Antimicrobial resistance of isolated Streptococcus pneumoniae in a hospital of the Brazilian public system

Streptococcus pneumoniae is the predominant bacterial agent that affects the human population with pneumonia. This disease is an important cause of death in the elderly and the children under five years old. In this study, 29 strains of invasive S. pneumoniae were isolated from 29 patients of pneumonia, bacteremia and meningitis in the laboratory of the Municipal Hospital in Paulinia, Brazil, from May 2006 to October 2007. Patients' age ranged from 8 months old to 60 years old. These strains of S. pneumoniae were isolated from blood, pleural fluid and cerebrospinal fluid (CSF) of patients. After typing of encapsulated strains of S. pneumoniae through quellung reaction, their resistance to antimicrobial agents was gauged through Disc Diffusion Technique followed by determination of minimum inhibitory concentration (MIC). Among the 29 strains analyzed, 23 were methicillin-sensitive and six were methicillin-resistant and penicillin intermediate resistant. No strain presented full resistance to penicillin. Serotyping was performed only in two samples, which belonged to serotype 18. Our data may alert ambulatory regarding the incidence of pneumococcal strains resistant to the most common drugs due to inappropriate use of antimicrobials and also collaborate to the elaboration of pneumococcal conjugate vaccines specific to each region.

Perioperative cardiac arrest and its mortality in children. A 9-year survey in a Brazilian tertiary teaching hospital

Background: the incidence of perioperative cardiac arrest and mortality in children is higher than in adults. This survey evaluated the incidence, causes, and outcome of perioperative cardiac arrests in a pediatric surgical population in a tertiary teaching hospital between 1996 and 2004.Methods: the incidence of cardiac arrest during anesthesia was identified from an anesthesia database. During the study period, 15 253 anesthetics were performed in children. Data collected included patient demographics, surgical procedures (elective, urgent, or emergency), ASA physical status classification, anesthesia provider information, type of surgery, surgical areas, and outcome. All cardiac arrests were reviewed and grouped by the cause of arrest and death into one of four groups: totally anesthesia-related, partially anesthesia-related, totally surgery-related, or totally child disease or condition-related.Results: There were 35 cardiac arrests (22.9 : 10 000) and 15 deaths (9.8 : 10 000). Major risk factors for cardiac arrest were neonates and children under 1 year of age (P < 0.05) with ASA III or poorer physical status (P < 0.05), in emergency surgery (P < 0.05), and general anesthesia (P < 0.05). Child disease/condition was the major cause of cardiac arrest or death (P < 0.05). There were seven cardiac arrests because of anesthesia (4.58 : 10 000) - four totally (2.62 : 10 000) and three partially related to anesthesia (1.96 : 10 000). There were no anesthesia attributable deaths reported. The main causes of anesthesia attributable cardiac arrest were respiratory events (71.5%) and medication-related events (28.5%).Conclusions: Perioperative cardiac arrests were relatively higher in neonates and infants than in older children with severe underlying disease and during emergency surgery. The fact that all anesthesia attributable cardiac arrests were related to airway management and medication administration is important in prevention strategies.

Chlamydial infection in a high risk population: association with vaginal flora patterns

This study aimed to determine the frequency of Chlamydia trachomatis (CT) infection among high risk Brazilian women and evaluate its association with vaginal flora patterns.This was a cross-sectional study, performed in an outpatient clinic of Bauru State Hospital, So Paulo, Brazil. A total of 142 women were included from 2006 to 2008. Inclusion criteria was dyspareunia, pain during bimanual exam, presence of excessive cervical mucus, cervical ectopy or with three or more episodes of abnormal vaginal flora (AVF) in the previous year before enrollment. Endocervical CT testing was performed by PCR. Vaginal swabs were collected for microscopic assessment of the microbial flora pattern. Gram-stained smears were classified in normal, intermediate or bacterial vaginosis (BV), and recognition of Candida sp. morphotypes. Wet mount smears were used for detection of Trichomonas vaginalis and aerobic vaginitis (AV).Thirty-four of 142 women (23.9%) tested positive for CT. AVF was found in 50 (35.2%) cases. The most frequent type of AVF was BV (17.6%). CT was strongly associated with the presence of AV (n = 7, 4.9%, P = 0.018), but not BV (n = 25, 17.6%, P = 0.80) or intermediate flora (n = 18, 12.7%, P = 0.28).A high rate of chlamydial infection was found in this population. Chlamydia infection is associated with aerobic vaginitis.

