Resistance determinants of emerging pathogens isolated from an intensive care unit as a parameter of population health conditions of the Legal Amazon microregion.

Bacteria responsible for causing infections are common in hospital environments, water, soil, and food products. The infection risk is intensified by the absence of public sanitation, poor quality of life, and food scarcity. These external factors promote the dissemination of pathogens by direct contamination or biofilm formation. In this work, we identified bacterial isolates obtained from intensive care units in the southern region of Tocantins, Brazil. We compared matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) techniques and 16S ribosomal ribonucleic acid (rRNA) molecular analysis; we also performed phenotypic characterization. Fifty-six isolates characterized using morphotinctorial tests were classified as gram-positive (80.4%; n = 45) and gram-negative (19.6%; n = 11) and were resistant to several antibiotic classes; notably, we identified the blaOXA-23 resistance gene in the ILH10 isolate. Microbial identification using MALDI-TOF MS resulted in the identification of Sphingomonas paucimobilis and Bacillus circulans. 16S rRNA sequencing revealed four isolates belonging to the genera Bacillus and Acinetobacter. The similarity was superior to 99% for Acinetobacter schindleri in the Basic Local Alignment Search Tool (BLAST), grouped in the clade superior to 90%. Several strains isolated from intensive care units (ICU) were resistant to various antibiotic classes. These techniques allowed for the identification of several microorganisms of importance in public health, enabling improvements in human infection control and proving the quality of inputs, food, and water.

[Use of botulinum toxin in the treatment of laryngeal dystonia (spasmodic dysphonia): preliminary study of twelve patients]. / O uso da toxina botulínica no tratamento da distonia laríngea (disfonia espasmódica): estudo preliminar com doze pacientes.

Laryngeal dystonia (spasmodic dysphonia) is a movement disorder characterized by involuntary contractions of laryngeal muscles involved with vocalization. The introduction of botulinum toxin in the treatment of laryngeal dystonia had a major clinical impact due to the striking improvement of symptoms. We report the preliminary results of therapeutical use of botulinum toxin in the treatment of twelve patients with laryngeal dystonia. After an extensive clinical evaluation, the patients underwent a videostroboscopic exam for diagnostic confirmation. Botulinum toxin was injected in the cricothyreoid membrane, directed towards the thyreoaritenoid muscle, with the aid of eletromyography needles. Most of patients who underwent botulinum toxin injection had a significant improvement of their symptoms (83%), with effects lasting for four months in average and without important side effects.

Reversible posterior leucoencephalopathy syndrome associated with bone marrow transplantation.

Reversible posterior leucoencephalopathy syndrome (RPLS) has previously been described in patients who have renal insufficiency, eclampsia, hypertensive encephalopathy and patients receiving immunosuppressive therapy. The mechanism by which immunosuppressive agents can cause this syndrome is not clear, but it is probably related with cytotoxic effects of these agents on the vascular endothelium. We report eight patients who received cyclosporine A (CSA) after allogeneic bone marrow transplantation or as treatment for severe aplastic anemia (SSA) who developed posterior leucoencephalopathy. The most common signs and symptoms were seizures and headache. Neurological dysfunction occurred preceded by or concomitant with high blood pressure and some degree of acute renal failure in six patients. Computerized tomography studies showed low-density white matter lesions involving the posterior areas of cerebral hemispheres. Symptoms and neuroimaging abnormalities were reversible and improvement occurred in all patients when given lower doses of CSA or when the drug was withdrawn. RPLS may be considered an expression of CSA neurotoxicity.

ELISA and modified toxin-binding inhibition test for quality control of the clostridial vaccine processes / ELISA direto e ToBI-test modificado para o controle de qualidade de processos de vacinas clostridiais

This study aimed to assess and standardize the ELISA and modified ToBI test in vitro methods in order to verify the potency of epsilon toxicoid in comparison with the in vivo TCP method. The following epsilon toxoids were used: NIBSC standard from batches 375/07, 532/08, 551/08, 373/07 and 378/07. These were evaluated using a TCP test, ELISA and ToBI tests. The results indicate that the correlation ratio between the dilutions of standard NIBSC toxicoid and absorbance values of 89.44% obtained with the ELISA method support the use of the curve to evaluate epsilon toxoids. However, it was observed that the absorbance values were similar for all toxoids, thus presenting no significant difference between higher and lower concentration toxoids. For the ToBI test, the correlation ratio of 96.76, obtained in the curve pattern, demonstrates the effectiveness of the curve to be used in the epsilon toxoid evaluation. The correlation ratio between the titration degrees of toxoids obtained through TCP and ToBI tests was higher than 90%. It is concluded that the type of ELISA test used does present discriminative power for toxoids with different concentrations, which does not support the use of this technique for such a purpose. The ToBI test can be used as a screening method for it is sensitive and effective to detect epsilon toxicoid produced by C. perfringens type D...

Teve-se por objetivo avaliar e padronizar as metodologias in vitro, ELISA e ToBI-test modificado, para a análise de toxoide épsilon, em comparação com a metodologia in vivo TCP. Foram utilizados os seguintes toxoides épsilon: padrão NIBSC e os lotes 375/07, 532/08, 551/08, 373/07 e 378/07, os quais foram avaliados por métodos in vivo, TCP, e in vitro, ELISA e ToBI-test. A análise do título de toxoide épsilon por meio dos métodos in vitro foi realizada a partir de uma curva-padrão, estabelecida previamente. Os principais resultados mostram que os valores de absorbância foram semelhantes para todos os toxoides, não apresentando diferença significativa entre os toxoides mais concentrados e menos concentrados. No ToBI-test, o coeficiente de correlação de 96,76%, obtido na curva-padrão, demonstra a eficiência da curva para avaliação do toxoide épsilon. O coeficiente de correlação entre os títulos de toxoide obtidos pelo TCP e ToBI-test foi superior a 90%. Conclui-se que o tipo de ELISA utilizado não apresenta poder discriminativo para toxoides com diferentes concentrações, inviabilizando a técnica para esse fim. O ToBI-test pode ser utilizado como um método de triagem sensível e eficaz para a detecção de toxoide épsilon de C. perfringens tipo D...

Biossegurança: uma revisão / Biosafety: a review

A biossegurança é o conjunto de ações voltadas para a prevenção, minimização ou eliminação de riscos que possam comprometer a saúde do homem e dos animais e o meio ambiente. Os primeiros debates sobre a biossegurança tiveram início na década de 1970, devido a preocupações com a segurança nos espaços laboratoriais e com as consequências que os constantes avanços tecnológicos na área de engenharia genética poderiam significar para o homem, bem como para os sistemas ecológicos. No Brasil, a regulamentação para atividades relacionadas a essas áreas teve início em 1995, com a criação da Comissão Técnica Nacional de Biossegurança. Suas funções são fiscalizar a manipulação de organismos geneticamente modificados (OGM) e certificar a segurança dos espaços laboratoriais. Este trabalho tem como finalidade disseminar os conceitos de biossegurança e proporcionar informações que auxiliarão na segurança do homem e do meio ambiente em aspectos relacionados às atividades de pesquisa, produção, ensino, desenvolvimento tecnológico e prestação de serviços.

Biosafety is a set of actions directed to the prevention, minimization or elimination of risks that could jeopardize the human's and animal's health and of the environment. The first debates about biosafety were held in the early 1970's due to the outbreak of transmissible diseases and to the concern to the safety in laboratory arenas. In Brazil, the regulations to activities related to these areas began in 1995 with the formation of the National Technical Biosafety whose functions are the inspection of the manipulated Genetically Modified Organisms (GMO) and of the laboratory arena safety. This review describes the biosafety concepts and their applicability known in order to improve the human safety as well as the environment in related issues to the research activities, production, teaching, technological development and given service.