Avaliação microbiológica de polpas congeladas de frutas comercializadas em feiras públicas da cidade de Macapá, Amapá

The fruit pulp preserves several nutritional characteristics of the fruits and for this reason they are highly appreciated. However, due to the difficulties in sanitary inspection, little is known about the hygienic-sanitary conditions of its processing, which can pose health risks if good hygienic practices are not followed during the pulp manufacturing process. In this way, the present research had the objective of analyzing the microbiological characteristics of pulps (pineapple, mango and passion fruit) marketed in the popular fairs of the Buritizal and Jardim Felicidade neighborhoods in the city of Macapá-AP. 500g to 1kg of fruit pulp (pineapple, mango and passion fruit) were collected at fairs in two districts of the city of Macapá-AP, after which they were submitted to microbiological analysis for thermotolerant coliforms and Salmonella ssp at the IEPA Laboratory. It was observed that in all the samples studied were negative for Salmonella ssp, however, three samples were positive for thermotolerant coliforms and were outside the parameters required by the legislation. It was possible to verify that fruit pulp producers still need to improve sanitary and sanitary issues and to provide higher quality food safety for these products consumed by the population.La pulpa de fruta conserva varias características nutricionales de las frutas y, por lo tanto, es muy apreciada. Sin embargo, debido a las dificultades en la inspección sanitaria, se sabe poco acerca de las condiciones higiénico-sanitarias de su procesamiento, que pueden presentar riesgos para la salud si no se siguen las buenas prácticas de higiene durante el proceso de fabricación de pulpa. Así, la presente investigación tuvo como objetivo analizar las características microbiológicas de las pulpas (piña, mango y maracuyá) vendidas en las ferias populares de los barrios de Buritizal y Jardim Felicidade en la ciudad de Macapá-AP. Recolectamos de 500 ga 1 kg de pulpa de fruta (piña, mango y maracuyá) en ferias de dos vecindarios de Macapá-AP, luego nos enviaron para análisis microbiológicos de coliformes termotolerantes y Salmonella ssp en el Laboratorio IEPA. Se observó que todas las muestras estudiadas fueron negativas para la presencia de Salmonella ssp, sin embargo, tres muestras fueron identificadas positivas para coliformes termotolerantes y estaban fuera del parámetro requerido por la legislación. Fue posible verificar que los productores de pulpa de fruta todavía necesitan mejorar los problemas sanitarios y sanitarios y proporcionar alimentos de mayor calidad.A polpa de fruta conserva diversas características nutricionais das frutas e por isso são bastante apreciadas. Porém, devido as dificuldades na fiscalização sanitária, pouco se sabe sobre as condições higiênico-sanitárias de seu processamento, o que pode trazer riscos à saúde caso não sejam seguidas boas práticas de higiene durante o processo de fabricação da polpa. Desta forma, a presente pesquisa teve como objetivo analisar as características microbiológicas das polpas (abacaxi, manga e maracujá) comercializadas nas feiras populares dos bairros Buritizal e Jardim Felicidade na cidade de Macapá-AP. Foram coletados 500 g a 1kg de polpas de frutas (abacaxi, manga e maracujá) em feiras de dois bairros da cidade de Macapá-AP, posteriormente foram submetidas para análise microbiológicas para coliformes termotolerantes e Salmonella ssp no Laboratório do IEPA. Foi observado que em todas as amostras estudadas apresentaram-se negativas para presença de Salmonella ssp, entretanto foram identificadas três amostras positivas para coliformes termotolerantes e estavam fora do parâmetro exigido pela legislação. Foi possível verificar que os produtores de polpas de frutas, ainda precisam melhorar as questões higiênico-sanitário e proporcionar maior qualidade na segurança alimentar desses produtos consumidos pela população

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society