Detection of Streptococcus agalactiae colonization in pregnant women by using combined swab cultures: cross-sectional prevalence study

CONTEXT AND OBJECTIVE: Maternal Streptococcus agalactiae colonization and early-onset neonatal sepsis have aroused interest in the worldwide literature. Streptococcal neonatal disease is associated with significant morbidity and mortality in the perinatal period, especially among premature neonates. The aim of this study was to assess the prevalence of maternal streptococcal colonization by using combined swab cultures, compared with swab collection from a single site. DESIGN AND SETTING: Cross-sectional study at Faculdade de Medicina de Botucatu, Universidade Estadual Paulista. METHODS: Samples were obtained from 405 patients at gestational ages of 35 to 37 weeks. Swabs from the perianal (rectal) region, vaginal introitus and upper lateral vaginal vault were cultured in Todd-Hewitt selective broth. Colonies suggestive of Streptococcus agalactiae were subjected to the catalase and CAMP (Christie, Atkins, Munch-Petersen) tests. To evaluate the positivity of combined swab cultures, Tukey's test was used for comparison of proportions. RESULTS: The prevalence of streptococcal colonization was 25.4%. Among the patients with positive cultures, 28.1% had this at only one collection site, 24.2% simultaneously at two sites and 47.5% at all three sites. Associating the swabs from two collection sites significantly increased streptococcal isolation, compared with a single swab (P < 0.05), except for perianal (rectal) collection. Use of combined swabs from three collection sites showed statistically higher isolation rates. CONCLUSION: In combined swab cultures collected from three collection sites, the prevalence of maternal Streptococcus agalactiae colonization was higher than in swabs collected from a single site

Platelet aggregation and TGF-beta(1) plasma levels in pregnant women with preeclampsia

Objectives: Platelets and transforming growth factor-beta(1) (TGF-beta(1)) are thought to be involved in the pathogenesis of preeclampsia. Our objectives were to determine plasma concentration of TGF-beta(1) in normotensive and preeclamptic women in the third trimester of pregnancy and to evaluate the correlation of TGF-beta(1) plasma levels with platelet count and agonist-induced aggregation capacity.Methods: Thirty-three women with preeclampsia were compared with 36 healthy women with uncomplicated pregnancies. Peripheral venous blood samples were obtained, and TGF-beta(1) plasma levels measured by an enzyme-linked immunoassay. Platelet aggregation was induced by the agonist agents adenosine diphosphate (ADP), collagen and epinephrine, and was determined in platelet-rich plasma by aggregometry.Results: Plasma concentrations of active TGF-beta(1) were significantly higher in preeclamptic women (10.41 +/- 2.07 ng/mL) compared with normotensive pregnant women (7.01 +/- 3.29 ng/mL). Platelet number and platelet agonist-induced aggregation percent were significantly lower in patients with precclampsia than in healthy pregnant women. A significant correlation was observed between TGF-beta(1) plasma levels and platelet agonist-induced aggregation percent as between plasma levels of TGF-beta(1) and platelet number in preeclamptic patients.Conclusion: The association between impairment in platelet responsiveness and higher levels of TGF-beta(1) in the plasma of patients with preeclampsia suggests that this cytokine may play a role in the pathophysiological events of preeclampsia that are dependent on platelet activation. (C) 2008 Elsevier B.V. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Increased Reactive Oxygen Species and Tumor Necrosis Factor-Alpha Production by Monocytes are Associated with Elevated Levels of Uric Acid in Pre-Eclamptic Women

ProblemTo evaluate associations between hyperuricemia and increases in production of reactive oxygen species (ROS) and tumor necrosis factor alpha (TNF-alpha) in pre-eclamptic pregnancies.Method of studyThis study investigated serum uric acid levels, monocyte production of TNF-alpha, superoxide anion (O-2(-)) and hydrogen peroxide (H2O2), as well as superoxide dismutase (SOD) and catalase (CAT) activities in erythrocytes from 30 women with pre-eclampsia (PE) compared with 30 normotensive (NT) pregnant women in the last trimester of pregnancy.ResultsSerum uric acid levels (6.1 versus 2.8 mg/dL) as well as endogenous O-2(-) (2.2 versus 1.6 nm), H2O2 (1.8 versus 1.4 nm) and TNF-alpha (91.6 versus 40.4 pg/mL) released from monocytes were significantly higher in the pre-eclamptic group than in the NT group (P < 0.05). SOD activity in erythrocytes was also significantly elevated in the PE group (5969.2 versus 4834.7 U/g Hb). No significant difference between groups was observed in relation to CAT activity.ConclusionsElevated serum uric acid levels are correlated with higher O-2(-) and TNF-alpha production by monocytes in women with PE. This may contribute to the enhanced oxidative and inflammatory state characteristic of this disorder.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Monocytes from Pregnant Women with Pre-Eclampsia are Polarized to a M1 Phenotype

