Intraoperative anaphylaxis after intravenous atropine.
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Adjuvants, Anesthesia↗
Biomedical subjects
J Rodrigues
Publications and source records attributed to J Rodrigues.
Phenotypic and genotypic study of gelatinase and beta-haemolysis activities in faecal enterococci of poultry in Portugal.
The detection of gelatinase and beta-haemolysis activities was carried out in 83 faecal enterococci (43 Enterococcus faecalis, 33 E. faecium, five E. durans and two E. hirae) of poultry origin. In addition, the presence of genes of the gelE-fsrABC locus and of the cyl operon (cylL(L), cylL(S), cylA, cylB and cylM) were studied by polymerase chain reaction and correlated with gelatinase and beta-haemolysis production, respectively. Most of our E. faecalis isolates were gelatinase-positive (88%), being this activity not frequent in the other enterococcal species (2.5%). Only one of the 33 E. faecium isolates showed a positive gelatinase reaction. All enterococci that showed gelatinase activity harboured the gelE and fsrABC genes, although these genes were also detected in four E. faecalis and one E. durans gelatinase-negative isolates. Most of our non-E. faecalis gelatinase-negative isolates did not harbour gelE-fsrABC genes. A high proportion of faecal enterococci of poultry origin harboured genes of the cyl operon (71%), although only 7% contained the five cyl tested genes (all of them E. faecalis). Only one isolate of our series could express beta-haemolysis, harbouring the whole cyl operon. The cylL(S) genotype was the most prevalent in our enterococci (39%) and also the most prevalent among our E. faecalis isolates (60%). Other genotypes detected were the following ones (% of enterococci): cylA + cylB + cylM (13%), cylL(L) + cylA (4%), cylL(L) (4%), cylL(L) + cylA + cylB + cylM (2%), cylL(L) + cylA + cylM (1%) and cylA + cylM (1%). Both phenotypic and genotypic assays are important to evaluate the virulence potential of enterococci.
Animals↗
Characterization of antibiotic resistance genes and virulence factors in faecal enterococci of wild animals in Portugal.
Antibiotic susceptibility was tested in 140 non-selected enterococci (73 Enterococcus faecalis, 45 E. faecium and 22 of other species) recovered from faecal samples of 77 wild animals in Portugal. Susceptibility testing for 11 antibiotics (vancomycin, teicoplanin, ampicillin, streptomycin, gentamicin, kanamycin, chloramphenicol, tetracycline, erythromycin, quinupristin-dalfopristin and ciprofloxacin) was determined by disk diffusion and agar dilution methods. Forty-four isolates (31.4%) showed susceptibility to all the antibiotics tested (5.5% of E. faecalis; 62.2% of E. faecium; and 78.6% of E. hirae). Neither ampicillin-resistance nor acquired-vancomycin-resistance was detected and 1.4% of the isolates showed high-level-resistance for gentamicin or streptomycin. Tetracycline and erythromycin resistances were shown in 28.6% and 20.1% of the isolates, respectively. Antibiotic resistance genes were studied by polymerase chain reaction (PCR) and sequencing and tet(M) + tet(L), erm(B) or aac(6')-aph(2'') genes were detected in most of tetracycline-, erythromycin- or gentamicin-resistant enterococci respectively. Genes encoding virulence factors were studied by PCR and a wide variety of virulence genes were detected in most of E. faecalis isolates but were rarely found in E. faecium and not detected in the other species. The prevalence of genes encoding virulence factors in E. faecalis was as follows: cpd (98.6%), gelE (75.3%), agg (30.1%), fsr (17.8%), ace (9.6%) and esp (4.1%). Low percentages of antibiotic resistance was found in the faecal enterococci of wild animals but a wide variety of virulence genes were detected among E. faecalis isolates although were rare in the other species.
Animals↗
Sustainable sewage solutions for small agglomerations.
In a significant number of European countries, the need for providing appropriate treatment for the effluents of small rural communities is still especially relevant. In fact, in countries like Portugal, Spain, and many others, significant amounts of investment will be addressed in the next few years to the construction of small Wastewater Treatment Plants (WWTP). The problems faced when constructing and operating WWTP serving small communities may be relevant when energy and labour costs are relatively high, or when the visual impact on the surrounding areas is especially negative. Sustainable treatment solutions require the selection of appropriate technologies using fewer resources. In this paper, information is presented about sustainability indicators of twenty-one small secondary wastewater treatment plants, including conventional (trickling filters and extended aeration plants) and non-conventional treatment systems (constructed wetlands). The data refer to allocated areas per inhabitant, amounts of concrete per inhabitant, power per inhabitant, and construction and installation costs per inhabitant. The data seem to show that for different reasons, constructed wetlands are promising treatment solutions for application to rural areas in particular because of the relatively low power requirements and relatively low construction costs for served populations below 500 inhabitants.
Animals↗
Evaluation of the Asthma Life Quality test for the screening and severity assessment of asthma.
BACKGROUND: Asthma Life Quality (ALQ) test, a 20-question questionnaire developed by the American College of Allergy, Asthma and Immunology, has been shown to be useful for asthma diagnosis. We aimed to determine the relation between ALQ scores and (a) diagnosis of asthma; (b) physician's classification of asthma severity according to National Institutes of Health/Global Initiative for Asthma (GINA). METHODS: Standard translation and cultural adaptation to Portuguese was performed. Patients self-administered the ALQ in the waiting room; the attending allergist classified them, blindly for the test. The scores of nonasthmatics were compared with those of asthma patients. Asthma patients were analyzed in two severity groups: intermittent and mild persistent asthma (IMPA), and moderate and severe persistent asthma (MSPA); sensitivity, specificity, positive and negative predictive values were calculated and receiver operating characteristic curve plotted. Logistic regression analysis models were computed. RESULTS: From 283 patients, 237 tests were analyzed. Non-asthmatic patients ALQ scores (mean +/- SD) were 6 +/- 4 and, for asthmatics, 10 +/- 5 [mean difference 4.6 (95%CI 3.3-5.9)]. The odds of positive diagnosis increased 1.27 times (95%CI 1.17-1.38) for each one-unit increase in the test. For asthma severity ALQ scores were 9 +/- 4 for IMPA, 15 +/- 3 for MSPA [difference 6.0 (95%CI 4.8-7.1)]; with a sensitivity of 88% and specificity of 74% for a score of 12. The odds of MSPA increased 1.49 times (95%CI 1.28-1.74) per unit increase in ALQ. CONCLUSIONS: ALQ can help both to identify patients with asthma and to differentiate those more likely to have moderate/severe asthma. These are relevant characteristics for the possible use of this simple, self-administered questionnaire in the assessment of asthma patients needing additional medical management.
Adolescent↗
Exercise-induced bronchoconstriction and respiratory symptoms in elite athletes.
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Adult↗
The importance of pets as reservoirs of resistant Enterococcus strains, with special reference to vancomycin.
The purpose of the present study was to determine the prevalence of antibiotic resistance, with special attention to vancomycin, in 104 strains of Enterococcus, which is the sentinel bacterium isolated from dog and cat faeces samples. The phenotypic characterization of the isolates classified them as E. faecium (58%), E. avium (41%) and E. faecalis (1%). Sensitivity testing used the diffusion method according to the recommendations of CASFM (Comite de l'Antibiogramme de la Société Française de Microbiogie), to oxacillin, amoxycillin, amoxycilin + clavulanic acid, ampicillin, piperacillin, cefoperazone, imipenem, enrofloxacin, ciprofloxacin, ofloxacin, nalidixic acid, tetracycline, lincomycin, erythromicin and vancomycin. Minimum inhibitory concentration (MIC) determination by E test revealed a MIC to vancomycin of between 0.5 microg/ml and 3 microg/ml. All the strains were resistant to nalidixic acid, erythromycin, cefoperazone and oxacillin. We detected resistance to amoxycillin + clavulanic acid in 1.9% of isolates, to amoxycillin in 4.8%, to piperacillin in 13.5%, and to ampicillin in 21.2% of strains. A high prevalence of antibiotic resistance to lincomycin, tetracycline, enrofloxacin, ciprofloxacin and ofloxacin was found in 98.1%, 95.2%, 76.9%, 73.1% and 64.4% of strains, respectively. Resistance to vancomycin was not found, which indicates that there is no transmission risk of vancomycin-resistant enterococcal strains to man or transfer of their resistance genes to other bacteria belonging to the endogenous flora of humans.
