Made available in DSpace on 2015-07-08T12:28:19Z (GMT). No. of bitstreams: 2 6.pdf: 926522 bytes, checksum: f6e46b30951c9cffb7632bb9dd259770 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2013 / Fundação Oswaldo Cruz. Instituto Nacional de Controle de Qualidade em Saúde / As bactérias do gênero Haemophilus, família Pasteutelleaceae têm ainda na espécie influenzae influenzae (Hi)a mais importante nas infecções humanas. Hi, que inclui os sorotipos capsulares (a-f) e os NT é responsável por diversos quadros infecciosos. Haemophilus influenzae b (Hib) era um dos principais responsáveis pelos casos de meningites em diversos países do mundo. Estava também associado a outras infecções graves como epiglotite, artrite séptica, bacteremia, pneumonia e septicemia, principalmente em crianças. As doenças associadas ao Hib são preveníveis pela vacina conjugada formada do PRP e uma proteína carreadora, incluída no PNI/MS em agosto de 1999. Após a introdução da vacina conjugada contra o Hib houve redução expressiva das doenças causadas pelo Hib, nos diversos países que introduziram a vacina em seus calendários de imunização, porém, os outros sorotipos, inclusive os HiNT passaram a ser isolados com maior frequência como agente infeccioso de meningites sendo também atualmente um dos principais agentes etiológicos da Otite Média Aguda (OMA), o que o torna alvo de importantes pesquisas para novas vacinas. A colonização desta é fundamental para que ocorra a infecção e, crianças de creches e orfanatos apresentam variáveis taxas desta bactéria. A importância deste estudo continuando uma linha de pesquisa sobre o Hi no INCQS-FIOCRUZ, com ênfase no estudo de cepas isoladas após a implantação da vacina está associada à necessidade de verificar a situação de portadores, em uma população fechada (creche) para contribuir com o conhecimento da situação do Hi após treze anos da introdução da vacina conjugada contra o Hib no Brasil, que reduziu, mas não impediu a ocorrência da doença. O objetivo principal deste estudo foi determinar a ocorrência de Hi em crianças frequentadoras de uma creche em Jacobina, Bahia. Realizou-se coleta de material da nasofaringe de 73 crianças. / The Bacterial genus Haemophilus is inclued in the family Pasteutelleaceae and the influenzae specie (Hi) is the most important in human infections. Hi includes capsular serotypes (a-f) and non-capsulated strains (NT), which are responsible for many infections. Haemophilus influenzae b (Hib) has been one of the main cause of meningitis in many countries worldwide. It has been also associated with other severe infections such as epiglottitis, septic arthritis, bacteremia, pneumonia and septicemia, mainly in children. Since 1988 these infections are preventable by Hib conjugate vaccine consisting of PRP and a carrier protein, and it has been included in the national vaccination program (PNI/ MS) in 1999. After the introduction of Hib conjugate vaccine, diseases caused by Hib had significantly decreased in several countries where the vaccine was introduced into their immunization schedules however, other serotypes, including HiNT, has been isolated with greater frequency as agents of infectious meningitis which is currently one of the main etiological agents of Acute Otitis Media (AOM) and the subject of important researches on new vaccines. Colonization is essential to start the infection, and children from daycare centers present variable rates of the bacteria in their nasopharynx. The importance of this study on an ongoing line of research at INCQS-FIOCRUZ with emphasis on the study of strains isolated after the introduction of the vaccine, is associated with the monitor of carriers in a closed population (daycare) to contribute to the knowledge of the circulation of Hi after thirteen years using conjugate vaccine against Hib in Brazil, which reduced but did not prevent the occurrence of the disease. The main objective of this study was to determine the occurrence of Hi in children attending a daycare center in Jacobina, Bahia. For the study we collected material from the nasopharynx of 73 children. We found a colonization rate of 78.08% and all isolates were classified as HiNT. Biotype III was the most prevalent. The study of antimicrobial susceptibility showed ampicillin-resistant strains producing and non-producing β-lactamase. We also observed high rates of resistance to ampicillin (41.8%) and trimethoprim+sulfametoxazol (67.2%). The gene blaTEM, which is primarily responsible for ampicillin resistance was found in 81.8% of the strains. The blaROB gene, was not observed among the strains analyzed. The PBP3 gene of βLNAR samples was sequenced and changes were observed, the major changes were in positions 547V → 547I found in three samples, 422N→ 422S and 273S→ 273F. Strain susceptibility was evaluated against amoxicillin/clavulanic acid, ceftriaxone, rifampicin, chloranphenicol and were susceptible. This study confirms the efficacy of the vaccine against Hib and points to the relevance to vigilance HiNT, as presented high percentage of colonization and resistance to some antimicrobials.

