Listeriosis is a rare, serious, and mainly food-borne infection caused by the bacterium Listeria monocytogenes. This food-borne infection primarily affects pregnant women and immunologically compromised individuals. L. monocytogenes is recognized as a problem for the food industry, mainly due to its environmental persistence, attributed in part to its ability to form biofilms. Biofilms are microbial communities adhered to biotic or abiotic surfaces coated by self-produced extracellular polymers. These structures confer protection to bacterial cells and decrease the efficiency of cleaning and disinfection procedures. This article presents a brief review of current perspectives on the formation of biofilms, with emphasis on L. monocytogenes, highlighting the importance of cell-to-cell communication and structural composition of the microbial communities. The techniques currently used to study biofilms and the need to develop new strategies for the prevention and control of biofilm-forming pathogens are also discussed.
Applying a physical training program to a group of obese women after 3 months of bariatric surgery could promote a significant increase in CRF only in the trained group, yet also showing that bariatric surgery alone caused an improvement in the lung function of both groups.
Our results show that PCOS is associated with alterations in the autonomic modulation of heart rate, possibly due to the influence of weight gain.
ObjectivesTo evaluate the relationship between drug interactions and QT-interval prolongation in patients admitted to a general intensive care unit (ICU).MethodsThis study was approved by the Institutional Review Board and written informed consent was obtained from all patients. From May 2015 to July 2016, all patients over 18 years-old admitted to the ICU for more than 24 h and in whom the QT-interval on the ECG could be read were prospectively included in this observational, cross-sectional study. All medications administered in the 24 h prior to admission were recorded and the QT-interval was measured upon ICU admission and corrected with Bazzet’s formula (QTc). Drug-drug interactions involving drugs potentially associated with QTc prolongation (DDIQT) were searched and QTc increase associated with pharmacokinetic (PK-DDIQT) and pharmacodynamic (PD-DDIQT) interactions was assessed with multiple regression adjusted by patient varibles.ResultsThe study population consisted of 283 patients, 54.4% males, mean age 57.6 ± 16.7 years-old. Forty five (15.9%) patients presented 65 DDIQT with predominance of pharmacodynamic (66.1%). The risk of DDIQT prescription increased with lower systolic blood pressure, in hypokalemia, in non-diabetics and with the number of medications. PK-DDIQT alone did not affect the QTc interval (7.75 ms, 95%CI: –22.4 to 37.9 ms, p = 0.61), but PD-DDIQT increased QTc by 28.4 ms (95%CI: 9.67 to 47.4 ms, p = 0.003). Most PD-DDIQT involved metoclopramide with ondansetron or amiodarone, and ondansetron with ciprofloxacin.ConclusionsIn patients exposed to drugs associated with prolonged QTc in the 24 h prior to ICU admission, pharmacodynamic DDIQT are associated with increased risk of QTc prolongation.
Background: The optimum intensity of resistance training for hypertensive elderly has not been studied yet and the few studies in the literature used training with distinct intensities. Objective: To verify the effect of two resistance training intensities on blood pressure (BP) of elderly women with controlled hypertension. Methods: Sixteen older women with hypertension controlled by anti-hypertensive drug were randomly divided into two groups. Nine patients were submitted to moderate resistance training (G1) and seven patients were submitted to mild resistance training (G2). The patients underwent eight weeks of resistance training, with frequency of three times per week on alternate days in the afternoon. The exercises performed were: leg press, bench press, knee extension, lat pull-down, knee flexion, shoulder abduction, standing cable hip abduction and biceps curl. Results: G1 patients presented reduction in both resting values in diastolic blood pressure (DBP) p<0.03 and mean arterial pressure (MAP) p<0.03. G2 presented decrease in resting values of MAP (p<0.03) and a tendency to decrease in DBP (p<0.06). Magnitude of values decrease in both groups was higher than the ones reported in the literature. Conclusion: Both light and moderate training promoted cardiovascular benefits, even when initiated at old age. Moreover, both can be indicated as supporting treatment for older women with hypertension controlled by medication.
Introduction: This study aimed to analyze the survival of septic patients and to assess prognostic factors. Methods: Patients with sepsis, severe sepsis, and septic shock were followed up and clinical and laboratory data were collected. The sepsis-related organ failure assessment (SOFA) score was calculated. Results: The overall 30-day survival rates of patients with sepsis, severe sepsis, and septic shock were 86.3%, 72.5%, and 20%, respectively. Mortality was related to old age, septic shock, coagulopathy, lactate level, and high SOFA score among other factors. Conclusions: Identification of prognostic variables may reduce sepsisrelated mortality.
OBJETIVO Analisar o efeito de uma intervenção multifacetada no cuidado das gestantes com sífilis na atenção primária à saúde. MÉTODOS Trata-se de projeto de melhoria da qualidade realizado em 26 unidades básicas de saúde do município do Rio de Janeiro, entre janeiro e dezembro de 2017. O desenho foi quase-experimental misto, com análises anteriores, posteriores e de série temporal. Avaliou-se o cuidado prestado a todas as gestantes com sífilis e pré-natal encerrado no período, mediante dez critérios de qualidade e um indicador. A intervenção foi multifacetada, abrangendo educação permanente, melhoria dos registros e sistemas de informação, auditoria e feedback, educação do paciente, mudanças organizacionais e nos processos de trabalho. Estimaram-se as melhorias absoluta e relativa dos critérios e sua significância estatística (α = 5%). Os facilitadores e dificultadores da intervenção foram analisados segundo o Model for Understanding Success in Quality. RESULTADOS Após a intervenção, observou-se melhoria absoluta total de 6,7% (64,4% versus 71,0%) e relativa de 28,8% (p > 0,05). Oito dos dez critérios de qualidade tiveram melhoria, sendo esta significativa em quatro deles (p < 0,05). O indicador mensal de tratamento adequado também melhorou (p < 0,05), porém manteve baixo desempenho em todo o projeto. Destacou-se positivamente o aumento da conformidade do esquema de tratamento com o protocolo (91,4% versus 99,1%), porém as principais oportunidades de melhoria foram a testagem (42,8% versus 48,5%) e o tratamento das parcerias sexuais (42,8% versus 44,2%). Pressões regulatórias para melhorar o indicador mensal e a crise político-econômica vivenciada pelo município modularam o efeito da intervenção. CONCLUSÃO O projeto foi útil para identificar prioridades e orientar intervenções para a melhoria da qualidade da assistência à sífilis, embora ainda exista ampla margem para avanços. Os problemas identificados, bem como os moduladores contextuais do efeito, devem ser considerados em futuras intervenções.
Este livro visa contribuir para uma práxis de alfabetização de jovens e adultos desde uma perspectiva histórico-cultural marxista, adotada pelo Grupo de ensino, pesquisa e extensão em educação popular e estudos filosóficos histórico culturais (Genpex), desde seu projeto original em fins da década de 1980, no Paranoá e Itapoã. Seu foco é sobre a formação, que se prefere nomear constituição, de alfabetizadoras/es e formadoras/es de alfabetizadoras/es, na atividade pedagógica de elaboração de texto coletivo em sala de aula, como parte de um processo alfabetizador mais amplo, que se dá nas etapas de planejamento coletivo, execução do planejamento e avaliação do trabalho executado. O objetivo deste trabalho é iluminar o processo de elaboração de texto coletivo com base nas significações que alfabetizandas, alfabetizadoras, estudantes e professoras/es universitários/as constroem sobre a atividade ao nela se engajar durante um determinado tempo. Para isso, foram realizadas entrevistas com essas/es atoras/es e procedidas análises coletivas em várias rodadas de leitura e interlocução sobre os textos transcritos. Como principais achados tem-se que o texto coletivo se constitui nas relações sociais de contradição (avanços e recuos, acordos e desacordos) nos vários ambientes educativos numa perspectiva dialógica-dialética-transformadora. Sua elaboração é, ao mesmo tempo, produto e procedimento metodológico. Possibilita o dessilenciamento das alfabetizandas, alfabetizadoras, dirigentes do movimento popular, professoras, estudantes e demais atoras/es. Assim, a ampliação da compreensão sobre o texto coletivo revela as várias fases do seu movimento de constituição e de seus desdobramentos no processo alfabetizador.
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