101 resultados para Study of multiple cases
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Nasopharyngeal colonization with methicillin-resistant Staphylococcus aureus (MRSA) often precedes the development of nosocomial infections. In order to identify risk factors for MRSA colonization, we conducted a case-case-control study, enrolling 122 patients admitted to a medical-surgical intensive care unit (ICU). All patients had been screened for nasopharyngeal colonization with S. aureus upon admission and weekly thereafter. Two case-control studies were performed, using as cases patients who acquired colonization with MRSA and methicillin-susceptible S. aureus (MSSA), respectively. For both studies, patients in whom colonization was not detected during ICU stay were selected as control subjects. Several potential risk factors were assessed in univariate and multivariable (logistic regression) analysis. MRSA and MSSA were recovered from nasopharyngeal samples from 27 and 10 patients, respectively. Independent risk factors for MRSA colonization were: length-of-stay in the ICU (Odds Ratio [OR]=1.12, 95%Confidence Interval[CI]=1.06-1.19, p<0.001) and use of ciprofloxacin (OR=5.05, 95%CI=1.38-21.90, p=0.015). The use of levofloxacin had a protective effect (OR=0.08, 95%CI=0.01-0.55, p=0.01). Colonization with MSSA was positively associated with central nervous system disease (OR=7.45, 95%CI=1.33-41.74, p=0.02) and negatively associated with age (OR=0.94, 95%CI=0.90-0.99, p=0.01). In conclusion, our study suggests a role for both cross-transmission and selective pressure of antimicrobials in the spread of MRSA.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Systematic studies in manganites of spinel structure have been undertaken. We report on the magnetic properties of two particular cases, in which one of the transition metals, Mg2+ is non-magnetic (NiMgxMn2-xO4) or presents a stable oxidation state, Cu2+ (CoxCuyMnzO4, x + y + z = 3). The magnetic behaviour is described with respect to varying contents of cobalt, copper or manganese. A ferrimagnetic transition is observed at 110-120 K, which depends on the cobalt content. Presence of copper increases the coercive field by a factor of ten with respect to the parent compound NiMn2O4. (c) 2006 Elsevier B.V. All rights reserved.
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The binding of the cations thallium(I), calcium(II) and terbium(III) to methyl methacrylate-methacrylic acid copolymers with different fractions of acid groups (x) has been studied in aqueous solution at, various pH values using the fluorescence of covalently bonded 9-vinyl anthracene as a probe. In all cases, the extent of binding increases as a function of the charge of the polymer with either increasing fraction of carboxylic acids or of pH. However, differences are observed in the behavior of the three cations, With Tl(I), quenching of the anthracene group fluorescence is observed. indicating that the thallium(I) approaches the probe and suggesting that the alkylanthracene is probably in a relatively polar region. Binding constants have been determined from anthracene quenching data and from studies with the fluorescent-probe sodium pyrenetetrasulfonate, Good agreement is obtained between the two methods, and values for the binding constants increase from 250 to 950 M-1 as x increases from 0.39 to 1. It is suggested that the cation is held in the polyelectrolyte domain, partly by Debye-Huckel effects and partly by more specific interactions. Stronger binding is found with calcium(II) and terbium(III), and in this case increases in fluorescence intensity are observed on complexation due to the anthracene group being in a more hydrophobic region, probably as a result of conformational changes in the polymer chain. In the former case the stoichiometry of the interaction was determined from the fluorescence data to involve two carboxylate groups bound per calcium. Association constants were found using murexide as an indicator of free calcium to vary from 8400 to 37 000 M-1 as x increases from 0.39 to 1. It is suggested that in this case specific calcium(II)-carboxylate interactions contribute to the binding. With terbium(III), a greater increase in the probe fluorescence intensity was observed than with calcium, and it is suggested that the interaction with the polymer is even stronger, leading to a more pronounced conformational change in the polymer. It is proposed that the terbium(III) interacts with sis carboxylic groups on the polymer chain, with three being coordinated and three attracted by electrostatic interactions.
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The purpose of this study was to describe the anatomy of the lungs of wild boars for comparison with those of domestic swine. It was found that the right lung of the wild boar is divided into four lobes: cranial, median, caudal and accessory, whereas the left lung is divided into two lobes: cranial and caudal. In 93.4% of the cases, right pulmonary artery separates into the ascendant, descendant, median, accessory and caudal branches. In 73.3% of the cases, left pulmonary artery separates most frequently to form three branches to the cranial lobe, whereas the median lobe is generally supplied by only one arterial branch. There is a single pattern of bronchial distribution: in the right lung a tracheal bronchus leads to the cranial lobe, where it separates into the cranial and caudal bronchi and there are also bronchi to the median, caudal and accessory lobes. In the left lung, the large bronchus separates to form two branches, one of which further separates to form two branches to the cranial lobe whereas the other forms a single branch to the caudal lobe.
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The kinetics of aggregation of tetraethoxysilane (TEOS)-derived silica sols, produced by acid-catalyzed and ultrasound-stimulated hydrolysis, were studied by 'in situ' measurements of small-angle X-ray scattering (SAXS) at the temperatures 40 degreesC, 60 degreesC and 70 degreesC. The results were analyzed in terms of the evolution with time (t) of the SAXS intensity probing the mass fractal characteristics of the system, the average radius of gyration (Rc,) of the clusters and the number of primary particles per cluster. The aggregation process yields mass fractal structures which exhibit a scattering exponent (alpha) practically equal to 2, in the probed length scale range (5.3 nm < 1/q < 0.22 nm), beneath and even far beyond the gel point. This suggests that a is a direct measure of the real mass fractal dimension (D) of the structure. The precursor sol (pH = 2) exhibits I nm mean sized clusters with mass fractal dimension D similar to 1.9. Increasing the pH to 4.5, the cluster mean size and the number of primary particles per cluster increase but the system keeps a more opened structure (D similar to 1.4). In the first aggregation stages, D increases up to similar to2 by incorporating primary particles to the clusters without changing their mean size. From this stage, the aggregation progresses following a thermally activated scaling law well described by R-G similar tot(1/D) in all cases. This is indicative of a diffusion-controlled cluster-cluster aggregation process. The activation energy of the process was found to be 91.7 kJ/mol. (C) 2001 Elsevier B.V. B.V. All rights reserved.
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The research evaluated the efficacy of high frequency waves in the treatment of onychomycosis in three patients during twelve months through the clinical examination of nails and also through mycological examination. The causative agent of the mycosis, in the three patients, was the dermatophyte Trichophyton rubrum and after application of high frequency, it was possible to notice a great improvement in the appearance of nails and also growth inhibition in culture despite the fact that the mycological examination remained positive. The preliminary study of the three cases demonstrated that the fungistatic activity of high frequency waves is a promising method to be used in combination with conventional drugs.
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Nobiletin (NOB) and tangeretin (TAN), two of the main polymethoxylated flavones (PMFs) in citrus, influence a number of key biological pathways in mammalian cells. Although the impacts of NOB and TAN on glucose homeostasis and cholesterol regulation have been investigated in human clinical trials, much information is still lacking about the metabolism and oral bioavailability of these compounds in animals. In this study, NOB and TAN were administered to rats by gavage and intraperitoneal (ip) injection, and the blood serum concentrations of these compounds and their main metabolites were monitored by high-performance liquid chromatography-electrospray ionization-mass spectrometry (HPLC-ESI-MS). In addition to the administered compounds, two metabolites of TAN and eight metabolites of NOB were detected and measured over 24 h. With identical oral doses, nearly 10-fold higher absorption of NOB occurred compared to TAN. For both compounds, maximum levels of glucuronidated metabolites occurred in the blood serum at later time points (similar to 5-8 h) compared to the earlier T(max) a values for NOB and TAN. In most cases the glucuronides occurred at substantially higher concentrations than the aglycone metabolites. Low levels of NOB and TAN and their metabolites were detectable in rat blood serum even at 24 h after treatment.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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This article presents methodological contributions and a conceptual innovation for thinking about the production of health care, stemming from a study on access and barriers in mental health carried out in the municipality of Campinas (São Paulo, Brazil). The study used a cartographic approach and, after an initial identification of the most complex cases (on the part of the teams of workers), adopted the users as guides to explore the different levels of production of their lives and to evaluate the possibility of forming a network of existential connections that produce life as a fundamental analyzer of access or barriers to care.
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In view of the relevance of the mylohyoid nerve to clinical difficulties in achieving deep analgesia of the lower incisors, a dissection study was undertaken. Dissections from 29 adult cadavers of both sexes were studied with the aid of a dissecting microscope. The following observations were made: a supplementary branch of the mylohyoid nerve entered the mandible through accessory foramina in the lingual side of the mandibular symphysis in 50% of the cases; it generrally arose from the right side (76.9%) and entered the inferior retromental foramen (84.6%); the mylohyoid nerve branch either ended directly in the incisor teeth and the gingiva or joined the ipsilateral or contralateral incisive nerve. In view of this information concerning the high incidence of possible involvement of the mylohyoid nerve in mandibular sensory innervation, it is advisable to block it whenever intervention in the lower incisors is indicated. Routine mylohyoid injection is recommended after mental nerve block. If the inferior alveolar nerve is chosen for anesthetic purposes, additional mylohyoid injection should be given only if pain persists. The mylohyoid injection should be given at the inferior retromental foramen on the median aspect of the inferior border of the mandible through extraoral approach.
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The participation of the trapezius (pars media) and rhomboideus major muscles were studied electromyographically in movements of lateral and medial rotation (free and against resistance) of the arm. In the majority of cases both muscles were inactive during the performance of the analysed movements. Cases in which only one or both muscles acted in free rotation occurred only at the second half or ending of the movement. Records of electrical potentials during against resistance rotation were due to tensional efforts at the shoulder level.
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The electromyographic study of the trapezius (pars superior) and levator scapulae mm. in the head movements was carried out in 30 young, adult male volunteers of both sexes and with no antecedent muscular or articular problems. The analysis was carried out with a two-channel TECA TE4 electromyograph and with single coaxial needle electrodes. Inactivity of the trapezius (pars superior) and levator scapulae mm. was noticed in all cases, in flexion and extension movements, whereas in homolateral and heterolateral rotation movements, these muscles showed to be inactive in most cases.