63 resultados para Variation of hospital medical costs


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The increasing population of Aedes aegypti mosquitoes on Madeira Island (Portugal) resulted in the first autochthonous dengue outbreak, which occurred in October 2012. Our study establishes the first genetic evaluation based on the mitochondrial DNA (mtDNA) genes [cytochrome oxidase subunit I (COI) and NADH dehydrogenase subunit 4 (ND4)] and knockdown resistance ( kdr ) mutations exploring the colonisation history and the genetic diversity of this insular vector population. We included mosquito populations from Brazil and Venezuela in the analysis as putative geographic sources. The Ae. aegyptipopulation from Madeira showed extremely low mtDNA genetic variability, with a single haplotype for COI and ND4. We also detected the presence of two important kdr mutations and the quasi-fixation of one of these mutations (F1534C). These results are consistent with a unique recent founder event that occurred on the island of Ae. aegyptimosquitoes that carry kdr mutations associated with insecticide resistance. Finally, we also report the presence of the F1534C kdr mutation in the Brazil and Venezuela populations. To our knowledge, this is the first time this mutation has been found in South American Ae. aegypti mosquitoes. Given the present risk of Ae. aegypti re-invading continental Europe from Madeira and the recent dengue outbreaks on the island, this information is important to plan surveillance and control measures.

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Malassezia pachydermatis is associated with dermatomycoses and otomycosis in dogs and cats. This study compared the susceptibility of M. pachydermatis isolates from sick (G1) and healthy (G2) animals to azole and polyene antifungals using the M27-A3 protocol. Isolates from G1 animals were less sensitive to amphotericin B, nystatin, fluconazole, clotrimazole and miconazole.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Objectives: The aim of this study was to evaluate the association between serum levels of 25(OH) vitamin D-3 with midupper arm muscle circumference (MUAMC), handgrip strength and length of hospital stay (LOS) after hip fracture.Methods: In total, 102 consecutive patients with hip fracture over the age of 65 were admitted to the orthopedic unit and prospectively evaluated. All of the patients were treated according to specific protocols depending on the type of fracture. Anthropometric measurements and handgrip strength were performed, and blood samples were taken for serum biochemistry and 25(OH) vitamin D-3 analysis within the first 72 h of admission. All of the patients were followed during their hospital stay, and the length of stay was recorded.Results: Of the patients, two were excluded because of pathologic fractures. In total, 100 patients with a mean age of 80 +/- 7 y were included in the analysis. Among these patients, 73% were female, and 37% had vitamin D deficiency. The median LOS was 7 (5-11) d. Patients with vitamin D deficiency had lower handgrip strength in univariate analysis. In the multiple linear regression analysis with robust standard error, serum vitamin D levels adjusted by age and sex were associated with handgrip strength but not with MUAMC and LOS after hip fracture.Conclusions: In conclusion, vitamin D serum levels were associated with handgrip strength but not with muscle mass or length of hospital stay after hip fracture. (C) 2015 Elsevier Inc. All rights reserved.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Nano- (30-60 nm) and submicron (100-350 nm) ZnO particles were synthesized using solvothermal method at 200 degrees C from an ethanolic solution of zinc acetate dihydrate, applying different reaction conditions, i.e., pH value of precursor and time of the reaction. The X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM), UV-vis diffuse reflectance (DR), Raman spectroscopy, and photoluminescence (PL) spectroscopy have been employed for characterization of synthesized ZnO powders. It was shown that the structural, morphological, and optical properties are largely determined by reaction conditions during solvothermal synthesis. The particle crystallinity improves with the decrease of pH value and/or the increase of time of the reaction. The Raman and PL spectra analyses indicate that the oxygen interstitials are dominant intrinsic defects in solvothermally synthesized ZnO powders. It was observed that concentration of defects in wurtzite ZnO crystal lattices slightly changes with the variation of pH value of the precursor and time of the solvothermal reaction. The correlation between structural ordering and defect structure of particles and corresponding growth processes was discussed.

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Investigation of carbon isotope fractionation by plants was carried out at two sub-areas located in Reserva Ducke, central Amazonia: open reserve (virgin forest with low density of plant species); and closed reserve (virgin forest with high density of plant species). Preliminary results (δ‰ 13C: 12C values, PDB) of leaf analysis at different plant heights indicate the following: Eschweilera matamata Hub. (Lecythidaceae), common name 'matamata', -31.55±0.61; Protium heptaplyllum March. (Burseraceae), common name 'breu branco', -32.34±1.39; Calophyllum brasiliense Camb. (Guttiferae), common name 'jacareúba', -30.72±0.23; Scleronema micrantthum Ducke. (Bombacaceae), common name 'cardeiro'. -28.81±0.68; and Carapa guianensis Aubl. (Meliaceae), common name 'andiroba', -31.07±0.51. It is possible that the plant species analysed belong to the C3 photosynthetic cycle. In general, the species in the open reserve show differences of the order of 1.66±0.34‰ (greater in 13C) as compared with the same species in the closed reserve. The old leaves show differences in the relative isotopic enrichment (δ) of the order of 1‰, being smaller in new leaves in both reserves. The probable occurrence of an isotopic gradient from the lower (2-5 m) to the upper part (15-20 m) of the plant, of the order of 1.3‰, smaller in 13C, in species from the dense forest was noted. However, only two plants from each species were analysed during a two-year period, data obtained to far are still preliminary, and results should, therefore, be revised. Moreover, according to the literature, the natural carbon isotope fractionation by plants shows metabolic, physiological and environmental dependence. © 1991.

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Nychthemeral and annual rhythms of the rectal temperature were determined for Corriedale sheep in a tropical climate. The minimum rectal temperature averaged 39.55 degrees C at 0500 hours in summer, and 38.87 degrees C at 0600 hours in winter. The maximum was 40.03 degrees C in summer (1700 hours) and 39.33 degrees C in winter (1830 hours). Annual cycle of the rectal temperature showed a minimum in July and maximum in December.

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Over the last decades, the prevalence of diabetes mellitus (DM) has been increasing globally such that nowadays the disease constitutes an important outcome related to early mortality among adults. In parallel with the high prevalence, healthcare costs related to DM treatment have increased significantly, exacerbating its burden on modern society. The scientific literature points out that obesity and physical inactivity have a central role in the development of most DM cases. In fact, either physical exercise practice or an increase in the level of physical activity, constitute relevant tools in the guidelines for treatment of the disease. On the other hand, the effect of physical activity on the economic consequences of DM is not completely clear. The identification of the actual burden of lifestyle changes on the reduction of healthcare costs related to DM is relevant, primarily for developing nations, where it could represent a cheaper strategy for treating the disease and its complications than paying for drug treatment, which is commonly related to collateral effects. That being said, the prevention of DM and other diseases and consequently the mitigation of the costs related to these outcomes seem to depend essentially on the promotion of healthy habits. The aim of the present review was therefore to discuss recent evidence on the effects of physical activity/exercise on mitigation of health care cost related to DM.

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Background: Imbalance in bacterial species composition of the gut microbiota is one of the factors associated with the cause or complication of the symptoms of Crohn's disease (CD). This disequilibrium consists in the reduction of biodiversity, decrease of genus such as Bifidobacterium and elevation of species such as Escherichia coli. Human microbiota varies among subjects of a same population irrespective of their health condition and among individuals living in distinct geographic locations. In animal models, sex related differences could also be observed in gut bacterial species composition under some pathological conditions. Experiments conducted with mice have demonstrated that the manifestation of type 1 diabetes (T1D) could be under the influence of the animal sex and its serum level of testosterone, which in turn could be modulated by a particular gut microbiota. Considering the existence of similar features between T1D and CD, such as strong genetic component and malfunctioning of the immune system, we investigated whether differences could be observed in the gut microbiota dysbiosis of male and female CD patients. Methods: Fifty and 5 gut mucosal biopsies from 25 adult CD patients (11 males and 14 females) and 43 specimens of an equivalent clinical material from 22 control subjects (11 males and 11 females) were screened for bacterial biodiversity by analyzing sequences of 16SrDNA V6 region. A number of 2-3 samples each from distinct gut segments (from ileum to rectum) were taken from each subject. The 16SrDNA sequences were obtained by sequencing PCR amplicons of the corresponding gene in the Ion torrent PGM sequencer. Identification and classification of the bacterial groups followed the Ribosomal Database Project (RDP) website pipeline. The relationships of the bacterial taxa with each of the study parameters was performed by compiling the data in a MS Excel and the level of statistical significance determined by the Chi-square test. Results: A total of 3203 16SrDNA sequences were detected in the 98 biopsies samples, the majority of which matching Proteobacteria, Firmicutes, Bacterioidetes, and Actinobacteria. The percentage of DNA sequences for each of these phyla found in Male control subjects/Male CD patients was 40.5/33, 32.7/32.4, 20.8/24.5, and 4.4/4,4 for Proteobacteria, Firmicutes, Bacterioidetes, and Actinobacteria, respectively. In Female comparisons, these values were 35.6/42, 39.2/26.3, 19.8/23.3, 5.2/7. Both Male and Female CD patients presented higher numbers of sequences of Actinobacteria and Bacterioidetes than those of control subjects of the same gender. Case-control differences for Firmicutes could be observed only in female comparisons and, for Proteobacteria, although case-control differences were observed in both genders, the nature of difference was distinct, since while in CD female patients a higher number of sequences matching this phylum was detected, in males a reduced number was observed, in comparison with controls. The species responsible for the Proteobacteria variation in both gender was Escherichia coli. Conclusions: The data presented above suggest that any analysis of dysbiosis in CD must take in account the patient's gender, an observation particularly relevant for Escherichia coli, whose association with CD has been most intensively investigated and for which the present study shows a reverse quantitative variation regarding the patients' gender.

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The objective of this work is to study the relation between humidity, density, porosity and shrinkage of the floodplain soil and riparian vegetation and their ability to store water. For this purpose, two locations for every type of soils were evaluated. Both were placed at the Agronomy University (Faculdade de Ciências Agronômicas) in São Manuel, State of São Paulo, Brazil. The floodplain soil was vegetated with Southern Cattail (Typha domingensis). In both places, soil samples were collected from several depths: 0, 30, 60 and 100 cm. Results show that lower soil density values (0.15 g/cm3) with organic texture and high porosities values (up to 86.2%) were found in samples with the highest organic material content in the floodplain soil. For this field experiment, flood plains soils (characterised as basin gley soils) presented high volumetric instability with a retratibility of 67.49% and higher water storage capacities compared to riparian stands soils (characterised as fluvic neosoils).

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Leaf-cutting ants of the genera Atta and Acromyrmex (tribe Attini) are symbiotic with basidiomycete fungi of the genus Leucoagaricus (tribe Leucocoprineae), which they cultivate on vegetable matter inside their nests. We determined the variation of the 28S, 18S, and 5.8S ribosomal DNA (rDNA) gene loci and the rapidly evolving internal transcribed spacers 1 and 2 (ITS1 and ITS2) of 15 sympatric and allopatric fungi associated with colonies of 11 species of leafcutter ants living up to 2,600 km apart in Brazil. We found that the fungal rDNA and ITS sequences from different species of ants were identical (or nearly identical) to each other, whereas 10 GenBank Leucoagaricus species showed higher ITS variation. Our findings suggest that Atta and Acromyrmex leafcutters living in geographic sites that are very distant from each other cultivate a single fungal species made up of closely related lineages of Leucoagaricus gongylophorus. We discuss the strikingly high similarity in the ITS1 and ITS2 regions of the Atta and Acromyrmex symbiotic L. gongylophorus studied by us, in contrast to the lower similarity displayed by their non-symbiotic counterparts. We suggest that the similarity of our L. gongylophorus isolates is an indication of the recent association of the fungus with these ants, and propose that both the intense lateral transmission of fungal material within leafcutter nests and the selection of more adapted fungal strains are involved in the homogenization of the symbiotic fungal stock.