Evaluación del valor de acidez Dornic de la leche humana según el tiempo de conservación en freezer y el lugar de extracción / Assessment of Dornic acidity in breast milk based on storage time in the freezer and place of expression

Introducción. El grado de acidez Dornic (AD), medida indirecta del grado de contaminación de la leche humana cruda (LHC), proporciona información sobre la calidad de esta. Recién extraída, el valor oscila entre 1,0° y 4,0° (óptimo). Descalifica el consumo si es >8,0 °D. Se evaluó la correlación de la AD de la LHC de donantes internas (DI) y externas (DE) según el tiempo de conservación hasta la pasteurización, y se determinó la prevalencia de AD ≤4 ºD. Población y método. Estudio retrospectivo analítico. Resultados. Sobre 13 203 muestras, la AD a partir del día 14 de conservación fue menor en las donantes internas, de 2,92; (IC95% 2,69-3,15) versus 4,01 (IC95%: 3,94-4,08); p <0,001] con mayor proporción de AD ≤4 ºD (88 % en DI versus 76 % en DE); OR: 2,30 (IC95%: 1,25-4,24); p = 0,003. Coeficiente de correlación para las DI: R 2 :0; p = 1). Conclusión. La AD a partir del día 14 fue menor en DI, presentando mayor prevalencia de AD ≤ 4ºD. No existió correlación entre el tiempo de conservación y la AD en las DI.

Introduction. The degree of Dornic acidity (DA) is an indirect measure of milk contamination and quality. In freshly expressed milk, DA ranges between 1.0 and 4.0 (optimal). If DA is > 8.0 °D, it should be discarded. The correlation between DA in raw breast milk from internal donors (ID) and external donors (ED) based on storage time until pasteurization was assessed. Population and method. Retrospective, analytical study. Results. In 13 203 samples, DA was lower in IDs as of 14 days of storage: 2.92 (95% CI: 2.69­3.15) versus 4.01 (95% CI: 3.94­4.08), with a higher proportion of DA ≤ 4 °D (88% in IDs versus 76% in EDs); odds ratio: 2.30 (95% CI: 1.25­4.24). Conclusion. DA as of 14 days of storage was lower in IDs, with a higher prevalence of DA ≤ 4 °D. No correlation was observed between storage time and DA in ID samples.

The application value of GeneXpert MTB/RIF Ultra in the detection of special specimens of tuberculosis / 中国热带医学

@#Abstract: Objective To compare the diagnostic efficacy of the upgraded version of the GeneXpert automated fluorescent quantitative PCR system (GeneXpert MTB/RIF Ultra, GeneXpert Ultra) and the original version of the GeneXpert system (GeneXpert MTB/RIF, Xpert), real-time fluorescent quantitative nucleic acid detection (FQ-PCR), real-time fluorescent thermostatic amplification of Mycobacterium tuberculosis RNA (SAT-RNA), real-time fluorescent thermostatic amplification detection of DNA (thermostatic amplification method) and traditional BACTEC MGIT 960 liquid culture (culture method) for special specimens of tuberculosis, in order to analyze its application value in clinical detection. Methods Using prospective research methods, a total of 170 special specimens (including 47 pleural and ascites effusion samples, and 34 24-hour urinary sediment specimens, 49 tissue specimens and 40 fester specimens) were collected i'an Chest Hospital from January to September 2021. GeneXpert Ultra, Xpert, FQ-PCR, SAT-RNA, isothermal amplification, and traditional culture were used for detection. Clinical diagnosis was used as the standard, and sensitivity, specificity, positive predictive value, negative predictive value, coincidence rate, and Kappa value were compared among the methods. Results The sensitivities of GeneXpert Ultra, Xpert, FQ-PCR, SAT-RNA, isothermal amplification, and traditional culture were 65.18% (73/112), 49.11% (55/112), 37.50% (42/112), 19.64% (22/112), 8.04% (9/112), and 22.32% (25/112), respectively. The sensitivity of GeneXpert Ultra was higher than that of the other five methods, and the differences were statistically significant (χ2=66.25, 42.10, 28.89, 13.09, 4.92, 15.18, all P<0.05). GeneXpert Ultra result analysis showed that: 5.48%(4/73) cases had trace, that is, trace Mycobacterium tuberculosis load, 79.45% (58/73) cases were extremely low, 10.96% (8/73) cases were low, 2.74% (2/73) were medium, , and 1.36% (1/73) were high load. In 4 trace samples, the Xpert detection was negative for all. Of the 73 GeneXpert Ultra positive reports, 63 were rifampicin-sensitive, 6 were rifampicin-resistant, and 4 were rifampicin-resistant but of unclear resistance. Of the 55 Xpert positive reports, 45 were rifampicin-sensitive, 2 were rifampicin-resistant, and 8 were rifampicinresistant but of unclear resistance.. Conclusions The new generation of GeneXpert MTB/RIF Ultra has high sensitivity, specificity and drug resistance detection rate, and its advantage is even more apparent in the pathogenic diagnosis of special specimens of tuberculosis. It can be used as one of the preferred methods in samples with low bacterial load.

Caracterización de la flora bacteriana en los pacientes con colelitiasis y colecistitis atendidos en un centro hospitalario de alta complejidad / Characterization of the bacterial flora in patients with cholelithiasis and cholecystitis treated in a high complexity hospital

Introducción. Las infecciones del árbol biliar surgen principalmente por estasis asociada a colecistitis aguda, coledocolitiasis y colecistitis alitiásica, siendo pilar del tratamiento un drenaje apropiado y un régimen antibiótico eficaz. El objetivo de esta investigación fue caracterizar la flora bacteriana de los cultivos de bilis. Métodos. Se realizó un estudio observacional, descriptivo, de corte transversal y retrospectivo de pacientes llevados a colecistectomía, colangiopancreatografía retrograda endoscópica y colecistostomía en nuestra institución, a quienes se les tomó cultivo de líquido biliar entre 2017 - 2021. Resultados. Se incluyeron 119 pacientes intervenidos, de los cuales 55,4 % fueron mujeres y el promedio de edad fue de 63,1 (± 16). La clasificación Tokio 2 fue la más frecuente (55,4 %). El germen aislado con mayor frecuencia fue E. coli (51,2 %). El antibiótico más usado fue ampicilina más sulbactam (44,6 %) seguido de piperacilina tazobactam (40,3 %). Conclusión. La Escherichia coli es el germen aislado con mayor frecuencia en infecciones del árbol biliar. No hay claridad con respecto al uso de antimicrobianos de manera profiláctica en esta patología, por esto es conveniente generar protocolos para la toma de muestras y cultivos de bilis en esta población, con el fin de establecer la necesidad del uso de antibióticos y conocer los perfiles de resistencia bacteriana.

