RESUMEN

BACKGROUND: Exercise therapy is a recognized non-pharmacological intervention for peripheral arterial disease (PAD); however, the effects of combined exercise remain under investigation. This study aimed to compare the effects of a 6-month combined supervised exercise program (SUP) with a usual care (UC) approach on walking ability, physical fitness, and peripheral blood flow in people with PAD and claudication. METHODS: Twenty-three male participants (Age=64.1 ± 6.2years and ABI=0.58±0.07) with PAD and claudication were assigned to either the SUP group (n = 10), engaging in structured supervised treadmill walking combined with three resistance exercises, three times a week, or the UC group (n = 13), receiving advice to walk. The primary outcome measure was walking ability, with assessments conducted at baseline (M0), after 3 months (M3), and 6 months (M6). RESULTS: After the 6-month intervention, the SUP group exhibited significant improvements in absolute claudication time (ACT, p = 0.045), maximal walking time (MWT, p = 0.045), maximal walking distance (MWD, p = 0.027), and pause duration (p = 0.045) during the 6-minute walk test (6MWT), when compared to the UC group. Over time, a significant increase in walking speed during the 6MWT (Speed6MWT, p = 0.001) and walking speed without claudication (SpeedNoC, p < 0.001) was found, although no significant differences were found between the groups. The SUP group increased by 0.8 km/h in both Speed6MWT and SpeedNoC, while the UC group increased by 0.3 km/h and 0.6 km/h, respectively. Despite claudication consistently occurring at the same time, the SUP group demonstrated an improved tolerance to pain or a better understanding of pain, enabling them to walk longer distances at higher speeds. A positive effect of SUP was found for chair sit-and-reach test (p = 0.023), percentage of fat mass (p = 0.048), fat-free mass (p = 0.040), and total body water (p = 0.026), suggesting potential benefits attributed to the resistance strength exercises. CONCLUSION: A 6-month combined treadmill and resistance exercise program improved walking ability, walking speed, lower body and lower back flexibility, and body composition in people with PAD and claudication.

Asunto(s)

Terapia por Ejercicio , Claudicación Intermitente , Enfermedad Arterial Periférica , Aptitud Física , Entrenamiento de Fuerza , Prueba de Paso , Caminata , Humanos , Masculino , Enfermedad Arterial Periférica/fisiopatología , Enfermedad Arterial Periférica/terapia , Proyectos Piloto , Persona de Mediana Edad , Terapia por Ejercicio/métodos , Entrenamiento de Fuerza/métodos , Aptitud Física/fisiología , Claudicación Intermitente/terapia , Claudicación Intermitente/fisiopatología , Caminata/fisiología , Anciano , Ejercicio Físico/fisiología , Resultado del Tratamiento

RESUMEN

CASE PRESENTATION: A pregnant woman developed hepatitis due to a herpes simplex virus 2 primary infection with a severe systemic inflammatory response. Treatment with acyclovir and human immunoglobulin was given and both mother and baby survived. PURPOSE: We provide the first description of the inflammatory response associated with herpetic hepatitis in pregnancy.

Asunto(s)

Hepatitis A , Hepatitis , Herpes Simple , Complicaciones Infecciosas del Embarazo , Embarazo , Femenino , Humanos , Herpesvirus Humano 2 , Herpes Simple/diagnóstico , Herpes Simple/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Síndrome de Liberación de Citoquinas/complicaciones , Aciclovir/uso terapéutico , Hepatitis/complicaciones

RESUMEN

BACKGROUND: In peripheral arterial disease (PAD) patients with intermittent claudication (IC), the combination of aerobic and resistance exercises could counteract muscle loss and attenuate disease progression. This study analyzed the effects of six months of a combined exercise program on walking ability, lower limb body composition, cardiovascular risk factors, and Ankle-Brachial Index (ABI). METHODS: Twenty-three patients (age 63.2±1.5 years and ABI 0.58±0.07) with PAD and IC were allocated to a control group (CG) or a supervised exercise group (SUP). Ten patients underwent six months of treadmill walking combined with resistance exercises, three times a week. The CG (N.=13) received a recommendation for walking. All patients were measured at baseline (M0), after three months (M3), and six months (M6). RESULTS: During constant treadmill protocol, the claudication onset time/distance (COT/COD), absolute claudication time/distance (ACT/ACD), and number of pauses of overall patients significantly improved at M3 and M6. Between groups were found significant differences in COT and COD at M6 (P=0.005 and P=0.007, respectively); and in ACT and ACD at M3 (P=0.003 for both) and at M6 (P=0.005 and P=0.005, respectively), with major improvements in the SUP. Over the six months, a significant group effect was found in fat-free mass (P=0.041) and predicted muscle mass (P=0.039) of the lower ABI leg, with greater improvements in the SUP. CONCLUSIONS: A supervised exercise program that combines aerobic and resistance training improves PAD symptoms and has additional benefits for patients. Patients in the program showed improvements in walking ability, lower-limb body composition, perceived exertion, and heart rate during treadmill walking.

