Quality of hand hygiene in a pediatric hospital in Rio de Janeiro, Brazil.

We assessed the quality of hand hygiene among healthcare workers at a pediatrics hospital in Rio de Janeiro, Brazil. Hand hygiene was performed in 491 (34%) of 1,455 opportunities. Of these hand hygiene events, correct performance was observed in only 173 (35%). Multivariate analysis revealed that correct performance of hand hygiene was associated with the use of an alcohol-based product and a lack of jewelry (for all events) and employment in an infirmary with a comparatively higher ratio of nurses to patients (for events involving nurses).

Histological alterations found in the ureter during organ preservation and early phases of renal transplantation.

INTRODUCTION: There are no studies on the phenomena that occur on the ureter during organ preservation and immediately after transplantation. MATERIAL AND METHODS: We studied ureteral fragments obtained during organ harvesting in the cadaver (n = 9), after cold preservation period (n = 18), and immediately after kidney graft reperfusion (n = 126). In addition to the histological analysis, we evaluated the risk factors for the development of lesions and their relation to the evolution of the transplant. RESULTS: Alterations were detected in 120 of the 126 fragments studied after graft reperfusion. Global cellular infiltration was considered to be normal, mild, and moderate to severe in 34.9%, 41.3%, and 23.8%, respectively, consisting mainly of CD8(+) T lymphocytes. Urothelial exfoliation and cell vacuolization were detected in 42% and 52.4% of the cases, respectively. There was an inverse relationship between donor ventilation time and the intensity of the cellular infiltration. Seven and three of the nine fragments obtained during organ harvesting showed mild cellular infiltration of the chorion and urothelium, respectively. Cold storage promoted minor histological changes. After reperfusion, there was increased urothelial infiltration in 11 of the 18 cases. There was no relation between the lesions encountered and human leukocyte antigen compatibilities, renal rejections episodes, or the evolution of the graft itself. CONCLUSIONS: Consequences of brain death mechanical ventilation were detected at the ureteral level, with abnormal lymphocytic infiltration in most cases. Cold storage did not produce any major histological changes. The lesions detected after graft reperfusion do not seem to involve immunological phenomena.

Ureteric lesions detected in normally functioning kidney allografts: risk factors and clinical implications.

INTRODUCTION: We characterized the alterations in ureteral biopsies from normally functioning kidney allografts to study risk factors. MATERIALS AND METHODS: We studied 55 ureteral fragments from kidney grafts obtained during cystoscopy for routine double-J stent extraction. We evaluated the type and severity of the lesions, the risk factors for their occurrence, and their relation to the evolution of the transplant, including the occurrence of renal rejection episodes or ureteral complications. RESULTS: Borderline or rejection lesions were detected in 21 of the 55 fragments. Rejection lesions were more common among biopsies performed in the first 80 days (54.6%) than during the 120 days afterward (15.4%, P = .043). Similarly, urothelium reactivity was detected in 71.4% and 30.7% of the biopsies performed up to and after 4 months, respectively (P = .008). Urothelial atrophy was detected in 20% of the fragments, the age of the donors being higher in these cases (P = .026). There was a trend to the association of borderline or rejection lesions in the ureteral biopsies and a history of an acute renal rejection episode (P = .053). There were no detectable relations between those findings and the evolution of the transplant. CONCLUSIONS: Thirty-eight percent of the biopsed ureters showed rejection or borderline lesions, these lesions were more common among biopsies done in the first months after transplantation. These findings are similar to the ones found in routine renal biopsies. We did not find any significant relation between the nature of the lesions encountered on the ureteral biopsies and the evolution of the transplant.

Chromosomal mapping and quantitative analysis of estrogen-related receptor alpha-1, estrogen receptors alpha and beta and progesterone receptor in the bovine mammary gland.

Steroid receptors are key transcriptional regulators of mammary growth, development and lactation. Expression of estrogen receptors alpha (ERalpha) and beta (ERbeta), progesterone receptor (PR), and estrogen-related receptor alpha-1 (ERRbeta) have been evaluated in bovine mammary gland. The ERRalpha is an orphan receptor that, in other species and tissues, appears to function in the regulation of estrogen-response genes including lactoferrin and medium chain acyl-CoA dehydrogenase and in mitochondrial biogenesis. Expression of ERalpha, ERbeta, PR and ERRalpha was characterized in mammary tissue obtained from multiple stages of bovine mammary gland development using quantitative real-time RT-PCR. Expression was evaluated in prepubertal heifers, primigravid cows, lactating non-pregnant cows, lactating pregnant cows and non-lactating pregnant cows (n=4 to 9 animals/stage). In addition, ERalpha, ERbeta, PR and ERRalpha were mapped to chromosomes 9, 10, 15 and 29 respectively, by linkage and radiation hybrid mapping. Results indicated that expression of ERalpha, PR and ERRalpha was largely coordinately regulated and they were present in significant quantity during all physiological stages evaluated. In contrast, ERbeta transcripts were present at a very low concentration during all stages. Furthermore, no ERbeta protein could be detected in bovine mammary tissue by immunohistochemistry. The ERalpha and PR proteins were detected during all physiological states, including lactation. Our results demonstrate the presence of ERalpha, PR and ERRalpha during all physiological stages, and suggest a functional role for ERRalpha and a relative lack of a role for ERbeta in bovine mammary gland development and lactation.

Characterization of open reading frame-expressed sequence tags generated from Bos indicus and B. taurus mammary gland cDNA libraries.

Sequence-based gene expression data are used to interpret results from functional genomic and proteomics studies. Although more than 300 000 bovine-expressed sequence tags (ESTs) are available in public databases, a more thorough and directed sampling of the expressed genome is needed to identify new transcripts and improve assembly and annotation of existing transcript sequences. Accordingly, we examined the utility of constructing cDNA libraries synthesized by arbitrarily primed RT-PCR of mRNA from tissues not well represented in the publicly available bovine EST database. A total of 33 cDNA libraries were constructed from healthy and infected mammary gland tissues of Brazilian Gir and Holstein cattle. This series of libraries was used to generate 6481 open reading frame-expressed sequence tags (ORESTES) that assembled into 1798 unique sequence elements of which, 1157 did not significantly match sequence assemblies available in the Bos taurus gene index. However, a total of 264 of these 1157 sequence elements aligned with mouse and human expressed sequences demonstrating that ORESTES is an effective resource for discovery of novel expressed sequences in cattle. Furthermore, comparison of the alignment position of bovine ORESTES-derived sequence elements to human gene reference sequences suggested that the priming events for cDNA synthesis more often occurred at the central portion of a transcript, which may have contributed to the relatively high rate of novel sequence discovery.

Genotyping BoLA-DRB3 alleles in Brazilian Dairy Gir cattle (Bos indicus) by temperature-gradient gel electrophoresis (TGGE) and direct sequencing.

BoLA-DRB3 is a gene of the major histocompatibility complex (MHC) in cattle. The product of the BoLA-DRB3 gene is a beta chain of an MHC class II molecule, a glycoprotein expressed on the surface of antigen-presenting cells (APCs). Responses of CD4+ T lymphocytes to peptides are dependent on the presentation of peptide ligands bound to class II molecules on APCs. Genotyping of the BoLA-DRB3 gene is relatively complex due to the extensive polymorphism of this locus. Current techniques for assignment of genotypes are polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), direct sequencing of PCR products, cloning-sequencing, polymerase chain reaction using sequence-specific oligonucleotide probes (PCR-SSOP), and denaturant-gradient gel electrophoresis. These techniques are time-consuming, do not discriminate all possible alleles, or are not readily reproducible. The objective of this study was to genotype BoLA-DRB3 using temperature-gradient gel electrophoresis (TGGE) to separate alleles before sequencing. PCRs using 28 DNA samples from Gir Dairy cattle (a Brazilian breed of Bos indicus) were submitted to TGGE. New PCR products were generated from separated alleles, purified, and sequenced. Allele separation was possible in 21 out of 26 heterozygote samples (81%). Results indicate that two sequence reads (forward and reverse) were sufficient for accurate genotyping of BoLA-DRB3 alleles. Separation of alleles by TGGE provides high-throughput, reliable typing of BoLA-DRB3, which is critical in disease association studies in cattle.

Distribution of bovine lymphocyte antigen (BoLA-DRB3) alleles in Brazilian dairy Gir cattle (Bos indicus).

Brazilian dairy Gir (Bos indicus) cattle are a tropical, well-adapted breed, for which no information on the major histocompatibility complex (MHC) is presently available. The second exon of the bovine lymphocyte antigen (BoLA-DRB3) was amplified by polymerase chain reaction (PCR) of DNA samples from 28 Brazilian dairy Gir cows. Two experimental genotyping approaches were used: direct sequencing of PCR gene products (PCR-DS) and sequencing of cloned PCR fragments (S-CLO). Results demonstrate the viability of both typing approaches. PCR-DS allowed typing of 39% of the animals while the remainder were genotyped by S-CLO. Seventeen BoLA-DRB3 alleles were assigned, including some that were only recently described for zebu cattle. Allelic frequencies ranged from 0.02 to 0.18. The most frequent alleles were *3601 (frequency = 0.18), *2201 (0.14) and *2101 (0.11).

Abordagem cirúrgica do megacólon congênito: estudo retrospectivo / Surgical approach of congenital megacolon: retrospective study

Estudo retrospectivo realizado entre janeiro de 1986 e junho de 1998 no Hospital Universitário da Universidade Federal de Sergipe com o objetivo de analisar os dados epidemiológicos, quadro clínico, meios diagnósticos, opçöes terapêuticas e índice de morbimortalidade de pacientes portadores da Doença de Hirschsprung que foram submetidos a tratamento cirúrgico. Foram avaliados 29 pacientes com predomínio do sexo masculino(80 por cento) e incidência maior em pacientes abaixo de um ano de idade (72,5 por cento). As manifestaçöes clínicas mais freqüentes foram a distensäo abdominal (48,3 por cento) seguida da obstruçäo intestinal (38 por cento), constipaçäo (34,5 por cento), toque retal com fezes explosivas (31 por cento) e vômitos biliosos (31 por cento). Os exames complementares mais utilizados foram o enema opaco (58,6 por cento), seguido da radiografia simples de abdome (48,3 por cento) e da biópsia de cólon (45 por cento). O procedimento cirúrgico definitivo mais executado foi a cirurgia de Duhamel modificada (44,5 por cento). Em 27,6 por cento dos pacientes houve relato de algum tipo de complicaçäo pós-operatória. A infecçäo de ferida operatória foi a complicaçäo mais freqüente nos pacientes submetidos à cirurgia definitiva (37,5 por cento). O procedimento cirúrgico que apresentou maior índice de morbidade foi a cirurgia de Duhamel Haddad (67 por cento). Ocorreram 2 óbitos, ambos em pacientes com enterocolite que foram colostomizados. A morbidade do procedimento cirúrgico definitivo foi zero. De acordo com os dados encontrados, a cirurgia de Duhamel mostrou-se vantajosa e eficaz no tratamento da Doença de Hirschsprung. O índice de morbidade da cirurgia definitiva foi alto, porém, foram complicaçöes de fácil correçäo e sem mortalidade