RESUMO
Two new species related to Candida glabrata, i.e., Candida nivariensis and Candida bracarensis, have been proposed. The occurrence of these species among isolates collected in a Spanish mycology reference laboratory in 2008-2009 was reviewed. In addition, strains recovered as part of an active population-based surveillance of candidemia conducted in Barcelona between 2002 and 2003 were also analyzed. Among 143 clinical isolates received in 2008-2009, three (2%) were identified as C. bracarensis and none as C. nivariensis through sequencing of their ribosomal DNA. Of the 31 strains initially identified as C. glabrata in the 2002-2003 population-based study (0.38 cases/100,000 population), none were found to belong to these related new species. Results from in vitro susceptibility studies of C. bracarensis isolates were comparable to those found with C. glabrata. Since new and cryptic species have been described, periodic surveillance including the use of molecular identification methods seems to be necessary in order to determine their frequency, geographical distribution and susceptibility profile.
Assuntos
Candida/classificação , Candida/isolamento & purificação , Candidemia/epidemiologia , Candidemia/microbiologia , Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candida/genética , DNA Fúngico/química , DNA Fúngico/genética , DNA Espaçador Ribossômico/química , DNA Espaçador Ribossômico/genética , Testes de Sensibilidade Microbiana , Prevalência , Análise de Sequência de DNA , Espanha/epidemiologiaRESUMO
BACKGROUND.: Western ideologies and systems of occupation and justice are implicated in the colonization of indigenous peoples worldwide. Yet, colonialism, racism, and privilege are minimally acknowledged and examined within occupational therapy and occupational science literature, as evidenced in uncritical development of notions of "occupational justice." PURPOSE.: First, to open a discussion of how and why theories and approaches to justice have developed as they have in Aotearoa New Zealand. Second, to further a burgeoning field of Indigenous perspectives and critiques of colonial theorizing within the profession, while highlighting local Indigenous justice frameworks including Te Tiriti o Waitangi and Matike Mai Aotearoa. KEY ISSUES.: Colonialism is minimally examined in occupational justice approaches and promotion. IMPLICATIONS.: Honest examination of colonialism alongside Indigenous justice frameworks can advance critical praxes of decolonising occupation and re-connect occupation with justice and equity.
Assuntos
Terapia Ocupacional , Justiça Social , Colonialismo , Humanos , Povos Indígenas , Nova ZelândiaRESUMO
A detector based only on RR intervals capable of classifying other tachyarrhythmias in addition to atrial fibrillation (AF) could improve cardiac monitoring. In this paper a new classification method based in a 2D non-linear RRI dynamics representation is presented. For this aim, the concepts of Poincaré Images and Atlases are introduced. Three cardiac rhythms were targeted: Normal sinus rhythm (NSR), AF and atrial bigeminy (AB). Three Physionet open source databases were used. Poincaré Images were generated for all signals using different Poincaré plot configurations: RR, dRR and RRdRR. The study was computed for different time window lengths and bin sizes. For each rhythm, the Poincaré Images of the 80% of that rhythm's patients were used to create a reference image, a Poincaré Atlas. The remaining 20% were used as test set and classified into one of the three rhythms using normalized mutual information and 2D correlation. The process was iterated in a tenfold cross-validation and patient-wise dataset division. Sensitivity results obtained for RRdRR configuration and bin size 40 ms, for a 60 s time window were 94.35% ±3.68, 82.07% ±9.18 and 88.86% ±12.79 with a specificity of 85.52% ±7.46, 95.91% ±3.14, 96.10% ±2.25 for AF, NSR and AB respectively. Results suggest that a rhythms general RRI pattern may be captured using Poincaré Atlases and that these can be used to classify other signal segments using Poincaré Images. In contrast with other studies, the former method could be generalized to more cardiac rhythms and does not depend on rhythm-specific thresholds.
Assuntos
Fibrilação Atrial , Algoritmos , Fibrilação Atrial/diagnóstico , Bases de Dados Factuais , Eletrocardiografia , Frequência Cardíaca , Humanos , Monitorização FisiológicaRESUMO
Recently, a remarkable increase in the incidence of zygomycosis has been reported from institutions in the USA and Europe. The use of voriconazole for the treatment of aspergillosis and, less frequently, the use of echinocandins as empirical treatment for invasive fungal infections are thought to be responsible for the increase. In addition, an increased incidence of this infection has been observed in transplant recipients, including both haematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) patients. There are no global surveys on the prevalence or incidence of zygomycosis, but data from individual institutions and countries show that zygomycosis is an emerging infection. The increased incidence of zygomycosis most probably reflects a greater frequency of predisposing factors, such as higher numbers of patients undergoing HSCT and immunosuppressive chemotherapy. In addition, the emergence of rare pathogens as a result of the rise in the use of antifungal therapy against common species can be postulated. Further, the availability of antifungal agents with activity profiles that are more specific for selected fungi increases the necessity of identifying pathogenic fungi; the frequency of Zygomycetes infections may have been underestimated until now because therapeutic decisions did not depend on the precise identification of pathogenic fungi.