Plano de contingencia municipal de enfrentamento a doença pelo coronavirus (covid-19) / Municipal contingency plan for coping with coronavirus disease (covid-19)

Orienta na campanha para ações de combate ao Coronavírus (Covid-19) no município de Augustinópolis no Tocantins. Busca promover a prevenção e evitar a transmissão de casos de infecção pelo COVID19. Tenta garantir a detecção, notificação, investigação de casos suspeitos de forma oportuna. Organiza o fluxo de ações de prevenção e controle do Coronavirus. Estabelece insumos estratégicos na utilização de casos suspeitos. Traz estratégias para redução da transmissão da doença, por meio do monitoramento e controle dos pacientes já detectados. Intensifica ações de capacitação dos profissionais de saúde da rede municipal. Garante assistência ao paciente, com garantia de acesso e manejo clinico adequado. Monitora e avalia a situação epidemiológica para orientar a tomada de decisão. Define as atividades de educação, mobilização social e comunicação que serão implementadas.

He guides in the campaign for actions to combat the Coronavirus (Covid-19) in the municipality of Augustinópolis in Tocantins. It seeks to promote prevention and avoid the transmission of cases of infection by COVID19. It tries to ensure the detection, notification, investigation of suspected cases in a timely manner. Organizes the flow of Coronavirus prevention and control actions. Establishes strategic inputs in the use of suspected cases. It brings strategies to reduce the transmission of the disease, through the monitoring and control of patients already detected. Intensifies training actions for health professionals in the municipal network. Ensures patient care, with guaranteed access and adequate clinical management. Monitors and evaluates the epidemiological situation to guide decision making. Defines the activities of education, social mobilization and communication that will be implemented.

Orienta en la campaña de acciones de combate al Coronavirus (Covid-19) en el municipio de Augustinópolis en Tocantins. Busca promover la prevención y evitar la transmisión de casos de infección por COVID19. Intenta garantizar la detección, notificación e investigación de casos sospechosos de manera oportuna. Organiza el flujo de acciones de prevención y control del coronavirus. Establece insumos estratégicos en el uso de casos sospechosos. Aporta estrategias para reducir la transmisión de la enfermedad, mediante el seguimiento y control de los pacientes ya detectados. Intensifica las acciones formativas de los profesionales sanitarios de la red municipal. Asegura la atención al paciente, con acceso garantizado y un adecuado manejo clínico. Monitorea y evalúa la situación epidemiológica para orientar la toma de decisiones. Define las actividades de educación, movilización social y comunicación que se implementarán.

Il guide dans la campagne d'actions de lutte contre le Coronavirus (Covid-19) dans la municipalité d'Augustinópolis à Tocantins. Il vise à promouvoir la prévention et à éviter la transmission des cas d'infection par COVID19. Il essaie d'assurer la détection, la notification et l'enquête des cas suspects en temps opportun. Organise le flux des actions de prévention et de contrôle des coronavirus. Établit des apports stratégiques dans l'utilisation des cas suspects. Il apporte des stratégies pour réduire la transmission de la maladie, à travers le suivi et le contrôle des patients déjà détectés. Intensifie les actions de formation des professionnels de santé du réseau municipal. Assure les soins aux patients, avec un accès garanti et une prise en charge clinique adéquate. Surveille et évalue la situation épidémiologique pour guider la prise de décision. Définit les activités d'éducation, de mobilisation sociale et de communication qui seront mises en œuvre.

Plano de contingência municipal de enfrentamento à doença pelo Coronavírus 2019 (Covid-19) de Lagoa da Confusão- TO / Municipal contingency plan for coping with the disease by Coronavirus 2019 (Covid-19) from Lagoa da Confusão- TO

Orienta na campanha para ações de combate ao Coronavírus (Covid-19) no município de Lagoa da Confusão no Tocantins. Apresenta quais as definições de casos de infecção humana pelo COVID-19. Orientações de como notificar ao Centro de Informações Estratégicas de Vigilância em Saúde (CIEVS). Quais os períodos de incubação da doença. Fatores sobre a transmissão e tratamento. Investigação epidemiológica. Quais atribuições da Vigilância em Saúde. Orientações para a coleta de amostras no Laboratório Central de Saúde Pública do Tocantins (LACEN-TO) bem como a técnica de coleta de Swabde nasofaringe e orofaringe (swabs combinados), o acondicionamento, transporte e envio das amostras. Traz as recomendações para a coleta de amostras em situação de óbito. Mostra as medidas de prevenção e controle Precauções padrão, as medidas de isolamento. Transporte do paciente. Como se dá a Limpeza e desinfecção de superfícies.

He guides in the campaign for actions to fight Coronavirus (Covid-19) in the municipality of Lagoa da Confusão in Tocantins. It presents the definitions of cases of human infection by COVID-19. Guidelines on how to notify the Health Surveillance Strategic Information Center (CIEVS). What are the disease incubation periods. Factors about transmission and treatment. Epidemiological investigation. Which attributions of the Health Surveillance. Guidelines for the collection of samples in the Central Laboratory of Public Health of Tocantins (LACEN-TO) as well as the technique of collection of Swabde nasopharynx and oropharynx (combined swabs), the packaging, transport and sending of the samples . It provides recommendations for the collection of samples in situations of death. Shows prevention and control measures Standard precautions, isolation measures. Transporting the patient. How to clean and disinfect surfaces.

