Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 19 de 19
Filter
1.
Eur J Trauma Emerg Surg ; 49(4): 1909-1916, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37264152

ABSTRACT

PURPOSE: Trauma leagues (TLs) are extracurricular programs that offer medical students supervised exposure to trauma and acute care surgery, mentorship, and participation in other academic activities. TLs are fully approved medical schools, and currently, over 100 TLs exist in Brazil. We hypothesized that the performance/competence of medical students who participated in TLs was superior compared to non-participants. This study evaluated and compared the cognitive performance and technical skills of the two groups. METHODS: This retrospective cohort study evaluated the performance of TL medical students to non-TL alumni from 2005 to 2017, using the students' academic performance coefficient, Clinical Competence Assessment, and Progress Test results. SigmaPlot 12.0 software was used to perform statistical analyses, including Mann-Whitney comparison tests and the Kruskal-Wallis test to confirm the data. RESULTS: Of the 1366 medical students who graduated from a Brazilian university, 966 were included, with 17.9% having participated in TL. Compared to non-TL participants, TL students demonstrated better cognitive performance according to the performance coefficient (p = 0.017) and Progress Test result (p < 0.001), and higher achievement in the Clinical Competence Assessment (p < 0.001). CONCLUSION: The academic performance of TL students was superior to that of non-TL students at the University of Campinas (Unicamp), suggesting a positive impact of TL in the preparation of future doctors. The study findings suggest that participation in TL at Unicamp was beneficial in preparing better doctors and should be considered by medical schools worldwide. EVIDENCE LEVEL: II (Retrospective cohort).


Subject(s)
Students, Medical , Humans , Retrospective Studies , Students, Medical/psychology , Cognition , Brazil , Clinical Competence
2.
Microorganisms ; 12(1)2023 Dec 28.
Article in English | MEDLINE | ID: mdl-38257887

ABSTRACT

Gulls act as intermediaries in the exchange of microorganisms between the environment and human settlements, including Salmonella spp. This study assessed the antimicrobial resistance and molecular profiles of Salmonella spp. isolates obtained from fecal samples of gulls in the city of Porto, Portugal, in 2008 and 2023 and from water samples in 2023. Antimicrobial susceptibility profiling revealed an improvement in the prevalence (71% to 17%) and antimicrobial resistance between the two collection dates. Two isolate collections from both 2008 and 2023 underwent serotyping and whole-genome sequencing, revealing genotypic changes, including an increased frequency in the monophasic variant of S. Typhimurium. qacE was identified in 2008 and 2023 in both water and fecal samples, with most isolates exhibiting an MDR profile. The most frequently observed plasmid types were IncF in 2008 (23%), while IncQ1 predominated in 2023 (43%). Findings suggest that Salmonella spp. circulate between humans, animals, and the environment. However, the genetic heterogeneity among the isolates from the gulls' feces and the surface water may indicate a complex ecological and evolutionary dynamic shaped by changing conditions. The observed improvements are likely due to measures to reduce biological contamination and antimicrobial resistance. Nevertheless, additional strategies must be implemented to reduce the public health risk modeled by the dissemination of pathogens by gulls.

5.
Rev Col Bras Cir ; 45(3): e1710, 2018.
Article in Portuguese, English | MEDLINE | ID: mdl-29924130

ABSTRACT

OBJECTIVE: to compare the students' performance in face-to-face and telemedicine courses for the training and necessary action in disasters, using telemedicine as an effective training tool. METHODS: online research conducted after the end of the course of preparation in disasters, carried out in-person, as well as by videoconference. We compared the performance of students in the in-person course and through telemedicine. RESULTS: in the comparison of the results obtained with the pre- and post-test data between the students who attended via telemedicine and in-person, we observed that in the two modalities there was an increase in knowledge (p<0.001). We also observed no statistically significant differences in the posterior evaluation between the in-person and telemedicine courses (p=1.0), however, there was a significant difference at the pre-test evaluative moment (p<0.001). CONCLUSION: videoconferencing can be effectively used to train health professionals in disaster management, being able to provide adequate knowledge and become an important tool to distance reaching in continuing education.


