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1.
Braz. j. biol ; 84: e257473, 2024. tab, graf, ilus
Artigo em Inglês | LILACS-Express | VETINDEX | ID: biblio-1374639

RESUMO

Feathers make up 7% of the total weight of adult chickens and keratin protein makes up 85% of the feathers. Today, the keratinase enzymes of some Bacillus strains are used to degrade and process raw keratin waste for animal and poultry feed. According to various studies, the probiotic properties of some spore-shaped Bacillus have also been proven. The study aimed to isolation of the keratinolytic Bacillus bacteria that they have probiotic properties for using in the livestock and poultry feed industry. We were able to isolate 8 strains of Bacillus licheniformis with kreatin degrading properties from the soil of Baharan chicken slaughterhouse (Qom city, Iran) applying heat shock, alcohol- and keratin-rich culture medium, and after microscopic and biochemical analysis, 16S rDNA gene was isolated. The measurement results of keratinase activity showed that the three strains of Bacillus licheniformis pvkr6, pvkr 15, and pvkr41 had the highest activity with 124.08, 101.1, and 100.18 U/ml. The results of probiotic properties evaluation also revealed that among all the isolates, only Bacillus licheniformis pvkr15 and Bacillus licheniformis PTCC 1595 (positive control) were γ-hemolytic strains. The percentage of surface hydrophobicity of the strains was obtained from 3.27 to 30.57. It was also shown that, on average, all the strains had acceptable susceptibility to the tested antibiotics except penicillin G. Bacillus licheniformis pvkr15 with highest keratinase activity (101.1U/ml) was considered an optional probiotics due to its abilities such as (biofilm formation, being safe cause of γ-hemolytic activity, high susceptibility to antibiotics such as streptomycin, gentamicin, cefixime, amoxicillin, tetracycline, vancomycin, erythromycin and having a moderate hydrophilic (hydrophobicity: 19.09%), high survivability in pH 2, 2.5 and 3, strong resistance to bile salts and moderate antagonistic activity against pathogenic bacterium like Proteus mirabilis and the ability to grow under anaerobic conditions). By using this strain, after hydrolysis of keratin protein in the feather structure, to replace part of the protein of livestock and poultry feed, not only is no need to separate bacteria from the feed, but also the strain play role of an useful and effective additive in animal growth.


As penas representam 7% do peso total das galinhas adultas e a proteína de queratina compõe 85% das penas. Hoje, as enzimas queratinase de algumas cepas de Bacillus são usadas para degradar e processar resíduos de queratina brutos para alimentação de animais e aves. De acordo com vários estudos, as propriedades probióticas de alguns Bacillus em forma de esporos também foram comprovadas. O estudo teve como objetivo o isolamento das bactérias queratinolíticas Bacillus que possuem propriedades probióticas para uso na indústria de ração animal e avícola. Conseguimos isolar 8 cepas de Bacillus licheniformis com propriedades degradantes de creatina do solo do abatedouro de frangos de Baharan (cidade de Qom, Irã) aplicando choque térmico, meio de cultura rico em álcool e queratina e, após análise microscópica e bioquímica, o gene 16S rDNA foi isolado. Os resultados da medição da atividade da queratinase mostraram que as três cepas de Bacillus licheniformis pvkr6, pvkr15 e pvkr41 tiveram a maior atividade com 124,08, 101,1 e 100,18 U/ml. Os resultados da avaliação das propriedades probióticas também revelaram que dentre todos os isolados apenas Bacillus licheniformis pvkr15 e Bacillus licheniformis PTCC 1595 (controle positivo) eram cepas γ-hemolíticas. A porcentagem de hidrofobicidade superficial das cepas foi obtida de 3,27 a 30,57. Também foi demonstrado que, em média, todas as cepas apresentaram suscetibilidade aceitável aos antibióticos testados, exceto penicilina G. Bacillus licheniformis pvkr15 com maior atividade de queratinase (101,1U/ml) foi considerado um probiótico opcional devido às suas habilidades como formação de biofilme, sendo causa segura de atividade γ-hemolítica, alta suscetibilidade a antibióticos como estreptomicina, gentamicina, cefixima, amoxicilina, tetraciclina, vancomicina, eritromicina e ter uma hidrofílica moderada (hidrofobicidade: 19,09%), alta capacidade de sobrevivência em pH 2, 2,5 e 3, forte resistência aos sais biliares e atividade antagonista moderada contra bactérias patogênicas como Proteus mirabilis e a capacidade de crescer em condições anaeróbicas. Ao utilizar esta cepa, após a hidrólise da proteína queratina na estrutura da pena, para substituir parte da proteína da ração de gado e aves, não só não há necessidade de separar as bactérias da ração, mas também a cepa desempenha um papel útil e eficaz aditivo no crescimento animal.


Assuntos
Animais , Solo , Resíduos , Probióticos , Bacillus licheniformis , Queratinas , Ração Animal
2.
Med Intensiva (Engl Ed) ; 46(9): 508-520, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35840495

RESUMO

Pseudomonas aeruginosa is the microorganism most frequently involved in the main ICU-acquired infections, with special importance in ventilator associated pneumonia. Its importance lies, in addition to its high incidence in critically ill patients, in the severity of the infections it causes and in the difficulty of its antimicrobial treatment, directly related to the high percentage of resistance to antibiotics classically considered first-line. New active antibiotics have recently been developed against Pseudomonas aeruginosa, even against multi-drug resistant strains. This review analyzes both the differential characteristics of Pseudomonas aeruginosa infections and the new therapeutic options, focusing on multi-drug resistant Pseudomonas aeruginosa.