Guía en la campaña de acciones para combatir el Coronavirus (Covid-19) en el municipio de Lagoa da Confusão en Tocantins. Presenta las definiciones de casos de infección humana por COVID-19. Directrices sobre cómo notificar al Centro de Información Estratégica de Vigilancia Sanitaria (CIEVS). Cuáles son los períodos de incubación de la enfermedad. Factores de transmisión y tratamiento. Investigación epidemiológica. Qué atribuciones de la Vigilancia Sanitaria. Lineamientos para la recolección de muestras en el Laboratorio Central de Salud Pública de Tocantins (LACEN-TO) así como la técnica de recolección de Swabde nasofaringe y orofaringe (hisopos combinados), el empaque, transporte y envío de las muestras . Proporciona recomendaciones para la recolección de muestras en situaciones de muerte. Muestra medidas de prevención y control Precauciones estándar, medidas de aislamiento. Transporte del paciente. Cómo limpiar y desinfectar superficies.

Il guide dans la campagne d'actions de lutte contre le coronavirus (Covid-19) dans la municipalité de Lagoa da Confusão à Tocantins. Il présente les définitions des cas d'infection humaine par COVID-19. Lignes directrices sur la notification du Centre d'information stratégique de surveillance sanitaire (CIEVS). Quelles sont les périodes d'incubation de la maladie. Facteurs de transmission et de traitement. Enquête épidémiologique. Quelles attributions de la Surveillance de la Santé. Directives pour le prélèvement d'échantillons au Laboratoire Central de Santé Publique de Tocantins (LACEN-TO) ainsi que la technique de prélèvement de Swabde nasopharynx et oropharynx (écouvillons combinés), l'emballage, le transport et l'envoi des échantillons . Il fournit des recommandations pour le prélèvement d'échantillons en cas de décès. Affiche les mesures de prévention et de contrôle Précautions standard, mesures d'isolement. Transport du patient. Comment nettoyer et désinfecter les surfaces.

Detection of some virulence factors genes in Staphylococcus aureus isolated from different clinical cases

Staphylococcus aureus is one of the most important pathogenic type to humans, and the most common species responsible for a wide range of diseases such as furuncles, various abscesses, wounds abscesses resulting from surgical operations, dermatitis, soft tissue inflammation, arthritis, bones inflammation, bronchial pneumonia, inflammation of internal parts of the heart and injuries caused by toxins such as toxic shock syndorome and staphylococcus aureus syndrome and food poisoning. The current study aimed by finding the genes responsible for the virulence factors in S. aureus isolates by using the Single and Multiplex PCR mechanism (technology). A total of 60 specimens (urine, burn swabs, wound swaabs) from different clinical cases were collected from patients (in different age groups) who admitted to several health centers in Al-Diwaniyah Teaching Hospital, Iraq, during a period extending from October 2016 to January 2017. Some virulence factors were investigated for 30 isolate only of MRSA using Single and Multiplex PCR for detection virulence factor genes which both coa gene encoding production of coagulase, clfA gene encoding for clumpting factor, spa gene encoding for protein A, fnbA gene encoding for fibronectin binding proteins, luks gene encoding prouction of Panton Valentine Leukocidin (PVL). Results 30 (100%) were possess coa, clfA, spa and fnbA genes, 13 (43.3%) were possess luks gene

Enteroparasites in vegetables marketed in an ancient Brazilian city / Enteroparásitos en verduras comercializadas en una antigua ciudad de Brasil

ABSTRACT Objective To assess contamination by enteroparasites in raw vegetables consumed in the city of São Mateus, Espírito Santo, Brazil. Material and Methods Samples of lettuce (Lactuca sativa) and parsley (Petrosolium sativum) were collected from six popular establishments, such as supermarkets and street markets. The obtained material was analyzed, after washing, by the spontaneous sedimentation method in the Clinical Analysis Laboratory of the Federal University of Espírito Santo, São Mateus Campus. Results From a total of 120 analyzed samples, 71 (59 %) had one or more parasitic contaminants. Lettuce samples had a contamination rate of 78.3 %, and parsley samples of 40 %. Conclusions The results show that the vegetables consumed in the city had protozoa, helminths and arthropods, which points to the need for implementing hygienic-sanitary measures in production, handling and transportation of these vegetables.(AU)

RESUMEN Objetivo Evaluar la contaminación por enteroparásitos de verduras consumidas crudas, vendidas en la ciudad de São Mateus, Espírito Santo, Brasil. Materiales y Métodos Se recolectaron muestras de lechuga (Lactuca sativa) y perejil (Petrosolium sativum) de seis establecimientos populares, como supermercados y mercados callejeros y se analizó el material obtenido, luego del lavado, mediante el método de sedimentación espontánea en el Laboratorio de Análisis Clínicos de la Universidad Federal de Espírito Santo, campus de São Mateus. Resultados De un total de 120 muestras analizadas, 71 (59 %) tenían uno o más contaminantes parasitarios. Las muestras de lechuga tenían una tasa de contaminación del 78,3 % y muestras de perejil, 40 %. Conclusión Los resultados muestran que las verduras consumidas en la ciudad tenían protozoos, helmintos y artrópodos, lo que indica la necesidad de adoptar medidas higiénico-sanitarias en la producción, manejo y transporte de estos vegetales.(AU)

