Abstract Background Enhanced Recovery After Surgery (ERAS) protocol is composed by evidence-based interventions that aim to improve recovery through a reduction in surgical stress response. Although ERAS protocols have been introduced across the globe, exhaustive implementation is not as common. We aimed to study the ERAS protocol compliance in colorectal surgery, assessing the relationship between compliance and postoperative complications. Methods A single-center cohort study was conducted. All consecutive patients admitted to elective colorectal surgery were included. We assessed study endpoints according to ERAS protocol perioperative compliance score above 75%. Our primary endpoint was a composite of postoperative events, which includes in-hospital postoperative complications and need for reoperation after 30 days and need for readmission after discharge. Secondary endpoints were surgery-to-discharge time, postoperative use of only non-opioid adjuvants and the individual components of the primary endpoint. Results A total of 224 colorectal patients were included. The primary endpoint occurred in 59.2% (n = 58) of non-compliant patients comparing to 34.1% (n = 43) in compliant patients. In univariate analysis, compliance to ERAS protocol had an inferior risk for the primary endpoint (p< 0.001). In a logistic regression model, compliance was independently associated with a reduced risk for the primary endpoint with a odds-ratio of 0.42 (95% CI 0.23-0.75, p= 0.004). Conclusion Compliance with the ERAS protocol is associated with less complications, a reduced surgery-to-discharge time and use of only non-opioid adjuvants in the postoperative period. More studies are needed to target the most appropriate compliance goal.

Abstract This work describes the circulation over the continental slope and the São Paulo Plateau in the Santos Basin during the SANSED winter 2019 survey. The cruise consisted of four legs in the period between June, 11 and August, 03 2019. The observed circulation is dominated by the Atlantic southwestern boundary current regime and remotely-generated anticyclones and cyclones. The former is composed by the Brazil Current, the Intermediate Western Boundary Current and their mesoscale meanders; the latter are 300km vortical rings with origin in the eastern side of the South Atlantic Basin. A Lagrangian scheme applied over satellite altimeter maps indicate that the origin of these rings is primarily the Cape Basin of South Africa. The interaction between the boundary currents, their cyclonic meanders, and the anticyclonic rings is complex, and varies widely. During the SANSED winter 2019 survey period, three anticyclones interacted with the Brazil Current, instabilizing it, forming dipoles with the current cyclonic meanders, leading to their downstream propagation. Ancienter cyclonic eddies within Santos Basin may interfere with the propagation of the large anticyclones further south. In addition, the continuous arrival of remotely-originated anticyclones, the larger portion over the São Paulo Plateau presented a tendency of counter-clockwise circulation during the whole cruise period.

ABSTRACT BACKGROUND: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, studies have shown that this disease has affected the male population on a significant scale in various parts of the world, making men one of the main risk groups. OBJECTIVE: To analyze the clinical and epidemiological characteristics and experiences of illness in men with COVID-19. DESIGN AND SETTING: A mixed sequential-explanatory study with cross-sectional and exploratory-descriptive approaches. METHOD: Data was collected from a small municipality located in the central-north region of the state of Bahia, Brazil. Primary quantitative data was extracted from compulsory notification forms from 598 men. Qualitative data from individual interviews of 30 men was analyzed by the Discourse of the Collective Subject method. RESULTS: The findings identified the characterization of reports of suspected and confirmed cases of COVID-19 in men, the organization of the healthcare system, and strategies for the control and combat of COVID-19 directed towards the men of the investigated municipality. They revealed the clinical characteristics based on the collective discourse of men with COVID-19. CONCLUSION: In men, the individual experience of disease explicitly explains the clinical markers of COVID-19 expressed by the self-reported syndromic approach. Additionally, this understanding also explains the behaviors observed in their search for health care, as well as the adoption of prevention and control measures and therapies recommended by health professionals.

Resumo Antecedentes A telemedicina para pacientes com parkinsonismo é viável, econômica e satisfatória. No entanto, a viabilidade dessa modalidade de atendimento para essa subpopulação não é conhecida no cenário da vida real de países em desenvolvimento como o Brasil. Objetivo Avaliar a viabilidade da telemedicina para pacientes com parkinsonismo em um país em desenvolvimento. Métodos Estudo transversal com pacientes com parkinsonismo atendidos na rede pública de saúde brasileira. Foram incluídos 130 pacientes, que foram contatados por telefone; os que responderam foram submetidos a uma entrevista estruturada para coleta de dados. Os resultados primários foram a viabilidade para teleconsultas e videoconsultas, mas também foi realizada uma regressão logística entre a viabilidade de uma videoconsulta e fatores associados. Resultados A participação em telemedicina era possível ou consentida por 69 (53,08%) dos pacientes com relação a teleconsultas, e por 50 (38,5%) com relação a videoconsultas. As teleconsultas e videoconsultas eram viáveis para 80,2% e 58,1% dos pacientes acessíveis por telefone, respectivamente. Uma maior renda familiar foi positivamente correlacionada com a viabilidade de uma videoconsulta, enquanto uma associação negativa foi observada com relação a ser casado ou estar em união estável e ter baixo grau de escolaridade. Conclusões Uma proporção significativa de pacientes com parkinsonismo em um país em desenvolvimento é inacessível, não quer, ou não pode participar da tele-medicina. Entre os pacientes contatáveis, a viabilidade é maior, mas ainda menor do que a relatada em estudos em países desenvolvidos. Renda familiar, escolaridade e estado civil foram associados à viabilidade das videoconsultas.

Abstract Background Telemedicine for patients with parkinsonism is feasible, cost-effective and satisfactory. However, the feasibility of this modality of care for this subpopulation is not known in real-life scenarios of developing countries like Brazil. Objective To evaluate the feasibility of telemedicine for patients with parkinsonism in a developing country. Methods A cross-sectional study with patients with parkinsonism treated in the Brazilian public healthcare system. We included 130 patients, who were contacted by telephone; those who could be reached underwent a structured interview for data collection. The primary outcomes were the feasibility of teleconsultations and video consultations, but we also performed a logistic regression regarding the feasibility of a video consultation and associated factors. Results Telemedicine was feasible and accepted by 69 (53.08%) patients regarding teleconsultations and by 50 (38.5%) patients regarding video consultations. Tele-consultations were feasible for 80.2%, and video consultations were feasible for 58.1% of the patients reachable through telephone calls. Having a higher family income was positively correlated with the feasibility for a video consultation while a negative association was observed regarding being married or in a stable union and having a low level of schooling. Conclusions A significant proportion of patients with parkinsonism in a developing country are unreachable, unwilling, or unable to participate in telemedicine. Among the reachable patients, feasibility is higher but still lower than what is reported in studies in developed countries. Family income, level of schooling, and marital status were associated with the feasibility of video consultations.

Abstract There are gaps concerning the dissemination of school-based antibullying interventions in the Latin American context. For this reason, the objective was to conduct a systematic literature review to analyze the results of initiatives intended to prevent or decrease the occurrence of bullying and cyberbullying. A bibliographic search was conducted in LILACS, PsycINFO, SciELO, SCOPUS, and Web of Science. Only school-based randomized clinical trials conducted were included. Nine studies classified as having high methodological quality were included. This review synthesizes knowledge reported by studies conducted in various countries and clarifies the limitations and contributions of experimental programs focused on students, parents, and school staff, enabling reflections regarding future interventions.

