Fatores associados à infecção pelo uso do cateter central de inserção periférica em Unidade de Terapia Intensiva Neonatal

Estudo epidemiológico, longitudinal e analítico, desenvolvido em um hospital de Minas Gerais, com o objetivo de analisar os fatores associados à infecção pelo uso do cateter central de inserção periférica em recém-nascidos internados em unidade de terapia intensiva. A coleta dos dados foi realizada por meio de uma ficha estruturada, preenchida pelos profissionais e verificada pelos pesquisadores. Foram estudados 291 cateteres inseridos em 233 recém-nascidos. Os fatores associados à retirada por suspeita de infecção foram: prematuridade, peso ao nascer até 1.500 gramas, cateter de poliuretano, localização não centralizada do cateter e tempo de uso superior a 30 dias. Após ajuste multivariado, permaneceram independentemente associados: peso inferior a 2.500 gramas na inserção, reparo e tempo de uso do cateter. Conclui-se que fatores relacionados à prática dos profissionais contribuíram para a retirada dos cateteres, sinalizando para a necessidade de intervenções que melhorem a segurança e a eficácia em seu uso.

O processo do cateterismo venoso central em Unidade de Terapia Intensiva Neonatal e Pediátrica

Estudo descritivo, longitudinal e abordagem quantitativa, que objetivou analisar e discutir o processo do cateterismo venoso central nas Unidades de Terapia Intensiva neonatal e pediátrica; descrever as variáveis relacionadas à caracterização da população do estudo (unidade de internação, faixa etária e sexo) e descrever as variáveis relacionadas ao processo do cateterismo venoso central (tipo de cateter, motivo de indicação, número de lumens, sítio de inserção, profissional que realizou o procedimento, terapêutica medicamentosa infundida via cateter, motivo de retirada, tempo de permanência e as complicações mecânicas e infecciosas). A coleta de dados foi realizada em unidade de terapia intensiva neonatal e pediátrica, em 82 prontuários. As indicações dos cateteres foram, em sua maioria, para infusão medicamentosa prolongada e Nutrição Parenteral Total. A remoção foi indicada predominantemente por complicações mecânicas e infecciosas. Esse estudo viabilizou rever a prática assistencial para estabelecer o aprimoramento da assistência prestada à clientela neonatal e pediátrica.

Analgesia e sedação durante a instalação do cateter central de inserção periférica em neonatos

Objetivou-se caracterizar as estratégias de analgesia e sedação em neonatos submetidos à instalação do cateter central de inserção periférica (CCIP) e relacioná-las ao número de punções venosas, duração do procedimento e posicionamento da ponta do cateter. Estudo transversal com coleta prospectiva de dados, realizado em uma unidade de cuidados intensivos neonatais de um hospital privado na cidade de São Paulo, no período de 31 de agosto de 2010 a 01 de julho de 2011, em que foram avaliadas 254 inserções do CCIP. A adoção de estratégias analgésicas ou sedativas ocorreu em 88 (34,6%) instalações do cateter e não esteve relacionada ao número de punções venosas, duração do procedimento ou posicionamento da ponta do cateter. As estratégias mais frequentes foram a administração endovenosa de midazolam em 47 (18,5%) e fentanil em 19 (7,3%) inserções do cateter. Recomenda-se maior adoção de estratégias analgésicas antes, durante e após o procedimento.

Effectiveness of heparin versus 0.9% saline solution in maintaining the permeability of central venous catheters: a systematic review

Abstract OBJECTIVE Determining which is the most effective solution (heparin flush compared to 0.9% saline flush) for reducing the risk of occlusions in central venous catheters (CVC) in adults. METHOD The systematic review followed the principles proposed by the Cochrane Handbook; critical analysis, extraction and synthesis of data were performed by two independent researchers; statistical analysis was performed using the RevMan program 5.2.8. RESULTS Eight randomized controlled trials and one cohort study were included and the results of the meta-analysis showed no difference (RR=0.68, 95% CI=0.41-1.10; p=0.12). Analysis by subgroups showed that there was no difference in fully deployed CVC (RR=1.09, CI 95%=0.53-2.22;p=0.82); Multi-Lumen CVC showed beneficial effects in the heparin group (RR=0.53, CI 95%=0.29-0.95; p=0.03); in Double-Lumen CVC for hemodialysis (RR=1.18, CI 95%=0.08-17.82;p=0.90) and Peripherally inserted CVC (RR=0.14, CI 95%=0.01-2.60; p=0.19) also showed no difference. CONCLUSION Saline solution is sufficient for maintaining patency of the central venous catheter, preventing the risks associated with heparin administration.

