Características y perfil microbiológico de pacientes con colecistitis moderada y severa en Mederi de 2014 a 2016

Introducción: Las guías de Tokyo de 2013 lograron un consenso respecto al manejo antibiótico de la infección biliar. Sus recomendaciones están sustentadas en estudios internacionales de la epidemiología bacteriana, pero también recalcan la importancia de conocer la microbiología local para ajustar las guías de manejo. Materiales y métodos: Se diseñó un estudio descriptivo tipo serie de casos de pacientes tratados por colecistitis aguda moderada y severa en Méderi Hospital Universitario Mayor (HUM), describiendo los aislamientos microbiológicos y perfiles de resistencia de los cultivos de bilis tomados durante la cirugía. Resultados: Se analizaron 131 pacientes con una edad promedio de 63 años, la mayoría sin comorbilidades médicas. Se encontró un 48% de positividad en los cultivos, predominantemente enterobacterias siendo la más frecuente Escherichia coli, seguida de especies de Klebsiella y de Enterococcus. Los perfiles de resistencia evidenciaron un 93% de multisensibilidad antibiótica y se aislaron 4 microorganismos multirresistentes. No se encontraron diferencias en comorbilidades, alteraciones paraclínicas, presencia de síndrome biliar obstrutivo, pancreatitis o instrumentación previa de la vía biliar entre los pacientes con cultivo positivo y negativo. Conclusiones: Los resultados concuerdan con los reportes internacionales en cuanto a la flora bacteriana aislada, pero los perfiles de resistencia evidenciados en esta serie son diferentes a los que sustentan las guías de manejo de Tokio revisadas en 2013. Este hallazgo obliga a ajustar las guías de manejo institucionales con base en la epidemiología local.

Differences between root traits of early- and late-successional trees influence below-ground competition and seedling establishment.

The competitive influence of the root system of the exotic grass Urochloa brizantha and the widespread forb Leonotis nepetifolia on the emergence, survival and early growth of the seedlings of eight tropical heliophilous herbaceous species, six early-successional woody species and five late-successional woody species from Brazil, grown in 3500-cm3 pots and in greenhouse without light restriction were assessed. The density of fine-root systems produced by the forb and the grass in pots were 6.8 cm cm-3 soil and 48.1 cm cm-3 soil, respectively. Seedlings survival of the heliophilous herbaceous, early- and late-successional woody species were 86%, 70% and 100% in presence of the forb root system and 12%, 14% and 100% in competition with grass root system, respectively. The competitive pressure applied by the grass root system on seedling growth of the heliophilous herbaceous, early- and late-successional woody species were 2.4, 1.9 and 1.4 times greater than the forb root system. Total root length of the heliophilous herbaceous, early- and late-successional woody species grown without competitors were 13, 33 and 5 times greater than in competition with forb, and were 66, 54 and 6 times greater than in competition with grass root system, respectively. The averages of fine-root diameter of plants grown without competitors were 209 microm for the heliophilous herbaceous, 281 microm for early-successional trees and 382 microm for late-successional trees. The root system of the forb did not avoid seedling establishment of most plant species, but the grass root system hampered more the establishment of heliophilous herbaceous and early-successional woody species than the seedling establishment of late-successional woody species. The different density of root systems produced in soil by the forb and the grass, and the distinct root traits (e.g. root diameter and root tissue density) of the early- and late-successional plant species can explain the differences in the establishment of seedlings of plant species belonging to different groups of tropical succession when exposed to below-ground competition.

Senecavirus A outbreak affecting piglets and sows in southern Brazil.

2016

Inoculação de bactérias diazotroficas e fungos micorrizico-arbusculares na cultura da mandioca

A versatilidade da mandioca (Manihot esculenta Crantz) em adaptar-se a solos de baixa fertilidade, apesar de possuir alto requerimento de nutrientes, tem sido relacionada à ocorrência de associações com os fungos micorrízico-arbusculares (FMA) e a bactérias diazotróficas. Visando avaliar o efeito da inoculação dos FMA e das bactérias diazotróficas, foi conduzido um experimento com plântulas micropropagadas em vasos de 3,5 litros de volume, com solo arenoso desinfestado como substrato. A inoculação das bactérias diazotróficas não apresentou efeito estimulatório, ao passo que inoculações dos FMA isoladamente e em conjunto com bactéria incrementaram todos os parâmetros de crescimento e nutricionais. A inoculação dos FMA, com a Bactéria E, aumentou a parte aérea e as raízes em até 50% e 105%, respectivamente, em relação à inoculação exclusiva com FMA. Efeitos sinergísticos também foram observados no acúmulo de N da parte aérea e das raízes com aumento de até 88% e 173% e no de fósforo em até 83% e 158%, respectivamente. A co-inoculação da Bactéria E com Glomus clarum também aumentou a colonização micorrízica em 40% e a esporulação em 168%, comparada à inoculação do fungo isolado. Estes efeitos benéficos podem ocorrer tanto pela maior absorção de nutrientes pela planta, como pelo estímulo na colonização dos fungos MA.

Ocorrência de micorrizas arbusculares e da bactéria diazotrofica Acetobacter diazotrophicus em cana-de-açúcar.

Foi avaliada a ocorrência e a distribuição de espécies de fungos micorrízicos arbusculares e A. diazotrophicus em plantios de cana-de-açúcar em diferentes tipos de manejo nos Estados do Rio de Janeiro e Pernambuco. Foram feitas 35 coletas de amostras de solo da rizosfera e de raízes de 14 variedades de cana-de-açúcar para extração de esporos e isolamento da bactéria. O numero de esporos variou de 18 a 2.070/ 100 mL de solo, e os maiores numero e diversidade de espécies foram verificados nos canaviais de Campos, RJ, especialmente naqueles que não adotam a queima de palhico. As espécies predominantes nas três localidades amostradas foram: Acaulospora sp., Scutellospora heterogama, Glomus etunicatum, Glomus occultum e Gigaspora margarita. A. diazotrophicus estava presente nas amostras de raízes colhidas em canaviais de Campos, com exceção de uma coleta de cana-de-açúcar plantada num solo usado como bacia de sedimentação de vinhaça. Não foi possível isolar essa bactéria a partir de esporos desinfestados dos FMAs nativos, apenas dos esporos lavados com agua estéril The occurrence and distribution of species of arbuscular mycorrhizae fungi and Acetobacter diazotrophicus in sugar cane (Saccharum officinarum) grown in different regimes of crop management in the States of Rio de Janeiro and Pernambuco were studied. Thirty five samples of the rhizosphere soil and roots were collected from 14 varieties of sugar cane for the extraction of spores and isolation of the bacterium. The number of spores varied from 18 to 2.070 per 100 mL of soil, and the greatest diversity of fungal species was found in the sugarcane fields of Campos (Rio de Janeiro State), especially in those where the sugarcane trash was not burned at harvest. The predominant species found in the three localities sampled were: Scutellospora heterogama, Glomus etunicatum, Glomus occultum, Glomus macrocarpum, Acaulospora sp. and Gigaspora margarita. A. diazotrophicus was present in almost all samples of root with the exception of one harvest of sugar cane taken from an area used for the sedimentation of vinasse (distillery waste). It was not possible to detect the bacterium from surface sterilised spores of native arbuscular mycorrhizal fungi (AMF), only from washed ones using sterile water.

Ocorrência de bactérias diazotroficas e fungos micorrizicos arbusculares na cultura da mandioca.

