Epidemiology of healthcare-associated infections among patients from a hemodialysis unit in southeastern Brazil

Patients submitted to hemodialysis are at a high risk for healthcare-associated infections (HAI). Presently there are scarce data to allow benchmarking of HAI rates in developing countries. Also, most studies focus only on bloodstream infections (BSI) or local access infections (LAI). Our study aimed to provide a wide overview of HAT epidemiology in a hemodialysis unit in southeastern Brazil. We present data from prospective surveillance carried out from March 2010 through May 2012. Rates were compared (mid-p exact test) and temporally analyzed in Shewhart control charts for Poisson distributions. The overall incidence of BSI was 1.12 per 1000 access-days. The rate was higher for patients performing dialysis through central venous catheters (CVC), either temporary (RR = 13.35, 95% CI = 6.68-26.95) or permanent (RR = 2.10,95% CI = 1.09-4.13), as compared to those with arteriovenous fistula. Control charts identified a BSI outbreak caused by Pseudomonas aeruginosa in April 2010. LAI incidence was 3.80 per 1000 access-days. Incidence rates for other HAI (per 1000 patients-day) were as follows: upper respiratory infections, 1.72; pneumonia, 1.35; urinary tract infections, 1.25; skin/soft tissues infections, 0.93. The data point out to the usefulness of applying methods commonly used in hospital-based surveillance for hemodialysis units. (C) 2013 Elsevier Editora Ltda. All rights reserved.

Nitrogen fertilization (15NH4NO3) of palisadegrass and residual effect on subsequent no-tillage corn

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

Nutrient accumulation and biomass production of alfafa after soil amendment with silicates

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

A comparative evaluation of the CF:CS and CRS models in Pb-210 chronological studies applied to hydrographic basins in Brazil

The Constant Flux: Constant Sedimentation (CF:CS) and Constant Rate of Supply (CRS) of unsupported/excess Pb-210 models have been applied to a Pb-210 data set providing of eighteen sediments profiles sampled at four riverine systems occurring in Brazil, South America: Corumbatai River basin (S1=Site 1, Sao Paulo State), Atibaia River basin (S2=Site 2, Sao Paulo State), Ribeirao dos Bagres basin (S3=Site 3, Sao Paulo State) and Amazon River mouth. (S4=Site 4, Amapa State). These sites were chosen for a comparative evaluation of the performance of the CF:CS and CRS models due to their pronounced differences on the geographical location, geological context, soil composition, biodiversity, climate, rainfall, and water flow regime, among other variable aspects. However, all sediments cores exhibited a common denominator consisting on a database built from the use of the same techniques for acquiring the sediments major chemical composition (SiO2, Al2O3, Na2O, K2O, CaO, MgO, Fe2O3, MnO, P2O5, TiO2 and LOI-Loss on Ignition) and unsupported/excess 210Pb activity data. In terms of sedimentation rates, the performance of the CRS model was better than that of the CF:CS model as it yielded values more compatible with those expected from field evidences. Under the chronological point of view, the CRS model always provided ages within the permitted range of the Pb-210-method in the studied sites, whereas the CF:CS model predicted some values above 150 years. The SiO2 content decreased in accordance with the LOI increase in all cores analyzed and such inverse relationship was also tracked in the SiO2-LOI curves of historical trends. The SiO2-LOI concentration fluctuations in sites S1 and S3 also coincided with some Cu and Cr inputs in the drainage systems. (C) 2014 Elsevier Ltd. All rights reserved.

Electrocatalytic effect of Pb and Sn adatoms on the oxidation of 1-propanol on platinized platinum electrodes: Determination of the apparent activation energy

The electrocatalytic oxidation of 1-propanol was investigated on platinum electrodes modified by submonolayers of Pb and Sn in acid media. An increase of oxidation rates observed for both Pb and Sn, and the influence of theta values was investigated. The values of the apparent activation energy evaluated from the Arrhenius plots concerning the electrochemical oxidation of 1-propanol on modified platinzed platinum electrodes, reveal a significant decrease in the presence of upd Sn and Ph adatoms. A decrease from 56 to 26 U mol(-1) in the presence of Sn. and from 78 to 25 U mol(-1) for Ph adatoms are some illustrative values which reflect the promoting effect of the upd adatoms.

RESPONSE OF CORN GROWN IN TILLAGE SYSTEM FOR THE APPLICATION OF NITROGEN DOSES IN A SEQUENCE OF PLANT COVER

The use of cover crops can produce large amounts of biomass, improving the cycling of nutrients, particularly nitrogen, promoting productivity gains and cost savings. Given this, the objective was to evaluate the use of N rates associated to cover crops grown in pre-harvest nutritional status, nitrogen accumulation and corn yield in both years. The experiment was conducted in an Oxisol with maize, no-tillage system. The experimental design was a randomized block, split plot with four replications. The main treatments were: six cropping systems (sun hemp, jack bean, lablab, millet, and velvet bean fallow) in secondary treatments: four doses of nitrogen (0, 60, 120 and 180 kg ha(-1) N). Corn yield was not affected by the type of coverage for pre-season, regardless of the nitrogen applied in the soil. Still, the use of nitrogen fertilizer in the soil promotes gains in grain yield in the first year of cultivation, regardless of the type of coverage in pre-season. In the first year (2006/2007) the species of coverage produced more biomass were velvet bean, jack bean, sun hemp and lablab, while in the second year (2007/08) were the sun hemp, millet, lablab, jack bean and velvet bean, respectively.

Mathematical modeling of a continuous alcoholic fermentation process in a two-stage tower reactor cascade with flocculating yeast recycle

Experiments of continuous alcoholic fermentation of sugarcane juice with flocculating yeast recycle were conducted in a system of two 0.22-L tower bioreactors in series, operated at a range of dilution rates (D (1) = D (2) = 0.27-0.95 h(-1)), constant recycle ratio (alpha = F (R) /F = 4.0) and a sugar concentration in the feed stream (S (0)) around 150 g/L. The data obtained in these experimental conditions were used to adjust the parameters of a mathematical model previously developed for the single-stage process. This model considers each of the tower bioreactors as a perfectly mixed continuous reactor and the kinetics of cell growth and product formation takes into account the limitation by substrate and the inhibition by ethanol and biomass, as well as the substrate consumption for cellular maintenance. The model predictions agreed satisfactorily with the measurements taken in both stages of the cascade. The major differences with respect to the kinetic parameters previously estimated for a single-stage system were observed for the maximum specific growth rate, for the inhibition constants of cell growth and for the specific rate of substrate consumption for cell maintenance. Mathematical models were validated and used to simulate alternative operating conditions as well as to analyze the performance of the two-stage process against that of the single-stage process.

Inflammatory bowel disease: an overview of immune mechanisms and biological treatments

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

Direct retrospective comparison of adalimumab and infliximab in preventing early postoperative endoscopic recurrence after ileocaecal resection for crohn's disease: results from the MULTIPER database

Both adalimumab [ADA] and infliximab [IFX] seem to be effective in the prevention of early postoperative endoscopic recurrence [EPER] after ileocaecal resection in Crohn's disease [CD] patients. There is lack of data with direct comparison between the two agents in the postoperative scenario. The aim of this study was to compare the rates of EPER in patients treated with ADA and IFX after ileocaecal resection for CD. This was a multicentre retrospective analysis of EPER rates in CD patients after ileocaecal resections, from seven referral centres in three countries. Endoscopic recurrence was defined as Rutgeerts' score ≥ i2. The patients were allocated according to treatment to two groups: ADA or IFX. The EPER rates were compared between the two treatment groups. Among the 168 patients included in the database, 96 received anti-tumour necrosis factor [TNF] agents after resection [37 in the ADA and 59 in the IFX groups] and were included in this comparative study. The groups were comparable in all baseline characteristics, mainly age, gender, previous resections, perianal CD, and mono or combination therapy. EPER was identified in 9/37 [24.32%] in the ADA group vs 16/59 [27.12%] in the IFX group [p = 0.815]. In this retrospective direct comparison between ADA and IFX therapy after ileocaecal resection, there was no significant difference between the two anti-TNF agents in terms of EPER rates. However, prospective randomised studies are needed to confirm these data and better define the role of each agent in the prevention of EPER.

Conventional versus biological therapy for prevention of postoperative endoscopic recurrence in patients with Crohn's disease: an international, multicenter, and observational study

Postoperative endoscopic recurrence (PER) occurs in nearly 80% of patients 1 year after ileocecal resection in patients with Crohn's disease (CD). Biological agents were more effective in reducing the rates of PER in comparison with conventional therapy, in prospective trials. The aim of this study was to compare the PER rates of biological versus conventional therapy after ileocecal resections in patients with CD in real-world practice. The MULTIPER (Multicenter International Postoperative Endoscopic Recurrence) database is a retrospective analysis of PER rates in CD patients after ileocecal resection, from 7 referral centers in 3 different countries. All consecutive patients who underwent ileocecal resections between 2008 and 2012 and in whom colonoscopies had been performed up to 12 months after surgery, were included. Recurrence was defined as Rutgeerts' score ≥i2. The patients were allocated to either biological or conventional therapy after surgery, and PER rates were compared between the groups. Initially, 231 patients were evaluated, and 63 were excluded. Of the 168 patients in the database, 96 received anti-tumor necrosis factor agents and 72 were treated with conventional therapy after resection. The groups were comparable regarding age, gender, and perianal disease. There was longer disease duration, more previous resections, and more open surgical procedures in patients on biologicals postoperatively. PER was identified in 25/96 (26%) patients on biological therapy and in 24/72 (33.3%) patients on conventional therapy (P=0.310). In this retrospective observational analysis from an international database, no difference was observed between biological and conventional therapy in preventing PER after ileocecal resections in CD patients.