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Exploring the resistome, virulome and microbiome of drinking water in environmental and clinical settings
No full textAquatic ecosystems harbor a vast pool of antibiotic resistance genes (ARGs), which can suffer mutation, recombination and selection events. Here, we explored the diversity of ARGs, virulence factors and the bacterial community composition in water samples before (surface raw water, RW) and after (disinfected water, DW) drinking water conventional treatment, as well as in tap water (TW) and ultrafiltration membranes (UM, recovered from hemodialysis equipment) through metagenomics. A total of 852 different ARGs were identified, 21.8% of them only in RW, which might reflect the impact of human activities on the river at the sampling point. Although a similar resistance profile has been observed between the samples, significant differences in the frequency of clinically relevant antibiotic classes (penam and peptide) were identified. Resistance determinants to last resort antibiotics, including sequences related to mcr, optrA and poxtA and clinically relevant beta-lactamase genes (i.e. blaKPC, blaGES, blaIMP, blaVIM, blaSPM and blaNDM) were detected. 830 coding sequences (CDSs - related to 217 different ARGs) were embedded in contigs associated with mobile genetic elements, specially plasmids, of which 68% in RW, DW and TW, suggesting the importance of water environments in resistance dissemination. Shifts in bacterial pathogens genera were observed, such as a significant increase in Mycobacterium after treatment and distribution. In UM, the potentially pathogenic genus Halomonas predominated. Its draft genome was closely related to H. stevensii, hosting mainly multidrug efflux pumps. These results broaden our understanding of the global ARGs diversity and stress the importance of tracking the ever-expanding environmental resistome.2100-01-0
Pregnancy-induced hypertension, preterm birth, and cord blood adipokine levels
No full textMaternal hypertension may alter physiological parameters, dysregulating the release of hormones such as adipokines, thus influencing the fetal growth course. This study investigated whether hypertensive disorders of pregnancy alter cord blood adipokine levels and correlate these with anthropometric parameters in preterm infants. This is a prospective cohort study with pregnant women < 37-week gestation with and without hypertension and their offspring. Cord blood leptin, adiponectin, and ghrelin were analyzed by LUMINEX®. These adipokines were compared between the groups exposed or not to gestational hypertension using non-parametric statistical tests. The hypertensive pregnancies had significantly higher cord blood leptin (1.00 (IQR 0.67-1.20 ng/mL)) and adiponectin (18.52 (IQR 17.52-25.13 μg/mL)) levels than those without hypertension (0.07 (IQR 0.06-0.08 ng/mL) and 8.13 (IQR 6.50-8.68 μg/mL), respectively, p < 0.0001). The adipokine levels were higher in AGA and SGA infants in the exposed group for both moderate and late preterm. SGA had significantly higher ghrelin levels than the AGA infants. Ghrelin levels were negatively correlated with birth weight (r = - 0.613, p < 0.001), birth length (r = - 0.510, p < 0.001), head circumference (- 0.346, p < 0.002), and gestational age (r = - 0.612, p < 0.001).Conclusions: Our findings demonstrate an increase in adipokine levels in the cord blood of preterm newborn infants exposed to maternal hypertension. What is Known: • Clinical evidence suggests that concentration of the serum adipokines may be affected by risk of hypertension in both adults and pregnant women. • Maternal profile as hypertension alters intrauterine environment and could affect the function of fetal metabolism, impairing fetal growth. What is New: • Gestational hypertension modifies the adipokine profile, with higher rates already present at birth in cord blood samples. • Within the hypertensive group and stratifying for gestation age, ghrelin concentrations were higher in SGA newborns, both in the moderate and late preterm, compared with AGA newborns
Infección y muerte de profesionales de la salud por COVID-19: revisión sistemática
No full textObjetivo: Identifi car as evidências quanto à infecção pelo SARS-CoV-2 e óbitos dos profi ssionais de saúde e
fatores de risco relacionados.
Métodos: Realizou-se uma revisão sistemática buscando-se artigos nas bases de dados Scopus, Portal
Regional da BVS, Pubmed e Embase, relacionados à infecção e óbito de profi ssionais da saúde envolvidos no
tratamento de pacientes com a COVID-19. Não houve restrição quanto a data de publicação, idioma ou tipo
de estudo. Para a busca foi considerado publicações até 14 de abril de 2020.
