ABSTRACT INTRODUCTION Newborns in need of surgery are a challenge to manage and require highly specialized centers with multidisciplinary surgical teams. Since the 1980s, neonatal surgical survival has increased by up to 70% in some countries, mainly due to advances in neonatal intensive care, anesthesia and surgical technique. OBJECTIVE Describe surgical case fatality and survival in a neonatal reference hospital in Cuba, estimate risk of death, and identify potential risk predictors among neonatal characteristics. METHODS A retrospective cohort study was conducted based on hospital administrative data and clinical records for a series of surgical cases in the neonatal intensive care unit of Havana’s William Soler University Children’s Hospital from January 2005 to December 2015. All neonates who underwent surgery during the study period were included. The dependent variable was discharge status (alive, deceased); independent variables were: sex, age (in days) at time of surgery, gestational age, birth weight, indication for surgery, surgical order (first, repeat), and presence of sepsis or other postoperative complications. The study used contingency tables to analyze associations between neonatal characteristics and discharge status. A classifi cation tree was used to obtain simple estimates of surgical risk. RESULTS Survival was 91.3% (675/739) among 739 neonates who underwent surgery. The majority were male (58.7%, 434/739), full term (84.2%, 622/739), and of normal birth weight (80.6%, 596/739). Most surgeries were performed in the first 10 days of life. Digestive system anomalies constituted the most common surgical indication (57.6%, 426/739); among these anorectal malformations (26.8%, 114/426) and esophageal atresia (17.4%, 74/426) predominated. Survival rates were lower for digestive perforation (57.7%, 15/26), gastroschisis (57.1%, 4/7) and intestinal atresia (73%, 27/37). Neonates in the youngest and oldest age groups at time of surgery faced highest risk of death, especially those in the older group. Term infants with normal birth weight operated on for the first time had survival rates >95%. CONCLUSIONS Survival was high and low birth weight conferred the worst prognosis. Infants with normal birth weight operated on for the first time had the greatest probability of survival.

El objetivo del presente estudio fue evaluar química y sensorialmente las características de morocotos, Piaractus brachypomus, cultivados en dos sistemas de cultivo: intensivo sistema heterotrófico (HS) con cero intercambio de agua y un sistema de recirculación de agua (RAS); y compararlos con los cultivados en un medio intensivo de flujo de agua continuo (control). Los morocotos se cultivaron durante 192 días en 6 tanques de concreto a razón de 150 peces por tanque y en 4,8 m³ de agua (31,25 peces/m³). El contenido de proteína resultó ser significativamente diferente (P<0.05) entre los tratamientos. La humedad resultó ser diferente entre peces de RAS y control. No se observaron cambios en los lípidos; sólo, el perfil de lípidos mostró que el EPA y DHA desaparecen en HS, manteniéndose constante en RAS. La evaluación sensorial no presentó diferencias significativas entre los dos tipos de tratamientos respectos al olor, sabor, textura y color evidenciando que el cultivo intensivo de morocotos en sistemas de biofloc no tiene efectos negativos en la calidad de los peces

The objective of this study was to evaluate chemical and sensory characteristics of red bellied pacu (Piaractus brachypomus) cultured in two types of intensive systems, Heterotrophic System (HS) with zero water exchange and Recirculating Aquaculture System (RAS), and compare them to those cultured in a semi intensive flow-through system (control). Red bellied pacu were cultured for 192 days in 6 concrete tanks at the rate of 150 fish per tank in 4.8 m³ of water (31.25 fish/m³). Protein content were significantly different (P<0.05) between treatments. Moisture differed significantly between fish from RAS and control. No changes were observed for lipid contents; however, lipids profile showed that EPA and DHA disappeared on HS, and were constant on RAS. Sensory evaluation did not present significant differences among treatments regarding odor, flavor, texture and color

The objective of this work was to evaluate the tolerance of red-bellied pacu, Piaractus brachypomus, to high-density in closed production systems. Nine hundred fingerlings with 44.3±26 g weight were distributed in six 4.8 m³ concrete tanks. Three tanks had zero water exchange rate (SCR), and in the other three water was connected to a bioclarifier (SRA). All tanks had strong aeration to keep solids suspended and air supply to the system. Fish were fed to satiety for 192 days with a commercial feed. Water quality parameters such as dissolved oxygen, total ammonia nitrogen, nitrites, nitrates, alkalinity, hardness, temperature and pH were measured weekly. Fish in the SCR had an average growth rate of 2.34±0.05 g per day, showed a food conversion rate of 1.5±0.06, reached a final density of 12.96±0.53 kg m-3, and a final weight of 449.5±99 g. In the SRA, fish grew at 2.33±0.03 g per day, had a food conversion rate of 1.6±0.07, reached a final average density of 12.13±1.12 kg m-3 and a final weight of 446.5±10 g. Red-bellied pacu can be grown in closed systems with zero water exchange at high culture densities.

El objetivo de este trabajo fue evaluar la tolerancia de la cachama blanca, Piaractus brachypomus, a cultivos en altas densidades en sistemas cerrados. Novecientos alevines de 44,3±26 g de peso, se distribuyeron en seis tanques de concreto, con 4,8 m³ de agua. Tres tanques presentaron cero recambio de agua (SCR), y en otros tres, el agua se hizo circular a través de un bioclarificador (SRA). Ambos tratamientos presentaron fuerte aireación para mantener los sólidos en suspensión y suministrar aire. Los peces se alimentaron a saciedad con pienso comercial por 192 días. Los parámetros de calidad de agua como: oxígeno disuelto, amonio total, nitritos, nitratos, alcalinidad, dureza, temperatura y pH, se midieron semanalmente. Los peces en el SCR crecieron a una tasa de 2,34±0,05 g por día, y tuvieron conversión alimenticia de 1,5±0,06, densidad final de 12,96±0,53 kg m-3, y peso final de 449,5±99 g. En el SRA, los peces crecieron 2,33±0,03 g por día, con conversión alimenticia de 1,6±0,07, densidad final de 12,13±1,12 kg m-3, y peso final de 446,5±10 g. La cachama blanca puede ser cultivada en sistemas cerrados con cero recambio de agua en altas densidades.

The secondary or reactive hemophagocytosis syndrome is an uncommon entity clinically manifested by a severe clinical picture and a high mortality rate. It is characterized by a macrophages benign activation, associated with viral, bacterial, fungoid or parasitic infections and immunodeficiencies and neoplams. This is the clinical case of a 17 days male neonate with fever, suffering from cold and digestive manifestations who clinically evolving with jaundice, hepatosplenomegaly and anemia. A cytomegalovirus was diagnosed in urine. Was discharged being alive at 68 days with a regression of clinical picture.

El síndrome hemofagocítico secundario o reactivo es una entidad poco frecuente, de etiología multifactorial, que clínicamente se manifiesta como un cuadro grave y de alta letalidad. Se caracteriza por activación benigna de los macrófagos, asociada a infecciones virales, bacterianas, fúngicas o parasitarias, a inmunodeficiencias y a neoplasias. Se presenta el caso clínico de un neonato varón, de 17 días de vida, que presentó fiebre, manifestaciones catarrales y digestivas. Evolucionó clínicamente con ictericia, hepatoesplenomegalia, trombocitopenia y anemia. Se diagnosticó un citomegalovirus en la orina. Egresó vivo a los 68 días de vida, con regresión del cuadro clínico.