Influence of kaolin and red clay on ceramic specimen properties when galvanic sludge is incorporated to encapsulate heavy metals.

This study presented the influence of two types of clay: kaolin (Kao) and red clay (RC) on the chemical and physical properties of ceramic specimens when galvanic sludge (GS) is incorporated to encapsulate heavy metals. Samples were obtained of GS from the industrial district of Manaus - Amazonas State, Brazil, and kaolin (Kao), and red clay (RC) from the Central Amazon. A fourth sample was prepared by mixing GS, Kao, and RC in the ratio 1:1:8 (GS + Kao + RC). This mixture was ground, and ceramic specimens were prepared, and heat treated at 950 °C and 1200 °C for three hours for phase detection, compressive strength, leaching of Fe, Ni and Cr metals and life cycle assessment. Galvanic sludge, Kao, and RC were also, and heat treated to at 950 °C and 1200 °C for three hours, obtaining GS950, GS1200, Kao950, Kao1200, RC950, and RC1200. The samples were submitted to XRF, XRD, Rietveld refinement, Mössbauer spectroscopy, TG/DTG/DSC, and SEM. The results show that the formation of nickel oxide and a spinel solid solution of the type Fe3+{Fe1-y3+,Fe1-x2+,Nix2+,Cry3+}O4 (in which [] = tetrahedral site, {} octahedral site) occurs in GS1200, which is caused by sulfate decomposition to SO2. At 1200 °C, heavy metals are encapsulated, forming other phases such as nickel silicate and hematite. Life cycle assessment was used to verify the sustainability and value of GS in clay for making bricks, and it indicated that the production of ceramics is feasible, reduces the use of clays, and is sustainable.

Adverse drug events related to extemporaneous compounding medicines / Eventos adversos a medicamentos relacionados a adequações posológicas

In the present study, we investigated the causality between adverse drug events and extemporaneous compounding from spontaneous reports generated by a healthy team in a medium-complexity public hospital in São Paulo state, Brazil. An observational cross-sectional study was conducted between August/2017 to July/2018. All adverse drug events spontaneous reports, which mentioned extemporaneous compounding, were evaluated. The selected variables were patient’s clinical history, pharmacotherapy, adverse drug reactions, medication error and type of extemporaneous compounding. Causality assessment between the adverse drug reaction and extemporaneous compounding was performed by World Health Organization – Uppsala Monitoring Center algorithm and medication error analysis was performed by the National Council for Coordination of Reporting and Prevention of Medication Errors algorithm. 3,211 spontaneous reports were evaluated. Only 144 (4.5%) reports mentioned extemporaneous compounding, being 110 eligible for analysis. The causality assessment showed that in 27 (24%) reports the adverse drug reaction and medication error identified were possibly related to extemporaneous compounding, with an underreporting index of 0.87. From these 27 reports, 3 adverse drug reactions were classified as “probable” and 23 as “possible” whereas 4 medication error were classified as “error, harm: category E”. Although extemporaneous compounding is a common practice in hospitals, only a small portion of the reports included it. Future studies may investigate the use of extemporaneous compounding as a trigger tool for adverse drug reactions since this study shows that one out of four reports that mentioned it leads to patient harm. (AU)

No presente estudo, foi investigada a causalidade entre eventos adversos a medicamentos (EAM) e adequações posológicas (AP) a partir de notificações espontâneas geradas pela equipe de saúde de um hospital público de média complexidade no estado de São Paulo, Brasil. Foi conduzido um estudo observacional transversal entre agosto/ 2017 a julho/ 2018. Todas as notificações de EAM, que mencionavam AP, foram avaliadas. As variáveis selecionadas foram história clínica do paciente, farmacoterapia, reações adversas a medicamentos, erro de medicação e a técnica de manipulação extemporânea. A avaliação da causalidade entre a EAM e a AP foi realizada pelo algoritmo da Organização Mundial da Saúde – Centro de Monitoramento de Uppsala e a análise do erro de medicação foi realizada pelo algoritmo do Conselho Nacional para Coordenação de Notificação e Prevenção de Erros de Medicação. Foram avaliadas 3.211 notificações espontâneas. Apenas 144 (4,5%) notificações mencionaram AP, sendo 110 elegíveis para análise. A avaliação de causalidade mostrou que em 27 (24%) notificações, a reação adversa ao medicamento e o erro de medicação identificados estavam possivelmente relacionados à AP, com um índice de subnotificação de 0,87. Destas 27 notificações, 03 reações adversas a medicamentos foram classificadas como “prováveis” e 23 como “possíveis”, e 04 erros de medicação, classificados “erro com dano: categoria E”. Embora as AP seja uma prática comum em hospitais, são escassas as notificações que as descrevem. Estudos futuros podem investigar o uso de AP como uma ferramenta para rastrear EAM, porque observamos que um em cada quatro notificações com relato de AP estava relacionado a EAM. (AU)

