Search

Proper assessment of fluid responsiveness using accurate predictors is crucial to guide fluid therapy and avoid the serious adverse effects of fluid overload. The main objective of this study was to investigate the accuracy of respiratory variations in inferior vena cava diameter (∆IVC) to predict fluid responsiveness in mechanically ventilated children. This prospective single-center study included 32 children (median age and weight of 17 months and 10 kg, respectively) who received a fluid infusion of 10 ml kg -1 of crystalloid solutions over 10 min. ∆IVC and respiratory variation in aortic blood flow peak velocity (∆Vpeak) were determined over one controlled respiratory cycle before and after fluid loading. Thirteen (41%) participants were fluid-responders. ∆IVC, ∆Vpeak, stroke volume index, and cardiac index were found to be predictors of fluid responsiveness. However, the area under the ROC curve of ∆IVC was smaller when compared to ∆Vpeak (0.709 vs. 0.935, p < 0.012). The best cut-off values were 7.7% for ∆IVC (sensitivity, 69.2%; specificity 78.9%, positive predictive value, 69.2%; and negative predictive value, 78.9%) and 18.2% for ∆Vpeak (sensitivity, 84.6%; specificity, 89.5%; positive predictive value, 84.6%; negative predictive value, 89.5%). Changes in stroke volume were positively correlated with ∆IVC (ρ = 0.566, p < 0.001) and ∆Vpeak (ρ = 0.603, p < 0.001). A significant correlation was also found between changes in MAP and ∆Vpeak (ρ = 0.382; p = 0.031), but the same was not observed with ∆IVC (ρ = 0.011; p = 0.951). In conclusion, ∆IVC was found to have a moderate accuracy in predicting fluid responsiveness in mechanically ventilated children and is an inferior predictor when compared to ∆Vpeak., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Antimicrobial resistance is a global health issue, in which microorganisms develop resistance to antimicrobial drugs, making infections more difficult to treat. This threatens the effectiveness of standard medical treatments and necessitates the urgent development of new strategies to combat resistant microbes. Studies have increasingly explored natural sources of new antimicrobial agents that harness the rich diversity of compounds found in plant species. This pursuit holds promise for the discovery of novel treatments for combating antimicrobial resistance. In this context, the chemical composition, antibacterial, and antibiofilm activities of the essential oil from Croton urticifolius Lam. leaves (CuEO) were evaluated. CuEO was extracted via hydrodistillation, and its chemical constituents were identified via gas chromatography-mass spectrometry (GC/MS). The antibacterial activity of CuEO was evaluated in a 96-well plate via the microdilution method, and the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values were determined. The effect of CuEO on biofilm formation was assessed by quantifying the biomass using crystal violet staining and viable cell counting. In addition, alterations in the cellular morphology of biofilms treated with CuEO were examined using scanning electron microscopy (SEM) and laser confocal microscopy. GC/MS analysis identified 26 compounds, with elemicine (39.72%); eucalyptol (19.03%), E-caryophyllene (5.36%), and methyleugenol (4.12%) as the major compounds. In terms of antibacterial activity, CuEO showed bacteriostatic effects against Staphylococcus aureus ATCC 700698, S. aureus ATCC 25923, Staphylococcus epidermidis ATCC 12228, and Escherichia coli ATCC 11303, and bactericidal activity against S. aureus ATCC 700698. In addition, CuEO significantly inhibited bacterial biofilm formation. Microscopic analysis showed that CuEO damaged the bacterial membrane by leaching out the cytoplasmic content. Therefore, the results of this study show that the essential oil of C. urticifolius may be a promising natural alternative for preventing infections caused by bacterial biofilms. This study is the first to report the antibiofilm activity of C. urticifolius essential oil., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Acute myeloid leukemia (AML) is a myeloid neoplasm associated with a high morbidity and mortality. The diagnosis, risk stratification and therapy selection in AML have changed substantially in the last decade with the progressive incorporation of clinically relevant molecular markers., Methods: In this work, our aim was to describe a real-world genomic profiling experience in AML and to demonstrate the impact of the European Leukemia Net 2022 update on risk stratification in AML., Results and Discussion: One hundred and forty-one patients were evaluated with an amplicon-based multi-gene next-generation sequencing (NGS) panel. The most commonly mutated genes were FLT3, DNMT3A, RUNX1, IDH2, NPM1, ASXL1, SRSF2, NRAS, TP53 and TET2. Detection of FLT3 ITD with NGS had a sensitivity of 96.3% when compared to capillary electrophoresis. According to ELN 2017, 26.6%, 20.1%, and 53.3% of patients were classified as having a good, moderate, or unfavorable risk. When ELN 2022 was used, 15.6%, 27.8%, and 56.6% of patients were classified as favorable, moderate, or unfavorable risk, respectively. When ELN 2022 was compared to ELN 2017, thirteen patients (14.4%) exhibited a different risk classification, with a significant decrease in the number of favorable risk patients, what has immediate clinical impact., Conclusions: In conclusion, we have described a real-world genomic profiling experience in AML and the impact of the 2022 ELN update on risk stratification., (© 2023. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).)

