Postoperative renal function evaluation, through RIFLE criteria, of elderly patients who underwent femur fracture surgery under spinal anesthesia

Introduction. The postoperative acute renal failure (ARF) incidence in different kinds of surgery has rarely been studied. Age, cardiac dysfunction, previous renal dysfunction, intraoperative hypoperfusion, and use of nephrotoxic medications are mentioned as risk factors for ARF at the postoperative period. The postoperative ARF definition was based on the creatinine increase by the RIFLE classification (R = risk, I = injury, F = failure, L = loss, E = end stage), which corresponds to a 1.5 creatinine increase, two to three times, respectively, above the basal value. This study aimed to evaluate the postoperative ARF incidence in elderly patients who underwent femur fracture surgery under subarachnoid anesthesia and stratify it by the RIFLE criteria. Methods. Ninety patients older than 65 years under spinal anesthesia with fixed dosage of 15 mg of 0.5% isobaric bupivacaine associated with morphine 50 g were studied. Immediate postoperative creatinine was considered basal and compared with maximal creatinine evaluated at 24, 48, and 72 postoperative hours. Results. The mean age of the patients was 80.27 years. ARF incidence was 24.44% and stratified this way: R = 21.11% and I = 3.33%. Conclusions. In conclusion, the postoperative ARF incidence after femur fracture surgery in patients over 65 years was 24.44%. By analyzing the stratification based on the RIFLE classification, the incidence was categorized as Risk (R) = 21.11% and Injury (I) = 3.33%.

Different criteria of feed formulation for broilers aged 43 to 49 days

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Geochemical Study of the Itabirite Iron Ores of the Alegria Mine - Quadrilátero Ferrífero, Minas Gerais, Brazil

The iron ores of Alegria mine are composed of itabirites enclosing minor bodies of high-grade ores. The itabirites are classified according to mineralogical composition in five types: martite-rich, goethite-rich, specularite-rich, magnetite-rich and anphibolite-rich ores. The hematites are martite-rich, magnetite-rich, specularite-rich and more rarely, amphibolite-rich. Other classification criteria of the ores are based on the physical properties and the degree of compaction. As such, the itabirites and hematites can be classified as hard, friable and soft types. The mineralogical/textural evolution of the ores is linked to the pressure and temperature conditions that accompanied the tectonic processes in anphibolite facies and the different degrees of subsequent surficial weathering processes. Petrographic and microstructural studies indicate that the magnetite and amphibole bearing itabirites represent the parent rocks that created the other itabirites and that the specularite itabirites and the hard martite types are related to silica dissolution and redeposition in zones of high and low strain. Most of itabirites ores correspond to chert oxide facies banded iron formation, except the goethite and amphibole bearing itabirite that resemble a silicate or oxide-silicate facies with minor carbonate impurities. The great mass and pods of soft martite itabirites are probably shaley oxide facies BIFs with little volcanic contribution. Trace element contents of the Alegria's itabirites show strong dissimilarities with BIFs associated with volcanism (Algoma type), but closely ressemble to the Lake Superior type, with high content in Cr, Co and low V, Ni, Cu and Zn. Although the absolute contents of REE present in the Alegria's itabirites are, in general very low, the pattern when normalised by NASC is similar to the great majority of the Archean and Paleoproterozoic BIFs elsewhere in the world, and characterised by positive Eu anomaly.

Distribuição, tamanho populacional, hábitat e conservação do bicudinho-do-brejo Stymphalornis acutirostris Bornschein, Reinert e Teixeira, 1995 (Thamnophilidae)

