Effect of essential oils from Eucalyptus on the growth of aflatoxigenic species

In Brazil, Eucalyptus species has been cultivated as source of energy and cellulose. They represent the most important cultivated forest in the country. In production areas, the leaves from the trees decay on the soil as green fertilizer. In this study were evaluated pure and blends of essential oils from different species of eucalyptus trees grown in Brazil for antifungal activity against aflatoxigenic species Aspergillus flavus and A. parasiticus. These fungal species can grow and contaminate grains during the storage period under high r.h. conditions, with an eventual production of aflatoxins. Antifungal activity was evaluated by the radial growth measurement of the fungi inoculated on maize meal extract agar basic medium. The eucalyptus oils were evaluated in a contact assay and a fumigant assay using pure and blended oils. Six concentrations of pure and blended oils were evaluated at the following doses: 0, 2, 4, 16, 32 and 84 μL per 20 mL of fungi culture medium. Fungal inocula from conidia suspensions containing 106 spores/mL was inoculated by a needle. Glass Petri dishes were incubated for 9 days at 28°C (± 0.3°C) in the dark. Antifungal activity was observed in all pure and blended oils, in different concentrations of contact and fumigant assay, for both fungi. Eucalyptus stageiriana oil and E. stageiriana + the hybrid E. grandis x E. urophylla oils blend controlled the total fungal growth at the lowest dose (20 μL). Keywords: Essential oil; Eucalyptus spp.; Aspergillus flavus; Aspergillus parasiticus; Antifungal activity

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt