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.

Integração e contextualização de modelos 3D no ensino da área da saúde

Mestrado em Engenharia Informática. Sistemas Gráficos e Multimédia.

A perspective on LCA application in site remediation services: critical review of challenges

The remediation of contaminated sites supports the goal of sustainable development but may also have environmental impacts at a local, regional and global scale. Life cycle assessment (LCA) has increasingly been used in order to support site remediation decision-making. This review article discusses existing LCA methods and proposed models focusing on critical decisions and assumptions of the LCA application to site remediation activities. It is concluded that LCA has limitations as an adequate holistic decisionmaking tool since spatial and temporal differentiation of non-global impacts assessment is a major hurdle in site remediation LCA. Moreover, a consequential LCA perspective should be adopted when the different remediation services to be compared generate different site’s physical states, displacing alternative post-remediation scenarios. The environmental effects of the post-remediation stage of the site is generally disregarded in the past site remediation LCA studies and such exclusion may produce misleading conclusions and misdirected decision-making. In addition, clear guidance accepted by all stakeholders on remediation capital equipment exclusion and on dealing with multifunctional processes should be developed for site remediation LCA applications.

Development of a meso-microscale coupling procedure for site assessment in complex terrain

A procedure for coupling mesoscale and CFD codes is presented, enabling the inclusion of realistic stratification flow regimes and boundary conditions in CFD simulations of relevance to site and resource assessment studies in complex terrain. Two distinct techniques are derived: (i) in the first one, boundary conditions are extracted from mesoscale results to produce time-varying CFD solutions; (ii) in the second case, a statistical treatment of mesoscale data leads to steady-state flow boundary conditions believed to be more representative than the idealised profiles which are current industry practice. Results are compared with measured data and traditional CFD approaches.