778 resultados para KT-invexity
Resumo:
Eutrophication has been listed as one of the main problems of water pollution on a global level. In the Brazilian semi-arid areas this problem takes even greater proportions due to characteristical water scarcity of the region. It is extremely important to the predictive eutrophication models development and to the reservoirs management in the semi-arid region, studies that promotes understanding of the mechanisms responsible for the expansion and control of algae blooms, essential for improving the water quality of these environments. The present study had as its main aims, evaluate the temporal pattern of trophic state, considering the influence of nutrients (N and P) and the light availability in the water column in the development of phytoplankton biomass, and perform the mathematical modelling of changes in phosphorus and chlorophyll a concentrations in the Cruzeta man-made lake located on Seridó, a typical semi-arid region of Rio Grande do Norte. To this, a fortnightly monitoring was performed in the reservoir in 05 stations over the months of March 2007 to May 2008. Were measured the concentrations of total phosphorus, total organic nitrogen, chlorophyll a, total, fixed and volatile suspended solids, as well as the measure of transparency (Secchi) and the profiles of photosynthetic active radiation (PAR), temperature, pH, dissolved oxygen and electrical conductivity in the water column. Measurements of vertical profiles have shown some periods of chemical and thermal stratification, especially in the rainy season, due to increased water column depth, however, the reservoir can be classified as warm polimitic. During the study period the reservoir was characterized as eutrophic considering the concentrations of phosphorus and most of the time as mesotrophic, based on the concentrations of chlorophyll a, according to the Thornton & Rast (1993) classification. The N:P relations suggest N limitation, conversely, significant linear relationship between the algae biomass and nutrients (N and P) were not observed in our study. However, a relevant event was the negative and significant correlation presented by Kt and chlorophyll a (r ² = 0.83) at the end of the drought of 2007 and the rainy season of 2008, and the algal biomass collapse observed at the end of the drought season (Dec/07). The equation used to simulate the change in the total phosphorus was not satisfactory, being necessary inclusion of parameters able to increase the power of the model prediction. The chlorophyll a simulation presented a good adjustment trend, however there is a need to check the calibrated model parameters and subsequent equation validation
Resumo:
Objective:To analyze the immediate effects of the Kinesio Taping® application on the quadriceps neuromuscular performance, postural balance and lower limb function in healthy subjects. Materials andmethods:This is a randomized, controlled, blinded clinical trial. Sixtyfemale volunteers(age: 23.3±2.5 years old, BMI: 22.2±2.1kg/m2)wererandomly assigned intothreegroups with20memberseach,and performedone of these threeprotocols: control -10 minutesof rest,experimental 1- patch application ontherectusfemoris (RF), vastuslateralis(VL) and vastusmedialis(VM) and experimental 2-KT application on the same muscles. Allunderwent an evaluationfor singleand triple hop distance, postural balance (baropodometry), joint position sense(JPS), peak torque (concentric and eccentricevaluation at 60°/s)and electromyographic activityof VL,before andafter intervention.Results: There wasasignificant increasein the jump distanceof thethreestudied groups,with no differencebetween groups.There were nosignificant changesin postural balance,JPS, concentricpeak torqueand RMSof the VLin none of the groups. There was a reduction ineccentricpeak torquein all groups, without differencesbetween groups.Conclusion:The KT application on the RF, VL and VMmusclesis not able tosignificantly improvelower limbfunction and postural balance, as well as the kneeextensor peaktorque, JPSand the VL muscleactivation amplitudeof healthy women.
Resumo:
Many studies have demonstrated the relationship between dialysis dose and survival. Global mortality is similar among men and women; however, the influence of dialysis dose in the survival could be more intensive between women. Therefore, we conduct an observational study to evaluate the gender-related impact of single pool Kt/V (spKt/V) on the survival of patients submitted to hemodialysis in a university hospital. We found that survival was lower in groups with spKt/V smaller than 1.2 than in those with Kt/V between 1.2 and 1.4. Among female patients, spKt/V smaller than 1.2 had a more adverse effect in survival than among men with a comparable Kt/V. Otherwise, among women, the dialysis dose had an impact in survival even with Kt/V greater than 1.4. Thus, fractional urea clearance more heavily influenced the survival of females than males in hemodialysis patients.
