Assessment of central venous catheter-associated infections using semi-quantitative or quantitative culture methods

Semiquantitative (Maki) and quantitative (Brun- Buisson) culture techniques were employed in the diagnosis of catheter-related bloodstream infections (CRBSI) in patients who have a short-term central venous catheter (inserted for 30 days). The diagnosis of CRBSI was based on the results of semiquantitative and quantitative culture of material from the removed catheters. Catheter tips (118) from 100 patients were evaluated by both methods. Semiquantitative analysis revealed 34 catheters (28.8%) colonized by ≥15 colonyforming units (cfu), while quantitative cultures (34 catheters, 28.8%) showed the growth of ≥103 cfu/mL. Bacteremia was confirmed in four patients by isolating microorganisms of identical species from both catheters and blood samples. Using the semiquantitative culture technique on short-term central venous catheter tips, we have shown that with a cut-off level of ≥15 cfu, the technique had 100.0% sensitivity, specificity of 68.4%, 25.0% positive predictive value (PPV) and 100.0% negative predictive value (NPV), efficiency of 71.4% and a prevalence of 9.5%. The quantitative method, with a cut-off limit of ≥103 cfu/mL, gave identical values: the sensitivity was 100.0%, specificity 68.4%, positive predictive value (PPV) 25.0%, negative predictive value (NPV) 100.0%, efficiency 71.4% and prevalence 9.5%. We concluded that the semiquantitative and quantitative culture methods, evaluated in parallel, for the first time in Brazil, have similar sensitivity and specificity. Keywords: central venous catheter; semi-quantitative culture; quantitative culture; catheter-related bacteremia.

Avaliação de propriedades criadoras do jacaré-de-papo-amarelo (Caiman latirostris: Alligatoridae) do Estado de São Paulo

Pós-graduação em Aquicultura - FCAV

Viabilidade econômica de três miniusinas para produção de biodiesel utilizando como matéria prima o óleo de crambe (Crambe Abyssinica Hochst)

Pós-graduação em Agronomia (Energia na Agricultura) - FCA

Análise econômica do plantio e condução do eucalipto de curta rotação para fins energéticos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A simulação de Monte Carlo como instrumento fundamental para a análise de viabilidade econômica: a implementação de uma fundição de ferro em uma empresa metalúrgica

In uncertainly economic scenarios, an economic feasibility analysis must be done to accept a project based on investment criteria, such as NPV and IRR, mainly because the shareholders tend to invest their budget in a project if it has a great chance to return their investments. The studied company outsources all of its foundry services, what makes it very dependent of its suppliers, because the products have a lower quality level, long delivery periods and high prices. Therefore, this work will analyze the project of building an iron-casting foundry to decrease the dependence of its suppliers. In order to develop this research, all needed data related to the construction of the foundry and sales were collected to create deterministic and probabilistic (Monte Carlo Simulation) cash flows using MsExcel® and Oracle's Crystal Ball® software. As a result, the project was found to be risky by the NPV and IRR in the case of this new production line supplying only the internal needs. However, when the company offers its services to the foundry market, the project turns to be feasible

Efeitos da ação central do peróxido de hidrogênio na ingestão de água, na excreção renal de água e eletrólitos e na expressão de Fos induzidos pela estimulação colinérgica da área sptal medial

A área septal medial (ASM), situada no prosencéfalo, está envolvida na regulação cardiovascular e no controle do balanço hidroeletrolítico. Esta área é rica em receptores colinérgicos e a ativação dos mesmos induz ingestão de água, natriurese e antidiurese. A ASM também envia projeções aos núcleos paraventricular (NPV) supra-óptico (NSO), os quais contêm os neurônios que secretam vasopressina e ocitocina. Existem evidências experimentais demonstrando que as espécies reativas de oxigênio podem participar do controle de respostas fisiológicas. Resultados recentes de nosso laboratório demonstraram que uma espécie reativa de oxigênio, o peróxido de hidrogênio (H2O2), injetado no ventrículo lateral (VL) reduz a ingestão de água e a resposta pressora induzida por ANG II e carbacol (agonista colinérgico) também injetados no VL. Por isso, o presente estudo teve como objetivo estudar os efeitos da injeção de H2O2 na ASM sobre a ingestão de água, sobre a excreção renal de água e eletrólitos e sobre a expressão da proteína c-Fos no NSO produzidos pela injeção de carbacol também na ASM. Para realizar este trabalho, foram utilizados ratos com cânulas de aço inoxidável implantadas na ASM. A ingestão de água e a excreção renal de água e eletrólitos foram estudadas em ratos que receberam injeções de H2O2 (5 mol/0,5 μl) ou PBS (veículo, 0,5 l) na ASM e, após um minuto, injeção de carbacol (4 nmol/0,5 l) ou salina (NaCl 0,15 M / 0,5 l) também na ASM. A ingestão de água induzida pelo carbacol, através da estimulação colinérgica, foi menor nos ratos que receberam a injeção prévia de peróxido de hidrogênio (8 ± 2,0 ml / 1 h, p<0,05) comparado àqueles que receberam veículo, também na ASM (16,6 ± 1,9 ml / 1 h, p<0,05). Além disso, houve diferença significativa na ingestão de água dos ratos + salina, grupo controle... (Resumo completo, clicar acesso eletrônico abaixo)

