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Rapid bacterial identification by MALDI-TOF MS directly from blood cultures and rapid susceptibility testing: A simple approach to reduce the turnaround time of blood cultures
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Barth, Patricia Orlandi

; Roesch, Eliane Wurdig

; Lutz, Larissa

; de Souza, Ândrea Celestino

; Goldani, Luciano Zubaran

; Pereira, Dariane Castro

Brazilian Journal of Infectious Diseases

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2023, Volumen 27 Nº 1 elocation 102721

Resumen: En | Texto: En | PDF: En

Abstract Antimicrobial treatment of patients with bloodstream infections (BSI) is time-sensitive. In an era of increasing antimicrobial resistance, rapid detection and identification of bacteria with antimicrobial susceptibility are critical for targeted therapy early in the disease course. This study describes the performance of a rapid method for identifying and testing antimicrobial susceptibility of Gram-negative bacteria performed directly from blood culture bottles in a routine microbiology laboratory. A total of 284, 120, and 24 samples were analyzed by rapid identification (Rid), rapid susceptibility testing (RAST), and rapid broth microdilution for polymyxin B (rMIC), respectively, and compared with standard methods. Our protocol was able to identify 93% of isolates at the species level using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). We obtained 100% agreement for RAST compared to the standard method and 96% agreement for rMIC. Our protocol has proven to be an excellent tool for rapid identification of Gram-negative bacilli causing BSIs. It can also be used in microbiology laboratory routine along with RAST and faster polymyxin microdilution, especially for carbapenemase-producing bacteria, allowing for rapid, simple, accurate, and cost-effective diagnosis.

https://doi.org/10.1016/j.bjid.2022.102721

The influence of perception of care and maternal protection on breastfeeding practices on the infants’ third month of life
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Matos, Salete de

; Bernardi, Juliana Rombaldi

; Guimarães, Luciano Santos Pinto

; Werlang, Isabel Cristina Ribas

; Silva, Clécio Homrich da

; Goldani, Marcelo Zubaran

Revista Brasileira de Saúde Materno Infantil

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2023, Volumen 23 elocation e20200278

Resumen: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Objectives: to evaluate the influence of perception of care and maternal protection on breastfeeding practices on the infants’ third month of life. Methods: longitudinal study with mother-infant pairs distributed in five groupsof gestational clinical conditions. The recruitment occurred in the period 2011 to 2016 at three hospitals in the public health systems in Porto Alegre, Brazil. The Parental Bonding Instrument and the Edinburgh Postpartum Depression Scale were assessed. Exclusive and prolonged breastfeeding were analyzed by questionnaires. Data were analyzed by one-way ANOVA with Tukey’s post-hoc test, Kruskal-Wallis with Dunn’s post-hoc test, or Pearson’s chi-squared test. The significance was set at 5%. Results: 209 mother-infant pairs were investigated. Among those who did not practice breastfeeding, a lower perception of care, a higher perception of maternal protection, and a higher score of postpartum depression were observed (p=0.022, p=0.038, and p<0.001, respectively), when compared to peers who practiced. The control group had a significantly higher perception of care when compared to thediabetes mellitus group (p=0.006), and the perception of maternal protection and postpartum depression had no differences between the intrauterine groups (p>0.05). Conclusions: the perception of care and maternalprotection and the postpartum depressive symptomatology influenced breastfeeding at three months. It is possible to assume a transgenerational effect on breastfeeding, suggesting the existence of a complex model related to mental health in a sample of women who had different backgrounds of gestational clinical conditions

Resumo Objetivos: avaliar a influência da percepção do cuidado e da proteção materna sobre as práticas de aleitamento materno em lactentes no terceiro mês de vida. Métodos: estudo longitudinal, com pares mães-lactentes distribuídos em cinco grupos de diferentes condições clínicas gestacionais. O recrutamento ocorreu no período de 2011 a 2016 em três hospitais da rede pública de saúde de Porto Alegre, Brasil. Foram utilizados o Parental Bonding Instrument e o Edinburgh Postpartun Depression Scale. O aleitamento materno exclusivo e continuado foi analisado por questionários. Na análise de dados foram utilizados os testes de ANOVA com post-hoc de Tukey, Kruskal-Wallis com post-hoc de Dunn e Qui-quadrado. Resultados: foram investigados 209 pares mães-lactentes. Entre aqueles que não praticaram o aleitamento materno foi observadouma menor percepção de cuidado materno, uma maior percepção de proteção materna e ummaior escore de depressão pós-parto (p=0,022, p=0,038 e p<0,001, respectivamente) quandocomparados aos pares mães-lactentes que praticaram. O grupo controle teve significativamente maior percepção do cuidado materno quando comparado ao grupo com diabetes mellitus (p=0,006) enquanto a percepção de proteção materna e a depressão pós-parto não apresentaram diferenças entre os cinco grupos intrauterinos (p>0,05). Conclusões: a percepção de cuidado e proteção materna e asintomatologia depressiva pós-parto influenciaram o aleitamento materno aos três meses. É possível assumir um efeito transgeracional no aleitamento materno, sugerindo a existência de um modelo complexo relacionado à saúde mental numa amostra de mulheres que tinham diferentes antecedentes de condições clínicas gestacionais.

https://doi.org/10.1590/1806-9304202300000278-en

Maternal Weight Variation in Different Intrauterine Environments: An Important Role of Hypertension
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Cazarotto, Bianca da Rosa

; Ferreira, Charles Francisco

; Ferreira, Amanda Pereira

; Guimarães, Luciano Santos Pinto

; Bosa, Vera Lúcia

; Bernardi, Juliana Rombaldi

; Goldani, Marcelo Zubaran

; Silva, Clécio Homrich da

Revista Brasileira de Ginecologia e Obstetrícia

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Abr 2019, Volumen 41 Nº 4 Paginas 220 - 229

Resumen: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Objetivo Diferentes ambientes intrauterinos podem influenciar a variação de peso corporal pré-gestacional materno até 6 meses pós-parto. O objetivo do presente estudo foi verificar a associação de fatores sociodemográficos, obstétricos, nutricionais e comportamentais com a variação de peso em mulheres divididas em quatro grupos: hipertensas (HM), diabéticas (DM), tabagistas (SM) e controles (CM). Métodos Amostra de conveniência de 124 puérperas recrutadas em 3 hospitais públicos da cidade de Porto Alegre, Rio Grande do Sul, Brasil, entre 2011 e 2016. Regressões lineares múltiplas e modelos de equações de estimativas generalizadas (GEE) foram realizados para identificar os fatores associados à variação do peso materno. Para todas as GEE, as medidas de peso materno foram ajustadas para a estatura materna, paridade, escolaridade e tipo de parto, e três medidas de peso (prégravidez, anterior ao parto e 15 dias pós-parto) foram fixadas. Resultados Um modelo hierárquico associou o diagnóstico materno de hipertensão e o índice de massa corporal (IMC) pré-gestacional de sobrepeso com ganho de peso materno medido até o 6° mês pós-parto (diferença entre o peso materno aos 6 meses pós-parto e o peso pré-gestacional). Estes resultados mostraram que o grupo HM e mulheres comsobrepeso aumentaram o peso corporal em ~ 5,2 kg 6 meses pós-parto, em comparação com os demais grupos. Além disso, as mulheres classificadas com sobrepeso tiveram uma variação maior de peso corporal, de 3,150 kg. Conclusão Evidenciou-se a necessidade de diretrizes nutricionais específicas para distúrbios hipertensivos gestacionais, bem como de maior atenção dos serviços de saúde públicos para mulheres com excesso de peso em idade fértil.

Abstract Objective Different intrauterine environments may influence the maternal prepregnancy body weight (BW) variation up to 6 months postpartum. The objective of the present study was to verify the association of sociodemographic, obstetric, nutritional, and behavioral factors with weight variation in women divided into four groups: hypertensive (HM), diabetic (DM), smokers (SM), and control mothers (CM). Methods It was a convenience sample of 124 postpartum women recruited from 3 public hospitals in the city of Porto Alegre, state of Rio Grande do Sul, Brazil, between 2011 and 2016.Multiple linear regressions and generalized estimating equations (GEE) were conducted to identify the factors associated with maternal weight variation. For all GEE, the maternal weight measurements were adjusted for maternal height, parity, educational level, and the type of delivery, and 3 weight measurements (prepregnancy, preceding delivery, and 15 days postpartum) were fixed. Results A hierarchical model closely associated the maternal diagnosis of hypertension and a prepregnancy body mass index (BMI) classified as overweight with maternal weight gain measured up to the 6th month postpartum (the difference between the maternal weight at 6months postpartum and the prepregnancy weight). These results showed that the BW of the HM group and of overweight women increased ~ 5.2 kg 6 months postpartum, compared with the other groups. Additionally, women classified as overweight had a greater BW variation of 3.150 kg. Conclusion This evidence supports the need for specific nutritional guidelines for gestational hypertensive disorders, as well as great public attention for overweight women in the fertile age.

