RESUMO

Relatar a experiência vivenciada por enfermeiras mestrandas e docente de disciplina eletiva de universidade pública do interior de Minas Gerais. Método: estudo descritivo, do tipo relato de experiência, a fim de relatar reflexões críticas acerca da Política Nacional de Humanização (PNH) realizadas em disciplina de Programa de Pós-graduação stricto sensu ministrada entre agosto e novembro de 2023. Resultados: participaram sete enfermeiras, todas do sexo feminino, com vivências em instituições de saúde públicas e privadas. Foi possível compreender sobre diversos aspectos, e duas categorias foram elaboradas: Repercussões e entraves referentes à implantação plena da PNH; Humanização e ensino teórico-prático nas instituições formadoras. Também foi produzido um mapa mental sobre a temática. Conclusão: destaca-se a importância de discutir sobre humanização nas instituições de ensino para o aprofundamento do tema e disseminação do conhecimento associado ao olhar prático humanizado.(AU)

To report on the experience of master's degree nurses and a lecturer in an elective course at a public university in the interior of Minas Gerais. Method: this is a descriptive, experience-report type study, aimed at reporting critical reflections on the National Humanization Policy (NHP) carried out in a stricto sensu postgraduate program course taught between August and November 2023. Results: Seven nurses took part, all female, with experience in public and private healthcare institutions. It was possible to understand various aspects, and two categories were created: Repercussions and obstacles regarding the full implementation of the PNH; Humanization and theoretical-practical teaching in training institutions. A mind map on the subject was also produced. Conclusion: The importance of discussing humanization in educational institutions is highlighted in order to deepen the subject and disseminate knowledge associated with a practical humanized approach.(AU)

Relatar la experiencia de enfermeros de maestría y de un profesor en un curso electivo de una universidad pública del interior de Minas Gerais. Método: se trata de un estudio descriptivo, de tipo experiencia-informe, con el objetivo de relatar reflexiones críticas sobre la Política Nacional de Humanización (PNH) realizadas en una asignatura del programa de posgrado stricto sensu impartida entre agosto y noviembre de 2023. Resultados: Participaron siete enfermeras, todas del sexo femenino, con experiencia en instituciones de salud públicas y privadas. Se pudieron conocer diversos aspectos y se desarrollaron dos categorías: repercusiones y obstáculos en la plena implantación de la PNH; humanización y enseñanza teórico-práctica en las instituciones de formación. También se elaboró un mapa mental sobre el tema. Conclusión: Se destaca la importancia de discutir la humanización en las instituciones de enseñanza para profundizar el tema y difundir el conocimiento asociado a un abordaje humanizado práctico.(AU)

Assuntos

RESUMO

INTRODUCTION: Invasive Haemophilus influenzae (Hi) disease poses a significant global health challenge. With the relaxation of COVID-19 pandemic measures and declining H. influenzae serotype b (Hib) vaccination coverage, there is concern about a potential increase in Hi cases worldwide. METHODOLOGY: This study analyzed 1437 invasive Hi isolates in Brazil over 13 years, determining capsular serotypes, antimicrobial susceptibility, and genetic relatedness through multilocus sequence typing. RESULTS: The primary source of isolation for these invasive H. influenzae isolates was blood (54.4%), followed by cerebrospinal fluid (37.1%) and lung specimens (8.5%), respectively. Consequently, bacteremia (47%) was the most common clinical presentation, followed by meningitis (39.6%) and pneumonia (13.4%). Non-encapsulated Hi (NTHi) predominated among the isolates (51.4%), along with serotype a (22%) and serotype b (21.5%) among the encapsulated isolates. The majority of the encapsulated isolates were isolated from children under 14 years of age (76.7%), while NTHi isolates were identified in patients older than 15 years, particularly those ≥ 60 years old (40%). Ampicillin resistance was observed in 17.1% of cases, displaying ß-lactamase production as the principal resistance mechanism. MLST revealed a diverse NTHi population, whereas the encapsulated isolates presented a clonal structure. CONCLUSION: This study describes the prevalence of NTHi isolates circulating in Brazil after two decades of the Hib vaccine immunization program. Continuous universal surveillance is crucial for implementing prompt public health measures to prevent and control invasive Hi disease and monitor changes in antibiotic resistance profiles.