Problem This study evaluated whether the monocyte inflammatory state in pre-eclampsia (PE) might be associated with polarization to either M1 classically or M2 alternatively activated monocyte subsets. Method of Study Eighty-five women with (PE) and 52 normotensive (NT) pregnant women matched for gestational age were included. Expression of surface receptors characteristic of M1, such as Toll-like receptor (TLR)2, TLR4, and CD64, or M2, such as CD163 and CD206 monocyte subsets were evaluated in peripheral blood monocytes by flow cytometry. Tumour necrosis factor-alpha (TNF-), interleukin-(IL)-12p40, IL-12p70, and IL-10 were evaluated in the supernatant of monocyte cultures by ELISA. Results Expression of TLR4 and CD64 by monocytes from pre-eclamptic women was significantly higher, while the expression of CD163 and CD206 expression was significantly lower compared with NT pregnant women. Endogenous production of TNF-, IL-12p40, and IL-12p70 by monocytes was increased, while synthesis of IL-10 was lower in women with PE than in NT pregnant women. Conclusions Monocytes from women with PE are classically activated, producing higher levels of pro-inflammatory cytokines, and express surface receptors characteristic of the M1 subset. These results provide evidence that the systemic inflammatory environment in PE may differentiate and polarize these cells to the M1 phenotype.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Formação de docentes na educação superior: a experiência do núcleo de apoio pedagógico da faculdade de medicina de botucatu - fmb/unesp

A FMB/UNESP tem promovido iniciativas para qualificar o ensino de graduação, para atender as Diretrizes Curriculares Nacionais na área da saúde, demanda da comunidade local e adequação às necessidades sociais em saúde. Em 2000,a FMB instituiu o Núcleo de Apoio Pedagógico (NAP), com os objetivos de elaborar proposta de avaliação contínua do ensino na graduação; oferecer apoio técnico e infra-estrutura às mudanças para a melhoria do ensino; promover a formação docente para o aprendizado de inovações metodológicas; ampliar o desenvolvimento de pesquisa em educação médica; promover a ampliação do ensino no SUS, particularmente do ensino na comunidade e na atenção primária à saúde. A criação do NAP, como órgão assessor ao Conselho de Curso de Graduação (CCG) e à Direção foi entendida pela comunidade como fundamental para implementação das mudanças. Para desempenhar seus objetivos o NAP é constituído por frentes de atuação: estrutura curricular, pesquisa e planejamento em avaliação, desenvolvimento da docência, infra-estrutura e ensino na comunidade. Participam do NAP docentes, discentes, profissionais dos serviços de saúde e duas pedagogas.Toda a formação docente realizada pauta-se por responder demandas apontadas pelo CCG, direção e de estudos da própria frente de avaliação. As características do NAP o capacitam a apoiar tanto o ensino de graduação como programas de pósgraduação voltados ao ensino na saúde. O NAP tem apoiado a postura próativa da Instituição frente às iniciativas de aperfeiçoamento e inovação do ensino, promovidas em âmbito local e nacional. Com o fortalecimento do trabalho docente e o apoio à elaboração de projetos e programas o NAP tem possibilitado a participação da FMB em iniciativas do MEC e MS para a reorientação da formação profissional em saúde

High levels of heat shock protein 70 are associated with pro-inflammatory cytokines and may differentiate early- from late-onset preeclampsia

Preeclampsia (PE), a specific syndrome of pregnancy, can be classified into early and late onset, depending on whether clinical manifestations occur before or after 34 weeks' gestation. We determined whether plasma concentrations of Hsp60 and Hsp70 were related to circulating cytokine levels, as well as kidney and liver functions, in early- and late-onset PE. Two hundred and thirty-seven preeclamptic women (95 with early- and 142 with late-onset PE) were evaluated. Plasma levels of Hsp60, Hsp70, and their specific antibodies, tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1, IL-10, IL-12, and soluble TNF-α-receptor I (sTNFRI) concentrations, were determined by enzyme-linked immunosorbent assay (ELISA). Concentrations of Hsp70, TNF-α, IL-1β, IL-12, and sTNFRI were significantly elevated in patients with early-onset PE compared with women with late-onset PE; IL-10 levels were significantly lower in the early-onset PE group. Concentrations of urea, uric acid, proteinuria, glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), and lactate dehydrogenase (LDH) were also significantly higher in early-onset PE. The percentage of infants with intrauterine growth restriction was also significantly higher in women with early-onset PE. There were positive correlations between Hsp70 levels and TNF-α, TNFRI, IL-1β, IL-12, GOT, GPT, LDH, and uric acid concentrations in early-onset PE group. Thus, early-onset PE was associated with greater maternal and fetal impairment. There are differences in pathophysiology between early- and late-onset PE, highlighting by the difference in Hsp70 levels. © 2013 Elsevier B.V. All rights reserved

Gestão pública II: relatos, pesquisas, experiências e visão de trabalho.

