95 resultados para EPISODES


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In this study, the graft outcome in renal allograft recipients with [high cholesterol group (HCG), n = 30] or without [normal cholesterol group (NCG), n = 42] hypercholesterolemia and with [high triglyceride group (HTG), n = 33] or without [normal triglyceride group (NTG), n = 36] hypertriglyceridemia were prospectively compared. At 6 months post-transplantation, no significant difference was observed between the groups (NTG compared with HTG, and NCG compared with HCG) regarding age, presence of arterial hypertension, kind of donor (living related or cadaveric), immunosuppressive therapy, number of rejection episodes per patient, frequency of patients with acute cellular rejection, prevalence of patients with diabetes mellitus or proteinuria > 3 g/24 h, and mean serum creatinine. The probability of doubling serum creatinine during follow-up was statistically different between NTG and HTG (12 months: NTG = 0.03, HTG = 0.15; 36 months: NTG = 0.08, HTG = 0.33; 60 months: NTG = 0.08, HTG = 0.48; and 120 months: NTG = 0.18, HTG = 0.48), but not between NCG and HCG (12 months: NCG = 0.05, HCG = 0.13; 36 months: NCG = 0.13, HCG = 0.24; 60 months: NCG = 0.19, HCG = 0.31; 84 months: NCG = 0.27, HCG = 0.31). There was no significant difference in actuarial graft survival between HCG and NCG or between NTG and HTG. Hypertriglyceridemia, but not hypercholesterolemia, was associated with loss of graft function.

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While conducting projects on ticks from deer and on tick ecology in animal trails in an Atlantic rainforest reserve in Southeastern Brazil, researchers of our group were bitten by ticks several times. Some of these episodes were recorded. Three species of adult ticks attached to humans: Amblyomma brasiliense Aragauo, Amblyomma incisum Neumann, and Amblyomma ovale Koch. Eight nymphal attachments with engorgement on humans were recorded. From these, six molted to adults of A. incisum, one to an adult of A. brasiliense, and one had an anomalous molting, therefore the adult tick could not be properly identified. Local reactions to tick attachment varied among individual hosts from almost imperceptible to intense. Especially itching, but hyperemia and swelling as well, were prominent features of the reaction. Overall it can be affirmed that human beings can be a physiologically suitable host species for ticks in the Atlantic rainforest and that itching was an important if not the major component of the resistance to tick bite.

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Rapakivi granites and associated mafic and ultramafic rocks in the Rondonia Tin Province, southwestern Amazonian craton, Brazil were emplaced during six discrete episodes of magmatism between ca 1600 and 970 Ma. The seven rapakivi granite suites emplaced at this time were the Serra da Providencia Intrusive Suite (U-Pb ages between 1606 and 1532 Ma); Santo Antonio Intrusive Suite(U-Pb age 1406 Ma), Teotonio Intrusive Suite (U-Pb age 1387 Ma); Alto Candeias Intrusive Suite (U-Pb ages between 1346 and 1338 Ma); Sao Lourenco-Caripunas Intrusive Suite (U-Pb ages between 1314 and 1309 Ma); Santa Clara Intrusive Suite (U-Pb ages between 1082 and 1074 Ma); and Younger Granites of Rondonia (U-Pb ages between 998 and 974 Ma). The Serra da Providencia Intrusive Suite intruded the Paleoproterozoic (1.80 to 1.70 Ga) Rio Negro-Juruena crust whereas the other suites were emplaced into the 1.50 to 1.30 Ga Rondonia-San Ignacio crust. Their intrusion was contemporaneous with orogenic activity in other parts of the southwestern Amazonian craton, except for the oldest, Serra da Providencia Intrusive Suite. Orogenic events coeval with emplacement of the Serra da Providencia Intrusive Suite are not clearly recognized in the region. The Santo Antonio, Teotonio, Alto Candeias and Sao Lourenco-Caripunas Intrusive Suites are interpreted to represent extensional anorogenic magmatism associated with the terminal stages of the Rondonian-San Ignacio orogeny. At least the Sao Lourenco-Caripunas rapakivi granites and coeval intra-continental rift sedimentary rocks may, in contrast, represent the products of extensional tectonics and rifting preceding the Sunsas/Aguapei orogeny (1.25 to 1.0 Ga). The two youngest rapakivi suites, the Santa Clara Intrusive Suite and Younger Granites of Rondonia, seemingly represent inboard magmatism in the Rondonian-San Ignacio Province during a younger episode of reworking in the Rio Negro-Juruena Province during the waning stages of the collisional 1.1 to 1.0 Ga Sunsas/Aguapei orogeny. The six intra-plate rapakivi granite episodes in the southwestern part of the Amazonian craton form three broad periods of anorogenic magmatism that have age-correlative events composed of similar rocks and geologic environments in eastern Laurentia and Baltica, although the exact timing of magmatism appears slightly different. Recognition of lithologic and chronological correlations between various cratons provide important constraints to models explaining the interplay between rapakivi granite magmatism and deep crustal evolution of an early Mesoproterozoic supercontinent. They are, furthermore, important to plate tectonic models for the assembly, dispersal and reassembly of Amazonia, Laurentia and Baltica in the Mesoproterozoic and Neoproterozoic. (C) 1999 Elsevier B.V. B.V. All rights reserved.