https://doi.org/10.1055/s-0039-1683373 732 descargas

Human immunodeficiency virus in a cohort of systemic lupus erythematosus patients
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Hax, Vanessa

; Moro, Ana Laura Didonet

; Piovesan, Rafaella Romeiro

; Goldani, Luciano Zubaran

; Xavier, Ricardo Machado

; Monticielo, Odirlei Andre

Advances in Rheumatology

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2018, Volumen 58 elocation 12

Resumen: En | Texto: En | PDF: En

Abstract Background: Systemic lupus erythematosus (SLE) and acquired immunodeficiency syndrome (AIDS) share many clinical manifestations and laboratory findings, therefore, concomitant diagnosis of SLE and human immunodeficiency virus (HIV) can be challenging. Methods: Prospective cohort with 602 patients with SLE who attended the Rheumatology Clinic of the Hospital de Clínicas de Porto Alegre since 2000. All patients were followed until 01 May 2015 or until death, if earlier. Demographic, clinical and laboratory data were prospectively collected. Results: Out of the 602 patients, 11 presented with the diagnosis of AIDS (1.59%). The following variables were significantly more prevalent in patients with concomitant HIV and SLE: neuropsychiatric lupus (10.9% vs. 36.4%; p = 0.028) and smoking (37.6% vs. 80%; p = 0.0009) while malar rash was significantly less prevalent in this population (56% vs. 18.2%; p = 0.015). Nephritis (40.5% vs. 63.6%; p = 0.134) and hemolytic anemia (28.6% vs. 54.5%; p = 0.089) were more prevalent in SLE patients with HIV, but with no statistical significance compared with SLE patients without HIV. The SLICC damage index median in the last medical consultation was significantly higher in SLE patients with HIV (1 vs. 2; p = 0,047). Conclusions: Our patients with concomitant HIV and SLE have clinically more neuropsychiatric manifestations. For the first time, according to our knowledge, higher cumulative damage was described in lupus patients with concomitant HIV infection. Further studies are needed to elucidate this complex association, its outcomes, prognosis and which therapeutic approach it's best for each case.

https://doi.org/10.1186/s42358-018-0003-2 986 descargas

Erratum on "Consensus of the Brazilian Society of Infectious Diseases and Brazilian Society of Clinical Oncology on the management and treatment of Kaposi's sarcoma" [Braz. J. Infect. Dis. 18 (3) (2014) 315-326]
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Arruda, Érico

; Jacome, Alexandre Andrade dos Anjos

; Toscano, Ana Luiza de Castro Conde

; Silvestrini, Anderson Arantes

; Rêgo, André Santa Bárbara

; Wiermann, Evanius Garcia

; Cunha Jr., Geraldo Felicio da

; Melo, Heloisa Ramos Lacerda de

; Morejón, Karen Mirna Loro

; Goldani, Luciano Zubaran

; Pereira Jr., Luiz Carlos

; Silva, Mariliza Henrique

; Treistman, Mauro Sergio

; Pereira, Mônica Cristina Toledo

; Romero, Patricia Maria Bezerra Xavier

; Schmerling, Rafael Aron

; Guedes, Rodrigo Antonio Vieira

; Camargo, Veridiana Pires de

Brazilian Journal of Infectious Diseases

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Ago 2014, Volumen 18 Nº 4 Paginas 468 - 468

Resumen: En | Texto: En | PDF: En

https://doi.org/10.1016/j.bjid.2014.06.002 1041 descargas

Consensus of the Brazilian Society of Infectious Diseases and Brazilian Society of Clinical Oncology on the management and treatment of Kaposi's sarcoma
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Arruda, Érico

; Jacome, Alexandre Andrade dos Anjos

; Toscano, Ana Luiza de Castro Conde

; Silvestrini, Anderson Arantes

; Rêgo, André Santa Bárbara

; Wiermann, Evanius Garcia

; Cunha Jr., Geraldo Felicio da

; Melo, Heloisa Ramos Lacerda de

; Morejón, Mirna Loro

; Goldani, Luciano Zubaran

; Pereira Jr., Luiz Carlos

; Silva, Mariliza Henrique

; Treistman, Mauro Sergio

; Pereira, Mônica Cristina Toledo

; Romero, Patricia Maria Bezerra Xavier

; Schmerling, Rafael Aron

; Guedes, Rodrigo Antonio Vieira

; Camargo, Veridiana Pires de

Brazilian Journal of Infectious Diseases

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Jun 2014, Volumen 18 Nº 3 Paginas 315 - 326

