Microbiological profile of bloodstream infections and antimicrobial resistance patterns at a tertiary referral hospital in Amazon, Brazil

ABSTRACT Background: Bloodstream infections (BSI) are a global health issue, leading to high mortality and morbidity among hospitalized patients. Methods: A retrospective, observational and descriptive study was conducted by reviewing blood culture records collected from patients with suspected BSI, between January 2017 and December 2019. Results: The most frequent antimicrobial resistant (AMR) pathogens were methicillin-resistantStaphylococcus aureus(MRSA) (40%), methicillin-resistantS. epidermidis (MRSE) (9.5%), and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (35.3%). Conclusions: Our findings underscore the importance of continued vigilance and advocate for the rational use of antimicrobial agents.

Increased levels of reactive oxygen species in platelets and platelet-derived microparticles and the risk of respiratory failure in HIV/AIDS patients

Respiratory failure (RF) is the main cause of hospital admission in HIV/AIDS patients. This study assessed comorbidities and laboratory parameters in HIV/AIDS inpatients with RF (N = 58) in relation to those without RF (N = 36). Tuberculosis showed a huge relative risk and platelet counts were slightly higher in HIV/AIDS inpatients with RF. A flow cytometry assay for reactive oxygen species (ROS) showed lower levels in platelets of these patients in relation to the healthy subjects. However, when stimulated with adrenaline, ROS levels increased in platelets and platelet-derived microparticles of HIV/AIDS inpatients, which may increase the risk of RF during HIV and tuberculosis (HIV-TB) coinfection.

Ischemic stroke related to HIV and SARS-COV-2 co-infection: a case report

Abstract A 56-year-old male with human immunodeficiency virus required hospitalization due to the onset of both dyspnea and asthenia. A computed tomography of the chest exam showed the radiological pattern of coronavirus SARS-CoV-2 pulmonary involvement. Based on immunochromatographic analysis, the patient evolved as a reagent for immunoglobulin M (IgM) and immunoglobulin G (IgG) anti-SARS-CoV-2 antibodies. The individual developed complete hemiparesis with a predominance in the right arm and conduction aphasia. T1-weighted magnetic resonance sequence of the brain showed an area of hypointensity with a high intrinsic cortical signal and hyperintensity in the T2-sequence. A Doppler velocimetric examination showed total/critical sub occlusion, suggesting an ischemic stroke.

Analysis of translational errors in frame-based and frameless cranial radiosurgery using an anthropomorphic phantom / Análise dos erros de posicionamento translacionais em radiocirurgia craniana frame e frameless com uso de objeto simulador antropomórfico

Abstract Objective: To evaluate three-dimensional translational setup errors and residual errors in image-guided radiosurgery, comparing frameless and frame-based techniques, using an anthropomorphic phantom. Materials and Methods: We initially used specific phantoms for the calibration and quality control of the image-guided system. For the hidden target test, we used an Alderson Radiation Therapy (ART)-210 anthropomorphic head phantom, into which we inserted four 5mm metal balls to simulate target treatment volumes. Computed tomography images were the taken with the head phantom properly positioned for frameless and frame-based radiosurgery. Results: For the frameless technique, the mean error magnitude was 0.22 ± 0.04 mm for setup errors and 0.14 ± 0.02 mm for residual errors, the combined uncertainty being 0.28 mm and 0.16 mm, respectively. For the frame-based technique, the mean error magnitude was 0.73 ± 0.14 mm for setup errors and 0.31 ± 0.04 mm for residual errors, the combined uncertainty being 1.15 mm and 0.63 mm, respectively. Conclusion: The mean values, standard deviations, and combined uncertainties showed no evidence of a significant differences between the two techniques when the head phantom ART-210 was used.

Resumo Objetivo: Comparar os erros de posicionamento e erros residuais translacionais tridimensionais de uma radiocirurgia guiada por imagem, frame versus frameless, com uso de um objeto simulador antropomórfico. Materiais e Métodos: Para a calibração e qualidade do sistema de imagem foram utilizados objetos simuladores específicos. Para o teste hidden target foi utilizado o crânio do objeto simulador antropomórfico Alderson Radiation Therapy (ART)-210, dentro do qual foram inseridas quatro esferas metálicas de 5 mm de diâmetro como volumes alvos de tratamento. Imagens tomográficas foram realizadas com o ART-210 devidamente posicionado para ambos os métodos de imobilização. Resultados: Para o método frameless, a média foi 0,22 ± 0,04 mm para os erros setup e 0,14 ± 0,02 mm para os erros residuais, apresentando uma incerteza combinada de 0,28 mm e 0,16 mm, respectivamente. Para o método frame, a média foi 0,73 ± 0,14 mm para os erros setup e 0,31 ± 0,04 mm para os erros residuais, apresentando uma incerteza combinada de 1,15 mm e 0,63 mm, respectivamente. Conclusão: Com base nas médias, desvios-padrão e incertezas combinadas, os resultados mostraram não haver evidências de diferença significativa entre as técnicas em questão quando utilizado um objeto simulador antropomórfico craniano ART-210.