RESUMO

Cutaneous tuberculosis is a rare manifestation of extrapulmonary tuberculosis caused by Mycobacterium tuberculosis in most cases and rarely by Mycobacterium bovis. Diagnosis may be challenging due to a wide range of clinical findings and similarities to other chronic dermatoses, leading to delayed treatment. We present a case of scrofuloderma in a 4-year-old girl that arose from a contiguous spread from the anterior mediastinum with associated pulmonary involvement.

Assuntos

RESUMO

Despite the introduction of the pneumococcal vaccine, Streptococcus pneumoniae remains a cause of invasive diseases in Brazil. This study provides the distribution of serotypes and antimicrobial susceptibility patterns for pneumococcal isolates before and during the years of the COVID-19 pandemic in two age groups, <5 and ≥50 years. This is a national laboratory-based surveillance study that uses data from the Brazilian national laboratory for invasive S. pneumoniae from the pre-COVID-19 (January 2016 to January 2020) and COVID-19 (February 2020 to May 2022) periods. Antimicrobial resistance was evaluated by disk diffusion and minimum inhibitory concentration. The year 2020 was marked by a 44.6% reduction in isolates received and was followed by an upward trend from 2021 onwards, which became evident in 2022. No differences were observed in serotypes distribution between the studied periods. The COVID-19 period was marked by the high prevalence of serotypes 19A, 3, and 6C in both age groups. Serotypes 19A and 6C were related to non-antimicrobial susceptibility. We observed a reduction in S. pneumoniae, without changes in serotypes distribution and epidemiological capsular switch during the COVID-19 period. We observed elevated resistance rates, mainly to penicillin and ceftriaxone for non-meningitis cases in children under 5 years of age.

RESUMO

Many biological activities are described for the Clusiaceae family. Clusia fluminensis, a species from Brazilian flora, is mainly employed for ornamental purposes. This review aimed to depict the current knowledge of C. fluminensis from a bioprospecting standpoint. "Clusia fluminensis" search term was applied in Scopus, Web of Science, PubMed and Bireme databases according to PRISMA-ScR statement. Selected papers on Phytochemistry or Bioactivity followed hand searching procedures. Bioactivity preclinical studies considered in vitro or in vivo biological systems, treated with plant extracts or isolated compounds. The outcomes were compared with standard or no treatment control groups. Critical appraisal of individual trials considered completeness in the research fields. Our results showed that 81% of the selected papers presented high level of completeness, 69% revealed phytochemical parameters and 31% biological applications of plant extracts and isolated compounds. Polyisoprenylated benzophenones, terpenoids, sterols and phenolic compounds were identified. Antiviral, insecticidal and snake antivenom activities were reported. In conclusion, the phytochemical data reinforce the reported activities. Potential applications in personal care, nutritional supplementation and pharmaceutical, food, chemical or textile industries were also identified. Toxicological and phytochemical complementary studies may be required.

Assuntos

RESUMO

Prosopis juliflora is a xerophytic, nitrogen-fixing plant distributed in arid and semi-arid regions. The fruits of this plant are pods, which have seeds inside, and both pods and seeds have high nutritional value and bioactive potential. Different derivatives can be obtained from the pods and seeds: flour, starch, syrup, protein concentrate, and gums. This review aims to gather information from the literature on P. juliflora. It focuses on the nutritional value, bioactive activity, and technological application of pods, seeds, and their derivatives, highlighting their use in human nutrition and new research perspectives. The pod of P. juliflora can be used in several ways, as it has high levels of nutrients. It is used as a food supplement; it has antimicrobial effects and phytochemicals associated with other bioactive activity. Among the pod derivatives, flour is the most studied and can be widely used in bakery products. The seed of P. juliflora also has high nutritional potential and bioactive activity. Among its other derivatives, the gum stands out and can be used for various purposes in the food industry. To expand the use of pods, seeds, and their derivatives in human nutrition, further studies are needed on chemical composition, bioactive activity, toxicity, and nutritional, bioactive, technological, and sensory effects of their application in food products. © 2023 Society of Chemical Industry.