Introduction. Infections of the biliary tree arise mainly from stasis associated with acute cholecystitis, choledocholithiasis, and acalculous cholecystitis, with appropriate drainage and an effective antibiotic regimen being the mainstay of treatment. This research is proposed with the aim aim to characterize the bacterial flora of bile cultures.Methods. An observational, descriptive, cross-sectional and retrospective study of patients who underwent cholecystectomy, endoscopic retrograde cholangiopancreatography and cholecystostomy in our institution, whom bile fluid culture was taken between 2017 and 2021, was performed. Results. 119 operated patients were included, of which 55.4% were women, the average age was 63.1 (± 16). The TOKIO 2 classification was the most frequent with 55.4% of the patients. The most frequently isolated germ was E. coli with 51.2%. The most used antibiotic was ampicillin plus sulbactam with 44.6% prescription followed by piperacillin tazobactam with a prescription frequency of 40.3%.Conclusion. Escherichia coli is the most frequently isolated germ in infections of the biliary tree. There is no clarity regarding the use of antimicrobials prophylactically in this pathology. For this reason it is convenient to generate protocols for taking samples and bile cultures in this population, in order to establish the need for the use of antibiotics and to know the profiles of bacterial resistance.

Avaliação da carga microbiana e fúngica de sistemas de canais radiculares infectados e a expressão apical de integrinas, citocinas e quimiocinas nos tecidos / Assessment of the microbial and fungal load of infected root canal systems and the apical expression of integrins, cytokines and chemokines in adjacent perirradicular tissues

Este estudo busca avaliar quantitativamente a expressão do RNA mensageiro (mRNA) das integrinas alfa1, alfa4, alfa 5, alfa L, citocinas e quimiocinas, a partir de células presentes no líquido intersticial periapical adjacente a dentes com infecção do canal radicular. Foram selecionados 22 indivíduos com necessidade de tratamento endodôntico e encaminhados à Faculdade de Odontologia da Universidade Federal de Minas Gerais (Belo Horizonte, MG, Brasil). As amostras foram coletadas em 11 dentes necróticos e portadores de infecções endodônticas e 11 dentes hígidos que necessitavam de tratamento endodôntico por motivos protéticos. Após a cirurgia de acesso e antes dos procedimentos de limpeza e modelagem do sistema de canais radiculares (T0), imediatamente após a limpeza e formatação do sistema de canais radiculares(T1), em 7 (T2) e 14 dias (T3), um cone de papel esterilizado endodôntico # 20 foi inserido no SCR, mantido por 2 min, e posteriormente armazenado a -70°C. Real-Time PCR analisou microbiologicamente essas amostras para ler a expressão gênica do rRNA microbiano 16S e fragmentos da região ITS do gDNA fúngico da espécie Candida. Após os procedimentos de limpeza e formatação do SCR, três cones de papel absorvente esterilizados foram inseridos. Passivamente, a ponta do papel ultrapassou o ápice radicular em 2 mm e permaneceu por 2 minutos. As amostras foram coletadas imediatamente após a limpeza e modelagem do RCS, 7 e 14 dias após a primeira sessão. As pontas de papel tiveram os 4 mm finais cortados, inseridos em Eppendorf e armazenados a - 70°C. Com este procedimento, o RNA foi extraído do líquido intersticial periapical para caracterizar as expressões dos genes ITGA1, ITGA4, ITGA5, ITGAL, IL-1ß, TNF-α, IL-17A, IL-10, IFN-γ, CCL2/MCP-1, CCL5, CXCR4, e 16S usando PCR em tempo real. O DNA genômico (gDNA) foi extraído para se avaliar a abundância de Candida utilizando-se sequências ITS, por PCR em tempo real. Os resultados demonstraram que os níveis de expressão de mRNA do 16S diminuíram após os procedimentos de limpeza e modelagem e que a abundância de Candida foi insipiente na amostra analisada. As citocinas pro- inflamatórias IL-1ß e IL-17 apresentaram níveis de expressão elevados frente a infecção, reduzindo significativamente após os procedimentos de limpeza e formatação. Os níveis de expressão gênica de TNF-α significantemente aumentaram, em ambos os grupos. Não se observou diferença significativa quanto a expressão gênica das citocinas IFN-γ, IL-10, CCL-2 e CCL-5 e das integrinas ITGAL e ITGA5 nos tempos avaliados. A expressão gênica de CXCR4 reduziu significativamente do tempo T1 para o T2, no grupo experimental. As expressões gênicas de ITGA1 e ITGA4, no grupo experimental, reduziram significativamente de maneira tempo dependente. Finalmente, não houve alteração significativa na expressão de marcadores de macrófagos (CD64), enquanto expressão de marcadores de fibroblastos (S100A4) aumentou significativamente no grupo controle. Concluiu-se que a carga microbiana e a abundância de leveduras correlacionam-se positivamente com a expressão de mediadores pró-inflamatórios e que a que terapia endodôntica negativamente impacta a expressão dos mediadores pró-inflamatórios e das integrinas nos tecidos perirradiculares.

