Nutritional parameters are associated with mortality in acute kidney injury

OBJECTIVE: The objective of this study was to perform a nutritional assessment of acute kidney injury patients and to identify the relationship between nutritional markers and outcomes.METHOD: This was a prospective and observational study. Patients who were hospitalized at the Hospital of Botucatu School of Medicine were evaluated between January 2009 and December 2011. We evaluated a total of 133 patients with a clinical diagnosis of acute kidney injury and a clinical presentation suggestive of acute tubular necrosis. We explored the associations between clinical, laboratory and nutritional markers and in hospital mortality. Multivariable logistic regression was used to adjust for confounding and selection bias.RESULTS: Non-survivor patients were older (67 +/- 14 vs. 59 +/- 16 years) and exhibited a higher prevalence of sepsis (57.1 vs. 21.4%) and higher Acute Tubular Necrosis-Individual Severity Scores (0.60 +/- 0.22 vs. 0.41 +/- 0.21) than did survivor patients. Based on the multivariable analysis, laboratorial parameters such as blood urea nitrogen and C-reactive protein were associated with a higher risk of death (OR: 1.013, p = 0.0052; OR: 1.050, p = 0.01, respectively), and nutritional parameters such as low calorie intake, higher levels of edema, lower resistance based on bioelectrical impedance analysis and a more negative nitrogen balance were significantly associated with a higher risk of death (OR: 0.950, p = 0.01; OR: 1.138, p = 0.03; OR: 0.995, p = 0.03; OR: 0.934, p = 0.04, respectively).CONCLUSIONS: In acute kidney injury patients, a nutritional assessment seems to identify nutritional markers that are associated with outcome. In this study, a low caloric intake, higher C-reactive protein levels, the presence of edema, a lower resistance measured during a bioelectrical impedance analysis and a lower nitrogen balance were significantly associated with risk of death in acute kidney injury patients.

A single bout of exercise with a flexible pole induces significant cardiac autonomic responses in healthy men

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

Treatment of osteochondral injuries with platelet gel

OBJECTIVES: Treatments for injured articular cartilage have not advanced to the point that efficient regeneration is possible. However, there has been an increase in the use of platelet-rich plasma for the treatment of several orthopedic disorders, including chondral injuries. Our hypothesis is that the treatment of chondral injuries with platelet gel results in higher-quality repair tissue after 180 days compared with chondral injuries not treated with gel.METHODS: A controlled experimental laboratory study was performed on 30 male rabbits to evaluate osteochondral injury repair after treatment with or without platelet gel. Osteochondral injuries were surgically induced in both knees of each rabbit at the medial femoral condyle. The left knee injury was filled with the platelet gel, and the right knee was not treated. Microscopic analysis of both knee samples was performed after 180 days using a histological grading scale.RESULTS: The only histological evaluation criterion that was not significantly different between treatments was metachromasia. The group that was treated with platelet gel exhibited superior results in all other criteria (cell morphology, surface regularity, chondral thickness and repair tissue integration) and in the total score.CONCLUSION: The repair tissue was histologically superior after 180 days in the study group treated with platelet gel compared with the group of untreated injuries.

Diagnóstico de gestação em cadelas: aspectos radiográficos e ultrassonográficos

The modernization of image equipaments associate to the veterinary professionals qualification allowed an advance in diagnosis veterinary medicine, and, consequently, in premature pregnancy diagnosis in bitches. Currently, owners and creators search for information related to pregnancy detection, fetal development and viability and litter size determination. Through diagnosis methods as radiology and ultrasonography, associated to clinics aspects, the diagnosis of early pregnancy become more acurated and precise, allowing more quality in the accompaniment of prenatal of these bitches. Ultrasonographic exams help the accompaniment of these pregnancies through of visuals recourses, which can supply information related to pregnancy detection, embrionary and fetal development, fetal viability e litter size determination through fetals mensurations. The radiographic study has as principal indication the fetal counting, and has been the most acurated for this analyses. It may be done after the da s after the luteini ing hormone surge, when occurs the fetal mineralization. Due to its importance in the present time and in small animals clinic, the objective of this study is to discuss the main radiographics and ultrassonographics aspects of the diagnosis of pregnancy in bitches