Background: Next-generation sequencing has had a significant impact on genetic disease diagnosis, but the interpretation of the vast amount of genomic data it generates can be challenging. To address this, the American College of Medical Genetics and Genomics and the Association for Molecular Pathology have established guidelines for standardized variant interpretation. In this manuscript, we present the updated Hospital Israelita Albert Einstein Standards for Constitutional Sequence Variants Classification, incorporating modifications from leading genetics societies and the ClinGen initiative., Results: First, we standardized the scientific publications, documents, and other reliable sources for this document to ensure an evidence-based approach. Next, we defined the databases that would provide variant information for the classification process, established the terminology for molecular findings, set standards for disease-gene associations, and determined the nomenclature for classification criteria. Subsequently, we defined the general rules for variant classification and the Bayesian statistical reasoning principles to enhance this process. We also defined bioinformatics standards for automated classification. Our workgroup adhered to gene-specific rules and workflows curated by the ClinGen Variant Curation Expert Panels whenever available. Additionally, a distinct set of specifications for criteria modulation was created for cancer genes, recognizing their unique characteristics., Conclusions: The development of an internal consensus and standards for constitutional sequence variant classification, specifically adapted to the Brazilian population, further contributes to the continuous refinement of variant classification practices. The aim of these efforts from the workgroup is to enhance the reliability and uniformity of variant classification., (© 2023. The Author(s).)

Brazilian porcupine poxvirus (BPoPV) is a new poxvirus recently described in porcupines (Coendou prehensilis) from Brazil. Herein, we described a free-ranging adult male Coendou (Sphiggurus) spinosus rescued after being found lethargic on the ground in a rural area. The animal presented crusty, edematous, and suppurative skin lesions on the face, tail, and perineum, and yellowish ocular secretion. The diagnosis was performed by histopathology, transmission electron microscopy (TEM), PCR, and sequencing. Microscopically, proliferative and necrotizing dermatitis, subacute, multifocal with ballooning degeneration, and eosinophilic intracytoplasmic viral inclusion bodies were observed. TEM confirmed large brick-shaped virions inside the keratinocyte cytoplasm, measuring about 200-280 × 120-180 nm. Partial fragment of intracellular mature virion membrane protein gene and putative metalloproteinase gene was successfully amplified and sequenced, and the strain herein denoted IAL/21 V-102 was classified as BPoPV, showing 99.4% of nucleotide identity to the reference strain UFU/USP001. Enrofloxacin 10% (10 mg/kg) was administered every 24 h through intramuscular injection for 10 days, dipyrone/metamizole (25 mg/kg) every 24 h orally (PO) for 3 days, 0.5 ml (mL) of thymomodulin every 24 h PO for 30 days, and each 48 h for another 15 days. The lesions were cleaned and debrided every 15 days. Seventy-five days after the beginning of the treatment, the cutaneous lesions regressed, the animal gained weight, and was clinically stable. After treatment, the skin biopsy showed only mild epidermal acanthosis, intra-cellular edema, and mild lymphoplasmacytic perivascular dermatitis. No viral particles were observed by TEM and no poxviral DNA was amplified by PCR. This study documents the first case of confirmed and treated BPoPV infection in a hairy dwarf porcupine. The implemented therapeutic plan eliminated the infection and improved the general state of the animal., (© 2022. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.)

