Bráulio Roberto Gonçalves Marinho Couto

Prevalence of nosocomial infections in general hospitals in Belo Horizonte

OBJECTIVE To assess the magnitude of nosocomial infections (NI) in general hospitals of Belo Horizonte. DESIGN Multicenter point-prevalence study of nosocomial infections. SETTING All of the 11 general hospitals of Belo Horizonte that have more than 20 beds, from August 27 to October 5, 1992. RESULTS Of the 2,339 patients surveyed, 267 patients had 328 nosocomial infections. The global prevalence rate of NI was 14.0%, ranging from 4.6% to 27.3% in the hospitals surveyed. The most prevalent infections were found to be pneumonia and surgical-wound infections, representing 19.5% and 19.2%, respectively, of the total infections. The highest prevalence rates of NI were observed in the cardiac surgery (31.9%), pediatric (27.2%), and orthopedic (20.7%) services. The most frequently isolated microorganisms were Staphylococcus aureus, Escherichia coli, Pseudomonas species, and Klebsiella species. CONCLUSION The study allowed a thorough evaluation of the NI distribution profile in Belo Horizonte, Minas Gerais, Brazil, and showed it to be a serious public health problem that requires interinstitutional efforts so that effective action can be taken.

Improving Water Quality Can Reduce Pyrogenic Reactions Associated With Reuse of Cardiac Catheters

OBJECTIVE To report the results of our preintervention investigation and subsequent 19-month three-phase intervention study designed to reduce pyrogenic reactions among patients undergoing cardiac catheterization using reprocessed catheters. DESIGN A case-control study for the preintervention period and a prospective cohort study for the intervention period. SETTING A 400-bed hospital in Belo Horizonte, Brazil. PARTICIPANTS Any patient undergoing cardiac catheterization in the hospital. INTERVENTIONS Three intervention phases were implemented to improve the quality of the water supplied to the cardiac catheter reprocessing laboratory. Standard operating procedures for reprocessing cardiac catheters were established and reprocessing staff were trained and educated. RESULTS The rate of pyrogenic reactions decreased significantly during the intervention phases, from 12.8% (159 of 1,239) in phase 1 to 5.3% (38 of 712) in phase 2 to 0.5% (4 of 769) in phase 3 (chi-square test for linear trend, 97.5; P < .001). CONCLUSION Improving water quality and using standard operating procedures for reprocessing catheters can prevent pyrogenic reactions in hospitalized patients.

Length of preoperative hospital stay: a risk factor for reducing surgical infection in femoral fracture cases

Objective To analyze infections of the surgical site among patients undergoing clean-wound surgery for correction of femoral fractures. Methods This was a historical cohort study developed in a large-sized hospital in Belo Horizonte. Data covering the period from July 2007 to July 2009 were gathered from the records in electronic medical files, relating to the characteristics of the patients, surgical procedures and surgical infections. The risk factors for infection were identified by means of statistical tests on bilateral hypotheses, taking the significance level to be 5%. Continuous variables were evaluated using Students t test. Categorical variables were evaluated using the chi-square test, or Fishers exact test, when necessary. For each factor under analysis, a point estimate and the 95% confidence interval for the relative risk were obtained. In the final stage of the study, multivariate logistic regression analysis was performed. Results 432 patients who underwent clean-wound surgery for correcting femoral fractures were included in this study. The rate of incidence of surgical site infections was 4.9% and the risk factors identified were the presence of stroke (odds ratio, OR = 5.0) and length of preoperative hospital stay greater than four days (OR = 3.3). Conclusion To prevent surgical site infections in operations for treating femoral fractures, measures involving assessment of patients’ clinical conditions by a multiprofessional team, reduction of the length of preoperative hospital stay and prevention of complications resulting from infections will be necessary.

Uma abordagem robusta de cálculo aplicada a um sistema potenciométrico de medida de concentrações hidrogeniônicas em soluções aquosas

The data analyzed in this work were generated following the methodology developed by Molina et al.(J. Electroanal. Chem., 1979) for the calibration of a potentiometric system of measurement of hydrogen-ion concentrations resulting from neutralizations, at 25 oC, of acidic or alkaline solutions at constant ionic strength (0.1 mol.l-1) held with NaClO4. The observed data present a serious deviation in relation to the mathematical model derived from the Nernst equation, for pH values ranging from 3 to 11, where pH=-log[H+]. We show that the minimization of the sum of the absolute values of the residuals gives estimates that are not influenced by outlying values.

Artroplastia do quadril: prevenção de infecção do sítio cirúrgico

Objective: To investigate preventive measures of the surgical site infection in patients undergoing hip arthroplasty. Method: Retrospective and descriptive study of procedures performed in a teaching hospital, from May 2010 to June 2012. Results: A total of 78 hip arthroplasties were conducted, with predominance of elderly and women. The main diagnosis was head femoral fracture. Half of the revision surgeries were performed due to infection. The mean preoperative hospital stay was 13.6 days and 94.9% of the patients were discharged. The preoperative bath was done by 86% of the participants; 23.1% had no hair removed; 80.8 and 83.3% had their skin prepared by scrubbing and antisepsis respectively; and antimicrobial prophylaxis was administered in 97% of them. Conclusion: Lack of registration of preventive measures in patients’ records was the main limitation of this study. Preventive measures of the surgical site infection have been partially adopted, so it is necessary to train healthcare workers and investig ate the causes of low compliance to preventive measures.

Genome Visualization in Space

Phylogeny is an important field to understand evolution and the organization of life. However, most methods depend highly on manual study and analysis, making the construction of phylogeny error prone. Linear Algebra methods are known to be efficient to deal with the semantic relationships between a large number of elements in spaces of high dimensionality. Therefore, they can be useful to help the construction of phylogenetic trees. The ability to visualize the relationships between genomes is crucial in this process. In this paper, a linear algebra method, followed by optimization, is used to generate a visualization of a set of complete genomes. Using the proposed method we were able to visualize the relationships of 64 complete mitochondrial genomes, organized as six different groups, and of 31 complete mitochondrial genomes of mammals, organized as nine different groups. The prespecified groups could be seen clustered together in the visualization, and similar species were represented close together. Besides, there seems to be an evolutionary influence in the organization of the graph.

Retrieval of Enterobacteriaceae drug targets using singular value decomposition

MOTIVATION The identification of potential drug target proteins in bacteria is important in pharmaceutical research for the development of new antibiotics to combat bacterial agents that cause diseases. RESULTS A new model that combines the singular value decomposition (SVD) technique with biological filters composed of a set of protein properties associated with bacterial drug targets and similarity to protein-coding essential genes of Escherichia coli (strain K12) has been created to predict potential antibiotic drug targets in the Enterobacteriaceae family. This model identified 99 potential drug target proteins in the studied family, which exhibit eight different functions and are protein-coding essential genes or similar to protein-coding essential genes of E.coli (strain K12), indicating that the disruption of the activities of these proteins is critical for cells. Proteins from bacteria with described drug resistance were found among the retrieved candidates. These candidates have no similarity to the human proteome, therefore exhibiting the advantage of causing no adverse effects or at least no known adverse effects on humans. CONTACT rita_silverio@hotmail.com. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.

Perfil das solicitações de medicamentos de alto custo ao Sistema Único de Saúde em Minas Gerais

El acceso universal a los servicios de salud por parte de la Constitucion Federal, debe garantizar la atencion integral, incluyendo componente especializado de los medicamentos (alto costo). Teniendo en cuenta que este es uno de los mayores retos para el Sistema de Salud, el objetivo de este estudio fue analizar los costos de la prestacion de estos medicamentos para los usuarios de los planes privados de salud, el Departamento de Salud del estado, estado de Minas Gerais. Metodo de vinculacion de registros se seleccionaron Procesa las solicitudes de componente especializado de los medicamentos rechazados por el Departamento de Salud del Estado, en el primer semestre de 2008. Se utilizo para comprobar con la Agencia Nacional de Salud, si los demandantes eran beneficiarios de los planes privados la salud. Los datos mostraron que cerca del 37% del gasto en estos medicamentos eran las peticiones de los usuarios de los planes privados y la mediana del costo de estos medicamentos fue mayor, con una diferencia significativa en relacion a las solicitudes de los usuarios que no tenian ningun plan. Tambien se observo que el costo de los medicamentos solicitados por la Administracion de Salud Regional de Belo Horizonte fue significativamente mayor en relacion con el otro. Se concluye la necesidad de realizar mas estudios sobre la aplicacion de politicas de atencion farmaceutica por planes de salud privados con el fin de minimizar el gasto publico.Universal access to health services, predicted by the Federal Constitution, should ensure integrated care, including specialized component medications (high cost). Considering that this is one of the biggest challenges to the Unified Health System, the aim of this study was to analyze the costs of providing these drugs to users of private health plans, by the state Department of Health of Minas Gerais, Brazil. Processes requests for specialized component of the medications rejected by the State Department of Health in the first semester of 2008 were selected. Record Linkages method was used to check with the National Health Agency, whether or not the applicants were beneficiaries of health private plans. The data showed that about 37% of the expenses on these drugs were requests from users of private plans and the median cost of these medications was higher, with a significant difference in relation to requests from users who had no plan. It was also observed that the cost of drugs requested by the Regional Health Management of Belo Horizonte was significantly higher when compared to others. We can conclude that it is necessary further studies on policy implementation of pharmaceutical care by private health plans in order to minimize public expenses.

Applying Causal Inference in Educational Data Mining: A Pilot Study.

Understanding the reasons that leads students to succeed during their course is a challenge for every Institution of Education, independently of the modality of teaching and learning adopted. In this paper we use the theory of Causal Inference for analyzing the main factors that causes the success, or failure, of an engineering student enrolled in an online course of Algorithm . We used data extracted from the Learning Management System Moodle and, after preprocessing the dataset, analyzed the actions performed by the students during the six months (20 weeks) that the online course lasted. We concluded that before submitting an evaluation activity to be assessed, it is important that students analyze the problem thoroughly. Students that took a little bit longer to submit their work got more chances to be approved.

A Virtual Environment to Support Classroom Face-to-Face Teaching of Engineering Courses.

The objective of our study is to answer three questions: a) How to build a low cost online teaching tool to support face-to-face classrooms of introductory engineering disciplines? b) What is the effectiveness of the use of virtual environment in promoting learning? c) Does the number of accesses by the students onto the virtual environment increases their grades and reduces their failure in introductory engineering disciplines? The online teaching tool was developed in Moodle environment, being composed by three components for each discipline: a) video lectures, b) video lessons explaining how to solve proposed exercises, c) a list of unsolved exercises. To evaluate the effectiveness of the virtual environment we collected data during JanDec/2016, amongst engineer students. The main predictor variable, the number of access to the online support tool, was firstly evaluated in univariate analysis. Multiple linear regression was used to assess how the outcome of “final grade” were influenced by all predictors variables together, in a multivariate way. The number of accesses by the students onto the virtual environment increases their grades and reduces their failure in introductory engineering disciplines, especially for General Chemistry, Differential Calculus, Physics Electricity and Algorithms.