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1.
J Mater Sci Mater Med ; 34(8): 40, 2023 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-37515640

RESUMO

The present work studies the effect of Mn doping on the crystalline structure of the Hap synthesized by the hydrothermal method at 200 °C for 24 h, from Ca(OH)2 and (NH4)2HPO4, incorporating MnCl2 to 0.1, 0.5, 1.0, 1.5 and 2.0 %wt of Mn concentrations. Samples were characterized by the X-Ray Diffraction technique, which revealed the diffraction peaks that corresponded to the hexagonal and monoclinic phase of the Hap; it was observed that the average size of crystallite decreased from 23.67 to 22.69 nm as the concentration of Mn increased. TEM shows that in all samples, there are two distributions of particle sizes; one corresponds to nanorods with several tens of nanometers in length, and the other in which the diameter and length are very close. FTIR analysis revealed absorption bands corresponding to the PO4-3 and OH- groups characteristic of the Hap. It was possible to establish a substitution mechanism between the Mn and the ions of Ca+2 of the Hap. From the Alamar blue test, a cell viability of 86.88% ± 5 corresponding to the sample of Hap at 1.5 %wt Mn was obtained, considered non-cytotoxic according to ISO 10993-5. It also evaluated and demonstrated the good osteoinductive properties of the materials, which were verified by histology and immunofluorescence expression of osteogenic markers. Adhesion, viability, biocompatibility and osteoinductive properties, make these materials candidates for future applications in bone tissue engineering with likely uses in regenerative medicine.


Assuntos
Durapatita , Nanotubos , Durapatita/química , Osteogênese
2.
J Mater Sci Mater Med ; 33(12): 81, 2022 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-36484847

RESUMO

Bone Regeneration represents a clinical need, related to bone defects such as congenital anomalies, trauma with bone loss, and/or some pathologies such as cysts or tumors This is why a polymeric biomaterial that mimics the osteogenic composition and structure represents a high potential to face this problem. The method of obtaining these materials was first to prepare a stabilized hydrogel by means of physical bonds and then to make use of the lyophilization technique to obtain the 3D porous scaffolds with temperature conditions of -58 °C and pressure of 1 Pa for 16 h. The physicochemical and bioactive properties of the scaffolds were studied. FTIR and TGA results confirm the presence of the initial components in the 3d matrix of the scaffold. The scaffolds exhibited a morphology with pore size and interconnectivity that promote good cell viability. Together, the cell viability and proliferation test, Alamar BlueTM and the differentiation test: alizarin staining, showed the ability of physically stabilized scaffolds to proliferate and differentiate swine dental pulp stem cell (DPSCs) followed by mineralization. Therefore, the Cs-PCL-PVA-HA scaffold stabilized by physical bonds has characteristics that suggest great utility for future complementary in vitro tests and in vivo studies on bone defects. Likewise, this biomaterial was enhanced with the addition of HA, providing a scaffold with osteoconductive properties necessary for good regeneration of bone tissue. Graphical abstract.


Assuntos
Quitosana , Durapatita , Suínos , Animais , Durapatita/química , Engenharia Tecidual/métodos , Quitosana/química , Álcool de Polivinil , Alicerces Teciduais/química , Polpa Dentária , Osteogênese , Materiais Biocompatíveis/química , Diferenciação Celular , Osso e Ossos , Células-Tronco , Proliferação de Células
3.
Bioinspir Biomim ; 17(6)2022 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-36270503

RESUMO

In this study, we present a novel, bioinspired experimental apparatus, its construction, data acquisition methodology, and validation for the study of peristaltic flows. The apparatus consists of a series of stepper motor actuators, which deflect a deformable membrane to produce peristaltic flows. We show that this apparatus design has significant advantages over previous designs that have been used to study peristaltic flows by offering a much wider range of modeling capabilities. Comparisons between the capabilities of our apparatus and previous ones show our apparatus spanning a larger range of wavelengthλ, wave speedc, amplitudeA, and waveform (i.e. the apparatus is not constrained to nondispersive waves or to a sinusoidal shape). This large parameter range makes the apparatus a useful tool for biomimetic experimental modeling, particularly for systems that have complex waveforms, such as peristaltic flows in perivascular vessels, arteries, the cochlea, and the urethra. We provide details on the experimental design and construction for ease of reconstruction to the reader. The apparatus capabilities are validated for a large parameter range by comparing experimental measurements to analytic results from (Ibanezet al2021Phys. Rev. Fluids6103101) for high Reynolds number (Re > 1) and (Jaffrin and Shapiro 1971Annu. Rev. Fluid Mech.33-37) for low Reynolds number (Re < 1) applications. We show that the apparatus is useful for biophysical peristaltic studies and has potential applications in other types of studies.


Assuntos
Modelos Biológicos , Peristaltismo , Biofísica , Biomimética
4.
Cuad. psicol. deporte ; 22(2): 247-257, may. - ago. 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-209132

RESUMO

El presente trabajo persigue delimitar el desempeño técnico-táctico en combate en la iniciación al karate y mostrar las posibilidades de aplicación de la técnica de análisis de árbol de decisión en metodología observacional. El muestreo observacional ha ascendido a 887 acciones técnico-tácticas ofensivas realizadas en 40 combates por participantes de la franja de 8-9 años de edad. El instrumento de observación se ha introducido en el seno del softwarede registro y codificación, Lince. La calidad del dato ha quedado garantizada, por un lado, mediante un procedimiento de concordancia inter-observadores a partir del coeficiente Kappa de Cohen y, por otro lado, por un diseño de generalizabilidad. Se han realizado dos árboles de decisiónutilizando dos algoritmos diferentes (CHAID y CART). Los resultados obtenidos con ambos algoritmos coinciden en señalar como mejor predictor de la “zona del cuerpo a la que se dirige la técnica” a la dimensión “segmento”; pero se diferencian en el segundo mejor pronosticador: dimensión“grupo de técnica” mediante el algoritmo CHAID,y dimensión “técnica detallada” con el algoritmo CART. (AU)


This work analyze the technical-tactical performance in combat in the initiation to karate and show the possibilities of application of the decision tree analysis technique in observational methodology. The observational sampling is made up of 887 offensive technical-tactical actions executed in 40 combats by participants of the 8-9 age group. Regarding the recording and coding process, the observation instrument has been introduced in the software LINCE. The quality of the data has been guaranteed bymeans of an inter-observer concordance procedure based on Cohen's Kappa coefficient and by a design of generalizability. Two decision trees have been made using two different algorithms (CHAID and CART). The results obtained with both algorithms coincide in pointing out the "segment" dimension as the best predictor of the "body area to which the technique is directed";but they differ in the second best forecaster: dimension "technique group" through the CHAID algorithm,and "concrete technique" dimension with the CART algorithm. (AU)


Este trabalho analisa o desempenho técnico-tático em combate na iniciação ao karatê e mostra as possibilidades de aplicação da técnica de análise de árvore de decisão na metodologia observacional. A amostragem observacional é composta por 887 ações técnico-táticas ofensivas executadas em 40 combates por participantes da faixa etária de 8 a 9 anos. Em relação ao processo de registro e codificação, o instrumento de observação foi introduzido no softwareLINCE. A qualidade dos dados foi garantida por meio de um procedimento de concordância interobservador baseado no coeficiente Kappa de Cohen e por um desenho de generalização. Duas árvores de decisão foram feitas usando dois algoritmos diferentes (CHAID e CART). Os resultados obtidos com ambos os algoritmos coincidem em apontar a dimensão "segmento" como o melhor preditor da “área do corpo para a qual a técnica é direcionada”; mas diferem no segundo melhor preditor: dimensão “grupo de técnicas” usando o algoritmo CHAID,e dimensão “técnica detalhada” com o algoritmo CART. (AU)


Assuntos
Humanos , Criança , Artes Marciais , Árvores de Decisões , Esportes , Espanha , Algoritmos , Análise de Dados
5.
Rev Esp Anestesiol Reanim (Engl Ed) ; 69(1): 48-53, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35033481

RESUMO

Patients with COVID-19 who are admitted to intensive care unit (ICU) are at high risk of developing secondary infections, including invasive fungal infections such as invasive pulmonary aspergillosis (IPA). The main purpose was to analyse the putative COVID-19 Associated Pulmonary Aspergillosis (CAPA) patients in our setting. In these patients, we performed mycological culture in bronchoalveolar lavage (BAL) for isolation of Aspergillus sp. We followed the AspICU algorithm to diagnose putative IPA. Moreover, we considered relevant the positivity of Galactomannan in BAL. We diagnosed putative IPA in 3 patients. The common features of these 3 patients were: more than 21 days of stay in ICU, severe acute respiratory distress syndrome (ARDS) and treatment with steroids (1 mg/kg per day). Therefore, CAPA has to be systematically considered although a new algorithm to diagnose it is needed to treat patients in early stages in order to avoid catastrophic outcomes.


