838 resultados para Infectious Disease Transmission, Patient-to-Professional


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

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OBJECTIVE: To assess the presence of microorganism contamination in the preservation solution for transplant organs (kidney/pancreas). Method: Between August 2007 and March 2008, 136 samples of preservation solution were studied prior to graft implantation. Variables related to the donor and to the presence of microorganisms in the preservation solution of organs were evaluated, after which the contamination was evaluated in relation to the recipient culture variable. Univariate and multivariate statistical analyses were performed. RESULTS: The contamination rate of the preservation solution was 27.9%. Coagulase-negative Staphylococcus was the most frequently isolated microorganism. However, highly virulent agents, such as fungi and enterobacteria, were also isolated. In univariate analysis, the variable donor antibiotic use was significantly associated to the contamination of the preservation solution. on the other hand, multivariate analysis found statistical significance in donor antibiotic use and donor's infectious complications variables. CONCLUSIONS: In this study, 27.9% of the preservation solutions of transplant organs were contaminated. Infectious diseases and non-use of antibiotics by the donor were significantly related to the presence of microorganisms in organ preservation solutions. Contamination in organ preservation solutions was not associated with infection in the recipient.

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Syphilis is a sexually transmitted infectious disease caused by Treponema pallidum. This study reports 3 cases of syphilis and highlights the importance of identifying oral lesions for its final diagnosis. Case 1: a 48-year-old male patient presented with a bleeding ulcer in the lower lip. Overall clinical examination revealed patchy alopecia and skin target lesions. Case 2: a 61-year-old male patient presented with white spots on the lateral tongue and nodules on the dorsum of the tongue. Overall clinical examination showed erythematous target lesions on the abdomen, forearm, palms of the hand, and soles of the feet. Case 3: a 17-year-old male patient presented with an ulcerated lesion on the tongue and lymph node involvement. The following serologic tests were requested: Venereal Disease Research Laboratory, fluorescent treponemal antibody-absorption, anti-HIV-1 and anti-HIV-2, and anti-hepatitis C virus. An incisional biopsy revealed epithelial hyperplasia associated with intense and diffuse mononuclear inflammatory cell infiltration consisting mainly of plasma cells, in a perivascular and perineural distribution. The final diagnosis in the 3 patients was syphilis. Treatment consisted of 1 weekly dose of penicillin (2.4 million units, intramuscular) for 2 or 3 weeks. Immunohistochemical reactions for XIIIa, CD3, CD20, CD68, CD163, S100, CD1a, CD11c, CD83, CD138, and CD208 were performed. Clinicians should be familiarized with oral syphilis lesions in order to be able to diagnose this emerging infectious disease of variable clinical presentation.

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

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This is a clinical case report of a patient who presented with dental stains in the buccal and proximal aspects of the anterior teeth. Buccal stains were removed using the enamel microabrasion technique, and vital tooth bleaching with carbamide peroxide was also performed. Restorative procedures employing composite resin were done for a better result in the proximal aspect of teeth. Clinical significance: The authors observed the combination of these esthetic techniques improved the patient's smile. Today, dental esthetics attempts to imitate natural teeth by making them white, well-shaped, and aligned with no spots. This has enabled the development of several esthetic techniques, such as microabrasion to remove dental enamel surface stains and surface irregularities,1-6 and vital tooth bleaching to treat yellowish teeth.7 The enamel microabrasion technique uses different abrasive agents associated with chemical solutions,1,2,4,6 allowing the removal of intrinsic, hard-texture stains, and different coloring spots on the enamel surface, as well as correction of irregularities on the dental buccal surface.1,8 The various microabrasive products include the Opalustre® (Ultradent Products, http://www.ultradent.com)or Prema® Compound (Premier Dental Products, http://www.premusa.com), a low-concentration hydrochloric acid product associated with silica microparticles that is certainly effective for microabrasion technique,4,6,9,10 providing a good safety profile for the patient and professional. The microabrasion technique also promotes micro-reduction on the adamantine surface.4,5,10 In some cases, after its completion, microabrasion may cause teeth to become darker or yellowish because of the thinner remaining enamel surface, leading to more evident observation of the dentinal tissue, which in general determines tooth color. In these clinical conditions, correction of the color pattern of dental elements can be obtained with carbamide peroxide products applied in custom trays, such as the bleaching products Whiteness Perfect at 10% or 16% (FGM Productos Odontologicos, http://www.fgm.ind.br) or Opalescence® at 10% or 15% (Ultradent Products), with a considerable margin of clinical success, provided it is well indicated, well performed, and supervised by the professional.4,6,9,10 Considering all the aforementioned aspects, the authors present a clinical case about a dental-enamel microabrasion technique used to remove buccal enamel surface stains associated with dental vital bleaching and restorative procedures in the proximal aspect of anterior teeth. - See more at: https://www.dentalaegis.com/cced/2010/08/different-esthetic-techniques-used-in-combination-to-recover-the-smile#sthash.McFoH7El.dpuf

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This study had the aim of verify the perception of women and pregnant women about the HIV vertical transmission. It was approved by the Ethical Review Board. A semistructured questionnaire, pretested, was used, with open and closed questions which presented variables about socioeconomiccultural status and HIV vertical transmission. After informed consent, 114 women were enrolled in the study, 72 of them pregnant women, who looked for health care on the public health service of a Brazilian city, at São Paulo State, from October, 2009 to January, 2010. None of the interviewed women knew the meaning of HIV vertical transmission term. When asked about HIV transmission from mother to child, 86.8% answered it could happen, but half of them didn’t know how it occurred and only 34.2% knew how to prevent, but in a deficient way. As conclusion, these women did not know the HIV vertical transmission term and when they had some knowledge this was limited. These results serve as support for a preventive program for conscientization of women about HIV vertical transmission.

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Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

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Model Study: An experimental study Introduction: Chronic Kidney Disease (CKD) refers to a syndromic diagnosis which leads to a progressive and irreversible loss of renal function. A hemodialysis patient may have limitations in functional capacity, pulmonary function and respiratory musclular strength impacting in quality of life. Objective: To evaluate the effects of an exercise program on pulmonary function, functional capacity, quality of life and pain in patients undergoing hemodialysis. Methodology: The study included 28 patients of both genders, women and men aged between 40 and 60 years undergoing dialysis at the Kidney Institute, Santa Casa de Misericordia in Presidente Prudente-SP. Primary outcomes included respiratory muscular strength measurements assessed by manovacuometry. The functional capacity was evaluated by a six minute walking test. A life quality questionnaire was applied to evaluate quality of life (SF36-KDQOL). Lung function was evaluated by spirometry. Pain was assessed by a visual analogue scale. The exercise program consisted of training 3 times a week for 40 minutes on hemodialysis during eight weeks. At the end of the program all patients were reassessed. Results: There was no significant difference in the values of FVC and FEV1 before and after the exercise program as well as the index Tiffenau. The value of post MIP was significantly higher than the value obtained in the pre program. For variable MEP no significant difference was found. Functional capacity evaluations showed that there were no significant differences (p> 0.05). The evaluation of quality of life, about the domains of specific areas of CKD showed statistical significance when comparing the list of symptoms and problems with overloading of renal disease and professional role. Indicators related to pain were significantly reduced after the program (P <0.05). Discussion: A chronic kidney patient faces complex situations of physical, social and financial aspects. Although no statistically significant results were found in all variables, the study corroborates to others found in the literature, which suggests that an exercise program can be positive for this population. Conclusion: Although lung capacity and functional capacity did not submit changes to the end of the study, reduced levels of pain, fatigue and dyspnea suggest improvement in functional performance after exercise programs.

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

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Chagas disease affects 8 to 10 million people worldwide and, although most of them live in Latin America, there has been an increase in cases occurring in countries of Europe and North America although most of them live in Latin America. This study aims to describe the epidemiological situation in the present as well as government and research centers actions, particularly the study group of Chagas disease of the School of Medicine of Botucatu (FMB/UNESP)/Brazil.