Asunto(s)

Enfermedad Arterial Periférica , Humanos , Persona de Mediana Edad , Proyectos Piloto , Enfermedad Arterial Periférica/diagnóstico , Enfermedad Arterial Periférica/terapia , Claudicación Intermitente/diagnóstico , Claudicación Intermitente/terapia , Claudicación Intermitente/etiología , Ejercicio Físico , Caminata/fisiología , Terapia por Ejercicio/métodos , Prueba de Esfuerzo/efectos adversos

RESUMEN

Mycobacterium tuberculosis infection remains a common disease in developing countries with the potential to involve the osteoarticular system. The authors report a case of knee arthritis due to tuberculosis (TB) in a 34-year-old woman. The patient presented with pain and swelling of the right knee as major complaints, without a history of respiratory symptoms. Magnetic resonance imaging (MRI) demonstrated a marked joint effusion, involving synovial tissue with cartilaginous lesion compatible with pigmented villonodular synovitis (PVNS). After several physiotherapy courses without significant relief, total knee arthroplasty was proposed. Two months after surgery and rehabilitation, symptoms did not completely resolve, with limited active range of motion. Microbial bone biopsy culture at the time of the arthroplasty revealed a TB infection. Due to the rarity and clinical nonspecificity of TB bone manifestations, early diagnosis may be challenging. Yet, attempted diagnosis and prompt pharmacological intervention are paramount to improve outcomes.

RESUMEN

Malaria is frequently associated with splenomegaly. However, spontaneous splenic rupture is a rare and life-threatening complication. It is mostly seen in acute infection in non-immune adults and Plasmodium vivax and Plasmodium falciparum have been associated with the majority of cases. We describe a case of splenic rupture in an adult with complicated malaria by Plasmodium falciparum in which a conservative approach was used.

Asunto(s)

Malaria Falciparum , Malaria Vivax , Malaria , Rotura del Bazo , Adulto , Humanos , Malaria Falciparum/complicaciones , Malaria/complicaciones , Rotura del Bazo/cirugía , Rotura del Bazo/complicaciones , Plasmodium vivax , Plasmodium falciparum , Malaria Vivax/complicaciones , Malaria Vivax/tratamiento farmacológico

RESUMEN

Honey from different botanical sources presents a great variability in chemical composition, physical properties, and sensorial attributes. The association between honey qualities and its geographical origin allows the recognition of honey, and beekeepers are economically benefited. The objective of this study was to evaluate the physicochemical characteristics of honey produced in Ortigueira, Brazil and to compare it with the honey produced in the neighboring localities for the request of geographical indication certification. In the 112 honey samples collected between 2010 and 2013 from Ortigueira and the neighboring localities, moisture acidity, pH, hydroxymethyl furfural (HMF), diastase activity (DA), sugars, proline (Pro), electrical conductivity (EC), color absorbance at 635 nm (C635), and Cielab color parameters were evaluated. HMF, reducing sugars (RS), total sugars (TS), proline, and color parameters (L*, a* and b*) were significantly different in Ortigueira 2010 honey seasons. Principal component analysis separated assapeixe (Vernonia sp) and capixingui (Croton floribundus) honeys from wild honeys (polyfloral). In addition, HMF, RS, L*, and lactonic acidity values promoted the separation between assapeixe and capixingui honeys. Ortigueira honey differs significantly from honeys from neighboring locality in pH, proline, HMF, DA, EC, RS, sucrose, TS, free and total acidity, and color parameters (C635, L*, a*, b*). The multivariate analysis applied to variables was efficient to discriminate honeys from different botanical sources and different locals, and is recommended for studies on the geographical indication of honey.