Comunidade de formigas que nidificam em pequenos galhos da serrapilheira em floresta da Amazônia Central, Brasil

Community of ants that nest in dead twigs on the ground of Central Amazonian forest, Brazil. A total area of 2,880 m² in four forest sites, near Manaus, Brazil, was searched for ant colonies nesting in dead twigs on the ground. An amount of 3,706 twigs (0.5-5 cm in diameter) were gathered, of which only 623 (16.8%) had ants, which is equivalent to a density of 0.22 nests per m². Seventy species have been found. The predominant genera were Pheidole (Westwood), Crematogaster (Lund), and Solenopsis (Westwood). For most species, many of the nests found had only workers and brood, suggesting that colonies either use multiple twigs to nest or do not live exclusively in the twigs, using other types of substrate (e.g., leaf-litter, soil, fruit pods) to nest. Most colonized twigs were hollow or partially hollow inside and relatively easy to break apart. There were significant differences among species with respect to the size (diameter) of twig used as nest. No correlation was found between the number of twigs available and the number colonized by ants, suggesting that ant populations were not limited by the amount of nesting sites (twigs). The three most common Pheidole species had small colonies with less than 200 workers. Colony size was not related to twig size (volume), for any of these three species.

Distribuição de abundância e tamanho do corpo de invertebrados do folhiço em uma floresta de terra firme na Amazônia Central, Brasil

Abundace and body size distribution of invertebrates of leaf litter in Amazonian forest, Brazil. Based on 605 invertebrates sampled of the litter in an Amazonian Forest, some basic macroecological patterns for this assemblage were described. The relationship between abundance and body size, at logarithmic scale, was triangular, and the distribution of species was constrained in an asymmetric triangular envelope, that was tested using null model procedures in ECOSIM (P= 0,0002). The most abundant species were at an intermediated body size. The relationship between maximum abundance with different mean body size classes confirmed the Energetic Equivalent Rule (b = -1,069; t-0,75 = -2,13; P = 0.079). This way, species tend to consume energy from the community independent of their body size, since requirements are compensated by local population density.

An illustrated key to nymphs of Perlidae (Insecta, Plecoptera) genera in Central Amazonia, Brazil

An illustrated key to nymphs of Perlidae collected in streams of Central Amazonia, Brazil is provided. Three genera are reported for this region: Macrogynoplax Enderlein, Anacroneuria Klapálek and Enderleina Jewett. Additional diagnostic characters are provided for Enderleina nymphs.

Activities of tabanids (Diptera, Tabanidae) attacking domestic duck-Cairina moschata (Linnaeus) (Aves, Anatidae), introduced in a forest area in the Central Amazon, Manaus, Brazil

Presented here are the feeding habits, attack behavior, daily and annual activity of adult of Phorcotabanus cinereus (Wiedeman, 1821), Chrysops laetus (Fabricius, 1805) and Phaeotabanus cajennensis (Fabricius, 1787), while biting a domestic duck, Cairina moschata (Linnaeus, 1758). The last two species were recorded for the first time attacking birds. This study comprehended monthly observations of two consecutive days from April/97 to March/98 between 5:30 a.m. and 6:30 p.m. at the Army Instructional Base ((BI-2/CIGS) near Manaus. Annual occurrence of P. cinereus was from July to September, with a daily occurrence between 9:00 a.m. and 5:00 p.m. and highest activity at 12:00 a.m. and 2:00 p.m. C. laetus ocurred from June to October; with a daily occurrence between 8:00 a.m. and 3 p.m. and highest activity at 11:00 and 12:00 a.m. Occurrence of P. cajennensis with one specimen only, was in July between 10:00 and 11:00 a.m.

Chaves de identificação de larvas para famílias e gêneros de Trichoptera (Insecta) da Amazônia Central, Brasil

Chaves de identificação de larvas aos níveis de família e gênero de Trichoptera da Amazônia Central são apresentadas.

Diversidade de Chironomidae (Diptera) em dois córregos de baixa ordem na região central do Estado de São Paulo, através da coleta de exúvias de pupa

Estimamos a diversidade e a riqueza de Chironomidae (Diptera) em dois diferentes córregos através da análise de exúvias de pupa. As coletas realizadas no período de estiagem (agosto/2001) foram feitas com auxílio de redes de deriva e de mão, em trechos de 100 metros de cada córrego. Foram analisadas e identificadas 1264 exúvias de 61 táxons (36 no Córrego do Fazzari e 31 no trecho do Rio do Monjolinho). Ambos os sistemas apresentaram baixa similaridade faunística refletindo as diferentes características do substrato, da cobertura vegetal e da água de cada sistema. Possivelmente a maior riqueza faunística e a ocorrência de táxons minadores, como Stenochironomus spp., Xenochironomus spp. e Endotribelos spp. refletem a presença da mata ciliar no córrego do Fazzari que resulta em maior heterogeneidade ambiental e maior disponibilidade de alimento para esses grupos. O método de coleta e análise de exúvias de pupa de Chironomidae mostrou-se eficiente para estudos de caracterização ambiental de levantamentos da biodiversidade de sistemas lóticos de baixa ordem.

Descrição da larva, exúvia pupal e macho de Leucotabanus albovarius (Walker) (Diptera, Tabanidae) da Amazônia Central

Estágios imaturos e macho adulto de Leucotabanus albovarius (Walker, 1854) são descritos e ilustrados pela primeira vez. A larva foi encontrada em tronco de pupunheira em decomposição, Bactris gasipaes Kunth (Arecaceae), nas proximidades de Manaus. Diagnoses diferenciais dos imaturos de Leucotabanus Lutz são apresentadas.

Why do the ithomiines (Lepidoptera, Nymphalidae) aggregate? Notes on a butterfly pocket in central Brazil

This study provides information on the species composition and the number of butterflies in different phases of an ithomiine aggregation during the 2004 dry season in central Brazil, and tests some hypotheses concerning the pocket formation. The results obtained suggest that ithomiine pockets constitute primarily an adaptation of butterflies to the adverse climatic conditions of the dry season, such as high temperatures and low air relative humidity, rather than the occurrence of large concentrations of adult food resources (flowers visited for nectar were not found in the pocket site) or defense against visually hunting predators (contrary to the prediction tested, the frequency of butterflies bearing birds beak marks on the wings significantly increased along the period of pocket formation, especially in the case of Mechanitis polymnia, the most abundant species in the pocket). Other hypotheses concerning the pocket formation are also discussed.

New species and records of Chimarra Stephens (Trichoptera, Philopotamidae) from Central Amazonia, Brazil

Chimarra (Curgia) paucispina sp. nov., of the aurivittata group Flint, 1998 is described and illustrated from specimens collected in Amazonas State. The key to species of Chimarra (Curgia) Walker, 1860 presented by Flint was modified to include the new species. Chimarra (Chimarrita) chela Blahnik, 1997 and Chimarra (Curgia) jugescens Flint, 1998 are for first time reported for the Amazonas State. This is the first record of C. chela in Brazil.

Mosquitoes (Diptera, Culicidae) inhabiting foliar tanks of Guzmania brasiliensis Ule (Bromeliaceae) in central Amazonia, Brazil

Mosquitoes in the family Culicidae develop their immature forms in different environments depending on various circumstances. This study represents the first contribution to the ecological knowledge of culicids living in the bromeliad G. brasiliensis. The objectives of the study were to compare the Culicidae fauna of bromeliads in two seasonal periods, analyzing their abundance, richness and the influence of pH, conductivity and water volume, on the populations. Sampling was done at Reserva Adolpho Ducke, Manaus, Amazonas, Brazil between 2003 and 2005. Six samplings were done in the rainy season and six in the dry season. On each sampling day, six terrestrial and six epiphytic bromeliads, totaling 144 sampling units, were retrieved. A total of 444 immature mosquitoes were collected, distributed in the following species: Culex (Microculex) stonei Lane & Whitman, Culex (Microculex) chryselatus Dyar & Knab, Culex (Microculex) sp., Wyeomyia (Hystatomyia) autocratica Dyar & Knab and Wyeomyia (Hystatomyia) splendida Bonne-Wepster & Bonne. The relationship between abundance of Culicidae and sampling period was not significant, although abundance was higher in the dry period. There were significant correlations between water volume and the abundance (p = 0.003) and richness (p = 0.001) of culicids. The pH was positively related to the occurrence of the species Wy. autocratica (p= 0.010) and Wy. splendida (p= 0.006), demonstrating the influence of this factor in the structuring of bromeliad-inhabiting communities.

Insects associated with syconia of Ficus citrifolia (Moraceae) in central Brazil

Insects associated with syconia of Ficus citrifolia in central Brazil. Fig trees present a diverse interaction with different groups of organisms. The inflorescence, or syconium, has characteristics that form a microenvironment in which interactions occur between fig trees and invertebrates. This study aimed to identify the insect fauna associated with the figs of Ficus citrifolia and to quantitatively describe the distribution pattern of the insects in the syconium, in an urban area in central Brazil. The syconia were used by 12 species of insects. Our results showed that the insects found on Ficus citrifolia presented a pattern of occurrence that depends on the composition of species found within each syconium.