Valores hematológicos em Geochelone carbonária (Jabuti)

Hematology has a great importance in assessing the health of all animals, including reptiles, since it aids in the diagnosis of certain diseases and help to monitor patient's clinical evolution, although studies and articles in this area are rare, even with the increasing number of calls of these animals in veterinary clinics. Moreover, there are a lot of environmental and individual factors, which influence the hematological values of this group, such as age, sex, stress levels, nutrient levels and season which the exam was made, among others. For these reasons studies that aimed to evaluate the reference values of some specie, are essential to increase the knowledge in the field and to assist on the clinical approach. This paper aim’s to study the patterns of Hematology of Tortoise (Geochelone carbonaria) seeking the greater knowledge of clinical pathology of this species and increasing the possibilities for diagnosis, monitoring clinical outcome, and assessment of the general state and treatment

Dosimetria Física e Controle de Qualidade em Radioterapia

Radiotherapy is a multidisciplinary speciality which uses complex equipment and radiation sources for delivery of treatment, using high-energy ionizing radiation to treat cancer at several stages of complexity. Since radiation therapy is a technique which involves a precalculated radiation dose, it shall be established quality assurance programs that provide an efficient and safety treatment. The International Commission on Radiation Units and Measurements (ICRU) report No. 50 has recommended dose uniformity between 5% of the prescribed dose throughout the region of interest. This is one of the most primordial points that justify the importance of a suitable attendance of the equipments quality and performance. For quality control, the medical physicist will be involved with establishing and running a Quality Control Program (QCP). He must adapt or develop the procedures of equipment acceptance and commissioning, besides verifying the use of principles and accepted protocols of national and international reports to assure the correct quality, quantity, and placement of radiation during the performance of a radiological procedure, establishing adequate protocols to ensure accurate patient dosimetry. This present work consists of a description of the activities carried through the Sectors of Radiation Therapy of the Hospital of Clinics of the Campinas State University (Unicamp), particularly in the implementation of the Quality Control Program

Fístula infraorbitária associada à doença periodontal em cães

Veterinary Dentistry has grown considerably in recent years. This growth, associated to increase of knowledge among pet owners regarding responsible ownership of their pets, resulted in growing concern about the oral health of the animals that already can be observed at veterinary clinics. Among the oral diseases in dogs, infraorbital fistula, so called carnassial” fistula, is a periapical osteolytic lesion of the fourth premolar (4 SPM), often associated with periodontal disease. In its early stages, is characterized clinically by a swelling in the region of the jawbone before the formation of the fistula and leakage of a liquid serosanguineous or purulent secretion. Because of these clinical features, it is often misdiagnosed as a skin condition unrelated to the teeth. It is very important to obtain intraoral radiographs to confirm the diagnosis for performing the most appropriate treatment, according to the cause of the injury

Análise do Mapa da Cadeia de Valor em um Hospital do Vale do Paraíba

The Lean Thinking is a method used by various industries in order to eliminate waste and ensure quality for the customer. In the current scenario, Lean has been used in other areas such as the hospital in which many tools are being adopted in order to improve its internal processes. One such tool is the Value Stream Mapping, which proved to be an effective tool in industrial environments, and is being adopted by several hospitals. Thus, this paper presents a case study on the use of this tool in a sector of a hospital in the Vale do Paraíba, evaluating its importance, its impacts, positive and negative points and future projections. This is in the context of Lean Healthcare, a new model based on the principles of Lean Thinking which has been adopted by several hospitals and clinics throughout Brazil successfully