This study seeks to quantitatively evaluate the expression of messenger RNA (mRNA) of integrins alpha1, alfa4, alpha 5, alpha L, cytokines, and chemokines, from cells present in the periapical interstitial fluid adjacent to teeth with root canal infection. Twenty-two individuals needing endodontic treatment and referred to the School of Dentistry of the Federal University of Minas Gerais (Belo Horizonte, MG, Brazil) were selected. The samples were collected in 11 necrotic teeth and carriers of endodontic infections and 11 healthy teeth needing endodontic treatment for prosthetic reasons. After access surgery and before root canal system (RCS) cleaning and shaping procedures (T0), immediately after cleaning and shaping the root canal system (T1), in 7 (T2) and 14 days (T3) an endodontic sterilized paper point #20 was inserted into the RCS, maintained for 2 min, and subsequently stored at -70°C. Real-Time PCR microbiologically analyzed these samples to read the gene expression of microbial rRNA 16S and fragments of the ITS region of the Fungus Candida species gDNA. After RCS cleaning and shaping procedures, three sterilized absorbent paper cones were inserted. Passively, the paper point exceeded the root apex by 2 mm and remained for 2 minutes. Samples were collected immediately after RCS cleaning and shaping, 7 and 14 days after the first session. The paper points have the 4 mm of their tip cut, inserted in Eppendorf, and stored at - 70°C. This procedure extracted RNA from the periapical interstitial fluid to characterize the expressions of the genes ITGA1, ITGA4, ITGA5, ITGAL, IL-1ß, TNF- α, IL-17A, IL-10, IFN-γ, CCL2/MCP-1, CCL5, CXCR4, ITS using Real-Time PCR. The results showed that 16S mRNA expression levels decreased after cleaning and modeling procedures and that Candida abundance was incipient in the analyzed sample. Pro-inflammatory cytokines IL-1ß and IL-17 showed high expression levels against infection, significantly reduced after cleaning and formatting procedures. TNF-α gene expression levels significantly increased in both experimental and control groups. No significant difference was observed regarding the gene expression of the cytokines IFN-γ, IL-10, CCL-2, and CCL-5 and the integrins ITGAL and ITGA5. The gene expressions of ITGA1 and ITGA4 in the experimental group were significantly reduced time-dependent. Finally, there was no significant change in their macrophage markers (CD64) expression, while fibroblast markers (S100A4) expression significantly increased in the control group. It was concluded that microbial load and yeast abundance are positively correlated with the expression of pro-inflammatory mediators and that endodontic therapy negatively impacts the expression of pro-inflammatory mediators and integrins in periradicular tissues.

Subfertility in Buffaloes and the Association of Detected Milk Microbes

Lactogenesis is a complex physiology and an outcome of a successful reproductive cycle in mammalians. The purpose itself is to nourish the newborn with the nutrients necessary for its protection and growth a continuation from the in utero survival strategy. Thus, mammary development and physiology are intriguingly linked to the uterine changes that happen in a normal reproductive individual. Milk is a highly nutritious food that also favours the growth of microorganisms that can enter through the bloodstream or the discharge system. Briefly, the mastitis-induced release of inflammation mediators such as cytokines, interleukins, and prostaglandin F2? are established to be associated with infertility. Before breeding, mastitis can disrupt hormonal patterns (depression of estradiol production, delayed surge of luteinizing hormone) and delay ovulation. The issue of clinical mastitis is obvious but when subclinical mastitis persists for long the problem gets compounded. Thus, microbes get easily established in the mammary glands of buffaloes whose udder and teat anatomy, love for dirt, and swamp to wallow makes them more vulnerable exposing them to various kinds of pathogenic and opportunistic microbes. Buffaloes, by nature, have issues with silent heat, seasonal anestrus, more sensitive to direct radiation heat stress when faced with a pathological attack of infectious microbes in the milk chamber compromises their fertility.

Recuento de Streptococcus mutans sobre restauraciones realizadas con adhesivo con y sin carga de nanopartículas de óxido de zinc y cobre / Streptococcus mutans count on restorations made with adhesive with and without loading zinc and copper oxide nanoparticles

Objetivo: Determinar las propiedades antimicrobianas de la incorporación de nanopartículas de óxido de zinc y cobre en un adhesivo de grabado y lavado total sobre Streptococcus mutans en pacientes con restauraciones de resina compuesta confeccionadas con adhesivo cargado. Métodos: Estudio experimental, randomizado, la muestra estuvo conformada por 25 pacientes, de ambos sexos, pertenecientes al posgrado de Ortodoncia de la Facultad de Odontología de la Universidad de Chile, en los cuales se confirmó presencia de Streptococcus mutans en saliva. Se confeccionaron restauraciones de resina compuesta oclusales, en premolares superiores con indicación de exodoncia por el tratamiento de ortodoncia, con adhesivo cargado (cuya composición fue 5/0,2 por ciento ZnO y Cu, respectivamente) y control (sin presencia de nanopartículas en su composición), según el listado de aleatorización. Se tomaron muestras microbiológicas en tres tiempos con la técnica de la cubeta (antes, 1 semana y 4 semanas posterior a la confección de las restauraciones). Se obtuvieron, aislaron e identificaron colonias de Streptococcus mutans a partir de las muestras obtenidas. Se usó el test de Mann-Whitney mediante el paquete estadístico SPSS v.21 Resultados: El promedio del recuento de UFC de Streptococcus mutans en el grupo experimental fue mayor posterior a la confección de las restauraciones de resina compuesta. Los resultados de la identificación molecular por PCR demuestran la presencia de Streptococcus mutans en 20 de 25 muestras. Conclusiones: No existen diferencias en el recuento de Streptococcus mutans antes y después de la aplicación del adhesivo sobre las restauraciones de resina compuesta(AU)

Objective: To determine the antimicrobial properties of the incorporation of zinc and copper oxide nanoparticles in an etching and total wash adhesive on Streptococcus mutans in patients with composite resin restorations made with loaded adhesive. Methods: Experimental and randomized trial, the sample were 25 patients, of both sexes, belonging to the FOUCH Orthodontic postgraduate program, in whom the presence of Streptococcus mutans in saliva was confirmed. Occlusal composite resin restorations were made in upper premolars with indication of extraction by orthodontic treatment, with loaded adhesive (whose composition is 5 / 0.2% ZnO and Cu respectively) and control (without the presence of nanoparticles in their composition), according to the scrambling listing. Microbiological samples were taken in three stages with the cuvette technique (before, 1 week and 4 weeks after the restoration was made). Colonies of Streptococcus mutans were obtained, isolated and identified from the samples obtained. The statistical analysis used the SPSS v.21 software, the data was analyzed by Mann Whitney test Results: The average CFU count of Streptococcus mutans in the experimental group (adhesive modified with zinc oxide and copper nanoparticles) was higher after the fabrication of composite resin restorations. The results of molecular identification by PCR demonstrate the presence of Streptococcus mutans in 20 of 25 samples. Conclusions: There are no differences in the count of Streptococcus mutans before and after the application of the adhesive on the composite resin restorations(AU)

Bacterial analysis of biofilms from tooth root surfaces presenting different caries activity / Análise bacteriológica de biofilmes de superfícies dentárias radiculares apresentando diferentes estágios de atividade de cárie

This study evaluated the numbers and determined the proportion of mutans streptococci and Lactobacillus spp., which are possible relevant cariogenic organisms, in biofilms recovered from lesions at root surfaces with active caries lesions (ARC), inactive caries lesions, and sound root surfaces (SRS). Samples were cultured in MSB agar for mutans streptococci counts, Rogosa agar for Lactobacillus spp. counts, and brain-heart infusion agar for total viable anaerobic counts. After incubation, the number of colony-forming units (CFUs) was determined and compared between groups by the Mann-Whitney U test with a significance level set at 95%. The proportion of counts of mutans streptococci and Lactobacillus spp. in the total viable microorganisms was also analyzed by Chi-square test. Ninety samples (30 from each surface) from 37 patients were cultured and analyzed. The CFU was similar between mutans streptococci and Lactobacillus spp.These species were present in at least half of the samples and no difference was found in the frequency of isolation of these species. Only 6 samples showed a proportion of more than 10% of mutans streptococci; 4 of the samples were from ARC. Most (93%) SRS samples did not contain viable Lactobacillus spp. The data indicate the low counts of mutans streptococci and Lactobacillus spp. in root sur-faces, regardless of the activity of caries lesions.

O estudo analisou contagens e proporções de mutans strep-tococci e Lactobacillus spp., que podem ser microorganismos importantes em lesões de cárie radicular com diferentes atividades. Biofilmes foram coletados em três locais: ARC ­ superfície radicular com lesão ativa de cárie; IRC ­ superfícies radiculares com lesão inativa de cárie; SRS ­ superfícies de raizes hígidas. As amostras foram cultivadas em agar MSB para contagens de mutans streptococci; agar Rogosa para Lactobacillus spp., e agar BHI para contagens de microrganis-mos viáveis anaeróbicos totais. Após a incubação, o número de unidades formadoras de colônias (UFCs) foi determinado e comparado entre os grupos pelo teste de Mann-Whitney U test. O nível de significância foi estabelecido em 95%. A pro-porção de contagem de mutans streptococci e Lactobacillusspp. no total de microrganismos viáveis também foi analisado através do teste de qui-quadrado. Um total de 90 amostras de 37 pacientes foram cultivadas e analisadas: 30 amostras de ARC, 30 de IRC e 30 de SRS. Números de UFC foram seme-lhantes entre os grupos para ambos, mutans streptococci e Lactobacillus spp. Estas espécies estavam presentes em pelo menos metade de todas as amostras e nenhuma diferença foi encontrada na frequência de isolamento dessas espécies dentro dos grupos. Apenas 6 amostras apresentaram mais de 10% de mutans streptococci e 4 foram de ARC. Em relação aos Lactobacillus spp., 93% das amostras não apresentaram proporção dessas bactérias nas SRS. Mutans streptococci e Lactobacillus spp. estão presentes em baixa proporção nas superfícies radiculares, independentemente da atividade das lesões de cárie.

The bactericidal effect of an atmospheric-pressure plasma jet on Porphyromonas gingivalis biofilms on sandblasted and acid-etched titanium discs

PURPOSE: Direct application of atmospheric-pressure plasma jets (APPJs) has been established as an effective method of microbial decontamination. This study aimed to investigate the bactericidal effect of direct application of an APPJ using helium gas (He-APPJ) on Porphyromonas gingivalis biofilms on sandblasted and acid-etched (SLA) titanium discs. METHODS: On the SLA discs covered by P. gingivalis biofilms, an APPJ with helium (He) as a discharge gas was applied at 3 different time intervals (0, 3, and 5 minutes). To evaluate the effect of the plasma itself, the He gas–only group was used as the control group. The bactericidal effect of the He-APPJ was determined by the number of colony-forming units. Bacterial viability was observed by confocal laser scanning microscopy (CLSM), and bacterial morphology was examined by scanning electron microscopy (SEM). RESULTS: As the plasma treatment time increased, the amount of P. gingivalis decreased, and the difference was statistically significant. In the SEM images, compared to the control group, the bacterial biofilm structure on SLA discs treated by the He-APPJ for more than 3 minutes was destroyed. In addition, the CLSM images showed consistent results. Even in sites distant from the area of direct He-APPJ exposure, decontamination effects were observed in both SEM and CLSM images. CONCLUSIONS: He-APPJ application was effective in removing P. gingivalis biofilm on SLA titanium discs in an in vitro experiment.

Real-time PCR quantification of 9 periodontal pathogens in saliva samples from periodontally healthy Korean young adults

PURPOSE: Few studies have examined periodontal pathogens from saliva samples in periodontally healthy young adults. The purposes of this study were to determine the prevalence of periodontopathic bacteria and to quantify periodontal pathogens in saliva samples using real-time polymerase chain reaction (PCR) assays in periodontally healthy Korean young adults under 35 years of age. METHODS: Nine major periodontal pathogens were analyzed by real-time PCR in saliva from 94 periodontally healthy young adults. Quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Fusobacterium nucleatum, Campylobacter rectus, Peptostreptococcus anaerobius, and Eikenella corrodens was performed by DNA copy number measurement. RESULTS: F. nucleatum and E. corrodens were detected in all subjects; the numbers of positive samples were 87 (92.6%), 91 (96.8%), and 90 (95.7%) for P. gingivalis, P. anaerobius, and C. rectus, respectively. Other pathogens were also detected in periodontally healthy subjects. Analysis of DNA copy numbers revealed that the most abundant periodontal pathogen was F. nucleatum, which was significantly more prevalent than all other bacteria (P < 0.001), followed by P. anaerobius, P. gingivalis, E. corrodens, C. rectus, and T. denticola. There was no significant difference in the prevalence of each bacterium between men and women. The DNA copy number of total bacteria was significantly higher in men than in women. CONCLUSIONS: Major periodontal pathogens were prevalent in the saliva of periodontally healthy Korean young adults. Therefore, we suggest that the development of periodontal disease should not be overlooked in periodontally healthy young people, as it can arise due to periodontal pathogen imbalance and host susceptibility.

