23 resultados para assessment change

em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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INTRODUCTION: Metabolic investigation in patients with urinary lithiasis is very important for preventing recurrence of disease. The objective of this work was to diagnose and to determine the prevalence of metabolic disorders, to assess the quality of the water consumed and volume of diuresis as potential risk factors for this pathology. PATIENTS and METHODS: We studied 182 patients older than 12 years. We included patients with history and/or imaging tests confirming at least 2 stones, with creatinine clearance > 60 mL/min and negative urine culture. The protocol consisted in the collection of 2, 24-hour urine samples, for dosing Ca, P, uric acid, Na, K, Mg, Ox and Ci, glycemia and serum levels of Ca, P, Uric acid, Na, K, Cl, Mg, U and Cr, urinary pH and urinary acidification test. RESULTS: 158 patients fulfilled the inclusion criteria. Among these, 151 (95.5%) presented metabolic changes, with 94 (62.2%) presenting isolated metabolic change and 57 (37.8%) had mixed changes. The main disorders detected were hypercalciuria (74%), hypocitraturia (37.3%), hyperoxaluria (24.1%), hypomagnesuria (21%), hyperuricosuria (20.2%), primary hyperparathyroidism (1.8%) secondary hyperparathyroidism (0.6%) and renal tubular acidosis (0.6). CONCLUSION: Metabolic change was diagnosed in 95.5% of patients. These results warrant the metabolic study and follow-up in patients with recurrent lithiasis in order to decrease the recurrence rate through specific treatments, modification in alimentary and behavioral habits.

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

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Um total de 3518 espécimes (1607 machos e 1911 fêmeas) de Dipturus chilensis foi amostrado. Os machos tiveram comprimentos totais entre 44.0 e 99.0 cm e as fêmeas entre 45.0 e 110.0 cm. A composição de comprimentos totais das capturas agrupadas foi significativamente diferente entre ambos os sexos, sendo as fêmeas maiores do que os machos. A razão sexual favoreceu as fêmeas. O comprimento total em que 50% dos espécimes foram retidos pelo aparelho de pesca foi de 69.0 cm nos machos e de 73.0 cm nas fêmeas. Uma sub-amostra de 124 espécimes (48 machos e 76 fêmeas) foi analisada para avaliação dos parâmetros reprodutivos. Para os machos, o tamanho de 50% de maturidade resultou em 78.5 cm enquanto que para as fêmeas este parâmetro foi estimado em 81.4 cm. Observações preliminares sobre a descrição da cápsula ovígera são também fornecidas.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Objective. To evaluate the effectiveness of the color change of hybrid light-emitting diode (LED) and low-intensity infrared diode laser devices for activating dental bleaching and to verify the occurrence of a color regression with time. Material and methods. A total of 180 specimens obtained from human premolars were immersed in a coffee solution for 15 days for darkening and then divided into eight experimental groups (n = 20 in each) as follows: G1, bleaching without light; G2, bleaching with halogen light; G3, bleaching with a blue LED (1000 mW/470 nm) and a laser device (120 mW/795 nm) simultaneously; G4, bleaching with an LED emitting blue light (1000 mW/470 nm); G5, bleaching with a blue LED (800 mW/470 nm) and a laser device (500 mW/830 nm) simultaneously; G6, bleaching with a blue LED device (800 mW); G7, bleaching with a green LED (600 mW/530 nm) and a laser device (120 mW/795 nm) simultaneously; and G8, bleaching with a green LED (600 mW). Three measurements were performed (at baseline and 14 days and 12 months after bleaching) using a Vita Easyshade spectrophotometer. The data were submitted to two-way ANOVA and a Tukey test. Results. All groups showed significantly higher Delta E values than Group G1, with the exception of Group G8. Variations in the Delta E values at 14 days were significant when compared with those obtained at baseline and after 12 months. Conclusions. Light activation of the bleaching gel provided faster and more intense bleaching than use of the bleaching gel without light activation. Combinations of low-intensity diode lasers are ineffective as a bleaching gel activator. Color regression was observed after 12 months of storage.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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The present study aimed to estimate the prevalence of elderly using potentially inappropriate medications (PIM) and with occurrence of potentially hazardous drug interactions (PHDI), to identify the risk factors for the prescription of PIM and to evaluate the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. Therefore, a cross-sectional study was performed in a long-term care facility in São Paulo State, between December/2010 and January/2011. The medical records of the patients >= 60 years old who took any drugs were consulted to assess the pharmacotherapeutic safety of the medical prescriptions, in order to identify PIM and PHDI, according to the Beers (2003) and World Health Organization criteria, respectively. PI consisted of a guidance letter to the physician responsible for the institution, with the suggestions of safer equivalent therapeutics. Approximately 88% of the elderly took at least one drug, and for 30% of them the PIM had been prescribed. Most of the PIM identified (53.4%) act on the central nervous system. Among the 13 different DI detected, 6 are considered PHDI. Polypharmacy was detected as a risk factor for PIM prescription. After the PI there was no change in medical prescriptions of patients who had been prescribed PIM or PHDI. The data suggests that PI performed by letter, as the only interventional, method was ineffective. To contribute it a wide dissemination of PIM and PHDI among prescriber professionals is necessary for the selection of safer treatment for elderly. Additionally, a pharmacist should be part of the health care team in order to help promote rational use of medicines.