Subject(s)
Disaster Planning , Telecommunications , Telemedicine/methods , Brazil , Education, Medical/methods , Education, Nursing/methods , Firefighters/education , Humans , Reproducibility of Results , Surveys and Questionnaires
6.
World J Surg ; 42(2): 549-556, 2018 02.
Article in English | MEDLINE | ID: mdl-28913597

ABSTRACT

BACKGROUND: In Brazil, most medical schools do not offer trauma surgery in their undergraduate curriculum. The Trauma Leagues arose in Brazil as an important promoter of trauma education and stimulated activities related to surgical skills and practices. In recent decades, studies have demonstrated that the number of surgical residency applicants has decreased worldwide. Strategies to motivate medical students to choose surgery are needed. OBJECTIVE: To evaluate the impact of participation in the Unicamp Trauma League (UTL) during a 20-year period in the choice for a surgical career. METHODS: The study included 276 students in a Brazilian university hospital who were part of the Trauma League. Research of records in universities and medical societies about the specialties chosen during residency were evaluated. A Likert questionnaire was sent to participants to evaluate the impact of participating in the Trauma League in the student's professional career. RESULTS: The questionnaire was answered by 76% of the participants. Of those, 38.4% chose general surgery. About 55.1% did not know what medical career to choose when joined the league. Participation in the league had an influence on specialty choice in 79.1% of the students. Of those choosing surgery, 93.2% believed that participating in the league had positively influenced their career choice. Overall, 93.1% believed that participating in the league provided knowledge and information that the medical school curriculum was not able to provide. CONCLUSION: Participation in Trauma League has been an effective strategy to encourage medical students to choose a career in general surgery in Campinas, Brazil.


Subject(s)
Career Choice , Societies, Medical , Students, Medical/psychology , Traumatology , Adult , Brazil , Cross-Sectional Studies , Curriculum , Female , Hospitals, University , Humans , Internship and Residency/statistics & numerical data , Male , Surveys and Questionnaires
7.
Rev. Col. Bras. Cir ; 45(3): e1710, 2018. tab, graf
Article in English | LILACS | ID: biblio-956560

ABSTRACT

ABSTRACT Objective: to compare the students' performance in face-to-face and telemedicine courses for the training and necessary action in disasters, using telemedicine as an effective training tool. Methods: online research conducted after the end of the course of preparation in disasters, carried out in-person, as well as by videoconference. We compared the performance of students in the in-person course and through telemedicine. Results: in the comparison of the results obtained with the pre- and post-test data between the students who attended via telemedicine and in-person, we observed that in the two modalities there was an increase in knowledge (p<0.001). We also observed no statistically significant differences in the posterior evaluation between the in-person and telemedicine courses (p=1.0), however, there was a significant difference at the pre-test evaluative moment (p<0.001). Conclusion: videoconferencing can be effectively used to train health professionals in disaster management, being able to provide adequate knowledge and become an important tool to distance reaching in continuing education.


RESUMO Objetivo: comparar o desempenho dos alunos nos cursos presenciais e via telemedicina para a capacitação e atuação necessária em desastres, se valendo da telemedicina como uma ferramenta efetiva de treinamento. Métodos: pesquisa online realizada após o término do curso de preparação em desastres, realizado presencialmente, bem como, por videoconferência. Comparou-se o desempenho dos alunos do curso presencial e via telemedicina. Resultados: na comparação dos resultados obtidos com os dados pré e pós-teste entre os alunos que cursaram via telemedicina e presencialmente, observou-se que nas duas modalidades do curso houve aumento do conhecimento (p<0,001). Constatou-se ainda que não houve diferenças estatisticamente significativas na avaliação posterior entre os cursos presenciais e via telemedicina (p=1,0), no entanto, houve diferença com significância no momento avaliativo pré-teste (p<0,001). Conclusão: as videoconferências podem ser utilizadas de forma efetiva para a capacitação de profissionais da área de saúde na gestão de desastres, sendo capaz de prover o conhecimento de forma adequada e ser ferramenta importante para alcance à distância em educação continuada.


