Proposta de antibioticoterapia empírica para tratamento de SEPSE primária em CTI / Empirical antibiotic therapy proposal for the treatment of primary SEPSIS in the ICU

Os antimicrobianos se apresentam como uma das principais drogas utilizadas nos centros de terapia intensiva (CTIs). Contudo, sua indicação ainda é preocupantemente caracterizada por tratamentos inadequados, apresentando um consequente aumento de bactérias multirresistentes. Nesse contexto, tem-se a antibioticoterapia empírica como importante ferramenta para redução de taxas de mortalidade em quadros de sepse primária. Assim, este estudo objetiva avaliar o perfil de sensibilidade antimicrobiana dos agentes etiológicos de sepse primária em CTI de adultos, embasando terapia empírica para tratamento dessa complicação e, por conseguinte, contribuindo para a elaboração de estratégias de uso racional dos antimicrobiano

Human T-lymphotropic virus 1/2 infection among immigrants and refugees in Central Brazil, an emerging vulnerable population

IntroductionMigratory flows play a significant role in the spread of human T-lymphotropic virus 1/2 (HTLV-1/2). In the last decade, a substantial migration of individuals occurred from Haiti and Venezuela to Brazil. However, data on the prevalence of HTLV-1/2 infection among these international migrants in Brazil are scarce. This study describes the prevalence of this infection among immigrants and refugees in Central Brazil.MethodsA cross-sectional study was conducted with 537 international migrants in the State of Goiás, Central Brazil. Participants were interviewed, and blood samples were collected. Serological screening for anti-HTLV-1/2 was performed using an enzyme-linked immunosorbent assay (ELISA; Murex HTLV-I + II, DiaSorin, Dartford, UK), and seropositive samples were submitted for confirmation by a line immunoassay (INNO-LIA HTLV I/II, Fujirebio, Europe N.V., Belgium).ResultsThe majority of participants were males (54.4%), between 18 and 50 years old (78%; mean age: 29.1 years), self-declared black (55.1%), reported 1 to 12 years of formal education (70.9%), and were either Venezuelans (47.9%) or Haitians (39.7%). Additionally, 50.1% were immigrants, 49% were refugees, and five were Brazilian children (0.9%) born to Haitian immigrant parents. The overall prevalence of anti-HTLV-1/2 was 0.95% (95% CI: 0.31–2.28), with HTLV-1 at 0.19% and HTLV-2 at 0.76%. All seropositive individuals (n = 5) were refugees from Venezuela, resulting in a rate of 2.26% for anti-HTLV-1/2, HTLV-1 (0.45%) and HTLV-2 (1.81%) among Venezuelan refugees. Of the demographic and behavioral characteristics evaluated, unprotected sexual intercourse and having more than one sexual partner (≥2) in the previous 12 months were associated with HTLV-1/2 seropositivity among Venezuelans.ConclusionThis study revealed, despite the low seroprevalence of HTLV-1/2 among international migrants in Central Brazil, evidence of HTLV-1 and HTLV-2 infections in Venezuelan refugees. In addition, their characteristics highlight that specific social and health programs should be implemented for these emergent and socially vulnerable migrant groups

Aspectos anatomopatológicos das neoplasias malignas renais: Anatomopathological aspects of malignant renal neoplasms

