963 resultados para 6-59


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

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Prolonged intermittent renal replacement therapy (PIRRT) has emerged as an alternative to continuous renal replacement therapy in the management of acute kidney injury (AKI) patients. This trial aimed to compare the dialysis complications occurring during different durations of PIRRT sessions in critically ill AKI patients. We included patients older than 18 years with AKI associated with sepsis admitted to the intensive care unit and using noradrenaline doses ranging from 0.3 to 0.7 mu g/kg/min. Patients were divided into two groups randomly: in G1, 6-h sessions were performed, and in G2, 10-h sessions were performed. Seventy-five patients were treated with 195 PIRRT sessions for 18 consecutive months. The prevalence of hypotension, filter clotting, hypokalemia, and hypophosphatemia was 82.6, 25.3, 20, and 10.6%, respectively. G1 was composed of 38 patients treated with 100 sessions, whereas G2 consisted of 37 patients treated with 95 sessions. G1 and G2 were similar in male predominance (65.7 vs. 75.6%, P=0.34), age (63.6 +/- 14 vs. 59.9 +/- 15.5 years, P=0.28) and Sequential Organ Failure Assessment score (SOFA; 13.1 +/- 2.4 vs. 14.2 +/- 3.0, P=0.2). There was no significant difference between the two groups in hypotension (81.5 vs. 83.7%, P=0.8), filter clotting (23.6 vs. 27%, P=0.73), hypokalemia (13.1 vs. 8.1%, P=0.71), and hypophosphatemia (18.4 vs. 21.6%, P=0.72). However, the group treated with sessions of 10h were refractory to clinical measures for hypotension, and dialysis sessions were interrupted more often (9.5 vs. 30.1%, P=0.03). Metabolic control and fluid balance were similar between G1 and G2 (blood urea nitrogen [BUN]: 81 +/- 30 vs. 73 +/- 33mg/dL, P=1.0; delivered Kt/V: 1.09 +/- 0.24 vs. 1.26 +/- 0.26, P=0.09; actual ultrafiltration: 1731 +/- 818 vs. 2332 +/- 947mL, P=0.13) and fluid balance (-731 +/- 125 vs. -652 +/- 141mL, respectively) . In conclusion, intradialysis hypotension was common in AKI patients treated with PIRRT. There was no difference in the prevalence of dialysis complications in patients undergoing different durations of PIRRT.

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A GC method to determine caprolactam in water, 15 ethanol, and olive oil food simulants was developed and validated. Linear ranges varied from 0.96 to 642.82 g/mL for water, 0.64 to 800.32 g/mL for 15 ethanol, and 1.06 to 1062.34 g/g for olive oil, with correlation coefficients higher than 0.999. Method precision studies showed RSD values lower than 5.45, while method accuracy studies showed recovery from 72 to 111 for all simulants. The effect of gamma irradiation on caprolactam migration from multilayer polyamide 6 (PA-6) films intended for cheese into water, 15 ethanol, olive oil, and 3 acetic acid simulants was also studied. For migration assay, non-irradiated and irradiated (12 kGy) films were placed in contact with the simulant and exposed at 40C for 10 days. The validated method was used to quantify caprolactam migration from multilayer PA-6 films into the simulants, which ranged from 1.03 to 7.59 mg/kg for non-irradiated films, and from 4.82 to 11.32 mg/kg for irradiated films. Irradiation caused almost no changes in caprolactam levels, with the exception of olive oil, which showed an increase in the caprolactam level. All multilayer PA-6 films were in accordance with the requirements of the legislation for caprolactam migration.

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We describe a female patient with developmental delay, dysmorphic features and multiple congenital anomalies who presented a normal G-banded karyotype at the 550-band resolution. Array and multiplex-ligation probe amplification (MLPA) techniques identified an unexpected large unbalanced genomic aberration: a 17.6 Mb deletion of 9p associated to a 14.8 Mb duplication of 20p. The deleted 9p genes, especially CER1 and FREM1, seem to be more relevant to the phenotype than the duplicated 20p genes. This study also shows the relevance of using molecular techniques to make an accurate diagnosis in patients with dysmorphic features and multiple anomalies suggestive of chromosome aberration, even if on G-banding their karyotype appears to be normal. Fluorescence in situ hybridization (FISH) was necessary to identify a masked balanced translocation in the patient's mother, indicating the importance of associating cytogenetic and molecular techniques in clinical genetics, given the implications for patient management and genetic counseling. (C) 2012 Elsevier B.V. All rights reserved.

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BACKGROUND: Studies continue to identify percutaneous coronary intervention procedural volume both at the institutional level and at the operator level as being strongly correlated with outcome. High-volume centers have been defined as those that perform >400 percutaneous coronary intervention procedures per year. The relationship between drug-eluting stent procedural volume and outcome is unknown. We investigated this relationship in the German Cypher Registry. METHODS AND RESULTS: The present analysis included 8201 patients treated with sirolimus-eluting stents between April 2002 and September 2005 in 51 centers. Centers that recruited >400 sirolimus-eluting stent patients in this time period were considered high-volume centers; those with 150 to 400 patients were considered intermediate-volume centers; and those with <150 patients were designated as low-volume centers. The primary end point was all death, myocardial infarction, and target-vessel revascularization at 6 months. This end point occurred in 11.3%, 12.1%, and 9.0% of patients in the low-, intermediate-, and high-volume center groups, respectively (P=0.0001). There was no difference between groups in the rate of target-vessel revascularization (P=0.2) or cerebrovascular accidents (P=0.5). The difference in death/myocardial infarction remained significant after adjustment for baseline factors (odds ratio 1.85, 95% confidence interval 1.31 to 2.59, P<0.001 for low-volume centers; odds ratio 1.69, 95% confidence interval 1.29 to 2.21, P<0.001 for intermediate-volume centers). Patient and lesion selection, procedural features, and postprocedural medications differed significantly between groups. CONCLUSIONS: The volume of sirolimus-eluting stent procedures performed on an institutional level was inversely related to death and myocardial infarction but not to target-vessel revascularization at 6-month follow-up. Safety issues are better considered in high-volume centers. These findings have important public health policy implications.

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The aim of this study was to evaluate the difference between a 5-day and a 1-day postoperative course of antibiotic on the incidence of infection after mandibular fractures involving the alveolus. Sixty-two patients with fractures of the mandible involving the dentoalveolar region were randomly assigned to 2 groups, both of which were given amoxicillin/clavulanic acid 1.2 g intravenously every 8 h from admission until 24 h postoperatively. The 5-day group were then given amoxicillin/clavulanic acid 625 mg orally every 8 h for another 4 days. The 1-day group was given an oral placebo at the same intervals. Follow-up appointments were 1, 2, 4, 6, 12 weeks and 6 months postoperatively. Development of an infection was the primary end point. Fifty-nine of the 62 patients completed this study. Six of the 30 patients in the 5-day group (20%) and 6 out of the 29 in the 1-day group (21%) developed local wound infections. Three of the 6 in the 1-day group developed purulent discharge and swelling. One patient in the 5-day group developed a rash on the trunk. There were no significant differences in the incidence of infection or side effects between the groups. In fractures of the mandible involving the alveolus, a 1-day postoperative course of antibiotic is as effective in preventing infective complications as a 5-day regimen.

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BACKGROUND AND OBJECTIVES During pregnancy, gammadelta T cells expand at the fetomaternal interface where they induce a tolerogenic milieu. Patients with rheumatoid arthritis (RA) experience a spontaneous improvement of their disease during pregnancy and a postpartum aggravation. By contrast, pregnant patients with ankylosing spondylitis (AS) often experience persistent active disease. We hypothesised that the pregnancy related modulation of disease activity in RA patients versus AS patients is associated with numerical and functional changes of circulating gammadelta T cells. MATERIAL AND METHODS The frequency of surface markers and the intracellular cytokine profile of freshly isolated gammadelta T cells from RA (n = 54) and AS (n = 26) patients and healthy controls (n = 40) were analysed at each trimester during pregnancy and 6-8 weeks postpartum by flow cytometry. RESULTS Very discrete changes of Vdelta1 or Vdelta2 frequency were seen during pregnancy and postpartum in healthy controls and AS patients. In RA, however, the frequency of Vdelta2 cells decreased in the third trimester when disease activity was low. Low percentages of Vdelta 2 cells were also found in non-pregnant RA patients with active arthritis, yet only pregnant RA patients showed reduced percentages of Vdelta2 cells positive for the activation marker CD69 and the intracellular cytokine TNFalpha. Similarly, Vdelta1 + TNFalpha + cells were lower in pregnant RA patients compared to non-pregnant RA patients. The percentage of Vdelta2 + TNFalpha + cells, Vdelta2+ CD69+ and Vdelta1+ CD69+ cells correlated with disease activity in RA. As for the receptors which modulate cytotoxicity, RA patients showed a rise of the anti-cytotoxic receptor NKG2A on Vdelta1 cells in the 2(nd) trimester and a decrease postpartum. Since the pro-cytotoxic receptor NKG2D remained unchanged, the NKG2D/NKG2A ratio on Vdelta1 cells was reduced in RA patients during pregnancy. In AS patients, persistent disease activity during pregnancy was reflected by an increased frequency of Vdelta2+ CD69+ cells and an unchanged frequency of Vdelta2+ TNFalpha+ cells. In addition, pregnant AS patients showed an increased frequency of Vdelta1+CD161+ cells. CONCLUSIONS Disease amelioration of RA during pregnancy correlates with changes of cell activation, pro-inflammatory cytokines and anti-cytotoxic receptors of gammadelta T cells. By contrast, active disease during pregnancy as found in AS is associated with unchanged inflammatory responses of gammadelta T cells. Since gammadelta T cells remain unchanged in healthy pregnant controls, the modulation of gammadelta T cells in RA rather seems to be an effect of improved disease than of pregnancy itself.

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We analyzed the species distribution of Candida blood isolates (CBIs), prospectively collected between 2004 and 2009 within FUNGINOS, and compared their antifungal susceptibility according to clinical breakpoints defined by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) in 2013, and the Clinical and Laboratory Standards Institute (CLSI) in 2008 (old CLSI breakpoints) and 2012 (new CLSI breakpoints). CBIs were tested for susceptiblity to fluconazole, voriconazole and caspofungin by microtitre broth dilution (Sensititre® YeastOne™ test panel). Of 1090 CBIs, 675 (61.9%) were C. albicans, 191 (17.5%) C. glabrata, 64 (5.9%) C. tropicalis, 59 (5.4%) C. parapsilosis, 33 (3%) C. dubliniensis, 22 (2%) C. krusei and 46 (4.2%) rare Candida species. Independently of the breakpoints applied, C. albicans was almost uniformly (>98%) susceptible to all three antifungal agents. In contrast, the proportions of fluconazole- and voriconazole-susceptible C. tropicalis and F-susceptible C. parapsilosis were lower according to EUCAST/new CLSI breakpoints than to the old CLSI breakpoints. For caspofungin, non-susceptibility occurred mainly in C. krusei (63.3%) and C. glabrata (9.4%). Nine isolates (five C. tropicalis, three C. albicans and one C. parapsilosis) were cross-resistant to azoles according to EUCAST breakpoints, compared with three isolates (two C. albicans and one C. tropicalis) according to new and two (2 C. albicans) according to old CLSI breakpoints. Four species (C. albicans, C. glabrata, C. tropicalis and C. parapsilosis) represented >90% of all CBIs. In vitro resistance to fluconazole, voriconazole and caspofungin was rare among C. albicans, but an increase of non-susceptibile isolates was observed among C. tropicalis/C. parapsilosis for the azoles and C. glabrata/C. krusei for caspofungin according to EUCAST and new CLSI breakpoints compared with old CLSI breakpoints.

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Tübingen, Univ., Universitätsprogramm, 1881

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Über das Forschungsprogramm: The Philosophy of Western Society. Teilstück des allgemeinen Forschungsprogramms, veröffentlicht unter dem Untertitel: "The Philosophy of Social Science", in: "International Institute of Social Research. A Report of Its History, Aims and Activites, 1933-1938", New York (1938?), S. 19, Typoskript mit eigenhändiger Korrektur, 2 Blatt; Bericht über die Aktivitäten des Instituts für Sozialforschung für Robert M. MacIver, 1938-39: 1. Bericht vom 7.12.1939; a) Typoskript, englisch, 9 Blatt; b) Typoskript, als Brief von Pollock an Robert M. MacIver, Typoskript 10 Blatt; c) Entwurf Typoskript, englisch, 15 Blatt; d) Entwurf Typoskript, deutsch, 17 Blatt; MacIver, Robert M.: 1 Brief mit Unterschrift an Friedrich Pollock, New York, 27.04.1938, 1 Blatt; "Some data on the Institut`s Staff and Activities", 11.03.1938, zwei Typoskripte, je 2 Blatt; Über die Tätigkeiten des Instituts für Sozialforschung. Verschiedene Berichte. 1939; Aufstellung der Forschungsgebiete verschiedener Mitarbeiter des Instituts. Ohne Datum, Typoskript, 9 Blatt; Aufstellung der Forschungsgebiete verschiedener Mitarbeiter des Institutes, aus einem Bericht. Typoskript, 7 Blatt; Bericht an den Präsidenten des Columbia University. Typoskript, 2 Blatt; "Contribution of Dr. Franz Neumann to the Round Table Discussion, Chicago, Social Science Reaserach Building" Dezember 1939; a) Typoskript mit Handschriftlichen Korrekturen, 3 Blatt; b) Typoskript, 3 Blatt; "Statment on the objectives of the International Institut of Social Research". Typoskript, 2 Blatt; Stipendiaten des Instituts für Sozialforschung: Forschungsberichte, Ende 1939; Adorno, Theodor W.: a) Typoskript, englisch, mit eigenhändigen Korrekturen, 4 Blatt; b) Typoskript, deutsch, 3 Blatt; Beck, Maximilian: "Geschichte des Begriffs der Vernunft von Platon bis Husserl (Outline)". Typoskript, englisch und deutsch, mit handschriftlichen Korrekturen, 7 Blatt; Flechtheim, Ossip K.: Typoskript mit handschriftlichen Ergänzungen, 1 Blatt; Fried, Hans Ernest: Typoskript, 1 Blatt, 16.11.1939; Grossmann, Henryk: "Capitalism in the 13th Century"; a) Typoskript, englisch, mit handschriftlichen Korrekturen, 6 Blatt; b) Typoskript, englisch, 6 Blatt; c) Typoskript, deutsch, 4 Blatt; Grossmann, Henryk: "The Classical Theory and Marxism"; a) Typoskript, englisch, mit handschriftlichen Korrekturen, 2 Blatt; b) Typoskript, deutsch, mit handschriftlichen Korrekturen, 2 Blatt; Kirchheimer, Otto: Manuskript, 1 Blatt; Lauterbach, Albert: a) Typoskript, englisch, mit handschriftlichen Korrekturen, 2 Blatt; b) Typoskript, deutsch, mit handschriftlichen Korrekturen, 1 Blatt; Marcuse, Herbert: Typoskript mit handschriftlichen Korrekturen, 2 Blatt; Neumann, Franz L.: Typoskript, 2 Blatt; Wittfogel, Karl August: Typsokript, 2 Blatt; Zilsel, Edgar: Typoskript, 4 Blatt; Research Projects of the International Institute of Social Research. nicht vor 1939; Beschreibung der Forschungsprojekte: Pollock, Friedrich: "Economic and Social Cosequences of a Prepardness Economy". Neumann, Franz L.: "The Rule of Law". Fromm, Erich: "The German Worker in the Weiman Republic". Kirchheimer,Otto: "Criminal Law and Social Structure". Marcuse, Herbert: " A Text and Source Book for the History of Philosophy". Fromm, Erich: "Character Structure of Modern Man". Neumann, Franz L.: "The Theory and Practice of European Labor Law". Wittfogel, Karl August; Wittfogel-Lang, Olga: "The Chinese Family"; Dasselbe wie in "Beschreibung der Forschungsprojekte", ausgenommen Pollock, Friedrich: "Economic and Social Cosquences of a Prepardness Economy" und Fromm, Erich: "The German Worker in the Weimar Republic", zusätzlich Kirchner, Otto; Weil, Felix: "Changes in Social Stratification, National Income, and Living Standards of Germany since 1933"; 1 Ordner, Typoskript mit eigenhändigen Korrekturen, 49 Blatt;

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Grossmann, Henrik: "The Nature of Economic Crisis". Typoskript, 4 Blatt; Über die Tätigkeiten des Institutes für Sozialforschung. Verschiedene Berichte. 1940- 1941; "Report to the Trustees of the Kurt Gerlach Memorial Foundation". 25.01.1940, Typoskript, 5 Blatt; "Manuskript under preparation". Januar 1940, handschriftliche Liste, 1 Blatt; Horkheimer, Max: "Über die allgemeine Lage des Instituts". Bericht für das Advisory Bord (New York members) Meeting, 22.04.1940; sowie ein Protokoll des Treffens, Typoskript, 5 Blatt; "Annual Report on the Activities of the Société International de Recherces Sociales, Presented to the Eight General Meeting in New York City on April 27, 1940"; sowie "Report on the Activities of the International Institute of Social Research for the Year 1939". Typoskript, 13 Blatt; "Report to the Trustees of the Kurt Gerlach Memorial Foundation". 23.02.1941, Typoskript mit eigenhändigen Ergänzungen von Max Horkheimer und handschriftlichen Ergänzungen und Korrekturen von Leo Löwenthal, 7 Blatt; Liste der Veröffentlichungen und der Forschungsgebiete des Instituts für Sozialforschung; "Content of Periodicals. List of Articles and Selected Major Book Reviews Arranged According to Contibutors. List of Articles and Selected Major Book Reviews Arranged According Topics. 1934-1941". a) Typoskript, 14 Blatt; b) Typoskript , 15 Blatt; "Literatur über features". 03.02.1941, Veröffentlichungsliste, 1 Blatt; Veröffentlichungsliste zu den Gebieten Nationalsozialismus, Massenkultur, Sozialgeschichte des späteren Mittelalters; 19.12.1941, Typoskript, 1 Blatt; Ankündigung und Übersicht über die ersten Nummern der "Studies in Philosophy and Social Science". 1941; Typoskripte und Drucksachen, 3 Blatt; "Supplementary Memorandum on the Activities of the Institute from 1939 to 1941. (supplemented to December, 1942)". 1942, als Typoskript vervielfältigt, 5 Blatt; Über Organisation und Mitarbeiter des Institutes für Sozialforschung. 1943; a) Typoskript, 6 Blatt; b) Typoskript, 7 Blatt; c) Teilstück, Typoskript mit handschriftlichen Korrekturen, 2 Blatt; d) Teilstück, Typoskript, 3 Blatt; e) Entwurf, Typoskript mit handschriftlichen Korrekturen, 8 Blatt; "Annual Report on the Activities of the Social Studies Association, Inc.". 15.05.1943, Typoskript, 6 Blatt; "Statement of Prof. Dr. Max Horkheimer, Director of the Institut of Social Research on June 9, 1943. Reponse: Certain Charges made against the Institut of Social Research (Columbia University)". 1943; a) Typoskript, 6 Blatt; b) Typoskript mit handschriftlichen Randbemerkungen, 6 Blatt; c) deutsche Rückübersetzung, 1969, Typoskript mit handschriftlichen Korrekturen, 4 Blatt;