RESUMEN

Polymers may be used to deliver compounds in freezing extenders to minimize injuries in spermatozoa during cryopreservation, although their activity and toxicity for boar sperm are unknown. This study investigated the effects of the polymer (N-vinylcaprolactam) (PNVCL), when included in extenders for boar sperm cryopreservation. In Experiment 1, sperm was exposed to PNVCL at: 0 (control); 39.1; 78.1; 156.3; and 312.5 µg/mL. Spermatozoa structure, kinetics and biochemical functions were unaltered in contact with PNVCL at 38 °C (P > .05) but declined with prolonged exposure (10, 60 and 120 min) in all treatments (P > .05). In Experiment 2, after inclusion of PNVCL in the freezing extender at the same concentrations, post-thawing sperm quality did not differ compared to the control (P > .05). Lipid peroxidation and the production of reactive oxygen species were the only parameters of sperm quality that were unaffected in both experiments, even after contact with PNVCL for 120 min (P > .05). As no negative effects were observed in post-thawing boar sperm quality, PNVCL did not incur in cytotoxicity and may be a potential carrier for antioxidants in freezing extenders.

Asunto(s)

Caprolactama/análogos & derivados , Criopreservación , Crioprotectores/administración & dosificación , Portadores de Fármacos/administración & dosificación , Polímeros/administración & dosificación , Preservación de Semen , Animales , Caprolactama/administración & dosificación , Daño del ADN , Peroxidación de Lípido , Masculino , Mitocondrias/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Espermatozoides , Porcinos

RESUMEN

ABSTRACT: There has been a significant advance in the poultry industry, and new technological and biological processes have accompanied the development of animals and inputs. Alongside the new possibilities for growth, there has been an emergence of new paradigms, including the rise of myopathies among which PSE, DFD, deep pectoral myopathy, oregon disease, acid breast, white stripping, wooden breast and spaghetti meat stand out. They cause considerable damage to the industry, as well as to ride hypotheses for studies in an attempt to better describe them. Researches seek to know about the behavior of proteins and specific protein groups in these anomalies. Groups of proteases are determinant to understand what may be occurring in muscle activity and; consequently, to understand the process in a more detailed way. Therefore, proteolytic systems may be acting on abnormal tissues. Proteases act differently in birds and mammals, but how altered they may be is still unknown. Besides, it is essential to relate the activities of these proteases, measures that indicate technological aspects that are relevant to meat quality standards. These quality standards must be directly associated with the consumption of raw meat in the material destined for processing, regardless of the final product. The important thing is to guarantee information that will lead the industry and consumers that will have, even with the anomaly developed, products that are nutritionally safe . This review discusses the biochemical and technological changes in poultry with pectoral anomalies, and how this affectsmeat quality.

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RESUMO: Sabe-se que houve um avanço considerável na indústria de frangos de corte nos últimos sessenta anos, e que consequentemente novos processos tecnológicos e biológicos acompanharam o desenvolvimento tanto de animais quanto de insumos. Com novas possibilidades de crescimento houve também o surgimento de novos paradigmas, sendo um deles o surgimento de diferentes tipos de miopatias. Como o peito é um dos pontos fortes da indústria de aves, muito tem se estudado sobre o assunto, e pode-se destacar PSE, DFD, Miopatia peitoral profunda ou peito verde, Peito ácido, White striping, Wooden breast e Spaghetti meat são as mais comuns. As três ultimas são mais recentes quando comparadas as outras citadas, e ainda há necessidade de compreensão do seu desenvolvimento, mas sabe-se que acarretam prejuízos consideráveis para o setor, além de permear a mente dos pesquisadores com hipóteses para estudos na tentativa de descrever melhor o que ocorre, o porquê de sua ocorrência e, futuramente, compreende-la ao ponto de poder gerar mecanismos para minimiza-las ou até mesmo suprimi-las. Os grupos de pesquisa nos USA, Italia, Brasil, Finlândia, Canadá e Inglaterra estão em busca destas respostas, todavia, até o momento, a Itália é o país que mais tem reportado informações sobre a problemática em torno de White striping e Wooden breast. Mas com todos os artigos até o presente momento, pouco se sabe sobre o comportamento de proteínas e grupos proteicos específicos nestas anomalias. O que há descrito trata-se de diferença entre conteúdo proteico e colágeno e taxa de degradação proteica. Contudo, sabe-se que grupos de proteases são determinantes para compreender o que pode estar ocorrendo na atividade muscular e consequentemtne entender o processo de forma mais detalhada. Logo, uma possibilidade é a compreensão de sistemas preoteolícos como as calpaínas, caspases e como podem estar atuando nos tecidos anômalos. Sabe-se que estas proteases atuam de maneira diferenciada em aves, quando comparada a mamíferos, mas o quão alterada podem estar ainda não se sabe. Além disto, é importante relacionar a atividades destas proteases com medidas que indiquem aspectos tecnológicos que sejam relevantes para padrões de qualidade de carnes. Estes padrões de qualidade devem estar diretamente associados ao consumo da carne in natura quanto ao material destinado à processamento, não importando qual seja o produto final. O mais importante é garantir informações que levem a indústria e os consumidores que terão, mesmo com a anomalia desenvolvida, produtos seguros nos aspectos nutricionais, bioquímicos e tecnológicos. Com base nestas breves informações, foi definido o procedimento metodológico desta proposta que permeia aspectos que incluam o maior número de informações sobre a alteração White striping em carne de aves, e com a reunião destas informações a possibilidade de entender melhor o que ocorre nestas carnes, levando a um conjunto de analises ainda não relatado na atual literatura.

RESUMEN

Reactions of two vanadium(IV) complex anions that are homologues of amavadin, [V(HIDPA)2 ]2- and [V(HIDA)2 ]2- (HIDPA=N-oxyiminodipropionate, HIDA=N-oxyiminodiacetate), with the nitrite ion (NO2- ) in aqueous solution were investigated by experimental (absorption spectroscopy in the visible range, through measurements of dioxygen formed in solution from water oxidation and identification of nitrogen oxide species of a gaseous atmosphere from nitrite reduction by using an IR analyser) and theoretical methods. Two reactions, mediated by the vanadium complexes, with environmental and biological significance, were observed in this system, namely, reduction of nitrite to N2 O and oxidation of water to molecular oxygen. The reduction of nitrite, as studied by DFT calculations, occurs through the formation of NO (ΔG≠ =14.3 kcal mol-1 ), which is strongly dependent on pH and slightly endergonic, and is then easily converted into N2 O, with an overall activation barrier of ΔG≠ =11.8 kcal mol-1 . The later process includes dimerisation of NO assisted by one molecule of the V complex, protonation and oxidation of the formed ONNO.- ligand by another amavadin molecule or by nitrite, and NO bond cleavage/proton transfer in the ONNOH- ligand. The results indicate that amavadin exhibits an unusual nitrite reductase type activity that could be involved in nitrogen metabolism of Amanita muscaria and other fungi containing this vanadium complex.

RESUMEN

BACKGROUND: Hamburger is a meat-based food that is easy to prepare and is widely consumed. It can be enriched using different ingredients, such as chia's by-product, which is rich in omega-3. Chemometrics is a very interesting tool to assess the influence of ingredients in the composition of foods. A complete factorial design 2(2) (two factors in two levels) with duplicate was performed to investigate the influence of the factors (1) concentration of textured soy proteins (TSP) and (2) concentration of chia flour partially defatted (CFPD) as a partial replacement for the bovine meat and porcine fat mix in hamburgers. RESULTS: The results of proximal composition, lipid oxidation, fatty acids sums, ratios, and nutritional indexes were used to propose statistical models. The factors TSP and CFPD were significant, and the increased values contributed to improve the composition in fatty acids, crude protein, and ash. Principal components analysis distinguished the samples with a higher content of chia. In desirability analysis, the highest level of TSP and CFPD was described as the optimal region, and it was not necessary to make another experimental point. CONCLUSION: The addition of chia's by-product is an alternative to increase the α-linolenic contents and to obtain nutritionally balanced food.

Asunto(s)

Ácidos Grasos Omega-3/análisis , Aditivos Alimentarios , Alimentos Fortificados/análisis , Productos de la Carne/análisis , Salvia/química , Semillas/química , Animales , Brasil , Bovinos , Proteínas en la Dieta/análisis , Ácidos Grasos/análisis , Ácidos Grasos Omega-3/administración & dosificación , Ácidos Grasos Omega-3/efectos adversos , Ácidos Grasos Omega-3/economía , Aditivos Alimentarios/efectos adversos , Aditivos Alimentarios/economía , Alimentos Fortificados/economía , Industria de Procesamiento de Alimentos/economía , Residuos Industriales/análisis , Residuos Industriales/economía , Peroxidación de Lípido , Productos de la Carne/economía , Industria para Empaquetado de Carne/economía , Valor Nutritivo , Proteínas de Plantas/análisis , Alimentos de Soja/análisis , Estadística como Asunto , Sus scrofa

RESUMEN

Background: Residual oils were characterized according to their physicochemical properties, i.e. acidity, iodine value, peroxide value and saponification number, to evaluate the degradation level and viability for biodiesel production. Results: The methyl esters of fatty acids (FAME) from samples of residual bovine, chicken and soybean oils were quantified by using four transesterification methods, using acidic and basic catalysis and, gas chromatography with flame ionization detector (GC-FID). Methods that used acidic catalysis at a lower temperature were the most efficient. Methyl biodiesel samples were synthesized by basic catalysis (KOH) for all quantified oils and the physicochemical properties of the biofuel were evaluated, i.e. viscosity, flash and fire points, density, water content, iodine and acidity numbers. Conclusions: The obtained results suggesting that it is possible to take advantage of these residues for biodiesel production as the obtained products were approved according to the rules established by the National Association of Petroleum (ANP); the bovine samples were the exception regarding moisture and acidity.

Asunto(s)

Aceites/química , Biocombustibles , Residuos , Catálisis , Cromatografía de Gases , Esterificación , Ésteres/análisis , Ácidos Grasos , Ionización de Llama

RESUMEN

The purpose of this study was to evaluate outcomes such as success of the initial therapy, failure of outpatient treatment, and death in outpatient treatment during intravenous antimicrobial therapy in patients with febrile neutropenia (FN) and hematological malignancies. In addition, clinical and laboratory data and the Multinational Association for Supportive Care of Cancer index (MASCC) were compared with failure of outpatient treatment and death. In a retrospective study, we evaluated FN following chemotherapy events that were treated initially with cefepime, with or without teicoplanin and replaced by levofloxacin after 48 h of defervescence in patients with good general conditions and ANC>500/mm3. Of the 178 FN episodes occurred in 126 patients, we observed success of the initial therapy in 63.5% of the events, failure of outpatient treatment in 20.8%, and death in 6.2%. The success rate of oral levofloxacin after defervescence was 99% (95 out of 96). Using multivariate analysis, significant risks of failure of outpatient treatment were found to be smoking (odds ratio (OR) 3.14, confidence interval (CI) 1.14-8.66; p=0.027) and serum creatinine levels>1.2 mg/dL (OR 7.97, CI 2.19-28.95; p=0.002). With regard to death, the risk found was oxygen saturation by pulse oximetry<95% (OR 5.8, IC 1.50-22.56; p=0.011). Using the MASCC index, 165 events were classified as low risk and 13 as high risk. Failure of outpatient treatment was reported in seven (53.8%) high-risk and 30 (18.2%) low-risk episodes (p=0.006). In addition, death occurred in seven (4.2%) low-risk and four (30.8%) high-risk events (p=0.004). Ours results show that MASCC index was able to identify patients with high risk. In addition, non-smoking, serum creatinine levels≤1.2 mg/dL, and oxygen saturation by pulse oximetry≥95% were protection factors.

Asunto(s)

Antibacterianos/administración & dosificación , Fiebre/tratamiento farmacológico , Neoplasias Hematológicas/tratamiento farmacológico , Terapia de Infusión a Domicilio , Levofloxacino , Neutropenia/tratamiento farmacológico , Ofloxacino/administración & dosificación , Ofloxacino/uso terapéutico , Adulto , Antibacterianos/uso terapéutico , Cefepima , Cefalosporinas/uso terapéutico , Fiebre/fisiopatología , Neoplasias Hematológicas/fisiopatología , Humanos , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , Neutropenia/fisiopatología , Estudios Retrospectivos , Teicoplanina/uso terapéutico , Resultado del Tratamiento

RESUMEN

We describe the response of imatinib as lifesaving treatment of chronic myeloid leukemia (CML) relapse in seven patients who underwent allogeneic bone marrow transplantation (alloBMT) at our institution over a period of 4 years. Retrospective analysis of their medical records revealed that a mean age at transplant was 45.2 years. The median time to diagnosis was 7.4 years after transplant. At relapse, four, two, and one patients were classified as having hematologic, major molecular, and cytogenetic relapse, respectively. At imatinib initiation, five had CML in a chronic phase, while one patient was diagnosed as having accelerated phase and blast crisis. All these patients could be evaluated for the therapeutic efficacy. At a mean of follow-up of 1.9 years of therapy, all evaluable patients achieved major molecular response without compromising safety. Consistent with available data, our results indicate that imatinib is safe and effective treatment option for patients with relapse after BMT.

Asunto(s)

Cromosomas Humanos Par 7 , Leucemia Mielógena Crónica BCR-ABL Positiva/patología , Monosomía , Inhibidores de Proteínas Quinasas/efectos adversos , Benzamidas , Células Clonales/patología , Dasatinib , Humanos , Mesilato de Imatinib , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/etiología , Masculino , Persona de Mediana Edad , Síndromes Mielodisplásicos/diagnóstico , Síndromes Mielodisplásicos/etiología , Piperazinas , Pirimidinas , Tiazoles , Adulto Joven

RESUMEN

BACKGROUND: The purpose of this retrospective study was to investigate the efficacy, toxicity and mobilization rate after modified Magrath IVAC (mIVAC) chemotherapy regimen prescribed in relapsed disease (RD) or primary refractory disease (PRD) in aggressive non-Hodgkin lymphoma (NHL). PATIENTS AND METHODS: Twenty-four patients (16 males, 8 females) aged 18-59 years (median age 37 year) were analyzed. The most frequent histopathological subgroup was diffuse large B-cell lymphoma (DLCL-B) (n=21/24), 13 (54%) were considered RD and 11 (46%) PRD. The mIVAC consisted of ifosfamide (IFM), high dose cytarabine and etoposide repeated every 28 days. RESULTS: The overall response (OR) after three cycles of mIVAC was 66. 6%. Among the patients with PRD, OR was 45.5% (5 out of 11) and with RD was 86.4%, p>0.05, however, it was observed in RD better complete response (CR) than PRD 53.8x9.1% (p<0.05). Eighty-eight percent (14 out of 16) of patients with chemosensitive disease to mIVAC underwent autologous stem cell transplantation (ASCT). The median number of collected CD34+ cells was 2.86x10(6) (range 2.17x10(6) to 4.9x10(6)). The median overall survival rate (OS) for chemosensitive to mIVAC was 16.3 months, with a median follow-up of 16 months. Grades III-IV neutropenia was observed in 85.6% per cycles and grades III-IV thrombocytopenia in 87.5%. Grades III-IV febrile neutropenia was the most common nonhematological toxicity, it occurred in 28% of the cycles and no deaths by toxicity were observed. DISCUSSION: Although a statistic comparative study was not carried out for these 24 patients, the rate of OR to mIVAC was alike the other second-line infusion regimens. The mobilization failure rate was 57.1% and it was similar to other regimens with high dose cytarabine, but it did not limit performed ASCT.

Asunto(s)

Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Linfoma de Células B/prevención & control , Linfoma no Hodgkin/prevención & control , Trasplante de Células Madre , Adolescente , Adulto , Brasil , Citarabina/administración & dosificación , Países en Desarrollo , Supervivencia sin Enfermedad , Etopósido/administración & dosificación , Femenino , Humanos , Ifosfamida/administración & dosificación , Masculino , Persona de Mediana Edad , Recurrencia , Trasplante Autólogo

RESUMEN

PURPOSE: Infection is the leading complication of long-term central venous catheters, and its incidence may vary according to catheter type. The objective of this study was to compare the frequency and probability of infection between two types of long-term intravenous devices. METHODS: Retrospective study in 96 onco-hematology patients with partially implanted catheters (n = 55) or completely implanted ones (n = 42). Demographic data and catheter care were similar in both groups. Infection incidence and infection-free survival were used for the comparison of the two devices. RESULTS: In a median follow-up time of 210 days, the catheter-related infection incidence was 0.2102/100 catheter-days for the partially implanted devices and 0.0045/100 catheter-days for the completely implanted devices; the infection incidence rate was 46.7 (CI 95% = 6.2 to 348.8). The 1-year first infection-free survival ratio was 45% versus 97%, and the 1-year removal due to infection-free survival ratio was 42% versus 97% for partially and totally implanted catheters, respectively (P <.001 for both comparisons). CONCLUSION: In the present study, the infection risk was lower in completely implanted devices than in partially implanted ones.

