Lactobacillus bacteremia, with special focus on the safety of probiotic Lactobacillus rhamnosus GG

Lactobacilli are gram positive rods, which belong to normal oropharyngeal, gastrointestinal and urogenital flora. They are widely used in food industry and as food additives. Although their virulence is presumed to be very low, opportunistic bacteremic infections, especially in immunocompromised hosts, have been detected. In the present study, the possible effects of increasing probiotic use of Lactobacillus rhamnosus GG (LGG) on the occurrence of bacteremia due to lactobacilli was evaluated on population level. In Finland, 90 Lactobacillus bacteremia cases were reported to the National Infectious Disease Register maintained by National Public Health Institute, during 1995-2000. Their proportion of all bacteremia cases was on average 0.24%, corresponding to 0.3 cases/100 000 inhabitants annually. In the Helsinki University Central Hospital district the corresponding proportion of all bacteremia cases was observed during 1990-2000. Despite LGG intake increased six folded no increasing trend in the occurrence of lactobacilli bacteremia was seen. A total of 85 Lactobacillus sp. blood isolates collected from different human bacteremic cases were characterised and compared with the commercial probiotic LGG strain. In species characterisation 46 L. rhamnosus strains, 12 L. fermentum and L. casei strains each, three each of L. gasseri, L. salivarius and L. jensenii species, two L. curvatus, and one each of L. plantarum, L. sakei, L. zeae and L. reuteri species were detected. Nearly half of the L. rhamnosus findings turned out to be indistinguishable from the probiotic LGG strain. Common predisposing factors to Lactobacillus bacteremia were immunosuppression, prior prolonged hospitalisation and prior surgical interventions. Severe or fatal comorbidities were found in 82% of the patients. Mortality at one month was 26% and severe underlying diseases were a significant predictor of death (OR 15.8). Antimicrobial susceptibility of Lactobacillus strains was species dependent. The Lactobacillus isolates were generally susceptible to imipenem, piperacillin-tazobactam, clindamycin and erythromycin, whereas all other than L. gasseri and L. jensenii species were not at all susceptible to vancomycin. The susceptibility to cephalosporin varied greatly even within species why they might not be recommended for treatment of Lactobacillus infections. The effect and safety of probiotic LGG preparation in amelioration of gastric symptoms and diarrhea in HIV-infected patients was evaluated. No significant differences in gastrointestinal symptoms or diarrhoea in LGG treated patients compared to placebo could be found. LGG was well tolerated with no adverse effects including bacteremic outbreaks could be observed. The use of probiotic LGG can be regarded safe in this immunocompromised patient group.

Gastrointestinal complications after kidney transplantation

The aim of the study was to evaluate gastrointestinal (GI) complications after kidney transplantation in the Finnish population. The adult patients included underwent kidney transplantation at Helsinki University Central Hospital in 1990-2000. Data on GI complications were collected from the Finnish Kidney Transplantation Registry, patient records and from questionnaires sent to patients. Helicobacter pylori IgG and IgA antibodies were measured from 500 patients before kidney transplantation and after a median 6.8-year follow up. Oesophagogastroduodenoscopy with biopsies was performed on 46 kidney transplantation patients suffering from gastroduodenal symptoms and 43 dyspeptic controls for studies of gastroduodenal cytomegalovirus (CMV) infection. Gallbladder ultrasound was performed on 304 patients after a median of 7.4 years post transplantation. Data from these 304 patients were also collected on serum lipids, body mass index and the use of statin medication. Severe GI complications occurred in 147 (10%) of 1515 kidney transplantations, 6% of them fatal after a median of 0.93 years. 51% of the complications occurred during the first post transplantation year, with highest incidence in gastroduodenal ulcers and complications of the colon. Patients with GI complications were older and had more delayed graft function and patients with polycystic kidney disease had more GI complications than the other patients. H.pylori seropositivity rate was 31% and this had no influence on graft or patient survival. 29% of the H.pylori seropositive patients seroreverted without eradication therapy. 74% of kidney transplantation patients had CMV specific matrix protein pp65 or delayed early protein p52 positive findings in the gastroduodenal mucosa, and 53% of the pp65 or p52 positive patients had gastroduodenal erosions without H.pylori findings. After the transplantation 165 (11%) patients developed gallstones. A biliary complication including 1 fatal cholecystitis developed in 15% of the patients with gallstones. 13 (0.9%) patients had pancreatitis. Colon perforations, 31% of them fatal, occurred in 16 (1%) patients. 13 (0.9%) developed a GI malignancy during the follow up. 2 H.pylori seropositive patients developed gastroduodenal malignancies during the follow up. In conclusion, severe GI complications usually occur early after kidney transplantation. Colon perforations are especially serious in kidney transplantation patients and colon diverticulosis and gallstones should be screened and treated before transplantation. When found, H.pylori infection should also be treated in these patients.

