Continuous peritoneal dialysis compared with daily hemodialysis in patients with acute kidney injury

Background: In some parts of the world, peritoneal dialysis is widely used for renal replacement therapy (RRT) in acute kidney injury (AKI), despite concerns about its inadequacy. It has been replaced in recent years by hemodialysis and, most recently, by continuous venovenous therapies. We performed a prospective study to determine the effect of continuous peritoneal dialysis (CPD), as compared with daily hemodialysis (dHD), on survival among patients with AKI.Methods: A total of 120 patients with acute tubular necrosis (ATN) were assigned to receive CPD or dHD in a tertiary-care university hospital. The primary endpoint was hospital survival rate; renal function recovery and metabolic, acid-base, and fluid controls were secondary endpoints.Results: of the 120 patients, 60 were treated with CPD (G1) and 60 with dHD (G2). The two groups were similar at the start of RRT with respect to age (64.2 +/- 19.8 years vs 62.5 +/- 21.2 years), sex (men: 72% vs 66%), sepsis (42% vs 47%), shock (61% vs 63%), severity of AKI [Acute Tubular Necrosis Individual Severity Score (ATNISS): 0.68 +/- 0.2 vs 0.66 +/- 0.22; Acute Physiology and Chronic Health Evaluation (APACHE) II: 26.9 +/- 8.9 vs 24.1 +/- 8.2], pre-dialysis blood urea nitrogen [BUN (116.4 +/- 33.6 mg/dL vs 112.6 +/- 36.8 mg/dL)], and creatinine (5.85 +/- 1.9 mg/dL vs 5.95 +/- 1.4 mg/dL). In G1, weekly delivered Kt/V was 3.59 +/- 0.61, and in G2, it was 4.76 +/- 0.65 (p < 0.01). The two groups were similar in metabolic and acid-base control (after 4 sessions, BUN < 55 mg/dL: 46 +/- 18.7 mg/dL vs 52 +/- 18.2 mg/dL; pH: 7.41 vs 7.38; bicarbonate: 22.8 +/- 8.9 mEq/L vs 22.2 +/- 7.1 mEq/L). Duration of therapy was longer in G2 (5.5 days vs 7.5 days; p = 0.02). Despite the delivery of different dialysis methods and doses, the survival rate did not differ between the groups (58% in G1 vs 52% in G2), and recovery of renal function was similar (28% vs 26%).Conclusion: High doses of CPD provided appropriate metabolic and pH control, with a rate of survival and recovery of renal function similar to that seen with dHD. Therefore, CPD can be considered an alternative to other forms of RRT in AKI.

Continuous and gradual photo-activation methods: influence on degree of conversion and crosslink density of composite resins

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Predictive factors of outcome following staphylococcal peritonitis in continuous ambulatory peritoneal dialysis

Background and aims: Staphylococcus epidermidis and other coagulase-negative staphylococci (CoNS) are the most common agents of continuous ambulatory peritoneal dialysis (CAPD) peritonitis. Episodes caused by Staphylococcus aureus evolve with a high method failure rate while CoNS peritonitis is generally benign. The purpose of this study was to compare episodes of peritonitis caused by CoNS species and S. aureus to evaluate the microbiological and host factors that affect outcome. Material and methods: Microbiological and clinical data were retrospectively studied from 86 new episodes of peritonitis caused by staphylococci species between January 1996 and December 2000 in a university dialysis center. The influence of microbiological and host factors (age, sex, diabetes, use of vancomycin, exchange system and treatment time on CAPD) was analyzed by logistic regression model. The clinical outcome was classified into two results (resolution and non-resolution). Results: the odds of peritonitis resolution were not influenced by host factors. Oxacillin susceptibility was present in 30 of 35 S. aureus lineages and 22 of 51 CoNS (p = 0.001). There were 32 of 52 (61.5%) episodes caused by oxacillin-susceptible and 20 of 34 (58.8%) by oxacillin-resistant lineages resolved (p = 0.9713). of the 35 cases caused by S. aureus, 17 (48.6%) resolved and among 51 CoNS episodes 40 (78.4%) resolved. Resolution odds were 7.1 times higher for S. epidermidis than S. aureus (p = 0.0278), while other CoNS had 7.6 times higher odds resolution than S. epidermidis cases (p = 0.052). Episodes caused by S. haemolyticus had similar resolution odds to S. epidermidis (p = 0.859). Conclusions: S. aureus etiology is an independent factor associated with peritonitis non-resolution in CAPD, while S. epidermidis and S. haemolyticus have a lower resolution rate than other CoNS. Possibly the aggressive nature of these agents, particularly S. aureus, can be explained by their recognized pathogenic factors, more than antibiotic resistance.