The Marsh Antwren (Stymphalornis acutirostris) is restricted to the lowlands between Antonina Bay, in the coastal plain of the state of Paraná, and Itapocu river, in the northern coastal plain of the state of Santa Catarina (from 0 to c. 5 m a.s.l.). It doesn't occur continuously in this region, being found in eight populations that span over an total area of about 6,060 ha (= area of occupancy; 4,856.67 in Paraná and c. 1,200 in Santa Catarina). Nine habitat types used by the Marsh Antwren were defined, based on vegetation physiognomy, localization, dominancy of botanical species, dominant life-form and history of the region. Five of these are herbaceous (marshes), while four have an upper arboreal stratum and an herbaceous lower stratum with marsh plants. According to the classification criteria of the Brazilian vegetation proposed by the Radambrasil Project, they were classified as Pioneering Formation of Fluvial Influence, Pioneering Formation of Fluvial-marine Influence, and/or Pioneering Formation of Lacustrine Influence. They occur as patches or narrow strips ranging from 0.001 to 203.0 ha in the state of Paraná. They are found mainly in the interior of bays, in the lower courses of rivers that drain into bays, in alluvial plains, and between sand dunes in the coastal plain. Characteristic herbaceous species are cattail (Typha domingensis), bulrush (Scirpus californicus), Crinum salsum, Panicum sp. cf. P. mertensii, saw grass (Cladium mariscus) and Fuirena spp. Hibiscus pernambucensis is the characteristic bush species, and Calophyllum brasiliense, Tabebuia cassinoides, Annona glabra and Laguncularia racemosa are the characteristic arboreal species. The Marsh Antwren lives in herbaceous vegetation, but also uses bushes and branches of small tress. It has low flight capacity and a single flight of more than 25 m was never recorded. Territories of 0.25 ha were estimated in one kind of habitat (tidal marsh) (= 8 individuals per hectare) and of 3.2 ha in another one (saw grass marsh) (= 0.62 individual per hectare). The global population estimate is of about 17,700 mature individuals (13,700 in Paraná and 4,000 in Santa Catarina). The species is really under threat of extinction, mainly because of it's restricted geographical distribution and habitat loss by human activities and biological contamination caused by invasion of exotic grasses (Urochloa arrecta and Brachiaria mutica).

Potencial hidromineral das águas hipertermais do sistema aquífero Guarani no Estado de São Paulo

Pós-graduação em Geociências e Meio Ambiente - IGCE

Critical analysis of the international classification of headache disorders diagnostic criteria (ICHD I-1988) and (ICHD II-2004), for migraine in children and adolescents

The present study analyzed the (ICHD I-1988) and ( ICHD II-2004) diagnostic criteria in children and adolescents. Our population consisted of 496 patients of the Headache Outpatient Ward for Children and Adolescents retrospectively studied from 1992 to 2002. Individuals were classified according to three diagnostic groups: Intuitive Clinical Diagnosis ( Gold Standard), ICHD I-1988 and ICHD II-2004. They were statistically compared using the variables: Sensitivity ( S), Specificity (Sp), Positive Predictive Value (PPV), Negative Predictive Value (NPV). When ICHD I-1988 was used, the sensitivity of migraine without and with aura was 21% and 27%, respectively, whereas in ICHD II-2004 it changed to 53% and 71% without affecting specificity. As a conclusion, the current classification criteria ( ICHD II-2004) showed greater sensitivity and high specificity for migraine than ICHD I-1988, although it improved migraine diagnosis in children and adolescents, the sensitivity remains poor.

Classificação morfológica e imunostoquímica em microarranjo de tecido (TMA) de linfomas não-Hodgkin em cães conforme os critérios da Histological Classification od Hematopoietic Tumors of Domestic Animals (WHO)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Traumatic subdural hygromas: Proposed pathogenesis based classification