Resumo:
Intensity of dialysis dose in acute kidney injury (AKI) might benefit critically ill patients. The aim of this study was to evaluate the effect of intermittent hemodialysis (IHD) dose on mortality in patients with AKI. Methods: Prospective observational study was performed on AKI patients treated with IHD. The delivered dialysis dose per session was calculated based on single-pool Kt/V urea. Patients were allocated in two groups according to the weekly delivered median Kt/V: higher intensity dialysis dose (HID: Kt/V higher than median) and lower intensity dialysis dose (LID: Kt/V lower than median). Thereafter, AKI patients were divided according to the presence or absence of sepsis and urine output. Clinical and lab characteristics and survival of AKI patients were compared. Results: A total of 121 AKI patients were evaluated. Forty-two patients did not present with sepsis and 45 did not present with oliguria. Mortality rate after 30 days was lower in the HID group without sepsis (14.3% x 47.6%; p = 0.045) and without oliguria (31.8% x 69.5%; p = 0.025). Survival curves also showed that the HID group had higher survival rate when compared with the LID group in non-septic and non-oliguric patients (p = 0.007 and p = 0.003, respectively). Conclusion: Higher dialysis doses can be associated with better survival of less seriously ill AKI patients.
Resumo:
There is no consensus in the literature on the best renal replacement therapy (RRT) in acute kidney injury (AKI), with both hemodialysis (HD) and peritoneal dialysis (PD) being used as AKI therapy. However, there are concerns about the inadequacy of PD as well as about the intermittency of HD complicated by hemodynamic instability. Recently, continuous replacement renal therapy (CRRT) have become the most commonly used dialysis method for AKI around the world. A prospective randomized controlled trial was performed to compare the effect of high volume peritoneal dialysis (HVPD) with daily hemodialysis (DHD) on AKI patient survival. A total of 120 patients with acute tubular necrosis (ATN) were assigned to HVPD or DHD in a tertiary-care university hospital. The primary end points were hospital survival rate and renal function recovery, with metabolic control as the secondary end point. Sixty patients were treated with HVPD and 60 with DHD. The HVPD and DHD groups were similar for age ( 64.2 +/- 19.8 and 62.5 +/- 21.2 years), gender ( male: 72 and 66%), sepsis ( 42 and 47%), hemodynamic instability ( 61 and 63%), severity of AKI ( Acute Tubular Necrosis-Index Specific Score (ATN-ISS): 0.68 +/- 0.2 and 0.66 +/- 0.2), Acute Physiology, Age, and Chronic Health Evaluation Score (APACHE II) (26.9 +/- 8.9 and 24.1 +/- 8.2), pre-dialysis BUN (116.4 +/- 33.6 and 112.6 +/- 36.8mg per 100 ml), and creatinine ( 5.8 +/- 1.9 and 5.9 +/- 1.4 mg per 100 ml). Weekly delivered Kt/V was 3.6 +/- 0.6 in HVPD and 4.7 +/- 0.6 in DHD ( P<0.01). Metabolic control, mortality rate ( 58 and 53%), and renal function recovery ( 28 and 26%) were similar in both groups, whereas HVPD was associated with a significantly shorter time to the recovery of renal function. In conclusion, HVPD and DHD can be considered as alternative forms of RRT in AKI.
Continuous peritoneal dialysis compared with daily hemodialysis in patients with acute kidney injury
Resumo:
Background: In some parts of the world, peritoneal dialysis is widely used for renal replacement therapy (RRT) in acute kidney injury (AKI), despite concerns about its inadequacy. It has been replaced in recent years by hemodialysis and, most recently, by continuous venovenous therapies. We performed a prospective study to determine the effect of continuous peritoneal dialysis (CPD), as compared with daily hemodialysis (dHD), on survival among patients with AKI.Methods: A total of 120 patients with acute tubular necrosis (ATN) were assigned to receive CPD or dHD in a tertiary-care university hospital. The primary endpoint was hospital survival rate; renal function recovery and metabolic, acid-base, and fluid controls were secondary endpoints.Results: of the 120 patients, 60 were treated with CPD (G1) and 60 with dHD (G2). The two groups were similar at the start of RRT with respect to age (64.2 +/- 19.8 years vs 62.5 +/- 21.2 years), sex (men: 72% vs 66%), sepsis (42% vs 47%), shock (61% vs 63%), severity of AKI [Acute Tubular Necrosis Individual Severity Score (ATNISS): 0.68 +/- 0.2 vs 0.66 +/- 0.22; Acute Physiology and Chronic Health Evaluation (APACHE) II: 26.9 +/- 8.9 vs 24.1 +/- 8.2], pre-dialysis blood urea nitrogen [BUN (116.4 +/- 33.6 mg/dL vs 112.6 +/- 36.8 mg/dL)], and creatinine (5.85 +/- 1.9 mg/dL vs 5.95 +/- 1.4 mg/dL). In G1, weekly delivered Kt/V was 3.59 +/- 0.61, and in G2, it was 4.76 +/- 0.65 (p < 0.01). The two groups were similar in metabolic and acid-base control (after 4 sessions, BUN < 55 mg/dL: 46 +/- 18.7 mg/dL vs 52 +/- 18.2 mg/dL; pH: 7.41 vs 7.38; bicarbonate: 22.8 +/- 8.9 mEq/L vs 22.2 +/- 7.1 mEq/L). Duration of therapy was longer in G2 (5.5 days vs 7.5 days; p = 0.02). Despite the delivery of different dialysis methods and doses, the survival rate did not differ between the groups (58% in G1 vs 52% in G2), and recovery of renal function was similar (28% vs 26%).Conclusion: High doses of CPD provided appropriate metabolic and pH control, with a rate of survival and recovery of renal function similar to that seen with dHD. Therefore, CPD can be considered an alternative to other forms of RRT in AKI.