Avaliação das características microbiológicas das saladas de frutas comercializadas por ambulantes de Juazeiro do Norte, CE / Evaluation of microbiological features of fruit salads sold by street vendors in Juazeiro do Norte, CE

Introdução: A salada de frutas é um alimento saboroso, nutritivo e comercializado pronto para consumo, porém, muitas vezes o seu preparo e manipulação podem ser feitos de forma inadequada, tornando-a, quando contaminada, um veículo para a disseminação de doenças. Objetivo: O presente trabalho teve como objetivo avaliar as características microbiológicas das saladas de frutas comercializadas por ambulantes em Juazeiro do Norte, CE. Método: As amostras foram coletadas aleatoriamente nas ruas do município em estudo e, posteriormente, diluídas em solução salina estéril, filtradas e inoculadas em tubo contendo o meio Brain Heart Infusion e posteriormente em Ágar Sabouraud, Ágar Eosin Methilen Blue e Ágar Salmonella Shigella. Resultados: Das 10 amostras, 60% apresentaram Klebsiella spp. e Escherichia coli, seguido de E. coli, com 20%, Klebsiella spp., com 10%. Os 10% restantes não apresentaram contaminação. Quanto à análise micológica, todas as amostras apresentaram-se contaminadas por fungos. As amostras ainda foram submetidas à técnica de Hoffman Modificado para análise parasitológica, tendo como parasita mais prevalente Endolimax nana, estando presente de forma isolada, em 40% das amostras, e associada com Entamoeba coli em 20%, Entamoeba histolytica em 10%, Giardia spp. em 10%, enquanto 20% não apresentou contaminação parasitária. Conclusão: Os dados demonstraram que a maioria das saladas de frutas analisadas estava contaminadas por microrganismos patogênicos, havendo assim uma necessidade ainda maior de programas de capacitação higiênica e que os órgãos responsáveis disponibilizem produtos para a higienização dos manipuladores e do local onde acontece a manipulação desses alimentos no momento do seu preparo.(AU)

Introduction: A fruit salad is a delicious food, nutritious and sold ready to eat, but often their preparation and handling can be performed improperly, making it, when contaminated, a vehicle for the spread of diseases. Objective: This study aimed to evaluate the microbiological characteristics of fruit salads sold by street vendors in Juazeiro do Norte, CE. Methods: The samples were collected randomly in the city's streets in study and further diluted in sterile saline, filtered, and inoculated into tube containing the medium Brain Heart Infusion Agar Sabouraud and later, Agar Eosin Methilen Blue Agar Salmonella and Shigella. Results: Of the 10 samples, 60% were Klebsiella spp. and Escherichia coli, E. coli followed with 20%, Klebsiella spp. with 10% and the remaining 10% showed no contamination. The mycological analysis, all samples had infected by fungi. The samples were further subjected to Hoffman technique modified for parasitological analysis, with the more prevalent parasitic Endolimax nana, being present separately, in 40% of samples, and is associated with Entamoeba coli 20%, Entamoeba histolytica in 10% Giardia spp. 10%, while 20% showed no parasitic contamination. Conclusion: The data show that most of the analyzed fruit salads were contaminated by pathogenic microorganisms, so there is an even greater need for hygienic training programs and the bodies make available products for the hygiene of food handlers and where happens the handling of these foods in time of its preparation.(AU)

Análise bacteriológica de frutos e hortaliças em mercados frutíferos públicos e privados de Juazeiro do Norte-CE / Bacteriological analysis of fruits and vegetables in public and private fruit markets in Juazeiro do Norte-CE

Introdução: Os frutos e hortaliças são essenciais para o corpo humano como fonte de nutrientes e energia. Apesar do seu comércio ser bastante popular em mercados livres, onde seus preços são mais acessíveis, as condições higiênicas não são adequadas, colocando em risco o consumidor. A cada ano, os surtos de doenças transmitidas por alimentos aumentam, tornando-se um grande problema de saúde pública. As bactérias destacam-se entre o grupo de microrganismos mais patogênicos aos alimentos, podendo infectá-los desde a fabricação até a venda, se as medidas higiênicas não forem tomadas de maneira correta e se o ambiente for propício à multiplicação. Objetivo: Analisar frutas e hortaliças provenientes de mercados públicos e privados de Juazeiro do Norte, CE, avaliando a presença de microrganismos em meio Ágar Sangue, EMB, Sabouraud e Ágar BHI. Método: Estudo de caráter analítico descritivo, sendo avaliadas a presença ou ausência de microrganismos nas superfícies dos frutos e hortaliças. Estas amostras foram randomizadas e obtidas diretamente das superfícies dos alimentos comercializados nos mercados públicos e privados. As coletas foram realizadas em 20 frutos e 30 hortaliças, totalizando 50 amostras. Resultados: Tanto nos mercados públicos como privados, houve crescimento bacteriano e fúngico, destacando-se a Eschechiria coli. Também foi identificada a contaminação por Klebsiella, Staphylococcus aureus e Bacillus sp. Além disso, foi constatada a presença de bactérias e crescimento de fungos em todas as amostras. Conclusão: Em função da presença desses microrganismos, é possível alertar sobre cuidados que devem ser tomados na hora da compra do alimento, para que possa evitar surtos de doenças e, assim, garantir a saúde da população.