The chemical composition, the antioxidant and antimicrobial potential of crude extract from leaves Cinnamomum verum and their enriched fractions was studied. Phytochemical analyses were performed by TLC and HPLC, and the antioxidant capacity was verified by DPPH • and ABTS •+ . The Minimal Inhibitory/Bactericidal Concentration was conducted against twenty-two bacteria to select five strains susceptible to extracts/fractions and resistant to the antibiotics tested. Interference of Ethyl Acetate Fraction (EAF) in resistance to synthetic antibiotic was assayed by modulatory and checkerboard model. The chromatographic data showed phenolic compounds in crude extract, as well the flavonoid enrichment in the EAF. The combination of EAF and synthetic antibiotics (ampicillin, azithromycin, ciprofloxacin, or gentamicin) provides a synergistic effect against multidrug resistant strains). The results are useful to obtain multi-targeting in a single therapy solution, which on antioxidants molecules plant-derivatives can act synergistically in antimicrobial combinations, a valuable aid as bacterial resistance modifying compounds.

This study evaluated the long-term effect of biochar application on the sorption and desorption of thiamethoxam in a Haplic Plinthosol. The experiment was conducted in a randomized block design with combination of doses of mineral fertilizer NPK (0 and 300 kg·ha -1 formula 05-25-15) and biochar (0, 16 and 32 Mg ha -1 ). Deformed soil samples were collected in the field from the 0-0.10 m layer of all plots to determine the sorption and desorption of the thiamethoxam insecticide in the soil; fulvic acid (FA), humic acid (AH) and humin (HUM) carbon contents; and total organic carbon. The Batch slurry method was used to evaluate sorption and desorption. The Freundlich isotherm adequately described thiamethoxam sorption in all treatments. The application of biochar increased the sorption (Kf s ) and decreased the desorption (Kf d ) of thiamethoxam. The sorption intensity (1/n) showed reduction characteristics as the soil concentration of thiamethoxam increased. Biochar has a sorption effect on the soil through covalent bonds and H-bonds with the insecticide molecules, thereby indirectly increasing the sorption potential in the chemical fractions of the organic matter of soil. The application of 32 Mg ha -1 of biochar significantly reduced thiamethoxam in the soil solution. Altogether, the present study reveals that biochar application in soil is a promising tool for mitigating the contaminant potential of thiamethoxam in subsurface waters.

The aim of this study was to evaluate the phytochemical composition, antioxidant, and antimicrobial potential of crude extract and fractions of Punica granatum leaves. The extract was produced by turbo extraction, after which hexanic, ethyl acetate, and aqueous fractions were obtained by partitioning. The chemical analyses were performed by thin layer chromatography and high-performance liquid chromatography, and the antioxidant activities were assayed by DPPH . and ABTS .+ . Minimal inhibitory and bactericidal concentrations (MIC/MBC) were applied to twenty-two bacteria. Most strains susceptible to extract/fractions and resistant to antibiotics were selected, and ampicillin, azithromycin, ciprofloxacin, and gentamicin were associated with the ethyl acetate fraction (EAF) against multidrug-resistant strains in modulatory and checkboard models. The data from chromatographic analyses showed flavonoids and tannins in the extract, as well as the enrichment of EAF in phenols, mainly flavonoids. The flavonoids were connected to the electron transfer activity demonstrated in the DPPH . and ABTS .+ assays. Gram-positive strains are more susceptible to EAF. The subinhibitory concentrations of P. granatum enhanced the antimicrobial activity of the agents and reduced the EAF individual MIC, and the combination of EAF and antibiotics demonstrated a synergistic effect. These results present a promising approach for developing a therapy in which antioxidant extracts and fractions can be used in combination with antibiotics., (© 2021 Wiley-VHCA AG, Zurich, Switzerland.)

