Peritoneal dialysis in acute renal failure

The definition of adequate dialysis in acute renal failure (ARF) is complex and involves the time of referral to dialysis, dose, and dialytic method. Nephrologist experience with a specific procedure and the availability of different dialysis modalities play an important role in these choices. There is no consensus in literature on the best method or ideal dialysis dose in ARF. Peritoneal dialysis (PD) is used less and less in ARF patients, and is being replaced by continuous venovenous therapies. However, it should not be discarded as a worthless therapeutic option for ARF patients. PD offers several advantages over hemodialysis, such as its technical simplicity, excellent cardiovascular tolerance, absence of an extracorporeal circuit, lack of bleeding risk, and low risk of hydro-electrolyte imbalance. PD also has some limitations, though: it needs an intact peritoneal cavity, carries risks of peritoneal infection and protein losses, and has an overall lower effectiveness. Because daily solute clearance is lower with PD than with daily HD, there have been concerns that PD cannot control uremia in ARF patients. Controversies exist concerning its use in patients with severe hypercatabolism; in these cases, daily hemodialysis or continuous venovenous therapy have been preferred. There is little literature on PD in ARF patients, and what exists does not address fundamental parameters such as adequate quantification of dialysis and patient catabolism. Given these limitations, there is a pressing need to re-evaluate the adequacy of PD in ARF using accepted standards. Therefore, new studies should be undertaken to resolve these problems. Copyright © Informa Healthcare.

Necrotizing soft tissue infection of the breast: Case report and literature review

Background: Necrotizing soft tissue infection (NSTI) is characterized by progressive infectious gangrene of the skin and subcutaneous tissue. Its treatment involves intensive care, broad-spectrum antibiotic therapy, and full debridement. Methods: We present two cases of NSTI of the breast, adding these cases to the 14 described in the literature, reviewing the characteristics and evolution of all cases. Case Report: On the fourth day after mastectomy, a 59-year-old woman with ulcerated breast cancer developed Type I NSTI caused by Pseudomonas aeruginosa, which had a favorable evolution after debridement and broad-spectrum antibiotics. The second patient was a 57-year-old woman submitted to a mastectomy and axillary dissection, who had recurrent seromas. On the 32nd post-operative day, after a seroma puncture, she developed Type II NSTI caused by β-hemolytic streptococci. She developed sepsis and died on the tenth day after debridement, intensive care, and broad-spectrum antibiotics. The cases are the first description of breast NSTI after mammary seroma aspiration and the first report of this condition caused by P. aeruginosa. Conclusion: Necrotizing soft tissue infection is rare in breast tissue. It frequently is of Type II, occurring mainly after procedures in patients with breast cancer. The surgeon's participation in controlling the focus of the infection is of fundamental importance, and just as important are broad-spectrum antibiotic therapy and support measures, such as maintenance of volume, correction of electrolytic disorders, and treatment of sepsis and septic shock. Once the infection has been brought under control, skin grafting or soft tissue flaps can be considered. The mortality rate in breast NSTI is 18.7%, all deaths being in patients with the fulminant Type II form. Surgical oncologists need to be alert to the possibility of this rare condition. © 2012, Mary Ann Liebert, Inc.

Exercise intensity, but not electrolyte reposition, alters plasmatic cortisol and glucose levels of horses submitted to 30 and 60km distance endurance rides

O presente estudo teve como objetivo comparar os níveis plasmáticos de glicose e cortisol de um grupo de eqüinos atletas submetidos ao esforço de longa duração (enduro eqüestre) em distâncias de 30 e 60km, com velocidades médias de 10 e 15km h-1, respectivamente. Os animais foram aleatoriamente separados em dois grupos, sendo que a um deles foi administrada, por via oral, uma pasta eletrolítica hipertônica antes, durante e após as referidas provas. O outro grupo foi usado como controle. Os resultados das concentrações de cortisol revelaram um aumento significativo, no primeiro momento, em que a intensidade do esforço era maior (15km/h), ou com a continuação deste (30km de distância), no segundo momento, para todos os grupos. Os resultados referentes à concentração de glicose permaneceram constantes durante a prova de 30km; entretanto, nos primeiros 20km da prova de 60km, tais resultados revelaram um aumento significativo no grupo controle, retornando a valores basais no momento subseqüente. A reposição eletrolítica tem a sua importância na manutenção do equilíbrio hidroeletrolítico e ácido básico e, no presente estudo, pode ter contribuído para a manutenção da concentração média de glicose plasmática.

The succession dynamics of a macroalgal community after a flood disturbance in a tropical stream from São Paulo State, southeastern Brazil

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

Stabilizability and Disturbance Rejection with State-Derivative Feedback

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Dynamic Tracking with Zero Variation and Disturbance Rejection Applied to Discrete-Time Systems

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

Evaluation of a portable clinical analyzer for the determination of blood gas partial pressures, electrolyte concentrations, and hematocrit in venous blood samples collected from cattle, horses, and sheep