New techniques for wound management: A systematic review of their role in the management of chronic wounds

Debridement is a crucial component of wound management. Recent technologies such as hydrosurgery (Versajet), ultrasound therapy (the MIST therapy device), or plasma-mediated bipolar radio-frequency ablation therapy (Coblation) seem to represent interesting alternatives for wound debridement. The purpose of this systematic review was to describe, evaluate, and compare these three recently developed methods for the management of chronic wounds. In January 2016, an electronic database search was conducted of MEDLINE, PubMed Central, and Embase for articles concerning these three innovative methods for the management of chronic wounds. A total of 389 references were identified by our search strategy, and 15 articles were included. We extracted data regarding the number and age of patients, indications, operating time, number of procedures, costs, wound healing time, decrease in exudation, perioperative blood loss, bacterial load, and the occurrence of complications. The 15 articles included studies that involved 563 patients who underwent hydrosurgery (7 studies), ultrasound therapy (6 studies), or Coblation (2 studies). Six randomized controlled trials were included that compared the use of a scalpel or curette to hydrosurgery (2 studies) or ultrasound therapy (6 studies). Hydrosurgery, in addition to being a very precise and selective tool, allows significantly faster debridement. Ultrasound therapy provides a significant reduction of exudation, and improves the wound healing time. No comparative study dedicated to Coblation was identified. Despite the obvious clinical interest of the topic, our review of the current literature revealed a lack of prospective randomized studies comparing these devices with each other or with standard techniques, particularly for Coblation and hydrosurgery.

Armazenar tubos de silicone antes do empacotamento impede a esterilização? / ¿Almacenar tubos de silicona antes del empaque impide la esterilización? / Does storage of silicone tubes prior to packaging prevent sterilization?

Resumo Objetivo: Determinar a carga microbiana de tubos de silicone imediatamente após a limpeza e em diferentes intervalos de armazenamento. Métodos: Estudo experimental que analisou tubos de silicone oriundos da assistência ao paciente cirúrgico. Foi conduzido após aprovação do Comitê de Ética (protocolo n° 1.277.077), no período de setembro a novembro de 2015, com tubos oriundos do Centro de Material e Esterilização (CME) de um hospital geral de grande porte da região Centro-Oeste do Brasil. Os tubos foram segmentados: extremidade 01, 02 e meio e novamente segmentados, conforme intervalos de tempo preestabelecidos em zero, 12 e 24 horas. Os fragmentos foram preenchidos com água estéril, vedados e submetidos a cinco minutos de sonicação. A água foi filtrada em Millipore 0,45 µm e as membranas incubadas a 35°C por 24 horas em ágar nutriente. As membranas foram removidas e dispostas em tubos de ensaio, contendo 1mL de solução salina, que foram agitadas por cinco minutos e submetidos a técnica de alça calibrada. Resultados: Houve aumento da carga microbiana na ordem de uma grandeza na escala logarítmica a cada 12 horas (p<0,05), nas condições de limpeza e armazenamento proporcionados pela instituição, nos grupos experimental e controle positivo, e não houve diferença quando comparados o meio e extremidades dos tubos de silicone (p>0,05) nos períodos zero, 12 e 24 horas. Conclusão: A depender da carga microbiana inicial, o aumento da ordem uma grandeza pode resultar no insucesso da esterilização, achados que ratificam a não permanência de PPS na área limpa aguardando o processamento.

Resumen Objetivo: Determinar la carga microbiana de tubos de silicona inmediatamente después de su limpieza e en diferentes intervalos de almacenamiento. Métodos: Estudio experimental en el que se analizaron tubos de silicona propios de la asistencia al paciente quirúrgico, en el período de septiembre a noviembre de 2015. Los tubos provenían del Centro de Material y Esterilización (CME) de un hospital general de gran tamaño de la región Centro-Oeste de Brasil. Los tubos fueron segmentados así: extremo 01, 02 y medio y nuevamente segmentados según intervalos de tiempo preestablecidos en cero, 12 y 24 horas. Los fragmentos se llenaron con agua estéril, fueron sellados y sometidos a cinco minutos de sonicación. El agua fue filtrada en Millipore 0,45 μm y las membranas incubadas a 35°C por 24 horas en agar nutriente. Las membranas fueron removidas y dispuestas en tubos de ensayo que contenían 1mL de solución salina, fueron agitados durante cinco minutos y sometidos a técnica de alza calibrada Resultados: Se observó un aumento de la carga microbiana en el orden de una magnitud en la escala logarítmica cada 12 horas (p <0,05), en las condiciones de limpieza y almacenamiento proporcionadas por la institución, en los grupos experimental y de control positivo. No hubo diferencia cuando se compararon el medio y los extremos de los tubos de silicona (p> 0,05) en los períodos cero, 12 y 24 horas. Conclusión: Dependiendo de la carga microbiana inicial, el aumento del orden de una magnitud puede resultar en el fracaso de la esterilización. Estos hallazgos ratifican la no permanencia de PPS en el área limpia mientras se aguarda el procesamiento.

Abstract Objective: To determine the microbial load of silicone tubes, immediately after cleaning, and at different storage intervals. Methods: Experimental study that analyzed silicone tubes from surgical patient care, conducted after approval by the Ethics Committee (protocol no. 1,277,077), from September to November of 2015, with tubes from the Central Processing Department (CPD) of a large general hospital in the West Central region of Brazil. The tubes were segmented (end 1 and 2, and the middle) and were then segmented again, according to established time intervals (zero, 12, and 24 hours). The fragments were filled with sterile water, sealed, and exposed to five minutes of sonication. The water was filtered via 0.45μm Millipore, and the membranes were incubated at 35°C for 24 hours, on nutrient agar. The membranes were removed and placed in test tubes containing 1mL of saline, which were mixed for five minutes, and subjected to a calibrated loop technique. Results: An increase in microbial load was identified, in the order of a logarithmic magnitude every 12 hours (p<0.05), in the cleaning and storage conditions provided by the institution, in the experimental and positive control groups, and no difference was identified when comparing the middle and ends of the silicone tubes (p> 0.05) at periods zero, 12, and 24 hours. Conclusion: Depending on the initial microbial load, an increase in the order of magnitude can result in sterilization failure, which corroborates the need to not maintain healthcare products in the storage place while awaiting processing.