Background: Traumatic subdural hygroma (TSHy) is an accumulation of cerebrospinal fluid (CSF) in the subdural space after head injury. It appears to be relatively common, but its onset time and natural history are not well defined. Considered a benign epiphenomenon of trauma, the pathogenesis of TSHy is still unclear and many questions remain unanswered. This study adds to the information on TSHy, and proposes a classification based on pathogenesis.Methods: Thirty-four consecutive adult patients with TSHy were analyzed for clinical evolution and serial CT scan, during a period of several months. TSHy diagnosis was based on published CT scan criteria of hypodense subdural collection after trauma, without enhancement and neomembrane, with a minimum distance of 3 mm between the skull and brain. Ventricle size was analyzed by calculating the bicaudate index (BCI). For comparison, the BCI was measured from CT scan at three moments: admission, at time of TSHy diagnosis, and from last CT scan.Results: There were 34 patients, aged between 16 and 85 years (mean 40), half of them were below 40 years. Road traffic crashes were the main cause of head injury. The mean time for hygroma diagnosis was 9 days. Twenty-one patients (61.8%) underwent conservative treatment for TSHy and 13 (38.2%), surgical treatment. TSHy are early lesions and can be detected in the first 24 hours after trauma, usually as small subdural effusion (SSEff). Based on clinical and CT scan findings, we divided the 34 patients into 3 groups, (Ia and Ib) without evident mass effect and (II) with evident mass effect. Group Ia includes patients without ventricle dilation; Ib, patients with associated ventricle dilations.Conclusions: SSEff detected in the first 24 hours posttrauma in our series evolved into TSHy suggesting that this is an early lesion; all THSy were divided in three groups according to the pathophysiologic mechanism. These three groups probably represent a continuum of CSF absorption impairment. Group la represents what most authors consider a simple hygroma, with no impairment on CSF absorption. Group Ib represent the external hydrocephalus form with various degrees of CSF imbalance, and group II were the cases presenting marked mass effect.

EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part I: Overall methodology and clinical characterisation

Objectives To report methodology and overall clinical, laboratory and radiographic characteristics for Henoch-Schonlein purpura (HSP), childhood polyarteritis nodosa (c-PAN), c-Wegener granulomatosis (c-WG) and c-Takayasu arteritis (c-TA) classification criteria.Methods The preliminary Vienna 2005 consensus conference, which proposed preliminary criteria for paediatric vasculitides, was followed by a EULAR/PRINTO/PRES-supported validation project divided into three main steps. Step 1: retrospective/prospective web-data collection for HSP, c-PAN, c-WG and c-TA, with age at diagnosis <= 18 years. Step 2: blinded classification by consensus panel of a subgroup of 280 cases (128 difficult cases, 152 randomly selected) enabling expert diagnostic verification. Step 3: Ankara 2008 Consensus Conference and statistical evaluation (sensitivity, specificity, area under the curve, kappa-agreement) using as 'gold standard' the final consensus classification or original treating physician diagnosis.Results A total of 1183/1398 (85%) samples collected were available for analysis: 827 HSP, 150 c-PAN, 60 c-WG, 87 c-TA and 59 c-other. Prevalence, signs/symptoms, laboratory, biopsy and imaging reports were consistent with the clinical picture of the four c-vasculitides. A representative subgroup of 280 patients was blinded to the treating physician diagnosis and classified by a consensus panel, with kappa-agreement of 0.96 for HSP (95% CI 0.84 to 1), 0.88 for c-WG (95% CI 0.76 to 0.99), 0.84 for c-TA (95% CI 0.73 to 0.96) and 0.73 for c-PAN (95% CI 0.62 to 0.84), with an overall. of 0.79 (95% CI 0.73 to 0.84).Conclusion EULAR/PRINTO/PRES propose validated classification criteria for HSP, c-PAN, c-WG and c-TA, with substantial/almost perfect agreement with the final consensus classification or original treating physician diagnosis.

DUCTAL CARCINOMA IN-SITU OF THE BREAST - HISTOLOGIC CATEGORIZATION AND ITS RELATIONSHIP TO PLOIDY AND IMMUNOHISTOCHEMICAL EXPRESSION OF HORMONE RECEPTORS, P53, AND C-ERBB-2 PROTEIN

