Growth and survival of pacu Piaractus mesopotamicus (Holmberg, 1887) juveniles reared in ponds or at different initial larviculture periods indoors

Five-day-old pacu larvae (Piaractus mesopotamicus) with average length and weight of 5.96 mm and 0.42 mg, respectively, were reared as follows: in a semi-intensive system with larvae stocked directly into fertilized ponds (IL0)-and an initial intensive larviculture system with larvae maintained in a laboratory for 3 (IL3), 6 (IL6) and 9 (IL9) days, before being transferred to fertilized ponds. During the indoor phase, larvae were fed Artemia nauplii. Intensive-culture survivals were high (95.6%, 86.4% and 83.8% for IL3, IL6 and IL9, respectively) and at the end of the 45-day period, the longer the larvae were kept in the intensive system, the better the juvenile survival in the ponds. IL9 and IL6 survival rates were 54.0% and 45.4%, respectively, significantly higher (P < 0.05) than IL0 (11%) and IL3 presented an intermediate rate (25.3%). Due to the low survival rate of IL0, length and weight were higher (P < 0.05) when compared to IL6 and IL9; and the differences between their survival rates affected size distribution of juveniles among treatments. Treatments, which resulted in high survival (IL6 and IL9), presented a great number of small fish. In contrast, IL0 and IL3 produced many large and extra large individuals. In general, the results indicate that pacu juvenile production by initial intensive larviculture (IL6 and IL9) was the most efficient method. Therefore, further studies should be conducted in order to improve larval growth in the laboratory and handling techniques in both the laboratory and ponds. (C) 2003 Elsevier B.V. B.V. All rights reserved.

Economic evaluation of Piaractus mesopotamicus juvenile production in different rearing systems

In this study, the costs and gross income related to the production of pacu Piaractus mesopotamicus juveniles were evaluated. This evaluation took into consideration a semi-intensive rearing, with direct stocking of the larvae into fertilized ponds (IL 0), or an initial intensive larviculture system, in which the larvae were fed in the laboratory for 3 (IL 3), 6 (IL 6), or 9 days (IL 9) before being transferred to the ponds. After 45 days of rearing, a gradual increase in production costs was observed as intensive larviculture time increased. Gross income also increased due to better survival rates (11.0, 25.3, 45.4, and 54.0% for IL 0, IL 3, IL 6, and IL 9, respectively). Therefore, increased profits were obtained under intensive larviculture (US$ 0.27, US$ 6.07, US$ 11.99, and US$ 13.16 per one thousand larvae in treatments IL 0, IL 3, IL 6, and IL 9, respectively). In a larger scale production simulation, the results obtained with initial intensive larviculture also showed evident economic advantages, confirming the feasibility of this system in comparison with the direct stocking of larvae in ponds for the production of pacu juveniles. © 2004 Elsevier B.V. All rights reserved.

Água levemente salinizada aumenta a eficiência da larvicultura de peixes neotropicais

The objective of this work was to evaluate the effect of slightly saline water in an intensive larviculture of tambaqui, matrinxã, apaiari, and piau, during the initial days of active feeding. Larvae were reared in artificial saline water, at concentrations from 0 (freshwater) to 14 g L-1 NaCl (at a 2.0 g L-1), and fed with two portions of Artemia nauplii, following a specific protocol for each species, in a completely randomized design, with 3 replicates. Tambaqui, matrinxã and apaiari larvae can be reared at saline concentrations till 2 g L-1 without impairing growth and survival. Piau larvae were more tolerant and endured saline water until 4 g L-1. At saline concentrations above that, fish mortality increased and reached 100% at 6 g L-1, for matrinxã and apaiari, and at 10 g L-1, for tambaqui. Saline water at 2 g L-1 provided a higher survival for matrinxã, and higher growth for tambaqui, apaiari and piau. These last two species showed a better growth performance with the highest quantity of nauplii. Slightly saline water at 2 g L-1 is beneficial to these studied species, as it optimizes larval growth potential and the use of Artemia nauplii as live food.

Genetic diversity and antifungal susceptibility testing of Trichosporon asahii isolated of Intensive Care Units patients

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Detection of mixed microbial biofilms on central venous catheters removed from Intensive care Unit Patients

Cateteres venosos centrais inseridos em pacientes internados em unidade de terapia intensiva foram avaliados por métodos microbiológicos (cultura semi-quantitativa) e microscopia eletrônica de varredura a fim de detectar adesão microbiana e correlacionar com a cultura de sangue. Durante o período de estudo, foram avaliados 59 pacientes com cateter venoso central. A idade dos pacientes, sexo, sítio de inserção e tempo de permanência do cateter foram anotados. O cateter era de poliuretano não tunelizado e de único lúmen. O sangue para cultura foi coletado no momento da remoção do cateter. de 63 pontas de cateteres, 30 (47,6%) foram colonizadas e a infecção encontrada em 5 (23,8%) cateteres. A infecção foi mais prevalente em 26 pacientes (41,3%) com cateteres inseridos em veia subclávia do que nos 3 (3,2%) inseridos em veia jugular. A infecção foi observada com mais freqüência em cateteres com tempo de permanência maior do que sete dias. Os microrganismos isolados incluíram 32 estafilococos coagulase-negativa (29,7%), 61 bactérias Gram-negativas (52,9%), 9 estafilcocos coagulase-positiva (8,3%) e 3 leveduras (2,7%). Como agentes causais de infecções em unidade de terapia intensiva foram isolados E. aerogenes, P. aeruginosa, A. baumannii. Os antimicrobianos com maior atividade in vitro contra as bactérias Gram-negativas foram o imipenem e contra as Gram-positivas vancomicina, cefepime, penicilina, rifampicina e tetraciclina. As análises por microscopia eletrônica de varredura revelaram biofilmes sobre a superfície de todos os cateteres examinados.

Weight and neuro-psycho-motor development in children discharged from neonatal intensive care unit

Background: Low birth weight affects child growth and development, requiring the intensive use of health services. There are conversely proportional associations between prematurity and academic performance around the world. In this study we evaluated factors involved in weight and neuropsychomotor profile in one and two years old discharged from Intensive Care Units (ICU).Methods/Design: We investigated 203 children from the ICU who were followed for 24 +/- 4 months. The research was conducted by collecting data from medical records of patients in a Follow-up program. We investigated the following variables: inadequate weight at one year old; inadequate weight at two years old and a severe neurological disorder at two years old.Results: We observed increase of almost 20% in the proportion of children which weighted between the 10th and 90th percentiles and decrease of around 40% of children below the 15th percentile, from one to two years old. In almost 60% of the cases neuropsychomotor development was normal at 2 years old, less than 15% of children presented abnormal development. Variables that remained influential for clinical outcome at 1 and 2 years old were related to birth weight and gestational age, except for hypoglycemia. Neurological examination was the most influential variable for severe neurological disturbance.Conclusion: Hypoglycemia was considered a new fact to explain inadequate weight. The results, new in Brazil and difficult in terms of comparison, could be used to identify risk factors and for a better approach of newborn discharged from ICUs.

Risk factors of oropharyngeal carriage of Pseudomonas aeruginosa among patients from a Medical-Surgical Intensive Care Unit

Oropharyngeal carriage of Pseudomonas aeruginosa is associated with increased risk of infection and may provide a source for spread of drug-resistant strains. In order to assess the incidence and risk factors of oropharyngeal carriage, we conducted a retrospective cohort study based on results of surveillance cultures (oropharyngeal swabs) from a medical-surgical intensive care unit, collected from March 2005 through May 2006. Variables investigated included demographic characteristics, comorbid conditions, invasive procedures, use of devices and use of antimicrobials. Thirty case patients with P. aeruginosa carriage were identified. Other 84 patients with surveillance cultures negative to P. aeruginosa were enrolled as control subjects. Case patients were more likely to have a solid malignancy (Odds Ratio [OR] = 12.04, 95% Confidence Interval [CI] = 1.93-75.09, p=0.008), Acquired Immunodeficiency Syndrome (AIDS, OR = 7.09, 95% CI=1.11-45.39, p = 0.04), central nervous system disease (OR = 4.51, 95% CI = 1.52-13.39, p = 0.007), or to have a central venous catheter placed (OR = 7.76, 95% CI = 1.68-35.79, p=0.009). The use of quinolones was a protective factor (OR = 0.13, 95% CI = 0.03-0.47, p = 0.002). The predominance of comorbidities as risk factors points out a group of patients to whom preventive measures should be directed.

Knowledge and attitudes of health care workers from intensive care units regarding nosocomial transmission of influenza: a study on the immediate pre-pandemic period

The transmission of influenza in health care settings is a major threat to patients, especially those with severe diseases. The attitude of health care workers (HCWs) may influence the transmission of countless infections. The current study aimed to quantify knowledge and identify attitudes of HCWs involved in intensive care units (ICUs) regarding the risk of nosocomial influenza transmission. A questionnaire was applied through interviews to HCWs who worked in one of the five ICUs from a teaching hospital. Questions about influenza were deliberately dispersed among others that assessed several infectious agents. Forty-two HCWs were interviewed: nine physicians, ten nurses and 23 nursing technicians or auxiliaries. Among the 42 HCWs, 98% were aware of the potential transmission of influenza virus in the ICUs, but only 31% would indicate droplet precautions for patients with suspected infection. Moreover, only 31% of them had been vaccinated against influenza in the last campaign (2008). Nursing technicians or auxiliaries were more likely to have been vaccinated, both by univariate and multivariable analysis. When asked about absenteeism, only 10% of the study subjects stated that they would not go to work if they had an influenza-like illness. Those findings suggest that, in non-pandemic periods, influenza control in hospitals requires strategies that combine continuous education with changes in organizational culture.

Caring for organ donors: the intensive care unit physicians' view

This study examined the meanings that the intensive care unit (ICU) physicians attribute to their practice when caring for brain-dead organ donors. It is a phenomenological study, a qualitative method that searches for describing and understanding the experiences lived. Data were collected through recorded individual interviews made with 10 ICU physicians who work in a university hospital in the interior of São Paulo, Brazil. Three categories emerged from data: (1) providing care for brain-dead organ donors; (2) relating to donors and their families; and (3) the ethical concerns and self-awareness of the physicians. There is consensus as to-many aspects: demand of technical qualification and excellence in practice; need of investing in technology of organ transplant; and donors seen as human beings and holders of human rights. Participants understand that family participation is decisive in the donation process, although interactions between the family members and the physicians are difficult because of the sensitive nature of the situation. The physicians often felt ill-prepared to openly discuss the topic of brain death and organ donation. Educational programs for physicians and family members may assist with this difficult process.

Nasopharyngeal colonization with methicillin-resistant staphylococcus aureus and mortality among patients in an intensive care unit

A colonização de nasofaringe por Staphylococcus aureus, resistente à meticilina (Methicillin-resistant S.aureus - MRSA), é comum em pacientes criticamente doentes, mas seu significado prognóstico não é inteiramente conhecido. Realizou-se estudo de coorte retrospectivo com 122 pacientes de uma unidade de terapia intensiva que realizaram triagem semanal para colonização por MRSA. Os desfechos de interesse foram: mortalidade geral e mortalidade por infecção. Diversas variáveis de exposição (gravidade, procedimentos, intercorrências e colonização nasofaríngea por MRSA) foram analisadas em modelos univariados e multivariados. Fatores significativamente associados à mortalidade geral ou por infecção foram: APACHE II e doença pulmonar. A colonização por MRSA não foi preditora de mortalidade geral (OR=1,02; IC95%=0,35-3; p=0,97) ou por infecção (OR=0,96; IC95%=0,33-2,89; p=0,96). Os resultados sugerem que, na ausência de fatores de gravidade, a colonização por MRSA não caracteriza pior prognóstico.

Case-case-control study of risk factors for nasopharyngeal colonization with methicillin-resistant Staphylococcus aureus in a medical-surgical intensive care unit

Nasopharyngeal colonization with methicillin-resistant Staphylococcus aureus (MRSA) often precedes the development of nosocomial infections. In order to identify risk factors for MRSA colonization, we conducted a case-case-control study, enrolling 122 patients admitted to a medical-surgical intensive care unit (ICU). All patients had been screened for nasopharyngeal colonization with S. aureus upon admission and weekly thereafter. Two case-control studies were performed, using as cases patients who acquired colonization with MRSA and methicillin-susceptible S. aureus (MSSA), respectively. For both studies, patients in whom colonization was not detected during ICU stay were selected as control subjects. Several potential risk factors were assessed in univariate and multivariable (logistic regression) analysis. MRSA and MSSA were recovered from nasopharyngeal samples from 27 and 10 patients, respectively. Independent risk factors for MRSA colonization were: length-of-stay in the ICU (Odds Ratio [OR]=1.12, 95%Confidence Interval[CI]=1.06-1.19, p<0.001) and use of ciprofloxacin (OR=5.05, 95%CI=1.38-21.90, p=0.015). The use of levofloxacin had a protective effect (OR=0.08, 95%CI=0.01-0.55, p=0.01). Colonization with MSSA was positively associated with central nervous system disease (OR=7.45, 95%CI=1.33-41.74, p=0.02) and negatively associated with age (OR=0.94, 95%CI=0.90-0.99, p=0.01). In conclusion, our study suggests a role for both cross-transmission and selective pressure of antimicrobials in the spread of MRSA.

Influence of sedation on morbidity and mortality in the intensive care unit

CONTEXTO: Embora cerca de 30% a 50% dos pacientes hospitalizados em unidades de terapia intensiva (UTI) recebam algum tipo de sedativo, existe escassez de informações sobre efeitos adversos desta prática, especialmente no Brasil. Estes efeitos podem ser significantes e o uso de sedativos é associado a elevação de infecção e mortalidade, mesmo sendo difícil avaliar o impacto clínico deste procedimento. OBJETIVO: Avaliar o impacto da sedação sobre incidência de complicações e mortalidade em doentes graves durante internação em unidade de terapia intensiva. TIPO DE ESTUDO: Estudo prospectivo. LOCAL: Unidade de Terapia Intensiva Cirúrgica da Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina. PARTICIPANTES: Após excluídos pacientes que permaneceram menos de 24 horas ou sem exames indispensáveis para o cálculo do índice de gravidade (APACHE II), restaram 307 pacientes. Estes foram divididos em dois grupos: Grupo Sedado e Grupo Não Sedado. Constatada heterogeneidade com relação ao APACHE II, foram pareados 97 sedados e 97 não sedados com idênticos índices de gravidade. VARIÁVEIS ESTUDADAS: Impacto da sedação e das técnicas sobre a mortalidade, tempo de internação, além da incidência de escara de decúbito ou pressão, trombose venosa profunda e infecção. RESULTADOS: Não houve diferença na incidência de trombose venosa profunda, entre os grupos Sedado e Não Sedado, enquanto que escara de decúbito foi significativamente maior nos sedados (p = 0,03). Infecção foi detectada em 45,4% dos pacientes com sedação e em 21,6% dos pacientes sem sedação (p = 0,006). A mortalidade para os pacientes que não receberam qualquer tipo de sedativo foi de 20,6% e, para aqueles que foram sedados durante a internação, foi de 52,6% (p < 0,0001). CONCLUSÕES: Conclui-se que a sedação está associada a maior duração da internação, morbidade e mortalidade significativas. Apesar da intensidade das associações encontradas, não é possível estabelecer relação causal entre sedação e mortalidade.

Influência do formato do aquário na sobrevivência e no desenvolvimento de larvas de matrinxã Brycon cephalus (Osteichthyes, Characidae)

Neste experimento, utilizaram-se cinco aquários cilíndricos com relevo no fundo (em forma de anel) e cinco retangulares com fundo liso para estudo da influência do formato do aquário na sobrevivência e no desenvolvimento de larvas de matrinxã Brycon cephalus. Observou-se melhor eficiência dos aquários retangulares, confirmada pela maior sobrevivência e biomassa. Os valores de temperatura, pH, condutividade e oxigênio dissolvido foram similares entre os tipos de aquários, sugerindo que esses parâmetros não influenciaram os resultados. O relevo no fundo dos aquários cilíndricos afetou negativamente o cultivo de larvas de matrinxã, pela criação de zonas com pequena capacidade da água em suspender partículas, o que resultou em acúmulo de dejetos, predadores, competidores e alimento. Aquários retangulares com fundo liso são mais adequados ao cultivo de larvas de matrinxã, por promover melhor circulação da água.

Influence of Intensive Agriculture on Dry Deposition of Aerosol Nutrients

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)