Assuntos
Pneumonia Associada à Ventilação Mecânica , Infecções por Pseudomonas , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana Múltipla , Humanos , Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa
3.
Arch Esp Urol ; 73(10): 895-905, 2020 12.
Artigo em Espanhol | MEDLINE | ID: mdl-33269708

RESUMO

Bladder cancer was one of the first to have a successful treatment based on immune system stimulation, recognized by patient survival and tumor recurrence data. In addition, bladder tumors are now known to have high antigenic load and are therefore considered to be susceptible to respond well to new immunotherapies. For these reasons, studying the mechanism of action of bladder cancer immunological-based treatments can provide valuable information both to improve their current use and to under stand why they work in some patients while others do not tolerate this therapy or have tumor progression. In this article, we will focus on the immune response generated by treatment of non-muscle invasive bladder tumors with BCG, as well as the relationship between this knowledge and new immunotherapies. We will first describe the main activities of the immune system, to continue with the treatment of bladder cancer with BCG, its mechanism of action and biomarkers. Finally, we will summarize the observations that led to the useof monoclonal antibody immunotherapy in cancer and will describe some of the new immunotherapies in use to treat bladder cancer patients.


El cáncer vesical fue uno de los primeros en tener un tratamiento de éxito basado en la estimulación del sistema inmunitario, apoyado por los datos de supervivencia de los pacientes y recurrencia de los tumores. Además, hoy día se sabe que los tumores de vejiga presentan alta carga antigénica y, por ello, se considera que son susceptibles de responder favorablemente a las nuevas inmunoterapias. Por estos motivos, estudiar el mecanismo de acción de los tratamientos inmunológicos de cáncer de vejiga nos puede aportar información muy valiosa tanto para mejorar su uso actual como para comprender por qué funcionan en unos pacientes mientras que otros no toleran la terapia o tienen progresión tumoral. En este artículo vamos a centrarnos en la respuesta inmunitaria generada por el tratamiento de los tumores devejiga no-músculo invasivos con BCG, así como la relación entre estos conocimientos y las nuevas inmunoterapias. Para ello, en primer lugar describiremos las principales actividades del sistema inmunitario para continuar con los fundamentos del tratamiento del cáncer devejiga con BCG, su mecanismo de acción y biomarcadores. Por último, recordaremos las observaciones que llevaron al uso de la inmunoterapia con anticuerpos monoclonales en cáncer y describiremos algunas de las nuevas inmunoterapias que se están introduciendo para tratar cánceres vesicales.


Assuntos
Neoplasias da Bexiga Urinária , Adjuvantes Imunológicos/uso terapêutico , Administração Intravesical , Vacina BCG/uso terapêutico , Biomarcadores , Humanos , Imunoterapia , Recidiva Local de Neoplasia , Neoplasias da Bexiga Urinária/tratamento farmacológico
4.
Bol Med Hosp Infant Mex ; 77(5): 252-261, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064679

RESUMO

Since the emergence of the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China at the end of 2019, when its characteristics were practically unknown, one aspect was evident: its high contagion rate. This high infection rate resulted in the spread of the virus in China, Europe, and, eventually, the rest of the world, including Mexico. At present, around 9 million people are infected, and around 470,000 have died worldwide. In this context, the need to generate protective immunity, and especially the generation of a vaccine that can protect the world population against infection in the shortest possible time, is a challenge that is being addressed in different countries using different strategies in multiple clinical trials. This opinion article will present the evidence of the induction of immune response in some of the viruses of the coronavirus family before COVID-19, such as SARS-CoV and MERS-CoV (Middle East respiratory syndrome coronavirus). The information collected about the induction of an immune response by SARS-CoV-2 will be presented, as well as a description of the vaccine candidates reported to date in the various ongoing clinical trials. Finally, an opinion based on the evidence presented will be issued on the potential success of developing vaccine prototypes.


Desde el surgimiento del nuevo coronavirus SARS-CoV-2 (coronavirus tipo 2 del síndrome respiratorio agudo severo) en China a finales del año 2019, cuando todavía era desconocido prácticamente en todos los aspectos, una característica era evidente: el alto índice de contagio entre la población. Esto resultó en la expansión del virus en China, Europa y, finalmente, en el resto del mundo, incluyendo México. Actualmente, alrededor de 9 millones de personas están infectadas, y han muerto cerca de 500,000 en todo el mundo. En este contexto, la necesidad de generar inmunidad protectora y, sobre todo, el desarrollo de una vacuna que pueda proteger a la población mundial contra la infección en el menor tiempo posible, es un reto que se está abordando en distintos países utilizando diversas estrategias en múltiples ensayos clínicos. En este artículo de opinión se presentan las evidencias de la inducción de respuesta inmunitaria con algunos de los virus de la familia de coronavirus previos al SARS-CoV-2, como el SARS-CoV (coronavirus del síndrome respiratorio agudo severo) y el MERS-CoV (síndrome respiratorio por coronavirus de Oriente Medio). Además, se presenta lo reportado hasta el momento acerca de la inducción de respuesta inmunitaria por el SARS-CoV-2, así como una descripción de los candidatos a vacunas informados hasta el momento en los distintos ensayos clínicos en curso. Finalmente se emite una opinión, basada en las evidencias presentadas, acerca del éxito potencial de los prototipos de vacunas en desarrollo.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Vacinas Virais , Vacina de mRNA-1273 contra 2019-nCoV , Animais , Betacoronavirus/isolamento & purificação , COVID-19 , Vacinas contra COVID-19 , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Humanos , Coronavírus da Síndrome Respiratória do Oriente Médio/imunologia , Coronavírus da Síndrome Respiratória do Oriente Médio/isolamento & purificação , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Vírus da SARS/imunologia , Vírus da SARS/isolamento & purificação , SARS-CoV-2 , Síndrome Respiratória Aguda Grave/imunologia , Síndrome Respiratória Aguda Grave/prevenção & controle
5.
Bol. méd. Hosp. Infant. Méx ; 77(5): 252-261, Sep.-Oct. 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1131986

RESUMO

Abstract Since the emergence of the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China at the end of 2019, when its characteristics were practically unknown, one aspect was evident: its high contagion rate. This high infection rate resulted in the spread of the virus in China, Europe, and, eventually, the rest of the world, including Mexico. At present, around 9 million people are infected, and around 470,000 have died worldwide. In this context, the need to generate protective immunity, and especially the generation of a vaccine that can protect the world population against infection in the shortest possible time, is a challenge that is being addressed in different countries using different strategies in multiple clinical trials. This opinion article will present the evidence of the induction of immune response in some of the viruses of the coronavirus family before COVID-19, such as SARS-CoV and MERS-CoV (Middle East respiratory syndrome coronavirus). The information collected about the induction of an immune response by SARS-CoV-2 will be presented, as well as a description of the vaccine candidates reported to date in the various ongoing clinical trials. Finally, an opinion based on the evidence presented will be issued on the potential success of developing vaccine prototypes.


