Patrón sensibilidad/resistencia en los urocultivos de pacientes con I.T.U. que consultan a urgencias de adultos, Hospital de San José entre enero de 2014 y diciembre de 2014 / Pattern Sensitivity/Resistance in the Urocultives of Patients with U.T.I. who Consult Adult Urgencies, San Jose Hospital between January 2014 and December 2014

Introducción: La infección del tracto urinario (ITU) es un motivo de consulta frecuente en urgencias, siendo necesario el tratamiento antibiótico empírico antes de obtener un urocultivo. Objetivo Determinar el patrón de sensibilidad/resistencia de los gérmenes aislados en los urocultivos de pacientes que ingresan por urgencias de adultos con sintomatología sugestiva de ITU. Métodos Se realizó un estudio observacional, descriptivo de corte transversal, recolectando los datos de los urocultivos de pacientes con diagnóstico de ITU que asistieron por urgencias adultos, y cumplieron los criterios de inclusión en el año 2014. Resultados Se analizaron 133 pacientes (133 urocultivos), 50,4% mujeres, edad promedio de 64,1 años (DE 19,1). Se encontró una frecuencia mayor de ITU alta (54,9%), e ITU no complicada (54,1%), la mayoría de origen en la comunidad (95,5%). El germen más frecuentemente aislado fue E. coli (56,4%), seguido por Klebsiella oxytoca (7,1%). La resistencia de E. coli fue del 55,7% para ampicilina sulbactam, 58,2% para nitrofurantoina, 40% para quinolonas y 32% para cefazolina. En pacientes con factores de riesgo urológico se encontró una resistencia entre el 40% al 50%. Se evidenció patrón BLEA (12,9%), AMPc (20%) y KPC (1,4%). Conclusión Los uropatógenos han aumentado de forma significativa su resistencia a las diferentes familias de antibióticos, entre ellas las cefalosporinas y las quinolonas, confirmando que medicamentos como ampicilina sulbactam, nitrofurantoina, y ciprofloxacina no están indicados en el manejo empírico de ITU en nuestra institución, especialmente al presentar factores de riesgo urológicos.

Introduction Urinary tract infection (UTI) is a frequent cause for assistance to the emergency services, in most cases is necessary initiate empirical antimicrobial management while obtaining the result of the uroculture. Therefore, it is vital to know the pattern of sensitivity/resistance of the most frequent uropathogens and thus offer the best initial treatment. Objective To determine the pattern of sensitivity / resistance of isolated germs in the urine cultures of adults patients admitted to the emergency room with UTI suggestive symptoms. Methods An observational, descriptive, cross-sectional study was conducted, collecting urine culture data from patients diagnosed with UTI who were attended in adult emergencies in 2014. Results A total of 133 patients were analyzed (133 urine cultures), 50.4% were women, with average age of 64.1 years (SD 19.1). Higher frequency of high urinary tract infection was found (54.9%), and uncomplicated UTI (54.1%), most UTI originated in the community (95.5%). The most frequently isolated germ was E. coli (56.4%), followed by Klebsiella oxytoca (7.1%). The resistance of E. coli was 55.7% for ampicillin sulbactam, 58.2% for nitrofurantoin, 40% for quinolones and 32% for cefazolin. In patients with urological risk factors, resistance was found between 40% and 50%. BLEA pattern (12.9%), cAMP (20%) and KPC (1.4%) were evidenced. Conclusion Uropathogens have significantly increased their resistance to different families of antibiotics, including cephalosporins and quinolones, confirming that drugs such as ampicillin sulbactam, nitrofurantoin, and ciprofloxacin are not indicated in the empirical management of UTI in our institution, especially with the presence of urological risk factors.

Efeito do estresse térmico calórico agudo e crônico sobre a qualidade oocitária de bovinos de raças adaptadas / Effect of acute and chronic caloric heat stress on oocyte quality of adapted breeds cattle

Nos trópicos, o uso de raças adaptadas tem sido uma estratégia para minimizar o efeito do estresse térmico calórico (ETC). No entanto, faltam informações que quantifiquem o estresse e o seu efeito sobre a reprodução dessas raças. O objetivo deste estudo foi avaliar a qualidade do oócito recuperado e alguns parâmetros fisiológicos indicadores de ETC em bovinos de raças adaptadas. Animais Bos taurus x Bos indicus (n=6) e Bos taurus (raça Pantaneira; n=12), localizados na região de transição entre o Cerrado e o Pantanal brasileiro, foram submetidos à aspiração folicular guiada por ultrassonografia (OPU) em diferentes condições climáticas. Foram realizadas oito sessões de OPU, com intervalo mínimo de sete dias e máximo de 54 dias entre as coletas. Para caracterização climática, foi realizado o cálculo do índice de temperatura e umidade (ITU). Foram quantificados os ITUs do dia da OPU, sete dias antes e 60 dias antes de cada sessão. Os parâmetros fisiológicos e a viabilidade oocitária de fêmeas das raças Girolando e Pantaneira não foram afetados negativamente por ITUs entre 72 e 78. O ETC crônico (60 dias) parece afetar a viabilidade oocitária de doadoras na raça Pantaneira quando ITU é superior a 75.(AU)

In tropical regions, the use of adapted breeds has been a strategy to minimize the effect of heat stress (HS) in cattle. However, information quantifying stress and its effect on reproduction of these breeds is lacking. The aim of this study was to evaluate the quality of the recovered oocyte and some physiological parameters that indicate HS in adapted breed. Bos taurus x Bos indicus (n=6) and Pantaneira (n=12) cows, located in the transition region between Cerrado and Brazilian Pantanal, underwent follicular aspiration guided by ultrasound (OPU) in different weather conditions. Eight sessions of OPU were carried out, with a minimum interval of 7 days and maximum 54 days between sessions. For weather characterization, the temperature and humidity index (THI) was calculated. THI of the day of OPU, 7 days before and 60 days before each session were calculated. The physiological parameters and oocyte viability of Girolando and Pantaneira cows were not negatively influenced under ITU between 72 and 78. The chronic HS (60 days)may affect the oocyte viability of Pantaneira donors when ITU is over 75.(AU)

Estudo bioclimático das regiões litorânea, agreste e semiárida do estado de Sergipe para a avicultura de corte e postura / Bioclimatic study for broiler production and posture in the of coastal, agreste and semi arid regions of Sergipe state, Brazil

Objetivou-se com o presente trabalho realizar o estudo bioclimático do estado de Sergipe para a avicultura, como forma de definir os limites de aceitabilidade da espécie às condições ambientais prevalecentes nas regiões litorânea, agreste e semiárida do estado. Para isso, foi realizado o levantamento histórico dos valores médios mensais de temperatura e umidade relativa do ar e o cálculo mensal do índice de temperatura e umidade (ITU) das três regiões do estado de Sergipe. Verificou-se que, apesar de suas particularidades climáticas, as regiões litorânea, agreste e semiárida do estado de Sergipe apresentam as melhores condições de conforto térmico para a avicultura de corte e postura apenas durante os meses de junho a setembro; no período seco, nenhuma das regiões apresenta condições de conforto térmico para a atividade avícola; no período chuvoso, apenas a região agreste apresenta condições de conforto para a avicultura de corte; para a avicultura de postura, apenas a região litorânea não apresenta condições de conforto térmico.

This research aimed to carry out a bioclimatic study of Sergipe state to poultry farming, as a way to define the limits of acceptability of the species to the prevailing environmental conditions in coastal, agreste and semi arid regions of the state. For this survey it was conducted a history of the monthly mean values of temperature and relative humidity of the air and the calculation of the monthly index of temperature and humidity (ITU) of the three regions of the state of Sergipe. It was found that despite its special climate, coastal, agreste and semi arid region of Sergipe present the best thermal comfort conditions for the poultry industry and posture only during the months from June to September. In the dry season, no region presents thermal comfort conditions for the poultry activity. Only in the rainy season the region has rugged comfort conditions for the poultry industry. For laying poultry only the coastal region not provides thermal comfort.