Assuntos

RESUMO

INTRODUCTION: Invasive meningococcal disease (IMD) is a major health problem. Given the post-COVID-19 pandemic scenario with the loosening of the non-pharmacological measures to control the virus transmission and considering the observed global reduction of meningococcal vaccination coverage, an increase in IMD cases can be expected. METHODOLOGY: Using whole-genome sequencing, we characterized six Neisseria meningitidis serogroup X (MenX) isolates recovered from IMD cases in Brazil in the last 30 years. RESULTS: The predominance (66.6%, 4/6) of ST2888 presenting fHbp 160, NHBA 129, NadA 21, and PorA 19,15 was found on isolates. Two novel STs, 15458 and 15477, were described. CONCLUSION: This study describes the circulation of MenX lineage ST2888 in Brazil, previously reported only in Europe. Continuous universal surveillance is crucial to implement prompt public health measures aiming to prevent and control non-vaccine preventable serogroup X IMD cases.

Assuntos

RESUMO

Este artigo apresenta parte dos resultados de uma dissertação de mestrado cujo objetivo foi compreender as vivências de sofrimento e as estratégias defensivas desenvolvidas por manicures atuantes em salões de beleza. Nesta pesquisa, de caráter qualitativo, conduziram-se entrevistas em profundidade a partir de roteiro semiestruturado com 12 manicures de nove diferentes salões de beleza localizados no município do Rio de Janeiro. As informações levantadas foram analisadas sob a ótica da análise dos núcleos do sentido. Nos resultados, observou-se o agravamento do sofrimento diretamente relacionado às políticas de remuneração praticadas nos salões, à assimilação do ônus do custeamento dos instrumentos de trabalho e à carência de benefícios sociais e trabalhistas. Como estratégias de defesa, observou-se a predominância de estratégias individuais. A pesquisa buscou contribuir para a redução da invisibilização do trabalho de manicures e, a partir da psicodinâmica do trabalho, desvelar a reciprocidade entre as precárias condições de laborais e os fatores geradores de adoecimento psíquico dessas trabalhadoras

This article presents part of the results of a master's degree whose objective was to understand the experiences of suffering and the defensive strategies experienced by manicurists in beauty salons. In this qualitative research, in-depth interviews were conducted based on a semi-structured script with 12 manicurists from nine different beauty salons located in the municipality of Rio de Janeiro. The data obtained were analyzed from the perspective of the analysis of nuclei of sense. The results showed the worsening of suffering is directly related to the remuneration policies practiced in the salons, the assimilation of the burden of funding work instruments, and the lack of social and labor benefits. As defense strategies, the predominance of individual strategies was observed. This research contributes to reduce the invisibility of manicurists' work and, based on the psychodynamics of work, show the reciprocity between precarious working conditions and the factors that generate these workers' mental illness

Assuntos

RESUMO

Invasive meningococcal disease persists as a fulminant disorder worldwide. Although cases caused by Neisseria meningitidis serogroup X (MenX) occur infrequently, outbreaks have been reported in countries in Africa in recent decades. We report 2 cases of MenX invasive meningococcal disease in São Paulo, Brazil, in 2021 and 2022, during the COVID-19 pandemic.

