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3.
PLoS One ; 8(11): e78303, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24324543

RESUMO

BACKGROUND: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is now the most common cause of skin and skin structure infections (SSSI) in several world regions. In Argentina prospective, multicenter clinical studies have only been conducted in pediatric populations. OBJECTIVE: PRIMARY: describe the prevalence, clinical and demographic characteristics of adult patients with community acquired SSSI due to MRSA; secondary: molecular evaluation of CA-MRSA strains. Patients with MRSA were compared to those without MRSA. MATERIALS AND METHODS: Prospective, observational, multicenter, epidemiologic study, with molecular analysis, conducted at 19 sites in Argentina (18 in Buenos Aires) between March 2010 and October 2011. Patients were included if they were ≥ 14 years, were diagnosed with SSSI, a culture was obtained, and there had no significant healthcare contact identified. A logistic regression model was used to identify factors associated with CA-MRSA. Pulse field types, SCCmec, and PVL status were also determined. RESULTS: A total of 311 patients were included. CA-MRSA was isolated in 70% (218/311) of patients. Clinical variables independently associated with CA-MRSA were: presence of purulent lesion (OR 3.29; 95%CI 1.67, 6.49) and age <50 years (OR 2.39; 95%CI 1.22, 4.70). The vast majority of CA-MRSA strains causing SSSI carried PVL genes (95%) and were SCCmec type IV. The sequence type CA-MRSA ST30 spa t019 was the predominant clone. CONCLUSIONS: CA-MRSA is now the most common cause of SSSI in our adult patients without healthcare contact. ST30, SCCmec IV, PVL+, spa t019 is the predominant clone in Buenos Aires, Argentina.


Assuntos
Infecções Comunitárias Adquiridas/epidemiologia , Staphylococcus aureus Resistente à Meticilina/fisiologia , Pele/microbiologia , Infecções Cutâneas Estafilocócicas/diagnóstico , Infecções Cutâneas Estafilocócicas/epidemiologia , Adulto , Argentina/epidemiologia , Infecções Comunitárias Adquiridas/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
4.
Gac. sanit. (Barc., Ed. impr.) ; 24(4): 303-308, jul.-ago. 2010. tab
Artigo em Espanhol | IBECS | ID: ibc-85690

RESUMO

ObjetivoIdentificar los factores asociados a la aceptación por parte del paciente de la hospitalización a domicilio directamente desde el servicio de urgencias.Pacientes y métodosEstudio de cohortes prospectivo observacional de pacientes que, una vez visitados en urgencias, reunían criterios de ingreso en sala convencional, podían responder a una entrevista y disponían de un posible cuidador. Se tomó como variable dependiente la predisposición a aceptar o no un ingreso en hospitalización a domicilio. De cada paciente, como variables independientes se recogieron aspectos demográficos, factores de su estado de salud-comorbilidad y de su enfermedad actual, y percepciones psicosociales relacionadas con la hospitalización a domicilio. La relación entre variables se estableció por análisis de regresión logística múltiple.ResultadosSe realizaron 129 entrevistas. La predisposición a aceptar un ingreso en hospitalización a domicilio fue del 71%. Sólo las percepciones psicosociales del paciente, con independencia de sus aspectos demográficos e incluso de su estado de salud actual y comorbilidad, se relacionaron con la predisposición a aceptar un ingreso en hospitalización a domicilio, en concreto las adecuadas condiciones físicas del domicilio (odds ratio [OR]: 4,31; intervalo de confianza del 95% [IC95%]: 1,18–15,78), la ausencia de miedo por tener que manejar el oxígeno (OR: 5,99; IC95%: 2,05–17,52), la ausencia de miedo a una mala evolución clínica (OR: 6,07; IC95%: 1,94–18,96) y la percepción de una mayor libertad de horarios (OR: 12,61; IC95%: 3,31–48,01).ConclusionesLa hospitalización a domicilio tendría una buena aceptación si se ofreciera directamente en el Servicio de Urgencias como alternativa a la hospitalización convencional. Esta aceptación se asocia a percepciones psicosociales, que deberían tenerse en cuenta al ofrecer esta modalidad asistencial (AU)


