Septic Arthritis: Clinical Algorithm Implementation

Introdução: A artrite séptica é uma entidade pouco frequente, cujo diagnóstico e tratamento precoces podem evitar sequelas graves. Em Janeiro de 2007, foi implementado no nosso hospital um protocolo de actuação com a finalidade de melhorar a abordagem das crianças com artrite séptica. Objectivos: Comparar resultados pré e pós-protocolo; avaliação do cumprimento do protocolo e dos efeitos da sua implementação na abordagem diagnóstica, terapêutica e morbilidade da artrite séptica. Materiais e Métodos: Estudo retrospectivo das crianças e adolescentes internadas por artrite séptica, durante 8 anos. Foram constituídos dois grupos: pré-protocolo (2003-2006) e pós-protocolo (2007-2010). Analisaram-se dados demográficos, clínicos, laboratoriais, imagiológicos, de terapêutica e evolução. Resultados: Foram incluídos 93 doentes (42 pré-protocolo; 51 pós-protocolo). Após a implementação do protocolo, verificou-se um aumento significativo das colheitas de líquido sinovial para análise citoquimica (0/42 (0%) vs 14/51 (27,5%), p<0.001) e bacteriológica (25/41 (59,5%) vs 45/51 (90,2%), risco relativo 1.52, IC 1,13-1,94). De igual modo, a avaliação de proteína C reactiva [37/42 (88,1%) vs 50/51 (98%); RR 1,11 (0,99-1,25)] e, principalmente, da velocidade de sedimentação [25/42 (40,5%) vs 41/51 (80,4%); RR 1.98 (1,34-2,94)] registaram aumentos. Verificou-se um aumento do isolamento de Staphylococcus aureus meticilino-resistente [1/42 (2,4%) vs 3/51 (5,9%); RR 2,47 (0,27-22,89)]. O esquema terapêutico foi instituído em conformidade com o protocolo em cerca de 60% dos casos e a duração da antibioticoterapia endovenosa foi ajustada em mais de três quartos dos casos (82%). Identificaram-se registos de seguimento na quase totalidade dos doentes (92,1%). Conclusão: Esta avaliação revelou uma melhoria global no padrão de cuidados prestados aos doentes com artrite séptica embora haja margem para evolução no futuro. O perfil de susceptibilidade aos antimicrobianos permite manter a flucloxacilina na terapêutica empírica destas infecções. A elaboração de um protocolo nacional com a colaboração de outras instituições, poderá permitir uma melhor adesão, tendo em vista a optimização de resultados

SURVEYING POPULATIONS OF RED-BILLED CURASSOWS (CRAX BLUMENBACHII) IN THE ATLANTIC FOREST OF BRAZIL

Threatened species are frequently difficult to monitor, leading to a lack of information for the selection of the best conservation strategies. A case in point is the Red-billed Curassow (Crax blumenbachii, Cracidae, Galliformes), whose populations have declined due to deforestation of the northern Atlantic Forest and increased poaching in the late 1960s. The species is presently absent from most forest frag- ments within its geographic range, occurring only in forest remnants on the states of Bahia and Espírito Santo, Brazil. In this study, we esti- mated encounter rates and recorded the periods of activity of the Red-billed Curassow in three large Atlantic Forest fragments in the north- eastern Brazilian state of Bahia, using line-transect sampling. The northern region of Serra do Conduru State Park (0.29 sighting/10 km) and Descobrimento National Park (0.27 sighting/10 km) presented slightly greater encounter rates of this endangered cracid, compared to the Una Biological Reserve (0.13 – 0.20 sighting/10 km). We recorded Red-billed Curassows throughout the day, mainly between 10:00–11:00 h and 14:00–17:00 h. Our study is the first step for long-term monitoring of the Red-billed Curassow. These findings serve as baseline infor- mation, which may contribute to future assessments of the conservation status and support future conservation actions for the species

Hydrological effects of spatial harvest patterns in a small catchment Covered by fast-growing plantations in the neotropics.

ABSTRACT: Eucalyptus forests are expanding worldwide and concerns exist about their impact on water resources. There is a lack of information about the hydrological effects of spatial harvest patterns in terms of their effects on streamflow. In this paper, we examined harvest amount and hillslope position effects on flow indices (Q70; Q50 and Q10) and water yield in a small catchment covered with a fast-growing Eucalyptus plantation. To do that, we used the Gridded Surface Subsurface Hydrologic Analysis (GSSHA), a physical-based distributed hydrological model, to simulate harvesting scenarios with different harvest amounts(30% and 70% of the forest plantation) at two hillslope positions (downslope and upslope). We also verified the influence of the amount of rainfall on peak flows for all scenarios. The results showed that the increase in water yield is positively related to the harvest amount and that, under the same harvest amount, harvests in downslope areas caused a larger increase in water yield than harvests in upslope areas. Downslope harvests led to a greater increase in peak flow under the 30% harvest. For the 70% harvest, no substantial effects of harvest position on peak flow could be detected. Incorporating harvest amounts and spatial patterns in Eucalyptus plantations management practices may be useful to mitigate their effects on water resources, especially in regions where water availability is generally lower