As neoplasias renais correspondem ao crescimento exacerbado de células tumorais no interior dos rins, classificadas como benignas ou malignas. Neste estudo será abordado sobre as neoplasias malignas renais, a qual correspondem a maior prevalência e são representadas pelo carcinoma de células renais e o tumor de Wilms, com a finalidade de descrever a respeito dos aspectos anatomopatológicos, disseminando informações para o diagnóstico e manejo precoce. O carcinoma de células renais é mais prevalente no sexo masculino, indivíduos mais velhos, geralmente assintomático, contribuindo para o diagnóstico tardio junto a existência de metástases e terapêutica irresponsiva. Não se trata de uma doença genética, sendo o caráter esporádico o predominante, neste contexto os fatores de risco, sobretudo o tabagismo em seguida de obesidade hemodiálise e doenças genéticas são potenciais desencadeantes da enfermidade. Os exames complementares associado a clínica, junto ao acompanhamento eleva a possibilidade de identificação antes de avanços metastáticos. O tumor de Wilms é típico de crianças, acometendo um ou ambos os rins, normalmente com alguma anomalia genética, sendo os sinais inespecíficos, mas sempre manifestando massa palpável e dor abdominal, a qual os métodos de imagem confirmam o diagnóstico e estimam o prognóstico deste. Neste contexto, elucida-se a transcendência que os aspectos anatomopatológicos das neoplasias malignas renais oferecem para a diagnose precoce, devido a escassez e inespecificidafe das manifestações clínicas. Logo, a junção do perfil de cada neoplasia abordado conduz ao manejo adequado e reduz a incidência de tratamentos agressivos e irresponsivos

epidemiology of hepatitis C virus infection among recyclable waste collectors in Goiânia, Goiás

Submitted by Erika Demachki ([email protected]) on 2014-10-20T18:58:59Z No. of bitstreams: 2 Dissertação - Thais Augusto Marinho - 2012.pdf: 1266028 bytes, checksum: cd93decbadceaf3e44ca429c0702442e (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Approved for entry into archive by Jaqueline Silva ([email protected]) on 2014-10-20T20:08:18Z (GMT) No. of bitstreams: 2 Dissertação - Thais Augusto Marinho - 2012.pdf: 1266028 bytes, checksum: cd93decbadceaf3e44ca429c0702442e (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Made available in DSpace on 2014-10-20T20:08:18Z (GMT). No. of bitstreams: 2 Dissertação - Thais Augusto Marinho - 2012.pdf: 1266028 bytes, checksum: cd93decbadceaf3e44ca429c0702442e (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2012-02-29Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPqHepatitis C represents an important public health problem. Although acute hepatitis C virus (HCV) infection is often asymptomatic, 50 to 85% of these cases progress to chronic disease, and can lead to liver cirrhosis and hepatocellular carcinoma. Accidents involving contaminated sharps occur in recyclable waste collectors as a result of contact with glass, ferrous sharp, needles and syringes, demonstrating, thus, the increased risk of these professionals in acquiring infections by the parenteral route, such as hepatitis C. There is currently very little data on HCV infection among recyclable waste collectors. This study aimed to investigate the epidemiological and molecular profile of the hepatitis C virus infection among recyclable waste collectors in Goiânia, Goiás. A total of 431individuals were interviewed for socio-demographic characteristics and risk factors for HCV infection. Blood samples were collected and sera were tested for the presence of antibodies to HCV (anti-HCV) using an enzyme-linked immunosorbent assay (ELISA) and immunoblot. All samples were submitted to HCV RNA detection by polymerase chain reaction (PCR) with primers complementary to the conserved area of the 5’ non-coding (NC) region of HCV. Positive HCV RNA samples were genotyped by direct sequencing analysis of the NS5B region of viral genome, followed by phylogenetic analysis. The HCV infection prevalence was 1.6% (95% CI: 0.6-3.6) in recyclable waste collectors in Goiânia-GO. In a multivariate analysis, history of sexually transmitted disease was independently associated with this infection, while the variables history of blood transfusion and number of sexual partners showed an association with a borderline P value (p = 0.05 and p = 0.07, respectively). Viral RNA was detected in five of the seven anti-HCV positive samples, and the genotype 1, subtypes 1a (n = 1), 1b (n = 2) and 1a/1b (n = 2) were identified in the study population. Although the HCV infection prevalence found among recyclable waste collectors in Goiânia-GO is similar to that observed in local blood donors (1.4%), this population is in risk to HCV by sexual and parenteral transmission.A hepatite C representa um importante problema de saúde pública. Apesar da infecção aguda pelo vírus da hepatite C (HCV) ser geralmente assintomática, 50 a 85% dos casos evoluem para cronicidade, podendo desenvolver cirrose hepática e carcinoma hepatocelular. Acidentes com objetos perfurocortantes contaminados podem ocorrer em catadores de materiais recicláveis como consequência do contato com vidros, materiais ferrosos pontiagudos, agulhas e seringas, evidenciando-se, assim, o risco aumentado desses profissionais em adquirir infecções por via parenteral, como a hepatite C. São escassos os trabalhos sobre a infecção pelo HCV em catadores de materiais recicláveis. O presente estudo teve como objetivo investigar o perfil soroepidemiológico e molecular da infecção pelo vírus da hepatite C em catadores de materiais recicláveis em Goiânia, Goiás. Um total de 431 indivíduos foi entrevistado sobre características sociodemográficas e fatores de risco para infecção pelo HCV. Amostras de sangue foram coletadas e os soros testados para detecção de anticorpos para o HCV (anti- HCV), por ensaio imunoenzimático (ELISA) e immunoblot. Todas as amostras foram submetidas à detecção do RNA viral por reação em cadeia da polimerase (PCR) com iniciadores complementares as região 5’ não codificante (NC) do HCV. As amostras RNA-HCV positivas foram genotipadas por sequenciamento direto da região NS5B do genoma viral, seguido de análise filogenética. A prevalência da infecção pelo HCV em catadores de materiais recicláveis em Goiânia-GO foi de 1,6% (IC 95%: 0,6–3,6). Pela análise multivariada, história de doença sexualmente transmissível foi independentemente associada a esta infecção, enquanto as variáveis história de transfusão e número de parceiros sexuais apresentaram associação marginal (p = 0,05 e p = 0,07, respectivamente). O RNA viral foi detectado em cinco das sete amostras anti- HCV positivas, sendo identificado o genótipo 1, subtipos 1a (n=1), 1b (n=2) e 1a/1b (n=2) na população estudada. Apesar da prevalência da infecção pelo HCV em catadores de materiais recicláveis em Goiânia-GO ser semelhante a observada previamente em doadores de sangue (1,4%), a referida população mostrou-se em risco transmissão sexual e parenteral do HCV

