Enteroaggregative Escherichia coli (EAEC) is an important agent that causes endemic and epidemic diarrhoeal diseases worldwide. Several EAEC virulence-related genes (VRGs) have been described but ...their role in the clinical outcome of infection is not completely defined. This study investigated the prevalence of EAEC and potential associations of its VRGs with risk of or protection from diarrhoeal diseases in children from urban communities in north-eastern Brazil. The case-control study included 166 children, who had their stools evaluated for the EAEC diagnostic genes (aaiC and aatA) using PCR. Positive samples were further analysed by multiplex PCR and identified 18 VRGs. EAEC was found in the same proportion in both groups (41%). The plasmid-borne gene encoding a hexosyltransferase homologue (capU) was the most frequently detected (89.6%), followed by dispersin protein (aap, 58.2%) and EAEC HilA homologue (eilA, 57.8%). The AAF/III fimbrial subunit (agg3A) gene was observed at lower frequency (1.5%). Plasmid-encoded toxin (pet) or AAF/II fimbrial subunit (aafA) was associated significantly with disease. AAF/IV fimbrial subunit (agg4A) or hypothetical plasmid-encoded haemolysin (orf61) was detected significantly more in controls than in children with diarrhoea. In addition, one set of genes in combination, aaiC and agg3/4C but lacking agg4A and orf61, was associated with diarrhoea cases; and another one, orf61 in the absence of pet and aafA, was correlated with control children. These data confirm a high prevalence, endemicity and heterogeneity of EAEC strains in the developing urban areas of north-eastern Brazil. Statistical correlation between cases and controls was seen with either isolated or combined sets of genes, suggesting that the pathophysiology of EAEC infection involves a complex and dynamic modulation of several VRGs.
To describe and evaluate the pharmacotherapeutic follow-up by a clinical pharmacist in an intensive care unit.
A descriptive and cross-sectional study carried out from August to October 2016. The ...data were collected through a form, and pharmacotherapeutic follow-up conducted by a clinical pharmacist at the respiratory intensive care unit of a tertiary hospital. The problems recorded in the prescriptions were quantified, classified and evaluated according to severity; the recommendations made by the pharmacist were analyzed considering the impact on pharmacotherapy. The medications involved in the problems were classified according to the Anatomical Therapeutic Chemical Classification System.
Forty-six patients were followed up and 192 pharmacotherapy-related problems were registered. The most prevalent problems were missing information on the prescription (33.16%), and those with minor severity (37.5%). Of the recommendations made to optimize pharmacotherapy, 92.7% were accepted, particularly those on inclusion of infusion time (16.67%), and dose appropriateness (13.02%), with greater impact on toxicity (53.6%). Antimicrobials, in general, for systemic use were drug class most often related to problems in pharmacotherapy (53%).
Pharmacotherapeutic follow-up conducted by a pharmacist in a respiratory intensive care unit was able to detect problems in drug therapy and to make clinically relevant recommendations.
Abstract This study determined the prevalence of Campylobacter jejuni / coli and its relation with nutritional status in children from Northeastern Brazil. This was a case-control study design. Stool ...samples were evaluated for hipO ( C. jejuni ), ask ( C. coli ), and cdtABC ( C. jejuni 's cytolethal distending toxin) genes. The nutritional status from these children was assessed by anthropometric measures and z-scores. C. jejuni and C. coli were detected in 9.6% (8/83) and 6.0% (5/83) in the diarrhea group and in 7.2% (6/83) and 1.2% (1/83) of the nondiarrhea group, respectively. Children with positive molecular detection of C. jejuni showed significantly lower z-scores than children without C. jejuni . The cdtABC operon was found in 57% of hipO+ samples. C. jejuni / coli prevalence was similar in diarrhea and nondiarrhea groups. There was a significant association of C. jejuni infection with lower nutritional status.
CARVALHO, Eunice Bobô de. Efeito da modulação da glutamina, alanil-glutamina, ß-caroteno, zinco e do leite de cabra transgênico contendo lisozima humana, em células epiteliais intestinais sob ação da ...Escherichia coli enteroagregativa. 2011. 167 f. Tese (Doutorado em Ciências Médicas) - Universidade Federal do Ceará. Faculdade de Medicina, Fortaleza, 2011.
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Previous issue date: 2011
The enteric infections cause 2.5 million deaths each year. The Enteroaggregative Escherichia coli (EAEC) is associated with persistent cause of diarrheal diseases. This study examined in vitro (IEC-6, Caco-2 and HEp-2 cells) the role of the micronutrients glutamine (Glu), alanyl-glutamine (Ala-Glu), beta-carotene (ß-Carot), zinc (Zn), and the milk of transgenic goats containning human lysozyme (M-Lyso) and their respective controls (Ctrle) in the following assays: proliferation, migration, viability, apoptosis, cell necrosis, and bacterial adhesion in response to infection caused by the EAEC-042 bacterial strain at a concentration of 2.5 x 105 CFU/mL. The effect of infection by EAEC-042 bacterial strain was evidenced by significant reduction in migration (p <0.001) and cellular viability (p <0.001); also increased apoptosis (p <0.001) and necrosis (p <0.001) in response to damage to the intestinal epithelium. It was observed that the micronutrients in the presence of bacteria significantly reduced apoptosis and necrosis caused by EAEC-042, as well as significantly reduced bacterial adhesion and increases cell migration. The control and transgenic milk abolished bacterial adhesion (p <0.001), independent of milk fat, and significantly reduce apoptosis (p <0.001) and necrosis (p <0.001) caused by EAEC-042. The qualitative analysis of EAEC adherence, considered as gold standard method, showed a reduction in bacterial adherence associated with intervention with micronutrients when compared with the EAEC-042 infection control. In conclusion, our study demonstrates the importance of intervention with micronutrients and milk (transgenic or not) in protecting the intestinal epithelial challenged by bacterial aggression.
As infecções entéricas causam cerca de 2,5 milhões de mortes ao ano. A EAEC está associada à causa de doenças diarréicas persistentes. Este estudo analisou in vitro (IEC-6, Caco-2 e HEp-2), o papel dos micronutrientes glutamina, alanil-glutamina, ß-caroteno, zinco, e dos leites de cabra transgênico com lisozima humana e controle nos ensaios de proliferação, migração, viabilidade, apoptose, necrose celular, adesão bacteriana em resposta à infecção causada pela cepa de EAEC-042 na concentração de 2,5 x 105 UFC/mL. A cepa bacteriana de EAEC-042 mostrou redução significativa na migração (p<0,001) e na viabilidade celular (p<0,001) e esta aumentou a apoptose (p<0,001) e necrose (p<0,001) em resposta a lesão ao epitélio intestinal. Foi observado que os micronutrientes na presença da bactéria reduziram significativamente a apoptose e necrose ocasionados por esta, bem como reduziram significativamente a adesão bacteriana, além de aumentar a migração celular. Os leites controle e transgênico apresentaram redução significativa da adesão bacteriana (p<0,001), independente da presença da camada de gordura, além de reduzirem significativamente a apoptose (p<0,001) e a necrose (p<0,001) ocasionadas pela EAEC-042. A análise qualitativa de aderência celular, considerada padrão ouro, mostrou redução na aderência bacteriana quando associados aos micronutrientes, comparados ao controle com EAEC-042. Nota-se a quase ausência de aderência em ambos os leites. Este estudo mostra a importância dos micronutrientes e leite de cabra transgênico ou não, sobre a proteção epitelial intestinal nas agressões bacterianas.
CARVALHO,Eunice Bobô. Detecção do fator V Leiden em pacientes trombofílicos no Estado do Ceará. 2004. 78 f. Dissertação (Mestrado em Patologia) - Universidade Federal do Ceará. Faculdade de Medicina, ...Fortaleza, 2004.
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Previous issue date: 2004
As doenças trombóticas constituem um sério problema na saúde mundial. Diversas desordens hereditárias, que afetam o sistema fisiológico anticoagulante, estão atualmente estabelecidas como fatores de risco para a ocorrência do evento trombótico. Dentre estes o fator V Leiden é o mais freqüente. A associação entre alterações no gene do fator V e a ocorrência de eventos trombóticos desencadeou o desenvolvimento de diversas pesquisas. Neste estudo, 100 pacientes portadores de eventos trombóticos, atendidos no ambulatório de Hematologia do Centro de Hematologia e Hemoterapia do Ceará - HEMOCE/SESA/UFC, foram analisados para a detecção da presença do fator V Leiden. O grupo controle consistiu de 110 voluntários sadios. A freqüência encontrada na população controle foi de 2,7% (03/110), enquanto que nos pacientes trombofílicos foi de 9% (09/100). Destes, 77,8% (07/09) eram do sexo feminino e 22,2% (02/09) do sexo masculino e a cor predominante foi a parda 66,7% (06/09). A faixa etária mais freqüente foi entre 26 e 33 anos 33,4% (03/09). Do total dos pacientes portadores do fator V Leiden, 88,9% (08/09) apresentaram trombose venosa profunda e 11,1% (01/09) trombose arterial com recorrência do evento trombótico de 22,2% (02/09). A correlação entre a presença do evento trombótico/presença do fator V Leiden e o uso de contraceptivo oral foi de 71,4% (05/07). Das pacientes portadoras e que usaram contraceptivo oral não ocorreu o aborto. A localização do primeiro evento trombótico, nos portadores, foi predominantemente nos membros inferiores 88,9% (08/09) e 11,1% (01/09), nas artérias coronárias. Em 44,4% (04/09) havia um ou mais fatores de risco/morbidade associado. A freqüência da mutação encontrada no estado do Ceará mostrou-se inferior aos dados obtidos na região de Botucatu (SP) - 12% e ao estudo de Benson, em Atlanta (EUA)- 12,4 e ainda menor que os encontrados na região de Campinas (SP)- 20% e à população com ancestral europeu-18%. A diferença entre pacientes trombofílicos e população controle não foi estatisticamente significante (p=0,19), mas o risco estimado para o evento trombótico foi de 2,46.
Una de las principales capacidades físicas exigida para la práctica de la gimnasia rítmica es la flexibilidad. En este sentido este estudio tiene como objetivo comprobar los niveles de flexibilidad ...de las extremidades inferiores y los posibles índices de asimetría de las gimnastas júnior de la Primera División de Portugal. La muestra está constituida por 30 gimnastas con una edad media de 13,73 ± 0,17 años. Para la evaluación se utiliza una batería de test en la que se recogen las imágenes de las gimnastas ejecutando cada elemento del estudio para un posterior análisis y clasificación en una escala de cinco niveles (0-4). Para el análisis estadístico de los datos se recurre a pruebas no paramétricas (Test de Mann-Whitney y Test de Wilcoxon). De acuerdo con los principales resultados obtenidos se constata que un 86,7 % de las gimnastas presentan índices de asimetría de flexibilidad entre la extremidad dominante y la no dominante de diferentes magnitudes.
One of the main physical abilities required in rhythmic gymnastics is flexibility. This study aimed to determine the levels of lower limb flexibility and the possible asymmetry indexes of gymnasts in ...the Junior 1st Division in Portugal. The sample consisted of 30 gymnasts with a mean age of 13.73 ± 0.17 years. For the evaluation we used a battery of tests in which we gathered images of the gymnasts performing each movement in the study for subsequent analysis and classification on a scale of five levels (0-4). For statistical analysis we used non-parametric tests (Mann-Whitney and Wilcoxon). The main results showed that 86.7% of the gymnasts presented high indexes of flexibility asymmetry between the dominant and non-dominant limbs of different magnitudes.
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