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- Evaluation of antibiotic resistance patterns of food and clinical Listeria monocytogenes isolates in PortugalPublication . Barbosa, Joana; Magalhães, Rui; Santos, Isabel; Ferreira, Vânia; Brandão, Teresa R. S.; Silva, Joana; Almeida, Gonçalo; Teixeira, PaulaThe aim of this study was to characterize a broad collection of isolates of Listeria monocytogenes, of different serotypes, recovered in Portugal between 2003 and 2007 from foods (n = 353) and from clinical cases of human listeriosis (n = 95), in terms of antimicrobial susceptibility. All the isolates were susceptible to ampicillin, the preferred agent to treat listeriosis. Resistances to nitrofurantoin (n = 99), to ciprofloxacin (n = 18), to erythromycin (n = 10), to tetracycline (n = 2), to gentamicin (n = 1) and to rifampicin (n = 1) were observed. One hundred (28.3%) and 20 (21.0%) food and clinical isolates, respectively, were resistant to at least one antibiotic. Eight isolates (1.8%) were resistant to two or more antimicrobials of different classes, and all were collected from foods. Serogroup IVb included the highest percentage of isolates resistant to erythromycin. The highest percentages of isolates resistant to nitrofurantoin were of serogroup IVb and IIc. It was demonstrated that the incidence of antibiotic-resistant isolates of L. monocytogenes, during the period 2003 to 2007, was low in Portugal but still higher than that observed in other countries. Given the increasing population at greater risk of listeriosis, namely, the elderly, the high mortality rate of the infection and the detection of resistant isolates, monitoring for antibiotic resistance in strains of L. monocytogenes on a large scale, and assessing the risk of infection by these strains, is highly recommended.
- Balneotherapy and rheumatoid arthritis: a randomized control trialPublication . Santos, Isabel; Cantista, Pedro; Vasconcelos, Carlos; Amado, JoãoBackground: The effects of balneotherapy on rheumatoid arthritis (RA) are still controversial partly due to poor metho- dology used in randomized controlled trials, as reported in the international medical literature. Objectives: To determine whether spa therapy plus pharmacological treatment offers any benefit in the management of RA as compared to pharmacological treatment alone. methods: We conducted a prospective, controlled, unblinded randomly assigned study of patients with RA according to American College of Rheumatology criteria. Following the 2007recommendations of FRETH, the method designed for this study was “immediate treatment versus delayed treatment.” All patients were followed at the Oporto Hospital Centre and each physician observed the same patients throughout the study. Patients continued with their usual medications and maintained their daily life activities at home, at leisure and/or in the workplace. The spa therapy group received spa treatments for 21 days at S. Jorge Spa-Santa Maria da Feira. The main outcome measure was the HAQ-DI; the moderated regression analysis, together with the Johnson-Neyman technique, was used for statistical analysis. results: HAQ-DI at the end of treatment (21 days) and at the 3 month follow-up was improved in the spa group (odds ratio 0.37, confidence interval 0.09–0.64, P = 0.01 at 21 days, and 0.44, 0.15–0.72, P = 0.004 at 3 months). conclusions: In individuals in whom pain (physical and psychological) predominates, any complementary gain in function is beneficial. The main goal is to enhance quality of life.