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1.
Rev. clín. esp. (Ed. impr.) ; 223(8): 470-478, oct. 2023.
Artículo en Español | IBECS | ID: ibc-225872

RESUMEN

Objetivos Analizar el impacto en la actividad asistencial, tiempo de los intervalos de derivación y diagnósticos y la incidencia de cáncer durante los 2primeros años de pandemia por SARS-CoV-2 en una Unidad de Diagnóstico Rápido. Material y métodos Estudio retrospectivo observacional realizado durante el año prepandémico (1 marzo del 2019-29 febrero del 2020) y los 2primeros años de pandemia (1 marzo del 2020-28 febrero del 2022). Se evaluaron y compararon variables demográficas, clínicas, el intervalo de la primera visita, el intervalo diagnóstico y el intervalo primera visita-diagnóstico. Resultados Durante la primera ola pandémica hubo una reducción de derivaciones (–32,6%), registrándose desde la segunda ola hasta el final del primer año y segundo año de pandemia un incremento del 8,1 y el 17,7%, respectivamente. Se identificó un incremento de derivaciones de Atención Primaria y disminución de urgencias. El aumento de diagnósticos de cáncer del 2,7 y el 15,7% en los 2años de pandemia fue proporcional al incremento de derivaciones. No se observaron cambios en procesos benignos ni en las localizaciones y estadificaciones del cáncer. El intervalo de la primera vista fue superior en enfermedades benignas (p<0,0001). Se objetivó una prolongación del intervalo diagnóstico en pacientes con cáncer, aunque durante los 3años del estudio la mediana fue <15 días. Conclusiones El impacto de la pandemia incidió en el tiempo de los intervalos y en las procedencias de las derivaciones. La unidad de diagnóstico rápido constituye una ruta diagnóstica de cáncer complementaria de carácter urgente con un alto rendimiento diagnóstico (AU)


Objectives To analyse changes in health care activity, time of referral and diagnosis intervals and the incidence of cancer during the first 2years of the SARS-CoV-2 pandemic in a quick diagnosis unit. Materials and methods A retrospective observational study was carried out during the prepandemic year (March 1, 2019 to February 29, 2020) and the first 2years of the pandemic (March 1, 2020 to February 28, 2022). Demographic and clinical variables, the first visit interval, the diagnosis interval and the first visit-diagnosis interval were evaluated and compared. Results During the first pandemic wave, there was a reduction in referrals (−32.6%), which then increased 8.1% and 17.7% from the second wave until the end of the first pandemic year and the second pandemic year, respectively. An increase in referrals to primary care and a decrease in emergencies were identified. The increase in cancer diagnoses of 2.7% and 15.7% in the 2years of the pandemic was proportional to the increase in referrals. No changes were observed in benign processes or in cancer locations and stages. The first visit interval was higher for benign diseases (p < 0.0001). A prolongation of the diagnosis interval was observed in cancer patients, although during the 3years of the study the median was <15 days. Conclusions The impact of the pandemic affected the length of intervals and the origins of referrals. The quick diagnosis units constitute and urgent complementary cancer diagnostic route with a high diagnosis yield (AU)


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/epidemiología , Pandemias , Neoplasias/diagnóstico , Derivación y Consulta , Estudios Retrospectivos
2.
Rev Clin Esp (Barc) ; 223(8): 470-478, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37451541

RESUMEN

OBJECTIVES: To analyse changes in health care activity, time of referral and diagnosis intervals and the incidence of cancer during the first two years of the SARS-CoV-2 pandemic in a quick diagnosis unit. MATERIALS AND METHODS: A retrospective observational study was carried out during the prepandemic year (March 1, 2019, to February 29, 2020) and the first two years of the pandemic (March 1, 2020, to February 28, 2022). Demographic and clinical variables, the first visit interval, the diagnosis interval and the first visit-diagnosis interval were evaluated and compared. RESULTS: During the first pandemic wave, there was a reduction in referrals (-32.6%), which then increased 8.1% and 17.7% from the second wave until the end of the first pandemic year and the second pandemic year, respectively. An increase in referrals to primary care and a decrease in emergencies were identified. The increase in cancer diagnoses of 2.7% and 15.7% in the two years of the pandemic was proportional to the increase in referrals. No changes were observed in benign processes or in cancer locations and stages. The first visit interval was higher for benign diseases (p<0.0001). A prolongation of the diagnosis interval was observed in cancer patients, although during the three years of the study the median was <15 days. CONCLUSIONS: The impact of the pandemic affected the length of intervals and the origins of referrals. The quick diagnosis units constitutes and urgent complementary cancer diagnostic route with a high diagnosis yield.


Asunto(s)
COVID-19 , Neoplasias , Humanos , COVID-19/diagnóstico , COVID-19/epidemiología , Neoplasias/diagnóstico , Neoplasias/epidemiología , Pandemias , Estudios Retrospectivos , SARS-CoV-2
3.
JDS Commun ; 3(5): 312-316, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36340905

RESUMEN

The aim of this study was to evaluate the effect of added Cd and Pb to milk on its stability by determining antioxidant enzymatic activities, lysozyme content, and protein degradation. Antioxidant enzymatic activities were spectrophotometrically determined by superoxide dismutase, catalase, xanthine oxidase, and glutathione peroxidase assays; lysozyme was identified and quantified by HPLC-UV analysis, and protein degradation was investigated by spectrophotometric analysis of advanced oxidation protein products (AOPP) and dityrosine content. In this study, contaminated milk samples showed a significant reduction in activity of all studied enzymes compared with control milk. The contamination of milk also led to a significant reduction in the lysozyme content; lysozyme content was decreased about 22% and 18% in Pb milk and Cd milk, respectively, compared with control milk. The presence of the contaminants in the milk resulted in a significant increase of both dityrosine concentration and AOPP compared with the control milk. Moreover, between types of contaminated milk, dityrosine and AOPP values were significantly higher in the Pb milk than in the Cd milk. Therefore, it is important to monitor the presence of these toxic elements in milk for the damage they cause to consumer health both directly due to their ingestion and indirectly due to loss of milk stability.

4.
Clin Microbiol Infect ; 23(10): 774.e1-774.e7, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28336384

RESUMEN

OBJECTIVE: Our objective was to identify clinical predictors of antibiotic treatment effects in hospitalized patients with community-acquired pneumonia (CAP) who were not in the intensive care unit (ICU). METHODS: Post-hoc analysis of three prospective cohorts (from the Netherlands and Spain) of adult patients with CAP admitted to a non-ICU ward having received either ß-lactam monotherapy, ß-lactam + macrolide, or a fluoroquinolone-based therapy as empirical antibiotic treatment. We evaluated candidate clinical predictors of treatment effects in multiple mixed-effects models by including interactions of the predictors with empirical antibiotic choice and using 30-day mortality, ICU admission and length of hospital stay as outcomes. RESULTS: Among 8562 patients, empirical treatment was ß-lactam in 4399 (51.4%), fluoroquinolone in 3373 (39.4%), and ß-lactam + macrolide in 790 (9.2%). Older age (interaction OR 1.67, 95% CI 1.23-2.29, p 0.034) and current smoking (interaction OR 2.36, 95% CI 1.34-4.17, p 0.046) were associated with lower effectiveness of fluoroquinolone on 30-day mortality. Older age was also associated with lower effectiveness of ß-lactam + macrolide on length of hospital stay (interaction effect ratio 1.14, 95% CI 1.06-1.22, p 0.008). CONCLUSIONS: Older age and smoking could influence the response to specific antibiotic regimens. The effect modification of age and smoking should be considered hypothesis generating to be evaluated in future trials.


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/patología , Técnicas de Apoyo para la Decisión , Hospitalización , Neumonía Bacteriana/tratamiento farmacológico , Neumonía Bacteriana/patología , Factores de Edad , Anciano , Anciano de 80 o más Años , Infecciones Comunitarias Adquiridas/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Neumonía Bacteriana/mortalidad , Pronóstico , Estudios Prospectivos , Fumar , España , Análisis de Supervivencia , Resultado del Tratamiento
5.
Clin Microbiol Infect ; 23(9): 653-658, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28267637