Subject(s)
Humans , Telecommunications , Telemedicine/methods , Disaster Planning , Brazil , Surveys and Questionnaires , Reproducibility of Results , Firefighters/education , Education, Medical/methods , Education, Nursing/methods
8.
J Zoo Wildl Med ; 46(4): 723-31, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26667528

ABSTRACT

The presence of multidrug-resistant (MDR) Escherichia coli has recently been reported in wild birds (gulls and birds of prey) that had no apparent exposure to antimicrobials. Little work has been done to assess the role of the food chain in the emergence and spread of MDR E. coli . In this study, we evaluated the presence of MDR E. coli in 29 fecal samples collected from wild birds living in a rehabilitation center (the center receives injured animals found in their natural habitat) and in eight feed samples. In total, 166 E. coli isolates were obtained: 129 from cloacal swabs and 37 from raw feed samples. The antimicrobial resistance profile of these isolates was determined, and we found that 75 isolates showed resistance to five or more drugs, resulting in a total of 38 different antimicrobial resistance patterns. Subsequently, the molecular characterization of 36 isolates, performed by pulsed-field gel electrophoresis, revealed a great similarity between isolates collected from various species of birds and also between these last ones and the ones found in their feed samples.


Subject(s)
Anti-Bacterial Agents/pharmacology , Birds/microbiology , Drug Resistance, Multiple, Bacterial , Escherichia coli Infections/veterinary , Escherichia coli/drug effects , Food Chain , Animals , Animals, Wild , Escherichia coli Infections/microbiology , Fishes/microbiology , Mice , Rabbits
9.
Rev Col Bras Cir ; 41(4): 297-302, 2014.
Article in English, Portuguese | MEDLINE | ID: mdl-25295993

ABSTRACT

OBJECTIVE: to compare the knowledge of medical students between those who are members of the Trauma League (TL) and those from a non-Trauma League (NTL) group of the Federal University of Espírito Santo (UFES). METHODS: cross-sectional, analytical and descriptive study. Two knowledge tests, with 30 questions each, were applied to students from 3rd to 12th period, randomly selecting five students per period, with 50 students in the TL group and 50 in NTL. The questionnaire topics were: pre-hospital care, the mnemonic ABCDE trauma sequence, advanced trauma and imaging. The students' performances were evaluated by graduation-period group: basic (3rd-5th period), intermediary/clinical (6th-8th) and internship (9th-12th). RESULTS: in the first test the average accuracy of the TL group was 20.64 ± 3.17, while for the NTL group, it was 14.76 ± 5.28 (p<0.005). In the second test the average accuracy for the TL group was 21.52 ± 3.64, while for the NTL group, the average was 15.36 ± 29.5 (p<0.005). When divided into graduation periods, it was observed that the TL group showed a higher average across all three groups (p<0.05) in both tests. CONCLUSION: the students who attended the academic league activities have greater knowledge of the issues that are considered relevant to patient trauma care. In all periods of undergraduate academic training, the TL group had greater knowledge of the subject than the NTL group.


Subject(s)
Education, Medical, Undergraduate/methods , Traumatology/education , Brazil , Clinical Competence , Cross-Sectional Studies , Humans
10.
Rev. Col. Bras. Cir ; 41(4): 297-302, Jul-Aug/2014. tab, graf
Article in English | LILACS | ID: lil-724106

ABSTRACT

OBJECTIVE: to compare the knowledge of medical students between those who are members of the Trauma League (TL) and those from a non-Trauma League (NTL) group of the Federal University of Espírito Santo (UFES). METHODS: cross-sectional, analytical and descriptive study. Two knowledge tests, with 30 questions each, were applied to students from 3rd to 12th period, randomly selecting five students per period, with 50 students in the TL group and 50 in NTL. The questionnaire topics were: pre-hospital care, the mnemonic ABCDE trauma sequence, advanced trauma and imaging. The students' performances were evaluated by graduation-period group: basic (3rd-5th period), intermediary/clinical (6th-8th) and internship (9th-12th). RESULTS: in the first test the average accuracy of the TL group was 20.64 ± 3.17, while for the NTL group, it was 14.76 ± 5.28 (p<0.005). In the second test the average accuracy for the TL group was 21.52 ± 3.64, while for the NTL group, the average was 15.36 ± 29.5 (p<0.005). When divided into graduation periods, it was observed that the TL group showed a higher average across all three groups (p<0.05) in both tests. CONCLUSION: the students who attended the academic league activities have greater knowledge of the issues that are considered relevant to patient trauma care. In all periods of undergraduate academic training, the TL group had greater knowledge of the subject than the NTL group. .


OBJETIVO: comparar o conhecimento dos estudantes de Medicina da Liga do Trauma (LT) com os alunos Não Ligantes do Trauma (NLT), sobre os temas do atendimento ao trauma que os acadêmicos possuem maior domínio, avaliando a performance do conhecimento dos dois grupos. MÉTODOS: estudo transversal, analítico, descritivo. Aplicou-se teste de conhecimento para os alunos do terceiro ao 12º período. Desses, foram sorteados cinco acadêmicos de cada período, constituindo dois grupos: 50 no LT e 50 no NLT. Foram aplicados dois testes contento 30 questões para cada prova com os temas: atendimento pré-hospitalar, sequência mnemônica ABCDE do trauma, condutas avançadas e imagem no trauma. Avaliou-se a performance dos estudantes por grupo de períodos da graduação: cadeira básica (3º - 5º período), clínica (6º -8º) e internato (9º - 12º). RESULTADOS: no primeiro teste, a média de acertos do grupo LT foi 20,64±3,17 e 14,76± 5,28 no NLT (p<0,005). No segundo teste, a média do LT foi 21,52±3,64 e 15,36±5,29 no NLT (p<0,005). O grupo LT teve maior média de acerto nas três cadeiras da graduação (p<0,05), nos dois testes. CONCLUSÃO: o grupo LT teve maior média de acerto em relação ao NLT e melhor aproveitamento dos temas estudados em todas as fases do curso médico. .


Subject(s)
Humans , Education, Medical, Undergraduate/methods , Traumatology/education , Brazil , Clinical Competence , Cross-Sectional Studies
11.
Rev. Col. Bras. Cir ; 40(5): 370-373, set.-out. 2013. graf
Article in Portuguese | LILACS | ID: lil-698072

ABSTRACT

OBJETIVO: analisar os resultados da herniorrafia inguinal bilateral pela técnica de Lichtenstein. MÉTODOS: estudo dos prontuários de 59 pacientes submetidos à herniorrafia inguinal bilateral simultânea, eletiva, no período entre 2003 e 2007. Foram analisados: sexo, idade, peso, tempo operatório, tempo total de internação, classificação de Nyhus, intercorrências no pós-operatório imediato e tardio, e recidiva. Esses dados foram submetidos à análise estatística descritiva. RESULTADOS: dos 59 pacientes, 95% eram homens; e 5%, mulheres. A idade variou de 40 a 60 anos, o peso de 50 a 103 kg, o tempo operatório de 60 a 180 minutos, o tempo de internação de um a seis dias. Trinta pacientes apresentavam hérnias do tipo IIIB; nove, do tipo II; dez, do tipo IIIA; sete, do tipo IV; um, do tipo II à esquerda e tipo IIIB à direita; um, tipo IIIA à direita e IIIB à esquerda; e um, do tipo IIIA à direita e do tipo II à esquerda. No pós-operatório imediato, a dor foi a manifestação mais importante em 30,5% dos casos. Em 94,92% dos casos, não houve complicações tardias. Ocorreram dois casos de inguinodinia e um de dor em queimação local. Observou-se uma recidiva, no 29º mês de pós-operatório. CONCLUSÕES: a herniorrafia inguinal bilateral simultânea pela técnica de Lichtenstein foi segura e eficaz, pois houve baixo índice de complicações, curta permanência hospitalar e, em um período médio de 48 meses de acompanhamento, houve apenas um caso de recidiva.


OBJECTIVE: To analyze the results of bilateral inguinal hernia repairs by the Lichtenstein technique. METHODS: We studied the charts of 59 patients who underwent elective simultaneous bilateral inguinal hernia repair between 2003 and 2007. We analyzed: gender, age, weight, operative time, length of hospital stay, Nyhus classification, complications in the immediate and late postoperative periods, and recurrence. These data were submitted to descriptive statistical analysis. RESULTS: Of the 59 patients, 95% were men. Age ranged from 40 to 60 years; weight, from 50 to 103 kg; operative time, from 60 to 80 minutes; and the length of stay, from one to six days. Thirty patients had type IIIB hernias; nine, type II; ten, type IIIA; seven, type IV; one, type II on the left and type IIIB on the right; one, type IIIA on the right and IIIB on the left; and one, type IIIA on the right and type II on the left. In the immediate postoperative period, pain was the most important manifestation, in 30.5% of subjects. In 94.92% of cases there were no complications. There were two cases of inguinodinia and one of burning pain in the surgical site. There was one recurrence 29 months after the procedure. CONCLUSIONS: Simultaneous bilateral inguinal hernia repair by Lichtenstein technique was safe and effective, with a low rate of complications, short hospital stay, and only one case of recurrence at an average of 48 months follow-up.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Hernia, Inguinal/surgery , Herniorrhaphy/methods , Hernia, Inguinal/pathology , Herniorrhaphy/adverse effects
12.
J Environ Health ; 75(6): 74-81, 2013.
Article in English | MEDLINE | ID: mdl-23397653

