Lesson From the New York City Out-of-Hospital Uncontrolled Donation After Circulatory Determination of Death Program.

STUDY OBJECTIVE: In 2006, the Institute of Medicine emphasized substantial potential to expand organ donation opportunities through uncontrolled donation after circulatory determination of death (uDCDD). We pilot an out-of-hospital uDCDD kidney program for New York City in partnership with communities that it was intended to benefit. We evaluate protocol process and outcomes while identifying barriers to success and means for improvement. METHODS: We conducted a prospective, participatory action research study in Manhattan from December 2010 to May 2011. Daily from 4 to 12 pm, our organ preservation unit monitored emergency medical services (EMS) frequencies for cardiac arrests occurring in private locations. After EMS providers independently ordered termination of resuscitation, organ preservation unit staff determined clinical eligibility and donor status. Authorized parties, persons authorized to make organ donation decisions, were approached about in vivo preservation. The study population included organ preservation unit staff, authorized parties, passersby, and other New York City agency personnel. Organ preservation unit staff independently documented shift activities with daily operations notes and teleconference summaries that we analyzed with mixed qualitative and quantitative methods. RESULTS: The organ preservation unit entered 9 private locations; all the deceased lacked previous registration, although 4 met clinical screening eligibility. No kidneys were recovered. We collected 837 notes from 35 organ preservation unit staff. Despite frequently recounting protocol breaches, most responses from passersby including New York City agencies were favorable. No authorized parties were offended by preservation requests, yielding a Bayesian posterior median 98% (95% credible interval 76% to 100%). CONCLUSION: In summary, the New York City out-of-hospital uDCDD program was not feasible. There were frequent protocol breaches and confusion in determining clinical eligibility. In the small sample of authorized persons we encountered during the immediate grieving period, negative reactions were infrequent.

Composition and seasonality of mollusks from the upper Paraná river, Brazil, and their potentiality as intermediate hosts for digeneans - DOI: 10.4025/actascibiolsci.v30i3.5018 / Composição e sazonalidade dos moluscos do alto rio Paraná, Brasil, e sua potencialidade como hospedeiros intermediários de digenéticos - DOI: 10.4025/actascibiolsci.v30i3.5018

This study analyzes the composition and seasonality of mollusk species as potential intermediate hosts for digenean trematodes, and also supplies information regarding the possible infections by diplostomidae in that community, in lentic environments of the upper Paraná river floodplain. Ten species of mollusks were collected and analyzed, with noticeable seasonality in the density and abundance of mollusks, significantly correlated with water temperature. The highest values observed were in the period between November 2002 and February 2003. Only Biomphalaria peregrina was characterized as a host for diplostomidae, given that 32 cercariae of Hysteromorpha triloba were found in this species in March 2003.

Este trabalho analisa a composição e a sazonalidade das espécies de moluscos potenciais hospedeiros intermediários de trematódeos digenéticos, bem como fornece informações a respeito das possíveis infecções por diplostomídeos nesta comunidade, em ambientes lênticos da planície de inundação do alto rio Paraná. Foram coletadas e analisadas dez espécies de moluscos, e houve nítida sazonalidade na densidade e abundância dos moluscos, correlacionada significativamente com a temperatura da água. Os maiores valores observados foram entre os meses de novembro de 2002 a fevereiro de 2003. Apenas Biomphalaria peregrina caracterizou-se como hospedeiro para Diplostomidae, pois nesta espécie foram encontradas 32 cercárias de Hysteromorpha triloba em março de 2003.

Occurrence and ecological aspects of the metazoan fish parasites from Ingá lake, Maringá, Paraná State - DOI: 10.4025/actascibiolsci.v29i3.507 / Ocorrência e aspectos ecológicos de metazoários parasitos de peixes do Lago do Parque do Ingá, Maringá, Estado do Paraná - DOI: 10.4025/actascibiolsci.v29i3.507

Ingá lake was dammed in 1970 and, since then, no study on fish and parasites had been done, but it has suffered anthropic influences. This study analyzed some ecological aspects of the metazoan parasites form this lake. From analyzed fish, 69.5% had at least one species of parasite. Among them, 1.372 parasites were found, prevailing Nematoda (larvae) and Platyhelminthes (Monogenea and Cestoda). The discovery of cestode larvae in Tilapia rendalli and Oreochromis nitolicus confirms the importance of these species as participants of intermediate trophic levels. The great number of Tilapia rendalli and Oreochromis nitolicus in the lake can be a determining factor for the presence of parasites, because they take advantage of host species that are plentiful to guarantee the development of their life cycle and also because they are more susceptible to predator birds, which makes it a place of great importance for the continuation of these parasites life cycle. The low diversity of endoparasites collected can be justified by the presence of heavy metal Cu and Pb on the sediment, which must be interfering in the invertebrate development, a possible intermediate host.

Nenhum estudo de peixes e parasitos foi realizado, até o momento, no Lago do Parque do Ingá que sofre influências antrópicas desde seu represamento, em 1970. Este trabalho analisou alguns aspectos ecológicos dos parasitos metazoários dos peixes deste lago. Dos peixes analisados, (69,5%) estavam parasitados por pelo menos uma espécie de parasito. Foram encontrados 1.372 parasitos pertencentes à Nematoda (larvas) e Platyhelminthes (Monogenea e Cestoda), sendo estes os mais prevalentes e numerosos. O encontro de larvas de cestóides em Tilapia rendalli e Oreochromis niloticus confirma a importância destas espécies como participantes de níveis tróficos intermediários. A maior abundância de T. rendalli e O. niloticus, no local, pode ser um fator determinante no recrutamento de parasitos. O parasito aproveita-se das espécies de hospedeiros mais abundantes para garantir o desenvolvimento de seu ciclo de vida e também por serem os mais disponíveis à predação pelas aves piscívoras ali presentes, o que torna o local de grande importância para a sustentação do ciclo de vida desses parasitos. A baixa diversidade de endoparasitos coletados pode ser justificada pela presença de metais pesados Cu e Pb no sedimento, o que deve estar interferindo no desenvolvimento dos invertebrados, possíveis hospedeiros intermediários.

Effect of parasitic load of Rondonia rondoni, Travassos, 1920 (Nematoda, Atrictidae) over the condition factor of thorny catfish Pterodoras Granulosus (Valenciennes, 1833) (Pisces, Doradidae) - DOI: 10.4025/actascibiolsci.v26i2.16 / Carga parasitária de Rondonia rondoni, Travassos, 1920 (Nematoda, Atrictidae) e fator de condição do armado, Pterodoras granulosus, Valenciennes, 1833 (Pisces, Doradidae) - DOI: 10.4025/actascibiolsci.v26i2.1613

Aiming to evaluate the effect of parasitic load of Rondonia rondoni over the condition factor of Pterodoras granulosus. Fifty one specimens of P. granulosus were collected in Paraná River, (Porto Rico/Paraná). To analyze were used: Students t, to determine if length of hosts males and females were similar; Mann-Whitney test U, to determine the effect of sex of host on the intensity of infestion of the parasite; G Log-likelihood test, to determine the effect of sex of the host on the prevalence of parasite; coefficient of correlation r, to determine the correlation between the length of host and the prevalence of infection; Spearman rank correlation coefficient rs, to determine as possible correlations between the intensity of infection and the parasitic diversity with the length of the host, and to examine the correlation between the parasitic intensity and the condition factor (K). Based in this results we conclude, that despite of variations in the length, between males and females, the sex does not influence in the intensity and prevalence of infection. However, the intensity of parasites and the prevalence of R. rondoni increased with the length of host being that, the intensity does not affect the condition factor of Pterodoras granulosus, which mean to be in equilibrium with the parasite in this local

Objetiva-se avaliar o efeito da carga parasitária de Rondonia rondoni sobre o fator de condição de armados, Pterodoras granulosus. Foram necropsiados 51 espécimes de armados, coletados no rio Paraná (Porto Rico/Paraná). Para as análises, utilizaram-se os testes de t, de Student, para determinar se o comprimento dos hospedeiros machos e fêmeas eram semelhantes; U, de Mann-Whitney, para determinar o efeito do sexo do hospedeiro na intensidade de infecção da espécie de parasito; G Log-likelihood, para determinar o efeito do sexo do hospedeiro na prevalência do parasito; coeficiente de correlação (CC) r, para determinar a correlação entre o comprimento do hospedeiro e a prevalência de infecção; CC por postos de Spearman rs, para determinar as possíveis correlações entre a intensidade de infecção e a diversidade parasitária com o comprimento do hospedeiro e para verificar a correlação entre a intensidade parasitária e o fator de condição (K). Os resultados permitiram concluir que, apesar das variações no comprimento entre machos e fêmeas, o sexo não influencia na intensidade e na prevalência de infecção. Porém a intensidade de parasitismo e a prevalência aumentaram com o incremento do comprimento do hospedeiro, e a intensidade parece não afetar o fator de condição de armado, o qual parece estar em equilíbrio com esse parasita nesse ambiente

Scanning electron microscopy of Ithyoclinostomum dimorphum (Trematoda: Clinostomidae), a parasite of Ardea cocoi (Aves: Ardeidae).

Scanning electron microscopy is used for the first time to study the surface topography of Ithyoclinostomum dimorphum (Diesing, 1850), collected from Ardea cocoi Linnaeus, 1766 on the floodplain of the upper Paraná River Basin, Brazil. The body surface exhibits annular furrows, ridges and sensory papillae but no spines, and the tegument is reticulate. The oral sucker is terminal, bears radial furrows and is surrounded by a collar. The ventral sucker is located close to the oral sucker but lacks a collar. When extruded, the cirrus can be seen to bear papillae in its base, and the aperture of the ejaculatory duct is visible distally. The excretory pore is dorso-subterminal. Various incrustations and secretions are present on the body surface. These detailed observations make it possible for to us speculate on the functional significance of some of our findings in relation to the large size and contractile nature of these worms, and their ability to survive and mate in an apparently hostile environment.

Structure and diversity of endoparasitic infracommunities and the trophic level of Pseudoplatystoma corruscans and Schizodon borelli (Osteichthyes) of the High Parana River

One hundred and ten specimens of Pseudoplatystoma corruscans (Pimelodidae) and 582 specimens of Schizodon borelli (Anostomidae) collected in the high Paraná river analyzed. One necropsy 74 per cent of P. corruscans were found to be parasitized; proteocephalidean cestodes presented the greatest number. With regard to S. borelli, the percentage of parasitism reached 19.42 per cent and the nematode Cucullanus pinai was the most abundant. The absence of correlation between the endoparasitic diversity and the standard length of the two host species indicates that each one presents homogeneity in alimentary behaviour during all its life time, permiting the uniform recruitment of the same species of endoparasites during all its ontogenetic development. Independence of diversity values in relation to sex of P. corruscans and S. borelli evidences that the ecological relationships are similar between males and females in these species. Both host's infrapopulations presented a typical overdispersed pattern of distribution with isolationist characteristics.