Impact of the COVID-19 Pandemic on the Outcomes of Patients Undergoing Oncological Surgeries: CORONAL Study.

BACKGROUND: The impact of coronavirus disease 2019 (COVID-19) on postoperative recovery from oncology surgeries should be understood for the clinical decision-making. Therefore, this study was designed to evaluate the postoperative cumulative 28-day mortality and the morbidity of surgical oncology patients during the COVID-19 pandemic. METHODS: This retrospective cohort study included patients consecutively admitted to intensive care units (ICU) of three centres for postoperative care of oncologic surgeries between March to June 2019 (first phase) and March to June 2020 (second phase). The primary outcome was cumulative 28-day postoperative mortality. Secondary outcomes were postoperative organic dysfunction and the incidence of clinical complications. Because of the possibility of imbalance between groups, adjusted analyses were performed: Cox proportional hazards model (primary outcome) and multiple logistic regression model (secondary outcomes). RESULTS: After screening 328 patients, 291 were included. The proportional hazard of cumulative 28-day mortality was higher in the second phase than that in the first phase in the Cox model, with the adjusted hazard ratio of 4.35 (95% confidence interval [CI] 2.15-8.82). The adjusted incidences of respiratory complications (odds ratio [OR] 5.35; 95% CI 1.42-20.11) and pulmonary infections (OR 1.53; 95% CI 1.08-2.17) were higher in the second phase. However, the adjusted incidence of other infections was lower in the second phase (OR 0.78; 95% CI 0.67-0.91). CONCLUSIONS: Surgical oncology patients who underwent postoperative care in the intensive care unit during the COVID-19 pandemic had higher hazard of 28-day mortality. Furthermore, these patients had higher odds of respiratory complications and pulmonary infections. Trials registration The study is registered in the Brazilian Registry of Clinical Trials under the code RBR-8ygjpqm, UTN code U1111-1293-5414.

Perspectives for Synergic Blends of Attractive Sources in South American Palm Weevil Mass Trapping: Waiting for the Red Palm Weevil Brazil Invasion.

Coupling several natural and synthetic lures with aggregation pheromones from the palm weevils Rhynchophorus palmarum and R. ferrugineus reveals a synergy that results in an increase in pest captures. The combined attraction of pure pheromones, ethyl acetate, and decaying sweet and starchy plant tissue increases the net total of mass-trapped weevils. The 2018 entrance of the red palm weevil (RPW) into South America has threatened palm-product income in Brazil and other neighboring countries. The presence of the new A1 quarantine pest necessitates the review of all available options for a sustainable mass-trapping, monitoring, and control strategy to ultimately target both weevils with the same device. The effective lure-blend set for the mass-trapping system will attract weevils in baiting and contaminating stations for entomopathogenic fungi that the same weevils will spread.

Epidemiological and microbiological analysis of ventilator-associated pneumonia patients in a public teaching hospital.

Ventilator-associated pneumonia (VAP) is the most commonly-acquired infection in patients in intensive care units. We analyzed epidemiological and microbiological characteristics and the outcome, in a cohort of critically-ill patients with confirmed diagnosis of VAP. All patients who had been on mechanical ventilation (MV) for more than 48 hours were included in our study; material collection for microbiological analysis was done within the first 24 hours after beginning treatment or after changing antibiotics. There were 55/265 (20.7%) VAP cases diagnosed, at a rate of 21.6 episodes per 1,000 days of mechanical ventilation. Mean age of the patients was 66 years, with a mean APACHE II score of 26.7 + 7.0; male patients were more prevalent. The mortality rates in the intensive care unit (ICU) and during the hospital stay were 71% and 80%, respectively. MV duration in patients with VAP was 17 (range 3-43) days and among patients who had not developed VAP, 6 (2-32) days (p < 0.0001). 98.2% of the samples were positive, with a high prevalence of Gram-negative bacteria, mainly Acinetobacter calcoaceticus. Risk factors for death included age, MV duration and surgery. VAP incidence in this sample of critically-ill patients was high, with a high mortality rate. Control and prevention strategies based on continuing education of healthcare workers, developed by a multidisciplinary team, should be encouraged to minimize morbimortality of this infection.

