Epidemiology of healthcare-associated infections among patients from a hemodialysis unit in southeastern Brazil

Patients submitted to hemodialysis are at a high risk for healthcare-associated infections (HAI). Presently there are scarce data to allow benchmarking of HAI rates in developing countries. Also, most studies focus only on bloodstream infections (BSI) or local access infections (LAI). Our study aimed to provide a wide overview of HAT epidemiology in a hemodialysis unit in southeastern Brazil. We present data from prospective surveillance carried out from March 2010 through May 2012. Rates were compared (mid-p exact test) and temporally analyzed in Shewhart control charts for Poisson distributions. The overall incidence of BSI was 1.12 per 1000 access-days. The rate was higher for patients performing dialysis through central venous catheters (CVC), either temporary (RR = 13.35, 95% CI = 6.68-26.95) or permanent (RR = 2.10,95% CI = 1.09-4.13), as compared to those with arteriovenous fistula. Control charts identified a BSI outbreak caused by Pseudomonas aeruginosa in April 2010. LAI incidence was 3.80 per 1000 access-days. Incidence rates for other HAI (per 1000 patients-day) were as follows: upper respiratory infections, 1.72; pneumonia, 1.35; urinary tract infections, 1.25; skin/soft tissues infections, 0.93. The data point out to the usefulness of applying methods commonly used in hospital-based surveillance for hemodialysis units. (C) 2013 Elsevier Editora Ltda. All rights reserved.

Classificação e mapeamento de áreas de risco de enchentes e inundações no bairro Jardim Inocoop - Rio Claro - SP

In the last few decades, Brazil has experienced an accelerated urbanization process in which many cities have grown in a disorderly way occupying environmentally fragile areas unsuitable for habitation. Anthropogenic actions such as high levels of impermeable soil, structural changes in watercourses, lack of riparian vegetation, illegal presence of trash and rubbish along the river banks added to irregular settlements in floodplains result in the rise of high risk areas. When accompanied by intense and prolonged rainfall phenomena, those areas have been the scenery of serious accidents such as floods. This study aims to classify the level of the risk of floods in the neighborhood of Jardim Inocoop, in the town of Rio Claro, São Paulo countryside, Brazil. One of the main technical support to tackle this issue is the identification and classification of the risks. In order to classify the risk level of flood in this case study, the methodology adopted was developed by the Ministry of Cities and Technology Research Institute, and take into account the arrangement of the hydrological scenario, vulnerability of households and dangerous process according to the distance of the houses from the axis of drainage. Therefore, the risk levels adopted to classify are listed below: very high (MA), high risk (A), moderate (M) and low risk (B). In conclusion, it is imperative to develop prevention plans in order to avoid or to minimize the damages caused by natural disasters. Therefore, the zoning of the risk sceneries remains as an important issue once it helps to identify the areas with high level risk of flood. Consequently, the occupation must be regulated where there is low or absent risk and it must be often forbidden where the high risk of flood is detected. Thus, the present study remains as an attempt to notify the risk of floods through its spatialization on a map, remainig...(Complete abstract click electronic access below)

Uso do modelo de simulação 'ABC 6' para avaliação de áreas sujeitas à ocorrência de ondas de cheia e corridas de massa/detritos: estudo de caso na bacia do Ribeirão da Prata (SP)

Pipelines are linear engineering works, designed mostly for transporting oil and its derivatives for long distances, furnishing even the farthermost zones of the country. Due to oil sector needs to ensure for the safety and conservation of its properties, several geotechnical studies are being held at the pipelines field, in order to preserve this important transportation, and also to prevent accidents, which might seriously compromise the environment and the population who lives around it. The OSBRA pipeline, who connects the city of Paulínia to the capital Brasília, is one of these engineering works that deserves to be pointed out. This research, performed at the Ribeirão da Prata Basin, was a pilot study conducted with the main objective of testing the current methodology efficiency, for future applications in the closest watersheds to the OSBRA pipeline. The objective of this research is to analyze flood wave and debris flow processes in a non-fictional watershed, by comparing two different kinds of methods: the first one based on simulation models (software ‘ABC 6’), and the other one by flood wave and debris flow susceptibility mapping. The results from the hydrological modeling were both hydrographs and ietographs that estimated values of outputs and infiltration. To construct the susceptibility maps were necessary three other maps: ground use and occupation maps, divided according to the different protection degrees that were offered to the ground; maps of dam locations in the area and physiographic compartimentation maps, divided according to the local geology. To complete the methodology, the results were collected from both methods for comparison. The obtained product for this methodology was series of data whose different susceptibility degrees to flood wave and debris flow could define the safest route for a pipeline crossing in this watershed...

