International Medical Publisher Journals (iMedPub)
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Streptococcus pneumoniae carriage, resistance and serotypes among Jordanian children from Wadi Al Seer District, Jordan
Get PDFObjectives: Isolation of Streptococcus pneumoniae from healthy children in Wadi Al Seer, Jordan before vaccination with prevenar.  Methods: Nasopharyngeal and throat swabs were colloected from 118 healthy children with age range from one to 50 months and mean age 13.4 months. Isolates were analysed for antimicrobial susceptibility, serotyping and macrolide resistant genotypes and phenotypes.Results: The overall nasopharyngeal carriage rate was 55.1% (n= 65/118). The percentage of resistance was as follows: Penicillin (80%), erythromycin (61.5%), clindamycin (33.8%), trimethoprim-sulfamethoxazole (73.8%), and tetracycline (53.8%). Vancomycin, Amoxicillin, cefotaxime, levofloxacin and telithromycin showed no resistance. 37/ 65 isolates (56.9%) were multiresistant. (MIC50, MIC90) were as follows (µg/ml): Penicillin (0.5, 2), erythromycin (2, >=32), clindamycin (0.06, >=32), trimethoprim-sulfamethoxazole (4, >=32), tetracycline (16, 32), and and levofloxacin (0.5, 1). Among macrolide resistant isolates 40 (61.5%), macrolide resistant phenotypes indicated were (n, %): M-Phenotypes (18, 45%), iMLSB (1, 2.5%) and cMLSB (21, 52.5%) with genotypes erm(B) 55%, and mef(A) 45%. The most common serotypes indicated were: 19F (18.5%), 6B (16.9%), 23F (12.3%), 35B (6.2%), 11A, NT and 15A (4.6%) each, and 14, 34, 23A, 6A, and 19A (3.1%) each. Coverage of PCV7, PCV10 and PCV13 was 52.3%, 52.3% and 58.5%, respectively.Conclusions: Carriage of pneumococci in Jordan is relatively high with high resistance rate which is a serious risk of future invasive and non invasive pneumococcal infections, and their spread is worrisome
Antibiotic Resistance and its Association with Biocides Susceptibilities among Microbial Isolates in an Egyptian Hospital
Get PDFBackground: Recently there has been a growing concern that the indiscriminate use of antimicrobial agents in the household, food industry and in hospitals may contribute to the emergence of bacteria resistant to antibiotics.Aim of the work: To detect any possible link between the susceptibility profiles of different clinical and environmental isolates to biocides and antibiotics in an Egyptian hospital.Methods: 66 different microbial isolates were isolated from different clinical specimens and different environmental samples obtained from a University Hospital in Alexandria. These isolates were screened for their susceptibility to 22 broad spectrum antibiotics using disc agar diffusion technique. Also the susceptibility of the isolates to 6 commonly used biocides was screened through MIC determination by agar dilution technique. Correlations between the obtained data were made through Spearman’s correlation using SPSS® Statistical program.Results: 62% of the isolates were multidrug resistant (MDR); and 11% were extremely drug resistant (XDR). On the other hand, 34% of the tested isolates were multi-disinfectant reduced susceptibility (MDRS) isolates. The statistical analysis of the obtained data revealed a moderate positive correlation between antibiotic resistance and biocide tolerance (0.376≥Ï≥0.278, p<0.05). In addition, strong significant correlations (p<0.01) were also found between reduced susceptibilities to multiple biocides such as benzalkonium chloride (BK), cetrimide (CET), chlorhexidine (CHX), povidone-iodine (PVPI) and Dettol®.Conclusion: Cross-resistance between biocides and antibiotics can aggravate the existing problem of antibiotic resistance in hospitals
Learning disorders related to exposure to general anesthetic in children
Get PDFBackground: There are many animal studies demonstrating increased neuroapoptose in the first periods of development, especially in stronger neural development regions. In young cobais neuroapoptose also noted, however, more localized area as the dentate nucleus and the olfactory bulb of the brain regions that show sinaptogênse even in adulthood and is responsible for learning. Objective: To describe the current studies about learning disabilities and cognitive impairment related to exposure to general anesthetics in children.  Method: This is a systematic review, performed from the search in the PubMed database using the keywords "general anesthetics," "neurotoxicity", "children", "young child" and "pediatric" with the criterion inclusion, published in the last five years, in English and related exposure to anesthetics in human children . Were excluded from the articles concerning the studies in experimental animals or that they focus on side effects of other substances on the central nervous system, such as alcohol.    Results: So were found 108 articles. All were analyzed by two researchers individually. Only 27 met the inclusion criteria. Discussion: In recent years, several studies have been conducted addressing neurotoxicity triggered by general anesthetics. The vast majority using experimental animals or stem cells. Suggest that both inhaled anesthetics such as venous are able to trigger the activation neuroapoptose with release of caspase 3:09, especially in phases of high growth and neural development. There is a strong association between duration of anesthesia and multiple exposures with learning disabilities and behavior. Conclusion: Currently, you can not say that the damage caused by agents in animals can be replicated humans. However, the severity of outcomes, the FDA recommends avoiding anesthesia and surgery in children under three years, at least those that do not have an emergency basis
Cardiovascular Diseases: Electron Transfer, Reactive Oxygen Species, Oxidative Stress, Toxicity, Antioxidants and Arrhythmia
Get PDFHeart attacks comprise one of the main causes of death in the USA. A main adverse influence in the heart is arrhythmia involving disruption of cardiac electrical function. Another category of injury is necrosis. Mounting evidence implicates electron transfer (ET), reactive oxygen species (ROS) and oxidative stress (OS) as important factors in cardiovascular diseases. In the generation of ROS, many in vivo enzymes are involved, in addition to exogenous agents. Less attention has been paid to ET functions as the source of ROS. Participation of OS is supported by beneficial effects of antioxidants, but not in all cases. It should be recognized that reaction mechanism is often multifacete
PatologÃa inflamatoria ocular: coriorretinitis serpinginosa
Get PDFDentro de la patologÃa inflmatoria ocular, la coriorretinitis serpinginosa es un tipo de uveitis posterior que afecta a la coroides y al epitelio pigmentario de la retina. Es una entidad de muy baja prevalencia pero con un curso recurrente y progresivo que puede llevar a la pérdida irreversible de la agudeza visual. Presentamos dos casos con afectación inflmatoria caracterÃstica asà como el tratamiento y pronóstico con el que cursaron y se comenta la literatura más reciente respecto a las caracterÃsticas demográfias y clÃnicas de las diferentes series de casos publicados asà como una actualización terapéutica
Condicionantes demográficos y clÃnicos para la elección inicial de la vÃa de administración de metotrexato y motivos para un posterior cambio de vÃa (Estudio MOTICAR)
Get PDFEstudio observacional, retrospectivo y multicéntrico que analizó los condicionantes demográficos y clÃnicos para la elección de vÃa oral (VO) o inyectable (VI) en la administración de metotrexato al paciente con artritis reumatoide y los motivos de los cambios posteriores. Se incluyeron 386 pacientes: 57,3% VO y 42,7% VI. El grupo VI presentaba una mayor actividad de la enfermedad y recibió inicialmente dosis más altas. El principal motivo de elección de VO por el reumatólogo fue la preferencia del paciente (63,3%) y para VI, su mayor eficacia (39,4%). De los que cambiaron de vÃa, el 92,4% pasó de oral a inyectable y el 7,6% de inyectable a oral. Los principales motivos de cambio a inyectable fueron: falta de eficacia del oral (35,7%) y efectos adversos (12,7%). Se observaron diferencias en las caracterÃsticas analizadas de los pacientes. Aquellos tratados por VI, presentaban una mayor actividad de la enfermedad, pero cambiaron menos de vÃa, tanto por razones de eficacia como de tolerabilida
Serum aldosterone levels in hemodialysis patients: a systematic review
Get PDFBackground: According to the data provided by the Brazilian Nephrology Society, between the years 2000 and 2011 the number of dialysis patients gradually increased. It is known aldosterone levels contribute to the onset of hypertension given the fact it is related to the increase in sodium absorption with a resultant increase of volemia. The aim of this study was to perform a systematic review regarding the relation between aldosterone levels and hemodialysis. Methods: A review was performed, based on the articles provided by databases Lilacs and Medline, with the descriptors “aldosterone†AND “hemodialysis†until the year 2014. Those articles with the descriptors in their titles or abstracts, or that evaluated the relation between aldosterone and hemodialysis in trials with humans were included. Findings: About 14 articles were excluded and 15 were included. Among the included articles, one was epidemiologic, five were clinical trials, two were prospective cohorts and seven were reviews. Conclusions: It was observed that aldosterone blockade in hemodialysis patients represents an important and safe therapeutic strategy owing to the consequent proteinuria and blood pressure reduction. These factors help reduce cardiovascular risk. Moreover, this strategy contributes to decrease renal injury, suggesting a beneficial effect on the prevention of chronic kidney disease
Traumatic brain injury (TBI): morbidity, mortality and economic implications
Get PDFTraumatisms, in general, result in high costs for health systems worldwide. They consist of the leading cause of death in young adults, primarily males. Traumatic brain injury (TBI) represents good part of this spending, reaching globally significant mortality rate, around 1.5 million victims a year. Only in the United States (US) attendances related to traumatic brain injuries in emergency departments revolve around 1.35 million annually, plus about 275,000 hospitalizations and 52,000 deaths. In Brazil, only in 2012 was spent over one billion dollars with hospitalizations related to external causes, including TBI. Mild TBI (Glasgow Coma Scale (GCS) 14-15) occur in about 80% of the total demand, moderate (GCS 9-13) in 10% and serious (GCS 3-8) in 10 %. Regarding mortality rate, this is relatively low compared to the total number, since much of fatal outcomes fits in the moderate to severe groups. One of lesions a valuable prognostic factor related to the TBI is the subdural hematoma (SDH), responsible for complications in up to 45% of cases of TBI, expressing mortality between 60-80% depending on the implemented workup and may even reach 90% when in delay of appropriate treatment. The acute subdural hematoma (ASDH) thus represents a neurosurgical emergency, taking most of these patients to be subjected to urgent evacuation of the hematoma by craniotomy, which also is not without risks, with several reports in literature of new contralateral hematoma formation after craniotomy for evacuation of hematoma, further aggravating the patient's prognosis. For best results of the TBI is needed better understanding of the pathophysiology, identification of newer parameters of brain function and development of innovative therapeutic modalities. According to the Centers for Disease Control and Prevention (CDC), under the Department of Health and Human Services, population data on TBI are fundamental for understanding its impact on the society and know the profile of patients and the mechanisms trauma, to assist in the formulation of prevention strategies and in setting priorities for research and support services to patients living with traumatic brain injury
Factors associated with survival of burned patients
Get PDFBackground: It is scarce in the literature studies regarding treatment and objective analysis of the survival chances of burned patients. Some investigations indicates the need for obtaining specific data to the population studied and characteristics such as social condition and nutritional status are suggested to be relevant to the patient’s evolution. We aimed to describe the mortality of a Treatment Center Burn Unit (BU) in Brazil. Methods: We analyzed 76 burned victims hospitalized with a fatal outcome in the General Hospital of São Matheus in 10 years (1999-2009). The following collected data were investigated were: age, sex, period of permanence, body surface burned (BSB), degree of burns, the causal agent, inhalation injury, nature of the event, clinical complications, mortality and survival rates. Results: We observed predominantly male and the median age was 44 years old. The highest incidence was on June. The mean body surface area burned was 40%, and upper limbs, the most affected region. The causative agents involved were more flammable agents and fire. Pulmonary infection was the most frequent clinical complication. The mortality found in this center was 4.9%. The subgroup of suicide were predominantly female and the mortality rate was 22.44%. When studying survival rate, patients with inhalation injury and trauma were associated with shorter survival. Patients with sepsis remained alive for longer. Conclusion:The clinical, epidemiological and survival of patients with burns, enables the design of peculiar characteristics of this trauma in the studied area, thus, from these data, charts be established treatment and prognostic estimates, and assist in developing preventive public health policy more effective. Factors associated with survival of burned patient
Trauma in Elderly People Attended by a Mobile Emergency Service
Get PDFIntroduction: The process of aging causes bio-psychosocial changes, that commonly, make the elderly more likely to be affected by chronic diseases and disorders due to external causes. Objective: Analize the occurrence of trauma and demographic characteristics of elderly people attended by a mobile emergency service. Method: This is a cross-sectional study conducted in the city of Sousa, in northeast region of Brazil, using data from 190 records of elderly victims of trauma attended by the MES from January 1St to December 31St of 2011. The Pearson’s chi-square test (χ2) or Fisher’s exact test with Freeman-Halton extension, were used to observe possible associations between variables. A significance level of α<5% was considered. Results: From the total of 190 elderly, 51.1% were male, aged between 60 and 104 years, mean age of 75.3 years (SD 10.44 years) and median of 74.0 years. Regarding the occurrence of trauma, 91.6% occurred in urban areas, 35.8% in the morning, 46.3% at weekend and 42.1% in the months from May to August. Falls stood out with 65.3% of cases and 87.9% had no alcohol on their breath during first-aid care. Among the injuries, wounds were predominant (62.3%) and 87.4% were referred to hospital. A significant association was observed between the presence of alcohol on the breath and sex (p<0.001) and age group (p=0.004) and between trauma mechanism and sex (p<0.001). Higher susceptibility was observed among males in the most advanced age group. Among the types of trauma, falls occurred mainly among women and traffic accidents among men. The presence of alcohol on the breath was verified especially among men and the majority of them were referred to hospitals. Conclusion: Knowledge of the characteristics of the demographics and occurrences of trauma in elderly people is necessary for the early identification of those individuals more exposed to this risk. Thus, it is considered that this research was relevant to characterize the elderly people requiring first-aid assistance and the occurrences of trauma, furthermore it is hoped that educational measures should be implemented in the community in order to prevent such traumas