Perfil de suscetibilidade, genes de resistência aos aminoglicosídeos e similaridade genética em amostras de Acinetobacter baumannii isoladas em um Hospital Terciário

Pós-graduação em Microbiologia - IBILCE

Tratamentos pré-germinativos e substratos na emergência de sementes e qualidade de mudas de pinhão manso (Jatropha curcas L.)

The physic nut can be propagated asexually or sexually. Using cuttings have been earlier yield and more fidelity characteristics of the parent plant. However, there is less initial vegetative growth. The seeds from the plants have increased genetic variability, are more vigorous and begin production later. To get quality changes, the substrate is an important factor. With that the objective was to taste pre-germinated treatments and different substrate on seeds emergence and quality physic nut seedlings. The experimental design was completely randomized, in factorial scheme 6 x 3 (pre-germinated treatments x substrate), 18 treatments and 4 repetition, 8 seeds to each repetition. It was evaluated six pre-germination treatments: T1: witness (without treatments); T2: water immersion for 12 hours; T3: water immersion for 24 hours; T4: mechanical scarification; T5: mechanical scarification + water immersion for 12 hours; T6: mechanical scarification + water immersion for 24 hours, using as substrate: commercial, expanded vermiculite and sand washed. The mechanical scarification was realized opposite the micropyle using sandpaper n. 60. After the pre-germination treatments, the seeds were emergence in plastic cups (200mL) with substrates. We evaluated the characteristics: percentage, beginning and emergence speed index, mean length of plant, diameter of plant stem, SPAD index, fresh and dry shoot and root. The results showed that in seeds of Jatropha do not need pre-germinative treatments; and the use of commercial substrate showed seedling development.

Baixa umidade do solo na eficácia de herbicidas aplicados em pré-emergência

The aim of this study was to evaluate the effect of low soil moisture on the efficacy of applying herbicides ametryn + clomazone, sulfentrazone and tebuthiuron in pre-emergence application submitted to simulated rainfalls at different time intervals after application in control of B. pilosa, C. echinatus and U. plantaginea plants. The experiment was carried out in pots with a capacity of 2.5 L in green-house conditions and experimental design was completely randomized with four replications, arranged in a 3x5 factorial (three herbicides and five rains intervals). The herbicides clomazone + ametryn (Sinerge EC) 5.0 L commercial product (cp) ha(-1), sulfentrazone (Boral 500 SC) 1.2 L cp ha(-1) and tebuthiuron (combine SC) 2.0 L cp ha(-1) were applied in pre-emergence and the precipitation of 20 mm were applied under de pots in five time intervals after the herbicide application (0h, 4h, 8h, 12h and 24hours). Visual evaluations of plants control that emerged plants were realized at 14 and 21 days after treatment application and the plant emergence percentage was calculated. The application of these three herbicides in dry soil then rain within 24 hours after application provided C. echinatus plants emergence, reduced B. pilosa emergency but in the end of the experiment effectively controlled these two species and U. plantaginea plants.

Estratégias pedagógicas no ensino da clínica ampliada na atenção primária à saude: percepções e vivências dos alunos de graduação médica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Registro do perfil de emergência para mimetização dos dentes naturais na região estética

Introdução: o tratamento com implantes dentários para a reposição de dentes na região estética exige a utilização de materiais e técnicas que permitam o máximo de naturalidade entre a restauração, os dentes vizinhos e o tecido gengival. Dessa forma, torna-se necessário criar o correto perfil de emergência para o dente, assim como a utilização de materiais com alto potencial estético. Objetivo: o objetivo do presente trabalho foi ilustrar, através de um caso clínico, a utilização de uma técnica de moldagem para a correta cópia do perfil de emergência do dente e sua transferência para o modelo de trabalho, tornando possível a confecção de uma restauração totalmente cerâmica, perfeitamente integrada ao tecido gengival. Caso clínico: paciente de 30 anos, procurou o clínica de prótese dentária com desejo de melhorar a estética dos dentes. Após diagnóstico e planejamento, foram confeccionadas 2 coroas totalmente cerâmicas sobre os dentes 12 e 21, e confecção de 1 coroa cerâmica sobre um pilar de zircônia após o estabelecimento e registro do perfil de emergência do dente 11. Conclusão: após a conclusão do tratamento, observou-se naturalidade, estética e perfeita integração entre as restaurações, os dentes remanescentes e o tecido gengival.

