Estudo de resistência da bactéria Escherichia Coli a antibióticos em infecções urinárias na população da Região Autónoma da Madeira

As infecções do tracto urinário (ITU) são doenças infecciosas comuns e distinguem-se em dois grandes grupos: o das infecções do tracto urinário superior e o das infecções do tracto urinário inferior. O principal agente etiológico envolvido nas ITU é a bactéria Escherichia coli (E. coli), representando 80-95% dos invasores do tracto urinário na população em geral. É mais comum entre os adultos do sexo feminino, principalmente com actividade sexual, embora as crianças, mulheres grávidas e idosos também apresentam grande susceptibilidade. Paralelamente, a problemática da resistência aos antimicrobianos é um tema actual e muito debatido internacionalmente. Como tal, o presente estudo teve como principal objectivo contribuir para a identificação fiável da bactéria E. coli em infecções urinárias bem como a determinação do seu perfil de resistência a antibióticos. Os dados apresentados referem-se a um estudo efectuado entre Outubro de 2008 e Junho de 2009 no Laboratório de Análises Clínicas Castro Fernandes – MMC. Foram analisadas 6522 amostras de urina, das quais 390 corresponderam a uroculturas positivas. Verificou-se que o sexo feminino tem uma maior propensão para infecções urinárias, havendo uma tendência para o aumento das ITU com a idade. Na interpretação da cultura revelou-se importante a informação dada pelo exame cultural acerca do número de leucócitos. Concluiu-se que nas uroculturas cujo número de colónias foi superior a 105 com menos de três espécies de colónias diferentes na cultura, o número de leucócitos foi superior a 30 milhares de células por μL, o que sugere a existência de infecção urinária. No estudo do perfil de sensibilidade da bactéria E. coli isolada, para a família dos betalactâmicos (Ampicilina (AMP), Amoxicilina/Ácido Clavulânico (AMC), Piperacilina/Tazobactam (PIP/TZP)), família das cefalosporinas (Cefalotina (KF), Cefuroxima (CXM), Cefuroxima Acetil (CA), Cefotaxima (CTX), Ceftazidima (CAZ), Cefepima (FEP)), família dos aminoglicosídeos (Amicacina (AM), Gentamicina (GM), Tobramicina (TOB)) e para as nitrofurantoínas (F), verificou-se uma grande sensibilidade e pouca resistência em termos quantitativos, mas para a família das quinolonas (Ciprofloxacina (CIP), Levofloxacina (LEV), Norfloxacina (NOR)) e para os Trimetoprim/Sulfametoxazol (TMP/SMX) verificou-se resistências quantitativamente superiores aos das famílias anteriormente referidas, sugerindo valores convergentes aos da tendência europeia. Foram identificados famílias de fenótipos tais como: os beta-lactâmicos, os aminoglicosídeos, quinolonas, tetraciclinas, furanos e trimetoprim/sulfamidas.E. coli é um microganismo cujo fenótipo selvagem não tem resistências intrínsecas. Todas as resistências são adquiridas. Actualmente, a realização dos antibiogramas para E. coli tornou-se fundamental tendo em vista os factores ecológicos, genéticos, ambientais e pelo facto de que mais isolados são resistentes à maioria dos antibióticos. Como conclusão, este estudo permitirá alertar para um problema sério que é uma grande ameaça à Saúde Pública.

Definições para o resultado de enfermagem comportamento de prevenção de quedas: uma revisão integrativa

Devido à necessidade de mensurar o risco de quedas em concordância à linguagem padronizada de enfermagem, foi selecionado o resultado de enfermagem Comportamento para Prevenção de Quedas da Nursing Outcomes Classification (NOC), com objetivo de identificar evidências sobre seus elementos, mensuração, comparação com indicadores existentes e construir definições constitutivas. Foi efetuada revisão integrativa entre abril e novembro de 2009, mediante identificação da questão, estabelecimento de critérios de inclusão/exclusão, extração das informações, avaliação, interpretação e síntese. Destacaram-se pesquisas transversais e perspectivas de especialistas. Os indicadores Uso de recursos de correção da visão e Uso de sapatos amarrados e do tamanho adequado foram considerados insuficientes para avaliar fatores de risco como déficits sensoriais e roupas/calçados inadequados. Percebe-se que algumas definições precisam ser melhor desenvolvidas e que esse resultado de enfermagem merece refinamento sobretudo referente aos indicadores. Foram identificados 22 indicadores e definições foram propostas baseadas nas evidências da literatura

