Antibiotic treatment schemes for very severe community-acquired pneumonia in children: a randomized clinical study

Objective. To compare clinical response to initial empiric treatment with oxacillin plus ceftriaxone and amoxicillin plus clavulanic acid in hospitalized children diagnosed with very severe community-acquired pneumonia (CAP).Methods. A prospective randomized clinical study was conducted among children 2 months to 5 years old with a diagnosis of very severe CAP in the pediatric ward of São Paulo State University Hospital in Botucatu, São Paulo, Brazil, from April 2007 to May 2008. Patients were randomly divided into two groups by type of treatment: an oxacillin/ceftriaxone group (OCG, n = 48) and an amoxicillin/clavulanic acid group (ACG, n = 56). Analyzed outcomes were: time to clinical improvement (fever and tachypnea), time on oxygen therapy, length of stay in hospital, need to widen antimicrobial spectrum, and complications (including pleural effusion).Results. The two groups did not differ statistically for age, sex, symptom duration before admission, or previous antibiotic treatment. Time to improve tachypnea was less among ACG patients than OCG patients (4.8 +/- 2.2 versus 5.8 +/- 2.4 days respectively; P = 0.028), as was length of hospital stay (11.0 +/- 6.2 versus 14.4 +/- 4.5 days respectively; P = 0.002). There were no statistically significant differences between the two groups for fever improvement time, time on oxygen therapy, need to widen antimicrobial spectrum, or frequency of pleural effusion.Conclusions. Both treatment plans are effective in treating very severe CAP in 2-monthto 5-year-old hospitalized children. The only analyzed outcome that favored amoxicillin/clavulanic acid treatment was time required to improve tachypnea.

Alho em pó na alimentação alternativa de frangos de corte

O objetivo deste trabalho foi estudar o efeito da inclusão de alho em pó (Allium sativum) em rações para frangos, sobre desempenho, rendimento de carcaça e partes, peso de órgãos, níveis de colesterol e triacilgliceróis sangüíneos, e morfometria intestinal. Foram utilizados 720 pintainhos machos Cobb, com um dia de idade, distribuídos em blocos casualizados com seis tratamentos: ração sem promotor de crescimento (PC), sem anticoccidiano (AC) e com 0,00, 0,25, 0,50, 0,75 e 1,00% de alho; e ração com PC+AC, com quatro repetições de 30 aves cada. Peso, ganho de peso, consumo de ração, conversão alimentar e mortalidade foram obtidos aos 21 e 42 dias de idade. Aos 42 dias de idade foram abatidas 20 aves por tratamento para determinação do rendimento de carcaça e 4 aves para avaliação do peso de órgãos e morfometria intestinal. Sangue de 8 aves por tratamento foi colhido para determinação de colesterol e triacilgliceróis. em aves alimentadas até 42 dias de idade com ração sem promotor de crescimento e anticoccidiano, a inclusão de até 1,00% de alho em pó beneficiou a conversão alimentar e não alterou o rendimento de carcaça e partes, peso relativo dos órgãos, mucosa intestinal, nem os níveis séricos de colesterol e triacilgliceróis. O alho não substitui com eficiência o antibiótico usado como promotor de crescimento em rações de frangos.

Occurrence of Odontogenic Infections in Patients Treated in a Postgraduation Program on Maxillofacial Surgery and Traumatology