Background. Ductal carcinoma in situ (DCIS) of the breast has been diagnosed increasingly since the advent of mammography. However, the natural history of these lesions remains uncertain. Ductal carcinoma in situ of the breast does not represent a single entity but a heterogeneous group with histologic and clinical differences. The histologic subtype of DCIS seems to have an influence on its biologic behavior, but there are few studies correlating subtype with biologic markers.Methods. The authors studied a consecutive series of 40 cases of DCIS and after its histologic categorization verified its relationship with ploidy using image analysis and analyzing estrogen receptor (ER), progesterone receptor (PR), p53 and c-erbB-2 expression using immunohistochemistry.Results. The three groups proposed according to the grade of malignancy were correlated significantly with some of the additional parameters studied, including aneuploidy and c-erB-2 expression. Aneuploidy was detected in 77.5% of cases of DCIS mainly in high and intermediate grade subtypes (100% and 80% vs. 35.7% in low grade) whereas immunoreactivity for c-erbB-2 was detected in 45% of cases of DCIS mainly in the high grade group. Expression of ER and PR were observed frequently in this study (63.9% and 65.7% respectively), but without correlation with the histologic subtype of DCIS, although we found a somewhat significant association between high grade DCIS and lack of ER. p53 protein expression was detected in 36.8% of these cases, but no relationship between this expression and histologic subtype or grading of DCIS was found.Conclusions. These results provide further evidence for the morphologic and biologic heterogeneity of DCIS. Besides histologic classification and nuclear grading, some biologic markers such as aneuploidy and c-erbB-2 expression constitute additional criteria of high grade of malignancy.

Assessment of health-related quality of life in children with functional defecation disorders

Objective: To evaluate the health-related quality of life in children with functional defecation disorders. Methods: One hundred children seen consecutively were enrolled and subdivided into three subsets according to the Roma II classification criteria: functional constipation (n = 57), functional fecal retention (n = 29) and nonretentive functional soiling (n = 14). The generic instrument Child Health Questionnaire - Parent Form 50 (CHQ-PF50®), was used to measure quality of life and to assess the impact of these disorders from the point of view of parents. The instrument measures physical and psychosocial wellbeing in 15 health domains, each of which is graded on a scale from 0 to 100, with higher values indicating better health and greater wellbeing. Ten of these are then used to obtain two aggregated and summary scores: the physical and psychosocial scores. Results: No statistically significant differences were detected between subsets in terms of demographic or anthropometric characteristics. In 14 domains, children with defecation disorders scored lower than healthy children. When subsets were compared, statistically significant differences were detected between children with nonretentive functional soiling (lower scores) and those with functional constipation. Physical and psychosocial scores for the entire sample were lower than those for the group of healthy children used as controls. Conclusions: The CHQ-PF50® was considered adequate for demonstrating compromised quality of life in children with functional defecation disorders, as has been reported for other diseases, being a useful tool for making treatment decisions and for patient follow-up. Copyright © 2006 by Sociedade Brasileira de Pediatria.

Interferences and interventions after acute myocardial infarction: an integrative review of the literature

Objective: to identify the interference of acute myocardial infarction (AMI) in the quality of life of affected, interventions and understanding by health professionals. Method: an integrative review, aiming to answer << What are the interference in the quality of life of post-AMI customers? >> and << What are the interventions proposed in order to minimize them? >>. We selected 12 articles available in the LILACS database, between 2000 and 2011, based on the criteria of inclusion and exclusion. Results: we have selected a total of 12 articles selected according to the inclusion and exclusion criteria pre-established. We obtained a classification into two themes (1) interference with quality of life and (2) proposals for interventions to minimize interference. Conclusions: highlights the importance of patient involvement in care plan well structured, multidisciplinary team integration and quantity of publications by heterogeneous country on the subject.

Use of classification in organizing and searching the web

The traditional characteristics and challenges for organizing and searching information on the World Wide Web are outlined and reviewed. The classification features of two of these methods, such as Google, in the case of automated search engines, and Yahoo! Directory, in the case of subject directories are analyzed. Recent advances in the Semantic Web, particularly the growing application of ontologies and Linked Data are also reviewed. Finally, some problems and prospects related to the use of classification and indexing on the World Wide Web are discussed, emphasizing the need of rethinking the role of classification in the organization of these resources and outlining the possibilities of applying Ranganathan's facet theories of classification.