Colonização por ESKAPES e características clínicas de pacientes críticos

Objective: To identify colonization by ESKAPES and clinical characteristics of patients admitted in Adult Intensive Care Unit of a mixed hospital in Paraná.Method: Field research, descriptive, documentary and experimental quantitative approach, developed in adult Intensive Care Unit of a mixed hospital in Southwest Paraná, Brazil. The study population consisted of patients with admission from 48 hours in the Intensive Care Unit, from April to August 2018 and April to August 2019. The sample has 102 individuals. For the collection of clinical data, a checklist was used and for microbiological analysis the sample was collected from nasal and oral cavities and tracheal secretion. The analysis of clinical data occurred through the Statistical Package for the Social Sciences software. Descriptive frequency and chi-square test, considering significant p <0,05.Results: A total of 102 patients admitted to the Intensive Care Unit during the period studied were evaluated. On these ones, 57 (55,8%) were colonized by pathogenic microorganisms. Regarding the colonization of microorganisms, there was predominance of Staphylococcus aureus (61,4%), followed by Klebsiella pneumoniae (40,4%), Pseudomonas aeruginosa (26,3%) and Staphylococcus epidermidis (21,1%). It is noteworthy that Klebsiella pneumoniae and Staphylococcus aureus were present in the three regions evaluated.Conclusion: The study identified the presence of colonization in critically ill patients studied, being this colonization, mostly, resistant bacteria belonging to the ESKAPE groupObjetivo: Identificar la colonización por ESKAPES y las características clínicas de los pacientes hospitalizados en una Unidad de Cuidados Intensivos para Adultos de un hospital mixto en Paraná.Método: Investigación de campo, descriptiva, documental y experimental con enfoque cuantitativo, desarollada en una Unidad de Cuidados Intensivos adultos de un hospital mixto en el suroeste de Paraná, Brasil. La población del estudio consistió en pacientes con ingreso de 48 horas en la Unidad de Cuidados Intensivos, de abril a agosto de 2018 y de abril a agosto de 2019. La muestra totalizó 102 individuos. Para la recopilación de datos clínicos, se utilizó un Checklist y para el análisis microbiológico se recogieron muestras de las cavidades nasales y orales y la secreción traqueal. El análisis de los datos clínicos se produjo a través del software Statistical Package for the Social Sciences. Se realizaron pruebas de frecuencia y chi-cuadrado, teniendo en cuenta la p<0,05 significativa.Resultados: Se evaluaron un total de 102 pacientes ingresados en la Unidad de Cuidados Intensivos durante el período estudiado. De ellos, 57 (55,8%) fueron colonizados por microorganismos patógenos. En cuanto a la colonización por microorganismos, predominan Staphylococcus aureus (61,4%), seguido de Klebsiella pneumoniae (40,4%), Pseudomonas aeruginosa (26,3%) y Staphylococcus epidermidis (21,1%). Cabe destacar que Klebsiella pneumoniae y Staphylococcus aureus estuvieron presentes en las tres regiones evaluadas.Conclusión: El estudio identificó la presencia de colonización en pacientes en estado crítico estudiados, siendo esta colonización, en su mayoría, por bacterias resistentes pertenecientes al grupo ESKAPE.Objetivo: Identificar a colonização por ESKAPES e características clínicas de pacientes internados em uma Unidade de Terapia Intensiva Adulto de um hospital misto do Paraná.Método: Pesquisa de campo, descritiva, documental e experimental com abordagem quantitativa, desenvolvida em uma Unidade de Terapia Intensiva adulto de um hospital misto do Sudoeste do Paraná, Brasil. A população do estudo constituiu-se pelos pacientes com admissão a partir de 48 horas na Unidade de Terapia Intensiva, no período de abril a agosto de 2018 e de abril a agosto de 2019. A amostra totalizou 102 indivíduos. Para a coleta de dados clínicos foi utilizado um Checklist e para a análise microbiológica foram coletadas amostras das cavidades nasal e oral e secreção traqueal. A análise dos dados ocorreu por meio do software Statistical Package for the Social Sciences. Realizou-se frequência descritiva e teste de qui-quadrado, considerando significativo p <0,05.Resultados: Foram avaliados 102 pacientes admitidos na Unidade de Terapia Intensiva durante o período pesquisado. Destes, 57 (55,8%) estavam colonizados por microrganismos patogênicos. Em relação à colonização de microrganismos, houve predominância de Staphylococcus aureus (61,4%), seguido por Klebsiella pneumoniae (40,4%), Pseudomonas aeruginosa (26,3%) e Staphylococcus epidermidis (21,1%). Vale ressaltar que, Klebsiella pneumoniae e Staphylococcus aureus estiveram presentes nas três regiões avaliadas.Conclusão: O estudo identificou a presença de colonização nos pacientes criticamente enfermos pesquisados, sendo essa colonização, em sua maioria, por bactérias resistentes pertencentes ao grupo ESKAPE

