Dinâmica de nutrientes em milho para alimentação de gado em agroecossistemas baseados na conservação de savanas neotropicais

Mineral deficiencies in soil-plant-animal relations are linked to chemical properties and reproductive problems in grazing animals. The objective of this study was to determine the dynamics of K, Ca, and Mg in the green leaf biomass of two types of introduced forages, Brachiaria dyctioneura (Bd) and Centrosema macrocarpum (Cm), compared to the natural vegetation of the neotropical savannah (NS) in an agricultural ecosystem. The three types of vegetation, associated with the corn crop, served as livestock feed during the dry season. The soil’s nutrient content (0-15 cm depth), the production and nutritional dynamics of green leaf biomass, and leaf/stem relationships in the fields during the grazing period were determined. In the corn crop-livestock agroecosystem, K decreased (%) in concentration as the grazing period progressed, presenting the following trend: Bd>Cm>NS. The dynamics of Ca and Mg in green leaf biomass increased slightly (p<0.05) by the end of the grazing period for Bd and Cm, in contrast to a significant decrease in the natural vegetation of the savannah. The concentration of K in the soil did not reveal significant differences between ground cover and NS plants, and the soils under Cm evidenced the highest percentage of Ca. A higher percentage of Mg was observed in the soil planted with Cm. For the three types of vegetation, an improvement was observed in the nutritional quality of the forage and soil and in the yield (kg/ha). These findings are valuable contributions within the context of production in savannas and to forage quality for livestock.  Deficiências minerais no eixo solo-planta-animal estão relacionadas as propriedades químicas e estão ligadas a problemas reprodutivos em animais em pastejo. O objetivo deste estudo foi determinar a dinâmica de K, Ca e Mg na biomassa foliar verde de dois tipos de forrageiras introduzidas (Brachiaria dyctioneura (Bd) e Centrosema macrocarpum (Cm)) em relação à vegetação natural do cerrado (NS) em um ecossistema agrícola. Os três tipos de vegetação, associados ao cultivo do milho, serviam de ração para o gado durante a estação seca. Foram determinados o conteúdo de nutrientes no solo (0-15 cm de profundidade), a produção de biomassa de folhas verdes e sua dinâmica nutricional e as relações folha-colmo nas lavouras durante o pastejo. No agroecossistema milho-pecuária, o K apresentou redução (%) em sua concentração com o avanço do período de pastejo, apresentando a seguinte tendência: Bd> Cm> NS. A dinâmica do Ca e Mg na biomassa foliar verde aumentou ligeiramente (p <0,05) ao final do período de pastejo em Bd e Cm, contrastando com uma diminuição significativa na vegetação natural do cerrado. A concentração de K no solo não apresentou diferenças significativas entre as plantas de cobertura e o NS, sendo que os solos sob Cm apresentaram a maior porcentagem de Ca. Uma maior porcentagem de Mg foi observada no solo plantado com Cm. Nos três tipos de vegetação examinados, observou-se melhora na qualidade nutricional da forragem e solo e na produtividade (kg/ha). Essas descobertas são contribuições valiosas nos contextos de produção das savanas e na qualidade da forragem para o gado

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Calidad del forraje en una sabana neotropical basada en diferentes tipos de fertilización

The application of different sources of nutrients to the soil with varying degrees of solubility, as well as the use of organic and inorganic fertilizers, can generate different responses in agroecosystems. The objective of this study was to evaluate the effect of different fertilization options on the quality of forage in the conservation-based agroecosystems of neotropical savannas. Both perennial species Brachiaria dictyoneura and the legume Centrosema macrocarpum are associated with corn cultivation. Four fertilization treatments were evaluated within each cover crop, applying 150 kg ha-1 of nitrogen, 150 kg ha-1 of P2O5, 100 kg ha-1 of K2O, and varying the source of phosphorus, being the treatments distributed as follows: i) phosphoric rock, high dose of phosphorus (100% of P2O5 as phosphoric rock), ii) diammonium phosphate, high dose of P (50% of P2O5 as phosphoric rock and 50% as diammonium phosphate), iii) biological fertilization, low dose of P (25% of P2O5 as phosphoric rock and inoculation with biofertilizer based on native arbuscular mycorrhizal fungi, such as Gigaspora, Scutellospora, Acaulospora, and Glomus), and finally, iv) the unfertilized treatment. The results show that under direct sowing and the use of biological fertilization sources using phosphoric rock as a source of P, similar and even higher levels of raw protein can be reached than when using fertilization with soluble sources such as the diammonium phosphate, which induce greater sustainability of the cover biomass, being an alternative in the management of this types of agroecosystems.La aplicación de distintas fuentes de nutrientes al suelo, con variados grados de solubilidad, así como el uso de fertilizantes de tipo orgánico e inorgánico, pueden generar diferentes respuestas en los agroecosistemas. El objetivo de este estudio fue evaluar el efecto de diferentes opciones de fertilización sobre la calidad del forraje en el manejo conservacionista de sabanas neotropicales. Las especies introducidas fueron Brachiaria dictyoneura y la leguminosa Centrosema macrocarpum, ambas perennes, asociadas al cultivo de maíz. Dentro de cada cobertura se evaluaron cuatro tratamientos de fertilización, aplicando 150 kg ha-1 de nitrógeno, 150 kg ha-1 de P2O5, 100 kg ha-1 de K2O, y variando la fuente de fósforo, quedando los tratamientos distribuidos de la siguiente forma: i) roca fosfórica, dosis alta de fósforo (100% del P2O5 como roca fosfórica), ii) fosfato diamónico, dosis alta de P (50% del P2O5 como roca fosfórica y 50% como fosfato diamónico , iii) fertilización biológica, dosis baja de P (25% del P2O5 como roca fosfórica e inoculación con biofertilizante a base de hongos micorrízicos arbusculares nativos, como Gigaspora, Scutellospora, Acaulospora y Glomus) y por último, iv) el tratamiento sin fertilizar. Los resultados permiten concluir que bajo siembra directa y uso de fuentes de fertilización biológica empleando roca fosfórica como fuente de P, se pueden alcanzar niveles de proteína cruda similares e incluso mayores, que al utilizar fertilización con fuentes solubles como el fosfato diamonio, por lo cual se induce a una mayor sostenibilidad de la biomasa de las coberturas, siendo una alternativa en el manejo de este tipo de agroecosistema

