Fitomejoramiento participativo del arroz de secano en Nicaragua: metodologías, resultados y lecciones aprendidas

Fitomejoramiento participativo del arroz de secano en Nicaragua: metodologías, resultados y lecciones aprendidas. En varias regiones de Nicaragua, el cultivo de arroz de secano asume un papel importante para la seguridad alimenticia de las familias campesinas, además es fuente de ingresos para éstas. Apartir del 2002, el CIRAD y el CIAT implementan en colaboración en Nicaragua un proyecto de investigación en fitomejoramiento participativo del arroz de secano dirigido a los pequeños y medianos productores.Este proyecto esta manejado en asociación con la Institución Nacional de Investigación Agropecuaria, varias ONGs e instituciones de extensión y organizaciones campesinas locales. En este trabajo, se describen la metodología general aplicada en el proyecto, los actores involucrados y los marcos de concertación entre los socios, las estrategias y métodos de evaluación y selección participativa aplicados y los principales resultados obtenidos al final de tres años. Esta experiencia deriva lecciones, con respecto al manejo de un proyecto de investigación asociando estrechamente fitomejoradores y productores, la selección de los socios, los métodos de trabajo, las competencias adquiridas por los actores y la diversidad genética explorada y valorizada, las que podrían ser utilizadas en la implementación de otros proyectos en este tema. Para la continuación del proyecto, los cambios de escala (scalingup), la organización de una producción descentralizada de semilla de calidad, el desarrollo de investigaciones en agronomía y la creación de un sistema permanente de evaluación y selección del arroz, reuniendo todos los actores de la cadena productiva, son los mayores retos

Productividad y calidad nutricional de genotipos de sorgo para doble propósito

The objective of this study was to evaluate a set of dual purpose sorghum genotypes for their grain and fodder productivity, as well as for nutritional quality of leaves and stems for livestock. From 2003 through 2005, 26, 15 and 8 genotypes were evaluated respectively, in comparison with the control variety INTA CNIA during the postrera season (August to November) in the experimental fields of the National Agricultural Research Centre (INTA CNIA), Nicaragua. Agronomic traits were measured as well as nutritional quality of leaves and stems using the Near Infrared Spectrometry method. For all agronomic and nutritional quality traits were found significant differences among genotypes, except for grain yield in 2004, and the neutral and acid detergent fiber contents in stems. The heritability of agronomic and quality traits in leaves was high (≥ 0.50), with values between 0.96 and 0.51 but lower for most of quality parameters in stems, with values between 0.47 and 0.20. The only significant positive correlation was among crude protein (MAT) and leave – stem ratio in fresh stems (H/RF). The genotypes BF 95-11/195, Sureño, SH 688, V142 and V 144, achieved the best results for grain and fodder yield and fodder quality (regarding both leaves and stems). Sureño out-yielded the control variety for crude protein content per hectare (MPB/ha) in 50 and 33 % for leaves and stems respectively.El objetivo del presente trabajo fue evaluar genotipos de sorgo para productividad de grano y rastrojo, así como la calidad nutricional para la alimentación del ganado. En los años 2003, 2004 y 2005 se evaluaron 26, 15 y 8 genotipos, respectivamente, con el testigo INTA CNIA en época de postrera (agosto-noviembre), en las instalaciones del Centro Nacional de Investigación Agropecuaria (INTA CNIA), Nicaragua. Se midieron variables agronómicas y se determinó la calidad nutricional de hojas y tallos, usando el método de espectrometría en el infrarrojo cercano. Para todas las variables agronómicas y de calidad nutricional, se encon-traron diferencias significativas entre genotipos, a excepción de rendimiento de grano en 2004 y contenido de fibra detergente neutro y ácido en tallos. La heredabilidad de características agronómicas y de los componentes de calidad en hojas fue alta (≥ 0,50), con valores comprendidos entre 0,96 y 0,51 e inferior para la mayoría de los parámetros de calidad en tallos, comprendidos entre 0,47 y 0,20. La única correlación positiva fue entre materia proteica total (MAT) y hoja/rastrojo fresco (H/RF) en los tallos. Los genotipos BF 95-11/195, Sureño, SH 688, V 142 y V 144 sobresalieron en rendimiento de grano, rastrojo y calidad nutricional (hojas-tallos). Sureño superó en materia proteica bruta por hectárea (MPB/ha) al testigo en 50 y 33% en hojas y tallos, respectivament

Impact of intensive care unit relocation and role of tap water on an outbreak of Pseudomonas aeruginosa expressing OprD-mediated resistance to imipenem

Background: To assess the impact of the incidental relocation of an intensive care unit (ICU) on the risk of colonizations/infections with Pseudomonas aeruginosa exhibiting OprD-mediated resistance to imipenem (PA-OprD). Aim: The primary aim was to compare the proportion of PA-OprD among P. aeruginosa samples before and after an incidental relocation of the ICU. The role of tap water as a route of contamination for colonization/infection of patients with PA-OprD was assessed as a secondary aim. Methods: A single-centre, observational, before/after comparison study was conducted from October 2013 to October 2015. The ICU was relocated at the end of October 2014. All P. aeruginosa-positive samples isolated from patients hospitalized ≥48 h in the ICU were included. Tap water specimens were collected every three months in the ICU. PA-OprD strains isolated from patients and tap water were genotyped using pulse-field gel electrophoresis. Findings: A total of 139 clinical specimens of P. aeruginosa and 19 tap water samples were analysed. The proportion of PA-OprD strains decreased significantly from 31% to 7.7% after the relocation of the ICU (P = 0.004). All PA-OprD clinical specimens had a distinct genotype. Surprisingly, tap water was colonized with a single PA-OprD strain during both periods, but this single clone has never been isolated from clinical specimens. Conclusion: Relocation of the ICU was associated with a marked decrease in P. aeruginosa strains resistant to imipenem. The polyclonal character of PA-OprD strains isolated from patients and the absence of tap-water-to-patient contamination highlight the complexity of the environmental impact on the endogenous colonization/infection with P. aeruginosa.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Association of ventilator type with hospital mortality in critically ill patients with SARS-CoV2 infection:a prospective study

BACKGROUND: To evaluate the association between ventilator type and hospital mortality in patients with acute respiratory distress syndrome (ARDS) related to COVID-19 (SARS-CoV2 infection), a single-center prospective observational study in France. RESULTS: We prospectively included consecutive adults admitted to the intensive care unit (ICU) of a university-affiliated tertiary hospital for ARDS related to proven COVID-19, between March 2020 and July 2021. All patients were intubated. We compared two patient groups defined by whether an ICU ventilator or a less sophisticated ventilator such as a sophisticated turbine-based transport ventilator was used. Kaplan–Meier survival curves were plotted. Cox multivariate regression was performed to identify associations between patient characteristics and hospital mortality. We included 189 patients (140 [74.1%] men) with a median age of 65 years [IQR, 55–73], of whom 61 (32.3%) died before hospital discharge. By multivariate analysis, factors associated with in-hospital mortality were age ≥ 70 years (HR, 2.11; 95% CI, 1.24–3.59; P = 0.006), immunodeficiency (HR, 2.43; 95% CI, 1.16–5.09; P = 0.02) and serum creatinine ≥ 100 µmol/L (HR, 3.01; 95% CI, 1.77–5.10; P < 0.001) but not ventilator type. As compared to conventional ICU (equipped with ICU and anesthesiology ventilators), management in transient ICU (equipped with non-ICU turbine-based ventilators) was associated neither with a longer duration of invasive mechanical ventilation (18 [IQR, 11–32] vs. 21 [13–37] days, respectively; P = 0.39) nor with a longer ICU stay (24 [IQR, 14–40] vs. 27 [15–44] days, respectively; P = 0.44). CONCLUSIONS: In ventilated patients with ARDS due to COVID-19, management in transient ICU equipped with non-ICU sophisticated turbine-based ventilators was not associated with worse outcomes compared to standard ICU, equipped with ICU ventilators. Although our study design is not powered to demonstrate any difference in outcome, our results after adjustment do not suggest any signal of harm when using these transport type ventilators as an alternative to ICU ventilators during COVID-19 surge. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13613-022-00981-2

Unchanged Characteristics and Survival among Critically Ill COVID-19 Patients during First, Second, and Third Waves: A Prospective Observational Cohort

International audienceBackground: This study was carried out to compare characteristics and outcomes in patients with acute respiratory failure related to COVID-19 during first, second, and third waves. Methods: We included consecutive adults admitted to the intensive care unit between March 2020 and July 2021. We compared three groups defined by the epidemic intake phase: waves 1 (W1), 2 (W2), and 3 (W3). Results: We included 289 patients. Two hundred and eight (72%) patients were men with a median age of 63 years (IQR: 54-72), of whom 68 (23.6%) died in hospital. High-flow nasal oxygen (HFNO) was inversely associated with the need for invasive mechanical ventilation (MV) in multivariate analysis (p = 0.003) but not dexamethasone (p = 0.25). The day-90 mortality rate did not vary from W1 (27.4%) to W2 (23.9%) and W3 (22%), p = 0.67. By multivariate analysis, older age (odds ratio [OR]: 0.94/year, p < 0.001), immunodeficiency (OR: 0.33, p = 0.04), acute kidney injury (OR: 0.26, p < 0.001), and invasive MV (OR: 0.13, p < 0.001) were inversely associated with higher day-90 survival as opposed to the use of intermediate heparin thromboprophylaxis dose (OR: 3.21, p = 0.006). HFNO use and dexamethasone were not associated with higher day-90 survival (p = 0.24 and p = 0.56, respectively). Conclusions: In patients with acute respiratory failure due to COVID-19, survival did not change between first, second, and third waves while the use of invasive MV decreased. HFNO or intravenous steroids were not associated with better outcomes, whereas the use of intermediate dose of heparin for thromboprophylaxis was associated with higher day-90 survival. Larger multicentric studies are needed to confirm our findings

Functional outcome after convulsive status epilepticus

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Jugular versus Femoral Short-Term Catheterization and Risk of Infection in Intensive Care Unit Patients. Causal Analysis of Two Randomized Trials

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Effects of Fluid Resuscitation With Colloids vs Crystalloids on Mortality in Critically Ill Patients Presenting With Hypovolemic Shock

International audienceIMPORTANCE:Evidence supporting the choice of intravenous colloid vs crystalloid solutions for management of hypovolemic shock remains unclear.OBJECTIVE:To test whether use of colloids compared with crystalloids for fluid resuscitation alters mortality in patients admitted to the intensive care unit (ICU) with hypovolemic shock.DESIGN, SETTING, AND PARTICIPANTS:A multicenter, randomized clinical trial stratified by case mix (sepsis, trauma, or hypovolemic shock without sepsis or trauma). Therapy in the Colloids Versus Crystalloids for the Resuscitation of the Critically Ill (CRISTAL) trial was open label but outcome assessment was blinded to treatment assignment. Recruitment began in February 2003 and ended in August 2012 of 2857 sequential ICU patients treated at 57 ICUs in France, Belgium, North Africa, and Canada; follow-up ended in November 2012.INTERVENTIONS:Colloids (n = 1414; gelatins, dextrans, hydroxyethyl starches, or 4% or 20% of albumin) or crystalloids (n = 1443; isotonic or hypertonic saline or Ringer lactate solution) for all fluid interventions other than fluid maintenance throughout the ICU stay.MAIN OUTCOMES AND MEASURES:The primary outcome was death within 28 days. Secondary outcomes included 90-day mortality; and days alive and not receiving renal replacement therapy, mechanical ventilation, or vasopressor therapy.RESULTS:Within 28 days, there were 359 deaths (25.4%) in colloids group vs 390 deaths (27.0%) in crystalloids group (relative risk [RR], 0.96 [95% CI, 0.88 to 1.04]; P = .26). Within 90 days, there were 434 deaths (30.7%) in colloids group vs 493 deaths (34.2%) in crystalloids group (RR, 0.92 [95% CI, 0.86 to 0.99]; P = .03). Renal replacement therapy was used in 156 (11.0%) in colloids group vs 181 (12.5%) in crystalloids group (RR, 0.93 [95% CI, 0.83 to 1.03]; P = .19). There were more days alive without mechanical ventilation in the colloids group vs the crystalloids group by 7 days (mean: 2.1 vs 1.8 days, respectively; mean difference, 0.30 [95% CI, 0.09 to 0.48] days; P = .01) and by 28 days (mean: 14.6 vs 13.5 days; mean difference, 1.10 [95% CI, 0.14 to 2.06] days; P = .01) and alive without vasopressor therapy by 7 days (mean: 5.0 vs 4.7 days; mean difference, 0.30 [95% CI, -0.03 to 0.50] days; P = .04) and by 28 days (mean: 16.2 vs 15.2 days; mean difference, 1.04 [95% CI, -0.04 to 2.10] days; P = .03).CONCLUSIONS AND RELEVANCE:Among ICU patients with hypovolemia, the use of colloids vs crystalloids did not result in a significant difference in 28-day mortality. Although 90-day mortality was lower among patients receiving colloids, this finding should be considered exploratory and requires further study before reaching conclusions about efficacy