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Here, we report draft genomic sequences from three Paenibacillus larvae isolates, the causative agent of American Foulbrood (AFB), obtained from honeybee colonies of Apis mellifera in Fiji, which allow both enterobacterial repetitive intergenic consensus and multilocus sequence typing genotypes to be elucidated for Fijian AFB.
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Here, we present complete genome assemblies of Pasteurella multocida strains isolated from porcine, bovine, and cervine farms as part of bacteriology incursion investigations to identify pathogens that might present a sanitary risk to New Zealand.
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Introducción: La analgosedación es una prioridad en el cuidado de pacientes en unidades de intensivos pediátricos. La combinación de ketamina y propofol puede ser una alternativa para aquellos pacientes con necesidad de sedación prolongada, con dificultad para la sedación y para disminuir el empleo de benzodiacepinas y opiáceos. El objetivo de este estudio es analizar la eficacia y seguridad de la combinación de ketamina y propofol en perfusión continua para la analgosedación en unidades de cuidados intensivos pediátricos.Materiales y métodos: Estudio de cohorte única prospectivo observacional en pacientes de 1 mes a 16 años ingresados en unidades de cuidados intensivos pediátricos entre 2016 y 2018 que recibieron tratamiento con ketamina y propofol en perfusión continua para analgosedación. Se recogieron datos clínicos y demográficos, scores de analgesia y sedación (MAPS, COMFORT-B y SOPHIA), parámetros hemodinámicos y efectos adversos. Resultados: Treinta y dos pacientes fueron incluidos. La dosis máxima de ketamina fue de 1,5mg/kg/h (RI 1-2mg/kg/h) y la duración, 5 días (RI 3-5 días). La dosis máxima de propofol fue de 3,2mg/kg/hora (RI 2,5-3,6mg/kg/hora) y la duración, 5 días (RI 3-5 días). Treinta pacientes (93,7%) habían recibido midazolam y 29 (90,6%) fentanilo previamente. Tras el inicio de la perfusión de ketamina y propofol la puntuación en la escala de analgesia no se modificó. El COMFORT-B mostró un incremento estadísticamente significativo, pero se mantuvo dentro del rango de sedación adecuada (12-17). Se produjo una leve disminución en la presión arterial media tras una hora de administración, que fue estadísticamente significativa (de 64mmHg a 60mmHg; P=0,006) así como en la presión arterial diastólica (de 50,5 a 48mmHg; P=0,023). Esta diferencia desapareció a las 12 horas del inicio y no requirió uso de drogas vasoactivas. No se detectaron efectos adversos graves durante la administración. (AU)
Introduction: Analgesia and sedation are a priority in paediatric intensive care. The combination of ketamine and propofol is a possible option in patients requiring prolonged or difficult sedation and to reduce the use of benzodiazepines and opiates. The aim of this study was to assess the efficacy and safety of combination ketamine and propofol in continuous infusion for prolonged analgesia/sedation in the paediatric intensive care setting. Patients and methods: Prospective, observational single-group cohort study in patients aged 1 month to 16 years admitted to the paediatric intensive care unit in 20162018 that received ketamine and propofol in continuous infusion for analgesia and sedation. We collected data on demographic and clinical characteristics, analgesia and sedation scores (MAPS, COMFORT-B and SOPHIA), haemodynamic parameters and adverse events. Results: The study included 32 patients. The maximum dose of ketamine was 1.5mg/kg/h (interquartile range [IQR], 12mg/kg/h) and the infusion duration was 5 days (IQR, 35 days). The maximum dose of propofol was 3.2mg/kg/h (IQR, 2.53.6mg/kg/h) and the infusion duration, 5 days (IQR, 35 days). Thirty (93.7%) patients had previously received midazolam and 29 (90.6%) fentanyl. Analgesia scores did not change after initiation of the ketamine and propofol infusion. There was a statistically significant increase in the COMFORT-B score, but the score remained in the adequate sedation range (1217). There were small but statistically significant decreases in the mean arterial pressure (from 64mmHg to 60mmHg; P=.006) and the diastolic blood pressure (from 50.5 to 48mmHg; P=.023) 1h after the initiation of the ketamine and propofol infusion, but this difference was not observed 12h later and did not require administration of vasoactive drugs. No other major adverse events were detected during the infusion. (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Ketamine/therapeutic use , Propofol/therapeutic use , Analgesia , Prospective Studies , Intensive Care Units, PediatricABSTRACT
INTRODUCTION: Analgesia and sedation are a priority in paediatric intensive care. The combination of ketamine and propofol is a possible option in patients requiring prolonged or difficult sedation and to reduce the use of benzodiazepines and opiates. The aim of this study was to assess the efficacy and safety of combination ketamine and propofol in continuous infusion for prolonged analgesia/sedation in the paediatric intensive care setting. PATIENTS AND METHODS: Prospective, observational single-group cohort study in patients aged 1 month to 16 years admitted to the paediatric intensive care unit in 2016-2018 that received ketamine and propofol in continuous infusion for analgesia and sedation. We collected data on demographic and clinical characteristics, analgesia and sedation scores (MAPS, COMFORT-B and SOPHIA), haemodynamic parameters and adverse events. RESULTS: The study included 32 patients. The maximum dose of ketamine was 1.5â¯mg/kg/h (interquartile range [IQR], 1-2â¯mg/kg/h) and the infusion duration was 5 days (IQR, 3-5 days). The maximum dose of propofol was 3.2â¯mg/kg/h (IQR, 2.5-3.6â¯mg/kg/h) and the infusion duration, 5 days (IQR, 3-5 days). Thirty (93.7%) patients had previously received midazolam and 29 (90.6%) fentanyl. Analgesia scores did not change after initiation of the ketamine and propofol infusion. There was a statistically significant increase in the COMFORT-B score, but the score remained in the adequate sedation range (12-17). There were small but statistically significant decreases in the mean arterial pressure (from 64â¯mmHg to 60â¯mmHg; Pâ¯=â¯.006) and the diastolic blood pressure (from 50.5 to 48â¯mmHg; Pâ¯=â¯.023) 1â¯h after the initiation of the ketamine and propofol infusion, but this difference was not observed 12â¯h later and did not require administration of vasoactive drugs. No other major adverse events were detected during the infusion. CONCLUSIONS: The combination of ketamine and propofol in continuous infusion is a safe treatment in critically ill children that makes it possible to achieve an appropriate level of analgesia and sedation without relevant haemodynamic repercussions.
Subject(s)
Ketamine , Propofol , Child , Humans , Propofol/adverse effects , Ketamine/adverse effects , Hypnotics and Sedatives/adverse effects , Prospective Studies , Cohort Studies , Critical Care , PainABSTRACT
BACKGROUND: High levels of standing genomic variation in wide-ranging marine species may enhance prospects for their long-term persistence. Patterns of connectivity and adaptation in such species are often thought to be influenced by spatial factors, environmental heterogeneity, and oceanographic and geomorphological features. Population-level studies that analytically integrate genome-wide data with environmental information (i.e., seascape genomics) have the potential to inform the spatial distribution of adaptive diversity in wide-ranging marine species, such as many marine mammals. We assessed genotype-environment associations (GEAs) in 214 common dolphins (Delphinus delphis) along > 3000 km of the southern coast of Australia. RESULTS: We identified 747 candidate adaptive SNPs out of a filtered panel of 17,327 SNPs, and five putatively locally-adapted populations with high levels of standing genomic variation were disclosed along environmentally heterogeneous coasts. Current velocity, sea surface temperature, salinity, and primary productivity were the key environmental variables associated with genomic variation. These environmental variables are in turn related to three main oceanographic phenomena that are likely affecting the dispersal of common dolphins: (1) regional oceanographic circulation, (2) localised and seasonal upwellings, and (3) seasonal on-shelf circulation in protected coastal habitats. Signals of selection at exonic gene regions suggest that adaptive divergence is related to important metabolic traits. CONCLUSION: To the best of our knowledge, this represents the first seascape genomics study for common dolphins (genus Delphinus). Information from the associations between populations and their environment can assist population management in forecasting the adaptive capacity of common dolphins to climate change and other anthropogenic impacts.
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Common Dolphins , Animals , Genetics, Population , Genomics , Genotype , OceanographyABSTRACT
Estuarine ecosystems have very high ecological and economic value, and also act as a buffer for coastal oceans by processing nutrient inputs from terrestrial sources. However, ongoing pressures from increased urbanisation and agriculture, overlaid by climate change, has reduced inflows and increased nutrient loads that challenge the health and buffering capacity of these ecosystems. This study aimed to investigate whether restoring the bioturbating activity of Simplisetia aequisetis (Polychaeta: Nereididae) and other macrofauna could improve biogeochemical conditions in 'hostile' (i.e. hypersaline, sulfide-rich) sediments. To achieve this aim, we conducted an in situ experiment in the Coorong estuarine-lagoon ecosystem, translocating hostile hypersaline sediments, devoid of bioturbating macrofauna, to a 'healthy' (lower salinity) location where macrobenthic fauna naturally occur, and manipulating the S. aequisetis density in the sediments. Porewater, solid-phase, and diffusive equilibrium and diffusive gradient in thin-films (DET/DGT) measurements showed that bioturbation by macrobenthic fauna significantly influenced sediment biogeochemistry and remediated hostile conditions in sediment within a short time (four weeks) irrespective of S. aequisetis density. Bioturbation promoted sediment oxygenation, while salinity and the concentrations of total organic carbon and porewater sulfide, ammonium, and phosphate all decreased over time at all sediment depths. This research highlights the importance of macrobenthic communities and their functional traits for improving sediment conditions, promoting resilience to eutrophication, providing a nature-based remediation option, and in general ensuring healthy functioning of estuarine ecosystems.