Aplicação dos princípios de radioproteção em medicina nuclear

The Nuclear Medicine is a medical specialty which uses different radioisotopes for diagnostic and therapeutic purposes. The isotopes are radioactive elements which are administered in vivo and present distribution to specific organs or cell types. The knowledge of radioactivity and notions related to ionizing radiation allow to contextualize the radiological protection measures to be taken in Nuclear Medicine. So it is possible to minimize unnecessary exposure to patients, the public, and individuals occupationally exposed and the environmental. For this it is necessary to relate the physical and technological bases apply to this mode with the standards established by regulatory agencies, including the CNEN (National Nuclear Energy Commission) and ANVISA (National Agency for Sanitary Vigilance). In this scenario, it is important that the theoretical endorse the activities which are periodically audited for verification of compliance with the standards that aim to radioprotection. One role of the Medical Physicist in these services is, therefore, act as Radiation Protection Supervisor exerting numerous activities and ensuring compliance with these standards. In this context the stage in the area of Nuclear Medicine was developed in many customers of the enterprise Rad Dimenstein & Associados LTDA, among them the hospitals Israelita Albert Einstein (HIAE), Nossa Senhora de Lourdes (HNSL), Santa Paula (HSP), Cruz Azul (CRAZ), Grupo Fleury, among other clinics. Following the routine and then carrying out various activities pertaining to the Medical Physicist in the area, it was noted that the measures and actions are extremely effective and fundamental in terms of radiological protection

Endoscopia do trato gastrointestinal de cães e gatos

Endoscopy of the gastrointestinal tract is a specialized minimally invasive diagnostic method and with both diagnostic and therapeutic possibilities. It is divided into two major groups, the rigid and flexible endoscopy. The first most widely used for visualization of body cavities that do not have a light, like the chest, for example, and the second for those with light as the gastrointestinal tract. In Brazil there are few professionals, veterinary hospitals or clinics that offer this type of service. Thus, endoscopy is an area of expertise of the veterinarian who is in huge expansion and has shown great applicability with excellent results in both clinical medicine and surgical small animals

Análise ergonômica de equipamentos odontológicos

This is study proposes to evaluate the ergonomic aspects of dental equipments. Based on the characteristics proposed by ISO/FDI, on the existing literature and related researches an evaluating system was devised. Thirty nine dental clinics were examined using the 165 pointssystem proposed, distributed in 12 criteria. None of the dental clinics examined showed a bad ergonomics level, 41% were good and 59% reached excellent levels. The point-supported evaluation system proposed is effective in the analysis of the ergonomic conditions of dental equipments, allowing a quantification of their characteristics. Using this system, the dentist can also know the level of ergonomic satisfaction existing in his equipment, and identify the conditions to be improved. It was concluded that the equipment belonging to dental workplaces evaluated had excellent level of compliance, however corrective measures are needed since even the presence of a few non-conforming items is a sufficient condition to cause injury to users, decreased efficiency and comfort and loss quality of service

Sistema de cálculo computacional da unidade monitora para feixes de elétrons em radioterapia

In radiation theraphy with electron beam, the electrons are produced in linear accelerators, and energy the most used have between 4MeV and 20MeV. Generally, the treatments are done for superficial injuries, because the low penetration of these particles. In this work a system for calculation of monitor units (U.M.) for cases of treatments with electron beam was developed. The Excel program of Microsoft was used and is easily found in the operational system of the personal microcomputers. In the Excel has been inserted the pertinent data of the linear accelerator of Varian, model 2100C, used in the Service of radiation theraphy of the Hospital of the Clinics of the College of Medicine of the UNESP of Botucatu. For some values of the physical parameters, such as: factors field and factors calibration, not supplied in the tests of acceptance of the machine, still proceeded calculations from interpolation and extrapolation. The mathematical formulas for automatic search of these and others factors used in the calculations of the determination of the U.M had been developed in agreement available routines in Excel. For this the functions had been used the function IF (that it imposes search condition) and the PROCH (that looks a value in a column from determined line), beyond the basic functions of addition, multiplication and division. It is intended to optimize the routine of the Services of radiation theraphy that perform through eletrontheraphy procedures, speeding the calculations and minimizing the occurrence of errors and uncertainties deriving of the maken a mistake manipulation of the parameters gotten in tables of data of electron beams

Retrospecto de lesões radiológicas da cabeça de cães e gatos

Pós-graduação em Cirurgia Veterinária - FCAV

O conceito de TDAF: concepções e práticas de profissionais da saúde e educação

Pós-graduação em Saúde Coletiva - FMB