The impact of saline and water stress on the agronomic performance of beet crops.

Excessive salts in irrigation water and water stress have a negative impact on the productive yield of agricultural crops. In this regard, the objective was to evaluate the effect of combined saline and water stress on the agronomic performance of the beet crop. The experiment was conducted in a greenhouse located at the Universidade da Integração Internacional da Lusofonia Afro-Brasileira, in Redenção, Ceará. The experimental design used was completely randomized with split-plots arrangement. The main plots were formed by the electrical conductivities of the irrigation water (0.8, 1.5, 3.0, 4.5, and 6.0 dS m-1), while the irrigation depths of 50 and 100% of the crop evapotranspiration (ETc) were the subplots, with 6 replications. Saline stress negatively affected growth, biomass, tuber root length, and productivity, while increasing the soluble solids of the beet crop. Excessive salts in the irrigation water caused reductions in physiological indices of the beet crop, although with less severity under the 100% ETc.

Effects of water produced by oil segment on aquatic organisms after treatment using advanced oxidative processes.

The water produced (PW) by the petroleum industry is a potential contaminant to aquatic biota, due to its complex mixture that may contain polycyclic aromatic hydrocarbons (PAHs), organic chemical compounds, including benzene, toluene, ethylbenzene and xylene (BTEX), metals and other components that are known to be toxic. The aim of this investigation was to examine the acute toxicity produced by a PW sample in aquatic organisms Vibrio fischeri and Daphnia similis prior to and after 4 treatments using advanced oxidative processes such as photocatalysis, photoelectrocatalysis, ozonation and photoelectrocatalytic ozonation. Data demonstrated that exposure to PW was toxic to both organisms, as evidenced by reduced luminescence in bacterium Vibrio fischeri and induced immobility in Daphnia similis. After treatment of PW with 4 different techniques, the PW remained toxic for both tested organisms. However, photoelectrocatalysis was more efficient in decreasing toxicity attributed to PW sample. Therefore, data demonstrate the importance of treating PW for later disposal in the environment in order to mitigate ecotoxicological impacts. Further photoelectrocatalysis appeared to be a promising tool for treating PW samples prior to disposal and exposure of aquatic ecosystems.

Cultivable bacterial diversity associated with bromeliad roots from ironstone outcrops in central Brazil / Diversidade de bactérias cultiváveis associadas a raízes de bromélias de afloramentos ferruginosos do Brasil central

Abstract Studies on the bacterial diversity associated with wild plants are rare, especially on those that grow in association with bromeliads. In the present study, we isolated and identified epiphytic and endophytic bacteria from the roots of the bromeliads Dyckia excelsa, Dyckia leptostachya and Deuterocohnia meziana occurring in the "cangas" in the Pantanal from Mato Grosso do Sul State, Brazil. The epiphytic bacteria were isolated from washed roots, while the endophytic bacteria were isolated from surface disinfested roots. Bacterial representatives corresponding to each BOX-PCR fingerprint, as well as those that did not result in amplicons, were selected for 16S rDNA gene sequence analysis. The BOX-PCR data showed intrageneric and intraspecific diversity and could discriminate strains and identify their phenotypic characteristics. The 16S rDNA gene sequence and phylogeny analysis showed a higher occurrence of strains belonging to the genus Bacillus than Mycobacterium and Brevibacterium, which were found in lower numbers. Species from the Bacillus genus are well known for their sporulation capacity and longer survival in arid locations, such as the "cangas". This study clearly showed that the bromeliad species represent a vast reservoir of bacterial community diversity, and the cultivable strains represent a new source for biotechnological prospecting.

Resumo Estudos sobre a diversidade bacteriana associada a plantas silvestres são raros, especialmente naqueles que crescem em associação com bromélias. No presente estudo, isolamos e identificamos bactérias epífitas e endofíticas das raízes das bromélias Dyckia excelsa, D. leptostachya e Deuterocohnia meziana ocorrentes nas "cangas" no Pantanal do Mato Grosso do Sul, Brasil. As bactérias epifíticas foram isoladas de raízes lavadas, enquanto as bactérias endofíticas foram isoladas de raízes desinfestadas na superfície. Representantes bacterianos correspondentes a cada perfil do BOX-PCR, bem como aqueles que não resultaram em amplificações, foram selecionados para o sequenciamento do gene 16S rDNA. Os dados da BOX-PCR mostraram diversidade intragênica e intraespecífica e puderam discriminar cepas e identificar suas características fenotípicas. A seqüência do gene 16S rDNA e a análise filogenética mostraram uma maior ocorrência de cepas pertencentes ao gênero Bacillus do que as bactérias Mycobacterium e Brevibacterium, encontradas em menor número. Espécies do gênero Bacillus são bem conhecidas por sua capacidade de esporulação e maior sobrevida em locais áridos, como as "cangas". Este estudo mostrou claramente que as espécies de bromélias representam um vasto reservatório de diversidade de comunidades bacterianas, e as linhagens cultiváveis podem representar uma nova fonte para a prospecção biotecnológica.

