Successful prevention of tunneled central catheter infection by antibiotic lock therapy using cefazolin and gentamicin

Catheter-related bacteremia (CRB) is one of the various complications related to hemodialysis (HD). As a result of this high rate of infection, the antibiotic lock technique (ALT) has been recommended to prevent CRB. However, adverse effects of ALT such as increased emergence of strains resistant to antibiotics and increased mechanical dysfunction catheter were poorly evaluated. We prospectively evaluated the efficacy of catheter-restricted filling using an antibiotic lock solution in preventing CRB. A total of 233 HD patients requiring 325 new tunneled catheters while waiting for placement and maturation of an arteriovenous fistula or graft were enrolled in this study. Patients with a tunneled catheter were assigned to receive either an antibiotic-heparin lock solution (antibiotic group: cefazolin 10 mg/ml, gentamicin 5 mg/ml, heparin 1,000 U/ml) or a heparin lock solution (no-antibiotic group: heparin 1,000 U/ml) as a catheter lock solution during the interdialytic period. The present study aimed to assess the efficacy of ALT using cefazolin and gentamicin in reducing CRB in patients undergoing HD with tunneled central catheter and to identify its adverse effects. CRB developed in 32.4 % of patients in the no-antibiotic group and in 13.1 % of patients in the antibiotic group. CRB rates per 1,000 catheter-days were 0.57 in the antibiotic group versus 1.74 in the no-antibiotic group (p < 0.0001). Kaplan-Meier analysis also showed that mean CRB-free catheter survival was significantly higher in the antibiotic group than in the no-antibiotic group (log-rank statistic 17.62, p < 0.0001). There was statistically significant difference between the two groups in causative organisms of CRB, with predominance of negative culture in both groups, but this prevalence was higher in ALT group (57.9 vs 90.1 %, p < 0.0001), and the two groups also were different in prevalence of gram-positive bacteria as causing organisms (ALT group 21.05 vs = 0 % in control group, p < 0.0001). There was no statistically significant difference between the two groups in drug-resistant germs. There were statistically significant differences between the two groups in the catheter removal causes, with higher rate of infectious cause in control group (12.32 vs 2.22 %, p < 0.0001) and mechanical cause in ALT group (28.26 vs 37.78 %, p < 0.0001). The results suggest that ALT may be a beneficial means of reducing the CRB rate in HD patients with tunneled catheter, without association between ALT and emergence of strains resistant. However, mechanical complications were more prevalent in antibiotic group. Further studies are required to determine the optimal drug regimen, concentrations for ALT, and its adverse effects. © 2012 Springer Science+Business Media Dordrecht.

Comportamento, produção e qualidade do leite de vacas Holandês-Gir com climatização no curral

This study was conducted with the objective to evaluate the duration of exposure of animals to the evaporative cooling system in the waiting barn on the weather variables (temperature and relative humidity), animal behavior, production and quality aspects of milk from Girolando cows. Sixteen multiparous lactating cows were used having a genetic composition of 7/8 Holstein-Gir and mean milk production of 18 kg animal-1day-1. A 4 × 4 Latin square design was used. The experiment was conducted during the summer season (February-March 2009) and lasted 56 days. The treatments consisted of different periods of 10, 20 and 30 minutes of exposure to acclimatization and control. Time of 30 minutes of exposure to thermal conditioning system enabled the second milking (evening shift), providing an increase in milk production in the next milking of 0.640 kg animal-1. A higher percentage of time spent on food intake and rumination (17.31 and 30.19%) in 30 minutes treatment, compared to control (15.50 and 27.37%), respectively. There was no significant effect of treatments in the composition of milk.

Molecular epidemiology and extended-spectrum β-lactamases production of klebsiella pneumoniae isolated from three dairy herds

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Basic ingredients for mathematical modeling of tumor growth in vitro: Cooperative effects and search for space

Based on the literature data from HT-29 cell monolayers, we develop a model for its growth, analogous to an epidemic model, mixing local and global interactions. First, we propose and solve a deterministic equation for the progress of these colonies. Thus, we add a stochastic (local) interaction and simulate the evolution of an Eden-like aggregate by using dynamical Monte Carlo methods. The growth curves of both deterministic and stochastic models are in excellent agreement with the experimental observations. The waiting times distributions, generated via our stochastic model, allowed us to analyze the role of mesoscopic events. We obtain log-normal distributions in the initial stages of the growth and Gaussians at long times. We interpret these outcomes in the light of cellular division events: in the early stages, the phenomena are dependent each other in a multiplicative geometric-based process, and they are independent at long times. We conclude that the main ingredients for a good minimalist model of tumor growth, at mesoscopic level, are intrinsic cooperative mechanisms and competitive search for space. © 2013 Elsevier Ltd.

A influência da restrição motora na tarefa A não B e as implicações da memória motora no alcance manual de crianças

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Biolixiviação de minério de cobre da mina de Sossego, PA - Companhia Vale do Rio Doce

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise de dispensação de medicamentos em uma farmácia hospitalar. -

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Padrão alimentar de mulheres obesas que subnotificam ou não a ingestão energética

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Subnotificação da ingestão energética entre obesas candidatas à cirurgia bariátrica

Pós-graduação em Alimentos e Nutrição - FCFAR

Implantes do sistema T. F. (Tissue functional) em alvéolos imediatamente após exodontia com e sem membrana de osso bovino: estudo histológico em cães

Pós-graduação em Odontologia - FOA

Análise da penetração de material resinoso ao esmalte dental em função de agente clareador e tempo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Ocorrência de Salmonella spp. em carcaças e vísceras de rãs (Rana catesbeiana - Rã de Touro): avaliação do processo de abate

Pós-graduação em Medicina Veterinária - FMVZ

Evolução da obesidade da infância até a vida adulta entre mulheres da fila de espera para a cirurgia bariátrica pelo sistema único de saúde

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O paciente que busca atendimento odontológico na Faculdade de Odontologia de Araçatuba: seus motivos, seus anseios, suas expectativas e dificuldades

Pós-graduação em Odontologia Preventiva e Social - FOA

Agentes públicos e privados na refuncionalização de formas urbanas na cidade de Campinas - SP

Pós-graduação em Geografia - IGCE