Abstract Purpose The purpose of this study was to determine whether Tranexamic Acid (TXA) can significantly reduce perioperative blood loss in Total Shoulder Arthroplasty (TSA) performed under regional anesthesia. Methods We performed a randomized, single blinded, controlled study. Forty-five patients were submitted to TSA under regional anesthesia to treat cuff tear arthropathy, proximal humeral fractures, chronic instability, primary osteoarthrosis, and failures of previous prosthesis. Patients were randomized to either group TXA therapy (TXA), with 1 g intravenous (IV), or no Intervention (NTXA). Postoperative total drain output, hemoglobin variation, total blood loss, hemoglobin loss, and need for transfusion were measured. Pain-related variables were also assessed: postoperative pain assessment by visual analog scale, inpatient pain breakthrough, quality of recovery, length of stay, and coagulation function testing. Results Participants presented a mean age of 76 years, 15.6% were male, 82.2% were American Society of Anesthesiologists (ASA) physical status I or II. There were no differences between groups concerning transfusions, operative time, Post-Anesthesia Care Unit (PACU) length of stay and in-hospital stay, and QoR-15 or postoperative pain. Bleeding measured by drain output at 2, 24 and 48 hours was significantly less in the TXA group at each timepoint. There was a difference in Hb variation - TXA: median (IQR) -1.4 (1.3) g.dL-1 vs. NTXA: -2.2 (1.3) g.dL-1; median difference: 0.80 (0.00-1.20); p = 0.047. aPTT was lower in TXA administered patients - TXA: median (IQR) 29.6 (14.0)s vs. NTXA: 33 (5.8)s; difference in medians: -4.00 (-6.50--1.00); p = 0.012. Conclusion TXA use significantly decreased blood loss measured by drain output and Hb drop in TSA under regional anesthesia.

Abstract Introduction: Surgical site infections are associated with devastating consequences in vascular surgery patients but the data on Methicillin Resistant Staphylococcus aureus (MRSA) infection among those remains scant and conflicting. Most vascular surgery antibiotic prophylaxis assume that all patients submitted to surgery are tested prior to the intervention or that all patients with risk factors for MRSA are presumed to be colonized. However, the costs associated with testing all patients are not negligible, and most of the vascular surgery patients have risk factors for MRSA colonization. The purpose of this study was to evaluate the burden of MRSA clinical infection and its outcome and to adjust clinical practice accordingly. Methods: A retrospective analysis of clinical data from all patients with MRSA isolations that were submitted to vascular surgery in the year 2019 was conducted. The primary endpoint was in-hospital mortality. Secondary endpoints were timing of infection (pre-existent infection or post-surgical infection), need for ICU and length of hospital stay. Results: Out of 1681 patients admitted for surgery in the year 2019 in the vascular surgery ward, only 21 had clinical infection with positive MRSA isolates. All the patients had risk factors for MRSA colonization. Seventeen were admitted for PAD (Rutherford grade 5 or 6). Eight patients had post-operatory infections, whilst the remaining presented with MRSA infection prior to the intervention. Post-operatory infections ranged from superficial incisional in three patients, deep incisional in one patient, and organ/space/prosthesis infection in four patients (of the last group, two had prosthesis infection). There were five deaths, of which two were unrelated to the infection. Of the three deaths probably infection-related, all were post-operatory surgical site infections, and all were organ/space/prosthesis infections (one with prosthesis infection). There was no patient admitted to the ICU that survived. The mean hospital stay was increased by 26 days (31 days, 95% CI, 19-43). Conclusion: Infection by MRSA was less frequent than expected in our population, which may mean that colonization might be smaller than expected. Pre-operative infection was almost always related to chronic wounds and did not increase the risk of post-operative wound infection or death, contrary to post-operative infection, which seems to significantly increase mortality.

Abstract This study evaluated the microbiological quality and prevalence of Escherichia coli and diarrheagenic E. coli pathotypes (DEP) among fresh-squeezed orange juice from street vendors and their hygienic practices. Sixty orange juice stalls in Mexico City were visited, and 60 samples were purchased. Most (65%) of the street vendors had poor hygienic practices. Twelve (20%) prepared orange juice at the time of purchase, while the other stalls sold already-squeezed orange juice. All samples analyzed were positive for aerobic mesophilic bacteria, with limits ranging from 1 to 6.8 log CFU/mL. A total of 35 (58.3%), 27 (45%), and 5 (8.3%) samples were positive for total coliforms, fecal coliforms, and E. coli, respectively, present at concentrations ranging from < 3 to > 1100, < 3 to > 1100, and < 3 to 53 MPN/mL, respectively. Two samples harbored DEP at concentrations of 3.6 and 9.2 MPN/mL. Both samples harbored Shiga toxin-producing E. coli strains, positive for the Shiga toxin 2 (stx2) locus. Our results suggest that consumption of fresh-squeezed street-vended orange juice may pose a health risk for consumers, revealing the necessity to implement adequate hygiene and safety practices to protect the health of consumers.

RESUMO O enorme interesse gerado pela responsabilidade social corporativa tanto no mundo acadêmico quanto no empresarial forma o pano de fundo para este estudo. Seu objetivo é analisar a relação entre a responsabilidade social corporativa e o desempenho financeiro em vista do debate existente na literatura sobre o tema. O estudo concentra-se em uma amostra de empresas espanholas tomadas do índice IBEX 35, da bolsa de valores de Madri, utilizando a metodologia de dados em painel, que oferece vantagens em comparação com metodologias utilizadas em outros estudos. Analisamos o período que abrange os anos de 2003 a 2010. Nossas conclusões sugerem que não há relação óbvia entre a responsabilidade social corporativa e os resultados financeiros, ao menos no caso da Espanha.

ABSTRACT The enormous interest aroused by corporate social responsibility both in the academic and the business worlds forms the background for this study. Its objective is to analyze the relationship between corporate social responsibility and financial performance in view of the debate in the literature on the subject. The study focuses on a sample of Spanish companies taken from the IBEX 35 stock market index, using panel data methodology, which offers advantages in comparison to methodologies used in other studies. We analyzed the period from 2003 to 2010. Our findings suggest that there is no obvious relationship between corporate social responsibility and financial results, at least in the case of Spain.

RESUMEN El enorme interés que despierta la responsabilidad social corporativa tanto en el ámbito empresarial como académico da sentido a este trabajo. El objetivo del trabajo es analizar la relación entre la responsabilidad social corporativa y sus resultados financieros, ya que existe debate en la literatura académica sobre esta cuestión. La cuestión de análisis se aplica a una muestra de empresas españolas que cotizan en el IBEX 35, utilizando una metodología de datos de panel que aporta novedades a otros análisis realizados. El período de análisis abarca desde 2003-2010. Los resultados sugieren que la relación entre responsabilidad social y resultados no es tan obvia, al menos para el caso español.

As atividades dos estabelecimentos de abate de frangos são conhecidas por utilizarem grandes volumes de água durante seus processos, principalmente no processo de resfriamento das carcaças de frangos. Parte desse volume utilizado se faz necessário, em cumprimento à legislação que determina que cada tanque do sistema de pré-resfriadores contínuos por imersão deve ser completamente esvaziado, limpo e desinfetado no final de cada período de trabalho (oito horas). O objetivo deste estudo foi comparar a carga microbiana das águas do sistema de resfriamento e das carcaças de frango ao final de oito, dezesseis e vinte e quatro horas de trabalho do abatedouro, para possível redução do número de vezes do completo esvaziamento dos tanques do sistema de resfriamento. Foram avaliadas, por meio de métodos convencionais microbiológicos e físico-químicos, amostras da água de abastecimento (n=69), visando a evitar possível interferência nas contagens das águas do sistema de resfriamento, amostras de carcaças de frango antes (n=345) e após (n=345) sua passagem pelo sistema de resfriamento e amostras de águas do último estágio do sistema de resfriamento de carcaças (n=69). Os resultados obtidos demonstraram que não houve diferença significativa na carga microbiana das amostras entre as três jornadas de trabalho do estabelecimento, sugerindo que a redução é segura, diminuindo assim o volume de águas residuais e seu impacto no meio ambiente, bem como melhorando o uso racional do tempo de processamento.

Poultry processing facilities are known for using a great amount of water, which is mainly used on carcasses chilling stage. In Brazil, meat regulations state that each chiller tank must be emptied, cleaned and sanitized every 8 working hours. The aim of the current study was to assess the microbial load of chiller water used in poultry immersion chilling system after 8, 16 and 24 working hours in order to evaluate the reduction of water changes and chiller sanitization. Conventional physicochemical and microbiological assays were done in water supply samples (n=69) to suppress interferences caused by freshwater addition; pre chilled (n=345) post chilled carcasses (n=345) and chiller water samples of the last stage (n=69). The results showed no significant differences on microbial load samples between the three shifts suggesting that the proposed reduction may be secure and reduces the volume of wastewater that would impact the environment, besides improving the rational use of processing time.