Carriage of multidrug-resistant Gram-negative bacilli: duration and risk factors.

Identification of risk factors influencing the duration of carriage of multidrug-resistant Gram-negative bacilli (MDR-GNB) may be useful for infection control. The aim of this study is to estimate the impact of several factors collected for routine hospital surveillance on the duration of carriage of selected MDR-GNB. From January 2015 to July 2021, patients with at least two clinical/surveillance samples positive for MDR-GNB different from ESBL-producing E. coli or AmpC - exclusively producing Enterobacterales were assessed. Microorganisms, age, number of admissions, clinical or rectal sample, sex, and admission service were evaluated as risk factors. Multivariate analysis was performed by a Cox proportional hazard model. A total of 1981 episodes of colonization were included. Involved microorganisms were ESBL-Klebsiella pneumoniae (KP) in 1057 cases (53.4%), other ESBL-non-E. coli Enterobacterales in 91 (4.6%), OXA-48-KP in 263 (13.3%), KPC-KP in 90 (4.5%), VIM-KP in 29 (1.5%), carbapenemase-producing non-KP Enterobacterales (CP-non-KP) in 124 (6.3%), and MDR Pseudomonas aeruginosa (MDR-PAER) in 327 (16.5%). No differences in duration of colonization were observed among ESBL-KP (median colonization time 320 days), ESBL-non-E. coli Enterobacterales (226 days), OXA48-KP (305 days), and MDR-PAER (321 days). For each group, duration of colonization was significantly longer than that of KPC-KP (median colonization time 60 days), VIM-KP (138 days), and CP-non-KP (71 days). Male sex (HR = 0.88; 95% CI 0.78-0.99), detection in Hepatology-Gastroenterology (HR = 0.71; 95% CI 0.54-0.93), clinical sample (HR = 0.61; 95% CI 0.53-0.69), and > 2 admissions after first detection (HR = 0.47; 95% CI 0.42-0.52) were independent predictors of longer carriage, whereas VIM-KP (HR = 1.61; 95% CI 1.04-2.48), KPC-KP (HR = 1.85; 95% CI 1.49-2.3), and CP-non-KP (HR = 1.92; 95% CI 1.49-2.47) were associated with shorter colonization time. Duration of colonization was significantly longer for ESBL-KP, other ESBL-non-E. coli Enterobacterales, OXA-48-KP, and MDR-PAER. For these microorganisms, prolonging surveillance up to 2.5-3 years should be considered. Male sex, clinical sample, multiple readmissions, admission service, and type of microorganism are independent predictors of the duration of carriage.

A short review on the features of the non-obese diabetic Goto-Kakizaki rat intestine.

The Goto-Kakizaki (GK) rat is a non-obese experimental model of type 2 diabetes mellitus (T2DM) that allows researchers to monitor diabetes-induced changes without jeopardizing the effects of obesity. This rat strain exhibits notable gastrointestinal features associated with T2DM, such as marked alterations in intestinal morphology, reduced intestinal motility, slow transit, and modified microbiota compared to Wistar rats. The primary treatments for diabetic patients include administration of hypoglycemic agents and insulin, and lifestyle changes. Emerging procedures, including alternative therapies, metabolic surgeries, and modulation of the intestinal microbiota composition, have been shown to improve the diabetic state of GK rats. This review describes the morpho-physiological diabetic-associated features of the gastrointestinal tract (GIT) of GK rats. We also describe promising strategies, e.g., metabolic surgery and modulation of gut microbiota composition, used to target the GIT of this animal model to improve the diabetic state.

