967 resultados para Pneumonia, Ventilator-Associated


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O Staphylococcus aureus resistente a meticilina (MRSA) foi inicialmente descrito como um patógeno associado a infecções relacionadas à assistência em saúde; porém, um clone de MRSA, o CA-MRSA emergiu na comunidade e está atualmente incrementando nos hospitais. O objetivo desta tese foi descrever aspectos relacionados com a epidemiologia das infecções por cepas CA-MRSA no Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro (HUPE/UERJ), avaliando especificamente fatores de risco relacionado com as infecções por CA-MRSA. Usando informações das bases de dados do laboratório de microbiologia, da farmácia e da Comissão para Controle da Infecção Hospitalar do HUPE/UERJ foi realizado um estudo retrospectivo de infecções/colonizações por cepas de S. aureus (fevereiro 2005 a Julho 2011). Foi realizado um estudo caso e controle, utilizando como casos os pacientes com infecções por cepas CA-MRSA. Na avaliação da susceptibilidade aos antimicrobianos usados em infecções graves por MRSA (vancomicina, teicoplanina, daptomicina e linezolida), foram determinadas as concentrações inibitórias mínimas (CIM) das amostras por diferentes metodologias (testes de difusão em agar, microdiluição em caldo e E-test). Nas analises das tendências temporais da apresentação dos subtipos de MRSA, usando um critério fenotípico para classificação das cepas MRSA, foi observada uma diminuição do número de cepas de MRSA multirresistente (HA-MRSA) (p<0.05). Também foi observada uma tendência ao aumento de cepas não-multirresistentes (CA-MRSA), mas sem alcançar a significância estatística (p = 0.06) igual que os S. aureus sensíveis a meticilina (MSSA) (p = 0.48). Não houve associação entre o subtipo de MRSA e a mortalidade devida à infecção por cepas MRSA. Uma idade acima de 70 anos (OR: 2.46, IC95%: 0.99 - 6.11), a presença de pneumonia adquirida no hospital (OR: 4.94, IC95%: 1.65 -14.8), a doença pulmonar obstrutiva crônica (OR: 6.09, IC95% 1.16 31.98) e a leucemia (OR: 8.2, IC95%: 1.25 54.7) foram fatores de risco associadas à mortalidade nas infecções por cepas de S. aureus. Usando curvas de Kaplan-Meier, foi observada uma tendência ao aumento da mortalidade em infecções causadas por MSSA na primeira semana, porém sem alcançar significância estatística (p = 0.07). Não foram observadas amostras MRSA com susceptibilidade intermediaria a vancomicina, linezolida, daptomicina ou teicoplanina. A dinâmica das infecções por S. aureus no HUPE/UERJ mudou durante o período de estudo, com menor número de episódios infecciosos causados por cepas de MRSA multirresistentes. Existe uma tendência ao aumento das cepas não-multirresistentes de MRSA entanto que a taxa de infecções por MSSA permaneceu estável no período do estudo. O perfil de resistência dos estafilococos não teve associação com a mortalidade

