Trend of Maximal Inspiratory Pressure in Mechanically Ventilated Patients: Predictors

INTRODUCTION: It is known that mechanical ventilation and many of its features may affect the evolution of inspiratory muscle strength during ventilation. However, this evolution has not been described, nor have its predictors been studied. In addition, a probable parallel between inspiratory and limb muscle strength evolution has not been investigated. OBJECTIVE: To describe the variation over time of maximal inspiratory pressure during mechanical ventilation and its predictors. We also studied the possible relationship between the evolution of maximal inspiratory pressure and limb muscle strength. METHODS: A prospective observational study was performed in consecutive patients submitted to mechanical ventilation for > 72 hours. The maximal inspiratory pressure trend was evaluated by the linear regression of the daily maximal inspiratory pressure and a logistic regression analysis was used to look for independent maximal inspiratory pressure trend predictors. Limb muscle strength was evaluated using the Medical Research Council score. RESULTS: One hundred and sixteen patients were studied, forty-four of whom (37.9%) presented a decrease in maximal inspiratory pressure over time. The members of the group in which maximal inspiratory pressure decreased underwent deeper sedation, spent less time in pressure support ventilation and were extubated less frequently. The only independent predictor of the maximal inspiratory pressure trend was the level of sedation (OR=1.55, 95% CI 1.003 - 2.408; p = 0.049). There was no relationship between the maximal inspiratory pressure trend and limb muscle strength. CONCLUSIONS: Around forty percent of the mechanically ventilated patients had a decreased maximal inspiratory pressure during mechanical ventilation, which was independently associated with deeper levels of sedation. There was no relationship between the evolution of maximal inspiratory pressure and the muscular strength of the limb

Desmodus rotundus and Artibeus spp. bats might present distinct rabies virus lineages

In Brazil, bats have been assigned an increasing importance in public health as they are important rabies reservoirs. Phylogenetic studies have shown that rabies virus (RABV) strains from frugivorous bats Artibeus spp. are closely associated to those from the vampire bat Desmodus rotundus, but little is known about the molecular diversity of RABV in Artibeus spp. The N and G genes of RABV isolated from Artibeus spp. and cattle infected by D. rotundus were sequenced, and phylogenetic trees were constructed. The N gene nucleotides tree showed three clusters: one for D. rotundus and two for Artibeus spp. Regarding putative N amino acid-trees, two clusters were formed, one for D. rotundus and another for Artibeus spp. RABV G gene phylogeny supported the distinction between D. rotundus and Artibeus spp. strains. These results show the intricate host relationship of RABV's evolutionary history, and are invaluable for the determination of RABV infection sources. (C) 2012 Elsevier Editora Ltda. All rights reserved.CAPESCAPESCNPqCNP

Desmodus rotundus and Artibeus spp. bats might present distinct rabies virus lineages

In Brazil, bats have been assigned an increasing importance in public health as they are important rabies reservoirs. Phylogenetic studies have shown that rabies virus (RABV) strains from frugivorous bats Artibeus spp. are closely associated to those from the vampire bat Desmodus rotundus, but little is known about the molecular diversity of RABV in Artibeus spp. The N and G genes of RABV isolated from Artibeus spp. and cattle infected by D. rotundus were sequenced, and phylogenetic trees were constructed. The N gene nucleotides tree showed three clusters: one for D. rotundus and two for Artibeus spp. Regarding putative N amino acid-trees, two clusters were formed, one for D. rotundus and another for Artibeus spp. RABV G gene phylogeny supported the distinction between D. rotundus and Artibeus spp. strains. These results show the intricate host relationship of RABV's evolutionary history, and are invaluable for the determination of RABV infection sources

Sequenciamento parcial do gene Citocromo C oxidase (COI) para determinação de espécies de morcegos enviados para diagnóstico de raiva no Instituto Pasteur

Os morcegos são mamíferos de grande diversidade, amplamente distribuídos no mundo. Apesar da importância desses animais na manutenção dos ecossistemas, estes também representam uma preocupação na saúde pública, uma vez que atuam como reservatórios ou hospedeiros de diferentes patógenos, principalmente vírus. A identificação das espécies de morcegos é essencial para melhor compreensão da origem e da epidemiologia de diversas doenças. Além disso, o entendimento sobre a interação vírus/hospedeiro e o papel dos morcegos na disseminação das doenças é essencial para a manutenção da diversidade e consequente conservação desses animais, permitindo assim, o controle racional dos patógenos albergados por estes. Desta forma, é imprescindível realizar a identificação correta das espécies de morcegos recebidas nos laboratórios, a fim de implantar medidas adequadas de vigilância. Neste sentido, este estudo teve como objetivo identificar geneticamente as espécies de morcegos enviados para diagnóstico de raiva no Instituto Pasteur através do sequenciamento genético parcial do gene citocromo C oxidase subunidade I (COI). Para este estudo foram selecionadas 127 amostras de pulmão de morcegos negativos para raiva obtidos em 2015. As amostras foram submetidas a extração de DNA e PCR tendo como alvo o COI e sequenciamento genético. Como resultado, foram identificadas oito espécies: Artibeus lituratus, Cynomops planirostris, Eumops glaucinus, Glossophaga soricina, Lasiurus ega, Molossus molossus, Molossus rufus e Myotis riparius, distribuídas em três famílias (Phyllostomidae, Molossidae e Vespertilionidae) comumente encontradas no Brasil. O sequenciamento parcial do gene COI foi eficaz na identificação das espécies de quirópteros podendo ser uma ferramenta auxiliar na identificação morfológica e facilmente implantada em laboratórios de biologia molecular

Desmodus rotundus and Artibeus spp. bats might present distinct rabies virus lineages

In Brazil, bats have been assigned an increasing importance in public health as they are important rabies reservoirs. Phylogenetic studies have shown that rabies virus (RABV) strains from frugivorous bats Artibeus spp. are closely associated to those from the vampire bat Desmodus rotundus, but little is known about the molecular diversity of RABV in Artibeus spp. The N and G genes of RABV isolated from Artibeus spp. and cattle infected by D. rotundus were sequenced, and phylogenetic trees were constructed. The N gene nucleotides tree showed three clusters: one for D. rotundus and two for Artibeus spp. Regarding putative N amino acid-trees, two clusters were formed, one for D. rotundus and another for Artibeus spp. RABV G gene phylogeny supported the distinction between D. rotundus and Artibeus spp. strains. These results show the intricate host relationship of RABV's evolutionary history, and are invaluable for the determination of RABV infection sources. (C) 2012 Elsevier Editora Ltda. All rights reserved.CAPESCAPESCNPqCNP

Diagnosis of rabies and eastern and western equine viral encephalitides in equids by multiplex Hemi-Nested RT-PCR technique

Financial support: CNPq and Pasteur Institute of São PauloTrabalho apresentado à 23ª Reunião Internacional da Raiva nas Américas, 2012, São Paulo

A review of the classification of rabies virus lineages maintained by insectivorous bats in Brazil

Trabalho apresentado à 23ª Revista de Educação Continuada em Medicina Veterinária e Zootecnia, 2012, São Paul

Digoxigenin-labeled probe for rabies virus nucleoprotein gene detection

A digoxigenin-labeled probe was produced from the Pasteur virus strain for the detection of the rabies virus N gene. The probe hybridization was performed from amplified N gene obtained by reverse transcription polymerase chain reaction and the results by RT-PCR and hybridization showed 100% agreement. The hybridization, when carried out in products amplified by RT-PCR, increases the sensitivity of this technique even more and confers specificity to the diagnosis. The technique described in this work will be useful in rabies diagnosis laboratories, once the cost is compatible with traditional rabies diagnostic techniques