Corporate Governance Mechanisms and Firm Performance:Evidence from Finland

This paper examines the association between corporate governance attributes and firm performance of Finnish firms during 1990 – 2000. The empirical results suggest that corporate governance matters for firm performance. First, univariate test results indicate that firms characterized by a high (efficient) level of corporate governance have delivered greater stock returns, are higher valued based on the measure of Tobin’s Q, and exhibit higher ratios of cash flow to assets, on average, in comparison to their counterparts characterized by a low (inefficient) level of corporate governance. Second, controlling for a number of well-known determinants of stock returns, we find evidence that firms categorized by inefficient corporate governance have delivered inferior returns to shareholders during the investigation period. Finally, after controlling for several common determinants of firm value, we find that firms characterized by efficient corporate governance have been valued higher during the investigation period, measured by Tobin’s Q.

Wood procurement in the pressure of change.

Linear optimization model was used to calculate seven wood procurement scenarios for years 1990, 2000 and 2010. Productivity and cost functions for seven cutting, five terrain transport, three long distance transport and various work supervision and scaling methods were calculated from available work study reports. All method's base on Nordic cut to length system. Finland was divided in three parts for description of harvesting conditions. Twenty imaginary wood processing points and their wood procurement areas were created for these areas. The procurement systems, which consist of the harvesting conditions and work productivity functions, were described as a simulation model. In the LP-model the wood procurement system has to fulfil the volume and wood assortment requirements of processing points by minimizing the procurement cost. The model consists of 862 variables and 560 restrictions. Results show that it is economical to increase the mechanical work in harvesting. Cost increment alternatives effect only little on profitability of manual work. The areas of later thinnings and seed tree- and shelter wood cuttings increase on cost of first thinnings. In mechanized work one method, 10-tonne one grip harvester and forwarder, is gaining advantage among other methods. Working hours of forwarder are decreasing opposite to the harvester. There is only little need to increase the number of harvesters and trucks or their drivers from today's level. Quite large fluctuations in level of procurement and cost can be handled by constant number of machines, by alternating the number of season workers and by driving machines in two shifts. It is possible, if some environmental problems of large scale summer time harvesting can be solved.

Projeto de Lei do Plano Nacional de Educação (PNE-2011/2020) : Projeto em tramitação no Congresso Nacional - PL nº 8.035/2010

Apresenta o Projeto de Lei 8530/10 de autoria do Poder Executivo, que institui o Plano Nacional de Educação (PNE).

O legislativo e a sociedade construindo juntos o novo Plano Nacional de Educação

Reúne a legislação pertinente para o debate sobre o novo Plano Nacional de Educação (PNE) que estará em vigor no período de 2011 a 2020: Portaria CNE/CP de 2009 e a Lei nº 10.172/2001.

Responsabilidade na gestão pública: os desafios dos municípios

Traz reflexões e análises sobre o desafio enfrentado pelas prefeituras de aplicar as diretivas de uma legislação sintonizada com tempos de austeridade, a saber, a Lei de Responsabilidade Fiscal e a Lei de Licitações e Contratos. Este estudo identifica as dificuldades para aplicação das referidas leis.

Trilhas da saúde das mulheres

Audiência pública realizada pela Comissão de Legislação Participativa, em 14 de outubro de 2009, para discutir o projeto "Trilhas da Saúde das Mulheres" e homenagear os dezoito anos da Rede Nacional Feminista da Saúde.