Animals↗
Prevalence of diarrheogenic Escherichia coli and rotavirus among children from Botucatu, São Paulo State, Brazil.
In a one-year prospective study carried out to define the role of rotavirus and Escherichia coli in local childhood diarrhea, we determined the prevalence of both agents in 54 diarrheic children attending a health center in Botucatu. Diarrheogenic E. coli (DEC) strains were characterized by O:H serotyping, a search for virulence genetic markers, and assays of adherence to HEp-2 cells. Except for enteroaggregative E. coli (EAEC), no other DEC category was detected in the children's stools. Both EAEC and rotavirus were isolated from 22 of the 54 (41.0%) diarrheic children as single agents or in combination with other enteropathogens. However, when considering the presence of a single agent, EAEC was dominant and isolated from 20.4% of the patients, whereas rotavirus was detected in 14.8%. These results indicate that rotavirus and EAEC play a significant role as agents of childhood diarrhea in the local population.
Adolescent↗
Internet marketing essential to physician and patient successes.
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Communication↗
Rhinitis and nasal continuous positive air pressure?
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Air↗
Rapid crossing of the pulmonary endothelial barrier by polyethylenimine/DNA complexes.
Intravenous administration could become a delivery route of choice for prophylactic and curative gene therapies on condition that genes cross the capillary barrier and reach target tissues without being degraded. We investigated the kinetics and process of transgene delivery through mouse lung capillaries following DNA complexation with linear polyethylenimine (L-PEI) and intravenous injection. Using digoxin-labeled DNA we followed the cellular localization of DNA at different times after injection and correlated these findings with cell markers and transgene expression. At 2 h after injection some DNA was still localized on the interior of the capillary lumen, but other complexes had already crossed the barrier and resulted in gene expression. At 24 h after injection most labeled DNA was localised in pulmonary cells, as was transgene expression. Only rarely was transgene expression found in endothelial cells, suggesting that the complexes cross the capillary barrier rapidly. Levels of caspase-1-like activity did not increase following transfection implying that L-PEI/DNA complexes are transported across cellular barriers by a non-damaging, physiological process, without causing inflammation. The high levels of expression of different transgenes in pneumocytes indicates that transport of L-PEI/DNA complexes through the endothelial barrier does not affect their transfection capacity. These findings open up new possibilities for gene delivery and its application to the lung.
Animals↗
Height, mass and skeletal maturity of elite Portuguese soccer players aged 11-16 years.