Introduction: Fruits and vegetables are essential for the human body as a source of nutrients and energy. Although its trade is very popular in free markets, where its prices are more affordable, the hygienic conditions are not adequate, thus putting at risk the consumer. Each year, outbreaks of foodborne illnesses increase, becoming a major public health problem. Bacteria stand out among the group of microorganisms most pathogenic to food, and can infect them from manufacturing to sale if the hygienic measures are not done correctly and if the environment is conducive to multiplication. Objective: To analyze fruits and vegetables from public and private markets, from Juazeiro do Norte, CE, evaluating the presence of microorganisms in Blood Agar, EMB, Sabouraud and BHI Agar. Methods: The study is analytical descriptive, being evaluated the presence or absence of microorganisms on the surfaces of fruits and vegetables. These samples were randomized and obtained directly from the surfaces of fruits and vegetables from public and private markets. Twenty fruits and 30 vegetables were assessed, totaling 50 samples. Results: In both public and private markets, there was bacterial and fungal growth, especially Eschechiria coli. Contamination by Klebsiella, Staphylococcus aureus and Bacillus sp. In addition, bacteria and fungi growth were observed in all samples. Conclusion: The presence of these microorganisms makes it possible to alert about the care that should be taken when buying food, so that it can prevent disease outbreaks and thus guarantee the health of the population.

Informação nutricional de fórmulas infantis sem lactose comercializadas em Sete Lagoas, MG / Nutritional information in infant formula without lactose marketed in Sete Lagoas-MG

Introdução: Fórmula infantil para lactentes com necessidades dietoterápicas específicas é aquela cuja composição foi alterada ou especialmente formulada para atender, por si só, às necessidades específicas decorrentes de alterações fisiológicas e/ou doenças temporárias ou permanentes e/ou para a redução de risco de alergias em indivíduos predispostos. Objetivo: Este trabalho objetivou avaliar a questão da conformidade das informações contidas na rotulagem de fórmulas infantis sem lactose para lactentes encontradas à venda no varejo da cidade de Sete Lagoas, MG. Método: Foram analisadas, em triplicata, amostras de cinco marcas de fórmulas infantis ditas "zero" lactose. Foram determinados os teores de proteínas, gorduras totais, carboidratos, lactose e sódio e também as informações de peso líquido. Os resultados encontrados foram comparados com as informações declaradas pelo fabricante. Resultados: Com relação ao peso líquido, ao valor energético e aos teores declarados de carboidratos, proteínas, gorduras totais e lactose, os valores declarados estavam de acordo. Já para o teor de sódio, todas as marcas apresentaram valores acima daqueles especificados nos rótulos. Conclusão: Todas as marcas analisadas podem ser comercializadas com a declaração de zero lactose. Com exceção do sódio, todas as demais informações estavam de acordo com o declarado pelos fabricantes.(AU)

Introduction: Infant formula for infants with specific dietetics needs, is one whose composition was changed or specially formulated to meet alone the specific needs arising from physiological and/or temporary or permanent illness and/or to reduce risk of allergies in susceptible individuals. Objective: This study aimed to evaluate the conformity of the information contained in the labeling of infant formula without lactose for infants found on sale at retail in the city of Sete Lagoas, MG. Methods: We analyzed in triplicate samples of five brands of said infant formula "zero" lactose. They were determined protein, total fat, carbohydrates, lactose, and sodium and also the net weight information. The results were compared to the information declared by the manufacturer. Results: Regarding to the wet weight, the energy value and the declared content carbohydrates, protein, total fat, and lactose the declared values agreed. As for the sodium content of all brands showed values above those specified on the labels. Conclusion: All the analyzed brands may be marketed with the declaration of zero lactose. Excepting sodium, all other information agreed with the declared by manufacturers.(AU)

Higher positive identification of malignant CSF cells using the cytocentrifuge than the Suta chamber / A identificação de células neoplásicas no LCR foi maior com o uso da citocentrifuga do que com câmara de Suta

ABSTRACT Objective To define how to best handle cerebrospinal fluid (CSF) specimens to obtain the highest positivity rate for the diagnosis of malignancy, comparing two different methods of cell concentration, sedimentation and cytocentrifugation. Methods A retrospective analysis of 411 CSF reports. Results This is a descriptive comparative study. The positive identification of malignant CSF cells was higher using the centrifuge than that using the Suta chamber (27.8% vs. 19.0%, respectively; p = 0.038). Centrifuge positively identified higher numbers of malignant cells in samples with a normal concentration of white blood cells (WBCs) (< 5 cells/mm3) and with more than 200 cells/mm3, although this was not statistically significant. There was no lymphocyte loss using either method. Conclusions Cytocentrifugation positively identified a greater number of malignant cells in the CSF than cytosedimentation with the Suta chamber. However, there was no difference between the methods when the WBC counts were within the normal range.

RESUMO Objetivo Definir qual a melhor forma de concentrar amostras de LCR para obter maior porcentagem de positividade para o diagnóstico de infiltração neoplásica. comparando dois métodos diferentes de concentração de células, sedimentação e citocentrifugação. Métodos Análise retrospectiva de 411 laudos de LCR. Resultados Estudo comparativo descritivo. A identificação de células neoplásicas no LCR foi mais elevada quando usada a citocentrífuga do que a câmara de Suta (28% vs 19,0%, respectivamente; p = 0,038). Centrifugação identificou maior número de células neoplásicas em amostras com concentração de células < 5 células/mm3 e superior a 200 células/mm3, embora não significativo. Não houve perda de linfócitos usando qualquer um dos métodos. Conclusões A citocentrifugação identificou um número maior de células malignas no LCR do que a sedimentação com a câmara de Suta. No entanto, não houve diferença entre os métodos quando as contagens de leucócitos estavam dentro do intervalo normal.

Specimen processing during laparoscopic renal surgery: a review of techniques and technologies

Laparoscopic surgery has well-defined benefits for patients and has become accepted over time as a standard access strategy for the management of benign and malignant urologic diseases. Unlike in open surgery, the surgeon is often faced with the additional challenges of specimen retrieval and extraction at the end of laparoscopic extirpative procedures. This final step often requires significant laparoscopic skill to entrap and safely extract the laparoscopic specimens. Failure to apply safe exit steps at the end of a laparoscopic procedure may lead to significant morbidity. The aim of this review is to explore the different techniques and technologies available for laparoscopic kidney retrieval, entrapment and safe extraction. .

Evaluation of three different DNA extraction methods from blood samples collected in dried filter paper in Plasmodium subpatent infections from the Amazon region in Brazil / Avaliação de três métodos de extração de DNA obtidos de amostras de sangue coletadas em papel de filtro em infecções subpatentes de Plasmodium da região Amazônica no Brasil

Asymptomatic Plasmodium infection is a new challenge for public health in the American region. The polymerase chain reaction (PCR) is the best method for diagnosing subpatent parasitemias. In endemic areas, blood collection is hampered by geographical distances and deficient transport and storage conditions of the samples. Because DNA extraction from blood collected on filter paper is an efficient method for molecular studies in high parasitemic individuals, we investigated whether the technique could be an alternative for Plasmodium diagnosis among asymptomatic and pauciparasitemic subjects. In this report we compared three different methods (Chelex®-saponin, methanol and TRIS-EDTA) of DNA extraction from blood collected on filter paper from asymptomatic Plasmodium-infected individuals. Polymerase chain reaction assays for detection of Plasmodium species showed the best results when the Chelex®-saponin method was used. Even though the sensitivity of detection was approximately 66% and 31% for P. falciparum and P. vivax, respectively, this method did not show the effectiveness in DNA extraction required for molecular diagnosis of Plasmodium. The development of better methods for extracting DNA from blood collected on filter paper is important for the diagnosis of subpatent malarial infections in remote areas and would contribute to establishing the epidemiology of this form of infection.

Infecção assintomática por Plasmodium é um novo desafio para a saúde pública no Brasil. A reação em cadeia da polimerase (PCR) é o melhor método para detectar baixas parasitemias presentes em pacientes com infecção assintomática. Nas áreas endêmicas, a coleta de sangue total é dificultada pela distancia geográfica, transporte e adequada armazenagem das amostras. A coleta de sangue em papel de filtro pode ser uma alternativa nessas áreas de difícil acesso. Neste estudo foram comparados três diferentes métodos de extração de ADN a partir de papel de filtro usando como controle extração a partir de sangue total. O protocolo Chelex®-Saponina foi o que obteve o melhor resultado quando comparado com os outros três protocolos. No entanto a sensibilidade foi de 66,7% para o P. falciparum e 31,6% para o P. vivax. Conclui-se que em caso de infecção assintomática o papel de filtro não é ainda uma boa alternativa para coleta de amostras.

Identification of dengue viruses in naturally infected Aedes aegypti females captured with BioGents (BG)-Sentinel traps in Manaus, Amazonas, Brazil

Introduction In Manaus, the first autochthonous cases of dengue fever were registered in 1998. Since then, dengue cases were diagnosed by the isolation of viruses 1, 2, 3, and 4. Methods One hundred eighty-seven mosquitoes were collected with BioGents (BG)-Sentinel traps in 15 urban residential areas in the Northern Zone of Manaus and processed by molecular tests. Results Infections with dengue viruses 1, 2, 3, and 4 and a case of co-infection with dengue viruses 2 and 3 were identified. Conclusions These findings corroborate the detection of dengue in clinical samples and reinforce the need for epidemiological surveillance by the Health authorities. .

