Repositório Institucional - Unifesp :: Navegando por Palavras-chave "Infection"

Navegando por Palavras-chave "Infection"

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Altered cardiomyocyte function and trypanosoma cruzi persistence in chagas disease
(Wiley-Blackwell, 2016) Cruz, Jader Santos [UNIFESP]; Santos-Miranda, Artur [UNIFESP]; Sales-Junior, Policarpo Ademar [UNIFESP]; Monti-Rocha, Renata [UNIFESP]; Campos, Paula Peixoto [UNIFESP]; Machado, Fabiana Simao [UNIFESP]; Roman-Campos, Danilo [UNIFESP]
Chagas disease, caused by the triatominae Trypanosoma cruzi, is one of the leading causes of heart malfunctioning in Latin America. The cardiac phenotype is observed in 20-30% of infected people 10-40 years after their primary infection. The cardiac complications during Chagas disease range from cardiac arrhythmias to heart failure, with important involvement of the right ventricle. Interestingly, no studies have evaluated the electrical properties of right ventricle myocytes during Chagas disease and correlated them to parasite persistence. Taking advantage of a murine model of Chagas disease, we studied the histological and electrical properties of right ventricle in acute (30 days postinfection [dpi]) and chronic phases (90 dpi) of infected mice with the Colombian strain of T. cruzi and their correlation to parasite persistence. We observed an increase in collagen deposition and inflammatory infiltrate at both 30 and 90 dpi. Furthermore, using reverse transcriptase polymerase chain reaction, we detected parasites at 90 dpi in right and left ventricles. In addition, we observed action potential prolongation and reduced transient outward K+ current and L-type Ca2+ current at 30 and 90 dpi. Taking together, our results demonstrate that T. cruzi infection leads to important modifications in electrical properties associated with inflammatory infiltrate and parasite persistence in mice right ventricle, suggesting a causal role between inflammation, parasite persistence, and altered cardiomyocyte function in Chagas disease. Thus, arrhythmias observed in Chagas disease may be partially related to altered electrical function in right ventricle.
Embargo
Aplicação de um método de restrição enzimática sobre o gene da protease do HIV-1 para detecção de infecções duplas em pacientes infectados pelo HIV-1
(Universidade Federal de São Paulo (UNIFESP), 2011-01-26) Nunes, Edsel Renata de Morais [UNIFESP]; Janini, Luiz Mário Ramos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Introduction: One of the significant characteristics of the HIV-1 epidemic is the increase of the recombinant forms which can be explained by the existence of individuals being infected by 2 or more distinct viruses, simultaneously or subsequently: a dual infection. Consequently, a recombination requires the presence of a dual infection. In this way, the intense process of recombination between the B and F subtypes in the Brazilian epidemic especially in the southeastern region of the country can only be explained by the high frequency of dual infections. Objective: The aim of this work was to evaluate the prevalence of HIV- 1 dual infections in individuals submitted to antiretroviral treatment which is distributed by the National Program of Sexually Transmitted Diseases, Ministry of Health of Brazil. The objective was to verify if the RFLP standards can be used in the discrimination of Brazilian subtypes and recombinants and develop a RFLP test for the protease gene applied to the Brazilian epidemic and which contemplates the main circulating types currently in the south- eastern region of the Brazilian epidemic so as to develop the sequencing of isolated viruses involved in dual infections e identify their genetic sub- types. Methods: The HIV-1 dual infections were traced using the RFLP assay for the HIV-1 protease gene and cloned afterwards. The dual infections were submitted to the sequencing method to confirm the subtypes and recombinants. The sequences were aligned and the phylogenetic trees were constructed. The recombination standard was determined by using a phylogenetic tree with data generated in Bootscan by SimPlot v3.5 software. Results: According to the protease gene and pol fragment analyses, 32 dual infections were identified in 126 samples corresponding to 25.4% of the samples analyzed. Dual infections and even triple infections were detected being composed of pure subtypes (B and F) and recombinants (BF, FB, BFB, and BCB) or even by the recombinants (BF and FB). In spite of the diversity found in the detected dual infections, the RFLP can still be used as a tool to detect them. Conclusion: The increase of the emerging recombinant forms can be explained by the surge of dual infections in the HIV- 1 epidemic over the years. Dual infections were detected in only 3.8% of the samples in Brazil in the 1990s. In this study, 25,4% of the analyzed samples had dual infections, showing an 8- fold increment in this type of infection in the country. A majority of the dual infections had a recombinant virus as a component. This increase of the viral diversity can lead to the selection of the viruses that can evade vaccine trials even when these vaccines show some effectiveness against the isolated subtypes.
Acesso aberto (Open Access)
Aplicação de um sistema de vigilância de infecções de corrente sanguínea em crianças acompanhadas na Unidade de Hemodiálise Pediátrica do Hospital São Paulo
(Universidade Federal de São Paulo (UNIFESP), 2010-10-27) Sucupira, Carolina [UNIFESP]; Moraes-Pinto, Maria Isabel de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Background: Hemodialysis vascular access infections are a great concern in children with end stage renal disease because in the majority of the pediatric population a venous catheter is used for the initiation of hemodialysis. Methods: From October 2006 to April 2009, the bloodstream infection surveillance system proposed by the Centers for Disease Control and Prevention was prospectively conducted in a pediatric outpatient hemodialysis unit. Results: Thirty pediatric patients were included. Male gender was predominant and mean age was 9.5 years. Most patients (73%) had a catheter for vascular access at study entry. While the mean permanent catheter duration was 170.6 days, it was 2.2 years for fistulas. The main reasons for catheter removal were mechanical problems and infection. During the period of study, one in three patients were hospitalized each month and 20% of them died. We reported 181 events and 450 patients-month. The rate of vascular access infection was 21.1 per 100 patients-month, 16.7 per 100 patients-month for patients on temporary catheters and 30 per 100 patients-month for those on permanent catheters. Staphylococcus aureus was the microorganism most frequently identified, having been isolated in 34% of the blood samples. Conclusions: Our study showed different results than what is observed in adult patients, with higher rates of vascular access infection in children. The use of this surveillance system will help identify and monitor local infection rates, implement strategies for preventing vascular access infection and evaluate the effectiveness of interventions to prevent infections in the pediatric population on hemodialysis.
Acesso aberto (Open Access)
Avaliação da mortalidade após o tranplante renal
(Universidade Federal de São Paulo (UNIFESP), 2016-12-31) Ruiz, Priscila Ruppel [UNIFESP]; Felipe, Claudia Rosso [UNIFESP]; http://lattes.cnpq.br/7969656914530107; http://lattes.cnpq.br/1825350430081086; Universidade Federal de São Paulo (UNIFESP)
Methods: This was a retrospective, single-center, case-control study which assessed 324 primary recipients of kidney transplant to evaluate the incidence of infection related deaths in the first 5 years after kidney transplantation. Case group (N = 162) consisted of patients who received renal transplantation in Hospital do Rim between Jan/2007 to Dec/2009 and died in the first five years after transplantation, excluding multi-organ transplant recipients , re-transplants and pediatric transplants. Control group (N = 162) was matched considering the date of transplantation; recipient age (+/- 5 years); donor age (+/- 5 years); recipient gender; donor gender; recipient race; induction with thymoglobulin and type of donor (living or deceased). Results: Patients in case group (death in 5 years) showed higher time on dialysis (53.9 ± 41.5 x 36.9 ± 31.0 months, p <0.001), higher incidence of pre-transplant diabetes (29% vs. 18.5% p = 0.026), lower level of education (5.6% x 13.6% of university graduates, p = 0.008), higher incidence of unemployment (48.8% vs. 32.7%, p <0.001), lower intermediate profession classification (4.9% vs. 17.9%, p <0.001), higher incidence of delayed graft function (41.3% vs. 29%, p = 0.012) lower serum creatinine and creatinine clearance MDRD , higher incidence of acute rejection, higher density of visits to the center (1.48 ± 1.32 x 0.76 ± 0.41 visits / month, p <0.001) and higher density of hospitalized days (12.69 ± 32, 71 x ± 2.78 16.26 days / month, p <0.001). Multivariate analysis identified as variables that impact on the risk of death: time on dialysis, intermediate profession classification, density of visits to the center, density of hospitalized days and peritoneal dialysis. Conclusion: Patients who died are patients with more pre-transplant comorbidities, worse post-transplant follow-up, with higher incidence of delayed graft function and acute rejection and worse renal function, and therefore required more outpatient visits and readmissions.
Acesso aberto (Open Access)
Avaliação do impacto de um programa de intervenções para prevenção de infecção do trato urinário associada ao uso de sonda vesical em pacientes transplantados renais
(Universidade Federal de São Paulo (UNIFESP), 2010-05-26) Regagnin, Dejanira Aparecida [UNIFESP]; Medeiros, Eduardo Alexandrino Servolo de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The urinary tract infection is one of the most ordinary complications after a renal transplant and it may lead to rejection, donor kidney failure, long hospital stay period and increased cost. Although the use of a urinary catheter as its period of stay is considered a risk factor, little has been studied about the nursing staff knowledge to prevent urinary tract infection due to a urinary catheter. Objectives: Evaluate the nursing staff practice and knowledge related to the maintenance of a urinary catheter as the risks of its use, implement an intervention guide and measure its impact on the incidence of urinary tract infection and also on the nursing assistance to patients undergoing renal transplantation. Method: A prospective interventional study was performed in a hospital in São Paulo, from August first 2008 to July 31st 2009, and divided into two phases. In the first phase, which occurred from August 2008 to January 2009, the urinary catheter insertion and the procedures for its safe maintenance were observed and a questionnaire to access the nurses’ information about the subject was applied as well. In the second phase, from February first to July 31st 2009, a group of new actions based on data collected from the first round were implemented, the same questionnaire was applied once more followed by another period of observation which the main purpose was to verify the effect and changes caused by the new guide developed. Results: The nursing professionals’ theoretical knowledge assessment showed a meaningful statistical difference between the distinct study phases such as urethral meatus hygiene procedure (p=0,007), hygiene frequency urethral meatus (p<0.001), the cleaning product used in the hygiene of the urethral meatus (p<0,001), the catheter exchange frequency (p<0,001) and HRIM infection rates (p<0,001) awareness indicating an improvement after the intervention. The practice observation also showed a hand hygiene improvement among physicians: 9,1% of frequency before procedure and 68,2% after the procedure. Among the nursing staff members again positive results were noticed: 26,7% to 48% of hand washing before procedure and 76% to 86,7% after procedure. Better adherence to the use of personal protective equipment comparing 60 to 75% in the first round against 98% to 100% in the second. There were 44 (11,33%) cases of urinary tract infection in the first phase of the study, 26 deceaseddonor while 17 living-donor, which 37 (84,09%) due to urinary catheter presence. The average time between the urinary tract infection diagnosis and the kidney transplant was 13,5 days (5 to 30 days). In both phases, there was a bacterial infection predominance being the gram-negatives responsible for 97,7% of the infections in the first round against 82,25% in the second. E. coli itself was responsible for 34 (32%) cases of infection, followed by K. pneumoniae which caused 18 (16,9%) cases of infection. Conclusions: A meaningful practice and theoretical knowledge improvement can be noticed due to the educational program. Despite all the better results achieved in the second phase of this study, with reduction of urinary tract infection associated with vesical catheter (p=0,674), any impact on decreasing urinary tract infections could be demonstrated.
Acesso aberto (Open Access)
Avaliação do tipo de curativo utilizado em cateter venoso central para hemodiálise
(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2009-01-01) Barros, Luciene de Fátima Neves Monteiro de [UNIFESP]; Arênas, Valquíria Grego; Bettencourt, Ana Rita de Cassia [UNIFESP]; Diccini, Solange [UNIFESP]; Fram, Dayana Souza [UNIFESP]; Belasco, Angélica Gonçalves Silva [UNIFESP]; Barbosa, Dulce Aparecida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
OBJECTIVES: To evaluate the efficacy of two types of dressings used on central venous catheter (CVC) in patients undergoing hemodialysis and to determine the rate of local and systemic bacterial infection when using gauze and micropore dressings or transparent film dressings. METHODS: This study was a controlled randomized clinical trial with 66 subjects who were equally assigned to two groups (33 subjects per group). Group 1 used gauze and micropore dressings and group 2 used transparent film dressings. Measures consisted of a socio demographic questionnaire, clinical data, and catheter tip and blood culture tests. Subjects remained in the study until removal of the catheter. RESULTS: There were no statistically significant differences regarding the types of dressings. Positioning of CVCs at 90 degrees in relation to the skin had higher rate of infections by S. Aureus. CONCLUSION: Although the use of transparent film dressings did not reduce infection, qualitative data analysis suggested that this type of dressing was preferred by the patients and by the health care providers from a university hospital.
Acesso aberto (Open Access)
Avaliação dos efeitos da ligadura da base do appendix vermiformis do coelho
(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2000-03-01) Bazzano, Félix Carlos Ocáriz; Souza, Virginio Cândido Tosta de [UNIFESP]; Corrêa, José Carlos [UNIFESP]; Vieira, Antônio Mauro; Ramos, Eduardo Chibeni Fernandes; Nascimento, Luis Roberto; Novo, Neil Ferreira [UNIFESP]; Juliano, Yara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Pouso Alegre Departamento de Ciências Fisio-morfológicas
120 female rabbits were studied, with a weight range from 2.400 to 3.100 g. with the purpose of evaluating the effect of the ligadure in the bottom of the appendix vermiformis of the rabbit and its action, from macroscopic and microscopic aspects, about this organ. The animals were, therefore, distributed in 2 groups of 60 animals called experiment and sham, and were subdivided in 3 sub-groups of 20 rabbits for each group which were called 24 h, 48 h, 72 h, 24 Sh, 48 Sh and 72 Sh, that corresponded to the observation period of 24, 48 and 72 hours. Its was verified the occurrence of both, macroscopic and microscopic appendicities in all rabbits from the experiment group on the 3 studied periods, with no significant differences between the groups, but observing the evidence, in all groups, of more onward appendicities. There was no alteration in the rabbits of the sham group. In statistic valuation there was significance in the reading of the appendix end diameter, evaluated at the beginning and in the end of the observation period in each group, when comparing the groups, however, there was no statistics significance. The evaluation of the macroscopic changes about adherence, appendix collor changes, peritonitis, necrosis, perforation and the microscopic changes weren t significant on a statistics view. It follows that the obstruction in the bottom of the appendix vermifomis of the rabbit induces to both, macroscopic and microscopic acute appendicities.
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Bordetella pertussis infection in paediatric healthcare workers
(W B Saunders Co Ltd, 2015-06-01) Cunegundes, K. S. A. [UNIFESP]; Moraes-Pinto, M. I. de [UNIFESP]; Takahashi, T. N. [UNIFESP]; Kuramoto, D. A. B. [UNIFESP]; Weckx, L. Y. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
An increased incidence of pertussis has been observed recently in adults, and healthcare workers (HCWs) are considered a risk group for transmission to infants. Prevalence of recent pertussis infection was assessed in HCWs from a paediatric department of a tertiary care hospital in Brazil. Serum pertussis toxin IgG antibodies were measured by enzyme-linked immunosorbent assay. of 388 HCWs included in the analysis, 6.4% had serology suggestive of recent infection. Medical residents [odds ratio (OR): 4.15; 95% confidence interval (CI): 1.42-12.14; P = 0.009] and those working >40 h a week (OR: 3.29; 95% CI: 1.17-9.26; P = 0.024) had increased risk of pertussis infection. (C) 2015 the Healthcare Infection Society. Published by Elsevier B.V. All rights reserved.
Acesso aberto (Open Access)
Caracterização do perfil de segurança infeccioso dos anticorpos monoclonais imunossupressores
(Universidade Federal de São Paulo (UNIFESP), 2021) Silva, Nayara Aparecida De Oliveira [UNIFESP]; Melo, Daniela Oliveira de [UNIFESP]; Universidade Federal de São Paulo
The occurrence of infections is a widely known adverse event for immunosuppressive drugs, including monoclonal antibodies (mAB). However, immunosuppressive therapy is not the only risk factor for the development of infections. The autoimmune disease also increases susceptibility to site-specific infections, which may be enhanced by immunosuppression. Thus, the same immunosuppressive mAB may present differences in the infectious profile for each indication due to the influence of autoimmune disease on the risk of certain infections. Given this scenario, the aim of the study was to evaluate the infectious profile, by indication, of immunosuppressive mABs approved for the treatment of two or more autoimmune diseases. A crosssectional, retrospective case/non-case type study was conducted using data from spontaneous reports of suspected adverse drug events (ADEs) received by the Food and Drug Administration (FDA) through June 2020 via the FDA Adverse Event Reporting System (FAERS). Disproportionality analysis on the chance of reporting was performed from the calculation of Reporting Odds Ratios (ROR) with confidence interval at the 95% level (95% CI) and chi-square test with Yates' correction. Ten mABs were analyzed, being 4 anti-TNF alpha (adalimumab, certolizumab, golimumab, and infliximab), 4 anti-interleukin (ixekizumab, secukinumab, tocilizumab, and ustekinumab), and 2 anti-integrin (natalizumab and vedolizumab). Disproportionality analysis identified increased odds of reporting infectious events that appears to be associated with either the (i) indication alone, as these were infections that had disproportionality to an indication independent of the mAB used - as was the case with Clostridium difficile intestinal infections in patients with inflammatory bowel disease, abscesses in patients with Crohn's disease (CD), cytomegalovirus infection in patients with ulcerative colitis (UC), and osteomyelitis in patients with rheumatoid arthritis (RA); or to (ii) the binomial of indication and mAB use, i.e. infections with disproportionality in the chance of reporting for some indication and for one or more mABs, not all of them - such as increased chance of reporting pneumonia, infectious arthritis, and joint tuberculosis in RA patients on anti-TNF use and sepsis in CD patients on anti-integrins. The conclusion is that autoimmune diseases can modulate the infectious profile, increasing the risk of reporting certain infectious events. Thus, the same mAB may show differences in the profile of infectious ADEs according to the indication of use, and these differences should be taken into consideration when designing risk minimization plans to increase treatment safety.
Acesso aberto (Open Access)
Colonização e infecção em pacientes com cateter peridural não tunelizado para analgesia
(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2010-10-01) Diccini, Solange [UNIFESP]; Ilsilara, Maria Cecília Torres de Araújo Pimenta [UNIFESP]; Miyake, Mara Harumi [UNIFESP]; Belasco, Angélica Gonçalves Silva [UNIFESP]; Barbosa, Dulce Aparecida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: To correlate the colonization and infection in patients using non-tunneled epidural catheter for analgesia effects. METHODS: This is a prospective study of 109 clinical or surgical patients, with catheter dwell time> 72 hours, in a private hospital in the city of São Paulo. The culture of surveillance was carried out based on the collection of the epidural catheter tip, swab peri-catheter and peripheral blood cultures. RESULTS: Among the 109 patients accompanied, 106 (97.2%) were surgical and 3 (2.8%) clinical. The catheter dwell time ranged from 3 to 18 days and the rate of colonization was 11%. Twelve patients had epidural catheter colonization and the main organism isolated was coagulase-negative Staphylococcus. CONCLUSIONS: The positive culture of epidural catheter was a predictive factor for colonization; however, it was not found positive patients who evolved to infection.
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Construction and Validation of an Instrument for Assessment of the Nursing Diagnosis, Risk for Infection, in Patients Following Cardiac Surgery
(Wiley-Blackwell, 2014-06-01) Filippi Schulz, Carla Ethel [UNIFESP]; Lopes, Camila Takao [UNIFESP]; Herdman, Trace Heather; Lopes, Juliana de Lima [UNIFESP]; Barros, Alba Lucia Bottura Leite de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); NANDA Int Inc; Univ Wisconsin
Purpose To construct and validate a data collection instrument (DCI), and a corresponding instructional guide, for assessment of the nursing diagnosis, risk for infection, in patients following cardiac surgery. Methods Construction of conceptual and operational definitions for risk factors based on literature, content validation by experts, and clinical validation by clinical nurses. Findings There were significant internal consistency and reproducibility in the content validation. in the clinical validation, agreement among nurses was higher than 70% for all risk factors. Conclusions the DCI was constructed and validated. Implications for Nursing Practice This DCI could be used for assessment of adult patients after cardiac surgeries worldwide because of its detailed cues for risk factors, which facilitate clinical reasoning and diagnostic judgment. Objetivo Construir e validar um instrumento de coleta de dados (ICD) e seu roteiro instrucional (RI) para avaliacAo do diagnostico de enfermagem Risco de infeccAo em pacientes pos-cirurgia cardiaca. Metodos ConstrucAo de definicoes conceituais e operacionais dos fatores de risco baseada na literatura, validacAo de conteudo por experts e validacAo clinica por enfermeiras assistenciais. Resultados Consistencia interna e reprodutibilidade significativas na validacAo de conteudo. Na validacAo clinica, a concordancia foi maior que 70% para todos os fatores de risco. Conclusoes O ICD foi construido e validado. Implicacoes Para Pratica de Enfermagem O ICD poderia ser utilizado para avaliacAo de adultos pos-cirurgia cardiaca internacionalmente devido as suas pistas detalhadas sobre os fatores de risco, que facilitam o raciocinio clinico julgamento diagnostico.
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The diversity and expansion of the trans-sialidase gene family is a common feature in trypanosoma cruzi clade members
(Elsevier science bv, 2016) Chiurillo, Miguel Angel; Cortez, Danielle Rodrigues [UNIFESP]; Lima, Fabio Mitsuo [UNIFESP]; Cortez, Caroline [UNIFESP]; Ramirez, José Luis; Costa-Martins, André Guilherme da; Serrano, Myrna Garcia; Teixeira, Marta Maria Geraldes; Silveira, Jose Franco da [UNIFESP]
Trans-sialidase (TS) is a polymorphic protein superfamily described in members of the protozoan genus Trypanosoma. Of the eight TS groups recently described, TS group I proteins (some of which have catalytic activity) are present in the distantly related Trypanosoma brucei and Trypanosoma cruzi phylogenetic clades, whereas other TS groups have only been described in some species belonging to the T. cruzi clade. In the present study we analyzed the repertoire, distribution and phylogenetic relationships of TS genes among species of the T. cruzi clade based on sequence similarity, multiple sequence alignment and tree-reconstruction approaches using TS sequences obtained with the aid of PCR-based strategies or retrieved from genome databases. We included the following representative isolates of the T. cruzi clade from South America: T. cruzi, T. cruzi Tcbat, Trypanosoma cruzi marinkellei, Trypanosoma dionisii, Trypanosoma rangeli and Trypanosoma conorhini. The cloned sequences encoded conserved TS protein motifs Asp-box and VTVxNVxLYNR but lacked the FRIP motif (conserved in TS group I). The T. conorhini sequences were the most divergent The hybridization patterns of IS probes with chromosomal bands confirmed the abundance of these sequences in species in the T. cruzi clade. Divergence and relationship analysis placed most of the TS sequences in the groups defined in T. cruzi. Further examination of members of TS group II, which includes T. cruzi surface glycoproteins implicated in host cell attachment and invasion, showed that sequences of T. cruzi Tcbat grouped with those of T. cruzi genotype TcI. Our analysis indicates that different members of the T. cruzi clade, with different vertebrate hosts, vectors and pathogenicity, share the extensive expansion and sequence diversification of the TS gene family. Altogether, our results are congruent with the evolutionary history of the T. cruzi clade and represent a contribution to the understanding of the molecular evolution and role of TS proteins in trypanosomes. (C) 2015 Elsevier B.V. All rights reserved.
Acesso aberto (Open Access)
Effect of lung resection and sham surgery on the frequency of infection in alloxan-diabetic rats
(Associação Brasileira de Divulgação Científica, 2003-03-01) Seidel, A.c.; Fagundes, Djalma José [UNIFESP]; Bazotte, R.b.; Novo, Neil Ferreira [UNIFESP]; Juliano, Y. [UNIFESP]; Meister, H.; Universidade Estadual de Maringá Departamento de Medicina; Universidade Estadual de Maringá Departamento de Farmácia e Farmacologia; Universidade Federal de São Paulo (UNIFESP)
The present study was carried out in order to determine the effect of lung resection on the frequency of infections in alloxan-diabetic rats. Adult female Wistar rats were injected with alloxan (40 mg/kg, iv) to induce diabetes mellitus (group D; N = 45) or with vehicle (1.0 ml/kg, iv) to be used as controls (group C; N = 45). Thirty-six days after receiving alloxan both groups were randomly divided into three subgroups: no operation (NO; N = 15), sham operation (SO; N = 15), and left pneumonectomy (PE; N = 15). The rats were sacrificed 36 days after surgery and their lungs were examined microscopically and macroscopically. The occurrence of thoracic wall infection, thoracic wall abscess, lung abscess and pleural empyema was similar in groups D and C. In contrast, the overall infection rate was higher (P<0.05) in the diabetic rats (SO-D and PE-D subgroups, but not in the NO-D subgroup). Considering that the overall infection rate was similar in the SO-D and PE-D subgroups, we suggest that surgery but not pneumonectomy was related to the higher prevalence of infection in diabetic rats.
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Enucleação de células L929
(Universidade Federal de São Paulo (UNIFESP), 2003) Yamamoto, Denise [UNIFESP]; Rabinovitch, Michel [UNIFESP]; Rabinovitch, Michel Pinkus [UNIFESP]
A infeccao por patogenos intracelulares paradigmaticos e, em muitos casos, induzida e dirigida pela modulacao de cascatas de sinalizacao da celula hospedeira por determinantes de virulencia sequencialmente secretados pelas bacterias. Estudos pelo metodo dos microarrays do perfil de expressao genica de celulas hospedeiras infectadas por diferentes patogenos revelaram a modulacao de numerosos genes no decorrer da infeccao. Muitas das respostas transcricionais identificadas se revelaram protetoras, outras poderiam favorecer a sobrevida intracelular dos patogenos, e outras ainda poderiam ser neutras. A interpretacao destes resultados e dificil porque: nao se conhece a funcao de um grande numero de genes; a modulacao genica de curta duracao poderia nao ser registrada; os perfis de mRNA podem nao refletir a abundancia e a atividade das proteinas; por sua complexidade e conectividade as cascatas de sinalizacao poderiam secundariamente afetar a funcao de genes que podem nao estar relacionados a infeccao intracelular. Com o desenvolvimento de metodos para enucleacao em massa de celulas em monocamadas, estudos pioneiros demonstraram que celulas enucleadas (denominadas citoplastos), podiam ser infectadas com Toxoplasma gondu, Chlamydia psittaci, C. trachomatis, e RAckettsia prowazekii, todos patogenos intracelulares obrigatorios. Alem disso, em experiencias nas quais muito poucos citoplastos foram infectados, nao foi documentada a proliferacao de amastigotas de T. cruzi em celulas enucleadas. Considerando a ampla diversidade dos fenotipos de infeccao induzidos pelos diferentes patogenos, acreditamos que a participacao do nucleo celular para a infeccao ideve ser examinada caso por caso. Esta dissertacao examina a infeccao por Shigella flexneri serotipo 5a de celulas de camundongo L929, aderidas a substratos de vidro e enucleadas por uma modificacao do metodo de Prescott, por centrifugacao na presenca de citocalasina Ba(au)
Acesso aberto (Open Access)
Epidemiologia das doenças fúngicas invasivas em pacientes oncológicos pediátricos de um centro de referência
(Universidade Federal de São Paulo (UNIFESP), 2018-10-25) Marques, Leticia Maria Acioli [UNIFESP]; Fram, Dayana Souza [UNIFESP]; http://lattes.cnpq.br/8357646821341086; http://lattes.cnpq.br/1576805942427220; Universidade Federal de São Paulo (UNIFESP)
Objective: Analyze the epidemiology and incidence of invasive fungal diseases in oncological pediatric patients. Identify associated factors, analyze the seasonality, sites affected and outcome of these episodes. Methods: Retrospective cohort study from January 2011 to December 2016 developed in a reference hospital in pediatric oncology. We included all episodes of probable or proven invasive fungal disease, according to European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy Infectious Diseases Mycoses Study Group definitions, that occurred in cancer patients, submitted or not to stem cell hematopoietic cells transplantation, from 0 to 18 years old and followed at the institution during the study period. Demographic and clinical data were collected, the infections were classified as caused by yeast or filamentous fungi. Descriptive analysis was performed on absolute frequency (n) and relative frequency (%) and for analysis of the association between the two groups of agents causing the infections, p <0.05 was used for statistical significance. Results: were identified 103 episodes of invasive fungal disease in 94 patients. The mean age was 8.6 years, 60.6% (57/94) were males and 52.1% had (49/94) solid tumors as underlying disease. Among proven invasive fungal diseases, 77.3% (68/88) were caused by yeast and 22.7% (20/88) by mold. The overall incidence of fungal invasive disease in this population was 5.6 per thousand patients in treatment / year, 3.72 caused by yeast and 1.92 caused by mold. The most identified agents were Candida parapsilosis in the bloodstream (p <0.0001) and Fusarium solani affecting cutaneous tissue (p 0.003). The occurrence of invasive fungal disease occurred during spring was significant (p 0.012). Mortality in 30 days by yeasts was 29% and 21% caused by mold. Conclusion: The overall incidence of invasive fungal diseases was 5.6 / 1000 patients undergoing treatment year. A higher incidence of yeast was identified in patients with solid tumors. The main agent identified was C. parapsilosis in the bloodstream. There was higher in 30day mortality for DFI caused by yeast.
Acesso aberto (Open Access)
Estudo do efeito imunomodulador de vesículas isoladas durante a infecção por trypanosoma cruzi na célula hospedeira
(Universidade Federal de São Paulo (UNIFESP), 2018-06-28) Andrade, Andre Cronemberger [UNIFESP]; Torrecilhas, Ana Claudia Trocoli [UNIFESP]; http://lattes.cnpq.br/7344293560367809; http://lattes.cnpq.br/7731140733602286
The extracellular vesicles shed by trypomastigote forms of Trypanosoma cruzi have the ability to interact, increase tissue invasion and modulate the host innate response via TLR2. In T. cruzi infection, induction of the Th1-type response is crucial for promoting protection against the parasite. The aim of the study was to investigate the role of these vesicles as immunomodulatory agents that act during the initial phase of host immune response. THP-1 cells were differentiated into macrophages and infected with T. cruzi. Infected cell culture supernatants of macrophages were collected by ultracentrifugation at different times after infection and the released material was analyzed by NTA. Increased numbers of EVs ranging from 50 to 300 nm were found in the macrophages supernatant 24 hours post infection. Large number of EV from infected compared to non-infected macrophages was observed by scanning electron microscopy. Released EVs contained CD63, CD9, and MHC class II revealing their exosomal and macrophagic origin. No parasite antigens were detected. In addition, the ability of these EVs to translocate NF-kB by TLR2 receptors was evidenced. As a consequence of this interaction, the expression of these receptors is increased. EVs were also able to stimulate the production of proinflammatory cytokines (TNF-α, IL-6 and IL-1β). In this way we observed the potential of EVs derived from T. cruzi infection in the maintenance of the inflammatory response and increase the number of parasites and infected cells in the host.
Acesso aberto (Open Access)
Evaluation of effectiveness of 10% polyvinylpyrrolidone-iodine solution against infections in wire and pin holes for Ilizarov external fixators
(Associação Paulista de Medicina - APM, 2005-03-01) Camilo, Adelina Morais [UNIFESP]; Bongiovanni, José Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Orthopedics and Traumatology Center of Jundiaí
CONTEXT AND OBJECTIVE: Superficial infection at wire and pin insertions in the skin is a frequent disorder among patients utilizing the Ilizarov method. The objective of this study was to evaluate the effectiveness of daily topical application of 10% polyvinylpyrrolidone-iodine solution against infections of the holes for Kirschner wires and Schanz pins among patients using Ilizarov external fixators, in comparison with cleaning these holes only with 0.9% sterile physiological saline solution. DESIGN AND SETTING: Controlled randomized clinical trial, in the Orthopedics and Traumatology Outpatient Clinic, Hospital São Paulo, and Orthopedics and Traumatology Center of Jundiaí. METHODS: 30 patients were treated using the Ilizarov technique: 15 were instructed to apply 0.9% physiological saline dressing on the wire and pin insertions and 15 to apply 0.9% physiological saline plus 10% polyvinylpyrrolidone-iodine. Patients were evaluated at outpatient return visits for identification of signs and symptoms of superficial infection at wire and pin insertion sites. Samples were collected from cases of purulent exudate secretion, for culturing and clinical tests. RESULTS: The chi-squared and Fischer exact tests were applied, but no statistically significant association between the intervention of topical polyvinylpyrrolidone-iodine solution and the prevention of infections at wire and pin insertions could be found. CONCLUSIONS: Topical 10% polyvinylpyrrolidone-iodine solution applied daily to Kirschner wire and Schanz pin insertions did not reduce the incidence of superficial infection at these holes, in comparison with mechanical removal of dirt using 0.9% physiological saline solution.
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Fatores de risco para infecção em pacientes pós-cirurgia de revascularização do miocárdio
(Universidade Federal de São Paulo (UNIFESP), 2014-12-17) Lopes, Joanilva Ribeiro [UNIFESP]; Barbosa, Dulce Aparecida Barbosa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Esta pesquisa objetivou identificar fatores de risco pré, intra e pós-operatórios no desenvolvimento de infecção de sítio cirúrgico (ISC) em pacientes submetidos à revascularização do miocárdio. Estudo de coorte retrospectivo, constituído de pacientes submetidos à cirurgia de revascularização do miocárdio no período entre 2008 a 2012, em um hospital filantrópico e de ensino. Foram coletados dados de prontuários e das fichas de notificação de infecção hospitalar e os pacientes foram divididos em dois grupos de acordo com a presença ou ausência de ISC. Utilizou-se o modelo de regressão logística binária. Os resultados evidenciaram que dos 120 pacientes estudados, 27 (22,5%) apresentaram ISC, sendo considerados casos e 93 (77,5%) não tiveram diagnóstico de ISC, constituindo, portanto, o grupo controle. Houve significância estatística (p<0,05) entre ISC e os fatores de risco: hipertensão arterial sistêmica, permanência hospitalar maior que 18 dias e utilização de dreno de tórax por um período maior que 3 dias. Conclui-se que entre os casos de ISC, houve predominância do sexo masculino, com média de idade de 67,3 anos. Além da hipertensão arterial sistêmica, a permanência hospitalar prolongada e o uso de dreno de tórax por período superior a 3 dias sugerem maior ocorrência de ISC. O mediastino foi o sítio cirúrgico de maior incidência de ISC.
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Fatores de risco para infecção por Klebsiella Pneumoniae Carbapenemase em pacientes submetidos a transplante renal
(Universidade Federal de São Paulo (UNIFESP), 2019-05-30) Ribeiro, Jecielle Cerqueira De Oliveira [UNIFESP]; Barbosa, Dulce Aparecida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Objective - Infection is the second most frequent cause of mortality among renal transplant patients. The objective of the study was to analyze the outcome of Carbapenemase-producing Klebsiella pneumoniae (KPC) infection, to identify the risk factors for graft and renal transplant patient survival with KPC infection and to compare the results obtained with other services. Method - Observational study, retrospective cohort in subjects submitted to renal transplantation by deceased donor in the year 2014 and analyzed during the first and second year after transplantation. Patients older than 18 years, on the first transplant of the recipient, who received a deceased donor organ and only renal transplantation were included. A descriptive analysis was performed considering demographic, clinical, laboratorial variables and parameters related to the treatment. The primary outcome was KPC infection. The variables were tested using the chi-square test or Fisher's exact test and the association between continuous variables and the presence of infection was done using “t” Student's or Mann-Whitney's tests. In the analysis of the associations, the odds ratios were calculated with the respective confidence intervals at the 95% level. The tests used were bi-caudal and the level of significance was alpha <0.05. Results – A total of 852 records were reviewed and of these, 164 did not meet the inclusion criteria. Eighteen patients presented positive culture for KPC and 34 presented other pathogens. KPC infection according to the site of infection showed that the largest number occurred in the urinary tract (9.8%), followed by bloodstream (2.3%) and respiratory tract (1.5%). The highest risk for mortality or loss of graft was associated with Diabetes Mellitus, Systemic Hypertension, alcoholism, use of Central Venous Catheter and presence of KPC infection in the first 2 years after transplantation. Conclusion – Klebsiella pneumoniae infections resistant to carbapenem KPC in kidney transplant patients are progressively increasing and are associated with worse outcomes. Risk factors and therapeutic strategies need to be better defined. As for KPC infection according to the site, it was observed that the largest number occurred in the urinary tract, followed by bloodstream and respiratory tract, and no case was recorded in an operative wound. Individuals with a history of DM, hypertension, alcoholism and CVC were more likely to develop KPC infection when compared to individuals who did not present infection during the analyzed period. Renal transplant therapy presented a higher risk for mortality when associated with DM, hypertension, alcoholism, CVC use and presence of KPC infection in the first 2 years after transplantation.
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Genital prevalence of HPV types and co-infection in men
(Brazilian Soc Urol, 2014-01-01) Freire, Marcos P. [UNIFESP]; Pires, Daniel; Forjaz, Raphael; Sato, Sergio; Cotrim, Ismael [UNIFESP]; Stiepcich, Monica; Scarpellini, Bruno; Truzzi, Jose C. [UNIFESP]; Fleury Grp; Anhembi Morumbi Med Sch; Universidade Federal de São Paulo (UNIFESP)
Introduction: HPV infection is a highly prevalent sexually transmitted disease and there is evidence of the relationship of HPV infection and the development of genital warts, penile intraepitelial neoplasia, invasive penile carcinoma and cervical cancer. However, there is sparse data regarding the prevalence of HPV types and co-infection of different HPV types among men.Objectives: To assess the prevalence of HPV subtypes infections and rates of co-infection among men.Materials and Methods: 366 men were evaluated from March to October 2010. Men were referred to our institution for HPV diagnostic evaluation based on the following criteria: 1. presence of a genital wart; 2. presence of an atypical genital lesion; 3. absence of symptoms and a partner with a HPV diagnosis; 4. absence of symptoms and a desire to undergo a full STD diagnostic evaluation. Genital samples were collected from the urethra, penile shaft, scrotum and anus with Digene (R) collection and preservation kit and submitted to HPV genotype microarray detection (Papillocheck (R)). All men were tested for the low-risk HPV types 6-11-40-42-43-44 and for the high-risk HPV types 16-18-31-33-35-39-45-51-52-53-56-58-59-66-68-70-73-82.Results: of the 366 men, 11 were tested inconclusive and were excluded from the analysis. 256 men (72.1% of the men from the cohort referred to our institution) tested positive with genotype micro-array detection and 99 tested negative. the most prevalent HPV-subtypes in the studied population were 6, 42, 51 and 16. Co-infection was found in 153 men. of those, 70 (19.7%) had a co-infection by 2 types, 37 (10.4%) by 3 types; 33 men (9.2%) by 4 types; 8 men (2.2%) by 5 types; 1 man (0.3%) by 6 types; 1 man (0.3%) by 7 types; 2 men (0.6%) by 8 types and 1 man (0.3%) by 9 types.Conclusion: the most frequent HPV types were 6, 16, 42 and 51. Co-infection was found in 59% of our patients. This information is vital to drive future public health policies including massive public vaccination campaign.

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