Autor: Marketing Côrtes

Distribution of ESBL-producing enterobacteria associated to community-acquired monomicrobial urinary tract infections and antimicrobial susceptibility trends over a 9-year period

Publicado em por .

Abstract

Urinary tract infections (UTIs) are among the most common infectious diseases affecting men and especially women, with increased frequency related to gender and age.1 In general, treatment is empiric and regional, with several expanded-spectrum antimicrobials supported most of the time, by microbiological and epidemiological data provided by antibiotic resistance surveillance systems.2 When considering the worldwide spread of bacterial resistance determinants, prospective regional and international data on aetiology and drug susceptibility patterns of bacteria
related to UTI are important.3,4 Additionally, the characteristics of the disease, whether it is a nosocomial or community-related UTI, are known to play an important role in empirical antimicrobial therapy, especially when considering urinary tract pathogens.5

 

*Não disponível em português.

 

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Epidemiological, Clinical and Laboratory Aspects of Infectious Processes Caused by Sars-Cov-2

Publicado em por .

Abstract

Since December 2019, COVID-19 (coronavirus disease 2019) originating in Wuhan, China, caused by SARS-CoV-2, responsible for severe acute respiratory syndrome, has become a major global public health problem. The presentation of these diseases ranges from asymptomatic to severe cases, which may lead to death. Such differences in pictures are due to both clinical and epidemiological factors. This study aims to evaluate epidemiological, clinical and laboratory information from patients in the community with a positive result for the coronavirus obtained at a primary laboratory in Juiz de Fora/Minas Gerais. This research was based on the analysis of data from individuals of both sexes, over 18 years old, exclusively outpatients, with a positive result for COVID-19. This study showed a predominance of male individuals as carriers of SARS-CoV-2 (65%, n=13) and a mean age of 41.9 years, ranging from 28 to 64 years. According to the medical records, all evaluated patients had some symptoms for COVID-19, the most frequent being myalgia (50%, n=10), fever and cough (45%, n=9, both). Regarding comorbidities, the most prevalent were alcoholism (25%, n=5) and systemic arterial hypertension (25%, n=5), with a portion also presenting upper respiratory tract disease 10%, n=2). The biomarkers (red cells, hemoglobin, hematocrit, white blood cells, eosinophils, rods neutrophils, segmented neutrophils,
lymphocytes, platelets, fibrinogen, partial thromboplastin time, prothrombin time, lactate dehydrogenase, ferritin, D-dimer and C-reactive protein) determined 14 days after diagnosis of COVID-19 were mostly within the reference or negative values. From this research, it was concluded that the clinical, epidemiological and laboratory data are compatible with clinical findings in the literature on mild cases of COVID-19.

 

Keywords: COVID-19; SARS-CoV-2; Epidemiology; Laboratory Biomarkers.

 

*Não disponível em português.

 

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Association of Leptin and Dried Fruit Mix and Nuts With Craving During Smoking Cessation

Publicado em por .

Abstract

Objective:
The objective of this study was to assess dried fruitmix and nuts and their effect on craving associated with the serum leptin of tobacco smokers.
Materials and Methods:

This is a clinical intervention study with a nonproba-bilistic sample (n = 23). The intervention group (IG) received 30 g of dried fruit and mix, and the control group (CG) received standard interventions. Test craving was analyzed using the Questionnaire of Smoking Urges (QSU-Brief). Serum leptin was assessed at the beginning and after 3 weeks. The data was tested using the SPSS program through the Shapiro-Wilk, unpaired Student t, or Mann-Whitney tests and multivariate linear regression.

 

Results:
The study showed significant difference between initial and final weights and body mass indices. The IG showed a high degree of smoking dependence. The IG showed reduced craving. In the CG, median serum leptin levels showed increased craving in the second and third weeks.

Conclusions:
Our results establish that craving decreased among smokers only in the IG. In the CG, above-median serum leptin levels reported a greater sense of pleasure in the second week. And in the third week, they experienced difficulties maintaining abstinence.

Keywords: tobacco smoking, craving, serum leptin, dried fruit, nuts.

 

*Não disponível em português.

 

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Structural Study of Prepuce in Hypospadias—Does Topical Treatment With Testosterone Produce Alterations in Prepuce Vascularization?

Publicado em por .

Abstract

Purpose: Androgen stimulation before hypospadias surgery has resulted in increased penile size, fewer complications and improved cosmesis, and suggests increased neovascularization. To our knowledge the real effect on neovascularization remains to be proved. We studied the histological effects of testosterone on neovascularization.