RESUMEN

OBJECTIVES: Concerns have arisen regarding the equivalence of levofloxacin and some macrolides for treating community-acquired legionella pneumonia (LP). We aimed to compare the outcomes of current patients with LP treated with levofloxacin, azithromycin and clarithromycin. METHODS: Observational retrospective multicentre study of consecutive patients with LP requiring hospitalization (2000-2014) conducted in two hospitals. The primary outcome assessed was 30-day mortality. To control for confounding, therapy was assessed by multivariate analysis. RESULTS: We documented 446 patients with LP, of which 175 were treated with levofloxacin, 177 with azithromycin and 58 with clarithromycin. No significant differences in time to defervescence (2 (interquartile range (IQR) 1-4) versus 2 (IQR 1-3) days; p 0.453), time to achieve clinical stability (3 (2-5) versus 3 (2-5) days; p 0.486), length of intravenous therapy (3 (2-5.25) versus 4 (3-6) days; p 0.058) and length of hospital stay (7 (5-10) versus 6 (5-9) days; p 0.088) were found between patients treated with levofloxacin and those treated with azithromycin. Patients treated with clarithromycin had longer intravenous antibiotic treatment (3 (2-5.25) versus 5 (3-6.25) days; p 0.002) and longer hospital stay (7 (5-10) versus 9 (7-14) days; p 0.043) compared with those treated with levofloxacin. The overall mortality was 4.3% (19 patients). Neither univariate nor multivariate analysis showed a significant association of levofloxacin versus azithromycin on mortality (4 (2.3%) versus 9 (5.1%) deaths; p 0.164). The results did not change after incorporation of the propensity score into the models. CONCLUSIONS: In our study, no significant differences in most outcomes were found between patients treated with levofloxacin and those treated with azithromycin. Due to the small number of deaths, results regarding mortality should be interpreted with caution.


Asunto(s)
Antibacterianos/uso terapéutico , Azitromicina/uso terapéutico , Enfermedad de los Legionarios/tratamiento farmacológico , Enfermedad de los Legionarios/epidemiología , Levofloxacino/uso terapéutico , Anciano , Antibacterianos/administración & dosificación , Azitromicina/administración & dosificación , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Levofloxacino/administración & dosificación , Masculino , Persona de Mediana Edad , Puntaje de Propensión , Estudios Retrospectivos , España/epidemiología , Resultado del Tratamiento
6.
Clin Microbiol Infect ; 22(6): 567.e1-7, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27021421

RESUMEN

Little information is available on the changes over time in community-acquired pneumonia (CAP) management and their impact on 30-day mortality in hospitalized patients. We performed a prospective, observational study of non-severely immunosuppressed hospitalized adults with CAP from 1995 to 2014. A total of 4558 patients were included. Thirty-day mortality decreased from 9.6% in the first study period (1995-99) to 4.1% in the last period (2010-14); with a progressive downward trend (-0.2% death/year; p for trend = 0.003). Over time, patients were older (p 0.02), had more co-morbidities (p 0.037), more frequently presented severe illness according to the Pneumonia Severity Index (p <0.001) and septic shock (p <0.001), and more often required intensive care unit admission (p <0.001). Combination antibiotic therapy (p <0.001) and fluoroquinolone use (p <0.001) increased. Factors independently associated with 30-day mortality were increasing age (OR 1.04; 95% CI 1.03-1.05), co-morbidities (OR 1.48; 95% CI 1.04-2.11), shock at admission (OR 4.95; 95% CI 3.49-7.00), respiratory failure (OR 1.89; 95% CI 1.42-2.52), bacteraemia (OR 2.16; 95% CI 1.58-2.96), Gram-negative bacilli aetiology (OR 4.79; 95% CI 2.52-9.10) and fluoroquinolone use (OR 0.45; 95% CI 0.29-0.71). When we adjusted for a propensity score to receive fluoroquinolones, the protective effect of fluoroquinolone use was not confirmed. In conclusion, 30-day mortality decreased significantly over time in hospitalized patients with CAP in spite of an upward trend in patient age and other factors associated with poor outcomes. Several changes in the management of CAP and a general improvement in global care over time may have caused the observed outcomes.


Asunto(s)
Infecciones Comunitarias Adquiridas/mortalidad , Neumonía/mortalidad , Anciano , Anciano de 80 o más Años , Femenino , Hospitalización , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Análisis de Supervivencia
7.
J Water Health ; 13(4): 1123-9, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26608773

RESUMEN

In the present study, molecular detection of human adenoviruses (HAdV) and enteroviruses (EV) was performed in surface water samples collected from beaches Ipanema and Lami, located on the shores of Lake Guaíba, city of Porto Alegre, RS, southern Brazil. Furthermore, water safety was evaluated by counting thermotolerant coliforms (TC), following local government regulations. A total of 36 samples were collected monthly from six different sites along the beaches. Viral genomes were found in 30 (83.3%) samples. The higher detection rate was observed for HAdV (77.8%), followed by EV (22.2%). Although low concentrations of TC have been found, the occurrence of viral genomes in water samples was frequent and may pose a potential risk of infection for people bathing in these beaches.


Asunto(s)
Adenovirus Humanos/aislamiento & purificación , Enterobacteriaceae/aislamiento & purificación , Enterovirus/aislamiento & purificación , Lagos/microbiología , Playas , Brasil , Humanos , Lagos/virología
8.
Braz J Biol ; 75(3): 541-7, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26421768

RESUMEN

The introduction of biodiesel to diesel may allow the fuel to be more susceptible to microorganism growth, especially during incorrect storage. To evaluate the effect of adding biodiesel in pure diesel on the growth of Paecilomyces variotii, microcosms containing pure diesel (B0), blend diesel/biodiesel (B7) and pure biodiesel (B100) were used. In microcosm with minimal mineral medium and B0, B7 or B100, after 60 days, the biomass (dry weight) formed at interface oil-water in B7 and B100 was significantly higher when compared to that of B0. Infrared analysis showed reduction of the carbonile fraction in B7 and B100 suggesting formation of intermediate compounds in B7. To monitor possible contamination of fuel storage tank by P. variotii samples were collected and analysed by specific-PCR assay for detection of P. variotii spores in the aqueous phase. This method was able to detect a minimum of 103 spores ml-1, corresponding to 0.0144 ng µl-1 of DNA. Specificity was tested against Aspergillus fumigatus and Pseudallescheria boydii.


Asunto(s)
Biocombustibles/microbiología , Gasolina/microbiología , Glycine max/química , Paecilomyces/crecimiento & desarrollo , Paecilomyces/efectos de los fármacos
9.
Clin Microbiol Infect ; 20(9): O531-7, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24707906

RESUMEN

Information on the influence of pre-hospital antibiotic treatment on the causative organisms, clinical features and outcomes of patients with community-acquired pneumonia (CAP) remains scarce. We performed an observational study of a prospective cohort of non-immunosuppressed adults hospitalized with CAP between 2003 and 2012. Patients were divided into two groups: those who had received pre-hospital antibiotic treatment for the same episode of CAP and those who had not. A propensity score was used to match patients. Of 2179 consecutive episodes of CAP, 376 (17.3%) occurred in patients who had received pre-hospital antibiotic treatment. After propensity score matching, Legionella pneumophila was more frequently identified in patients with pre-hospital antibiotic treatment, while Streptococcus pneumoniae was less common (p <0.001 and p <0.001, respectively). Bacteraemia was less frequent in pre-treated patients (p 0.01). The frequency of positive sputum culture and the sensitivity and specificity of the pneumococcal urinary antigen test for diagnosing pneumococcal pneumonia were similar in the two groups. Patients with pre-hospital antibiotic treatment were less likely to present fever (p 0.02) or leucocytosis (p 0.001). Conversely, chest X-ray cavitation was more frequent in these patients (p 0.04). No significant differences were found in the frequency of patients classified into high-risk Pneumonia Severity Index classes, in intensive care unit admission, or in 30-day mortality between the groups. In conclusion, L. pneumophila occurrence was nearly three times higher in patients who received pre-hospital antibiotics. After a propensity-adjusted analysis, no significant differences were found in prognosis between study groups. Pre-hospital antibiotic use should be considered when choosing aetiological diagnostic tests and empirical antibiotic therapy in patients with CAP.


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Neumonía Bacteriana/epidemiología , Neumonía Bacteriana/microbiología , Adulto , Anciano , Bacteriemia/epidemiología , Bacteriemia/microbiología , Bacteriemia/patología , Infecciones Comunitarias Adquiridas/patología , Femenino , Humanos , Legionella pneumophila/aislamiento & purificación , Masculino , Persona de Mediana Edad , Neumonía Bacteriana/patología , Pronóstico , Streptococcus pneumoniae/aislamiento & purificación , Análisis de Supervivencia
10.
J Dairy Sci ; 97(4): 1909-17, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24508437

RESUMEN

The objective of this experiment was to evaluate the effects of genetic type, stage of lactation, and ripening time on proteolysis in Caciocavallo cheese. One hundred twenty Caciocavallo cheeses made from the milk of 2 breeds, Italian Brown and Italian Holstein and characterized by different stages of lactation were obtained and ripened for 1, 30, 60, 90, and 150d. Cheese proteolysis was investigated by ripening index (ratio of water-soluble N at pH 4.6 to total protein, %) and by the study of degradation of the protein fractions (αS1-, ß-, and para-κ-casein), which was determined by densitometric analysis of isoelectric focusing results. The statistical analysis showed a significant effect of the studied factors. Ripening index was higher in Italian Brown Caciocavallo cheese and in cheeses made with early lactation milk, whereas casein solubilization was greater in the first 2mo of ripening. Isoelectric focusing analysis of cheese samples during ripening showed extensive hydrolysis of caseins. In particular, the protein fraction that underwent major degradation by proteolytic enzymes was αS1-casein, followed by ß-casein, whereas para-κ-casein was less degraded. Italian Brown cheese showed a lower residual quantity of ß- and para-κ-casein, whereas Italian Holstein cheese showed a lower residual quantity of αS1-casein. In addition, significant interactions of both first and second order were found on both ripening index and degradation of protein fractions. This study demonstrated that the analyzed factors influenced proteolysis of Caciocavallo cheese, which forms the basis of new knowledge that could lead to the production of a pasta filata cheese with specific characteristics.


Asunto(s)
Caseínas/metabolismo , Bovinos/fisiología , Queso/análisis , Animales , Bovinos/genética , Femenino , Manipulación de Alimentos , Lactancia , Proteolisis , Tiempo
11.
Ann Ig ; 25(4): 281-9, 2013.
Artículo en Italiano | MEDLINE | ID: mdl-23703302

RESUMEN

OBJECTIVE: We aimed to describe the pattern of nosocomial infections in an adult medical-surgical intensive care unit (ICU). METHODS: A 2-year prospective cohort study of nosocomial infection surveillance in a 12 - bed adult medical and surgical ICU of the Federico II University Hospital in Naples, was carried out. Data were collected between January 2009 and December 2010 using the standard surveillance protocols and nosocomial infection site definitions of the National Healthcare Safety Network's ICU surveillance component. RESULTS: Out of 768 patients hospitalized during this period, 434 with an ICU stay longer than 48 h were included in the study. Fifty-three patients acquired a total of 71 nosocomial infections; 55 (77,5%) ventilatorassociated pneumonia (VAP), 10 (14,1%), central-line-associated bloodstream infection (CLA-BSI) and 6 (8,4%) catheter-associated urinary tract infection (CA-UTI). The overall patient day rate was 12,9 patient days. The patient infection rate was 16,3 patients at risk. The mean VAP rate was 15,0/1.000 ventilator days, the CLA-BSI rate 2,9/1.000 central line days and the CA-UTI rate 1,2/1.000 catheter days. Of the nosocomial infections, 65 were Gram-negative, 6 Gram-positive and 5 fungal. The most frequent organism was Acinetobacter baumannii (61,9%), followed by Pseudomonas aeruginosa (22,5%), Enterococcus fecalis (4,2%) and Candida albicans (4,2%). The crude mortality was 35% among ICU-infected patients. CONCLUSIONS: VAP was the most common nosocomial infection in our ICU. Gram-negative organisms were more commonly reported as etiologic agents of ICU infections.


Asunto(s)
Infección Hospitalaria/epidemiología , Unidades de Cuidados Intensivos , Adulto , Estudios de Cohortes , Humanos , Estudios Prospectivos
12.
J Dairy Sci ; 96(6): 3435-41, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23548278

RESUMEN

The aim of this work was to investigate the antioxidant activity of yogurt made from the milk of 2 breeds-Italian Brown and Italian Holstein-characterized by different casein haplotypes (αS1-, ß-, and κ-caseins) during storage up to 15 d. The casein haplotype was determined by isoelectric focusing; antioxidant activity of yogurt was measured using 2,2'-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid). The statistical analysis showed a significant effect of the studied factors. Antioxidant activity increased during storage of both yogurt types, but yogurt produced with Italian Brown milk showed higher antioxidant activity than those produced with Italian Holstein milk. A high scavenging activity was present in yogurts with the allelic combination of BB-A(2)A(2)-BB. The results of this study suggest that the genetic type and the haplotype make a significant contribution in the production of yogurts with high nutraceutical value.


Asunto(s)
Antioxidantes/análisis , Caseínas/genética , Genotipo , Haplotipos , Yogur/análisis , Animales , Bovinos , Femenino , Fermentación , Manipulación de Alimentos/métodos , Conservación de Alimentos , Italia , Leche/química , Polimorfismo Genético , Yogur/microbiología
13.
Int J Immunopathol Pharmacol ; 26(1): 15-26, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23527705

RESUMEN

Congenital HCMV infection is the most frequent congenital infection, with an incidence of 0.2- 2.5 percent among all live births. About 11 percent of infected newborns show symptoms at birth, including hepato-splenomegaly, thrombocytopenia, neurologic involvement, hearing impairment and visual deficit. Moreover, 5-25 percent of the asymptomatic congenital HCMV-infected neonates will develop sequelae over months or even years. The relevant social burden, the economic costs of pre-natal screening, post-natal diagnosis, follow-up and possible therapy, although still limited, are the major factors to be considered. Several types of vaccines have been explored in order to develop an effective and safe HCMV vaccine: live attenuated, subunit, vectored, peptide, DNA, and subviral ones, but none are available for use. This review illustrates the different vaccine types studied to date, focusing on the possible vaccination strategy to be implemented once the HCMV vaccine is available, in terms of target population.


