Paracoccidioidomicose subaguda progressiva: tratamento de um doente com anfotericina B e nutrição parenteral

Os Autores descrevem um caso de paracoccidioidomicose subaguda progressiva, com quadro clínico sugestivo de síndrome de má absorção, em que o doente não se beneficiara apenas com o tratamento antifúngico convencional. Ao se introduzir como medida auxiliar a nutrição parenteral houve evidente melhora clínica e laboratorial. Desta maneira os Autores propõe o uso associado da nutrição parenteral no tratamento de doentes com esta forma clínica de paracoccidioidomicose.

Factors predictive of inappropriateness in requests for parenteral antimicrobials for therapeutic purposes: A study in a small teaching hospital in Brazil

Background: The identification of patterns of inappropriate antimicrobial prescriptions in hospitals contributes to the improvement of antimicrobial stewardship programs (ASP). Methods: We conducted a cross-sectional study to identify predictors of inappropriateness in requests for parenteral antimicrobials (RPAs) in a teaching hospital with 285 beds. We reviewed 25% of RPAs for therapeutic purposes from y 2005. Appropriateness was evaluated according to current guidelines for antimicrobial therapy. We assessed predictors of inappropriateness through univariate and multivariate models. RPAs classified as 'appropriate' or 'probably appropriate' were selected as controls. Case groups comprised inappropriate RPAs, either in general or for specific errors. Results: Nine hundred and sixty-three RPAs were evaluated, 34.6% of which were considered inappropriate. In the multivariate analysis, general predictors of inappropriateness were: prescription on week-ends/holidays (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.20-2.28, p = 0.002), patient in the intensive care unit (OR 1.57, 95% CI 1.11-2.23, p = 0.01), peritoneal infection (OR 2.15, 95% CI 1.27-3.65, p = 0.004), urinary tract infection (OR 1.89, 95% CI 1.25 -2.87, p = 0.01), combination therapy with 2 or more antimicrobials (OR 1.72, 95% CI 1.15-2.57, p = 0.008) and prescriptions including penicillins (OR 2.12, 95% CI 1.39-3.25, p = 0.001) or 1(st) generation cephalosporins (OR 1.74, 95% CI 1.01-3.00, p = 0.048). Previous consultation with an infectious diseases (ID) specialist had a protective effect against inappropriate prescription (OR 0.34, 95% CI 0.24-0.50, p < 0.001). Factors independently associated with specific prescription errors varied. However, consultation with an ID specialist was protective against both unnecessary antimicrobial use (OR 0.04, 95% CI 0.01-0.26, p = 0.001) and requests for agents with an insufficient antimicrobial spectrum (OR 0.14, 95% CI 0.03-0.30, p = 0.01). Conclusions: Our results demonstrate the importance of previous consultation with an ID specialist in assuring the quality of prescriptions. Also, they highlight prescription patterns that should be approached by ASP policies.

Determination of oligoelements in parenteral formulations by planar chromatography and spectrophotometry

The authors have studied the chromatographic behavior of parenteral preparations for pediatric use containing inorganic cations. After separation and identification by thin-layer chromatography, Mn2+, Zn2+, and Cu2+ were analyzed by a method based on reaction with an appropriate reagent and extraction with an organic solvent which yielded elution and preconcentration, resulting in an appropriate solution for colorimetric quantitation. Cr3+ cation was determined by atomic absorption spectrophotometry after appropriate chromatographic separation, using microcrystalline cellulose (adsorbent) and an acetone:water:hydrochloric acid mixture (80:5:8) as the mobile phase.

Serum Vitamins in Adult Patients With Short Bowel Syndrome Receiving Intermittent Parenteral Nutrition

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

Índice de acidez del aceite de pez en la nutrición de alevines de pacú Piaractus mesopotamicus

The aim of this study was to evaluate the effects of fish oil acidity on the growth of pacu (Piaractus mesopotamicus) juveniles. Two hundred juveniles with 10.53±0.65 g of weight and 8.74±0.13 cm of total length, were distributed in a totally randomized design in 20, 0.15 m3 meshmade tanks placed in a 25 m3 holding tank. Extruded commercial diets sprayed with soybean oil (control) with acidity index of 0.24 and fish oil with acidity index of 1.48, 6.40 and 9.85 were used. The fish were fed four times a day until apparent satiety. Productive performance, centesimal composition and blood biochemistry were analysed. At the end of the feeding period none of the analyzed parameters was affected by the use of acidified fish oil. Therefore, fish oil may be supplied to the pacu juveniles regardless of their pH.

Formas de aplicación de zinc para las plantas de maíz que crecen en Oxisol: Efectos sobre el suelo, la nutrición de las plantas y la productividad

The way of applying zinc can influence the zinc uptake and productivity of crops, especially cereals that have high demand for this nutrient. The aim of this study is to evaluate methods of Zn application on soil, nutritional status and productivity of maize. For this, an experiment was undertaken at FCAV/UNESP, Jaboticabal-SP, in Oxisol clay (DTPA on Zn: 0.5 mg dm-3) with maize (hybrid Simple Impact), from December through May 2009. Nine treatments with three doses of Zn in soil banded application (in furrows) and three doses of Zn by incorporation in soil (0-20 cm depth), foliar application, seed application and control (no Zn). The treatments were arranged in a randomized block design with four replications. Regardless of the method, Zn application promoted higher contents of this micronutrient in soil and higher accumulation in the shoots as well as increasing Zn in the maize grain. However, it did not affect the nutritional status and yield of the maize. The Zn application in the soil resulted in a greater Zn uptake by plants and maize yield, compared to Zn application in the plant by seed or foliar.

Nutrição e nutrição parenteral no animal hospitalizado

The beneficial effects derived from the nutritional support in human patients and experimental animal models include the improvement of immune function, repair of wounds, answer to the treatment, time of recovery and survival. In front of these benefits, we end up alienating the nutritional needs of hospitalized patients, especially those with clinical or surgical affections threatening. The objective of the nutritional support is to indicate the importancea and the proportions of energy and nutrients that the patient can use with the maximum effectiveness. The majority of hospitalized patients do not have voluntary food intake adequate to meet even the minimal nutritional needs. It is often perceived that lack of adequate food intake, will have serious impact on the patient’s clinical outcome. The nutritional assessment will help determine which route of feeding will be the safest, most effective and best tolerated by the patient. Diet choice is based on which of the patient’s problems can and should be addressed with nutrition and the feeding access available