Perfil clínico e microbiológico da infecção no pé diabético por bactérias carbapenêmico-resistentes em um hospital do sul do Brasil

Carbapenem-resistant bacteria are a major cause of diabetic foot (DF) infection. They are resistant to almost all available antimicrobial agents and lead to increased hospital costs. The clinical and microbiological characteristics of DF infection due to these microorganisms and the association of DF with outcomes such as mortality and amputation are not yet well established. This was a retrospective cohort study involving 60 vascular surgery patients who were admitted to Nossa Senhora da Conceição Hospital due to DF infection caused by carbapenem-resistant bacteria and who underwent debridement or amputation, and a control group with 60 randomly selected patients. The analyzed parameters were mortality and amputation rates and patients’ epidemiological and microbiological profiles. A significant association was observed between bacterial resistance and previous amputation, previous hospitalizations, and DF ulcer classification into ischemic and neuroischemic; however, there were no differences in mortality and amputation rates between the groups, even after using the Charlson comorbidity index. Although DF infections by carbapenem-resistant bacteria were not statistically associated with worse outcomes, their study is important given that there are few therapeutic options for treating these specific infections.As bactérias carbapenêmico-resistentes são uma causa importante de infecção no pé diabético (PD). Elas são resistentes à maioria dos agentes antimicrobianos disponíveis e estão associadas com aumento dos custos hospitalares. O perfil clínico e microbiológico da infecção no PD por esses microorganismos e a associação do PD com desfechos como mortalidade e amputação não são bem estabelecidos. Foi realizado um estudo de coorte retrospectiva envolvendo 60 pacientes internados na cirugia vascular do Hospital Nossa Senhora da Conceição devido a infecção do PD por bactérias carbapenêmico-resistentes e que foram submetidos a amputação ou desbridamento e um grupo controle de 60 pacientes randomicamente selecionados. Foram analisados o perfil epidemiológico e microbiológico desses pacientes bem como as taxas de mortalidade e amputação. Observou-se uma associação significante entre resistência bacteriana e amputação prévia, hospitalização prévia e classificação do PD em isquêmico e neuro-isquêmico. No entanto, não houve diferença nas taxas de mortalidade e de amputação entre os grupos, mesmo com o uso do escore de comorbidades de Charlson. Apesar das infecções no PD por bactérias carbapenêmico-resistentes não serem associadas estatisticamente com piores desfechos, seu estudo é importante em função das poucas opções terapêuticas disponíveis para tratar essas infecções

Clinical and microbiological characteristics of diabetic foot infection by carbapenem-resistant bacteria in a hospital in southern Brazil

Carbapenem-resistant bacteria are a major cause of diabetic foot (DF) infection. They are resistant to almost all available antimicrobial agents and lead to increased hospital costs. The clinical and microbiological characteristics of DF infection due to these microorganisms and the association of DF with outcomes such as mortality and amputation are not yet well established. This was a retrospective cohort study involving 60 vascular surgery patients who were admitted to Nossa Senhora da Conceição Hospital due to DF infection caused by carbapenem-resistant bacteria and who underwent debridement or amputation, and a control group with 60 randomly selected patients. The analyzed parameters were mortality and amputation rates and patients’ epidemiological and microbiological profiles. A significant association was observed between bacterial resistance and previous amputation, previous hospitalizations, and DF ulcer classification into ischemic and neuroischemic; however, there were no differences in mortality and amputation rates between the groups, even after using the Charlson comorbidity index. Although DF infections by carbapenem-resistant bacteria were not statistically associated with worse outcomes, their study is important given that there are few therapeutic options for treating these specific infections

Clinical and microbiological characteristics of diabetic foot infection by carbapenem-resistant bacteria in a hospital in southern Brazil

Carbapenem-resistant bacteria are a major cause of diabetic foot (DF) infection. They are resistant to almost all available antimicrobial agents and lead to increased hospital costs. The clinical and microbiological characteristics of DF infection due to these microorganisms and the association of DF with outcomes such as mortality and amputation are not yet well established. This was a retrospective cohort study involving 60 vascular surgery patients who were admitted to Nossa Senhora da Conceição Hospital due to DF infection caused by carbapenem-resistant bacteria and who underwent debridement or amputation, and a control group with 60 randomly selected patients. The analyzed parameters were mortality and amputation rates and patients’ epidemiological and microbiological profiles. A significant association was observed between bacterial resistance and previous amputation, previous hospitalizations, and DF ulcer classification into ischemic and neuroischemic; however, there were no differences in mortality and amputation rates between the groups, even after using the Charlson comorbidity index. Although DF infections by carbapenem-resistant bacteria were not statistically associated with worse outcomes, their study is important given that there are few therapeutic options for treating these specific infections

