Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Unravelling feeding territoriality in the Little Blue Heron, Egretta caerulea, in Cananéia, Brazil

Habitat use by the Little Blue Heron (Egretta caerulea) and discovery of feeding territoriality are discussed here. The results showed the existence of a territorial individual defending an area (2,564.46 ± 943.56 m²) close to the mangrove, and non-territorial individuals (9.17 ± 2.54) in the rest of a demarcated area (mean area for the non-territorial: 893.25 ± 676.72). A weak positive correlation (r = 0.47, df = 46, p < 0.05) was found between the overlapping of territorial and non-territorial individuals (2.85 ± 3.07 m²) and the mean overlapped area for territorial individuals (171.41 ± 131.40 m²). Higher capture (1.52 ± 1.14 × 1.00 ± 1.37 catches/minutes) and success rates (0.45 ± 0.31 × 0.21 ± 0.27) and lower energy expenditure rates (45.21 ± 14.96 × 51.22 ± 14.37 steps/minutes; and 3.65 ± 2.55 × 4.94 ± 3.28 stabs/minutes) were observed for individuals foraging in areas close to the mangrove. The results suggest that the observed territorial behaviour is more related to a number of food parameters than to intruder pressure, and also that the observed territoriality might be related to defense of areas with higher prey availability

Detection of human parvovirus B19 in a patient with hepatitis. Brazilian

Abstract Parvovirus B19 has been associated by some investigators with cases of severe hepatitis. The aim of the present study was to determine the presence of active parvovirus B19 infection among 129 Brazilian patients with non-A-E hepatitis. The patients were assayed for antibodies against parvovirus B19, IgM class, by ELISA. In IgM-positive cases, parvovirus B19 DNA was assayed by PCR in serum and liver tissue and parvovirus VP1 antigen in liver tissue was assayed by immunohistochemistry. Antibodies against parvovirus B19, IgM class, were detected in 3 (2.3%) of 129 patients with non-A-E hepatitis. Previous surgery and blood transfusions were reported by these 3 patients. One patient was a 56-year-old female with severe hepatitis, with antimitochondrial antibody seropositivity and submassive necrosis at liver biopsy, who responded to corticosteroid therapy. Strong evidence for active parvovirus B19 infection was found in this patient, with parvovirus B19 DNA being detected by PCR in liver tissue. Furthermore, parvovirus VP1 antigen was also detected in liver tissue by immunohistochemistry. The other two IgM-positive patients were chronic hepatitis cases, but active infection was not proven, since neither viral DNA nor antigen were detected in their liver tissues. This and other reports suggest a possible relation between parvovirus B19 infection and some cases of hepatitis

Diagnosis and outcome of acute respiratory failure in immunocompromised patients after bronchoscopy

Objective: We wished to explore the use, diagnostic capability and outcomes of bronchoscopy added to noninvasive testing in immunocompromised patients. In this setting, an inability to identify the cause of acute hypoxaemic respiratory failure is associated with worse outcome. Every effort should be made to obtain a diagnosis, either with noninvasive testing alone or combined with bronchoscopy. However, our understanding of the risks and benefits of bronchoscopy remains uncertain.Patients and methods: This was a pre-planned secondary analysis of Efraim, a prospective, multinational, observational study of 1611 immunocompromised patients with acute respiratory failure admitted to the intensive care unit (ICU). We compared patients with noninvasive testing only to those who had also received bronchoscopy by bivariate analysis and after propensity score matching.Results: Bronchoscopy was performed in 618 (39%) patients who were more likely to have haematological malignancy and a higher severity of illness score. Bronchoscopy alone achieved a diagnosis in 165 patients (27% adjusted diagnostic yield). Bronchoscopy resulted in a management change in 236 patients (38% therapeutic yield). Bronchoscopy was associated with worsening of respiratory status in 69 (11%) patients. Bronchoscopy was associated with higher ICU (40% versus 28%; p&lt; 0.0001) and hospital mortality (49% versus 41%; p=0.003). The overall rate of undiagnosed causes was 13%. After propensity score matching, bronchoscopy remained associated with increased risk of hospital mortality (OR 1.41, 95% CI 1.08-1.81).Conclusions: Bronchoscopy was associated with improved diagnosis and changes in management, but also increased hospital mortality. Balancing risk and benefit in individualised cases should be investigated further