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Many studies have assessed the process of forest degradation in the Brazilian Amazon using remote sensing approaches to estimate the extent and impact by selective logging and forest fires on tropical rain forest. However, only a few have estimated the combined impacts of those anthropogenic activities. We conducted a detailed analysis of selective logging and forest fire impacts on natural forests in the southern Brazilian Amazon state of Mato Grosso, one of the key logging centers in the country. To achieve this goal a 13-year series of annual Landsat images (1992-2004) was used to test different remote sensing techniques for measuring the extent of selective logging and forest fires, and to estimate their impact and interaction with other land use types occurring in the study region. Forest canopy regeneration following these disturbances was also assessed. Field measurements and visual observations were conducted to validate remote sensing techniques. Our results indicated that the Modified Soil Adjusted Vegetation Index aerosol free (MSAVI(af)) is a reliable estimator of fractional coverage under both clear sky and under smoky conditions in this study region. During the period of analysis, selective logging was responsible for disturbing the largest proportion (31%) of natural forest in the study area, immediately followed by deforestation (29%). Altogether, forest disturbances by selective logging and forest fires affected approximately 40% of the study site area. Once disturbed by selective logging activities, forests became more susceptible to fire in the study site. However, our results showed that fires may also occur in undisturbed forests. This indicates that there are further factors that may increase forest fire susceptibility in the study area. Those factors need to be better understood. Although selective logging affected the largest amount of natural forest in the study period, 35% and 28% of the observed losses of forest canopy cover were due to forest fire and selective logging combined and to forest fire only, respectively. Moreover, forest areas degraded by selective logging and forest fire is an addition to outright deforestation estimates and has yet to be accounted for by land use and land cover change assessments in tropical regions. Assuming that this observed trend of land use and land cover conversion continues, we predict that there will be no undisturbed forests remaining by 2011 in this study site. Finally, we estimated that 70% of the total forest area disturbed by logging and fire had sufficiently recovered to become undetectable using satellite data in 2004. (C) 2010 Elsevier B.V. All rights reserved.

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The assessment of welfare issues has been a challenge for poultry producers, and lately welfare standards needs to be reached in order to agree with international market demand. This research proposes the use of continuous behavior monitoring in order to contribute for assessing welfare. A software was developed using the language Clarium. The software managed the recording of data as well as the data searching in the database Firebird. Both software and the observational methodology were tested in a trial conducted inside an environmental chamber, using three genetics of broiler breeders. Behavioral pattern was recorded and correlated to ambient thermal and aerial variation. Monitoring video cameras were placed on the roof facing the used for registering the bird's behavior. From video camera images were recorded during the total period when the ambient was bright, and for analyzing the video images a sample of 15min observation in the morning and 15 min in the afternoon was used, adding up to 30 min daily observation. A specific model so-called behavior was developed inside the software for counting specific behavior and its frequency of occurrence, as well as its duration. Electronic identification was recorded for 24h period. Behavioral video recording images was related to the data recorded using electronic identification.. Statistical analysis of data allowed to identify behavioral differences related to the change in thermal environment, and ultimately indicating thermal stress and departure from welfare conditions.

