Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.424
Filtrar
1.
Altern Ther Health Med ; 25(5): 30-38, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31550680

RESUMO

Context: Small intestinal bacterial overgrowth (SIBO) has gained popularity on the internet in addition to certain clinical and research circles. This interest has expanded awareness of important new dietary, nutraceutical, and pharmaceutical treatments in addition to laboratory evaluation assessment options. Concomitantly, there appears a loss of parsimony regarding how to use these tools resulting in an untenable degree of testing and treatment for this condition. Objectives: A balanced review of the data regarding SIBO testing, treatment, and management with the goal of establishing non-biased best practices. Design: Non-systematic review. Results: The results for the review fall into two categories. Ineffective Action: Treat only SIBO labs; Treat for SIBO if no symptoms are exhibited; Recommending eating or avoiding foods because they might be good or bad for SIBO; Recommending treatments that are non-validated. Effective Action: Use SIBO breath results, in addition to history and current symptoms, to determine the best treatment; Find foods that work for patients based on dietary elimination and reintroduction; Apply validated treatment for SIBO and IBS in a logical 'step-up' like treatment approach. Conclusions: Testing and treating for SIBO can offer patients clinically significant relief. However, these tests and treatments must be applied with circumspection to prevent over-testing, over-treatment, squandering resources, or creating a fear around certain foods.


Assuntos
Infecções Bacterianas/diagnóstico , Enteropatias/microbiologia , Intestino Delgado/microbiologia , Síndrome do Intestino Irritável/microbiologia , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Testes Respiratórios , Dietoterapia , Fármacos Gastrointestinais , Humanos , Enteropatias/diagnóstico , Enteropatias/terapia
2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 904-910, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484252

RESUMO

Objective: To analyze the etiologic and epidemiological characteristics of adult acute respiratory infections in Shanghai during 2015-2017. Methods: Data was collected from outpatients with acute respiratory infections who visited the Fever Clinics in three hospitals of different levels in three administrative regions of Shanghai, from 2015 to 2017. Basic information and nasopharyngeal swabs were collected from cases in line with the inclusion criteria. Multiplex RT-PCR and bacterial cultures were performed to detect the respiratory pathogens. Results: A total of 806 individuals were enrolled from 2015 to 2017. Respiratory pathogens were identified in 73.45% (592/806) of the cases, with the virus detection rate as 66.75% (538/806). It was found that the major respiratory pathogens for virus detection were influenza A in 326 (40.45%), influenza B in 116 (14.39%), rhinovirus/enterovirus in 39 (4.84%) of the cases. The overall detection rate of bacteria was 16.13% (130/806), including Klebsiella pneumoniae in 90 (11.17%) cases, Staphylococcus Aureus in 46 (5.71%) cases. Other kind of bacteria were not detected in our study. The detection rates on Mycoplasma pneumoniae was 5.33% (43/806) and on Chlamydia pneumonia was 0.37% (3/806). Co-infection with multiple pathogens was detected in 18.61% (150/806) of the cases, including 135 with double infection (accounting for 90.00%), 14 with triple infection and 1 with quadruple infection (accounted for 9.33% and 0.67%, respectively). Among the 150 cases with co-infections, the main identified pathogens were influenza A, Klebsiella pneumoniae, Staphylococcus aureus, and Mycoplasma pneumoniae. Pathogens of acute respiratory infections that identified among the outpatients from the Fever Clinics at different time, region or population, the characteristics were different (P<0.001). Conclusions: In 2015-2017, outpatients with acute respiratory infections in Shanghai were mainly caused by influenza virus or other viruses, however dynamically with its composition, time, region and characteristics of the population. It is necessary to strengthen and combine related medical and preventive services and to develop the appropriate strategies regarding clinical diagnosis and treatment.


Assuntos
Bactérias/isolamento & purificação , Infecções Bacterianas/diagnóstico , Influenza Humana/diagnóstico , Reação em Cadeia da Polimerase Multiplex/métodos , Nasofaringe , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/etiologia , Viroses/diagnóstico , Vírus/isolamento & purificação , Doença Aguda , Adulto , Bactérias/genética , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , China/epidemiologia , Coinfecção/diagnóstico , Enterovirus/genética , Enterovirus/isolamento & purificação , Monitoramento Epidemiológico , Humanos , Incidência , Vírus da Influenza A/genética , Vírus da Influenza A/isolamento & purificação , Vírus da Influenza B/genética , Vírus da Influenza B/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Mycoplasma pneumoniae , Nasofaringe/microbiologia , Nasofaringe/virologia , Vigilância da População , Infecções Respiratórias/diagnóstico , Rhinovirus/genética , Rhinovirus/isolamento & purificação , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação , Viroses/epidemiologia , Viroses/virologia , Vírus/genética
3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 911-916, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484253

RESUMO

Objective: To understand the epidemiological and pathogenic characteristics of hospitalized severe acute respiratory infections (SARI) in Shanghai, China. Methods: From 2015 to 2017, one Tertiary hospital and one Secondary hospital were chosen as the surveillance sites. Two respiratory tract specimens per case were collected from SARI cases aged 15 years and older. One specimen was tested for 22 respiratory pathogens by RT-PCR, and the other specimen was cultured for 6 respiratory bacteria. Results: A total of 287 SARI cases were enrolled for sampling and lab testing. 70.73% of the cases were aged 60 years and older, with 41.46% (119/287) were positive for at least one pathogen. Influenza virus was the predominant pathogen, accounting for 17.77% (51/287) of all SARI cases. Human rhinovirus/Enterovirus and Coronavirus were both accounting for 7.32% (21/287), followed by Mycoplasma pneumoniae (5.57%, 16/287). The positive rates of parainfluenza virus, bocavirus, adenovirus, respiratory syncytial virus and human metapneumo virus were all less than 5%. Bacterial strains were identified in seven SARI cases, including Klebsiella pneumoniae (3 strains), Staphylococcus aureus (2 strains), Streptococcus pneumoniae (1 strain) and Pseudomonas aeruginosa (1 strain). Two or Three pathogens were co-detected from 40 cases, accounting for 33.61% of 119 positive cases. The most common co-detected pathogens were influenza virus and Mycoplasma pneumoniae (10 cases). Influenza cases peaked in winter-spring and summer. Mycoplasma pneumoniae peaked in winter-spring season and overlapped with influenza. The positive rates of pathogens were not significantly different between different age groups. Conclusions: Various respiratory pathogens can be detected from SARI cases aged 15 years and older. Influenza virus was the predominant pathogen and the co-detection of influenza virus with Mycoplasma pneumoniae the most common one.


Assuntos
Bactérias/isolamento & purificação , Infecções Bacterianas/diagnóstico , Influenza Humana/diagnóstico , Pacientes Internados/estatística & dados numéricos , Mycoplasma pneumoniae/isolamento & purificação , Infecções Respiratórias , Viroses/diagnóstico , Vírus/isolamento & purificação , Doença Aguda , Adolescente , Bactérias/genética , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , China/epidemiologia , Coinfecção/epidemiologia , Hospitalização , Humanos , Lactente , Influenza Humana/epidemiologia , Influenza Humana/virologia , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Viroses/epidemiologia , Viroses/virologia , Vírus/genética
4.
Klin Lab Diagn ; 64(8): 503-506, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31479608

RESUMO

The results of the bacteriological catheter investigation on the analyzer with the technology of laser light scattering and using D. Maki culture technique coincided in 91.8% of cases. Catheter-associated infections are proven in 8 cases. The following obtained from blood and intravascular catheter in 5 patients: Staphylococcus epidermidis (n=1), Staphylococcus haemolyticus (n=1), Escherichia coli (n=1), Staphylococcus aureus (n=2); Staphylococcus epidermidis (n=1) was detected in 1 child from ventricular shunt and cerebrospinal fluid and Escherichia coli lactose-negative + Staphylococcus haemolyticus were detected in 1 child from ventricular shunt, whily only Escherichia coli lactose-negative was detected from cerebrospinal fluid; Pseudomonas aeruginosa (n=1) was foud out in 1 patient from the urinary catheter and urine. Clinical significance of the isolated microorganisms from the catheter must be assessed in each particular case taking into account its quantity and type of the isolated microorganism.


Assuntos
Infecções Bacterianas/diagnóstico , Infecções Relacionadas a Cateter/diagnóstico , Lasers , Criança , Escherichia coli , Humanos , Pseudomonas aeruginosa , Staphylococcus aureus , Staphylococcus epidermidis , Staphylococcus haemolyticus
5.
Pan Afr Med J ; 33: 35, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384350

RESUMO

Introduction: Spontaneous bacterial peritonitis (SBP) is one of the most common and life-threatening complications of patients with cirrhotic ascites. Recognition and prompt treatment of this condition is essential to prevent serious morbidity and mortality. This study aimed to determine the prevalence of SBP among in-patients with cirrhotic ascites attending our facility and to determine the clinical and laboratory parameters associated with SBP. Methods: A cross-sectional study was conducted involving one hundred and three (103) patients admitted at medical block in the Korle-Bu Teaching Hospital (KBTH) with cirrhotic ascites from 25th March, 2016 to 25th November, 2016. Demographic and clinical data were collected using a standardized questionnaire. Ascitic fluid culture and cell count were conducted. Positive ascitic fluid culture and/or ascitic polymorphonuclear leukocyte ≥ 250cells/mm3 were diagnostic for SBP. Results: Of the 103 patients with cirrhotic ascites, the mean age was 43.5 ± 12.2 years. There were fifty eight (58) male patients. The prevalence of SBP was 25.24% (26/103). Majority, 5 (55.6%) of the bacteria isolated from ascitic fluid with SBP was Escherichia coli. Severe ascites and high INR were found to be independent predictors of SBP. Conclusion: SBP is common among patients with cirrhotic ascites admitted at KBTH. Severe ascites and high INR were highly suggestive of SBP. Diagnostic paracentesis should be done immediately on admission to confirm the diagnosis irrespective of the clinical characteristics as part of baseline investigation.


Assuntos
Ascite/epidemiologia , Infecções Bacterianas/epidemiologia , Cirrose Hepática/complicações , Peritonite/epidemiologia , Adolescente , Adulto , Idoso , Ascite/microbiologia , Líquido Ascítico/microbiologia , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/microbiologia , Estudos Transversais , Feminino , Gana/epidemiologia , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Peritonite/diagnóstico , Peritonite/microbiologia , Prevalência , Adulto Jovem
6.
Medicine (Baltimore) ; 98(33): e16798, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415387

RESUMO

To explore the values of C-reactive protein (CRP) and procalcitonin (PCT) in identifying infection and disease activity in systemic lupus erythematosus (SLE) patients.Patients with SLE and infection from April 2015 to January 2018 were included in this study. We compared the clinical characteristics and biomarkers between different groups and calculated the receiver operating characteristic curve, sensitivity, and specificity of the corresponding biomarkers. Logistic regression analysis was performed on the variables exhibiting significant differences in univariate analysis.A total of 177 SLE patients were retrospectively analyzed. The patients were divided into noninfected-inactive group, noninfected-active group, infected-inactive group, and infected-active group. CRP level of infected-inactive group was significantly higher than noninfected-inactive group (P < .05), but not significantly in infected-active group than noninfected-active group (P > .05). Multivariate analysis showed that CRP (>24.0 mg/L) was the only independent risk factor for SLE infection (odds ratio, OR = 2.896, P = .032). PCT level of infected-active group was significantly higher than infected-inactive group (P < .05), but not significantly in noninfected-active group than noninfected-inactive group (P > .05). SLE active group had shorter disease course, lower infection rate, higher PCT level, and lower platelet count (PLT). Multivariate logistic analysis showed that PCT (>0.048 ng/mL) and PLT (<150 × 10/L) were independent risk factors for SLE activity (OR = 3.498 and 4.391, P = .011 and 0.009), and disease course (>96 months) was independent protective factor (OR = 0.169, P < .001). The area under the curve of the logistic model was significantly larger than any single variable (all P < .05).CRP is the only effective marker for diagnosing infection in SLE patients. Moreover, PCT helps predict SLE activity.


Assuntos
Infecções Bacterianas/diagnóstico , Proteína C-Reativa/análise , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/microbiologia , Pró-Calcitonina/sangue , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
7.
Medicine (Baltimore) ; 98(29): e16501, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335719

