Repositório RCAAP

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

This study describes the first changes signatures and networks of chemokines and cytokines serum of patients with congenital toxoplasmosis infants (TOXO), compared to non infected controls (NI). TOXO group was divided according to retinochoroidal injury status: without injuty (SL), active injury (RA), scar and active injury (RAC) and scar injury (RC). The author found out that TOXO displays an outstanding profile of chemokine mediated by IL-8/CXCL8, MIG/CXCL9, IP-10/CXCL10 e RANTES/CCL5. WHILE il-8/cxcl8 AND ip-10/cxcl10 are general biomarkers associated with ocular injury MIG/CXCL9 appears with an active selection biomarker for retinlchoroidal injury. Furthermore, TOXO is characterized by a mixed pattern of cytokines with proinflamatory/regulatory action mediated by IL-6, IFN-, IL-4, IL-5 e IL-10. While TNF appears as a putative biomarker for SL and IFN-e IL-5 as immunological characteristic of RA, IL-10 appears as an important mediator in RAC/RC. Signatures of serum biomarkers confirm that TOXO is accompanied by a significant storm of chemokines/cytokines with a wide range of proinflamatory/regulatory mediators. IL-8/CXCL8 e IP-10/CXCL10 are indicators of broad ocular disease spectrum, while TNF is a biomarker for SL, IFN- and MIG/CXCL9 point for RA and IL-10 is highlighted as an excellent serum biomarker of ACRL/CRL. In the RA network a clear shortening neighboring connections are observed, while SL and CR showed a balanced network, as it was observed in NI. This network balancing, however, similar to the one observed in NI is supported by a signature of chemokines/cytokines in separate SL and CR. Thus, we concluded that infants infected with T. gondii produce a wide range of biomarkers that characterize the different types of toxoplasmosis lesion, which may assist in prognosis and diagnosis of the disease.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

The first objective of this work was to study aspects epidemiologic, clinical, laboratory and treatment of 23 cases of Hantavirus Cardiopulmonary Syndrome (HCPS) diagnosed in the Uberlândia County, Minas Gerais, Brazil in the period among August of 1998 to December of 2005. All the analyzed parameters were obtained through the medical records of each patient one, filed at the researched hospitals and in the database of the surveillance service county. Fever, dyspnea and myalgia were the symptoms more frequently observed in this casuistry. The most prevalent physical signs were hypotension (65.0%) and tachycardia (65.0%). More common laboratory findings included thrombocytopenia (96.0%), hemoconcentration (83.0%) and leukocytosis (74.0%). Abnormal values of hepatic enzymes and abnormalities in chest radiography were equally frequent. In 55.5% of the patients were required orotraqueal intubation and hemodynamic support. There was statistically significant association between the type of mechanic ventilation used and the survival (p<0.01). Intravenous liquid infusion (p=0.5), as well as the use of drugs for increasing systemic vascular resistance and inotropism (p=0.2) and of corticosteroids (p=0.6), didn't have association with the patients' survival. The present study confirmed the seasonal pattern of HCPS in the Uberlândia region and the involvement of professional groups considered of low infection risk in the transmission cycle of the disease.The second objective was to detect the soroprevalence of antibodies against hantavirus in urban and rural population samples of the municipal district of Uberlândia - MG and to correlate the soroprevalence found to the possible risk factors researched. It was raffled, randomly, 200 inhabitants of the urban zone and 200 of the rural, totaling 400 people. Individual interviews were led to characterize the population with relationship to the demographic and socioeconomic aspects, besides investigating possible factors associated SCPH. It was obtained, for venopuncture, blood samples of 400 inhabitants between 13 and 76 years. The participants survey sera were submitted to indirect ELISA, in the dilution 1:400, seeking to the detection of IgG antibodies for Araraquara hantavirus. General positivity rated 3.0%, being of 2.0% in the urban zone and 4.0% in the rural zone. In the urban zone, there was not statistical significance for the positivity difference for hantavirus in relation to the sex (p=0.43). The mean age of the seropositives participants was higher significantly when compared with those with negative serology (p=0.03). In relation to the activities, exposure and risk indicators for the hantavirus disease, statistically significant association was not observed for none that variables in relation to the positivity. In the rural zone, the positivity difference in relation to the sex was significant (p=0.03). All were of the male sex and with higher age to 40 years. The mean age of participants with positive serology was higher in relation to the seronegatives individuals (p=0.05). Among the activities, exposure and risk indicators associated to the hantavirus disease, only the activity "soil plowing " just showed significant association in relation to the positivity (p=0.02). There was not significant difference among the positivity for hantavirus and dwelling place (urban/rural) (p=0.19). There also was not difference among the means of age of the seropositives individuals of the urban and rural zone (p=1.0). However, the sex of the seropositives individuals was statistically different in those areas (p=0.02).The prevalence of antibodies Araraquara-reagents in inhabitants of Uberlândia-MG demonstrates that the transmission of the hantavirus is not rare, and, once again it is also confirmed in that area, the hypothesis of the existence of oligo or asymptomatic infections.

Handwashing frequency may result in harmful effects on the skin, promoting the increase of the prevalence of nosocomial important microorganisms. This study purpose was to assess the quantitative and qualitative changes of the total microbiota (both permanent and transient) from hands of nursing professionals and university laboratory technicians and students due to the irritant action provoked by frequent washing and/or wearing gloves. Sixty health professionals were enrolled from whom collections were performed by the sterile polyethylene bag, before and after washing hands with 3 mL of nonantimicrobial soap for 30 seconds. In the group formed by students and laboratory technicians (n=30), these collections were performed before and after consecutive washings with water and soap. Damaged hands health professionals hands contamination was higher when compared with healthy hands. Hygiene proved to be efficient in both students and laboratory technicians without complaints of irritation after successive washings, a fact not seen among health care workers. Nurses with damaged hands presented higher frequency of S. aureus, Gram negative bacteria and yeast than the healthy ones (P>0.05), as well as the sum of these microorganisms (P=0.07) and presence of S. haemolyticus (P=0.02). The frequency of S. aureus and antimicrobial resistant Gram negative bacteria was higher among nurses damaged hands. The irritation caused on the skin by the frequent washing and/or wearing of gloves may cause changes of hands microbiota and should be considered when choosing hygiene products.

Nosocomial infections caused by antibiotic resistant bacteria represents a substantial problem due to increasing in mortality, morbidity and health-care costs, especially in intensive care units. This study evaluated the frequencies of epidemiologically important antibiotic resistance phenotypes, recovered from ventilator-associated pneumonia (VAP) in critically ill patients and urinary tract infection (UTI) and bloodstream infections (BSI) in critical and non-critical patients. An one year study was performed in the adult intensive care unit (AICU) of the Clinical Hospital (CH) of Federal University of Uberlândia, where clinical specimens were obtained for diagnosis of VAP and UTI; moreover, the laboratory of the CH provided data that was used to define all the cases of BSI and UTI in non-critical units; additionally, a monthly inquiry of the antimicrobials consumption was carried through in AICU at the period of the study. Coagulase-negative staphylococci predominated as etiological agent of BSI in critically ill (24.6%) and non-critical (30.6%) patients, with frequency of 60,0% of oxacilin-resistant coagulase-negative staphylococci; Klebsielleae (23.4%) and E. coli (29.6%) were the major cause of UTI in critical and non-critical patients, respectively, with resistance above 20.0% to third generation cephalosporins and P. aeruginosa (42.0%) was the main etiological agent of VAP, with rates of resistance to imipenem and fluoroquinolons above 70,0%. The prevalence study of antibiotic consumption in the AICU pointed to cephalosporins (49.6%), followed by vancomycin (37.4%) and carbapenems (26.6%) as the most prescribed antibiotics in the unit. The comparison of our findings with other national and international studies demonstrated a highest frequency of antibiotic resistant phenotype in our hospital, in critical and non-critical units, especially among the Gram-negative bacterias, however, it was not observed a significant variation between the frequency of resistance phenotypes recovered from critical and non-critical units, what strongly suggests that these phenotypes had already spread in the hospital, except P. aeruginosa whose resistance to antibiotic was more expressive when recovered from critical patients than non-critical ones.

Hospital environment represents a secondary reservoir of pathogens as Staphylococcus aureus, including MRSA, mainly the surfaces that can be touched and cotaminated by healthcare personnel hands. This study was achieved in the Uberlândia University Hospital, MG - Brazil, between January and August 2004. The objective of this study was to assess qualitative and quantitatively the contamination of surfaces touched by hands (over-bed tables, room door handles and side rails) and floors by S. aureus (MRSA and MSSA) in rooms from patients with infection by this microorganism. Fifty two patients were investigated, including 26 with infection (cases) and 26 controls. The surface was sampled during bedmaking by using the stamp method with sterile adhesive tapes (6 cm2) which was placed on Egg Yolk Salt Agar. S. aureus was identified by Gram staining and the coagulase test. S. aureus was detected in 50% of rooms without differences between the two groups (46,2% in the infected patients versus 53,8% in the controls). The difference in the density of S. aureus contamination was also not significant in both groups but the floor contamination was 5 fold higher than in other sites. This results suggest extensive contamination of S. aureus in the hospital but the density was less than 1 CFU/cm2. The numbers of S. aureus on the floor and the other sites did not correlated with those in the air in the room. Despite of more patients were infected and / or colonized by MRSA than MSSA isolates the latter were more frequent (65,7% versus 34,3%) in the environmental sites. In conclusion, we found an extensive environmental contamination with S. aureus in a hospital caring for many infected and colonized patients. Actually this is not generally regarded as a major source of S. aureus infection but is widely recognized that further investigations in the clinical significance of the hospital environmental contamination and of more effective cleaning methods are necessary.

In spite of the good results in food industry and institutional restaurants the Hazard Analysis Critical Control Point (APPCC) system has not been widely applied to the problems of hospital infection control. The aim of this study was to investigate the microbiological quality of blenderized (powder and artisanal) and ready-to-use feed Pré and Pós implementation of APPCC system in Brazilian teaching hospital. The presence of mesophilics, total and fecal coliforms, Staphylococcus aureus, Bacillus cereus, C. perfringens, Salmonella spp and Listeria was researched in 76 samples of enteral feeds into two different Groups of foodhandlers (one Group worked in a day and other worked in the next day) and stored at 4ºC for until 18 h, critical control points as blenders were also researched, surface of cans, water and foodhandlers nostril and handlers. Artisanal and powder feeds Pré the APPCC system was around 50% above the recommended, and Pós the APPCC system implementation these value increased to 57 % and 97% above the recommended respectively. The ready to use feeds conserved 100% adequacy in two moments, Pré and Pós APPCC. Blenders used in preparing of enteral feeds were found to be the important source of contamination. It was noticed the importance of personnel hygiene mainly in one of two Groups of workers Pré implementation of the APPCC system. Contamination of enteral feeds can be reduced and powder feeds can be available with microbiologic quality similarly to ready-to-use diets if principles of the APPCC system are implemented.

The Insect Growth Regulators are considered more selective than the conventional insecticides, are not toxic to mammals if used in the recomended dose and are easily degradable in environment. Diflubenzuron and Methoprene are IGRs from the chitin sinthesis inibithors and juvenile hormones analogs classes, respectively. These IGRs show comprovated eficience against Haematobia irritans, one of the most important bovine ectoparasite. Digitonthophagus gazella is a natural enemy of H. irritans because it changes the structure and bury the bovine feces, habitat of the imatures stages from this parasite. The purposes of this work were to measure the suceptibility of adults and imatures of D. gazella to the IGRs Diflubenzuron e Methoprene, analyse the interference of this insecticides in the progeny production, verify the action of the insecticides in the duration of the life cicle and in the sex ratio of beetles that have been exposed along all their development cicle and analyse, according the IOBC (International Oranization for Biological Control), the toxicity of the IGRs to the beetle D. gazella. Pairs of beetles were placed in buckets partially filled with humid soil and were fed with bovine feces containing 1, 0,5 and 0,2 ppm of Diflubenzuron and 0,2 ppm of Methoprene, during the time necessary to oviposition and development of the progeny. Thereafter, they were recovered by pitfall traps, as well as their respective progenies. The IGRs not affected the survival of the adults inicially exposed, but interfered on the production of their progenies according to the methodology used. Diflubenzuron 1 and 0,5 ppm also interfered in the duration of the life cicle of the beetles. None of the tested concentrations of the IGRs modified the sex ratio of the beetles progenies. Diflubenzuron tested concentrations showed to be moderately harmful to the beetles whereas Methoprene 0,2 ppm was only slightly harmful, according to the IOBC.

Respiratory syncytial virus is well recognized as the most important pathogen accounting for acute respiratory disease in infants and young children, mainly bronchiolitis and pneumonia. Two major antigenic subgroups, A and B, have been identified; however, there is a disagreement between the severity of the disease caused by them. This study investigated a possible association between RSV subgroups and severity of the cases. Reverse transcriptionpolymerase chain reaction was used to characterize 128 RSV nasopharyngeal specimens from children less than five years old experiencing acute respiratory disease. It was possible to subgroup 64.1% samples in RSV A (64) and RSV B (18). Severity was measured by clinical evaluation associated with demographic factors. For RSV A-infected patients, 53.1% were hospitalized, whereas for RSV B it was 27.8%. Around 35.0% of the patients presented risk factors for severity. The hospitalization happened for 47.6% of RSV A patients and for 18.2% of RSV B, for children without risk factors. It was observed a trend for RSV B infection to be milder than RSV A. Even though RSV A infected patients were more likely to require hospitalization than those infected by RSV B, including cases without underlying condition and prematurity, the disease severity could not to be attributed to the RSV subgroups.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Background: Lolium multiflorum (Lm) grass pollen, Poaceae family, is the major cause of pollinosis in South Brazil. There are no studies evaluating the cross-reactivity between allergenic fractions from L. multiflorum and other pollen grass species. Objective: To evaluate the sensitization to Lm pollen allergens in patients with pollinosis through the detection of specific IgE by skin prick test (SPT) and immunoassays (ELISA). To characterize immunodominant fractions from L. multiflorum pollen allergens, and crossreactivity with other allergens from commercial grass pollen extracts. Methods: Thirty eight serum samples from patients with seasonal allergic rhinitis (SAR group), 35 serum samples from patients with perennial allergic rhinitis (PAR group) and 30 serum samples from non atopic patients (NA group) were tested for IgE reactivity. The sensitization was evaluated using SPT and IgE specific levels against L. multiflorum pollen extract were determined by ELISA. Inhibition ELISA and Immunoblotting were used to evaluate the cross-reactivity between allergens from L. multiflorum and commercial grass pollen extracts. Results: Serum specific IgE antibodies against Lm were detected in 100% of patients from SAR group and in 8.6% of patients from PAR group. Inhibitions observed in specific IgE ELISA demonstrated Lm cross-reactivity between homologous (Lm) and heterologous (L. perenne [Lp] or Gramíneas II [GII]) grass pollen extracts, but not for Gramíneas I (GI). Fourteen IgE binding fractions were observed and the fractions of 26, 28 and 32 kDa were the most frequent (> 90%). For IgE Immunoblotting inhibition Lm, Lp and GII inhibited significantly IgE binding to the most Immunodominant fractions of Lm, particularly the 55kDa fraction. The 26 kDa fraction were not inhibited by the Lp extract, but it was inhibited by Lm and, GII in lower proportion. Conclusion: Lm pollen extract is more appropriate instead of other phylogenetic related grass pollens for determining quantitative sensitization in diagnostic and therapeutic purposes to pollinosis due to L. multiflorum pollen.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

The VAPs associated with antibiotics multi-resistant bacteria characterize themselves by higher morbidity, mortality and costs. The aim of this study was to evaluate epidemiological differences among resistant (ORSA) and sensible (OSSA) S. aureus to oxacillin VAPs, as well as its prognostic when of the empirical antimicrobial therapeutic, beyond the relationship between the antibiotic consumption of carbapenems, 3rd and 4th-generations cephalosporins, vancomycin and the etiology multi-resistant microorganisms VAPs in patients in a mixing ICU of adults. A prospective control (10)-case (13) study was conducted. Cases of VAP caused by these phenotypes (ORSA and OSSA) in 23 patients were carried out from May 2006 to April 2007. VAPs were defined based on clinical, when its onset occurred after 48 hours of mechanical ventilation, radiological and microbiological ( 106 CFU/ml count in the tracheal aspirate) criteria. A total antibiotic usage density was determined and stratified by group of antimicrobial agents. Resistance rates profile was defined in vitro by the diffusion in gel technique. Altogether 53 cases of VAPs were diagnosed. S. aureus pneumonia was observed in 23 cases, 53.5% and 43.5%, respectively, by ORSA and OSSA, predominant in late-onset VAPs with frequencies of 92.3% and 60.0%, respectively. Age > 60 was the only risk factor for VAP by ORSA (P<0.05). Mortality rate was higher (P>0.05) in this group with 38.5% versus 20.0% in the group with OSSA, although the inadequate antibiotic therapy in the group with pneumonia by ORSA was lower (P>0.05) than that observed in the cases of VAP by OSSA (23.1% versus 30.0%). The two most frequent pathogens isolated in the participating patients were P. aeruginosa (40.0%) and S. aureus (38.3%) with about 2/3 of the samples resistant to imipenem and oxacylin, respectively. The consumption of 3rd and 4th-generations cephalosporins (496.9 DDDs/1.000 patient-days) was highest and associated with the increase in the incidence of VAPs by P. aeruginosa and S. aureus, as well as by resistance to antibiotics phenotypes. The prescribing of vancomycin and carbapenems (143.0 and 184.3 DDDs/1.000 patient-days) were proportionally lower and the latter linked with higher P. aeruginosa rates. S. aureus was the second agent of VAPs with 56,5% of cases by ORSA, associated with age, late-onset VAP, use of corticoids and antibiotics and hospitalization time > 8 days. Although statistically significant differences were not observed, there was a worse prognostic in the cases of VAPs by this phenotype, and a relationship with the prescription of some antibiotics and the etiology higher than 50% of multi-resistant microorganisms.

Universidade Federal de Uberlândia

In order to plan, apply and discuss a series of activities with the intent of contributing to the 9th grade student of Elementary School to be able to read, understand and write texts of opinion. In order to show how the proposal of working the genre as a tool can help students to be successful on the comprehension and production of text of opinion, we proposed a production of this type of writing from the perspective of interactional sociodiscursive Dolz, Noverraz and Schneuwly (2004) and didactic sequences. We also adopted the Bakhtinian assumptions, from that is possible to contemplate the three constitutive dimensions of genre (thematic content, compositional structure and style). To develop the proposal, we followed the planned steps by the didactic sequence. From that, the students were taken to the knowledge of the work object, the text of opinion; then, we propose the first production with diagnostic purposes. From the difficulties presented by the students in the first production, we prioritized in modules, activities that addressed the three elements of the genre, and finally, the final production work that was read by other students of the same school year that the participating students in the research. All the students productions were exposed on the school message board. The results showed that working with text of opinion in classroom, from the didactic sequence, helps students to obtain the writing competence. We noticed that in the course of initial production to final production, many students have built learning from the three constituents elements of the genre text of opinion, since many of them were able to stand by in relation to the proposed theme for the text productions that was dating without commitment - \"hook up\" and build argumentative strategies that supports their opinions. Besides, they have brought other voices to text built in the final production and appropriated themselves of the specific language of the genre being studied. Negative points were also noticed, both during the application of research and during data analysis. We found out, for example, that the time of the application of the methodological proposal was inadequate for a greater number of students could be able to achieve satisfactory results. Similarly, another point was considered, the large number of students who were participating in the activities affected the application of the research as it was planned.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais