Occurrence of Myxobolus spp. (Myxozoa) in the blood of Metynnis lippincottianus (Osteichthyes: Serrasalmidae) from eastern Amazon, Brazil.

Myxozoans are obligatory parasites and can be found in various organs and bloodstreams of fish, thus, the objective of this work was to describe the occurrence of Myxobolus spp. in the circulating blood of Metynnis lippincottianus from River Curiaú, Macapá City, eastern Amazon, Brazil. The samples of M. lippincottianus (11) were caught using cast net and gillnets. The fish blood was collected by puncturing the caudal vessel, using needles and syringes containing 10% of EDTA solution. Blood smear were prepared and panchromatic stained with a combination of May Grunwald-Giemsa-Wright, for observation and examination of the parasitic structures in optical microscope. Tissues from the kidney was examined using specific stereoscopic binoculars to check for the presence of cysts, lesions and parasites. The prevalence of Myxobolus spp. infecting the circulating blood of the fish was 36.36% (4/11) and 15 spores of mixosporyds were visualized. Myxobolus spp. had a prevalence of 54.55% (6/11) in host's kidney tissue and the morphometric spores data converge with observed in the blood. The morphological characteristics of the spores in the blood samples revealed two morphotypes of Myxobolus spp. This is the sixth occurrence recorded of Myxobolus spp. infecting fish blood in Brazil.

Essential Oil of Piper marginatum (Piperaceae) Against Monogeneans, and Its Hematological and Histopathological Effects on Colossoma macropomum.

PURPOSE: This study investigated the anthelmintic efficacy of therapeutic baths with the essential oil of Piper marginatum Jacq against the monogeneans Anacanthorus spathulatus Kritsky, Thatcher & Kayton, 1979, Notozothecium janauachensis Belmont-Jégu, Domingues & Laterça 2004, Mymarothecium boegeri Cohen & Kohn, 2005 and Linguadactyloides brinkmanni Thatcher & Krytsky, 1983 in Colossoma macropomum Cuvier, 1818, and its hematological and histopathological effects on this fish. METHODS: Short six therapeutic baths with 100 mg/L of the essential oil of P. marginatum and two control groups (water from the cultivation tank and water from the cultivation tank + 70% alcohol) were used for 20 min every two days. RESULTS: The therapeutic baths with 100 mg/L of the essential oil of P. marginatum had efficacy of 42.8% against monogeneans of C. macropomum gills. Toxicity was low for C. macropomum, because there were few physiological and histopathological changes that did not compromise the functioning of the gills of this fish. CONCLUSION: Short therapeutic baths with 100 mg/L of the essential oil of P. marginatum had low efficacy for controlling monogeneans in C. macropomum and thus cannot be recommended.

Essential oil of Piper hispidum (Piperaceae) has efficacy against monogeneans, and effects on hematology and gill histology of Colossoma macropomum.

This study investigated for the first time the effectiveness of therapeutic baths with essential oil (EO) of Piper hispidum against monogeneans Anacanthorus spathulatus, Notozothecium janauachensis, Mymarothecium boegeri and Linguadactyloides brinkmanni from the gills of Colossoma macropomum, as well as the hematological and histological effects on this fish. In therapeutic baths, 100 mg/L of P. hispidum essential oil and two control groups (water from the culture tank and water from the culture tank with 70% alcohol) were exposed for 1 h/day, with intervals of 48 hours for 3 days, and three replicates each were used. Therapeutic baths with 100 mg/L of P. hispidum essential oil had an efficacy of 78.6% against monogeneans. The toxicity of this essential oil was low, since there were a few physiological and histopathological changes that did not compromise the functioning of the gills of the fish. Therefore, 100 mg/L of P. hispidum essential oil was effective for controlling monogeneans in C. macropomum, when short therapeutic baths were used without compromising the health of the exposed fish.

Efficacy of Carapa guianensis oil (Meliaceae) against monogeneans infestations: a potential antiparasitic for Colossoma macropomum and its effects in hematology and histopathology of gills.

