Occurrence and sensitivity profile of extended spectrum beta-lactamase-producing Enterobacteriaceae at a tertiary hospital in Southern Brazil

Abstract: INTRODUCTION: Nosocomial infections are closely associated with antimicrobial drug resistance. One of the most important mechanisms of resistance to β-lactam antibiotics is the production of extended spectrum β-lactamases (ESBLs). The objective of the present study was to evaluate the prevalence and antimicrobial susceptibility profile of ESBL-producing strains and to assess the evolution of antimicrobial drug resistance between 2007 and 2013 at the Hospital São Vicente de Paulo, Passo Fundo, State of Rio Grande do Sul, Brazil. METHODS: We conducted a descriptive, observational, cross-sectional study. Bacterial culture was performed from January to December 2013. The antimicrobial susceptibility profile of these cultures was determined using the disk diffusion method. Phenotypic screening for ESBL production was performed using the disk approximation method. RESULTS : We analyzed a total of 19,112 cultures, 11.5% of which were positive for Enterobacteriaceae. Of these, 30.3% of the isolates were positive for ESBL production, and the most prevalent species was Klebsiella sp. (37.5%). Over 95% of these isolates showed reduced susceptibility to all cephalosporins, aztreonam, and amoxicillin/clavulanic acid. The isolates also showed high sensitivity to the following antimicrobials: amikacin, meropenem, and piperacillin/tazobactam. Overall, the resistance rates among ESBL-producing Enterobacteriaceae decreased from 2007 to 2013. CONCLUSIONS : In our hospital, the increased sensitivity to certain antimicrobial agents seems to be directly related to the implementation of improvements in the methods to prevent and control nosocomial infections in addition to the natural development of other resistance mechanisms.

Primary lymphoma of the liver treated by extended hepatectomy and chemotherapy: a case report

Primary lymphoma of the liver is an extremely rare entity. A case of anaplastic large B-cell (both CD-20 and lambda positive) non-Hodgkin's lymphoma that was confined to the liver in a 33-year-old man is reported. The patient was treated with an extended right hepatectomy and combination chemotherapy: cyclophosphamide, adriamycin, vincristine, and prednisone. The patient was disease free 24 months after the procedure.

Leverage instability and persistence: Evidence from the United States and Europe

We find that leverage behavior both in level and time-series variation is very similar between the United States and Europe throughout the 1990-2013 period. Leverage regimes are simultaneously unstable and persistent for both regions. We define instability as the extent to which firms largely deviate from their long-term leverage mean, while persistence as the extent to which today’s leverage influences its future levels. We then show that this simultaneous evidence imply a mean-reversion behavior of leverage and discuss some of its implications for future research on this field.

Prognostic factors in locally advanced colon cancer treated by extended resection

The impact of clinical, pathologic, and surgical variables on the postoperative morbidity, mortality, and survival of patients undergoing extended resections of colon carcinoma were evaluated. METHODS: The medical records of 95 patients who underwent extended resections for colon carcinoma between 1953 and 1996 were reviewed. In all cases, in addition to colectomy, 1 or more organs and/or structures were resected en bloc due to a macroscopically based suspicion of tumor invasion. The clinical, pathologic, and surgical parameters were analyzed. Overall survival rates were analyzed according to the method of Kaplan and Meier. Multivariate analysis was performed using the Cox proportional hazards model. RESULTS: Eighty-six patients were treated by curative surgeries and the remaining by palliative resections. Invasion of the organs and/or adjacent structures and regional lymph nodes was found microscopically in 48 and 31 patients, respectively. The median follow-up without postoperative mortality was 47.7 months. The 5-year overall survival rates was 52.6%. The 5-year overall survival rates for patients undergoing curative and palliative surgeries was 58.3% and 0%, respectively. The mean survival time in the palliative surgery group was 3.1 months. Multivariate analysis showed that Karnofsky performance status was strongly related to the risk of postoperative complications (P = .01), and postoperative deaths were associated with the type of surgery and Karnofsky performance status at the time of admission (P = .001). CONCLUSIONS: Some patients with locally advanced colon adenocarcinomas undergoing extended resections have a 5-year overall survival rates of 58.3%. Patients could benefit from palliative-intent procedures, but these measures should cautiously be indicated and avoided in patients with low Karnofsky performance status due to high rates of postoperative mortality and poor survival.

The relationship between liquidity and profitability in the food & beverage industry evidence from Europe and United States

This Work Project clarifies the relationship between liquidity and profitability based on a sample in the Food & Beverage (F&B) industry, and comparing the largest European and United States companies. The research concludes that liquidity, proxied by current ratio or quick ratio, correlates with return on assets taken as the measure of profitability, and so does the cash conversion cycle and its components. Moreover, company size correlates with liquidity, and indirectly affects ROA. This research contributes and addresses to managers in the F&B industry and recommends how they should act in order to improve profitability in the industry.