Resumen Desde el surgimiento del nuevo coronavirus SARS-CoV-2 (coronavirus tipo 2 del síndrome respiratorio agudo severo) en China a finales del año 2019, cuando todavía era desconocido prácticamente en todos los aspectos, una característica era evidente: el alto índice de contagio entre la población. Esto resultó en la expansión del virus en China, Europa y, finalmente, en el resto del mundo, incluyendo México. Actualmente, alrededor de 9 millones de personas están infectadas, y han muerto cerca de 500,000 en todo el mundo. En este contexto, la necesidad de generar inmunidad protectora y, sobre todo, el desarrollo de una vacuna que pueda proteger a la población mundial contra la infección en el menor tiempo posible, es un reto que se está abordando en distintos países utilizando diversas estrategias en múltiples ensayos clínicos. En este artículo de opinión se presentan las evidencias de la inducción de respuesta inmunitaria con algunos de los virus de la familia de coronavirus previos al SARS-CoV-2, como el SARS-CoV (coronavirus del síndrome respiratorio agudo severo) y el MERS-CoV (síndrome respiratorio por coronavirus de Oriente Medio). Además, se presenta lo reportado hasta el momento acerca de la inducción de respuesta inmunitaria por el SARS-CoV-2, así como una descripción de los candidatos a vacunas informados hasta el momento en los distintos ensayos clínicos en curso. Finalmente se emite una opinión, basada en las evidencias presentadas, acerca del éxito potencial de los prototipos de vacunas en desarrollo.

6.
Tese em Português | VETTESES | ID: vtt-213543

RESUMO

Tartarugas marinhas de vida livre são constantemente expostas à fatores estressores e agressões fisiológicas. O objetivo desta tese foi relatar e quantificar a ocorrência e associações entre Helicobacter spp., parasitas e lesão em esôfago e estômago de Tartarugas marinha de vida livre encontradas mortas nas praias da Microrregião dos Lagos, Rio de Janeiro (RJ), por meio das análises bacterioscópica, anatomopatológica e imuno-histoquímica. Neste estudo foram submetidas à necropsia e análise 25 tartarugas marinhas de vida livres e realizado um estudo retrospectivo dos arquivos de necropsia de tartarugas marinhas arquivadas em Iguaba Grande. Amostras estomacais e esofágicas foram coletadas e submetidas ao teste bacterioscópico, de urease, histológica, impregnação por prata (métodos de Whatin-Starry) e à técnica de imuno-histoquímica (IHQ). Com base nos dados foram produzidos, e ou estão em fase de produção, artigos científicos que serão aqui transcritos em forma de capítulos. O primeiro capítulo aborda o estudo retrospectivo de 186 fichas de necropsia de tartarugas marinhas e teve como objetivo descrever as características observadas entre as tartarugas marinhas de vida livre que ingeriram detritos inorgânicos de origem antropogênica em comparação com as que não ingeriram. O estudo revelou que quase metade das mortes destes quelônios no estado do RJ resultou da ingestão de lixo. Demonstrou que a ingestão se repete ao longo da vida e o intestino grosso era o local com maior acúmulo. No segundo capítulo foram descritos as lesões gástricas de 22 tartarugas marinhas, sendo observado gastrites em 86.4% destes animais, parasitismo em 81.3% e alterações morfológicas celulares adaptativas em 59,1%. No terceiro capítulo foi descrito 15 casos de esofagite caseosa em Chelonia mydas, todos em região de esfíncter gastroesofágico. Estas esofagites apresentaram diferentes graus de intensidade, podendo evoluir para obstruição esofágica. No quarto capítulo, foi descrito a identificação de bactérias do gênero Helicobacter no estômago de 20 tartarugas marinhas de vida livre através das análises bacterioscópicas, anatomo-patológicas e imuno-histoquímica. Este estudo demonstrou enfermidades sofridas por tartarugas marinhas de vida livre oriundas da Microrregião do Lagos, RJ. Estes quêlonios estavam diretamente expostos à agressões do ambiente, como ingestão do lixo disperso na água e de parasitos que residem o ambiente onde vivem. A identificação de Helicobacter sp. nestas tartarugas forneceu novos parâmetros para a identificação da causa de agressão à estes animais.


Free-living sea turtles are constantly exposed to stressors and physiological aggressions. The purpouse of this thesis was to report and quantify the occurrence and associations between Helicobacter spp., Parasites and esophageal and stomach lesions of free-living marine turtles found dead in the beaches of the microregion of Lagos, Rio de Janeiro, through bacterioscopic analysis. anatomopathological and immunohistochemical. In this study, 25 free-living sea turtles were necropsied and analyzed and a retrospective study of archival sea turtle necropsy archives in Iguaba Grande was performed. Stomach and esophageal samples were collected and submitted to bacterioscopic, urease, histological, silver impregnation (Whatin-Starry methods) and immunohistochemistry (IHQ). Based on the data, scientific articles have been produced, or are being produced, which will be transcribed here as chapters. The first chapter deals with the retrospective study of 186 sea turtle necropsy records and aimed to describe the characteristics observed among freeliving sea turtles that ingested inorganic debris of anthropogenic origin compared with those that did not ingest. The study revealed that almost half of the deaths of these turtles in the state of RJ resulted from the ingestion of garbage. It showed that ingestion is repeated throughout life and the large intestine was the site with the highest accumulation. In the second chapter, gastric lesions of 22 sea turtles were described, with gastritis being observed in 86.4% of these animals, parasitism in 81.3% and adaptive cellular morphological changes in 59.1%. In the third chapter 15 cases of caseous esophagitis in Chelonia mydas were described, all in the gastroesophageal sphincter region. These esophagitis presented different degrees of intensity and may progress to esophageal obstruction. In the fourth chapter, the identification of bacteria of the genus Helicobacter in the stomach of 20 free-living sea turtles was described through bacterioscopic, pathological and immunohistochemical analyzes. These chelonios were directly exposed to environmental aggressions, such as ingestion of waterborne waste and parasites residing in the environment where they live. The identification of Helicobacter sp. These turtles provided new parameters for identifying the cause of aggression to these animals.