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The spread of wildlife diseases is a major threat to livestock, human health, resource-based recreation, and biodiversity conservation (Cleaveland, Laurenson, and Taylor). The development of economically sound wildlife disease-management strategies requires an understanding of the links between ecological functions (e.g., disease transmission and wildlife dispersal) and economic choices, and the associated tradeoffs. Spatial linkages are particularly relevant. Yet while ecologists have long-argued that space is important (Hudson et al.), prior economic work has largely ignored spatial issues. For instance, Horan and Wolf analyzed a case study of bovine tuberculosis (bTB) in Michigan deer, a problem where the disease appears to be confined to a single, spatially confined, wildlife population—an island. But wildlife disease matters generally are not spatially confined. Barlow, in analyzing bTB in possums in New Zealand, accounted for immigration of susceptible possums into a disease reservoir. However, he modeled immigration as fixed and unaffected by management. Bicknell, Wilen, and Howitt, also focusing on possums in New Zealand, developed a model that incorporates simple density-dependent net migration. This allowed the authors to account for endogenous immigration when deriving optimal culling strategies.

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Livestock face complex foraging options associated with optimizing nutrient intake while being able to avoid areas posing risk of parasites or disease. Areas of tall nutrient-rich swards around fecal deposits may be attractive for grazing, but might incur fitness costs from parasites. We use the example of dairy cattle and the risks of tuberculosis transmission posed to them by pastures contaminated with badger excreta to examine this trade-off. A risk may be posed either by aerosolized inhalation through investigation or by ingestion via grazing contaminated swards. We quantified the levels of investigation and grazing of 150 dairy cows at badger latrines (accumulations of feces and urine) and crossing points (urination-only sites). Grazing behavior was compared between strip-grazed and rotation-grazed fields. Strip grazing had fields subdivided for grazing periods of <24 h, whereas rotational grazing involved access to whole fields for 1 to 7 d each. A higher proportion of the herd investigated badger latrines than crossing points or controls. Cattle initially avoided swards around badger latrines but not around crossing points. Avoidance periods were shorter in strip- compared with rotation-grazing systems. In rotation-grazing management, latrines were avoided for longer times, but there were more investigative contacts than with strip-grazing management. If investigation is a major route of tuberculosis transmission, the risk to cattle is greatest in extensive rotation-grazing systems. However, if ingestion of fresh urine is the primary method of transmission, strip-grazing management may pose a greater threat. Farming systems affect the level and type of contact between livestock and wildlife excreta and thus the risks of disease.

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The expansion of the cellulosic biofuels industry throughout the United States has broad-scale implications for wildlife management on public and private lands. Knowledge is limited on the effects of reverting agriculture to native grass, and vice versa, on size of home range and habitat use of white-tailed deer (Odocoileus virginianus). We followed 68 radio-collared female deer from 1991 through 2004 that were residents of DeSoto National Wildlife Refuge (DNWR) in eastern Nebraska, USA. The refuge was undergoing conversion of vegetation out of row-crop agriculture and into native grass, forest, and emergent aquatic vegetation. Habitat in DNWR consisted of 30% crop in 1991 but removing crops to establish native grass and wetland habitat at DNWR resulted in a 44% reduction in crops by 2004. A decrease in the amount of crops on DNWR contributed to a decline in mean size of annual home range from 400 ha in 1991 to 200 ha in 2005 but percentage of crops in home ranges increased from 21% to 29%. Mean overlap for individuals was 77% between consecutive annual home ranges across 8 years, regardless of crop availability. Conversion of crop to native habitat will not likely result in home range abandonment but may impact disease transmission by increasing rates of contact between deer social groups that occupy adjacent areas. Future research on condition indices or changes in population parameters (e.g., recruitment) could be incorporated into the study design to assess impacts of habitat conversion for biofuel production.