The quorum-sensing molecule 2-phenylethanol impaired conidial germination, hyphal membrane integrity and growth of Penicillium expansum and Penicillium nordicum.

AIMS: The aim of the study was to investigate the antifungal effects of a quorum sensing-molecule, 2-phenylethanol, against the food spoilage moulds Penicillium expansum and Penicillium nordicum. METHODS AND RESULTS: Conidial germination of the tested Penicillium spp. (three strains in total) were inhibited by treatments with 2-phenylethanol in a concentration-dependent manner. Germinated conidia was significantly reduced from 4·4-16·7% at 7·5 mmol l-1 and completely inhibited at 15 mmol l-1 2-phenylethanol. Integrity of conidial cell membranes was unaffected by 2-phenylethanol resulting in reversible inhibition pattern of germination. In contrast, membrane permeability of actively growing hyphae was severely compromised, showing 63·5 - 75·7% membrane damage upon treatment with 15 mmol l-1 2-phenylethanol. The overall inhibitory effect of 2-phenylethanol on colony development and growth of P. expansum and P. nordicum was additionally confirmed. CONCLUSIONS: 2-phenylethanol inhibits conidial germination and growth of P. expansum and P. nordicum in a nonlethal, reversible and concentration-dependent manner. SIGNIFICANCE AND IMPACT OF THE STUDY: The study indicates that 2-phenylethanol can find potential application as an antifungal agent for biological control of moulds in the food industry.

Cultivable bacterial diversity associated with bromeliad roots from ironstone outcrops in central Brazil.

Studies on the bacterial diversity associated with wild plants are rare, especially on those that grow in association with bromeliads. In the present study, we isolated and identified epiphytic and endophytic bacteria from the roots of the bromeliads Dyckia excelsa, Dyckia leptostachya and Deuterocohnia meziana occurring in the "cangas" in the Pantanal from Mato Grosso do Sul State, Brazil. The epiphytic bacteria were isolated from washed roots, while the endophytic bacteria were isolated from surface disinfested roots. Bacterial representatives corresponding to each BOX-PCR fingerprint, as well as those that did not result in amplicons, were selected for 16S rDNA gene sequence analysis. The BOX-PCR data showed intrageneric and intraspecific diversity and could discriminate strains and identify their phenotypic characteristics. The 16S rDNA gene sequence and phylogeny analysis showed a higher occurrence of strains belonging to the genus Bacillus than Mycobacterium and Brevibacterium, which were found in lower numbers. Species from the Bacillus genus are well known for their sporulation capacity and longer survival in arid locations, such as the "cangas". This study clearly showed that the bromeliad species represent a vast reservoir of bacterial community diversity, and the cultivable strains represent a new source for biotechnological prospecting.

Para avanzar en el conocimiento de la seguridad del paciente: a propósito de la biblioteca breve de seguridad del paciente / To promote knowledge on patient safety: the case of the Biblioteca Breve de Seguridad del Paciente(Brief Patient Safety Library)

FUNDAMENTOS: En el marco de la Estrategia de Seguridad del Paciente 2015-2020 la Consejería de Sanidad de la Comunidad de Madrid desarrolló dos líneas de actuación para consolidar la cultura de seguridad a través de la difusión del conocimiento científico en Seguridad del Paciente. El objetivo principal fue identificar, difundir y mejorar el acceso a la información relevante en seguridad del paciente a pacientes-ciudadanos, profesionales y a la propia organización mediante un catálogo de recursos accesible en internet e intranet. MÉTODOS: Tras un análisis de las herramientas y canales de comunicación disponibles para difundir el conocimiento en seguridad del paciente, se seleccionaron las referencias de interés por un grupo de expertos, se desarrolló una herramienta de consulta en un formato navegable en internet y se realizaron distintas acciones de difusión para darla a conocer. RESULTADOS: Se desarrolló la Biblioteca Breve de Seguridad del Paciente, accesible en la web de la Comunidad de Madrid para navegación y como documento para descargar, con 154 referencias, estructuradas en 4 áreas: Recursos generales (74 referencias), Recursos por Área temática (51 referencias), Videos y multimedia (12 referencias) y Organismos y sitios web de interés (17 referencias). CONCLUSIONES: La Biblioteca Breve de Seguridad del Paciente puede contribuir a impulsar la cultura de seguridad en los centros sanitarios y a lograr mayor implicación de los ciudadanos en su seguridad, al poner a su disposición información fiable sobre esta dimensión transversal de la práctica clínica

BACKGROUND: Within the framework of the Patient Safety Strategy 2015-2020, the Regional Ministry of Health of the Community of Madrid developed two lines of action to consolidate the Patient Safety Culture through the dissemination of scientific knowledge in Patient Safety. The main objective was to identify, disseminate and improve access to relevant information on patient safety for patient-citizens, professionals and the organization itself through a pool of resources accessible on the Internet and intranet. METHODS: After an analysis of the tools and communication channel savailable to disseminate knowledge in patient safety, the references of interest were selected by a group of experts, a consultation tool was developed in a navigable format on the internet and various dissemination actions were carried out to make it known. RESULTS: The Biblioteca Breve de Seguridad del Paciente( Brief Patient Safety Library) was developed, accessible for navigation on the web of the Community of Madrid and as a download document, with 154 references, structured in 4areas: General resources (74 references), Resources by thematic area (51references), Videosand multimedia (12references) and Organizations and websites of interest (17references). CONCLUSIONS: The Biblioteca Brevede Seguridad del Paciente (Brief Patient Safety Library) can help to promote the safety culture in health centers and to achieve greater citizen involvement in their safety, by providing reliable information on this crosscutting dimension of clinical practice

Cultivable bacterial diversity associated with bromeliad roots from ironstone outcrops in central Brazil

Abstract Studies on the bacterial diversity associated with wild plants are rare, especially on those that grow in association with bromeliads. In the present study, we isolated and identified epiphytic and endophytic bacteria from the roots of the bromeliads Dyckia excelsa, Dyckia leptostachya and Deuterocohnia meziana occurring in the cangas in the Pantanal from Mato Grosso do Sul State, Brazil. The epiphytic bacteria were isolated from washed roots, while the endophytic bacteria were isolated from surface disinfested roots. Bacterial representatives corresponding to each BOX-PCR fingerprint, as well as those that did not result in amplicons, were selected for 16S rDNA gene sequence analysis. The BOX-PCR data showed intrageneric and intraspecific diversity and could discriminate strains and identify their phenotypic characteristics. The 16S rDNA gene sequence and phylogeny analysis showed a higher occurrence of strains belonging to the genus Bacillus than Mycobacterium and Brevibacterium, which were found in lower numbers. Species from the Bacillus genus are well known for their sporulation capacity and longer survival in arid locations, such as the cangas. This study clearly showed that the bromeliad species represent a vast reservoir of bacterial community diversity, and the cultivable strains represent a new source for biotechnological prospecting.

Resumo Estudos sobre a diversidade bacteriana associada a plantas silvestres são raros, especialmente naqueles que crescem em associação com bromélias. No presente estudo, isolamos e identificamos bactérias epífitas e endofíticas das raízes das bromélias Dyckia excelsa, D. leptostachya e Deuterocohnia meziana ocorrentes nas cangas no Pantanal do Mato Grosso do Sul, Brasil. As bactérias epifíticas foram isoladas de raízes lavadas, enquanto as bactérias endofíticas foram isoladas de raízes desinfestadas na superfície. Representantes bacterianos correspondentes a cada perfil do BOX-PCR, bem como aqueles que não resultaram em amplificações, foram selecionados para o sequenciamento do gene 16S rDNA. Os dados da BOX-PCR mostraram diversidade intragênica e intraespecífica e puderam discriminar cepas e identificar suas características fenotípicas. A seqüência do gene 16S rDNA e a análise filogenética mostraram uma maior ocorrência de cepas pertencentes ao gênero Bacillus do que as bactérias Mycobacterium e Brevibacterium, encontradas em menor número. Espécies do gênero Bacillus são bem conhecidas por sua capacidade de esporulação e maior sobrevida em locais áridos, como as cangas. Este estudo mostrou claramente que as espécies de bromélias representam um vasto reservatório de diversidade de comunidades bacterianas, e as linhagens cultiváveis podem representar uma nova fonte para a prospecção biotecnológica.

The use of unsafe abbreviations in discharge report and medical prescription: Observational and retrospective study / El uso de abreviaturas no recomendadas en el informe de alta y prescripción médica: Estudio observacional retrospectivo.

Background. The medical record represents the transcript of the pathologic narrative of a patient. Our aims were: to identify the most common abbreviations present in medical records; to identify discouraged abbreviations; to identify polysemic abbreviations; and to show the distribution of the abbreviations according to the type of ward (medical-surgical). Methods. An observational, descriptive and retrospective study by auditing the digital clinical records of patients discharged from FuenlabradaUniversityHospital in 2013 was conducted. Abbreviations in discharge reports and medical order prescriptions present in 78 medical records, corresponding to 39 men and 39 women of different services, were reviewed. Results. All medical records showed abbreviations. The mean of abbreviations in each medical record was 38.9±17.7. Medical records showed 688 different abbreviations, which were repeated up to a total of 3,038 times. The most frequent abbreviations were HTA (n=98; 3.23%), AP (n=89; 2.93%). Twenty-eight abbreviations considered unsafe appeared and were repeated 646 times. The most frequent included SC (n=63; 9.75%), ui (n=49; 7.59%), > (n=38; 5.88%), mcg (n=36; 5.57%). Twenty-three polysemic abbreviations were also identified, the most frequent being H (n=117; 12.81%), MC (n= 109; 11.94%), MP (n=99; 10.84%). Finally, medical wards had 1,866 abbreviations and surgical 1,172 (P <0.001). Conclusions. All medical records revised included unsafe abbreviations. The use of unsafe abbreviations was common among medical services.

El uso de abreviaturas no recomendadas en el informe de alta y prescripción médica: estudio observacional retrospectivo / The use of unsafe abbreviations in discharge report and medical prescription: observational and retrospective study

Fundamento: La historia clínica es la transcripción del relato patográfico del paciente. Los objetivos de este trabajo fueron: identificar las abreviaturas más frecuentes presentes en la historia clínica, identificar las abreviaturas desaconsejadas, identificar abreviaturas polisémicas, y describir su distribución según servicio (médico-quirúrgico). Material y métodos: Estudio observacional, descriptivo y retrospectivo mediante auditoría de historia clínica digitalizada de pacientes dados de alta del hospital Universitario Fuenlabrada en el año 2013. Se revisaron las abreviaturas de los informes de alta y las órdenes de prescripción en 78 historias clínicas (39 hombres y 39 mujeres) de diferentes servicios. Resultados: El 100% de las historias revisadas presentaron abreviaturas (media: 38,95; DS 17,7). Se encontraron 688 abreviaturas diferentes, que se repetían hasta llegar a un total de 3.038. Las más frecuentes fueron: HTA (n=98; 3,23%), AP (n=89; 2,93%), SC (n=63; 2,07%). Se identificaron 28 abreviaturas desaconsejadas, repitiéndose 646 veces. Las más frecuentes fueron: SC (n=63; 9,75%), ui (n=49; 7,59%), > (n=38; 5,88%), mcg (n=36; 5,57%). Se identificaron 23 abreviaturas polisémicas, siendo las más frecuentes: H (n=117; 12,81%), MC (n= 109; 11,94%), MP (n=99; 10,84%). Finalmente, los servicios médicos presentaron 1.866 abreviaturas y los quirúrgicos 1.172 (p<0,001). Conclusiones: Todas las historias clínicas presentaron abreviaturas de riesgo, y el uso de abreviaturas desaconsejadas fue habitual en los servicios de medicina (AU)

Background: The medical record represents the transcript of the pathologic narrative of a patient. Our aims were: to identify the most common abbreviations present in medical records; to identify discouraged abbreviations; to identify polysemic abbreviations; and to show the distribution of the abbreviations according to the type of ward (medical-surgical). Methods: An observational, descriptive and retrospective study by auditing the digital clinical records of patients discharged from Fuenlabrada University Hospital in 2013 was conducted. Abbreviations in discharge reports and medical order prescriptions present in 78 medical records, corresponding to 39 men and 39 women of different services, were reviewed. Results: All medical records showed abbreviations. The mean of abbreviations in each medical record was 38.9±17.7. Medical records showed 688 different abbreviations, which were repeated up to a total of 3,038 times. The most frequent abbreviations were HTA (n=98; 3.23%), AP (n=89; 2.93%). Twenty-eight abbreviations considered unsafe appeared and were repeated 646 times. The most frequent included SC (n=63; 9.75%), ui (n=49; 7.59%), > (n=38; 5.88%), mcg (n=36; 5.57%). Twenty-three polysemic abbreviations were also identified, the most frequent being H (n=117; 12.81%), MC (n= 109; 11.94%), MP (n=99; 10.84%). Finally, medical wards had 1,866 abbreviations and surgical 1,172 (P <0.001). Conclusions: All medical records revised included unsafe abbreviations. The use of unsafe abbreviations was common among medical services (AU)

Choosing sheep (Ovis aries) as animal model for temporomandibular joint research: Morphological, histological and biomechanical characterization of the joint disc.

