Factors influencing endothelial cell density of corneas for transplantation.

To evaluate factors affecting corneal endothelial cell density (ECD) under enucleation and preservation time studies at Eye Bank of the Federal District of Brazil. We conducted a case-control study collecting data from 1128 corneas where death-to-enucleation time and enucleation-to-preservation time were within 24 h. Low cell count were those corneas with an ECD less than 2000 cells/mm2 and high cell count was defined as those with ECD greater than 2000 cells/mm2. We calculated the independent risk factors related to: cause of death, donor age, death-to-enucleation time, enucleation-to-preservation time and primary graft failure. Correlation analysis was used to assess which parameters influence ECD: death-to-enucleation time, enucleation-to-preservation time, average cell area (AVE), coefficient of variation and percentage of hexagonal cells. Of the total number of corneas, 1004 had ECD data and were selected for the study. 87.4% (n = 877) had high cell counts with 2699 ± 412 cells/mm2. The mean donor age was 38.8 ± 16 years. The most common causes of death were external causes (48.6%, n = 488). Longer times from death-to-enucleation, up to 24 h were not associated with a decrease in ECD (OR 0.58; P = 0.44) or risk of graft survival (P = 0.74). Enucleation-to-preservation intervals greater than 12 h showed increased risk of graft survival (P = 0.04). AVE was the main parameter for ECD (R2 = 0.96, P < 0.001). The overall graft survival rate was 98.2% (n = 761). Donors with 40 years of age and above did not present a higher risk of graft survival (P = 0.09). We suggest that the maximum time from death-to-enucleation should be 24 h, assuming the body has been refrigerated after 6 h; and from enucleation-to-preservation time of 12 h, followed by proper processing and cornea morphology examination.

Cuidados em doenças infecciosas e parasitárias: endêmicas, emergentes e re-emergentes

Este módulo é dividido em nove lições e aborda epidemiologia, manifestações clínicas, diagnóstico, tratamento, medidas de controle e vigilância epidemiológica das seguintes doenças: Influenza, Febre Amarela, Leishmaniose, Malária, Doença de Chagas, Parasitoses, Esquistossomose, Doenças Sexualmente Transmissíveis e Hantavirose.

Inequalities in infant mortality among municipalities in Brazil according to the Family Development Index, 2006-2008.

OBJECTIVE: To describe inequalities in the infant mortality rate (IMR) according to socioeconomic indicators among geographic areas and municipalities in Brazil. METHODS: This was an exploratory ecological study of space aggregates that described IMR in 2006-2008 according to municipalities, states, and the Family Development Index (FDI), a socioeconomic indicator that ranges from 0 to 1. All the municipalities in Brazil were categorized according to four strata as defined by FDI quartiles, where stratum 4 included those with better FDI conditions, and stratum 1, worse conditions. The selected inequality measures were: Concentration Index, Attributable Risk Percent, Population Attributable Risk Percent, Rate Ratio, and number of avoidable events (number of infant deaths). RESULTS: The average IMR (per 1 000 live births) according to the FDI strata were: stratum 1 (FDI = 0.41-0.52) = 18.8; stratum 2 (FDI = 0.53-0.55) = 17.9; stratum 3 (FDI = 0.56-0.58) = 15.0; and stratum 4 (FDI = 0.59-0.73) = 13.4. Overall, the Concentration Index was 0.02. Moreover, stratum 1, with a proportion of 17% of all live births in the population, had a concentration of 20% of infant deaths. Additionally, the profile of causes and ages of infant mortality also differed qualitatively when stratum 1 was compared to stratum 4. CONCLUSIONS: The results suggest an association between the socioeconomic indicators, specifically the FDI, and the risk of infant death. These results call attention to the specific population groups in Brazil that are most vulnerable to infant mortality and demonstrate that the FDI can be used to identify these populations.

