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Thesis (Masters Diploma(Technology )--Cape Technikon, Cape Town,1988. / Nosocomical or hospital-aqired infection, can be defined as an infection not present when the patient enters a hospital. It usually manifests itself seventy two hours after admission and sometimes it is not apparent until after the patient has been discharged. When the incubation period is unknown, any infection developing after admission to a hospital, may be classified as a nosocomical infection.

Orientador: Edmur Franco Carelli / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-15T06:09:57Z (GMT). No. of bitstreams: 1 Aquino_HumbertoBelemde_D.pdf: 2197081 bytes, checksum: cc5953d9effb8cb84ca28b6d43985315 (MD5) Previous issue date: 2009 / Resumo: Complicações infecciosas decorrentes do tratamento cirúrgico da hidrocefalia, através do implante de um sistema de derivação ventricular (SDV) permanecem como condição de grande desafio na prática diária do neurocirurgião, seja para adultos e crianças. Algumas estratégias cirúrgicas e clínicas são adotadas em todo o mundo, mas ainda não há consenso sobre qual estratégia poderia ser considerada a melhor. Prevenir a infecção parece ser a melhor opção, assim, discute-se a validade do uso rotineiro e rígido de protocolos pré, intra e pós-operatório, a avaliação dos possíveis fatores de risco para o desenvolvimento de uma infecção, a experiência do cirurgião, o meio ambiente cirúrgico e o tempo de cirurgia, o uso de antibióticos como profilaxia e mais recentemente o uso de cateteres impregnados com antibióticos. No entanto, a incidência para infecção de um SDV é considerada alarmante (1% a 40% com uma média de 8,5% a 10%), a morbidade e mortalidade são altas (30% a 40%), o tratamento requer um longo tempo de permanência hospitalar (mais de 3 semanas), apresenta um alto custo operacional, além de uma alta taxa de reinfecção ao redor de (26%). O objetivo do trabalho é apresentar uma pesquisa entre Neurocirurgiões Brasileiros, realizada através de um questionário, sobre o estado atual do tratamento das infecções em um sistema de derivação ventricular entre eles e suas variabilidades. Neurocirurgiões Brasileiros foram pesquisados através de um questionário eletrônico, via página oficial da Sociedade Brasileira de Neurocirurgia (SBN), via e-mail do autor, e questionários entregues pessoalmente em 2 grandes Congressos Brasileiros de Neurocirurgia no ano de 2007. O questionário apresentava um caso clínico hipotético como referência de infecção em um SDV e perguntas sobre critérios clínicos, laboratoriais e/ou radiológicos de infecção e cura e a estratégia de tratamento. Trezentos e trinta e sete respostas foram envolvidas na pesquisa, o que corresponde a (14,04%) de 2.400 Neurocirurgiões cadastrados Na SBN, na época da pesquisa. Os questionários foram analisados, interpretados e posicionados em ordem de preferência de respostas dos pesquisados em um banco de dados. É nossa impressão que há uma significante variabilidade de informações sobre o estado atual de tratamento das infecções de um SDV entre os Neurocirurgiões pesquisados e com tendências similares à literatura / Abstract: Infectious complications following surgical treatment of hydrocephalus with shunt implantation remains a very challenging condition in pediatric and adult neurosurgical practice. Some surgical strategies and clinical therapy have been used by many neurosurgical centers around the world but still now there isn't a consensus regarding what general strategy can be considered better. To prevent it seems to be the best option but. The literature discusses about protocols, risk factors, expertise of the surgeons, operating room environment, surgery time, antibiotic prophylaxis, antibiotic-impregnated shunts and specifics strategies of surgical treatment and antibiotics. The incidence ranging from 1% to 40% with an average of 8.5% - 15%, raised morbidity and mortality (40%), long hospital stay (more than 3 weeks), elevated costs and elevated rate of reinfection (26%). We presented a practice survey among Brazilian Neurosurgeons to know the current state of treatment strategies of shunt infections and variabilities. Brazilian neurosurgeons were surveyed by a questionnaire by Brazilian Neurosurgery Society (SBN) and questionnaires by personal e-mail and personally taken to and handed in two important Brazilian Neurosurgery Congresses (2007), about treatment strategy facing shunt infections and criteria used to define diagnosis and cure. About 337 questionnaires were evolved on the survey (14.04%) from the 2,400 neurosurgeons. All the questionnaires were analyzed, interpreted and inserted in the database and all answers were termed using at same literature words. It is our impression that there is a significant variability among the Brazilian Neurosurgeons surveyed, with tendencies and there is similarity with literature / Doutorado / Neurologia / Doutor em Ciências Médicas