Height, mass and skeletal maturity (Fels method) were assessed in 135 elite youth soccer players aged 10.7-16.5 years (only two boys were < 11.0 years). Sample sizes, years of training and current weekly training volume by two-year age groups were: 11-12 years (n = 63), 2.6 +/- 1.0 years and 4.1 +/- 1.7 h; 13-14 years (n = 29), 3.1 +/- 1.6 years and 4.5 +/- 1.7 h; 15-16 years (n = 43), 4.7 +/- 2.4 years and 6.1 +/- 2.0 h. The oldest age group included members of the national youth team. Heights and masses were compared to US reference values, and skeletal age and chronological age were contrasted. The players were also classified as late, average ('on time') and early maturers on the basis of differences between skeletal and chronological age, with the average category including boys with skeletal ages within +/- 1 year of chronological age. The mean heights and masses of 11- to 12-year-old soccer players equalled the US reference values, while those of players aged 13-14 and 15-16 years were slightly above the reference values. The mean skeletal age approximated mean chronological age in players aged 11-12 years (12.4 +/- 1.3 and 12.3 +/- 0.5 years, respectively), while mean skeletal age was in advance of mean chronological age in the two older groups (14.3 +/- 1.2 and 13.6 +/- 0.7 years, respectively, in 13- to 14-year-olds; 16.7 +/- 1.0 and 15.8 +/- 0.4 years, respectively, in 15- to 16-year-olds). Seven boys in the oldest age group were already skeletally mature and were not included when calculating differences between skeletal and chronological age. The proportion of late maturing boys in this sample of elite soccer players decreased with increasing chronological age. Among 11- to 12-year-old players, the percentages of late and early maturing boys were equal at 21% (n = 13). Among 13- to 14-year-old players, the percentages of late and early maturing boys were 7% (n = 2) and 38% (n = 11) respectively, while among players aged 15-16 years the percentages of late and early maturing boys were 2% (n = 1) and 65% (n = 28) respectively. The results of this comparative analysis suggest that the sport of soccer systematically excludes late maturing boys and favours average and early maturing boys as chronological age and sport specialization increase. It is also possible that late maturing boys selectively drop-out of soccer as age and sport specialization increase.
Adolescent↗
Autoimmune progesterone urticaria.
Autoimmune progesterone dermatitis is a rare cutaneous disorder characterized by recurrent and cyclic skin eruption with variable morphology, occurring during the luteal phase. A case of autoimmune progesterone urticaria in a 47-year-old woman is reported. An intradermal progestin test revealed a strong reactivity against this hormone. Treatment with tamoxifen and leuprolide acetate induced only a partial remission of urticaria. Bilateral oophorectomy was performed with absolute clearing of cutaneous lesions.
Autoimmune Diseases↗
Incident HIV infection in a high-risk, homosexual, male cohort in Rio de Janeiro, Brazil.
An HIV seroincidence study was conducted to identify a high-risk population for HIV prevention trials. Inclusion criteria were male gender, homosexual behavior, age between 18 and 50 years, and negative HIV serostatus; 862 study subjects were screened and 753 were enrolled and observed during follow-up for a mean of 1.5 years. In this population, 34 people had HIV seroconversions for an overall annual seroincidence of 3.1% (95% confidence interval [CI], 2.1%-4.1%). Among study subjects <20 years old, annual incidence was 8.4% (95% CI, 1.7%-15%). Independent risk factors for seroconversion were age <25 years (p = .01), hepatitis B core antibody seropositivity (p > .01), sex at first encounter in the preceding 6 months (p = .11), and a history of gonorrhea or condyloma in the 6 months before seroconversion (p = .04 and p = .08, respectively). At enrollment, 85% of the eventual seroconverters said they would participate in a vaccine trial; all agreed to participate when told there would be a placebo arm. Follow-up rates were 97%, 91%, and 88% at 6, 12, and 18 months, respectively. The HIV-1 subtype was B for each of the first 17 seroconverters. These data demonstrate the suitability of this cohort for HIV prevention trials, based on high HIV incidence and retention rates, and a willingness to participate in such trials.
AIDS Vaccines↗
Clonal relationship among invasive and non-invasive strains of enteroinvasive Escherichia coli serogroups.
The genetic relatedness among 96 invasive Escherichia coli belonging to several serogroups and 13 non-invasive of several serotypes that share the same O antigen was investigated by multilocus enzyme electrophoresis analysis. The invasive strains were isolated in different parts of the world and most of them recovered from dysentery. Twenty-nine electrophoretic types were distinguished and the most invasive strains were found to belong to two major lineages. These results suggested that the invasive ability in these strains has evolved in divergent chromosomal backgrounds, presumably through the horizontal spread of plasmid-borne invasion genes. The maintenance of invasive phenotypes in separate lineages suggests that this ability confers a selective advantage to invasive strains.
Dysentery↗
Characterisation of diarrhoeagenic Escherichia coli clones by ribotyping and ERIC-PCR.
The ability of ribotyping and enterobacterial repetitive intergenic concensus-polymerase chain reaction (ERIC-PCR) to discriminate diarrhoeagenic Escherichia coli clones of 122 strains belonging to 26 distinct serotypes was evaluated. The 26 serotypes corresponded to 24 ribotypes and 25 ERIC-types. Correlation between multilocus enzyme electrophoresis, ERIC-PCR and ribotyping was c. 90% for the dominant ribotypes. Related clones such as O55:H7 and O157:H7 presented similar ribotypes and clustered together in a dendrogram, and the two divergent clonal groups of enteropathogenic E. coli (EPEC) and enterohaemorrhagic E. coli (EHEC) were included in distinct branches. The results suggest the possibility of applying these two simpler techniques as tools to identify clones of diarrhoeagenic E. coli.
Bacterial Typing Techniques↗
Reverse dorsal metacarpal osteocutaneous flap.
There are a number of possibilities for local and vascularized bone transfer when a small amount of cortico-cancellous bone is required in the hand and fingers. The authors describe the dissection technique and a clinical application of a reverse dorsal metacarpal osteocutaneous flap to reconstruct the proximal phalanx of a fifth finger. They emphasise the bone vascularisation, studied 48 hours postoperatively with a bone scan and confirmed with bone healing 4 weeks later. The advantages are: it is a compound flap, easy to dissect under tourniquet in one operation, it can be done in an emergency care situation and it does not require ligation of an important vascular axis. The essential precaution is to visualise the patency of the fourth dorsal metacarpal artery before flap dissection, acknowledging that in only 63% of cases is there a vascular pattern that allows flap dissection with a long arc of rotation.
Bone Transplantation↗
Virulence properties and clonal structures of strains of Escherichia coli O119 serotypes.
A total of 110 Escherichia coli strains of serogroup O119 were examined for the presence of virulence properties characteristic of enteropathogenic E. coli (EPEC). Three virulence patterns were distinguished based on the detection of a chromosomal gene mediating intimate attachment (eaeA) and plasmid DNA involved in localized adherence (EAF and bfpA). The first pattern, represented by strains which hybridized with three gene probes, was the most common (68%) and, with a single exception, included only O119:H6 strains. Of these strains, 90% showed a typical localized adherence (LA) pattern in HEp-2 cells and 96% were positive for intimate attachment in a fluorescent-actin staining test with a 3-h incubation period. The second pattern was represented by strains which hybridized with the eaeA gene only. Most (89.5%) of these strains showed the LA phenotype but only after 6 h of incubation (LA-like phenotype). The third pattern consisted of strains which were positive for eaeA and bfpA but did not hybridize with the EAF probe. Most (80%) of these strains exhibited the LA-like phenotype. Analysis of several eaeA+ bfpA+ strains for the expression of the pilin subunit (BfpA) of the bundle-forming pili demonstrated that all LA strains expressed BfpA whereas the LA-like strains did not. The study of the clonal relationships, carried out by multilocus enzyme electrophoresis in 79 representative strains, defined 11 distinct electrophoretic types (ETs). ET1 included 66% of the strains, most of which displayed the eaeA+ bfpA+ EAF+ pattern and were serotyped as O119:H6 or O119:H-. The remaining 10 ETs were each represented by no more than five strains and, with the exception of ET8, included strains of a single serotype. The genetic relatedness of the ETs revealed two main clusters, with most strains in cluster A having the eaeA+ bfpA+ EAF+ combination and a O119:H6 serotype. Cluster B was represented by atypical EPEC strains with only the eaeA+ and the eaeA+ bfpA+ virulence pattern.
Bacterial Adhesion↗