Evolução de pacientes clínicos e cirúrgicos com injúria renal aguda

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo clínico e eletromiográfico da dinâmica do sistema mastigatório em pacientes adultos com paralisia cerebral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Farmacomagnetografia colônia: estudo in vitro da desintegração de comprimidos magnéticos revestidos

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

Avaliação da mortalidade e recuperação renal de pacientes com insuficiência renal aguda submetidos à diálise com diferentes níveis de uréia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos determinados pela amitriptilina, administrada pela via subaracnóidea, sobre a medula e as meninges: estudo experimental em cães

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudando geometria através de dobraduras

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Extended Daily Dialysis in Acute Kidney Injury Patients: Metabolic and Fluid Control and Risk Factors for Death

Intermittent hemodialysis (IHD) and continuous renal replacement therapies (CRRT) are used as Acute Kidney Injury (AKI) therapy and have certain advantages and disadvantages. Extended daily dialysis (EDD) has emerged as an alternative to CRRT in the management of hemodynamically unstable AKI patients, mainly in developed countries.Objectives: We hypothesized that EDD is a safe option for AKI treatment and aimed to describe metabolic and fluid control of AKI patients undergoing EDD and identify complications and risk factors associated with death.Study Selection: This is an observational and retrospective study describing introduction of EDD at our institution. A total of 231 hemodynamically unstable AKI patients (noradrenalin dose between 0.3 and 1.0 ucg/kg/min) were assigned to 1367 EDD session. EDD consisted of 6-8 h of HD 6 days a week, with blood flow of 200 ml/min, dialysate flows of 300 ml/min.Data Synthesis: Mean age was 60.6 +/- 15.8 years, 97.4% of patients were in the intensive care unit, and sepsis was the main etiology of AKI (76.2). BUN and creatinine levels stabilized after four sessions at around 38 and 2.4 mg/dl, respectively. Fluid balance decreased progressively and stabilized around zero after five sessions. Weekly delivered Kt/V was 5.94 +/- 0.7. Hypotension and filter clotting occurred in 47.5 and 12.4% of treatment session, respectively. Regarding AKI outcome, 22.5% of patients presented renal function recovery, 5.6% of patients remained on dialysis after 30 days, and 71.9% of patients died. Age and focus abdominal sepsis were identified as risk factors for death. Urine output and negative fluid balance were identified as protective factors.Conclusions: EDD is effective for AKI patients, allowing adequate metabolic and fluid control. Age, focus abdominal sepsis, and lower urine output as well as positive fluid balance after two EDD sessions were associated significantly with death.

Influência da terapia de contensão induzida na funcionalidade do membro superior de indivíduos hemiparéticos

Introduction: The Constraint-induced Movement Therapy (CIMT) is a therapeutic program which main goal is the functional recuperation of paretic upper extremity of stroke patients with motor deficits by an intensive treatment, practice of functional repetition and wear of restriction in non-paretic during 90% of the daily hours. Objective: The aim of this study was evaluate the CIMT influence on upper extremity function of hemiparetic individuals. Method: The CIMT was provided for 3 daily hours for 10 consecutive days. Besides, patients were asked to wear a restraint dispositive on the unaffected hand during 90% of their activities daily living hours. Before and after the intervention period, 2 tests were administered to evaluate motor function, the Motor Activity Log (MAL) and the Wolf Motor Function Test (WMFT). Results: The results of MAL showed significant difference in quantity (p=0,011) and quality (p=0,016) of paretic upper extremity movements. Analysis of WMFT indicated a significant reduction of time that patients performed the tasks (p= 0,042) and a difference for quality of movement (p<0,0001). Conclusion: The present results showed that CIMT improves upper extremity function in hemiparetic individuals.

Acupuntura no tratamento de discopatias intervertebrais em cães

The intervertebral disc disease is considered a major neurological disorder involving the spinal cord, being a disease commonly seen in dogs in clinical practice of small animals. The pathophysiology of most discopathies have not been fully elucidated, but it is known that the symptoms observed will depend on the severity of spinal cord compression and location of spinal injury, ranging from localized pain to complete paralysis. Through a detailed clinical examination and laboratory tests, we choose the most appropriate treatment for each patient, which can be conservative, through the use of anti-inflammatories, analgesics and acupuncture or surgical, through decompression techniques. Acupuncture, therapeutic method of ancient Chinese medicine, uses the stimulation of specific points on the body in order to balance the body's physiological. The action mechanism of acupuncture in discopathies has not been fully elucidated, but its analgesic effects, anti-inflammatory and restoration of sensory and motor function are known, showing results as good as surgical therapy

Qualidade de vida em portadores de paralisia cerebral: associação com nível funcional e aspectos sócio-demográficos

Pós-graduação em Saúde Coletiva - FMB

Electrical activity of the orbicularis muscles before and after installation of ocular prostheses

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

Influence of dental chair backrest inclination on the registration of the mandibular position

Varying the inclination of the dental chair backrest might alter the distribution of occlusal contact points. The purpose of this study was to identify the influence of backrest inclination on the registration of the mandibular position. Ten participants aged between 18 and 30 years with a complete permanent dentition, uncompromised motor function, no tooth mobility, and no temporomandibular disorders were selected. To register interocclusal contacts, an autopolymerizing methylmethacrylate device was adapted to the maxillary anterior teeth and a composite resin increment was added to the mandibular central incisors. Contacts were registered with the following variations in the inclination of the dental chair backrest: 90 degrees, 120 degrees, and 180 degrees. A standardized digital photograph was made of each mark in each backrest position, and the images were superimposed to measure the distances in registration from 90 to 120 and from 90 to 180 degrees. Data were analyzed with the Student paired t test (α=.05). When the chair was inclined from the 90-degree to the 120-degree position, the mandible was repositioned posteriorly by a mean of 0.67 mm, but the difference was not statistically significant. When the chair was inclined from the 90-degree to the 180-degree position, however, the mandible was repositioned posteriorly by a statistically significant mean of 1.41 mm. Mandibular position is influenced by increasing inclination, and this influence was statistically significant at a 180-degree incline.

Does spinal block through tattooed skin cause histological changes in nervous tissue and meninges?: an experimental model in rabbits

Although there is no documented evidence that tattoo pigments can cause neurological complications, the implications of performing neuraxial anesthesia through tattooed skin are unknown. In this study, we aimed to assess whether spinal puncture performed through tattooed skin of rabbits determines changes over the spinal cord and meninges. In addition, we sought to evaluate the presence of ink fragments entrapped in spinal needles. Thirty-six young male adult rabbits, each weighing between 3400 and 3900 g and having a spine length between 38.5 and 39 cm, were divided by lot into 3 groups as follows: GI, spinal puncture through tattooed skin; GII, spinal puncture through tattooed skin and saline injection; and GIII, spinal puncture through skin free of tattoo and saline injection. After intravenous anesthesia with ketamine and xylazine, the subarachnoid space was punctured at S1-S2 under ultrasound guidance with a 22-gauge 2½ Quincke needle. Animals in GII and GIII received 5 μL/cm of spinal length (0.2 mL) of saline intrathecally. In GI, the needle tip was placed into the yellow ligament, and no solution was injected into the intrathecal space; after tattooed skin puncture, 1 mL of saline was injected through the needle over a histological slide to prepare a smear that was dyed by the Giemsa method to enable tissue identification if present. All animals remained in captivity for 21 days under medical observation and were killed by decapitation. The lumbosacral spinal cord portion was removed for histological analysis using hematoxylin-eosin stain. None of the animals had impaired motor function or decreased nociception during the period of clinical observation. None of the animals from the control group (GIII) showed signs of injuries to meninges. In GII, however, 4 animals presented with signs of meningeal injury. The main histological changes observed were focal areas of perivascular lymphoplasmacyte infiltration in the pia mater and arachnoid. There was no signal of injury in neural tissue in any animal of both groups. Tissue coring containing ink pigments was noted in all GI smears from the spinal needles used to puncture the tattooed skin. On the basis of the present results, intrathecal injection of saline through a needle inserted through tattooed skin is capable of producing histological changes over the meninges of rabbits. Ink fragments were entrapped inside the spinal needles, despite the presence of a stylet.

Efeito do treinamento intradialítico resistido e aeróbio sobre a função cognitiva e capacidade funcional de pacientes em hemodiálise: estudo controlado

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Investment recovery period in electric motor of higher efficiency in pumping for irrigation

Neste trabalho, ajustou-se um modelo matemático para quantificar o efeito do rendimento do motor elétrico sobre os custos de um sistema de bombeamento para irrigação na estrutura tarifária de energia elétrica convencional e horo-sazonal verde, bem como calcular o tempo de recuperação do capital investido no equipamento de maior rendimento. em seguida, o mesmo foi aplicado a um sistema de irrigação tipo pivô central em duas opções de rendimento do motor elétrico: 92,6% (linha padrão) e 94,3% (linha alto rendimento), sendo que o custo de aquisição do primeiro correspondeu a 70% do segundo. A potência do motor elétrico era de 100 cv. Os resultados mostraram que o modelo permitiu avaliar se um motor de alto rendimento era viável economicamente em relação ao motor-padrão em cada estrutura tarifária. Nas duas estruturas tarifárias, o motor de alto rendimento não foi viável. Na tarifa horo-sazonal verde, somente seria viável se seu rendimento fosse 4,46% superior ao do motor-padrão. Na tarifa convencional, somente seria viável se o ganho de rendimento superasse 2,71%.