Decreased mortality among patients with catheter-related bloodstream infections at Catalan hospitals (2010-2019).

BACKGROUND: The incidence of catheter-related bloodstream infections (CRBSIs) has fallen over the last decade, especially in intensive care units (ICUs). AIM: To assess the existence of concomitant trends in outcomes and to analyse the current risk factors for mortality. METHODS: A multicentre retrospective cohort study was conducted at 24 Catalan hospitals participating in the Surveillance of healthcare-associated infections in Catalonia (VINCat). All hospital-acquired CRBSI episodes diagnosed from January 2010 to December 2019 were included. A common protocol including epidemiological, clinical, and microbiological data was prospectively completed. Mortality at 30 days after bacteraemia onset was analysed using the Cox regression model. FINDINGS: Over the study period, 4795 episodes of CRBSI were diagnosed. Among them, 75% were acquired in conventional wards and central venous catheters were the most frequently involved (61%). The 30-day mortality rate was 13.8%, presenting a significant downward trend over the study period: from 17.9% in 2010 to 10.6% in 2019 (hazard ratio (HR): 0.95; 95% confidence interval (CI): 0.92-0.98). The multivariate analysis identified age (HR: 1.03; 95% CI: 1.02-1.04), femoral catheter (1.78; 1.33-2.38), medical ward acquisition (2.07; 1.62-2.65), ICU acquisition (3.45; 2.7-4.41), S. aureus (1.59; 1.27-1.99) and Candida sp. (2.19; 1.64-2.94) as risk factors for mortality, whereas the mortality rate associated with episodes originating in peripheral catheters was significantly lower (0.69; 0.54-0.88). CONCLUSION: Mortality associated with CRBSI has fallen in recent years but remains high. Intervention programmes should focus especially on ICUs and medical wards, where incidence and mortality rates are highest.

A short review on the features of the non-obese diabetic Goto-Kakizaki rat intestine

The Goto-Kakizaki (GK) rat is a non-obese experimental model of type 2 diabetes mellitus (T2DM) that allows researchers to monitor diabetes-induced changes without jeopardizing the effects of obesity. This rat strain exhibits notable gastrointestinal features associated with T2DM, such as marked alterations in intestinal morphology, reduced intestinal motility, slow transit, and modified microbiota compared to Wistar rats. The primary treatments for diabetic patients include administration of hypoglycemic agents and insulin, and lifestyle changes. Emerging procedures, including alternative therapies, metabolic surgeries, and modulation of the intestinal microbiota composition, have been shown to improve the diabetic state of GK rats. This review describes the morpho-physiological diabetic-associated features of the gastrointestinal tract (GIT) of GK rats. We also describe promising strategies, e.g., metabolic surgery and modulation of gut microbiota composition, used to target the GIT of this animal model to improve the diabetic state.

A short review on the features of the non-obese diabetic Goto-Kakizaki rat intestine

The Goto-Kakizaki (GK) rat is a non-obese experimental model of type 2 diabetes mellitus (T2DM) that allows researchers to monitor diabetes-induced changes without jeopardizing the effects of obesity. This rat strain exhibits notable gastrointestinal features associated with T2DM, such as marked alterations in intestinal morphology, reduced intestinal motility, slow transit, and modified microbiota compared to Wistar rats. The primary treatments for diabetic patients include administration of hypoglycemic agents and insulin, and lifestyle changes. Emerging procedures, including alternative therapies, metabolic surgeries, and modulation of the intestinal microbiota composition, have been shown to improve the diabetic state of GK rats. This review describes the morpho-physiological diabetic-associated features of the gastrointestinal tract (GIT) of GK rats. We also describe promising strategies, e.g., metabolic surgery and modulation of gut microbiota composition, used to target the GIT of this animal model to improve the diabetic state.

Tipos de carbapenemasas expresadas en Klebsiella spp, y Pseudomonas aeruginosa resistente a carbapenémicos en seis hospitales de alta complejidad de la Ciudad de Bogotá - Colombia / Carbapenemases produced in Klebsiella spp, and Pseudomonas aeruginosa in six hospitals in Bogotá - Colombia

INTRODUCCIÓN: En las últimas décadas, se ha incrementado la prevalencia de infecciones por bacilos gramnegativos resistentes a carbapenémicos. OBJETIVO: Determinar los tipos y la frecuencia de las distintas carbapenemasas en aislados de Klebsiella spp. y Pseudomonas aeruginosa, en seis hospitales de alta complejidad de Bogotá-Colombia. MÉTODOS: Estudio observacional descriptivo en seis hospitales de la ciudad de Bogotá, en el período de enero de 2017 a agosto de 2018. Se realizaron RPC para genes de KPC, GES, VIM, NDM, IMP y OXA-48 en cepas de Klebsiella spp y P aeruginosa resistentes a carbapenémicos. RESULTADOS: 52 aislados de P aeruginosa amplificaron para una carbapenemasa, de los cuales 39 (75%) fueron positivos para KPC, 11 (21%) para VIM y 2 co-producciones de KPC y VIM. En cuanto a Klebsiella spp., 165 cepas amplificaron al menos para una carbapenemasa, 98% expresaron KPC y 4 aislados tuvieron co-producciones de metalo-beta-lactamasas y KPC. DISCUSIÓN: Este estudio aporta información valiosa, como el incremento de producción de KPC en P. aeruginosa y la co-producción de KPC y metalo-beta-lactamasas, locual tiene una implicancia tanto en la selección del tratamiento, las medidas de aislamiento de contacto y el pronóstico de los pacientes.

BACKGROUND: In the last decades, the prevalence of infections by carbapenem resistant gram-negative bacilli has been increased. OBJECTIVE: To determine types and frequency of the different carbapenemases in Klebsiella spp. and Pseudomonas aeruginosa, in six hospitals in Bogotá-Colombia. METHODS: Descriptive and observational study, in six hospitals in the city of Bogotá, in the period ftom January 2017 to August 2018. PCR were performed for KPC, GES, VIM, NDM, IMP and OXA-48 genes, in carbapenem resistant Klebsiella spp. and P aeruginosa. RESULTS: 52 P aeruginosa isolates amplified a carbapenemase gene, of which 39 (75%) were positive for KPC, 11 (21%) for VIM and two co-productions of KPC and VIM. Regarding Klebsiella spp. 165 strains amplified at least one carbapenemase gene, 98% expressed KPC and four isolates had co-productions of metallo-P-lactamases and KPC. DISCUSSION: This study provides valuable information, such as the increased production of KPC in P. aeruginosa información valiosa, como el incremento de producción de KPC en P. aeruginosa and the co-production of KPC plus metallobetalactamases, which has an implication both in treatment selection, isolation precautions and patient prognosisy.

[Carbapenemases produced in Klebsiella spp., and Pseudomonas aeruginosa in six hospitals in Bogotá - Colombia]. / Tipos de carbapenemasas expresadas en Klebsiella spp., y Pseudomonas aeruginosa resistente a carbapenémicos en seis hospitales de alta complejidad de la Ciudad de Bogotá - Colombia.

BACKGROUND: In the last decades, the prevalence of infections by carbapenem resistant gram-negative bacilli has been increased. OBJECTIVE: To determine types and frequency of the different carbapenemases in Klebsiella spp. and Pseudomonas aeruginosa, in six hospitals in Bogotá-Colombia. METHODS: Descriptive and observational study, in six hospitals in the city of Bogotá, in the period ftom January 2017 to August 2018. PCR were performed for KPC, GES, VIM, NDM, IMP and OXA-48 genes, in carbapenem resistant Klebsiella spp. and P aeruginosa. RESULTS: 52 P aeruginosa isolates amplified a carbapenemase gene, of which 39 (75%) were positive for KPC, 11 (21%) for VIM and two co-productions of KPC and VIM. Regarding Klebsiella spp. 165 strains amplified at least one carbapenemase gene, 98% expressed KPC and four isolates had co-productions of metallo-P-lactamases and KPC. DISCUSSION: This study provides valuable information, such as the increased production of KPC in P. aeruginosa información valiosa, como el incremento de producción de KPC en P. aeruginosa and the co-production of KPC plus metallobetalactamases, which has an implication both in treatment selection, isolation precautions and patient prognosisy.