Aceptabilidad del tratamiento empírico de la infección urinaria aguda en el niño / Acceptability of the «empirical» treatment of acute urinary infection in children

Las guías propuestas por grupos internacionales enfatizan en la importancia del diagnóstico de la infección del tracto urinario en la atención primaria de salud, para poder iniciar un tratamiento precoz con antibióticos en los casos de mayor riesgo. El médico de atención primaria en ocasiones realiza su trabajo lejos de los laboratorios de microbiología y no puede realizar el urocultivo con la rapidez necesaria para un tratamiento adecuado. Este médico necesita disponer de pruebas diagnósticas rápidas que le ayuden a tomar la decisión médica más adecuada, aunque ninguna combinación de ellas puede sustituir al urocultivo. En esta propuesta se analizan las situaciones en las que el médico debe esperar el resultado del estudio bacteriológico y en las que puede iniciar un tratamiento empírico después de tomar la muestra para el urocultivo, si este puede realizarse. En los casos excepcionales de imposibilidad de realizar el estudio bacteriológico, el médico tiene que actuar utilizando los llamados métodos de diagnóstico rápido

The guidances proposed for international groups emphasize the significance of diagnosis of the urinary tract infection in primary health care to start an early antibiotics treatment in cases of a major risk. The primary care physician sometimes works far from the microbiology laboratories and can not to carry out a fast uroculture for an appropriate treatment. This physician needs to have available fast diagnostic tests helping him to make a more suitable medical decision, although any combination of them may to replace the uroculture. In present proposal are analyzed those situations where the physician must to await for bacteriological study results to start the empirical treatment after the sample take for uroculture if it may to be carry out. In exceptional cases of impossibility to conduct the bacteriological study, the physician must to act using the so called fast diagnosis methods

Comportamiento de la infección del tracto urinario en pacientes del hospital Héroes de Baire 2006 / Features of the urinary tract infection in patients of the Héroes de Baire 2006

Se realizó un estudio descriptivo retrospectivo relacionado con las Infecciones del tracto urinario en el Hospital Héroes de Baire del municipio Isla de la Juventud, desde enero a diciembre del 2006. Para conformar la muestra de los pacientes con infección del tracto urinario, se seleccionaron como población, las historias clínicas de todos ellos, admitidos en los diferentes servicios del hospital en el período antes mencionado. Se analizó, en primera opción, el porciento de infección del total de casos admitidos y se determinó la frecuencia de gérmenes en estos casos; el germen más frecuente resultó la Escherichia Coli, aislado en 80 por ciento de los urocultivos. Para determinar en los gérmenes sus patrones de sensibilidad y resistencia, se analizaron los urocultivos realizados con sus respectivos antibiogramas. El antibiótico que demostró ser más efectivo para el tratamiento de la infección del tracto urinario fue el Ciprofloxaxino. Los más inefectivos fueron: Rocefín, Ac Nalidíxico, Ampicillín, Cefuroxima y Nitrofurantoína(AU)

A retrospective study related to Urinary Tract Infections was performed at the Heroes de Baire Hospital, in the Isla de la Juventud Municipality from January to December 2006. All records of the patients admitted during the above mentioned period of time in the different hospital's wards were included. In the first option, the percentage of Urinary Tract Infections among the total admitted patients and the frequency of causing germs bacteria was determined, being Escherichia Coli the most frequent appearing in 80 percent of the urine culture studies. In order to determine the patterns of sensibility to antibiotics and their resistance all urine culture studies were analyzed. The antibiotic proving more effective for the treatment of Urinary Tract Infections was Ciprofloxacin. The least effective were Rocephin (Ceftrioxone), Nalidixic Acid, Ampicillin Cefuroxima and Nitrofurantoin(AU)

Frecuencia de infección urinaria en lactantes con fiebre sin foco infeccioso evidente que consultan a la Unidad Vida Infantil de la Universidad de Antioquia del Hospital Francisco Valderrama, Turbo (Antioquia) / Frequency of urinary tract infections in febrile infants without evidence of an infectious source, from the clinic of the unidad vida infantil of the university of antioquia, hospital francisco valderrama, Turbo, Colombia