MECANISMOS DE CARCINOGÊNESE INDUZIDOS POR AGROTÓXICOS: REVISÃO SISTEMÁTICA: AGROCHEMICAL-INDUCED CARCINOGENESIS MECHANISMS: SYSTEMATIC REVIEW

A exposição crônica a pesticidas e desreguladores endócrinos causam alterações na expressão gênica em tecido mamário, o que torna mulheres submetidas a essa condição mais propicias a desenvolverem o câncer de mama. Este estudo teve como objetivo investigar e revisar sistematicamente a correlação entre exposição aos agrotóxicos e a carcinogênese mamária, apontando mecanismos observados in vivo e in situ. Foi utilizado o protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA), a busca foi realizada no PubMed, resultando em 58 artigos, incluídos no presente estudo. Diante do exposto pode-se observar genotoxicidade celular mediado pela exposição a pesticidas de diferentes classes químicas e desreguladores endócrinos, o que em tese desencadeiam o estresse genotóxico em tecido mamário normal promovendo a carcinogênese, e naquelas já diagnosticadas com câncer de mama levam a maior probabilidade de desenvolverem metástases. A presente revisão destaca a necessidade de estudos que explorem e identifiquem os mecanismos envolvidos em tal condição, sendo que evidências inequívocas relacionam a carcinogênese mamária com exposição a compostos químicos e desreguladores endócrinos

Brief research report pesticide occupational exposure leads to significant inflammatory changes in normal mammary breast tissue

Studies have documented the high occurrence of several tumors, including female breast cancer, in populations occupationally exposed to pesticides worldwide. It is believed that in addition to direct DNA damage, other molecular alterations that indicate genomic instability are associated, such as epigenetic modifications and the production of inflammation mediators. The present study characterized the profile of inflammatory changes in the breast tissue of women without cancer occupationally exposed to pesticides. In samples of normal breast tissue collected during biopsy and evaluated as negative for cancer by a pathologist, oxidative stress levels were assessed as inflammatory markers through measurements of lipoperoxides and total antioxidant capacity of the sample (TRAP) by high-sensitivity chemiluminescence, as well as levels of nitric oxide (NOx) metabolites. The levels of inflammation-modulating transcription factors PPAR-γ (peroxisome proliferator-activated receptor gamma) and NF-κB (nuclear factor kappa B) were also quantified, in addition to the pro-inflammatory cytokines tumor necrosis factor-alpha (TNF-α) and interleukin 12 (IL-12). The levels of lipoperoxides, TRAP, and NOx were significantly lower in the exposed group. On the other hand, PPAR-γ levels were increased in the breast tissue of exposed women, with no variation in NF-κB. There was also a rise of TNF-α in exposed women samples without significant variations in IL-12 levels. These findings suggest an inflammatory signature of the breast tissue associated with pesticide exposure, which may trigger mechanisms related to mutations and breast carcinogenesis

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Search for heavy resonances decaying to two Higgs bosons in final states containing four b quarks

A search is presented for narrow heavy resonances X decaying into pairs of Higgs bosons (H) in proton-proton collisions collected by the CMS experiment at the LHC at root s = 8 TeV. The data correspond to an integrated luminosity of 19.7 fb(-1). The search considers HH resonances with masses between 1 and 3 TeV, having final states of two b quark pairs. Each Higgs boson is produced with large momentum, and the hadronization products of the pair of b quarks can usually be reconstructed as single large jets. The background from multijet and t (t) over bar events is significantly reduced by applying requirements related to the flavor of the jet, its mass, and its substructure. The signal would be identified as a peak on top of the dijet invariant mass spectrum of the remaining background events. No evidence is observed for such a signal. Upper limits obtained at 95 confidence level for the product of the production cross section and branching fraction sigma(gg -> X) B(X -> HH -> b (b) over barb (b) over bar) range from 10 to 1.5 fb for the mass of X from 1.15 to 2.0 TeV, significantly extending previous searches. For a warped extra dimension theory with amass scale Lambda(R) = 1 TeV, the data exclude radion scalar masses between 1.15 and 1.55 TeV

Search for anomalous couplings in boosted WW/WZ -> l nu q(q)over-bar production in proton-proton collisions at root s=8TeV

Peer reviewe

Search for supersymmetry in events with one lepton and multiple jets in proton-proton collisions at root s=13 TeV

Peer reviewe

Measurement of the top quark mass using charged particles in pp collisions at root s=8 TeV

Peer reviewe

Inclusive search for supersymmetry using razor variables in pp collisions at root s=13 TeV

Peer reviewe

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030