Prevalência de uropatógenos no laboratório de saúde pública de Macapá ­ AP entre 2009 e 2012 / Uropathogens prevalence in public health laboratory Macapá ­ AP between 2009 and 2012

Objetivo: Investigar a prevalência de uropatógenos de usuários atendidos no Laboratório Central de Saúde Pública de Macapá no período de 2009 a 2012. Métodos: Trata-se de um estudo retrospectivo de corte transversal, realizado no Laboratório Central de Saúde Públicade Macapá no período de 2009 a 2012, identificando os principais microrganismos responsáveis por infecções do trato urinário. O universo amostral foi composto pela população ambulatorial e hospitalar atendida no laboratório, sendo realizado o teste qui-quadrado. Os resultados foram expressos em números absolutos e em porcentagens utilizando-se o Programa Bioestat (5.0) e Excel Windows (2010). Resultados: Os resultados foram avaliados pela frequência das variáveis e analisados pelo teste qui-quadrado, destacando-se comocritérios: ocorrência, gênero, idade e o tipo de microrganismo causador e apresentados por meio de tabelas e gráficos. Das 10.026 (100%) uroculturas, observaram-se 7.758 (77,38%) com resultado negativo e 2.268 (22,62%) com resultado positivo. Os casos positivos foram separados em quatro grandes grupos: Enterobactérias ­ 1.422 (62,70%); Cocos Gram positivos ­ 663 (29,23%); Bacilo Gram negativo não fermentador ­102 (4,50%) e Fungo ­ 81 (3,57%). Os patógenos isolados mais prevalentes foram: Escherichia coli ­ 67,09%, Staphylococcus coagulase negativa ­ 20,8%, Acinetobacter baumanii ­ 38,23% e Candida albicans ­ 44,45%. Conclusão: O perfil epidemiológico de microrganismos e suas variáveis torna-se uma ferramenta imprescindível às investigações direcionadas à população susceptível. Tal conhecimento é relevante para a Saúde prestar maior assistência aos pacientes contribuindo para o planejamento, execução e avaliação das ações de prevenção, controle e tratamento

Objective: To investigate the prevalence of uropathogens of users served at the Central Laboratory of Public Health Macapá the period 2009 to 2012. Methods: This is a retrospective cross-sectional study, carried out at the Central Laboratory of Public Health Macapá the period 2009 to 2012, identifying key microorganisms responsible for urinary tract infections. The sample was composed of the Universe out patient population treated at the hospital and laboratory, which performed the chi-square test. Results were expressed in absolute numbers and in percentage using the Program Bioestat (5.0) and Windows Excel (2010). Results: The results were evaluated by variable frequency and analyzed by chi-square test, especially as criteria: occurrence, gender, age and type of causative microorganism and were presented descriptively and analytically through tables and graphs. Of 10.026 (100%) urine culture, there was 7.758 (77.38%) with negative and 2.268 (22.62%) with positive results. Positive cases were separated into four groups: Enterobacteria 1.422 (62.70%); Cocos Gram positive 663 (29.23%), Gram negative bacillus not fermentor 102 (4.50%) and Fungus 81 (3, 57%). The most prevalent pathogens isolated were Escherichia coli ­ 67.09%, 20.8% coagulase-negative Staphylococcus, Acinetobacter baumannii ­ 38.23% and 44.45% Candida albicans. Conclusion: The epidemiological profile of microorganisms and their variables becomes an indispensable tool for investigations directed at susceptible population. Such knowledge is relevant to health provide greater patient care by contributing to the planning, implementation and evaluation of prevention, control and treatment

Effect of Hydroxysafflor Yellow A on Pro/Anti-Inflammatory Cytokines in Peripheral Blood with Sepsis in Mice / 中山大学学报(医学科学版)

[Objective]To explore the effect of HSYA on pro/anti-inflammatory cytokine′s levels and mRNA expression in peripheral blood of mice.with sepsis.[Methods]Dividing NIH mice into four groups,as normal group,sham group,CLP group and HSYA group,24 mice in each group. The CLP sepsis mouse model was established. HSYA(120 mg/kg)were injected intravenously at 12 h before the operation ,and 0 h and 12 h following CLP ,and other groups were given normal saline. observed the animals behavior changes,measured the levels WBC,PLT,ALT,AST,BUN in serum,detected the levels and mRNA expression of IL-6, IL-10 ,TNF-α in peripheral blood. cultured of peripheral blood bacteria loads.[Results]24 h after surgery ,mice in CLP group appeared furring,feces residues on anus etc. compared to normal group,sham group and HSYA group,WBC,PLT,ALT,AST, BUN,levels and mRNA expression of IL-6,IL-10,TNF-αshowed significant increases,it was also found that bacterial load was significant increased in model group.[Conclusions]HSYA has a therapeutic effect in mice with sepsis ,can reduce bacteria into the blood,and inhibit inflammatory mediators which caused tissue damage.

Ex vivo effect of copper sulfate on Enterococcus faecalis in root canals / Efecto ex vivo del sulfato de cobre sobre Enterococcus faecalis en canales radiculares

The incomplete disinfection of root canal system has been reported as the main cause of post-treatment disease, due to the persistence of bacteria. For over thirty years Enterococcus faecalis has been considered the most common bacterial species isolated from persistent root canal infections, resisting antibacterial agents, such as chlorhexidine and calcium hydroxide. Several studies have indicated that copper has optimal disinfecting capacities in a hospital environment. Aimed to know the ex vivo effect of copper sulfate (CuSO4) on E. faecalis. Thirty-six extracted human tooth root canals were inoculated with E. faecalis ATCC 29212. These root canals had undergone endondontic procedures with a rotatory system. The effect of CuSO4 was determined by plate count method of E. faecalis obtained from one sample of each tooth under three incubation times (4th, 7th and 10th day). The canals medicated with CuSO4, the bacterial count decreased 6 log after 4 days and remained as such without statistically significant change until the tenth day. It is an indisputable fact of its antibacterial action. The bacterial persistence may be due to the ability of E. faecalis to remain viable in root canals up to 12 months without additional nutrients. These preliminary results couldbe used for further scientific work assessing the potential for the use of cooper in dentistry.

La desinfección incompleta del sistema de canales radiculares ha sido reportada como la principal causa de infección post tratamiento, debido a la persistencia bacteriana. Por más de 30 años, Enterococcus faecalis se ha considerado una de las especies bacterianas más comunes aisladas de infecciones persistentes del canal radicular, resistiendo a agentes antibacterianos, como clorhexidina e hidróxido de calcio. Varios estudios han indicado que el cobre tiene una capacidad de desinfección óptima en un entorno hospitalario. Con el objetivo de conocer el efecto ex vivo de sulfato de cobre (CuSO4) sobre E. faecalis. Treinta y seis canales radiculares de dientes humanos extraídos fueron inoculados con E. faecalis ATCC 29212. Estos canales radiculares fueron previamente sometidos a instrumentación con un sistema de rotación. El efecto de CuSO4 se determinó por el método de recuento en placa de E. faecalis a partir de una muestra de cada diente en tres tiempos de incubación (4, 7 y 10 días). En los canales medicados con CuSO4, el recuento de bacterias se redujo 6 log después de 4 días y se mantuvo como tal sin cambio estadísticamente significativo hasta el día 10. Esto demuestra su poder antibacteriano. La persistencia bacteriana pudo ser deberse a la capacidad de E. faecalis para seguir siendo viable en canales hasta 12 meses sin nutrientes adicionales. Estos resultados preliminares podrían ser utilizados para otros trabajos científicos que evaluen el potencial uso de cobre en odontología.

Preliminary screening for in vitro anti-enteritic properties of a traditional herb Dillenia pentagyna Roxb. fruit extracts

OBJECTIVE@#To explore anti-enteric properties of Dillenia pentagyna Roxb. (D. pentagyna) fruit extract fractions of different polarities by comparative antimicrobial activity against municipal sewage microflora and to assess its urease inhibition potential.@*METHODS@#Different polar fractions of D. pentagyna fruit extracts were studied by antimicrobial susceptibility test with several adjustments in this resource limited setup. Tests were done against municipal sewage microbes at various bacterial load (initially with 1.0 McFarland followed by 1.5 McFarland) using basal (nutrient agar) and selective medium (MacConkey's agar with and without supplementation of 5% NaCl). All assays statistically scaled with a gradient for uniformity and comparison with ciprofloxacin standard. Fraction with highest activity was studied for urease inhibition potential by kinetic method.@*RESULTS@#DP-47 separated by 30% ethyl acetate (EtOAc) in CHCl3 from CHCl3 extract had slightly higher antimicrobial potency (y=0.758x+7.571) as dissolved in methanol than in dimethylsulfoxide (y=0.300x+6.000). EtOAc extract fractioned by 10% methanol in EtOAc (DP-43) was more potent antimicrobial (y=1.428x+8.392) and soluble in water. Butanol extract fractioned by water (DP-50) showed highest antimicrobial potency (y=3.384x+2.000) than both DP-47 and DP-43 in disk diffusion assays. In higher microbial load DP-50 was potent antimicrobial (y=1.538x+3.000) and completely inhibited any vegetative growth at lower load of 0.5 McFarland. In selective environment DP-50 was effective (y=1.076x+7.500 in MacConkey's, y=1.307x+6.000 in 5% NaCl supplemented). It was evident that enteric pathogens may not easily develop resistance against DP-50 and at high concentration it inhibited urease activity by 94.87%. The standard inhibition by thiourea (1%) is 33.914%.@*CONCLUSIONS@#Highly polar fraction of D. pentagyna Roxb. fruit extract DP-50 have potential antimicrobial activity against sewage microflora in basal and selective culture indicating its potential against non-fastidious, coliforms and Vibrio pathogens. Urease inhibition indicates efficacy against Helicobactor pylory.

Limpeza manual X limpeza automatizada: uma análise de carga microbiana de instrumentais cirúrgicos após o uso clínico em cirurgias do aparelho digestivo / Manual cleaning x automated cleaning: an analysis of microbial load on surgical instruments after clinical use in surgery of the digestive tract

Diversos produtos para a saúde (PPS), dentre eles a maioria dos instrumentais cirúrgicos, são planejados com a finalidade de permitir sua reutilização. A presença da contaminação microbiana em PPS após o processamento pode inviabilizar a reutilização destes instrumentais, devido ao risco de transmissão cruzada de micro-organismos, favorecendo a ocorrência da Infecção Relacionada à Assistência à Saúde. Objetivou-se avaliar a carga microbiana presente em instrumentais cirúrgicos utilizados em cirurgias do aparelho digestivo após uso clínico e limpeza manual e automatizada. Tratou-se de uma pesquisa experimental realizada no Laboratório de Microbiologia Oral e Anaeróbios. A amostra foi composta por 125 instrumentais provenientes de 25 cirurgias do aparelho digestivo, potencialmente contaminadas e contaminadas, submetidos a dois processos de limpeza, manual e automatizado. Os instrumentais foram imersos em sacos plásticos estéreis contendo água destilada estéril e submetidos a sonicação em lavadora ultrassônica, seguida de agitação. As amostras foram divididas em cinco partes iguais e submetidas à filtração em membrana Millipore® de 0,45μm. As membranas foram então depositadas em meios de cultura específicos para a avaliação da carga microbiana e o isolamento de grupos microbianos de relevância epidemiológica. A identificação dos micro-organismos foi realizada no sistema Vitek II Biomeriéux, com cartões específicos para cada grupo de micro-organismos. A média de carga microbiana nas diferentes etapas foi 93,1UFC/100ml após o uso, 41UFC/100ml e 8,24UFC/100ml nas duas etapas sequenciais de limpeza manual e 75UFC/100ml e 16,1UFC/100ml em instrumentais submetidos a limpeza automatizada. A redução de carga microbiana entre as etapas sequenciais de limpeza não foi significativa para instrumentais submetidos a limpeza em lavadora ultrassônica. A carga microbiana após o uso foi influenciada pelo potencial de contaminação da cirurgia. Após o uso...

Several health products (HP), among them the most surgical instruments, are designed in order to allow its reuse. The presence of microbial contamination on HP after its processing can limit the reuse of these instruments, because of the risk of cross-transmission of microorganisms, favoring the occurrence of Health Care-Associated Infections. The aim was to evaluate the microbial load present in surgical instruments used in the digestive tract surgeries after its clinical use and manual and automated cleaning. This was an experimental study carried out in the Laboratory of Oral Microbiology and Anaerobes. The sample was composed of 125 instruments from 25 gastrointestinal surgeries, potentially contaminated and contaminated, undergone two cleaning processes, manual and automated. The instruments were immersed in sterile plastic bags containing sterile distilled water and exposed to sonication in ultrasonic washer, followed by stirring. The samples were divided into five equal parts and filtrated on Millipore® membrane of 0.45μm. The membranes were then deposited in specific culture substance for the assessment of microbial load and isolation of microbial groups of epidemiologic relevance. The identification of micro-organisms was performed on the system Vitek II Biomeriéux, with specific cards for each group of microorganisms. The average microbial load in the different stages was 93.1CFU/100ml after use, 41CFU/100ml and 8.24CFU/100ml in the two sequential steps of manual cleaning and 75CFU/100 and 16.1CFU/100ml in instrumental that went to automated cleaning. The reduction of microbial load between the sequential cleaning steps was not significant for instrumental undergoing the cleaning in ultrasonic washer. The microbial load after use was influenced by the potential for contamination of surgery. After the clinical use, 64% of the instruments showed microbial load higher than 101 and 102CFU/100ml. After the first stage of the manual...

Preliminary screening for in vitro anti-enteritic properties of a traditional herb Dillenia pentagyna Roxb. fruit extracts

Objective: To explore anti-enteric properties of Dillenia pentagyna Roxb. (D. pentagyna) fruit extract fractions of different polarities by comparative antimicrobial activity against municipal sewage microflora and to assess its urease inhibition potential. Methods: Different polar fractions of D. pentagyna fruit extracts were studied by antimicrobial susceptibility test with several adjustments in this resource limited setup. Tests were done against municipal sewage microbes at various bacterial load (initially with 1.0 McFarland followed by 1.5 McFarland) using basal (nutrient agar) and selective medium (MacConkey's agar with and without supplementation of 5% NaCl). All assays statistically scaled with a gradient for uniformity and comparison with ciprofloxacin standard. Fraction with highest activity was studied for urease inhibition potential by kinetic method. Results: DP-47 separated by 30% ethyl acetate (EtOAc) in CHCl

Food safety knowledge and practices of abattoir and butchery shops and the microbial profile of meat in Mekelle City, Ethiopia

Objective: To assess the food safety knowledge and practices in meat handling, and to determine microbial load and pathogenic organisms in meat at Mekelle city. Methods: A descriptive survey design was used to answer questions concerning the current status of food hygiene and sanitation practiced in the abattoir and butcher shops. Workers from the abattoir and butcher shops were interviewed through a structured questionnaire to assess their food safety knowledge. Bacterial load was assessed by serial dilution method and the major bacterial pathogens were isolated by using standard procedures. Results: 15.4% of the abattoir workers had no health certificate and there was no hot water, sterilizer and cooling facility in the abattoir. 11.3% of the butchers didn't use protective clothes. There was a food safety knowledge gap within the abattoir and butcher shop workers. The mean values of bacterial load of abattoir meat, butcher shops and street meat sale was found to be 1.1×105, 5.6×105 and 4.3×106 cfu/g, respectively. The major bacterial pathogens isolated were Escherichia coli, Staphylococcus aureus and Bacillus cereus. Conclusions: The study revealed that there is a reasonable gap on food safety knowledge by abattoir and butcher shop workers. The microbial profile was also higher compared to standards set by World Health Organization. Due attention should be given by the government to improve the food safety knowledge and the quality standard of meat sold in the city.

Food safety knowledge and practices of abattoir and butchery shops and the microbial profile of meat in Mekelle City, Ethiopia

<p><b>OBJECTIVE</b>To assess the food safety knowledge and practices in meat handling, and to determine microbial load and pathogenic organisms in meat at Mekelle city.</p><p><b>METHODS</b>A descriptive survey design was used to answer questions concerning the current status of food hygiene and sanitation practiced in the abattoir and butcher shops. Workers from the abattoir and butcher shops were interviewed through a structured questionnaire to assess their food safety knowledge. Bacterial load was assessed by serial dilution method and the major bacterial pathogens were isolated by using standard procedures.</p><p><b>RESULTS</b>15.4% of the abattoir workers had no health certificate and there was no hot water, sterilizer and cooling facility in the abattoir. 11.3% of the butchers didn't use protective clothes. There was a food safety knowledge gap within the abattoir and butcher shop workers. The mean values of bacterial load of abattoir meat, butcher shops and street meat sale was found to be 1.1×10(5), 5.6×10(5) and 4.3×10(6) cfu/g, respectively. The major bacterial pathogens isolated were Escherichia coli, Staphylococcus aureus and Bacillus cereus.</p><p><b>CONCLUSIONS</b>The study revealed that there is a reasonable gap on food safety knowledge by abattoir and butcher shop workers. The microbial profile was also higher compared to standards set by World Health Organization. Due attention should be given by the government to improve the food safety knowledge and the quality standard of meat sold in the city.</p>

Bacterial contaminants of salad vegetables in Abuja Municipal Area Council, Nigeria

Salad vegetables are essential part of people’s diet all around the world. They are usually consumed raw and often without heat treatment or thorough washing; hence have been known to serve as vehicles for the transmission of pathogenic microorganism associated with human diseases. Fresh samples of lettuce, carrot and cucumber collected from different markets and vendors in Abuja Municipal Area Council, Federal Capital Territory, Nigeria were evaluated for bacterial loads using spread plate agar dilution method. Bacterial loads ranged from 1.6 x 106 to 2.9 x 108 cfu/g. Escherichia coli, Klebsiella and Enterobacter were amongst the coliforms (lactose fermenters), while Proteus, Pseudomonas aeruginosa, Salmonella and Shigella were non-lactose fermenters associated with the samples. Staphylococcus aureus was isolated from majority of the samples.