Antimicrobial resistance, integron carriage, and gyrA and gyrB mutations in Pseudomonas aeruginosa isolated from dogs with otitis externa and pyoderma in Brazil.

BACKGROUND: Pseudomonas aeruginosa is associated with otitis and pyoderma in dogs and is frequently resistant to several antimicrobial drugs. Resistance genes can be carried by integrons with quinolone resistance mainly due to mutations in DNA topoisomerases II and IV. OBJECTIVE: To evaluate the antimicrobial susceptibility, integron carriage, and gyrA and gyrB mutations in P. aeruginosa isolates from canine otitis and pyoderma. ANIMALS: One hundred and four P. aeruginosa strains isolated from dogs with otitis externa (n = 93) and pyoderma (n = 11). METHODS: Antimicrobial susceptibility against 16 antibacterial agents was evaluated through agar diffusion tests. Integron carriage, class and gyrA and gyrB mutations were analysed by PCR, restriction fragment length polymorphism (RFLP)-PCR and genetic sequencing assays. RESULTS: Isolates were mostly resistant to enrofloxacin (72.2%) and ticarcillin (59.7%). Lower resistance to ciprofloxacin (7.7%), tobramycin (3.8%) and polymixin B (0.0%) was detected. Ten (9.6%) multidrug-resistant (MDR) strains were detected. Eight (7.7%) strains carried class 1 integrons and this was associated with MDR (three isolates, P ≤ 0.05). Five of the integron-carrying strains exhibited aminoglycoside resistance genes. Mutations of gyrA and gyrB were observed in 10 isolates, seven of them resistant to all fluoroquinolones tested. CONCLUSIONS AND CLINICAL IMPORTANCE: Enrofloxacin and ticarcilin resistance was widespread in P. aeruginosa isolated from dogs in Brazil. Pseudomonas aeruginosa carrying integrons may present a significant challenge for treatment.

An epidemiological scoring system for tooth wear and dental erosive wear.

BACKGROUND: The prevalence and severity of tooth wear and dental erosion is rising in children and there is no consensus about an index to be employed. AIM: To assess the reliability of an epidemiological scoring system dental wear index (DWI) to measure tooth wear and dental erosive wear. DESIGN: An epidemiological cross-sectional survey was conducted to evaluate and compare tooth wear and dental erosion using the dental wear index and erosion wear index (EWI). The study was conducted with randomised samples of 2,371 children aged between 4 years and 12 years selected from the State of São Paulo, Brazil. Records were used for calculating tooth wear and dental erosion; the incisal edge and canine cusp were excluded. RESULTS: As the schoolchildren's ages increased the severity of primary tooth wear increased in canines (P = 0.0001, OR = 0.34) and molars (P = 0.0001, OR = 2.47) and erosion wear increased in incisal/occlusal (P = 0.0001, OR = 5.18) and molars (P = 0.0001, OR = 2.47). There was an increased prevalence of wear in the permanent teeth of older schoolchildren, particularly on the incisal/occlusal surfaces (P = 0.0001, OR = 7.03). CONCLUSION: The prevalence of tooth wear and dental erosion increased as age increased in children. The epidemiological scoring system Dental Wear Index is able to measure both tooth wear and dental erosive wear. This index should be used to monitor the progression of non-carious lesions and to evaluate the levels of disease in the population.

Acolhimento aos usuários: uma revisão sistemática do atendimento no Sistema Único de Saúde / The user’s attendance: a Systematic Review on the Brazilian Health Care System (SUS)

Introdução: O Ministério da Saúde (MS) propôs por meio do programa Humaniza SUS, a humanização como eixo norteador das práticas de atenção e gestão em todas as instâncias do Sistema Único de Saúde (SUS). De acordo com tal programa, humanizar é: “ofertar atendimento de qualidade articulando os avanços tecnológicos com acolhimento, como melhoria nos ambientes de cuidado e das condições de trabalho dos profissionais”.Objetivo: O presente artigo apresenta uma revisão sistemática para investigar o modo de operacionalização do acolhimento aos usuários nos serviços públicos de saúde e sua incorporação frente aos princípios do SUS. Metodologia: Foram revisadas informações apresentadas em trabalhos anteriores, incluídas em artigos publicados nos últimos dez anos, considerando-se a produção registrada nas seguintes bases de dados bibliográficos: LILACS, MEDLINE e SciELO. Resultados: Dos 148 trabalhos identificados, 10 artigos foram selecionados conforme os critérios pré-estabelecidos e serviram de base para este trabalho. Conclusão: Apostura de acolhimento aos usuários do SUS deve se estender desde a porta de entrada aos serviços deníveis de complexidade, segundo a necessidade de cada usuário. Para que o acesso possa contemplar os princípios da integralidade, torna-se relevante a presença de uma equipe humanizada que atue como facilitadora na consolidação de estratégias de acolhimento.

Introduction: The Ministry of Health proposed by means of Humanize-SUS Program the humanization as guideline for the practice of care and management in all the instances of the SUS. According to such program, to humanize is: “to offer quality of health care articulating the technological advances with the user´s attendance to improve health care environment and the professionals´working conditions”. Objective: This work presents a systematic review of related studies with the purpose of investigating the way to operationalize the user´s attendance in the public health services and its incorporation according to the SUS principles. Methodology: A review was performed on studies mainly in papers published in the last ten years; considering the following bibliographical databases: LILACS, MEDLINE and SciELO. Results: Out of 148 studies, 10 papers were selected according to the pre-established criterion and used as guideline for this study. Conclusion:The care related to the user´s attendance must start from the entrance door to the wards of complexity levels, according to each user´s needs. In such way, the access can contemplate the principles of the Integral HealthCare; being important the presence of a humanized team to perform as facilitator to consolidate some attendance strategies.