Variability on red blood cell transfusion practices among Brazilian neonatal intensive care units

BACKGROUND:Guidelines for red blood cell (RBC) transfusions exist; however, transfusion practices vary among centers. This study aimed to analyze transfusion practices and the impact of patients and institutional characteristics on the indications of RBC transfusions in preterm infants.STUDY DESIGN and METHODS:RBC transfusion practices were investigated in a multicenter prospective cohort of preterm infants with a birth weight of less than 1500 g born at eight public university neonatal intensive care units of the Brazilian Network on Neonatal Research. Variables associated with any RBC transfusions were analyzed by logistic regression analysis.RESULTS:Of 952 very-low-birth-weight infants, 532 (55.9%) received at least one RBC transfusion. The percentages of transfused neonates were 48.9, 54.5, 56.0, 61.2, 56.3, 47.8, 75.4, and 44.7%, respectively, for Centers 1 through 8. The number of transfusions during the first 28 days of life was higher in Center 4 and 7 than in other centers. After 28 days, the number of transfusions decreased, except for Center 7. Multivariate logistic regression analysis showed higher likelihood of transfusion in infants with late onset sepsis (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.8-4.4), intraventricular hemorrhage (OR, 9.4; 95% CI, 3.3-26.8), intubation at birth (OR, 1.7; 95% CI, 1.0-2.8), need for umbilical catheter (OR, 2.4; 95% CI, 1.3-4.4), days on mechanical ventilation (OR, 1.1; 95% CI, 1.0-1.2), oxygen therapy (OR, 1.1; 95% CI, 1.0-1.1), parenteral nutrition (OR, 1.1; 95% CI, 1.0-1.1), and birth center (p < 0.001).CONCLUSIONS:The need of RBC transfusions in very-low-birth-weight preterm infants was associated with clinical conditions and birth center. The distribution of the number of transfusions during hospital stay may be used as a measure of neonatal care quality.

Policultivo do camarão de água doce Macrobrachium amazonicum (Heller, 1862) com a Tilápia do Nilo (Oreochromis niloticus) alimentadas com rações peletizada e farelada

The objective of this work was to evaluate the influence of fresh water shrimp Macrobrachium amazonicum (Heller, 1862) in performance of Nile tilapia (Oreochromis niloticus) cultivated in polyculture system and feeding with ration pelleted and mashed. The work was realized in Centro de Pesquisa em Aqüicultura Ambiental-CPAA/IAP - Toledo/PR during 37 days. Were utilized like experimental unit 16 ponds excavated, covered with concrete but with bottom of soil with dimension the 4 x 3 m and useful volume the 3,5 m 3. Were utilized 30 tilapias e 150 shrimps for experimental unit distributed at an entirely randomized design with 4 treatments and 4 replications, where TF: tilapia feeding with ration mashed; TCF: tilapia and shrimp feeding with ration mashed; TP: tilapia feeding with ration pelleted; TCP: tilapia and shrimp feeding with ration pelleted. The density used were the 2,6 fishes/m 2 with medium initial weight the 5,58 ± 0,10 g and initial length the 5,56 cm, and the density of shrimp was the 13 shrimps/m 2 with initial length the 1,04 cm. The temperature was gauged daily, while the variables dissolved oxygen, pH and electrical conductivity, weekly. The quantity of ration supplied was the 10% of total biomass of fishes, with feed frequency the 4 times a day, being corrected weekly in function of the biometry. During the experimental period the medium values of temperature, dissolved oxygen, pH and electrical conductivity of the ponds water were 23,42 ± 0,83°C, 5,32 ± 0,52 mg/L, 7,02 ± 0,39, e 100,96 ± 1,81 μS/ cm respectively. Won't registering any influence of shrimp during the cultivation and the ration pelleted provide the better conversion alimentary and performance of tilapias.

Identificação de espécies fúngicas nas onicomicoses do idoso institucionalizado

BACKGROUND: Superficial fungal infections are caused by dermatophytes, yeasts or filamentous fungi. They are correlated to the etiologic agent, the level of integrity of the host immune response, the site of the lesion and also the injured tissue. OBJECTIVE: The purpose of this study is to isolate and to identify onychomycosis agents in institutionalized elderly (60 years old +). METHODS: The identification of the fungi relied upon the com-bined results of mycological examination, culture isolation and micro cultures observation under light microscopy from nail and interdigital scales, which were collected from 35 elderly with a clinical suspicion of onychomycosis and a control group (9 elderly with healthy interdigital space and nails). Both groups were insti-tutionalized in two nursing homes in Sao Bernardo do Campo, SP, Brazil. RESULTS: The nail scrapings showed 51.40% positivity. Of these, dermatophytes were found in 44.40% isolates, 27.78% identified as Trichophyton rubrum and 5.56% each as Trichophyton tonsurans, Trichophyton mentagrophytes and Microsporum gypseum. The second more conspicuous group showed 38.89% yeasts: 16.67% Candida guilliermondii, 11.11% Candida parapsilosis, 5.56% Candida glabrata, and 5.56% Trichosporon asahii. A third group displayed 16.70% filamen-tous fungi, like Fusarium sp, Aspergillus sp and Neoscytalidium sp (5.56% each). The interdigital scrapings pre-sented a positivity rate of 14.29%. The agents were coincident with the fungi that caused the onychomycosis. In the control group, Candida guilliermondii was found at interdigital space in one person. CONCLUSION: Employing a combination of those identification methods, we found no difference between the etiology of the institutional-ized elderly onychomycosis from that reported in the literature for the general population. © 2013 by Anais Brasileiros de Dermatologia.

Prevalência de síndrome metabólica em nipo-brasileiros de acordo com diferentes critérios de definição

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudos por imagem e físico dos membros pélvicos de pacas (Cuniculus paca) criadas em cativeiro

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Aspectos citológicos e microbiológicos na mastite em ovelhas da raça Bergamácia em lactação

Pós-graduação em Medicina Veterinária - FMVZ

Avaliação do teste do anel na vigilância epidemiológica da brucelose bovina em rebanhos e laticínios

Pós-graduação em Medicina Veterinária - FMVZ

Características anatômicas foliares e morfológicas de quatro espécies de gramas sob aplicação de trinexapac-ethyl

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Toxicidade Aguda do Triclorfom em pacus juvenis (Piaractus mesopotamicus Holmberg, 1887)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Implementação de um sistema eletrônico para medir taxa de fluência de energia de radiação na faixa de radioterapia com sensor piroelétrico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Níveis de vitamina “e” em dietas de frangos sobre o desempenho, características da carcaça e da carne e resposta imune

Pós-graduação em Zootecnia - FMVZ

Phosphorus reduction by sifting fish waste meal

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estudo químico e avaliação da atividade mutagênica dos extratos hidroalcoólicos das folhas de Pouteria torta e Pouteria ramiflora (Sapotaceae)

Pós-graduação em Química - IQ

Reduced levels of intracellular reactive oxygen species and apoptotic status are not correlated with increases in cryotolerance of bovine embryos produced in vitro in the presence of antioxidants

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Studies on the application of Myceliophthora thermophila JCP1-4 cellulases cocktail on sugarcane bagasse pretreated by different methods

The hydrolysis step for sugar production in biorefineries is crucial for the sequential processes involved and cellulases cocktails behave differently according to the pretreatment employed. In this study, the application of the cellulases cocktail produced by the fungus Myceliophthora thermophila JCP1-4 was studied on the saccharification of sugarcane bagasse pretreated by ozonolysis and thermic ferric nitrate (TFN), and the results were compared with commercial enzymes (Novozymes Celluclast 1.5L, Novozym 188). The fungal cellulases cocktail hold an activity of FPU:β-glucosidase of 1:4(U/mL); time, temperature, FPU by g of cellulose load and percentage of dry matter (DM) were studied. The analysis of central composite design of TFN pretreated showed that fungal cellulases works better in DM values of 3–3.5% (4.5% for commercial), temperatures higher than 50 °C (<45 °C for commercial) and 15FPU for both; commercial enzymes yielded 7.78 g/L of reducing sugars and the fungal enzymes 5.42 g/L. With the ozone pretreated, the fungal enzymes presented a higher thermostability with faster kinects, being able to produce 5.56 g/L of reducing sugars (60 °C, 8 h), against 5.20 g/L for commercial enzymes (50 °C, 24 h), (10FPU, 3%DM for both). The FPU derivate analysis revels better yields with 7.5FPU, and the increase of DM to 7.5% resulted 13.28 g/L of reducing sugars.