Resumo:
Background and objectives Peritoneal dialysis is still used for AKI in developing countries despite concerns about its limitations. The objective of this study was to explore the role of high-volume peritoneal dialysis in AM patients in relation to metabolic and fluid control, outcome, and risk factors associated with death.Design, setting, participants, & measurements A prospective study was performed on 204 AKI patients who were assigned to high-volume peritoneal dialysis (prescribed Kt/V=0.60/session) by flexible catheter and cycler; 150 patients (80.2%) were included in the final analysis.Results Mean age was 63.8 +/- 15.8 years, 70% of patients were in the intensive care unit, and sepsis was the main etiology of AKI (54.7%). BUN and creatinine levels stabilized after four sessions at around 50 and 4 mg/dl, respectively. Fluid removal and nitrogen balance increased progressively and stabilized around 1200 ml and -1 g/d after four sessions, respectively. Weekly delivered Kt/V was 3.5 +/- 0.68. Regarding AKI outcome, 23% of patients presented renal function recovery, 6.6% of patients remained on dialysis after 30 days, and 57.3% of patients died. Age and sepsis were identified as risk factors for death. In urine output, increase of 1 g in nitrogen balance and increase of 500 ml in ultrafiltration after three sessions were identified as protective factors.Conclusions High-volume peritoneal dialysis is effective for a selected AKI patient group, allowing adequate metabolic and fluid control. Age, sepsis, and urine output as well as nitrogen balance and ultrafiltration after three high-volume peritoneal dialysis sessions were associated significantly with death. Clin J Am Soc Nephrol 7: 887-894, 2012. doi: 10.2215/CJN.11131111
Resumo:
Inadequate dialysis causes accumulation of toxic residues that may lead to the development of dialysis-associated pericardial effusion, but several other factors could be associated with this abnormality. The purpose of this study was to evaluate clinical risk factors to asymptomatic pericardial effusion in peritoneal dialysis.This cross-sectional study included 34 patients aged a parts per thousand yen18 years on peritoneal dialysis for at least 3 months, who showed no symptomatic pericardial effusion, hepatic cirrhosis, neoplasias, lupus or amputations, none in minoxidil use. Asymptomatic pericardial effusion was diagnosed by echocardiography. Risk factors were evaluated by logistic regression and Roc curve. Significance level was set at P < 0.05.Patient age was 51 +/- A 15.9 years. of the 34 patients enrolled, 16 were men and 11 diabetic. Five of them presented pericardial effusion. Logistic regression identifies low hemoglobin level (RR 0.454 CI 95%: 0.225-0.913; P = 0.027), low phase angle (RR 0.236 CI 95%: 0.057-0.984; P = 0.048) and low Kt/V (RR 0.001 CI 95%: 0.0-0.492; P = 0.03) as risk factors to pericardial effusion. Roc curve showed that hemoglobin levels below 12.2 g/dL, Kt/V lower than 1.9 and phase angle lower than 4.5A degrees were the best cutoffs to predict pericardial effusion. Four patients showed these three parameters in the unfavorable range, and all these four patients presented pericardial effusion. The other patient with pericardial effusion had two of these parameters reduced.These findings corroborate the hypothesis that uremia plays a significant role in the pathogenesis of dialysis-associated pericardial effusion.