Résumé Il existe des lacunes dans le contexte latino-américain par rapport à la diffusion des résultats des interventions anti-harcèlement dans les écoles. Nous avons analysé les résultats des actions visant à prévenir ou réduire l’apparition de l’intimidation et cyberintimidation (révision systématique de la littérature). L’enquête bibliographique a eu lieu dans les bases de données LILACS, PsycINFO, SciELO, SCOPUS et Web of Science. Seuls les essais cliniques randomisés en milieu scolaire ont été inclus. Au total, neuf études de haute qualité méthodologique ont été incluses dans la révision, synthétisant les connaissances obtenues à partir d’études menées dans plusieurs pays, clarifiant les limites et apports des programmes expérimentaux destinés aux élèves, parents et personnel scolaire. Cela permet des réflexions pour des interventions futures

Resumen Existen vacíos en el contexto latinoamericano referentes a la divulgación de resultados de intervenciones antibullying en la escuela; así, se pretendió analizar los resultados de acciones para prevención o reducción de la ocurrencia de bullying/cyberbullying. Se trata de revisión sistemática de la literatura. El levantamiento bibliográfico se realizó en las bases de datos LILACS, PsycINFO, SciELO, SCOPUS y Web of Science. Fueron incluidos apenas ensayos clínicos aleatorios en el ambiente escolar. Nueve estudios fueron incluidos en la revisión, que fueron evaluados como siendo de alta calidad metodológica. Esta revisión sintetiza conocimientos obtenidos con estudios realizados en diversos países, esclareciendo limitaciones y contribuciones de programas experimentales dirigidos a estudiantes, padres y equipo escolar, lo que posibilita reflexionar sobre futuras intervenciones.

Resumo Existem lacunas no contexto latinoamericano no que se refere à divulgação resultados de intervenções antibullying na escola, desta forma, pretendeu-se analisar os resultados de ações para prevenção ou redução da ocorrência de bullying e cyberbullying. Trata-se de uma revisão sistemática da literatura. O levantamento bibliográfico ocorreu nas bases de dados LILACS, PsycINFO, SciELO, SCOPUS e Web of Science. Foram incluídos apenas ensaios clínicos randomizados no ambiente escolar. Um total de nove estudos foram incluídos na revisão, sendo avaliados como de alta qualidade metodológica. Esta revisão sintetiza conhecimentos obtidos com estudos realizados em diversos países, esclarecendo limitações e contribuições de programas experimentais voltados a estudantes, pais e equipe escolar, o que possibilita reflexões para futuras intervenções.

RESUMO Objetivo: A alta prevalência e gravidade da toxoplasmose congênita no Brasil, com muitos indivíduos afetados desenvolvendo baixa visão, reforça a importância da avaliação da sua qualidade de vida. Este estudo tem como objetivo adaptar o Children's Visual Function Questionnaire (CVFQ) para a realidade sociocultural de crianças brasileiras e investigar suas propriedades psicométricas para avaliação da qualidade de vida relacionada à visão nesses indivíduos. Métodos: Estudo epidemiológico transversal aninhado de coorte de 142 crianças pré-escolares acompanhadas prospectivamente em hospital universitário de referência em Belo Horizonte, Brasil. Todas foram submetidos a exame oftalmológico completo, incluindo medida da acuidade visual e oftalmoscopia binocular indireta. Questionários foram aplicados aos pais e cuidadores, para avaliar a percepção da qualidade de vida, bem como o nível sócio-econômico das famílias. Análise estatística multivariada foi realizada para avaliar as propriedades psicométricas da escala de qualidade de vida. Resultados: Adaptações na versão brasileira do Children's Visual Function Questionnaire-7 originaram o Children's Visual Function Questionnaire-7-BR-toxo, um questionário para avaliar a percepção de pais/cuidadores sobre a qualidade de vida relacionada à visão de crianças pré-escolares com toxoplasmose congênita. Pela descrição, estrutura de variabilidade, e interpretação do agrupamento dos itens do questionário adaptado, identificaram-se seis subescalas: saúde geral, capacidade visual, desempenho visual/visão funcional, comportamento social e pessoal, impacto na família e tratamento. Crianças com baixa visão associada a toxoplasmose congênita tiveram escores mais baixos nas seguintes subescalas: acuidade visual (p=0,004), desempenho visual/visão funcional (p=0,008), impacto na família (p=0,001) e saúde geral (p=0,001). Conclusão: As propriedades psicométricas foram adequadas no tocante à validade do construto. O Children's Visual Function Questionnaire-7-BR-toxo foi capaz de registrar o impacto da deficiência visual nas famílias de crianças com toxoplasmose congênita.

