Size structure, age, and growth of the blue shark, Prionace glauca (Linnaeus, 1758) in southern Brazil.

The blue shark is a highly migratory species with a worldwide distribution, making it susceptible to multiple fishing fleets across the globe. In southern Brazil, it is an important target, comprising up to 40% of the total biomass landed by the commercial surface longline fleet. This study aims to contribute to a better understanding of how the species uses the region and to update its life-history information available for future assessments. Over five consecutive years (2018-2022) of landings and onboard monitoring, we gathered size data and vertebral samples to describe the species size composition in the region, as well as its seasonal and interannual variability and to update estimated life-history parameters. The results showed that southern Brazil is mainly inhabited by large juvenile males that arrive during winter (July-September) and stay until spring (October-December), when their frequency decreases. Small adult males are present throughout the year but in higher frequencies during summer. A small number of adult females are present with higher frequencies during spring and summer, which decreases during the austral autumn and winter. Some variability in the presence of each life stage was observed among years. The estimated life-history parameters were as follows: L∞: 255.02 cm fork length (FL), k: 0.20, L0:35.68 cm FL for males; L∞: 246.47 cm FL, k: 0.23, L0:36.77 cm FL for females; and L∞: 269.58 cm FL, k: 0.18, L0:36.19 cm FL for pooled sexes. However, the estimated values must be cautiously interpreted, as the obtained samples cannot be construed as representative of the entire harvested stock due to the lack of consistent presence of some life stages in the study region.

Discrimination of red porgy Pagrus pagrus (Sparidae) potential stocks in the south-western Atlantic by otolith shape analysis.

Otolith shape analysis is a powerful method for fish stock identification. We compared the otolith shape of Pagrus pagrus (Linnaeus 1758) along with its distribution in four south-western Atlantic regions where it is commercially fished: Rio de Janeiro, Rio Grande do Sul in southern Brazil, the Argentine-Uruguayan Common Fishing Zone (UA) and the Argentinian Exclusive Fishing Zone (AR). Otolith shapes were compared by Elliptical Fourier and Wavelet coefficients among specimens in a size range with similar otoliths, morphometric parameters and ages. Four potential stocks were identified: one in the AR, a second along the UA which included specimens from southern Brazil with well-marked opaque bands in its otoliths (MRS), the third in southern Brazil with faint or absent opaque bands in its otoliths (FRS) and the fourth along Rio de Janeiro. The difference in the otolith shape among regions followed differences reported using other stock identification techniques. The similarity between otoliths from UA and MRS (ANOVA-like, P > 0.01) can be explained by seasonal short-range migrations. Otoliths shape differences between MRS and FRS (ANOVA-like, P < 0.01) suggest that P. pagrus does not form a homogeneous group in southern Brazil.

Cost-utility analysis of outpatient parenteral antimicrobial therapy (OPAT) in the Brazilian national health system.

BACKGROUND: Outpatient parenteral antimicrobial therapy (OPAT) has been used for decades in different countries to reduce hospitalization rates, with favorable clinical and economic outcomes. This study assesses the cost-utility of OPAT compared to inpatient parenteral antimicrobial therapy (IPAT) from the perspective of a public university hospital and the Brazilian National Health System (Unified Health System -SUS). METHODS: Prospective study with adult patients undergoing OPAT at an infusion center, compared to IPAT. Clinical outcomes and quality-adjusted life year (QALY) were assessed, as well as a micro-costing. Cost-utility analysis from the hospital and SUS perspectives were conducted by means of a decision tree, within a 30-day horizon time. RESULTS: Forty cases of OPAT (1112 days) were included and monitored, with a favorable outcome in 97.50%. OPAT compared to IPAT generated overall savings of 31.86% from the hospital perspective and 26.53% from the SUS perspective. The intervention reduced costs, with an incremental cost-utility ratio of -44,395.68/QALY for the hospital and -48,466.70/QALY for the SUS, with better cost-utility for treatment times greater than 14 days. Sensitivity analysis confirmed the stability of the model. CONCLUSION: Our economic assessment demonstrated that, in the Brazilian context, OPAT is a cost-saving strategy both for hospitals and for the SUS.

Is the incidence of candidemia caused by Candida glabrata increasing in Brazil? Five-year surveillance of Candida bloodstream infection in a university reference hospital in southeast Brazil.

