RESUMO

BACKGROUND: Gastrointestinal endoscopic procedures (GIEP's) are an essential part of patient care both diagnostically and therapeutically. Post-GIEP infections may be higher than previously reported and may not have been accurately captured in the past. The aim of this study was to determine the incidence and associated factors of bacteremia associated with GIEP's. METHODS: This is retrospective study of GIEPs performed over a five-year period (2018-2022) at an academic medical center. Electronic health records (EHR) identified GIEPs and positive blood cultures within 30 days of procedure. Statistical analysis was performed using non-parametric testing to compare variables due to the small number of positive blood cultures. RESULTS: EHR identified 18,986 GIEP's and 52 true and unique bacteremia out of 17,093 blood cultures during the five-year study period. The highest rate of positive blood culture of 2.84% (18/ 634) was associated with ERCP and the lowest 0.08% (7/ 9029) was associated with colonoscopy. DISCUSSION: Our study showed a reflection of the endemic rate of bacteremia post GIEP's. Our study cannot differentiate endogenous infection versus contaminated (exogenous) endoscopes. ERCP procedures are disproportionately associated with higher incidence of bacteremia. CONCLUSIONS: Clinical surveillance in non-outbreak settings is essential for estimating GIEP related infections. It should be combined with endoscopic reprocessing audits for appropriate prevention of GIEP associated infections.

Assuntos

RESUMO

Industrial egg residue (IER) possesses substantial concentrations of calcium and crude protein. The objective of this study was to measure the digestibility and performance of broilers when IER was added to the feed. Four treatments were tested, which caused increasing replacement of calcitic limestone by IER (0, 35, 70 and 100%) during a 42-day production cycle. First, total bird excreta were collected from broilers with and without IER, and we determined dry matter digestibility, apparent metabolizable energy (AME), calcium, and nitrogen retention. The IER presented 7.5% of crude protein, 31% of calcium, 209 kcal/kg of AME and the digestibility coefficients for dry matter, crude protein, and calcium were calculated at 83.95%, 86.20%, and 67%, respectively. After the digestibility test, the effects of IER on performance, carcass and meat yield were evaluated. No significant differences between the treatments were found in terms of performance (weight gain, feed conversion, consumption, and mortality), and no differences were found in terms of carcass or meat yield. A linear decrease in the percentage of abdominal fat was observed with increasing inclusion of IER in feed. These findings suggest that IER can totally replace limestone (calcium carbonate) in broiler diets.

Assuntos

RESUMO

Resumo A emergência da pandemia ocasionada pela covid-19 impôs modelos de cuidados preventivos, por meio de ações adotadas para evitar o agravamento da disseminação viral. Dentre essas medidas, o isolamento físico proposto pela Organização Mundial de Saúde (OMS) foi o que certamente trouxe maiores repercussões e ressignificações para as diferentes dimensões da vida social. Atividades habituais, como ir à escola passaram, a ser incorporadas ao ambiente domiciliar, reorganizando práticas tradicionais já estabelecidas socialmente. Este estudo qualitativo objetiva descrever as experiências das mães e identificar quais os principais desafios em relação ao acompanhamento das atividades escolares de seus filhos durante as aulas não presenciais. Para esta finalidade, foram realizadas entrevistas por meio telefônico. Os relatos foram divididos em três categorias temáticas a respeito do ensino remoto-domiciliar, na qual a primeira mostra as adaptações para o novo modelo de ensino, a segunda categoria abarca as diferentes experiências e a terceira aborda as dificuldades de acesso aos equipamentos e conexões. Por meio dos relatos, nota-se o quanto se torna complexa a experiência dessa modalidade de ensino quando associada à sobrecarga de afazeres domésticos e profissionais das participantes dentro de seus lares. Esta queixa é mais intensa entre as participantes que exercem profissão remunerada.

Abstract The pandemic caused by COVID-19 imposed models of preventive care through a series of measures aimed to avoid the virus spread. Among them, the physical isolation proposed by the World Health Organization (WHO) was the one that certainly had the greatest repercussions and resignifications to the different dimensions of social life, forcing the reorganization and incorporation of traditional practices into the domestic environment, such as studying at school. This qualitative study aims to describe the experiences and identify the main challenges faced by mothers in monitoring their children's school activities during non-presential classes. Data were collected by means of telephone interviews and divided into three thematic categories regarding the home-remote teaching: the first category shows the adaptations for distance learning, the second addresses participants' different experiences with this learning modality, and the third reports the difficulties in accessing equipment and internet connections. The reports evince the complexity of this teaching modality when associated with mothers' domestic and professional overload, especially for participants with a paid occupation.