This study evaluated the efficacy of therapeutic baths with Carapa guianensis (andiroba) oil against monogeneans of Colossoma macropomum (tambaqui), as well as the hematological and histological effects on fish. Among the fatty acids identified in C. guianensis oil, oleic acid (53.4%) and palmitic acid (28.7%) were the major compounds, and four limonoids were also identified. Therapeutic baths of 1 hour were performed for five consecutive days, and there was no fish mortality in any of the treatments. Therapeutic baths using 500 mg/L of C. guianensis oil had an anthelmintic efficacy of 91.4% against monogeneans. There was increase of total plasma protein and glucose, number of erythrocytes, thrombocytes, leukocytes, lymphocytes and number of monocytes and decrease in mean corpuscular volume. Histological changes such as epithelium detachment, hyperplasia, lamellar fusion and aneurysm were found in the gills of tambaqui from all treatments, including controls with water of culture tank and water of culture tank plus iso-propyl alcohol. Therapeutic baths with 500 mg/L of C. guianensis oil showed high efficacy and caused few physiological changes capable of compromising fish gill function. Results indicate that C. guianensis oil has an anthelmintic potential for control and treatment of infections by monogeneans in tambaqui.

Conhecimento de Enfermeiros sobre o Manejo da Dor Oncológica / Nurses' Knowledge about Cancer Pain Management / Conocimiento de Enfermeros sobre el Manejo del Dolor Oncológico

Introdução: A dor oncológica pode afetar o bem-estar físico, emocional e espiritual dos pacientes. O enfermeiro tem papel fundamental no controle desse sintoma, e a falta de conhecimento desse profissional pode ser uma barreira para o manejo adequado da dor. Objetivo: Avaliar o conhecimento de enfermeiros sobre manejo da dor oncológica e sua relação com variáveis sociodemográficas e de formação profissional. Método: Estudo descritivo transversal, realizado com enfermeiros de um Centro Oncológico no Estado de São Paulo. Os enfermeiros foram avaliados por meio de dois instrumentos para caracterização sociodemográfica/profissional e avaliação do conhecimento sobre manejo da dor no câncer, entre julho e setembro de 2019. Aplicaram-se os testes exato de Fisher e qui-quadrado de Pearson para avaliar a associação entre as variáveis. Resultados: Participaram do estudo 93 enfermeiros, predominantemente do sexo feminino (81,7%), católicos (36,6%), com média de seis anos de atuação profissional. Houve 50,5% de conhecimento inadequado sobre o manejo da dor oncológica e não se encontrou associação entre o conhecimento, as variáveis sociodemográficas e de formação profissional. Conclusão: Metade dos enfermeiros tem conhecimento inadequado sobre manejo da dor oncológica, e a falta de conhecimento não esteve associada às variáveis analisadas. Há necessidade de realizar intervenções educativas para melhorar o conhecimento dos enfermeiros e possivelmente aprimorar a assistência aos pacientes com dor oncológica

Introduction: Cancer pain can affect physical, emotional and spiritual well-being of patients. The nurse has a fundamental role in controlling this symptom and the lack of knowledge of this professional can be a barrier to an adequate pain management. Objective: To evaluate nurses' knowledge about cancer pain management and its relationship with sociodemographic and professional training variables. Method: Cross-sectional study conducted with nurses from an Oncology Clinic in São Paulo State who were assessed with two instruments for sociodemographic/professional characterization and knowledge about cancer pain management, between July and September 2019. Fisher's exact test and Pearson's chi-square test were used to assess the association between variables. Results: The study included 93 nurses, predominantly females (81.7%), Catholic (36.6%), with an average of six years of experience as a professional. There was 50.5% of inadequate knowledge about cancer pain management and no association was found between knowledge, sociodemographic and professional training variables. Conclusion: Half of the nurses have inadequate knowledge about cancer pain management and the lack of knowledge was not associated with the variables analyzed. It is necessary to carry out educational interventions to improve nurses' knowledge and possibly the care to patients with cancer pain