Assuntos
COVID-19 , Aspergilose Pulmonar Invasiva , Aspergilose Pulmonar , Aspergillus , Humanos , Aspergilose Pulmonar Invasiva/diagnóstico , Aspergilose Pulmonar Invasiva/tratamento farmacológico , SARS-CoV-2
6.
Rev. esp. anestesiol. reanim ; 69(1): 48-53, Ene 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-206698

RESUMO

Los pacientes con COVID-19 que ingresan en una unidad de cuidados intensivos (UCI), tienen un alto riesgo de desarrollar infecciones secundarias, incluyendo infecciones fúngicas invasivas como aspergilosis pulmonar invasiva (API). El objetivo principal fue el análisis de los casos con sospecha de COVID-19 Associated Pulmonary Aspergillosis (CAPA) en nuestra unidad. En estos pacientes realizamos cultivo micológico en el lavado broncoalveolar como métodos de aislamiento de Aspergillus sp. Se siguió el algoritmo AspICU para establecer el diagnóstico de API probable. Además, considerando también relevante la positividad del antígeno de galactomanano. Se confirmó API probable en 3 de ellos. Los 3 pacientes permanecieron ingresados más de 21 días por SDRA grave, y recibieron corticoterapia (1mg/kg/día). Por tanto, la CAPA se debe considerar de forma sistemática, aunque se necesita un nuevo algoritmo diagnóstico que permita tratamiento precoz por las consecuencias deletéreas que puede implicar en los pacientes críticos.(AU)


Patients with COVID-19 who are admitted to intensive care unit (ICU) are at high risk of developing secondary infections, including invasive fungal infections such as invasive pulmonary aspergillosis (IPA). The main purpose was to analyse the putative COVID-19 Associated Pulmonary Aspergillosis (CAPA) patients in our setting. In these patients, we performed mycological culture in bronchoalveolar lavage (BAL) for isolation of Aspergillus sp. We followed the AspICU algorithm to diagnose putative IPA. Moreover, we considered relevant the positivity of galactomannan in BAL. We diagnosed putative IPA in 3 patients. The common features of these 3 patients were: more than 21 days of stay in ICU, severe acute respiratory distress syndrome (ARDS) and treatment with steroids (1mg/kg per day). Therefore, CAPA has to be systematically considered although a new algorithm to diagnose it is needed to treat patients in early stages in order to avoid catastrophic outcomes.(AU)


Assuntos
Humanos , Aspergilose Pulmonar Invasiva , Betacoronavirus , Pandemias , Unidades de Terapia Intensiva , Pacientes Internados , Tratamento Farmacológico , Anestesiologia , Espanha , Reanimação Cardiopulmonar
7.
Rev Esp Anestesiol Reanim ; 69(1): 48-53, 2022 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-33994593

RESUMO

Patients with COVID-19 who are admitted to intensive care unit (ICU) are at high risk of developing secondary infections, including invasive fungal infections such as invasive pulmonary aspergillosis (IPA). The main purpose was to analyse the putative COVID-19 Associated Pulmonary Aspergillosis (CAPA) patients in our setting. In these patients, we performed mycological culture in bronchoalveolar lavage (BAL) for isolation of Aspergillus sp. We followed the AspICU algorithm to diagnose putative IPA. Moreover, we considered relevant the positivity of galactomannan in BAL. We diagnosed putative IPA in 3 patients. The common features of these 3 patients were: more than 21 days of stay in ICU, severe acute respiratory distress syndrome (ARDS) and treatment with steroids (1 mg/kg per day). Therefore, CAPA has to be systematically considered although a new algorithm to diagnose it is needed to treat patients in early stages in order to avoid catastrophic outcomes.