In vitro bioprospecting of rhizospheric fungi associated to cactus (Opuntia cochenillifera) to plant growth promotion / Bioprospección in vitro de hongos rizosféricos asociados al cactus (Opuntia cochenillifera) para la promoción del crecimiento vegetal

Abstract This study aimed to evaluate in vitro the plant growth promotion capacity of rhizospheric fungi from Opuntia cochenillifera. The isolates were submitted to phosphate solubilization, acetic acid-3-indole (AIA) production, antagonism against phytopathogens, and growth under water activity. All test results were subjected to statistical analysis. The studied isolates were able to solubilize phosphate, being F04 (Aspergillus sp.) and F05 (Coprinellus radians) the ones that presented the highest solubilization indices. As to produce AIA, F02 (Penicillium sp.) and F07 (Aspergillus sp.) were the most promising. All isolates could inhibit the growth of Colletotrichum sp. and Fusarium sp. Water restriction provided mycelial growth for all isolates. Therefore, these characteristics confer characteristics as growth promoters in plants.

Resumen El objetivo de este estudio fue evaluar in vitro la capacidad de los hongos rizosféricos aislados del cactus Opuntia cochenillifera para promover el crecimiento de las plantas. Los aislados fueron sometidos a pruebas de solubilización de fosfato, producción de ácido 3-indol acético (AIA), antagonismo contra fitopatógenos y crecimiento bajo actividad de agua. Todos los resultados de las pruebas se sometieron a análisis estadístico. Los aislados estudiados fueron capaces de solubilizar fosfato, siendo F04 (Aspergillus sp.) y F05 (Coprinellus radians) los que presentaron los mayores índices de solubilización. Sobre la producción de AIA, los que más produjeron fueron F02 (Penicillium sp.) y F07 (Aspergillus sp.). Todos los aislados pudieron inhibir el crecimiento de Colletotrichum sp. e Fusarium sp.. La restricción de agua proporcionó el crecimiento del micelio para todos los aislados. Por lo tanto, estes aspectos les confieren características como promotores del crecimiento en las plantas.

Imipenem in burn patients: pharmacokinetic profile and PK/PD target attainment.

Unpredictable pharmacokinetics (PK) in burn patients may result in plasma concentrations below concentrations that are effective against common pathogens. The present study evaluated the imipenem PK profile and pharmacokinetic/pharmacodynamics (PK/PD) correlation in burn patients. Fifty-one burn patients, 38.7 years of age (mean), 68.0 kg, 36.3% total burn surface area (TBSA), of whom 84% (43/51) exhibited thermal injury, 63% inhalation injury and 16% electrical injury (8/51), all of whom were receiving imipenem treatment were investigated. Drug plasma monitoring, PK study (120 sets of plasma levels) and PK/PD correlation were performed in a series of blood samples. Only 250 µl of plasma samples were required for drug plasma measurements using the ultra filtration technique for the purification of biological matrix and quantification using liquid chromatography. Probability of target attainment (PTA) was calculated using a PD target of 40% free drug concentrations above the minimum inhibitory concentration (40%fT>MIC). Significant differences in PK parameters (medians), such as biological half-life (2.2 vs 5.5 h), plasma clearance (16.2 vs 1.4 l h(-1)) and volume of distribution (0.86 vs 0.19 l kg(-1)), were registered in burn patients via comparisons of set periods with normal renal function against periods of renal failure. Correlations between creatinine clearance and total body plasma clearance were also obtained. In addition, the PK profile did not change according to TBSA during sets when renal function was preserved. PTA was >89% for MIC values up to 4 mg l(-1). In conclusion, imipenem efficacy for the control of hospital infection on the basis of PK/PD correlation was guaranteed for burn in patients at the recommended dose regimens for normal renal function (31.1±9.7 mg kg(-1) daily), but the daily dose must be reduced to 17.2±9.7 mg kg(-1) during renal failure to avoid neurotoxicity.