14 resultados para Marlene Kandel

em Biblioteca Digital da Produção Intelectual da Universidade de São Paulo


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This paper describes a device developed on the pilot scale and a simple approach to compare liquid distributor efficiencies. The technique consists basically of analyzing the mass of the liquid collected in 21 vertical pipes measuring 52 mm in internal diameter and 800 mm in length placed in a quadratic arrangement and positioned below the distributor A 50 mm thick acrylic blanket that does not disperse liquids was placed between the distributor and the pipe bank to avoid splashes. Assays were carried out with ladder-type distributors equipped with 4 parallel pipes each for a column measuring 400 nun in diameter as an example of the application. The number (n) of orifices (95, 127, and 159 orifices/m(2)), orifice diameter (d) (2, 3, and 4 mm) and the flowrate (q) (1.2; 1.4; and 1.6 m(3)/h) were varied. The best spread efficiency, which presented the lowest standard deviation, was achieved with 159 orifices, 2 mm and 1.4 m(3)/h. The pressure (p) at the distributor inlet for this condition was only 51000 Pa (0.51 kgf/cm(2)), while the average velocity (v) was 6.3 m/s in each orifice. These results show some limitations of the practical rules used in distributor designs.

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Malaria associated-acute kidney injury (AKI) is associated with 45% of mortality in adult patients hospitalized with severe form of the disease. However, the causes that lead to a framework of malaria-associated AKI are still poorly characterized. Some clinical studies speculate that oxidative stress products, a characteristic of Plasmodium infection, as well as proinflammatory response induced by the parasite are involved in its pathophysiology. Therefore, we aimed to investigate the development of malaria-associated AKI during infection by P. berghei ANKA, with special attention to the role played by the inflammatory response and the involvement of oxidative stress. For that, we took advantage of an experimental model of severe malaria that showed significant changes in the renal pathophysiology to investigate the role of malaria infection in the renal microvascular permeability and tissue injury. Therefore, BALB/c mice were infected with P. berghei ANKA. To assess renal function, creatinine, blood urea nitrogen, and ratio of proteinuria and creatininuria were evaluated. The products of oxidative stress, as well as cytokine profile were quantified in plasma and renal tissue. The change of renal microvascular permeability, tissue hypoxia and cellular apoptosis were also evaluated. Parasite infection resulted in renal dysfunction. Furthermore, we observed increased expression of adhesion molecule, proinflammatory cytokines and products of oxidative stress, associated with a decrease mRNA expression of HO-1 in kidney tissue of infected mice. The measurement of lipoprotein oxidizability also showed a significant increase in plasma of infected animals. Together, our findings support the idea that products of oxidative stress, as well as the immune response against the parasite are crucial to changes in kidney architecture and microvascular endothelial permeability of BALB/c mice infected with P. berghei ANKA.

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Purpose: To compare 2 methods used to determine the disk position based on sagittal magnetic resonance images. Patients and Methods: A cross-sectional study of patients with the signs and symptoms of temporomandibular disorders was conducted. The patients' ages and gender distributions were collected. The disk position diagnosis from the clinical examination was considered the primary outcome. Three observers evaluated the presence of anterior displacement on magnetic resonance images according to 2 criteria: method 1 (12-o'clock position) and method 2 (location of the intermediate zone). To assess the intraobserver variability of the 2 methods, the examiners evaluated the same magnetic resonance images at the beginning of the study (time 1) and 40 days later (time 2). The intraobserver agreement was assessed using the observed agreement and the kappa statistic. McNemar's test was used to assess the differences between each method and the clinical examination findings (P < .05). The accuracy, sensitivity, specificity, and positive and negative predictive values were calculated by comparing the diagnosis from each method with that from the clinical examination (considered the reference standard). Results: The final sample was composed of 20 subjects with a mean age of 33.0 +/- 33.7 years; 3 were men (15%) and 17 were women (85%). A statistically significant difference between the 2 methods was found. Method 1 yielded a greater percentage of anterior displaced disks (52.5%). The agreement between the clinical diagnosis and method 1 was lower (70.0%) than that between the clinical diagnosis and method 2 (87.5%). No statistically significant difference was found between the clinical diagnosis and method 2. Conclusion: The disk position should be judged according to the intermediate zone criterion. (C) 2012 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 70:1534-1539, 2012