Plataforma legislativa para a biodiversidade

Trata de uma contribuição do Grupo de Trabalho criado no âmbito da Comissão de Meio Ambiente e Desenvolvimento Sustentável (CMADS) da Câmara dos Deputados com intuito de fornecer instrumento aos parlamentares e à sociedade em geral no sentido de alcançar os objetivos da Convenção sobre Diversidade Biológica. Pretende, ainda, nortear as discussões entre parlamentares e sociedade sobre as prioridades nacionais e buscar soluções criativas e inovadoras que tenham a biodiversidade e a sustentabilidade como pilares centrais das políticas públicas.

Conservação da biodiversidade : legislação e políticas públicas

A obra pretende discutir quais são os fundamentos científicos e os valores que sustentam as normas de proteção da flora e da fauna; apresentar um panorama da biodiversidade brasileira; mostrar como a biodiversidade está inserida na Constituição Federal; apontar as leis que tratam de proteção da biodiversidade; mostrar como foi o processo histórico de construção das normas nacionais e internacionais sobre a matéria; discutir como se dividem as competências relativas à gestão do patrimônio biológico, entre a União, os estados e os municípios; apresentar os instrumentos de proteção da flora e da fauna, dos recursos pesqueiros, de acesso ao patrimônio genético e aos conhecimentos tradicionais associados; e, por fim, expor a situação atual das unidades de conservação, dos instrumentos de gestão integrada da biodiversidade e das políticas de controle do desmatamento.

Energias renováveis : riqueza sustentável ao alcance da sociedade

O décimo volume dos Cadernos de Altos Estudos apresenta estudo realizado com o objetivo de propor aprimoramentos na legislação brasileira, visando a superação de barreiras e a criação de mecanismos de incentivo que contribuam para a utilização das fontes renováveis de energia de maneira diversificada e sustentável, valorizando as potencialidades regionais, o desenvolvimento tecnológico e a geração de empregos. Para tanto, procurou-se examinar as tecnologias disponíveis, as políticas adotadas internacionalmente e os resultados obtidos, bem como a situação dessas fontes no Brasil e as normas jurídicas que disciplinam seu aproveitamento. Para subsidiar os trabalhos, o Conselho de Altos Estudos e Avaliação Tecnológica realizou palestras com especialistas do setor energético e promoveu um seminário internacional. Além disso, apoiou o Fórum sobre Energias Renováveis e Consumo Responsável (IV Sustentar 2011), em Chapecó, Santa Catarina.

Liberalização financeira e controles de capitais

Abordagens desenvolvidas durante o II Ciclo de Conferências da Comissão de Finanças e Tributação (CFT), realizado em junho de 2011, pela Comissão de Finanças e Tributação (CFT) da Câmara dos Deputados para debater temas da agenda sobre a liberalização financeira e os controles de capitais. As conferências contaram com a participação de parlamentares, de especialistas de renome internacional em assuntos relacionados à pesquisa e às políticas macroeconômicas, e de representante da área de normatização de câmbio e capitais estrangeiros do Banco Central.

Reforma tributária : competitividade, equidade e equilíbrio federativo

A publicação "é produto do ciclo de conferências, realizado pela Comissão de Finanças e Tributação (CFT) da Câmara dos Deputados, em maio de 2011, para debater temas componentes das agendas referentes ao aperfeiçoamento institucional do sistema tributário brasileiro, em especial aos aspectos relacionados à competitividade empresarial, à equidade social e ao equilíbrio federativo vertical e horizontal."

O poder legislativo e as políticas públicas educacionais no período 1995-2010

Analisa a atuação do poder legislativo brasileiro na definição das políticas públicas educacionais no período de 1995 a 2010. Traz exame minucioso do conteúdo de projetos de lei e propostas de emendas à Constituição apresentados pelos deputados, além de estudos de casos sobre duas questões estruturantes: o financiamento da educação e a avaliação de educação superior.

Legislação sobre o índio

Coletânea da legislação indígena na qual estão incluídas as convenções internacionais que formulam e instituem princípios e conceitos gerais destinados ao desenvolvimento social, econômico e cultural das comunidades indígenas. As leis e decretos divulgados nesta coletânea compõem o arcabouço legal destinado a promover a política indigenista apregoada pela Constituição Federal.