Integrating bacterial identification and susceptibility testing : a simple and rapid approach to reduce the turnaround time in the management of blood cultures

We evaluated a rapid bacterial identification (rID) and a rapid antimicrobial susceptibility testing by disk diffusion (rAST) from positive blood culture to overcome the limitations of the conventional methods and reduce the turnaround time in bloodstream infection diagnostics.-e study included hemocultures flagged as positive by bacT/ALERT®, identification by MALDI-TOF MS, and rAST.-eresults were compared to identification and antimicrobial susceptibility testing (AST) results by current standard methods, after 24 h incubation. For rAST categorical agreement (CA), very major errors (VME), major errors (ME), and minor errors (mE) were calculated. A total of 524 bacterial samples isolated from blood cultures were obtained, including 246 Gram-negative (GN) and 278 Gram-positive (GP) aerobes. -e overall concordance of rID was 88.6%, and it was highest among GN (96%). A total of 2196 and 1476 antimicrobial agent comparisons were obtained for GN and GP, respectively. Evaluation of rAST, CA, VME, ME, and mE disclosed 97.7, 0.7, 0.5, and 1.1% for GN and 98.0, 0.5, 0.7, and 0.8% for GP, respectively. Meropenem CA, VME, and ME were 98.3, 0.5, and 0.5%, respectively; mE was not observed. Oxacillin CA, ME, and mE were 97.4, 1.6, and 0.6%, respectively; VME was not observed. Overall, kappa scores of the results of the comparisons demonstrated the high agreement between rAST and the standard method. Identification and ASTof aerobic bacteria from positive blood cultures after a short period of incubation on solid blood agar is a fast and reliable method that may improve the management of bloodstream infections

Ciguatera fish poisoning in Brazilian traveler to Caribbean

Ciguatera poisoning is the most common form of non-bacterial food-poisoning from fish worldwide. The incidence among Brazilians returning from high-risk regions is unclear because it is not a mandatory reportable disease. We describe a previously healthy 53- year-old Brazilian woman developed Ciguatera fish poisoning while traveling to Havana, Cuba. Physicians and health care professionals should advise travelers to avoid eating ciguatoxic fish species and potentially toxic fish species in the Caribbean islands. Despite the prognosis for most cases is good with a short duration of self-limited symptoms, early recognition of the identifying clinical features of ciguatera can result in improved patient care

Screening tools for postpartum depression: validity and cultural dimensions

Objective: The purpose of this study is to review the main postpartum screening tools currently used in terms of their ability to screen for postnatal depression. Furthermore, the cultural characteristics of depressive postpartum symptomatology are examined.Method: A systematic literature search was conducted for the period 1987-2009, using the Medline electronic database for the following keywords: postpartum depression and postnatal depression. These terms were combined with: assessment, screening and psychometric tools. Results: Of the four screening tools reviewed and compared, the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Depression Screening Scale (PDSS) presented substantial sensitivity and specificity as screening tools. However, none of the instruments could be rated flawless when applied to different cultural contexts. Conclusions: In addition to the EPDS, a new generation of instruments is currently available. Supplementary research is needed to substantiate their use as screening tools in general practice. Additional studies are needed to adapt and test instruments to detect postnatal depression within a wider range of languages and cultures.Key words: Acculturation; Postnatal depression; Postpartum depression; Scales; Screenin

Maternal pre-pregnancy overweight/obesity and gestational diabetes interaction on delayed breastfeeding initiation

