Detection of multidrug-resistant Enterobacteriaceae isolated from river waters flowing to the Guanabara Bay and from clinical samples of hospitals in Rio de Janeiro, Brazil / Detección de enterobacterias multirresistentes aisladas en aguas de los ríos que desembocan en la bahía de Guanabara y en muestras de hospitales de Río de Janeiro, Brasil

Abstract Introduction: The use of antibiotics in humans, animal husbandry and veterinary activities induces selective pressure leading to the colonization and infection by resistant strains. Objective: We evaluated water samples collected from rivers of the Guanabara Bay, which have suffered minor and major environmental degradation, and clinical samples of hospital origin to detect evidence of the presence of resistance genes to aminoglycosides, beta-lactam antibiotics and fluoroquinolones in strains of Klebsiella pneumoniae subsp. pneumoniae, K. pneumoniae subsp. ozaenae and Escherichia coli. Materials and methods: For isolation of the water strains we employed culture media containing 32 μg/ml cephalotin and 8 μg/ml gentamicin. The strains from clinical materials were selected using culture media containing 8 μg/ml gentamicin. The strains were identified and subjected to antimicrobial susceptibility testing (AST), plasmid DNA extraction and polymerase chain reaction (PCR) to detect genes encoding enzymes modifying aminoglycosides (EMA), extended-spectrum beta-lactamases (ESBL) and plasmid mechanisms of quinolone resistance (PMQR). Results: The AST of the isolates recovered from water samples showed multidrug-resistance profiles similar to those found in isolates recovered from clinical materials. All isolates from water samples and 90% of the isolates from clinical samples showed at least one plasmid band. In the PCR assays, 7.4% of the isolates recovered from water samples and 20% of those from clinical materials showed amplification products for the three antimicrobial classes. Conclusion: We believe that the detection of microorganisms presenting genetic elements in environments such as water is necessary for the prevention and control of their dissemination with potential to infect humans and other animals in eventual contact with these environments.

Resumen Introducción. El uso de antibióticos en seres humanos, en la industria pecuaria y en las actividades veterinarias induce una presión selectiva que resulta en la colonización e infección con cepas resistentes. Objetivo. Determinar la presencia de genes de resistencia a aminoglucósidos, betalactámicos y fluoroquinolonas en cepas de Klebsiella pneumoniae subsp. pneumoniae, K. pneumoniae subsp. ozaenae y Escherichia coli, obtenidas de muestras de agua de los ríos que desembocan en la bahía de Guanabara y de muestras clínicas de hospitales de Río de Janeiro. Materiales y métodos. En la selección de las cepas resistentes obtenidas de las muestras de agua de los ríos, se emplearon medios de cultivo que contenían 32 μg/ml de cefalotina y 8 μg/ ml de gentamicina. En el caso de las muestras de especímenes clínicos, se usaron medios de cultivo que contenían 8 μg/ml de gentamicina. Las cepas se identificaron y se sometieron a pruebas de sensibilidad antimicrobiana, extracción de ADN plasmídico y pruebas de reacción en cadena de la polimerasa (PCR) para detectar los genes que codifican aquellas enzimas que modifican los aminoglucósidos, las betalactamasas de espectro extendido (BLEE) y los mecanismos de resistencia a las quinolonas mediados por plásmidos. Resultados. Se encontraron perfiles de resistencia a los antimicrobianos similares en los dos grupos. En todas las bacterias obtenidas de las muestras de agua y en 90 % de las muestras clínicas, se evidenciaron bandas de plásmidos asociados con la transferencia de genes de resistencia. En las pruebas de PCR, se obtuvieron productos de amplificación de los genes de resistencia para las tres clases de antimicrobianos analizados, en el 7,4 % de las bacterias recuperadas de las muestras de agua y en el 20 % de aquellas recuperadas de las muestras clínicas. Conclusión. La detección de microorganismos con elementos genéticos que confieren resistencia a los antibióticos en ambientes como el agua, es una estrategia necesaria para prevenir y controlar la diseminación de estos agentes patógenos con potencial para infectar a humanos y a otros animales en dichos ambientes.