Eficacia de las técnicas de energía muscular en síndromes dolorosos musculoesqueléticos: una revisión sistemática / Efficacy of muscular energy techniques in musculoskeletal pain syndromes: a systematic review

OBJETIVOS: Evaluar la eficacia de las técnicas de energía muscular en el tratamiento de síndromes musculoesqueléticos. ESTRATEGIA DE BÚSQUEDA: Se realizó una búsqueda bibliográfica de artículos publicados hasta noviembre de 2018 en las siguientes bases de datos: Medline (PubMed), Scopus, Web of Science, Cochrane Library y Science Direct. SELECCIÓN DE ESTUDIOS: Se seleccionaron 13 artículos con más de 6 puntos en la escala PEDro. RESULTADOS: Se seleccionaron 13 artículos con una muestra total de 694 sujetos y una media de 7,85 sobre 10 en la escala PEDro. Todos los estudios señalan que las técnicas de energía muscular disminuyen el dolor, aumentan los rangos articulares y también la funcionalidad. Se observaron diferencias significativas al comparar estas técnicas con otras intervenciones, como el concepto Mulligan, inyecciones de corticoesteroides intramusculares o tratamientos pasivos. Aplicar las técnicas de energía muscular junto con la punción seca o el método McKenzie ha demostrado ser más eficaz que su empleo de forma individual. CONCLUSIONES: Las técnicas de energía muscular muestran resultados positivos en la disminución del dolor, el aumento del rango articular y la funcionalidad en pacientes con síndromes musculoesqueléticos

OBJECTIVES: To assess the efficacy of muscle energy techniques in the treatment of musculoskeletal syndromes. SEARCH STRATEGY: A literature search was made for articles published up to November 2018 in the following databases: Medline (PubMed), Scopus, Web of Science, Cochrane Library, and Science Direct. STUDY SELECTION: A total of 13 articles with more than 6 points on the PEDro scale were selected RESULTS: The 13 articles selected had a total sample of 694 subjects, and a mean of 7.85 out of 10 on the PEDro scale. All studies indicated that muscle energy techniques decrease pain and increase ranges of motion, as well as motor function. Significant differences were observed when comparing these techniques with others interventions such as the Mulligan concept, intramuscular corticosteroid injections, or passive treatments. Applying muscle energy techniques in conjunction with dry needling or the McKenzie method has been shown to be more effective than using them individually. CONCLUSIONS: Muscle energy techniques show positive results in pain reduction, increased joint range, and functionality in patients with musculoskeletal síndromes

Pathological profiles of systemic infections by Panton-Valentine leukocidin-positive, methicillin-resistant Staphylococcus aureus strains in a murine model.

AIMS: Staphylococcus aureus is one of the most common pathogens in hospital environment and community. Panton-Valentine leukocidin (PVL) production is clinically associated with skin abscesses, soft tissues infections, bacteraemia and sepsis. This study aimed to investigate the effects of the presence of genes lukF/S-PV coding for PVL, in histological and haematological features during systemic infection, using a Swiss mice experimental model. METHODS AND RESULTS: Experiments were performed using 25 mice distributed into five experimental groups, intravenously inoculated with 50 µl suspensions at density 1·0 × 107  CFU per ml of strains: methicillin-susceptible (MSSA) and pvl-negative strains isolated from nasal colonization; MSSA pvl-positive strains isolated from nasal colonization; methicillin-resistant (MRSA) and pvl-positive strains isolated from peripheral blood of a patient with severe pulmonary infection; and a MRSA pvl-positive strains isolated from a peripheral blood culture of a patient with bacteraemia. Haematological analysis was performed at 24, 48, 72 and 96 h post-infection. Morphoanatomy and histopathological analyses were performed at 96 h post-infection. For all S. aureus strains tested, the capability of intravenous dissemination and survival into mice tissues was demonstrated. Inflammatory processes at different levels were related to the presence of pvl genes, and included alterations in the format, size and colour of the organs. Staphylococcus aureus pvl-positive strains were detected in greater numbers in the organs of the infected animals. CONCLUSIONS: The pvl-positive strains isolated from blood cultures were capable to induce the greatest modifications in both haematological and histopathological profiles, and seemed to aggravate the systemic infections. SIGNIFICANCE AND IMPACT OF THE STUDY: These findings are valuable in characterizing infections caused by S. aureus in humans and murine.