From 2006 to 2010, a retrospective study was conducted in a university referral tertiary care hospital to study the frequency and distribution of Candida species in different medical specialties. The use of mechanical ventilation, central venous catheter, and urinary catheter were recorded per 1,000 patient-days and the use of antifungals was calculated using defined daily dose (DDD). A total of 313 episodes were identified and the overall incidence was 0.54 (0.41-0.71) episodes per 1,000 patient-days. Candida albicans caused 44% of the overall episodes, followed by C. tropicalis (21.7%), C. parapsilosis (14.4%), C. glabrata (11.2%), and C. krusei (3.5%). The incidence of C. glabrata significantly increased from 2006-2010 (range: 4.8-23.5%) (P = 0.024). Candida glabrata was associated with malignancies (P = 0.004) and C. krusei with hematologic malignancies (P < 0.0001). The use of antifungals was higher in the hematology/bone marrow transplant units and represented 40% of all fluconazole prescription in the hospital. There was no correlation with the use of fluconazole and the increasing ratio of C. glabrata (r = 0.60). The use of invasive devices was significantly higher in the intensive care units (ICUs) than the medical and surgical emergencies units (P < 0.001). In contrast, the emergencies had higher incidence of candidemia (2-2.1 episodes/1,000 patient-days) than the ICUs (1.6 episodes 1,000 patient-days). Candida glabrata candidemia showed a significant increase in contrast to the current national literature where C. parapsilosis remained the most important non-C. albicans Candida species in Brazilian hospitals. Our findings suggested that the increasing incidence of C. glabrata was not associated with use of fluconazole and other risk factors might play an important role.

Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital.

INTRODUCTION: Vancomycin-resistant enterococci (VRE) can colonize or cause infections in high-risk patients and contaminate the environment. Our objective was to describe the epidemiological investigation of an outbreak of VRE, the interventions made, and their impact on its control. METHODS: We conducted a retrospective, descriptive, non-comparative study by reviewing the charts of patients with a VRE-positive culture in the University Hospital of Campinas State University, comprising 380 beds, 40 of which were in intensive care units (ICUs), who were admitted from February 2008-January 2009. Interventions were divided into educational activity, reviewing the workflow processes, engineering measures, and administrative procedures. RESULTS: There were 150 patients, 139 (92.7%) colonized and 11 (7.3%) infected. Seventy-three percent were cared for in non-ICUs (p = 0.028). Infection was more frequent in patients with a central-line (p = 0.043), mechanical ventilation (p = 0.013), urinary catheter (p = 0.049), or surgical drain (p = 0.049). Vancomycin, metronidazole, ciprofloxacin, and third-generation cephalosporin were previously used by 47 (31.3%), 31 (20.7%), 24 (16%), and 24 (16%) patients, respectively. Death was more frequent in infected (73%) than in colonized (17%) patients (p < 0.001). After the interventions, the attack rate fell from 1.49 to 0.33 (p < 0.001). CONCLUSIONS: Classical risk factors for VRE colonization or infection, e.g., being cared for in an ICU and previous use of vancomycin, were not found in this study. The conjunction of an educational program, strict adhesion to contact precautions, and reinforcement of environmental cleaning were able to prevent the dissemination of VRE.

Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital / Sucesso no controle da transmissão hospitalar de Enterococos resistentes a vancomicina em um hospital universitário público brasileiro

INTRODUCTION: Vancomycin-resistant enterococci (VRE) can colonize or cause infections in high-risk patients and contaminate the environment. Our objective was to describe theepidemiological investigation of an outbreak of VRE, the interventions made, and their impact on its control. METHODS: We conducted a retrospective, descriptive, non-comparative study by reviewing the charts of patients with a VRE-positive culture in the University Hospital of Campinas State University, comprising 380 beds, 40 of which were in intensive care units (ICUs), who were admitted from February 2008-January 2009. Interventions were divided into educational activity, reviewing the workflow processes, engineering measures, and administrative procedures. RESULTS: There were 150 patients, 139 (92.7%) colonized and 11 (7.3%) infected. Seventy-three percent were cared for in non-ICUs (p = 0.028). Infection was more frequent in patients with a central-line (p = 0.043), mechanical ventilation (p = 0.013), urinary catheter (p = 0.049), or surgical drain (p = 0.049). Vancomycin, metronidazole, ciprofloxacin, and third-generation cephalosporin were previously used by 47 (31.3%), 31 (20.7%), 24 (16%), and 24 (16%) patients, respectively. Death was more frequent in infected (73%) than in colonized (17%) patients (p < 0.001). After the interventions, the attack rate fell from 1.49 to 0.33 (p < 0.001). CONCLUSIONS: Classical risk factors for VRE colonization or infection, e.g., being cared for in an ICU and previous use of vancomycin, were not found in this study. The conjunction of an educational program, strict adhesion to contact precautions, and reinforcement of environmental cleaning were able to prevent the dissemination of VRE.