RESUMO

By 2030, the annual number of combined total hip and knee arthroplasty is estimated to reach 3.5 to 4 million in the US alone. In the context of a constant increase of the number of primary and revision total hip and knee arthroplasty, an increased risk of complication is expected. Prosthetic joint infections (PJIs) represent major cause of healthcare expenditure and morbidity. PJI still remain the most common and feared arthroplasty complication. A rapid and correct diagnosis of infection is decisive for a correct therapeutical management. In this setting, the Academic Emergency Hospital Sibiu adopted and implemented, with the beginning of September 2016, a new strategy for the diagnosis of PJIs strategy that uses sonication and beacon-based fluorescent in situ hybridization (bbFISH) technology.Until November 2017, 40 patients (40 retrieved implants) were enrolled in the study. Sonication fluid (SF) was collected after sonication of the implants, and samples were harvested on aerobic and anaerobic culture media. A bbFISH was used as a rapid method of bacteria detection.16 patients were diagnosed with PJIs (all 16 patients presented a positive culture of the SF). Comparing bbFISH with culture, 11 samples tested true-positive. As the kit doesn't contain probes for Pseudomonas fluorescens or Ralstonia pickettii, 4 strains of R pickettii and 1 strain of P fluorescens that was associated with Staphylococcus epidermidis were not detected.Bacteria culture of SF remains the gold standard. bbFISH holds promise to be a diagnostic tool for rapid identifying of PJIs. The bbFISH assay needs to be optimized for the detection of bacterial strains that are relevant for the PJIs field.


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Infecções Bacterianas/diagnóstico , Técnicas Bacteriológicas/métodos , Hibridização in Situ Fluorescente/métodos , Infecções Relacionadas à Prótese/diagnóstico , Sonicação , Idoso , Idoso de 80 Anos ou mais , Tecido Conjuntivo/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , RNA Bacteriano/análise , RNA Ribossômico 16S/análise , Líquido Sinovial/microbiologia
9.
Acta Gastroenterol Belg ; 82(2): 261-266, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31314186

RESUMO

BACKGROUND AND AIMS: The microbiological characteristics of spontaneous bacterial peritonitis (SBP) are changing worldwide with a shift in patterns of SBP and increasing prevalence of antibiotic-resistant bacteria. We, therefore, conducted this retrospective study aiming to characterise the current patterns and microbiology of SBP in our region. METHODS: We performed a retrospective chart review of patients presenting with their first episodes of SBP. The demographical, clinical and laboratory parameters of all patients at first paracentesis were recorded. RESULTS: The study included 200 cirrhotic patients with SBP. Mean age was 60.4±13.5 years and 116 (58%) patients were males. Liver cirrhosis was predominantly viral in 138 (69%) patients. Ascitic fluid cultures were positive in 103 (51.5%) patients and negative in 97 (48.5%). Ninety-eight (95.1%) patients had monomicrobial bacterial growth. The most common variants of spontaneous ascitic fluid infection were culture negative neutrocytic ascites (CNNA) in 97(48.5%) patients and SBP in 65 (32.5%) patients. E.Coli was most frequently isolated microorganism in 41 (39.8%) patients followed by staphylococcus species in 19 (18.4%) patients, Klebsiella pneumonae in 14(13.6%) patients and streptococcus species in 13 (10.7%) patients. The prevalence of extended spectrum beta-lactamases (ESBL) resistant E.Coli was 29.3%. Antibiotic resistance rate for meropenem, piperacillin\ tazobactam, ceftriaxone and ciprofloxacin was 0%, 22.0%, 29.0%, and 28.6% respectively. CONCLUSIONS: Changes in the patterns and microbiology of SBP are evident in our region with increasing prevalence of culture negative SBP, extended spectrum beta-lactamases resistant E.Coli, and increased resistance rate to first line antibiotics. Our data argue for relying on periodic hospital based antibiotic susceptibility data whenever SBP is treated.


Assuntos
Ascite/microbiologia , Líquido Ascítico/microbiologia , Infecções Bacterianas/microbiologia , Cirrose Hepática/microbiologia , Cirrose Hepática/virologia , Peritonite/microbiologia , Idoso , Infecções Bacterianas/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Peritonite/diagnóstico , Estudos Retrospectivos
10.
Acta Vet Scand ; 61(1): 25, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31146786

RESUMO

BACKGROUND: Although artificial insemination (AI) was developed as a means of controlling disease transmission, pathogens can still be transmitted to females in semen used for AI. In addition, bacteria can cause deterioration in sperm quality during storage. Semen becomes contaminated by the male's normal bacterial flora as it passes out of the reproductive tract but potential pathogens may also contaminate the semen. Therefore, semen samples from stallions to be used for AI are tested before the breeding season to minimize transmission of pathogens to inseminated mares. In Sweden, semen samples are tested at the National Veterinary Institute, Uppsala (SVA). For the present study, a retrospective analysis was made of potentially pathogenic bacteria isolated from samples submitted to the SVA from 2007 to 2017. RESULTS: In our study, Taylorella equigenitalis was found infrequently (53 out of 25,512 samples), representing 11 out of 2308 stallions. If T. equigenitalis was detected, the stallions were treated with antibiotics and re-tested later in the same year. Klebsiella pneumoniae and beta haemolytic streptococci were the most commonly found potential pathogens, whereas Pseudomonas aeruginosa was also isolated occasionally. There were considerable differences in the number of species isolated each year. CONCLUSIONS: Potential pathogens were identified in relatively few of the samples submitted to SVA during this period, with T. equigenitalis not being identified since 2015. Of the other potential pathogens, K. pneumoniae and beta haemolytic streptococci were the most common. The information is relevant for determining guidelines on the testing and treatment of stallions before breeding.


Assuntos
Infecções Bacterianas/veterinária , Fenômenos Fisiológicos Bacterianos , Líquidos Corporais/microbiologia , Genitália Masculina/microbiologia , Doenças dos Cavalos/microbiologia , Infecções do Sistema Genital/veterinária , Sêmen/microbiologia , Animais , Antibacterianos/uso terapêutico , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Doenças dos Cavalos/diagnóstico , Doenças dos Cavalos/tratamento farmacológico , Cavalos , Inseminação Artificial , Masculino , Infecções do Sistema Genital/diagnóstico , Infecções do Sistema Genital/tratamento farmacológico , Infecções do Sistema Genital/microbiologia , Suécia
12.
BMC Res Notes ; 12(1): 244, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31036061

RESUMO

OBJECTIVES: Diabetic foot ulcers (DFUs) often lead to hospital admissions, amputations and deaths; however, there is no up-to-date information on microbial isolates from DFUs and no mention of utilization of molecular techniques in Sub-Saharan Africa. We conducted a cross-sectional study among 83 adult patients at a tertiary hospital in Kenya over 12 months. The study aimed to isolate, identify bacteria, their antibiotic susceptibility patterns in active DFUs, and to compare standard microbiological methods versus a real-time PCR commercial kit in the detection of Staphylococcus aureus DNA and methicillin-resistant S. aureus (MRSA) DNA. RESULTS: Eighty swabs (94%) were culture-positive; 29% were Gram-positive and 65% were Gram-negative. The main organisms isolated were S. aureus (16%), Escherichia coli (15%), Proteus mirabilis (11%), Klebsiella pneumoniae (7%) and Pseudomonas aeruginosa (7%). The bacterial isolates showed resistance to commonly used antibiotics such as ampicillin, amoxicillin, cefepime, ceftazidime, cefuroxime, clindamycin, erythromycin, piperacillin-tazobactam, tetracycline and trimethoprim-sulphamethoxazole (TMPSMX). Thirty-one percent of the S. aureus isolated and 40% of the Gram-negatives were multi-drug resistant organisms (MDROs). There was a high prevalence of nosocomial bacteria. MRSA were not identified using culture methods but were identified using PCR. PCR was more sensitive but less specific than culture-based methods to identify S. aureus.


Assuntos
Antibacterianos/uso terapêutico , Infecções Bacterianas/diagnóstico , Pé Diabético/diagnóstico , Farmacorresistência Bacteriana Múltipla , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacos , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Técnicas de Tipagem Bacteriana , Cefalosporinas/uso terapêutico , Clindamicina/uso terapêutico , Estudos Transversais , Pé Diabético/tratamento farmacológico , Pé Diabético/epidemiologia , Pé Diabético/microbiologia , Escherichia coli/classificação , Escherichia coli/efeitos dos fármacos , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Humanos , Quênia/epidemiologia , Klebsiella pneumoniae/classificação , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Macrolídeos/uso terapêutico , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Penicilinas/uso terapêutico , Proteus mirabilis/classificação , Proteus mirabilis/efeitos dos fármacos , Proteus mirabilis/genética , Proteus mirabilis/isolamento & purificação , Pseudomonas aeruginosa/classificação , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , Staphylococcus aureus/classificação , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação , Sulfanilamidas/uso terapêutico
14.
J Dairy Sci ; 102(6): 5323-5329, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30954256

RESUMO

Chronic subclinical mastitis (SCM), characterized by changes in milk composition and high somatic cell count (SCC) in milk for a prolonged period of time, is often caused by a bacterial infection. Different levels of SCC have been suggested and used as threshold to identify subclinical infection. The aim of this study was to examine different definitions of SCM based on test-day SCC and estimate genetic parameters for these traits and their genetic correlation to milk production. Test-day SCC records from 1,209,128 Norwegian Red cows in lactation 1 to 3 were analyzed. Twelve SCM traits were defined as binary with 2 test-day SCC in a row above SCC thresholds from 50,000 to 400,000 cells/mL (SCM50, SCM100, SCM150, SCM200, SCM250, SCM300, SCM350, and SCM400), with 3 test-day SCC in a row above 200,000 and 400,000 cells/mL (SCM200_3 and SCM400_3), and the number of days before the first case with SCM50 (D50) or SCM400 (D400). The heritability and genetic correlations were estimated for SCM traits and the mean lactation-average somatic cell score (LSCS) using linear animal repeatability models. The total mean frequency of SCM ranged from 1.2% to 51.8%, for different trait definitions, high for low SCC threshold (SCM50) and low for the highest SCC threshold (SCM400_3). For the 2 traits based on number of days, the mean values were 104 (D50) and 117 (D400) days. The mean LSCS was 4.4 (equivalent to around 82,000 SCC). Heritabilities for the 12 alternative SCM traits were low and varied from 0.01 (SCM400_3) to 0.1 (SCM100), whereas for LSCS the estimated heritability was 0.3 and standard error varied from 0.001 to 0.003. Genetic correlations among the SCM traits ranged from 0.7 (D50 and SCM400) to 1 (SCM350 and SCM400), whereas between SCM traits and milk production the correlation ranged from 0.07 (LSCS) to 0.3 (D400). The standard error for genetic correlations varied from 0.001 to 0.06. The heritability was low and the genetic correlations were strong among SCM traits. Genetic correlations lower than 1 suggest that the alternative SCM traits are genetically different from LSCS, the trait currently used in genetic evaluations for Norwegian Red. Hence, the alternative traits will add information and improve breeding for better udder health.


Assuntos
Infecções Bacterianas/veterinária , Mastite Bovina/diagnóstico , Animais , Infecções Bacterianas/diagnóstico , Cruzamento , Bovinos , Contagem de Células/veterinária , Feminino , Predisposição Genética para Doença , Lactação/genética , Modelos Lineares , Mastite Bovina/genética , Leite/citologia
15.
Methods Mol Biol ; 1968: 195-202, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30929216

RESUMO

Imaging through the IVIS Spectrum CT system does not provide the resolution at cellular level like the high-resolution or super-resolution microscopy. Rather, it detects bacterial infections in specific anatomical compartments/organs of the animals. The IVIS Spectrum imaging system is a unique imaging technology that allows for real-time monitoring of disease progression in living animals through the use of either bioluminescent or fluorescent probes.


Assuntos
Infecções Bacterianas/diagnóstico , Medições Luminescentes/métodos , Infecções Pneumocócicas/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Animais
16.
J Orthop Surg Res ; 14(1): 100, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30971277

RESUMO

BACKGROUND: Spondylodiscitis is a chameleon among infectious diseases due to the lack of specific symptoms with which it is associated. It is nevertheless a serious infection, with 7% mortality of hospitalized patients, in large part because of delayed diagnosis. The aim of this study was to develop a diagnosis and course-of-disease index to optimize its treatment. MATERIAL AND METHODS: Through analysis of 296 patients between January 1998 and December 2013, we developed a scoring system for spondylodiscitis, which we term SponDT (Spondylodiscitis Diagnosis and Treatment) based on three traits: (1) the inflammatory marker C-reactive protein (CRP) (mg/dl), (2) pain according to a numeric rating scale (NRS) and (3) magnetic resonance imaging (MRI), to monitor its progression following treatment. RESULTS: The number of patients receiving treatment increased over the past 15 years of our study. We also found an increasing age of patients at the point of diagnosis across the study, with an average age of 67.7 years. In 34% of patients, spondylodiscitis developed spontaneously. Almost 70% of them did not receive treatment until the first diagnosis using SponDT. Following treatment against spondylodiscitis, pain intensity decreased from 6.0 to 3.1 NRS. The inflammatory markers also decreased (CRP from 119.2 to 46.7 mg/dl). Similarly, MRI revealed a regression in inflammation following treatment. By employing SponDT, patients were diagnosed and entered into treatment with a score of 5.6 (severe spondylodiscitis) and discharged with a score of 2.4 (light/healed spondylodiscitis). CONCLUSION: SponDT can be used to support the diagnosis of spondylodiscitis, particularly in patients suffering from back pain and elevated levels of inflammation, and can be used during the course of treatment to optimize control of therapy. LEVEL OF EVIDENCE: IIa-evidence from at least one well-designed controlled trial which is not randomized.