Orientador: Marcelo Lancellotti / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-23T12:32:22Z (GMT). No. of bitstreams: 1 Cury_GiseleCristianeGentile_D.pdf: 5956781 bytes, checksum: b28217e4d95beb4734f0357ed4181696 (MD5) Previous issue date: 2013 / Resumo: O resumo poderá ser visualizado no texto completo da tese digital quando for liberada / Abstract: The abstract is available with the full electronic document when available / Doutorado / Bioquimica / Doutora em Biologia Funcional e Molecular

Orientador: Marcelo Lancellotti / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-22T07:21:21Z (GMT). No. of bitstreams: 1 Varela_JuliaNogueira_M.pdf: 1464845 bytes, checksum: 930cccae996588333b99f1aaa50988c0 (MD5) Previous issue date: 2013 / Resumo: Haemophilus influenzae é uma bactéria causadora de doenças tipicamente associadas ao trato respiratório superior e inferior. Tal bactéria é classificada em linhagens capsuladas e não capsuladas - as não tipadas. As grandes responsáveis por patogenias mais severas são as capsuladas, especialmente as do sorotipo b, a existência de uma vacina para somente esse sorotipo, faz com que ocorra uma emergência de casos com H. influenzae não tipado - NTHi. A crescente resistência a antibióticos dessa bactéria está associada à plasmídios de resistência, bem como sua competência natural. A presença desses patógeno é maior em países nos quais não existe acesso a vacina, devido ao alto custo da mesma, que acabam utilizando antibióticos mais acessíveis como o cloranfenicol no tratamento. Esse trabalho estudou a transferência horizontal do gene ompP2 em diversas cepas de H. influenzae com a ajuda de nanopartículas de óxido de grafeno. Essas nanopartículas mimetizam uma atmosfera rica em partículas suspensas como as grandes cidades e zonas de agricultura precoce, já que, nesses locais ocorrem com maior frequência mutações e adaptações desse patógeno. Quando as nanopartículas encontravam-se no meio de cultura, verificou-se um aumento da taxa de transformação dessas bactérias. Assim como uma modificação no padrão de adesão celular das bactérias mutadas quando comparadas com as selvagens em linhagens celulares distintas e expostas ao antibiótico de resistência, levando a um aumento da taxa de adesão das cepas mutadas com relação às cepas selvagens. Como esse gene é e de possível aquisição entre cepas de H. influenzae em seu ambiente natural seria possível utilizá-lo para obtenção de uma proteína recombinante, com possível antigenicidade. Uma vez que a taxa de adesão aumenta com a presença do mesmo, levando a uma possível nova vacina que também protegeria contra cepas não tipadas e não somente capsuladas / Abstract: Haemophilus influenzae is a bacteria that causes diseases typically associated with the upper and lower respiratory tract. Their strains are divided in capsulated and non-capsulated - the non typable. The major responsible for more severe cases are the capsulated types, specially the b type. The existence of a vaccine for the serotype b, allows the emergence of cases of non typable H. influenzae - NTHi. The growing resistance is associated with resistance plasmids, and with its natural competence, that enables the bacteria to acquire DNA fragments between it's' species. Since this pathogen is common in countries that there is no access to this vaccine, therefore the use of accessible and cheaper antibiotics, such as chloramphenicol for treatment is. This work studied the horizontal transference of the ompP2 gene from multiresistant strains of H. influenzae, with the aid of grafen oxide nanoparticles, that mimesis an atmosphere rich in suspended particles, such as great urban areas and ancient agricultural zones. In these environments a great frequency in mutation and adaptations of these bacteria is verified. When we look at the adhesion patterns of these bacteria we can see that it is modified when they are mutated and exposed to the resistance antibiotic. Leading to an augmentation of the adhesion patterns when we compare to the wild strains. Since this gene was present in all strains and it was of easy acquisition between strains, it would be possible to use it to obtain a recombinant protein with likely antigen properties. Because the adhesion tax enhances with the presence of this gene. Leading to a possible new vaccine target, for NTHi and capsulated strains also / Mestrado / Fármacos, Medicamentos e Insumos para Saúde / Mestra em Biociências e Tecnologia de Produtos Bioativos