Materials and Methods: A total of 26 boys with hypospadias were randomly allocated to 2 groups before surgical correction. Group 1 did not  eceive any treatment and group 2 received 1% testosterone propionate ointment twice daily for 30 days before surgery. During the surgical  rocedure a fragment of prepuce was excised and prepared for histological evaluation. The number and volume density of blood vessels were  etermined by labeling for von Willebrand’s factor. Blood vessel quantification as volume density was done using a video microscopy system with   superimposed cycloid arch test system.

 

Results: The groups were similar in age and hypospadias classification. Testosterone treated prepuces (group 2) had an increased absolute number of bloodvessels (mean SD 8.5 1.3 vs 4.8 1.8 vessels per field) and increased bloodvessel volume density (mean 50.5% 7.8% vs 24.8% 8.6% vessels per point) (each p 0.001) compared to those in untreated patients (group 1).

 

Conclusions: The use of 1% testosterone propionate ointment before hypospadias surgery produces neovascularization in absolute numbers and in volume density.

 

Keywords: urethra; neovascularization, physiologic; hypospadias;  testosterone; foreskin.

 

*Não disponível em português.

 

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Physiological and molecular characteristics of carbapenem resistance in Klebsiella pneumoniae and Enterobacter aerogenes

Publicado em por .

Abstract

Introduction: Bacterial resistance is a growing concern in the nosocomial environment in which Klebsiella pneumoniae and Enterobacter
aerogenes play an important role due to their opportunism and carbapenemase-production. This work aimed to evaluate physiological and
molecular characteristics of carbapenem-resistant K. pneumoniae and E. aerogenes isolated in a Brazilian tertiary hospital.
Methodology: In total, 42 carbapenem-resistant bacteria isolated from clinical specimens were included (21 K. pneumoniae and 21 E.
aerogenes). Drug-sensitive K. pneumoniae (n = 27) were also included. Antimicrobial susceptibility and biocide tolerance patterns, hemolytic

activity, tolerance to oxidative stress, and aggregative ability were assessed. Genetic markers related to carbapenem resistance, or ESBL-
production were screened by PCR.

Results: Compared to drug-sensitive strains, carbapenem-resistant K. pneumoniae were more tolerant to biocides and to oxidative stress, and
they displayed an increase in biofilm formation. The genetic markers blaKPC (95.2%) and blaTEM (90.5%) were the most frequent. Among the
carbapenem-resistant E. aerogenes strains, blaKPC, and blaTEM were detected in all bacteria. Drug-sensitive E. aerogenes were not isolated in
the same period. blaSHV, blaVIM, and blaCTX markers were also observed among carbapenem-resistant bacteria.
Conclusions: Results suggest that carbapenemase-producing enterobacteria might show peculiar characteristics regarding their physiology
associated with their environmental persistency, virulence, and multidrug resistance. The observed phenomenon may have implications not
only for antimicrobial chemotherapy, but also for the prognosis of infectious diseases and infection control.

 

Keywords: Carbapenemases; enterobacteria; antimicrobial resistance; biocide tolerance.

 

*Não disponível em português.

 

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Epidemiological characteristics and antimicrobial susceptibility among carbapenem-resistant non-fermenting bacteria in Brazil

Publicado em por .

Introduction: Non-fermenting Gram-negative bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii are widespread in the
environment and are increasingly associated with nosocomial infections. Extensive and indiscriminate use of antibiotics in hospitals has
contributed to an increased number of infections caused by these microorganisms, that are resistant to a wide variety of antimicrobials, including
β-lactams. This study aimed to isolate and identify carbapenem-resistant Acinetobacter spp. and P. aeruginosa from hospitalized patients, to
determine their antimicrobial susceptibility patterns and to screen for blaOXA-23, blaOXA-24, blaOXA-51, blaOXA-58, and blaOXA-143 genes among the isolated bacteria.

 

Methodology: Antimicrobial resistance patterns were performed using the disk-diffusion method. Genetic markers related to carbapenem
resistance were screened by polymerase chain reaction.

 

Results: Carbapenem-resistant Acinetobacter spp. (n = 44) and P. aeruginosa (n = 28) samples were isolated from patients admitted to a tertiary
hospital. Polymyxin B was the only effective drug for all isolates. Considering the oxacillinase gene screening, genetic markers were observed
only in Acinetobacter isolates. The most frequent genotype observed was blaOXA-23+/blaOXA-51+(45.5%), followed by blaOXA-51+/blaOXA-143+(41%). The oxacillinase genes blaOXA-24 and blaOXA-58 were not detected. High mortality rates (> 70%) were observed.

 

Conclusions: The data suggest the need for rational use of antimicrobials associated with early diagnosis of multidrug-resistant bacteria,
especially considering non-fermenting Gram-negative rods, which are widespread in hospitals. The findings of blaoxa-51-strains suggest the
occurrence and spread of non-A. baumannii species throughout our hospitals. Effective implementation of surveillance programs in hospitals
is needed to reduce infectious and resistant intra- and inter-species bacteria.

 

Key words: Pseudomonas; Acinetobacter; carbapenem-resistant bacteria.

 

*Não disponível em português.

 

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Sacar de la Invisibilidad a los Fumadores con Múltiples Condiciones Crónicas: Enfoque Nutricional en la Deshabitución Tabáquica

Publicado em por .

Abstract

El tabaquismo es una enfermedad crónica resultante de la dependencia de la nicotina, y constituye un importante factor de riesgo para el desarrollo y el agravamiento de las enfermedades crónicas no transmisibles (ECNT). Actualmente, un número creciente de personas viven con dos (o más) de estas afecciones, reconocidas en consecuencia como condiciones crónicas múltiples (CCM). Es inmediato que en casos de CCM dejar de fumar es esencial y beneficioso para el control y paliación de las complicaciones de la enfermedad [RESUMEN TRUNCADO DESPUÉS DE LAS PRIMERAS 80 PALABRAS].

 

*Não disponível em português.

 

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Phenotypic and genotypic evaluation of betalactamases (ESBL and KPC) among enterobacteria isolated from communityacquired monomicrobial urinary tract infections

Publicado em por .

Abstract

Beta-lactamases enzymes such as extended-spectrum beta-lactamases (ESBL) and carbapenemase type beta-lactamases (KPC) confer resistance to beta-lactam drugs among Gram-negative rods, mainly Enterobacteriaceae, as those frequently related to urinary tract infections (UTI). The aim of this study was to evaluate ESBL and KPC among enterobacteria isolated from monomicrobial UTI and to establish correlations between the presence of genetic markers and the phenotypic resistance to beta-lactam antibiotics. Out of 12 304 urine samples collected during 2009, 93 enterobacteria showing an ESBL phenotype were recovered. Imipenem was used for KPC screening and modified disk approximation assay was used for detection of ESBL phenotype. Polymerase chain reaction was used for screening of bla(SHV), bla(TEM), bla(CTX-M), and bla(KPC). Considering the isolated bacteria showing ESBL phenotype 56% of the isolates were positive for two genes. The bla(TEM) was the most frequent (87·1%). Neither KPC phenotype nor bla(KPC)-harboring bacteria were observed. Monitoring the antimicrobial resistance is extremely important to sustain empirical therapy of community-acquired urinary tract infections (Co-UTI).

 

Keywords: ESBL,; Enterobacteria,; KPC,; Urinary tract infections.

 

*Não disponível em português.

 

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Homem consciente cuida da saúde

Publicado em por .

#NovembroAzul

 

No Brasil, o câncer de próstata é o segundo mais comum entre os homens. De acordo com o INCA (Instituto Nacional do Câncer), o Brasil contabilizou 65.840 novos casos de câncer de próstata em 2020, correspondendo a 29,2% dos tumores incidentes no sexo masculino. Mais do que qualquer outro tipo, é considerado um câncer da terceira idade, já que cerca de 75% dos casos no mundo ocorrem a partir dos 65 anos. Quando diagnosticado precocemente, há 90% de chances de cura.

 

 

Quais são os sintomas do Câncer de Próstata?

O câncer de próstata geralmente surge como uma doença silenciosa e indolor. Além disso, muitas vezes os sintomas podem ser confundidos ou atribuídos a outras doenças. Os sinais são frequentemente detectados pela primeira vez durante exames de rotina.

Na fase inicial, o câncer de próstata não apresenta sintomas e quando alguns sinais começam a aparecer, cerca de 95% dos tumores já estão em fase avançada, dificultando a cura.

  • dor óssea;
  • dores ao urinar;
  • vontade de urinar com frequência;
  • presença de sangue na urina e/ou no sêmen.

 

Além disso, alguns fatores de risco podem colaborar com a doença:

  • histórico familiar de câncer de próstata: pai, irmão e tio;
  • raça: homens negros sofrem maior incidência deste tipo de câncer;
  • obesidade.

Como prevenir? 

Segundo o Ministério da Saúde, a única forma de garantir a cura do câncer de próstata é o diagnóstico precoce. Mesmo na ausência de sintomas, homens a partir dos 45 anos com fatores de risco, ou 50 anos sem estes fatores, devem ir ao urologista para conversar sobre o exame de toque retal, que permite ao médico avaliar alterações da glândula, como endurecimento e presença de nódulos suspeitos, e sobre o exame de sangue PSA (antígeno prostático específico).

Cerca de 20% dos pacientes com câncer de próstata são diagnosticados somente pela alteração no toque retal. Outros exames poderão ser solicitados se houver suspeita de câncer de próstata, como as biópsias, que retiram fragmentos da próstata para análise, guiadas pelo ultrassom transretal.

Segundo o  infográfico disponibilizado pelo INCA, a doença pode estar relacionada com as condições de trabalho.

 

 

 

Confira todas as informações no infográfico:

https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//inca-info-prostata.pdf

 

Quebrar tabus é salvar vidas.

Ir ao urologista regularmente é o caminho para a detecção precoce. A recomendação médica é que se façam exames de PSA e toque retal a partir dos 50 anos. Para pessoas com parentes próximos que tiveram a doença mais jovens, os exames podem começar um pouco antes. Por isso, cuidar do seu corpo deve ser prioridade.

 

Fontes: Ministério da Saúde; INCA – Instituto Nacional do Câncer; ONG OncoGuia

Exames para o cuidado com a saúde da mulher

Publicado em por .

Você conhece todos os exames e as vacinas que ajudam no cuidado com a saúde da mulher?

No Laboratório Côrtes Villela você encontra uma lista completa para se cuidar com qualidade e zelo pela nossa equipe.

Desde exames mais simples até exames mais detalhistas, temos: Papanicolau, exames de tireoide e hormonais, exames genéticos – BRCA1, BRCA2, Painel (sequenciamento) e MLPA [P-BRCA], e vacinas como a da HPV.

 

Papanicolau

Sabe o que é o exame Papanicolau e sua importância para a saúde da mulher?

Também conhecido como preventivo, ele é um teste ginecológico feito, basicamente, a partir do momento em que se inicia a vida sexual. O exame é bem simples, rápido.

Tem como objetivo detectar alterações e doenças no colo do útero, como inflamações, lesões provocadas pelo Papilomavírus Humano (HPV) e o câncer do colo do útero, o terceiro tumor maligno mais frequente na população feminina.

Por isso, é importante passar com seu ginecologista todos os anos e estar sempre atenta a sua saúde!

 

Exames de Tireoide e Hormonais

Sabia que o mau funcionamento da tireoide pode comprometer a saúde cardíaca, ciclos menstruais, capacidade de concentração, musculatura, intestino e até mesmo o humor?O hipotireoidismo e o hipertireoidismo são os principais problemas ocasionados pelo funcionamento incorreto da tireoide, mas eles não são os únicos.Para diagnosticar distúrbios da glândula você precisa realizar exames específicos e especializados, como:

– Exames de sangue para medir os níveis de hormônios tireoidianos e TSH
– Exames de imagem (como ultrassom) para investigar o tamanho e a presença de nódulos na tireoide
– Biópsia e punção aspirativa por agulha fina
– Cintilografia de tireoide

 

Sequenciamento Gênico completo (BRCA1 e BRCA2)

Além dos exames de rotina da mulher, existem os mais específicos e que são recomendados para pessoas com histórico de câncer na família. Como é o caso do Sequenciamento Gênico completo (BRCA1 e BRCA2).

Esse exame molecular é capaz de detectar as principais alterações dos genes BRCA1 e BRCA2, que estão diretamente envolvidos nos vários tipos de câncer, como: câncer de mama, ovário, próstata e o câncer de pâncreas.

Ele é importante para descobrir, principalmente, o alto risco de câncer de mama em mulheres jovens. Tendo esse resultado e diagnóstico mais precoce pode auxiliar o médico na definição de uma conduta diferenciada e assertiva.

 

Vacina da HPV

Vacinas são decisivas na prevenção de diversas doenças. A vacina HPV, por exemplo, foi desenvolvida para evitar a contaminação pelo HPV (Papiloma Vírus), que é uma das doenças sexualmente transmissíveis mais comuns do mundo, e causadora de câncer de colo do útero.

Existem duas vacinas da HPV:

-Vacina quadrivalente (HPV 6, 11, 16 e 18) para meninas e mulheres de 9 à 26 anos, durante o período de 2 a 6 meses.

-Vacina bivalente (HPV 16, 18) para meninas e mulheres de 10 à 25 anos, durante o período de 1 a 6 meses.

E todos esses exames podem ser feitos aqui no Côrtes Villela.