Genetic similarity between staphylococcus sp isolated from human and hospital settings, and susceptibility to different antimicrobials

Foram coletadas 143 amostras de mãos de humanos e camas hospitalares, através de swabs no caldo BHI, em um hospital escola da cidade de Ribeirão Preto/SP. As amostras coletadas foram incubadas a 37ºC por 24 horas e após este período as culturas foram semeadas em placas de Petri contendo agar Staphylococcus Médium 110. As colônias típicas do gênero Staphylococcus foram colhidas e estocados a 4ºC até o momento de elaboração das provas de catalase, manitol, hemólise, DNAse e coagulase. As cepas isoladas foram analisadas através da técnica de RAPD-PCR para verificar o grau de similaridade. A sensibilidade das cepas isoladas foi testada frente a 10 diferentes antibióticos. Das 92 cepas de Staphylococcus sp isoladas, 67 (72,8%) foram identificados como Staphylococcus coagulase-negativas e 25 (27,2%) como Staphylococcus coagulase-positivas. A análise de similaridade mostrou uma grande heterogeneidade entre as cepas, entretanto foram isoladas algumas cepas com 100% de similaridade. Resistência a oxacilina foi encontrada em 39 (42%) cepas. Duas cepas de estafilococos coagulase-negativos mostraram-se resistentes a vancomicina. Onze cepas (12%) de estafilococos foram consideradas multirresistentes. Medidas de desinfecção das mãos de pessoal e dos leitos hospitalares e a racionalização do uso indiscriminado de antibióticos podem contribuir para a queda da transmissão de patógenos e diminuição da pressão de seleção, e conseqüentemente diminuindo a freqüência e letalidade das infecções nosocomiais.

Early administration of inhaled nitric oxide to children with acute respiratory distress syndrome and its effects on oxygenation and ventilator settings: prospective preliminary report of ten patients

Aim. To establish a protocol for the early introduction of inhaled nitric oxide (iNO) therapy in children with acute respiratory distress syndrome (ARDS) and to assess its acute and sustained effects on oxygenation and ventilator settings.Patients and Methods. Ten children with ARDS, aged 1 to 132 months (median, 11 months), with arterial saturation of oxygen <88% while receiving a fraction of inspired oxygen (FiO(2)) 0.6 and a positive end-expiratory pressure of greater than or equal to 10 cm H2O were included in the study. The acute response to iNO was assessed in a 4-hour dose-response test, and positive response was defined as an increase in the PaO2/FiO(2) ratio of 10 mmHg above baseline values. Conventional therapy was not changed during the test. In the following days, patients who had shown positive response continued to receive the lowest iNO dose. Hemodynamics, PaO2/FiO(2), oxygenation index, gas exchange, and methemoglobin levels were obtained when needed. Inhaled nitric oxide withdrawal followed predetermined rules.Results. At the end of the 4-hour test, all the children showed significant improvement in the PaO2/FiO(2) ratio (63.6%) and the oxygenation index (44.9%) compared with the baseline values. Prolonged treatment was associated with improvement in oxygenation, so that FiO(2) and peak inspiratory pressure could be quickly and significantly reduced., No toxicity from methemoglobin or nitrogen dioxide was observed.Conclusion. Administration of iNO to children is safe. iNO causes rapid and sustained improvement in oxygenation without adverse effects. Ventilator settings can safely be reduced during iNO treatment.

Thermotectonic and fault dynamic analysis of Precambrian basement and tectonic constraints with the Parana basin

The Precambrian crystalline basement of southeast Brazil is affected by many Phanerozoic reactivations of shear zones that developed during the end of the Neoproterozoic in the Brasiliano orogeny. These reactivations with specific tectonic events, a multidisciplinary study was done, involving geology, paleostress, and structural analysis of faults, associated with apatite fission track methods along the northeastern border of the Parana basin in southeast Brazil.The results show that the study area consists of three main tectonic domains, which record different episodes of uplift and reactivation of faults. These faults were brittle in character and resulted in multiple generations of fault products as pseudotachylytes and ultracataclasites, foliated cataclasites and fault gouges.Based on geological evidence and fission track data, an uplift of basement rocks and related tectonic subsidence with consequent deposition in the Parana basin were modeled.The reactivations of the basement record successive uplift events during the Phanerozoic dated via corrected fission track ages, at 387 +/- 50 Ma (Ordovician); 193 +/- 19 Ma (Triassic); 142 +/- 18 Ma (Jurassic), 126 +/- 11 Ma (Early Cretaceous); 89 +/- 10 Ma (Late Cretaceous) and 69 +/- 10 Ma (Late Cretaceous). These results indicate differential uplift of tectonic domains of basement units, probably related to Parana basin subsidence. Six major sedimentary units (supersequences) that have been deposited with their bounding unconformities, seem to have a close relationship with the orogenic events during the evolution of southwestern Gondwana. (c) 2005 Elsevier Ltd. All rights reserved.

