30 resultados para Cultural impact on sexual views
em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Background. Patients who develop acute kidney injury (AKI) in the intensive care unit (ICU) have extremely high rates of mortality and morbidity. The objectives of this study were to compare clinical and laboratory characteristics of AKI patients evaluated and not evaluated by nephrologists in ICU and generate the hypothesis of the relationship between timing of nephrology consultation and outcome.Methods. We explored associations among presence and timing of nephrology consultation with ICU stay and in-ICU mortality in 148 ICU patients with AKI at a Brazilian teaching hospital from July 2008 to May 2010. Multivariable logistic regression was used to adjust confounding and selection bias.Results. AKI incidence was 30% and 52% of these AKI patients were evaluated by nephrologists. At multivariable analysis, AKI patients evaluated by nephrologists showed higher Acute Tubular Necrosis-Index Specific Score and creatinine level, more dialysis indications, lower urine output and longer ICU stay. The mortality rate was similar to AKI patients who were not evaluated. Nephrology consultation was delayed (>= 48 h) in 62.3% (median time to consultation, 4.7 days). Lower serum creatinine levels (P - 0.009) and higher urine output (P = 0.002) were associated with delayed consultation. Delayed consultation was associated with increased ICU mortality (65.4 versus 88.2%, P < 0.001).Conclusions. In AKI, patients evaluated by nephrologists seem to be more seriously ill than those not evaluated and present similar mortality rate. The delayed nephrology consultation can be associated with increased ICU mortality.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Since the nineteenth century ships have been using ballast water (BW) for safety, stability, propulsion and maneuverability, as well as to redress loss of fuel weight and water consumption, and to maintain structural stress at acceptable levels. Ballast water has been spreading many non-native species around the globe, but little is known about the extent and potential significance of ship-mediated transfer of microorganisms. The global movements of ballast water by ships create a long-distance dispersal mechanism for human pathogens that may be important in the worldwide distribution of microorganisms, as well as for the epidemiology of waterborne diseases. Only a few studies have been carried out on this subject, most of them involving ballast water containing crustacean larvae and phytoplankton. Specialized microbiological studies on these waters are necessary to avoid a repeat of what happened in 1991, when epidemic cholera was reported in Peru and rapidly spread through Latin America and Mexico. In July of 1992, Vibrio cholerae was found in the USA and the Food and Drug Administration (FDA) determined that it came from ballast water of ships whose last port of call was in South America. In Brazil, just a few studies about the subject have been performed. An exploratory study by the Brazilian National Health Surveillance Agency (Agencia Nacional de Vigilancia Sanitaria - ANVISA) found in ballast water different microorganisms, such as fecal coliforms, Escherichia coli, Enterococcus faecalis, Clostridium perfringens, coliphages, Vibrio cholerae O1 and Vibrio cholerae non-O1. Until now, Brazil has been focusing only on organisms transported to its territory from other countries by ballast water, to avoid their establishment and dissemination in Brazilian areas. Studies that can assess the probability that water ballast carries pathogenic microorganisms are extremely important, as is the examination of ships that arrive in the country. Treatment of the human infections caused by BW exists but none is completely safe and efficient.
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Depression is a frequently observed neuropsychiatric phenomenon in Parkinson's disease (PD) and it has been lately considered as a manifestation of such disease. The aim of the study was to investigate the relationship between depression and clinical aspects of PD and to assess the impact of the co-occurrence of such condition on the burden imposed by PD. Fifty Outpatients diagnosed with idiopathic PD according to the London Brain Bank criteria were examined. PD was evaluated using Hoehn & Yahr staging (H&Y), United Parkinson's Disease Rating Scale (UPDRS) and Schwab & England (S&E) functional capacity evaluation. A semi-structured clinical interview was used. The diagnosis of PD was made by neurologist experts on movement disorders, and the diagnosis of depression was trade by a psychiatrist, according to the ICD-10 diagnostic criteria. Depressive symptoms were additionally measured using the Montgomery-Asberg Depression Scale. The analysis of quantitative data was performed using descriptive statistics, Univariate linear regression, T-Student Test and ANOVA. Seventeen (34%) patients were diagnosed as clinically depressed and, when compared to the non-depressed ones, presented the following results: H&Y: 3.2 vs. 2.8; UPDRS total: 75.7 vs. 65.3; S&E: 53.5% vs. 65.8% and PD duration: 114.4 months vs. 125.8 months. Depressed patients showed more advanced staging (H&Y), a more severe global clinical condition (UPDRS) and also a greater decrease in their functional capacity (S&E). These data reinforce the hypothesis that depression is associated to poorer functioning in patients with PD. (C) 2008 Elsevier B.V All rights reserved.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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This study reviews the stratigraphy, palaeobiogeography and palaeoecology of some important Albian-Maastrichtian pelagic calcispheres: Bonetocardiella conoidea, Pithonella ovalis, P. perlonga, P. sphaerica and P. trejoi. It also presents a significant new data set on these organisms from the western South Atlantic Ocean. The group reached its acme simultaneously all over the world during the highest Cretaceous sea level in late Albian to Coniacian times. A strong association also existed between the maximum temperature and the salinity of the Tethyan water mass and the climax of these opportunistic microfossils. Their remarkable presence along the Brazilian and west African margins during the Albian, in association with other typical Tethyan pelagic biotic elements, indicates that during this period the northern South Atlantic was a long, narrow arm of the Tethys Sea. (C) 2000 Academic Press.
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O trato olivococlear medial realiza o controle eferente das células ciliadas externas, regulando as contrações lentas e atenuando as rápidas. Com a pesquisa da amplitude das emissões otoacústicas sem e com estimulação acústica contra, ipsi ou bilateralmente, é possível estimar as condições desse trato, uma vez que o efeito resultante de redução/supressão das emissões indica seu funcionamento. O envelhecimento implica em diminuição da atividade do sistema auditivo central, em função da degeneração das estruturas envolvidas nas habilidades auditivas. OBJETIVO: O objetivo foi investigar o efeito da idade na atividade do trato sobre a cóclea, com a análise da amplitude das emissões com estimulação acústica contralateral. MATERIAL E MÉTODO: A casuística foi composta por 75 indivíduos agrupados conforme a idade. A metodologia foi o modo convencional, com clique linear e o ruído branco. ESTUDO DE CASO: A análise considerou a resposta das orelhas e a comparação entre os grupos. RESULTADOS: Os resultados revelam diferenças estatisticamente significantes entre o response das emissões sem e com estimulação acústica contralateral, nos indivíduos (20 a 39 anos). O efeito redução/supressão das emissões diminui com a idade (quarta década). CONCLUSÃO: O envelhecimento prejudica a efetividade da atividade do trato.
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CONTEXTO: A desnutrição protéico-energética constitui causa previsível para o desenvolvimento de complicações pós-operatórias e pior prognóstico de pacientes cirúrgicos. OBJETIVO: Estudar a associação de indicadores de estado nutricional com estádio da doença e as principais complicações e mortalidade pós-operatória de pacientes com câncer de esôfago. MÉTODO: Foram avaliados retrospectivamente 100 prontuários de pacientes com câncer de esôfago (38-81 anos) de ambos os sexos (85% masculino e 15% feminino) submetidos a esofagectomia (n = 25) e gastrojejunostomia (n = 75), no período de 1995 a 2004. Os dados coletados foram: história clínica, exame endoscópico, estádio (TNM-UICC), estado nutricional (índice de massa corporal, percentual de perda de peso - %PP, albuminemia e contagem de linfócitos total) e evolução clínica pós-operatória. Houve composição dos grupos de acordo com o porte da cirurgia (grande x pequeno). Foi realizada a associação entre as complicações pós-operatórias e a mortalidade (após pós-operatório de 30 dias). As comparações entre médias dos dois grupos foram feitas pelo teste t de Student e a existência de associações entre variáveis testadas pelos testes de χ2 ou exato de Fisher com P = 0,05. RESULTADOS: Houve predomínio dos tumores avançados (estádio III e IV), com a presença de disfagia em 95% dos pacientes e perda ponderal >10%, anterior ao diagnóstico, em 78%. A obstrução esofágica, presente em 77 pacientes, foi associada (P = 0,0021) com o baixo índice de massa corporal (desnutrição protéico-energética). A %PP e a hipoalbuminemia associaram-se estatisticamente (P<0,05) com o estádio avançado da doença. As complicações pós-operatórias precoces ocorreram em 69,2% e 30,7% dos pacientes submetidos a esofagectomia e ostomias, respectivamente, com predomínio das infecciosas nas ostomias (80%) e as pleuropulmonares nas esofagectomias (61%). A albuminemia foi menor nos pacientes submetidos as ostomias, tendo sido a hipoalbuminemia associada (P<0,05) com a ocorrência de complicações pós-operatórias e mortalidade. A %PP e a contagem de linfócitos total associaram-se com as complicações pós-operatórias precoces e infeccionas nas ostomias e a contagem de linfócitos total, com a mortalidade operatória nas esofagectomias. CONCLUSÕES: O estado de DPE esteve associado às complicações pós-operatórias apenas nos pacientes submetidos a ostomias, sem presença destas associações nas esofagectomias.
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A avaliação antropométrica (pêso, altura, circunferência branquial, prega cutânea tricipital, prega cutânea subescapular, índice de Quetelet e circunferência muscular do braço) e bioquímica (proteínas e lipides) foi realizado em 120 indivíduos (93 masculinos e 27 do sexo feminino), de 17 a 72 anos de idade, moradores de área endêmica de malária (Humaitá -AM). de acordo com a história da doença (malária) eles foram divididos em 4 grupos: G1 - controle (n = 30), sem história de malária; G2 - controle (n = 40), com história de malária, mas sem manifestação de doença atual; G3 - doentes com Plasmodium vivax (n = 19) e G4 - doentes com Plasmodium faleiparum (n = 31). O diagnóstico de malária foi estabelecido por manifestações clínicas e confirmado laboratorialmente (gota espessa e esfregaço). No global as medidas antropométricas e bioquímicas discriminaram os grupos diferentemente. As medidas antropométricas do pêso, altura, reservas calóricas e estoque proteicos somáticos, apresentaram pouca sensibilidade, discriminado apenas os grupos extremos (Gl > G4). As medidas bioquímicas, no geral diferenciaram dois grandes grupos, os sadios e os doentes (G1+G2) e (G3+G4). Os doentes com Plasmodium falciparum (G4) foram os que se apresentaram em pior estado nutricional para a maioria das variáveis, sem entretanto, nenhuma variável individual que os discriminasse significativamente do G3. Estes dados permitem concluir que a malária resulta em desnutrição do hospedeiro, cuja gravidade está relacionada ao tipo e estágio da doença.
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Energy generation is needed in São Paulo and MSW represents a promising alternative, although it is more expensive than hydroelectric power. About 14 900 t/day of MSW is generated, of which 8433 t/day is domestic and commercial MSW. From this amount, 1800 t will be destined to generate 30 MW of power. The eco-balance of CO2 has been considered for incineration and recycling. The recycling program of plastics, metals, paper and glass would represent a significant reduction in energy and CO2 emission. The total CO2 released is 3.34 x 10(5) t/yr without recycling. and is 1.25 x 10(5) t/yr with a recycling program. Most of the CO2 comes from plastics and paper production. Economic aspects could probably favor Incineration with energy production as the best option. (C) 1998 Published by Elsevier B.V. Ltd. All rights reserved.
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The present study examined the effects of letrozole exposure during brain sexual differentiation on endocrine, behavioural and neurochemical parameters in male rat descendants. Pregnant female rats received 1 mg kg(-1) day(-1) letrozole or vehicle by oral gavage on gestational Days 21 and 22. Exposure to letrozole reduced anogenital distance in males on postnatal Day (PND) 22. At adulthood (PND 75), plasma testosterone levels and hypothalamic dopaminergic activity were increased, but sexual competence was impaired, because fewer successful sexual behaviours (mount, intromission and principally ejaculation) were observed. The impairment of reproductive function by prenatal exposure to an aromatase inhibitor reinforces the importance of adequate oestrogenic activity during perinatal sexual differentiation for complete masculinisation of the hypothalamus.
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Report some of the changes in production and consumption occurring in the state of São Paulo. through the restructuring in motion systems, logistics and standards and taxation, as well as the impacts on urban spaces through new economic dynamics, imposed by the demands of corporate, is the purpose of this article. The decentralization of production and consumption towards the interior was made possible by the combination of hierarchical and ordered some basic elements such as technological innovations (ways and means of transport) and organizational (logistics, standards and taxation) which optimized the flow territorial state São Paulo. It is noteworthy, therefore: 1) the improvement of logistics as a strategy, planning and management of transport, storage and communications (including the granting of public services to private), 2) the technological improvement and expansion of motion systems (infrastructure, means of transport) and 3) the systems of rules and regulations through taxation and deregulation affect the circulatory system of a given space. Thus, both systems aims to disentangle the economic flows (goods, services, information, capital and people) and provide a more fluid territorial. The impacts on the State of São Paulo, mainly through its economic dynamics, revert positively and negatively, by changing the way one thinks and performs planning.