Knowledge and attitudes of health care workers from intensive care units regarding nosocomial transmission of influenza: a study on the immediate pre-pandemic period

The transmission of influenza in health care settings is a major threat to patients, especially those with severe diseases. The attitude of health care workers (HCWs) may influence the transmission of countless infections. The current study aimed to quantify knowledge and identify attitudes of HCWs involved in intensive care units (ICUs) regarding the risk of nosocomial influenza transmission. A questionnaire was applied through interviews to HCWs who worked in one of the five ICUs from a teaching hospital. Questions about influenza were deliberately dispersed among others that assessed several infectious agents. Forty-two HCWs were interviewed: nine physicians, ten nurses and 23 nursing technicians or auxiliaries. Among the 42 HCWs, 98% were aware of the potential transmission of influenza virus in the ICUs, but only 31% would indicate droplet precautions for patients with suspected infection. Moreover, only 31% of them had been vaccinated against influenza in the last campaign (2008). Nursing technicians or auxiliaries were more likely to have been vaccinated, both by univariate and multivariable analysis. When asked about absenteeism, only 10% of the study subjects stated that they would not go to work if they had an influenza-like illness. Those findings suggest that, in non-pandemic periods, influenza control in hospitals requires strategies that combine continuous education with changes in organizational culture.

A gripe de longe e de perto: comparações entre as pandemias de 1918 e 2009

Neste debate, historiadores latino-americanos comparam a pandemia de gripe de 1918-1919 com a que varre o continente em 2009, sobretudo as experiências de México, Argentina e Brasil. Analisam as estratégias adotadas nos dois momentos, com ênfase em isolamento, vigilância em portos e aeroportos, intervenções nas cidades. Comparam a atuação dos Estados nacionais e governos locais, a posição dos médicos e dos meios de comunicação e o comportamento das populações, especialmente no tocante ao medo e à morte. Analisam o desempenho das estruturas de assistência às populações e as medidas terapêuticas e profiláticas recomendadas por órgãos públicos de saúde, por interesses privados ligados à venda de medicamentos e pelas medicinas populares e caseiras. O debate trata, ainda, da influência que a experiência de 1918 teve sobre as avaliações da crise atual, bem como do legado que deixará para o futuro.

Triplet entropy analysis of hemagglutinin and neuraminidase sequences measures influenza virus phylodynamics

The influenza virus has been a challenge to science due to its ability to withstand new environmental conditions. Taking into account the development of virus sequence databases, computational approaches can be helpful to understand virus behavior over time. Furthermore, they can suggest new directions to deal with influenza. This work presents triplet entropy analysis as a potential phylodynamic tool to quantify nucleotide organization of viral sequences. The application of this measure to segments of hemagglutinin (HA) and neuraminidase (NA) of H1N1 and H3N2 virus subtypes has shown some variability effects along timeline, inferring about virus evolution. Sequences were divided by year and compared for virus subtype (H1N1 and H3N2). The nonparametric Mann-Whitney test was used for comparison between groups. Results show that differentiation in entropy precedes differentiation in GC content for both groups. Considering the HA fragment, both triplet entropy as well as GC concentration show intersection in 2009, year of the recent pandemic. Some conclusions about possible flu evolutionary lines were drawn. © 2013 Elsevier B.V.

Tabagismo e mecanismos de defesa: resposta imune e transporte mucociliar

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Impacto das doenças cardiovasculares no serviço público: análise de custos

Pós-graduação em Bases Gerais da Cirurgia - FMB

Caracterização da abordagem ao hipertenso tabagista por profissionais de saúde na zona rural do município de Gália

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Dengue no Brasil: abordagem geográfica na escala nacional

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação dos edeitos de Bidens pilosa L., Brassica campestris L. e sua associação sobre a obesidade induzida por dieta hipercalórica

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

Estudo do método Monte Carlo e sua aplicação no modelo SIR

In this work we present a discussion and the results of the simulation of disease spread using the Monte Carlo method. The dissemination model is the SIR model and presents as main characteristic the disease evolution among individuals of the population subdivided into three groups: susceptible (S), infected (I) and recovered (R). The technique used is based on the introduction of transition probabilities S-> I and I->R to do the spread of the disease, they are governed by a Poisson distribution. The simulation of the spread of disease was based on the randomness introduced, taking into account two basic parameters of the model, the power of infection and average time of the disease. Considering appropriate values of these parameters, the results are presented graphically and analysis of these results gives information on a group of individuals react to the changes of these parameters and what are the chances of a disease becoming a pandemic

Methicillin resistance in Staphylococcus aureus and coagulase-negative staphylococci: Epidemiological and molecular aspects

Infections caused by the genus Staphylococcus are of great importance for human health. Staphylococcus species are divided into coagulase-positive staphylococci, represented by S. aureus, a pathogen that can cause infections of the skin and other organs in immunocompetent patients, and coagulase-negative staphylococci (CNS) which comprise different species normally involved in infectious processes in immunocompromised patients or patients using catheters. Oxacillin has been one of the main drugs used for the treatment of staphylococcal infections; however, a large number of S. aureus and CNS isolates of nosocomial origin are resistant to this drug. Methicillin resistance is encoded by the mecA gene which is inserted in the SCCmec cassette. This cassette is a mobile genetic element consisting of five different types and several subtypes. Oxacillin-resistant strains are detected by phenotypic and genotypic methods. Epidemiologically, methicillin-resistant S. aureus strains can be divided into five large pandemic clones, called Brazilian, Hungarian, Iberian, New York/Japan and Pediatric. The objective of the present review was to discuss aspects of resistance, epidemiology, genetics and detection of oxacillin resistance in Staphylococcus spp., since these microorganisms are increasingly more frequent in Brazil.