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Streptococcus pneumoniae é um importante agente etiológico de infecções invasivas e não invasivas, incluindo meningite, pneumonia e otite média. A cápsula polissacarídica é o principal fator de virulência desse microrganismo, sendo também considerada um importante marcador em estudos epidemiológicos. Dentre os mais de 90 tipos capsulares conhecidos, o sorotipo 14 se destaca pela prevalência elevada em várias regiões, inclusive no Brasil. A avaliação da diversidade genética desse microrganismo também inclui a aplicação de métodos moleculares, como PFGE e MLST. Entretanto, essas metodologias são relativamente onerosas, consomem muito tempo e os resultados obtidos com a técnica de PFGE são de difícil comparação entre diferentes laboratórios. A técnica de análise do polimorfismo numérico de segmentos repetitivos em múltiplos loci [MLVA, do inglês Multiple Loci VTNR (Variable-Number Tandem Repeat) Analysis] se apresenta como uma alternativa, embora ainda necessite de padronização e avaliação mais ampla para a espécie em questão. No presente estudo, 60 amostras de Streptococcus pneumoniae pertencentes ao sorotipo 14, isoladas de diversas fontes clínicas, em diferentes locais e períodos de tempo, foram caracterizadas pelas técnicas de MLVA (baseada na análise de 18 loci distintos), MLST, PFGE e tipagem do gene pspA. O gene pspA2 predominou entre as amostras analisadas, seguido pelo gene pspA1. Os tipos de MLVA, perfis de PFGE, e STs encontrados apresentaram resultados, em geral, concordantes, indicando o elevado poder discriminatório da versão da técnica de MLVA empregada. Cinco complexos clonais (CC) de MLVA e cinco singletons puderam ser definidos. O CC de MLVA denominado de L7 foi o predominante, compreendendo 36,7% da amostragem estudada. O CC L7 mostrou-se relacionado com genes pspA da família 2, com o CC1 de MLST, com o CC Pen14-H de PFGE, e com a não susceptibilidade à penicilina, Entre os complexos clonais de MLST, o CC1 foi o prevalente e incluiu predominantemente o ST156, pertencente ao clone internacional Spain9V-3. O CC L3 e o singleton L17 de MLVA apresentaram-se associados ao CC de PFGE Eri14-A, a família 1 de PspA e ao CC2 de MLST, que por sua vez também estava relacionado com o clone internacional England14-9. O CC L15 de MLVA esteve associado ao CC de PFGE Pen14-A, ao gene pspA2, aos CC3 e CC4 de MLST e ao clone internacional do PMEN Tennessee14-18. A técnica de MLVA revelou-se significativamente mais discriminatória que as técnicas de PFGE e MLST, conforme exemplificado pela detecção de 21 perfis de MLVA, 13 perfis de PFGE e cinco STs, entre as 22 amostras pertencentes ao CC de MLVA L7. Uma versão de MLVA, compreendendo um painel com os oito loci de maior poder discriminatório, pôde ser proposta a partir da análise dos resultados obtidos. Estes aspectos, aliados ao menor tempo e custo de execução, indicam que a técnica de MLVA constitui uma alternativa importante e satisfatória para uso em estudos sobre a diversidade genética de S. pneumoniae.

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We evaluated the effectiveness of wooden artificial reefs (ARs) as fish habitat. Three types of ARs, made of cedar logs, broadleaf tree logs, and PVC pipes, respectively, were deployed in triplicate at 8-m depth off Maizuru, Kyoto Prefecture, Sea of Japan, in May 2004. Fish assemblages associated with each of the nine ARs were observed by using SCUBA twice a month for four years. Fish assemblages in the adjacent habitat were also monitored for two years before and four years after reef deployment. In the surveyed areas (ca. 10 m2) associated with each of the cedar, broadleaf, and PVC ARs, the average number of fish species was 4.14, 3.49, and 3.00, and the average number of individuals was 40.7, 27.9, and 20.3, respectively. The estimated biomass was also more greater when associated with the cedar ARs than with other ARs. Visual censuses of the habitat adjacent to the ARs revealed that the number of fish species and the density of individuals were not affected by the deployment of the ARs. Our results support the superiority of cedar as an AR material and indicate that deployment of wooden ARs causes no reduction of fish abundance in adjacent natural reefs.

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The community structure of fishes associated with pelagic Sargassum spp. and open water lacking Sargassum was examined during summer and fall cruises, 1999–2003, in the Gulf Stream off North Carolina. Significantly more individual fishes (n= 18,799), representing at least 80 species, were collected from samples containing Sargassum habitat, compared to 60 species (n=2706 individuals) collected from openwater habitat. The majority (96%) of fishes collected in both habitats were juveniles, and planehead filefish (Stephanolepis hispidus) dominated both habitats. Regardless of sampling time (day or night), Sargassum habitat yielded significantly higher numbers of individuals and species compared with open-water collections. Overall, fishes collected by neuston net tows from Sargassum habitat were significantly larger in length than fishes collected from open-water habitat with neuston nets. A significant positive, linear relationship existed between numbers of fishes and the quantity of Sargassum collected by neuston net. Underwater video recordings indicated a layered structure of fishes among and below the algae and that smaller fishes were more closely associated with the algae than larger fishes. Observations of schooling behaviors of filefishes (Monacanthidae), dolphinfish (Coryphaena hippurus), and jacks (Carangidae), and fish-jellyfish associations were also recorded with an underwater video camera. Our data indicate that Sargassum provides a substantial nursery habitat for many juvenile fishes off the U.S. southeast coast.