Preclinical trials are essential to the development of scientific technologies. Remarkable molecular and cellular research has been done using small animal models. However, significant differences exist regarding the articular behavior between these models and humans. Thus, large animal models may be more appropriate to perform trials involving the temporomandibular joint (TMJ). The aim of this work was to make a morphological (anatomic dissection and white light 3D scanning system), histological (TMJ in bloc was removed for histologic analysis) and biomechanical characterization (tension and compression tests) of sheep TMJ comparing the obtained results with human data. Results showed that sheep processus condylaris and fossa mandibularis are anatomically similar to the same human structures. TMJ disc has an elliptical perimeter, thinner in the center than in periphery. Peripheral area acts as a ring structure supporting the central zone. The disc cells display both fibroblast and chondrocyte-like morphology. Marginal area is formed by loose connective tissue, with some chondrocyte-like cells and collagen fibers in diverse orientations. Discs obtained a tensile modulus of 3.97±0.73MPa and 9.39±1.67MPa, for anteroposterior and mediolateral assessment. The TMJ discs presented a compressive modulus (E) of 446.41±5.16MPa and their maximum stress value (σmax) was 18.87±1.33MPa. Obtained results suggest that these animals should be considered as a prime model for TMJ research and procedural training. Further investigations in the field of oromaxillofacial surgery involving TMJ should consider sheep as a good animal model due to its resemblance of the same joint in humans.

Reduction in the incidence of pressure ulcers upon implementation of a reminder system for health-care providers.

PURPOSE: To measure the clinical impact of the introduction of a reminder system for healthcare professionals to alert patients who are at risk for pressure ulcers (PU). METHODS: This was a pre- and post-test study of patients who were discharged from 6 medical-surgical units of the University Hospital of Fuenlabrada in 2009 and 2010. Beginning in January 2010, implementation of an on-screen list of reminders was automatically updated daily on the units' computers including patient arrival date, last assessment of ulceration risk and location of any PU. The cumulative incidence of PU was measured for patients discharged in 2009 (group A: healthcare professionals were not exposed to on-screen reminder) and 2010 (group B: healthcare professionals were exposed to on-screen reminder list). The relative risk (RR) was estimated. The study was completed with a stratified analysis and binary logistic regression. RESULTS: In group A, there were 84 cases of PU among 9263 patients discharged (0.9%); whereas in group B, there were 59 cases among 9220 patients discharged (0.6%). The RR of PU for group B/group A was 0.706 (p=0.038). In the logistic regression analysis, after adjusting for study variables, the odds ratio of PU B/A was 0.558. CONCLUSION: A list of on-screen reminders at the beginning of a healthcare professional's shift to inform them of patients at risk for developing a PU was effective at reducing the incidence of these clinical burdens.

Analysis of allergy alerts registered in a hospital electronic health record system

No disponible

[Validity of clinical register of pressure ulcers]. / La validez de un registro clínico de úlceras por presión.

BACKGROUND: To compare pressure ulcers (PU) found in this prospective observational study with PU recorded in the Electronic Medical Record (EHR). METHOD: We use a prospective observational study to record PU, with daily monitoring by an observer in the medical-surgical units of hospitalization, as well as a clinical record review of PU tracking. Patient monitoring was conducted between December 2008 and March 2009 at Fuenlabrada University hospital. We calculated the absolute and relative frequency of PU in the patients followed, as well as the association among qualitative variables and the validity of the registration in the EHR with regard to the reference standard, the observational study. RESULTS: Among the 1,001 patients followed-up in this study, 42 of them showed PU (4.2% of the total patients), compared to 25 (2.5%) patients who had registered PU in the Electronic Health Record, which means a statistically significant difference (p<0.001). The record of PU presents a Kappa index of 0.548, with a sensitivity of 47.62 % and a specificity of 99.48 %, with regard to the reference standard, the observational study. CONCLUSION: The number of patients with pressure ulcers almost doubled if the observational data collection is done by an expert nurse compared to what was recorded in the EHR.

