Could albumin level explain the higher mortality in hemodialysis patients with pulmonary hypertension?

Background: The pathogenesis of pulmonary hypertension (PH) in hemodialysis is still unclear. The aim of thisstudy was to identify the risk factors associated with the presence of PH in chronic hemodialysis patients and toverify whether these factors might explain the highest mortality among them.Methods: We conducted a retrospective study of hemodialysis patients who started treatment from August 2001to October 2007 and were followed up until April 2011 in a Brazilian referral medical school. According to theresults of echocardiography examination, patients were allocated in two groups: those with PH and those withoutPH. Clinical parameters, site and type of vascular access, bioimpedance, and laboratorial findings were comparedbetween the groups and a logistic regression model was elaborated. Actuarial survival curves were constructed andhazard risk to death was evaluated by Cox regression analysis.Results: PH > 35 mmHg was found in 23 (30.6%) of the 75 patients studied. The groups differed in extracellularwater, ventricular thickness, left atrium diameter, and ventricular filling. In a univariate analysis, extracellular waterwas associated with PH (relative risk = 1.194; 95% CI of 1.006 1.416; p = 0.042); nevertheless, in a multiple model,only left atrium enlargement was independently associated with PH (relative risk =1.172; 95% CI of 1.010 1.359;p = 0.036). PH (hazard risk = 3.008; 95% CI of 1.285 7.043; p = 0.011) and age (hazard risk of 1.034 per year of age;95% CI of 1.000 7.068; p = 0.047) were significantly associated with mortality in a multiple Cox regression analysis.However, when albumin was taken in account the only statistically significant association was between albuminlevel and mortality (hazard risk = 0.342 per g/dL; 95% CI of 0.119 0.984; p = 0.047) while the presence of PH lost itsstatistical significance (p = 0.184). Mortality was higher in patients with PH (47.8% vs 25%) who also had astatistically worse survival after the sixth year of follow up.Conclusions: PH in hemodialysis patients is associated with parameters of volume overload that sheds light on itspathophysiology. Mortality is higher in hemodialysis patients with PH and the low albumin level can explain thisassociation.© 2012 Greenfield et al.; licensee BioMed Central Ltd.

Endurance training does not change the relative intensity at lactate threshold in elderly

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.

Carcass and meat quality traits of rabbits under heat stress

Rabbits are very sensitive to heat stress because they have difficulty eliminating excess body heat. The objective of the current study was to evaluate the effects of heat stress on slaughter weight, dressing percentage and carcass and meat quality traits of rabbits from two genetic groups. Ninety-six weaned rabbits were used: half were from the Botucatu genetic group and half were crossbreds between New Zealand White sires and Botucatu does. They were assigned to a completely randomized design in a 2 × 3 factorial arrangement (two genetic groups and three ambient temperatures: 18°C, 25°C and 30°C) and kept under controlled conditions in three environmental chambers from 5 to 10 weeks of age. Slaughter took place at 10 weeks, on 2 consecutive days. Meat quality measurements were made in the longissimus muscle. Actual average ambient temperature and relative humidity in the three chambers were 18.4°C and 63.9%, 24.4°C and 80.2% and 29.6°C and 75.9%, respectively. Purebred rabbits were heavier at slaughter and had heavier commercial and reference carcasses than crossbreds at 30°C; however, no differences between genetic groups for these traits were found at lower temperatures. No genetic group × ambient temperature interaction was detected for any other carcass or meat quality traits. The percentages of distal parts of legs, skin and carcass forepart were higher in crossbred rabbits, indicating a lower degree of maturity at slaughter in this group. The percentage of thoracic viscera was higher in the purebreds. Lightness of the longissimus muscle was higher in the purebreds, whereas redness was higher in the crossbreds. Slaughter, commercial and reference carcass weights and the percentages of thoracic viscera, liver and kidneys were negatively related with ambient temperature. Commercial and reference carcass yields, and the percentage of distal parts of legs, on the other hand, had a positive linear relationship with ambient temperature. Meat redness and yellowness diminished as ambient temperature increased, whereas cooking loss was linearly elevated with ambient temperature. Meat color traits revealed paler meat in the purebreds, but no differences in instrumental texture properties and water-holding capacity between genetic groups. Purebred rabbits were less susceptible to heat stress than the crossbreds. Heat stress resulted in lower slaughter and carcass weights and proportional reductions of organ weights, which contributed to a higher carcass yield. Moreover, it exerted a small, but negative, effect on meat quality traits. © 2012 The Animal Consortium.

Evaluación de la primera alimentación en larvas de capaz pimelodus grosskopfii bajo condiciones de laboratorio

Evaluate the performance and survival of capaz larvae Pimelodus grosskopfii after supplying live food (Cladocera, Copepod and Artemia Salina). Materials and methods. Capaz larva were placed in plastic containers with an useful volume of 3 L , and a larvae density of 10 L-1, they were fed four times a day during 15 days with newly hatched Artemia nauplii, Cladocerans of the genders Moina and Ceriodaphnia and Copepods calanoides. Capaz larva were weighed and measured at the beginning and the end of the experiment in order to evaluate their weight gain (WG), length gain (LG), specific growth rate (SGR), relative growth factor (RGF), and survival rate(S). Results. The treatment that showed the best results in WG, LG and S was the lot fed with Artemia nauplii (3.8±0.2 mg, 8±0.7 mm and 48.3% respectively), followed by sample supplied with Cladocera and Copepods. Conclusions. The Artemia nauplii treatment revealed the best results on the productive variables evaluated in P. grosskopfii larvae at the beginning of their exogenous feeding.