Resumen: En | Texto: En | PDF: En

Kaposi's sarcoma is a multifocal vascular lesion of low-grade potential that is most often present in mucocutaneous sites and usually also affects lymph nodes and visceral organs. The condition may manifest through purplish lesions, flat or raised with an irregular shape, gastrointestinal bleeding due to lesions located in the digestive system, and dyspnea and hemoptysis associated with pulmonary lesions. In the early 1980s, the appearance of several cases of Kaposi's sarcoma in homosexual men was the first alarm about a newly identified epidemic, acquired immunodeficiency syndrome. In 1994, it was finally demonstrated that the presence of a herpes virus associated with Kaposi's sarcoma called HHV-8 or Kaposi's sarcoma herpes virus and its genetic sequence was rapidly deciphered. The prevalence of this virus is very high (about 50%) in some African populations, but stands between 2% and 8% for the entire world population. Kaposi's sarcoma only develops when the immune system is depressed, as in acquired immunodeficiency syndrome, which appears to be associated with a specific variant of the Kaposi's sarcoma herpes virus. There are no treatment guidelines for Kaposi's sarcoma established in Brazil, and thus the Brazilian Society of Clinical Oncology and the Brazilian Society of Infectious Diseases developed the treatment consensus presented here.

https://doi.org/10.1016/j.bjid.2014.01.002 3007 descargas Citado 2 veces en SciELO

Autologous transplant: microbial contamination of hematopoietic stem cell products
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Almeida, Igor Dullius

; Schmalfuss, Tissiana

; Röhsig, Liane Marise

; Goldani, Luciano Zubaran

Brazilian Journal of Infectious Diseases

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Ago 2012, Volumen 16 Nº 4 Paginas 345 - 350

Resumen: En | Texto: En | PDF: En

Hematopoietic progenitor cells from peripheral blood (HPCPB) are commonly used for autologous and allogenic transplants in patients with most various onco-hematological diseases, and despite the utilization of sterile techniques during collection and processing of these products, bacterial contamination can occur. This study aimed to investigate the microbial contamination of HPCPB products. Microbial cultures of 837 HPCPB products between the year 2000 and 2009 were retrospectively analyzed to determine the incidence of culture positivity and identify the main organisms that cause contamination. The microbiological studies were performed with an automated system (BacT/Alert® bioMérieux Corporate). Thirty-six (4.3%) of 837 microbial cultures were contaminated. Coagulase-negative Staphylococcus was the most frequent bacteria isolated from HPCPB products (20 [56%] of the 36 positive microbial cultures). Considering the 36 contaminated samples, 22 HPCPB products were infused and 14 discarded. Pre-and post-infusion antibiotic therapy of the patients transfused with contaminated products was established based on the isolated microorganism and its antibiogram. Microbial contamination rate of HPCPB products was low. Clinically significant outcomes after infusion of contaminated HPCPB products were not observed.

https://doi.org/10.1016/j.bjid.2012.06.012 3185 descargas Citado 1 vez en SciELO

The multidimensional evaluation and treatment of anxiety in children and adolescents: rationale, design, methods and preliminary findings
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Salum, Giovanni Abrahão

; Isolan, Luciano Rassier

; Bosa, Vera Lúcia

; Tocchetto, Andrea Goya

; Teche, Stefania Pigatto

; Schuch, Ilaine

; Costa, Jandira Rahmeier

; Costa, Marianna de Abreu

; Jarros, Rafaela Behs

; Mansur, Maria Augusta

; Knijnik, Daniela

; Silva, Estácio Amaro

; Kieling, Christian

; Oliveira, Maria Helena

; Medeiros, Elza

; Bortoluzzi, Andressa

; Toazza, Rudineia

; Blaya, Carolina

; Leistner-Segal, Sandra

; Salles, Jerusa Fumagalli de

; Silveira, Patrícia Pelufo

; Goldani, Marcelo Zubaran

; Heldt, Elizeth

; Manfro, Gisele Gus

Brazilian Journal of Psychiatry

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Jun 2011, Volumen 33 Nº 2 Paginas 181 - 195

Resumen: Pt En | Texto: Pt En | PDF: Pt | PDF: En

OBJETIVO: o objetivo deste estudo é descrever o desenho, os métodos e as características amostrais da Avaliação Multidimensional e Tratamento da Ansiedade em Crianças e Adolescentes - Projeto PROTAIA. MÉTODO: Escolares entre 10 e 17 anos de todas as escolas pertencentes à área de abrangência da unidade de atenção primária do Hospital de Clínicas de Porto Alegre foram incluídos no projeto. O projeto compreende cinco fases: 1) triagem comunitária; 2) diagnóstico psiquiátrico; 3) avaliação multidimensional, incluindo fatores ambientais, neuropsicológicos, nutricionais e marcadores biológicos; 4) tratamento; e 5) fase translacional. RESULTADOS: Um total de 2.457 sujeitos foram triados para transtornos de ansiedade na comunidade. Dos indivíduos que compareceram à avaliação diagnóstica, 138 foram detectados com ao menos um transtorno de ansiedade (excluindo fobia específica) e 102 indivíduos sem nenhum transtorno de ansiedade. Dentre os casos de ansiedade, o transtorno de ansiedade generalizada (n = 95; 68,8%), transtorno de ansiedade social (n = 57; 41,3%) e o transtorno de ansiedade de separação (n = 49; 35,5%) foram os mais frequentes. CONCLUSÃO: O projeto PROTAIA é um projeto de pesquisa promissor que pode contribuir para o entendimento da relação entre transtornos de ansiedade e fenótipos relacionados à ansiedade com vários fatores de risco, tanto genéticos quanto ambientais.

OBJECTIVE: This study aims to describe the design, methods and sample characteristics of the Multidimensional Evaluation and Treatment of Anxiety in Children and Adolescents - the PROTAIA Project. METHOD: Students between 10 and 17 years old from all six schools belonging to the catchment area of the Primary Care Unit of Hospital de Clínicas de Porto Alegre were included in the project. It comprises five phases: (1) a community screening phase; (2) a psychiatric diagnostic phase; (3) a multidimensional assessment phase evaluating environmental, neuropsychological, nutritional, and biological factors; (4) a treatment phase, and (5) a translational phase. RESULTS: A total of 2,457 subjects from the community were screened for anxiety disorders. From those who attended the diagnostic interview, we identified 138 individuals with at least one anxiety disorder (apart from specific phobia) and 102 individuals without any anxiety disorder. Among the anxiety cases, generalized anxiety disorder (n = 95; 68.8%), social anxiety disorder (n = 57; 41.3%) and separation anxiety disorder (n = 49; 35.5%) were the most frequent disorders. CONCLUSION: The PROTAIA Project is a promising research project that can contribute to the knowledge of the relationship between anxiety disorders and anxiety-related phenotypes with several genetic and environmental risk factors.

10782 descargas Citado 7 veces en SciELO

Prevalence, susceptibility profile for fluconazole and risk factors for candidemia in a tertiary care hospital in southern Brazil
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Aquino, Valério Rodrigues

; Lunardi, Luciano W.

; Goldani, Luciano Zubaran

; Barth, Afonso Luis

Brazilian Journal of Infectious Diseases

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Oct 2005, Volumen 9 Nº 5 Paginas 411 - 418

Resumen: En | Texto: En | PDF: En

Bloodstream infections caused by yeast, Candida spp, are quite important clinically and epidemiologically due to a high mortality rate and an increasing number of non-albicans species with a more resistant (differentiated susceptibility) profile. We examined species prevalence and susceptibility profile for fluconazole and the risk for nosocomial infections by Candida spp at the Hospital de Clínicas de Porto Alegre, a general tertiary care hospital in southern Brazilian, through a retrospective study, beginning with positive cultures of hospitalized patients. The distribution by species in 131 documented episodes was as follows: Candida albicans (45%), C. parapsilosis (24.4%), C. tropicalis (15.3%), C. glabrata (6.9%), C. krusei (4.6%) and 3.8% other species (C. pelicullosa, C. guilliermondii, C. lusitaniae and C. kefyr). The vast majority of samples (121- 92.4%) were susceptible to fluconazole; the resistant or dose-dependent sensitive samples included only C. krusei and C. glabrata. Blood diseases (leukemia, lymphoma), or neoplasias (solid tumors), were found in 35.0% of the candidemia episodes. We noted the previous use of antibiotics in 128 (97.7%) patients, with 79.7% using three or more antibiotics before the candidemia episode. Other risk factors included a central venous catheter in 94 (71.8%) and abdominal surgery in 32 (24.4%) patients. The overall mortality rate was 51.9%, which varied according to the underlying disease. We found that C. albicans was the most prevalent species, although the non-albicans species predominated. However, in vitro resistance to fluconazole was detected only among the species (C. glabrata and C. krusei) that tend to be resistant to the azolic compounds. Previous use of antibiotic and the use of a central venous catheter were the main risk factors among patients with candidemia.

3935 descargas Citado 8 veces en SciELO

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