La validez de un registro clínico de úlceras por presión / Validity of clinical register of pressure ulcers

Objetivos: Comparar las úlceras por presión (UPP) encontradas en este estudio observacional prospectivo con las registradas en la historia clínica electrónica (HCE). Método: Estudio observacional prospectivo para registrarlas UPP, con seguimiento diario por una observadora en las unidades de hospitalización médico-quirúrgicas y revisión del registro clínico de seguimiento de UPP. El seguimiento de los pacientes se realizó entre diciembre de 2008 y marzo de 2009 en el hospital Universitario de Fuenlabrada. Se ha calculado la frecuencia absoluta y relativa de UPP en los pacientes seguidos, la asociación entre variables cualitativas y la validez del registro en la HCE con respecto al patrón de referencia, el estudio observacional. Resultados: Se ha completado un seguimiento a 1.001 pacientes encontrando 42 pacientes con UPP frente a los 25 pacientes que tenían registrada UPP en la HCE, siendo estadísticamente significativa la diferencia (p<0,001). El registro de la UPP en la HCE presenta un índice Kappa de 0,584 con una sensibilidad de 47,62% y una especificidad de 99,48% con respecto a la observación directa. Conclusión: El número de pacientes que presentan UPP prácticamente se duplica si la recogida de datos es observacional por una enfermera experta frente a lo registrado en la HCE (AU)

Background: To compare pressure ulcers (PU) found in this prospective observational study with PU recorded in the Electronic Medical Record (EHR). Method: We use a prospective observational study to record PU, with daily monitoring by an observer in the medical-surgical units of hospitalization, as well as a clinical record review of PU tracking. Patient monitoring was conducted between December 2008 and March 2009 at Fuenlabrada University hospital. We calculated the absolute and relative frequency of PU in the patients followed, as well as the association among qualitative variables and the validity of the registration in the EHR with regard to the reference standard, the observational study. Results: Among the 1,001 patients followed-up in this study, 42 of them showed PU (4.2% of the total patients), compared to 25 (2.5%) patients who had registered PU in the Electronic Health Record, which means a statistically significant difference (p<0.001). The record of PU presents a Kappa index of 0.548, with a sensitivity of 47.62 % and a specificity of 99.48 %, with regard to the reference standard, the observational study. Conclusion: The number of patients with pressure ulcers almost doubled if the observational data collection is done by an expert nurse compared to what was recorded in the EHR (AU)

Impacto de la implantación de recordatorios para disminuir eventos adversos en pacientes con accesos venosos periféricos / Impact of implementation of reminders to reduce adverse effects in patients with peripheral venous catheterizations

Fundamento. Medir el impacto clínico de la implantación de un sistema de recordatorios, que avise de los pacientes que tienen riesgo de presentar un evento adverso (EA) relacionado con los catéteres venosos periféricos. Métodos. A partir de los registros que se utilizan para seguimiento de los catéteres intravenosos se desarrolló una consulta automatizada que elabora un listado de los pacientes ingresados que incluye fecha de ingreso, fecha colocación, vía y tipo de vía. Se actualiza por turno en los ordenadores de la unidad. Se implantó en enero de 2010. Se ha realizado un estudio cuasi experimental midiendo la incidencia acumulada de flebitis, extravasaciones y obstrucciones en los pacientes dados de alta en 2009 y en 2010. Se ha evaluado la asociación entre variables cualitativas con el test de Chicuadrado, se ha estimado riesgo relativo (RR) y el número necesario de pacientes a tratar (NNT). Resultados. En el año 2009 fueron dados de alta en las unidades de estudio 9.263 pacientes y en 2010, 9.220 pacientes. Los resultados encontrados han sido: Pacientes que desarrollan flebitis 2010/2009: RR: 0,827 (p<0,001). Pacientes que presentan extravasaciones 2010/2009: RR: 0,804 (p<0,001).Pacientes que presentan obstrucciones 2010/2009: RR:0,954 (p=0,554). Conclusiones. Un listado de recordatorios que incluye los pacientes con acceso vascular y la fecha de éste, ha servido para disminuir el número de flebitis y extravasaciones, pero no las obstrucciones(AU)

