No abstract

The prevalence of patients hospitalized in ICUs with COVID-19 and co-infected by pathogenic bacteria is relevant in this study, considering the integrality of treatment. This systematic review assesses the prevalence of co-infection in patients admitted to ICUs with SARS-CoV-2 infection, using the PRISMA guidelines. We examined the results of the PubMed, Embase, and SciELO databases, searching for published English literature from December 2019 to December 2021. A total of 542 rec ords were identified, but only 38 were eligible and, and of these only 10 were included. The tabulated studies represented a sample group of 1394 co-infected patients. In total, 35%/138 of the patients were co-infected with Enterobacter spp., 27% (17/63) were co-infected with methicillin-sensitive Staphylococ cus aureus, 21% (84/404) were co-infected with Klebsiella spp., 16% (47/678) of patients were co-infected with coagulase-negative Staphylococcus, 13% (10/80) co-infected with Escherichia coli (ESBL), and 3% (30/1030) of patients were co-infected with Pseudomonas aeruginosa. The most common co-infections were related to blood flow; although in the urinary and respiratory tracts of patients Streptococcus pneumoniae was found in 57% (12/21) of patients, coagulase negative Staphylococcus in 44% (7/16) of patients, and Escherichia coli was found in 37% (11/29) of patients. The present research demonstrated that co-infections caused by bacteria in patients with COVID-19 are a concern.

The clonal relationships and antimicrobial resistance of Staphylococcus aureus isolates from three fresh Minas cheese production lines were investigated. Putative S. aureus were confirmed by 16S rRNA gene sequencing and were characterised by multilocus sequence typing (MLST) and antimicrobial susceptibility. Overall, 33 out of 64 samples were contaminated with S. aureus (51.6%). The contamination rates of the dairies were 60.8%, 21% and 68.2%. Thirty representative isolates were selected to be typed by MLST and five sequence types (ST) were found (ST1, 97, 126, 3531), including the new ST 3816. The clonal complex 1 (CC1) was dominant. Resistance to commonly used antimicrobials was observed but only one strain was resistant to methicillin. This methicillin resistant S. aureus strain belonged to the CC126 that is commonly associated with mastitis in ruminants. The dissemination of zoonotic bacteria through the food chain is not a frequent event but represents a concern to public health.

O pseudo-aneurisma de ventrículo esquerdo após infarto agudo do miocárdio é entidade rara. Quando diagnosticado, deverá ser operado logo que possível, devido ao risco aumentado de rotura de sua parede. No período de novembro de 1992 a junho de 1995, foram encaminhados ao nosso Serviço 3 pacientes com suspeita clínica de pseudo-aneurisma de ventrículo esquerdo (VE), com sinais clínicos, radiológicos, ecocardiográficos e angiográficos característicos da lesão. O objetivo do trabalho é discutir o diagnóstico, a indicação cirúrgica, as técnicas e táticas empregadas, as complicações e os resultados cirúrgicos. Todos os pacientes foram submetidos ao ecodopplercardiograma transtorácico, que foi suficiente para o diagnóstico. Após propedêutica adequada, com realização de angiografia e ventriculografia, os pacientes foram submetidos à correção utilização de pericárdio bovino. Um dos pacientes apresentava comunicação interventricular (CIV), que foi corrigida no mesmo ato cirúrgico. Os pacientes receberam alta em bom estado geral, com controle ecocardiográfico evidenciando a correção do pseudo-aneurisma.
The postinfarction pseudoaneurysm of the left ventricle is a rare entity. When diagnosed it surgery is necessary, as soon as possible, due to the increased risk of rupture of its wall. During November 1992 to June 1995 three patients were sent to our Hospital with a clinical diagnosis of pseudoaneurysm of the left ventricle. They showed clinical, radiological, echocardiographic and angiographic signs characteristic of this pathology. Our objective is to discuss the diagnosis, surgical indication techniques, complications and surgical results. All patients were submitted to transthoracic echodopplercardiogram and it was enough for the diagnosis. After the realization of angiography and ventriculography the patients were submitted to surgery to correct the pseudoaneurysm using bovine pericardium. One patient showed an interventricular communication that was also corrected during the same operation. All patients were discharged in good condition with echocardiogram showing complete correction of the pseudoaneurysm

Buscando a revascularização completa do miocárdio, 165 casos foram analisados dentre 359 pacientes submetidos a cirurgia de revascularização do miocárdio, no período de janeiro de 1995 a janeiro de 1996, com pontes de veia safena e/ou artéria torácica interna, de forma seqüencial, ou associadas como enxertos compostos. Destes, 132 receberam pontes seqüenciais de veia safena servindo a 2 ou mais ramos arteriais coronários, 25 foram tratados através de anastomoses seqüenciais de artéria torácica interna, de forma simples, interessando aos ramos interventricular anterior e diagonais da coronária esquerda, enquanto 8 receberam enxertos compostos de artéria torácica interna direita e esquerda associados a segmentos de veias safenas, que terminavam em ramos das artérias coronárias direita e esquerda. Em 96% os casos a operação programada foi realizada, obtendo-se revascularização completa. Ocorreu um único (0,6%) óbito hospitalar conseqüente a infarto do miocárdio transoperatório, seguido de síndrome de baixo débito cardíaco; a morbidade não diferiu daquela presente nos procedimentos usuais de revascularização cirúrgica do miocárdio. Os cuidados na dissecção e preparo dos pedículos da artéria torácica interna, bem como na retirada e preparo para implante das veias safenas, somados àqueles necessários à obtenção da perfeita anastomose seqüencial, de modo a evitar torções, angulações e acotovelamentos dos enxertos, são enfatizados como fundamentais para o excelente resultado obtido na série analisada. Nossos resultados entusiasmam o emprego da crescente freqüência no uso da técnica da revascularização completa do miocárdio.
The authors analyse 165 patients out of 359 submitted to myocardial revascularization during the period between January 1995 and January 1996, in which the saphenous veins and the internal thoracic arteries have been used as a sequential graft, or associated with a composit graft; 132 received saphenous veins as a sequential graft to two or more coronary branches, 25 had sequential anastomosis of the left internal thoracic artery to IVA and diagonal branches of the left coronary artery, and 8 cases had both saphenous veins and internal thoracic arteries used as a composite graft to branches of the left and right coronary arteries. In 96% of the cases the scheduled surgery was performed, one patient died in the immediate post-operative period (0.6%) and the morbidity was not different from that found in the standard coronary artery surgery. Details of the preparation of the grafts, as well as operative technique is discussed, and the results of this series stimulated us for further use of the sequential grafts aiming for complete myocardial revascularization