Optical and electrical properties of MoO2 and MoO3 thin films prepared from the chemically driven isothermal close space vapor transport technique.

Chemically-driven isothermal close space vapour transport was used to prepare pure MoO2 thin films which were eventually converted to MoO3 by annealing in air. According to temperature-dependent Raman measurements, the MoO2/MoO3 phase transformation was found to occur in the 225 °C-350 °C range while no other phases were detected during the transition. A clear change in composition as well as noticeable modifications of the band gap and the absorption coefficient confirmed the conversion from MoO2 to MoO3. An extensive characterization of these two pure phases was carried out. In particular, a procedure was developed to determine the dispersion relation of the refractive index of MoO2 from the shift of the interference fringes of the used SiO2/Si substrate. The obtained data of the refractive index was corrected taking into account the porosity of the samples calculated from elastic backscattering spectrometry. The Debye temperature and the residual resistivity were extracted from the electrical resistivity temperature dependence using the Bloch-Grüneisen equation. MoO3 converted samples presented a very high resistivity and a typical semiconducting behavior. They also showed intense and broad luminescence spectra composed by several contributions whose temperature behavior was examined. Furthermore, surface photovoltage spectra were taken and their relation with the photoluminescence is discussed.

Identification and mapping of real acupoints in the anatomical topography of Boa constrictor / Identificação e mapeamento de acupontos reais na topografia anatômica de Boa constrictor

Abstract Acupuncture is a therapy of the traditional Chinese medicine technique, which over the years has been widespread in the West. Defined as a needle-point treatment technique (acupoints), exactly preconfigured in the body to produce a specific physiological reaction to restore the balance between the function of conflicting states and homeostasis, alternating states of energy and thus maintain the ideal organ and body organization. Thus, the objective of this study was to map and describe the main points of acupuncture in the species Boa constrictor , and their indications to promote the balance of this species. The unprecedented result of the mapping was the discovery of specific acupoints with individual location indications without distribution in specific meridians and dispersedly distributed in the body.

Resumo A acupuntura é uma técnica terapêutica da Medicina Tradicional Chinesa, que ao longo dos anos tem sido muito difundida no Ocidente. Definida como uma técnica de tratamento com inserção de agulhas em pontos (acupontos) exatamente pré-estabelecidos sobre o organismo, para produzir uma reação fisiológica específica com o intuito de restabelecer o equilíbrio entre estados contraditórios de função e a homeostase, alternando os estados de energia e com isto mantendo a organização do órgão e do organismo. Com isso, o objetivo do presente trabalho foi mapear e descrever os principais pontos de acupuntura nas espécies Boa constrictore suas indicações para promover o equilíbrio dessa espécie. O resultado inédito do mapeamento foi à descoberta de pontos de acupuntura específicos com indicações de localização individuais sem distribuição em meridianos específicos e dispersamente distribuídos no corpo.

Identification and mapping of real acupoints in the anatomical topography of Boa constrictor.

Acupuncture is a therapy of the traditional Chinese medicine technique, which over the years has been widespread in the West. Defined as a needle-point treatment technique (acupoints), exactly preconfigured in the body to produce a specific physiological reaction to restore the balance between the function of conflicting states and homeostasis, alternating states of energy and thus maintain the ideal organ and body organization. Thus, the objective of this study was to map and describe the main points of acupuncture in the species Boa constrictor , and their indications to promote the balance of this species. The unprecedented result of the mapping was the discovery of specific acupoints with individual location indications without distribution in specific meridians and dispersedly distributed in the body.