Este trabalho teve como objetivo avaliar a ocorrencia, isolar e identificar fungos micorrízicos carbunculares associados a cultura da mandioca (Manihot esculenta). Amostras de solo rizosférico e de varias partes da planta (raízes, tubérculos, manivas e folhas) de locais nos Estados do Rio de Janeiro, São Paulo e Paraná, foram inoculadas nos meios LGI-P, NFb-malato e NFb-GOC, avaliando-se o numero mais provável de células e a atividade de redução de acetileno. Bactérias diazotróficas foram isoladas de todas as partes da planta, com exceção das folhas, sendo identificadas como Klebsiella sp., Azospirillum lipoferum e uma bactéria denominada "E", provavelmente pertencente ao gênero Burkholderia. A bactéria E acumulou de 7,63 mg a 14,84 mg de N/g de C em meio semi-solido, isento de N, e conseguiu manter a capacidade de fixação biológica de N, mesmo apos uma dezena de repicagens consecutivas. A colonização micorrízica variou de 31% a 69%, e a densidade de esporos de 10 a 384 esporos/100 mL de solo, predominando as espécies Entrophospora colombiana e Acaulospora scrobiculata no Rio de Janeiro, A. scrobiculata e Scutellospora heterogama no Paraná e em Piracicaba (São Paulo) e A. appendicula e S. pellucida em Campinas (São Paulo). This study was performed to evaluate the occurrence and to isolate and identify diazotrophic bacteria and arbuscular mycorrhizal fungi associated with the cassava (Manihot esculenta) crop. Samples from rhizosperical soil, roots, tubers, stems and leaves from several localities of the States of Rio de Janeiro, Sao Paulo and Parana, in Brazil, were inoculated in three media specific for diazotrophic associative bacteria, LG1-P, NFb-malate and NFb-GOC, evaluating the most probable number of cells and the acetylene-reducing activity. Diazotrophic bacteria were detected in all plant parts except for the leaves, and were identified as Klebsiella sp., Azospirillum lipoferum and a bacterium called "E", probably belonging to the Burkholderia genus. Bacterium E was able to accumulate, in the N-free semi-solid media, from 7.63 to 14.84 mg of N/g of C and to maintain N fixation capacity after ten consecutive transferences. Mycorrhizal root colonization varied from 31% to 69% and spore density from 10 to 384 spores/100 mL of soil, predominanting the species Entrophospora colombiana and Acaulospora scrobiculata in Rio de Janeiro, A. scrobiculata and Scutellospora heterogama in Parana and in Piracicaba (Sao Paulo), and A. appendicula and S. pellucida in Campinas (Sao Paulo).

Importância das micorrizas na araucária para produção de pinhão.

2016

Impacto de mudanças climáticas globais sobre a microbiota terrestre.

2008

The impact of phosphoinositide metabolic enzymes in glioblastoma: a tale of phosphoinositide-specific phospholipase C PLCβ1 and 5-phosphatase SKIP

Background: Glioblastoma multiforme (GBM) is one of the deadliest and most aggressive form of primary brain tumor. Unfortunately, current GBM treatment therapies are not effective in treating GBM patients. They usually experience very poor prognosis with a median survival of approximately 12 months. Only 3-5% survive up to 3 years or more. A large-scale gene profile study revealed that several genes involved in essential cellular processes are altered in GBM, thus, explaining why existing therapies are not effective. The survival of GBM patients depends on understanding the molecular and key signaling events associated with these altered physiological processes in GBM. Phosphoinositides (PI) form just a tiny fraction of the total lipid content in humans, however they are implicated in almost all essential biological processes, such as acting as second messengers in spatio-temporal regulation of cell signaling, cytoskeletal reorganization, cell adhesion, migration, apoptosis, vesicular trafficking, differentiation, cell cycle and post-translational modifications. Interestingly, these essential processes are altered in GBM. More importantly, incoming reports have associated PI metabolism, which is mediated by several PI phosphatases such as SKIP, lipases such as PLCβ1, and other kinases, to regulate GBM associated cellular processes. Even as PLCβ1 and SKIP are involved in regulating aberrant cellular processes in several other cancers, very few studies, of which majority are in-silico-based, have focused on the impact of PLCβ1 and SKIP in GBM. Hence, it is important to employ clinical, in vitro, and in vivo GBM models to define the actual impact of PLCβ1 and SKIP in GBM. AIM: Since studies of PLCβ1 and SKIP in GBM are limited, this study aimed at determining the pathological impact of PI metabolic enzymes, PLCB1 and SKIP, in GBM patient samples, GBM cell line models, and xenograft models for SKIP. Results: For the first time, this study confirmed through qPCR that PLCβ1 gene expression is lower in human GBM patient samples. Moreover, PLCβ1 gene expression inversely correlates with pathological grades of glioma; it decreases as glioma grades increases or worsens. Silencing PLCβ1 in U87MG GBM cells produces a dual impact in GBM by participating in both pro-tumoral and anti-tumoral roles. PLCβ1 knockdown cells were observed to have more migratory abilities, increased cell to extracellular matrix (ECM) adhesion, transition from epithelial phenotype to mesenchymal phenotype through the upregulation of EMT transcription factors Twist1 and Slug, and mesenchymal marker, vimentin. On the other hand, p-Akt and p-mTOR protein expression were downregulated in PLCβ1 knockdown cells. Thus, the oncogenic pathway PI3K/Akt/mTOR pathway is inhibited during PLCβ1 knockdown. Consistently, cell viability in PLCβ1 knockdown cells were significantly decreased compared to controls. As for SKIP, this study demonstrated that about 48% of SKIP colocalizes with nuclear PtdIns(4,5)P2 to nuclear speckles and that SKIP knockdown alters nuclear PtdIns(4,5)P2 in a cell-type dependent manner. In addition, SKIP silencing increased tumor volume and weight in xenografts than controls by reducing apoptosis and increasing viability. All in all, these data confirm that PLCβ1 and SKIP are involved in GBM pathology and a complete understanding of their roles in GBM may be beneficial.