Biological activities and phytochemical profile of Passiflora mucronata from the Brazilian restinga

ABSTRACT In general, Passiflora species have been reported for their folk medicinal use as sedative and anti-inflammatory. However, P. caerulea has already been reported to treat pulmonary diseases. Severe pulmonary tuberculosis, generally caused by Mycobacterium tuberculosis strains resistant to multiple drugs, can lead to deleterious inflammation and high mortality, encouraging new approaches in drug discovery. Thus, the aim of this work was to evaluate the Passiflora mucronata Lam., Passifloraceae, potential for tuberculosis treatment. Specifically, related to antimycobacterial activity and anti-inflammatory related effects (based on inhibition of nitric oxide, tumor necrosis factor-alpha production and antioxidant potential), as well as the chemical profile of P. mucronata. High performance liquid chromatography coupled with diode-array ultraviolet and mass spectrometer analyses of crude hydroalcoholic extract and ethyl acetate fraction showed the presence of flavonoids. Ethyl acetate fraction showed to be as antioxidant as Ginkgo biloba standard extract with EC50 of 14.61 ± 1.25 µg/ml. One major flavonoid isolated from ethyl acetate fraction was characterized as isoorientin. The hexane fraction and its main isolated compound, the triterpene β-amyrin, exhibited significant growth inhibitory activity against Mycobacterium bovis BCG (MIC50 1.61 ± 1.43 and 3.93 ± 1.05 µg/ml, respectively). In addition, Passiflora mucronata samples, specially hexane and dichloromethane fractions, as well as pure β-amyrin, showed a dose-related inhibition of lipopolysaccharide (LPS)-induced nitric oxide production. In conclusion, Passiflora mucronata presented relevant biological potential and should be considered for further studies using in vivo pulmonary tuberculosis model.

Atitudes infantis face aos cuidados de saúde e perceção de dor: papel mediador dos medos médicos / Children's attitudes regarding health care and perception of pain: the mediating role of medical fears

O presente estudo pretende contribuir para a compreensão das atitudes e opiniões das crianças acerca dos cuidados de saúde, com enfoque nos procedimentos médicos, instituições e eficácia dos profissionais. Participaram no estudo 381 crianças, recrutadas em diversas instituições escolares da área de Lisboa. As atitudes mais negativas foram atribuídas às instituições, enquanto as mais positivas incidiram na eficácia dos profissionais. Os procedimentos médicos foram considerados menos dolorosos comparativamente aos potenciais acidentes do quotidiano. Os níveis mais elevados de dor percebida foram reportados pelas crianças do sexo feminino e pelas do 1º ciclo de escolaridade. Os medos médicos mediaram significativamente a relação entre a perceção de dor e as atitudes infantis face aos cuidados de saúde. A maior perceção de dor mostrou estar associada a atitudes mais negativas, porém, esta relação ficou enfraquecida quando contemplados os medos infantis face a temáticas médicas. Em suma, é fundamental poder avaliar as atitudes infantis face aos cuidados de saúde, o que poderá contribuir para o desenvolvimento de programas de intervenção no âmbito da promoção de comportamentos.

This study sought to contribute to a better understanding of children's attitudes and opinions regarding health care, mainly in terms of medical procedures, institutions and the efficacy of health professionals. The sample included 381 children, recruited from different schools in Lisbon. The more negative attitudes were attributed to institutions, while positive attitudes were related to the efficacy of health professionals. Medical procedures were considered less painful compared to potential day-to-day accidents. Higher levels of pain were reported by children of the female sex and by children during the primary education phase. Medical fears mediated the relationship between the perception of pain and children's attitudes with respect to health care. Higher levels of pain perception were seen to be related to more negative attitudes regarding health care. However, this relationship was diminished when children's fears about medical issues were contemplated. In conclusion, a translated instrument to assess children's attitudes regarding health care is needed, as it may even contribute to the development of intervention programs within the scope of the promotion of attitudes towards health care.

Confirmatory factor analysis and temporal invariance of the Positive and Negative Affect Schedule (PANAS) / Análise fatorial confirmatória e invariância temporal da Positive and Negative Affect Schedule (PANAS)

This paper analyzes the structure and the temporal invariance of the Portuguese version of the Positive and Negative Affect Schedule. Previous studies are not consensual whether PANAS measures two or three affect factors and whether such factors are independent or correlated. In order to fill in this gap, we compared the original PANAS, as an independent bi-dimensional structure, with several other alternative structures. Two hundred forty five university students and professional trainees answered the questionnaire in two distinct moments with a two month interval. The model of PANAS with a structure of two independent factors, Positive Affect (PA) and Negative Affect (NA), as proposed by the authors of the scale, was tested. However, the best model consisted of two independent factors, PA and NA, with the cross-loading of the item "excited" between PA and NA, and specified error correlations between the same categories of emotions. Another gap in the literature is the temporal invariance analysis of the PANAS. This paper assesses the temporal invariance of the scale, using the structural equation modeling analysis. Although it was used in its state form version, the PANAS scale showed temporal stability in a two month interval...

O artigo analisa a estrutura e a invariância temporal da versão portuguesa da Positive and Negative Affect Schedule. A investigação científica anterior não é consensual acerca da estrutura da PANAS, se é constituída por dois ou três fatores e se esses fatores são independentes ou correlacionados. De forma a colmatar esta lacuna, procedemos à comparação da estrutura da PANAS como tendo duas dimensões independentes com várias outras estruturas alternativas. Duzentos e quarenta e cinco estudantes universitários e de cursos de formação profissional responderam ao questionário em dois momentos, com dois meses de intervalo. Foi testado o modelo da PANAS que representa uma estrutura de dois fatores independentes, Afeto Positivo (AP) e Afeto Negativo (AN), tal como definida pelos autores da escala. Contudo, o melhor modelo foi o que representa uma estrutura de dois fatores independentes, com a ponderação dupla do item "excitado" entre o AP e o AN e especificando correlações entre os erros dos itens que pertencem às mesmas categorias de emoções. Outra lacuna na investigação é a análise da invariância temporal da PANAS. Este artigo analisa a invariância temporal da escala, utilizando a análise de modelos de equações estruturais. Embora a escala tenha sido aplicada na sua versão afeto estado, a PANAS revelou invariância temporal num intervalo de dois meses...

Traumatic brain injury patients: does frontal brain lesion influence basic emotion recognition?

Adequate emotion recognition is relevant to individuals' interpersonal communication. Patients with frontal traumatic brain injury (TBI) exhibit a lower response to facial emotional stimuli, influencing social interactions. In this sense, the main goal of the current study was to assess the ability of TBI patients in recognizing basic emotions. Photographs of facial expressions of five basic emotions (happiness, sadness, fear, anger, and surprise) were presented to 32 TBI patients and 41 healthy controls. Emotion recognition was measured by accuracy and reaction time. Overall performance of the TBI group was poorer than control group for emotion recognition, both in terms of accuracy and reaction time. It is suggested that TBI patients show impairment on emotion recognition, and this relation seems to be moderated by the lesion localization.

Influence of water level fluctuation on the mortality and aboveground biomass of the aquatic macrophyte Eleocharis interstincta (VAHL) roemer et schults

O objetivo deste trabalho foi verificar as alterações biométricas de Eleocharis interstincta em resposta às variações no nível da água da Lagoa de Cabiúnas, localizada na região norte do Estado do Rio de Janeiro, no município de Macaé (22o00' e 22o30' S, 41o30' e 42o00' O). Três quadrados de 0,0625 m2 foram coletados quinzenalmente de junho/1997 a junho/1998; as amostras separadas em caules, detritos e rizoma; medidas, secas e pesadas. O nível da água variou sazonalmente no estande das macrófitas, apresentando dois períodos de seca. O primeiro período ocorreu naturalmente, no final do inverno e início da primavera, quando a precipitação na região é menor. O segundo período de seca foi resultado da abertura artificial da barra de areia, que separa a lagoa do mar. A abertura da barra foi feita no verão, período de maior precipitação, quando o nível da água registrou o máximo valor durante o período de estudo (1,35 m). Foi encontrada uma forte correlação positiva entre o nível da água com o tamanho médio dos caules e a biomassa aérea, indicando que o nível da água desempenha um importante papel na determinação destes parâmetros. Houve uma diferença significativa no tamanho (ANOVA; p < 0.001) e biomassa aérea dos caules (ANOVA; p < 0.001) entre os períodos amostrais, variando de 143,9 cm e 338,8 g peso seco.m-2, antes da abertura, a 16,3 cm e 20.2 g peso seco.m-2 respectivamente depois da abertura da barra. A drástica variação no nível da água, ocasionando a mortalidade em massa dos caules, juntamente com a menor razão biomassa /caule (0.057 g de peso seco.individuo-1), registrados depois da abertura de barra, não representou um grande distúrbio para E. interstincta, visto que o tempo de resiliência para esta população foi estimado em 30 dias.

Methane concentration in water column and in pore water of a coastal lagoon (Cabiúnas lagoon, Macaé, RJ, Brazil)

O objetivo dessa pesquisa foi determinar a concentração de metano na coluna d'água e na água intersticial do sedimento nas regiões limnética e litorânea de uma lagoa costeira (Lagoa Cabiúnas, Macaé, RJ). Na região litorânea as amostras foram coletadas em três estandes de macrófitas (Typha domingensis, Eleocharis interstincta e Potamogeton stenostachys). A concentração de metano na água intersticial na região litorânea foi maior do que aquela encontrada na região limnética em cada fração do sedimento. A maior concentração de metano na fração superficial do sedimento (0-2 cm) foi observada no estande de P. stenostachys (3.7 mM). Este resultado foi o único significativamente diferente (p<0.05) da região limnética. A concentração de metano na água intersticial aumentou com a profundidade nos estandes de macrófitas. A concentração de metano na coluna d'água não variou significativamente entre os pontos de coleta (p>0.05). Os resultados sugerem que há uma considerável influência das macrófitas aquáticas estudadas na concentração de metano na água intersticial do sedimento.

Natural diet of three species of shrimp in a tropical coastal lagoon

The gut content of 495 specimens of Farfantepenaeus brasiliensis, 131 of F. paulensis (Penaeidae) and 102 of Macrobrachium acanthurus (Palaemonidae) were analyzed to establish the composition of their diets F. brasiliensis had as the most important feeding items in its diet larvae of Chironomidae, Polychaeta and Heleobia australis (Mollusca). For F. paulensis, the most important items were the same as for F. brasiliensis, but the order of importance of H. australis and Polychaeta was inverted. M. acanthurus had detritus as the most important item, followed by Chironomidae larvae, Odonata nymphs, and fragments of the macroalgae Chara. The results showed that the three species were omnivorous, with a varied diet including both components of macrofauna of benthos and associated to the macroalgae Chara and plant fragments and detritus

Ecological aspects of the antimicrobial resistance in bacteria of importance to human infections

In view of the intimate relationship of humans with coastal lagoons (used for recreation, tourism, water supply, etc.), the discharge of domestic effluents may lead to the establishment of routes of dissemination of pathogenic microorganisms, including microorganisms carrying genes for resistance to antimicrobials, through the surrounding human communities. The objective of the present investigation was to relate the presence of antimicrobial-resistant bacteria to the environmental characteristics of three coastal lagoons, comparing the results with those from hospital sewage. Of the lagoons evaluated, two (Geriba and Imboassica) receive domestic sewage discharge, and the other (Cabiunas) is still in a natural state. We isolated in a culture medium containing 32 1/4ìg/ml of Cephalothin, fecal coliforms (E. coli), non-fecal coliforms (Klebsiella, Enterobacter, Serratia, and Citrobacter), non-glucose-fermenting Gram-negative bacilli, and Aeromonas sp. In cultures from the hospital drain we found strains showing numerous markers for resistance to most of the 11 antimicrobials tested. On the other hand, in cultures from Cabiunas and Imboassica lagoons, we found strains showing resistance only to antibiotics frequently observed in non-selective situations (considered as "common" markers). The capacity for dilution in the ecosystem, and salinity appeared related with the occurrence of multi-resistant bacterial strains. The intensity of recent fecal contamination was not shown to be associated with the numbers and types of markers found.

Bacterioplankton abundance, biomass and production in a Brazilian coastal lagoon and in two German lakes

The bacterioplanktonic abundance, biomass, and production within a tropical lagoon (Cabiúnas, Brazil) and two temperate lakes (Stechlin and Dagow, Germany) were compared. Bacterial abundance and production were significantly different among the three water bodies. The lowest bacterial production ( 0.8mug C l-1 d-1) was observed in the tropical Cabiúnas Lagoon despite its higher mean temperature and dissolved organic carbon concentration. Highest bacterioplankton abundance ( 2.6 x 10(9) cells l-1) and production ( 68.5mug C l-1 d-1) were measured in eutrophic Lake Dagow. In oligotrophic Lake Stechlin, the lowest bacterial biomass ( 48.05mug C l-1) was observed because of lower bacterial biovolume ( 0.248mum³) and lower bacterial abundance. Bacterial populations in the temperate lakes show higher activity (production/biomass ratio) than in the tropical lagoon. The meaning of isotopic dilution and leucine incorporation by non-bacterial micro-organisms were evaluated in the oligotrophic temperate system. Leucine uptake by non-bacterial micro-organisms did not have significant influence on bacterial production

Grupo de espera com familiares de pacientes psiquiátricos: "se tampá o coraçäo, ele incha!" / A waiting Groups with Relatives of Psychiatrical Patients

Em "Grupo de Espera com Familiares de Pacientes Psiquiátricos" relatamos a experiência em ambulatório de pós-alta de psiquiatria, destacando nossa atuaçäo como enfermeiro psiquiátrico, enquanto facilitador de grupo de espera. Fundamentamo-nos no Modelo de Grupo de Pichon e Modelo de Mútua-Ajuda de Caplan, situados no Capítulo I "Grupo em perspectiva histórica e modelos". A seguir no Capítulo II aprofundamos e discutimos concepçöes sobre as "Questöes Ambulatoriais: família, o enfermeiro psiquiátrico como facilitador em grupo de espera". No capítulo III abordamos o "Envolvimento de familiares de pacientes psiquiátricos: grupos de espera em ambulatório-pesquisa participante"; conclusöes, reflexöes finais e sugestöes, referências bibliográficas e os anexos da presente dissertaçäo. Ficou transparente no estudo e convivência nos grupos que as famílias têm interesse em participar desse tipo de espaço onde podem colocar suas ansiedades e dúvidas em relaçäo aos cuidados com o doente mental. A metodologia empregada favoreceu a abertura das famílias, e o trabalho de facilitaçäo do enfermeiro colaborou para que esse processo atingisse os objetivos. Trata-se de uma questäo a ser pensada em ambulatório de saúde mental.