Reactivation of Hepatitis B in a Patient with Breast Cancer Treated Using Capecitabine

Reactivation of hepatitis B virus (HBV) is a well-recognized complication following immunosuppressive drug therapy in patients with past infection. The International Guidelines for HBV screening before cytotoxic or immunosuppressive therapy are controversial, there is only agreement on the use of biological agent such as anti-CD 20. The literature data do not report HBV reactivation due to capecitabine and therefore the international guidelines do not recommend prophylaxis in that condition. In this paper, we describe the history of HBV reactivation of hepatitis B in a female patient with breast cancer treated using capecitabine observed in a Unit of Infectious Diseases of north-est of Italy

Herpes simplex virus (HSV) pneumonia in the non-ventilated immunocompromised host: Burden and predictors

Objectives: To evaluate burden and predictors of HSV pneumonia among immunocompromised patients not undergoing invasive mechanical ventilation according to a tailored diagnostic algorithm. Methods: This prospective, observational study included immunocompromised adults with pneumonia non-responding to empirical antibiotic therapy. Bronchoalveolar lavage (BAL) specimens were cultured for bacteria, mycobacteria and fungi. Real-time PCR for Herpesviruses and other microorganisms were performed on BAL and other specimens. Cytological examination of BAL samples was carried out for identification of intranuclear inclusion bodies and immunohistochemical staining for HSV. Results: We enrolled 45 patients (mean age 64.6 years) from January 2015 to June 2016. Nineteen (42.2%) cases tested positive for HSV-1 PCR on BAL. According to our definitions, 11 (24.4%) patients had HSV- 1 pneumonia with viral loads ranging between 10 3 copies/mL and 10 7 copies/mL. HSV-1 positive throat swab (OR 85.2, 95% CI 5.83\u20131245.1, P < 0.001) and solid organ transplant (SOT) (OR 53.3, 95% CI 1.37\u20132072.8, P < 0.03) as underlying condition were found to be independently associated with HSV pneumonia by multivariable analysis. Conclusions: HSV pneumonia turned out to be relatively common and should be investigated especially in individuals with HSV positive throat swab and SOT. Interventional studies are needed to assess the real clinical impact of HSV pneumonia in immunocompromised patients

Identidade gastronômica: patrimônio imaterial do oeste catarinense/ Gastronomic identity: immaterial heritage of the catarinense west

A cultura dos povos está ligada à alimentação e para entender sua diversidade e especificidade tornam-se imprescindíveis resgatar aspectos históricos, visitar o passado e trazer hábitos, costumes e crenças de cada etnia. Este estudo objetiva resgatar a memória gastronômica das etnias formadoras do Oeste de Santa Catarina. Como metodologia utilizou-se a pesquisa-ação, onde além da revisão de literatura buscou-se descrever as ações de um projeto de extensão denominado Patrimônio Gastronômico do Oeste de Santa Catarina. Como resultado chegou-se aos ingredientes chaves de quatro etnias: italiana, alemã, cabocla e polonesa e a partir deles criou-se um novo prato representando-as, o Revirado.   Abstract The objective was to develop and validate a culturally appropriate instrument to evaluate the impact of a pilot intervention program in the food environment to promote healthy eating in small food stores in an urban food desert. A formative research was carried out for the validation of the instrument, including meetings of researchers, visits to all the streets in the study's region to identify food stores, visits to food distribution system agents', community workshops with the local community and in-depth interviews with food store owners for content and apparent validity. Instrument reliability was tested by Cronbach alpha coefficient. The development of the instrument included questions to evaluate the Identification and Characterization of Store; Marketing Parameters (i.e. influencers for including new food itens and frequency of product acquisition and profitability); and Psychosocial Factors Scale (i.e. expectations regarding healthy food sales, expectations regarding impact of intervention, and self-efficacy in relation to the marketing of healthy foods). Validation process allowed a review of all questions and questions' responses, with Cronbach alpha between 0.440 to 0.967 in the final instrument questions. It can be concluded that the instrument was developed to identify relevant characteristics of the food distribution system and can be used in epidemiological studies and public policies to evaluate increase access to healthy foods. Key words:Validation Studies; Urban Health; Food Environmen

Identidade gastronômica: patrimônio imaterial do oeste catarinense/ Gastronomic identity: immaterial heritage of the catarinense west