Interrogation of human monoclonal antibodies induced by 4C-MenB to identify protective antigens contained in the OMV component

Neisseria meningitidis is a gram negative human obligated pathogen, mostly found as a commensal in the oropharyngeal mucosa of healthy individuals. It can invade this epithelium determining rare but devastating and fast progressing outcomes, such as meningococcal meningitidis and septicemia, leading to death (about 135000 per year worldwide). Conjugated vaccines for serogroups A, C, W135, X and Y were developed, while for N. meningitidis serogroup B (MenB) the vaccines were based on Outern Membrane Vesicles (OMV). One of them is the 4C-MenB (Bexsero). The antigens included in this vaccine’s formulation are, in addition to the OMV from New Zeland epidemic strain 98/254, three recombinant proteins: NadA, NHBA and fHbp. While the role of these recombinant components was deeply characterized, the vesicular contribution in 4C-MenB elicited protection is mediated mainly by porin A and other unidentified antigens. To unravel the relative contribution of these different antigens in eliciting protective antibody responses, we isolated human monoclonal antibodies (mAbs) from single-cell sorted plasmablasts of 3 adult vaccinees peripheral blood. mAbs have been screened for binding to 4C-MenB components by Luminex bead-based assay. OMV-specific mAbs were purified and tested for functionality by serum bactericidal assay (SBA) on 18 different MenB strains and characterized in a protein microarray containing a panel of prioritized meningococcal proteins. The bactericidal mAbs identified to recognize the outer membrane proteins PorA and PorB, stating the importance of PorB in cross-strain protection. In addition, RmpM, BamE, Hyp1065 and ComL were found as immunogenic components of the 4C-MenB vaccine.

Doença pulmonar obstrutiva crônica

(DPOC) é uma das principais causas de hospitalização e óbito. Enfatiza que a definição de DPOC é a limitação do fluxo aéreo expiratório não totalmente reversível, curso crônico e progressivo, associado à resposta inflamatória anormal do pulmão devido a partículas ou gases tóxicos. Segue salientando que a história clínica da DPOC se caracteriza pelos sintomas tosse crônica, aumento da produção de escarro, dispneia. Detalha que os fatores de risco envolvidos no desenvolvimento de DPOC são tabagismo – mesmo que passivo –, produtos químicos ou fumaça doméstica. Comenta que, no exame físico, os sinais mais comuns apresentados pelo paciente são a diminuição do murmúrio vesicular à ausculta, o prolongamento da expiração, o timpanismo à percussão e a hiperinsuflação torácica, dentre outros fatores que acontecem com a progressão da doença. Informa que o diagnóstico pode ser realizado através da anamnese e do exame físico, além de exames complementares, expostos em uma apresentação sobre o tema. Enumera os quatro componentes de manejo indicados pelo Global Initiative for Chronic Obstructive Lung Disease (GOLD) e apresenta um quadro sobre a classificação da DPOC segundo espirometria. Finaliza ressaltando que há a necessidade de acompanhamento sistemático por toda equipe de saúde. Unidade 5 do módulo 7 que compõe o Curso de Especialização em Saúde da Família.