Background: Cumulative evidence indicates an association between maternal overweight and gestational diabetes with delayed breastfeeding initiation; however, the presence of both conditions simultaneously has been little explored. This study aims to investigate the interaction between maternal overweight/obesity and gestational diabetes on breastfeeding initiation. Methods: This study comprises data from the IVAPSA Birth Cohort, a prospective follow-up of mothers and their newborns. Two of the five groups from IVAPSA were evaluated, considering women with and without gestational diabetes. These women were further categorized according to their pre-pregnancy body mass index as normal weight or overweight/obese. Results: 219 women were evaluated, 53.4% of them had pre-pregnancy overweight/obesity and 32% had gestational diabetes. Most women were able to initiate breastfeeding within 12 hours from delivery (92.7%) and only eight (3.7%) women had not breastfed in the first 24 hours postpartum. Of these, seven were overweight/obese (77.8%) and five had gestational diabetes (66.7%), with four of them having overweight/obesity and gestational diabetes concomitantly. Women with both adverse conditions had an adjusted relative risk of delayed breastfeeding initiation of 1.072 (95% CI 1.006; 1.141), p = 0.032. Conclusions: The results indicate an additive interaction between maternal pre-pregnancy overweight/ obesity and gestational diabetes on delayed breastfeeding initiation

Memórias e patrimônios documentais afro-brasileiros: implicações para a Educação

Este artigo discute, inicialmente, os conceitos de memória e de documento a partir da interpretação de alguns teóricos das ciências humanas e sociais. Analisa também as implicações da ausência das chamadas memórias negras na constituição de identidades de afrodescendentes e na educação de negros e negras. Finalmente, a partir de pesquisas realizadas sobre a imprensa negra, enfatiza a importância da preservação de documentos relativos às memórias negras para os processos de construção de identidades e para as pesquisas sobre a história da educação de afro-brasileiros no Brasil

The recognition of human immunodeficiency virus (HIV) discovery

Resumo não disponíve

Descoberta do HIV: o reconhecimento

O Prêmio Nobel de Medicina de 2008 foi eleito e os vencedores são da Europa. Os franceses Françoise Barre-Sinoussi e Luc Montagnier foram premiados pela descoberta do vírus causador da AIDS, o HIV, e o alemão Harald zur Hausen, pela descoberta de que o papilomavírus humano (HPV) causa câncer do colo de útero

Harmônica no Brasil : análise e registros sobre o instrumento

Este Trabalho é uma abordagem acerca da Harmônica Cromática no Brasil, sua origem e história da primeira fábrica no Brasil. Também apresenta uma linha do tempo dos harmonicistas pioneiros no Brasil e registros sobre uma das primeiras harmônicas cromáticas. Contempla a biografia de Emílio Damasceno e sua relevância no universo da harmônica, contendo um material inédito não foi publicado em vida por ele, incluindo entrevistas sobre Damasceno, para fins de acrescentar informações de sua vida e obra. Há também entrevistas com instrumentistas que são referência da harmônica no Brasil, além da minha atuação na harmônica, composições próprias e transcrições de improvisações.This work is an approach about the Chromatic Harmonica in Brazil, its origin and the history of the first factory in Brazil. It also presents a timeline of pioneer harmonicists in Brazil and information about one of the first chromatic harmonicas. It includes the biography of Emílio Damasceno, his relevance in the harmonica universe, containing unpublished material that was not published during his lifetime, include interviews about Damasceno, in order to add information about his life and work. There are also interviews with harmonica players who are referencial of harmonica in Brazil, my performance in the harmonica, my own compositions and transcriptions of improvisations

The application of the drug user quality of life scale (DUQOL) in Australia

<p>Abstract</p> <p>Background</p> <p>The concept of quality of life relates to the perceptions of individuals about their mental and physical health as well as non-health related areas. The evaluation of quality of life in the context of substance abuse has been conducted using generic instruments. The Drug Users Quality of Life Scale (DUQOL) is a specific assessment tool in which the most pertinent and salient areas to drug abusers are taken into consideration. In this study, the authors report the results of a validation study in which the DUQOL was used for the first time in Australia.</p> <p>Methods</p> <p>A sample of 120 participants from inpatient and outpatient treatment facilities completed a series of questionnaires, including the DUQOL and the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF). Parameters investigated in this study included the demographic characteristics of the sample, internal structure, and convergent validity. Correlations between the DUQOL scale scores and the scores of the WHOQOL-Bref test were investigated via Pearson product-moment correlation analyses.</p> <p>Results</p> <p>The English version of the DUQOL attained a significant overall Cronbach's alpha of 0.868. The factorial analysis of the DUQOL identified one principal factor that accounted for 28.499% of the variance. Convergent validity analyses demonstrate significant correlations (<it>p </it>< 0.01) between the DUQOL scores and the scores of all four dimensions of the WHOQOL-BREF questionnaire.</p> <p>Conclusions</p> <p>This study demonstrates that the DUQOL constitutes a reliable research instrument for evaluating quality of life of substance users in Australia.</p