Objective To compare results reported for blood gas partial pressures, electrolyte concentrations, and Hct in venous blood samples collected from cattle, horses, and sheep and analyzed by use of a portable clinical analyzer (PCA) and reference analyzer (RA).Animals-Clinically normal animals (24 cattle, 22 horses, and 22 sheep).Procedures-pH; Pco(2); Po(2); total carbon dioxide concentration; oxygen saturation; base excess; concentrations of HCO(3)(-), Na(+), K(+), and ionized calcium; Hct; and hemoglobin concentration were determined with a PCA. Results were compared with those obtained for the same blood sample with an RA. Bias (mean difference) and variability (95% confidence interval) were determined for all data reported. Data were also subjected to analyses by Deming regression and Pearson correlation.Results-Analysis of Bland-Altman plots revealed good agreement between results obtained with the PCA and those obtained with the RA for pH and total carbon dioxide concentration in cattle, K(+) concentration in horses and sheep, and base excess in horses. Except for Na(+) concentration and Hct in horses and sheep, correlation was good or excellent for most variables reported.Conclusions and Clinical Relevance-Data from blood gas and electrolyte analyses obtained by use of the PCA can be used to evaluate the health status of cattle, horses, and sheep. Furthermore, the handheld PCA device may have a great advantage over the RA device as a result of the ability to analyze blood samples on farms that may be located far from urban centers. (Am J Vet Res 2010;71:515-521)

Disturbance chemical cues determine changes in spatial occupation by the convict cichlid Archocentrus nigrofasciatus

I studied the effect of disturbance chemical cues on fish that make trade-offs between foraging in an open area and remaining in a safe refuge. I used convict cichlids Archocentrus nigrofasciatus that were either visually exposed to a predator (n = 8) or exposed to water conditioned by chemical cues from disturbed conspecifics (n = 8). Fish visually exposed to a predator decreased their ingestion rate and spent more time in the refuge than in the foraging area, while fish receiving water from frightened conspecifics did not alter their ingestion rate or time spent in the refuge and foraging site, but increased their spatial occupation (i.e., motion). These results suggest that convict cichlids recognized the predator by visual cues. Moreover, disturbance cues are a form of threatening public information that may increase fish spatial occupation due to increased exploring behaviour; but is not sufficiently alarming to alter feeding or increase refuge use. (C) 2004 Elsevier B.V. All rights reserved.

Determination of lead in the absence of supporting electrolyte using carbon fiber ultramicroelectrode without mercury film

The determination of lead ions directly in water, for application in analysis of samples of environmental interest, was studied by electroanalytical techniques. Linear sweep anodic stripping voltammetry with a carbon fiber disk ultramicroelectrode (7.0 mu m in diameter), without mercury film, has been used for lead determination, by standard addition, in purified water in the absence of supporting electrolyte. The response was linear in the range from 10.0 to 50.0 mu g L-1, with a detection limit of 0.8 mu g L-1, for 300 s preconcentration time, at -1.2 V and 1.0 V s(-1) scan rate. The reliability of the analytical procedure was evaluated by precision using relative standard deviations (5.6%, for three repetitive stripping current measurements of solution with 10.0 mu g L-1 lead ions) and by the accuracy with recovery experiments (mean of 110.8%) for the same concentration.

Gap disturbance regime and composition in the Atlantic Montane Rain Forest: the influence of topography

In the Atlantic Montane Rain Forest of south-eastern Brazil, a field study was carried out to describe the forest disturbance regime, analyse canopy gap composition and evaluate the influence of habitat parameters on gap tree species composition. We characterized canopy gaps considering the group of variables as follows: area, type and number of tree/branch falls, topographic position, soil coverage and surrounding canopy trees. Gap composition was assessed at species level by measuring all individuals inside gaps higher than one meter. Mean gap area of the 42 canopy gaps analysed was 71.9 +/- 9.0 m(2) (mean +/- SE). Out of the studied gaps, 35.7% were created by uprooted and by snapped trees, 16.7% by dead-standing trees and 11.9% by the fall of large branches. The disturbance regime was characterized by gap openings predominantly smaller than 150 m(2) and by spatial patterning related to topography. Ridges had smaller gaps and higher proportions of gaps created by branch falls; slopes had bigger gaps generally created by uprooting events. The more abundant and frequent species were shade tolerant and the more species-rich families found inside gaps did not differ from the forest as a whole. Pioneer species were rare and restricted to medium and large size classes. The Indicator Species Analysis and the Canonical Correspondence Analysis indicated gap area, topography and the percentage of soil cover by the genera Calathea and Ctenanthe were the predominant variables correlated with woody species distribution. So, topography emerged as an important issue not only to the gap disturbance regime, but also to gap colonization. In respect to the influence of gap processes on the Atlantic Montane Rain Forest regeneration, our results support the view that canopy gap events may not be working as promoters of community wide floristic shifts.

Serum electrolyte and total protein alterations in Pantaneiro horse during long distance exercise

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Fish as Indicators of Disturbance in Streams Used for Snorkeling Activities in a Tourist Region

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Disturbance and repair of solitary waves in blood vessels with aneurysm

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Immunological disturbance in West and Lennox-Gastaut syndromes

Investigamos a imunidade humoral e celular em 18 pacientes com sindrome de West, 12 com sindrome de Lennox-Gastaut e 19 controles. Os exames realizados foram os seguintes: percentagem de linfócitos Ô e  no sangue periférico, niveis séricos de IgG, IgA e IgM, sensibilização cutânea com o DNCB, PHA intra dérmica, teste de inibição de migração de leucócitos e transformação blástica de linfócitos em presença de PHA. Detectamos deficiência de imunidade celular em 28 crianças, (18 com sindrome de West e 10 com sindrome de Lennox-Gastaut) e baixos níveis de imunoglobulinas em apenas 6. A depressão imunitária mostrou-se mais intensa nas crianças que apresentam sindrome de West.