Identification of dementia cases in the community: A Brazilian experience

OBJECTIVES: To describe the application in Brazil of a simple, low-cost procedure, developed in India by the 10/66 Dementia Research Group, for the identification of dementia cases in the community.DESIGN: Community-based dementia case-finding method.SETTING: Piraju, São Paulo, Brazil.PARTICIPANTS: Twenty-five community health workers were trained to identify dementia cases in 2,222 people aged 65 and older in Piraju, a Brazilian town with 27,871 inhabitants.MEAUREMENTS: After the training, the health workers prepared a list of possible cases that afterward an experienced psychiatrist clinically evaluated, according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria and the Clinical Dementia Rating.RESULTS: of the 72 cases that were clinically assessed, 45 met the DSM-IV diagnostic criteria for dementia. Therefore, the positive predictive value of this case finding method was 62.5%; the estimated frequency of dementia was 2%. Most of the confirmed cases met clinical criteria for Alzheimer's disease and vascular dementia.CONCLUSION: This simple method was appropriate to identify cases of dementia in the general population and can possibly be extended to other developing countries with limited resources to be applied in health programs.

Depressive symptoms among elderly inpatients of a Brazilian university hospital: prevalence and associated factors

Background: This study aims to evaluate the prevalence of depressive symptoms and associated factors among elderly hospital inpatients.Methods: A cross-sectional study evaluated 189 participants using the Geriatric Depression Scale, the Mini-mental State Examination and the Katz and Lawton Index, to assess dependence regarding activities of daily living (ADL).Results: Most of the participants were women, aged between 60 and 92 years, with low levels of educational attainment and personal income, and non-qualified occupations. The prevalence of depressive symptoms was 56%, but only 3% had a psychiatric diagnosis registered in their medical records. Univariate analysis showed significant associations between depressive symptoms and low educational level and income, marital status, number of hospitalizations in the previous year, cognitive decline, dependence regarding basic and instrumental ADL, and death. After logistic regression, the only variables that remained significantly associated with depression were low educational level, dependence regarding basic ADL, and death.Conclusions: Depressive symptoms were independently associated with low educational level and dependence regarding basic ADL. Hospitalized elderly people with depressive symptoms were more likely to die. It is essential to diagnose and treat depression properly in this population to minimize its negative impacts.

EBNA-1 gene sequences in Brazilian and American patients with Hodgkin's disease

We examined the types of Epstein-Barr virus-associated nuclear antigen-1 (EBNA-1) gene carboxy (C)-terminal mutations occurring in Hodgkin's disease (HD) and reactive tissues from two different geographic regions. Previously reported EBNA-1 C-terminal region amino acid sequence variants, based on the amino acid at codon 487, include Prototype (P)-ala, which is found in the B95.8-derived prototype virus, P-thr, Variant (V)-leu, V-val, and V-pro. Using polymerase chain reaction (PCR) to amplify portions of the EBNA-1 gene, followed by DNA sequencing, we found a single EBNA-1 gene sequence variant in each tissue, whether reactive or neoplastic and whether from Brazil or the United States. Variant EBNA-1 gene sequences were more common in both neoplastic and non-neoplastic tissues from different geographic areas than the so-called prototype sequence. In the 17 Brazilian HD cases, 4 cases had P-thr variants and 13 had V-leu variants. In the six reactive tissues from Brazil, one had a P-ala variant, two had P-thr variants, and three had V-leu variants. In the 12 American HD cases, 2 had P-ala variants, 6 had P-thr variants, and 4 had V-leu variants. The 11 American reactive tissues included 2 P ala variants, 5 P-thr variants, and 4 V-leu variants. In both countries, there were similar variant EBNA-1 sequences present in normal tissues and HD cases. Compared with the P ala and P-thr cases, the V-leu cases were more likely to have the 30-bp latent membrane protein 1 (LMP1) gene deletion (P = 0.0075). In addition, cases of HD with the V-leu were statistically associated with a substitution of asparagine for glutamine at codon 322 of the C-terminal portion of the LMP1 gene. Our results suggest that any variation in EBNA-1 gene sequence is caused by a polymorphism present in pre-existing viral strains in the underlying population, and not a mutation occurring during oncogenesis. (C) 1999 by the American Society of Hematology.

Dietary factors associated with metabolic syndrome in Brazilian adults

Background: Metabolic Syndrome (MS) is defined as the association of numerous factors that increase cardiovascular risk and diet is one of the main factors related to increase the MS in the population. This study aimed to evaluate the association of diet on the presence of MS in an adult population sample.Methodology: 305 adults were clinically screened to participate in a lifestyle modification program. Anthropometric assessments included waist circumference (WC), body fat and calculated BMI (kg/m(2)) and muscle-mass index (MMI kg/m(2)). Dietary intake was estimated by 24 h dietary recall. Fasting blood was used for biochemical analysis. MS was diagnosed using NCEP-ATPIII (2001) criteria with adaptation for glucose (>= 100 mg/dL). Logistic regression (Odds ratio) was performed in order to determine the odds ratio for developing MS according to dietary intake.Results: An adequate intake of fruits, OR = 0.52 (CI:0.28-0.98), and an intake of more than 8 different items in the diet (variety), OR = 0.31 (CI: 0.12-0.79) showed to be a protective factor against a diagnosis of MS. Saturated fat intake greater than 10% of total caloric value represented a risk for MS diagnosis, OR = 2.0 (1.04-3.84).Conclusion: Regarding the dietary aspect, a risk factor for MS was higher intake of saturated fat, and protective factors were high diet variety and adequate fruit intake.

Animal cysticercosis in indigenous Brazilian villages

A inspeção sanitária da carne bovina e suína tem sido a principal forma diagnóstica da cisticercose animal e da prevenção da teníase no Brasil. As aldeias indígenas Jaguapirú e Bororó estão localizadas próximo à área urbana do município de Dourados-MS, com condições precárias de saneamento básico, onde bovinos e suínos são criados como fonte de alimento para consumo próprio, bem como para comercialização externa, geralmente sem inspeção sanitária oficial. Neste estudo, 96 carcaças bovinas e 117 amostras de soro de suínos, criados nas aldeias indígenas, foram avaliadas para a presença de formas metacestóides à inspeção sanitária e de anticorpos anti-Taenia sp. ao teste ELISA, respectivamente. Observaram-se 18,75% de positividade para cisticercose bovina e 9,4% para cisticercose suína. A ocorrência do complexo teníase-cisticercose nas aldeias pode favorecer a ocorrência desta zoonose na população indígena. Condições adequadas de abate e inspeção sanitária dos animais destas aldeias se fazem urgente para o controle do complexo teníase-cisticercose na população indígena.

External control of the public water supply in 29 Brazilian cities

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Occurrence of Aggregatibacter actinomycetemcomitans in Brazilian indians from Umutina Reservation, Mato Grosso, Brazil

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

Functional aspects of floral nectar secretion of Ananas ananassoides, an ornithophilous bromeliad from the Brazilian savanna

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

Isoenzymatic variation in the germplasm of Brazilian races of maize (Zea mays L.)

Existem mais de 200 raças de milho (Zea mays L.), as quais são divididas em três grupos (raças comerciais antigas, raças comerciais recentes e raças indígenas). As raças indígenas, embora não tenham valor comercial, possuem muitas características importantes que podem ser utilizadas em programas de melhoramento de milho. A maior parte do germoplasma brasileiro das raças de milho indígena foi coletada, no mínimo, 40 anos atrás e nada é conhecido sobre a variabilidade presente neste germoplasma. Quinze populações de 4 raças indígenas de milho (Caingang, Entrelaçado, Lenha e Moroti) e 5 cultivares indígenas foram analisados utilizando-se 5 sistemas isoenzimáticos codificados por 14 locos. A análise revelou um baixo nível de variabilidade entre as amostras estudadas. O número médio de alelos/loco foi três, com 64,3% de locos polimórficos e uma heterozigosidade média esperada de 0,352. Por população, a média de número de alelos por loco polimórfico foi 1,6, em média 47,5% dos locos foram polimórficos e a heterozigosidade média foi 0,195. A distância genética média entre as populações foi 0,821 e a proporção da variabilidade genética, que é atribuída ao componente entre populações (Gst), foi 0,156. Os dados sugerem que um efeito de fundador poderia explicar a baixa variabilidade detectada.

Phylogeography and genetic population structure of Caribbean sharpnose shark Rhizoprionodon porosus

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

Influence of cage fish farming on the diet of dominant fish species of a Brazilian reservoir (Tiete River, High Parana River basin)

The cage farming of aquatic organisms was initiated 50 years ago, and was introduced to Brazil in the 1990's. In these systems, there is an input of organic matter from ration that is not totally used by the cage fishes, becoming available for the organisms of adjacent biota, including fish fauna. The aim of this work is to evaluate the interference in the diet of three dominant fish species (Plagioscion squamosissimus Heckel, 1840, Astyanax altiparanae Garutti and Britski, 2000 and Metynnis maculatus Kner, 1858) associated with ish cage farming. For determination of the diet, the Alimentary Index (AI) was used. In both stretches (around cage farm and control), P. squamosissimus selected aquatic insects, while A. altiparanae preferred terrestrial insects and M. maculatus eats ration remains. Diferences in abundance of these feeding resources found of the stomach content were observed among the two stretches. Thus, the small alterations in the diets of P. squamosissimus and A. altiparanae, indicate that cage farming can change the diet of resident species in reservoirs. This practice also influences the population structure of fish species, since higher middle standard lengths were found in A. altiparanae and P. squamosissimus populations resident around cage farms, in relation to the control stretch.