Inequalities in infant mortality among municipalities in Brazil according to the Family Development Index, 2006-2008 / Desigualdades en la mortalidad de menores de un año entre los municipios del Brasil, según el índice de desarrollo familiar de 2006 a 2008

OBJECTIVE: To describe inequalities in the infant mortality rate (IMR) according to socioeconomic indicators among geographic areas and municipalities in Brazil. METHODS: This was an exploratory ecological study of space aggregates that described IMR in 2006-2008 according to municipalities, states, and the Family Development Index (FDI), a socioeconomic indicator that ranges from 0 to 1. All the municipalities in Brazil were categorized according to four strata as defined by FDI quartiles, where stratum 4 included those with better FDI conditions, and stratum 1, worse conditions. The selected inequality measures were: Concentration Index, Attributable Risk Percent, Population Attributable Risk Percent, Rate Ratio, and number of avoidable events (number of infant deaths). RESULTS: The average IMR (per 1 000 live births) according to the FDI strata were: stratum 1 (FDI = 0.41-0.52) = 18.8; stratum 2 (FDI = 0.53-0.55) = 17.9; stratum 3 (FDI = 0.56-0.58) = 15.0; and stratum 4 (FDI = 0.59-0.73) = 13.4. Overall, the Concentration Index was 0.02. Moreover, stratum 1, with a proportion of 17% of all live births in the population, had a concentration of 20% of infant deaths. Additionally, the profile of causes and ages of infant mortality also differed qualitatively when stratum 1 was compared to stratum 4. CONCLUSIONS: The results suggest an association between the socioeconomic indicators, specifically the FDI, and the risk of infant death. These results call attention to the specific population groups in Brazil that are most vulnerable to infant mortality and demonstrate that the FDI can be used to identify these populations.

OBJETIVO: Describir las desigualdades en la tasa de mortalidad de menores de un año entre las zonas geográficas y los municipios del Brasil según los indicadores socioeconómicos. MÉTODOS: Se realizó un estudio exploratorio y ecológico de los grupos de espacios que definieron la tasa de mortalidad de menores de un año en el período de 2006 a 2008 según los municipios, los estados y el índice de desarrollo familiar (IDF), un indicador socioeconómico que va del 0 al 1. Todos los municipios del Brasil se clasificaron según 4 estratos, de conformidad con lo definido por los cuartiles del IDF; el estrato 4 incluyó a aquellas personas con mejores condiciones de IDF y el estrato 1 a aquellas con peores condiciones. Se eligieron las siguientes medidas de la desigualdad: el índice de concentración, el porcentaje de riesgo atribuible a la población, la razón de la tasa y el número de sucesos evitables (número de defunciones de menores de un año). RESULTADOS: La tasa promedio de mortalidad de menores de un año (por 1 000 nacidos vivos) según los estratos del IDF fueron: estrato 1 (IDF = 0,41-0,52) = 18,8; estrato 2 (IDF = 0,53-0,55) = 17,9; estrato 3 (IDF = 0,56-0,58) = 15,0; y estrato 4 (IDF = 0,59-0,73) = 13,4. En términos generales, el índice de concentración fue 0,02. Al estrato 1, que tuvo una proporción de 17% de todos los nacidos vivos en la población, correspondió una concentración de 20% de defunciones de menores de un año. Además, el perfil de las causas y las edades de la mortalidad de menores de un año también difirió cualitativamente cuando se compararon los estratos 1 y 4. CONCLUSIONES: Los resultados indican que hay una asociación entre los indicadores socioeconómicos, en concreto el IDF, y el riesgo de mortalidad de menores de un año. Estos resultados destacan los grupos de población específicos en el Brasil que son más vulnerables a la mortalidad de menores de un año y demuestran que el IDF puede utilizarse para identificarlos.

Projeto de extensão de enfermagem no controle de infecções hospitalares / Nursing extension project about the control of nosocomial infections

Este artigo apresenta um projeto de extensão de enfermagem no controle de infecções hospitalares, que foi desenvolvido em um hospital-escola de Brasília (DF) e teve, como pre-supostos, a interação entre ensino, pesquisa e extensão e a integração entre univesidade e comunidade...

Multilocus variable-number tandem-repeat polymorphism among Brazilian Enterococcus faecalis strains.

Multilocus variable-number tandem-repeat analysis (MLVA) for seven genomic loci was developed for Enterococcus faecalis. MLVA and pulsed-field gel electrophoresis (PFGE) resulted in 37 and 31 genotypes among 83 strains, respectively. Both typing schemes were highly concordant (90.4%). MLVA is an excellent alternative to PFGE.