OBJECTIVE: The principal objective of this study was to measure various aspects of immunity in children with invasive infections due to Haemophilus influenzae type b and Staphylococcus aureus. These serious infections are a significant cause of childhood morbidity and mortality in all populations and affect healthy as well as compromised children. Evidence suggests that imbalances or deficiencies in certain aspects of immunity such as IgG subclasses, the capacity to make specific subclass antibodies, antibody affinities, complement isotypes, immunoglobulin allotypes or mannose binding protein may place certain children at risk for developing invasive disease. Investigation of these factors in a group of children with infection necessitated that normal ranges be established for children of comparable ages from the same population. A secondary objective of this study has therefore been to establish normal percentiles for the IgG subclasses in age, race and sex matched healthy controls. METHODS: Patients admitted to the Red Cross War Memorial Children's Hospital with septic meningitis due to Haemophilus influenzae type b and osteomyelitis/septic arthritis due to Haemophilus influenzae type b or Staphylococcus aureus formed the study population. Section A of this thesis describes the methods for establishing, validating and standardizing ELISAs for measuring the IgG subclasses (lgGl, IgG2, IgG3 and IgG4) and subclass antibodies specific to Haemophilus influenzae polyribosylribitol phosphate, Staphylococcus aureus teichoic acid and tetanus toxoid. The relative affinity of antibodies in these ELISAs was determined by the incorporation of diethylamine (DEA). In order to determine the immunoglobulin allotypes ELISAs were developed to measure the G1m(f), G2m(n) and Km(3) allotypes. The frequency of these allotypic markers in the different ethnic groups was established. The relationship between immunoglobulin allotypes and IgG subclass values were investigated in both patient and control groups. RESULTS: ELISA assays to measure IgG subclasses; IgG, IgG 1 and IgG4 tetanus toxoid antibodies; IgG, IgG 1 and IgG2 H. influenzae type b polyribosylribitol phosphate capsular polysaccharide antibodies; IgG, IgG1 and IgG2 S. aureus teichoic acid antibodies and G1m(f), G2m(n) and Km(3) allotypes were successfully established. Where possible the assays were standardized with reference sera and specimens were exchanged with international laboratories. Age, race and sex related percentile charts and tables of normal ranges for IgG and IgG subclasses of Black and Coloured children were established. The IgG and IgG 1 values were higher than those previously reported for children in developed countries. Black children with H. influenzae meningitis had significantly lower IgG 1, IgG2 and IgG3 levels compared to the controls and although similar trends were seen for IgG and IgG4 levels they were not statistically significant. Coloured children with H. influenzae meningitis and Coloured and Black children with H. influenzae osteomyelitis/septic arthritis also showed a similar tendency of lower IgG and IgG subclass levels than the controls but these trends were also not significantly different. All patients responded to tetanus toxoid antigen suggesting normal immunocompetence to protein antigens. H. influenzae type b capsular polysaccharide antibodies were low in children with H. influenzae type b meningitis and osteomyelitis/septic arthritis and did not increase during the illness. IgG and IgG 1 teichoic acid antibodies were raised in patients with S. aureus osteomyelitis/septic arthritis although no further rise in these antibodies was seen when measured several weeks after the illness. The antibody affinity ELISAs showed that IgG 1 tetanus toxoid antibody had a greater affinity than IgG4 tetanus toxoid antibody, the IgG 1 and IgG2 H. influenzae capsular polysaccharide antibodies were of similar affinity and the IgG 1 teichoic acid antibody was of higher affinity than the IgG2 antibody. The G1m(f) and G2m(n) positive allotypes were uncommon in Black but common in the Coloured populations whereas Km(3) was common in both groups. There was a significantly decreased frequency of the G2m(n) positive allotype in Coloured patients with H. influenzae type b meningitis and H. influenzae type b osteomyelitis/septic arthritis which was not found in patients with S. aureus osteomyelitis/septic arthritis. In both Coloured and Black children with H. influenzae meningitis there was a significantly decreased frequency of the Km(3) allotype. No differences in C4 isotypes and mannose binding protein levels were evident in the patient and control groups. CONCLUSION: This study has developed simple, specific and reproducible ELISAs to measure IgG subclasses and subclass antibodies specific to tetanus toxoid, H. influenzae polyribosylribitol phosphate and S. aureus teichoic acid. Age, sex and race related normal ranges for IgG subclasses in the local Black and Coloured populations have been established. Black children with H. influenzae type b meningitis had significantly lower IgG 1, IgG2 and IgG3 levels compared to the controls. There was a clear association between a decrease of the G2m(n) allotype and the Km(3) allotype and susceptibility to invasive infections caused by H. influenzae.

Nosocomial outbreaks of infection due to non-typeable Haemophilus influenzae (NTHi) are rarely described. There are a few published reports that suggest that elderly patients with underlying pulmonary disease are at risk and that person-to-person spread is key to disease transmission. During the summer months of 2005, we documented an outbreak of NTHi infections in a Veterans Affairs nursing home. Thirteen patients developed conjunctivitis or lower respiratory infection involving a β-lactamase-negative biotype III NTHi isolate, with an indistinguishable SmaI macrorestriction pattern. Patients were elderly males usually with underlying cardiac and pulmonary disease. A case-control study failed to demonstrate any specific significant risk factor for NTHi infection and there was no evidence of spatial clustering of cases within the nursing home. A random throat culture survey involving nursing home patients during the outbreak showed that only one of 19 persons was colonized with NTHi. The outbreak concluded following appropriate treatment and an emphasis on universal and respiratory droplet precautions. All patients recovered and a specific inciting event for the outbreak was never defined. Literature review revealed a spectrum of responses to nosocomial NTHi infections and a lack of consensus regarding the infection control approach towards NTHi outbreaks.

No description available.

Made available in DSpace on 2015-07-22T20:49:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-06-30 / Introdução: Apesar de relatos sobre a Atenção Integrada às Doenças Prevalentes na Infância (AIDPI) melhorar a assistência à saúde da criança até cinco anos, não são identificados estudos direcionados ao componente peri-neonatal dessa estratégia. Objetivo: avaliar, após a capacitação em AIDPI Neonatal, o conhecimento e a percepção de médicos e enfermeiros quanto à assistência à gestante e à criança do nascimento até os dois meses de vida, e sua aplicabilidade prática em uma região da Amazônia. Método: estudo de coorte constituída de 31 médicos e 61 enfermeiros provenientes de 24 municípios, que participaram de sete capacitações em seis Pólos Regionais de Saúde no interior do Pará, Amazônia, realizado de abr/2006 a dez/2008. O estudo foi conduzido em duas fases, consistindo a 1ª fase na aplicação presencial de cinco questionários antes (T1) e imediatamente após 24 horas (T2) de capacitação em AIDPI Neonatal, conforme diretrizes da OPAS em 2007, adaptadas ao nosso meio. A 2ª fase compreendeu a aplicação presencial dos mesmos questionários aos 92 profissionais, em média 16 (14-20) meses após a 1ª fase (T3). Os questionários abordaram dados demográficos dos profissionais em T1, o conhecimento sobre assistência à gestante, reanimação neonatal, puericultura e doenças até dois meses em T1, T2 e T3, além da avaliação da capacitação em T2 e da percepção das condições de assistência no município e no local de prática clínica em T1 e T3. Para estimar as diferenças entre os tempos e as categorias profissionais foram criados escores de zero (inadequação completa) a 100 (adequaçãocompleta) comparados por meio da análise de variância com medidas repetidas. Resultados: os 92 profissionais caracterizaram-se por ser do sexo feminino (83%), nascidos (74%) e graduados (79%) no Pará, atender crianças duas ou mais vezes por semana (86%) e possuir pós-graduação (63%). Os médicos eram graduados há 17 (1-35) anos e os enfermeiros há nove (0-31) anos (p<0,001). Os primeiros relataram maior atuação em pediatria, e qualificação específica, com residência ou especialização, do que os últimos. Observou-se variação do conhecimento de acordo com o tempo (T1, T2 e T3) e a profissão (médicos>enfermeiros: p<0,001). Entre T1 e T2 constatou-se acréscimo deconhecimento dos profissionais sobre a assistência à gestante (p=0,026), reanimação neonatal (p<0,001), puericultura (p<0,001) e doenças até dois meses (p<0,01). Tal conhecimento perdurou, no mínimo, após 16 meses da capacitação nas áreas de reanimação neonatal (p=0,028) e doenças até dois meses (p<0,001). A capacitação teve avaliação positiva dos profissionais (94%) que perceberam melhora na prática clínica no seu local de trabalho (p<0,001), porém sem relato de alteração nas condições de saúde do município (p=0,066) entre T1 e T3. Conclusão: os médicos e enfermeiros apresentaram acréscimo, no mínimo por 16 meses, no conhecimento sobre a assistência à gestante e à criança até dois meses, além de perceberem melhora em sua condição de prática clínica após a capacitação em AIDPI Neonatal. Essa capacitação pode servir de modelo a ser aplicado em outras regiões com semelhante contexto epidemiológico / Objective: to assess knowledge and perception of professionals about care of pregnant women and children to two months of life, after training in Neonatal Integrated Management of Childhood Illness (IMCI), and its practical applicability in the Amazon Region. Method: a cohort study comprising 92 professionals who participated in seven Neonatal IMCI training courses in Para, from April/2006 to December/2008. Five questionnaires were applied face-to-face before (T1) and 24h (T2) after training in Neonatal IMCI (PAHO, 2007), and 16 (14-20) months after training (T3). Scores ranging from zero (complete inappropriateness) to 100 (complete appropriateness) were compared by ANOVA with repeated measures. Results: Time since graduation was 17y (1-35) for physicians and 9y (0-31) for nurses (p<0.001). Variation of knowledge was observed according to time and profession (physicians>nurses: p<0.001). Between T1 and T2, enhanced knowledge was verified in care of pregnant women (p=0.026), neonatal resuscitation (p<0.001), neonatal and infant care (p<0.001) and diseases up to two months (p<0.01). Such knowledge was observed at least for 16 months in neonatal resuscitation (p=0.028) and diseases up to two months (p<0.001). The capacity-building was positively evaluated by professionals (94%), who perceived improvement in clinical practice (p<0.001), without report of change in health conditions of the city (p=0.066) between T1 and T3. Conclusion: Training in Neonatal IMCI enhanced knowledge about care of pregnant women and infants up to two months, in addition to acknowledging better clinical practice for physicians and nurses. This training can be a model to be applied in other regions with similar epidemiological context. / TEDE / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2016-08-17T18:39:34Z (GMT). No. of bitstreams: 1 3277.pdf: 7015864 bytes, checksum: 9834075e819d2bb62213cf25d21ce5e5 (MD5) Previous issue date: 2010-08-27 / Haemophilus influenzae type b (Hib) is a Gram negative bacterium responsible for causing meningitis worldwide. The capsular polysaccharide b, a polymer composed by repeating units of ribosyl-ribitol phosphate (PRP), is the major virulence factor and it is used in the formulation of the vaccine against this microorganism. Despite their high efficiency, the conjugated vaccine against Hib is a product of high production cost, which involves fermentation, purification and conjugation processes to obtain a final product within the specifications of the World Health Organization (WHO). The improvement of the culture medium and cultivation conditions can contribute to reduce the cost of this vaccine in order to facilitate its dissemination in developing countries. The main objective of this work was to identify culture conditions that result in higher production of capsular polysaccharide, helping to reduce costs in the steps of purification and conjugation. The experiments were carried out in shake flasks or in bioreactors with 7-13 liters of capacity. The temperature was maintained at 37 °C, pH controlled at 7.5 by adding NaOH 5M and the concentration of dissolved oxygen (CDO) maintained at 30% of air saturation. The specific flow rate of air ranged between 0.2 and 1 VVM. Samples were collected at regular time intervals to measure optical density (DO540nm), biomass concentration, capsular polysaccharide (PRP) production and concentrations of glucose and metabolites. Two possibilities for increasing polysaccharide production were studied: 1) different strategies of fed-batch cultivation consisting of: a) intermittent addition of glucose (FBIG), b) constant feeding (FBCF), c) exponential feeding (FBEF), e d) exponential feeding with cell recycle and perfusion (FBER + P); 2) improvement of culture media composition regarding the carbon/nitrogen ratio through the use of central composite rotational design (CCRD) methodology, having as independent variables: Soy Peptone (S), Yeast Extract (YE) and Glucose (G). Quality parameters were also evaluated to assess the molecular weight profile of the product (PRP) as well as morphological aspects of the microorganism. Economic analysis of different cultivation strategies was used to identify the more economically viable process. The results of the different cultivation strategies together with the outputs of the studied processes cost analysis showed that FBCF, with a cost of U.S.$ 425.50/g PRP and productivity of 88 mg/L.h, showed to be the best alternative among PRP production processes due to its lower cost with a good productivity. In the study of the culture media composition through the statistical analysis of the CCRD results showed that the best culture media composition (BCM) consisted of S 5 g/L; YE 5.5g /L and G of 15.25 g/L. DO540nm and PRP volumetric production values of 8.4 and 410 mg/L, respectively, were attained in validation experiments carried out in shake flasks at the BCM condition. For the bioreactor BCM validation experiment, biomass concentration of 3 g DW/L and polysaccharide production of 600 mg PRP/L were observed. Similar values were reached at validation runs performed in shake flasks and bioreactor for the central point CP condition, showing that both BCM and CP conditions belong to the optimum region. The analysis of quality parameters showed that the cultivation time influences strongly the size of the polysaccharide molecule. The longer the cultivation time, the lower molecular weight was found. The analysis by transmission electron microscopy (TEM) of H. influenzae cells revealed a predominance of round cells in the sixth hour of cultivation, whereas in the twelfth hour of cultivation the cells exhibited a more elongated morphology with the presence of cytoplasmic inclusions in the shape of granules, possibly due to the accumulation of some reserve material. Based on these results, the new composition of the culture medium resulted in an increased of cell growth and capsular polysaccharide production with half of the sources nitrogen (soybean peptone and yeast extract) concentrations, which reduces the production cost. The cultivations that resulted in higher production and productivity of polysaccharide were FBCF (1600 mg PRP/L and 88 mg PRP/(L.h)) and FBER+ P (1800 mg PRP/L and 129 mg PRP/(L.h)). The FBER+P reached 30% higher productivity of polysaccharide than the best result described in the literature (90 mg PRP/(L.h)). However, the FBCF cultivation was economically more viable. / Haemophilus influenzae tipo b (Hib) é uma bactéria Gram negativa responsável por causar meningite em todo o mundo. O polissacarídeo capsular b, um polímero composto por unidades repetidas de ribosil-ribitol-fosfato (PRP) e o principal fator de virulência, sendo utilizado na formulação da vacina contra este microrganismo. Apesar de sua elevada eficiência, a vacina conjugada contra Hib é um produto de alto custo de produção por envolver processos de fermentação, purificação e conjugação para obtenção de um produto final dentro das especificações da Organização Mundial da Saúde (OMS). O melhoramento do meio de cultura e das condições de cultivo pode contribuir para redução do custo desta vacina de forma a facilitar sua difusão nos países subdesenvolvidos. Assim, o principal objetivo deste trabalho foi identificar condições de cultivo que resultem em maior produção de polissacarídeo capsular, contribuindo para reduzir os custos nas etapas de purificação e conjugação. Os ensaios foram conduzidos em frascos agitados ou em biorreatores com 7 a 13 litros de capacidade nominal. A temperatura foi mantida em 37oC, o pH controlado em 7,5 através da adição de NaOH 5M e a concentração de oxigênio dissolvido (COD) mantida em 30 % da saturação do ar. A vazão especifica de ar variou entre 0,2 e 1 VVM. Amostras foram coletadas em intervalos regulares de tempo para mensurar densidade óptica (DO540nm), concentração celular, produção de polissacarídeo capsular (PRP) e concentrações de glicose e metabolitos. Duas possibilidades para aumentar a produção de polissacarídeo foram estudadas: 1) diferentes estratégias de cultivo descontinuo alimentado consistindo por: a) adição intermitente de glicose (CDAIG), b) vazão constante (CDAVC), c) vazão exponencial (CDAVE), e d) reciclo de células seguido de perfusão (CDAVE+P)); e 2) o melhoramento da composição do meio de cultura quanto à relação carbono/nitrogênio através do uso da metodologia de delineamento composto central rotacional (DCCR), tendo como variáveis independentes: Peptona de Soja (S), Extrato de Levedura (EL) e Glicose (G). Parâmetros de qualidade também foram avaliados para verificar o perfil da massa molecular do produto (PRP) e os aspectos morfológicos do microrganismo. Os resultados das diferentes estratégias de cultivo juntamente com os resultados da analise econômica do custo dos processos estudados mostraram que o CDAVC, com custo de US$ 425.50/g PRP por ano e produtividade de 88 mg/(L.h), demonstrou ser a melhor alternativa para o processo de produção de PRP por apresentar menor custo com boa produtividade. Já o estudo da composição do meio de cultura através da analise estatística dos resultados do DCCR mostraram que a melhor composição do meio de cultivo (MMC) consistia em S de 5 g/L, EL de 5,5 g/L e G de 15,25 g/L. Valores de DO540nm de 8,4 e de produção volumétrica de polissacarídeo de 410 mg PRP/L foram alcançados em experimentos de validação na condição MMC realizados em shaker. Para o ensaio de validação da condição MMC em reator, a concentração de biomassa de 3,0 g MS/L e a produção de polissacarídeo capsular de 600 mg PRP/L foram observadas. Valores semelhantes foram obtidos em experimentos de validação realizados em shaker e biorreator na condição CPC, mostrando que tanto a condição CPC como a MMC pertencem a região de ótimo. A analise dos parâmetros de qualidade mostrou que o tempo de cultivo influencia fortemente no tamanho da molécula do polissacarídeo, sendo que quanto maior o tempo de cultivo, menor a sua massa molecular. A analise por microscopia eletrônica de transmissão (MET) das células de H. influenzae mostrou a predominância de células com morfologia arredondada na sexta hora de cultivo, enquanto que, na décima segunda hora de cultivo, as células apresentaram morfologia mais alongada e exibiram a presença de inclusões citoplasmáticas na forma de grânulos, possivelmente devido ao acumulo de algum material de reserva. Diante dos resultados obtidos, a nova composição de meio resultou em maior crescimento celular e produção de polissacarídeo capsular, com metade das concentrações das fontes de nitrogênio (peptona de soja e extrato de levedura), o que reduz o custo de produção. Os cultivos que resultaram em maior produção e produtividade foram o CDAVC (1600 mg PRP/L e 88 mg PRP/L.h) e o CDAVE+P (1800 mg PRP/L e 129 mg PRP/L.h), sendo que este ultimo (CDAVE+P) atingiu produtividade 30 % maior que o melhor resultado ate então descrito na literatura (90 mg PRP/L.h). No entanto, o cultivo CDAVC apresentou maior viabilidade do ponto de vista econômico e de execução e passível de escalonamento.

Charles University First Medical Faculty Study programme: History of Medicine Summary of dissertation The Spanish Flu Pandemic 1918/19 with particular reference to the Bohemian Lands and Central European relations Dr. med. univ. Harald Salfellner Prague, 2017 Summary Towards the end of the First World War, in 1918 and 1919, humanity faced a previously unparalleled flu pandemic; within a few months, more people had been killed than in all the battles of the 1914-18 war put together. The precise number of victims is unknown but is today generally reckoned at between 20 and 50 million. The whole world was affected by the Spanish flu, with the exception of a few remote islands, and Europe, already bled to death by industrialised warfare, was particularly hard hit. In summer 1918, the pandemic reached Bohemia in an early, relatively benign wave. A few weeks later, thousands were struck down in Prague in a second and far more deadly phase of the illness. In October 1918, as the First Czechoslovakian Republic arose from the ashes of the multiethnic Austrian state, and the masses celebrated in the cities, thousands of feverish patients were coughing behind drawn curtains, and facing an uncertain fate. In the USA, the flu pandemic - the greatest health disaster of the 20th century - has been the subject of many...

"March 2004" / Includes bibliographical references (leaves 213-272) / xxiii, 272 leaves ; ill. (some col.), plates ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Paediatrics, 2004