Class of 2012 Abstract / Specific Aims: The primary aim of this study was to determine the time to appropriate therapy for all patients with candidemia and/or bacteriemia (due to either Enterococcus or Streptococcus species) during a one year period in relation to time of blood culture, time of Gram-stain result, time of PNA FISH species result, and time of final species determination result. The secondary and third aims were to compare the time to appropriate therapy based on clinician group that was notified of Gram-stain result and PNA FISH result and compare the time to appropriate therapy based on PNA FISH assay results reported during the day and night microbiology laboratory shifts. Methods: This Institutional Review Board approved project is a retrospective, chart review evaluation of the 24 hour/ 7 days a week use of PNA FISH assays with therapeutic interventions by infectious diseases pharmacists and physicians on patient outcome measures and time to appropriate therapy. All patients admitted to an academic medical center during a one year period (April 2010-March 2011) with either Enterococcus, Streptococcus, or Candida species isolated from blood were included. Main Results: A total of 168 subjects were identified with Candida species isolated from 31 subjects and Enterococcus/Streptococcus species isolated from blood in 137 subjects. Conclusions: While reporting conditions can affect interpretation and intervention rates, rapid species identification assays such as PNA FISH can be used by pharmacists to provide antimicrobial therapy recommendations based on the species identification and to decrease the time to appropriate antimicrobial therapy.

No description available.

Trichostrongylus tenuis is a nematode that lives in the caeca of wild red grouse. It causes disease in red grouse and can cause fluctuations in grouse pop ulations. The aim of the work described in this thesis was to study aspects of the ecology of the infective-stage larvae of T.tenuis, and also certain aspects of the pathology and immunology of red grouse and chickens infected with this nematode. The survival of the infective-stage larvae of T.tenuis was found to decrease as temperature increased, at temperatures between 0-30 C? and larvae were susceptible to freezing and desiccation. The lipid reserves of the infective-stage larvae declined as temperature increased and this decline was correlated to a decline in infectivity in the domestic chicken. The occurrence of infective-stage larvae on heather tips at caecal dropping sites was monitored on a moor; most larvae were found during the summer months but very few larvae were recovered in the winter. The number of larvae recovered from the heather showed a good correlation with the actual worm burdens recorded in young grouse when related to food intake. Examination of the heather leaflets by scanning electron microscopy showed that each leaflet consists of a leaf roll and the infective-stage larvae of T.tenuis migrate into the humid microenvironment' provided by these leaf rolls. Scanning electron microscopy showed that the adult nematodes burrowed into the mucosa as well as lying on its surface and that the caecal mucosa of heavily infected grouse became disrupted in areas of nematode activity. The caecal mucosa of lightly infected grouse exhibited little damage and the caecal mucosa of grouse treated with an anthelmintic and shot 5-6 months later was similar to that of lightly infected birds. Some of the nematodes from these treated birds were covered in rosette-shaped cells which have been tentatively identified as adherent lymphocytes. The cuticle of adult T.tenuis was superficially annulated but did not possess cuticular ridges, as described in some other trichostrongyle nematodes. Primary and challenge infections with T.tenuis were established in the domestic chicken and these reached patency but nematodes were expelled in blood-stained balls of mucus and all adult nematodes had been expelled from the birds 30 days after dosing with infective-stage. Following trickle doses of larvae, there was a rise and then a fall in nematode egg output but larvae administered later in the trickle infection appeared to fail to establish. Light and scanning electron microscopy showed haemorrhagic lesions and blood spots on the caecal mucosa of infected chickens and nematodes were found to burrow beneath mucus secreted on the mucosal surface. There were significant increases in the proportions of circulating leucocytes in infected chickens, but only on certain days of infection. No antibodies to T.tenuis were detected in the blood of infected chickens. There was a decrease in the length of the caeca of infected chickens during the period when the Ill nematodes were being expelled from the caeca. Nematode egg output continued to rise during an infection in young red grouse and there was no expulsion of nematodes from these infected birds. Infective-stage larvae that had been attenuated by cobalt 60 irradiation stimulated some degree of resistance to challenge infection in the domestic chicken but not in the red grouse. It was concluded that immunization with irradiated larvae would be of little use in the control of T.tenuis in red grouse.

No description available.

Using a multiple stage age of infection model, we derive an expression for the basic reproduction number, Ro. We apply this method to find Ro in analogous treatment models. We find, in the model without treatment, Ro depends only on the mean infective period, and not on the infective distribution. In treatment models, Ro depends on the mean infective and mean treatment period, as well as the distribution of the infective period, but not on the distribution of the treatment period. With an explicit formula for Ro and the final size relation, we provide a practical alternative to evaluating the effect of treatment and other control measures. We compare our models to previous models of SARS and TB. / Science, Faculty of / Mathematics, Department of / Graduate