Segurança e criminalidade organizada

Globalization brought some deep changes to the world (dis)order. Nowadays, more than in other moment in history, we are closer to the ones physically far, living in “global village” called by Marshall McLuhan (1962). The concepts and premises built in this new order, have totally broken with the ones that “came out from Westphalia”, which had last to the end of the cold war, like, for example, the concept of security. Since then, security has been facing one of its biggest transformations ever, completely disrupting the state border based idea and starting to be extended to other domains, as human, economic, environmental and IT security, among others. In this global and interdependent environment, “new” threats and risks have raised, which are demanding a comprehensive approach from the States, international organizations and other actors, to allow the analysis and understanding its impacts on the various society sectors and orders. Inside the enormous challenges to the global security, it is important to regard the organized crime, which covers, by itself, a set of threats and risks, enhanced by its connection to other types of criminality, such as terrorism. The goals pursued and the tactics used by criminal organizations during the perpetration of illegal activities, specially the drug smuggling, have impact in an wide spectrum of the social, economic financial and politic dimensions, which should not be underestimated, otherwise our own security may be compromised. Therefore, the current investigation intends to be an important catalyst to the idea debate inside security scope, through the analysis of the organized crime and the drug smuggling, adding to a discussion of this issue, which should be deeper and holistic, aiming a better understanding of the challenges provided by our society.

Mangrove vegetation in Amazonia: a review of studies from the coast of Pará and Maranhão States, north Brazil

The present study is a compilation of the literature about vegetation of mangrove forest of the north coast of Brazil. It synthesizes the knowledge about this important ecosystem and lists the currently available literature. The study focuses on the coast of Pará and Maranhão states, which are covered by a continuous belt of mangroves. The mangrove flora comprises six mangrove tree species and several associated species. Mangrove tree height and stem diameter vary as a function of abiotic local stand parameters. Seasonal variation in rainfall and salinity affect the species' phenology and litter fall. Local population use products derived from mangrove plants for different purposes (e.g. fuel; medicinal; rural construction). The increase in the coastal population has given rise to conflicts, which impact on mangrove forest.

Search for the Xb and other hidden-beauty states in the π+π-ϒ{hooked}(1S) channel at ATLAS

This Letter presents a search for a hidden-beauty counterpart of the X(3872) in the mass ranges 10.05--10.31 GeV and 10.40--11.00 GeV, in the channel Xb→π+π−Υ(1S)(→μ+μ−), using 16.2 fb−1 of s√=8 TeV pp collision data collected by the ATLAS detector at the LHC. No evidence for new narrow states is found, and upper limits are set on the product of the Xb cross section and branching fraction, relative to those of the Υ(2S), at the 95% confidence level using the CLS approach. These limits range from 0.8% to 4.0%, depending on mass. For masses above 10.1 GeV, the expected upper limits from this analysis are the most restrictive to date. Searches for production of the Υ(13DJ), Υ(10860), and Υ(11020) states also reveal no significant signals.

Search for low-scale gravity signatures in multi-jet final states with the ATLAS detector at s√ = 8 TeV

We search for evidence of physics beyond the Standard Model in the production of final states with multiple high transverse momentum jets, using 20.3 fb−1 of proton-proton collision data recorded by the ATLAS detector at s√ = 8 TeV. No excess of events beyond Standard Model expectations is observed, and upper limits on the visible cross-section for non-Standard Model production of multi-jet final states are set. Using a wide variety of models for black hole and string ball production and decay, the limit on the cross-section times acceptance is as low as 0.16 fb at the 95% CL for a minimum scalar sum of jet transverse momentum in the event of about 4.3 TeV. Using models for black hole and string ball production and decay, exclusion contours are determined as a function of the production mass threshold and the gravity scale. These limits can be interpreted in terms of lower-mass limits on black hole and string ball production that range from 4.6 to 6.2 TeV.