ABSTRACT

The objective of the study described in this article was to characterize the antimicrobial resistance profiles among E. coli strains isolated from cohabitant pets and humans, evaluating the concurrent colonization of pets, owners, and home surfaces by bacteria carrying the same antimicrobial-resistant genes. The authors also intended to assess whether household surfaces and objects could contribute to the within-household antimicrobial-resistant gene diffusion between human and animal cohabitants. A total of 124 E. coli strains were isolated displaying 24 different phenotypic patterns with a remarkable percentage of multiresistant ones. The same resistance patterns were isolated from the dog's urine, mouth, the laundry floor, the refrigerator door, and the dog's food bowl. Some other multiresistant phenotypes, as long as resistant genes, were found repeatedly in different inhabitants and surfaces of the house. Direct, close contact between all the cohabitants and the touch of contaminated household surfaces and objects could be an explanation for these observations.


Subject(s)
Drug Resistance, Bacterial/genetics , Drug Resistance, Multiple/genetics , Equipment Contamination , Escherichia coli Infections/transmission , Escherichia coli/drug effects , Pets/microbiology , Animals , Cats/microbiology , Child, Preschool , Dogs/microbiology , Escherichia coli/genetics , Escherichia coli Infections/veterinary , Female , Genotype , Humans , Male , Microbial Sensitivity Tests , Phenotype , Portugal , Recurrence , Urinary Tract Infections/transmission , Urinary Tract Infections/veterinary
13.
Rev Col Bras Cir ; 40(5): 370-3, 2013.
Article in English, Portuguese | MEDLINE | ID: mdl-24573584

ABSTRACT

OBJECTIVE: To analyze the results of bilateral inguinal hernia repairs by the Lichtenstein technique. METHODS: We studied the charts of 59 patients who underwent elective simultaneous bilateral inguinal hernia repair between 2003 and 2007. We analyzed: gender, age, weight, operative time, length of hospital stay, Nyhus classification, complications in the immediate and late postoperative periods, and recurrence. These data were submitted to descriptive statistical analysis. RESULTS: Of the 59 patients, 95% were men. Age ranged from 40 to 60 years; weight, from 50 to 103 kg; operative time, from 60 to 80 minutes; and the length of stay, from one to six days. Thirty patients had type IIIB hernias; nine, type II; ten, type IIIA; seven, type IV; one, type II on the left and type IIIB on the right; one, type IIIA on the right and IIIB on the left; and one, type IIIA on the right and type II on the left. In the immediate postoperative period, pain was the most important manifestation, in 30.5% of subjects. In 94.92% of cases there were no complications. There were two cases of inguinodinia and one of burning pain in the surgical site. There was one recurrence 29 months after the procedure. CONCLUSIONS: Simultaneous bilateral inguinal hernia repair by Lichtenstein technique was safe and effective, with a low rate of complications, short hospital stay, and only one case of recurrence at an average of 48 months follow-up.


Subject(s)
Hernia, Inguinal/surgery , Herniorrhaphy/methods , Adult , Female , Hernia, Inguinal/pathology , Herniorrhaphy/adverse effects , Humans , Male , Middle Aged
14.
Rev Col Bras Cir ; 39(3): 230-7, 2012.
Article in Portuguese | MEDLINE | ID: mdl-22836574