A cultura dos povos está ligada à alimentação e para entender sua diversidade e especificidade tornam-se imprescindíveis resgatar aspectos históricos, visitar o passado e trazer hábitos, costumes e crenças de cada etnia. Este estudo objetiva resgatar a memória gastronômica das etnias formadoras do Oeste de Santa Catarina. Como metodologia utilizou-se a pesquisa-ação, onde além da revisão de literatura buscou-se descrever as ações de um projeto de extensão denominado Patrimônio Gastronômico do Oeste de Santa Catarina. Como resultado chegou-se aos ingredientes chaves de quatro etnias: italiana, alemã, cabocla e polonesa e a partir deles criou-se um novo prato representando-as, o Revirado.   Abstract The objective was to develop and validate a culturally appropriate instrument to evaluate the impact of a pilot intervention program in the food environment to promote healthy eating in small food stores in an urban food desert. A formative research was carried out for the validation of the instrument, including meetings of researchers, visits to all the streets in the study's region to identify food stores, visits to food distribution system agents', community workshops with the local community and in-depth interviews with food store owners for content and apparent validity. Instrument reliability was tested by Cronbach alpha coefficient. The development of the instrument included questions to evaluate the Identification and Characterization of Store; Marketing Parameters (i.e. influencers for including new food itens and frequency of product acquisition and profitability); and Psychosocial Factors Scale (i.e. expectations regarding healthy food sales, expectations regarding impact of intervention, and self-efficacy in relation to the marketing of healthy foods). Validation process allowed a review of all questions and questions' responses, with Cronbach alpha between 0.440 to 0.967 in the final instrument questions. It can be concluded that the instrument was developed to identify relevant characteristics of the food distribution system and can be used in epidemiological studies and public policies to evaluate increase access to healthy foods. Key words:Validation Studies; Urban Health; Food Environmen

Identidade gastronômica: patrimônio imaterial do oeste catarinense/ Gastronomic identity: immaterial heritage of the catarinense west

The objective was to develop and validate a culturally appropriate instrument to evaluate the impact of a pilot intervention program in the food environment to promote healthy eating in small food stores in an urban food desert. A formative research was carried out for the validation of the instrument, including meetings of researchers, visits to all the streets in the study's region to identify food stores, visits to food distribution system agents', community workshops with the local community and in-depth interviews with food store owners for content and apparent validity. Instrument reliability was tested by Cronbach alpha coefficient. The development of the instrument included questions to evaluate the Identification and Characterization of Store; Marketing Parameters (i.e. influencers for including new food itens and frequency of product acquisition and profitability); and Psychosocial Factors Scale (i.e. expectations regarding healthy food sales, expectations regarding impact of intervention, and self-efficacy in relation to the marketing of healthy foods). Validation process allowed a review of all questions and questions' responses, with Cronbach alpha between 0.440 to 0.967 in the final instrument questions. It can be concluded that the instrument was developed to identify relevant characteristics of the food distribution system and can be used in epidemiological studies and public policies to evaluate increase access to healthy foods

Apresentação dos Dossiês

Apresentação dos Dossiê

Correlation between antibiotic consumption and resistance of bloodstream bacteria in a University Hospital in North Eastern Italy, 2008\u20132014

PURPOSE: The spread of multidrug-resistant bacteria is a worrisome problem worldwide. This study investigated the correlation between antibiotic consumption and antimicrobial resistance trends of the most important bacteria causing bacteremia at the University hospital of Trieste, Italy, from 2008 to 2014. METHODS: Antibiotic consumption (Defined Daily Dose-DDD-per 100 patient/days) and antibiotic resistance (percentage of antibiotic intermediate o resistant isolates) were analyzed independently with linear correlation by year. Potential correlations between antibiotic consumption and bacteria resistance rates were investigated through the Pearson's correlation. RESULTS: The overall consumption of antibiotic grew from 80 to 97 DDD 100 patient/days (p = 0.005) during the study period. The increased consumption of amoxicillin/clavulanate and piperacillin/tazobactam was associated with the reduction of MRSA rate from 48.5 to 25.9% (p = 0.007 and p = 0.04, respectively). The increased consumption of piperacillin/tazobactam was associated with the reduction of ESBL-positive Enterobacteriaceae rate from 28.9 to 20.9% (p = 0.01). The increased consumption of carbapenems was associated with the increased rate of carbapenem-resistant Acinetobacter baumannii from 0 to 96.4% (p = 0.03). No carbapenem-resistant Enterobacteriaceae isolates were reported. The consumption of vancomycin grew significantly (p = 0.005). A dramatic spread of vancomycin-resistant Enterococcus faecium occurred in 2014. The consumption of fluoroquinolones and extended-spectrum cephalosporins remained stable. CONCLUSIONS: An antibiotic stewardship program targeted to limit the consumption of extended-spectrum cephalosporins and fluoroquinolones in favor of amoxicillin/clavulanate and piperacillin/tazobactam correlates with a decreasing rate of MRSA and ESBL-positive Enterobacteriaceae. The analysis of correlations between antibiotic consumption and bacterial resistance rates is a useful tool to orient antimicrobial stewardship policies at local level