58 resultados para year three


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Background: Past studies have shown that mean values of Interleukin-6 (IL-6) and C-reactive protein (CRP) do not change significantly in COPD patients over a one-year period. However, longer period follow-up studies are still lacking. Thus, the aim of this study is to evaluate plasma CRP and IL-6 concentration over three years in COPD patients and to test the association between these inflammatory mediators and disease outcome markers. Methods: A cohort of 77 outpatients with stable COPD was evaluated at baseline, and 53 (mean FEV1, 56% predicted) were included in the prospective study. We evaluated Interleukin-6 (IL-6), C-reactive protein (CRP), six-minute walking distance (6MWD), and body mass index (BMI) at baseline and after three years. Plasma concentration of IL-6 was measured by high sensitivity ELISA, and CRP was obtained by high sensitivity particle-enhanced immunonephelometry. Results: IL-6 increased significantly after 3 years compared to baseline measurements [0.8 (0.5-1.3) vs 2.4 (1.3-4.4) pg/ml; p < 0.001] and was associated with worse 6MWD performance. In the Cox regression, increased IL-6 at baseline was associated with mortality [Hazard Ratio (95% CI) = 2.68 (0.13, 1.84); p = 0.02]. CRP mean values did not change [5 (1.6-7.9) vs 4.7 (1.7-10) pg/L; p = 0.84], although eleven patients (21%) presented with changes >3 mg/L in CRP after 3 years. Conclusions: The systemic inflammatory process, evaluated by IL-6, seems to be persistent, progressive and associated with mortality and worse physical performance in COPD patients. Trial registration: No.:NCT00605540. © 2013 Ferrari et al; licensee BioMed Central Ltd.

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Objectives: The objective of this study was to apply low-level laser therapy (LLLT) to accelerate the recovery process of a child patient with Bell's palsy (BP). Design: This was a prospective study. Subject: The subject was a three-year-old boy with a sudden onset of facial asymmetry due to an unknown cause. Materials and methods: The low-level laser source used was a gallium aluminum arsenide semiconductor diode laser device (660 nm and 780 nm). No steroids or other medications were given to the child. The laser beam with a 0.04-cm2 spot area, and an aperture with approximately 1-mm diameter, was applied in a continuous emission mode in direct contact with the facial area. The duration of a laser session was between 15 and 30 minutes, depending on the chosen points and the area being treated. Light was applied 10 seconds per point on a maximum number of 80 points, when the entire affected (right) side of the face was irradiated, based on the small laser beam spot size. According to the acupuncture literature, this treatment could also be carried out using 10-20 Chinese acupuncture points, located unilaterally on the face. In this case study, more points were used because the entire affected side of the face (a large area) was irradiated instead of using acupuncture points. Outcome measures: The House-Brackmann grading system was used to monitor the evolution of facial nerve motor function. Photographs were taken after every session, always using the same camera and the same magnitude. The three-year-old boy recovered completely from BP after 11 sessions of LLLT. There were 4 sessions a week for the first 2 weeks, and the total treatment time was 3 weeks. Results: The result of this study was the improvement of facial movement and facial symmetry, with complete reestablishment to normality. Conclusions: LLLT may be an alternative to speed up facial normality in pediatric BP. © Copyright 2013, Mary Ann Liebert, Inc. 2013.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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

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The objective of this study was to evaluate performance and daytime ingestive behavior of 84 Nellore young bulls in the post-weaning phase kept on Brachiaria brizantha cv. Marandu pastures during the dry season. Treatments were protein mineral supplementation (1 g/kg body weight) and protein+energy mineral supplementation (3 g/kg body weight). The experimental area comprised 12 paddocks in a total area of 27.36 ha, divided in two blocks of six paddocks each, having three replications per treatment in each block, with 42 animals/treatment. The data were subjected to variance analysis with repeated measures over time via procedure PROCMIXED of SAS (Statistical Analysis System, version 9.0) and means were compared by the Tukey test at 5% probability. The initial average weight of animals was 204.8 kg; final weights were 260.9 and 276.9 kg for animals that received protein and protein+energy supplement, respectively. The forage availability, sward height and stocking rate values did not differ with supplementation, but they showed difference between the experimental periods. The average time spent grazing during daylight of animals fed protein+energy supplement was shorter as compared with those which consumed protein supplement. Animals kept under the same pasture conditions during the dry season show better performance when they receive protein+energy supplement than protein supplement.

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Background: the incidence of perioperative cardiac arrest and mortality in children is higher than in adults. This survey evaluated the incidence, causes, and outcome of perioperative cardiac arrests in a pediatric surgical population in a tertiary teaching hospital between 1996 and 2004.Methods: the incidence of cardiac arrest during anesthesia was identified from an anesthesia database. During the study period, 15 253 anesthetics were performed in children. Data collected included patient demographics, surgical procedures (elective, urgent, or emergency), ASA physical status classification, anesthesia provider information, type of surgery, surgical areas, and outcome. All cardiac arrests were reviewed and grouped by the cause of arrest and death into one of four groups: totally anesthesia-related, partially anesthesia-related, totally surgery-related, or totally child disease or condition-related.Results: There were 35 cardiac arrests (22.9 : 10 000) and 15 deaths (9.8 : 10 000). Major risk factors for cardiac arrest were neonates and children under 1 year of age (P < 0.05) with ASA III or poorer physical status (P < 0.05), in emergency surgery (P < 0.05), and general anesthesia (P < 0.05). Child disease/condition was the major cause of cardiac arrest or death (P < 0.05). There were seven cardiac arrests because of anesthesia (4.58 : 10 000) - four totally (2.62 : 10 000) and three partially related to anesthesia (1.96 : 10 000). There were no anesthesia attributable deaths reported. The main causes of anesthesia attributable cardiac arrest were respiratory events (71.5%) and medication-related events (28.5%).Conclusions: Perioperative cardiac arrests were relatively higher in neonates and infants than in older children with severe underlying disease and during emergency surgery. The fact that all anesthesia attributable cardiac arrests were related to airway management and medication administration is important in prevention strategies.

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Nonalcoholic fatty liver disease (NAFLD) is a clinical-pathological syndrome that encompasses a wide spectrum of morphologic alterations, ranging from simple hepatic steatosis to a more severe stage, known as nonalcoholic steatohepatitis (NASH). The purpose of this clinical report was to contribute to the understanding of mitochondrial alterations in NAFLD. The child (13-month-old) underwent initial biopsy in the year 2000 and was diagnosed with diffuse macro and microvesicular steatosis. Two additional biopsies were performed in 2001 and 2004. A high percentage of microvesicular steatosis was observed in the biopsies performed in 2000 and 2001. Mitochondrial size was slightly increased in the biopsy performed in the year 2000, significantly increased in 2001 and decreased in 2004. The presence of "mitochondrial hypertrophy" in the hepatocytes of an asymptomatic pediatric patient whose disease presentation was typical of NAFLD, excluding other pathological processes, allowed us to suspect that such a defect was considered the primary mitochondrial disorder.

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Objectives. To describe the changes in the use of maternal and child health care services by residents of three municipalities-Embu, Itapecerica da Serra, and Taboao da Serra-in the São Paulo metropolitan area, 12 years after the implementation of the Unified Health System (SUS) in Brazil, and to analyze the potential of population-based health care surveys as sources of data to evaluate these changes.Methods. Two population-based, cross-sectional surveys were carried out in 1990 and 2002 in municipalities located within the São Paulo metropolitan area. For children under 1 year of age, the two periods were compared in terms of outpatient services utilization and hospital admission; for the mothers, the periods were compared in terms of prenatal care and deliveries. In both surveys, stratified and multiple-stage conglomerate sampling was employed, with standardization of interview questions.Results. The most important changes observed were regarding the location of services used for prenatal care, deliveries, and hospitalization of children less than 1 year of age. There was a significant increase in the use of services in the surrounding region or hometown, and decrease in the utilization of services in the city of São Paulo (in 1990, 80% of deliveries and almost all admissions for children less than 1 year versus 32% and 46%, respectively, in 2002). The use of primary care units and 24-hour walk-in clinics also increased. All these changes reflect care provided by public resources. In the private sector, there was a decrease in direct payments and payments through company-paid health insurance and an increase in payments through self-paid health insurance.Conclusions. The major changes observed in the second survey occurred simultaneous to the changes that resulted from the implementation of the SUS. Population-based health surveys are adequate for analyzing and comparing the utilization of health care services at different times.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Restricted breeding seasons used in beef cattle produce censored data for reproduction traits measured in regard to these seasons. To analyze these data, adequate methods must be used. The objective of this paper was to compare three approaches aiming to evaluate sexual precocity in Nellore cattle. The final data set contained 6699 records of age at first conception (AFC14) (in days) and of heifer pregnancy (HP14) (binary) obtained from females exposed to the bulls for the first time at about 14 months of age. Records of females that did not calve in the following year after being exposed to a sire were considered censored (77.5% of total). The models used to obtain genetic parameters and expected progeny differences (EPDs) were a Weibull mixed and a censored linear model for AFC14 and threshold model for HP14. The mean heritabilities obtained were 0.76 and 0.44, respectively, for survival and censored linear models (for AFC14), and 0.58 for HP14. Ranking and Pearson correlations varied (in absolute values) from 0.54 to 0.99 (considering different percentages of sires selected), indicating moderate changes in the classification. Considering survival analysis as the best selection criterion (that would result in the best response to selection), it was observed that selection for HP14 would lead to a more significant decrease in selection response if compared with selection for AFC14 analysed by censored linear model, from which results were very similar to the survival analysis.