Actividades de cooperación en estadística realizadas por la Comisión Económica para América Latina y el Caribe en el bienio 1993-1994 = Statistical cooperation activities of the Economic Commission for Latin America and the Caribbean during 1993 and 1994

Incluye Bibliografía

Helmintofauna de Chelonia mydas necropsiadas na base do Projeto Tamar-Ibama em Ubatuba, Estado de São Paulo, Brasil

Pós-graduação em Biologia Geral e Aplicada - IBB

CARISPLAN: manual de procedimientos para la indización

Incluye Bibliografía

Overview of development strategies in the English-speaking Caribbean countries

Includes bibliography

Trade patterns and policies of CDCC countries in rice, legumes, ground provisions, fresh vegetables and citrus products and identification of areas for joint action

Includes bibliography

Variação do ciclo estral de novilhas Bos taurus indicus (Nelore) em diferentes estações do ano

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Indicadores fisiológicos, desempenho, rendimentos ao abate e qualidade de carne de coelhos puros e mestiços submetidos ao estresse pelo calor intenso ou moderado

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

An assessment of the economic impact Of climate change on the health sector in Saint Lucia

Climate change has the potential to impact on global, regional, and national disease burdens both directly and indirectly. Projecting and valuing these health impacts is important not only in terms of assessing the overall impact of climate change on various parts of the world, but also of ensuring that national and regional decision-making institutions have access to the data necessary to guide investment decisions and future policy design. This report contributes to the research focusing on projecting and valuing the impacts of climate change in the Caribbean by projecting the climate change-induced excess disease burden for two climate change scenarios in Saint Lucia for the period 2010 - 2050, and by estimating the non-market, statistical life-based costs associated with this excess disease burden. The diseases initially considered in this report are a variety of vector and water-borne impacts and other miscellaneous conditions; specifically, malaria, dengue fever, gastroenteritis/diarrhoeal disease, schistosomiasis, leptospirosis, ciguatera poisoning, meningococcal meningitis, and cardio-respiratory diseases. Disease projections were based on derived baseline incidence and mortality rates, available dose-response relationships found in the published literature, climate change scenario population projections for the A2 and B2 IPCC SRES scenario families, and annual temperature and precipitation anomalies as projected by the downscaled ECHAM4 global climate model. Monetary valuation was based on a transfer value of statistical life approach with a modification for morbidity. Using discount rates of 1, 2, and 4%, results show mean annual costs (morbidity and mortality) ranges of $80.2 million (in the B2 scenario, discounted at 4% annually) -$182.4 million (in the A2 scenario, discounted at 1% annually) for St. Lucia.1 These costs are compared to adaptation cost scenarios involving direct and indirect interventions in health care. This comparison reveals a high benefit-cost ratio suggesting that moderate costs will deliver significant benefit in terms of avoided health costs from 2010-2050. In this context indirect interventions target sectors other than healthcare (e.g. water supply). It is also important to highlight that interventions can target both the supply of health infrastructure (including health status and disease monitoring), and households. It is suggested that a focus on coordinated data collection and improved monitoring represents a potentially important no regrets adaptation strategy for St Lucia. Also, the need for this to be part of a coordinated regional response that avoids duplication in spending is highlighted.

Condições de acessibilidade a uma unidade básica de saúde do município de Botucatu, São Paulo, 1999

Pós-graduação em Saúde Coletiva - FMB

Aspectos clínicos e epidemiológicos dos acidentes por arraias nos distritos de Mosqueiro e Outeiro, Belém-Pará-Brasil

As águas da Baía de Marajó tornam-se doce nos meses de maior precipitação pluviométrica e saloba no outro período, o que torna possível o encontro de arraias da família Potamotrygonidae e exemplares de águas marítimas, as que são providas de ferrões pontiagudos e retrosserrilhados que, ao penetrarem nas vítimas, danificam o tegumento que as células glandulares de veneno, expondo os tecidos a toxina, levando ao aparecimento de manifestações clínicas. Empregou-se um modelo observacional e descritivo da prevalência, para avaliar os aspectos clínicos e epidemiológicos de 116 acidentes por arraias, ocorridos nos Distritos de Mosqueiro e Outeiro, Belém-Pará, no período de julho de 1999 a agosto de 2001. Estes ocorreram, principalmente, em Mosqueiro (80,2%) com maior freqüência no sexo masculino (63,8%), no grupo etário dos adolescentes e adultos (38,8% e 50,0%), respectivamente, no mês de julho (37,9%). Em todas as marés houve vítimas, porém, com menor freqüência na preamar (4,3%). A maioria dos acidentes ocorreu no fundo do rio com areia (49,1%) e no período vespertino (62,1%). As arraias mais capturadas nas praias de Mosqueiro foram da família Potamotrygonidae. As vítimas socorridas na primeira hora em 79,3% dos casos, sendo o membro inferior a região mais atingida em 84,5%, particularmente o pé (75,0%). Todos os pacientes apresentaram manifestações clínicas locais, com dor em 99,1% e cianose em 42,2% dos casos. Os sintomas sistêmicos estiveram presentes em 14,6%, sendo a tontura (6,0%) e a sudorese (5,2%) os mais encontrados. A pressão arterial acima do normal presente em 6,0%, e a taquicardia em 9,5%. O debridamento foi o manejo cirúrgico mais utilizado (94,5%). Retornaram para reavaliação somente 18,1% dos pacientes, dos quais, 33,4% evoluíram com necrose e 28,6% com infecção local. Não houve significância estatística na correlação entre evolução clínica, os tratamentos instituídos e o tempo entre o acidente e o início do atendimento médico. Conclui-se que acidentes por arraias são um importante agravo de saúde para a população que apesar das complicações locais, as vítimas não apresentam quadro grave. O período das águas salobras parece que influencia no aumento dos casos.