Occupational exposure to contaminated biological material: perceptions and feelings experienced among dental students

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Lesões bucomaxilofaciais: estudo dos casos periciados de 2007 a 2013 no Instituto Médico Legal Nina Rodrigues - Salvador / BA

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Spatial epidemiology of American cutaneous leishmaniasis in a municipality of west Sao Paulo State, Brazil

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

Molecular identification of food sources in triatomines in the Brazilian northeast: roles of goats and rodents in Chagas disease epidemiology

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Simplificação no tratamento da fratura de ângulo mandibular por meio do acesso intrabucal

Mandibular fractures are the injury most commonly found in the facial bones. They have varied etiology, such as automobile, motorcycle and cycling accidents, physical abuse and falls. The choice of treatment of mandibular fractures most often employed is the reduction and fixation of bone fragments. Regarding fractures involving the mandibular angle, access headgear is the most widely used, in view of the action of masticatory muscles causing greater displacement of fractured stumps. Therefore, the proposal to introduce a conservative approach and facilitated for the treatment of fractures of the mandibular angle, as well as to demystify the contraindication to intraoral approach cases unfavorable fracture displacement, this work is to report a clinical casesurgical mandibular angle fracture, treated by intraoral approach. The fracture was fixed with two plates, one following the external oblique line system (1.5 mm) and a lower system (2.0 mm), with the help of percutaneous trocar. This approach is very promising for these cases, in order to ease the technical as well as by reducing the technical complications of extraoral approach.

A mini review of Candida species in hospital infection: epidemiology, virulence factor and drugs resistance and prophylaxis

The introduction of more efficient diagnostic methods, new techniques in surgery and transplantation, antibiotics and chemotherapeutics more potent and novel materials for prostheses, catheters and probes significantly increased the life expectancy and quality of life of critically ill patients, on the other hand, hospital-acquired infections emerged as important iatrogenic complications. Invasive infections are a growing problem in public health hospitals in Brazil and worldwide. Among the various etiological agents found in the hospital environment, the genus Candida has been the third most frequently isolated pathogen. In general, invasive fungal infections are associated with high morbidity and mortality, difficulties in diagnosis, antimicrobial resistance, length of hospital stay and increased hospital costs. This mini review of the literature describes about epidemiology of hospital infection of Candida species, as well as its virulence factors and drugs resistance

Mycobacterium tuberculosis population structure shift in a 5-year molecular epidemiology surveillance follow-up study in a low endemic agro-industrial setting in São Paulo, Brazil

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

Borreliosis in horses: epidemiology, experimental infection and therapeutic

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

Monitoring of Transmission of Tuberculosis between Wild Boars and Cattle: Genotypical Analysis of Strains by Molecular Epidemiology Techniques

An epidemiological survey for the monitoring of bovine tuberculosis transmission was carried out in western Liguria, a region in northern Italy. Fifteen Mycobacterium bovis strains were isolated from 63 wild boar samples (62 from mandibular lymph nodes and 1 from a liver specimen). Sixteen mediastinal lymph nodes of 16 head of cattle were collected, and 15 Mycobacterium bovis strains were subsequently cultured. All M. bovisstrains isolated from cattle and wild boars were genotyped by spoligotyping and by restriction fragment length polymorphism (RFLP) analysis with the IS6110 and IS1081 probes. All M. bovis strains showed the typical spoligotype characterized by the absence of the 39 to 43 spacers in comparison with the number in M. tuberculosis. A total of nine different clusters were identified by spoligotyping. The largest cluster included 9 strains isolated from wild boars and 11 strains isolated from cattle, thus confirming the possibility of transmission between the two animal species. Fingerprinting by RFLP analysis with the IS6110 probe showed an identical single-band pattern for 29 of 30 strains analyzed, and only 1 strain presented a five-band pattern. The use of IS1081 as a second probe was useful for differentiation of M. bovis from M. bovis BCG but not for differentiation among M. bovis strains, which presented the same undifferentiated genomic profile. In relation to the epidemiological investigation, we hypothesized that the feeding in pastures contaminated by cattle discharges could represent the most probable route of transmission of M. bovis between the two animal species. In conclusion, our results confirmed the higher discriminatory power of spoligotyping in relation to that of RFLP analysis for the differentiation of M. bovis genomic profiles. Our data showed the presence of a common M. bovis genotype in both cattle and wild boars, confirming the possible interspecies transmission of M. bovis.

The Role of a Wildlife Reservoir in the Epidemiology of Bovine Tuberculosis

The objective of this project was to study the epidemiology of bovine tuberculosis in the presence of a wildlife reservoir species. Cross-sectional and longitudinal studies of possum populations with endemic bovine tuberculosis infection were analyzed. The results were used to develop a computer simulation model of the dynamics of bovine tuberculosis infection in possum populations. A case-control study of breakdowns to tuberculosis infection in cattle herds in the Central North Island of New Zealand was conducted to identify risk factors other than exposure to tuberculosis in local possum populations.

Accidents by external causes in adolescents: care in sentinel urgency and emergency services in the Brazilian State Capitals-2009

Adolescents are seeking new references and experiences, which may involve attitudes of risk and exposure to accidents and violence from external causes. These events constitute a serious Public Health problem. The scope of this study was to analyze the occurrence of accidents by external causes in adolescents from 10 to 19 years of age attended at sentinel urgency and emergency services in Brazil. Data from the 2009 Surveillance System for Violence and Accidents (VIVA 2009) was analyzed in 74 emergency units in 23 state capitals and the Federal District. The findings revealed that 6,434 adolescents (89.8%) were victims of accidents and 730 (10.2 %) were victims of violence. The main causes of the accidents were falls and traffic accidents, and assaults were predominant in violence. For both accidents and violence, non-white male adolescents were predominant and the events occurred most frequently on the public highways. A marked increase was detected, with hospitalization of victims of violence between 15 and 19 years of age. Understanding the epidemiological reality of external causes among adolescents represents an important tool for health prevention and promotion policies and the culture of peace seeking to reduce morbidity and mortality.