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Spawning periodicities of white seabass (Atractoscion nobilis) were evaluated by observing spawning behavior, by collecting eggs, and monitoring recognizable sounds produced during the release of gametes. A total of 297 spawning events were documented from 15 male and 47 female white seabass contained within the seminatural confines of a 526-m3 net pen located in Catalina Harbor, Santa Catalina Island, California. Consistent spawning occurred from March through July 2001−03, and peaked in May at a photoperiod of 14 hours. Most spawning occurred within the 2-hour period following sunset or from 19:00−20:00 hours Pacific Standard Time. White seabass spawned at every phase of the lunar cycle; but an increase in successive spawning events followed the new moon. Most spawning occurred in water temperatures from 15 to 18°C, and there was no apparent correlation with tidal cycles. Seasonal and diel spawning periods were directly correlated with increases in the rate, intensity, and variety of white seabass sounds; this correlation may indicate that sounds function to enhance reproductive success. These findings can be extended to further develop seasonal fishery regulations and to better comprehend the role of sound in the reproduction of sound-producing fishes.

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Data collected during fish-ery-independent sampling programs were used to examine the impact of appendage damage (indicated by lost or regenerated legs and antennae) on the reproductive output of female western rock lobster (Panulirus cygnus). Most of the damaged females sampled had one (53%), two (27%), or three (13%) appendages that had been lost or that were regenerating. Appendage damage was associated with the reduced probability of a female developing ovigerous setae; and if setae were produced, with the reduced probability that females would produce more than one batch of eggs within a season. These effects were more pronounced as the number of damaged appendages increased. From data collected in 2002, it was estimated that the total number of eggs produced by mature females caught in the fishery was significantly reduced (P<0.001) by 3–9% when the impact of appendage damage was included.

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Nearshore fisheries in the tropical Pacific play an important role, both culturally and as a reliable source of food security, but often remain under-reported in statistics, leading to undervaluation of their importance to communities. We re-estimated nonpelagic catches for Guam and the Commonwealth of the Northern Mariana Islands (CNMI), and summarize previous work for American Samoa for 1950−2002. For all islands combined, catches declined by 77%, contrasting with increasing trends indicated by reported data. For individual island entities, re-estima-tion suggested declines of 86%, 54%, and 79% for Guam, CNMI, and American Samoa, respectively. Except for Guam, reported data primarily represented commercial catches, and hence under-represented contributions by subsistence and recreational fisheries. Guam’s consistent use of creel surveys for data collection resulted in the most reliable reported catches for any of the islands considered. Our re-estimation makes the scale of under-reporting of total catches evident, and provides valuable baselines of likely historic patterns in fisheries catches.

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In the present work, the nematic glassy state of the non-symmetric LC dimer -(4-cyanobiphenyl-4-yloxy)--(1-pyrenimine-benzylidene-4-oxy) undecane is studied by means of calorimetric and dielectric measurements. The most striking result of the work is the presence of two different glass transition temperatures: one due to the freezing of the flip-flop motions of the bulkier unit of the dimer and the other, at a lower temperature, related to the freezing of the flip-flop and precessional motions of the cyanobiphenyl unit. This result shows the fact that glass transition is the consequence of the freezing of one or more coupled dynamic disorders and not of the disordered phase itself. In order to avoid crystallization when the bulk sample is cooled down, the LC dimer has been confined via the dispersion of -alumina nanoparticles, in several concentrations.

