Predictors of incorrectness in antimicrobial prescription in the Bauru State Hospital (Bauru city, São Paulo State, Brazil)

The inappropriate use of antimicrobials in hospitals presents a negative impact on patient outcome and is associated with the emergence and spread of multidrug-resistant microorganisms. Antimicrobial stewardship programs (ASPs) have been instituted in order to improve the quality of prescriptions in hospitals. In this setting, the identification of patterns of inappropriate antimicrobial prescription is a valuable tool that allows ASPs to identify priorities for directing educative/restrictive policies. With this purpose, a study was conducted in the Bauru State Hospital, a teaching hospital with 285 beds affiliated to the Botucatu Medical School, São Paulo State University. The hospital maintains an active ASP since it was opened, in 2002. We selected 25% of the requests for parenteral antimicrobials (RPAs) from 2005 for analysis. Prescriptions for prophylactic purposes were excluded. All other RPAs were classified according to a modified Kunin and Jones categories. Univariate and multivariable analyses were performed to identify predictors of general inappropriateness and of specific prescription errors. Prescriptions classified as "appropriate'' or "probably appropriate" were selected as controls in all stages of the study. Among 963 RPAs included in our study, 34.6% were inappropriate. General predictors of inappropriateness were: prescription on weekends/holidays (OR = 1.67, 95% CI = 1.20-2.28, p = 0.002), patient from intensive care unit (OR = 1.57, 95% CI = 1.11-2.23, p = 0.01), peritoneal (OR = 2.15, 95% CI = 1.27-3.65, p = 0.004) or urinary tract infection (OR = 1.89, 95% CI = 1.25-2.87, p = 0.002), combined therapy with two or more antimicrobials (OR = 1.72, 95% CI = 1.15-2.57, p = 0.008) and prescriptions including penicillin (OR = 2.12, 95% CI = 1.39-3.25, p = 0.001) or first-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 insufficient spectrum (OR = 0.14, 95% CI = 0.03-0.30, p = 0.01). In conclusion, the analysis of factors predictive of inappropriateness in antimicrobial prescription allowed us to identify issues requiring intervention. Also, it provided a positive feedback of the ASP efficacy, demonstrating the importance of previous consultation with an ID specialist to assure the quality of antimicrobial prescriptions.

B-mode ultrasonography biometry of the Amazon Parrot (Amazona aestiva) eye

PurposeUltrasonographic evaluation of the eye is a relatively recent addition to routine ophthalmic diagnostics in small animal ophthalmology. Some parameters for ophthalmic biometry have been established. There are few studies in clinical avian ophthalmology that describe ultrasound images of eye in some nocturnal avian species and in other birds that do not belong to the Brazilian fauna, but the psittacine family is not represented. The purpose of this study was to describe the following measurements: the distances between cornea and anterior lens capsule (D1) between the anterior and posterior lens capsule (D2), between posterior lens capsule and optic papilla (D3) and the axial length.MethodSixty four transpalpebral ocular ultrasound examinations were performed on 32 Blue fronted Amazon parrots (Amazona aestiva) with no history of previous ophthalmic disease.Result and DiscussionThe measurements were taken in sagital planes using a 10 MHz linear probe without a standoff pad. The mean values for the left eye were; D1 0.17 +/- 0.03 cm, D2 0.35 +/- 0.02 cm, D3 0.73 +/- 0.04 cm and the axial length 1.26 +/- 0.06 cm. In the right eye D1 0.17 +/- 0.02 cm, D2 0.34 +/- 0.02 cm, D3 0.74 +/- 0.03 cm and the axial length 1.25 +/- 0.05 cm. No significant statistical difference was observed among the birds or between the left and right eye. The description of these parameters will allow the veterinary practitioner to evaluate the structural changes that specific diseases may cause in these animals.

The Rondonian-San Ignacio Province in the SW Amazonian Craton: An overview

The Rondonian-San Ignacio Province (1.56-1.30 Ga) is a composite orogen created through successive accretion of arcs, ocean basin closure and final oblique microcontinent-continent collision. The effects of the collision are well preserved mostly in the Paragua Terrane (Bolivia and Mato Grosso regions) and in the Alto Guapore Belt and the Rio Negro-Juruena Province (Rondonia region), considering that the province was affected by later collision-related deformation and metamorphism during the Sunsas Orogeny (1.25-1.00 Ga). The Rondonian-San Ignacio Province comprises: (1) the Jauru Terrane (1.78-1.42 Ga) that hosts Paleoproterozoic basement (1.78-1.72 Ga), and the Cachoeirinha (1.56-1.52 Ga) and the Santa Helena (1.48-1.42 Ga) accretionary orogens, both developed in an Andean-type magmatic arc; (2) the Paragua Terrane (1.74-1.32 Ga) that hosts pre-San Ignacio units (>1640 Ma: Chiquitania Gneiss Complex, San Ignacio Schist Group and Lomas Manechis Granulitic Complex) and the Pensamiento Granitoid Complex (1.37-1.34 Ga) developed in an Andean-type magmatic arc; (3) the Rio Alegre Terrane (1.51-1.38 Ga) that includes units generated in a mid-ocean ridge and an intra-oceanic magmatic arc environments; and (4) the Alto Guapore Belt (<1.42-1.34 Ga) that hosts units developed in passive marginal basin and intra-oceanic arc settings. The collisional stage (1.34-1.32 Ga) is characterized by deformation, high-grade metamorphism, and partial melting during the metamorphic peak, which affected primarily the Chiquitania Gneiss Complex and Lomas Manechis Granulitic Complex in the Paragua Terrane, and the Colorado Complex and the Nova Mamore Metamorphic Suite in the Alto Guapore Belt. The Paragua Block is here considered as a crustal fragment probably displaced from its Rio Negro-Juruena crustal counterpart between 1.50 and 1.40 Ga. This period is characterized by extensive A-type and intra-plate granite magmatism represented by the Rio Crespo Intrusive Suite (ca. 1.50 Ga), Santo Antonio Intrusive Suite (1.40-1.36 Ga), and the Teotonio Intrusive Suite (1.38 Ga). Magmatism of these types also occur at the end of the Rondonian-San Ignacio Orogeny, and are represented by the Alto Candeias Intrusive Suite (1.34-1.36 Ga), and the Sao Lourenco-Caripunas Intrusive Suite (1.31-1.30 Ga). The cratonization of the province occurred between 1.30 and 1.25 Ga. (C) 2009 Elsevier Ltd. All rights reserved.

Polysiloxane-poly(propylene oxide) hybrid discs as solid phase in anti-HCV detection using a recombinant core protein

In this work, siloxane-poly(propylene oxide) discs (PPO disc) prepared using the sol-gel process were used as solid phase in enzyme-linked immunosorbent assays (ELISA) for the detection of anti-hepatitis C virus (HCV) antibodies. The HCV RNA from serum (genotype 1b) was submitted to the RT-PCR technique and subsequent amplification of the HCV core 408 pb. This fragment was cloned into expression vector pET42a and expressed in Escherichia coli as recombinant protein with glutathione S-transferase (GST). Cell cultures were grown and induced having a final concentration of 0.4 x 10(-3) mol L-1 of IPTG. After induction, the cells were harvested and the soluble fraction was analyzed using polyacrilamide gel 15% showing a band with an approximate molecular weight of 44 kDa, the expected size for this GST-fused recombinant protein. The recombinant protein was purified and continued by immunological detection using HCV-positive serum and showed no cross-reactivity with positive samples for other infectious diseases. An ELISA was established using 1.25 ng of recombinant protein per PPO disc, a dilution of 1: 10,000 and 1:40 for a peroxidase conjugate and serum, respectively, and solutions of hydrogen peroxide and 3,3',5,5'-tetra-methylbenzidine in a ratio of 1: 1. The proposed methodology was compared with the ELISA conventional polystyrene-plate procedure and the performance of the PPO discs as a matrix for immunodetection gave an easy synthesis, good performance and reproducibility for commercial application. (c) 2007 Elsevier B.V. All rights reserved.

