MONITORAMENTO de Vancomicina em Pacientes em Tratamento Hemodialítico Com Infecções de Corrente Sanguínea Por Staphylococcus Spp

A vancomicina (van) é empiricamente prescrita para o tratamento de infecções por estafilococos em pacientes submetidos à hemodiálise (HD). O monitoramento das concentrações séricas mínimas (CSM) de van é utilizado como o mais preciso e prático método para se estimar sua eficácia, sendo recomendada a manutenção das CSM entre 10 e 20 µg/mL. O objetivo deste trabalho foi investigar as CSM de van de pacientes sob HD, em um período de dois anos e correlacioná-los com a concentração inibitória mínima (CIM) deste glicopeptídeo para Staphylococcus spp recuperados de bacteremias nestes mesmos indivíduos. As amostras recuperadas (N=80) foram testadas quanto à CIM (diluição em ágar ou caldo) de van, gentamicina (gen), oxacilina (oxa), tetraciclina (tet), rifampicina (rif), ciprofloxacino (cip), penicilina G (pen) e daptomicina (dap). Foram coletadas 101 amostras de soro de 22 pacientes em regime de administração de 1g a cada 4-5 dias, mais gen (1,5-2,0 mg/Kg) ao final de cada HD. As amostras foram coletadas antes de cada sessão de HD, nos tempos de 0, 48, 72, 96 e 120 horas após a infusão do fármaco. As CSM de van foram obtidas pelo imunoensaio de micropartículas quimioluminescentes (CMIA). Doseamento microbiológico de van foi realizado por meio da técnica pourplate com ágar sais mínimos. S. aureus foi a espécie mais frequentemente isolada (24%), seguida de Staphylococcus spp coagulase negativa (ScoN) (15%). Maiores taxas de resistência ocorreram para oxa (17% e 58%), pen (85% e 84%) e cip (26% e 45%) em S. aures e ScoN, respectivamente. Das amostras de sangue coletadas, 77,8% exibiram concentrações séricas de van <10 µg/mL e considerando apenas as coletadas imediatamente antes da próxima dose de van (CSM), 90,6% também continham concentrações inferiores àquelas recomendadas para efetiva atividade antiestafilocócica. Os valores de concentrações séricas de van obtidas pelo bioensaio apresentaram ótima correlação com o CMIA (padrão ouro) (R2 = 0,96), com valores estatísticamente similares (p<0,05) quando aplicado o fator de correção. A prevalência de Staphylococcus spp resistente à oxa sustenta o uso empírico de van, contudo, a alta taxa de isolados de S. aureus que exibiram CIM de van de 1 µg/mL (59,5%) associada às baixas CSM de van a que são submetidos a maioria dos pacientes indica chance de falha terapêutica e seleção de cepas resistentes. Assim, uma abordagem terapêutica individualizada e monitoramento da droga devem ser considerados. Para tanto foi validado o ensaio microbiológico que, pelo baixo custo e simplicidade da técnica facilita a implementação do monitoramento de van na rotina de laboratórios clínicos de pequeno porte

Lorentz and CPT symmetries in commutative and noncommutative spacetime

We investigate the fermionic sector of a given theory, in which massive and charged Dirac fermions interact with an Abelian gauge field, including a non standard contribution that violates both Lorentz and CPT symmetries. We offer an explicit calculation in which the radiative corrections due to the fermions seem to generate a Chern-Simons-like effective action. Our results are obtained under the general guidance of dimensional regularization, and they show that there is no room for Lorentz and CPT violation in both commutative and noncommutative spacetime.Comment: RevTex4, 7 pages, to be published in J. Phys.

Spinal cord vascular degeneration impairs duloxetine penetration

IntroductionChronic pain is a prevalent physically debilitating health-related morbidity. Frontline analgesics are inadequate, providing only partial pain relief in only a proportion of the patient cohort. Here, we explore whether alterations in spinal cord vascular perfusion are a factor in reducing the analgesic capability of the noradrenaline reuptake inhibitor, duloxetine.MethodAn established rodent model of spinal cord vascular degeneration was used. Endothelial-specific vascular endothelial growth factor receptor 2 knockout mouse was induced via hydroxytamoxifen administered via intrathecal injection. Duloxetine was administered via intraperitoneal injection, and nociceptive behavioural testing was performed in both WT and VEGFR2KO mice. LC-MS/MS was performed to explore the accumulation of duloxetine in the spinal cord in WT and VEGFR2KO mice.ResultsSpinal cord vascular degeneration leads to heat hypersensitivity and a decline in capillary perfusion. The integrity of noradrenergic projections (dopa - hydroxylase labelled) in the dorsal horn remained unaltered in WT and VEGFR2KO mice. There was an association between dorsal horn blood flow with the abundance of accumulated duloxetine in the spinal cord and analgesic capacity. In VEGFR2KO mice, the abundance of duloxetine in the lumbar spinal cord was reduced and was correlated with reduced anti-nociceptive capability of duloxetine.DiscussionHere, we show that an impaired vascular network in the spinal cord impairs the anti-nociceptive action of duloxetine. This highlights that the spinal cord vascular network is crucial to maintaining the efficacy of analgesics to provide pain relief

Comparison of acoustic voice features derived from mobile devices and studio microphone recordings

