Thesis (doctoral)--Lund University, 1997.

Thesis (doctoral)--Lund University, 1994.

Thesis (doctoral)--Lund University, 1997.

Thesis (doctoral)--Lund University, 1994.

Orientador: Débora de Barros Barbosa / Banca: Denisi Pedrini Ostini / Banca: Cristiane Duque / Banca: Elaine Cristina Guerbach Conti Vieira / Banca: Adelisa Rodolfo Ferreira Tiveron / Resumo: As p ropriedades antimicrobianas da r omã são atribuídas aos c ompostos fenólicos, mais especificamente a os taninos hidrolisáveis (THs) galotaninos (ácido gálico) e elagitaninos (ácido elágico), substâncias naturais de defesa da planta. O s objetivo s deste estudo foram avaliar os níveis de ácido elágico e fenóis totais, rendimento dos métodos de extração e o potencial inibitório sobre Candida albicans de extratos de partes da Punica granatum. Amostras em triplicata de cascas, sementes e folhas desidratadas, trituradas, pulverizadas, foram submetid as a dois métodos de ex tração: s oxhlet tendo como solventes etanol e metanol e percolação tendo como solvente o etanol . Após a obtenção dos extratos, foram determinados os teores de ácido elágico por cromatografia liquida de alta eficiência e fenóis totais expressos em ácido gál ico pelo método espectrofotométrico. A atividade antifúngica dos extratos foi avaliada pelo método de difusão em disco, seguindo - se as normas do National Committee for Clinical and Laboratory Standards ( NCCLS document M2 - A8, 2003a .) . As maiores concentraçõ es de fenóis totais e de ácido elágico foram encontrad a s nas folhas e na casca da romã . Verificou - se maior eficiência de rendimento por meio da percolação . Os resultados de difusão em disco revelaram maior sensibilidade da cepa de C. albicans aos extratos etanólicos da casca por ambos os métodos de extração . O método percolação alcoólica a 70% e 25ºC e a casca da romã apresentaram a maior eficiência de extraç ão e de atividade anti - fúngica contra uma cepa clínica de C. albicans. / Abstract: The antimicrobial properties of pomegranate are attributed to the phenolic compounds, more specifically the hydrolyzable tannins (THs) galotaninos (gallic acid) and elagitaninos (ellagic acid), natural plant defense substances. The objectives of this study were to evaluate the levels of ellagic acid and total phenols, yield of the extraction methods and the inhibitory potential against Candida albicans of extracts from parts of Punica granatum . Samples of dried, peels, seeds and leaves were used in triplicates and the extracts were obtained by Soxhlet system and percolation using respectively ethanol, methanol and ethanol solvents. After obtainin g the extracts, the ellagic acid contents were determined by high performance liquid chromatography (HPLC) and total phenols expressed in gallic acid by the spectrophotometric method. The antimicrobial activity was evaluated by the disc diffusion method, f ollowing the standards of the National Committee for Clinical and Laboratory Standards (NCCLS document M2 - A8, 2003a.). The highest concentrations of THs were found in leaves and pomegranate peel. Greater yield efficiency was verified by percolation. The re sults of diffusion on disc revealed higher sensitivity of the C. albicans strain to the ethanolic extracts of peels by both methods of extraction, presenting inhibition halos of approximately 10 mm. The alcoholic percolation method at 70% and 25ºC and the pomegranate peel showed the highest extraction efficiency and antifungal activity against a clinical strain of C. albicans . / Doutor

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 4 uppsatser.

Background: Gram-negative bloodstream infections (BSI) are common complications after kidney transplantation. In this cohort study, we evaluated the long-term effect of Gram-negative BSI on allograft survival in kidney transplant recipients. Methods: Among a cohort of 1820 kidney recipients who were prospectively followed at the Mayo Clinic (Rochester, MN) from January 1, 1996, to December 31, 2007, we identified 120 patients with initial episodes of Gram-negative BSI before allograft failure. Multivariable Cox proportional hazard regression was used to examine the association between Gram-negative BSI, as a time-dependent covariate, and allograft and patient survival. Results: The median age of kidney recipients was 51 years (interquartile range, 39-61 years) and 58% were men. Among patients with Gram-negative BSI, 75% had a urinary tract source of infection and Escherichia coli was the most common microorganism (50%). Gram-negative BSI after transplantation was independently associated with allograft loss due to allograft failure or death (hazard ratio [HR], 2.52; 95% confidence intervals [CI], 1.83-3.47; P<0.001), allograft failure with death-censored (HR, 3.17; 95% CI, 2.11-4.76; P<0.001) and all-cause mortality (HR, 2.25; 95% CI, 1.55-3.26; P<0.001). Conclusions: Prevention and proper management of urinary tract infections in kidney recipients is essential to reduce the risk of more serious complications, including Gram-negative BSI, that are associated with reduced allograft and patient survival.

No description available.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Background: We aimed to update the 2010 evidence- and consensus-based national clinical guideline on the diagnosis and management of uncomplicated urinary tract infections (UTIs) in adult patients. Results are published in 2 parts. Part 1 covers methods, the definition of patient groups, and diagnostics. This second publication focuses on treatment of acute episodes of cystitis and pyelonephritis as well as on prophylaxis of recurrent UTIs. Materials and Methods: An interdisciplinary group consisting of 17 representatives of 12 medical societies and a patient representative was formed. Systematic literature searches were conducted in MEDLINE, EMBASE, and the Cochrane Library to identify literature published in 2010–2015. Results: For the treatment of acute uncomplicated cystitis (AUC), fosfomycin-trometamol, nitrofurantoin, nitroxoline, pivmecillinam, and trimethoprim (depending on the local rate of resistance) are all equally recommended. Cotrimoxazole, fluoroquinolones, and cephalosporins are not recommended as antibiotics of first choice, for concern of an unfavorable impact on the microbiome. Mild to moderate uncomplicated pyelonephritis should be treated with oral cefpodoxime, ceftibuten, ciprofloxacin, or levofloxacin. For AUC with mild to moderate symptoms, instead of antibiotics symptomatic treatment alone may be considered depending on patient preference after discussing adverse events and outcomes. Primarily non-antibiotic options are recommended for prophylaxis of recurrent urinary tract infection. Conclusion: In accordance with the global antibiotic stewardship initiative and considering new insights in scientific research, we updated our German clinical UTI guideline to promote a responsible antibiotic use and to give clear hands-on recommendations for the diagnosis and management of UTIs in adults in Germany for healthcare providers and patients.