Resultados: Foram incluídos 28 artigos. Os fatores de risco mais citados foram: escassez, uso inadequado
ou não uso de equipamentos de proteção individual, sobrecarga de trabalho, contato próximo com pacientes
e/ou colegas de trabalho potencialmente contaminados, procedimento com risco de geração de aerossol,
diagnóstico tardio e renovação de ar ambiente inadequado. De acordo com cada país, o número de
profi ssionais infectados variou de 1.716 a 17.306. Quanto aos óbitos, existem dados de até 605 profi ssionais
falecidos no mundo inteiro. As evidências encontradas são editoriais, estudos transversais e de coorte.
Conclusão: As evidências identifi cadas demonstram um alto número de profi ssionais infectados e que foram
a óbito, sendo a sobrecarga do sistema de saúde um fator signifi cativo.Objective: To identify evidences regarding infection by SARS-CoV-2 and deaths of healthcare workers and
related-risk factors.
Methods: We conducted a systematic review by searching the following databases SCOPUS, VHL Regional
Portal, PubMed and Embase. We included studies on infection and death of healthcare workers who delivery
care for COVID-19 patients. There were no restriction on date of publication, idiom, or type of study. The
search was conducted until April 14, 2020.
Results: A total of 28 articles were selected. Most mentioned risk factors were: scarcity, inadequate use or
non-usage of personal protective equipment, work overload, close contact with potentially infected patients
and/or coworkers, risk for aerosol-generating procedures, late diagnosis and inadequate air renovation.
According to each country, the number of infected workers ranged from 1,716 to 17,306. Concerning deaths,
there are data of up to 605 healthcare workers who died of COVID-19 all over the world. Evidences found were
editorials, cross-sectional, and cohort studies. Conclusion: Studies identified showed high number of infection and deaths among healthcare workers. Overload of health system was a significant factor.Objetivo: Identificar evidencias sobre la infección por SARS-CoV-2 y muerte de profesionales de la salud y factores de riesgo relacionados.
Métodos: Se realizó una revisión sistemática en busca de artículos en las bases de datos Scopus, Portal Regional de la BVS, Pubmed y Embase, relacionados
con la infección y muerte de profesionales de la salud involucrados en el tratamiento de pacientes con COVID-19. No hubo restricción respecto a la fecha de
publicación, idioma ni tipo de estudio. Para la búsqueda se consideraron publicaciones hasta el 14 de abril de 2020.
Resultados: Se incluyeron 28 artículos. Los factores de riesgo más mencionados fueron: escasez, uso inadecuado o falta de uso de equipos de protección
individual; sobrecarga de trabajo; contacto cercano con pacientes o compañeros de trabajo potencialmente contaminados; procedimientos con riesgo
generador de aerosoles; diagnóstico tardío y renovación inadecuada del aire interior. El número de profesionales infectados varió de 1.716 a 17.306, de
acuerdo con cada país. Respecto a las muertes, hay datos de 605 profesionales fallecidos en todo el mundo. La evidencia se encontró en editoriales, estudios
transversales y de cohorte.
Conclusión: Las evidencias identificadas demuestran un alto número de profesionales infectados y fallecidos, y la sobrecarga del sistema de salud es un
factor significativo
Relatos sobre prácticas de maternidad en prisión: la encrucijada entre el orden discursivo de la prisión y el del cuidado
No full textQuando dão à luz durante o período de aprisionamento, as mulheres presas têm o direito de conviver com seus filhos em unidades específicas para mães e bebês, pelo período mínimo de seis meses. Essa convivência tem como foco o cuidado e a proteção da criança, mas ocorre em um ambiente ordenado pela ordem prisional. Este estudo tem como objetivo analisar o exercício das práticas de cuidado materno na prisão. Foram realizadas seis entrevistas narrativas no Rio de Janeiro, Brasil: duas com mulheres que vivenciaram a experiência de maternagem no período de aprisionamento na Unidade Materno Infantil do Complexo Penitenciário de Gericinó e quatro com profissionais de organizações não governamentais que trabalharam com mulheres que tiveram seus bebês no período de encarceramento. A análise das narrativas foi feita a partir da interpretação dos papéis e das relações entre as personagens narradas e a forma como suas interações modelam as histórias contadas. Por fim, realizou-se a articulação interpretativa entre as narrativas e o referencial teórico sobre gênero e prisões. Concluiu-se que as normas prisionais e as normas de cuidado se tensionam e convergem em uma dinâmica que busca beneficiar o bebê, sem deixar de punir a mulher. Dessa maneira, a experiência de maternagem na prisão atua como forma de reafirmar uma moralidade de gênero, definida no papel de boa mãe.When women inmates in Brazil give birth during their incarceration, they have the right to stay with their children in specific units for mothers and infants for at least six months. The focus of this living experience is care and protection of the child, but it takes places in a setting determined by the prison order. This study aims to analyze the exercise of motherhood in prison. Six narrative interviews were performed in Rio de Janeiro: two with women who experienced motherhood while in prison in the Maternal and Child Unit at the Gericinó Prison Complex, and four with staff members of nongovernmental organizations working with women who had given birth during incarceration. The narratives were analyzed via interpretation of the roles and relations between the narrated characters and the way their interactions shape the stories. Finally, an interpretative linkage was established between the narratives and the theoretical frame of reference on gender and prisons. The study concludes that the prison rules and standards of care produce tensions and convergences in a dynamic that seeks to benefit the infant without failing to punish the woman. Motherhood in prison thus acts as a way of reaffirming a gender morality, defined as the role of good mother.Cuando dan a luz durante el período de encarcelamiento, las mujeres presas tienen el derecho de convivir con sus hijos en módulos específicos para madres y bebés, durante un período mínimo de seis meses. Esta convivencia tiene como objetivo el cuidado y la protección del niño, pero se produce en un ambiente establecido por el reglamento carcelario. El objetivo de este estudio es analizar el ejercicio de las prácticas de cuidado materno en prisión. Se realizaron seis entrevistas narrativas en Río de Janeiro, Brasil: dos con mujeres que vivieron su maternidad durante su período de encarcelamiento en la Unidad Materno Infantil, en el Complejo Penitenciario de Gericinó, y cuatro con profesionales de organizaciones no gubernamentales, que trabajaron con mujeres que dieron a luz a sus bebés durante el período de encarcelamiento. El análisis de los relatos se realizó a partir de la interpretación de los papeles y de las relaciones entre los personajes narrados y la forma en la que sus interacciones modelan las historias contadas. Finalmente, se realizó la articulación entre los relatos y el marco de referencia teórico sobre género y prisiones. Se concluyó que las normas carcelarias y las normas de cuidado entran en tensión y convergen en una dinámica que busca beneficiar al bebé, sin dejar de castigar a la mujer. De este modo, la experiencia de la maternidad en prisión actúa como una forma de reafirmación de una moralidad de género, definida dentro del papel de lo que se considera una buena madre
La visión de residentes en enfermería obstétrica para el contexto de la violencia obstétrica en las instituciones
No full textEste trabalho pretendeu compreender a percepção de residentes em Enfermagem Obstétrica sobre violência obstétrica em uma maternidade referência do município de Belo Horizonte, estado de Minas Gerais, Brasil. Trata-se de estudo descritivo e exploratório de abordagem qualitativa. A coleta dos dados foi realizada por meio de grupo focal. Para análise dos dados foi utilizada a análise de conteúdo de Bardin, da qual emergiram três categorias: condutas inadequadas de assistência ao parto; procedimentos desnecessários com finalidades didáticas e/ou iatrogênicas; e preconceito de gênero, raça/etnia e de classe socioeconômica. O estudo aponta que as residentes reconhecem a prática da violência obstétrica no processo de formação e suas repercussões para a mulher e, ainda, evidencia a necessidade premente de investimento institucional em espaços que promovam discussões sobre a violência obstétrica.This article aims to understand the obstetric nursing residents’ perception of obstetric violence in a reference maternity hospital in the Brazilian city of Belo Horizonte. It is a descriptive, exploratory, and qualitative study. Data was collected through a focus group. Bardin’s content analysis was used to analyze data, from which three categories emerged: inadequate birth assistance conducts; unnecessary procedures with educational and/or iatrogenic purposes; and gender, race/ethnicity, and socioeconomic class bias. The study indicates that residents acknowledge obstetric violence in the educational process and its repercussions to women. It also evidences the pressing need for institutional investment in spaces that foster discussions on obstetric violence.El objetivo de este artículo es comprender la percepción de los residentes en Enfermería Obstétrica sobre la violencia obstétrica en una maternidad referencia del municipio de Belo Horizonte, Brasil. Se trata de un estudio descriptivo, exploratorio de abordaje cualitativo. La colecta de datos se realizó por medio de un grupo focal. Para el análisis de datos se utilizó el análisis de contenido de Bardín, del cual surgieron tres categorías: conductas inadecuadas de asistencia al parto; procedimientos innecesarios con finalidades didácticas y/o iatrogénicas, prejuicio de género, raza/etnia y de clase socioeconómica. El estudio señala que las residentes reconocen la práctica de la violencia obstétrica en el proceso de formación y sus repercusiones para la mujer y, también, muestra la necesidad urgente de inversión institucional en espacios que promuevan discusiones sobre la violencia obstétrica
Dopplervelocimetria do istmo aórtico em fetos com crescimento intrauterino restrito: Uma revisão da literatura
No full textIntrauterine growth restriction (IUGR) is associated with poor perinatal prognosis and a higher risk of stillbirth, neonatal death, and cerebral palsy. Its detection and the evaluation of its severity by new Doppler velocimetric parameters, such as aortic isthmus (AoI), are of great relevance for obstetrical practice. The AoI is a vascular segment that represents a point of communication between the right and left fetal circulations. It is considered to be a functional arterial shunt that reflects the relationship between the systemic and cerebral impedances, and has recently been proposed as a tool to detect the status of hemodynamic balance and prognosis of IUGR in fetuses. In the present review, we noticed that in healthy fetuses, the AoI net flow is always antegrade, but in fetuses with IUGR the deterioration of placental function leads to progressive reduction in its flow until it becomes mostly retrograde; this point is associated with a drastic reduction in oxygen delivery to the brain. The more impaired the AoI flow is, the greater is the risk of impairment in the Doppler velocimetry of other vessels; and the alterations of the AoI Doppler seem to precede other indicators of severe hypoxemia. Although there seems to be an association between the presence of retrograde flow in the AoI and the risk of long-term neurologic disability, its role in the prediction of perinatal morbi-mortality remains unclear. The AoI Doppler seems to be a promising tool in the management of fetuses with IUGR, but more studies are needed to investigate its employment in clinical practice
New opportunities in tuberculosis prevention: implications for people living with HIV
No full textTuberculosis (TB) is a leading cause of mortality among people living with HIV (PLHIV). An invigorated global END TB Strategy seeks to increase efforts in scaling up TB preventive therapy (TPT) as a central intervention for HIV programmes in an effort to contribute to a 90% reduction in TB incidence and 95% reduction in mortality by 2035. TPT in PLHIV should be part of a comprehensive approach to reduce TB transmission, illness and death that also includes TB active case-finding and prompt, effective and timely initiation of anti-TB therapy among PLHIV. However, the use and implementation of preventive strategies has remained deplorably inadequate and today TB prevention among PLHIV has become an urgent priority globally
Coronavírus faz educação à distância esbarrar no desafio do acesso à internet e da inexperiência dos alunos
No full textO aumento no número de casos de coronavírus no Brasil levou à suspensão de aulas da rede pública e privada em todo o país. A medida serve para evitar aglomerações e deslocamentos. Segundo autoridades de Saúde, uma das melhores formas de parar a transmissão de casos é ficar em isolamento social. Sem aulas, estabelecimentos de ensino têm adotado a educação à distância (EAD), com uso de computadores e atividades complementares, para dar continuidade à aprendizagem das crianças. No entanto, nem todos os estudantes do país têm acesso a computadores e à internet de qualidade. Outro problema é manter a concentração de crianças mais novas, enquanto os pais também trabalham em casa. Segundo a Unicef, 154 milhões de estudantes estão sem aulas na América Latina e Caribe. A entidade alerta que a situação poderá se estender, e há risco de abandono escolar definitivo
Detection of drug resistant mycobacterium tuberculosis strains using kit SIRE nitratase®: A multicenter study
No full text(1) Background:
The Commercial Kit SIRE Nitratase® PlastLabor, is a drug susceptibility test kit used to detect Mycobacterium tuberculosis resistance to first-line TB treatment drugs. The present study aimed at evaluating its performance in a multicenter study.
(2) Methods:
To determine its accuracy, the proportion methods in Lowenstein Jensen medium or the BACTECTMMGITTM960 system was used as a gold standard.
(3) Results:
The study revealed that the respective accuracies of the kit with 190 M. tuberculosis clinical isolates, using the proportion methods in Lowenstein Jensen medium or BACTECTMMGITTM960 system as a gold standard, were 93.9% and 94.6%, 96.9% and 94.6%, 98.0% and 97.8%, and 98.0% and 98.9%, for streptomycin, isoniazid, rifampicin, and ethambutol, respectively.
(4) Conclusion:
Thus, the kit can rapidly screen resistance to streptomycin, isoniazid, rifampicin, and ethambutol. Additionally, it does not require sophisticated equipment; hence, it can be easily used in the laboratories of low and middle income countries