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Background: the paradentat cyst is an odontogenic lesion of inflammatory origin that has few clinical signs and symptoms apart from recurring acute episodes. A well-defined radiolucency associated with the roots or distal to the crown may be seen radiographically. The purpose of this article is to report on different aspects of two cases involving paradental cysts. In the first case, the patient complained about recurring pericoronitis. A semilunar-shaped radiolucency on the distal aspect of the mandibular third molar was noted on the periapical radiograph. In the second case, the patient's main complaint was chronic trauma of the overlying mucosa. Radiographs revealed an enlarged pericoronal space.Methods: In both cases, the mandibular third molar was extracted due to a lack of space. Lesional samples were sent for histopathologic analysis.Results: In the first case, the drainage of cystic fluid and a regular concavity were found during tooth removal. In the second case, a nodular lesion was found adhering to the disto-buccal surface of the tooth arising from the distal wall of a periodontal pocket. The histopathologic analysis revealed a hyperplastic stratified squamous epithelium with arcading lining a fibrous capsule with inflammatory infiltrate, resulting in a final diagnosis of a paradental cyst.Conclusions: the presence of a paradental cyst should be considered when recurrent inflammatory periodontal processes are associated with partially erupted vital teeth, even when characteristic radiographic findings are absent. Definitive diagnosis requires a clinicopathologic correlation incorporating surgical, radiographic, and histologic findings.

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Despite improvements in connectology, peritoneal dialysis (PD) - associated peritonitis contributes significantly to morbidity and modality failure in patients maintained on PD therapy. A broad spectrum of organisms -gram-positive, gram-negative, fungal, anaerobic - are involved in this complication. In addition, a significant percentage of episodes involve polymicrobial and culture-negative infection. Technological advances are being developed to minimize the incidence of access-related complications such as peritonitis. Many traditional factors such as exit-site infection and poor technique have been already identified. In the present review, we discuss the geographic, patient selection, and clinical issues that can affect peritonitis rates in different areas of the world and in different centers in the same area.

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On the basis of geologic, petrologic, and U-Pb geochronologic data the basement rocks in the east-central part of the Rondonia Tin Province (RTP, southwestern Amazonian craton) are grouped into five lithologic associations: (1) tonalitic gneiss (1.75 Ga); (2) enderbitic granulite (1.73 Ga); (3) paragneiss; (4) granitic and charnockitic augen gneisses (1.57-1.53 Ga); and (5) fine-grained granitic gneiss and charnockitic granulite (1.43-1.42 Ga). The first three are related to development of the Paleoproterozoic Rio Negro-Juruena Province and represent the oldest crust in the region. The tonalitic gneisses and enderbitic granulites show calc-alkaline affinities and Nd isotopic compositions (initial epsilon(Nd) = +0-1 to -1.5; T-DM of 2.2-2.1 Ga) that suggest a continental arc margin setting for the original magmas. The paragneisses yield T-DM values of 2.2-2.1 Ga suggesting that source material was primarily derived from the Ventuari-Tapajos and Rio Negro-Juruena crusts, but detrital zircon ages and an intrusive granitoid bracket deposition between 1.67 and 1.57 Ga. The granitic and charnockitic augen gneisses show predominantly A-type and within-plate granite affinities, but also some volcanic arc granite characteristics. The initial epsilon(Nd) values (+0.6 to +2.0) indicate mixing of magmas derived from depleted mantle and older crustal sources. These rocks are correlated to the 1.60-1.53 Ga Serra da Providencia intrusive suite that reflects inboard magmatism coeval with the Cachoeirinha orogen located to the southeast. The fine-grained granitic gneiss and charnockitic granulites represent the first record of widespread magmatism at 1.43-1.42 Ga in northern Rondonia. Their geochemical signatures and the slightly positive initial epsilon(Nd) values (+0.7 to +1.2) are very similar to those of the most evolved granites of the calc-alkaline Santa Helena batholith farther southeast. U-Pb monazite and Sm-Nd whole-rock-garnet ages demonstrate that a high-grade tectonometa-morphic episode occurred in this region at 1.33-1.30 Ga. This episode attained upper-amphibolite conditions and is interpreted as the peak of the Rondonian-San Ignacio orogeny. The U-Pb and Sm-Nd data presented here and data published on rapakivi granites elsewhere indicate that the east-central part of the RTP is a poly-orogenic region characterized by successive episodes of magmatism, metamorphism, and deformation between 1.75 and 0.97 Ga. (C) 2002 Elsevier B.V. B.V. All rights reserved.

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We describe the first satellite observation of intercontinental transport of nitrogen oxides emitted by power plants, verified by simulations with a particle tracer model. The analysis of such episodes shows that anthropogenic NOx plumes may influence the atmospheric chemistry thousands of kilometers away from its origin, as well as the ocean they traverse due to nitrogen fertilization. This kind of monitoring became possible by applying an improved algorithm to extract the tropospheric fraction of NO2 from the spectral data coming from the GOME instrument.As an example we show the observation of NO2 in the time period 4-14 May, 1998, from the South African Plateau to Australia which was possible due to favourable weather conditions during that time period which availed the satellite measurement. This episode was also simulated with the Lagrangian particle dispersion model FLEXPART which uses NOx emissions taken from an inventory for industrial emissions in South Africa and is driven with analyses from the European Centre for Medium-RangeWeather Forecasts. Additionally lightning emissions were taken into account by utilizing Lightning Imaging Sensor data. Lightning was found to contribute probably not more than 25% of the resulting concentrations. Both, the measured and simulated emission plume show matching patterns while traversing the Indian Ocean to Australia and show great resemblance to the aerosol and CO2 transport observed by Piketh et al. (2000).

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The Precambrian crystalline basement of southeast Brazil is affected by many Phanerozoic reactivations of shear zones that developed during the end of the Neoproterozoic in the Brasiliano orogeny. These reactivations with specific tectonic events, a multidisciplinary study was done, involving geology, paleostress, and structural analysis of faults, associated with apatite fission track methods along the northeastern border of the Parana basin in southeast Brazil.The results show that the study area consists of three main tectonic domains, which record different episodes of uplift and reactivation of faults. These faults were brittle in character and resulted in multiple generations of fault products as pseudotachylytes and ultracataclasites, foliated cataclasites and fault gouges.Based on geological evidence and fission track data, an uplift of basement rocks and related tectonic subsidence with consequent deposition in the Parana basin were modeled.The reactivations of the basement record successive uplift events during the Phanerozoic dated via corrected fission track ages, at 387 +/- 50 Ma (Ordovician); 193 +/- 19 Ma (Triassic); 142 +/- 18 Ma (Jurassic), 126 +/- 11 Ma (Early Cretaceous); 89 +/- 10 Ma (Late Cretaceous) and 69 +/- 10 Ma (Late Cretaceous). These results indicate differential uplift of tectonic domains of basement units, probably related to Parana basin subsidence. Six major sedimentary units (supersequences) that have been deposited with their bounding unconformities, seem to have a close relationship with the orogenic events during the evolution of southwestern Gondwana. (c) 2005 Elsevier Ltd. All rights reserved.

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Background. Despite advances in immunosuppressive therapy in the past decade, allograft rejection remains an important cause of kidney graft failure. Cytokines play a major role in the inflammatory and immune responses that mediate allograft outcomes. Several studies have shown that the production of cytokines varies among individuals. These variations are determined by genetic polymorphisms, most commonly within the regulatory region of cytokine genes. The aim of the present study was to assess the effect of allelic variation on acute rejection episodes (ARE) or chronic allograft nephropathy (CAN) after kidney transplantation.Methods. To determine a possible correlation between the interferon (INF)-gamma +874 polymorphism and kidney allograft outcome, we isolated genomic DNA from 74 patients who underwent isolated kidney allografts and were classified into 2 groups-a rejection and a nonrejection group-for comparison with a control group of 163 healthy subjects.Results. We genotyped INF-gamma +874 polymorphisms in all groups. The transplant group showed a significantly increased homozygous genotype T/T (P = .0118) compared with healthy controls. Similarly, considering only patients with CAN, the homozygous genotype T/T (P = .0067) was significantly increased compared with the healthy controls. The rejection group indicated a significant increased homozygous genotype Tic compared with the control group (P = .0061).Conclusion. Homozygous genotype T/T was associated with increased levels of INF-gamma and greater numbers among the rejection and CAN cohorts.

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Objectives: The purpose of this study was to evaluate the prevalence of active and latent trigger points [TrPs], as well as analyze the prevalence of different types of headaches in chronic headache patients. The active and latent TrPs in muscles of orofacial and cervical regions were also evaluated. Methods: There were 290 subjects who participated in this study. Trigger points were identified according to Simons et al.'s diagnostic criteria. Trigger points were considered active if subjects recognized the evoked referred pain as their familiar headache. If the evoked referred pain was not recognized as the familiar headache, the TrPs were considered latent. Differential diagnosis for headache was performed on the basis of International Headache Society criteria. Results: Trigger points could be diagnosed in 77 percent of patients and, in 89 percent of these, active TrPs were found. Muscle tenderness could be observed in 22 percent of patients, and only 1 percent patients were muscle-pain-free. The headache diagnosis showed that 26 percent had tension-type headache, 13 percent had migraine, and 61 percent had combined episodes of tension-type headache and migraine. The highest number of TrPs were found in temporalis [N = 159], masseter [N = 126], and occiptofrontalis [N = 113] muscles. Active TrPs were more frequent in temporalis and occiptofrontalis muscles. Conclusions: Subjects with chronic headaches had a higher prevalence of TrPs, and headache complaints could be reproduced during stimulation of active TrPs that were localized more frequently in temporalis and occiptofrontalis muscles. The presence of TrPs may be a contributing factor in the initiation and/or perpetuation of chronic headaches.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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HLA-G is a non-classic Human Leukocyte Antigen (HLA-G) Class I of low polymorphism and restricted tissue distribution that displays tolerogenic functions. In heart transplantation and in combined liver/renal allograft transplantation, the expression of HLA-G has been associated with a lower incidence of acute graft rejection episodes and absence of chronic dysfunction. Since the expression of HLA-G in renal biopsies has been investigated only in few patients who received a combined kidney and liver transplant, in this study we performed a cross-sectional study, systematically comparing the expression of HLA-G in post-transplanted renal grafts, stratifying patients according to the presence or absence of rejection.Patients and Methods: Seventy-three renal specimens (10 with acute rejection and 13 with chronic allograft nephropathy, and 50 with no signs of rejection) were immunohistochemically evaluated for HLA-G expression.Results: In the group as a whole, HLA-G molecules were detected in 40 cases (54.8%). Among specimens that presented HLA-G expression, 2 out of 40 (5%) exhibited acute rejection, 2 (5%) exhibited chronic allograft nephropathy, and the remaining 36 (90%) exhibited no signs of rejection. The comparison between patients with rejection and those without rejection showed that the expression of HLA-G was significantly increased in specimens exhibiting no signs of rejection (p<0.0001). Considering only patients with acute rejection, 8 out of 10 patients showed no HLA-G expression in their kidney biopsies when compared to patients exhibiting no signs of rejection and absence of HLA-G was observed in 14 out of 50 (p=0.0032). Similarly, considering only patients with chronic allograft nephropathy, absence of HLA-G expression was observed in I I out of 13 specimens, whereas in patients without rejection absence of HLA-G was observed in 14 out of 50 (p=0.003). Therapy with tacrolimus was significantly associated with the expression of HLA-G and a better graft prognosis. Conclusions: Our results suggest that HLA-G expression in the kidney allograft and the use of tacrolimus are associated with a lower frequency of acute renal rejection and chronic allograft nephropathy. (c) 2007 Elsevier B.V. All rights reserved.

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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 Natividade Group is a metasedimentary sequence discontinuously exposed in the southeastern region of the Tocantins State. It rests unconformably on the Archean gneissic-granitoid complex and its associated supracrustals, as well as on granite intrusives of the Lajeado Suite (1.870 Ma). It is unconformably covered by the Monte do Carmo Formation and the Serra Grande Formation. The sequence is preserved on tilted blocks and grabens. The western portion is constituted of only detritic metasediments. The intermediate outcrops presents detritic and some carbonatic metasediments. A carbonatic sequence, with some detritic levels, is recognized at the eastern area. The sections of these different domains are interpreted as constituted of fining-up sequences due to three transgressive episodes into an ensialic paleobasin, with uplifted border to the western side and a carbonate platform to the east, which represents the western extension of the Mambui Group. The Natividade Group presents folds with variable styles and no defined vergence, which are synchronous to the regional metamorphism (lower to upper greenschist facies). Two groups of faults cut the sequence. -from English summary