8.
Prev Med ; 154: 106900, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34861338

RESUMO

An increasing body of evidence supports the validity of self-sampling as an alternative to clinician collection for primary Human Papillomavirus (HPV) screening. Self-sampling effectively reaches underscreened women and can be a powerful strategy in low- and high-resource settings for all target ages. This work aims to summarize the current use of HPV self-sampling worldwide. It is part of a larger project that describes cervical cancer screening programmes and produces standardized coverage estimates worldwide. A systematic review of the literature and official documents supplemented with a formal World Health Organisation country consultation was conducted. Findings show that the global use of HPV self-sampling is still limited. Only 17 (12%) of countries with identified screening programs recommend its use, nine as the primary collection method, and eight to reach underscreened populations. We identified 10 pilots evaluating the switch to self-sampling in well-established screening programs. The global use of self-sampling is likely to increase in the coming years. COVID-19's pandemic has prompted efforts to accelerate HPV self-sampling introduction globally, and it is now considered a key element in scaling up screening coverage. The information generated by the early experiences can be beneficial for decision-making in both new and existing programs.


Assuntos
COVID-19 , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Detecção Precoce de Câncer , Feminino , Humanos , Programas de Rastreamento , Papillomaviridae , Infecções por Papillomavirus/diagnóstico , SARS-CoV-2 , Autocuidado , Manejo de Espécimes , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal
9.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34565575

RESUMO

Patients with COVID-19 who are admitted to intensive care unit (ICU) are at high risk of developing secondary infections, including invasive fungal infections such as invasive pulmonary aspergillosis (IPA). The main purpose was to analyse the putative COVID-19 Associated Pulmonary Aspergillosis (CAPA) patients in our setting. In these patients, we performed mycological culture in bronchoalveolar lavage (BAL) for isolation of Aspergillus sp. We followed the AspICU algorithm to diagnose putative IPA. Moreover, we considered relevant the positivity of galactomannan in BAL. We diagnosed putative IPA in 3 patients. The common features of these 3 patients were: more than 21 days of stay in ICU, severe acute respiratory distress syndrome (ARDS) and treatment with steroids (1mg/kg per day). Therefore, CAPA has to be systematically considered although a new algorithm to diagnose it is needed to treat patients in early stages in order to avoid catastrophic outcomes.

10.
Rev Esp Quimioter ; 34(5): 468-475, 2021 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-34118801

RESUMO

OBJECTIVE: We evaluated the prevalence of microbiologically-confirmed influenza infection among patients with influenza-like symptoms and compared the clinical and epidemiological characteristics of patients with and without influenza infection. METHODS: Retrospective study of a cohort of patients with influenza-like symptoms from 2016 to 2018 who participated in a clinical trial in thirteen urban primary centres in Catalonia. Different epidemiological data were collected. Patients rated the different symptoms and signs on a Likert scale (absent, little problem, moderate problem and severe problem) and self-reported the measure of health status with the EuroQol visual analogue scale. A nasopharyngeal swab was taken for microbiological isolation of influenza and other microorganisms. RESULTS: A total of 427 patients were included. Microbiologically confirmed influenza was found in 240 patients (56.2%). The percentage of patients with moderate-to-severe cough, muscle aches, tiredness and dizziness was greater among patients with microbiologically confirmed influenza. The self-reported health status was significantly lower among patients with true flu infection (mean of 36.3 ± 18.2 vs 41.7 ± 17.8 in patients without influenza; p<0.001). CONCLUSIONS: Clinical findings are not particularly useful for confirming or excluding the diagnosis of influenza when intensity is not considered. However, the presence of moderate-to-severe cough, myalgias, tiredness and dizziness along with a poor health status is more common in patients with confirmed flu infection.


Assuntos
Influenza Humana , Humanos , Influenza Humana/epidemiologia , Prevalência , Atenção Primária à Saúde , Estudos Retrospectivos
11.
BMC Womens Health ; 21(1): 178, 2021 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-33902553

