Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice

Sínteses e caracterização de microesferas de poli (álcool vinilico) e sua utilização como suportes para imobilização de lipase produzida por Rhizomucor miehei e seu estudo catalítico na reação de transesterificação do óleo de soja para a produção de biodiesel via rota etílica

O biodiesel (ésteres de ácidos graxos) tem sido produzido a partir da transesterificação direta de óleos ou de gorduras, em que triglicerídeos reagem com um álcool de cadeia curta (metanol ou etanol) na presença de um catalisador químico como, por exemplo, certos ácidos ou hidróxidos. Alternativamente, foi utilizada a via enzimática. Nesse caso, empregam-se enzimas lipases como catalisadores. Reações de transesterificação catalisadas por lipases têm se tornado cada vez mais atrativa, uma vez que o glicerol gerado na reação pode ser facilmente recuperado e a purificação de ésteres de acido graxo é simples. Todavia, as enzimas utilizadas como catalisadores possuem alto custo no mercado, dificuldade de recuperação e, além disso, estão sujeitas à inativação. Desse modo, uma maneira encontrada para superar alguns desses obstáculos é a imobilização das enzimas em um suporte sólido. A imobilização da enzima em uma matriz aumenta sua estabilidade química e térmica, reduz a sua inativação, e facilita a sua recuperação na reação. Microesferas de Poli (álcool vinilico) (PVA) com diferentes graus de cristalinidade foram usados como suportes sólidos para a imobilização da lipase de Rhizomucor miehei. Microsferas de PVA com estrutura amorfa (PVA4) imobilizaram 0,03 mg da enzima/ g de suporte, enquanto que microesferas com estrutura cristalina (PVA12) imobilizaram 0,024 mg/g e a de alta cristalinidade (PVA25) imobilizou 0,029 mg/g. A atividade enzimática das enzimas imobilizadas foi dependente do grau de cristalinidade das microesferas de PVA. O complexo Enzima-PVA4 apresentou uma atividade enzimática de (6,13 U/mg de enzima), o complexo Enzima-PVA12 apresentou uma atividade enzimática de (67,23 U/mg de enzima) e o complexo Enzima-PVA25 revelou uma alta atividade enzimática (149,15 U/mg de enzima). A atividade...Biodiesel (fatty acid esters) is produced from the direct transesterification of oils or fats in which triglycerides react with a short chain alcohol (methanol or ethanol) in the presence of a chemical catalyst like acids or hydroxides. In the other hand, enzymatic route is used and, in this case, employing lipases as catalysts. Transesterification reactions catalyzed by lipases has become ever more attractive, since glycerol produced in the reaction can be easily recovered and purification of fatty acid esters is simple. One way to overcome these barriers by using free lipases is their immobilization on a solid support. The immobilized enzyme increases its chemical and thermal stability, reduces inactivation, improves handling and facilitates its recovery in the reaction. Microspheres of poly vinyl alcohol (PVA) with different degrees of crystallinity were then used as solid supports for immobilization of lipase from Rhizomucor miehei. PVA microspheres with amorphous structure (PVA4) immobilized 0,029 mg of enzyme/ g of support, while crystalline structure microspheres (PVA12) immobilized 0,024 mg/g and high crystallinity microspheres (PVA25) immobilized 0,03 mg/g. The enzymatic activity of the immobilized enzymes was dependent on the degree of crystallinity of PVA microspheres. The enzyme-PVA4 complex revealed an enzymatic activity of (6.13 U/mg of enzyme) while the Enzyme-PVA12 complex an enzymatic activity of (67.23 U/mg of enzyme) and Enzyme-PVA25 complex provided a high activity enzymatic (149.15 U/mg enzyme). The enzymatic activity of the lipase in its free form was also measured and, in this case, was found to be (11.6 U/mg enzyme). A synergistic effect was also observed for the complex Enzyme-PVA25 during the transesterification reaction. The yield of esters for complex Enzyme-PVA25 was 66.3% followed by Enzyme-PVA12 (40.7%)... (Complete abstract click electronic access below