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Soil microbial community changes associated to conventional and organic farming of two relevant crops (Beta vulgaris and Solanum lycopersicum) were analysed through 16s rRNA amplicon sequencing. This study revealed microbial communities in the agricultural soils studied to be similar to other reported nutrient-rich microbiomes, and some significant differences between the microbial communities associated to the two farming practices were found. Some phyla (Chloroflexi and Thermi) were found to be present in different abundances according to soil treatment. As chloroplast interference can be a stumbling block in plant-associated 16s rRNA amplicon metagenomics analysis of aerial plant tissues, two protocols for bacterial cell detachment (orbital shaking and ultrasound treatment) and two protocols for microbial biomass recovery (centrifugation and filtration) were tested regarding their efficiency at excluding plant-DNA. An alternative method to the one proposed by Rastogi et al (2010) for evaluating the chloroplast-amplicon content in post-PCR samples was tested, and the method revealed that filtration was the most efficient protocol in minimising chloroplast interference.

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Genome wide association studies (GWAS) have identified several low-penetrance susceptibility alleles in chronic lymphocytic leukemia (CLL). Nevertheless, these studies scarcely study regions that are implicated in non-coding molecules such as microRNAs (miRNAs). Abnormalities in miRNAs, as altered expression patterns and mutations, have been described in CLL, suggesting their implication in the development of the disease. Genetic variations in miRNAs can affect levels of miRNA expression if present in pre-miRNAs and in miRNA biogenesis genes or alter miRNA function if present in both target mRNA and miRNA sequences. Therefore, the present study aimed to evaluate whether polymorphisms in pre-miRNAs, and/or miRNA processing genes contribute to predisposition for CLL. A total of 91 SNPs in 107 CLL patients and 350 cancer-free controls were successfully analyzed using TaqMan Open Array technology. We found nine statistically significant associations with CLL risk after FDR correction, seven in miRNA processing genes (rs3805500 and rs6877842 in DROSHA, rs1057035 in DICER1, rs17676986 in SND1, rs9611280 in TNRC6B, rs784567 in TRBP and rs11866002 in CNOT1) and two in pre-miRNAs (rs11614913 in miR196a2 and rs2114358 in miR1206). These findings suggest that polymorphisms in genes involved in miRNAs biogenesis pathway as well as in pre-miRNAs contribute to the risk of CLL. Large-scale studies are needed to validate the current findings.

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Data from the Mexican purse seiner fleet operating in the eastern Tropical Pacific, for the year 1985-1990, are used to show that the fraction of surface schools of yellowfin tuna Thunnus albacares associated with dolphins (Stenella attenuata and others) increases with sea surface temperature. Possible reasons for this correlation are briefly discussed.

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O presente trabalho tem por objetivo investigar a microbiota de canais radiculares que apresentem lesão perirradicular e relacionar o perfil microbiano detectado com a área/volume destas lesões visualizadas por radiografias periapicais e tomografias computadorizadas tipo cone-beam. Foram selecionados 19 dentes com infecção endodôntica primária. As amostras microbiológicas foram coletadas dos canais com o auxílio de limas tipo Hedströen e cones de papel absorvente estéril. A técnica do Checkerboard DNA-DNA hybridization foi utilizada para detecção de até 79 espécies bacterianas em cada amostra, utilizando sondas de DNA específicas. Os dados microbiológicos foram expressos em percentagem média (prevalência), proporção e nível médio de cada espécie em cada amostra. Os testes t independente e de correlação de Pearson foram usados para correlacionar a contagem das bactérias testadas com os dados clínicos (p≤ 0,05). Foi encontrada uma média de 17 espécies por amostra. E. brachy (70%), S. pneumonia (67,5%), P. oris (67,5%), E. faecium (65%), N. gonorrhoeae (62,5%), K. pneumoniae (62,5%), P. melaninogenica (62,5%), P. nigrescens (62,5%) e P. micra (62,5%) foram as espécies mais prevalentes, e as espécies encontradas em níveis médios mais altos foram P. oris (7,5 x 105), E. brachy (7,3 x 105), E. faecium (7,2 x 105), K. pneumoniae (7,0 x 105), N. gonorrhoeae (6,8 x 105), S. epidermidis (6,5 x 105) e H. pylori (6,5 x 105). Houve correlação positiva entre as lesões periapicais de maior área e contagens significativamente mais altas da carga bacteriana total e de bactérias Gram-negativas (p<0,05). Baseado nos resultados obtidos é possível concluir que a microbiota presente em dentes com periodontite apical primária possui perfil misto e complexo, e que uma maior tamanho de lesão perirradicular pode estar associada a contagem elevada espécie totais e bactérias Gram-negativas.