Asunto(s)

Bacteriemia/etiología , Cateterismo Venoso Central/efectos adversos , Linfoma/tratamiento farmacológico , Adolescente , Adulto , Anciano , Atención Ambulatoria , Brasil/epidemiología , Cateterismo Venoso Central/instrumentación , Cateterismo Periférico/efectos adversos , Cateterismo Periférico/instrumentación , Métodos Epidemiológicos , Femenino , Humanos , Linfoma/mortalidad , Masculino , Persona de Mediana Edad

RESUMEN

OBJETIVO: Infecção é a principal complicação relacionada ao uso de cateteres venosos de longa permanência em pacientes oncológicos e sua incidência pode variar a depender do tipo de cateter utilizado. O objetivo deste estudo foi comparar a freqüência e risco de infecção entre dois tipos de dispositivos de longa permanência. MÉTODOS: Estudo retrospectivo com 96 pacientes onco-hematológicos portadores de cateteres parcialmente implantáveis (n=55) ou totalmente implantáveis (n=42). Dados demográficos e cuidados com o dispositivo foram similares entre os dois grupos. A comparação entre os dispositivos foi realizada através da avaliação da incidência de infecção e da sobrevida livre de infecção. RESULTADOS: Em uma mediana de acompanhamento de 210 dias, a incidência de infecção relacionada ao cateter foi de 0,2102/100 cateter-dias para os dispositivos parcialmente implantáveis e de 0,0045/100 cateter-dias para os totalmente implantáveis, com uma razão de incidência de 46,7 (IC 95% = 6,2 a 348,8). A taxa de sobrevida livre de primeira infecção em um ano foi de 45% versus 97% e a taxa de sobrevida livre de retirada por infecção foi de 42% versus 97%, respectivamente para cateter parcialmente ou totalmente implantável (p<0,001 para ambas comparações). Conclusão: No presente estudo, o risco de infecção foi menor nos dispositivos totalmente implantáveis do que nos parcialmente implantáveis.

Asunto(s)

Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Bacteriemia/etiología , Cateterismo Venoso Central/efectos adversos , Linfoma/tratamiento farmacológico , Atención Ambulatoria , Brasil/epidemiología , Cateterismo Venoso Central/instrumentación , Cateterismo Periférico/efectos adversos , Cateterismo Periférico/instrumentación , Métodos Epidemiológicos , Linfoma/mortalidad

RESUMEN

Durante 18 meses, 116 cateteres venosos foram enviados para cultura no Laboratório de Bacteriologia do Instituto Nacional de Câncer. Destes, 16 (22,2%) foram positivos para a presença de microrganismos. Pseudomonas aeruginosa foi o microrganismo mais freqüentemente isolado (23%), seguido de Staphylococcus epidermidis (19%). A maioria dos casos positivos para P. aeruginosa foram encontrados em pacientes internados no Serviço de Hematologia-Oncologia, enquanto que casos positivos em pacientes cirúrgicos foram, na maior parte das vezes, associados a infecçöes de ferida operatória

Asunto(s)

Humanos , Infecciones Bacterianas/etiología , Catéteres de Permanencia/efectos adversos , Amicacina/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Bacterias Gramnegativas/aislamiento & purificación , Tobramicina/uso terapéutico

RESUMEN

Cento e cinqüenta e quatro cepas de enterobactérias, Staphylococcus e Pseudomonas foram testadas quanto à induçäo da produçäo de beta-lactamase na presença de penicilina. Observamos depressäo enzimática em cepas de E.coli, Klebsiella e Proteus, sendo que Pseudomonas, Serratia e Enterobacter possivelmente precisem ser testados na presença de cefalosporina estável à beta-lactamase

Asunto(s)

beta-Lactamasas/biosíntesis , Bacterias Aerobias Gramnegativas/enzimología , Técnicas In Vitro , Penicilinas/farmacología , Farmacorresistencia Microbiana

Asunto(s)

Prótesis Valvulares Cardíacas