan Portela, Teresina, PI, BrazilUniv Sao Paulo, Fac Med, Dept Mol Infecciosas & Parasitarias, Sao Paulo, BrazilUniv Estadual Campinas, Fac Ciencias Med, Dept Clin Med, Campinas, SP, BrazilUniv Fed Uberlandia, Fac Med, BR-38400 Uberlandia, MG, BrazilFac Med Triangulo Mineiro, Dept Clin Med, Uberaba, MG, BrazilInst Infectol Emilio Ribas, Sao Paulo, BrazilUniv Estadual Sao Paulo, Fac Med Botucatu, Dept Doencas Trop & Diagnost Imagem, Sao Paulo, BrazilUniv Sao Paulo, Fac Med Ribeirao Preto, Dept Clin Med, Ribeirao Preto, SP, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Dept Med, Sao Paulo, BrazilWeb of Scienc

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Las Provincias : diario de Valencia: Año XL Número 14208 Edición extraordinaria - 1905 Julio 22

Objetivo: A membrana amniótica, uma membrana fina, pode ser utilizada como cobertura temporária em queimaduras profundas. O objetivo deste estudo é o de verificar as possíveis diferenças quanto à contaminação bacteriana entre as membranas de partos cesáreo e vaginal, assim como avaliar a viabilidade ou não do uso clínico-cirúrgico da membrana armazenada. Métodos: Foram coletadas 12 membranas amnióticas de mulheres submetidas a parto cesáreo e vaginal no Centro Obstétrico do HCPA. Cada membrana amniótica foi armazenada em cinco frascos diferentes contendo soro fisiológico, dos quais foram obtidas amostras para análise no momento da coleta e nos dias 7, 14, 21 e 28. Essas amostras foram testadas quanto à contaminação bacteriana, analisando sua relação com o tempo de armazenamento e com o tipo de parto realizado. O estudo é um piloto e tem um delineamento transversal. Resultados: A comparação entre os tipos de parto mostrou um risco relativo (RR) de 2,67 de contaminação no parto vaginal em relação à cesariana (IC de 95%: 1,09 a 6,52), P = 0,08. Não foi verificada contaminação em nenhum dos frascos no momento da coleta. Conclusão: Todas as membranas coletadas de parto vaginal apresentaram crescimento bacteriano no processo de estocagem, levando à sua inviabilidade teórica para uso em Bancos de Membrana Amniótica.Objective: The amniotic membrane, a thin membrane, may be used as a temporary cover on deep burns. The objective of this study is to identif y the dif ferences regarding bacterial contamination between membranes of vaginal and cesarean deliveries, as well as to assess the possibility of the clinical use of stored membranes. Methods: Twelve membranes were obtained from women submitted to vaginal and cesarean deliveries at the Obstetric Center of Hospital de Clínicas de Porto Alegre. Each amniotic membrane was stored in five dif ferent flasks containing a physiological solution. Samples were obtained from these flasks for analysis on days 1, 7, 14, 21 and 28. These samples were tested for bacterial contamination, analyzing its relation to time of storage and type of delivery. This is a pilot study with a transversal design. Results: The comparison between types of delivery yielded a relative risk of contamination in vaginal delivery (RR) of 2.67 (95% CI: 1.09-6.52) and no significance (P = 0.08). No contamination was found on day 1 flasks. Conclusion: All membranes derived from vaginal deliveries ended up showing bacterial contamination during the storage period, which lead to a theoretical unavailability for its use on Amniotic Membrane Banks

Prediction of Nitrogen Dosage in ‘Alicante Bouschet’ Vineyards with Machine Learning Models

Vineyard soils normally do not provide the amount of nitrogen (N) necessary for red wine production. Traditionally, the N concentration in leaves guides the N fertilization of vineyards to reach high grape yields and chemical composition under the ceteris paribus assumption. Moreover, the carryover effects of nutrients and carbohydrates stored by perennials such as grapevines are neglected. Where a well-documented database is assembled, machine learning (ML) methods can account for key site-specific features and carryover effects, impacting the performance of grapevines. The aim of this study was to predict, using ML tools, N management from local features to reach high berry yield and quality in ‘Alicante Bouschet’ vineyards. The 5-year (2015–2019) fertilizer trial comprised six N doses (0–20–40–60–80–100 kg N ha−1) and three regimes of irrigation. Model features included N dosage, climatic indices, foliar N application, and stem diameter of the preceding season, all of which were indices of the carryover effects. Accuracy of ML models was the highest with a yield cutoff of 14 t ha−1 and a total anthocyanin content (TAC) of 3900 mg L−1. Regression models were more accurate for total soluble solids (TSS), total titratable acidity (TTA), pH, TAC, and total phenolic content (TPC) in the marketable grape yield. The tissue N ranges differed between high marketable yield and TAC, indicating a trade-off about 24 g N kg−1 in the diagnostic leaf. The N dosage predicted varied from 0 to 40 kg N ha−1 depending on target variable, this was calculated from local features and carryover effects but excluded climatic indices. The dataset can increase in size and diversity with the collaboration of growers, which can help to cross over the numerous combinations of features found in vineyards. This research contributes to the rational use of N fertilizers, but with the guarantee that obtaining high productivity must be with adequate composition