Seroprevalence of Toxoplasma gondii in free-living Amazon River dolphins (Inia geoffrensis) from central Amazon, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Human chromosome aberrations induced in vitro by Paracoccidioides brasiliensis glycoproteic component (GP 43)

The in vitro cytogenetic effects of the 43-kDa molecular mass exocellular glycoproteic component (GP 43) from Paracoccidioides brasiliensis were studied in cultures from human lymphocytes. The sample included 10 healthy, white, non-smoking, non-related males (mean age of 31.3 ± 8.2 years). Besides the control, three concentrations of GP 43 (0.125, 1.25 and 5 μg/ml) were used. In each group, around 1000 cells were examined in search of chromosome aberrations, and 30,000 metaphases were analysed for the determination of the Mitotic Index. The authors conclude that GP 43 most probably causes inhibition of the cell cycle and aneugenic and clastogenic effects.

Growth of Channel Catfish, Ictalurus punctatus, in Southern Brazil

Despite successful introduction of channel catfish into Brazil in 1980, no studies have been conducted to assess the performance of channel catfish, Ictalurus punctatus, farming in southern Brazil. Fingerlings (27.0 ± 2.2 g) were stocked in sixteen 16-m2 tanks with cement walls and earthen bottoms. Four stocking densities were used: 0.5, 0.75, 1.0, and 1.25 fish/m2. Fish were fed a diet containing 32% protein according to a feeding chart for 257 days (from April to December). Water temperature ranged from 16.4°C to 30°C during the study. Final average weight (727.1 ± 70.6 g) was significantly higher (P < 0.05) for fish raised at 0.5 fish/m2. Food conversion ratio (FCR) was significantly higher (P < 0.05) for fish stocked at 1.25 fish/ m2. Survival averaged 95.4%, and no significant differences (P > 0.05) were found among treatments. There was no significant difference (P > 0.05) in tank production among the densities of 0.75, 1.0, and 1.25 fish/m2, but they were higher (P < 0.05) than the density of 0.5 fish/ m2. These results demonstrate the viability of channel catfish growth in southern Brazil.

Importance of early and continuous use of protein restriction on the progression of adriamycin nephropathy

Three experimental protocols were carried out with the aim of evaluating the role of protein restriction on the progression of the established adriamycin-induced nephropathy, and whether the protective effect of the diet persists after the diet is discontinued. The effect of a low protein diet (LPD) was studied for 6 weeks in protocol 1, 16 weeks in protocol 2 and for 28 weeks in protocol 3. In protocol 3, one group (LL) received LPD and another (NN) was given a normal protein diet (NPD). A third group (LN) received LPD for 16 weeks and then NPD for 12 weeks and a fourth group (NL) was fed NPD for 16 weeks and then LPD for 12 weeks. In protocol I the tubulo- interstitial index (TILl) of rats on LPD (Md = 2, P25 = 0.0; P75 = 3.5) after six weeks, was smaller than that of the animals on NPD (Md = 6.0; P25 = 3.0; P75 = 8.0; p < 0.05). In protocol 2, the group taking LPD presented an area of interstitial fibrosis (IF) (Md= 0.5%, P25 0.2%; P75 = 1.9%) smaller than that of the NPD group (Md = 6.8%; P25 = 5.2%; P75 = 7.1%; P < 0.05). No significant difference in the area of glomerulosclerosis (GSA) was observed between the animals on LPD (Md = 0.0%; P25 = 0.0%, P75 = 0.0%) and NPD (Md = 0.37%; P25 = 02% P75 = 1.25%; p > 0.05). In protocol 3, the group LL showed GSA (Md = 1.3%; P25 0.6%, P75 = 2.5%) and IF (Md = 3.60/0; P25 = 1.6%; P75 = 5.9%) smaller that those of LN (GSA Md = 10.1%; P25 = 6.6%; P75 = 14.8%; IF; Md = 17.3%; P25 = 14.1%; P75 = 24,5%), NL (GSA: Md = 9.1%; P25 = 5,8%; P75 = 11.7%; IF; Md = 25.0%; P25 = 20.4%; P75 = 30%), and NN (GSA: Md = 6. 75%; P25 = 4.9%; P75 = 11.7%; IF: Md = 20.9%; P25 = 16.2%; P75 = 32.4%). In conclusion, in order to be effective, LPD must be introduced early and maintained for a long period of tune.