AimTo identify the factors associated with patients’ acceptance of emergency department discharge directly to hospital-at-home care.Patients and methodsWe performed a prospective observational cohort study of patients seen at the emergency department who met the following inclusion criteria: need for hospital admission, ability to be interviewed, and availability of an informal caregiver. The dependent variable was defined as the predisposition to accept or refuse hospital-at-home care. For each patient, the following independent variables were recorded: demographic characteristics, health-related factors, comorbidities, current illness and psychosocial perceptions related to hospital-at-home care. The associations among the variables were tested by means of logistic regression analysis.ResultsWe included 129 patients. Seventy-one percent would have accepted hospital-at-home care. Acceptance of hospital-at-home care was associated with psychosocial perceptions only, independently of demographic characteristics, current illness severity and comorbidities. These psychosocial perceptions included adequate conditions at home (OR: 4.31; 95% CI: 1.18–15.78), not being afraid of oxygen manipulation (OR: 5.99; 95% CI: 2.05–17.52), lack of fear of a poor outcome (OR: 6.07; 95% CI: 1.94–18.96) and the possibility of enjoying a more flexible schedule (OR: 12.61; 95% CI: 3.31–48.01).ConclusionsHospital-at-home care would be well accepted by patients if offered in the emergency department as an alternative to conventional hospitalization. Acceptance depends on patients’ psychosocial perceptions, which should be assessed before this mode of care is proposed (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Alta do Paciente , Serviços Hospitalares de Assistência Domiciliar , Estudos Prospectivos
5.
Gac Sanit ; 24(4): 303-8, 2010.
Artigo em Espanhol | MEDLINE | ID: mdl-20663592

RESUMO

AIM: To identify the factors associated with patients' acceptance of emergency department discharge directly to hospital-at-home care. PATIENTS AND METHODS: We performed a prospective observational cohort study of patients seen at the emergency department who met the following inclusion criteria: need for hospital admission, ability to be interviewed, and availability of an informal caregiver. The dependent variable was defined as the predisposition to accept or refuse hospital-at-home care. For each patient, the following independent variables were recorded: demographic characteristics, health-related factors, comorbidities, current illness and psychosocial perceptions related to hospital-at-home care. The associations among the variables were tested by means of logistic regression analysis. RESULTS: We included 129 patients. Seventy-one percent would have accepted hospital-at-home care. Acceptance of hospital-at-home care was associated with psychosocial perceptions only, independently of demographic characteristics, current illness severity and comorbidities. These psychosocial perceptions included adequate conditions at home (OR: 4.31; 95% CI: 1.18-15.78), not being afraid of oxygen manipulation (OR: 5.99; 95% CI: 2.05-17.52), lack of fear of a poor outcome (OR: 6.07; 95% CI: 1.94-18.96) and the possibility of enjoying a more flexible schedule (OR: 12.61; 95% CI: 3.31-48.01). CONCLUSIONS: Hospital-at-home care would be well accepted by patients if offered in the emergency department as an alternative to conventional hospitalization. Acceptance depends on patients' psychosocial perceptions, which should be assessed before this mode of care is proposed.


Assuntos
Serviço Hospitalar de Emergência , Serviços Hospitalares de Assistência Domiciliar , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Alta do Paciente , Idoso , Feminino , Humanos , Masculino , Estudos Prospectivos
6.
BMC Plant Biol ; 10: 79, 2010 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-20429910

RESUMO

BACKGROUND: An interesting seed protein family with a role in preventing insect herbivory is the multi-gene, APA family encoding the alpha-amylase inhibitor, phytohemagglutinin and arcelin proteins of common bean (Phaseolus vulgaris). Variability for this gene family exists and has been exploited to breed for insect resistance. For example, the arcelin locus has been successfully transferred from wild to cultivated common bean genotypes to provide resistance against the bruchid species Zabrotes subfasciatus although the process has been hampered by a lack of genetic tools for and understanding about the locus. In this study, we analyzed linkage disequilibrium (LD) between microsatellite markers at the APA locus and bruchid resistance in a germplasm survey of 105 resistant and susceptible genotypes and compared this with LD in other parts of the genome. RESULTS: Microsatellite allele diversity was found to vary with each of the eight APA-linked markers analyzed, and two markers within the APA locus were found to be diagnostic for bruchid resistance or susceptibility and for the different arcelin alleles inherited from the wild accessions. Arc1 was found to provide higher levels of resistance than Arc5 and the markers in the APA locus were highly associated with resistance showing that introgression of this gene-family from wild beans provides resistance in cultivated beans. LD around the APA locus was found to be intermediate compared to other regions of the genome and the highest LD was found within the APA locus itself for example between the markers PV-atct001 and PV-ag004. CONCLUSIONS: We found the APA locus to be an important genetic determinant of bruchid resistance and also found that LD existed mostly within the APA locus but not beyond it. Moderate LD was also found for some other regions of the genome perhaps related to domestication genes. The LD pattern may reflect the introgression of arcelin from the wild into the cultivated background through breeding. LD and association studies for the arcelin gene, linked genes and other members of the APA family are essential for breaking linkage drag while maintaining high levels of bruchid resistance in common bean.