Asunto(s)
Infecciones por Citomegalovirus/prevención & control , Vacunas contra Citomegalovirus/administración & dosificación , Enfermedades del Recién Nacido/prevención & control , Animales , Humanos , Recién Nacido
14.
Clin Microbiol Infect ; 19(5): 474-9, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-22524597

RESUMEN

Recent changes in the management of patients with haematological malignancies might have influenced the aetiology, characteristics, antimicrobial resistance and outcomes of bloodstream infection (BSI) during neutropenia. We compared 272 episodes of BSI in adult neutropenic patients with cancer prospectively collected from January 1991 to December 1996 (first period), when quinolone prophylaxis was used, with 283 episodes recorded from January 2006 to March 2010 (second period), when antibacterial prophylaxis was stopped. Patients in the second period were significantly older and were more likely to have graft-versus-host disease and a urinary catheter in place, whereas the presence of a central venous catheter, parenteral nutrition, corticosteroids and antifungal and quinolone prophylaxis, were more frequent in the first period. More patients in the first period had mucositis and soft-tissue infection as the origin of BSI, but an endogenous source was more common during the second. Gram-positive BSI was more frequent in the first period (64% versus 41%; p <0.001), mainly due to coagulase-negative staphylococci and viridans group streptococci. In the second period gram-negative BSI increased (28% versus 49%; p <0.001), quinolone susceptibilities were recovered, but multidrug-resistant gram-negative BSI also increased (1% versus 6%; p <0.001). Although patients in the second period were more likely to need admission to the intensive-care unit, overall case-fatality rate was similar in the two periods (19% versus 15%). The aetiology of BSI in neutropenic patients with cancer has shifted from gram-positive to gram-negative organisms. Multidrug resistance among gram-negative bacilli is emerging as a therapeutic challenge. Overall case-fatality rate remains high.


Asunto(s)
Bacteriemia/epidemiología , Infecciones por Bacterias Gramnegativas/epidemiología , Infecciones por Bacterias Grampositivas/epidemiología , Neoplasias Hematológicas/complicaciones , Neutropenia/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/farmacología , Bacteriemia/microbiología , Bacteriemia/mortalidad , Bacteriemia/patología , Farmacorresistencia Bacteriana , Femenino , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Gramnegativas/aislamiento & purificación , Infecciones por Bacterias Gramnegativas/microbiología , Infecciones por Bacterias Gramnegativas/mortalidad , Infecciones por Bacterias Gramnegativas/patología , Bacterias Grampositivas/efectos de los fármacos , Bacterias Grampositivas/aislamiento & purificación , Infecciones por Bacterias Grampositivas/microbiología , Infecciones por Bacterias Grampositivas/mortalidad , Infecciones por Bacterias Grampositivas/patología , Neoplasias Hematológicas/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Neutropenia/inducido químicamente , Resultado del Tratamiento , Adulto Joven
15.
Ann Ig ; 24(1): 73-80, 2012.
Artículo en Italiano | MEDLINE | ID: mdl-22670339

RESUMEN

In the Region Campania (South Italy) the Hepatitis A infection reveals to be very present, despite of worldwide decreasing trend. Particularly Naples has a high incidence pathology as compared with other regional districts: the propose of this work is analysing the reasons by analysis of small but representative sample of this pathology. Health District of ASL Napoli 1 Center provides us with the notifications of this disease. The cases disease are attributable to consumption of contaminated shellfish purchased from mainly non-authorized dealers present on all city territory. A properly educational, of the population, increased repression control of dealers, careful monitoring of illegal dumping, can reduce the incidence of EVA in city live Naples.


Asunto(s)
Virus de la Hepatitis A , Hepatitis A/epidemiología , Hepatitis A/prevención & control , Adolescente , Adulto , Algoritmos , Niño , Preescolar , Femenino , Hepatitis A/transmisión , Virus de la Hepatitis A/aislamiento & purificación , Humanos , Incidencia , Lactante , Recién Nacido , Italia/epidemiología , Masculino , Vigilancia de la Población , Factores de Riesgo , Mariscos
16.
Clin Microbiol Infect ; 18(11): 1149-55, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22115052

RESUMEN

The effects of antibiotic timing on outcomes of patients with community-acquired pneumonia (CAP) are controversial. Moreover, no information is available regarding this issue in healthcare-associated pneumonia (HCAP). We aimed to determine the impact of antibiotic timing on 30-day mortality of patients with CAP and HCAP. Non-immunocompromised adults admitted to hospital through the emergency department (ED) with community-onset pneumonia were prospectively observed from 2001 to 2009. Patients who received prior antibiotics were excluded. Of 1593 patients with pneumonia who were analyzed, 1274 had CAP and 319 HCAP. The mean time from patient arrival at the ED until antibiotic administration was 5.8 h (standard deviation (SD) 3.5) in CAP and 6.1 h (SD 3.8) in HCAP (p 0.30). Mortality was higher in patients with HCAP (5.5% vs. 13.5%; p <0.001). After adjusting for confounding factors in a logistic regression analysis, the antibiotic administration ≤4 h was not associated with decreased 30-day mortality in patients with CAP (odds ratio (OR) 1.12, 95% confidence interval (CI) 0.57-2.21) and in patients with HCAP (OR 0.59, 95% CI 0.19-1.83). Similarly, antibiotic administration ≤8 h was not associated with decreased 30-day mortality in CAP (OR 1.58, 95% CI 0.64-3.88) and HCAP patients (OR 0.59, 95% CI 0.19-1.83). In conclusion, antibiotic administration within 4 or 8 h of arrival at the ED did not improve 30-day survival in hospitalized adults for CAP or HCAP.


Asunto(s)
Antibacterianos/administración & dosificación , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infección Hospitalaria/tratamiento farmacológico , Neumonía Bacteriana/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/mortalidad , Infección Hospitalaria/mortalidad , Humanos , Neumonía Bacteriana/mortalidad , Análisis de Supervivencia , Factores de Tiempo , Resultado del Tratamiento
17.
Neuropsychobiology ; 64(2): 61-85, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21701225

RESUMEN

BACKGROUND AND AIM: Obsessive-compulsive disorder (OCD) is a severe, highly prevalent and chronically disabling psychiatric disorder that usually emerges during childhood or adolescence. This paper aims to review the literature on functional neuroimaging in OCD, analysing the reported dysfunctional connectivity in the corticostriatothalamocortical circuitry. METHOD: This study included papers published in peer-reviewed journals dealing with functional imaging in OCD. RESULTS: Striatal dysfunction, mainly of the caudate nucleus, leads to inefficient thalamic gating, resulting in hyperactivity within the orbitofrontal cortex (intrusive thoughts) and the anterior cingulate cortex (non-specific anxiety). Compulsions consist of ritualistic behaviours performed to recruit the inefficient striatum and neutralise unwanted thoughts and anxiety. Functional neuroimaging findings are discussed against the background of specific cognitive impairments, mainly regarding visuospatial processing, executive functioning and motor speed. Cognitive deficits are partial and specific, matching imaging data. CONCLUSIONS: Several studies have targeted brain regions hypothesised to be involved in the pathogenesis of OCD, showing the existence of dysfunctional connectivity in the corticostriatothalamocortical circuitry. Improvements in spatial resolution of neuroimaging techniques may contribute to a better understanding of the neurocircuitry of OCD and other anxiety disorders.


Asunto(s)
Encéfalo , Diagnóstico por Imagen , Trastorno Obsesivo Compulsivo/diagnóstico , Encéfalo/diagnóstico por imagen , Encéfalo/metabolismo , Encéfalo/patología , Bases de Datos Factuales/estadística & datos numéricos , Humanos , Trastorno Obsesivo Compulsivo/epidemiología , Cintigrafía
18.
G Ital Med Lav Ergon ; 33(3 Suppl): 238-40, 2011.
Artículo en Italiano | MEDLINE | ID: mdl-23393845

RESUMEN

The aim of this study is to assess and reduce the risk due to manual material handling in a company involved in the foodstuff retailing. The risk assessment was performed by NIOSH Variable Lifing Index in 13 different occupational conditions. As result the risk was present in any case, with VLI values ranging from 2.12 to 2.81. A good risk reduction has been accomplished correcting properly the most important multiplier involved in the computation of the revised NIOSH Lifting equation (lifting frequency and weight of heavier products). Even if the performed risk reduction has been significant, the residual risk is still higher than the level of acceptability.


Asunto(s)
Ergonomía , Industria de Alimentos , Elevación , Humanos , Medición de Riesgo
19.
Geobiology ; 8(5): 372-90, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20698893

RESUMEN

Pillow lava rims and interpillow hyaloclastites from the upper part of the Pechenga Greenstone Belt, Kola Peninsula, N-Russia contain rare tubular textures 15-20 µm in diameter and up to several hundred µm long in prehnite-pumpellyite to lower greenschist facies meta-volcanic glass. The textures are septate with regular compartments 5-20 µm across and exhibit branching, stopping and no intersecting features. Synchrotron micro-energy dispersive X-ray was used to image elemental distributions; scanning transmission X-ray microscopy, Fe L-edge and C K-edge were used to identify iron and carbon speciation at interfaces between the tubular textures and the host rock. In situ U-Pb radiometric dating by LA-MC-ICP-MS (laser ablation multicollector inductively coupled plasma mass spectrometry) of titanite from pillow lavas yielded a metamorphic age of 1790 ± 89 Ma. Focused ion-beam milling combined with transmission electron microscopy was used to analyze the textures in three dimensions. Electron diffraction showed that the textures are mineralized by orientated pumpellyite. On the margins of the tubes, an interface between mica or chlorite and the pumpellyite shows evidence of dissolution reactions where the pumpellyite is replaced by mica/chlorite. A thin poorly crystalline Fe-phase, probably precipitated out of solution, occurs at the interface between pumpellyite and mica/chlorite. This sequence of phases leads to the hypothesis that the tubes were initially hollow, compartmentalized structures in volcanic glass that were mineralized by pumpellyite during low-grade metamorphism. Later, a Fe-bearing fluid mineralized the compartments between the pumpellyite and lastly the pumpellyite was partially dissolved and replaced by chlorite during greenschist metamorphism. The most plausible origin for a septate-tubular texture is a progressive etching of the host matrix by several generations of microbes and subsequently these tubes were filled by authigenic mineral precipitates. This preserves the textures in the rock record over geological time. The micro textures reported here thus represent a pumpellyite-mineralized trace fossil that records a Paleoproterozoic sub-seafloor biosphere.


Asunto(s)
Fósiles , Sedimentos Geológicos/análisis , Paleontología , Erupciones Volcánicas/análisis , Silicatos de Aluminio/química , Animales , Cloruros/química , Compuestos Férricos/química , Geología , Microscopía/instrumentación , Microscopía/métodos , Microscopía Electrónica de Rastreo , Minerales , Datación Radiométrica , Federación de Rusia , Espectrometría por Rayos X , Análisis Espectral
20.
Cell Mol Life Sci ; 66(3): 423-36, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19011758

RESUMEN

The assembly of the protein synthesis machinery occurs during translation initiation. In bacteria, this process involves the binding of messenger RNA(mRNA) start site and fMet-tRNA(fMet) to the ribosome, which results in the formation of the first codon-anticodon interaction and sets the reading frame for the decoding of the mRNA. This interaction takes place in the peptidyl site of the 30S ribosomal subunit and is controlled by the initiation factors IF1, IF2 and IF3 to form the 30S initiation complex. The binding of the 50S subunit and the ejection of the IFs mark the irreversible transition to the elongation phase. Visualization of these ligands on the ribosome has been achieved by cryo-electron microscopy and X-ray crystallography studies, which has helped to understand the mechanism of translation initiation at the molecular level. Conformational changes associated with different functional states provide a dynamic view of the initiation process and of its regulation.


Asunto(s)
Bacterias/genética , Iniciación de la Cadena Peptídica Traduccional , Biosíntesis de Proteínas , Bacterias/metabolismo , Modelos Moleculares , Complejos Multiproteicos/metabolismo , Complejos Multiproteicos/ultraestructura , Conformación de Ácido Nucleico , Factores de Iniciación de Péptidos/química , Factores de Iniciación de Péptidos/genética , Factores de Iniciación de Péptidos/metabolismo , Conformación Proteica , ARN Mensajero/química , ARN Mensajero/genética , ARN Mensajero/metabolismo , ARN de Transferencia de Metionina/química , Subunidades Ribosómicas Pequeñas Bacterianas/química , Subunidades Ribosómicas Pequeñas Bacterianas/genética , Subunidades Ribosómicas Pequeñas Bacterianas/metabolismo
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