Unveiling healthy carriers and subclinical infections among household contacts of leprosy patients who play potential roles in the disease chain of transmission

Leprosy transmission still occurs despite the availability of highly effective treatment. The next step towards successfully eliminating leprosy is interrupting the chain of transmission of the aetiological agent, Mycobacterium leprae. In this investigation, we provide evidence that household contacts (HHCs) of leprosy patients might not only have subclinical infections, but may also be actively involved in bacilli transmission. We studied 444 patients and 1,352 contacts using anti-phenolic glycolipid-I (PGL-I) serology and quantitative polymerase chain reaction (qPCR) to test for M. leprae DNA in nasal swabs. We classified the patients according to the clinical form of their disease and the contacts according to the characteristics of their index case. Overall, 63.3% and 34.2% of patients tested positive by ELISA and PCR, respectively. For HHCs, 13.3% had a positive ELISA test result and 4.7% had a positive PCR test result. The presence of circulating anti-PGL-I among healthy contacts (with or without a positive PCR test result from nasal swabs) was considered to indicate a subclinical infection. DNA detected in nasal swabs also indicates the presence of bacilli at the site of transmission and bacterial entrance. We suggest that the concomitant use of both assays may allow us to detect subclinical infection in HHCs and to identify possible bacilli carriers who may transmit and disseminate disease in endemic regions. Chemoprophylaxis of these contacts is suggested.

Tecnologia educacional: avaliação de um web site sobre Escala de Pessoal de Enfermagem

O uso da tecnologia de informática é uma realidade em todas as áreas do conhecimento humano, nos dias atuais. A incorporação tecnológica se faz nos serviços e no ensino, nos diferentes processos de trabalho do enfermeiro. Este estudo teve como objetivo avaliar um site desenvolvido sobre o tema Escala de Pessoal de Enfermagem, relevante na gestão de recursos humanos em saúde. A metodologia envolveu pesquisa quantitativa com docentes da área de administração em enfermagem, e alunos das oito Universidades Públicas do estado de São Paulo que formam enfermeiros. Entre os principais resultados, apontamos que 85% dos avaliadores consideraram o site excelente ou satisfatório. Além disso, foram analisados os comentários enviados por e-mail e as autoras fazem uma auto-avaliação. O site foi considerado de utilidade tanto para a prática profissional (81,7% entre excelente e satisfatório) como para o ensino (84,6% entre excelente e satisfatório).

Knowledge of the Portuguese population on Basic Life Support and availability to attend training

OBJECTIVETo evaluate the level of knowledge and the availability of the Portuguese population to attend training in Basic Life Support (BLS) and identify factors related to their level of knowledge about BLS.METHODObservational study including 1,700 people who responded to a questionnaire containing data on demography, profession, training, interest in training and knowledge about BLS.RESULTSAmong 754 men and 943 women, only 17.8% (303) attended a course on BLS, but 95.6% expressed willingness to carry out the training. On average, they did not show good levels of knowledge on basic life support (correct answers in 25.9 ± 11.5 of the 64 indicators). Male, older respondents who had the training and those who performed BLS gave more correct answers, on average (p<0.01).CONCLUSIONThe skill levels of the Portuguese population are low, but people are available for training, hence it is important to develop training courses and practice to improve their knowledge.

Evaluation of adherence to measures for the prevention of surgical site infections by the surgical team

AbstractOBJECTIVEEvaluate pre- and intraoperative practices adopted by medical and nursing teams for the prevention of surgical infections.METHODA prospective study carried out in the period of April to May 2013, in a surgical center of a university hospital in Belo Horizonte, Minas Gerais.RESULTS18 surgeries were followed and 214 surgical gloves were analyzed, of which 23 (10.7%) had postoperative glove perforation detected, with 52.2% being perceived by users. Hair removal was performed on 27.7% of patients in the operating room, with the use of blades in 80% of the cases. Antibiotic prophylaxis was administered to 81.8% of patients up to 60 minutes prior to surgical incision. An average of nine professionals were present during surgery and the surgery room door remained open in 94.4% of the procedures.CONCLUSIONPartial adhesion to the recommended measures was identified, reaffirming a need for greater attention to these critical steps/actions in order to prevent surgical site infection.