Introducción: El dolor por cáncer puede afectar el bienestar físico, emocional y espiritual de los pacientes. El enfermero tiene un papel fundamental en el control de este síntoma y el desconocimiento de este profesional puede ser una barrera para el adecuado manejo del dolor. Objetivo: Evaluar el conocimiento de los enfermeros sobre el manejo del dolor por cáncer y su relación con las variables sociodemográficas y de capacitación profesional. Método: Estudio transversal, realizado con enfermeros de un Centro de Oncología en el Estado de São Paulo que fueron evaluados utilizando dos instrumentos para la caracterización sociodemográfica/profesional y el conocimiento sobre el manejo del dolor por cáncer, entre julio y septiembre de 2019. Se aplicó la prueba exacta de Fisher y la prueba de chi-cuadrado de Pearson para evaluar la asociación entre variables. Resultados: El estudio incluyó a 93 enfermeros, predominantemente mujeres (81,7%), católicas (36,6%), con un promedio de seis años de experiencia profesional. Hubo un 50,5% de conocimiento inadecuado sobre el manejo del dolor por cáncer y no se encontró asociación entre el conocimiento y las variables sociodemográficas y de capacitación profesional. Conclusión: La mitad de las enfermeras tienen un conocimiento inadecuado sobre el manejo del dolor por cáncer y la falta de conocimiento no se asoció con las variables analizadas. Es necesario realizar intervenciones educativas para mejorar los conocimientos de las enfermeras y posiblemente mejorar la atención a los pacientes con dolor por cáncer

Toxicological, hematological and immunological effects of levamisole and ivermectin diet supplementation on Colossoma macropomum (Serrasalmidae).

This study investigated the toxicological, hematological and immunological effects of diets supplemented with levamisole and ivermectin on Colossoma macropomum. Fish were fed for 24, 96 and 240 h with diets containing 300, 600, 900 and 1200 mg of levamisole kg-1 of feed. None of the levamisole concentrations caused either mortality or behavioral alterations among the fish over 10 d of feeding. In comparison, a single feeding of ivermectin at 4500, 9000, 13500 or 18000 mg kg-1 caused 100% mortality among the fish within 10 h. There were no alterations in erythrocyte parameters or albumin in any treatments with levamisole after 24, 96 and 240 h of feeding. At concentrations of 900 and 1200 mg kg-1, levamisole caused decreases in the albumin-to-globulin ratio compared to the control group and the 300 and 600 mg kg-1 diet treatment groups. Levels of glucose and total plasma protein were higher in the fish fed with 600, 900 and 1200 mg kg-1 than in the controls and the 300 mg kg-1 diet treatment group. After 10 d of receiving feed supplemented with levamisole, globulin levels were higher in the 600 mg kg-1 group than in the controls. Respiratory burst activity of leukocytes also increased in the fish supplemented with the 900 and 1200 mg kg-1 diets compared to the controls and other treatments. This is the first study to investigate how diets supplemented with these drugs affect C. macropomum. Our research indicates that all the levamisole concentrations tested can be used in the diet of C. macropomum for antiparasitic treatments against helminth species, and that dietary treatments with levamisole can stimulate components of the innate immune system.

Heart structure in the Amazonian teleost Arapaima gigas (Osteoglossiformes, Arapaimidae).

The fish heart ventricle has varied morphology and may have a specific morpho-functional design in species adapted to extreme environmental conditions. In general, the Amazonian ichthyofauna undergoes constant variations in water temperature, pH and oxygen saturation, which makes these species useful for investigations of cardiac morphology. Arapaima gigas, a member of the ancient teleost group Osteoglossomorpha, is one of the largest freshwater fish in the world. This species has a specific heart metabolism that uses fat as the main fuel when O2 supplies are abundant but also can change to glycogen fermentation when O2 content is limiting. However, no information is available regarding its heart morphology. Here, we describe the heart of A. gigas, with emphasis on the ventricular anatomy and myoarchitecture. Specimens of A. gigas weighing between 0.3 and 4040 g were grouped into three developmental stages. The hearts were collected and the anatomy analyzed with a stereomicroscope, ultrastructure with a scanning electron microscope, and histology using toluidine blue, Masson's trichrome and Sirius red stains. The ventricle undergoes morphological changes throughout its development, from the initial saccular shape with a fully trabeculated myocardium and coronary vessel restricted to the subepicardium (Type I) (group 1) to a pyramidal shape with mixed myocardium and coronary vessels that penetrate only to the level of the compact layer (Type II) (groups 2 and 3). The trabeculated myocardium has a distinct net-like organization in all the specimens, differing from that described for other teleosts. This arrangement delimits lacunae with a similar shape and distribution, which seems to allow a more uniform blood distribution through this myocardial layer.

Growth, physiological and immune responses of Arapaima gigas (Arapaimidae) to Aeromonas hydrophila challenge and handling stress following feeding with immunostimulant supplemented diets.