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The objective of this study is to analyze the process of producing reflexive narratives on nursing students' portfolios. This qualitative study performed an analysis of the portfolios of the class discipline Health Promotion in Primary Education, taught in the fourth semester of the Nursing Licensure Course. Results showed an initial predominance of descriptive records, with the incipient approach of theoretical aspects associated with the aspects regarding their experience. Further, in the group and experience discussions, there were narratives containing more critical and reflexive elements, with justifications for the described actions and the relationships with the theoretical-practical aspects studied in the class and in the course. In conclusion, there is a process of producing critical-reflexive narratives in portfolios that could include a summarized description, using common sense and idealization which allows for including the differences and the theoretical review.

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Since around 1723, on the occasion of its initial colonization by Europeans, Rondonia has received successive waves of immigrants. This has been further swelled by individuals from northeastern Brazil, who began entering at the beginning of the twentieth century. The ethnic composition varies across the state according to the various sites of settlement of each wave of immigrants. We analyzed the frequency of the CCR5 Delta 32 allele of the CCR5 chemokine receptor, which is considered a Caucasian marker, in five sample sets from the population. Four were collected in Porto Velho, the state capital and the site of several waves of migration. Of these, two, from the Hospital de Base were comprised of HB Mothers and HB Newborns presenting allele frequencies of 3.5% and 3.1%, respectively, a third from the peri-urban neighborhoods of Candelaria/Bate-Estaca (1.8%), whereas a fourth, from the Research Center on Tropical Medicine/CEPEM (0.6%), was composed of malaria patients under treament. The fifth sample (3.4%) came from the inland Quilombola village of Pedras Negras. Two homozygous individuals (CCR5 Delta 32/CCR5 Delta 32) were detected among the HB Mother samples. The frequency of this allele was heterogeneous and higher where the European inflow was more pronounced. The presence of the allele in Pedras Negras revealed European miscegenation in a community largely comprising Quilombolas.

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Most of the patients with 5 alpha-RD 2 deficiency are reared in the female social sex due to their severely undervirilized external genitalia but similar to 60% who have not been submitted to orchiectomy in childhood undergo male social sex change at puberty. In our cohort of 30 cases from 18 families, all subjects were registered in the female social sex except for two children-one who had an affected uncle and the other who was diagnosed before being registered. The majority of the patients were satisfied with the long-term results of their treatment and surprisingly, penile length was not associated with satisfactory or unsatisfactory sexual activity. Steroid 5 alpha-RD2 deficiency should be included in the differential diagnosis of all newborns with 46,XY DSD with normal testosterone production before gender assignment or any surgical intervention because these patients should be considered males at birth.

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Adipose tissue-derived stem cells (ASCs) are an attractive source of stem cells with regenerative properties that are similar to those of bone marrow stem cells. Here, we analyze the role of ASCs in reducing the progression of kidney fibrosis. Progressive renal fibrosis was achieved by unilateral clamping of the renal pedicle in mice for 1 h; after that, the kidney was reperfused immediately. Four hours after the surgery, 2 x 10(5) ASCs were intraperitoneally administered, and mice were followed for 24 h posttreatment and then at some other time interval for the next 6 weeks. Also, animals were treated with 2 x 10(5) ASCs at 6 weeks after reperfusion and sacrificed 4 weeks later to study their effect when interstitial fibrosis is already present. At 24 h after reperfusion, ASC-treated animals showed reduced renal dysfunction and enhanced regenerative tubular processes. Renal mRNA expression of IL-6 and TNF was decreased in ASC-treated animals, whereas IL-4. IL-10, and HO-1 expression increased despite a lack of ASCs in the kidneys as determined by SRY analysis. As expected, untreated kidneys shrank at 6 weeks, whereas the kidneys of ASC-treated animals remained normal in size, showed less collagen deposition, and decreased staining for FSP-1, type I collagen, and Hypoxyprobe. The renal protection seen in ASC-treated animals was followed by reduced serum levels of TNF-alpha, KC, RANTES, and IL-1 alpha. Surprisingly, treatment with ASCs at 6 weeks, when animals already showed installed fibrosis, demonstrated amelioration of functional parameters, with less tissue fibrosis observed and reduced mRNA expression of type I collagen and vimentin. ASC therapy can improve functional parameters and reduce progression of renal fibrosis at early and later times after injury, mostly due to early modulation of the inflammatory response and to less hypoxia, thereby reducing the epithelial-mesenchymal transition.

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OBJECTIVES: The objectives of our study were as follows: 1) to analyze the prognostic value of macrophage infiltration in primary IgA nephropathy (IgAN) and 2) to study the relationship between macrophages and other factors associated with the development of renal fibrosis, including mast cells, TGF-beta 1, alpha-SMA and NF-kB. METHODS: We analyzed 62 patients who had been diagnosed with IgAN between 1987 and 2003. Immunohistochemical staining was performed with monoclonal antibodies against CD68 and mast cell tryptase and polyclonal antibodies against TGF-beta 1, alpha-SMA and NF-kB p65. We also used Southwestern histochemistry for the in situ detection of activated NF-kB. RESULTS: The infiltration of macrophages into the tubulointerstitial compartment correlated with unfavorable clinical and histological parameters, and a worse clinical course of IgAN was significantly associated with the number of tubulointerstitial macrophages. Kaplan-Meier curves demonstrated that increased macrophage infiltration was associated with decreased renal survival. Moreover, the presence of macrophages was associated with mast cells, tubulointerstitial alpha-SMA expression and NF-kB activation (IH and Southwestern histochemistry). In the multivariate analysis, the two parameters that correlated with macrophage infiltration, proteinuria and tubulointerstitial injury, were independently associated with an unfavorable clinical course. CONCLUSION: An increased number of macrophages in the tubulointerstitial area may serve as a predictive factor for poor prognosis in patients with IgAN, and these cells were also associated with the expression of pro-fibrotic factors.

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Strongyloidiasis is an intestinal parasitosis with an obligatory pulmonary cycle. A Th2-type immune response is induced and amplifies the cellular response through the secretion of inflammatory mediators. Although this response has been described as being similar to asthma, airway remodeling during pulmonary migration of larvae has not yet been established. The aim of this study was to identify the occurrence of airway remodeling during Strongyloides venezuelensis (S. v.) infection and to determine the ability of dexamethasone treatment to interfere with the mechanisms involved in this process. Rats were inoculated with 9,000 S. v. larvae, treated with dexamethasone (2 mg/kg) and killed at 1, 3, 5, 7, 14 and 21 days. Morphological and morphometric analyzes with routine stains and immunohistochemistry were conducted, and some inflammatory mediators were evaluated using ELISA. Goblet cell hyperplasia and increased bronchiolar thickness, characterized by edema, neovascularization, inflammatory infiltrate, collagen deposition and enlargement of the smooth muscle cell layer were observed. VEGF, IL1-beta and IL-4 levels were elevated throughout the course of the infection. The morphological findings and the immunomodulatory response to the infection were drastically reduced in dexamethasone-treated rats. The pulmonary migration of S. venezuelensis larvae produced a transitory, but significant amount of airway remodeling with a slight residual bronchiolar fibrosis. The exact mechanisms involved in this process require further study. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

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The aim of this study was to investigate the role of TLR2, TLR4 and MyD88 in sepsis-induced AKI. C57BL/6 TLR2(-/-), TLR4(-/-) and MyD88(-/-) male mice were subjected to sepsis by cecal ligation and puncture (CLP). Twenty four hours later, kidney tissue and blood samples were collected for analysis. The TLR2(-/-), TLR4(-/-) and MyD88(-/-) mice that were subjected to CLP had preserved renal morphology, and fewer areas of hypoxia and apoptosis compared with the wild-type C57BL/6 mice (WT). MyD88(-/-) mice were completely protected compared with the WT mice. We also observed reduced expression of proinflammatory cytokines in the kidneys of the knockout mice compared with those of the WT mice and subsequent inhibition of increased vascular permeability in the kidneys of the knockout mice. The WT mice had increased GR1(+low) cells migration compared with the knockout mice and decreased in GR1(+high) cells migration into the peritoneal cavity. The TLR2(-/-), TLR4(-/-), and MyD88(-/-) mice had lower neutrophil infiltration in the kidneys. Depletion of neutrophils in the WT mice led to protection of renal function and less inflammation in the kidneys of these mice. Innate immunity participates in polymicrobial sepsis-induced AKI, mainly through the MyD88 pathway, by leading to an increased migration of neutrophils to the kidney, increased production of proinflammatory cytokines, vascular permeability, hypoxia and apoptosis of tubular cells.

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The composition and abundance of the fish assemblage were evaluated in the fish ladder of Ourinhos Dam, the newest dam (closed in 2005) in the cascade of dams constructed on the Paranapanema River. Samplings were carried out three times on a diel cycle, in three sampling periods, two in the warm season and one in the cold season of 2008 - 2009. The ladder was closed and emptied and the entire fish assemblage was sampled and identified. Most individuals were released alive downstream of the dam. The assemblage found in the ladder was compared with the fish fauna sampled in the reservoir and in downstream sites, in the same period. Twenty seven species and a total of 4682 individuals were caught in the ladder. Pimelodus maculatus was the only migratory species, which was caught in low number in the ladder (0.04% of the total captured), where small sedentary species predominated. The most abundant species were the non-migratory Apareiodon affinis, Bryconamericus stramineus, Astyanax fasciatus and Parodon nasus. Individuals observed in the ladder's window were moving up-and down the passage. The fish ladder is a microhabitat inhabited by an abundant association of benthic organisms that is probably used as a food resource for the fish assemblage in the ladder. The similarity between the fish fauna in the ladder and that of the Ourinhos Reservoir was low (26%). The species richness of migrants in the stretch between the uspstream reservoir (Chavantes) and the downstream one (Salto Grande), before the Ourinhos dam closure (23 species) was reduced to 16 and 12 species in Salto Grande and Ourinhos reservoirs, respectively, after the dam closure, and to a single species in the ladder.

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Esta investigação visou analisar o processo de construção das narrativas reflexivas em portfólios de estudantes de enfermagem. Trata-se de um estudo qualitativo, que analisou os portfólios da disciplina Promoção da Saúde na Educação Básica, ministrada no quarto semestre do curso de Licenciatura em Enfermagem. Os resultados indicaram a predominância inicial de registros descritivos, com a incipiente abordagem de aspectos teóricos articulados aos aspectos vivenciais. Com o transcorrer das discussões em grupo e das vivências foram apresentadas narrativas com elementos mais críticos e reflexivos, com justificativas das ações descritas e relações com aspectos teórico-práticos estudados na disciplina e no curso. O estudo conclui que há um processo de produção das narrativas crítico-reflexivas em portfólios que pode incluir descrição sintética, senso comum, idealização, e que, de modo singular, possibilita a inclusão do outro, das diferenças e de revisão teórica.

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This study was focused on the predation upon microcrustaceans by an invertebrate predator (chaoborid larvae), and vertebrate predators (fish), in two small reservoirs in southeastern Brazil, with and without macrophytes, in two climatic periods (dry and rainy seasons). Chaoborus larvae were sampled in the limnetic zone, as they are scarce in the littoral, and fish in both limnetic and littoral zones. Their diets were evaluated by the analysis of the crop (chaoborid) or stomach contents (fish). Chaoborid larvae consumed the dinoflagellate Peridinium sp. or other algae, rotifers, and planktonic microcrustaceans. The fish species that included microcrustaceans in their diets were juveniles caught in the littoral. Aquatic insects, plant fragments, and detritus were their major dietary items, microcrustaceans representing a minor item. Planktonic copepods contributed more to the diet of chaoborid larvae than planktonic cladocerans. Fish preyed on planktonic microcrustaceans, as well as on benthic and macrophyte-associated species. Microcrustaceans were not heavily preyed on by chaoborid larvae and fish in both reservoirs.

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