Background and Aim: Despite worldwide case reports, including Brazilian cases, no frequency study on infection of pets by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been conducted to date in Brazil. Accordingly, the present study was aimed to assess dogs and cats belonging to positive owners in Recife, Northeastern Brazil., Materials and Methods: This was a longitudinal prospective study on dogs and cats in the city of Recife whose owners were in isolation at home due to a confirmed laboratory diagnosis of SARS-CoV-2 through reverse-transcriptase polymerase chain reaction (RT-qPCR). Oral and rectal swabs from the pets were tested for the presence of SARS-CoV-2-specific RNA by means of RT-qPCR., Results: Among the pets tested, 0/16 dogs and 2/15 cats were positive for SARS-CoV-2. Interestingly, the two positive cats were owned by two unrelated asymptomatic veterinary students, which, therefore, post a warning to veterinarians worldwide., Conclusion: The findings herein indicate that cats may act as sentinels for human cases, particularly sharing households with asymptomatic human cases. Although with small sampling and convenient recruiting, the presence of infected cats by SARS-CoV-2 was most likely due to close cat-human contact with positive owners, posting a human-animal health threat when pets share the same bed and interact with owners without protection, particularly during owner self-isolation. Thus, infected owners should follow the same human preventive guidelines with their pets to avoid spreading infection., (Copyright: © da Silva Epifanio, et al.)

The objective of this study was to conduct phytochemical characterization and biological evaluation of Hymenaea eriogyne . Crude extracts and fractions from the bark, leaves and pods, were obtained for phytochemical screening by TLC and HPLC, and evaluation of antibacterial and antioxidant potential. Chromatographic data revealed the presence of several metabolites, notably from the flavonoid class. HPLC analysis confirmed the presence of the flavanonol astilbin (taxifolin 3-O-ramnoside) and other flavonoids derived from aglycone taxifolin. In addition, it was possible to quantify phytochemical markers in the extracts and fractions, which showed an increased content of flavonoid and catechin derivatives in the fraction. Better results of the minimum inhibitory/bactericidal concentrations were obtained with extracts and fractions from bark. In the antioxidant activity using the DPPH method, the enriched bark fraction presented an IC 50 of 34.46 µg/mL. These results contribute to the continuity of studies on the chemical and biological composition of the species.

The aim of this study was to determine whether maternal diabetes induced by alloxan injection in the first gestational day of female Wistar rats interferes with the development of the nociceptive peripheral system of the offspring. Behavioral and histologic analysis was performed using the adult offspring of diabetic and control rats. It was found that the offspring of diabetic rats were more sensitive to thermal stimulation and showed an altered response to carrageenan-induced inflammatory hyperalgesia. The histological analysis showed an increased proportion of nociceptive neurons, while the population of non-nociceptive myelinated neurons was reduced. Therefore, exposition to hyperglycemia and/or hyperinsulinemia in uterus, caused by a diabetic mother, might result in altered nociceptive sensations in the offspring throughout life., (© 2020 International Society for Developmental Neuroscience.)

Purpose: To select and refine the outcomes and indicators of Nursing Outcomes Classification for the diagnosis of risk for perioperative positioning injury., Method: Validation study on expert consensus and refinement through pilot study., Findings: Eight outcomes and 35 indicators were selected in consensus. After clinical testing was performed, in which 10 patients were assessed at five different times. Eight outcomes and 33 indicators remained in the protocol., Conclusion: This study made it possible to select the most relevant outcomes and indicators to be measured for this diagnosis in clinical practice., Implications for Nursing Practice: Validation studies by consensus and clinical testing are important to promote the accuracy, creating opportunities to legitimize, and improve the concepts of taxonomies., (© 2018 NANDA International, Inc.)

The cytotoxic activity of the pimarane diterpene annonalide (1) and nine of its semisynthetic derivatives (2-10) was investigated against the human tumor cell lines HL-60 (leukemia), PC-3 (prostate adenocarcinoma), HepG2 (hepatocellular carcinoma), SF-295 (glioblastoma) and HCT-116 (colon cancer), and normal mouse fibroblast (L929) cells. The preparation of 2-10 involved derivatization of the side chain of 1 at C-13. Except for 2, all derivatives are being reported for the first time. Most of the tested compounds presented IC 50 s below 4.0 μM, being considered potential antitumor agents. The structures of all new compounds were elucidated by spectroscopic analyses including 2D NMR and HRMS. Additionally, the interaction of annonalide (1) with ctDNA was evaluated using spectroscopic techniques, and the formation of a supramolecular complex with the macromolecule was confirmed. Competition assays with fluorescent probes (Hoechst and ethidium bromide) and theoretical studies confirmed that 1 interacts preferentially via DNA intercalation with stoichiometric ratio of 1:1 (1:ctDNA). The ΔG value was calculated as -28.24 kJ mol -1 , and indicated that the interaction process occurs spontaneously. Docking studies revealed that van der Walls is the most important interaction in 1-DNA and EB-DNA complexes, and that both ligands (1 and EB) interact with the same DNA residues (DA6, DA17 and DT19)., (Copyright © 2018. Published by Elsevier B.V.)

In this study, the oxidation of the dye rhodamine B (RhB), present in a synthetic effluent, and the degradation of organic matter present in a textile effluent, were assessed by photolysis (H 2 O 2 , UV), homogeneous Fenton (Fe 2+ , H 2 O 2 ), and photocatalysis (TiO 2 , UV). The results showed that photolysis and Fenton had an efficiency of 100 % and photocatalysis, 96 %, to discoloration 10 mg L -1 RhB, present in the synthetic effluent. The best experimental conditions determined for these reactions showed that the one performed with 51 mg L -1 H 2 O 2 and UV light had the best results, where 100 % of RhB was discolored in only 6 min of reaction. The optimum conditions determined in the first part of this study for the RhB oxidation did not show satisfactory results for the degradation of organic matter present in the textile effluent sample, and it was necessary to increase the amount of reagents in the three processes. After resizing the concentration of the reagents for the reactions with the textile effluent, the following reductions of color, total organic carbon (TOC), and total soluble solids (SS) were obtained: photocatalysis 29, 25, and 32 %; photolysis 85, 69, and 35 %; Fenton 98, 90, and 23 %; and biological (followed by physicochemical) treatment carried out by the textile industry 96, 48, and 9 %. It is observed that the Fenton reaction showed the best result, followed by photolysis reaction, a treatment carried out by industry and, at last, photocatalysis.

Objective: To investigate possible stressors to which newborns are exposed in the neonatal intensive care unit., Methods: The levels of continuous noise were checked by a decibel meter positioned near the ear of the newborn, brightness was observed by a light meter positioned in the incubator in front of the newborn's eyes, and temperature was checked through the incubator display. The evaluations were performed in three periods of the day, with ten measurements taken at one-minute intervals during each shift for the subsequent statistical analysis., Results: All shifts showed noise above acceptable levels. Morning (p < 0.001), afternoon (p < 0.05) and night (p < 0.001) showed a significant increase compared to the control. The brightness significantly exceeded the normal range (p < 0.01) in the morning. We observed that only one of the incubators was within the normal temperature limits., Conclusion: The noise, brightness and temperature intensities were not in accordance with regulatory standards and thus might be possible stressors to newborns., Competing Interests: None.

The objective of this research was to assess the emission of nitrous oxide (N2O) from soil amended with biochar in the culture of upland rice. The experiment was conducted in the field in a Cerrado Haplic Plinthosol under randomized block experimental design. The treatments consisted of fertilization with 100 kg N ha(-1) split into two applications, 60% at sowing and 40% at 45 days after crop emergence, combined with four doses of biochar (0, 8, 16 and 32 Mg ha(-1)), with four replications. The application of N and the emission of N2O, moisture retention and soil temperature, respiration (C-CO2), microbial biomass carbon in the soil (C-SMB), total nitrogen (TN), pH and agronomic efficiency in N use (AENu) were evaluated five years after the application of biochar. There was a significant correlation of the application of biochar with moisture retention (r = 0.94**), N2O emission (r = 0.86**) and soil pH (r = 0.65*), and N2O emissions showed a positive correlation (p < 0.05) with soil moisture (r = 0.77**) and pH (r = 0.66*). Thus the highest N2O emissions were observed shortly after N fertilization and in the treatments with 32 Mg ha(-1) of biochar. Despite the higher N2O emissions from the application of 32 Mg ha(-1) of biochar, the emission factor was lower (0.81%) than the maximum recommended by the IPCC. The higher N2O emissions with application of biochar are offset by more efficient use of N and consequently the possibility of reduction of applied doses., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: this study aimed to using the Nursing Activities Score to assess nursing workload in a coronary care unit, to assess the distribution of workload between shifts, and to compare the current staff of the care unit with that recommended by the instrument., Method: this was a longitudinal study, conducted in a teaching hospital in Southern Brazil, between April to June 2012., Results: A total of 604 NAS measures were obtained from the 61 patients included. The mean workload per shift was 47% (±12), with the greatest workload being reported in the afternoon shifts., Conclusion: according to the NAS, a mean of two and a maximum of 2.4 nursing professionals would be required per shift to meet all patient demands, suggesting that the current staff size in the CCU is adequate. The NAS was successful in assessing nursing workload and changes in patient demands over time.

This study aimed to classify patients according to their degree of dependence on nursing care (Perroca Classification System) and correlate this with the anesthetic risk (American Society of Anesthesiologists--ASA classification) in a post-anesthesia care unit. A cross-sectional study was conducted, which included 402 patients, mean age 51.57 (±16.73) years, of which 216 (54%) were female. The results indicate that patients had a degree of dependence between intermediate and semi-intensive with an ASA classification of between two and three. There was a significant relationship between degree of dependence and ASA classification. The results indicate that the post-anesthesia care unit admits patients with semi-intensive care requirements and with moderate anesthetic risk.

Whenever patients and their families are faced to the possibility of undergoing surgery they experience feelings of hope for a positive result, as well as anxiety and distrust caused by fear of the unknown. When the patient is transferred to the Recovery Room, this time represents for the family a waiting time for information to brighten up its distress and anxiety. The objective of this study is getting to know the perceptions of nurses in a Recovery Room in relation to the information supplied to the family as a form of humanized care. This study was carried out with three nurses in a teaching hospital in the city of Porto Alegre, Rio Grande do Sul, Brazil. Data collection was conducted through semi-structured interview, using the thematic content analysis, which resulted in three categories of nurses' perception: facing the families' worries and the need of providing the necessary information, their own construction as a caregiver, and their own ways of looking for humanized care. This, in the perception of the nurses, strengthens the professional identity and care values.

The number of AIDS cases in men who have sex with men (MSM) decreased in the initial years of the epidemic, but the percentage of cases in this group has remained unaltered in the last five years. This study, aimed to improve knowledge on the impact of AIDS in the daily lives of MSM, was conducted in Campo Grande, Mato Grosso do Sul State, Brazil, using a questionnaire and interviews. The results show that MSM perceive their vulnerability to HIV infection, referring to inconsistent condom use and multiple sex partners, given that 65% of homosexuals, 75% of bisexuals, and 33% of transvestites reported up to 5 partners in the previous month and emphasizing that 59% of the group reported more than 11 partners during the same period. The susceptibility of certain groups and the identification and understanding of their specificities pose a major challenge in any geographic context where such conditions are present.

This case study discusses the application of a model to determine the number of nurses in the surgical unit in a general hospital of Porto Alegre, Rio Grande do Sul, Brazil. The obtained results were compared with literature findings. Results of calculations identifying the annual capacity of the unit and the annual capacity of nursing hours are presented. The results obtained by applying this model can allow higher precision when planning the number of nurses needed in this unit for nursing care during pre- and post-surgery, thereby contributing to improve productivity.