Background. The main purpose of this paper is to measure the clinical impact of the implementation of a reminder system that would warn of patients who are at risk of presenting an adverse event (AE) related to the peripheral venous catheter. Method. On the basis of the registers used for monitoring intravenous catheters, an automated consultation was realized that elaborated a list of the patients admitted, including: date of admission, date of the insertion of the venous access device, and type of device. It was implanted in January 2010and updated three times a day with the computers of the unit. A quasi-experimental study has measured the cumulative incidence of phlebitis, extravasation and obstructions in the patients registered in 2009 and 2010. The association between qualitative variables was evaluated with the Chisquared test, and relative risk (RR) and Number Needed to Treat (NNT) were estimated. Results. Nine thousand two hundred and sixty-three patientswere registered in the studied units in the year 2009, and 9,220 patients in 2010. The results were the following: Patients with phlebitis 2010/2009: RR: 0.827 (p < 0.001). Patients with extravasations 2010/2009: RR: 0.804 (p < 0.001).Patients with obstructions 2010/2009: RR: 0.954 (p < 0.554).Conclusion. With the help of a reminder list (which includes the patients with vascular access and the date), there has been a decrease in the number of phlebitis and extravasations but not in the number of obstructions(AU)

[Impact of implementation of reminders to reduce adverse effects in patients with peripheral venous catheterizations]. / Impacto de la implantación de recordatorios para disminuir eventos adversos en pacientes con accesos venosos periféricos.

BACKGROUND: The main purpose of this paper is to measure the clinical impact of the implementation of a reminder system that would warn of patients who are at risk of presenting an adverse event (AE) related to the peripheral venous catheter. METHOD: On the basis of the registers used for monitoring intravenous catheters, an automated consultation was realized that elaborated a list of the patients admitted, including: date of admission, date of the insertion of the venous access device, and type of device. It was implanted in January 2010 and updated three times a day with the computers of the unit. A quasi-experimental study has measured the cumulative incidence of phlebitis, extravasation and obstructions in the patients registered in 2009 and 2010. The association between qualitative variables was evaluated with the Chi-squared test, and relative risk (RR) and Number Needed to Treat (NNT) were estimated. RESULTS: Nine thousand two hundred and sixty-three patients were registered in the studied units in the year 2009, and 9,220 patients in 2010. The results were the following: Patients with phlebitis 2010/2009: RR: 0.827 (p < 0.001). Patients with extravasations 2010/2009: RR: 0.804 (p < 0.001). Patients with obstructions 2010/2009: RR: 0.954 (p < 0.554). CONCLUSION: With the help of a reminder list (which includes the patients with vascular access and the date), there has been a decrease in the number of phlebitis and extravasations but not in the number of obstructions.

Diversity of larvae of littoral Chironomidae (Diptera: Insecta) and their role as bioindicators in urban reservoirs of different trophic levels.

The Chironomidae (Diptera: Insecta) have a high species richness, with species adapted to live under widely different environmental conditions. The study of the taxonomic composition of chironomid larvae and the percentage of occurrence of deformities in mouthparts, mainly in the mentum, are used in biomonitoring programmes in order to obtain information on the levels of organic and chemical pollution of aquatic ecosystems. The objective of this study was to evaluate the abundance of chironomid larvae and to quantify the occurrence of mentum deformities in the specimens collected in three urban reservoirs with different trophic levels. The reservoirs are located in the hydrographic basin of the Paraopeba River, an affluent of the São Francisco River basin (Minas Gerais State, southeastern Brazil). The Serra Azul Reservoir is oligotrophic, the Vargem das Flores Reservoir is mesotrophic, and the Ibirité Reservoir is eutrophic. Along the littoral zone of each reservoir, 30 samples were collected during each sampling campaign. Sampling was carried out every three months for one year, with two sampling campaigns during the wet season and two during the dry season in 2008. Physical and chemical parameters measured in the water column included the water depth, Secchi depth, air and water temperature, electrical conductivity, total dissolved solids, redox potential, dissolved oxygen, pH, turbidity, Total-N, Total-P, P-ortho, and chlorophyll-a. The chironomid larvae were identified to the genus level. The structure of the chironomid assemblages was evaluated based on taxonomic richness (24 genera), density, equitability, and diversity. The potential indicator taxa for each reservoir were established through an Indicator Species Analysis. The values for taxonomic richness (20 taxa), equitability (0.737), and Shannon-Wiener diversity (2.215) were highest in the Serra Azul Reservoir. Fissimentum was the indicator taxon in Serra Azul, the oligotrophic reservoir; whereas Pelomus was the indicator taxon in Vargem das Flores, and Chironomus in Ibirité. The highest percentage of mentum deformities was found during the dry season in Serra Azul (6.9%), while the lowest percentage was found during the wet season in Vargem das Flores (0.8%). The results of this study evidenced significant differences in the taxonomic composition, richness, equitability, and diversity of the chironomid assemblages in these three reservoirs of different trophic levels.