Assuntos

RESUMO

The objective of this study was to evaluate whether the addition of a blend based on α-monolaurin mono-, di- and triglycerides of butyric acid, and lysolecithin on the performance even on diets containing reduced inclusion of oil in the diet and without the use of growth-promoting antibiotics of broilers considering the effect on health, performance, and meat. Three treatments were defined: positive control (TP: with enramycin), negative control (TN: no enramycin), and blend (T-FRA: with monolaurin and glycerides of acid butyric minus 0.8% soybean oil). At 21 days, broilers treated with TP and T-FRA obtained the lower feed conversion ratio (FC); at 35 days, T-FRA broilers obtained lower FC than TN broilers. Cholesterol levels were higher in the blood of T-FRA broilers. On day 42, levels of ROS and TBARS were lower in the intestine, muscles, and liver of T-FRA broilers. Moreover, glutathione S-transferase and total non-enzymatic antioxidants were greater at the intestinal and muscular levels. The T-FRA broilers had a lower percentage of lipids in the meat. The MIC indicated that 111mg of the blend/mL inhibited the growth of E. coli; however, the counts of total coliforms and E. coli in the feces and the broilers' litter did not differ between treatments. In conclusion, the addition of the blend T-FRA in broiler diets was able to improve the feed conversion and maintain the other performance parameters even considering a reduction of 0.8% in the inclusion of oil.

Assuntos

RESUMO

This study aimed to determine whether the addition of green propolis extract to the diet of laying hens would improve egg quality and bird performance and decrease bacterial contamination of eggs. Forty-five brown Hy-line laying hens were used, divided into five groups with three replicates each and three animals per cage: T0 - diet without propolis; T5 - 5 grams of propolis per kg of feed; T10 - 10 grams of propolis per kg of feed; T20 - 20 grams of propolis per kg of feed and T30 - 30 grams of propolis per kg of feed. The quality of fresh eggs was made on day 21 of the experiment, and eggs were stored for 21 days. Greater specific gravity was observed in fresh eggs in T5 birds and stored eggs for T10. TBARS in fresh eggs, we found that T30 eggs had lower levels compared to other treatments. T20 eggs had the lowest total bacterial count and the lowest total coliform count in the eggshells of T10 and T20 chickens. The count of E. coli in the peel was lower for T20 and T30 than T0 and T5. The consumption of propolis did not interfere with the hens' egg production rate but reduced food intake and consequently reduced feed conversion. We concluded that the addition of green propolis in the diet of laying birds proved efficient in reducing bacterial contamination in the eggshells and reducing the lipid peroxidation of fresh and stored eggs.

Assuntos

RESUMO

INTRODUCTION: To facilitate the command to the learner, therapist can use verbal cues for guidance: internal focus (own body) and external focus (consequence of movement in the environment). OBJECTIVE: To examine the effects of different attentional focus on upper limb motor performance in post-stroke. METHODS: Randomized controlled trial with 2 groups. Study realized at Integrated Clinic of the Faculty of Health Science at Trairi (Santa Cruz, Rio Grande do Norte, Brazil). Twelve participants allocated into 2 groups. Two motor tasks were used: task 1, reach-point; task 2, reach-grasp-fit, with the paretic extremity, using verbal commands directed by a trained therapist. In the first phase, Group 1 received commands with internal focus, while Group 2 was instructed with commands with external focus. After 1 week, the command type was changed between groups. The variables collected was movement time, velocity and number of peaks velocity. RESULTS: Both attentional focus promoted significant differences in movement time and velocity, however, only Internal Focus provided significant results in both tasks of the same variables. DISCUSSION: The benefits of 1 attentional focus on the other are not fully confirmed. However, not receiving any kind of attention guidance compromises motor performance. The results support the hypothesis that the benefits of the External Focus are accentuated when preceded by the Internal Focus. CLINICAL TRIAL REGISTRATION: Research Ethics Committee of the Faculty of Helth Science at Trairi (Facisa - UFRN)- Number CAAE 2.625.609, approved on April 13, 2018; Brazilian Registry of Clinical Trials - RBR-4995cr approved on July 4, 2019 retrospectively registered (http://www.ensaiosclinicos.gov.br/rg/RBR-4995cr/).

Assuntos

RESUMO

Colibacillosis is a disease caused by Escherichia coli that manifests itself when there are homeostatic imbalances or in the context of increased exposure, in which case the organism displays opportunistic behavior. To control this problem in poultry, antibiotics are used in the feed, because E. coli is component of the intestinal microbiota of birds. However, because of the changing dietary habits of the human population that seeks out healthier foods without antimicrobial residues, there have been many studies of alternatives to replace conventional antimicrobials as performance enhancers. Thus, the objective of the present study was to determine whether daily consumption of a homeopathic product (immune stimulator) by broilers stimulates immune responses and thereby minimizes the negative effects of experimental E. coli infection. We used 320 1-day-old Cobb 500 chicks, distributed in two groups with eight repetitions each, and 20 birds per repetition: control (CG) and homeopathy (HG). HG birds consumed doses of 0.02 mL/bird/day (1-7 d) via water, 0.01 ml/bird (8-21 d), 0.02 ml/bird (22-28 d), 0.01 mL/bird (29-35 d), and 0.02 mL/bird (35-45 d), as recommended by the manufacturer. At day 22 of the birds' life, the two groups were divided into four subgroups, with four repetitions per subgroup. On day 22, birds in CG1 and HG1 groups were infected intraperitoneally with 0.5 mL of inoculum containing 1.0 × 108 CFU of E. coli/mL. During the experimental period, data were collected for analysis of performance. On days 21 and 45 of age, we collected blood and feces. During the first 21 days of the experiment, we found that birds that consumed the immunostimulator had lower neutrophil counts and higher levels of globulins, however without significant difference between groups in terms of performance. Uninfected birds that consumed the homeopathic product in the water had less feed conversion (HG2) between days 1-35 and 1 to 45 compared to the other treatments. Mortality was higher in groups experimentally infected with E. coli (HG1 and CG1) from 22 to 35 days of life. There were greater numbers of lymphocytes in the HG2 group on day 45 than in CG1 and CG2; while numbers of neutrophils were lower at 42 days in birds of groups HG1 and HG2 than in CG1. Lower total bacterial counts, total coliforms and E. coli were observed in the feces of birds in the HG2 group compared to the other groups. Taken together, these findings suggest that inclusion of homeopathic product in the water of broilers had positive effects on the modulation of the immune response and on feed conversion in birds not challenged with E. coli. But the preventive protocol used in this study was not able to minimize the negative effects caused by the experimental E. coli intraperitoneal infection in broilers, featuring a substantial infectious challenge.

Assuntos

RESUMO

Escherichia coli is a bacterium normally found in the gastrointestinal tract of domestic animals that can usually control the infection. Nevertheless, some factors (high exposure, stress conditions, animal category, among others) can favor the exacerbation of E. coli infection and cause of disease. Because it is a zoonotic bacterium, it is important to control the infection, avoiding contamination of home interiors in the case of pets. There are various forms of treatment for E. coli; nevertheless, there are few options for prevention. In the present study, we evaluated homeopathy. Thus, the objective of this study was to determine whether administration of a prophylactic homeopathic in water would minimize the negative effects of E. coli infection, as well as reducing bacterial counts in the feces of a experimental model. Forty mice were divided into four experimental groups (n = 10/group). Groups NC (negative control) and PC (positive control) were not treated; in group T1, the animals received 0.002 mL/day/animal of the homeopathic in water, and animals in group T2 0.004 mL/day/animal. The experiment lasted 54 days, and on the 31st day, mice of T1, T2 and PC groups were infected orally a 0.2 mL inoculum of 1.5 × 108 CFU of E. coli. Euthanasia and sample collection were performed on the 40th and 54th days of the experiment (n = 5/group/time point). Blood, liver, spleen, intestine, and feces samples were collected from the final portion of the intestine. There was no significant difference in animal weight between groups at the end of the experiment. Neutrophil count was lower in PC group animals on day 40, while on day 54, the counts were lower in T2 and PC. Lymphocyte counts were lower only in the PC group than in the NC group on day 54. Globulins were lower in the NC and PC groups than in T1 and T2 on day 40, remaining lower the PC group and higher in T1 on day 54; levels of immunoglobulin IgG and IgM were higher in groups T1 and T2, which differed from PC and NC. TNF-α levels were higher in the T1 and T2 groups at 40 and 54 days. INF-γ levels were higher in T1, T2, and PC compared to NC on day 40, remaining higher than NC in groups T1 and T2 on day 54. Total bacterial count, total coliforms and E. coli counts were lower in group T1 and higher in NC and PC on days 40 and 54, when they were lower for T1 and T2. Histologically, no lesions were observed in extra-intestinal tissues; however the height of intestinal crypts in the PC group was smaller than the others on day 40. On day 54, villi and crypts of all infected groups were larger in T1 and T2 than in NC; sizes in the PC group were higher than those of all other groups. These data suggest that the homeopathic agent in the drinking water improved health of the mice.