Readmission from orthopedic surgical site infections: an integrative review

Abstract OBJECTIVE Characterizing readmissions from orthopedic surgical site infections. METHOD An integrative review of literature in the LILACS, IBECS, MEDLINE, Cochrane, SciELO and PUBMED databases, using the descriptors Patient readmission, Wound infection, Cross infection, Orthopedic procedures, Orthopedics. RESULTS 78 studies were identified and 10 publications were selected. Surgical site infections are the most common cause of unplanned orthopedic readmissions, representing long periods of hospitalization, new surgical procedures and high costs, and greater possibility of subsequent hospitalizations. Most significant predictors have indicated average length of hospitalization, need for intensive care, emergency status at admission, risk of death, age > 65 years, males and higher body mass index. CONCLUSION Readmission rates have increasingly become measures of quality and concerns about costs. New studies could involve issues related to indirect costs, specifically social and psychological costs.

Surgical site infection and its risk factors in colon surgeries

Abstract OBJECTIVE To identify the occurrence of surgical site infection (SSI) and its risk factors in patients undergoing colon surgery in a tertiary hospital located in the countryside of the state of São Paulo. METHOD Retrospective cohort study, with collection of information contained in the medical records of patients undergoing colon surgery in the period between January 2010 and December 2013. The studied variables were the possible risk factors related to the patient, to demographic characteristics and the surgical procedure. RESULTS In total, were evaluated 155 patients with an overall SSI incidence of 16.7%. A statistically significant association was found both in the univariate as in the multivariate analysis between the SSI and the following variables: male gender, Charlson index and mechanical bowel preparation. CONCLUSION The understanding of health professionals about the factors that influence the incidence of SSI in colon surgery may contribute to the quality of care provided to surgical patients, from effective actions to minimize the risk of infections.

Floral biology of Stachytarpheta maximiliani Scham. (Verbenaceae) and its floral visitors

This study describes the reproductive system of Stachytarpheta maximiliani (Verbenaceae), including its floral biology, nectar and pollen availability and insect foraging patterns, identifying whose species act as pollinators. It was carried out in a Brazilian Atlantic rain forest site. Observations on the pollination biology of the Verbenaceae S. maximiliani indicate that their flowering period extends from September through May. Anthesis occurs from 5:30 a.m. to 5:00 p.m. and nectar and pollen are available during all the anthesis. Many species of beetles, hemipterans, flies, wasps, bees and butterflies visit their flowers, but bees and butterflies are the most frequent visitors. The flowers are generally small, gathered in dense showy inflorescences. A complex of floral characteristcs, such as violet-blue color of flowers, long floral tubes, without scents, nectar not exposed, high concentration of sugar in nectar (about 32%), allowed identification of floral syndromes (melittophily and psicophily) and function for each visitor. The bees, Bombus morio, B. atratus, Trigonopedia ferruginea, Xylocopa brasilianorum and Apis mellifera and the butterflies Corticea mendica mendica, Corticea sp., Vehilius clavicula, Urbanus simplicius, U. teleus and Heraclides thoas brasiliensis, are the most important pollinators.

Nest descriptions of Megalopta aegis (Vachal) and M. guimaraesi Santos & Silveira (Hymenoptera, Halictidae) from the Brazilian Cerrado

We present the first data on the nesting biology of Megalopta aegis and M. guimaraesi from southeastern Brazil. Nests were collected in the Área de Proteção Ambiental Água Limpa, Bauru, São Paulo state. Our data suggest that nest architecture is conserved throughout all species of Megalopta. Two nests of M. guimaraesi consisted of a single female with brood. Of three M. aegis nests, two contained single females with brood and the third nest contained three adult females, with three times more brood than any single female nest. This observation suggests that social behavior in M. aegis is facultative, as known for other Megalopta species.

Nest structure and occurrence of three species of Azteca (Hymenoptera, Formicidae) in Cecropia pachystachya (Urticaceae) in non-floodable and floodable pantanal areas

Thirty Cecropia pachystachya trees were examined in non-floodable and floodable areas to investigate the association between C. pachystachya and Azteca ants in the Pantanal of Mato Grosso do Sul, Brazil. The species Azteca ovaticeps, Azteca isthmica, and Azteca alfari were found nesting inside domatia of C. pachystachya. A. ovaticeps was the most frequent species in the trees in the floodable area, while A. isthmica and A. alfari, in the non-floodable area. A. ovaticeps and A. isthmica maintained more entrance/exit holes in comparison to A. alfari. All Azteca species maintained entrance/exit holes in the closest domatia to the apical area of the branch, due to proximity to Müllerian and pearl bodies, suggesting that these species of Azteca were influenced by their environment during evolution and became specialized. All internodal septa of each examined branch were perforated by ants, indicating the branches were inhabited by a single colony.

Entering behavior of Gasteruption brachychaetum Schrottky (Hymenoptera, Gasteruptiidae) into a nest of Hylaeus Fabricius (Hymenoptera, Colletidae)

Nests of Hylaeus aff. guaraniticus (Schrottky, 1906) were parasited by females of Gasteruption brachychaetum Schrottky, 1906 in trap nests in São Paulo (Brazil). This is thefirst host record of a Gasteruptiidae in the Neotropical Region. The behavior of a G.brachychaetum female entering a host's nest is described as follows: an inquiline female hovered near the host's nest, landed and detected that a female of H. aff. guaraniticus was inside the nest, waited for the host female to fly out, entered backwards into the nest, remained there for almost six minutes, and then went out the nest. The development time of immature stages of G.brachychaetum varied between 16 and 299 days.

Energy substrate used by workers of leaf-cutting ants during nest excavation

Energy substrate used by workers of leaf-cutting ants during nest excavation. In this study we aimed to ascertain whether leaf-cutting ant workers lose body reserves (fat or sugars) as a function of nest excavation. For each treatment, we isolated 10 workers of Atta sexdens into two experimental groups, Control (C- without excavation) and Soil (S- with excavation), which were kept for different time intervals (0, 24, 48 or 72 hours), totaling 700 tested workers. We then determined the concentration of soluble carbohydrates and total lipid content in them. The total carbohydrates were determined colorimetrically, based on the reaction between carbohydrates and sulfuric acid-phenol. For determination of lipids, the insects were immersed in organic solvent until they reached a constant weight. Our results showed that carbohydrates are consumed during nest excavation activities. In the experimental groups S24, S48 and S72, there was an average reduction of 5.82 (20.42%), 14.31 (44.96%) and 13.27 (43.96%) µ.mg-1 in soluble sugar when compared with the experimental groups that did not excavate. Furthermore, the lipids were not used during this activity. With respect to dry mass of the workers, their values were C0 = 8%, C24 = 10.4%, C48 = 9.2%, C72 = 10%, S24 = 9.2%, S48 = 8.7% and S72 = 8.5%. Our results show experimentally that the source of energy for nest excavation is carbohydrates, whereas lipids are conserved for other activities.

Nest plasticity of Cornitermes silvestrii (Isoptera, Termitidae, Syntermitinae) in response to flood pulse in the Pantanal, Mato Grosso, Brazil

Nest plasticity of Cornitermes silvestrii (Isoptera, Termitidae, Syntermitinae) in response to flood pulse in the Pantanal, Mato Grosso, Brazil. The Pantanal is one of the largest wetlands in the world. Since many areas in Pantanal are flooded during part of the year, it is expected that plants and animals would have mechanisms for their survival during the flooded period. This study investigated the existence of differences in nest shape and inquilines of Cornitermes silvestrii in areas influenced by the flood pulse. We measured the volume, height, width, and height/width ratio of 32 nests in flooded areas and 27 in dry areas, and performed an one-way-Anova with the quasi-Poisson distribution to determine if there were differences in the nest measurements between the points. To analyze the relationship of nest inquilines to flood pulse and nest shape, we performed a regression with a Poisson distribution with the inquiline richness and flood pulse, and the above measurements. The nests of C. silvestrii in flooded areas were significantly higher than nests in dry areas, and had a larger height/width ratio. Colonies in periodically flooded areas would probably make a larger effort to extend their nests vertically, to maintain at least some portion of the structure out of the water and prevent the entire colony from being submerged. Neither the size of the nest nor the flood pulses influenced the assemblage of 11 species found in nests of C. silvestrii.

Estimation of water retention and availability in soils of Rio Grande do Sul

Dispersed information on water retention and availability in soils may be compiled in databases to generate pedotransfer functions. The objectives of this study were: to generate pedotransfer functions to estimate soil water retention based on easily measurable soil properties; to evaluate the efficiency of existing pedotransfer functions for different geographical regions for the estimation of water retention in soils of Rio Grande do Sul (RS); and to estimate plant-available water capacity based on soil particle-size distribution. Two databases were set up for soil properties, including water retention: one based on literature data (725 entries) and the other with soil data from an irrigation scheduling and management system (239 entries). From the literature database, pedotransfer functions were generated, nine pedofunctions available in the literature were evaluated and the plant-available water capacity was calculated. The coefficient of determination of some pedotransfer functions ranged from 0.56 to 0.66. Pedotransfer functions generated based on soils from other regions were not appropriate for estimating the water retention for RS soils. The plant-available water content varied with soil texture classes, from 0.089 kg kg-1 for the sand class to 0.191 kg kg-1 for the silty clay class. These variations were more related to sand and silt than to clay content. The soils with a greater silt/clay ratio, which were less weathered and with a greater quantity of smectite clay minerals, had high water retention and plant-available water capacity.

Potassium availability in a hapludalf soil under long term fertilization

In a system in which fertilization is recommended, diagnosis of soil K availability and the establishment of critical levels are made difficult by the possibility of a contribution of non-exchangeable forms of K for plant nutrition. Due to its magnitude, this contribution is well diagnosed in long term experiments and in those which compare fertilization systems with positive and negative balances in terms of replacement of the K extracted by plants. The objective of this study was to evaluate K availability in a Hapludalf under fertilization for sixteen years with the addition of K doses. The study was undertaken in an experiment set up in 1991 and carried out until 2007 in the experimental area of the Soil Department of the Federal University of Santa Maria (Universidade Federal de Santa Maria - UFSM), in Santa Maria (RS), Brazil. The soil was a Typic Hapludalf submitted to four doses of K (0, 60, 120 and 180 kg ha-1 K2O) and subdivided in the second year, when 60 kg ha-1 of K2O were reapplied in the subplots in 0, 1, 2 and 3 times. As of the fifth year, the procedure was repeated. Grain yield above ground dry matter and total K content contained in the plant tissue were evaluated. Soil samples were collected, oven dried, ground, passed through a sieve and submitted to exchangeable K analysis by the Mehlich-1 extractor; non-exchangeable K by boiling HNO3 1 mol L-1 and total K by HF digestion. Potassium fertilization guidelines should foresee the establishment of a critical level as of which the recommended dose should accompany crop needs, which coincides with the quantity exported by the grain, without there being the need for the creation of broad ranges of K availability to predict K fertilization. In adopting the K fertilization recommendations proposed in this manner, there will not be K translocation in the soil profile.

Availability of soil water under tillage systems, mulch management and citrus rootstocks

The increased availability of soil water is important for the management of non-irrigated orange orchards. The objective of this study was to evaluate the availability of soil water in a Haplorthox (Rhodic Ferralsol) under different tillage systems used for orchard plantation, mulch management and rootstocks in a "Pêra" orange orchard in northwest Paraná, Brazil. An experiment in a split-split-plot design was established in 2002, in an area cultivated with Brachiaria brizantha grass in which three tillage systems (no tillage, conventional tillage and strip-tillage) were used for orchard plantation. This grass was mowed twice a year between the rows, representing two mulch managements in the split plots (no mulching and mulching in the plant rows). The split-split-plots were represented by two rootstocks ("Rangpur" lime and "Cleopatra" mandarin). The soil water content in the plant rows was evaluated in the 0-20 cm layer in 2007 and at 0-20 and 20-40 cm in 2008-2009. The effect of soil tillage systems prior to implantation of orange orchards on soil water availability was less pronounced than mulching and the rootstocks. The soil water availability was lower when "Pêra" orange trees were grafted on "Cleopatra" mandarin than on "Rangpur" lime rootstocks. Mulching had a positive influence on soil water availability in the sandy surface layer (0-20 cm) and sandy clay loam subsurface (20-40 cm) of the soil in the spring. The production of B. brizantha between the rows and residue disposal in the plant rows as mulch increased water availability to the "Pêra" orange trees.