Viabilidade financeira da implantação do projeto de construção da estação de tratamento de esgotos - ETE - do Município de Lençóis Paulista - Estado de São Paulo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Viabilidade econômica da venda de energia elétrica em cogeração sob condições de risco: um estudo de caso

The availability of the electrical energy, in sufficient quantities and in competitive prices is a crucial factor to the economic development. The trade-in of the excess electrical energy produced in a system of cogeneration can be seen as an alternative to the creation of an additional source of revenues for ethanol power plants sector, besides contributing to the complementation of the Brazilian electrical headquarter with renewable sources. The objective of this study was to evaluate the economic feasibility of the implementation of a cogeneration electrical central using the excess of sugar cane bagasse and selling the excess of electrical energy with prices of the market. An ethanol power plant located in the state of Sao Paulo was used to this study. It was used the case study methodology, evaluating the potential of the investment under the viewpoint of the Net Present Value (NPV), Payback and Internal Rate of Return (IRR), and complementing the results of the Accounting Results (AC). It was created three alternative scenarios to reflect the level of the risk of every studied situation: the most likely, an optimistic and a pessimistic, each one with its assumptions. The Monte Carlo Simulations was used to insert the elements of risk to each scenario. The results showed that the project is feasible in all NPV scenarios. And the Payback and IRR analysis confirmed these evidences. The valuation with the AR showed that the project is most risky at the pessimistic scenario, but is feasibly in the most likely and the optimistic scenarios. It was concluded that the project is economic viable. However, the economic viability shown in the results is based on the maintenance of the future prices on the levels of the historical prices used in the analysis.

Viabilidade econômica do uso do biogás proveniente da suinocultura em substituição a fontes externas de energia

The swine culture potentially generates waste with high organic load and pollutants, being responsible for the spread of pathogens, contamination of rivers, groundwater and soils, besides it produces foul odors and emit greenhouse gases. However, the high amount of organic matter, which expresses the amount of pollutant load, reflects the energetic potential of these wastes used as raw material in biogas generation through technology of digesters. The properly use of theses digesters provides the production of clean energy and promotes the conservation of the environment. The economic viability of the implantation of an Indian model digester on a small swine farm was verified based on the value from initial investments of deployment, maintenance costs, depreciation, and on the interest and revenues arising from the system. Besides, the amount of biogas produced daily and the average consumption of biogas by the most common used devices such as refrigerator, stove, water heater, and generator of electricity was calculated.. For a backdrop of 10 years, the results of economic indicators NPV of BRL 57,598.95, IRR of 48.38%, Simple Payback of 2.06 years, and Discounted Payback of 2.3 years, demonstrated a favorable outlook for the use of this technology, with the possibility to generate economic, social and environmental benefits.

Avaliação técnica e econômica de um biodigestor de fluxo tubular: estudo de caso do modelo implantado na etec "orlando quagliato" em Santa Cruz do Rio Pardo, SP

Pós-graduação em Agronomia (Energia na Agricultura) - FCA

Avaliação técnico-econômica da produção de enzimas celulolíticas por fermentação em estado sólido

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação técnico-econômica da produção de enzimas celulolíticas por fermentação em estado sólido

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Negative and positive predictive values of nerve monitoring in thyroidectomy