Avaliação da DQO e da relação C/N obtidas no tratamento anaeróbio de resíduos fruti-hortículas=Evaluation of the COD and the C/N ratio in the anaerobic treatment of fruit and vegetable wastes

Diariamente são geradas grandes quantidades de resíduos de frutas e verduras nos atacados, feiras e supermercados. A geração excessiva desses resíduos pode acarretar em danos para o meio ambiente. Nesse sentido, o presente trabalho teve como objetivo verificar a capacidade de biodegradação anaeróbia dos resíduos de frutas e verduras por meio do monitoramento da DQO e da relação C/N. Os resíduos depois de coletados, picados, triturados, inoculados com lodo de esgoto e caracterizados em termos de carbono orgânico, nitrogênio Kjeldahl e DQO solúvel e total, foram colocados em um biodigestor por 300 dias com monitoramento periódico. Os resultados obtidos permitem verificar que, durante os 300 dias de codigestão anaeróbia, não foi possível degradar a matéria orgânica do resíduo, o que foi evidenciado pelas baixas reduções de carbono e pelas baixas remoções de DQO, fato que provavelmente se deve ao aspecto físico da mistura dos resíduos. Acredita-se que a diluição do resíduo ou a adição de mais inoculante ao meio facilitaria o processo de biodigestão.<br><br>Daily, there are generated large quantities of fruit and vegetable wastes on wholesale fruit and vegetable markets, local orthofruit shops and supermarkets. The excessive generation of these wastes can cause environmental problems. So, the aim of this study was to evaluate the anaerobic biodegradation of fruit and vegetable wastes by the COD and C/N ratio monitoring. The wastes were collected in a central distribution market for food, shredded, blended, inoculated with sewage sludge and characterized. The waste was characterized in terms of organic carbon, soluble and total COD and Kjeldahl nitrogen, so it was put in an anaerobic reactor for the biological degradation that was monitored during 300 days. The results show that during the experiment, the degradation of the organic material wasn’t possible, because of the low COD and C/N ratio removal. Probably, this fact was caused by the physical aspect of the waste, such as a semi-solid paste. A dilution or the addition of higher concentrations of sewage sludge could facilitate the biodigestion process

Dereplication of Bromotyrosine-derived Metabolites by LC-PDA-MS and Analysis of the Chemical Profile of 14 Aplysina Sponge Specimens from the Brazilian Coastline

In order to investigate the chemical profile of 14 specimens of Aplysina spp. marine sponges, we have developed a method based on LC-PDA-MS for the detection of bromotyrosine-derived metabolites. The method enabled the dereplication of three distinct chemotypes of bromotyrosine-derived compounds based on UV absorptions, which were further refined by electrospray ionization-mass spectrometry analysis of the brominated quasi-molecular ion clusters. This procedure led to either a single compound assignment, or a maximum of two possible isobaric compounds. The dereplication study indicated that the chemical profile of the 14 specimens of Aplysina spp. analyzed presented practically the same dibromotyrosine-derived compounds. The results obtained suggested a possible biogenetic pathway for the formation of dibromotyrosine-derived compounds of wide occurrence in Verongida sponges.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)[BIOTA/BIOprospecTA 05/60175-2]Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)CNPqConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)R.G.S.BR.G.S.BFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo - FAPESP[06/60510-9

Enzymatic transesterification of soybean oil with ethanol using lipases immobilized on highly crystalline PVA microspheres