Assuntos
Infecções Bacterianas/diagnóstico , Discite/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Dor nas Costas/microbiologia , Infecções Bacterianas/complicações , Infecções Bacterianas/tratamento farmacológico , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Discite/complicações , Discite/tratamento farmacológico , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Índice de Gravidade de Doença , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/diagnóstico
17.
Vet J ; 247: 65-70, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30971354

RESUMO

Clinical signs of lower urinary tract disease in dogs are characteristic but non-specific for infection. It has been hypothesized that age, sex and neuter status influences the prevalence of urinary tract infection (UTI), but the predictive value of the combined clinical presentation has not been explored in dogs. The aim of the study was to assess clinical predictors (sex/neuter status, age, dysuria/stranguria, pollakiuria, macroscopic hematuria, malodorous urine and history of recurrent UTI) for bacterial cystitis, and to develop a clinical decision rule. Data was retrieved from medical records (retrospective cases) or from standardized recording sheets (prospective cases). Bacterial cystitis was defined as significant bacteriuria on quantitative bacterial culture in dogs with compatible clinical signs of urinary tract disease. Dogs of any breed, sex and age were included. A total of 1727 microbiology records were screened and 424 samples were included in the analysis. Bacterial cystitis was confirmed in 46% of the cases. Four variables predicted bacterial cystitis: sex/neuter status, age, pollakiuria and hematuria. A score was designated to each variable and a clinical rule was constructed. This rule attained an AUC of 0.75 and had sensitivity of 83% and specificity of 55% at its optimal cut-off (score ≥2.0). A score cut-off of ≥3.0 had a positive predictive value of 70%. Several factors predicted bacterial cystitis, but the clinical rule had only modest predictive value. Other variables or point-of-care test results should be included in future research to optimize overall precision.


Assuntos
Cistite/veterinária , Doenças do Cão/diagnóstico , Infecções Urinárias/veterinária , Animais , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/veterinária , Tomada de Decisão Clínica , Estudos Transversais , Cistite/diagnóstico , Cistite/microbiologia , Diagnóstico Diferencial , Cães , Feminino , Masculino , Probabilidade , Estudos Prospectivos , Valores de Referência , Estudos Retrospectivos , Infecções Urinárias/diagnóstico
19.
Med. clín (Ed. impr.) ; 152(6): 216-221, mar. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182080

RESUMO

Antecedentes y objetivo: La procalcitonina (PCT) puede ayudar al diagnóstico precoz de las infecciones bacterianas y estimar la respuesta obtenida. El objetivo es estudiar el valor de la PCT para el diagnóstico de la neumonía asociada a ventilación mecánica (NAV). Pacientes y método: Estudio prospectivo y observacional, realizado durante 18 meses, en una Unidad de Cuidados Intensivos (UCI) polivalente. Se incluyeron mayores de 18 años, con sospecha de neumonía luego de 48h de ventilación mecánica (VM). Se recogieron: datos demográficos, patología de ingreso, motivo de inicio de la VM, escalas de gravedad (APACHE II, SAPS II y SOFA), proteína C reactiva (PCR) y PCT. Al momento de la sospecha de NAV: precoz o tardía, severidad radiológica, presencia de shock séptico, SOFA, PCR, PCT y microbiología. Resultados: Se incluyeron 91 pacientes con sospecha de NAV. La media de edad fue de 42 (17,76) años y la de internación en la UCI fue de 18,59 (11,69) días. La NAV fue confirmada en 74 pacientes, de los cuales 19 (25,7%) presentaron shock séptico. La mortalidad fue del 28,4%. No hubo diferencias significativas de la PCT en los pacientes que presentaron NAV y los que no la presentaron (p=0,449). Cuando se compararon los pacientes sin NAV, con NAV y NAV con shock, la mediana de PCT fue de 0,38 (IC95%: 0,22-1,90), 0,56 (IC95%: 0,19-1,77) y 1,93 (IC95%: 0,38-10,07), respectivamente (p=0,169). Conclusiones: En nuestro trabajo la PCT no demostró utilidad para el diagnóstico de la NAV


Background and objective: Procalcitonin (PCT) can help the early diagnosis of bacterial infections and estimate the response obtained. The objective is to study the value of PCT for the diagnosis of ventilator-associated pneumonia (VAP). Patients and method: Prospective and observational study, carried out for 18 months, in a polyvalent Intensive Care Unit (ICU). Those included were over 18 years of age, with suspected pneumonia after 48h of mechanical ventilation (MV). Collected were demographic characteristics; admission pathology; reason for beginning MV; gravity scores (APACHE II, SAPS II and SOFA); C-reactive protein (CRP) and PCT. At the time of suspicion of VAP: early or late, radiological severity, presence of septic shock, SOFA, CRP, PCT and microbiology. Results: Ninety-one patients with suspected VAP were included. The mean age was 42 (17.76) and that of hospitalisation in the ICU was 18.59 (11.69) days. VAP was confirmed in 74 patients, of which 19 (25.7%) presented septic shock. The mortality was 28.4%. There were no significant differences of the PCT in the patients who presented VAP versus those who did not present VAP (P=.449). When patients without VAP, with VAP and VAP with shock, were compared, the PCT median was 0.38 (CI95%: 0.22-1.90), 0.56 (CI95%: 0.19-1.77) and 1.93 (CI95%: 0.38-10.07), respectively (P=.169). Conclusions: In our study, PCT did not prove useful for the diagnosis of VAP


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Pró-Calcitonina/administração & dosagem , Diagnóstico Precoce , Respiração Artificial/efeitos adversos , Pneumonia Associada à Ventilação Mecânica/diagnóstico , Infecções Bacterianas/diagnóstico , Estudos Prospectivos , Biomarcadores , Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico
20.
Klin Lab Diagn ; 64(2): 122-127, 2019.
Artigo em Russo | MEDLINE | ID: mdl-30917255

RESUMO

The aim of the study was to determine the comparative significance of basal metabolism indicators and inflammatory process markers for the closest prognosis of patients in ICUs with systemic inflammation syndrome caused with infectious genesis. The paper presents the results of a retrospective analysis of the plan of treatment of 198 patients with confirmed clinical and laboratory signs of bacterial infection. The number of leukocytes, platelets, the percentage of lymphocytes, the concentration of procalcitonin, creatinine, bilirubin, C-reactive protein, acid-base balance values were determined in patients. Patients were assessed on a SOFA scale. The type of biomaterial for microbiological research was determined depending on the intended source of infectious inflammation. Identification of the isolated microorganisms was carried out using the MALDI ToF mass spectrometry method, followed by determination of antibiotic resistance. Empirical antibiotic therapy was prescribed upon admission of the patient to the ICU. Patients were switched to etiotropic antibacterial therapy after 48 hours, taking into account the results of a microbiological study. Determination of basal metabolic rate was carried out using the method of indirect calorimetry (CCM Express, Medical Graphics) with the calculation of basal metabolism, respiratory coefficient, absolute and relative amount of macronutrients. The calculation of the protein was made on the basis of the nitrogen level of the daily urine urea. Logistic analysis (ROC analysis) revealed that the antibacterial therapy strategy used, age, gender of patients, tinctorial properties of microorganisms isolated from patients, do not affect the nearest prognosis of the disease. On the contrary, SOFA score, the concentration of procalcitonin in the blood, and such parameters of the metabolic status as the need for kilocalories per kilogram of actual body weight and the percentage of protein calories significantly affect the nearest prognosis of the disease. The percentage of calories derived from protein metabolism, in the main exchange has a high reliable predictive value. The results of the study confirm the importance of adequate nutritional therapy in the treatment of patients with infectious inflammatory syndrome, including the calculation and correction of protein loss and total daily calorie.


Assuntos
Infecções Bacterianas/diagnóstico , Infecções Bacterianas/metabolismo , Metabolismo Basal , Inflamação/metabolismo , Biomarcadores , Humanos , Inflamação/microbiologia , Prognóstico , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA