SUSCEPTIBILITY OF Candida spp. ISOLATED FROM BLOOD CULTURES AS EVALUATED USING THE M27-A3 AND NEW M27-S4 APPROVED BREAKPOINTS

The high mortality rates associated with candidemia episodes and the emergence of resistance to antifungal agents necessitate the monitoring of the susceptibility of fungal isolates to antifungal treatments. The new, recently approved, species-specific clinical breakpoints (SS-CBPs)(M27-S4) for evaluating susceptibility require careful interpretation and comparison with the former proposals made using the M27-A3 breakpoints, both from CLSI. This study evaluated the susceptibility of the different species of Candida that were isolated from candidemias based on these two clinical breakpoints. Four hundred and twenty-two isolates were identified and, among them, C. parapsilosis comprised 46.68%, followed by C. albicans (35.78%), C. tropicalis (9.71%), C. glabrata (3.55%), C. lusitaniae (1.65%), C. guilliermondii (1.65%) and C. krusei (0.94%). In accordance with the M27-A3 criteria, 33 (7.81%) non-susceptible isolates were identified, of which 16 (3.79%) were resistant to antifungal agents. According to SS-CBPs, 80 (18.95%) isolates were non-susceptible, and 10 (2.36%) of these were drug resistant. When the total number of non-susceptible isolates was considered, the new SS-CBPs detected 2.4 times the number of isolates that were detected using the M27-A3 interpretative criteria. In conclusion, the detection of an elevated number of non-susceptible species has highlighted the relevance of evaluating susceptibility tests using new, species-specific clinical breakpoints (SS-CBPs), which could impact the profile of non-susceptible Candida spp. to antifungal agents that require continuous susceptibility monitoring.

THE PROCESS OF Leishmania INFECTION - DISEASE AND NEW PERSPECTIVES OF PALEOPARASITOLOGY

Species of the genus Leishmania (Kinetoplastida, Trypanosomatidae) are causative agents of leishmaniasis, a complex disease with variable clinical spectrum and epidemiological diversity, constituting, in some countries, a serious public health problem. The origin and evolution of leishmaniasis has been under discussion regarding some clinical and parasitological aspects. After the introduction of paleoparasitology, molecular methods and immunodiagnostic techniques have been applied allowing the recovery of parasite remains, as well as the diagnosis of past infections in humans and other hosts. The dating of archaeological samples has allowed the parasitological analysis in time and space. This manuscript presents the state of the art of leishmaniasis and prospects related to paleoparasitology studies and their contribution to the evolutionary and phylogenetic clarification of parasites belonging to the genus Leishmania, and the leishmaniasis caused by them.

Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools

Different aspects of hepatosplenic schistosomiasis are revisited here. Manson's schistosomiasis causes periportal fibrosis and portal hypertension in approximately 6% of infected subjects, usually with preservation of their hepatic function. The assessment of liver involvement is of major importance in determining the prognosis and risk of complications from schistosomiasis, such as upper digestive bleeding secondary to variceal rupture. For many years, the diagnosis of hepatosplenic schistosomiasis and liver fibrosis was made by abdominal palpation and the finding of liver and/or spleen enlargement. However, there is no consensus regarding the clinical parameters of the liver and spleen to be considered in this physical evaluation. For the last three decades, abdominal ultrasound (US) has become the best imaging technique to evaluate liver fibrosis caused by schistosomiasis mansoni. However, US is a subjective procedure and is therefore examiner-dependent. Magnetic resonance imaging (MRI) findings have provided valuable information in addition to ultrasound and clinical examination. The combination of a comprehensive history and physical examination, basic laboratory tests (a stool examination for Schistosoma mansoni eggs and a blood cell count), biomarkers for liver fibrosis/portal hypertension and imaging methods seem to offer the best approach for evaluating patients with this disease. In situations where research is involved or in patients with severe disease, MRI may be considered.

Cardiopulmonary resuscitation: update, controversies and new advances

Cardiopulmonary arrest is a medical emergency in which the lapse of time between event onset and the initiation of measures of basic and advanced support, as well as the correct care based on specific protocols for each clinical situation, constitute decisive factors for a successful therapy. Cardiopulmonary arrest care cannot be restricted to the hospital setting because of its fulminant nature. This necessitates the creation of new concepts, strategies and structures, such as the concept of life chain, cardio-pulmonary resuscitation courses for professionals who work in emergency medical services, the automated external defibrillator, the implantable cardioverter-defibrillator, and mobile intensive care units, among others. New concepts, strategies and structures motivated by new advances have also modified the treatment and improved the results of cardiopulmonary resuscitation in the hospital setting. Among them, we can cite the concept of cerebral resuscitation, the application of the life chain, the creation of the universal life support algorithm, the adjustment of drug doses, new techniques - measure of the end-tidal carbon dioxide levels and of the coronary perfusion pressure - and new drugs under research.

Recognition characters and new records of two species of Phylloscyrtini (Orthoptera, Gryllidae, Trigonidiinae) from southern Brazil

The Phylloscyrtini occurs from eastern United States to Argentina and includes 21 valid species. It is a highly neglected group of crickets and little is known about its biology and distribution. Cranistus colliurides Stål, 1861 and Phylloscyrtus amoenus (Burmeister, 1880) were recorded for the state of Rio Grande do Sul, southern Brazil, and information on calling song, stridulatory file and recognition characters were provided.

A new species of Phrixotrichus (Araneae, Theraphosidae) from southwestern Argentina and new distributional data for P. vulpinus

ABSTRACT A new species of Phrixotrichus Simon, 1889, P. pucara sp. nov., is described and illustrated based on a male from Pucará river, Neuquén province, Argentina. Male can be distinguished from all other species of the genus by the presence of a long strong spine on inner face of prolateral branch of tibial apophysis; also, it differs from P. scrofa (Molina, 1788) and P. vulpinus (Karsch, 1880) by a serrated prolateral keel of the male palpal bulb. Male resembles P. jara Perafán & Pérez-Miles, 2014 but can be distinguished by the uniform color on dorsal cephalothorax and by the palpal organ morphology being wider on the bulb base and embolus shorter and thicker, with the tip of embolus not so directed retrolaterally and prolateral keel bearing a serrated edge with three teeth. Additionally, P. vulpinus is reported for the first time for Argentina along with new distributional data.

Taxonomy of the Brazilian firefly Cladodes illigeri (Coleoptera, Lampyridae): morphology and new records

ABSTRACT Cladodes illigeri (Kirby, 1818) is redescribed, and can be distinguished by the following features: color pattern overall black, paired spots and elytral margins pale yellow; pygidium bisinuate, posterior angles rounded, as long as median margin; and aedeagus with phallus 1/3 shorter than the parameres, which are sinuated apically. Cladodes lamellicornis (Motschulsky, 1854) is proposed as a junior synomym of C. illigeri. New records from the Atlantic Rainforest and illustrations for structural features are provided.

Gorgorhynchus Trachinotus n.sp. and new host records for Dollfusentis Chandleri Golvan, 1969 (Paleacanthocephala, Echinorhynchoidea)

Gorgorhynchus trachinotus recovered from the intestine of trachinotus goodei Jordan & Evermann, 1896 is proposed as a new species and three new host records are reported for Dollfusentis chandleri Golvan, 1969.

New synonymy and new species in neotropical chloropidae (Diptera)

An ephydrid, Hyadina porteri Brèthes, 1919, is found to be a senior synonym of Hippelates australis Sabrosky, 1955. New combination: Liohippelates porteri (Brèthes). Two new species, Pseudogaurax souzalopesi from Peru and P. silbergliedi from Panama are described and placed in the synopsis by Sabrosky (1966).

Some monogenoidea parasitic on peruvian marine fishes, with description of Anoplocotyloides chorrillensis new species and new records

The presence of four Monogenoidea parasitic on marine fishes from the central Peruvian coast is recorded. One of them, Anoplocotyloides chorrillensis (Monocotylidae) described from the gills of Rhinobatos planiceps (Rhinobatidae) is considered a new species. The three other species are: Caballerocotyla autralis Oliva, 1986 (Capsalidae); Callorhynchocotyle marplatensis Suriano & Incorvaia, 1982 (Hexabothriidae) and Anoplocotyloides papillatus (Doran, 1953) (Monocotylidae) parasitic on Sarda chiliensis chiliensis (Scombridae), Callorhinchus callorhinchus (Callorhinchidae) and Rhinobatos planiceps (Rhinobatidae) respectively.

Studies on Procamallanus (Spirocamallanus) pereirai Annereaux, 1946 (Nematoda: Camallanidae), with new host records and new morphological data on the larval stages

Larval stages and adults of Procamallanus (Spirocamallanus) pereirai Annereaux, 1946 are described from naturally infected Paralonchurus brasiliensis (Steindachner) (Sciaenidae) from the coast of the State of Rio de Janeiro, Brazil. The translucent first-stage larvae have a denticulate process at the anterior end, no buccal capsule or esophagus undifferentiated into anterior muscular and posterior glandular parts and an elongate tail; third-stage larvae have a tail with three terminal projections, a buccal capsule divided into an anterior portion with 12-20 ridges running to the left and a posterior smooth portion, and an esophagus with muscular and glandular regions. Fourth-stage larvae exhibit a buccal capsule lacking a distinct basal ring with ridges running to the right and a tail with two terminal processes, as in adults. New host records are reported and their role in its life-cycle are discussed.

Two new species and new records of biting midges of the genus Culicoides from northwestern Argentina (Diptera: Ceratopogonidae)

The following two new species of Culicoides from the Argentinean Yungas are described, illustrated and placed to subgenus or species group and compared with related congeners: Culicoides calchaqui Spinelli & Veggiani Aybar and Culicoides willinki Spinelli & Veggiani Aybar. Culicoides daedaloides Wirth & Blanton is recorded for the first time for Argentina and Culicoides pseudoheliconiae Felippe-Bauer is firstly mentioned from the northwestern region of the country.

Critical thinking and accuracy of nurses' diagnoses. Part I: risk of low accuracy diagnoses and new views of critical thinking

Interpretations of patient data are complex and diverse, contributing to a risk of low accuracy nursing diagnoses. This risk is confirmed in research findings that accuracy of nurses' diagnoses varied widely from high to low. Highly accurate diagnoses are essential, however, to guide nursing interventions for the achievement of positive health outcomes. Development of critical thinking abilities is likely to improve accuracy of nurses' diagnoses. Newer views of critical thinking serve as a basis for critical thinking in nursing. Seven cognitive skills and ten habits of mind are identified as dimensions of critical thinking for use in the diagnostic process.