7.
Actas Urol Esp (Engl Ed) ; 43(8): 445-451, 2019 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31155372

RESUMO

INTRODUCTION AND OBJECTIVES: Various studies tried to validate Club Urológico Español de Tratamiento Oncológico (CUETO) tables, yet, none of this papers focused on the high and very high risk bladder cancers. The aim of the study was to externally validate the CUETO model for predicting disease recurrence and progression in group of T1G3 tumors treated with BCG immunotherapy. PATIENTS OR MATERIALS AND METHODS: Data from 414 patients with primary T1G3 bladder cancer were analysed. To evaluate the model discrimination, Cox proportional hazard regression models were created and concordance indexes were calculated. RESULTS: The median follow-up was 68 months. The recurrence was observed in 212 (51.2%) and 64 patients (15.5%) experienced the recurrence more than once during the study follow-up. Progression of the cancer was observed in 106 patients (25.6%). Radical cystectomy was performed in 115 patients (27.8%) and there were 64 (15.5%) cancer specific deaths. For recurrence and progression probability, the concordance index of the CUETO models was 0.633 and 0.697 respectively. CUETO tables underestimated significantly the risk of recurrence and marginally the risk of progression in the first year of observation. For 5 years of observation, the trend for the recurrence was much less clear. On the contrary, there was slight overestimation in the risk of progression. The study is limited by retrospective nature. CONCLUSIONS: It was shown that the CUETO risk tables exhibit a fair discrimination for both disease recurrence and progression in T1G3 patients treated with BCG. CUETO scoring model underestimates the risk of tumor recurrence, but predicts well risk of progression.


Assuntos
Adjuvantes Imunológicos/uso terapêutico , Vacina BCG/uso terapêutico , Carcinoma de Células de Transição/tratamento farmacológico , Modelos Estatísticos , Neoplasias da Bexiga Urinária/tratamento farmacológico , Idoso , Carcinoma de Células de Transição/epidemiologia , Carcinoma de Células de Transição/patologia , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/patologia
8.
Radiologia (Engl Ed) ; 61(4): 337-340, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30898332

RESUMO

The intravesical instillation of bacillus Calmette-Guérin (BCG) is an efficacious complementary treatment for superficial bladder cancer after transurethral resection. This treatment delays progression, decreases the probability that the patient will have to undergo cystectomy in the future, and improves survival; it is generally efficacious and well tolerated. Among the most common local complications are irritative symptoms, hematuria, local genitourinary infection. Systemic complications are much less common. We present the case of a 71-year-old man who developed miliary tuberculosis secondary to treatment with intravesical bacillus Calmette-Guérin for bladder cancer. This is exceptionally uncommon complication is potentially lethal and requires the immediate discontinuation of treatment.


Assuntos
Adjuvantes Imunológicos/efeitos adversos , Vacina BCG/efeitos adversos , Tuberculose Miliar/etiologia , Adjuvantes Imunológicos/administração & dosagem , Administração Intravesical , Idoso , Vacina BCG/administração & dosagem , Humanos , Masculino
9.
Arch Bronconeumol (Engl Ed) ; 55(7): 373-377, 2019 Jul.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30594319

RESUMO

Tuberculosis still is a major public health problem worldwide, and vaccines may play a major role in its eradication. However, despite 20 years of intensive research, we still do not have a better vaccine than the Bacille Calmette-Guérin vaccine, which has been used since 1921 but exhibits only limited efficacy in the field. This effort has not, however, been entirely in vain as our understanding of TB vaccinology has been substantially expanded and there are currently 17 vaccine candidates in clinical development and several more in preclinical trials. This manuscript reviews the most important recent advances, concerns raised and future prospects in the TB vaccinology field.


Assuntos
Vacinas contra a Tuberculose , Adjuvantes Imunológicos , Anticorpos Antibacterianos/biossíntese , Antígenos de Bactérias/imunologia , Vacina BCG/administração & dosagem , Vacina BCG/imunologia , Ensaios Clínicos como Assunto , Previsões , Vetores Genéticos , Humanos , Imunização Secundária , Imunogenicidade da Vacina , Lactente , Recém-Nascido , Mycobacterium tuberculosis/imunologia , Tuberculose/prevenção & controle , Vacinas contra a Tuberculose/classificação , Vacinas contra a Tuberculose/imunologia , Vacinas de Subunidades , Vacinas Sintéticas , Vírus Vaccinia/genética
10.
Med Clin (Barc) ; 152(7): 261-263, 2019 04 05.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30146354

RESUMO

INTRODUCTION AND OBJECTIVE: Contamination of sinks, even due to their underuse, is associated with the transmission of non-fermenting gram-negative bacilli (NFGNB) to patients in Augmented Care Units. After previous monitoring with environmental and patient samples, we now explore the impact of removing sinks from ICU cubicles on incidental isolations related to health care in bronchoaspirate samples of patients with invasive mechanical ventilation (IMV). MATERIAL AND METHODS: Quasi-experimental study, before-and-after, pre-intervention annuities April 2014-2016 and post-intervention April 2016-2017. Incidence densities per 1,000 days of IMV were studied, comparing by the exact method based on the binomial distribution and estimating the incidence density ratio. RESULTS: The incidence densities per 1,000 days of IMV of isolations by NFGNB in bronchoaspirate samples of the pre and post-intervention periods were 11.28 and 1.9, respectively. This implies a post-intervention incidence density 5.90 times lower than before (95% CI: 1.49-51.05, P=.003). CONCLUSIONS: Despite of the limitations of the design, the removal of sinks showed a reduction of the isolations.