Natal and neonatal teeth: Review of the literature

Child development from conception through the first years of life is marked by many changes. Tooth eruption follows a chronology corresponding to the date when the tooth erupts into the oral cavity. These dates have been established in the literature and are subjected to small variations depending on hereditary, endocrine and environmental features. At times, however, the chronology of tooth eruption suffers a more significant alteration in terms of onset, and the first teeth may be present at birth or arise during the first month of life. The expectations about the eruption of the first teeth are great and even greater when the teeth appear early in the oral cavity. The objective of the present study was to present a review of the literature with important aspects about natal and neonatal teeth.

Root growth and nutrient accumulation in cover crops as affected by soil compaction

Crop rotation using cover crops with vigorous root systems may be a tool to manage soils with some degree of compaction. Root and shoot growth as well as nutrient accumulation by summer species suitable for crop rotation in tropical areas were studied at different subsoil compaction levels. Crotalaria juncea (Indian hemp), Crotalaria spectabilis (showy crotalaria), Helianthus annuus (sunflower), Pennisetum americanum (pearl millet) and Sorghum bicolor (guinea sorghum) were grown for 40 days in pots 33.5 cm high with 10 cm internal diameter. Soil in the pots had uniform bulkdensity of 1.25 Mg m-3 for the top and bottom 15 cm sections. Bulk densities of 1.31, 1.43, 1.58 and 1.70 Mg m-3 Were established in the 3.5 cm middle section. H. annuus and P. americanum had the highest early macronutrient accumulation. The grasses S. bicolor and P. americanum yielded twice as much shoot dry matter as the other species. Root growth generally decreased with increasing soil bulk density with C. spectabilis less affected than other species. Although the grasses were more sensitive to high soil penetration resistance, they showed higher root length densities at all compaction levels. P. americanum had the highest potential to be used as cover crop due to its high root density at high soil penetration resistances, vegetative vigour and ability to accumulate macronutrients. © 2002 Elsevier Science B.V. All rights reserved.

Tabelas de esperança de vida e fertilidade para Lipaphis erysimi (Kalt.) (Hemiptera: Aphididae) em condições de laboratório e campo

In this study, the aphid Lipaphis erysimi (Kalt) was reared at different temperatures, under laboratory and field conditions, aiming to obtain age-specific life tables. In the laboratory, L. erysimi was fed on kale, Brassica oleracea L. var acephala, and kept in incubators adjusted to 10, 15, 20, 25 and 30°C, 14h photophase and 70±10% RH. The longest mean generation time (T) was observed at 15°C (23.86 days) and the shortest at 30°C (7.18 days), while the smallest net reproductive rate (R0) occurred at 15°C (4.30) and largest one at 25°C (38.29). For the temperatures of 15, 20, 25 and 30°C, the intrinsic rate of natural increase (rm) and the finite rate of increase (λ) were 0.06/1.06, 0.24/1.27, 0.28/1.33 and 0.23/1.25, respectively. The doubling time (DT) at 15, 20, 25 and 30°C were 11.55, 2.80, 2.47, and 3.01 days, respectively. Under field conditions, the net reproductive rate (R0) of L. erysimi was larger in the winter (53.50) than in the summer (40.99), the same being observed for the mean generation time (T), which was 13.85 days in the winter and 7.57 days in the summer. The intrinsic rate of natural increase (rm) and the finite rate of increase (λ) were 0.29/1.34 and 0.40/1.63 for winter and summer, respectively. The doubling time (DT) observed for winter (2.39 days) was larger than the one observed for summer (1.41 days). The temperature affects longevity of L. erysimi and the best parameters of life table of fertility under laboratory conditions are obtained at 25°C. The data obtained in field conditions reinforced this finding. The daily fecundity was higher and longevity was smaller in the summer than in the winter, thus increasing the innate capacity of increasing in number and duplicating the population in a shorter period of time.

Espécies do gênero Eimeria (Apicomplexa: Eimeriidae) em Tamanduás-bandeira (Myrmecophaga tridactyla Linnaeus, 1758) em cativeiro.