Does soy increase blood counts in myelodysplastic syndromes? / Será que a soja aumenta as contagens sanguíneas em síndrome mielodisplásica?

Myelodysplastic syndromes (MDS) are a group of clonal stem cell diseases characterized by ineffective hematopoiesis, bone marrow hyperproliferation, cytopenias in peripheral blood and risk of transformation into acute leukemia. We decided to investigate the effects of a soy concentrate on MDS patients based on the follow-up results of a 61 year-old Japanese female patient who was diagnosed with MDS and refractory cytopenia with multilineage dysplasia in 2003 (hemoglobin = 11g/dL; white blood cells count = 2,500/uL and platelets = 25,000/uL; marrow with mild dysplasia and normal karyotype; paroxysmal nocturnal hemoglobinuria was excluded). She started using soy as a dietary supplementation in May 2004 and presented a gradual increment in blood counts, achieving normalization approximately eight months afterwards. Among the soy components, the main compounds with anti-carcinogenic activity are the isoflavones (genistein and daidzein). Based on these lines of evidence, we proposed to administer daily a standard soy concentrate to 14 MDS out-patients for a minimum period of three months and maximum of 12 months, in an attempt to evaluate prospectively the possible increase in hemoglobin, neutrophils and platelet counts. A historical control group was used to compare results. The use of a soy concentrate in a standardized manner was associated with an increase in neutrophil and/or platelet counts in some cases, but spontaneous increments were also observed in historical controls. This preliminary study does not allow establishing a relation between soy supplementation and blood cell count increase.

As síndromes mielodisplásicas (SMD) são um grupo das doenças clonais de células-tronco caracterizado por hematopoese ineficaz, hiperproliferação de medula óssea, citopenias no sangue periférico e risco de transformação para leucemia aguda. Decidimos investigar os efeitos de um concentrado de soja em pacientes com SMD com base no fato de termos o seguimento de uma paciente japonesa, de 61 anos de idade, que foi diagnosticada em 2003 com SMD, citopenia refratária com displasia subtipo multilinhagens (hemoglobina = 11 g/dL; contagem de glóbulos brancos = 2.500/uL e plaquetas = 25.000/uL; medula com displasia leve e cariótipo normal; hemoglobinúria paroxística excluída), e que começou a usar a soja como suplemento alimentar em maio de 2004, apresentando gradual aumento da contagem das células sanguíneas, atingindo a normalização cerca de oito meses depois. Entre os componentes da soja, os principais compostos com propriedades anticarcinogênese são as isoflavonas (Ge nisteína e daidzeína). Com base nessas linhas de evidência, foi proposto oferecer diariamente um concentrado de soja padrão, por um período mínimo de três meses e máximo de doze meses, a 14 pacientes ambulatoriais, na tentativa de avaliar, prospectivamente, o possível aumento de hemoglobina, neutrófilos e plaquetas. Um grupo controle histórico foi utilizado para comparar os resultados. O uso de um concentrado de soja de forma padronizada foi associado ao aumento na contagem de neutrófilos e/ou de plaquetas em alguns casos, mas aumentos espontâneos também foram observados em controles históricos. Este estudo preliminar não permite estabelecer relação entre o uso de soja e o aumento na contagem sanguínea.

Cancer cluster among young Indian adults living near power transmission lines in Bom Jesus do Tocantins, Pará, brazil.

A case study was carried out to explore the occurrence of a cancer cluster in 1992 among young indian adults adults living in an Amazonian village near two 500 kV power transmission lines that began operating a decade ago. Current blood levels of DDT and organophosphorus pesticides and metal levels in hair samples were measured. Extremely low magnetic field exposure was determined during current daily activities carried out by the Indian villagers. Taking into account the cancer incidence rates in different Brazilian cities, the probability of the occurrence of this cluster by chance was considered remote (p< 0.003, Poisson distribution). High blood levels of p,p'-DDT (median levels ranging from 26 to 58 ppb) were observed. As a whole, this community showed a pattern of low exposure to organophosphorus pesticides, and high recent exposure was only observed in a few blood samples. Continuous exposure to extremely low electromagnetic fields originated in the power transmission lines (which reached 95.0 mG under the lines) was observed on several opportunities during daily activities carried out by Indian villagers. Further observational studies should evaluate the interaction between exposure to extremely low electromagnetic fields and prior exposure to tumor initiators in cancer development.