Highlights from the I international symposium of thrombosis and anticoagulation in internal medicine, October 23-25, 2008, Sao Paulo, Brazil

The importance of thrombosis and anticoagulation in clinical practice is rooted firmly in several fundamental constructs that can be applied both broadly and globally. Awareness and the appropriate use of anticoagulant therapy remain the keys to prevention and treatment. However, to assure maximal efficacy and safety, the clinician must, according to the available evidence, choose the right drug, at the right dose, for the right patient, under the right indication, and for the right duration of time. The first International Symposium of Thrombosis and Anticoagulation in Internal Medicine was a scientific program developed by clinicians for clinicians. The primary objective of the meeting was to educate, motivate and inspire internists, cardiologists and hematologists by convening national and international visionaries, thought-leaders and dedicated clinician-scientists in Sao Paulo, Brazil. This article is a focused summary of the symposium proceedings. © Springer Science+Business Media, LLC 2009.

Attack upon a bather by a swordfish: A case report

We report a case of a bather injured by a swordfish in shallow water off the coast of southern Brazil. The victim suffered multiple injuries from the fish's bill, including a puncture wound of his left knee and the tip of the bill remaining as a foreign body. The victim made a full recovery after field management and conservative care. The potential factors leading to this most unusual attack are discussed. © 2009 Wilderness Medical Society.

Bites caused by Giant Water Bugs belonging to belostomatidae family (Hemiptera, Heteroptera) in humans: A Report of Seven cases

We report 7 cases of patients bitten by giant water bugs, large predatory insects belonging to the Belostomatidae family (Hemiptera, Heteroptera). These insects have toxic saliva capable of provoking intense pain and paralysis in vertebrates. Victims experienced intense, excruciating pain and 1 manifested hypoesthesia in the forearm. Bites by Belostomatidae are often reported by clinicians working in areas where these insects live, but there are no detailed case reports in the medical literature. There are no specific treatment modalities known to be effective, making prevention an important strategy. © 2010 Wilderness Medical Society.

A fatal attack on a child by a black caiman (Melanosuchus niger)

We describe a fatal attack by a black caiman (Melanosuchus niger) on an 11-year-old child with comments on the reptile's aggression mechanisms and the conditions under which this kind of incident takes place in the Amazon region. © 2011 Wilderness Medical Society.

Attacks by jaguars (Panthera onca) on humans in central Brazil: Report of three cases, with observation of a death

Conflicts between humans and big cats have been known for centuries throughout the world, but have intensified in recent decades. Recently, attacks by Panthera onca on humans in Brazil have been brought to the forefront through exposure in the press and because of the severity of the attacks. We report 3 cases of patients attacked by jaguars in provoked and predatory situations. Two patients survived the attacks and one died. Attack mechanisms and lesions in victims are discussed. The attacks demonstrate a real risk of accidents from jaguars in certain regions, such as the Pantanal and the Amazon. © 2011 Wilderness Medical Society.

Uma Paris dos trópicos?: perspectivas da europeização do Rio de Janeiro na primeira metade do Oitocentos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Malaria at Humaita county, Amazonas state, Brazil: XVII - immune response in patients with Plasmodium falciparum according to gametocytes

Em agosto de 1983, os Autores, estudaram 36 doentes com infecção causada pelo Plasmodium falciparum e 14 indivíduos normais, nascidos na região de Humaitá, que nunca tiveram malária, sem esplenomegalia, com exame parasitológico de sangue e hemaglutinação passiva negativas. Todos eles foram submetidos à observação clínica completa, exame hematológico, exame parasitológico de sangue e tipagem de linfócitos. Os linfócitos foram isolados e congelados em nitrogênio líquido, para posterior tipagem pela formação de rosetas. Os doentes foram classificados em dois grupos de acordo com a presença (13 doentes), ou ausência (23 doentes) de gametócitos antes do tratamento. Houve predomínio de formas graves no grupo de doentes sem gametócitos. Os resultados mostraram diminuição do número de linfócitos T em ambos os grupos de doentes, com ou sem gametócitos antes do tratamento, enquanto que o número de linfócitos B foi normal apenas no grupo de doentes com gametócitos. Essas observações, assim como as que foram relatadas pelos Autores anteriormente, permitem associar a presença de gametócitos circulantes com o número normal de células B em doentes com formas leves de malária causada pelo Plasmodium falciparum.

The growing importance of materials that prevent microbial adhesion: antimicrobial effect of medical devices containing silver

Research has clarified the properties required for polymers that resist bacterial colonisation for use in medical devices. The increase in antibiotic-resistant microorganisms has prompted interest in the use of silver as an antimicrobial agent. Silver-based polymers can protect the inner and outer surfaces of devices against the attachment of microorganisms. Thus, this review focuses on the mechanisms of various silver forms as antimicrobial agents against different microorganisms and biofilms as well as the dissociation of silver ions and the resulting reduction in antimicrobial efficacy for medical devices. This work suggests that the characteristics of released silver ions depend on the nature of the silver antimicrobial used and the polymer matrix. In addition, the elementary silver, silver zeolite and silver nanoparticles, used in polymers or as coatings could be used as antimicrobial biomaterials for a variety of promising applications. (C) 2009 Elsevier B. V. and the International Society of Chemotherapy. All rights reserved.

Case-case-control study of risk factors for nasopharyngeal colonization with methicillin-resistant Staphylococcus aureus in a medical-surgical intensive care unit

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.

Characterization of PVDF/HAP composites for medical applications

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Costs estimates and rentability of the guava culture (Psidium guajava L Paluma cv) in Monte Alto County, São Paulo State

This work intended to calculate the rentability of the guava culture Paluma cv. in Monte Alto region-SP, estimating the costs of the implantation, maintenance, production and the gross income of this culture in the first three years of cultivation. The production system utilized refers to the cultural treatments usually used in this culture in the region. The costs estimates were based on the total operational costs methodology used by the Agricultural Economics Institute (I.E.A.). The results obtained showed that the implantation and maintenance costs of the culture, in the two first years was R$7.402,3 l/alqueire*. Considering the possibility that in guava orchard, on irrigated conditions, reach in the fourthy year a productivity of 80t/alqueire and that the current price is R$0,20/kg, it is possible to estimate the gross income around of R$16.000,00/alqueire, resulting in a net income of R$9.497,06/alqueire.

Gestão da atividade física no SUS: o processo de inserção do Programa de Exercícios Físicos em Unidades de Saúde no município de Rio Claro-SP : um estudo de caso

Pós-graduação em Ciências da Motricidade - IBRC