Identification of continuous interaction sites in PLA(2)-based protein complexes by peptide arrays

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Optimisation of a continuous flash fermentation for butanol production using the response surface methodology

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

Density and Spatial Distribution of Buffy-tufted-ear Marmosets (Callithrix aurita) in a Continuous Atlantic Forest

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

How to not inflate population estimates? Spatial density distribution of white-lipped peccaries in a continuous Atlantic forest

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

EFFECTS of PREFERRED and NONPREFERRED MUSIC on CONTINUOUS CYCLING EXERCISE PERFORMANCE

The aim of this study was to investigate the effects of preferred and nonpreferred music on exercise distance, Heart Rate (HR), and Rating of Perceived Exertion (RPE) during continuous cycling exercise performed at high intensity Fifteen participants performed five test sessions During two sessions, they cycled with fixed workload on ergometer to determine the Critical Power (Cl') intensity Then, they performed three more sessions cycling at CP intensity listening to Preferred Music, listening to Nonpreferred Music, and No Music The HR responses in the exercise sessions did not differ among all conditions However, the RPE was higher for Nonpreferred Music than in the other conditions The performance under Preferred Music (9 8 +/- 4 6km) was greater than under Nonpreferred Music (7 1 +/- 3 5km) conditions Therefore, listening to Preferred Music during continuous cycling exercise at high intensity can Increase the exercise distance, and individuals listening to Nonpreferred Music can perceive more discomfort caused by the exercise

Muscle protein metabolism in neonatal alloxan-administered rats: effects of continuous and intermittent swimming training

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

Thermodynamics of a Peyrard-Bishop One-Dimensional Lattice with On-site Hump Potential

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Topography of funneled landscapes determines the thermodynamics and kinetics of protein folding

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

Experimental pathogenicity of Candida albicans and Candida dubliniensis with continuous and discontinuous fringes morphotypes

A possible correlation between the presence of discontinuous fringes and high virulence has been previously suggested. The aim of this study was to compare the pathogenicity of Candida albicans and Candida dubliniensis with continuous and discontinuous fringes morphotypes on mice. For C. albicans, two discontinuous fringe morphotype isolates (PN 69, PN 74), two continuous fringe morphotype isolates (N 60, N 33) and one reference strain were used. For C. dubliniensis, three discontinuous fringe morphotype isolates (97487, 97464, 97519), two continuous fringe morphotype isolates (97040, 98026) and one reference strain were used. Swiss male mice were inoculated with a standardised suspension of the microorganisms and observed for 35 days. The pathogenicity of the isolates was analysed according to parameters proposed previously. Three isolates were considered pathogenic: PN 74, N 60 and 98026. Strain N 60 killed the highest amount of mice (80%). Animals inoculated with C. albicans did not show differences on survival estimate. Candida dubliniensis 98026 was more pathogenic than samples 97464 and 97519. on the other hand, the sample 97487 showed a higher pathogenicity when compared with 97040 (Kaplan-Meier test, P = 0.008). Strains with continuous fringe morphotypes were also associated with Candida sp. virulence in vivo.

Thermodynamics of quasi-particles

We present in this work a generalization of the solution of Gorenstein and Yang to the inconsistency problem of thermodynamics for systems with a temperature dependent Hamiltonian. We show that there are, in principle, an infinite number of solutions.

Limits of validity for a semiclassical mean-field two-fluid model for Bose-Einstein condensation thermodynamics

We reinvestigate the Bose-Einstein condensation (BEC) thermodynamics of a weakly interacting dilute Bose gas under the action of a trap using a semi-classical two-fluid mean-field model in order to find the domain of applicability of the model. Such a model is expected to break down once the condition of diluteness and weak interaction is violated. We find that this breakdown happens for values of coupling and density near the present experimental scenario of BEG. With the increase of the interaction coupling and density the model may lead to unphysical results for thermodynamic observables. (C) 2000 Published by Elsevier B.V. B.V, All rights reserved.

New thought experiment to test the generalized second law of thermodynamics

We propose an extension of the original thought experiment proposed by Geroch, which sparked much of the actual debate and interest on black hole thermodynamics, and show that the generalized second law of thermodynamics is in compliance with it.