OBJETIVO: establecer la frecuencia de infección urinaria en lactantes febriles menores de dos años de edad atendidos en la Unidad Vida Infantil de la Universidad de Antioquia y en el Hospital Francisco Valderrama de Turbo Antioquia, entre el 1º de febrero de 2003 y el 31 de enero de 2004. MÉTODOS: se incluyeron cincuenta niños menores de 24 meses de edad con fiebre sin causa aparente, entendiéndose como tal una enfermedad febril aguda en la que no se encuentra la causa luego de anamnesis y examen físico cuidadosos. Se realizaron los siguientes exámenes de laboratorio: leucograma, sedimentación, tirilla en orina para detectar estearasa leucocitaria y nitritos, uroanálisis (UA) (leucocitos en orina por mm3), tinción de gram de una gota de orina sin centrifugar, uroanálisis microscópico (leucocitos y bacterias por campo de alto poder) y urocultivo cuantitativo (se consideró positivo cuando se encontraron más de 10.000 unidades formadoras de colonias, UFC, por ml). Todas las muestras de orina se obtuvieron por sonda vesical. Para cada una de las pruebas se determinó la sensibilidad, la especificidad y el valor predictivo positivo y negativo. RESULTADOS: la frecuencia de infección urinaria (crecimiento de más de 10.000 UFC de un patógeno urinario por ml) fue 10 por ciento. La edad promedio fue siete meses. La mayoría de los niños con infección urinaria tenía anorexia, irritabilidad, malestar general y vómito. Los parámetros de laboratorio más específicos fueron tinción de gram positiva (cualquier bacteria) y piuria (>10 leucocitos por campo de alto poder). Todas las infecciones urinarias fueron causadas por CONCLUSIONES: la infección urinaria es una causa frecuente de síndrome febril agudo sin causa aparente en lactantes, en Turbo, Antioquia. En tales casos, los médicos deben ordenar un UA (leucocitos y bacterias por campo de ato poder) y tinción de gram. Si los resultados de estas pruebas son positivas, debe hacerse urocultivo. En este estudio las cepas de Escherichia coli identificadas mostraron resistencia a antibióticos frecuentemente utilizados.

ABSTRACT BACKGROUND: in infants, it has been documented that urinary tract infections (UTI) are a common cause of the acute febrile syndrome without apparent source for the fever. According to the results of some research, the prevalence of UTI varies between 4% and 13%. In infants, especially those under the age of 2 years, UTI are associated with an increased incidence of vesicoureteral reflux and renal parenchymal involvement. Moreover, this group of patients with UTI require special attention in order to prevent renal scarring, hypertension and chronic renal failure. OBJECTIVE: to establish the prevalence rate of UTI in febrile infants under 24 months of age, admitted to the Vida Infantil" Department of the University of Antioquia and the Francisco Valderrama Hospital in Turbo, Antioquia, (Colombia), from February 1st, 2003 through January 31st, 2004. METHODS: a total of 50 children under 24 months of age who had been admitted to the aforementioned Department were enrolled in this prospective study. Patients had fever the cause of which was not definitely known. The following laboratory tests were performed: white blood cell total and differential count (WBC), erythrocyte sedimentation rate (ESR), urine dipstick tests for leukocyte esterase and nitrites, urinalysis (UA) (urine white blood cell count/mm3), gram stain in a drop of uncentrifuged urine, microscopic UA (white blood cells and bacteria per high-powered field), and quantitative urine culture (positive urine results were defined as ³104 colony-forming units of an urinary tract pathogen per mL). All urine specimens were obtained by urethral catheterization. Sensitivity, specificity, and accuracy likelihood ratios were determined for each one of the screening tests. RESULTS: overall prevalence of UTI (growth of >104 CFU of an urinary tract pathogen per mL) was 10%. Average age was 7 months. Most children with UTI had anorexia, irritability, general malaise, and vomiting. The most specific laboratory parameters were urine positive gram stain (any bacteria), and pyuria (>10 WBC/high-powered field). All urinary tract infections were caused by Escherichia coli. Isolates of this urinary pathogen showed decreased susceptibility to trimetoprimsulfametoxasole, as well as resistance to ampicillin. CONCLUSIONS: UTI is a frequent cause of the acute febrile syndrome without apparent source for the fever in infants of Turbo, Antioquia. In such cases, particularly when there are not specific clinical signs or symptoms, physicians should take this disease into consideration, and order an UA (white blood cells and bacteria per high-powered field), and gram stain. If results of these tests are positive, an urine culture becomes necessary. In our study, E. coli isolates showed significant resistance to commonly prescribed antibiotics

Transition system for high-resolution non-standard medical video roentgenoscoped by X-ray / 医疗卫生装备

High -resolution non -standard medical video roentgenoscoped by X -ray can't make use of universal video interfaces such as VGA, S - Video. Based on non - standard video feature transition algorithm library, high - speed field integration technology for FPGA digital system and VHDL hardware description language, this paper develops a real-time transition system for high-resolution non-standard medical video roentgenoscoped by X-ray.