Assuntos

RESUMO

A realização de duas tarefas de forma simultânea exige a capacidade de concentrar atenção e executar duas tarefas ao mesmo tempo. Em indivíduos com Doença de Parkinson as interferências podem ser ainda maiores, visto que esses indivíduos necessitam de um grau maior de atenção apenas para executar uma tarefa única, como no caso, a marcha. OBJETIVO: Analisar a interferência da dupla tarefa na marcha de pacientes com DP. MATERIAIS E MÉTODOS: Estudo observacional de caráter transversal, de natureza quantitativa. Cinco indivíduos com Doença de Parkinson, de ambos os sexos, participaram do grupo experimental; e cinco indivíduos saudáveis fizeram parte do grupo controle. Os participantes tiveram a marcha avaliada com e sem interferência cognitiva, utilizando: Escala de Equilíbrio de Berg; Índice Dinâmico da Marcha; teste de mobilidade funcional (Time Up and Go Test), Esteira Ergométrica e o Stroop Test adaptado para analfabetos. RESULTADOS: Quando comparados Grupo Experimental e Grupo Controle foram encontradas diferenças estatisticamente significantes nas condições de marcha com interferência de dupla tarefa (Dupla Tarefa Número e Dupla Tarefa Cor) nas variáveis de quantidade de acertos e amplitude de movimento. CONCLUSÃO: A dupla tarefa em pacientes com DP, interfere principalmente na função cognitiva, enquanto a função motora da marcha permanece parcialmente preservada.

Performing dual tasks simultaneously requires the ability to focus attention and perform two activities at the same time. In individuals with Parkinson's disease, the interferences may be greater, as these individuals require a major degree of attention just to perform a single task, as in this case, walking. OBJECTIVE: To analyze the interference of dual task in the gait of PD individuals. MATERIAL AND METHODS: Observational cross-sectional study with a prospective structure of a quantitative nature. Five individuals with Parkinson Disease, of both gender, participated in the experimental group; five healthy individuals were part of the control group. The participants had their gait assessed with and without cognitive interference, using: Berg's Balance Scale; Dynamic Gait Index; functional mobility test (Time Up and Go Test), Treadmill gait and Stroop Test adapted for illiterates. RESULTS: When comparing the Experimental Group and the Control Group, statistically significant differences were found in the gait conditions with dual task interference (Dual Task Number and Dual Task Color) in the variables of number of correct answers and range of motion. CONCLUSION: The dual task in PD patients mainly interferes with cognitive function, while the motor function of gait remains partially preserved.

Assuntos

RESUMO

BACKGROUND: Reach-grasp movements are motor components commonly affected after stroke and directly related to the independence of these individuals. Evaluations of these activities can be performed using clinical instruments and assessed by detailed and costly kinematic analyses. The aim of this study was to develop an analysis of reach-grasp movements in post-stroke patients using a simple, inexpensive, and manageable instrument. RESULTS: A Mann-Whitney test was used to compare paretic and non-paretic limb motor performance. A statistically significant difference was found between the variables of total time (p = 0.02) and speed to reach target 3 (p = 0.04) for task 1, while in task 2 significance was found only in the aspect of speed to reach target 2 (p = 0.04). The correlation between clinical tests and variables of tasks was then performed using Spearman's rank correlation coefficient. At task 1, when compared with the REACH instrument, the close target sub-item; there was a high positive correlation between the parameters of total time (p = 0.028), target velocity 3 (p = 0.028), and target acceleration 3 (p = 0.028). Another instrument that showed a high positive correlation with the target time 3 (p = 0.01) and target acceleration 3 (p = 0.028) variables was the Box and Block Test. When correlated, the data between the task 2 variables and clinical instruments did not present statistically significant data. CONCLUSION: Our instrument-the Temporal Data Acquisition Instrument-TDAI-fulfilled the expected objectives and can be used as an option to evaluate the movements of reach and grasp of upper limb post-stroke, using an easy and fast application, without the need for calibration. Trial registration Trial Registration: Research Ethics Committee of the Trairi School of Health Sciences-Number 2.625.609, approved on April 13, 2018; Brazilian Registry of Clinical Trials-RBR-4995cr approved on July 4, 2019 retrospectively registered (http://www.ensaiosclinicos.gov.br/rg/RBR-4995cr/).

Assuntos