The Amazonian kambô frog Phyllomedusa bicolor (Amphibia: Phyllomedusidae): Current knowledge on biology, phylogeography, toxinology, ethnopharmacology and medical aspects.

Phyllomedusa bicolor (Phyllomedusidae), popularly known as the kambô in Brazil, is a tree frog that is widely distributed in South American countries and is known for producing a skin secretion that is rich in bioactive peptides, which are often used in indigenous rituals. The biological effects of the skin secretion were observed in the first studies with indigenous communities. Over the last six decades, researchers have been studying the chemical composition in detail, as well as the potential pharmacological applications of its constituents. For this reason, indigenous communities and health agents fear the misuse of the kambô, or the inappropriate use of the species, which can result in health complications or even death of users. This article seeks to provide a transdisciplinary review that integrates knowledge regarding the biology of P. bicolor, ethnoknowledge about the ritual of the kambô, and the chemistry and pharmacology of the skin secretion of this species, in addition to medical aspects of the indiscriminate use of the kambô. Furthermore, this review seeks to shed light on perspectives on the future of research related to the kambô.

Methicillin-Resistant Staphylococcus aureus in Poultry and Poultry Meat: A Meta-Analysis.

Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that colonizes and infects various host species and has been found in the poultry production chain, raising concerns about possible transmission from farm to fork. The objective of this study was to use meta-analytical methods to estimate the pooled prevalence of MRSA in chickens, turkeys, chicken meat, and turkey meat. Three electronic databases (PubMed, LILACS, and SciELO) were searched to establish MRSA prevalence from 51 studies published from 2003 through May 2017. The heterogeneity was assessed, and the pooled MRSA prevalence was calculated by using the random effects model according to the method of DerSimonian and Laird. Pooled MRSA prevalence (95% confidence interval [CI]) in turkeys, turkey meat, broilers, and chicken meat was 36% (1 to 78%), 13% (1 to 28%), 5% (2 to 9%), and 5% (3 to 8%), respectively. South America had the highest MRSA prevalence (27%; 95% CI, 17 to 37%), and North America had the lowest (1%; 95% CI, 0 to 2%). Livestock-associated MRSA has been isolated from poultry and poultry meat, indicating that this variant can spread from farm to fork. The presence of MRSA in poultry and poultry meat poses risks to public health, and steps should be taken to mitigate the contamination and spread of this bacterium along the poultry production chain.

Prevalence and antimicrobial susceptibility profile of ESKAPE pathogens from the Federal District, Brazil / Prevalência e perfil de suscetibilidade aos antimicrobianos de bactérias do grupo ESKAPE no Distrito Federal, Brasil

ABSTRACT Introduction: The leading cause of hospital-acquired infections are the pathogens named by the acronym ESKAPE, which are the initials for the following bacterial: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanni, Pseudomonas aeruginosa and Enterobacter spp., which have high resistance rates by escaping the action of the antimicrobial. Objective: To trace the antimicrobial susceptibility profile of the ESKAPE pathogens in a primary public hospital in the Federal District, Brazil. Methods: A cross-sectional, retrospective and descriptive study was conducted by analyzing the corresponding data from January 2010 to December 2015 of samples considered positive to ESKAPE pathogens in order to generate an antimicrobial susceptibility profile. Results: Analyzing the Gram-positive bacteria, almost 80% of E. faecium strains were vancomycin-resistant enterococci (VRE) and almost 40% of S. aureus strains were methicillin (oxacillin)-resistant Staphylococcus aureus (MRSA). It was observed that gram-negative strains (the ESKAPE group) examined in this study have a higher resistance rate to carbapenems than in other studies. In the molecular analysis, four Klebsiella pneumoniae strains were positive to blaKPC gene, three strains to blaNDM and one Acinetobacter baumanni strain was positive to blaOXA-23 gene. Conclusion: Studies such as this should be performed periodically in order to evaluate the bacterial susceptibility profile. They demonstrate the importance of implementing strategies to prevent hospital-acquired infections, as well as greater antibiotic prescribing control.

RESUMO Introdução: Os principais patógenos causadores de infecções nosocomiais foram resumidos pela sigla ESKAPE, que são as iniciais das seguintes bactérias: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanni, Pseudomonas aeruginosa e Enterobacter spp., as quais possuem altas taxas de resistência por conseguirem escapar das ações dos antimicrobianos. Objetivo: Traçar o perfil de suscetibilidade antimicrobiana do grupo ESKAPE em um hospital primário da rede pública do Distrito Federal, Brasil. Métodos: Foi realizado um estudo transversal, retrospectivo e descritivo, analisando os dados correspondentes de janeiro de 2010 a dezembro de 2015 para as amostras consideradas positivas para o grupo ESKAPE, com o intuito de gerar um perfil de sensibilidade aos antimicrobianos. Resultados: Ao analisar bactérias Gram positivas, quase 80% das cepas de Enterococcus faecium foram resistentes à vancomicina (VRE) e cerca de 40% das cepas de Staphylococcus aureus, resistentes à oxacilina (MRSA). Nas bactérias do grupo ESKAPE, observaram-se cepas com uma taxa de resistência maior aos carbapenens do que em outros estudos. Ao realizar uma análise molecular, quatro cepas de Klebsiella pneumoniae foram positivas para o gene blaKPC e três, para o blaNDM; uma de Acinetobacter baumanni foi positiva para o gene blaOXA-23. Conclusão: Estudos como este devem ser realizados periodicamente de modo a avaliar o perfil de suscetibilidade das bactérias. Eles demonstram a importância do uso de estratégias para evitar infecções nosocomiais, bem como um maior controle na prescrição de antimicrobianos.