Polyvinyl alcohol (PVA) microspheres with different degree of crystallinity were used as solid supports for Rhizomucor miehei lipase immobilization, and the enzyme-PVA complexes were used as biocatalysts for the transesterification of soybean oil to fatty acid ethyl esters (FAEE). The amounts of immobilized enzyme on the polymeric supports were similar for both the amorphous microspheres (PVA4) and the high crystalline microspheres (PVA25). However, the enzymatic activity of the immobilized enzymes was depended on the crystallinity degree of the PVA microspheres: enzymes immobilized on the PVA4 microspheres have shown low enzymatic activity (6.13 U mg-1), in comparison with enzymes immobilized on the high crystalline PVA25 microspheres (149.15 U mg-1). A synergistic effect was observed for the enzyme-PVA25 complex during the transesterification reaction of soybean oil to FAEE: transesterification reactions with free enzyme with the equivalent amount of enzyme that were immobilized onto the PVA25 microspheres (5.4 U) have yielded only 20% of FAEE, reactions with the pure highly crystalline microsphere PVA25 have not yielded FAEE, however reactions with the enzyme-PVA25 complexes have yielded 66.3% of FAEE. This synergistic effect of an immobilized enzyme on a polymeric support has not been observed before for transesterification reaction of triacylglycerides into FAEE. Based on ATR-FTIR, 23Na- and 13C-NMR-MAS spectroscopic data and the interaction of the polymeric network intermolecular hydrogen bonds with the lipases residual amino acids a possible explanation for this synergistic effect is provided. © 2013 Elsevier Ltd. All rights reserved

A vibração torácica na fisioterapia respiratória de recém-nascidos causa dor? Does chest vibration during respiratory physiotherapy in neonates cause pain?

OBJETIVO: Avaliar a dor em recém-nascidos pré-termo (RNPT) submetidos à fisioterapia respiratória em Unidade de Terapia Intensiva Neonatal. MÉTODOS: Estudo transversal realizado com recém-nascidos prematuros, com indicação de fisioterapia respiratória, em respiração espontânea. Foi aplicada uma técnica de vibração torácica com a mão do terapeuta realizando pequenas oscilações sobre o tórax do paciente e feita a avaliação da frequência cardíaca (FC), frequência respiratória (FR), saturação de pulso de oxigênio (SpO2) e do Sistema de Codificação da Atividade Facial Neonatal (NFCS) para a avaliação da dor antes, durante, imediatamente após (pós-i) e 30 minutos após (pós-30) a vibração no tórax do paciente. Utilizou-se a análise de variância para medidas repetidas para comparação entre as fases, considerando-se significante p<0,05. RESULTADOS: Foram avaliados 13 RNPT, com média de idade gestacional 32,5±2,0 semanas e peso de nascimento 1830±442g. Não foi observada pontuação de dor durante toda a avaliação: pré: 0,5±1,7; durante: 1,5±1,4; pós-i: 1,0±1,3; pós-30: 0±0,3, porém houve diferença estatisticamente significativa entre a fase pós-i e pós-30 na escala NFCS (p<0,05). A FC variou de 120 a 150bpm, a SpO2 permaneceu acima de 95%, e a FR entre 40 e 62rpm, sem diferenças entre os períodos. CONCLUSÕES: Neste grupo de pacientes prematuros internados em UTI neonatal e submetidos à realização de fisioterapia respiratória pela técnica de vibração torácica, não foram observadas alterações fisiológicas e comportamentais de dor<br>OBJECTIVE: To observe pain score during chest physiotherapy (CP) in preterm newborns (PTNB) assisted in a Neonatal Intensive Care Unit. METHODS: A cross-sectional study was carried out with PTNB with spontaneous breathing that needed respiratory physiotherapy. A vibration technique was employed, with the hand of the therapist applying oscillations on the patients' thorax. The following variables were assessed: heart rate (HR), respiratory rate (RR) and oxygen saturation (O2Sat), as well as the Neonatal Facial Coding System (NFCS) to analyze pain before (pre), during, just after and 30 minutes after the thoracic vibration technique. Repeated measures analysis of variance was applied to analyze the protocol phases, being significant p<0.05. RESULTS: Thirteen PTNB were assessed. The mean gestational age was 32.5±2.0 weeks, and the birth weight was 1830±442g. No pain was observed during the evaluation: "pre": 0.5±1.7; "during": 1.5±1.4; "just after": 1.0±1.3; "30 min after": 0±0.3, but there was difference in the NFCS scores between the periods "just after" and "30 minutes after" (p<0.05). The HR varied between 120 and 150bpm, O2Sat levels remained over 95%, and RR oscillated from 40 to 62mpm, without differences between periods. CONCLUSIONS: Preterm patients spontaneously breathing and submitted to respiratory physiotherapy by thoracic vibration, no evidence of physiological or behavioral pain indicators were observe