The current study tested the efficacy of a dietary immunostimulant additive (Aquate Fish™®) on the growth performance, and on the physiological and immune responses of Arapaima gigas. Two trials were carried out: a feeding trial for 30 days with the experimental diets and a challenge trial for 7 days, in which fish were bacterial challenge (Aeromonas hydrophila) following by 60 s handling stress. During the feeding trial, fingerlings were fed diets supplemented with 0 (control), 6, 9 and 12 g Aquate Fish™®/kg diet. Dietary supplementation did not influence feed intake, feed conversion and condition factor, but increased the final biomass, number of erythrocytes, thrombocytes, leukocytes, lymphocytes, monocytes, hemoglobin, glucose, globulins and plasma triglycerides in fish fed at a concentration of 12 g/kg diet. After bacterial infection, mortality occurred only in fish fed control treatment, whereas respiratory burst of leukocytes, number of leukocytes and lymphocytes increased in fish that received 12 g of dietary supplementation. The results indicated that dietary supplementation with 12 g of Aquate Fish™® improved biomass and immunity performance of A. gigas fingerlings, without negatively affecting blood biochemical parameters.

Hematological and biochemical responses of pirarucu (Arapaima gigas, Arapaimidae) fed with diets containing a glucomannan product derived from yeast and algae / Respostas hematológicas e bioquímicas de pirarucu (Arapaima gigas, Arapaimidae) alimentado com dietas contendo mananoligossacarídeos derivados de leveduras e algas

ABSTRACT The hematological and biochemical responses of pirarucu fingerlings (Arapaima gigas) fed with diets containing different concentrations of a glucomannan product derived from yeast and algae were evaluated in order to ascertain the effect of these diets on fish physiology. Four treatments were conducted, with three replications, with 12 fish in each tank. The product evaluated (MycosorbA+(r)) was incorporated into the commercial diet, at four concentrations: 0, 1, 2 and 4 g.kg-1, called M0%, M0.1%, M0.2% and M0.4%, respectively. After 45 days of feeding, blood samples from six fish in each replicate were collected to perform the analyses. Their weight and length were determined to calculate the condition factor and weight gain, but no differences (P > 0.05) were observed among the treatments. No changes to the hematocrit, hemoglobin or erythrocyte levels or to the hematimetric indices of the pirarucus were observed. The glucose and triglyceride levels of the pirarucus in the M0.1% and M0.2% groups were significantly lower than those of the M0% group. The M0.2% group showed higher albumin levels (P < 0.05) than M0% and M0.4%. The M0.4% group showed a total cholesterol level that was significantly higher than in all other treatments. MycosorbA+(r) contributed towards increasing the levels of defense cells in A. gigas. It would be possible to use this product at concentrations of between 0.1% and 0.2%, given that they increase the levels of some defense cells and plasma albumin concentrations, without changes to hematological parameters, cholesterol and triglyceride plasma levels or condition factor.

RESUMO As características hematológicas e bioquímicas de alevinos de pirarucu Arapaima gigas alimentados com diferentes concentrações de mananoligossacarídeos derivados de leveduras e algas na dieta foram avaliadas para verificar o efeito sobre sua fisiologia. Quatro tratamentos foram conduzidos com três repetições (12 peixes em cada). O produto avaliado (MycosorbA+(r)) foi incorporado à ração comercial, em quatro níveis: 0, 1, 2 e 4 g kg-1 de ração, denominados M0%, M0,1%, M0,2% e M0,4%, respectivamente. Após 45 dias de alimentação, amostras de sangue de seis peixes de cada repetição foram coletadas para realização das análises. O peso e comprimento foram obtidos para cálculo do fator de condição e ganho de peso, entretanto, não foram observadas diferenças (P>0,05) entre os tratamentos. Assim como não foram observadas alterações nos valores de hematócrito, hemoglobina, eritrócitos e índices hematimétricos dos pirarucus. A concentração de glicose e triglicérides dos pirarucus dos grupos M0,1% e M0,2% foram significativamente menores que o tratamento M0%. Os peixes do tratamento M0,2% apresentaram níveis de albumina maior (P<0,05) que do M0% e M0,4%. Os peixes alimentados com M0,4% mostraram nível de colesterol total significativamente maior que todos os demais tratamentos. MycosorbA+(r) contribuiu para o aumento das células de defesa de A. gigas, podendo ser utilizado nas concentrações de 0,1% a 0,2%, devido ao aumento do número de certas células de defesa e dos níveis plasmáticos de albumina e por não ter sido observadas outras alterações nos parâmetros hematológicos, nos níveis plasmáticos de colesterol e triglicérides e no fator de condição.