Assuntos

RESUMO

Objective To verify how the combined administration of alendronate (ALN) and vitamin D3 (VD) acts on the bone microarchitecture in rats with glucocorticoid-induced osteoporosis. Methods The experiment used 32 90-day-old female Wistar rats weighing between 300 and 400g. The induction of osteoporosis consisted of intramuscular administration of dexamethasone at a dose of 7.5 mg/kg of body weight once a week for 5 weeks, except for the animals in the control group. The animals were separated into the following groups: G1 (control group without osteoporosis), G2 (control group with osteoporosis without treatment), G3 (group with osteoporosis treated with ALN 0.2 mg/kg), G4 (group with osteoporosis treated with VD 10,000UI/500µL), and G5 (group with osteoporosis treated with ALN + VD). The right femurs of the rats were fixed in 10% buffered formaldehyde, decalcified, and processed for inclusion in paraffin. Histological sections were stained with hematoxylin-eosin for histomorphometric analysis. Cortical thickness and medullary cavity were measured in cross-sections. Results There was a statistical difference ( p < 0.05) between groups G3 and G5 compared with the positive control group (G2), both related to the measurement of cortical thickness and to the total diameter of the bone. In the evaluation of the spinal area, only the G3 group has shown to be statistically different from the G2 group. Conclusion Concomitant treatment with daily ALN and weekly VD is effective in preventing glucocorticoid-induced bone loss. However, there was no difference between the therapy tested and treatment with ALN alone.

RESUMO

Abstract Objective To verify how the combined administration of alendronate (ALN) and vitamin D3 (VD) acts on the bone microarchitecture in rats with glucocorticoid-induced osteoporosis. Methods The experiment used 32 90-day-old female Wistar rats weighing between 300 and 400g. The induction of osteoporosis consisted of intramuscular administration of dexamethasone at a dose of 7.5 mg/kg of body weight once a week for 5 weeks, except for the animals in the control group. The animals were separated into the following groups: G1 (control group without osteoporosis), G2 (control group with osteoporosis without treatment), G3 (group with osteoporosis treated with ALN 0.2 mg/kg), G4 (group with osteoporosis treated with VD 10,000UI/500μL), and G5 (group with osteoporosis treated with ALN þ VD). The right femurs of the rats were fixed in 10% buffered formaldehyde, decalcified, and processed for inclusion in paraffin. Histological sections were stained with hematoxylin-eosin for histomorphometric analysis. Cortical thickness and medullary cavity were measured in cross-sections. Results There was a statistical difference (p< 0.05) between groups G3 and G5 compared with the positive control group (G2), both related to the measurement of cortical thickness and to the total diameter of the bone. In the evaluation of the spinal area, only the G3 group has shown to be statistically different from the G2 group. Conclusion Concomitant treatment with daily ALN and weekly VD is effective in preventing glucocorticoid-induced bone loss. However, there was no difference between the therapy tested and treatment with ALN alone.

Resumo Objetivo Verificar como a administração conjunta de alendronato de sódio (ALN) e vitamina D3 (VD) atua na microarquitetura óssea em ratas com osteoporose induzida por glicocorticoide. Métodos O experimento utilizou 32 ratas da linhagem Wistar, com peso médio de 300 a 400g, com 90 dias de vida. A indução da osteoporose consistiu na administração de dexametasona na dose de 7,5 mg/kg de peso corporal, por via intramuscular, 1 vez por semana durante 5 semanas, à exceção dos animais do grupo controle. Os animais foram distribuídos nos seguintes grupos: G1 (grupo controle sem osteoporose), G2 (grupo controle com osteoporose sem tratamento), G3 (grupo com osteoporose tratado com ALN 0,2 mg/kg), G4 (grupo com osteoporose tratado com VD 10.000UI/500μL) e G5 (grupo com osteoporose tratado com ALN þ VD). Os fêmures direitos das ratas foram fixados em formol a 10% tamponado, descalcificados e processados para inclusão em parafina. Os cortes histológicos foram corados com hematoxilina-eosina para análise histomorfométrica. A espessura cortical e a cavidade medular foram medidas em cortes transversais. Resultados Houve diferença estatística (p< 0,05) entre os grupos G3 e G5 em relação ao grupo controle positivo (G2), tanto em relação à medida da espessura cortical quanto em relação ao diâmetro total do osso. Na avaliação da área medular, apenas o grupo G3 se mostrou estatisticamente diferente do grupo G2. Conclusão O tratamento concomitante com ALN diário e VD semanal é eficaz para prevenir a perda óssea induzida por glicocorticoide. No entanto, não houve diferença entre esta terapia testada e o tratamento apenas com o ALN.