Assuntos
Aparelho Sanitário , Contaminação de Equipamentos , Bactérias Gram-Negativas/isolamento & purificação , Unidades de Terapia Intensiva , Respiração Artificial , Acinetobacter baumannii/citologia , Bacillus/isolamento & purificação , Líquido da Lavagem Broncoalveolar/microbiologia , Burkholderia cepacia/isolamento & purificação , Chryseobacterium/isolamento & purificação , Reservatórios de Doenças/microbiologia , Flavobacteriaceae/isolamento & purificação , Humanos , Pseudomonas aeruginosa/isolamento & purificação , Pseudomonas putida/isolamento & purificação , Respiração Artificial/estatística & dados numéricos , Stenotrophomonas maltophilia/isolamento & purificação , Fatores de Tempo
11.
Tese em Português | VETTESES | ID: vtt-217183

RESUMO

A nível nacional, as aves são o grupo de animais de maior ocorrência e de maior taxa de mortalidade nos centros de reabilitação. Duas causas de debilidade nestes animais são as gastrites e úlceras em proventrículo e ventrículo gástrico. A morte de aves, domésticas e algumas silvestres, devido a este quadro, já foi relatada pela comunidade científica. O principal objetivo deste trabalho é avaliar a ocorrência de Helicobacter spp., em proventrículo e ventrículo gástrico de diferentes espécies de aves marinhas, assim como possíveis alterações histomorfológicas acarretadas por esta bactéria nas aves encontradas no litoral do estado do Rio de Janeiro, pelas análises bacterioscópica, anatomopatológica e imuno-histoquímica. Dezessete aves marinhas (oito Sula leucogastes, sete Fregata magnificens e duas Larus dominicatus) foram recolhidas por empresa de consultoria ambiental e monitoramento costeiro e posteriormente necropsiadas. As alterações observadas em proventrículo e ventrículo gástrico foram descritas, morfologicamente, em ficha individual, além de registro fotográfico. Esfregaços de proventrículo e ventrículo gástrico foram submetidos ao teste bacterioscópico e recolhido fragmentos para o teste de urease. Outros fragmentos foram fixados em formalina tamponada a 10% para estudos histopatológicos. Distribuição e quantificação da inflamação foram observadas em coloração de hematoxilina e eosina. Realizou-se, ainda, coloração especial de Warthin-Starry e análise imuno-histoquímica. O teste de urease foi positivo em 37,5% dos proventriculos e 43,8% dos ventrículos. A avaliação imunohistoquímica constatou a presença do gênero Helicobacter infectanto mucosa gástrica de aves marinhas.


At the national level, birds are the group of animals with the highest occurrence and highest mortality rate in the rehabilitation centers. Two causes of weakness in these animals are gastritis and ulcers in the proventriculus and gastric ventricle. The death of birds, domestic and some wild due to this picture, has already been reported by the scientific community. The main objective of this work is to evaluate the occurrence of Helicobacter spp., In the proventriculus and gastric ventricle of different species of seabirds, as well as possible histomorphological alterations caused by this bacterium in the birds found in the coast of the state of Rio de Janeiro, by the bacterioscopic analyzes , anatomopathological and immunohistochemistry. Seventeen seabirds (eight Sula leucogastes, seven Fregata magnificens and two Larus dominicatus) were collected by an environmental consultancy and coastal monitoring company and subsequently necropsied. The alterations observed in the proventriculus and gastric ventricle were described, morphologically, in individual file, besides photographic record. Progenitor and gastric ventricle smears were submitted to the bacterioscopic test and collected fragments for the urease test. Other fragments were fixed in 10% buffered formalin for histopathological studies. Distribution and quantification of inflammation were observed in staining of hematoxylin and eosin. Warthin-Starry staining and immunohistochemical analysis were also performed. The urease test was positive in 37.5% of the proventriculus and 43.8% of the ventricles. The immunohistochemical evaluation verified the presence of the genus Helicobacter infective gastric mucosa of seabirds. Key words:

12.
Enferm Infecc Microbiol Clin (Engl Ed) ; 36(4): 214-217, 2018 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28291668

RESUMO

INTRODUCTION: The under-utilisation of taps is associated with the generation of reservoirs of non-fermenting gram-negative bacilli with the ability to disseminate. We describe the detection and approach of the problem in an ICU. METHODS: Observational descriptive study in an ICU with individual cubicles with their own sink. We collected clinical samples from patients and environmental samples from tap aerators and reviewed the unit's hygiene measures. RESULTS: We detected four cases due to Chryseobacterium indologenes, one to Elizabethkingia meningoseptica and another to Pseudomonas aeruginosa; they were identified both in clinical and the environmental samples. The healthcare professionals reported that almost every hand hygiene opportunity was performed with a hydroalcoholic solution. After considered the daily flushing of water outlets as inefficient, it was decided to remove them. CONCLUSIONS: National recommendations were insufficient for preventing, detecting and controlling tap contamination in units with a high risk of infection. The management of taps in these units needs to be improved.