Lethal dose and clinical signs of Aeromonas hydrophila in Arapaima gigas (Arapaimidae), the giant fish from Amazon.

Aeromonas hydrophila is causing substantial economic losses in world aquaculture. This study determined the tolerance limit (LD50-96h) of A. hydrophila in Arapaima gigas, and also investigated the clinical signs after intradermal inoculation. Arapaima gigas fingerlings were inoculated intraperitoneally with 0 (control), 1.0×10(5), 1.0×10(6), 1.0×10(7), 1.0×10(9) and 1.0×10(10)CFU/mL of A. hydrophila for the determination of LD50-96h, which was 1.8×10(8)CFU/mL. In another trial with intradermal inoculation of 1.8×10(8)CFU/mL A. hydrophila, there was a 91.6% of mortality between 8 and 23h, and several clinical signs were found. As follows: depigmentation in the tegument, lesions in the tail and fins, loss of balance, reduction of respiratory movements, hemorrhagic foci, necrotic hemorrhages in the kidney, liver and swim bladder, splenomegaly, ascites in the abdominal cavity and hyperemia, enlargement of the gall bladder, among other clinical signs observed. The results showed that A. gigas has a relative tolerance to A. hydrophila when compared to other Neotropical fish species.

Hematological responses of tambaqui Colossoma macropomum (Serrassalmidae) fed with diets supplemented with essential oil from Mentha piperita (Lamiaceae) and challenged with Aeromonas hydrophila / Respostas hematológicas de tambaqui Colossoma macropomum (Serrassalmidae) alimentado com dietas suplementadas com óleo essencial de Mentha piperita (Lamiaceae) e desafiados com Aeromonas hydrophila

In fish farmings, diseases can be reduced by using immunostimulants. The aim of this study was to evaluate the immunostimulant potential of Mentha piperita in tambaqui fed with 0, 0.5, 1.0 and 1.5% of oil per kg of commercial fish feed. The fish were inoculated with Aeromonas hydrophila to challenge them. Hematological and biochemical parameters were determined after 30 days of feeding and seven days after the challenge. There was no mortality and M. piperita oil did not influence fish production parameters. However, blood hemoglobin concentration (Hb) increased in the fish fed with 0.5 and 1.5% of oil per kg of diet; albumin increased in those fed with 1.0%; cholesterol increased in all groups with oil; and triglycerides increased in those fed with 0.5%. After the bacterial challenge, the fish showed decreases in Hb when fed with diet enriched with 1.5% oil per kg of diet, in mean corpuscular volume with 1.0% and in mean corpuscular hemoglobin concentration with 0 and 1.5%. Protein levels increased in groups with 0 and 1.5% of oil and albumin when fed with 0 and 1.0%; cholesterol levels increased in the control group; and high levels of triglycerides were observed in the groups with 0, 0.5 and 1.5%. Thus, M. piperita essential oil promoted hematological alterations in tambaqui and can be recommended in diets containing up to 1.0% per kg, because of the minimal physiological modifications caused. However, additional studies are necessary to obtain more information regarding to the physiological effects of this immunostimulant.

Em pisciculturas, doenças podem ser minimizadas com o uso de imunoestimulantes. O objetivo deste estudo foi avaliar o potencial imunoestimulante do óleo essencial de Mentha piperita na dieta de tambaqui com dietas contendo 0; 0,5; 1,0; 1,5% de inclusão do óleo por kg de ração comercial para peixes. Os tambaquis foram desafiados com a bactéria Aeromonas hydrophila. Hematologia e bioquímica dos tambaquis foram determinados após 30 dias de alimentação e sete dias do desafio. Não houve mortalidade dos peixes durante o experimento, sendo que o óleo não influenciou os parâmetros produtivos dos peixes. Entretanto, a concentração de hemoglobina (Hb) aumentou em peixes alimentados com 0,5 e 1,5% de óleo por kg de dieta; a albumina aumentou em 1,0%; o colesterol aumentou em todos os grupos com óleo; e triglicérides em 0,5% por kg de dieta. Após desafio bacteriano ocorreram diminuições da Hb nos peixes alimentados com 1,5% de óleo; do volume corpuscular médio com 1,0%; e da concentração de hemoglobina corpuscular média com 0 e 1,5%. Níveis aumentados de proteína nos grupos 0 e 1,5%; da albumina em 0 e 1,0%; do colesterol no controle; e dos triglicérides em 0, 0,5 e 1,5% de óleo na dieta. Assim o óleo essencial de M. piperita na dieta promoveu alterações hematológicas e pode ser recomendado seu uso em inclusões de até 1,0% por kg da dieta de tambaqui, devido às mínimas alterações fisiológicas causadas. Entretanto, estudos adicionais são necessários, de modo a obter informações sobre os efeitos fisiológicos deste imunoestimulante.