Assuntos

RESUMO

Introduction. Invasive meningococcal disease is a major health problem, impacting morbidity and mortality worldwide. Exploratory genomics has revealed insights into adaptation, transmissibility and virulence to elucidate endemic, outbreaks or epidemics caused by Neisseria meningitidis serogroup W (MenW) strains.Gap Statement. Limited information on the genomics of Neisseria meningitis serogroup W ST11/cc11 is available from emerging countries, especially in contemporary isolates.Aim. To (i) describe the antigenic diversity and distribution of genetic lineages of N. meningitidis serogroup W circulating in Brazil; (ii) study the carriage prevalence of hypervirulent clones in adolescents students and (iii) analyse the potential risk factors for meningococcal carriage.Methodology. Using whole-genome sequencing, we analysed the genomic diversity of 92 invasive N. meningitidis serogroup W isolates circulating in Brazil from 2016 to 2019. A cross-sectional survey of meningococcal carriage was conducted in 2019, in the city of Florianópolis, Brazil, among a representative sample of 538 students.Results. A predominance (58.5 %, 41/82) of ST11/cc11 presenting PorB2-144, PorA VR1-5, VR2-2, FetA 1-1, and a novel fHbp peptide 1241 was found on invasive N. meningitidis W isolates, on the other hand, a high diversity of clonal complexes was found among carriage isolates. The overall carriage rate was 7.5 % (40/538). A total of 28 of 538 swab samples collected were culture positive for N. meningitidis, including four serogroup/genogroup B isolates (14.8 %;4/27), 1 serogroup/genogroup Y isolate (3.7 %;1/27), 22 (81.5 %; 22/27) non-groupable isolates. No MenW isolate was identified among carriages isolates.Conclusion. This report describes the emergence of the new MenW ST11/cc11 South America sublineage variant, named here, 2016 strain, carrying a novel fHbp peptide 1241, but its emergence, was not associated with an increased MenW carriage prevalence. Continuous surveillance is necessary to ascertain the role of this sublineage diversification and how its emergence can impact transmission.

Assuntos

RESUMO

Poly(lactic acid) (PLA) nanofibres containing different proportions of the essential oils from Ocimum basilicum L. and Ocimum gratissimum L. were prepared by solution blow spinning method. The essential oils were extracted by hydrodistillation and characterized by gas chromatography. MEV, contact angle, DSC and FTIR were used to characterize the nanofibres. The effect of bioative nanofibres on the growth of the fungus and on the production of ochratoxin A were evaluated using the fumigation test. Linalool, 1·8-cineole and camphor were the principal components of the essential oil from O. basilicum, and eugenol was the principal constituent in the oil from O. gratissimum. An increase in the average diameter of the nanofibres was observed with the addition of the essential oils. The essential oils acted as a plasticizer, resulting in a reduction in the crystallinity of the PLA. The encapsulation of essential oils in PLA nanofibres was verified by FTIR. An effective antifungal and antimicotoxygenic activity against Aspergillus ochraceus and Aspergillus westerdjikiae was observed for the bioative nanofibres. These results confirm the potential of PLA nanofibres containing the essential oils for the control of toxigenic fungi that cause the deterioration of food and are harmful to human health.

Assuntos

RESUMO

Introduction. Invasive meningococcal disease is a major health problem, impacting morbidity and mortality worldwide. Exploratory genomics has revealed insights into adaptation, transmissibility and virulence to elucidate endemic, outbreaks or epidemics caused by Neisseria meningitidis serogroup W (MenW) strains.Gap Statement. Limited information on the genomics of Neisseria meningitis serogroup W ST11/cc11 is available from emerging countries, especially in contemporary isolates.Aim. To (i) describe the antigenic diversity and distribution of genetic lineages of N. meningitidis serogroup W circulating in Brazil; (ii) study the carriage prevalence of hypervirulent clones in adolescents students and (iii) analyse the potential risk factors for meningococcal carriage.Methodology. Using whole-genome sequencing, we analysed the genomic diversity of 92 invasive N. meningitidis serogroup W isolates circulating in Brazil from 2016 to 2019. A cross-sectional survey of meningococcal carriage was conducted in 2019, in the city of Florianópolis, Brazil, among a representative sample of 538 students.Results. A predominance (58.5 %, 41/82) of ST11/cc11 presenting PorB2-144, PorA VR1-5, VR2-2, FetA 1-1, and a novel fHbp peptide 1241 was found on invasive N. meningitidis W isolates, on the other hand, a high diversity of clonal complexes was found among carriage isolates. The overall carriage rate was 7.5 % (40/538). A total of 28 of 538 swab samples collected were culture positive for N. meningitidis, including four serogroup/genogroup B isolates (14.8 %;4/27), 1 serogroup/genogroup Y isolate (3.7 %;1/27), 22 (81.5 %; 22/27) non-groupable isolates. No MenW isolate was identified among carriages isolates.Conclusion. This report describes the emergence of the new MenW ST11/cc11 South America sublineage variant, named here, 2016 strain, carrying a novel fHbp peptide 1241, but its emergence, was not associated with an increased MenW carriage prevalence. Continuous surveillance is necessary to ascertain the role of this sublineage diversification and how its emergence can impact transmission.

Assuntos

RESUMO

Resumo A pesquisa que originou este artigo teve como objetivo identificar experiências de apoio institucional no âmbito da Atenção Primária à Saúde, para apreender como ocorrem a difusão da proposta, os limites, dificuldades e resultados que ela alcançou em distintos contextos e realidades. O mapeamento foi realizado por meio de pesquisa documental na Comunidade de Práticas da Atenção Básica, resultando na inclusão de 38 relatos de experiência. Os dados corroboram o potencial do apoio institucional para fomentar práticas e arranjos de gestão compartilhada na implementação de políticas e programas de saúde, na promoção de mudanças no processo de trabalho de equipes e na integração intra e interinstitucional. Ele é empregado como recurso para transformar indicativos normativos em relações sociais e dispositivos organizacionais no cotidiano da atenção e da gestão do Sistema Único de Saúde. Os principais desafios identificados referem-se às resistências oriundas de dinâmicas culturais e comunicacionais atinentes a concepções e práticas de gestão influenciadas pelo modelo da administração clássica, além de um conjunto de questões operacionais que incidem negativamente nos resultados alcançados. A sistematização das experiências possibilitou-nos compreender que o apoio institucional demanda habilidades de mediação complexas, que precisam ser melhor compreendidas e instrumentalizadas, principalmente no tocante à participação da comunidade.

Abstract The research that originated this article aimed to identify experiences of institutional support within the scope of Primary Health Care, in order to understand how the proposal is disseminated, the limits, difficulties and results it has achieved in different contexts and realities. The mapping was carried out through documentary research in the Primary Care Community of Practice, resulting in the inclusion of 38 experience reports. The data corroborate the potential of institutional support to foster shared management practices and arrangements in the implementation of health policies and programs, in promoting changes in the teamwork process and in intra- and inter-institutional integration. It is used as a resource to transform normative indicators into social relations and organizational devices in the daily care and management of the Brazilian Unified Health System. The main challenges identified refer to resistance arising from cultural and communicational dynamics related to management concepts and practices influenced by the classical administration model, in addition to a set of operational issues that negatively affect the results achieved. The systematization of experiences made it possible for us to understand that institutional support demands complex mediation skills, which need to be better understood and implemented, especially with regard to community participation.