ABSTRACT Purpose: The high prevalence and severity of congenital toxoplasmosis in Brazil, with several affected individuals progressing to low vision, emphasize the importance of evaluating their quality of life. In this study, the Children's Visual Function Questionnaire (CVFQ) was adapted to the sociocultural context of Brazilian children, and its psychometric properties were investigated for evaluating the vision-related quality of life of these individuals. Methods: This was a nested cross-sectional epidemiological study that prospectively monitored a cohort of 142 preschool children at a single referral university hospital in Belo Horizonte, Brazil. All children underwent complete ophthalmological examination, including visual acuity testing and binocular indirect ophthalmoscopy. Questionnaires were applied to their parents and caregivers to evaluate quality of life perception, as well as socioeconomic status of their families. Psychometric properties of the quality of life scale were evaluated by multivariate statistical analyses. Results: Adaptation to the Brazilian version of CVFQ-7 resulted in CVFQ-BR-toxo, a questionnaire for evaluating the perception of parents/caregivers about the vision-related quality of life of preschool children with congenital toxoplasmosis. The following six subscales were identified based on description, variability structure, and interpretation/grouping of items: general health, visual acuity, visual performance/functional vision, personal and social behavior, impact on family, and treatment. Children with low vision related to congenital toxoplasmosis had significantly lower scores for the following subscales: visual acuity (p=0.004), visual performance/functional vision (p=0.008), impact on family (p=0.001), and overall health (p=0.001). Conclusion: Psychometric properties were appropriate concerning the validity of the quality of life construct. CVFQ-BR-toxo could demonstrate the impact of vision impairment on families of children with congenital toxoplasmosis.

ABSTRACT BACKGROUND: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, studies have shown that this disease has affected the male population on a significant scale in various parts of the world, making men one of the main risk groups. OBJECTIVE: To analyze the clinical and epidemiological characteristics and experiences of illness in men with COVID-19. DESIGN AND SETTING: A mixed sequential-explanatory study with cross-sectional and exploratory-descriptive approaches. METHOD: Data was collected from a small municipality located in the central-north region of the state of Bahia, Brazil. Primary quantitative data was extracted from compulsory notification forms from 598 men. Qualitative data from individual interviews of 30 men was analyzed by the Discourse of the Collective Subject method. RESULTS: The findings identified the characterization of reports of suspected and confirmed cases of COVID-19 in men, the organization of the healthcare system, and strategies for the control and combat of COVID-19 directed towards the men of the investigated municipality. They revealed the clinical characteristics based on the collective discourse of men with COVID-19. CONCLUSION: In men, the individual experience of disease explicitly explains the clinical markers of COVID-19 expressed by the self-reported syndromic approach. Additionally, this understanding also explains the behaviors observed in their search for health care, as well as the adoption of prevention and control measures and therapies recommended by health professionals.