Contaminação por metais pesados em peixes e água da bacia do rio Cassiporé, Estado do Amapá, Brasil / Heavy metal contamination in fish and water from Cassiporé River basin, State of Amapá, Brazil

A participação dos metais pesados nas reações químicas do metabolismo dos peixes tornou esses elementos um dos principais focos nos estudos de contaminação. O objetivo deste estudo foi determinar as concentrações dos metais Cd, Cr, Cu, Pb, Zn e Hg no tecido muscular de peixes da bacia do rio Cassiporé (Estado do Amapá) e ambiente, visando avaliar os riscos de contaminação. As concentrações de Cd em Plagioscion squamosissimus (1,061 µg g-1) e Pb em Poptella compressa (4,280 µg g-1) apresentaram valores que ultrapassam os limites estabelecidos pela legislação brasileira. As concentrações de Cr em P. compressa (0,937 ± 0,5 µg g-1), Pimelodella cristata (0,463 ± 0,03 µg g-1) e Cyphocharax gouldingi (0,364 ± 0,12 µg g-1), bem como de Hg em P. squamosissimus (0,670 µg g-1), Pseudoplatystoma fasciatum (0,630 µg g-1), Hoplias malabaricus (0,570 µg g-1 e Serrasalmus rhombeus (0,548 µg g-1) foram acima do limite legal. A coluna d'água apresentou altas concentrações de metais pesados em todos os pontos analisados, mostrando uma contaminação dessa bacia. Portanto, essas elevadas concentrações de metais pesados no ambiente e tecido muscular dos peixes indicam um elevado grau de contaminação na bacia do rio Cassiporé e risco a saúde do homem.

Heavy metals participate in chemical reactions of fish metabolism, which makes these elements a major focus on contamination studies. The objective of this study was to determine the concentrations of heavy metals Cd, Cr, Cu, Pb, Zn and Hg in muscle tissue of fish of Cassiporé River Basin (State of Amapá) and environment, aiming at assessing the risk of contamination. The concentrations of Cd in Plagioscion squamosissimus (1.061 µg g-1) and Pb in Poptella compressa (4.280 µg g-1) had values that exceed the boundaries established by Brazilian law. The Cr concentration in P. compressa (0.937 ± 0.5 µg g-1), Pimelodella cristata (0.463 ± 0.03 µg g-1) and Cyphocharax gouldingi (0.364 ± 0.12 µg g-1) and Hg in P. squamosissimus (0.670 µg g-1), Pseudoplatystoma fasciatum (0.630 µg g-1), Hoplias malabaricus (0.570 µg g-1 e Serrasalmus rhombeus (0.548 µg g-1) were above the legal limit. The water column showed high concentrations of heavy metals in all analyzed points, showing a contamination of this river basin. Therefore, the high concentrations of heavy metals in the environment and muscle tissue of fish indicate a high degree of contamination in the Cassiporé river basin and risk to human health.

Acute bacterial infection negatively impacts cancer specific survival of colorectal cancer patients.