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We report on the results of a double-blind, randomized, controlled clinical trial comparing two preparations of ethinylestradiol and cyproterone acetate in the treatment of women of reproductive age presenting menstrual irregularities of hyper-androgenic origin. After obtaining informed consent, subjects were randomized to a 4-month treatment period consisting of one daily dose of 0.035mg ethinylestradiol + 2mg cyproterone acetate. The treatment regimen cycle consisted of one pill, once daily for 21 days, followed by a 7-day pill-free period. We compared the efficacy of two presentations of the drug combination after each treatment cycle (Visits 2, 3, 4, and 5) in establishment and maintenance of menstrual regulation, intensity of menstrual flow, and dysmenorrhea, as well as a comparison of the two presentations in terms of Global Satisfaction and Drug Satisfaction assessments performed by the patients and the investigating physician. At each study visit, drug compliance and use of concomitant medications, as well as incidence, severity and duration of adverse events were recorded. A total of 86 subjects were randomized to treatment, with 43 subjects in each treatment group. At Visit 2 and each subsequent visit, all patients in both treatment groups reported an episode of withdrawal bleeding during the 7-day hormone-free period. We observed a statistically significant (p<0.0001) decrease in the incidence of dysmenorrhea at each study visit in relation to the pretreatment assessment. There was a significant reduction (p<0.0001) in the number of subjects reporting intermenstrual bleeding at each study visit in both treatment groups. Global Satisfaction scores by the patient and physician increased significantly at each successive study visit in both treatment groups. There were no clinically significant changes in vital signs, weight, and body mass index throughout the study period in either group. The number of subjects reporting adverse events at each visit did not vary between treatment groups. The combined oral contraceptive pill containing ethinylestradiol and cyproterone acetate was found to be both effective and safe in the menstrual irregularities of hyper-androgenic origin (amenorrhea, dysmenorrhea, and intermenstrual bleeding) assessed in this study. © Copyright Moreira Jr. Editora. Todos os direitos reservados.

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Background: Early trauma care is dependent on subjective assessments and sporadic vital sign assessments. We hypothesized that near-infrared spectroscopy-measured cerebral oxygenation (regional oxygen saturation [rSO 2]) would provide a tool to detect cardiovascular compromise during active hemorrhage. We compared rSO 2 with invasively measured mixed venous oxygen saturation (SvO2), mean arterial pressure (MAP), cardiac output, heart rate, and calculated pulse pressure. Methods: Six propofol-anesthetized instrumented swine were subjected to a fixed-rate hemorrhage until cardiovascular collapse. rSO 2 was monitored with noninvasively measured cerebral oximetry; SvO2 was measured with a fiber optic pulmonary arterial catheter. As an assessment of the time responsiveness of each variable, we recorded minutes from start of the hemorrhage for each variable achieving a 5%, 10%, 15%, and 20% change compared with baseline. Results: Mean time to cardiovascular collapse was 35 minutes ± 11 minutes (54 ± 17% total blood volume). Cerebral rSO 2 began a steady decline at an average MAP of 78 mm Hg ± 17 mm Hg, well above the expected autoregulatory threshold of cerebral blood flow. The 5%, 10%, and 15% decreases in rSO 2 during hemorrhage occurred at a similar times to SvO2, but rSO 2 lagged 6 minutes behind the equivalent percentage decreases in MAP. There was a higher correlation between rSO 2 versus MAP (R =0.72) than SvO2 versus MAP (R =0.55). Conclusions: Near-infrared spectroscopy- measured rSO 2 provided reproducible decreases during hemorrhage that were similar in time course to invasively measured cardiac output and SvO2 but delayed 5 to 9 minutes compared with MAP and pulse pressure. rSO 2 may provide an earlier warning of worsening hemorrhagic shock for prompt interventions in patients with trauma when continuous arterial BP measurements are unavailable. © 2012 Lippincott Williams & Wilkins.

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Aim. The aim of the study was to verify whether endurance training may induce changes on the percentage of peak heart rate (% peak HR) at the lactate threshold (LT) intensity in untrained elderly. Methods. Sixteen healthy men (64.3 ± 4.1 yrs) underwent an incremental test on cycloergometer to determine the LT and the corresponding % peak HR at LT intensity. Afterwards, they were randomly distributed into two groups (n = 8 each): endurance training (ET) and control (C). The ET exercised 3 days a week for 12 weeks. The training session was divided into warm-up (5 min at 50% of LT;), a main part, and a cool-down (5 min 50% below of LT). The main part had a gradual increased volume through the weeks of 2 min. The initial volume on the 1st week was 25 min reaching 47 min at the 12th week. The relative intensity was kept constant (90 to 100% of LT). Results. After 12 weeks, the % peak HR at LT did not change significantly for both groups P > 0.05 (ET 82.9 ± 4.1 vs. 82.5 ± 3.4 and Ç 80.2 ± 7.1 vs. 81.8 ± 7.1). Conclusion. We conclude that endurance training proposed does not change the relative intensity at LT in elderly.