Abstract Background Enhanced Recovery After Surgery (ERAS) protocol is composed by evidence-based interventions that aim to improve recovery through a reduction in surgical stress response. Although ERAS protocols have been introduced across the globe, exhaustive implementation is not as common. We aimed to study the ERAS protocol compliance in colorectal surgery, assessing the relationship between compliance and postoperative complications. Methods A single-center cohort study was conducted. All consecutive patients admitted to elective colorectal surgery were included. We assessed study endpoints according to ERAS protocol perioperative compliance score above 75%. Our primary endpoint was a composite of postoperative events, which includes in-hospital postoperative complications and need for reoperation after 30 days and need for readmission after discharge. Secondary endpoints were surgery-to-discharge time, postoperative use of only non-opioid adjuvants and the individual components of the primary endpoint. Results A total of 224 colorectal patients were included. The primary endpoint occurred in 59.2% (n = 58) of non-compliant patients comparing to 34.1% (n = 43) in compliant patients. In univariate analysis, compliance to ERAS protocol had an inferior risk for the primary endpoint (p< 0.001). In a logistic regression model, compliance was independently associated with a reduced risk for the primary endpoint with a odds-ratio of 0.42 (95% CI 0.23-0.75, p= 0.004). Conclusion Compliance with the ERAS protocol is associated with less complications, a reduced surgery-to-discharge time and use of only non-opioid adjuvants in the postoperative period. More studies are needed to target the most appropriate compliance goal.

RESUMO: Objetivou-se avaliar o efeito da utilização das farinhas de conchas de sururu, maçunim e ostra como fontes de cálcio sobre o desempenho produtivo, rendimento de carcaça e parâmetros ósseos de codornas de corte. Foram utilizadas 250 codornas europeias, não sexadas, com um dia de idade. As aves foram distribuídas em delineamento inteiramente casualizado, constituído por cinco fontes de cálcio (calcário calcítico, carbonato de cálcio, farinha de conchas de sururu, farinha de conchas de maçunim e farinha de conchas de ostras), com cinco repetições e dez aves por unidade experimental. Foram avaliados o consumo de ração, ganho de peso e conversão alimentar no período de um a 35 dias. Aos 35 dias, duas aves de peso médio de cada parcela foram abatidas e utilizadas para as análises de rendimento de carcaça e parâmetros ósseos. Não foram observadas diferenças significativas (P > 0,05) para os dados de consumo de ração, ganho de peso, conversão alimentar, rendimento de carcaça, matéria seca, cinzas e resistência óssea de tíbias. As farinhas de conchas de sururu, maçunim e ostra podem ser utilizadas na alimentação de codornas europeias, como fontes de cálcio, sem afetar o desempenho produtivo, rendimento de carcaça e a mineralização óssea das aves.

ABSTRACT: This study was developed to examine the effect of using charru mussel-, maçunim- and oyster-shell meals as calcium sources on the productive performance, carcass yield and bone parameters of meat quail. A total of 250 one-day-old non-sexed European quail were used. The birds were distributed into five treatments (calcium sources: calcitic lime, calcium carbonate, charru mussel shell meal, maçunim shell meal or oyster shell meal) in a completely randomized design with five replicates and ten birds per experimental unit. Feed intake, weight gain and feed conversion were evaluated from one to 35 days. At 35 days, two birds with the average weight of the plot were slaughtered per plot and used for analysis of carcass yield and bone parameters. There were no significant differences (P > 0.05) in feed intake, weight gain, feed conversion, carcass yield or tibia dry matter content, ash content and strength. The charru mussel-, maçunim- and oyster-shell meals can be used as calcium sources in the diet of European quail without affecting their productive performance, carcass yield or bone mineralization.

RESUMO: A descoberta de novos aditivos naturais a partir de resíduos agroindustriais é considerada um importante tópico de pesquisa. Este estudo teve como objetivo investigar a viabilidade da extração assistida por ultrassom (EAU) de compostos antioxidantes do estigma do milho (EM) e o efeito de variáveis independentes (tempo e relação sólido-solvente) e sua interação na extração de EM. Os resultados indicaram que a EUA aumenta a atividade antioxidante e reduz o tempo de extração em 67%. Condições otimizadas para a extração simultânea de antioxidantes e polifenóis do EM foram obtidas com 5 min e uma relação sólido-solvente de 0,05 g mL-1. O extrato de EM obtido pela EUA foi caracterizado por ESI-ToF-MS e 27 fitoquímicos foram encontrados. O extrato apresentou atividades antifúngicas e antibacterianas promissoras contra 23 dos micro-organismos estudados. Portanto, o extrato de EM obtido pela extração assistida por ultrassom pode ser utilizado como fonte de compostos bioativos e antimicrobianos para uso como ingrediente funcional na indústria alimentícia e farmacêutica.

ABSTRACT: The discovery of new natural additives from agro-industrial waste is considered an important research topic. This study investigated the feasibility of ultrasound-assisted extraction (UAE) of antioxidant compounds from corn stigma (CS) and the effect of independent variables (time and solid-solvent ratio) and their interaction in the extraction of CS. Results indicated that the UAE method increases the antioxidant activity and reduces the extraction time by 67%. Optimized conditions for the simultaneous extraction of antioxidants and polyphenols from CS were obtained using 5 min and a solid-solvent ratio of 0.05 g mL-1. The CS extract obtained by UAE was characterized by ESI-ToF-MS and 27 phytochemicals were reported. The extract showed promising antifungal and antibacterial activities against 23 of the studied microorganisms. Therefore, the CS extract obtained by the UAE can be used as a source of bioactive and antimicrobial compounds for use as a functional ingredient in the food and pharmaceutical industry.

Resumo Este artigo objetiva problematizar as percepções de psicólogas de um Creas/Paefi da região metropolitana de Florianópolis acerca dos atendimentos psicossociais a crianças e adolescentes em situação de violência sexual. Foram realizadas entrevistas semiestruturadas com três psicólogas que atuam no serviço Paefi de um Creas. A análise das entrevistas está amparada pela perspectiva teórico-metodológica de análise das práticas discursivas e de produção de sentidos, conforme proposta por Spink e Medrado (2004). Elencaram-se as seguintes categorias de análise: a) percepções acerca da violência sexual contra crianças e adolescentes; b) percepções acerca do atendimento psicossocial; e c) percepções acerca da gestão de trabalho e das estratégias de intervenções psicossociais. De modo geral, destaca-se que as percepções sobre violência sexual variam entre leituras complexas e reducionistas; que existem dificuldades em fazer valer o Sistema de Garantia de Direitos de Crianças e Adolescentes e a efetivação de uma gestão de trabalho intersetorial e em rede; que o Estado é ausente e/ou negligente em contextos de vulnerabilidades; que as intervenções centram-se mais nas famílias e nas vítimas e menos nos autores de violência; que, apesar de impasses técnicos, busca-se atuar de acordo com prerrogativas da atuação profissional da psicologia no contexto do Suas. Considera-se que este estudo pode contribuir para a ampliação de problematizações acerca dos atendimentos psicossociais, no contexto do Suas, a crianças e adolescentes vítimas de violência sexual.

Abstract This article aims to problematize the perceptions of psychologists of a CREAS (Specialised Social Aid Reference Centre)/PAEFI (Protection and Specialised Care Services for Families and Individuals) from the Florianópolis metropolitan area on psychosocial care for children and adolescents in situations of sexual violence. We conducted semi-structured interviews with three psychologists working at CREAS/PAEFI service. The analysis of the interviews was supported by the theoretical and methodological framework of the analysis of discursive practices and production of meanings proposed by Spink and Medrado (2004). We listed the following categories of analysis: a) perceptions on sexual violence against children and adolescents; b) perceptions on psychosocial care; and c) perceptions on work management and strategies for psychosocial interventions. In general, we highlighted that perceptions on sexual violence vary between complex and reductionist understandings; that assuring the Rights Guarantee System for Children and Adolescents and making effective the intersectoral and network management of work is difficult; that the State is absent and/or negligent in contexts of vulnerability; that interventions focus more on families and victims and less on perpetrators of violence; that, despite technical impasses, psychologists act according to the prerogatives of professional practices in the context of SUAS (Single Social Welfare System). We consider that this study can contribute to the expansion of problematizations on psychosocial care, in the context of SUAS, to children and adolescents who are victims of sexual violence.

Resumen El propósito de este artículo es problematizar las percepciones de psicólogas de un Centro de Referencia Especializado de Asistencia Social del Servicio de Protección y Atención Especializada a Familias e Individuos (Creas/Paefi) de la área metropolitana de Florianópolis (Brasil) sobre la atención psicosocial a niños y adolescentes en situación de violencia sexual. Se realizaron entrevistas semiestructuradas con tres psicólogas que actúan en el servicio Paefi de un Creas. El análisis de las entrevistas se fundamenta en la perspectiva teórico-metodológica de análisis de las prácticas discursivas y de producción de sentidos, propuesta por Spink y Medrado (2004). Se enumeraron las siguientes categorías de análisis: 1) percepciones sobre la violencia sexual contra niños, niñas y adolescentes; 2) percepciones sobre la atención psicosocial; y 3) percepciones sobre la gestión del trabajo y estrategias para intervenciones psicosociales. En general, se destaca que las percepciones sobre la violencia sexual varían entre lecturas complejas y reduccionistas; que existen dificultades para hacer cumplir el Sistema de Garantía de los Derechos de la Niñez y la Adolescencia y hacer efectiva la gestión del trabajo intersectorial y en red; que el Estado se encuentra ausente y/o negligente en contextos de vulnerabilidad; que las intervenciones se centran más en las familias y las víctimas, y menos en los perpetradores de violencia; que, a pesar de los impasses técnicos, buscamos actuar de acuerdo con las prerrogativas del ejercicio profesional en psicología en el contexto del Sistema Único de Asistencia Social (Suas). Se espera que este estudio pueda contribuir a la expansión de problematizaciones sobre la atención psicosocial a niños y adolescentes víctimas de violencia sexual, en el contexto del Suas.

RESUMO Objetivo: Investigar a susceptibilidade a antibióticos, o perfil clínico, epidemiológico e microbiológico das ceratites infecciosas. Métodos: Estudo retrospectivo longitudinal. Registros médicos e laboratoriais de 2015 a 2019 foram revisados retrospectivamente. Resultados: Trezentos e oitenta patógenos (321 bactérias e 59 fungos) foram isolados das córneas de 352 pacientes. As espécies de Staphylococcus foram os microorganismos mais isolados (45%), seguidos de Pseudomonas (18,4%), fungos (15,5%), Streptococcus (7,9%) e Serratia (3,2%). Não houve resistência das bactérias Gram-positivas à amicacina ou vancomicina, enquanto 14,8% isolados Gram-positivos foram resistentes à ciprofloxacina (p<0,05). Todos os organismos Gram-negativos eram suscetíveis à amicacina. Pacientes do sexo masculino representaram 62,8% de 129 casos com dados clínicos acessíveis. A média de idade foi 53,17 ± 21 anos. O tempo até a apresentação (desde o início dos sintomas) foi de 14,9 ± 19,4 dias (mediana: 7 dias). Úlceras grandes (>5mm em qualquer extensão) representaram 49,6% (64 olhos) dos casos. A duração do tratamento foi de 49 ± 45,9 dias (mediana: 38 dias). Trauma ocular direto foi relatado por 48 (37,2%) pacientes e uso de lentes de contato por 15 (11,6%) pacientes. Foi prescrito tratamento prévio para 72 (55.8%) pacientes. Outras classes de medicamentos foram prescritas para 16 (12.4%). Setenta e nove (61,2%) pacientes tiveram que ser hospitalizados. Como complicações maiores, 53 (41,1%) pacientes apresentaram perfuração corneana, 40 pacientes (31%) foram submetidos à ceratoplastia penetrante tectônica e 28 (21,7%) desenvolveram glaucoma secundário. Oito pacientes (6,2%) evoluíram para endoftalmite. O tratamento empírico da ceratite microbiana foi amplamente empregado, com 94 (72,9%) pacientes em uso de moxifloxacina e 56 (43,4%) em uso de ciprofloxacina antes do resultado da cultura. Conclusões: Nosso hospital tratou predominantemente de pacientes com úlceras microbianas graves. Embora bactérias Gram-positivas constituíssem a maioria dos isolados, bacilos e fungos Gram-negativos também foram frequentemente identificados nas ceratites microbianas. Os resultados de suscetibilidade sugerem a combinação de vancomicina e amicacina como um regime terapêutico empírico eficaz para essa condição grave com risco de perda visual permanente.

ABSTRACT Purpose: To investigate the antibiotic susceptibility as well as the clinical, epidemiological, and microbiological profiles of microbial keratitis. Methods: This was a longitudinal retrospective study, and we retrospectively reviewed medical and laboratory records from 2015 to 2019. Results: In total, 380 pathogens (321 bacteria and 59 fungi) were isolated from the corneas of 352 patients. Staphylococcus species (45%) were most abundant within the organisms that were isolated, followed by Pseudomonas (18.4%), fungi (15.5%), Streptococcus (7.9%), and Serratia species (3.2%). The isolated gram-positive bacteria were not resistant to amikacin or vancomycin, although 14.8% of the gram-positive isolates were resistant to ciprofloxacin (p<0.05). All the gram-negative isolates were susceptible to amikacin. Male patients represented 62.8% of the 129 cases with accessible clinical data. The mean age of the patients was 53.17 ± 21 years. The time to presentation (from onset of symptoms) was 14.9 ± 19.4 days (median: 7 days). Large ulcers (>5 mm in any dimension) were present in 49.6% (64 eyes) of the cases. The duration of treatment was 49 ± 45.9 days (median: 38 days). Direct ocular trauma was reported by 48 (37.2%) patients, and 15 patients (11.6%) reported using contact lenses. For 72 (55.8%) patients, topical treatment had been previously prescribed, and 16 (12.4%) patients reported using other classes of drugs. Hospitalizations were required for 79 (61.2%) patients, and in terms of major complications, 53 (41.1%) patients had corneal perforations. A total of 40 patients (31%) underwent tectonic penetrating keratoplasty, and 28 (21.7%) developed secondary glaucoma. A progression to endophthalmitis occurred in 8 (6.2%) patients, with 50% of those patients’ (3.1% of the total) endophthalmitis evolving to evisceration. The patients’ microbial keratitis was largely treated empirically, with 94 (72.9%) patients prescribed moxifloxacin and 56 (43.4%) prescribed ciprofloxacin before receiving their culture results. Conclusions: For the most part, our hospital treated patients with severe microbial keratitis. Despite identifying gram-positive bacteria in most of the isolates, we also frequently identified gram-negative rods and fungi. Our susceptibility results support prescribing a combination of vancomycin and amikacin as an effective empirical therapeutic regimen to treat microbial keratitis.

Abstract The use of Echinacea purpurea (EP), a plant native from North America, is widely diffused throughout the world, presenting many pharmacological applications, mainly for the treatment of infections of respiratory and urinary tracts. Due to the widespread commercialization of EP-based products, an effective evaluation of their pharmacological properties is essential to assure efficacy during clinical use. In this study, in vitro tests were performed to evaluate the antimicrobial activity of dried extracts of EP by the microdilution method. In addition, a phagocytosis model was employed to assess the immunomodulatory potential of the extracts. The increase in reactive oxygen species production, as well as the intracellular proliferation rate of Cryptococcus gatti after phagocytosis by macrophages in the presence of EP dried extracts were also evaluated. The analyzed samples showed no significant antibacterial activity; however, a slight antifungal activity was verified. Positive effects of EP extracts on the modulation of cellular immune response were observed in different experiments, indicating that this mechanism may contribute to the control and treatment of infections.