Resumen La investigación que dio origen a este artículo tuvo como objetivo identificar experiencias de apoyo institucional en el ámbito de la Atención Primaria de Salud, con el fin de comprender cómo se difunde la propuesta, los límites, las dificultades y los resultados alcanzados por esta práctica en diferentes contextos y realidades. El mapeo fue realizado a través de investigación documental en la Comunidad de Prácticas de Atención Primaria, resultando en la inclusión de 38 relatos de experiencia. Los datos corroboran el potencial del apoyo institucional para fomentar prácticas y arreglos de gestión compartida en la implementación de políticas y programas de salud, en la promoción de cambios en el proceso de trabajo en equipo y en la integración intra e interinstitucional. Se utiliza el mapeo como recurso para transformar indicadores normativos en relaciones sociales y dispositivos organizativos en el cotidiano de la atención y gestión del Sistema Único de Salud. Los principales desafíos identificados se refieren a resistencias provenientes de dinámicas culturales y comunicacionales relacionadas con conceptos y prácticas de gestión influenciadas por el modelo de administración clásica, además de un conjunto de cuestiones operacionales que inciden negativamente en los resultados obtenidos. La sistematización de las experiencias nos permitió comprender que el apoyo institucional demanda habilidades de mediación complejas, que necesitan ser mejor comprendidas y instrumentalizadas, especialmente en lo que se refiere a la participación de la comunidad.

Assuntos

RESUMO

Introdução: A produção de carbapenemases dos tipos KPC e NDM é um importante mecanismo enzimático de resistência aos carbapenêmicos em bactérias da família Enterobacteriaceae. Estas enzimas degradam os antibióticos beta-lactâmicos e são codificadas pelos genes blaKPC e blaNDM, que podem estar localizados em elementos genéticos móveis como plasmídeos e transposons. Objetivos: Avaliar a taxa de positividade de blaKPC e blaNDM em enterobactérias resistentes aos carbapenêmicos recebidos no Intituto Adofo Lutz (IAL) de São José do Rio Preto e pesquisar dados epidemiológicos dos pacientes cujos isolados foram recuperados. Métodos: No período de junho de 2015 a abril de 2019 foram recebidos isolados bacterianos resistentes aos carbapenêmicos da região de São José do Rio Preto. No laboratório de bacteriologia e biologia molecular foram realizadas a extração de DNA e a PCR em tempo real para investigação dos genes blaKPC e blaNDM. Em seguida, foi feito o levantamento dos dados epidemiológicos, tais como, o município de origem, idade e gênero dos pacientes cujos isolados bacterianos foram recuperados. Resultados: A amostragem total do estudo foi de 934 isolados de enterobactérias provenientes de diferentes hospitais localizados em cinco municípios da região. Destes; 93,4% foram positivos para blaKPC, sendo 96,3% em isolados do gênero Klebsiella sp. e 1,85% dos isolados do gênero Enterobacter sp. e da espécie Escherichia coli , respectivamente; 52,5% dos isolados foram obtidos de mulheres e 84,4% de pacientes idosos. O gene blaNDM, foi detectado apenas em três isolados, sendo dois deles provenientes de culturas de vigilância. Conclusão: Os resultados gerados evidenciaram que enterobactérias produtoras de KPC estão disseminadas em todas unidades de saúde dos cinco municípios estudados, sugerindo que os isolados de Klebsiella sp. carreadores de blaKPC possam ser endêmicos nestas instituições. Pudemos também notar o importante papel das culturas de vigilância na prevenção da disseminação de genes de resistência, como observado para blaNDM neste estudo.

RESUMO

Several studies have highlighted that cancer patients tend to be more susceptible to develop severe infection and to die from COVID-19. Certain medical conditions such as immunosuppression, presence of comorbidities, and underlying pulmonary damage are possible determinants of disease severity, especially in lung cancer patients. While recent studies have shown that lung cancer is one of the most prevalent tumor types among COVID-19 cancer patients, we still have an incomplete view of how data from several countries work as a whole. The aim of this review was to investigate COVID-19 prevalence in lung cancer patient cohorts and their probability to develop severe illness and death when compared to nonlung cancer patients from multiple nationalities, including countries that have been the epicenters of the pandemic. We also focus on some intrinsic lung cancer features that might influence COVID-19 outcomes. An integrative view of the susceptibility of lung cancer patients might be especially relevant to assist physicians in evaluating the risks of COVID-19 in these patients, and to foster better decisions on treatment delay.

Assuntos

RESUMO

BACKGROUND: The purpose of this study was to integrate the available data published on leukaemic infiltration in the oral and maxillofacial region into a comprehensive analysis of its clinical manifestations, imaginological characteristics, management and survival. MATERIALS AND METHODS: An electronic search with no publication date restriction was undertaken in October 2020 in the following databases: PubMed, Web of Science, Scopus and Embase. Overall survival was calculated by survival analysis with the Kaplan-Meier test. A critical appraisal of included articles was performed using the Joanna Briggs Institute tool. RESULTS: A total of 63 studies including 68 patients were selected for data extraction. The most common haematologic diagnosis was acute myeloid leukaemia (47%). The most affected individuals were 40 to 49 years old (20.9%). The male-to-female ratio was 1.2:1. The gingiva was the most affected site (37%). Swelling/mass/oedema (33.7%) and enlargement/hyperplasia/hypertrophy (25.5%) were the main clinical findings. Osteolytic lesions with bone destruction were the main imaginological characteristics among the reported cases. Follow-up was available for 36 patients. Overall, within the 21-month follow-up, the survival probability dropped to 14.3%. CONCLUSION: A considerable number of studies reported oral manifestations mainly in individuals with the acute form of leukaemia. Children and adults were affected, but the fifth decade of life was the most common. Dentists should be vigilant since these manifestations may be important for a diagnosis and for the monitoring of the treatment response and recurrence of haematological neoplasia.

Assuntos

Assuntos

RESUMO

BACKGROUND: Invasive meningococcal disease (IMD) is an acute, highly transmissible and potentially fatal disease caused by Neisseria meningitidis. Prompt antimicrobial therapy and prophylaxis are recommended, where penicillin or ciprofloxacin are the available choices. However, the emergence of resistant isolates of N. meningitidis poses a challenge for antimicrobial therapy. OBJECTIVES: To describe the clinical, epidemiological and biological characteristics of six penicillin- and ciprofloxacin-resistant, culture-confirmed IMD cases reported in El Salvador, Central America, between 2017 and 2019. METHODS: Following the detection of six patients presenting with IMD in El Salvador, clinical data were collected and epidemiological action plans conducted. Isolates were subjected to antimicrobial susceptibility testing by broth microdilution and WGS for genotyping and molecular characterization analysis, including phylogeny comparison with global sequences available from public databases. RESULTS: A total of six IMD cases caused by N. meningitidis serogroup Y, resistant to both penicillin (MIC >8.0 mg/L) and ciprofloxacin (MIC 0.125 mg/L), were detected from 2017 to 2019. Genomic analysis showed that penicillin resistance was mediated by the production of ß-lactamase ROB-1. Ciprofloxacin resistance was attributed to an amino acid substitution in DNA gyrase (T91I). All isolates were classified as ST3587, clonal complex 23, and were genetically highly similar, based on core-genome SNP analysis. CONCLUSIONS: To the best of our knowledge, we report the first cases of MDR N. meningitidis causing IMD in Latin America. Our findings highlight the emergence of this potential public health threat, with a profound impact on the efficacy of IMD treatment and prophylaxis protocols.

Assuntos