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Context Pseudohypoparathyroidism type 1b (PHP-Ib) is characterized by renal resistance to PTH (and, sometimes, a mild resistance to TSH) and absence of any features of Albright's hereditary osteodystrophy. Patients with PHP-Ib suffer of defects in the methylation pattern of the complex GNAS locus. PHP-Ib can be either sporadic or inherited in an autosomal dominant pattern. Whereas familial PHP-Ib is well characterized at the molecular level, the genetic cause of sporadic PHP-Ib cases remains elusive, although some molecular mechanisms have been associated with this subtype. Objective The aim of the study was to investigate the molecular and imprinting defects in the GNAS locus in two unrelated patients with PHP-Ib. Design We have analyzed the GNAS locus by direct sequencing, Methylation-Specific Multiplex Ligation-dependent Probe Amplification, microsatellites, Quantitative Multiplex PCR of Short Fluorescent fragments and array-Comparative Genomic Hybridization studies in order to characterize two unrelated families with clinical features of PHP-Ib. Results We identified two duplications in the GNAS region in two patients with PHP-Ib: one of them, comprising similar to 320 kb, occurred 'de novo' in the patient, whereas the other one, of similar to 179 kb in length, was inherited from the maternal allele. In both cases, no other known genetic cause was observed. Conclusion In this article, we describe the to-our-knowledge biggest duplications reported so far in the GNAS region. Both are associated to PHP-Ib, one of them occurring 'de novo' and the other one being maternally inherited.

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Background: In complex with its cofactor UAF1, the USP1 deubiquitinase plays an important role in cellular processes related to cancer, including the response to DNA damage. The USP1/UAF1 complex is emerging as a novel target in cancer therapy, but several aspects of its function and regulation remain to be further clarified. These include the role of the serine 313 phosphorylation site, the relative contribution of different USP1 sequence motifs to UAF1 binding, and the potential effect of cancer-associated mutations on USP1 regulation by autocleavage. Methods: We have generated a large set of USP1 structural variants, including a catalytically inactive form (C90S), non-phosphorylatable (S313A) and phosphomimetic (S313D) mutants, deletion mutants lacking potential UAF1 binding sites, a mutant (GG/AA) unable to undergo autocleavage at the well-characterized G670/G671 diglycine motif, and four USP1 mutants identified in tumor samples that cluster around this cleavage site (G667A, L669P, K673T and A676T). Using cell-based assays, we have determined the ability of these mutants to bind UAF1, to reverse DNA damage-induced monoubiquitination of PCNA, and to undergo autocleavage. Results: A non-phosphorylatable S313A mutant of USP1 retained the ability to bind UAF1 and to reverse PCNA ubiquitination in cell-based assays. Regardless of the presence of a phosphomimetic S313D mutation, deletion of USP1 fragment 420-520 disrupted UAF1 binding, as determined using a nuclear relocation assay. The UAF1 binding site in a second UAF1-interacting DUB, USP46, was mapped to a region homologous to USP1(420-520). Regarding USP1 autocleavage, co-expression of the C90S and GG/AA mutants did not result in cleavage, while the cancer-associated mutation L669P was found to reduce cleavage efficiency. Conclusions: USP1 phosphorylation at S313 is not critical for PCNA deubiquitination, neither for binding to UAF1 in a cellular environment. In this context, USP1 amino acid motif 420-520 is necessary and sufficient for UAF1 binding. This motif, and a homologous amino acid segment that mediates USP46 binding to UAF1, map to the Fingers sub-domain of these DUBs. On the other hand, our results support the view that USP1 autocleavage may occur in cis, and can be altered by a cancer-associated mutation.