Estudio de dos sistemas de transporte para mantener la viabilidad de bacterias de interés clínico / Study of the ability of two swab transport systems to maintain viability of clinically important bacteria / Estudo de dois sistemas de transporte para manter a viabilidade de bactérias de interesse clínico

Se compararon dos dispositivos de conservación de muestras tomadas por hisopado con cepas de referencia de Streptococcus pyogenes, Haemophilus influenzae, Neisseria gonorrhoeae y Streptococcus pneumoniae (ambos con medio de Stuart). El dispositivo Copan Venturi Transystem® (Copan Italia Spa, Brescia, Italia) resultó ser significativamente más efectivo que el Eurotubo (Deltalab, Rubí, Barcelona, España) probablemente porque la estrangulación que presenta al comienzo de la columna semisólida (sistema tipo Venturi) permitiría una mejor conservación de los microorganismos.

Two extendedly-used swab transport devices with Stuart medium using Streptococcus pyogenes, Haemophilus influenzae, Neisseria gonorrhoeae and Streptococcus pneumoniae reference strains, were compared. Copan Venturi Transystem® (Copan Italia Spa, Brescia, Italy) was significantly more effective than Eurotubo (Deltalab, Rubí, Barcelona, Spain), probably because the narrowing of the tube, just at the beginning of the semisolid column (Venturi system), would yield a better conservation of diffrerent organisms.

Foram comparados dois dispositivos de conservação de amostras tomadas por swab com cepas de referência de Streptococcus pyogenes, Haemophilus influenzae, Neisseria gonorrhoeae e Streptococcus pneumoniae (ambos com meio de Stuart). O dispositivo Copan Venturi Transystem® (Copan Italia Spa, Brescia, Itália) resultou ser significativamente mais efetivo que o Eurotubo (Deltalab, Rubí, Barcelona, Espanha) provavelmente porque o estrangulamento que apresenta no início da coluna semi-sólida (sistema tipo Venturi) permitiria uma melhor conservação dos microorganismos.

Comparação entre diferentes métodos de coleta para avaliação microbiológica de pacientes com rinossinusite crônica / Comparing different methods used to collect material for a microbiological evaluation of patients with chronic rhinosinusitis

There is still controversy on which is the best method to collect the secretion directly from the middle meatus or maxillary sinus in patients with chronic rhinosinusitis. AIM: To evaluate the prevalence of bacteria in patients with chronic rhinosinusitis and compare the suction trap collector to direct aspiration attached to a syringe for the microbiological analysis of these secretions. MATERIALS AND METHODS: Prospective study involving 31 patients who underwent endoscopically guided maxillary secretion aspiration by two different methods (aspiration with the collector tube "suction trap" and aspiration with the use of a catheter connected to a syringe), to determine the microbiological diagnosis and to compare the two methods used. RESULTS: microorganisms grew samples collected from 55 percent of the 31 patients. The most frequent bacteria were S. aureus, Pseudomonas aeruginosa and other aerobic Gram-negative bacteria. The results from cultures were similar between the two methods in 71 percent of patients. CONCLUSION: S. aureus, Pseudomonas aeruginosa and other aerobic Gram-negative bacteria make up the main flora in the maxillary sinus of the patients. There was good correlation between the microbiological results obtained by using a catheter attached to a syringe and the "suction trap" nasal collector.

Atualmente existe controvérsia sobre qual a melhor forma de se coletar secreção do meato médio ou seio maxilar em pacientes com rinossinusite crônica. OBJETIVO: Avaliar a prevalência de bactérias em pacientes com rinossinusite crônica e comparar o método de aspiração direta com seringa e coletor estéril como forma de análise microbiológica desses pacientes. MATERIAIS E MÉTODOS: Estudo prospectivo em 31 pacientes submetidos à coleta de secreção do seio maxilar sob visão endoscópica por dois métodos diferentes (aspiração com coletor estéril de secreção nasal "suction trap" e aspiração usando cateter com seringa acoplada), para determinação do diagnóstico microbiológico e comparação dos métodos utilizados. RESULTADOS: Dos 31 pacientes estudados, o crescimento de microrganismos foi observado em apenas 55 por cento das amostras cultivadas. Os microorganismos mais frequentes foram Staphylococcus aureus, Pseudomonas aeruginosa e outras bactérias aeróbicas Gram-negativas. Os resultados das culturas foram coincidentes entre os dois métodos em 71 por cento dos pacientes. CONCLUSÃO: Staphylococcus aureus, Pseudomonas aeruginosa e outras bactérias aeróbicas Gram-negativas constituem a flora predominante em pacientes com rinossinusite crônica. Houve correlação satisfatória entre os achados microbiológicos obtidos pelo uso de cateter acoplado à seringa com o do coletor nasal do tipo "suction trap".

Quanto a escova deve ser introduzida no canal anal para avaliação citológica mais eficaz? / How deep must the brush be introduced in the anal canal for a more effective cytological evaluation?