Coletânea de trabalhos publicados e premiados no II Seminário de Gestão Pública da UFRA e na 1ª edição do Prêmio Novos Ventos de Gestão Pública, sob a responsabilidade da Pró-Reitoria de Gestão de Pessoas (PROGEP).UNIVERSIDADE FEDERAL RURAL DA AMAZÔNIAEste livro, na forma de coletânea, se constituiu em um processo mais amplo de reflexão sobre a gestão pública dentro da Universidade. Aqui, partimos para uma importante reflexão, a partir do processo de sistematizar experiências, relatos de experiência, e pesquisas, sobre a Universidade Pública e sua relação com as pessoas e as ciências. Em especial, o capítulo 1, a partir da coletânea dos trabalhos apresentados no II Seminário de Gestão Pública, diferencia-se dos trabalhos submetidos para a primeira edição. As experiências destacadas para este livro reforçam a identidade e missão da UFRA, como os resultados dos trabalhos “OS CAMINHOS DA MERENDA ESCOLAR: análise da logística na cadeia de suprimentos do município de Tomé-Açu” e “ANÁLISE QVT NA GESTÃO DE UMA EMPRESA PRODUTORA DE DENDÊ EM TOMÉ-AÇU/PA”, e que também agregam valor a gestores e equipes de trabalho quando promovem a discussão de temas relacionados ao dia-a-dia do trabalho, tais como: QUALIDADE DE VIDA NO TRABALHO e GESTÃO ESTRATÉGICA DE PESSOAS NO SETOR PÚBLICO. Nesse sentido, servidores e pesquisadores cumprem a função de embasar inúmeras discussões que vêm sendo travadas pelas Instituições Públicas sobre qualidade de vida, inclusão, garantia de direitos, melhoria de procedimentos, dentre outros. O capítulo II, enquanto coletânea das experiências de trabalho indicada para premiação, é um momento riquíssimo de se perceber a quantidade e a qualidade de ações planejadas, organizadas e realizadas por servidores públicos. Em tempos que algumas práticas do serviço público não são bem vistas, reforça-se aqui que alguns dos relatos foram concebidos em meio a falta de recursos financeiros e estruturais, mas que não impediram os proponentes de seguir em frente. Mais do que isso, o reconhecimento dos beneficiários e usuários faz com que reforcemos a necessidade de fortalecer ações que agregam inúmeros valores a vida laboral dos servidores públicos e a própria Universidade Pública.This book, in the form of a collection, constituted a broader process of reflection on public management within the University. Here, we start an important reflection, based on the process of systematizing experiences, experience reports, and research, about the Public University and its relationship with people and the sciences. In particular, chapter 1, from the collection of works presented at the II Seminar on Public Management, differs from the works submitted for the first edition. The experiences highlighted for this book reinforce UFRA's identity and mission, such as the results of the work “THE PATHS OF SCHOOL BREAKFAST: analysis of logistics in the supply chain in the municipality of Tomé-Açu” and “QVT ANALYSIS IN THE MANAGEMENT OF A PRODUCING COMPANY OF DENDÊ IN TOMÉ-AÇU / PA ”, and which also add value to managers and work teams when promoting the discussion of topics related to day-to-day work, such as: QUALITY OF LIFE AT WORK and STRATEGIC PEOPLE MANAGEMENT IN THE PUBLIC SECTOR. In this sense, civil servants and researchers fulfill the function of supporting numerous discussions that have been held by Public Institutions on quality of life, inclusion, guarantee of rights, improvement of procedures, among others. Chapter II, as a collection of work experiences indicated for awards, is a very rich moment to realize the quantity and quality of actions planned, organized and carried out by public servants. In times when some public service practices are not well regarded, it is reinforced here that some of the reports were conceived amid a lack of financial and structural resources, but that did not prevent proponents from moving forward. More than that, the recognition of beneficiaries and users makes us reinforce the need to strengthen actions that add innumerable values ​​to the working life of public servants and the Public University itself

Resumos concluídos - Saúde Coletiva

Resumos concluídos - Saúde Coletiv