INTRODUÇÃO: Enterococos resistentes a vancomicina (ERV) podem colonizar e causar infecção em pacientes de alto risco, bem como contaminar o ambiente. Nosso objetivo foi descrever a investigação epidemiológica de um surto de ERV, as intervenções realizadas e o impacto no controle do surto. MÉTODOS: Estudo retrospectivo, descritivo, por revisão de prontuários de pacientes com cultura positiva para ERV em um hospital geral, público, universitário, admitidos entre fevereiro de 2008 e janeiro de 2009. As intervenções foram divididas em ações educacionais, revisão de processos de trabalho, medidas administrativas e de engenharia. RESULTADOS: Foram avaliados 150 pacientes, 139 (92,7%) colonizados e 11 (7,3%) infectados por ERV. Setenta e três por cento estavam internados em unidades de cuidados não intensivos (p=0,028). Infecção por ERV foi mais frequente em pacientes usando cateter venoso central (p=0,043), ventilação mecânica (p=0,013), cateter urinário (p=0,049) ou drenos cirúrgicos (p=0,049). Vancomicina, metronidazol, ciprofloxacina ou cefalosporina de terceira geração foram utilizados previamente por 47 (31,3%), 31 (20,7%), 24 (16%) e 24 (16%) pacientes, respectivamente. Óbito foi mais frequente em pacientes infectados por ERV (73%) em relação aos colonizados (17%) (p<0,001). Após as intervenções, a taxa de ataque diminuiu de 1,49 para 0,33 (p<0,001). CONCLUSÕES: Fatores de risco clássicos para colonização ou infecção por ERV, como internação em unidade de terapia intensiva e uso prévio de vancomicina, não foram identificados neste estudo. Um conjunto de intervenções, tais como programa educacional, maior adesão às precauções de contato e reforço da limpeza ambiental apresentou impacto no controle da disseminação hospitalar do ERV.

Lessons from the epidemiological surveillance program, during the influenza A (H1N1) virus epidemic, in a reference university hospital of Southeastern Brazil / Lições aprendidas pelo programa de vigilância epidemiológica, durante a epidemia pelo vírus da influenza A (H1N1), em um hospital universitário na região sudeste do Brasil

INTRODUCTION: The case definition of influenza-like illness (ILI) is a powerful epidemiological tool during influenza epidemics. METHODS: A prospective cohort study was conducted to evaluate the impact of two definitions used as epidemiological tools, in adults and children, during the influenza A H1N1 epidemic. Patients were included if they had upper respiratory samples tested for influenza by real-time reverse transcriptase polymerase chain reaction during two periods, using the ILI definition (coughing + temperature ≤ 38ºC) in period 1, and the definition of severe acute respiratory infection (ARS) (coughing + temperature ≤ 38ºC and dyspnoea) in period 2. RESULTS: The study included 366 adults and 147 children, covering 243 cases of ILI and 270 cases of ARS. Laboratory confirmed cases of influenza were higher in adults (50%) than in children (21.6%) ( p < 0.0001) and influenza infection was more prevalent in the ILI definition (53%) than ARS (24.4%) (p < 0.0001). Adults reported more chills and myalgia than children (p = 0.0001). Oseltamivir was administered in 58% and 46% of adults and children with influenza A H1N1, respectively. The influenza A H1N1 case fatality rate was 7% in adults and 8.3% in children. The mean time from onset of illness until antiviral administration was 4 days. CONCLUSIONS: The modification of ILI to ARS definition resulted in less accuracy in influenza diagnosis and did not improve the appropriate time and use of antiviral medication.

INTRODUÇÃO: A definição de síndrome gripal é uma ferramenta epidemiológica importante durante epidemias de influenza. MÉTODOS: Foi conduzido estudo de coorte prospectivo para avaliar o impacto das definições de síndrome gripal (SG) e doença respiratória aguda grave (DRAG) como ferramenta de vigilância epidemiológica, em adultos e crianças, durante a epidemia de influenza A H1N1. Os pacientes foram incluídos se tivessem coleta de secreção respiratória alta testada por PCR real time para o vírus da influenza. Os dados clínicos e epidemiológicos foram estudados comparando-se dois períodos: período 1: SG (tosse + temperatura ≤ 38ºC), e período 2: DRAG (tosse + temperatura ≤ 38 e dispnéia). RESULTADOS: Foram incluídos 366 adultos e 147 crianças, em um total de 243 casos de SG e 270 DRAG. A confirmação laboratorial de influenza em adultos (50%) foi significativamente maior do que em crianças (21,6%) (p < 0,0001) e a definição de SG foi mais confirmatória de infecção por influenza (53%) do que DRAG (24,4%) (p < 0,0001). Adultos referiam mais calafrios e mialgias do que as crianças (p = 0,0001). Oseltamivir foi prescrito, respectivamente, em 58% e 46% dos adultos e crianças com influenza A H1N1. A letalidade por influenza A H1N1 foi de 7% em adultos e 8,3% em crianças. CONCLUSÕES: A mudança de definição do critério de vigilância epidemiologia de SG para DRAG resultou em redução significativa da acurácia do diagnóstico de influenza e não contribuiu para melhor indicação do antiviral como também para a sua prescrição no tempo apropriado.

Lessons from the epidemiological surveillance program, during the influenza A (H1N1) virus epidemic, in a reference university hospital of Southeastern Brazil.

INTRODUCTION: The case definition of influenza-like illness (ILI) is a powerful epidemiological tool during influenza epidemics. METHODS: A prospective cohort study was conducted to evaluate the impact of two definitions used as epidemiological tools, in adults and children, during the influenza A H1N1 epidemic. Patients were included if they had upper respiratory samples tested for influenza by real-time reverse transcriptase polymerase chain reaction during two periods, using the ILI definition (coughing + temperature ≤ 38ºC) in period 1, and the definition of severe acute respiratory infection (ARS) (coughing + temperature ≤ 38ºC and dyspnoea) in period 2. RESULTS: The study included 366 adults and 147 children, covering 243 cases of ILI and 270 cases of ARS. Laboratory confirmed cases of influenza were higher in adults (50%) than in children (21.6%) ( p < 0.0001) and influenza infection was more prevalent in the ILI definition (53%) than ARS (24.4%) (p < 0.0001). Adults reported more chills and myalgia than children (p = 0.0001). Oseltamivir was administered in 58% and 46% of adults and children with influenza A H1N1, respectively. The influenza A H1N1 case fatality rate was 7% in adults and 8.3% in children. The mean time from onset of illness until antiviral administration was 4 days. CONCLUSIONS: The modification of ILI to ARS definition resulted in less accuracy in influenza diagnosis and did not improve the appropriate time and use of antiviral medication.

Gillnet fisheries as a major mortality factor of Magellanic penguins in wintering areas.

The incidental capture in fisheries is probably the main conservation problem affecting seabirds. While the capture of albatrosses and petrels on longline hooks is well-known worldwide, the bycatch of diving seabirds in gillnets is an overlooked conservation problem. During a winter coastal fishing trip, the capture of Magellanic penguins (Spheniscus magellanicus) was recorded in driftnet and bottom setnet fisheries for the first time in southern Brazil. The highest captures rates were found in driftnets, from 146.5 to 545.5 penguins/km² of net and a total of 56 dead penguins were recorded. In the bottom gillnet, a total of 12 birds were killed and the capture rates varied from 41.7 to 125.0 penguins/km² of net. Although preliminary, the results presented in this paper were consistent between sets. If we consider the magnitude of driftnet and setnet fishing fleets, and that most dead penguins were adults, the impact upon Magellanic penguin populations is probably significant.

Anti-inflammatory activity of aqueous and alkaline extracts from mushrooms (Agaricus blazei Murill).

The effects of aqueous and alkaline extracts from Agaricus blazei Murill, an edible mushroom used as folk medicine in Brazil, Japan, and China to treat several illnesses, were investigated on the basis of the inflammatory process induced by different agents. Oral administration of A. blazei extracts marginally inhibited the edema induced by nystatin. In contrast, when complete Freund's adjuvant was used as the inflammatory stimulus, both extracts were able to inhibit this process significantly (P < .05, analysis of variance followed by Tukey-Kramer multiple comparison post hoc test), although it inhibited the granulomatous tissue induction moderately. These extracts were able to decrease the ulcer wounds induced by stress. Also, administration of extracts inhibited neutrophil migration to the exudates present in the peritoneal cavity after carrageenin injection. Therefore, it is possible that A. blazei extracts can be useful in inflammatory diseases because of activation of the immune system and its cells induced by the presence of polysaccharides such as beta-glucans.

Low prevalence of vancomycin resistant enterococci colonization in intensive care patients in a Brazilian teaching hospital

Vancomycin-resistant enterococci (VRE) are important pathogens involved in nosocomial infections. Colonization precedes infection and the number of colonized individuals is about 10 times higher than the number of infected patients. We examined VRE colonization in two intensive care units from October 2003 to June 2004. Perirectal swab specimens were obtained from all patients, starting on the 5th day after admission, and then weekly. A total of 249 swabs were obtained from 112 patients. Nine patients had VRE-positive swabs, giving a positive rate of 8.0 percent. The rate of patients colonized by V-R E. faecalis was 1.8 percent (n=2), 4.5 percent by V-R E. gallinarun (n=5) and 1.8 percent by V-R E. casseliflavus (n=2). No V-R E. faeciun was isolated. None of the patients that had been colonized by VRE were found to be infected by these pathogens. In summary, a low prevalence of colonization by VRE was found in our institution. Only a structured surveillance program, based on active searching, was able to detect this low number of cases.

Low prevalence of vancomycin resistant enterococci colonization in intensive care patients in a Brazilian teaching hospital.

Vancomycin-resistant enterococci (VRE) are important pathogens involved in nosocomial infections. Colonization precedes infection and the number of colonized individuals is about 10 times higher than the number of infected patients. We examined VRE colonization in two intensive care units from October 2003 to June 2004. Perirectal swab specimens were obtained from all patients, starting on the 5th day after admission, and then weekly. A total of 249 swabs were obtained from 112 patients. Nine patients had VRE-positive swabs, giving a positive rate of 8.0%. The rate of patients colonized by V-R E. faecalis was 1.8% (n=2), 4.5% by V-R E. gallinarun (n=5) and 1.8% by V-R E. casseliflavus (n=2). No V-R E. faeciun was isolated. None of the patients that had been colonized by VRE were found to be infected by these pathogens. In summary, a low prevalence of colonization by VRE was found in our institution. Only a structured surveillance program, based on active searching, was able to detect this low number of cases.

Gastric antiulcer and anti-inflammatory activities of the essential oil from Casearia sylvestris Sw.

To investigate the antiulcer and antiinflammatory activities of the essential oil from Casearia sylvestris leaves (EOCS) the following tests were used: rat paw edema, granulomatous tissue test, vascular permeability, writhing test, gastric ulcer stress-induced and evaluation of gastric secretion (pylorus ligation test). The total yield of EOCS was 2.5% with LD50 of 1100 mg/kg in mouse. The major compounds identified using gas chromatography were caryophyllene, thujopsene, alfa-humulene, beta-acoradiene, germacrene-d, bicyclogermacrene, calamenene, germacrene B, spathulenol and globulol. The EOCS orally administered to the rats at 125 mg/kg resulted 36% of inhibition in carrageenan-induced edema in the rat paw assay (p<0.05, Student's t-test). However, both rat paw edema dextran-induced and vascular permeability assay using histamine showed no significant inhibition. Mice submitted to the writhing test using acetic acid presented 58% and 56% of inhibition in writhes with EOCS and indomethacin, respectively. Furthermore, EOCS inhibited 90% of stress-induced gastric ulcer, while cimetidine inhibited 70% (p<0.05, Student's t-test). The volume of gastric secretion in the group treated with EOCS was greater than the group treated with cimetidine. The EOCS also showed no changes related to H+ levels in the gastric secretion. With the overall results obtained in this study the authors suggest an anti-inflammatory activity for the EOCS of Casearia sylvestris beyond its anti-ulcer activity.