ABSTRACT

OBJECTIVE: To assess the quality of prehospital care agencies conducted in Vitória, capital of Espírito Santo State, Brazil. METHODS: We conducted a retrospective study in the archives of the League of Academic Surgery and Trauma Care of Espírito Santo (Lacates) regarding 40 victims of a simulated crash between a bus and two cars. The patients were treated by four teams: Military Fire Department of Espírito Santo, Samu 192, County Guard and Civil Defense. The performance of these teams was evaluated by Lacates, through analysis of a check-list with pre-established guidelines for each victim. RESULT: The Fire Department of Espírito Santo (CBMES), which extricated victims, outlined the danger zones and carried out the screening by the method START, acted correctly in 92.5% of cases. The Samu 192 victims, which attended victims by the mnemonic method (ABCDE) in medical outposts, acted correctly in 92.5% of cases in the category Airway; 97.5% in breathing, 92.5% in circulation, 90% in Neurological Assessment, and 50% in the Exhibition and Environmental Control. The analysis showed that the ABCDE care was correct in 42.5% of cases. The transport of patients was performed correctly in 95% of cases. The County Guard secured the patency of the avenues for transportation of patients and Civil Defense successfully coordinated the work of teams involved in the command post. CONCLUSION: The triage and transport of victims have been performed satisfactorily. However, more attention should be given to exposure and hypothermia protection of victims, since this item compromised treatment.


Subject(s)
Emergency Medical Services/standards , Quality of Health Care , Wounds and Injuries/therapy , Humans , Patient Simulation , Retrospective Studies
15.
Rev. Col. Bras. Cir ; 39(3): 230-237, maio-jun. 2012. ilus
Article in Portuguese | LILACS | ID: lil-643154

ABSTRACT

OBJETIVO: Analisar a qualidade do atendimento pré-hospitalar realizado pelas agências em Vitória-ES. MÉTODOS: Estudo retrospectivo realizado nos arquivos da Liga Acadêmica de Cirurgia e Atendimento ao Trauma do Espírito Santo (Lacates) dos dados de 40 vítimas de um acidente simulado entre um ônibus e dois automóveis. Os pacientes foram assistidos por quatro equipes: Corpo de Bombeiro Militar do Espírito Santo, Samu 192, Guarda Municipal e Defesa Civil. A atuação dessas equipes foi avaliada pela Lacates, através da análise do check-list com orientações pré-estabelecidas para cada vítima. RESULTADO: O Corpo de Bombeiros Militar do Espírito Santo (CBMES), que desencarcerou as vítimas, delimitou as zonas de perigo e realizou a triagem pelo método START atuou corretamente em 92,5% dos casos. O Samu 192 que atendeu as vítimas pelo método mnemônico (ABCDE) no posto médico avançado agiu corretamente em 92,5% dos casos, no quesito Via Aérea; 97,5%, no Respiração; 92,5%, no Circulação; 90%, no Avaliação Neurológica; e 50%, no Exposição e Controle do Ambiente. A análise conjunta do ABCDE mostrou que o atendimento foi correto em 42,5% dos casos. O transporte dos pacientes foi realizado corretamente em 95% dos casos. A Guarda Municipal garantiu a perviedade das avenidas para transporte dos pacientes, e a Defesa Civil coordenou eficazmente o trabalho das equipes envolvidas no posto de comando. CONCLUSÃO: A triagem e o transporte foram executados satisfatoriamente, entretanto, maior atenção deve ser dada à exposição e proteção contra hipotermia das vítimas, já que esse item comprometeu o tratamento.


OBJECTIVE: To assess the quality of prehospital care agencies conducted in Vitória, capital of Espírito Santo State, Brazil. METHODS: We conducted a retrospective study in the archives of the League of Academic Surgery and Trauma Care of Espírito Santo (Lacates) regarding 40 victims of a simulated crash between a bus and two cars. The patients were treated by four teams: Military Fire Department of Espírito Santo, Samu 192, County Guard and Civil Defense. The performance of these teams was evaluated by Lacates, through analysis of a check-list with pre-established guidelines for each victim. RESULT: The Fire Department of Espírito Santo (CBMES), which extricated victims, outlined the danger zones and carried out the screening by the method START, acted correctly in 92.5% of cases. The Samu 192 victims, which attended victims by the mnemonic method (ABCDE) in medical outposts, acted correctly in 92.5% of cases in the category Airway; 97.5% in breathing, 92.5% in circulation, 90% in Neurological Assessment, and 50% in the Exhibition and Environmental Control. The analysis showed that the ABCDE care was correct in 42.5% of cases. The transport of patients was performed correctly in 95% of cases. The County Guard secured the patency of the avenues for transportation of patients and Civil Defense successfully coordinated the work of teams involved in the command post. CONCLUSION: The triage and transport of victims have been performed satisfactorily. However, more attention should be given to exposure and hypothermia protection of victims, since this item compromised treatment.


