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We examined the effect of an antimicrobial stewardship program (ASP), procalcitonin testing and rapid blood-culture identification on hospital mortality in a prospective quality improvement project in critically ill septic adults. Secondarily, we have reported antimicrobial guideline concordance, acceptance of ASP interventions, and antimicrobial and health-resource utilization.
There are little data about renal follow-up of neonates after cardiovascular surgery and no guidelines for long-term renal follow-up. Our objectives were to assess renal function follow-up practice after neonatal cardiac surgery, evaluate factors that predict follow-up serum creatinine measurements including acute kidney injury following surgery, and evaluate the estimated glomerular filtration rate during follow-up using routinely collected laboratory values.
Two-centre retrospective cohort study of children 5–7 years of age with a history of neonatal cardiac surgery. Univariable and multivariable analyses were performed to determine factors associated with post-discharge creatinine measurements. Glomerular filtration rate was estimated for each creatinine using a height-independent equation.
Seventeen of 55 children (30%) did not have any creatinine measured following discharge after surgery until the end of study follow-up, which occurred at a median time of 6 years after discharge. Of the 38 children who had the kidney function checked, 15 (40%) had all of their creatinine drawn only in the context of a hospitalisation or emergency department visit. Acute kidney injury following surgery did not predict the presence of follow-up creatinine measurements.
A large proportion of neonates undergoing congenital heart repair did not have a follow-up creatinine measured in the first years following surgery. In those that did have a creatinine measured, there did not appear to be any identified pattern of follow-up. A follow-up system for children who are discharged from cardiac surgery is needed to identify children with or at risk of chronic kidney disease.
The aim of this study was to investigate the spatiotemporal variation in richness, abundance, structure and composition of phyllostomid bats over a successional gradient in a tropical dry forest in south-eastern Brazil. Four successional stages (pasture, early, intermediate and late) were sampled in the northern part of the state of Minas Gerais. Bats were sampled using mist nets at three sites for each of the four successional stages (12 sites in total) during eight periods between 2007 and 2009. A total of 537 individuals were captured (29 recaptured), distributed among four families and 22 species. Bat abundance and richness varied in space, being higher in the late-successional stage, and over time, being significantly lower during the dry season. When compared between guilds, only the abundance of omnivores varied significantly during the sampled months. Our results demonstrate that areas of late-successional stages showed higher bat richness and abundance in comparison with areas undergoing secondary succession. Our results also suggest the use of early-successional areas as flying routes by bats can lead to failure to detect differences in bat composition within successional gradients. We suggest future studies should assimilate landscape-level analyses into their studies to better evaluate the effects of successional gradients on bat assemblages.
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