RESUMO

BACKGROUND: HPV cervical cancer screening (CCS) must use validated HPV tests based on the molecular detection of either viral mRNA (Aptima HPV Assay-AHPV) or DNA. AHPV has demonstrated the same cross-sectional and longitudinal sensitivity for the detection of HSIL/CIN2+ lesions but with greater specificity than HPV-DNA tests. The study aimed to estimate the total costs of a CCS with a primary HPV test based on the detection of mRNA compared to DNA in women aged 35-65 years for the National Health System. METHODS: A decision-tree-based model to estimate the cost of the CCS until the first colposcopy was designed based on Spanish CCS guidelines. The total cost (€, 2019) for CCS with AHPV or DNA tests (HC2 and Cobas) was calculated, including HPV test, liquid-based cytology (LBC) and colposcopy, for a population of 7,263,529 women aged 35-65 years (assuming 70% coverage). Clinical inputs derived from a literature review were validated by a multidisciplinary expert panel. Data from head-to-head studies between different HPV tests were selected. RESULTS: The use of AHPV showed reduction of 290,541 (- 35%) and 355,913 (- 40%) LBC compared to HC2 or Cobas, respectively. Furthermore, AHPV avoided 151,699 (- 47%) colposcopies versus HC2 and 151,165 (- 47%) versus Cobas. The total cost of CCS was € 282,747,877 with AHPV, € 322,587,588 with HC2 and € 324,614,490 with Cobas. Therefore, AHPV savings € - 39,839,711 versus HC2 and € - 41,866,613 versus Cobas. CONCLUSIONS: Assuming that 70% of women from 35 to 65 years attend the CCS programme, the cost of screening up to the first colposcopy using AHPV would provide cost savings of up to € 41.9 million versus DNA tests in Spain.


Assuntos
Infecções por Papillomavirus , Neoplasias do Colo do Útero , Colposcopia , Custos e Análise de Custo , Estudos Transversais , DNA Viral , Detecção Precoce de Câncer , Feminino , Humanos , Técnicas de Diagnóstico Molecular , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Gravidez , Sensibilidade e Especificidade , Espanha , Neoplasias do Colo do Útero/diagnóstico
12.
Nurse Educ Today ; 98: 104726, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33493925

RESUMO

BACKGROUND: Medication errors account for 38% of adverse events reported among undergraduate nursing students. Simulation provides training for nursing students in the medication administration process. However, there is a lack of reliable and valid instruments to measure its assessment. OBJECTIVES: To design and validate a new tool (MEDICORRECT) to assess undergraduate nursing students in the medication administration process using a high-fidelity simulation scenario. DESIGN AND METHODS: Study participants were fourth year undergraduate nursing students at the University of Barcelona. Phase 1 consisted of tool design and drafting, and content validity and feasibility analyses. Phase 2 covered construct validity and interrater reliability. A factor analysis was conducted, involving a principal component analysis and varimax rotation. FINDINGS: Of 21 initial items, 11 were eliminated because of low content validity ratio, 4 of which assessed cognitive skills such as administering the right medicine at the right dose, which were impossible to observe in the simulation scenario. The final version of MEDICORRECT contained 10 items. The exploratory factor analysis identified a four-factorial model explaining 67.3% of the variance. Interrater agreement measured with Kappa was greater than 0.70 for 80% of items. CONCLUSIONS: The 10 items in MEDICORRECT are relevant and feasible, have suitable psychometric properties and reflect the practical skills identified in the medication administration process. The tool excludes cognitive skills, which should be included and assessed during prebriefing.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
13.
J Dairy Sci ; 103(2): 1175-1192, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31864749

RESUMO

Control of acidity is critical for cheese quality, as high acidity can be associated with poor flavor and textural attributes. We investigated an alternative method to control cheese acidity, specifically in low-fat (LF) and reduced-fat (RF) milled curd, direct-salted Gouda cheese, which involved altering the initial lactose content of cheesemilk. In traditional Gouda cheese manufacture, a critical technique to control acidity is whey dilution (WD); that is, partial removal of whey and its replacement with water. Direct standardization of the lactose content of milk during the ultrafiltration process could be a simpler and more effective technique to control cheese acidity. This study compared the effect of traditional WD at 2 different levels, 15 and 30% (WD15 and WD30), with the alternative approach of adjustment of the lactose content of milk using low-concentration-factor ultrafiltration (LCF-UF). The composition, texture, functionality, and sensory properties of these LF and RF Gouda cheeses were evaluated. A milled curd, direct-salted cheese manufacturing protocol was used. Milks used for cheesemaking had a lactose-to-casein (L:CN) ratio of approximately 1.8, which is the typical ratio found in milk, whereas milks prepared with lactose standardization (LS) were made from UF concentrated milks with water added during filtration to achieve a L:CN ratio of approximately 1.1. Cheeses made with LS exhibited lower lactose and lactic acid contents than WD30 and WD15, leading to significantly higher pH values in the cheese. Dynamic small-amplitude oscillatory rheology indicated that use of LS led to cheeses with a lower crossover temperature (melting point) than the cheeses made with WD. Cheeses made with LS had lower insoluble Ca contents, likely caused by the addition of water required to achieve the lower L:CN ratio in these milks. Sensory analysis also indicated that LS cheeses had lower acidity and softer texture. These results suggest that standardization of the L:CN ratio of milk could be a useful alternative to WD (or a curd rinse step) to reduce acidity in cheeses. In addition, LS could be used to help soften texture and increase meltability, if desired in lower-fat cheese types.