Assuntos
Reservatórios de Doenças/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Unidades de Terapia Intensiva , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
13.
Actas Urol Esp (Engl Ed) ; 42(1): 17-24, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28238343

RESUMO

CONTEXT: High-risk nonmuscle-invasive bladder cancer is a disease that includes a heterogeneous group of patients, for whom close follow-up is recommended due to the risk of progression to a muscle-invasive tumour. The treatment of choice for these tumours is transurethral resection of the bladder tumour followed by a programme of bacillus Calmette-Guerin instillations. There is a subgroup of patients who have a greater risk of progression and who benefit from early radical treatment. OBJECTIVE: To identify which patient group with nonmuscle-invasive bladder cancer will benefit from early radical treatment. SEARCHING THE EVIDENCE: We performed a literature review to identify the risk factors for progression for these patients and thereby recommend a treatment that improves their survival rate. SYNTHESIS OF THE EVIDENCE: We identified the various prognostic factors associated with tumour progression: the persistence of T1 tumour in re-resection of the bladder tumour, the presence of carcinoma in situ, patients refractory to bacillus Calmette-Guerin treatment, patients older than 70 years, tumours larger than 3cm, the substaging of T1 tumours, the presence of lymphovascular invasion and the presence of a tumour in the prostatic urethra. Similarly, we comment on the advantages of radical versus conservative treatment, considering that the performance of an early cystectomy due to a high-risk noninvasive vesical tumour has a better cancer prognosis than those in which the operation is deferred until the progression. CONCLUSIONS: In this disease, it is important to individualise the patients to provide them personalized treatment. For patients with the previously mentioned characteristics, it is recommended that early cystectomy not be delayed.


Assuntos
Cistectomia , Neoplasias da Bexiga Urinária/cirurgia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Vacina BCG/uso terapêutico , Carcinoma in Situ/diagnóstico , Carcinoma in Situ/cirurgia , Progressão da Doença , Medicina Baseada em Evidências , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Invasividade Neoplásica , Recidiva Local de Neoplasia/prevenção & controle , Medicina de Precisão , Fatores de Tempo , Uretra/patologia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/terapia
14.
Rev. méd. Urug ; 33(4): 261-268, dic. 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-875877

RESUMO

La instilación intravesical de bacilo de Calmette-Guérin (BCG) es el tratamiento de primera línea para el carcinoma superficial de células transicionales de la vejiga. Aunque su uso es relativamente seguro, complicaciones graves como hepatitis granulomatosa, osteomielitis, neumonía, sepsis y disfunción orgánica múltiple se producen en algunos pacientes. Presentamos el caso de un paciente con diagnóstico de carcinoma de células de transición superficial de la vejiga (T1), que fallece como consecuencia de una complicación sistémica grave con severo compromiso del sistema nervioso central, secundaria a la instilación intravesical de BCG.


Bacille Calmette-Guérin intravesical instillation (BCG) is the main treatment for superficial transitional cell carcinoma of the bladder. In spite of it being a safe procedure, severe complications as granulomatous hepatitis, osteomyelitis, pneumonia, sepsis and multiple organ dysfunction syndrome occur in a few patients. The study presents the case of a patient with a diagnosis of superficial transitional cell carcinoma of the bladder (T1), who died as a consequence of a severe systemic compromise of the central nervous system, secondary to instravesical instillation of BCG.


A instilação intravesical de bacilo de Calmette-Guérin (BCG) é o tratamento de primeira linha para o carcinoma superficial de células transicionais de bexiga. Embora seu seja relativamente seguro, as complicações graves como hepatite granulomatosa, osteomielite, pneumonia, sepse e disfunção orgânica múltipla possam ocorrem em alguns pacientes. Apresentamos o caso de um paciente com diagnóstico de carcinoma de células de transição superficial de bexiga (T1), que falece como consequência de uma complicação sistêmica grave com severo compromisso do Sistema Nervoso Central, secundária à instilação intravesical de BCG.


Assuntos
Humanos , Carcinoma , Mycobacterium bovis , Neoplasias da Bexiga Urinária
15.
Med Clin (Barc) ; 149(10): 449-455, 2017 Nov 22.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28736063

RESUMO

Bladder cancer has a high incidence and involves high associated morbidity and mortality. Since its initial clinical suspicion, early diagnostic confirmation and multimodal treatment involve different medical specialties. For this reason, we consider it important to spread the current consensus for its management. Recent advances in immunology and Chemotherapy make it necessary to expose and reflect on future perspectives.


Assuntos
Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/terapia , Biomarcadores Tumorais/urina , Terapia Combinada , Detecção Precoce de Câncer/métodos , Humanos , Gradação de Tumores , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/urina
16.
Biomédica (Bogotá) ; 37(2): 164-174, abr.-jun. 2017. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-888456

RESUMO

ABSTRACT Introduction: Light-emitting diode fluorescence microscopy (LED-FM) has been endorsed by the World Health Organization (WHO) for tuberculosis diagnosis, but its accuracy in HIV-infected patients remains controversial, and only some few studies have explored procedural factors that may affect its performance. Objective: To evaluate the performance of LED-FM for tuberculosis diagnosis in patients with and without HIV infection using a newer, less expensive LED lamp. Materials and methods: We compared the performance of LED-FM and Ziehl-Neelsen (ZN) microscopy on respiratory specimen smears from tuberculosis (TB) suspects and patients on treatment examined by different technicians blinded for HIV-status and for the result of the comparative test. We analyzed the effect of concentrating specimens prior to microscopy using different examination schemes and user-appraisal of the LED device. Results: Of the 6,968 diagnostic specimens collected, 869 (12.5%) had positive Mycobacterium tuberculosis cultures. LED-FM was 11.4% more sensitive than ZN (p<0.01). Among HIV-positive TB patients, sensitivity differences between LED-FM and ZN (20.6%) doubled the figure obtained in HIV-negative patients or in those with unknown HIV status (9.3%). After stratifying by direct and concentrated slides, the superiority of LED-FM remained. High specificity values were obtained both with LED-FM (99.9%) and ZN (99.9%).The second reading of a sample of slides showed a significantly higher positive detection yield using 200x magnification (49.4 %) than 400x magnification (33.8%) (p<0.05). The LED-device had a very good acceptance among the technicians. Conclusion: LED-FM better performance compared with ZN in HIV-infected patients and user-appraisal support the rapid roll-out of LED-FM. Screening at 200x magnification was essential to achieve LED-FM increased sensitivity.