This study assessed the occurrence and characteristics of oral and maxillofacial infections in patients treated at a Brazilian oral and maxillofacial emergency service during a 7-year period. The clinical files of all patients treated at the Oral and Maxillofacial Surgery and Traumatology Service of the Aracatuba Dental School, São Paulo State University, Brazil, between 2002 and 2008 were reviewed. From a population of 3645 patients treated in this period, the study sample consisted of 93 subjects who presented odontogenic infections. Data referring to the patients' sex, age, medical history, and the etiology, diagnosis, complications, drug therapy/treatment, and evolution of the pathologic diseases were collected and analyzed using the Epi Info 2000 software. of these patients, 54 were men (58.1%) and 39 were women (41.9%). Most patients were in the 31- to 40-year-old (20.7%) and 21- to 30-year-old (19.6%) age groups. The most frequent etiology was pulp necrosis due to caries (80.6%). Regarding the treatment, antibiotics were administered to all patients, surgical drainage was done in 75 patients (82.4%), and 44 patients (47.3%) needed hospital admission. First-generation cephalosporin alone or combined with other drugs was the most prescribed antibiotic (n = 26) followed by penicillin G (n = 25). Most patients (n = 85, 91.4%) responded well to the treatment. Five cases had complications: 3 patients needed hospital readmission, 1 case progressed to descending mediastinitis, and 1 patient died. Odontogenic infections can be life-threatening and require hospital admission for adequate patient care. Complications from odontogenic infections, although rare, may be fatal if not properly managed.

The controlled release of antibiotic by hydroxyapatite: Anionic collagen composites

Major problems with the treatment of osteomyelitis are associated with poor antibiotic distribution at the site of infection due to limited blood circulation to the skeletal tissue. Improved treatment procedures have been used in drug delivery systems that include bioceramics and natural and synthetic polymers. This work reports the development of anionic collagen:hydroxyapatite composite paste for sustained antibiotic release. Antibiotic release by the composite was characterized by two steps. In the first, 15.0 +/- 4.9% was released in the first 5 h (n = 53) by a normal Fick diffusion mechanism. In the second step, only 16.8 +/- 2.2% was released after 7 days. In conclusion, hydroxyapatite:anionic collagen composite can be an efficient support for sustained antibiotic release in the treatment of osteomyelitis because most of the antibiotic release may be associated with composite bioresorption, thus permitting antibiotic release throughout the healing process. Hydroxyapatite:anionic collagen paste showed good biocompatibility associated with bone tissue growth with material still being observed after 60 days from the time of implants.

Evaluation of chitosan gel as antibiotic and photosensitizer delivery

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

Evaluation of the Diramic system for urine cultures

O sistema Diramic foi avaliado para o diagnóstico das infecções do trato urinário (ITU). O sistema Diramic foi desenvolvido em Cuba e possibilita resultados de diagnóstico das infecções do trato urinário (ITU) em quatro horas e baseia-se na variação da turvação do crescimento microbiano no meio de cultura após incubação a 37ºC/4 horas. 396 amostras de urinas provenientes de ambulatórios e enfermarias do HC da FMB-UNESP-Botucatu/SP foram analisadas pelo sistema Diramic. O método da alça calibrada (AC) foi adotado como método de referência. A taxa de coincidência entre os dois métodos foi de 96,46% (382 amostras de urina), não havendo diferença significativa entre os resultados obtidos nos dois métodos. Os resultados para sensibilidade e especificidade foram 84,37 e 98,80% respectivamente e 10 resultados no Diramic foram falsos negativos (2,5%) e 4 falso positivos (1,01%). Os microrganismos identificados nas urinas positivas foram Escherichia coli (68,75%), Klebsiella pneumoniae (10,94%), leveduras (6,25%), Pseudomonas aeruginosa (4,69%), Enterobacter cloacae (3,12%) e Proteus mirabilis, Staphyloccocus coagulase negativo, Morganella morganii e Citrobacter freundii também foram identificadas (1,56% para cada espécie). O método Diramic foi eficiente na triagem das urinoculturas, porém verificou-se algumas restrições quanto ao diagnóstico das infecções do trato urinário quando causadas por leveduras e em pacientes submetidos a antibioticoterapia.

Opportunistic microorganisms in patients undergoing antibiotic therapy for pulmonary tuberculosis

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

Temperature dependence of dielectric properties for Ba(Zr0.25Ti0.75)O-3 thin films obtained from the soft chemical method

Ba(Zr0.25Ti0.75)O-3(BZT) thin films prepared by the polymeric precursor method (PPM) were annealed at 500, 600, and 700 degrees C for 4h. All films crystallized in the perovskite structure present a crack-free microstructure. Dielectric properties of the BZT thin films were investigated as a function of frequency and applied voltage. The dielectric constant of the films were 36, 152 and 145 at 1 kHz, while the dielectric loss were 0.08, 0.08, and 0.12 at 1 MHz. (c) 2007 Elsevier B.V. All rights reserved.

Intense visible photoluminescence in Ba(Zr0.25Ti0.75)O-3 thin films

Photoluminescence at room temperature in Ba(Zr0.25Ti0.75)O-3 thin films was explained by the degree of structural order-disorder. Ultraviolet-visible absorption spectroscopy, photoluminescence, and first principles quantum mechanical measurements were performed. The film annealed at 400 degrees C for 4 h presents intense visible photoluminescence behavior at room temperature. The increase of temperature and annealing time creates [ZrO6]-[TiO6] clusters in the lattice leading to the trapping of electrons and holes. Thus, [ZrO5]-[TiO6]/[ZrO6]-[TiO6] clusters were the main reason for the photoluminescence behavior.

Thermal behavior of ara double dagger a oil (Psidium cattleianum Sabine)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Variabilidades fenotípica e genotípica de estirpes de Staphylococcus aureus isoladas em casos de mastite subclínica bovina

Foram submetidas a PCR-Ribotipagem e aos testes de sensibilidade in vitro frente a 12 antimicrobianos 77 estirpes de Staphylococcus aureus isoladas em amostras de leite procedentes de 40 vacas da raça holandesa que apresentaram mastite subclínica, em uma propriedade rural localizada no Estado de São Paulo, Brasil. Os resultados obtidos revelaram quatro diferentes padrões de resistência a antimicrobianos, sendo observada a predominância de resistência à lincomicina entre 19 (24,7%) estirpes de S.aureus. As 58 (75,3%) estirpes restantes foram sensíveis aos 12 antimicrobianos testados. A PCR-ribotipagem revelou a ocorrência de nove padrões genotípicos distintos, além de apresentar uma capacidade discriminatória maior (D = 0,82) que a obtida nos antibiogramas (D = 0,42). Entre as 19 estirpes resistentes aos antimicrobianos, 14 (73,7%) foram agrupadas em três padrões de ribotipagem e, destas, 13 (92,9%) apresentaram resistência à eritromicina e à lincomicina, isoladamente ou em associação. O grande número de ribotipos e de padrões de resistência a antimicrobianos observados nesta propriedade demonstrou que há grande heterogeneidade genética em populações naturais de S. aureus, fato este que deve ser levado em consideração em programas de controle da mastite bovina.

cDNA cloning and 1.75 angstrom crystal structure determination of PPL2, an endochitinase and N-acetylglucosamine-binding hemagglutinin from Parkia platycephala seeds

Parkia platycephala lectin 2 was purified from Parkia platycephala (Leguminosae, Mimosoideae) seeds by affinity chromatography and RP-HPLC. Equilibrium sedimentation and MS showed that Parkia platycephala lectin 2 is a nonglycosylated monomeric protein of molecular mass 29 407 +/- 15 Da, which contains six cysteine residues engaged in the formation of three intramolecular disulfide bonds. Parkia platycephala lectin 2 agglutinated rabbit erythrocytes, and this activity was specifically inhibited by N-acetylglucosamine. In addition, Parkia platycephala lectin 2 hydrolyzed beta(1-4) glycosidic bonds linking 2-acetoamido-2-deoxy-beta-D-glucopyranose units in chitin. The full-lengthamino acid sequence of Parkia platycephala lectin 2, determined by N-terminal sequencing and cDNA cloning, and its three-dimensional structure, established by X-ray crystallography at 1.75 angstrom resolution, showed that Parkia platycephala lectin 2 is homologous to endochitinases of the glycosyl hydrolase family 18, which share the (beta alpha)(8) barrel topology harboring the catalytic residues Asp125, Glu127, and Tyr182.