Objectives/Hypothesis Improvements in mobile device technology offer new opportunities for remote monitoring of voice for home and clinical assessment. However, there is a need to establish equivalence between features derived from signals recorded from mobile devices and gold standard microphone-preamplifiers. In this study acoustic voice features from android smartphone, tablet, and microphone-preamplifier recordings were compared. Methods Data were recorded from 37 volunteers (20 female) with no history of speech disorder and six volunteers with Huntington's disease (HD) during sustained vowel (SV) phonation, reading passage (RP), and five syllable repetition (SR) tasks. The following features were estimated: fundamental frequency median and standard deviation (F0 and SD F0), harmonics-to-noise ratio (HNR), local jitter, relative average perturbation of jitter (RAP), five-point period perturbation quotient (PPQ5), difference of differences of amplitude and periods (DDA and DDP), shimmer, and amplitude perturbation quotients (APQ3, APQ5, and APQ11). Results Bland-Altman analysis revealed good agreement between microphone and mobile devices for fundamental frequency, jitter, RAP, PPQ5, and DDP during all tasks and a bias for HNR, shimmer and its variants (APQ3, APQ5, APQ11, and DDA). Significant differences were observed between devices for HNR, shimmer, and its variants for all tasks. High correlation was observed between devices for all features, except SD F0 for RP. Similar results were observed in the HD group for SV and SR task. Biological sex had a significant effect on F0 and HNR during all tests, and for jitter, RAP, PPQ5, DDP, and shimmer for RP and SR. No significant effect of age was observed. Conclusions Mobile devices provided good agreement with state of the art, high-quality microphones during structured speech tasks for features derived from frequency components of the audio recordings. Caution should be taken when estimating HNR, shimmer and its variants from recordings made with mobile devices

Uso de marcadores moleculares para seleção e introdução de novos acessos de moringa.

A Moringa oleifera Lam., pertence à família Moringaceae e foi introduzida no Brasil como planta ornamental por volta de 1950. Atualmente é amplamente cultivada por sua característica de espécie multiuso. O objetivo do presente trabalho foi avaliar a diversidade genética de moringa, oriundas de sementes, para introdução de acessos no Banco Ativo de Germoplasma, implantado pela Embrapa Tabuleiros Costeiros. Foram testados sete primers ISSR, que resultaram em 32 fragmentos polimórficos (100%). A distância genética entre os indivíduos será utilizada para seleção dos que serão inseridos no BAG moringa

Coinfections between persistent parasitic neglected tropical diseases and viral infections among prisoners from Sub-Saharan Africa and Latin America

© 2018 Lilian Da Silva Santos et al. In Swiss prisons, more than 70% of detained people are foreigners and over one-third originate from sub-Saharan Africa or Latin America. These two regions are endemic for various tropical diseases and viral infections, which persist after migration to nonendemic countries. Parasitic infections (schistosomiasis; strongyloidiasis) and cooccurrent viral infections (HIV, hepatitis B (HBV), and hepatitis C (HCV)) are especially of concern for clinical care but have been neglected in empirical research. These diseases often remain silent for years before causing complications, especially if they occur concomitantly. Our research aimed to study the prevalence rates and coinfections of two neglected tropical diseases, namely, Strongyloides stercoralis and Schistosoma sp. and viral infections among sub-Saharan Africans (SSA) and Latin Americans (LA) in Switzerland's largest pretrial prison. We carried out a cross-sectional prevalence study using a standardized questionnaire and serological testing. Among the 201 participants, 85.6% were SSA and 14.4% LA. We found the following prevalence ratios: 3.5% of HIV (4.1% in SSA, 0% in LA), 12.4% of chronic HBV (14.5% in SSA, 0% in LA), 2.0% of viraemic HCV (1.7% in SSA, 3.4% in LA), and 8.0% of strongyloidiasis (8.1% in SSA, 6.9% in LA). The serological prevalence of schistosomiasis among SSA was 20.3% (not endemic in Latin America). Two infections were simultaneously detected in SSA: 4.7% were coinfected with schistosomiasis and chronic HBV. Four other coinfections were detected among SSA: schistosomiasis-HIV, HIV-chronic HBV, HIV-HCV, and schistosomiasis-strongyloidiasis. To conclude, the high prevalence rates of persistent viral and parasitic infections and their potential coinfections among SSA and LA detained migrants highlight the need to implement control strategies and programs that reach people in detention centers in nonendemic countries

Caracterização molecular de acessos de jenipapeiro.

O Banco Ativo de Germoplasma de Jenipapo pertencente a Embrapa Tabuleiros Costeiros foi implantado em 2009, no Campo Experimento Jorge Sobral em Nossa Senhora das Dores, visando a conservação do material genético. O objetivo desse trabalho foi realizar a caracterização molecular e avaliar a diversidade genética de 160 indivíduos de 18 acessos de jenipapo por meio de marcadores moleculares ISSR. Os resultados mostraram através da análise de agrupamento ACoP a formação de quatro grupos. Há um grande número de indivíduos agrupados no grupo I da ACoP, indicando pouca divergência entre eles. Os grupos I, II e III, se agruparam em posições diferentes no dendrograma, porém na ACoP estão relacionados. O grupo IV é o mais diferente dos demais grupos. A análise comparativa dos agrupamentos revelou que os marcadores ISSR foram eficientes para a caracterização molecular e existe variabilidade genética entre os acessos