Assuntos
Queijo , Laticínios , Lactose/análise , Soro do Leite/química , Animais , Caseínas/análise , Bovinos , Queijo/análise , Queijo/normas , Laticínios/análise , Laticínios/normas , Filtração , Manipulação de Alimentos/métodos , Técnicas de Diluição do Indicador , Reologia , Cloreto de Sódio , Ultrafiltração
15.
Rev. esp. anestesiol. reanim ; 64(9): 490-498, nov. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-167088

RESUMO

Objetivo. La presencia de microorganismos resistentes es una causa importante de fallo en el tratamiento antimicrobiano inicial. Los objetivos de este estudio son conocer el perfil de resistencia de los microorganismos causantes de bacteriemia de origen abdominal e identificar si el uso previo de antibióticos y el lugar de adquisición de la bacteriemia son factores de riesgo para determinar la presencia de microorganismos resistentes. Material y método. Se diseñó un estudio de cohorte retrospectiva de todos los pacientes adultos que presentaron bacteriemia y/o fungemia cuyo foco infeccioso primario fue de origen abdominal ingresados en un hospital universitario durante los años 2011-2013. Se describieron los perfiles de resistencia a los antimicrobianos y se utilizó una comparación de proporciones con un test chi cuadrado al 95% de confianza para determinar si las variables estudiadas fueron factores de riesgo en el aislamiento de microorganismos resistentes. Resultados. De un total de 1.245 pacientes con bacteriemia, 212 (17%) presentaron bacteriemia de origen abdominal. Respecto al perfil de resistencias destacó Staphylococcus aureus resistente a meticilina (50%), estafilococos coagulasa negativos resistentes a linezolid (20,58%), enterococos resistentes a vancomicina (3,12%), Escherichia coli resistente a cefalosporinas de 3.a generación (9,9%) y fluorquinolonas (35,64%), Klebsiella pneumoniae resistente a fluorquinolonas (8,33%), Pseudomonas aeruginosa resistente a quinolonas y carbapenem (25 y 25% respectivamente), Acinetobacter baumanii resistente a quinolonas y carbapenem (100% y 100% respectivamente), Candida albicans resistente a fluconazol (11,11%), la única Candida krusei aislada resistente a fluconazol y Candida parapsilosis resistente a equinocandinas (12,5%). En nuestro estudio, el uso previo de antibiótico tuvo asociación estadísticamente significativa con el aislamiento de microorganismos resistentes (p=0,013) pero no el lugar de adquisición de la bacteriemia (p=0,239). Conclusiones. Conocer la incidencia de microorganismos resistentes en cada hospital puede mejorar el tratamiento antimicrobiano empírico inicial en pacientes con bacteriemia de origen abdominal. El uso previo de antibióticos se relacionó de forma estadísticamente significativa con el aislamiento de microorganismos resistentes (AU)


