RESUMO
PURPOSE: The MAST® D72C test is a phenotypical test which can detect ESBL and AmpC production in Enterobacterales. It can also identify the suspected presence of carbapenemase. The aim of the present study was to assess the sensitivity and specificity of this test and to discuss its usefulness in laboratories, especially those that use only an automated AST system. METHOD: The performance of the MAST® D72C test was assessed against a collection of 119 non-redundant Enterobacterales isolates characterized for their content in ß-lactamases, and compared with that of the reference double disk synergy test. ß-lactamase content was established from phenotypic and genotypic analyses to collect a broad diversity of resistance mechanisms and bacterial strains, including 30 ESBL-producing strains, 32 strains overproducing chromosomal AmpC, 10 strains producing plasmid-encoded AmpC, 12 carbapenemase-producing strains, 13 strains combining the production of several ß-lactamases, and 22 strains that produced other ß-lactamases. RESULTS: The sensitivity and specificity for ESBL-detection were comparable with those of the synergy test, 75 versus 72.5%, and 94.9 versus 93.7%, respectively. The sensitivity and specificity for AmpC-detection were 71.7% and 100%, respectively, and sensitivity reached 78.7% if we excluded carbapenem-resistant isolates. Carbapenemase-detection sensitivity was 90%. CONCLUSION: These results show that the MAST® D72C test can be a useful tool for the detection of ESBL- and AmpC-production in clinical laboratories.
Assuntos
Proteínas de Bactérias , Enterobacteriaceae , Sensibilidade e Especificidade , beta-Lactamases , beta-Lactamases/genética , beta-Lactamases/metabolismo , Proteínas de Bactérias/genética , Humanos , Enterobacteriaceae/enzimologia , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/genética , Testes de Sensibilidade Microbiana/métodos , Infecções por Enterobacteriaceae/microbiologia , Antibacterianos/farmacologiaRESUMO
OBJECTIVE: To compare the prevalence of hot flashes and health education regarding menopause in African-American and white American women in the late reproductive years. DESIGN: Cross-sectional study. SETTING: Population-based sample recruited through random digit dialing. PARTICIPANTS: The sample was 436 women between the ages of 35 and 48 years with regular menses. Half the sample was African American and half was white American. MAIN RESULTS: African-American women (53%) were more likely than white American women (29%) to have experienced hot flashes (p < .001). The difference remained after adjustment for body-mass index, education, menstrual cycle characteristics, and gynecologic and medical history. Despite the high prevalence of symptoms, few women had discussed menopausal management with their physicians. For white women the media were the primary source of menopause-related information, whereas African-American women reported that their family was the primary source of information. CONCLUSIONS: These results indicate that hot flashes occur commonly among women in their thirties and forties who have regular menstrual cycles and that the prevalence of hot flashes appears to differ by race. Studies should be designed to evaluate the hormonal and physiologic implications of these symptoms among women in their late reproductive years. Few of these women had discussed menopause with their physicians. Given the differences in sources of information about menopause, development of culture-specific health education programs should be considered.
Assuntos
População Negra , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Fogachos/etnologia , Menopausa/fisiologia , População Branca , Adulto , Negro ou Afro-Americano , Atitude Frente a Saúde/etnologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Fogachos/fisiopatologia , Humanos , Modelos Logísticos , Anamnese , Pessoa de Meia-Idade , Análise Multivariada , Pennsylvania/epidemiologia , Prevalência , Estudos de AmostragemRESUMO
We present three patients who were admitted to our institution with vertebrobasilar dolichoectasia diagnosed at CT angiography. Two patients had associated intraarterial thrombi and one patient had basilar artery dissection. Shaded surface display images were useful in showing arterial anatomy relative to the skull base. Source images and curved-reformatted images were helpful in diagnosing thrombi and dissection. CT angiography is a minimally invasive means of diagnosing and following up these patients.
Assuntos
Aneurisma/diagnóstico por imagem , Artéria Basilar/diagnóstico por imagem , Angiografia Cerebral , Tomografia Computadorizada por Raios X , Artéria Vertebral/diagnóstico por imagem , Insuficiência Vertebrobasilar/diagnóstico por imagem , Idoso , Dilatação Patológica/diagnóstico por imagem , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Embolia e Trombose Intracraniana/diagnóstico por imagem , Masculino , Pessoa de Meia-IdadeAssuntos
Hospitais Militares , Transtornos Mentais/reabilitação , Militares/psicologia , Equipe de Assistência ao Paciente , Unidade Hospitalar de Psiquiatria , Adulto , Distúrbios de Guerra/psicologia , Distúrbios de Guerra/reabilitação , Terapia Combinada , Feminino , Humanos , Masculino , Transtornos Mentais/psicologiaRESUMO
PIP: Difficulties encountered by foreign workers living in France are described. Consideration is given to the higher rate of unemployment among foreigners, the effect of the drop in industrial employment that occurred between 1983 and 1989, and the predominance of foreigners working in lower-paying service jobs. Social discrimination as a determinant of these differentials is discussed. (SUMMARY IN ENG AND SPA)^ieng