Conversion in Turkish : an overview

This paper presents an overview of possible cases of conversion in Turkish. I argue that apparent cases of conversion between nouns and adjectives are cases of syntactic transposition, and apparent cases of conversion between nouns/adjectives and verbs are end products of phonological changes in the history of the language, which resulted in pairs of lexemes that are formally identical synchronically, but not historically. This does not mean that no cases of morphological conversion can be traced in the language. I will present two cases of secondary word-class conversion from derived, inflected and uninflected words to toponyms which might be taken as instances of morphological conversion or derivation by zero-affixation

Genomics and epidemiology for gastric adenocarcinomas (GE4GAC): a Brazilian initiative to study gastric cancer

Abstract Gastric cancer (GC) is the fifth most common type of cancer worldwide with high incidences in Asia, Central, and South American countries. This patchy distribution means that GC studies are neglected by large research centers from developed countries. The need for further understanding of this complex disease, including the local importance of epidemiological factors and the rich ancestral admixture found in Brazil, stimulated the implementation of the GE4GAC project. GE4GAC aims to embrace epidemiological, clinical, molecular and microbiological data from Brazilian controls and patients with malignant and pre-malignant gastric disease. In this letter, we summarize the main goals of the project, including subject and sample accrual and current findings

Surgical repair of an extracranial carotid aneurysm

Aneurysms of the supra-aortic trunks are rare conditions that can cause peripheral neurological conditions or embolization resulting in stroke. The upper airways can even be affected and rupture is potentially fatal. We present a case of a patient with an aneurysm of the carotid bifurcation who was treated conventionally with reconstruction of the carotid bifurcation using a venous patch. Surgical treatment enabled accurate histopathological diagnosis and anatomic correction of the carotid bifurcation

Arterite de Takayasu e doença de Crohn: uma associação incomum Takayasu's arteritis and Crohn's disease: an unusual association

A arterite de Takayasu e a doença de Crohn são doenças inflamatórias com etiologia desconhecida. Raramente ocorrem de modo concomitante em um mesmo indivíduo, havendo menos de 30 casos relatados na literatura. Este trabalho descreve essa associação em uma paciente de 36 anos de idade portadora de doença de Crohn, que apresentou redução dos pulsos no membro superior esquerdo e pressão arterial de 60/40 mmHg. A angiotomografia evidenciou estenose segmentar de artéria subclávia esquerda e espessamento parietal circunferencial da aorta na transição toracoabdominal entre T10 e L1, estabelecendo o diagnóstico de arterite de Takayasu. Ambas as patologias são mediadas imunologicamente e apresentam granulomas e vasculite granulomatosa, o que contribui para reforçar a hipótese de uma origem imunológica comum no seu desenvolvimento. Acreditamos que este seja o primeiro caso relatado na literatura brasileira da presença concomitante destas duas enfermidades.<br>Takayasu's arteritis and Crohn's disease are chronic inflammatory diseases with unknown etiology. They rarely occur together in the same individual, with less than 30 cases reported in the literature. This case report describes this association in a 36-year-old woman with Crohn’s disease and weak pulses in her left arm with blood pressure of 60/40 mmHg. Angiotomography showed segmental stenosis in the left subclavian artery and circumferential thickening of the aortic wall between T10 and L1, establishing the diagnosis of Takayasu's arteritis. Both are organ-specific and immune-mediated diseases and exhibit granulomas and granulomatous vasculitis, which contribute to reinforce the hypothesis of a common immunologic origin. We believe that this is the first case of concomitant presence of these two diseases reported in the Brazilian literature

Lista preliminar dos anfíbios da Estação Ecológica do Taim, Rio Grande do Sul, Brasil

Das 67 espécies de anfíbios conhecidas do Rio Grande do Sul, 18 foram coletadas na Estação Ecológica do Taim, no sudeste deste Estado. Os Leptodactylidae são os mais diversificados na área, e os Hylidae os mais numerosos em indivíduos.<br>Out of the 67 species of amphibians known from Rio Grande do Sul, 18 were collected at the Estação Ecológica do Taim, in the southeastern part of that State. The Leptodactylidae are the most diversified ir the area, whereas the Hylidae were the most numerous in individuai