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Ecosystem , Polychaeta , Animals , Eutrophication , Geologic Sediments , Oceans and Seas , SulfidesABSTRACT
Introducción y objetivos: La tasa de reingresos hospitalarios es un indicador de calidad de la asistencia hospitalaria. El objetivo de este trabajo es describir factores de riesgo de reingreso prevenible en la hospitalización pediátrica. Material y métodos: Estudio analítico, retrospectivo, unicéntrico realizado en las plantas de Pediatría de un hospital terciario (junio de 2012 a noviembre de 2015). Se definió reingreso al que acontecía en los primeros 30 días del ingreso previo: muy precoz (en menos de 48 h), precoz (2-7 días) y tardío (a partir de 7 días). Se definió reingreso prevenible al que ocurrió en los primeros 15 días y por la misma causa del primer ingreso. Se analizaron variables epidemiológicas y clínicas. Se realizó un estudio univariante y posteriormente multivariante. Resultados: En el período de estudio ingresaron en las plantas de Pediatría General Hospitalaria 5.459 pacientes y reingresaron 226 (tasa de reingreso del 4,1%). Cuando la tasa de ocupación hospitalaria es mayor del 70%, el porcentaje global de reingresos es significativamente mayor (8,5 vs. 2,5%), p < 0,001. En el análisis de regresión de Cox se objetivó que la presencia de enfermedad de base y el número de visitas a urgencias desde el alta son factores de predicción de reingreso prevenible. Conclusiones: La tasa de reingresos es mayor en los períodos de mayor presión asistencial. El reingreso de los pacientes con patología crónica de base es prevenible, y por lo tanto hay que diseñar estrategias para intentar evitarlo
Introduction and objectives: Readmission rate is an indicator of the quality of hospital care. The aim of the study is to identify potential preventable factors for paediatric readmission. Material and methods: A descriptive, analytical, longitudinal, and single centre study was carried out in the Paediatric Hospitalisation ward of a tertiary hospital during the period from June 2012 to November 2015. Readmission was defined as the one that occurs in the first 30 days of previous admission, as very early readmission if it occurs in the first 48 hours, early readmission in the 2-7 days, and late readmission if occurs after 7 days. Preventable readmission is defined as one that takes place in the first 15 days and for the same reason as the first admission. Epidemiological and clinical variables were analysed. A univariate and multivariate study was carried out. Results: In the study period, 5,459 patients were admitted to the paediatric hospital, of which 226 of them were readmissions (rate of readmission: 4.1%). When the hospital occupation rate was greater than 70%, the overall percentage of readmissions was significantly higher (8.5% vs 2.5%; P < .001). In the multivariate analysis, it was found that having a chronic disease and the number of visits to emergency care units before admission, are predictive factors of preventable readmission. Conclusions: The rate of readmissions is greater in the periods of higher care pressure. The readmission of patients with chronic condition is preventable, and therefore strategies must be designed to try to avoid them
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Humans , Male , Female , Infant , Patient Readmission , Risk Factors , Hospitalization , Retrospective Studies , Quality of Health Care , Oxygen Inhalation Therapy/methods , Confidence IntervalsABSTRACT
INTRODUCTION AND OBJECTIVES: Readmission rate is an indicator of the quality of hospital care. The aim of the study is to identify potential preventable factors for paediatric readmission. MATERIAL AND METHODS: A descriptive, analytical, longitudinal, and single centre study was carried out in the Paediatric Hospitalisation ward of a tertiary hospital during the period from June 2012 to November 2015. Readmission was defined as the one that occurs in the first 30 days of previous admission, as very early readmission if it occurs in the first 48hours, early readmission in the 2-7 days, and late readmission if occurs after 7 days. Preventable readmission is defined as one that takes place in the first 15 days and for the same reason as the first admission. Epidemiological and clinical variables were analysed. A univariate and multivariate study was carried out. RESULTS: In the study period, 5,459 patients were admitted to the paediatric hospital, of which 226 of them were readmissions (rate of readmission: 4.1%). When the hospital occupation rate was greater than 70%, the overall percentage of readmissions was significantly higher (8.5% vs 2.5%; P<.001). In the multivariate analysis, it was found that having a chronic disease and the number of visits to emergency care units before admission, are predictive factors of preventable readmission. CONCLUSIONS: The rate of readmissions is greater in the periods of higher care pressure. The readmission of patients with chronic condition is preventable, and therefore strategies must be designed to try to avoid them.
Subject(s)
Hospitals, Pediatric/statistics & numerical data , Patient Readmission/statistics & numerical data , Quality of Health Care , Child , Child, Preschool , Chronic Disease , Emergency Service, Hospital/statistics & numerical data , Female , Hospitalization , Humans , Infant , Longitudinal Studies , Male , Retrospective Studies , Risk Factors , Tertiary Care Centers/statistics & numerical dataABSTRACT
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