Nordentoftanderson3168

BACKGROUND Statins are used as cholesterol-lowering drugs and may also have direct antimicrobial effects. OBJECTIVE To evaluate synergic interactions between simvastatin and both amphotericin B and fluconazole, against environmental strains of Cryptococcus neoformans isolated from captive birds' droppings. DESIGNAND SETTING Experimental study conducted at Federal University of Piauí, Parnaíba, in collaboration with Federal University of Triângulo Mineiro, Uberaba, Brazil. METHODS Statin susceptibility tests of Cryptococcus neoformans samples were performed as prescribed in standards. Interactions of simvastatin with amphotericin and fluconazole were evaluated using the checkerboard microdilution method. Presence of these interactions was quantitatively detected through determining the fractional inhibitory concentration index (FICI). RESULTS Isolates of Cryptococcus neoformans were obtained from 30 of the 206 samples of dry bird excreta (14.5%) that were collected from pet shops and houses. Ten isolates were selected for susceptibility tests. All of them were susceptible to amphotericin and fluconazole. All presented minimum inhibitory concentration (MIC) > 128 µg/ml and, thus, were resistant in vitro to simvastatin. An in vitro synergic effect was shown through combined testing of amphotericin B and simvastatin, such that six isolates (60%) presented FICI less then 0.500. Two isolates showed considerable reductions in MIC, from 1 µg/ml to 0.250 µg/ml. No synergic effect was observed through combining fluconazole and simvastatin. CONCLUSION These results demonstrate that simvastatin should be considered to be a therapeutic alternative, capable of potentiating the action of amphotericin B. However, further studies are necessary to clarify the real effect of simvastatin as an antifungal agent.BACKGROUND Progress tests are longitudinal assessments of students' knowledge based on successive tests. Calibration of the test difficulty is challenging, especially because of the tendency of item-writers to overestimate students' performance. The relationships between the levels of Bloom's taxonomy, the ability of test judges to predict the difficulty of test items and the real psychometric properties of test items have been insufficiently studied. OBJECTIVE To investigate the psychometric properties of items according to their classification in Bloom's taxonomy and judges' estimates, through an adaptation of the Angoff method. DESIGN AND SETTING Prospective observational study using secondary data from students' performance in a progress test applied to ten medical schools, mainly in the state of São Paulo, Brazil. METHODS We compared the expected and real difficulty of items used in a progress test. Siremadlin mw The items were classified according to Bloom's taxonomy. Psychometric properties were assessed based on their taxonomy and fields of knowledge. RESULTS There was a 54% match between the panel of experts' expectations and the real difficulty of items. Items that were expected to be easy had mean difficulty that was significantly lower than that of items that were expected to be medium (P less then 0.05) or difficult (P less then 0.01). Items with high-level taxonomy had higher discrimination indices than low-level items (P = 0.026). We did not find any significant differences between the fields in terms of difficulty and discrimination. CONCLUSIONS Our study demonstrated that items with high-level taxonomy performed better in discrimination indices and that a panel of experts may develop coherent reasoning regarding the difficulty of items.BACKGROUND People have been using psychoactive substances for a long time. Over the last few years, this practice has spread among university students, who use these substances to improve their academic performance, relieve stress and increase concentration and memory. OBJECTIVES To estimate the use of psychoactive drugs among healthcare students at a higher education institution in the city of Passo Fundo (RS), Brazil, and to ascertain the associated demographic and lifestyle factors. DESIGN AND SETTING Cross-sectional study in a higher education institution. METHODS We included 287 undergraduate medicine and dentistry students in this study. They answered a self-administered questionnaire regarding sociodemographic, lifestyle and health variables. The statistical analysis used univariate and bivariate analyses with Pearson's chi-square test (P-value less then 0.05). -Multivariate analyses were used to estimate odds ratios (OR) and their respective 95% confidence intervals. The SPSS software, version 20.0, was used. RESULTS The prevalence of use of psychoactive substances among the students was 24.7%. Among these students, high frequencies of psychoactive drugs had been prescribed by physicians (95.8%) and for the purpose of relaxation or stress relief (73.2%). Women, medical students (compared with dental students) and participants with lower academic performance were more likely to use psychoactive drugs. After the multivariate adjustment, the "course" and "academic performance" remained associated with use of psychoactive drugs. CONCLUSION There was high prevalence of psychoactive drug use among the students at the higher education institution investigated. Some variables (female sex, medical students and low academic performance) were associated with the outcome.BACKGROUND Studies have shown that physical activity levels can be inversely associated with high-sensitivity C-reactive protein (hs-CRP) levels. However, the amount of physical activity required to maintain normal hs-CRP levels is still a matter for speculation. OBJECTIVE To identify the amount of physical activity necessary to discriminate the hs-CRP levels in adults. DESIGN AND SETTING Cross-sectional study at six teaching and research institutions. METHODS The study sample comprised 10,231 adults aged 35 to 74 years who were participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Receiver operating characteristic (ROC) curves were constructed to compare the amount of physical activity in two domains (leisure time and commuting) with hs-CRP levels. The sensitivity and specificity were calculated to identify the best cutoff for physical activity level that would be needed to maintain normal levels of hs-CRP ( less then 3 mg/l). RESULTS The area under the ROC curve was only statistically significant for discriminating normal levels of hs-CRP according to the amount of physical activity when the two study domains were added together.