Assuntos
Loci Gênicos/genética , Inseticidas/metabolismo , Desequilíbrio de Ligação/genética , Phaseolus/genética , Proteínas de Plantas/genética , Alelos , Animais , Besouros/fisiologia , Marcadores Genéticos , Genoma de Planta/genética , Genótipo , Repetições de Microssatélites/genética , Tamanho do Órgão/genética , Fenótipo , Dinâmica Populacional
7.
Autoimmun Rev ; 9(5): A330-4, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19906360

RESUMO

Dermatomyositis (DM), polymyositis (PM), and sporadic inclusion-body myositis (sIBM) constitute a heterogeneous group of subacute or chronic acquired skeletal muscle diseases. Known as idiopathic inflammatory myopathies (IIM), they all share the presence of considerable weakness due to muscle inflammation and necrosis. Diagnosis is based on clinical findings, confirmed by laboratory examinations (serum muscle enzyme concentrations, autoantibodies against nuclear or cytoplasmatic antigens, electromyography, and muscle biopsy). Environmental exposures leading to immune activation in genetically susceptible individuals seem to be a probable pathogenic mechanism. Infectious agents, drugs, and ultraviolet radiation have been identified as a cause of the onset, exacerbation, or acceleration of these myopathies. Several case reports and population studies have been reported to support the relationship between inflammatory myopathy and the environment. Moreover, seasonal patterns of the onset of IIM have frequently been reported.


Assuntos
Doenças Autoimunes/epidemiologia , Doenças Musculares/epidemiologia , Doenças Autoimunes/patologia , Dermatomiosite/epidemiologia , Dermatomiosite/patologia , Humanos , Músculo Esquelético/patologia , Doenças Musculares/patologia , Miosite/epidemiologia , Miosite/patologia , Miosite de Corpos de Inclusão/epidemiologia , Miosite de Corpos de Inclusão/patologia , Polimiosite/epidemiologia , Polimiosite/patologia
8.
Eur J Pharm Biopharm ; 67(3): 766-76, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17499492

RESUMO

The present report highlights the difficulties of particle shape characterizations of multiparticulate systems obtained using different image analysis techniques. The report describes and discusses a number of shape factors that are widely used in pharmaceutical research. Using photographs of 16 pellets of different shapes, obtained by extrusion-spheronization, we investigated how shape factor estimates vary depending on method of calculation, and among different software packages. The results obtained indicate that the algorithms used (both for estimation of basic dimensions such as perimeter and maximum diameter, and for estimation of shape factors on the basis of these basic dimensions) have marked influences on the shape factor values obtained. These findings suggest that care is required when comparing results obtained using different image analysis programs.


Assuntos
Algoritmos , Processamento de Imagem Assistida por Computador/métodos , Material Particulado , Software , Química Farmacêutica/métodos , Química Farmacêutica/normas , Processamento de Imagem Assistida por Computador/normas , Tamanho da Partícula , Material Particulado/normas , Pós
9.
J Pharm Sci ; 95(2): 348-57, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16372305

RESUMO

This study investigated the effects of various process variables on some of the shape factors most widely used in the morphological characterization of pharmaceutical particles (including circularity, aspect ratio, er, and the recently proposed Vr and Vp). After optimization of the illumination system and greyscale thresholds for discrimination of particle background, we evaluated the effects of process variables within the image capture and analysis system, including the image capture device (video or digital camera), image color information (24-bits-per-pixel RGB or 8-bits-per-pixel black and white), file type (JPG or TIFF), and JPG file compression ratio. A key aspect was evaluation of the effect of scaling factor (microm/pixel), dependent on real pixel size and optical magnification, on shape factor estimates. The results obtained indicate that accurate estimation of shape factors requires use of a scaling factor below a certain maximum; however, use of very low scaling factors will mean that the field of view is very small, so that it will contain very few particles, implying a time-consuming increase in the number of images that must be analyzed. Finally, we use statistical procedures to estimate the minimum number of particles that must be analyzed in order to provide accurate estimates of shape factors.


Assuntos
Química Farmacêutica/métodos , Aumento da Imagem , Processamento de Imagem Assistida por Computador , Microscopia de Vídeo , Tamanho da Partícula
10.
J Pharm Sci ; 93(3): 621-34, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-14762901

RESUMO

This study presents and evaluates two new form factors for the characterization of pharmaceutical microparticles using image analysis techniques. The first factor, denoted Vr, is mean percentage variation in radial chord length (for a large number of radial chords drawn at small angular intervals) with respect to mean radial chord length. The second factor, denoted Vp, is percentage deviation of measured perimeter from the perimeter of a circle with radius equal to the mean radial chord length of the particle. Considering both ideal shapes and real pharmaceutical particle populations, these factors are compared with other form factors widely used in pharmaceutical technology. Our results indicate that Vr and Vp allow effective assessment of whether the particles of a given population show pharmaceutically significant deviations from sphericity. The two factors additionally facilitate identification of the basic shapes of particle outlines (notably ellipsoid, rectangular, and irregular). These factors may thus be of value for the characterization and monitoring of pharmaceutical pelleting processes.


Assuntos
Aumento da Imagem/métodos , Pós/química , Tamanho da Partícula , Pós/análise , Software
11.
Buenos Aires; Grupo MSD; 2000. 26 p. gráfs..(Economía de la salud, 6). (112199).
Monografia em Espanhol | BINACIS | ID: bin-112199

RESUMO

Antimicrobianos


Resistencia bacteriana

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