Analysis of the frequency of biological sample recollections as quality indicators in a clinical laboratory of Distrito Federal, Brazil / Análise da frequência de recoletas de amostras biológicas como indicadores de qualidade em um laboratório de análises clínicas do Distrito Federal, Brasil

ABSTRACT Introduction: Clinical laboratory results influence more than 60% of medical decisions, impacting on disease prevention, diagnosis, and treatment. The use of quality indicators (QIs) is fundamental for quality assurance, once it allows monitoring the process and directs the taking of corrective actions. Objective: Classify the biological sample recollection requests for QIs identification in a clinical laboratory of Distrito Federal, Brazil. Material and methods: Data about the requests made in the biennium 2013-2014 were gathered and analyzed. Results and discussion: Among the 304,361 samples received, 1,914 (0.62%) had a request for recollection made in accordance with laboratory criteria. Most orders originated in the pre-analytical phase (57.7%). The most frequent reason for sample rejection was result confirmation (40.7%), followed by insufficient sample (21.9%), coagulated sample (18.1%) and hemolyzed sample (11, 9%). The hematology sector was responsible for most recollection requests (43.6%), followed by the biochemistry (29%) and the immunology (25.7%) ones. The laboratory emergency department accounted for only 0.1%. Orders were mostly placed by the outpatient clinic (40.7%), emergency (30.4%), and internal medicine (12.4%) departments. The percentage of orders is low, but does not exclude the need to reach lower rates. Underreporting was detected in the emergency sector, which indicates need for improvement in information registration. Conclusion: The numbers mentioned were selected as IQs for the pre-analytical phase, serving as guidelines for future actions taken by the team.

RESUMO Introdução: Os resultados dos testes laboratoriais influenciam mais de 60% das decisões médicas, impactando na prevenção, no diagnóstico e no tratamento de doenças. O uso de indicadores de qualidade (IQs) é fundamental para a garantia da qualidade, pois permite monitoramento do processo e direciona a implementação de ações corretivas. Objetivo: Classificar pedidos de recoleta de amostras biológicas para identificação de IQs em um laboratório de análises clínicas do Distrito Federal. Material e métodos: Foram coletados e analisados dados acerca de pedidos de recoleta feitos no biênio 2013-2014. Resultados e discussão: Das 304.361 amostras registradas, 1.914 (0,62%) tiveram solicitação de recoleta de acordo com os critérios do laboratório. A maioria dos pedidos teve origem na fase pré-analítica (57,7%). O motivo de rejeição mais frequente foi confirmação de resultado (40,7%), seguido por amostra insuficiente (21,9%), amostra coagulada (18,1%) e amostra hemolisada (11,9%). O setor de hematologiafoi o responsável pelo maior número de pedidos de recoletas (43,6%), seguido pelo de bioquímica (29%) e o de imunologia (25,7%). O setor de emergência do laboratório representou apenas 0,1%. Quanto à procedência, a maioria das recoletas foi solicitada pelo ambulatório (40,7%), pelo pronto-socorro (30,4%) e pela clínica médica (12,4%). A porcentagem de pedidos de recoleta é baixa, porém não exclui a necessidade de busca por menores índices. Sugere-se que tenha ocorrido subnotificação no setor de emergência do laboratório, o que aponta necessidade de melhoria no registro de informações. Conclusão: Os números destacados foram selecionados como IQs para a fase pré-analítica, servindo como norteadores para as futuras ações corretivas efetuadas pela equipe.

Effects of total body irradiation followed by bone marrow transplantation on the disposition kinetics of methotrexate in the rat.

The effects of total body irradiation followed by bone marrow transplantation on the disposition kinetics of intravenously-administered methotrexate have been studied in the Wistar-Furth rat. Eight test animals received total body irradiation (1000 rads) followed by intravenous administration of 3 X 10(8) bone marrow cells per kg body weight. Eight control animals were sham-irradiated and received an equal volume of blank suspension medium. One day after these treatments each rat received methotrexate (25 mg/kg) by rapid intravenous injection and serial blood samples were obtained over a 3 hour period. Serum methotrexate concentrations were measured by high performance liquid chromatography and pharmacokinetic parameters were calculated after NONLIN analysis of data. No significant differences were observed in total body clearances of test and control animals. As methotrexate in the rat is cleared predominantly by renal excretion of unchanged drug, these findings suggest that this process is not affected by radiation. Significantly larger volumes of distribution were observed in test animals. Increased extent of distribution in irradiated animals could be a result of a radiation-induced increase in membrane permeability and/or increased blood flow to irradiated areas. Future studies should assess the clinical significance of such findings.