Objective. The presence of resistant microorganisms is a major cause of failure in initial empirical antimicrobial therapy. The objectives of this study are to determine the resistance profile of microorganisms that cause bacteraemia of abdominal origin and to identify whether the previous use of antibiotics and the place of acquisition of bacteraemia are risk factors associated with the presence of resistant organisms. Material and methods. A clinical, observational, epidemiological, retrospective cohort study was conducted with all the adult patients admitted to a university hospital from 2011-2013. Antimicrobial resistance profiles were described and a 95% confidence interval chi-square test was used to determine whether the variables studied were risk factors in the isolation of resistant microorganisms. Results. Of the 1245 patients with bacteraemia, 212 (17%) presented bacteraemia of abdominal origin. The resistance profile highlights the incidence of methicillin resistant Staphylococcus aureus (50%), coagulase-negative staphylococci resistant to linezolid (20.58%), enterococci resistant to vancomycin (3.12%), Escherichia coli resistant to third-generation cephalosporins (9.9%) and fluoroquinolones (35.64%), Klebsiella pneumoniae resistant to third-generation cephalosporins (8.33%), Pseudomonas aeruginosa resistant to fluoroquinolones and carbapenem (25% and 25% respectively) and Acinetobacter baumanii resistant to fluoroquinolones and carbapenem (100% and 100% respectively), Candida albicans resistant to fluconazole (11.11%), single Candida krusei isolate resistant to fluconazole and Candida parapsilosis resistant to echinocandins (12.5%). In our study, previous use of antibiotics had a statistically significant association with the isolation of resistant microorganisms (P=.013) but not the place of acquisition of bacteraemia (P=.239). Conclusion. Establishing the incidence of resistant organisms can improve empirical antimicrobial therapy in patients with bacteraemia of abdominal origin. Previous use of antibiotics was statistically significantly related to the isolation of resistant microorganisms (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Fungemia/tratamento farmacológico , Fungemia/epidemiologia , Fatores de Risco , Resistência Microbiana a Medicamentos , Antibacterianos/uso terapêutico , Estudos Retrospectivos , Estudos de Coortes , Staphylococcus aureus Resistente à Meticilina , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Streptococcus pneumoniae , Resistência a Vancomicina
20.
Rev Esp Anestesiol Reanim ; 64(9): 490-498, 2017 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28434558

RESUMO

OBJECTIVE: The presence of resistant microorganisms is a major cause of failure in initial empirical antimicrobial therapy. The objectives of this study are to determine the resistance profile of microorganisms that cause bacteraemia of abdominal origin and to identify whether the previous use of antibiotics and the place of acquisition of bacteraemia are risk factors associated with the presence of resistant organisms. MATERIAL AND METHODS: A clinical, observational, epidemiological, retrospective cohort study was conducted with all the adult patients admitted to a university hospital from 2011-2013. Antimicrobial resistance profiles were described and a 95% confidence interval chi-square test was used to determine whether the variables studied were risk factors in the isolation of resistant microorganisms. RESULTS: Of the 1245 patients with bacteraemia, 212 (17%) presented bacteraemia of abdominal origin. The resistance profile highlights the incidence of methicillin resistant Staphylococcus aureus (50%), coagulase-negative staphylococci resistant to linezolid (20.58%), enterococci resistant to vancomycin (3.12%), Escherichia coli resistant to third-generation cephalosporins (9.9%) and fluoroquinolones (35.64%), Klebsiella pneumoniae resistant to third-generation cephalosporins (8.33%), Pseudomonas aeruginosa resistant to fluoroquinolones and carbapenem (25% and 25% respectively) and Acinetobacter baumanii resistant to fluoroquinolones and carbapenem (100% and 100% respectively), Candida albicans resistant to fluconazole (11.11%), single Candida krusei isolate resistant to fluconazole and Candida parapsilosis resistant to echinocandins (12.5%). In our study, previous use of antibiotics had a statistically significant association with the isolation of resistant microorganisms (P=.013) but not the place of acquisition of bacteraemia (P=.239). CONCLUSION: Establishing the incidence of resistant organisms can improve empirical antimicrobial therapy in patients with bacteraemia of abdominal origin. Previous use of antibiotics was statistically significantly related to the isolation of resistant microorganisms.


Assuntos
Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bactérias/efeitos dos fármacos , Doenças do Sistema Digestório/microbiologia , Resistência Microbiana a Medicamentos , Adulto , Idoso , Antibacterianos/efeitos adversos , Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Bactérias/isolamento & purificação , Candidemia/tratamento farmacológico , Candidemia/epidemiologia , Candidemia/microbiologia , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Comorbidade , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Doenças do Sistema Digestório/complicações , Farmacorresistência Fúngica , Farmacorresistência Bacteriana Múltipla , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/microbiologia , Estudos Retrospectivos , Fatores de Risco , Sepse/epidemiologia , Sepse/microbiologia , Espanha/epidemiologia , Adulto Jovem
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