A teoria da cegueira deliberada e a sua (in)aplicabilidade ao direito penal pátrio

O presente trabalho tem por objetivo a verificação da aplicabilidade da teoria da cegueira deliberada no sistema jurídico penal brasileiro. Isto porque o instituto tem sido utilizado no ordenamento brasileiro apesar de ter origem em um sistema jurídico completamente diverso do vigente no país, baseado na common law, sem maiores estudos e indagações. Em relação ao desenvolvimento da pesquisa, tem-se como propósito inicial a análise da origem da teoria e sua evolução. O primeiro capítulo, desta maneira, se propõe a exibir a utilização da willful blindness na Inglaterra e nos Estados Unidos, e sua posterior adaptação para os ordenamentos espanhol e brasileiro. Posteriormente, no segundo capítulo, busca-se desbravar os conceitos estipulados no direito penal e processual penal estabelecidos no Brasil, com o fim de delimitar as molduras do sistema. No último capítulo, o escopo é demonstrar como vem sendo aplicada a ignorância deliberada no âmbito do Supremo Tribunal Federal e do Tribunal Regional Federal da 4ª Região. Ao final, a intenção foi elencar os problemas de aplicação de tal instituto em um país como o Brasil, em que se fazem presentes uma série de regras e delimitações e que, de pronto, não podem ser desrespeitadas.The following article has the aim to verify the applicability of the willful blindness doctrine in Brazilian criminal law. The subject was defined considering that the institute was born in a completely different legal system, based on the common law, with almost none investigation and inquiry. In terms of development, the intention is to analyze the theory and its evolution. Therefore, the first chapter of this essay has the purpose to show the willful blindness application in England and in the United States of America, and, later, its customization to the Spanish and Brazilian systems. Afterwards, the second chapter analyzes the concepts of the Brazilian criminal law and procedural criminal law, to demarcate the frame of our legal order. The last chapter exhibits the application of the willful blindness in the Brazilian Supreme Federal Court and Regional Federal Court of 4th Region. At the end, this work aims to show the problems regarding to the application of the doctrine in a country like Brazil, in which there is a long list of rules and boundaries, which should not be disregarded.El presente trabajo tiene como propósito la verificación de la aplicabilidad de la teoría de la ignorancia deliberada en el sistema penal brasileño. Esto porque el instituto fue importado de un sistema jurídico completamente distinto del que se utiliza en Brasil, basado en la common law, sin mayores estudios y investigaciones. Con relación al desarrollo de la pesquisa, se tiene como propósito inicial el análisis del origen del instituto y su evolución. El primer capítulo, así, se propone a exhibir la utilización de la willful blindness en Inglaterra y en Estados Unidos, y su posterior adaptación para los ordenamientos español y brasileño. Después, en el según capítulo, se busca examinar los conceptos estipulados en el derecho penal y procesal penal brasileños, con el fin de delimitar los marcos del ordenamiento. En el último capítulo, la finalidad es demostrar como viene siendo aplicada la ignorancia deliberada en el ámbito del Tribunal Supremo Federal y del Tribunal Regional Federal de la 4ª Región. Al final, la intención fue listar los problemas de aplicación de esto instituto en un país como Brasil, en que están presentes numerosas reglas y delimitaciones que no se pueden incumplir