AIM: To assess the impact of bacterial infections on cancer-specific survival in patients with colorectal cancer. METHODS: This was a retrospective cohort study of colorectal cancer patients treated at the A.C. Camargo Cancer Center between January 2006 and April 2010. The presence of bacterial infection during cancer treatment, or up to one year after, was confirmed by laboratory tests or by the physician. Infections of the urinary, respiratory or digestive tracts, bloodstream, skin or surgical site were defined by testing within a single laboratory. Criteria for exclusion from the study were: chronically immunosuppressed patients; transplant patients (due to chronic immunosuppression); human immunodeficiency virus carriers; chronic use of corticosteroids or other immunosuppressive drugs; patients with autoimmune disease or primary immunodeficiency; known viral or parasitic infections. Patients with infections that did not require hospitalization were not included in the study because of the difficulty of collecting and tracking data related to infectious processes. In addition, patients hospitalized for pulmonary thromboembolism, stroke, acute myocardial infarction, uncontrolled diabetes, malignant hypercalcemia or other serious non-infectious complications not directly related to infection were also excluded. Survival curves were plotted using the Kaplan-Meier method, and log-rank tests (univariate analysis) and a Cox test assuming a proportional hazards model (multivariate analysis) were performed to examine associations between clinical history and characteristics of infection with cancer-specific survival. RESULTS: One-hundred and six patients with colorectal cancer were divided into two groups based on the presence or absence of bacterial infection. Patient ages ranged from 23 to 91 years, with a median of 55 years. The majority of patients were male (57/106, 53.77%) with stage III colorectal cancer (45/106, 44.11%). A total of 86 bacteriologic events were recorded. Results indicate that the presence and number of infections during or after the end of treatment were associated with poorer-cancer specific survivals (P = 0.02). Elevated neutrophil counts were also associated with poorer cancer-specific survival (P = 0.02). Analysis of patient age revealed that patients > 65 years of age had a poorer cancer-specific survival (P = 0.04). A multivariate analysis demonstrated that infection was an independent predictor of poor survival (HR = 2.62, 95%CI: 1.26-5.45; P = 0.01) along with advanced clinical staging (HR = 2.63, 95%CI: 1.08-6.39; P = 0.03). CONCLUSION: Infection and high neutrophil counts are associated with a poorer cancer-specific survival in colorectal cancer patients.

A gerência de Enfermagem como unidade de apoio às unidades de negócio: relato de experiência / The nursing management and support unit business units: experience report

A gestão descentralizada permite que a tomada de decisão seja mais rápida, satisfazendo o trabalho do gestor, colaborador e cliente. Objetivo: Relatar a experiência da implantação do modelo de gestão compartilhada e descentralizada. Métodos: Relato de experiência sobre o gerenciamento de Enfermagem compartilhada e descentralizada. Resultados: Áreas como Centro Cirúrgico (CC), unidade de terapia intensiva (UTI), ambulatórios e foram denominadas unidades de negócio (UN) e passaram a ser geridas por gerente técnico operacional e líderes de Enfermagem (LEs) que passaram a ter maior autonomia, tornando-se responsáveis por orçamentos, receitas/despesas, recursos humanos e materiais. Os LEs passaram a responder para a gerência de Enfermagem (GE) em relação à qualidade da assistência de Enfermagem e diretamente ao gerente técnico operacional sobre a UN como um todo. Conclusão: Cada gerente da UN responsável permitiu que a GE tivesse uma visão de interdependência tornando-se uma unidade de apoio garantindo a qualidade da assistência, tornando a equipe coesa em sua assistência...

Decentralized management allows decision making is faster, satisfying work of manager,employee and customer. Objective: To report the experience of implementing the shared managementmodel and decentralized. Methods: Experience report on the management of shared, decentralized nursing. Results: Areas such as the operating room, ICU outpatient, were named “Business Units” (BU) and now managed by the Technical Manager and Operational Leaders in Nursing (LE) that have gained greaterautonomy, becoming responsible for budgets, income/expenses, human and material resources. The LE came to account for the Management of Nursing (MN) in relation to the quality of nursing care and directly to the Technical Operations Manager on the BU as a whole. Conclusion: Each manager responsible BU allowed MN had a vision of interdependence becoming a Unit Support ensuring the quality of care, making a cohesive team for their assistance...

Inflammation and remodeling in infantile, juvenile, and adult allergic sensitized mice.

BACKGROUND: Airway structural changes occur early in childhood asthma, but it is unknown whether the development of airway alterations in children is similar to that of adults. We compared inflammation and remodeling parameters in allergic sensitized infantile, juvenile, and adult mice. METHODS: Infantile mice (18D) were sensitized with three intraperitoneal injections (i.p.) of ovalbumin (OVA) at days 5 and 7 and challenged with OVA at days 14-16. The 18D1 group received an additional challenge at days 9-11. The juvenile mice (40D) received challenges at days 22-24 and 36-38. Adult mice (100D) were sensitized at days 60-62 and received three inhalations at days 77-79 and 96-98. Animals were submitted to whole body plethysmography. Airway eosinophils, CD3+ T-lymphocytes, IL-5+ cells, mucus content, collagen and reticular fibers density, and smooth muscle thickness were quantified. RESULTS: All sensitized animals presented with airway hyperresponsiveness, without differences in eosinophil cell density. The density of CD3+ T-cells was higher in the 100D and 18D1 groups than in the 18D and 40D groups. Infantile sensitized groups demonstrated increased interleukin-5 expression in the airways. Infantile mice demonstrated more mucus in the bronchiolar epithelium than the 40D and 100D mice. The 18D animals demonstrated less collagen than the 18D1 group. Juvenile and adult mice had increased airway smooth muscle thickness when compared to age-matched controls, but no differences were observed in the infantile groups. CONCLUSION: We have shown that infantile mice develop inflammatory and structural alterations in the airways that are partially different from those developed in older animals.

