High occurrence of ARE suggests maintenance of selective pressure by the use of antibiotics/other substances in the Portuguese poultry environment. Persistence of a number of widespread PFGE types containing different resistance genes might reflect environmental/host-adapted enterococcal strains that might contribute to the maintenance of antibiotic resistance, thus constituting a resistance reservoir that is non-sensitive to banning interventions.
Resumo As dermatofitoses são infecções superficiais capazes de produzir lesões em tecidos queratinizados, como pele, pêlo e unhas. Foram examinados 6068 indivíduos procedentes de Goiânia, com suspeita clínica de infecções fúngicas, durante 5 anos (1993Goiânia, com suspeita clínica de infecções fúngicas, durante 5 anos ( -1997 (1993)(1994)(1995)(1996)(1997)
Resumo Criptococose é considerada a infecção fúngica sistêmica oportunista mais comum em pacientes com AIDS. Nestes pacientes tem predominado como agente etiológico Cryptococcus neoformans var. neoformans, e muito raramente relata-se C. neoformans var. gattiii, mesmo nas regiões onde se verifica a sua prevalência. Foram estudados 50 pacientes com lesões de criptococose meningoencefálica associada com AIDS. Os isolados foram identificados através de características microscópicas e macroscópicas exibidas em meios de ágar Sabouraud, ágar niger e Christensen. As variedades de C. neoformans foram determinadas pela reação de coloração obtida em meio de L-canavanina glicina-azul de bromotimol (CGB). Em todos os pacientes examinados foram isolados C. neoformans, sendo identificados C. neoformans var. neoformans em 47 isolados e C. neoformans var. gattii em 3. Os resultados encontrados mostram que a criptococose em pacientes com AIDS pode também ser causada por C. neoformans var. gatti, apesar de haver predominância de C. neoformans var neoformans nesta população. Palavras-chaves: Criptococose. Cryptococcus neoformans. AIDS.Abstract Cryptococcosis is considered the most frequent fungal systemic opportunist infection in patients with AIDS. C. neoformans var. neoformans infects the patients with AIDS more often than C. neoformans var. gattii which has been rarely isolated from patients with AIDS. Even in endemic regions of C. neoformans var. gattii, the variety of neoformans is still the most common agent diagnosed in cryptococcosis of patients with AIDS. Cerebrospinal fluid (CSF) from fifty patients with neurocryptococcosis associated with AIDS were studied. The fungi were isolated in agar Sabouraud medium, and were identified by microscopic and macroscopic examination by agar Sabouraud, agar niger and Christensen's urea medium. The variety was determined based on a color characteristic reaction on glycine-L-canavanina-bromothymol blue agar. From all of the fifty patients' cerebrospinal fluid (CSF) we were able to recover C. neoformans. The isolates were identified as C. neoformans var. neoformans in 47 patients and as C. neoformans var. gattii. in the 3 remaining patients. These findings suggest that both varieties, gattii and neoformans, are agents of neurocryptococcosis in patients with AIDS.
OBJECTIVE:To estimate prevalence of cardivascular risk factors among older adults with self-reported hypertension compared to those without this condition. METHODS: Data used was obtained from the system Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico RESULTS:Prevalence of self-reported hypertension was 55% (95% CI 53;57). The majority of hypertensives showed three or more concomitant risk factors (69%; 95% CI 67;71). It was found a high prevalence of insuffi cient physical activity during leisure (88%; 95%CI 86;89) and of fruit and vegetable intake below fi ve daily portions (90%; 95% CI: 88;90) among hypertensive subjects, followed by adding salt to meals (60%; 95% CI: 57;63), regular intake of fatty meats (23%; 95% CI: 21;25), smoking (9%; 95% CI: 7;10), and binge drinking (3%; 95% CI: 2;4). With the exception of smoking, these prevalences were similar to those reported by non-hypertensive subjects (p>0.05). Prevalence of smoking was lower among hypertensives (adjusted prevalence ratio [APR] = 0.75; 95% CI: 0.64;0.89), whereas prevalence of overweight (APR = 1.37; 95% CI: 1.25;1.49), dyslipidemia (APR = 1.36; 95% CI: 1.26;1.36), and diabetes (APR = 1.37; 95% CI: 1.27;1.37) was higher. CONCLUSIONS:Results suggest that, with the exception of smoking, unhealthy behaviors persist among older adults after hypertension is diagnosed. DESCRIPTORS: 2Health behaviors among hypertensive older adults Lima-Costa MF et al Worldwide, arterial hypertension is the leading risk factor for mortality, and ranks third among causes of loss of disability-adjusted life years.8 Global prevalence of this condition in adults is currently at 26%, but is expected to increase in coming decades.13 Risk of developing hypertension increases with age, making this the most common disease among older adults with prevalence of 60% or more in the developed world and in Latin America and the Caribbean. 13Hypertension is not an isolated phenomenon. Most hypertensives also display other risk factors, and the coexistence of such factors increases cardiovascular risk.12 Since many of these risk factors are modifi able, guidelines for prevention and control of hypertension tend to encompass the multiple risk factors displayed by the individual, including health behaviors. 4,18Population strategies for promoting healthy behaviors aim to prevent hypertension. Strategies targeting highrisk groups aim to reduce arterial hypertension, control other risk factors for cardiovascular events, and reduce the dose of medications required for controlling arterial pressure.4,18 A consensus exists that such strategies must be aimed at smoking cessation, reducing weight among overweight individuals, moderating alcohol intake, encouraging physical activity, reducing salt intake, increasing intake of fruit and vegetables, and decreasing intake of fatty foods. 18Health behaviors in the population have become an area of growing interest in several countries, including Brazil.a However, studies investigating such behavior...
Dermatophytes are a group of closely related fungi that have the capacity to invade keratinized tissue (skin, hair, and nails) of humans and animals to produce infections called dermatophytosis. In order to review the etiology and epidemiology of dermatophytosis in Goiânia, GO, 1955 specimens with diagnostic suspicion of dermatophytic lesions, were collected from January to December, 1999, from the Mycology Laboratory in the Institute of Tropical Pathology and Public Health, Federal University of Goiás. A total of 445 (22.8%) samples were positive for dermatophytes and Trichophyton rubrum was the most frequently isolated species (49.4%) followed by Trichophyton mentagrophytes (30.8%) and Microsporum canis (12.6%). Concerning the location of the lesions, the inferior limbs, feet and nails together with tinea capitis were the most frequently found clinical pattern in the majority of patients. Correlation between sex, age, location of the lesions and etiologic agents is considered in the study.
SUMMARYA comparison of the Etest and the reference broth macrodilution susceptibility test for fluconazole, ketoconazole, itraconazole and amphotericin B was performed with 59 of Candida species isolated from the oral cavities of AIDS patients. The Etest method was performed according to the manufacturer´s instructions, and the reference method was performed according to National Committee for Clinical Laboratory Standards document M27-A guidelines. Our data showed that there was a good correlation between the MICs obtained by the Etest and broth dilution methods. When only the MIC results at ± 2 dilutions for both methods were considered, the agreement rates were 90.4% for itraconazole, ketoconazole and amphotericin B and 84.6% for fluconazole of the C. albicans tested. In contrast, to the reference method, the Etest method classified as susceptible three fluconazole-resistant isolates and one itraconazoleresistant isolate, representing four very major errors. These results indicate that Etest could be considered useful for antifungal sensitivity evaluation of yeasts in clinical laboratories.
SUMMARYWhat is known and Objective: Anti-tuberculosis drugs (ATD), although highly effective, often cause liver injury. Glutathione S-transferases (GST) play a crucial protective role in the detoxifying mechanisms of drugs. Several studies have investigated the genetic null variants of GSTM1 and GSTT1 as possible risk factors for ATD-induced liver injury; however, those findings are inconsistent. We investigated GSTM1 and GSTT1 null genotypes in Brazilian patients with tuberculosis (TB), adjusting for other possible predictors of ATD-induced liver injury. Methods: This was a prospective cohort study with patients who were treated for TB from 2006 to 2011. GSTM1 and GSTT1 gene deletions were analysed from genomic DNA by polymerase chain reaction (PCR). Demographic, clinical and laboratory data were extracted from medical records and possible predictors of liver injury were evaluated. Results and Discussion: This study enrolled 177 patients. Antituberculosis drugs-induced liver injury incidence was 33AE3%. Hepatitis B infection (HBV) and increased alanine aminotransferase (ALT) baseline were significant predictors. Neither GSTM1 nor GSTT1 null genotypes were associated with ATDinduced liver injury; nevertheless, the comparison among four different liver toxicity grades showed that GSTM1 non-null genotype was significant more frequent among the higher grades of liver toxicity. What is new and Conclusion: GSTM1 and GSTT1 null genotypes do not seem to play important roles in ATD-induced liver injury in Brazilians. However, there was evidence that GSTM1 polymorphisms were possibly related to the intensity of toxicity. Active HBV and initial high ALT could predict ATD-induced liver injury. WHAT IS KNOWN AND OBJECTIVEStandard tuberculosis (TB) treatment with rifampicin (R), isoniazid (H), pyrazinamide (Z) and ethambutol (E) is highly effective; however, the multi-drug regimen for TB often causes adverse events. Hepatotoxicity is one of the most frequent and most serious adverse effects observed during TB treatment.
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