The parasitism of the two giant anteaters adults (Myrmecophaga tridactyla), one male and one female, infected naturally with Eimeria escomeli, E. tamanduae e E. marajoensis was related in the present research. In E. escomeli oocysts were 23.9 +/- 1.89 by 19.7 +/- 1.60 microm and its sporocysts were 11.47 +/- 1.25 by 6.48 +/- 0.80 microm. In E. tamanduae oocysts were 23.52 +/- 0.95 by 20.59 +/- 0.92 microm and its sporocysts were 12.19 +/- 0.65 by 7.15 +/- 0.55 microm. In E. marajoensis oocysts were 13.5 +/- 1.7 by 13.1 +/- 1.8 microm and its sporocysts were 7.4 +/- 0.58 by 5.4 +/- 0.8 microm. Eimeria escomeli was described before parasitizing giants anteater from Bolivia, and it was point out as the first time in Brazil. The presence of E. tamanduae and E. marajoensis parasitizing giant anteaters indicate the possibility of having co-infection of them among animals of the family Myrmecophagidae.

Efeitos de níveis de cobertura do solo sobre a produtividade e crescimento do feijoeiro irrigado, em sistema de plantio direto

The objective of this research was to study the effects of five different treatments of grass (Brachiaria decumbens) straw mulch on common beans (Phaseolus vulgaris L.): 0% (0 t.ha-1), 25% (2,25 t.ha-1), 50% (4,5 t.ha-1), 75% (6,75 t. ha-1) and 100% (9,0 t/ha) designed by randomized blocks, with four replicates. The irrigation was applied when minimum soil water potential were reached about - 30kPa. The water management based on tensiometers and soil water characteristic curve. A microsprinkler irrigation system was used. The experiment was set up at the Experimental Station of Embrapa Rice and Bean (Empresa Brasileira de Pesquisa Agropecuária Arroz e Feijão) at Santo Antonio de Goiás, Brazil, in a Dark - Red Latosol soil. The results showed: the bean yield and his components were not affected by treatments, except grain number/pod,. The mulch increased the water use efficiency and, consequently, decreased the number of irrigations when the mulch reached more than 50% straw mulch. The treatment with 100% of mulching presented the largest leaf area index and dry matter accumulation was not affected by mulching.

Effects of gender on stroke rates, critical speed and velocity of a 30-min swim in young swimmers

Our objective was to analyze the effect of gender on the relationship between stroke rates corresponding to critical speed (SRCS) and maximal speed of 30 min (SRS30) in young swimmers. Twenty two males (GM1) (Age = 15.4 ± 2.1 yr., Body mass = 63.7 ± 12.9 kg, Stature = 1.73 ± 0.09 m) and fourteen female (GF) swimmers (Age = 15.1 ± 1.6 yr., Body mass = 58.3 ± 8.8 kg, Stature = 1.65 ± 0.06 m) were studied. A subset of males (GM2) was matched to the GF by their velocity for a 30 min swim (S30). The critical speed (CS) was determined through the slope of the linear regression line between the distances (200 and 400 m) and participant's respective times. CS was significantly higher than S30 in males (GM1 - 1.25 and 1.16 and GM2 - 1.21 and 1.12 m·s-1) and females (GF - 1.15 and 1.11 m·s-1). There was no significant difference between SRCS and SRS30 in males (GM1 - 34.16 and 32.32 and GM2 - 34.67 and 32.46 cycle·s-1, respectively) and females (GF - 34.18 and 33.67 cycle·s-1-1, respectively). There was a significant correlation between CS and S30 (GM1 - r = 0.89, GF - r = 0.94 and GM2 - r = 0.90) and between SRCS and SRS30 (GM1 - r = 0.89, GF - r = 0.80 and GM2 - r = 0.88). Thus, the relationship between SRCS and SRS30 is not influenced by gender, in swimmers with similar and different aerobic capacity levels. ©Journal of Sports Science and Medicine (2007).

Isolation of toxoplasma gondii from goats from Brazil

Goats are economically important in many countries, and little is known of caprine toxoplasmosis in Brazil. Antibodies to Toxoplasma gondii were assayed in the sera of 143 goats from 3 Brazilian states, using modified agglutination test (MAT titer ≥1:25); 46 (32.2%) tested positive. Samples of brain, heart, diaphragm, and masseter of seropositive animals were pooled, digested in pepsin, and bioassayed in mice. Viable T. gondii specimens were isolated from tissue homogenates of 12 goats; the isolates were designated TgGtBr1-12. Ten of the 12 isolates killed 100 of infected mice, indicating that goats can harbor mouse-virulent T. gondii and, hence, can serve as a source of infection for humans. © 2009 American Society of Parasitologists.