Alterações pulmonares e sistêmicas em modelo de lesão pulmonar aguda de etiologia pulmonar e extra pulmonar após ventilação mecânica de curto prazo / Pulmonary and extra pulmonary ALI: local and systemic pathophysiological differences after short term mechanical ventilation

A inflamação pulmonar pode variar de acordo com o sitio primário da injuria e poder ser afetado pelo estresse mecânico gerado pela ventilação mecânica. (VM) Objetivos: estudar as eventuais diferenças na reposta pulmonar e sistêmica na lesão pulmonar aguda pulmonar (LPA P ) e extra pulmonar (LPA Exp) após ventilação mecânica. Métodos: Camundongos BALB/c foram divididos em doze grupos. Os grupos controle pulmonar (CP) e extra pulmonar (C Exp) receberam solução salina (SAL) ou Lipopolissacarideo (LPS) via intratraqueal (IT) ou intraperitoneal (IP) respectivamente. Os grupos foram submetidos ou não a simples manobra de pressurização (SMP) até 45 cm H2O. Resultados: Os grupos LPAP e LPAExp não ventilados apresentaram o mesmo nível de inflamação; uma diferença estatisticamente significativa na densidade de células inflamatórias foi observada no grupo LPA P VM (3,84±1,28 cels/2) comparado ao grupo LPA Exp VM ((1,75±0,14 cels/2), p=0,013. O mesmo foi observado na LPA P SMP (2,92±0,44 cels/2) comparado ao LPA Exp SMP (1,46±0,23 cels/2), p<0,0001. LPAP mostrou estatisticamente significante aumento no El (56,19 ± 12,26 cm H2O) em comparação ao LPA Exp SMP (26,88 ± 36,38 cm H2O) após SMP (p = 0,029). Nenhuma diferença estatisticamente significante foi observada no estresse oxidativo no rim. Conclusão: Observamos um padrão diferente da resposta inflamatória e mecânica pulmonar comparando LPA pulmonar e extra-pulmonar submetido à ventilação mecânica de curto prazo. Embora a ventilação mecânica represente uma ferramenta essencial para estabilizar o paciente critico, é necessário individualizar a abordagem do tratamento ventilatório.

Lung inflammation may vary according to the primary site of injury and may be affected by the mechanical stress generated by mechanical ventilation (MV). Objectives: to address possible differences in lung and systemic responses in pulmonary and extra pulmonary ALI after mechanical ventilation. Methods: BALB/c mice were divided in twelve groups of six animals. In pulmonary and extrapulmonary control or ALI groups received either saline or LPS (intratracheally instilled or intraperitoneally injected), respectively. Ventilated groups were either recruited or not with a single recruitment maneuver (SRM) reaching 45 cm H2O. Results: At baseline ALI P and ALI EXP non ventilated groups presented the same level of inflammation; a statistically significant difference in density of inflammatory cells was noted in ALI P MV (3,84±1,28 cells/2) compared to ALI EXP MV (1,75±0,14 cells/2), p=0,013. The same was observed in ALI P SRM (2,92±0,44 cells/2) compared to ALI EXP SRM (1,46±0,23 cells/2) ventilated groups (p<0,0001). ALI P showed a statistically significant increase in El (56,19 ± 12,26 cm H2O) in comparison to ALI EXP (26,88 ± 36,38 cm H2O) after SRM (p = 0,029). No statistical differences were observed in kidney oxidative stress. Conclusion: We observed a different pattern of response in lung inflammation and mechanics comparing pulmonary and extra pulmonary ALI, submitted to short term mechanical ventilation. Although mechanical ventilation represents a fundamental tool to stabilize critical patients, it is essential to individualize the approach of the ventilatory treatment.