Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Graft- versus -host disease / Consenso Brasileiro de Nutrição no Transplante de Células Tronco Hematopoiéticas: doença do enxerto contra o hospedeiro

ABSTRACT The Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplantation: Graft- versus -host disease was approved by Sociedade Brasileira de Transplante de Medula Óssea , with the participation of 26 Brazilian hematopoietic stem cell transplantation centers. It describes the main nutritional protocols in cases of Graft- versus -host disease, the main complication of hematopoietic stem cell transplantation.

RESUMO O Consenso Brasileiro de Nutrição no Transplante de Células Tronco Hematopoiéticas: doença do enxerto contra o hospedeiro foi aprovado pela Sociedade Brasileira de Transplante de Medula Óssea, com a participação de 26 centros brasileiros de transplante de células-tronco hematopoiéticas. O Consenso descreve as principais condutas nutricionais em casos de doença do enxerto contra o hospedeiro, a principal complicação do transplante de células-tronco hematopoiéticas.

Goal-directed therapy in patients with early acute kidney injury: a multicenter randomized controlled trial

OBJECTIVES: Acute kidney injury is associated with many conditions, and no interventions to improve the outcomes of established acute kidney injury have been developed. We performed this study to determine whether goal-directed therapy conducted during the early stages of acute kidney injury could change the course of the disease. METHODS: This was a multicenter prospective randomized controlled study. Patients with early acute kidney injury in the critical care unit were randomly allocated to a standard care (control) group or a goal-directed therapy group with 8h of intensive treatment to maximize oxygen delivery, and all patients were evaluated during a period of 72h. ClinicalTrials.gov: NCT02414906. RESULTS: A total of 143 patients were eligible for the study, and 99 patients were randomized. Central venous oxygen saturation was significantly increased and the serum lactate level significantly was decreased from baseline levels in the goal-directed therapy group (p=0.001) compared to the control group (p=0.572). No significant differences in the change in serum creatinine level (p=0.96), persistence of acute kidney injury beyond 72h (p=0.064) or the need for renal replacement therapy (p=0.82) were observed between the two groups. In-hospital mortality was significantly lower in the goal-directed therapy group than in the control group (33% vs. 51%; RR: 0.61, 95% CI: 0.37-1.00, p=0.048, number needed to treat=5). CONCLUSIONS: Goal-directed therapy for patients in the early stages of acute kidney injury did not change the disease course.

Virulence genes and genetic relationship of L. monocytogenes isolated from human and food sources in Brazil

ABSTRACT The herein presented assay provided a bacteriological and molecular characterization of 100 samples of L. monocytogenes isolated from human (43) and food (57) sources, from several regions of Brazil, and collected between 1975 and 2013. Antigenic characterization defined 49% of serotype 4b samples, followed by 28% of serotype 1/2b, 14% of serotype 1/2c, 8% of serotype 1/2a, and 1% of serotype 3b. Both type of samples from human and food origin express the same serotype distribution. Multiplex PCR analysis showed 13 strains of type 4b with the amplification profile 4b-VI (Variant I). Virulence genes hly, inlA, inlB, inlC, inlJ, actA, plcA, and prfA were detected in all samples, highlighting a deletion of 105pb on the actA gene in 23% of serotype 4b samples. Macrorestriction profile with ApaI at PFGE showed 55 pulsotypes, with the occurrence of the same pulsotype in hospitalized patients in São Paulo in 1992 and 1997, and two other highly related pulsotypes in patients hospitalized in Rio de Janeiro in 2008. Recognized pulsotypes in listeriosis cases have also been detected in food. Thus, the prevalence of a serotype and the persistence of certain pulsotypes herald future problems.

Comparison of methods for determination of nutrient digestibility of a dry kibble diet for ocelots / Comparação de métodos para estimar coeficientes de digestibilidade de uma ração comercial de gatos-domésticos para jaguatiricas

In this experiment, methods of total fecal collection (TFC) and internal markers (acid-insoluble ash - AIA, crude fiber - CF, and acid-detergent fiber - ADF) were compared for determination of the coefficients of apparent digestibility (CAD) for dry matter (DM), crude protein (CP), ether extract (EE), nitrogen-free extracts (NFE), and gross energy (GE) of commercial feline dry kibble for ocelots (Leopardus pardalis). Six adult animals, weighing 12.45±1.37 kg, gradually received experimental kibble in their usual diet until the beginning of the experiment and were submitted to an adaptation period ten days prior to the collection period. CAD obtained by TFC, AIA, CF, and ADF were, respectively, 73.7, 76.83, 62.01, and 46.03% for dry matter; 81.9, 84.8, 75.8, and 63.8% for crude protein; 85, 86.7, 78.5, and 69.1% for ether extract; 78.52, 79.55, 69.11, and 53.04% for nitrogen-free extracts; and 80.5, 82.2, 71.4, and 58.4% for gross energy. The AIA method showed to be efficient in determining coefficients of apparent digestibility and may contribute to investigations on the digestibility of diets for wild felines. In comparison to the items of ocelot's usual diet, the kibble used in this paper provided an adequate nutritional supply with reduced daily costs per animal.

Neste experimento foram comparados os métodos de coleta total de fezes (CT) e de indicadores internos (cinza insolúvel em ácido - CIA, fibra bruta - FB e fibra em detergente ácido - FDA) na determinação dos coeficientes de digestibilidade aparente (CDA) da matéria seca (MS), proteína bruta (PB), extrato etéreo (EE), extrativo não nitrogenado (ENN) e energia bruta (EB) de uma ração comercial de gatos-domésticos para jaguatiricas (Leopardus pardalis). Seis animais adultos com peso de 12,45 ± 1,37kg receberam gradativamente a ração experimental na dieta habitual até o início do experimento e foram submetidos a um período de adaptação de 10 dias anteriores ao período de coleta. Os CDA obtidos pela CT, CIA, FB e FDA foram, respectivamente de 73,70; 76,83; 62,01 e 46,03% para matéria seca, 81,9; 84,8; 75,8 e 63,8% para proteína bruta, 85,0; 86,7; 78,5 e 69,1% para extrato etéreo, 78,52; 79,55; 69,11 e 53,04% para extrativo não nitrogenado e de 80,5; 82,2; 71,4 e 58,4% para energia bruta. O método de CIA mostrou-se eficiente na determinação dos coeficientes de digestibilidade aparente e pode contribuir com as investigações sobre a digestibilidade em dietas com felídeos selvagens. A ração utilizada permitiu aos animais um adequado aporte nutricional e apresentou menores custos/animal/dia em comparação aos itens que compunham a dieta habitual.

Sepse fatal após instilação intravesical de BCG: relato de caso / Fatal sepsis after intravesical instillation of BCG: case report

A instilação intravesical do bacilo de Calmette-Guérin (BCG) é o tratamento de escolha para carcinoma de bexiga in situ ou tumores superficiais de bexiga de alto grau não invasivos. Este tratamento geralmente é bem tolerado, mas podem ocorrer complicações graves. Paciente idoso, coronariopata, portador de carcinoma superficial de bexiga de alto grau recidivado foi submetido à instilação intravesical de BCG, evoluindo com choque séptico. Recebeu antibioticoterapia de amplo espectro, tuberculostáticos, corticóide, aminas vasoativas, suporte ventilatório e tratamento hemodialítico, sem melhora. Faleceu nove dias após a instilação intravesical de BCG por insuficiência de múltiplos órgãos.

Intravesical instillation of bacillus Calmette-Guérin (BCG) is the treatment of choice for carcinoma in situ and non-invasive high-grade superficial tumors of the urinary bladder. This treatment is well tolerated overall, but serious complications can occur. An elderly man with coronary disease and recurrent high-grade superficial carcinoma of the bladder underwent intravesical instillation of BCG and developed septic shock. He received wide range antibiotics, tuberculostatic and vasoactive drugs, corticosteroids, mechanical ventilation and renal replacement therapy without improvement. He died nine days after the intravesical instillation of BCG because of multiple organ failure.

Usage of green coconut water and different tissue culture media for in vitro honey bee semen storage (apis mellifera; hymenoptera: apoidea)

Se almacenó semen de abejas en agua de coco (Cocos nucifera L.) verde con dihidroestreptomicina y en medios de cultivo comerciales, a diferentes temperaturas, utilizando microtubos capilares de 0,1 cm de diámetro y microtubos de centrífuga con 0,2 ml de capacidad. La motilidad de los espermatozoides fue evaluada luego de 1,2,5,10,15,30,50,80 y 120 días. Reinas fueron inseminadas instrumentalmente con semen diluido y se evaluó su comportamiento reproductivo. El almacenamiento en agua de coco resulta en espermatozoides móviles hasta 80 días. Sin embargo, las reinas ovaron normalmente y resultaron obreras normales solamente cuando se utilizo para la inseminación semen almacenado en agua de coco hasta por 15 días. El agua de coco parece ser un diluente natural ideal para el almacenamiento in vitro de semen de abejas por períodos cortos y puede ser un método apropiado para programas de mejoramiento genético de obejas