Risk factors for treatment delay in pulmonary tuberculosis in Recife, Brazil

BACKGROUND: Tuberculosis is still a great challenge to public health in Brazil and worldwide. Early detection followed by effective therapy is extremely important in controlling the disease. Recent studies have investigated reasons for delays in treatment, but there is no agreed definition of what constitutes an "acceptable" delay. This study investigates factors associated with total delay in treatment of tuberculosis. METHODS: A cohort of adult cases of pulmonary tuberculosis diagnosed over a two-year period was studied. Patients were interviewed on entry, reporting the duration of symptoms before the start of treatment, and sputum and blood samples were collected. It was decided that sixty days was an acceptable total delay. Associations were investigated using univariable and multivariable analysis and the population attributable fraction was estimated. RESULTS: Of 1105 patients, 62% had a delay of longer than 60 days. Age, sex, alcoholism and difficulty of access were not associated with delays, but associations were found in the case of unemployment, having given up smoking, having lost weight and being treated in two of the six health districts. The proportion attributable to: not being an ex-smoker was 31%; unemployment, 18%; weight loss, 12%, and going to the two worst health districts, 25%. CONCLUSION: In this urban area, delays seem to be related to unemployment and general attitudes towards health. Although they reflect the way health services are organized, delays are not associated with access to care

Diversity analyses of microbial communities in petroleum samples from Brazilian oil fields

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Recent studies of oil fields have shown that the microbial diversity is represented by bacteria and archaea of wide distribution, and that many of these organisms have potential to metabolize organic and inorganic compounds. Biodegradation processes in oil industry are of great relevance, since it may be related with the loss of petroleum quality and can bring problems during production. The aim of this study was to compare the microbial communities present in biodegraded (GMR75) and non-biodegraded (PTS1) terrestrial oils from the Potiguar Basin (RN, Brazil) by using cultivation (microbial enrichments and isolation) and molecular approaches (16S rRNA gene libraries). The cultivated microorganisms recovered were affiliated with the phyla Actinobacteria, Firmicutes and Proteobacteria. Both bacterial 16S rRNA gene libraries revealed a great diversity, encompassing representatives from 8 different phyla (Actinobacteria, Bacteroidetes, Deferribacteres, Spirochaetes, Firmicutes, Proteobacteria, Thermotogae and Synergistetes) for the GMR75 sample, and from 5 different phyla (Actinobacteria, Chloroflexi, Firmicutes, Proteobacteria and Thermotoga) for the PTS1 sample. The archaeal 16S rRNA gene library was obtained only for GMR75 oil and all phylotypes were affiliated with the family Methanomicrobiaceae. Diversity results suggest that methanogenesis is the dominant terminal process for hydrocarbon degradation in GMR oil field, driven by anaerobic biodegradation. (C) 2012 Elsevier Ltd. All rights reserved.81SI5770PETROBRASCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Characterization of the structure for medication preparation in teaching-hospitals: factors that interfere with the quality of care Características en la estructura para la preparación de medicamentos en hospitales de enseñanza: factores que influyen en la calidad de la asistencia Caracterização da estrutura para o preparo de medicamentos em hospitais de ensino: fatores que interferem na qualidade da assistência

This article describes the physical environment, material and human resources of the structure for the preparation of medicaments. It is an exploratory descriptive study. Data were collected through scripts structured for observation and interview carried out with a sample of 92 (76%) nurse auxiliaries and all nurses of, two hospitals in Recife, PE, Brazil. Results showed that the environment in which medication is prepared is in disagreement with current legislation, the available materials need to be reviewed and professionals need to get their knowledge updated. It is concluded that the structure in the system of medication is essential and the factors pointed out in the study interfere with the quality of the process of medication.<br>Este artículo describe la estructura de preparación de medicamentos en su ambiente físico, recursos materiales y humanos. Se trata de un estudio exploratorio descriptivo. Los datos fueron recolectados por medio de guías estructuradas tanto para la observación y entrevista, las cuales fueron aplicadas en 92% y 76% de los auxiliares de enfermería y en el 100% de los enfermeros de dos hospitales de Recife, PE. Los resultados muestran que el ambiente de preparación de medicamentos no esta de acuerdo con la legislación vigente, considerando que los materiales requieren ser revisados y los profesionales capacitados. Se concluye que la estructura dentro del sistema de medicación es esencial y que los factores señalados influyen en la calidad de tal proceso.<br>Este artigo descreve a estrutura do preparo de medicamentos em seu ambiente físico, recursos materiais e humanos. Trata-se de estudo exploratório e descritivo. Os dados foram coletados por meio de roteiros estruturados para observação e entrevista, aplicados em amostras de 92 e 76% dos auxiliares de enfermagem e 100% dos enfermeiros, em dois hospitais na cidade de Recife, PE. Os resultados mostraram que o ambiente do preparo de medicamentos se encontra em discordância com a legislação vigente, os materiais disponíveis precisam ser revisados e os profissionais necessitam de capacitação. Concluiu-se que a estrutura em um sistema de medicação é essencial e que os fatores apontados interferem na qualidade do processo de medicação

Coccidioidomicose pulmonar em caçador de tatus Pulmonary coccidioidomycosis in a armadillo hunter

A coccidioidomicose, uma doença fúngica adquirida através da inalação do agente Coccidioides immitis sob forma de artroconídio, vem sendo descrita desde 1892. Restringe-se principalmente a áreas de clima árido, solo alcalino e regiões de baixo índice pluviométrico. Não por acaso, a maioria dos casos descritos no Brasil ocorreu na região Nordeste. Relata-se o caso de um homem de 19 anos, imunocompetente, com queixa de dor pleural bilateral, febre, adinamia e tosse seca havia dois meses. A radiografia de tórax evidenciou múltiplos nódulos bilaterais. O paciente participava de caçadas a tatus (Dasypus novemcinctus) e a pesquisa direta para fungos no escarro evidenciou Coccidioides sp. Tratado com anfotericina B, apresentou pneumotórax e insuficiência respiratória, indo a óbito. A biópsia pulmonar post mortem evidenciou Coccidioides immitis sob a forma de endósporos.<br>Coccidioidomycosis is a disease caused by inhalation of arthrospores of the fungus Coccidioides immitis. It has been recognized as a clinical entity since 1892. It is related to activities that involves dust exposure. It is found in many regions of the western hemisphere with dry and alkaline soil. In Brazil it has been described almost exclusively in the Northeast region where drought periods may favor its growth in its soil. We report a case of fatal coccidioidomycosis, in an immunocompetent host, associated to the activity of armadillo hunting (Dasypus novemcynctus) in a rural area of Ceará state