RESUMEN Introducción. La microscopía de fluorescencia con lámpara LED (MF-LED) ha sido recomendada por la Organización Mundial de la Salud (OMS) para el diagnóstico de la tuberculosis, pero su precisión en pacientes con HIV continúa siendo controversial y en pocos estudios se han explorado los factores metodológicos que pueden afectar su utilidad. Objetivo. Evaluar el rendimiento de la MF-LED en el diagnóstico de la tuberculosis en pacientes con HIV y sin él mediante un novedoso dispositivo LED. Materiales y métodos. Se comparó el rendimiento de la MF-LED y la microscopía en frotis de muestras respiratorias con tinción de Ziehl-Neelsen (M-ZN) examinados por técnicos cegados en cuanto al estado de HIV y el resultado de la prueba comparativa. Se analizó el efecto de concentrar muestras antes de la microscopía, usar diferentes esquemas de observación y la valoración con el dispositivo LED. Resultados. De las 6.968 muestras recolectadas, 869 (12,5 %) resultaron con cultivo positivo para Mycobacterium tuberculosis. La MF-LED fue 11,4 % más sensible que la M-ZN (p<0,01). Entre los pacientes con tuberculosis positivos para HIV, la diferencia de sensibilidad entre la MF-LED y la M-ZN (20,6 %) duplicó la cifra obtenida en pacientes negativos para HIV o con estatus desconocido (9,3 %). Al estratificar los frotis en directos y concentrados, se mantuvo la superioridad de la MF-LED. Las especificidades de la MF-LED (99,9 %) y la M-ZN (99,9 %) resultaron elevadas. La lectura de una muestra de frotis mostró una positividad significativamente mayor con un aumento de 200X (49,4 %) que con uno de 400X (33,8 %) (p<0,05). El dispositivo LED tuvo una buena aceptación entre los técnicos. Conclusión. Debido al mejor desempeño de la MF-LED comparada con la M-ZN en pacientes con HIV y su fácil utilización, se recomienda su adopción. La utilización del aumento de 200X fue esencial para el incremento de la sensibilidad de la MF-LED.

17.
Actas Urol Esp ; 41(9): 590-595, 2017 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28457495

RESUMO

BACKGROUND AND OBJECTIVE: Intravesical Bacille Calmette-Guérin (BCG) is essential for preventing the recurrence and progression of superficial bladder tumours. The aim of our study was to compare the efficacy and toxicity of the Connaught and Tice strains, as well as the importance of the maintenance regimen. MATERIAL AND METHODS: We retrospectively reviewed 110 patients with superficial bladder tumours who underwent adjuvant endovesical treatment. The patients were distributed into 3 groups, based on whether the treatment was with the Connaught strain, the Tice strain or both sequentially. We calculated the relapse-free survival rate in each group and compared the patients who completed the maintenance treatments against those who did not. To identify the predictors of relapse, we performed a multivariate analysis. We also assessed the toxicity by analysing the onset of BCGitis, urinary urgency, fever, urinary tract infection and treatment withdrawing due to adverse effects. RESULTS: We found no differences in the efficacy parameters. The patients in the Connaught group completed the maintenance to a lesser extent (38.4 vs. 72% for the Tice group and 76.3% for both groups; P=.010). The patients who completed the maintenance had better relapse-free survival at 60 months (88.5 vs. 74.2%; P=.036), regardless of the strain employed. The multivariate analysis identified a size larger than 3cm, more than 3 implants and not completing the maintenance as risk factors of relapse. The patients with the Connaught strain had higher rates of BCGitis, with no differences in the other events studied. CONCLUSION: Completing the maintenance phase is essential, regardless of the strain employed. The Connaught strain has a greater risk of BCGitis, and a sequential regimen could be useful in certain scenarios.


Assuntos
Adjuvantes Imunológicos/administração & dosagem , Vacina BCG/administração & dosagem , Neoplasias da Bexiga Urinária/tratamento farmacológico , Adjuvantes Imunológicos/efeitos adversos , Administração Intravesical , Idoso , Vacina BCG/efeitos adversos , Feminino , Humanos , Quimioterapia de Manutenção , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estudos Retrospectivos , Neoplasias da Bexiga Urinária/patologia
18.
Rev. Asoc. Méd. Argent ; 130(1): 37-40, mar. 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-973069

RESUMO

Desde 1947 se inició el tratamiento específico de la tuberculosis que adquirió un valor inusitado, dado que el mismo modificó en el mundo entero el curso de la enfermedad tuberculosa. Roentgen desde 1895 nos mostró su ubicación en el pulmón, pero fue el laboratorio que permitió su diagnóstico y tratamiento, sucesivamente modificado con el transcurrir de los años. Abel Cetrángolo, como quien fuera su maestro y padrino de tesis, Andrés Arena entre nosotros, logró caracterizar al bacilo de Koch y en esa misma tesis nos enseñó el valor diagnóstico del contenido gástrico. Se distinguió por la seriedad de sus trabajos científicos tanto en Córdoba en la escuela de Gumersindo Sayago como en la Cátedra de Patología y Clínica de la Tuberculosis con la conducción de Raúl F Vaccarezza; fue un verdadero maestro para sus discípulos sentando bases valederas en sus conclusiones. Todo jefe de servicio debe trascender por lo que dejacientíficamente, pero también en la formación de médicos que puedan continuar en la profesión desde el punto de vista asistencial y docente con el ejemplo que él les legó.


Since 1947 the specific treatment of tuberculosis acquired an unused value, since it changed over the world the course of tuberculosis. Roentgen from 1895 showed us its location in the lung, but it was the laboratory that allowed its diagnosis and treatment, successively modified with the passing of the years. Abel Cetrángolo, and his former teacher and thesis godfather Andrés Arena among us, characterized the Koch bacillus and in that same thesis reinforced the value of gastric content. It was distinguished by the seriousness of his scientific works, both in Córdoba in Gumersido Sayago school and in the Department of Pathology and Clinical Tuberculosis headed by Raul F Vaccarezza, was a true master for his disciples sitting valid bases of conclusions. All service manager must transcend so scientifically leaves, but also in the training of doctors that can continue in the profession from the point of view clinical and teaching by example that he bequeathed them.


Assuntos
História do Século XX , Médicos/história , Tuberculose Pulmonar/história , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/terapia , História da Medicina , Argentina
19.
Actas Urol Esp ; 40(6): 370-7, 2016.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-26922518

RESUMO

OBJECTIVE: To compare various conservative treatment options for high-grade T1 nonmuscle-invasive bladder cancer (NMIBC). Bacille Calmette-Guérin (BCG) is the preferred intravesical treatment for high-grade T1 tumours; however, a number of experts still question the need for maintenance BCG. MATERIAL AND METHODS: We retrospectively analysed data from 1039 patients with primary and recurrent T1G3 NMIBC. All patients underwent complete transurethral resection of the bladder tumour (TURBT), with muscle in the sample and multiple bladder biopsies. The patients were treated with the following: only one initial TURBT (n=108), re-TURBT (n=153), induction with 27mg of BCG (Connaught strain) (n=87), induction with 81mg of BCG (n=489) or induction with 81mg of BCG+maintenance (n=202). The time to first recurrence, progression (to T2 or greater or to metastatic disease) and specific mortality of the disease was assessed using the Kaplan-Meier survival function and were compared using the log-rank test and the Cox multivariate regression model of proportional risks. RESULTS: The mean follow-up was 62±39 months. The risk of recurrence was significantly lower for the patients treated with maintenance therapy of 81mg of BCG than in the other treatment groups (P<.001). The risk of tumour progression was also significantly lower for the patients treated with maintenance BCG than for the patients treated only with one TURBT, re-TURBT and with induction therapy with 27mg of BCG (P=.0003). The specific disease mortality was significantly lower with BCG maintenance (9.4%) than with only one TURBT (27.8%; P=.003). CONCLUSIONS: In the case of T1G3 NMIBC, a complete dose of BCG with maintenance is associated with better recurrence results than are other conservative treatment modalities. The results of progression and survival specific to the disease were also better with induction BCG, with or without maintenance.


Assuntos
Adjuvantes Imunológicos/uso terapêutico , Vacina BCG/uso terapêutico , Carcinoma de Células de Transição/tratamento farmacológico , Tratamento Conservador , Neoplasias da Bexiga Urinária/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células de Transição/patologia , Feminino , Humanos , Quimioterapia de Manutenção , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias da Bexiga Urinária/patologia , Adulto Jovem
20.
Arq. Inst. Biol. ; 83: 01-08, 2016. tab, ilus
Artigo em Português | VETINDEX | ID: vti-731088

RESUMO

The aim of this study was to compare different complementary diagnostic methods (macroscopic, histological, serological and molecular) of tuberculosis in naturally infected cattle. The study was conducted from samples taken from 40 reagents cattle in cervical comparative intradermal tuberculin test  (ITT). The macroscopic post mortem inspection of carcasses was followed by the collection of nasal swabs, blood and tissue samples (liver, lung and mediastinal lymph node) for polymerase chain reaction (PCR) test, EnzymeLinked Immunosorbent Assay (ELISA) and histopathologic test with hematoxylineosin (HE) and ZiehlNeelsen (ZN), respectively. Of the 40 cattle slaughtered, 22 (55%) carcasses had macroscopic lesions suggestive of tuberculosis. The histopathology HE identified 13 (32.5%) carcasses with histological changes: 6 (15%) in the mediastinal lymph nodes, 5 (12.5%) in the liver and 3 (7.5%) in the lung. At  ZN, the presence of acidfast bacilli was not detected in any of the samples tested. The ELISA/IDEXX® identified one (2.5%) reagent animal, and the PCR test detected DNA of Mycobacterium bovis in one (2.5%) cow. It is concluded that among the diagnostic methods reviews none was able to detect all animals that were positive in tuberculin test, but the association of different methods can ensure diagnostic accuracy.(AU)


Objetivou-se com este estudo comparar diferentes métodos complementares de diagnóstico (macroscópico, histopatológico, sorológico e molecular) da tuberculose, em bovinos naturalmente infectados. O trabalho deu-se por meio de amostras colhidas em abate sanitário de 40 bovinos reagentes no teste cervical comparativo (TCC) para tuberculose. A inspeção macroscópica post mor tem das carcaças foi acompanhada de colheita de amostras de muco nasal, sangue e tecido (fígado, pulmão e linfonodo mediastínico) para realização do exame de reação em cadeia pela polimerase (PCR), de EnzymeLinked Immunosorbent Assay (ELISA) e histopatológico com colorações de hematoxilinaeosina (HE) e ZiehlNeelsen (ZN), respectivamente. Dos 40 bovinos inspecionados no abate, 22 (55%) animais apresentaram algum tipo de lesão macroscópica sugestiva de tuberculose. Nos achados histopatológicos visualizados em HE, 13 (32,5%) carcaças apontaram alterações histológicas, sendo 6 (15%) nos linfonodos mediastínicos, 5 (12,5%) no fígado e 3 (7,5%) no pulmão. Não foi observada a presença de bacilos álcool-ácido resistentes em nenhuma das amostras avaliadas. O ensaio sorológico de ELISA/IDEXX® identificou um (2,5%) animal reagente, e o teste de PCR detectou DNA de Mycobacterium bovis em uma (2,5%) amostra. Concluiu-se que entre os exames complementares de diagnóstico avaliados nenhum foi capaz de detectar todos os animais que estavam positivos na tuberculinização, porém a associação de diferentes métodos pode garantir a confiabilidade do diagnóstico.(AU)


Assuntos
Animais , Diagnóstico , Tuberculose Bovina , Mycobacterium bovis , Ensaio de Imunoadsorção Enzimática , Vigilância Sanitária , Reação em Cadeia da Polimerase
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