The timing of Rapid-Response Team activations: a multicentre international study

Background:
Most studies of Rapid-Response Teams (RRTs) assess their effect on outcomes of all hospitalised patients. Little information exists on RRT activation patterns or why RRT calls are needed. Triage error may necessitate RRT review of ward patients shortly after hospital admission. RRT diurnal activation rates may reflect the likely frequency of caregiver visits.

Objectives:
To study the timing of RRT calls in relation to time of day and day of week, and their frequency and outcomes in relation to days after hospital admission.

Methods:
We prospectively studied RRT calls over 1 month in seven hospitals during 2009, collecting data on patient age, sex, admitting unit, admission source, limitations of medical therapy (LOMTs), and admission and discharge dates. We assessed the timing of RRT calls in relation to hospital admission and circadian variation; and differences in characteristics and outcomes of calls occurring early (Days 0 and 1) versus late (after Day 7) after hospital admission.

Results:
There were 652 RRT calls for 518 patients. Calls were more likely on Mondays (P=0.018) and during work hours (P<0.0001) but less likely on weekends (P=0.003) or overnight (P<0.001). There were 177 early calls (27.1%) and 198 late calls (30.4%). Early calls involved younger patients (median ages, 67.5 years [early calls] v 73 years [late calls]; P= 0.01), fewer LOMTs (P=0.029), and lower in hospital mortality (12.8% [early calls] v 32.3% [late calls]; P<0.0001). The mortality difference remained in patients without LOMTs (5.6% [early calls] v 19.6% [late calls]; P=0.003).

Conclusions:
About one-quarter of RRT calls occurred shortly after hospital admission, and were more common when caregivers were around. Early calls may partially reflect suboptimal triage, though the associated mortality appeared low. Late calls may reflect suboptimal end-of-life care planning, and the associated mortality was high. There is a need to further assess the epidemiology of RRT calls at different phases of the hospital stay.

Análise da variabilidade de Magnaporthe grisea no Estado de Santa Catarina

A rápida perda da resistência das cultivares de arroz à brusone, causada por Magnaporthe grisea (Herb.) Barr, é geralmente atribuída à variabilidade genética do patógeno ou ainda à ocorrência de escape durante a seleção de novas cultivares. Com o objetivo de caracterizar a estrutura genética de um grupo de isolados de M. grisea em Santa Catarina (SC), plantas com sintomas de brusone foram coletadas em 12 municípios e na Estação Experimental da Epagri em Itajaí (EEI), SC. Os isolados foram analisados através de rep-PCR baseado no transposon Pot-2. Para a identificação das raças, um subgrupo de isolados foi inoculado na série internacional de cultivares diferenciais de arroz. As raças identificadas tiveram seu espectro de virulência avaliado em um grupo de cultivares com genes de resistência conhecidos (isolinhas). Isolados que apresentaram características genéticas distintas, foram avaliados quanto a capacidade de recombinação parassexual. Noventa e dois isolados monoconidiais obtidos foram agrupados através de rep-PCR em 13 haplótipos e 2 linhagens. Nove haplótipos encontrados na amostragem dos municípios não foram encontrados na EEI, indicando a ocorrência de escape. Seis raças de M. grisea foram identificadas a partir da inoculação de 28 isolados, representando 12 haplótipos na série diferencial, sendo que, 5 destas, foram avirulentas à isolinha que possui os genes de resistência Pi-1 e Pi-11. Por outro lado, o isolado 25, agrupado na raça IA-65, superou 4 das 5 isolinhas testadas. A análise da capacidade de recombinação parassexual mostra a existência de compatibilidade vegetativa associado à ocorrência de anastomoses entre três haplótipos, sendo identificados três possíveis isolados recombinantes.

Growth, fat content and fatty acid profile of South American catfish, surubim (Pseudoplatystoma fasciatum) juveniles fed live, commercial and formulated diets

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Aquaculture Research and Development as an Entry-Point and Contributor to Natural Resources and Coastal Management

Recent, fervent international dialogue concerning the existence and magnitude of impacts associated with aquaculture has had both positive and negative outcomes. Aquaculture stakeholders have become sensitized to requirements for improved environmental management of aquaculture. on the other hand, in some cases aquaculture development has been negatively affected by some of the unwarranted and unproved allegations to the detriment of the stakeholders most in need of aquaculture development (i.e., resource users, particularly the poor, who are dependent on natural resources). These resource users are targeted by, and directly influence biodiversity and conservation agendas; hence the need to understand how to gain their active participation. This discussion focuses on examples of how aquaculture research and development can be a useful tool or strategy for resource management initiatives and provide tangible positive including increased stakeholder participation and cooperation, offering alternatives to resource extraction and use in otherwise difficult or intransigent resource management conflicts.

