Post-surgical wound infections involving Enterobacteriaceae with reduced susceptibility to ß-lactams in two Portuguese hospitals

The post-surgical period is often critical for infection acquisition. The combination of patient injury and environmental exposure through breached skin add risk to pre-existing conditions such as drug or depressed immunity. Several factors such as the period of hospital staying after surgery, base disease, age, immune system condition, hygiene policies, careless prophylactic drug administration and physical conditions of the healthcare centre may contribute to the acquisition of a nosocomial infection. A purulent wound can become complicated whenever antimicrobial therapy becomes compromised. In this pilot study, we analysed Enterobacteriaceae strains, the most significant gram-negative rods that may occur in post-surgical skin and soft tissue infections (SSTI) presenting reduced β-lactam susceptibility and those presenting extended-spectrum β-lactamases (ESBL). There is little information in our country regarding the relationship between β-lactam susceptibility, ESBL and development of resistant strains of microorganisms in SSTI. Our main results indicate Escherichia coli and Klebsiella spp. are among the most frequent enterobacteria (46% and 30% respectively) with ESBL production in 72% of Enterobacteriaceae isolates from SSTI. Moreover, coinfection occurred extensively, mainly with Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (18% and 13%, respectively). These results suggest future research to explore if and how these associations are involved in the development of antibiotic resistance.

New biomimetic sensors for the determination of tetracycline in biological samples: batch and flow mode operations

New potentiometric membrane sensors with cylindrical configuration for tetracycline (TC) are described based on the use of a newly designed molecularly imprinted polymer (MIP) material consisting of 2-vinylpyridine as a functional monomer in a plasticized PVC membrane. The sensor exhibited significantly enhanced response towards TC over the concentration range 1.59 10 5–1.0 10 3 mol L 1 at pH 3–5 with a lower detection limit of 1.29 10 5 mol L 1. The response was near-Nernstian, with average slopes of 63.9 mV decade 1. The effect of lipophilic salts and various foreign common ions were tested and were found to be negligible. The possibility of applying the proposed sensor to TC determination in spiked biological fluid samples was demonstrated.

Dispersion Modelling of Natural Radionuclides 238U, 232Th and 40K Released from Coal-fired Power Plants Operations

The aim of this work was to simulate the radionuclides dispersion in the surrounding area of a coal-fired power plant, operational during the last 25 years. The dispersion of natural radionuclides (236Ra, 232Th and 40K) was simulated by a Gaussian plume dispersion model with three different stability classes estimating the radionuclides concentration at ground level. Measurements of the environmen-tal activity concentrations were carried out by γ-spectrometry and compared with results from the air dispersion and deposition model which showed that the stabil-ity class D causes the dispersion to longer distances up to 20 km from the stacks.

Swordfish: an Autonomous Surface Vehicle for Network Centric Operations

The design and development of the swordfish autonomous surface vehicle (ASV) system is discussed. Swordfish is an ocean capable 4.5 m long catamaran designed for network centric operations (with ocean and air going vehicles and human operators). In the basic configuration, Swordfish is both a survey vehicle and a communications node with gateways for broadband, Wi-Fi and GSM transports and underwater acoustic modems. In another configuration, Swordfish mounts a docking station for the autonomous underwater vehicle Isurus from Porto University. Swordfish has an advanced control architecture for multi-vehicle operations with mixed initiative interactions (human operators are allowed to interact with the control loops).

Marine Operations with the SWORDFISH Autonomous Surface Vehicle

IEEE Robótica 2007 - 7th Conference on Mobile Robots and Competitions, Paderne, Portugal 2007

Structured Light System for Underwater Inspection Operations

In this work we propose the development of a stereo SLS system for underwater inspection operations. We demonstrate how to perform a SLS calibration both in dry and underwater environments using two different methods. The proposed methodology is able to achieve quite accurate results, lower than 1 mm in dry environments. We also display a 3D underwater scan of a known object size, a sea scallop, where the system is able to perform a scan with a global error lower than 2% of the object size.

A New Electronic Approach for the Surgical Safety Checklist

To improve surgical safety, and to reduce the mortality and surgical complications incidence, the World Health Organization (WHO) developed the Surgical Safety Checklist (SSC). The SSC is a support of information that aids health professionals to reduce the number of complications, induction of anaesthesia, period before skin incision and period before leaving the operating room (OR). The SSC was tested in several countries of the world and their results shown that after introduction of the SSC the incidence of patient complication lowered from 11.0% to 7.0% (P<0.001), the rate of death declined from 1.5% to 0.8% (P = 0.003) and the nurses recognized that patients identity was more often con rmed (81.6% to 94.2%, P<0.01) in many institutions. Recently the SSC was also implemented in Portuguese hospitals, which led us to its study in the real clinical environment. An observational study was performed: several health professionals were observed and interviewed, to understand the functioning of the SSC in an OR, during the clinical routine. The objective of this study was to understand the current use of the SSC, and how it may be improved in terms of usability, taking advantage of the technological advancements such as mobile applications. During two days were observed 14 surgeries, only 2 surgeries met the requirements for the three phases of the SSC, as de ned by the WHO. Of the remaining 12 observed surgeries, 9 surgeries completed the last phase at the correct time. It was also observed that only in 2 surgeries all the phases of the SSC were read aloud to the team and that, in 7 surgeries, several items were read aloud and answered but no one was checking the SSC, only after the end of the phase. The observational study results disclose that several health professionals do not meet with rules of the WHO manual. This study demonstrates that it is urgent to change the mindset of health professionals, and that di erent features in the SSC may be useful to make it more easy to use. With the results of the observational study, a SSC application proposal was developed with new functionalities to improve and aid the health professional in its use. In this application the user can chose between a SSC already created to a speci c surgery or to create a new SSC, adding and adapting some questions from the WHO standard. To create a new SSC, the application is connected to an online questionnaire builder (JotForm). The choice for this online questionnaire builder went through three essential characteristics: number of types of questions, mainly checkbox, radio button and text; the possibility of to create sections inside sections and the API. In addition, in this proposal the improvements are focused in forcing the user to focus in the work ow of the SSC and to save the input timestamps and any actions made by them. Therefore, the following features was implemented to achieve that goal: display one item of the SSC at a time; display the stage where the SSC is; do not allow going back to the previous step; do not allow going forward to the next item if the current is not lled; do not allow going forward to the next item if the time it took to ll the item was too short and log any action made by the user.

Water jet based autonomous surface vehicle for coastal waters operations

This paper presents the design of low cost, small autonomous surface vehicle for missions in the coastal waters and specifically for the challenging surf zone. The main objective of the vehicle design described in this paper is to address both the capability of operation at sea in relative challenging conditions and maintain a very low set of operational requirements (ease of deployment). This vehicle provides a first step towards being able to perform general purpose missions (such as data gathering or patrolling) and to at least in a relatively short distances to be able to be used in rescue operations (with very low handling requirements) such as carrying support to humans on the water. The USV is based on a commercially available fiber glass hull, it uses a directional waterjet powered by an electrical brushless motor for propulsion, thus without any protruding propeller reducing danger in rescue operations. Its small dimensions (1.5 m length) and weight allow versatility and ease of deployment. The vehicle design is described in this paper both from a hardware and software point of view. A characterization of the vehicle in terms of energy consumption and performance is provided both from test tank and operational scenario tests. An example application in search and rescue is also presented and discussed with the integration of this vehicle in the European ICARUS (7th framework) research project addressing the development and integration of robotic tools for large scale search and rescue operations.