OBJETIVO: A sensibilidade da citologia anal varia amplamente na literatura, entre 45 por cento e 98 por cento, o que pode ocorrer devido à falta de padronização quanto à distância que a escova deve ser introduzida no canal anal. Desta forma, nosso objetivo foi investigar se o local de coleta influencia no resultado desse exame. MÉTODOS: Colhemos amostras com escova introduzida 4 cm no canal anal de 114 doentes (Grupo A) e 2 cm em outros 94 pacientes (Grupo B), antes do exame proctológico. Realizamos cinco rotações com a escova antes de retirá-la e a esfregar sobre lâmina de vidro, posteriormente submetida ao exame citopatológico padrão. Todos os doentes são HIV-positivo. Submetemos os resultados à avaliação estatística. RESULTADOS: No Grupo A, 39 doentes possuíam condilomas no canal anal e a citologia foi positiva em 29 deles (74,3 por cento). Também observamos alterações citológicas em 30 de 75 doentes (40 por cento) sem lesões clínicas no canal anal. No Grupo B, havia 54 doentes com condilomas no canal anal e em 13 (24,1 por cento) houve confirmação citológica. Em 40 outros, sem lesões clínicas pelo HPV, notamos que em nove (22,5 por cento) havia anormalidades citológicas. Os testes estatísticos revelaram que os exames realizados nos doentes do Grupo A foram mais eficientes. CONCLUSÃO: Os espécimes coletados com escovas inseridas mais profundamente no canal anal melhoraram a eficácia do exame.

OBJECTIVE: In literature, sensitivity of Pap smears ranges widely from 45 to 98 percent. Possibly this is because there is no standard for how far the brush should be introduced into the anal canal. The aim was to evaluate whether the sampling site has an influence on the results of anal Pap smears. Design and setting. This is a non-randomized, non-blinded, retrospective review carried out in the Proctology and Pathology Sectors, Emilio Ribas Infectious Diseases Institute. METHOD: We obtained specimens with brushes introduced 4 cm into the anal canal in 114 patients (Group A) and 2 cm in 94 patients (Group B), before anorectal examination. These brushes were rotated five or six times before being withdrawn and rubbed on a slide that underwent Pap testing using standard cytopathology laboratory equipment. All patients were HIV-infected. Statistical tests were used. RESULTS: In Group A, 39 patients had anal canal condylomas and the cytology was positive in 29 of them (74.3 percent). We also observed cytological alterations in 30 of 75 patients (40 percent) without clinical lesions in the anal canal. In Group B, there were 54 patients with condylomas and 13 of them (24.1 percent) were confirmed by cytology. In 40 patients with no clinical lesions, we observed that nine (22.5 percent) had cytological abnormalities Statistical analysis revealed that examination in Group A was more efficient. CONCLUSION. Specimens collected by inserting the brush deeper into the anal canal improved the efficiency of anal Pap smears.

Measurement of Amylase in Saliva Collected by Salivette / 대한진단검사의학회지

BACKGROUND: Saliva is increasingly being used as a specimen for systemic disease as well as for oral health status. Especially, salivary amylase has been studied as an excellent index for psychological stress. Authors evaluated the measurement of salivary amylase activities collected by Salivettes (Sarstedt, Germany). METHODS: Saliva specimens were collected from 13 healthy adults between 10:00 and 11:00 a.m. Participants were asked to gently chew tampons of Salivettes for 1 min. Immediately after collection, all specimens were stored frozen. On the day of testing, they were centrifuged after thawing and diluted with distilled water. Amylase was measured by Dimension RxL Max (Dade Behring Inc., USA). We evaluated precision, linearity, and recovery rate of Salivette. Amylase activities between collection of saliva by Salivette and passive drool were compared, and also the changes of amylase by the storage temperature were evaluated. RESULTS: Intra-run CVs for three levels of amylase were excellent. Between-day CVs and total CVs were good only for mid and high levels. A good linear relationship was found at all diluted levels. Dosing Salivettes with 2 mL, 1.5 mL, and 1 mL yielded sample recovery 85.5+/-2.4%, 82.4+/-1.5%, and 72.2+/-3.1%, respectively and amylase recovery 78.9+/-10.9%, 74.1+/-13.7%, and 37.3+/-26.9%, respectively. Amylase by Salivette and passive drool were correlated well (r=0.757), although they showed a significant difference. Amylase activity was not affected by the storage temperature. CONCLUSIONS: Measurement of salivary amylase using Salivette could be a useful test having good intra-run CVs and linearity. More than 1.5 mL of saliva would be needed to have more than 70% recovery of Salivette.

A study for the production of containers used in the diagnosis and prevention of infection.

OBJECTIVES: 1. To study the need of containers used in the diagnosis and prevention of infection. 2. To produce the containers, 3. To test the practicability of the product. MATERIAL AND METHOD: - The study on the need of the containers was done by questionnaires answered by nurses and microbiology laboratory technicians in 56 hospitals. - The containers were produced by the researchers who later had them tested for their practicability by nurses and technicians in the same hospitals. - The study was done during 2002-2004. RESULTS: Fifty-six hospitals were enrolled by stratified random sampling. Questionnaires were responded by 424 nurses and 35 microbiology laboratory technicians. Sputum trap, body fluid and feces containers and needle disposal box were studied and the need for commercial products was 31.1%, 31.1%, 32.3% and 99.5% respectively. Sixteen percent to 58.5% of these containers were bought and 14.3% to 68.6% were home-made. Sputum trap, body fluid and feces containers, and needle disposal boxes were produced and tested by 400 nurses and 32 laboratory technicians. The products were evaluated as satisfactory in 59.4% to 80.0%. The lid of the needle disposal box designed as saw tooth was not convenient for use and was later modified to various slits. The costs of the containers produced were 1.3% to 29.8% of available commercial products. CONCLUSION: Sputum trap, body fluid and feces containers and needle disposal boxes of reasonable prices were needed in Thailand. These containers could be produced locally and were much cheaper than available commercial ones.

