The evaluation of an instrument for pediatric oncology patient classification

The objectives of this study were to assess the interrater reproducibility of the instrument to classify pediatric patients with cancer; verify the adequacy of the patient classification instrument for pediatric patients with cancer; and make a proposal for changing the instrument, thus allowing for the necessary adjustments for pediatric oncology patients. A total of 34 pediatric inpatients of a Cancer Hospital were evaluated by the teams of physicians, nurses and nursing technicians. The Kappa coefficient was used to rate the agreement between the scores, which revealed a moderate to high value in the objective classifications, and a low value in the subjective. In conclusion, the instrument is reliable and reproducible, however, it is suggested that to classify pediatric oncology patients, some items should be complemented in order to reach an outcome that is more compatible with the reality of this specific population.

Successful prevention of tunneled central catheter infection by antibiotic lock therapy using cefazolin and gentamicin

Catheter-related bacteremia (CRB) is one of the various complications related to hemodialysis (HD). As a result of this high rate of infection, the antibiotic lock technique (ALT) has been recommended to prevent CRB. However, adverse effects of ALT such as increased emergence of strains resistant to antibiotics and increased mechanical dysfunction catheter were poorly evaluated. We prospectively evaluated the efficacy of catheter-restricted filling using an antibiotic lock solution in preventing CRB. A total of 233 HD patients requiring 325 new tunneled catheters while waiting for placement and maturation of an arteriovenous fistula or graft were enrolled in this study. Patients with a tunneled catheter were assigned to receive either an antibiotic-heparin lock solution (antibiotic group: cefazolin 10 mg/ml, gentamicin 5 mg/ml, heparin 1,000 U/ml) or a heparin lock solution (no-antibiotic group: heparin 1,000 U/ml) as a catheter lock solution during the interdialytic period. The present study aimed to assess the efficacy of ALT using cefazolin and gentamicin in reducing CRB in patients undergoing HD with tunneled central catheter and to identify its adverse effects. CRB developed in 32.4 % of patients in the no-antibiotic group and in 13.1 % of patients in the antibiotic group. CRB rates per 1,000 catheter-days were 0.57 in the antibiotic group versus 1.74 in the no-antibiotic group (p < 0.0001). Kaplan-Meier analysis also showed that mean CRB-free catheter survival was significantly higher in the antibiotic group than in the no-antibiotic group (log-rank statistic 17.62, p < 0.0001). There was statistically significant difference between the two groups in causative organisms of CRB, with predominance of negative culture in both groups, but this prevalence was higher in ALT group (57.9 vs 90.1 %, p < 0.0001), and the two groups also were different in prevalence of gram-positive bacteria as causing organisms (ALT group 21.05 vs = 0 % in control group, p < 0.0001). There was no statistically significant difference between the two groups in drug-resistant germs. There were statistically significant differences between the two groups in the catheter removal causes, with higher rate of infectious cause in control group (12.32 vs 2.22 %, p < 0.0001) and mechanical cause in ALT group (28.26 vs 37.78 %, p < 0.0001). The results suggest that ALT may be a beneficial means of reducing the CRB rate in HD patients with tunneled catheter, without association between ALT and emergence of strains resistant. However, mechanical complications were more prevalent in antibiotic group. Further studies are required to determine the optimal drug regimen, concentrations for ALT, and its adverse effects. © 2012 Springer Science+Business Media Dordrecht.

Candida species: Current epidemiology, pathogenicity, biofilm formation, natural antifungal products and new therapeutic options

The incidence of fungal infections has increased significantly, so contributing to morbidity and mortality. This is caused by an increase in antimicrobial resistance and the restricted number of antifungal drugs, which retain many side effects. Candida species are major human fungal pathogens that cause both mucosal and deep tissue infections. Recent evidence suggests that the majority of infections produced by this pathogen are associated with biofilm growth. Biofilms are biological communities with a high degree of organization, in which micro-organisms form structured, coordinated and functional communities. These biological communities are embedded in a self-created extracellular matrix. Biofilm production is also associated with a high level of antimicrobial resistance of the associated organisms. The ability of Candida species to form drugresistant biofilms is an important factor in their contribution to human disease. The study of plants as an alternative to other forms of drug discovery has attracted great attention because, according to the World Health Organization, these would be the best sources for obtaining a wide variety of drugs and could benefit a large population. Furthermore, silver nanoparticles, antibodies and photodynamic inactivation have also been used with good results. This article presents a brief review of the literature regarding the epidemiology of Candida species, as well as their pathogenicity and ability to form biofilms, the antifungal activity of natural products and other therapeutic options. © 2013 SGM.

Onboard and real-time artificial satellite orbit determination using GPS

An algorithm for real-time and onboard orbit determination applying the Extended Kalman Filter (EKF) method is developed. Aiming at a very simple and still fairly accurate orbit determination, an analysis is performed to ascertain an adequacy of modeling complexity versus accuracy. The minimum set of to-be-estimated states to reach the level of accuracy of tens of meters is found to have at least the position, velocity, and user clock offset components. The dynamical model is assessed through several tests, covering force model, numerical integration scheme and step size, and simplified variational equations. The measurement model includes only relevant effects to the order of meters. The EKF method is chosen to be the simplest real-time estimation algorithm with adequate tuning of its parameters. In the developed procedure, the obtained position and velocity errors along a day vary from 15 to 20 m and from 0.014 to 0.018 m/s, respectively, with standard deviation from 6 to 10 m and from 0.006 to 0.008 m/s, respectively, with the SA either on or off. The results, as well as analysis of the final adopted models used, are presented in this work. © 2013 Ana Paula Marins Chiaradia et al.

Caracterização do tratamento medicamentoso com estatinas em unidade básica de saúde

Study Model: Retrospective study. Study Objective: To characterize statin treatment management due to lipid alterations and side effects throughout statin treatment in basic healthcare unit. Methods: Medical reports of women from a basic healthcare unit were analyzed, obtaining: disease presence, regular medication prescription, statin type and dosage, biochemical exams results, musculoskeletal complaints, and statin use cessation, going back the information until the medical consultation of first prescription. Results: Prescribed statins were Simvastatin and Atorvastatin at low doses (10-20 mg). Dose (48,4%) and/or type (25,4%) alterations occurred for lipid profile adequacy. Lipid levels were reduced without creatine kinase elevation. Treatment withdrawn (30,6%) was mainly due to their own decision (74%), which was strongly associated with records of musculoskeletal complaints (Odds Ratio: 6,40[1,53-26,78]). Conclusion: Statin treatment was effective in reducing serum lipid levels and self-reported pain was underestimated, characterizing the major limiting factor for treatment adherence.

Simulação de perdas de solo em função de cenários de adequação ambiental em microbacias agrícolas

In São Paulo state, deforestation and agriculture activities are increasing soil losses processes, especially in areas of susceptible soils where soil conservation practices are not adopted. Environmental adequacy at property level regarding Permanent Protection Areas and Legal Reserves is considered a potential factor for reducing soil losses and it was based on this fact that we assessed soil losses of different scenarios of environmental adequacy. Simulations of erosive processes were carried out in 15 catchments of the Corumbataí river basin, with different forest restoration scenarios, as well as the current situation of land use/ land cover. The scenarios include reforestation of Permanent Preservation Areas (PPA); the reforestation hydrological sensitive areas; and two scenarios, the Legal Reserve installation in 20% of each catchment, being one of them for most critical areas in terms of erosion and the other at random. It was observed that the establishment of PPA and the reforestation of hydrological sensitive areas (HSA), offered a small contribution to the control of the erosive process, resulting in a reduction of 10% and 7.4%, respectively, while the legal reserve in critical areas has the significant reduction of 69.8%. The random scenario, in turn, resulted in a reduction of 21.4% of erosion. Results show that reforestation can reduce soil losses, but previous studies of land prioritization and planning could significantly increase its efficiency.

Potenciais evocados auditivos de tronco encefálico e emissões otoacústicas evocadas transientes: achados em pacientes com doença renal crônica

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

Alterações odontológicas em pacientes urêmicos em hemodiálise e suas possíveis correlações com neuropatias de nervos cranianos

Pós-graduação em Bases Gerais da Cirurgia - FMB

Utilização de índices de vegetação para estimativa da proteção do solo pela cobertura vegetal: uma contribuição para o uso da equação universal das perdas de solo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise do período de defeso do camarão marinho Artemesia longinaris através da maturidade ovariana anual

Pós-graduação em Aquicultura - FCAV

Uso de equações de diferenças na obtenção de filtros para redução de ruído em sinais de voz no domínio wavelet

Pós-graduação em Engenharia Elétrica - FEIS

Ferramentas para a integração de redes de Petri e VHDL na síntese de sistemas digitais

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A formação inicial do professor de educação física: um estudo sobre os modelos de alternância e os saberes docentes

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Atividade física habitual, barreiras para prática de atividade física e indicadores de saúde de pacientes em hemodiálise

Pós-graduação em Ciências da Motricidade - IBRC

Efeito dos solutos urêmicos sobre espécies reativas de oxigênio em sistemas-modelo in vitro

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)