Subject(s)
Humans , Emergency Medical Services/standards , Quality of Health Care , Wounds and Injuries/therapy , Patient Simulation , Retrospective Studies
17.
PLoS One ; 6(3): e17630, 2011 Mar 02.
Article in English | MEDLINE | ID: mdl-21407807

ABSTRACT

BACKGROUND: The nosocomial prevalence of methicillin resistant Staphylococcus aureus (MRSA) in Portugal remains one of the highest in Europe and is currently around 50%. Transmission of S. aureus, including MRSA, occurs principally by direct human-to-human skin contact. However, S. aureus can survive for long periods on inanimate objects, which may represent an important reservoir for dissemination as well. METHODOLOGY/PRINCIPAL FINDINGS: Between May 2009 and February 2010, handrails of 85 public urban buses circulating in Oporto, Portugal, were screened for the occurrence of MRSA. Twenty-two (26%) buses showed MRSA contamination. The molecular characterization of a total of 55 MRSA, by pulsed-field gel electrophoresis (PFGE), staphylococcal cassette chromosome (SCC) mec typing, spa typing, and multilocus sequence typing (MLST), clustered the isolates into three clonal types. However, the overwhelming majority (n = 50; 91%) of the isolates belonged to a single clone (PFGE A, spa types t747, t032, t025 or t020, ST22, SCCmec type IVh) that exhibits the characteristics of the pandemic EMRSA-15, currently the major lineage circulating in Portuguese hospitals, namely in the Oporto region. Two additional clones were found but in much lower numbers: (i) PFGE B, ST5, spa type t002, SCCmec IVa (n = 3), and (ii) PFGE C, spa type t008, ST8, SCCmec IVa (n = 2). None of the 55 isolates was PVL positive. CONCLUSIONS/SIGNIFICANCE: Public buses in Oporto seem to be an important reservoir of MRSA of nosocomial origin, providing evidence that the major hospital-associated MRSA clone in Portugal is escaping from the primary ecological niche of hospitals to the community environment. Infection control measures are urgently warranted to limit the spread of EMRSA-15 to the general population and future studies are required to assess the eventual increase of MRSA in the Portuguese community, which so far remains low.


Subject(s)
Methicillin-Resistant Staphylococcus aureus/isolation & purification , Motor Vehicles , Clone Cells , Electrophoresis, Gel, Pulsed-Field , Humans , Pandemics , Portugal/epidemiology , Prevalence , Staphylococcal Infections/epidemiology
18.
Appl Environ Microbiol ; 76(12): 4118-20, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20418435

ABSTRACT

Extended-spectrum beta-lactamase-containing Escherichia coli isolates were detected in 32 of 119 fecal samples (26.9%) from birds of prey at Serra da Estrela, and these isolates contained the following beta-lactamases: CTX-M-1 (n = 13), CTX-M-1 plus TEM-1 (n = 14), CTX-M-1 plus TEM-20 (n = 1), SHV-5 (n = 1), SHV-5 plus TEM-1 (n = 2), and TEM-20 (n = 1).


Subject(s)
Bird Diseases/microbiology , Escherichia coli Infections/veterinary , Escherichia coli Proteins/genetics , Escherichia coli/enzymology , beta-Lactamases/genetics , Animals , Escherichia coli/genetics , Escherichia coli/isolation & purification , Escherichia coli Infections/microbiology , Feces/microbiology , Portugal , Raptors
19.
Emerg Infect Dis ; 16(1): 110-2, 2010 Jan.
Article in English | MEDLINE | ID: mdl-20031053

ABSTRACT

A variety of extended-spectrum Beta-lactamase-producing Escherichia coli isolates, with a high rate of cefotaximase-15 resistance, were identified in seagull feces from Porto, Portugal, beaches. Beaches may therefore present a risk to public health because of the potential pathogen-spreading capacity of migratory birds.


Subject(s)
Bathing Beaches , Charadriiformes/microbiology , Disease Reservoirs/microbiology , Escherichia coli/drug effects , Animals , Drug Resistance, Multiple, Bacterial , Escherichia coli/genetics , Escherichia coli Infections/drug therapy , Escherichia coli Infections/epidemiology , Escherichia coli Infections/etiology , Feces/microbiology , Genotype , Humans , Microbial Sensitivity Tests , Phylogeny , Portugal/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL
...