First report of fatal fungemia due Fusarium oxysporum in a patient with COVID-19 in Ecuador

Filamentous fungal infections are an important cause of systemic infections in immunocompromised patients. Fusarium genus members potentially cause disseminated infections, especially in patients with catheters, due to the ability to adhere to these devices. We describe a case of fatal fungemia due to Fusarium oxysporum in a patient with COVID-19 in Ecuador. The genus identification was carried out with conventional techniques and species identification by molecular and phylogenetic techniques through sequencing of the ITS region

Pig Slaughterhouse Wastewater: Medium Culture for Microalgae Biomass Generation as Raw Material in Biofuel Industries

Microalgae are photosynthetic microorganisms with high lipid content, capable of degrading nutrients from wastewater. In this research, two strains of microalgae, Scenedesmus sp. and Chlorella vulgaris were cultivated in sterilized pig slaughterhouse wastewater using outdoor flat photobioreactors. Cell growth, total lipids, free fatty acids (FFA), fatty acid methyl esters (FAME) and physicochemical parameters of wastewater were measured. The results indicated that pig slaughterhouse wastewater is adequate to grow these species of microalgae, obtaining a higher biomass growth for Scenedesmus sp. compared to Chlorella vulgaris (0.41 g/L vs. 0.2 g/L); additionally, these species can be used in bioremediation processes due to the nutrient removal achieved in terms of Total Nitrogen (TN), Total Phosphorous (TP) and Total Organic Carbon (TOC). Methylcyclohexane, chloroform: methanol (1:2) and ethyl acetate had better yield of lipids and FFA. The percentages of FAMEs from FFA were in the range of 52.5–89.5 wt% for Scenedesmus sp. and for Chlorella vulgaris from 52–80.5 wt%. Although the values of lipids, FFA and FAME are below of the range reported by other authors, the use of this type of wastewater as culture medium for the two species cannot be ruled out for lipid extraction in biofuel production

Pig Slaughterhouse Wastewater: Medium Culture for Microalgae Biomass Generation as Raw Material in Biofuel Industries

Microalgae are photosynthetic microorganisms with high lipid content, capable of degrading nutrients from wastewater. In this research, two strains of microalgae, Scenedesmus sp. and Chlorella vulgaris were cultivated in sterilized pig slaughterhouse wastewater using outdoor flat photobioreactors. Cell growth, total lipids, free fatty acids (FFA), fatty acid methyl esters (FAME) and physicochemical parameters of wastewater were measured. The results indicated that pig slaughterhouse wastewater is adequate to grow these species of microalgae, obtaining a higher biomass growth for Scenedesmus sp. compared to Chlorella vulgaris (0.41 g/L vs. 0.2 g/L); additionally, these species can be used in bioremediation processes due to the nutrient removal achieved in terms of Total Nitrogen (TN), Total Phosphorous (TP) and Total Organic Carbon (TOC). Methylcyclohexane, chloroform: methanol (1:2) and ethyl acetate had better yield of lipids and FFA. The percentages of FAMEs from FFA were in the range of 52.5&ndash;89.5 wt% for Scenedesmus sp. and for Chlorella vulgaris from 52&ndash;80.5 wt%. Although the values of lipids, FFA and FAME are below of the range reported by other authors, the use of this type of wastewater as culture medium for the two species cannot be ruled out for lipid extraction in biofuel production

Routine Immunization Programs for Children during the COVID-19 Pandemic in Ecuador, 2020&mdash;Hidden Effects, Predictable Consequences

The COVID-19 pandemic has led to a global disruption of several services, including routine immunizations. This effect has been described in several countries, but there are few detailed studies in Latin America and no reports in Ecuador. Therefore, this work aims to quantify the reduction in routine immunizations for infants during the 2020 COVID-19 pandemic in Ecuador. 2018, 2019, and 2020 data were obtained from the Ministry of Health, Ecuador. The number of doses and the extent of immunization coverage was descriptively compared for four vaccines: rotavirus (ROTA), poliovirus (PV), pneumococcal (PCV), and pentavalent (PENTA) vaccines. There was no significant difference in doses applied during the 2018 and 2019 years. However, a significant (p &lt; 0.05) drop of 137,000 delivered doses was observed in 2020 compared to the pre-pandemic years. Reductions in the percentage of coverage were more pronounced for the PENTA vaccine (17.7%), followed by PV (16.4%), ROTA (12%), and PCV vaccines (10.7%). Spatial analysis shows a severe impact on vaccination coverage on provinces from the Coast and Highland regions of the country. The pandemic has significantly impacted the immunization programs for infants across Ecuador. This retrospective analysis shows an urgent need to protect vulnerable zones and populations during public health emergencies