Effects of different dietary lipid sources on the survival, growth, and fatty acid composition of South American catfish, Pseudoplatystoma fasciatum, Surubim, juveniles

The present study examines the effect of four semi-purified diets (casein-gelatin based) where the source of fatty acids was free (esterified) oleic acid and linoleic acid (LA) (LOA diet), linseed and olive oil (predominantly LA and linolenic acid) (LO diet), cod liver oil (rich in highly unsaturated fatty acids) (CLO diet), and soybean lecithin (phospholipids; mostly LA) (LE diet) on the growth of juvenile South American catfish (surubim, Pseudoplatystoma fasciatum, Pimelodidae) (0.98 +/- 0.04 g individual weight). Fish were fed at a restricted-readjusted feeding rate for 8 wk. At the end of the experiment, LE-diet-fed fish grew significantly larger than those of the other three groups (P < 0.05). Considerable cannibalism was observed in all the treatments. It is suggested that the quantitative growth performance may possibly change under other conditions, with less or no cannibalism. Survival did not differ significantly among the fish fed four different diets. Muscle and liver lipid contents did not vary among dietary treatments (P > 0.05), but whole-body lipid concentrations were affected by dietary treatments. Fish fed LE diet contained significantly lower lipid level than those fed three other diets (P < 0.05). Muscle and liver fatty acid profiles reflected dietary fatty acid composition. Arachidonic acid level was significantly higher in muscle and liver of fish fed LOA and LE diets than in those fed LO and CLO diets. The results suggest that the efficiency of elongation and desaturation of 18C fatty acids depends on the dietary lipid source, and South American catfish has considerable capacity to transform linoleate to arachidonate.

Characterisation of the chromosome fusions in Oreochromis karongae

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

Diagnóstico da deficiência de fósforo em bovinos pelos exames histológicos e microrradiográficos de costelas

The objective of the present study was to show the efficiency of histologic and microradiographic techniques performed on rib bone samples as a mean of diagnosing the phosphorus status of cattle raised on phosphorus deficient pastures and receiving different mineral supplements. The rib samples were obtained from cattle of different ages which died from disease that was clinically and epidemiologically diagnosed as botulism. Ten out of 24 juvenile and adult animals studied exibited alterations of osteomalacia, while the others without those alterations served as controls. It is suggested that the method could be useful to improve the diagnosis of phosphorus deficiency of cattle in Brazil.

Lipoic acid and ascorbic acid affect plasma free amino acids selectively in the teleost fish pacu (Piaractus mesopotamicus)

Most studies on the antioxidants, lipoic acid (LA) and ascorbic acid (AA), focused on species that, unlike teleost fish, are not scurvy-prone, and are able to synthesize AA. The antioxidant properties of LA may make it useful in aquaculture nutrition, but several effects must first be investigated, and we address here plasma free amino acids (FAA). In mammals, LA and AA in high doses were claimed to alter plasma FAA profile; to our knowledge, however, no data are available in fish. We therefore studied the effects of dietary LA and AA on plasma FAA in the South American teleost fish pacu, which is being used increasingly in aquaculture. LA treatment decreased concentrations of 18 of 23 individual FAA; specifically, dispensable and total FAA were significantly affected. Ornithine was elevated (+26%) in LA-treated fish and significantly decreased ratios of plasma [Arg]/[Orn] and other individual [FAA]/[Orn] were observed. LA and AA both affected sulfur FAA concentrations. Plasma cystine levels were significantly increased in the LA-supplemented groups. AA had little effect on most amino acids, and no interaction with LA was detected. AA supplementation did, however, significantly lower taurine (-42%) and cystathionine (-31%) levels in plasma. No effect on the branched chain:aromatic amino acid ratios was observed. The data indicate that at the dietary level studied, LA and AA independently affect selected plasma FAA in pacu, and suggest that any use of LA in particular as a dietary supplement should take into account an altered plasma FAA profile.

α-Lipoic acid-enrichment partially reverses tissue ascorbic acid depletion in pacu (Piaractus mesopotamicus) fed vitamin C-devoid diets

Effects of dietary α-lipoic acid (LA) and ascorbic acid (AA) on the growth, tissue vitamin C and tocopherol (vitamin E) levels, and malondialdehyde levels were examined in the tropical fish pacu, Piaractus mesopotamicus. Pacu juveniles were fed one of four casein-gelatin-based diets for 8 weeks: with 0.05% AA and 0.1% LA (+AA+LA), with AA and without LA (+AA-LA), without AA and with LA (-AA+LA), and without AA and LA (-AA-LA). When the fish received quantities of feed equal to 1.9-2.5% of its body weight, growth was not influenced, regardless of the presence of AA or LA throughout most of the experimental period. Growth was, however, slightly but significantly lower at week 8 in the AA-deficient/LA-supplemented group. An AA-deficient diet caused a highly significant reduction in both total AA and dehydroascorbic acid content in the liver and gill tissues. This reduction of tissue AA concentrations was reversed in a significant manner by LA (antioxidant-sparing effect). The 8-week-long vitamin C deprivation was sufficient to initiate the reduction in tissue ascorbic acid; however, total ascorbate in the liver of fish in the (-)AA/(+)LA group was 127.7±54.3 nmol g-1 tissue, whereas it was 28.6±26.3 nmol g-1 in the (-)AA/(-)LA group, a 4.4-fold difference. This mitigating effect of the addition of the endogenous antioxidant LA to the diet indicates that LA exerts a vitamin C-sparing effect in teleost fish that by far exceeds the phenomena demonstrated in non-scurvy-prone mammals. There was no difference among the different diet groups for vitamin E and malondialdehyde levels in the liver. These results suggest that LA is a potent substance for the prevention of AA deficiency in cultured fishes. The optimal dietary level of LA needs to be determined in the light of the slight reduction in body weight gain after 8 weeks of feeding in the absence of AA. © Springer Science+Business Media, Inc. 2006.

¿Qué hacer después de Río?: lo que no se hizo antes de Estocolmo

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Efeito de sistemas de irrigação localizada sobre a produção e qualidade da acerola (Malpighia spp) na região da nova alta paulista

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