Determinantes da Estrutura de Capital de Companhias Abertas Brasileiras Não-Financeiras: Um Estudo Empírico com Dados em Painel

When a company desires to invest in a project, it must obtain resources needed to make the investment. The alternatives are using firm s internal resources or obtain external resources through contracts of debt and issuance of shares. Decisions involving the composition of internal resources, debt and shares in the total resources used to finance the activities of a company related to the choice of its capital structure. Although there are studies in the area of finance on the debt determinants of firms, the issue of capital structure is still controversial. This work sought to identify the predominant factors that determine the capital structure of Brazilian share capital, non-financial firms. This work was used a quantitative approach, with application of the statistical technique of multiple linear regression on data in panel. Estimates were made by the method of ordinary least squares with model of fixed effects. About 116 companies were selected to participate in this research. The period considered is from 2003 to 2007. The variables and hypotheses tested in this study were built based on theories of capital structure and in empirical researches. Results indicate that the variables, such as risk, size, and composition of assets and firms growth influence their indebtedness. The profitability variable was not relevant to the composition of indebtedness of the companies analyzed. However, analyzing only the long-term debt, comes to the conclusion that the relevant variables are the size of firms and, especially, the composition of its assets (tangibility).This sense, the smaller the size of the undertaking or the greater the representation of fixed assets in total assets, the greater its propensity to long-term debt. Furthermore, this research could not identify a predominant theory to explain the capital structure of Brazilian

Qualidade dos empregos e a carcinicultura marinha nos laboratórios da praia de Barreta/RN

To present research had for objective to study the quality of the employment in the maturation Laboratories and larviculture of the Beach of Barreta/RN, adopting for so much the criteria used by Reinecke(1999) to characterize a quality employment: surrender, benefits non salary, regularity and work reliability and of the wage, contractual status, social protection, work day, intensity of the work, risk of accidents and of occupational diseases, involvement in linked decisions to the section work, possibility for the development of professional qualifications. Of the exam of the data it was verified that the generated employments are considered employments of good quality. However, this result should be analyzed to the light of a context of extreme informality and of precarization of the work. Therefore, the results should be relativized. He/she/you imports to retain that one of the limitations of the study resides in the impossibility of generalizing the data for the whole section of the sea carcinicultura. In spite of that fact, he/she is considered that the objectives of the research were assisted fully and that the characterization of the profile of the employment generated by the section of the shrimpculture it is extremely important for the drawing of public politics gone back to foment this activity.

Análise do transcriptoma das glândulas venenosas do escorpião Tityus stigmurus

In Brazil, accidents with scorpions are considered of medical importance, not only by the high incidence, but also for the potentiality of the venom from some species in determining severe clinical conditions. Tityus stigmurus is a widely distributed scorpion species in Northeastern Brazil and known to cause severe human envenomations, inducing pain, hyposthesia, edema, erythema, paresthesia, headaches and vomiting. The present study uses a transcriptomic approach to characterize the molecular repertoire from the non-stimulated venom gland of Tityus stigmurus scorpion. A cDNA library was constructed and 540 clones were sequenced and grouped into 37 clusters, with more than one EST (expressed sequence tag) and 116 singlets. Forty-one percent of ESTs belong to recognized toxin-coding sequences, with antimicrobial toxins (AMP-like) the most abundant transcripts, followed by alfa KTx- like, beta KTx-like, beta NaTx-like and alfa NaTx-like. Our analysis indicated that 34% include other possible venom molecules , whose transcripts correspond to anionic peptides, hypothetical secreted peptides, metalloproteinases, cystein-rich peptides and lectins. Fifteen percent of ESTs are similar to cellular transcripts. Sequences without good matches corresponded to 11%. This investigation provides the first global view of cDNAs from Tityus stigmurus. This approach enables characterization of a large number of venom gland component molecules, which belong either to known or atypical types of venom peptides and proteins from the Buthidae family

Contribuição ao desenvolvimento de ontologias para processos petroquímicos : estudo de caso em uma planta DEA