Background Recurrent nerve injury is 1 of the most important complications of thyroidectomy. During the last decade, nerve monitoring has gained increasing acceptance in several centers as a method to predict and to document nerve function at the end of the operation. We evaluated the efficacy of a nerve monitoring system in a series of patients who underwent thyroidectomy and critically analyzed the negative predictive value (NPV) and positive predictive value (PPV) of the method. Methods. NIM System efficacy was prospectively analyzed in 447 patients who underwent thyroidectomy between 2001 and 2008 (366 female/81 male; 420 white/47 nonwhite; 11 to 82 years of age; median, 43 years old). There were 421 total thyroidectomies and 26 partial thyroidectomies, leading to 868 nerves at risk. The gold standard to evaluate inferior laryngeal nerve function was early postoperative videolaryngoscopy, which was repeated after 4 to 6 months in all patients with abnormal endoscopic findings. Results. At the early evaluation, 858 nerves (98.8%) presented normal videolaryngoscopic features after surgery. Ten paretic/paralyzed nerves (1.2%) were detected (2 unexpected unilateral paresis, 2 unexpected bilateral paresis, 1 unexpected unilateral paralysis, 1 unexpected bilateral paralyses, and 1 expected unilateral paralysis). At the late videolaryngoscopy, only 2 permanent nerve paralyses were noted (0.2%), with an ultimate result of 99.8% functioning nerves. Nerve monitoring showed absent or markedly reduced electrical activity at the end of the operations in 25/868 nerves (2.9%), including all 10 endoscopically compromised nerves, with 15 false-positive results. There were no false-negative results. Therefore, the PPV was 40.0%, and the NPV was 100%. Conclusions. In the present series, nerve monitoring had a very high PPV but a low NPV for the detection of recurrent nerve injury. (C) 2011 Wiley Periodicals, Inc. Head Neck 34: 175-179, 2012

Evaluating the performance of polypyrrole nanowires on the electrochemical sensing of ammonia in solution

This work encompasses the direct electrodeposition of polypyrrole nanowires onto Au substrates using different electrochemical techniques: normal pulse voltammetry (NPV) and constant potential method with the aim in applying these films for the first time in ammonia sensing in solution. The performance of these nanowire-based sensors are compared and evaluated in terms of: film morphology (analyzed with scanning electron microscopy); their sensitivity towards ammonia; electrochemical and contact angle measurements. For nanowires prepared by NPV, the sensitivity towards ammonia increases with increasing amount of electrodeposited polypyrrole, as expected due to the role of polypyrrole as electrochemical transducer for ammonia oxidation. On the other hand, nanowires prepared potentiostatically displayed an unexpected opposite behavior, attributed to the lower conductivity of longer polypyrrole nanowires obtained through this technique. These results evidenced that the analytical and physico-chemical features of nanostructured sensors can differ greatly from those of their conventional bulky analogous. (C) 2012 Elsevier B.V. All rights reserved.

Accuracy of Screening for Potentially Malignant Disorders of the Oral Mucosa by Dentists in Primary Care

Purpose: To examine the accuracy of a screening programme for potentially malignant disorders of the oral mucosa by visual inspection in primary health care. Materials and Methods: The study was based on secondary data from the Primary Care Information System maintained by seven units of family health in Sao Paulo City managed by a non-governmental agency. The reference population was composed of 15,072 residents 50 years old or more of both genders. The study population comprised 2,980 individuals. During screening in community settings, the oral mucosa was examined by trained dentists and distributed into two categories: (a) screen negative (b) screen positive. All participants underwent comprehensive clinical exams by a general dental practitioner supervised by a specialist. Individual records were grouped in a working dataset. Point and 95% confidence interval estimates were calculated regarding measures of sensitivity (Se), specificity (Sp) and positive and negative predictive values (PPV and NPV, respectively). Results: 18.0% of the population was considered screen positive. A total of 133 lesions (4.5%) were identified and 8 cases of oral cancer were confirmed, which corresponded to a prevalence rate of 27 cases in 10,000 people, a much higher rate than expected. The measures found were Se: 91.7% (85.3-95.6), Sp: 85.4% (84.1-86.7), PPV: 22.7% (19.3-26.5), NPV: 99.5% (99.2-99.8). The visual screen presented high accuracy. Conclusion: The test presented high sensibility and specificity values. From a public health point of view, the high accuracy levels showed the importance of oral health teams on family health strategy for more comprehensive primary care. Targeting risk groups and delegating the screening to community health agents may improve PPV and coverage.