The impact of physical activity on mitigation of health care costs related to diabetes mellitus: findings from developed and developing settings Diabetes mellitus and physical exercise

Over the last decades, the prevalence of diabetes mellitus (DM) has been increasing globally such that nowadays the disease constitutes an important outcome related to early mortality among adults. In parallel with the high prevalence, healthcare costs related to DM treatment have increased significantly, exacerbating its burden on modern society. The scientific literature points out that obesity and physical inactivity have a central role in the development of most DM cases. In fact, either physical exercise practice or an increase in the level of physical activity, constitute relevant tools in the guidelines for treatment of the disease. On the other hand, the effect of physical activity on the economic consequences of DM is not completely clear. The identification of the actual burden of lifestyle changes on the reduction of healthcare costs related to DM is relevant, primarily for developing nations, where it could represent a cheaper strategy for treating the disease and its complications than paying for drug treatment, which is commonly related to collateral effects. That being said, the prevention of DM and other diseases and consequently the mitigation of the costs related to these outcomes seem to depend essentially on the promotion of healthy habits. The aim of the present review was therefore to discuss recent evidence on the effects of physical activity/exercise on mitigation of health care cost related to DM.

A grande colisão pré-cambriana do sudeste brasileiro e a estruturação regional

This paper presents a review on the geotectonic framework of the Southeastern Brazil and neighborhoods, and its importance in the regional geologic evolution, which was exposed as a main conference at the XI Symposium of Southeast Geology (São Pedro, SP, 2009). Although the geologic history dates back to the Archean, and Paleo to Mesoproterozoic processes related to the evolution of the Columbia and Rodinia supercontinents occurred, it was in the Neoproterozoic that the most important structural features developed due to collisional tectonics. The collisions began in the Brasiliano I (900-700 Ma), but mainly developed during the Brasiliano II (670-530 Ma) and ended in the Brasiliano III (580-490 Ma), resulting the orogenic systems of Mantiqueira and Tocantins. The final consolidation resulted in Gondwana, around 460 My in the part which correspond to the South America Platform. The structural features represent an important heritage that controlled much the Phanerozic geologic and tectonic processes: the formation of the Paraná Basin in the Ordovician-Jurassic, the South Atlantian reactivation (active magmatism and Paraná LIP, rifting, morphogenesis and the Atlantic opening), and the Neogene-Quaternary intraplate discrete neotectonism.

Recognition of Cretaceous, Paleocene, and Neogene tectonic reactivation through apatite fission-track analysis in Precambrian areas of southeast Brazil: Association with the opening of the south Atlantic Ocean

Apatite fission-track analysis was used for the determination of thermal histories and ages in Precambrian areas of southeast Brazil. Together with geological and geomorphologic information, these ages enable us to quantify the thermal histories and timing of Mesozoic and Cenozoic epirogenic and tectonic processes. The collected samples are from different geomorphologic blocks: the high Mantiqueira mountain range (HMMR) with altitude above 1000 m, the low Mantiqueira mountain range (LMMR) under 1000 m, the Serra do Mar mountain range (SMMR), the Jundiá and Atlantic Plateaus, and the coastline, all of which have distinct thermal histories. During the Aptian (∼120 Ma), there was an uplift of the HMMR, coincident with opening of the south Atlantic Ocean. Its thermal history indicates heating (from ∼60 to∼80 °C) until the Paleocene, when rocks currently exposed in the LMMR reached temperatures of ∼100 °C. In this period, the Serra do Mar rift system and the Japi erosion surface were formed. The relief records the latter. During the Late Cretaceous, the SMMR was uplifted and probably linked to its origin; in the Tertiary, it experienced heating from ∼60 to ∼90 °C, then cooling that extends to the present. The SMMR, LMMR, and HMMR were reactivated mainly in the Paleocene, and the coastline during the Paleogene. These processes are reflected in the sedimentary sequences and discordances of the interior and continental margin basins. © 2002 Elsevier Science Ltd. All rights reserved.

Body dysmorphic disorder among dermatologic patients: Prevalence and clinical features

Background: An impairing preoccupation with a nonexistent or slight defect in appearance is the core symptom of body dysmorphic disorder (ODD), a psychiatric condition common in dermatology settings.Objective: We sought to determine the prevalence of ODD in dermatologic patients, comparing general and cosmetic settings, and describing some demographic and clinical characteristics.Methods: In all, 300 patients were consecutively assessed. Screening and diagnoses were performed with validated instruments plus a best estimate diagnosis procedure. The final sample comprised 150 patients in the cosmetic group, 150 patients in the general dermatology group, and 50 control subjects. Standard statistical analyses were performed (chi(2), nonparametric tests, logistic regression).Results: The current prevalence was higher in the cosmetic group (14.0%) compared with general (6.7%) and control (2.0%) groups. No patient had a previous diagnosis. Frequently the reason for seeking dermatologic treatment was not the main ODD preoccupation. Patients with ODD from the cosmetic group were in general unsatisfied with the results of dermatologic treatments.Limitations: Cross-sectional study conducted in a university hospital is a limitation. It is uncertain if the findings can be generalized. Retrospective data regarding previous treatments are not free from bias.Conclusions: BUD is relatively common in a dermatologic setting, especially among patients seeking cosmetic treatments. These patients have some different features compared with general dermatology patients. Dermatologists should be aware of the clinical characteristics of ODD to identify and refer these patients to mental health professionals. (J Am Acad Dermatol 2010;63:235-43.)

Tectonics and paleogeography of the Marajó Basin, northern Brazil

A área da Bacia do Marajó apresenta feições geológicas e geomorfológicas devidas principamente à distensão Mesozóica e à neotectônica pós-miocênica. O evento de distensão, com fases do Cretáceo Inferior e Superior, originou quatro sub-bacias que contituem a Bacia do Marajó, com uma espessa seqüência clástica continental mostrando influência marinha. Falhas normais NW e NNW e direcionais NE e ENE controlaram a geometria da bacia. A distensão, relacionada com a abertura do Atlântico Equatorial, propagou-se continente adentro ao longo de zonas de fraqueza crustal dos cinturões orogênicos pré-cambrianos Tumucumaque, Amapá e Araguaia. O evento neotectônico é um regime transcorrente que desenvolveu bacias transtensivas preenchidas por sedimentos marinhos rasos (Formação Pirabas) e seqüências transicionais (Grupo Barreiras) do Terciário Superior, seguidos por depósitos fluviais e seqüências transicionais do Quaternário, derivadas dos rios Amazoans e Tocantins e do estuário do Marajó. A paisagem atual tem morfologia tipicamente estuarina. A morfologia costeira apresenta escarpas em seqüências transicionais do Terciário Superior, enquanto no interior dominam elevações sustentadas por crosta laterítica do Pleistoceno Médio, aparadas por superfície erosiva a 70 m. No leste da Ilha do Marajó são reconhecidas várias gerações de paleocanais com seqüências estuarinas associadas, enquanto no lado oeste predomina uma planície flúvio-marinha.

Acute and sustained effects of early administration of inhaled nitric oxide to children with acute respiratory distress syndrome

OBJECTIVE: To determine the acute and sustained effects of early inhaled nitric oxide on some oxygenation indexes and ventilator settings and to compare inhaled nitric oxide administration and conventional therapy on mortality rate, length of stay in intensive care, and duration of mechanical ventilation in children with acute respiratory distress syndrome. DESIGN: Observational study. SETTING: Pediatric intensive care unit at a university-affiliated hospital. PATIENTS: Children with acute respiratory distress syndrome, aged between 1 month and 12 yrs. INTERVENTIONS: Two groups were studied: an inhaled nitric oxide group (iNOG, n = 18) composed of patients prospectively enrolled from November 2000 to November 2002, and a conventional therapy group (CTG, n = 21) consisting of historical control patients admitted from August 1998 to August 2000. MEASUREMENTS AND MAIN RESULTS: Therapy with inhaled nitric oxide was introduced as early as 1.5 hrs after acute respiratory distress syndrome diagnosis with acute improvements in Pao(2)/Fio(2) ratio (83.7%) and oxygenation index (46.7%). Study groups were of similar ages, gender, primary diagnoses, pediatric risk of mortality score, and mean airway pressure. Pao(2)/Fio(2) ratio was lower (CTG, 116.9 +/- 34.5; iNOG, 62.5 +/- 12.8, p <.0001) and oxygenation index higher (CTG, 15.2 [range, 7.2-32.2]; iNOG, 24.3 [range, 16.3-70.4], p <.0001) in the iNOG. Prolonged treatment was associated with improved oxygenation, so that Fio(2) and peak inspiratory pressure could be quickly and significantly reduced. Mortality rate for inhaled nitric oxide-patients was lower (CTG, ten of 21, 47.6%; iNOG, three of 18, 16.6%, p <.001). There was no difference in intensive care stay (CTG, 10 days [range, 2-49]; iNOG, 12 [range, 6-26], p >.05) or duration of mechanical ventilation (TCG, 9 days [range, 2-47]; iNOG, 10 [range, 4-25], p >.05). CONCLUSIONS: Early treatment with inhaled nitric oxide causes acute and sustained improvement in oxygenation, with earlier reduction of ventilator settings, which might contribute to reduce the mortality rate in children with acute respiratory distress syndrome. Length of stay in intensive care and duration of mechanical ventilation are not changed. Prospective trials of inhaled nitric oxide early in the setting of acute lung injury in children are needed.

Análise morfotectônica da Bacia do rio Santo anastácio, sp, através de parâmetros fluviomorfométricos e de registros paleossísmicos

Fluvial morphometry is method of great value regarding neotectonic analysis of extensive areas because streams, besides representing one of the main agents in the relief modeling, quickly adjust their thalwegs to even the most gentle crustal deformations. The purpose of this paper is to present the application of some morphometric techniques in the Santo Anastácio River hydrographic basin in order to identify recent tectonic deformations. Additionally, we show liquefaction structures identified in the basin and interpreted here as seismites linked to ancient earthquakes (magnitudes greater than 5). The morphometric survey includes longitudinal stream profile analysis, RDE (declivity versus stream length) index application, and the sinuosity study of the Santo Anastácio River channel. Geologic substrate comprises Cretaceous siliciclastic rocks of the Caiuá and Bauru groups, locally covered by Cenozoic sediments (alluvial plains, terrace deposits, colluvial aprons, as well as in situ regoliths). Considering that liquefaction structures affect dark clay layers of 32.340±320 year BP age (14C dating), a lower age limit for the ancient earthquake is triggered in that region. The authors believe that neotectonic understanding of the Western São Paulo State Plateau is important to the geologic and geomorphologic evolution of that landscape and to the consequent territorial planning and occupation.

O Grupo Canastra em sua área-tipo, região de Tapira, sudoeste do estado de Minas Gerais

This work aimed at describing the Neoproterozoic evolution of a Southern Brasília Fold Belt segment, in Tapira area (southwest of Minas Gerais state, Brazil), using detailed geologic mapping. This area, the Canastra Group type-area, has showed great tectonic and stratigraphic complexities unlike the simplicity suggested in previous works. From recognizing the main tectonic discontinuities, it was possible to subdivide the area into some domains. In the west domain, they were individualized in tectonic sheet I, marked by pelitic rocks and pelitic-graphite rocks with psammitic intercalations, and II, pelitic rocks with psammitic and mafic-ultramafic intercalations overlapped by gneisses. In the east domain, a group of three tectonic sheets was defined, in which, in the two lower tectonic sheets, pelitic and pelitic-graphite rocks with psammitic rock intercalations prevailed, which is different in metamorphic conditions. The lower tectonic sheet is marked by mineralogical associations with muscovite + chlorite + quartz ± graphite ± albite, without biotite; however, the superior one is with muscovite + quartz + garnet ± chlorite ± biotite ± chloritoid ± graphite ± albite. In the upper tectonic sheet, pelitic rocks with local contributions of psammitic and ultramafics rocks occur. In the south domain, psammitic rocks basically occur with contributions of pelitics and rudaceous rocks, where the preservation of textures and sedimentary structures is common. Rocks of the several domains are interpreted as part of a passive continental margin basin, located in the western margin of the São Francisco paleocontinent. Thus, the south domain rocks would represent the facies of proximal platform; rocks of the lower and middle tectonic sheets (east domain) and of the tectonic sheet I (west domain) are of facies distal platform; and the ones from the upper tectonic sheet (east domain) and tectonic sheet II (west domain) were acknowledged as deposited in an environment of continental shelf and/or oceanic seafoor.

Mild cognitive impairment (part 2): Biological markers for diagnosis and prediction of dementia in Alzheimer's disease

To present a critical review of publications reporting on the rationale and clinical implications of the use of biomarkers for the early diagnosis of Alzheimer's disease (AD). Methods: We conducted a systematic search of the PubMed and Web of Science electronic databases, limited to articles published in English between 1999 and 2012, and based on the following terms: mild cognitive impairment, Alzheimer's disease OR dementia, biomarkers. We retrieved 1,130 articles, of which 175 were reviews. Overall, 955 original articles were eligible. Results: The following points were considered relevant for the present review: a) rationale for biomarkers research in AD and mild cognitive impairment (MCI); b) usefulness of distinct biomarkers for the diagnosis and prediction of AD; c) the role of multimodality biomarkers for the diagnosis and prediction of AD; d) the role of biomarkers in clinical trials of patients with AD and MCI; and e) current limitations to the widespread use of biomarkers in research and clinical settings. Conclusion: Different biomarkers are useful for the early diagnosis and prediction of AD in at-risk subjects. Nonetheless, important methodological limitations need to be overcome for widespread use of biomarkers in research and clinical settings. © 2013 Associação Brasileira de Psiquiatria.

Caracterização dos granitóides brasilianos da faixa de dobramentos Paraguai, MS e MT

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

História tectônica e exumação das serras da Bocaina e Mantiqueira SP/RJ

Pós-graduação em Geologia Regional - IGCE

Análise integrada aplicada à exploração de água subterrânea na Bacia do Rio Jundiaí (SP)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)