Search for charged Higgs bosons decaying via H± → τ±ν in fully hadronic final states using pp collision data at √s = 8 TeV with the ATLAS detector

The results of a search for charged Higgs bosons decaying to a τ lepton and a neutrino, H±→τ±ν, are presented. The analysis is based on 19.5 fb−1 of proton--proton collision data at s√=8 TeV collected by the ATLAS experiment at the Large Hadron Collider. Charged Higgs bosons are searched for in events consistent with top-quark pair production or in associated production with a top quark. The final state is characterised by the presence of a hadronic τ decay, missing transverse momentum, b-tagged jets, a hadronically decaying W boson, and the absence of any isolated electrons or muons with high transverse momenta. The data are consistent with the expected background from Standard Model processes. A statistical analysis leads to 95% confidence-level upper limits on the product of branching ratios B(t→bH±)×B(H±→τ±ν), between 0.23% and 1.3% for charged Higgs boson masses in the range 80--160 GeV. It also leads to 95% confidence-level upper limits on the production cross section times branching ratio, σ(pp→tH±+X)×B(H±→τ±ν), between 0.76 pb and 4.5 fb, for charged Higgs boson masses ranging from 180 GeV to 1000 GeV. In the context of different scenarios of the Minimal Supersymmetric Standard Model, these results exclude nearly all values of tanβ above one for charged Higgs boson masses between 80 GeV and 160 GeV, and exclude a region of parameter space with high tanβ for H± masses between 200 GeV and 250 GeV.

Measurement of the WW+WZ cross section and limits on anomalous triple gauge couplings using final states with one lepton, missing transverse momentum, and two jets with the ATLAS detector at s√=7 TeV

The production of a W boson decaying to eν or μν in association with a W or Z boson decaying to two jets is studied using 4.6 fb−1 of proton--proton collision data at s√=7 TeV recorded with the ATLAS detector at the LHC. The combined WW+WZ cross section is measured with a significance of 3.4σ and is found to be 68±7 (stat.)±19 (syst.) pb, in agreement with the Standard Model expectation of 61.1±2.2 pb. The distribution of the transverse momentum of the dijet system is used to set limits on anomalous contributions to the triple gauge coupling vertices and on parameters of an effective-field-theory model.

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at s√=8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of s√=8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT>120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between EmissT>150 GeV and EmissT>700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with large extra spatial dimensions, pair production of weakly interacting dark matter candidates, and production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presented.

Search for high-mass diboson resonances with boson-tagged jets in proton-proton collisions at √s = 8TeV with the ATLAS detector

A search is performed for narrow resonances decaying into WW, WZ, or ZZ boson pairs using 20.3 fb−1 of proton--proton collision data at a centre-of-mass energy of s√ = 8 TeV recorded with the ATLAS detector at the Large Hadron Collider. Diboson resonances with masses in the range from 1.3 to 3.0 TeV are sought after using the invariant mass distribution of dijets where both jets are tagged as a boson jet, compatible with a highly boosted W or Z boson decaying to quarks, using jet mass and substructure properties. The largest deviation from a smoothly falling background in the observed dijet invariant mass distribution occurs around 2 TeV in the WZ channel, with a global significance of 2.5 standard deviations. Exclusion limits at the 95% confidence level are set on the production cross section times branching ratio for the WZ final state of a new heavy gauge boson, W′, and for the WW and ZZ final states of Kaluza--Klein excitations of the graviton in a bulk Randall--Sundrum model, as a function of the resonance mass. W′ bosons with couplings predicted by the extended gauge model in the mass range from 1.3 to 1.5 TeV are excluded at 95% confidence level.

Search for the associated production of the Higgs boson with a top quark pair in multilepton final states with the ATLAS detector

A search for the associated production of the Higgs boson with a top quark pair is performed in multilepton final states using 20.3 fb−1 of proton-proton collision data recorded by the ATLAS experiment at s√=8 TeV at the Large Hadron Collider. Five final states, targeting the decays H→WW∗, ττ, and ZZ∗, are examined for the presence of the Standard Model (SM) Higgs boson: two same-charge light leptons (e or μ) without a hadronically decaying τ lepton; three light leptons; two same-charge light leptons with a hadronically decaying τ lepton; four light leptons; and one light lepton and two hadronically decaying τ leptons. No significant excess of events is observed above the background expectation. The best fit for the tt¯H production cross section, assuming a Higgs boson mass of 125 GeV, is 2.1+1.4−1.2 times the SM expectation, and the observed (expected) upper limit at the 95% confidence level is 4.7 (2.4) times the SM rate. The p-value for compatibility with the background-only hypothesis is 1.8σ; the expectation in the presence of a Standard Model signal is 0.9σ.

Search for a new resonance decaying to a W or Z boson and a Higgs boson in the ℓℓ/ℓν/νν+bb¯final states with the ATLAS detector

A search for a new resonance decaying to a W or Z boson and a Higgs boson in the ℓℓ/ℓν/νν+bb¯ final states is performed using 20.3 fb−1 of pp collision data recorded at s√= 8 TeV with the ATLAS detector at the Large Hadron Collider. The search is conducted by examining the WH/ZH invariant mass distribution for a localized excess. No significant deviation from the Standard Model background prediction is observed. The results are interpreted in terms of constraints on the Minimal Walking Technicolor model and on a simplified approach based on a phenomenological Lagrangian of Heavy Vector Triplets.