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Clinical practice has shown that most avulsed teeth are replanted after an extra-alveolar time that compromises the prognosis of replantation. In cases of delayed replantation, the use of adequate media for storage and transportation of the avulsed teeth may improve this prognosis considerably. Difficulties inherent to accidental dental avulsion include the lack of immediate access to ideal storage media, which accentuates the importance of saliva as a viable and readily available option. The authors report the case of an accidentally avulsed permanent maxillary central incisor that was kept into the patient's oral cavity from the moment of trauma until its replantation, 90 min later. Three years of follow-up revealed absence of root resorption, ankylosis or abnormal mobility, which demonstrates the feasibility of keeping avulsed teeth in saliva, at least when more indicated storage media are not available immediately.

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Avaliaram-se o desenvolvimento e a sobrevivência dos estágios de vida livre de Haemonchus contortus em fezes obtidas de ovinos infectados por esse nematódeo, depositadas nas quatro estações do ano, em pastagens de três espécies de gramíneas (Brachiaria decumbens cv Australiana, Cynodon dactylon cv. Coast-cross e Panicum maximum cv. Aruana), com duas alturas (5cm e 30cm) no momento da deposição das fezes. Amostras de fezes e de capim foram coletadas uma, duas, quatro, oito, 12 e 16 semanas após a deposição das fezes e processadas em laboratório, para recuperação de larvas infectantes. O maior número de larvas infectantes foi recuperado das amostras de capim e de fezes nas pastagens com 30cm de altura. As condições climáticas que mais favoreceram o desenvolvimento e a sobrevivência das larvas nas fezes, bem como a sobrevivência e a manutenção das larvas no capim foram aquelas com temperaturas médias em torno de 17ºC, acompanhadas de baixas precipitações pluviométricas. As temperaturas mais altas e as precipitações elevadas, que ocorrem na chamada estação das águas, foram desfavoráveis para a recuperação de larvas infectantes da pastagem. de forma geral, a pastagem de Aruana foi a que possibilitou as maiores recuperações de larvas.

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Population and reproductive biology were studied in three populations of the crab Uca burgersi Holthuis, 1967, in the Indaia, Cavalo and Ubatumirim mangrove forests (Ubatuba, São Paulo State, Brazil). Crabs were collected during low tide (August 2001 through July 2002), by digging the sediment, with a standard capture effort (two persons for 30 min.). Carapace width was measured, and gonad developmental stage was recorded from all specimens. U. burgersi was most abundant in the Cavalo mangrove, where the largest mate was found. Juvenile crabs were found year-round at all three sites. However, the ratio of ovigerous females was very low, even null in the Cavalo mangrove. The gonad development rate indicated that U. burgersi was reproducing continuously, but more intensively during spring and summer, with recruitment occurring in winter. The synchrony between the populational and reproductive biology in the three areas showed that local features were not the limiting factors. It is suggested that this species is a habitat generalist.

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Strains belonging to three novel yeast species, Candida heliconiae (four isolates), Candida picinguabensis (three isolates) and Candida saopaulonensis (two isolates), were recovered in the year 2000 from water of flower bracts of Heliconia velloziana L. Emigd. (Heliconiaceae) found in a forest ecosystem site in an Atlantic rainforest of south-eastern Brazil. C. picinguabensis and C. saopaulonensis were nearly identical in morphology and physiology, but sequence divergence in the D1/D2 domain of the large-subunit rDNA indicated that they should be regarded as different species. They belong to the Metschnikowiaceae clade. C. heliconiae had affinities to Pichia mexicana and related species, but was genetically isolated from all currently accepted species in that group. The type strains are C. heliconiae UNESP 00-91 C1(T) (= CBS 10000(T) = NRRL Y-27813(T)), C. picinguabensis UNESP 00-89(T) (= CBS 9999(T) = NRRL Y-27814(T)) and C. saopaulonensis UNESP 00-99(T) (=CBS 10001(T) = NRRL Y-27815(T)).

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)