Phenotypic and Molecular Characterization of Nonfermenting Gram-Negative Bacilli Causing Peritonitis in Peritoneal Dialysis Patients

(1) Background: Peritonitis due to nonfermenting Gram-negative bacilli (NF-GNB) is a dramatic complication of peritoneal dialysis (PD) with bad outcomes. Previous studies of PD-related peritonitis due to Pseudomonas species have shown a low-resolution rate, without a high resistance rate to antipseudomonal antibiotics. This suggests that bacterial virulence factors can act and influence peritonitis evolution. This study aimed to describe the microbiological characteristics of NF-GNB causing PD-related peritonitis and analyze their influence on the outcome. (2) Methods: We analyze the 48 isolates from NF-GNB peritonitis, which were stored in our culture collection regarding bacterial resistance, biofilm, and other virulence factors’ production, and clonal profile. Additionally, we collected data on treatment and outcomes from patients’ clinical registers. (3) Results: The etiologies were species of Pseudomonas (50%), Acinetobacter (36%), and other NF-GNB (14%). There was a high (75%) proportion of biofilm producer lineages. The in vitro susceptibility rate of Pseudomonas spp. to amikacin, ciprofloxacin, and ceftazidime was significantly greater than that of Acinetobacter spp. and other species; however, there was a similar low-resolution rate (<45%) among the episodes attributable to them. Pseudomonas species have a polyclonal profile, while we found a clone of five multiresistant Acinetobacter baumannii over an 8-year interval (2000–2008), which suggest an origin from the healthcare environment. (4) Conclusions: We are not able to identify any predictor of outcome, but it is possible that biofilm and others virulence factors can act in concert and contribute to the bad outcome

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Núcleos de Ensino da Unesp: artigos 2007

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq