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The purpose of this study was to identify the risk factors that predispose patients who are hospitalized with pressure ulcers (PUs) colonized by Gram-negative bacilli (GNB) to develop bacteremia. In addition, we also detected main phenotypes of resistance in infected and uninfected PUs. A prospective cohort study was conducted at the Clinical Hospital of the Federal University of Uberlândia including patients with Stage II or greater PUs, colonized or not with GNB, from August 2009 to July 2010. Infected ulcers were defined based on clinical signs and on positive evaluation of smears of wound material translated by a ratio of polymorphonuclear cells to epithelial cells ≥2:1, after Giemsa staining. A total of 60 patients with Stage II PUs were included. Of these 83.3% had PUs colonized and/or infected. The frequency of polymicrobial colonization was 74%. Enterobacteriaceae and GNB non-fermenting bacteria were the most frequent isolates of PUs with 44.0% of multiresistant isolates. Among patients who had infected PUs, six developed bacteremia by the same microorganism with a 100% mortality rate. In addition, PUs in hospitalized patients were major reservoir of multiresistant GNB, also a high-risk population for the development of bacteremia with high mortality rates.

BACKGROUNDPsoriasis is a chronic inflammatory disease that affects the skin and joints and has a multifactorial etiology. Recently, it has been suggested that Helicobacter pylori infection may contribute as a trigger for the development of the disease.OBJECTIVESTo determine the prevalence of H. pylori seropositivity in patients with psoriasis and to evaluate the relation between disease severity and H. pylori infection.METHODSH. pylori infection was assessed in psoriatic patients and controls by using H. pylori IgG quantitative enzyme immunoassay (ELISA test). The patients were classified according to the severity of the disease (PASI score).RESULTSOne hundred and twenty six patients with psoriasis (73 females and 53 males); mean age 50.48 years; 65 patients (51.59%) had severe psoriasis, 40 (31.75%) moderate psoriasis and 21 (16.67%) mild psoriasis. Twenty one healthy volunteers included as a control group, mean age of 41.05 years, 13 females and 8 males. One hundred and eleven patients with psoriasis tested serologically, 80 (72.07%) were seropositive compared with 7 positive volunteers (33.33%; P=0.002). Forty-nine (75.38%) patients with severe psoriasis were positive, 25 (62.50%) with moderate psoriasis were positive and 6 (28.57%) with mild psoriasis were positive (P=0.045). Study limitations: none.CONCLUSIONSH. pylori infection influences the development of psoriasis and severity of the disease.

Methods: Methods: Methods: Methods: We used 45 male Wistar rats, divided into three equal groups; in all there was performed a partial resection of the cecum. The groups were designated as Group 1: the lesion was treated with application of ethyl-2-cyanoacrylate, Group 2: suture and application of ethyl-2-cyanoacrylate, Group 3: purse-string suture. The animals were monitored postoperatively and half of each group was necropsied 14 days after the procedure, the remaining on the 28 th . They were subjected to macroscopic evaluation, had cecal samples collected for histological examination and the findings were submitted to statistical analysis. Results:Results: Results: Results: Results: Weight gain after the experiment was different among groups (p=0.028). The presence of microabscesses was higher at 28 days postoperatively in group 2 when compared to group 3 (p=0.003). The collagen deposition on the 28th postoperative day was greater in group 1 (p=0.036) and intensity of inflammation at the 14th postoperative day was greater in group 1 (p=0.045). In the other parameters there was no statistical difference.Conclusion: Conclusion: Conclusion:Conclusion: Conclusion: The use of ethyl-2-cyanoacrylate was effective in the treatment of cecal stump exclusion of rats as for macroscopic and microscopic findings and postoperative outcome.

Purpose: To evaluate if latex coated polypropylene mesh leads to less adhesions formation. Methods: 90 rats were distributed in three groups. Group I (control) was submitted to median laparotomy and posterior synthesis; Group II (polypropylene) was submitted to a segment resection of the abdominal wall, and the defect was corrected with a polypropylene mesh; Group III using the new material (latex coated polypropylene). After 45 days the euthanasia procedure was done and the adhesions were evaluated in 2 ways: 1) classification in a grading system; 2) evaluation of the adhesion area, which was calculated by resection of the adhesions after dying with Indian blue ink. Results: The classification in a grading system showed that Group III animals had less adhesions formation (P<0.05), but the evaluation of the adhesion area did not show any difference (P>0.05). The severe complications (fistula, evisceration and obstruction), which were lethal, were not reduced by the latex coated material. Conclusion: Latex coated polypropylene causes fewer adhesion formations than polypropylene alone, although it does not diminish the severe early complications. Key words: Polypropylenes. Latex. Surgical Mesh. RESUMO Objetivo:Avaliar se o revestimento da tela de polipropileno com látex leva a menor formação de aderências. Métodos: Foram utilizados 90 ratos, distribuídos em três grupos de 30: grupo I (controle) animais submetidos a laparotomia mediana e posterior síntese; grupo II (polipropileno) ressecção de segmento da parede abdominal e síntese com tela de polipropileno; grupo III, (polipropileno revestido por látex). Eutanásia foi realizada após 45 dias e as aderências avaliadas sob duas formas: 1) classificação em graus; 2) avaliação da área aderida, calculada corando-se o segmento da parede contendo as aderências que posteriormente foram ressecadas produzindo uma região clara em contraste com o restante da peça, corada. Resultados: Na avaliação por meio de graus, o grupo III apresentou menor formação de aderências (p<0,05), mas quanto a avaliação da área aderida não houve diferença (p>0,05). As complicações graves não foram reduzidas pelo revestimento por látex (p>0,05). Conclusão: O revestimento da tela de polipropileno por látex leva a menor formação de aderências, porém não diminui as complicações graves precoces.

Postoperative epidural catheter analgesia, under this study conditions, was found to be low risk for bacterial colonization in patients at surgical wards.

Although central vascular catheters (CVC) are indispensable in modern medicine, they are an important risk factor for primary bacteremias. We examined the incidence and risk factors associated with catheter-related bloodstream infection (CR-BSI) caused by Staphylococcus aureus in surgical patients. A prospective study was carried out in the Hospital das Clínicas da Universidade Federal de Uberlândia (HC-UFU) from September 2000 to December 2002. The skin insertion site, catheter tip, and blood were microbiologically analyzed. Demographics and risk factors were recorded for each patient, and cultures were identified phenotypically. Staphylococcus aureus was the most frequent pathogen, with an incidence rate of 4.9 episodes of CR-BSIs per 1,000 catheter/days. Based on logistic regression, the independent risk factors were: colonization on the insertion site =200 colony forming units (CFU)/20 cm 2 (p=0.03; odds ratio (OR) =6.89) and catheter tip (p=0.01; OR=7.95). The CR-BSI rate was high; it was mainly associated with S. aureus, and skin colonization at the insertion site and on the catheter tip were important risk factors for CR-BSI.

Objective: to compare the degree of bacterial contamination of surgical instrument tables used in clean surgical procedures, either protected with plastic fields, sterilized with ethylene oxide, or disinfected with 70% alcohol and 1% iodine solutions. This is a randomized clinical trial in which samples were collected from the surfaces of surgical instrument tables before and after each procedure. Microbiological analysis was performed to identify microorganisms and their respective antimicrobial resistance. Results: Bacterial growth in the surgeries using sterilized plastic was 5.71% before and 28.6% after surgery and, 2.9% and 45.7% respectively in surgeries using disinfection with 70% alcohol and 1% iodine solutions; no statistical difference was found between the methods. Conclusion: both methods present similar protection, however, 70% alcohol and 1% iodine do not generate solid waste.