In the last decades, the oil, gas and petrochemical industries have registered a series of huge accidents. Influenced by this context, companies have felt the necessity of engaging themselves in processes to protect the external environment, which can be understood as an ecological concern. In the particular case of the nuclear industry, sustainable education and training, which depend too much on the quality and applicability of the knowledge base, have been considered key points on the safely application of this energy source. As a consequence, this research was motivated by the use of the ontology concept as a tool to improve the knowledge management in a refinery, through the representation of a fuel gas sweetening plant, mixing many pieces of information associated with its normal operation mode. In terms of methodology, this research can be classified as an applied and descriptive research, where many pieces of information were analysed, classified and interpreted to create the ontology of a real plant. The DEA plant modeling was performed according to its process flow diagram, piping and instrumentation diagrams, descriptive documents of its normal operation mode, and the list of all the alarms associated to the instruments, which were complemented by a non-structured interview with a specialist in that plant operation. The ontology was verified by comparing its descriptive diagrams with the original plant documents and discussing with other members of the researchers group. All the concepts applied in this research can be expanded to represent other plants in the same refinery or even in other kind of industry. An ontology can be considered a knowledge base that, because of its formal representation nature, can be applied as one of the elements to develop tools to navigate through the plant, simulate its behavior, diagnose faults, among other possibilities

Representações sociais sobre o acidente de trabalho em saúde

The aim of the present study was to identify the representational elements of workrelated accidents in the health field, as well as investigate their most frequent occurrences at a university hospital, seeking to understand the cognitive, affective and social elements subjacent to the work process involved in health. The analysis focused on 470 middle and senior support staff of this hospital, based on the theoretical-methodological support of the Social Representations Theory. A combination of the following instruments was used for data collection: a free wordassociation test, a questionnaire, an interview and a field journal. Evoc 2000 software was used to identify representational structure. Chi-square and Mann-Whitney tests, at a significance level of 5%, were performed to verify the association between the independent variables and the occurrence of work accidents. In addition, thematic content analysis and lexicographic analysis by ALCESTE software program were used to understand textual content. It was observed that social representations of work-related accidents in the health area are centered in the contamination category, while the categories of prevention and professional unpreparedness are found peripherally. There was a significant association between the existence of multiple employment, the use of personal protective equipment (PPI) during work, job satisfaction and the occurrence of work accidents. The conclusions indicate that perforating-cutting occupational accidents predominated in the hospital and that the representations of the subjects intertwined, with a traditional discourse of work accidents strongly present in Occupational Health. It is therefore suggested that certain subjective aspects related to culture, in terms of controlling work accidents, such as: management, process, organization and the increasing precariousness

Effect of Urucu oil (Brazilian Amazon) on the biomass of the aquatic macrophyte Eichhornia crassipes (Mart.) Solms (Pontederiaceae)

Os rios e lagos de várzea da província petrolífera de Urucu, na Amazônia Central, são amplamente colonizados por macrófitas aquáticas, que podem ser afetadas por acidentes durante a exploração e o transporte de petróleo. Entre as macrófitas, a espécie flutuante Eichhornia crassipes (aguapé) ocorre abundantemente na região; OBJETIVO: O objetivo desse estudo foi verificar o efeito de diferentes dosagens do petróleo de Urucu (0; 0,5; 1,5 e 3,0 L.m-2) na biomassa viva e morta de E. crassipes e em algumas características físicas e químicas da água; MÉTODOS: O experimento teve oitenta e quatro dias de duração. A cada sete dias foi determinada a biomassa (viva e morta) de E. crassipes e os valores de temperatura, pH, condutividade elétrica e oxigênio dissolvido da água; RESULTADOS: A dosagem de 0,5 L.m-2 foi suficiente para causar mortalidade parcial (48%) em E. crassipes após trinta e cinco dias de exposição ao petróleo. A dosagem de 3,0 L.m-2 causou mortalidade total (100%) em E. crassipes em oitenta e quatro dias de exposição. A decomposição do petróleo e da biomassa morta de E. crassipes provocam a redução do oxigênio dissolvido e do pH, e aumento da condutividade elétrica e de fósforo total na água; CONCLUSÕES: Nós concluímos que um derramamento de petróleo pode provocar mortalidade total em uma população de uma espécie de macrófita, mas não em uma outra. Isto pode alterar a diversidade de espécies de macrófitas na região impactada. No caso de Eichhornia crassipes e Pistia stratiotes, um derramamento de petróleo de Urucu pode favorecer E. crassipes, a espécie menos sensível ao petróleo.

Aplicação de nanopartículas de quitosana com potencial de adjuvante na produção de soro contra o venneno do escorpião Tityus serrulatus

In Brazil, several species of scorpions are known to cause accidents which can lead to death, which are mainly belonging to the genus Tityus. The scorpion Tityus serrulatus is the main responsible for more severe cases. Anti-scorpion serums are routinely produced by various institutions, despite their effectiveness, quality and action depends on how quickly treatment is started. Studies have been developed in the search for appropriate technologies to encapsulate and release recombinant or natives proteins capable of inducing antibody production. In this context, chitosan copolymer which can be obtained from the partial deacetylation of chitin or in some microorganisms and it is biocompatible and biodegradable has been widely used for this purpose. This study aimed to search for a system release from chitosan nanoparticles for peptide / protein of the venom of the scorpion T. serrulatus, able to provide a new model of immunization in animals, in order to obtain a potential novel polyclonal serum, anti-venom T. serrulatus. The chitosan nanoparticles were prepared by ionic gelation with polyanion tripolyphosphate (TPP). After standardizing the concentrations of TPP and chitosan was evaluated the efficiency of incorporation of bovine serum albumin (BSA) and scorpion venom, showed particle size compatible with the intended purpose. The particles showed adequate size around 200nm. The crosslinking was confirmed by absorption spectroscopy in the infrared. After verified the high encapsulation efficiency (EE) for acid bicinconínico method (BCA) protein assay and the particle size distribution, the success of the technique was proven and the potential for in vivo application of nanoparticles. The experimental animals were vaccinated and the antibodies measured by ELISA

Folha de São Paulo: o diário oficial do grande irmão

This project wants to analyze the newspaper like a collective organic intellectual thing, and its action like a conservator integral journalism, it makes it looks like a politics block. In this case, the newspaper inserts itself in a process to support the dominated fundamental class. In the same time, it searches to disqualify politically, using the news and the opinion, the sprouting of against-hegemony even untimely and distant in the historical time. Facing this proposal we take as study object the FOLHA DE S. PAULO, nowadays the most representative agency of the great conservative press. Our theoretical reference takes as base the Gramsci organic intellectual formularizations, hegemony, position´s war, integral journalism and private device of hegemony. We allow ourselves, in a subsidiary way to the Gramsci basement, using the novel 1984 written by George Orwell, as a method to explicit, in a comparative way, the manipulation of the reality by the newspaper in its activity of collective organic intellectual. The ideology is the heuristic connection point to make convergence between reality and fiction. For the intended evidences we develop analysis of the daily covering about two great accidents occurred in 2007: The landslide of part of the workmanships of the tunnel of the Companhia do Metropolitano de São Paulo-Metrô (line yellow 4). And the flying disaster involving the airbus of Transportes Aéreos Meridionais-TAM, flight 3054, also in that state. In the first accident we find endorsement of the newspaper to the São Paulo´s government, in the person of the politician actor José Serra (PSDB), representative of the conservative forces and responsible for the workmanships of the Subway, to who it tried to distance politically of the fact. In the second event, the opposition to the politician actor Luis Inácio Luis Lula da Silva and his politics block, the PT, as a possibility against-hegemonic contested, being the mentioned actor appointed as responsible for the occurrence. However, the newspaper says that it is independent and direct, and this direct action comes from the environment. In this environment, the diversity of conceptions of world would guide the publishing work, making the FOLHA DE S. PAULO to take it as a reference for the intended objective, hiding the politics block militancy

Caracterização do acidente de trânsito e gravidade do trauma: um estudo em vítimas de um hospital de emergência de Natal

Descriptive exploratory study, with quantitative approach and prospective data performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGH), in Natal/RN, aiming to classify the type of motor vehicle involved in the accident, the public roadway s user quality and the more frequent injuries; to evaluate the severity of trauma in traffic accident victims; characterized the severity of the injuries and the trauma, and the type of motor vehicle involved. The population comprises 605 traffic accident victims, with data collected between October and December 2007. We used as a support for the evaluation of severity of injuries and trauma the Glasgow Coma Scale (GCSl), the Condensed Abbreviated Injury Scale (CAIS) and the Injury Severity Score (ISS). The results show that 82.8% of the victims were male; 78.4% were aged 18 to 38; the victims originating from the State s Countryside prevailed (43.1%); 24.3% of the population had completed middle-level instruction; 23.1% worked on commerce and auxiliary activities; most (79.4%) was catholic; 48.8% were married/consensual union; 76.2% earned up to two monthly minimum wages; Sunday was the day with the most accidents (25.1%); 47.4% were attended to in under an hour after the event; the motorcycle on its own was responsible for 53.2% of the accidents; 42.3% were attended to by the SAMU; 61.8% were victims of crashes; over half (53.4%) used individual protection equipment (IPE); 49.4% were helmets and 4.0% the seatbelt; 61.3% were motorcycle drivers; 43.3% of the accidents took place in the afternoon shift; from 395 drivers, 55.2% were licensed, and 50.7% among those had been licensed for 1 to 5 years; 90.7% of the victims had GCS1 between 13 and 15 points at the time of evaluation; the body area most affected was the external surface (35.9%); 38.8% of the injuries were light or moderate (AIS=1 and AIS=2); 83.2% had light trauma (ISS between 1 and 15 points). In face of the results, we can conclude that there is a risk for the elevation of injury severity and trauma resulting from traffic accidents, when these events are related to certain variables such as gender, age, weekday, the interval between the accident and the first care, ingestion of drugs, type of accident, the public roadway s user quality, the use of IPE, day shift, body regions and the type of motor vehicle involved in the accident

Identificação de crianças e adolescentes com suspeita de câncer: uma proposta de intervenção

Unlike adult cancer, where cells usually originate from epithelial tissue and is linked to environmental factors, malignant tumors in childhood are mostly of embryonic origin and have a phase of rapid proliferation. When not started chemotherapy at this stage, the tumor increases in size, reducing their growth rate, thus reducing the response to chemotherapy. Childhood cancer is in Brazil, the second cause of mortality among children and adolescents from one to nineteen. His impact on the ranking of diseases becomes significantly important to public health since the first issue is related to accidents and violence. Many children are still sent to the centers of high complexity for cancer treatment with advanced stage disease. The delay in referral to diagnosis can be family, or the difficulty of access to the health sector, or the characteristics of the disease and lack of health staff regarding theme of childhood cancer. Before this problem, we aimed to assess the performance of health teams in the identification of child and adolescent symptoms of cancer in primary care, through the action research methodology, which includes the teaching-learning, seminars, describing the actions of the group and discussing the activities after the training. This study involved thirty-seven health professionals who provide care for children and adolescents in the USF Felipe Shrimp II, the Support Center for Children with Cancer and the pediatric hospital UFRN during the period from March to December 2010. The data were analyzed simultaneously to evaluate actions, following the direction of the analysis of ideas Freires, having as theoretical reference the primary health care. The diagnosis of current reality, as knowledge of the health team targeted for early identification of signs and symptoms raised through questioning, presented as generative themes: resistance to change, awareness of the need for apprehension of knowledge; prior knowledge through the media, fragmentation of the healthcare network, interfering with the operation of the reference and counter, the stigma of death, among others. The selected themes enabled the choice of content for the preparation of four seminars, such as implementation of collective action for discussion problematical. The teaching-learning process has allowed the study participants awareness of the problem and work through the knowledge acquired by interfering in decreasing the time interval between the identification of signs and symptoms of cancer and early specialist treatment. Their difficulties we are faced with a diagnosis of terminal cancer and associated with delayed access to laboratory tests and imaging necessary for the diagnosis of neoplasms. Thus, we find that when the team is consciously involved in the education process from identification of the problem situation, there may be significant changes in daily activities through awareness of being. However, we also realize that acquisition of knowledge and interest of the team are not enough, since to be efficiency of our service, we need an organization of cancer care network operating in the state of Rio Grande do Norte

Em busca do conhecimento da equipe de enfermagem na sua prática assistencial às vítimas de traumatismo raquimedular

The great demand of accidents resulting in victims with rachi-medullar traumatism (RMT) and the need for indetifying how they are being assisted, led us to proceed with this investigation. It had as its goal to identify and analyze the knowledge of nurses and nurse assistents regarding the nursing assistance to these patients. It consists of a descriptive exploratory study, with a quantitative method and prospective data. For its execution, 193 subjects were interviewed, 37 of them nurses and 157 nurse assistents in 02 hospitals of the metropolitan zone of Natal. The results reveal that the subjects are not coherent when questioned whether they are prepared to assist victim of RMT and the content described by order of piority regarding the steps followed in the assistance of these victims, both in the pre-hospital and hospital care. Thus, we observe that only 06 nurses and 07 assistents, described correctly all the steps necessary to pre-hospital care and only 01 nurse and 02 assistents registered all the steps in the correct sequence regarding the hospital care. We conclude that, in face of the obtained results, we can urgently modify this reality, improving the nursing staff and giving them better work conditions

Trauma em idosos atendidos pelo serviço pré-hospitalar móvel

O The aim of this study was to characterize the occurrence of trauma in the elderly population served by the mobile pre-hospital service, in Natal, Rio Grande do Norte. This is a descriptive, transversal and quantitative approach and whose population consisted of 2,080 trauma victims. The sample, of systematic random type, consisted of 400 elderly people, aged from 60 years old, assisted by the Office of Mobile Emergency in Natal / RN, between January 2011 and December 2012. Data collection began after consent and assent of the institution of a Research Ethics Committee under No. 309 505. It was proceeded to documentary retrospective analysis of records of this service through a form of self-development, validated by expert judges considered reliable (α> 0.75) and valid (CVI = 0.97) in their clarity and relevance. Data were tabulated by the Statistical Package for Social Sciences, version 20.0. The results show that older victims have an average age of 74.19 years old, with a prevalence of female involvement by chronic diseases, especially hypertension, average usage of 2.2 routine medications with vital signs within normal limits. The trauma prevailed during the daytime, in the residence of the victims, north of the city and on weekends. Among the mechanisms of trauma were falls, traffic accidents and physical aggression, whose most common type was brain-cerebral trauma and the main consequences were suture wounds and closed fractures. Basic Support Units were as more driven to pre-hospital care (87.8%) and the main destination place consisted of a referral hospital for emergency of the state (57.5%). Among the most commonly performed procedures by nursing staff immobilization with rigid board and neck collar and the peripheral venipuncture, and the main component used for volume replacement to saline were highlighted. There was a significant relationship between the deaths and the mechanism of injury, mechanism of injury and procedures, except medication administration procedures carried out, except immobilization and unit for service. It is highlighted the prevalence of trauma in the elderly, poor follow-up Pre-Hospital Trauma Life Support protocol and the paucity of records and nursing procedures performed. There is need for a protocol of care specific to elderly trauma victims and education strategies for the prevention of such events

Gestão ambiental: um estudo sobre a percepção do problema da desertificação no Estado do Rio Grande do Norte

The objective of this study was to investigate the environmental perception of: People with common-sense knowledge on the desertification process in RN. People with scientific knowledge on the desertification process in RN. Focal points in the combat at desertification of the RN and public ministery representant with actions in interinstitutional articulations promoter (and/or relative actions) at the desertification process in the RN. The research was carried in the city of Natal-RN and in two small cities of the Seridó region (RN): Caicó and Currais Novos. The research carried, is classified as exploratory and 22 people were interviewed. The research includes: The propension/intensity of the desertification in the RN and in the Seridó region; Evaluation of the knowledge of those interviewed, concerning the subject desertification ; Problems in order to combat desertification; Causes of desertification; The profile of the interviewed. The results of this present study indicate that the a desertification process is more agressive in the Seridó region than in the state of RN, being the two following: the absence of preocupation of the affected population with the process and the escarcity of governamental recurses, indicates how problems greather in the combat to the phenomen. Decreasing of produtivity in the agriculture and increasing of the migration to the urbans centers have been the main consequences of the process, that have at water scarcity, deforestation and extraction of argil (being this, regional factor), relevant variables in the influence to the surgiment of the desertification process of the RN