Violência interpessoal: estudo descritivo dos casos não fatais atendidos em uma unidade de urgência e emergência referência de sete municípios do estado de São Paulo, Brasil, 2008 a 2010

Objective: to describe the profile of non-fatal cases related to interpersonal violence treated in an emergency care unit of reference that serves seven municipalities of the state of São Paulo, Brazil, from 2008 to 2010. Methods: the study data came from the cases reported from the Epidemiological Vigilance in Penápolis-SP to the Brazilian Information System for Notifiable Diseases; variables were shown according to the Notification/Investigation Individual Formulary of Domestic, Sexual, and/or other Types of Violences. Results: 109 occurrences were studied; most of the victims were young and female (93.6%); and the aggressors, mostly were men (57.8%), partners or relatives/acquaintances of victims. Physical violence was the main form of aggression (93.6%), principally in the home (67.9%), on Sunday (16.5%), between 6:01pm and 12:00pm (57.8%). Conclusion: the cases reported had a consistent profile of domestic family violence against women, different from other studies about interpersonal violence in large cities and metropolitan regions

Absentismo laboral por patología odontológica y médica en una industria de gran porte del sector mecánico y mueblero

Introduction: The current Brazilian legislation states that health services must be performed by the Specialized Service of Safety Engineering and Labor Medicine (SESMT). Objective: To analyze the dental and medical reasons for absenteeism, checking the interference of factors such as age, gender and position of the worker, and most of the reasons that led the employee to miss work. Material and methods: The research appears as a descriptive study with a quantitative approach. The dental and medical certificates and statements of attendance were analyzed, duly approved, lodged in a acrylic industry in the city of Araçatuba-SP, from January to July 2011. Results: Of the total number of certificates (n = 1841), only 103 (5.6%) were for dental reasons. Predominance of the age group of 20-29 years, males and with non-administrative function. The reasons most dental and medical certificates stated that led the workers to miss working days were "inclusive and impacted teeth" and "diarrhea and gastroenteritis of presumed infectious origin", respectively. As to factors related to absenteeism, there was a severity index of 2.83, 1.33 frequency and average duration of absences of 2.12. Conclusions: It is concluded that dental reasons had little weight on total absences due to illness that caused the temporary leave of the worker for a shorter period. The age and function variables influence the occurrence of work absenteeism.

Carcinoma de lábio com prognóstico sombrio devido conduta médica inadequada

The Squamous Cell Carcinoma is what more happens among the oral cancers, being considered sweats incidence in more than 90%. As important prognostic factor competes the early diagnosis and the immediate institution of the treatment, that it can involve radiotherapy and chemotherapy besides the surgery. The initial lesions don’t offer great diagnostic difficulties and now complemental laboratory exams define the diagnosis quickly, In the present report, the initial medical conduct was inadequate, with incomplete interpretation of the laboratorial result and adoption of inadequate therapeutic conduct, what resulted in constant evolution of the lesion. The patient came to the consultation with that medical history, after six months of the first attendance accomplished in another center. To the physical exam, infiltrative ulcerated lesion was observed in the lower lip, with having accentuated tissue loss superficially. The patient accused spontaneous pain and she did use an ointment, recommended six months ago for occasion of the first attendance. As diagnostic conduct was indicated the accomplishment of cytology and biopsy, being defined the diagnosis of Squamous Cell Carcinoma. The patient was immediately guided to the medical service of its municipal district for manegement of the specialized oncologic treatment. The patient was submitted the surgery followed by radiotherapy, being verified involvement of another structures by contiguity. Now, the patient meets abed, without viable perspectives of cure. The present report emphasizes the importance of the clinical knowledge and professional responsibility in attendance of cases of that nature.

Opportunistic microorganisms in patients with head and neck trauma

The use of antimicrobial agents has facilitated the dissemination of multi-resistant microorganisms, compromising dental and medical treatment. The aim of this study was to evaluate the distribution of different opportunistic microbial species in patients who suffered head and neck trauma, under temporary maintenance in nosocomial environment, particularly intensive care units, on the occurrence of such microorganisms in the oral cavity of the patients. It was selected 38 patients subjected to head and neck traumas. After emergency surgical procedures, clinical samples of saliva, sub and supragingival biofilms and mucosal surfaces were collected at two different moments: just after stabilization of the patient and soon after patients’ release from medical units. The presence of opportunistic and superinfecting microorganisms was evaluated by culture on selective and non-selective media, and the presence of the family Enterobacteriaceae, as well as genera Enterococcus, Pseudomonas, and Staphylococcus was assessed by PCR. It was found that the use of antimicrobials, even for short periods of time was sufficient to facilitate colonization by microorganisms of the families Enterobacteriaceae and Pseudomonadaceae, as well as yeasts and enterococci. These results support the concept that medical and dental teams should make a periodically change of antimicrobials used in treatment protocols in hospital for head and neck trauma patients, in order to minimize dissemination of opportunistic or superinfecting microorganisms.

Música popular e resistência: emergência de um agente folkcomunicacional a partir de um caso de conflito ambiental

Tralcao, situated in the Rios region, named after the various rivers that flow nearby, in Chile, is bathed by the Pichoy River and it encounters the rivers Estero Colliaico and Cruces. A cellulose company was established there back in 2004, and since the it has been dumping waste in the Cruces river, causing grave environmental issues and bringing severe consequences to the region. In the middle of the crossfire, we find Mr. Francisco Manquecho, considered to be an opinion leader according to Luis Beltrão, who assesses the real situation in the region throughout his song lyrics, acting as a propagator of the resistance against the environmental degradation occurring in Tralcao. Francisco acts as a ‘folkcommunicacional’ agent by spreading a non-hegemonic bias through his songs. The objective of this article is to show how an opinion leader acts in a context of environmental degradation in Tralcao region using the basis of the Folkcommunication Theory and the communicational processes which involve music as a concrete action of popular resistance.

Emergência de relações condicionais com sentenças afirmativas e negativas por sobreposição de palavras

A construção de sentenças envolve a produção de estruturas sintaticamente corretas e pode envolver produtividade de novas sentenças,a partir de recombinações de palavras diretamente ensinadas. O objetivo do estudo foi verificar o efeito do ensino de sequências de duas palavras com sobreposição sobre a emergência de sentenças afirmativas e negativas; posteriormente verificou o efeito do estabelecimento do controle condicional por cores sobre a leitura recombinativa generalizada de sentenças nas formas afirmativa e negativa. Participaram seis crianças com histórico de fracasso escolar, de ambos os sexos. Como estímulos foram adotadas seis sentenças de ensino (três afirmativas e três negativas) e quatro de generalização recombinativa (duas afirmativas e duas negativas), e respectivas sentenças ditadas e figuras. O procedimento consistiu nas fases de ensino de sentenças com sobreposição e testes de construção; fases de ensino de discriminações condicionais com a construção de sentenças afirmativas na presença da cor verde e negativas na presença da cor vermelha; testes de leitura recombinativa com oito novas sentenças; e testes de compreensão de leitura pela relação entre figura e sentença impressa. Nos testes de leitura recombinativa, quatro participantes construíram corretamente sete das oito novas sentenças e os demais, seis. Nos testes de compreensão I, quatro participantes obtiveram 100% e dois 80% de acerto. Nos testes de compreensão II, três crianças obtiveram desempenho de 100%, duas acima de 60% e uma 40%. Os resultados sugerem que o procedimento de ensino de sentenças por sobreposição de palavras foi eficiente no auxílio da aquisição de repertório verbal, relativo à construção de frases e leitura com compreensão de sentença nessa população.

Binômio mãe-filho: estudo epidemiológico e de base populacional desenvolvido em maternidades de baixo e alto risco

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

Necrólise epidérmica tóxica/síndrome de Stevens Johnson: emergência em dermatologia pediátrica

Contexto: É descrito caso clínico de farmacodermia grave e de alta letalidade, cujo reconhecimento imediato é fundamental. Relato decaso: Paciente do sexo masculino de três anos de idade, cuja mãe refere histórico de crises convulsivas, consultou-se com neurologistaparticular, que prescreveu ácido valproico. Uma semana depois, voltou a ter crise convulsiva, sendo então introduzida lamotrigina.Poucos dias depois, a criança começou apresentar tosse e coriza hialina. Procurou pronto-socorro de sua cidade e foi orientada a usarfluimucil. Iniciou, então, febre e exantema máculo-papular inicialmente na face, que depois se generalizou. Foi levantada a hipótesediagnóstica de farmacodermia secundária à associação de anticonvulsivante. Discussão: Síndrome de Stevens-Johnson e necróliseepidérmica tóxica são variantes do mesmo processo mucocutâneo agudo, raro e grave, causado principalmente por reação adversaa fármacos e caracterizado por erupção cutânea macular de padrão eritematoso, formação de bolhas de conteúdo sero-hemático edestacamento epidérmico. As afecções são diferenciadas pela porcentagem de superfície corpórea acometida, sendo menor que10% na síndrome de Stevens-Johnson, e maior que 30% na necrólise epidérmica tóxica. O prognóstico pode ser estimado através doescore Severity Illness Score for Toxic Epidermal Necrolysis (SCORTEN), que prevê mortalidade de até 90% para os casos mais graves.O tratamento consiste na interrupção imediata da droga, transferência do paciente para unidade de queimados ou unidade de terapiaintensiva, e medidas de suporte. Terapias adjuvantes, como imunoglobulinas intravenosas e corticosteroides, ainda não têm papelconsolidado na literatura. Conclusões: Relata-se afecção rara e extremamente grave cuja suspeição clínica é importante na conduçãodo tratamento.

Enfermagem cuidando de paciente adulto e família no processo de morte em sala de emergência

The purpose of the study was to understand the experience of nursing professionals on the care provided to adult patients and relatives who experience the dying process in an emergency room. Statements of 12 nursing professionals, being 8 technicians and 4 registered nurses of the emergency room of a high-complexity university hospital were analyzed. Data was collected by means of semi-structured interviews and evaluated according to Bardin’s content analysis. As a result, the theme entitled the relative’s mourning process emerged with two categories: alterity as an opening and suffering as a limit. when subjectivity, which was revealed under the principle of alterity, permeated the subjects’ actions, the nursing practices were targeted at the patients and their relative’s needs, but suffering as a limit imposed distancing by the professionals during care provision, even when it was perceived as necessary.

Controle químico em pós-emergência de espécies de Brachiaria em três estádios vegetativos

The aim of this study was to correlate the chemical control efficacy in post-emergence of Brachiaria decumbens Stapf. (signal grass) and Brachiaria plantaginea Hitchc. (alexandergrass) through ACCase-inhibitor enzyme herbicide application in function of the stage of development of the plant in order to contribute to the chemical management of these weed species. B. decumbens and B. plantaginea were sown in plastic pots filled with soil and kept in a greenhouse. For chemical control evaluation, the following herbicides were tested (g ha-1): fluazifop-p-butyl at 150, haloxyfop-methyl at 50, and sethoxydim at 230. The herbicides were applied in all three plant development phases: stage 1 (plants presenting 4-6 leaves at 15 days after emergence), stage 2 (plants presenting 3-4 tillers at 23 days after emergence), and stage 3 (adult plants in the beginning of flowering at 48 days after emergence). Evaluations were done at 4, 7, 10, 14, 17, 21, 24, and 28 days after herbicide application. The developmental stage of the two Brachiaria species was instrumental in the efficiency of the control provided by different herbicides. Sethoxydim was the most efficient herbicide in controlling Brachiaria species in the three evaluated development stages.