Bacterial isolation with on-site inoculation of ascites fluid into hemoculture bottle in spontaneous bacterial peritonitis.

OBJECTIVE: To compare the on-site bacterial inoculation of ascites fluid into hemoculture bottle with routine method in the patients who were preliminary diagnosed of SBP. MATERIAL AND METHOD: A retrospective analysis of case records during January-December 2001. RESULTS: A total of 673 specimens from 325 patients were retrieved from the data records at the Department of Microbiology, Siriraj Hospital in 2001. The neutrocytic ascites were found in 163 specimens (94 patients). The routine method and on-site inoculation into the hemoculture bottle were employed in 107 and 56 specimens respectively. Culture-positive neutrocytic ascites was found in the routine method 16 (14.9%) specimens and in the on-site inoculation 26 (46.4%) specimens (p < 0.0001). Among these samples, the two methods were simultaneously performed in 42 specimens of which 18 paired specimens were eligible for analysis. Positive culture was found in 2 samples in which the routine method and in an additional 5 samples in which on-site inoculation into hemoculture bottle method. Using Kappa analysis (e score = 0.328, 95% CI = -0.172 to 0.829) that can be interpreted the on-site inoculation method had a higher yield than the routine technique. Moreover, 21 cases also had their blood and ascites samples simultaneously collected and cultured. 4 of ten (19%) and 5 of eleven (23.8%) cases were found in the routine and on-site and direct inoculation groups respectively. These finding suggested that the severity of infection in among two groups were similar and unlikely to be the cause of the difference of the positive isolation rate in both groups. CONCLUSION: The on-site and direct inoculation of ascites into hemoculture bottle method had a significantly higher isolation rate than routine method (i.e. 46.4% versus 14.9% p < 0.0001) either with separated or paired samples of ascites.

Detection of Mycobacterium tuberculosis from sputum collected on filter paper and stored at room temperature for 5 days by PCR assay and culture.

The efficacy of PCR assay and culture for direct detection of M. tuberculosis (MTB) from sputum specimens collected on filter paper and stored at room temperature for 5 days was evaluated in comparison with conventional culture of fresh sputum specimen. A total of 231 sputum specimens were examined. MTB was recovered from 124 samples by culture from fresh sputum samples before storage. The culture positivity rate was significantly decreased to 70 per cent after 5 day's storage on filter paper. For PCR assay, a fragment of 377-bp of the IS6110 sequence was amplified and detected using nested PCR. Compared with culture results performed on fresh sputum samples, the sensitivity, specificity, and efficiency for the nested PCR were 96.0, 97.2 and 96.5 per cent, respectively. The nested PCR showed sensitivity and specificity with no significant difference (p>0.05) from culture of fresh sputum specimens. CONCLUSION: The collection and storage of sputum on filter paper at room temperature for 5 days had no apparent effect on the performance of nested PCR. Sputum samples collected by this method could be sent by post in a minimum of space and inexpensive way and will enable a large number of samples collected in the field or from peripheral health centers to be sent to central laboratories for analysis by trained technicians and under a well-equipped and well-established quality control system. The rapid and reliable detection by PCR-based assay will be helpful for optimal patient management of therapy and effective control of tuberculosis.

Dispositivos para colección de saliva de las glándulas salivales mayores: resultados en sujetos normales / Assessment of devices for saliva collection from major salivary glands in groups of individuals

Background: Collection of saliva produced by the major salivary glands may be accomplished either by cannulation of the glandular ducts or by the application of specific collecting devices to the emergence area of the glandular ducts. Those procedures are complex, slow, invasive and require skilled personnel. Aim: To report the design and application of a device to collect parotid saliva (snail collector) and another device to collect saliva from the submandibular/sublingual complex. Material and methods: The saliva collection devices were tested in 40 healthy volunteers (20 male) aged 18 to 22 years old. Saliva was collected using conventional conditions, during 5 to 15 min. Results: An average of 1 to 1.5 ml of saliva was collected in the 10-15 min period from both parotid and submandibular/sublingual glands. Flow rates from parotid glands were 80 µl/min and 180 µl/min from submandibular/sublingual glands. Parotid saliva had a protein and organic material concentration twice as high than saliva from submandibular/sublingual glands. The presence of human a-amylase duplet (Mr 55 kD and 58 kD) predominated in parotid saliva, whereas saliva from submandibular/sublingual glands had other molecular markers such as the lysozyme duplet (Mr 18.5 kD and 17 kD). Conclusions: The tested devices were easily applicable, comfortable and allowed the collection of both parotid saliva and submandibular/sublingual saliva from various subjects at once, under the supervision of a single professional