Resumo:
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Resumo:
Este trabalho teve como objetivo avaliar a influência das formas do relevo na variabilidade espacial de atributos físicos e suas relações com a mineralogia da argila de um Latossolo Vermelho eutroférrico, utilizando a técnica da geoestatística. Os solos foram amostrados nos pontos de cruzamento de uma malha, com intervalos regulares de 10 m, nas profundidades de 0,0-0,2 m, 0,2-0,4 m e 0,4-0,6 m para os atributos físicos e 0,6-0,8 m para os atributos mineralógicos. Os valores médios para a densidade do solo e resistência do solo à penetração são maiores no compartimento I onde a relação Ct/Ct+Gb é relativamente maior, indicando a presença de maior teor de caulinita. No compartimento II a condutividade hidráulica e a macroporsidade são maiores, influenciados provavelmente pelo predomínio da gibbsita. Portanto, conclui-se que a identificação das pedoformas é muito eficiente para compreender a variabilidade espacial de propriedades do solo. Sendo que, as variações na forma da paisagem promovem variabilidade espacial diferenciada das propriedades físicas e mineralógicas do solo.
Resumo:
INTRODUÇÃO: A doença renal crônica (DRC) é decorrente de uma lesão renal e perda progressiva e irreversível da função dos rins. A hemodiálise substitui parcialmente essa função, com o objetivo de corrigir as alterações metabólicas na DRC. Para acompanhar a adequação da diálise, é determinado o Kt/V - índice de depuração da ureia por sessão de hemodiálise. O exercício físico de moderada intensidade tem se mostrado de fundamental importância para melhorar os efeitos adversos ao tratamento dialítico. OBJETIVOS: Avaliar o Kt/V em indivíduos com DRC submetidos ao exercício físico isotônico de baixa intensidade durante a hemodiálise. MATERIAIS E MÉTODOS: Analisados dados de 15 voluntários de ambos os sexos, submetidos à hemodiálise três vezes por semana. Após duas horas do início da diálise, foi aplicado um protocolo de exercícios isotônicos de baixa intensidade de membros superiores e inferiores com duração de 30 minutos, por um período de três meses. Os valores do Kt/V foram comparados no período de três meses anteriores sem exercício e após três meses de exercício. RESULTADOS: A média dos valores do Kt/V nos três meses sem exercício foi de 1,13 ± 0,11 e após aplicação do programa de exercícios foi de 1,29 ± 0,12 (p < 0,05). CONCLUSÃO: O programa de exercício físico isotônico de baixa intensidade em pacientes com DRC, aplicados durante a sessão de diálise mostrou a melhora da eficiência dialítica.
Resumo:
A diferença entre fontes alimentares da ordem de 14 , originárias de plantas com ciclos fotossintéticos Carbono-3 (C3) e Carbono-4 (C4) e seus subprodutos, abre novas perspectivas para o estudo do metabolismo do carbono em aves e animais de pequeno porte. Os autores propõem um modelo teórico e experimental capaz de exprimir os resultados de enriquecimento relativo, delta per mil (delta ) da razão 13C/12C versus tempo em diferentes tecidos. Utilizou-se a equação y(t) = (y0 -- q/k) e-kt + q/k onde, y(t) é a concentração isotópica no tempo desejado, y0 a concentração isotópica inicial existente no tecido, k é uma constante de troca isotópica com unidade 1/tempo, t é unidade de tempo e q é a taxa de entrada de metabólitos que contém carbono, com valores de delta /tempo. Para fígado de galinhas que tiveram a ração de ciclo fotossintético C4 substituída por dieta C3 obteve-se a equação delta13C = -24,74 + 12,37 e-0.237(nT), com meia-vida (T) de 2,9 dias. O patamar de equilíbrio de substituição do carbono foi alcançado em --24,48 , de modo que praticamente 98,4% do conteúdo isotópico do C4 no fígado foi substituído por C3 após 5,6 meias-vidas. O modelo foi adequado para determinar o tempo de reciclagem total ou parcial da concentração de carbono nos tecidos em estudo.
Resumo:
O conhecimento das fases de absorção de água das diferentes espécies é importante em pesquisas objetivando melhorar a qualidade das sementes, utilizando tratamentos como condicionamento osmótico, pré-hidratação e uso de bioreguladores. O objetivo do presente trabalho foi estabelecer uma metodologia para determinar o limite entre a primeira e a segunda fase do processo, considerando o modelo W = f(t) - (a - w0)exp(-kt), utilizando testes estatísticos. O limite entre as duas primeiras fases do processo de absorção de água pelas sementes, foi determinado utilizando-se a distribuição assintótica de uma função de estimadores. O ponto a partir do qual esta diferença (W*) deixa de ser significativa foi determinado utilizando-se o teste estatístico T de Student. Para os dados utilizados como exemplo, tem-se o modelo ou =(0,434 + 0,00162 t) - (0,434 - w o)exp(-0,121 t), com r² = 0,98 e W* = (0,434 - w o) exp(-0,121 t). O valor de t encontrado (27,2 horas) é menor do que o valor determinado, considerando-se como critério para mudança de fase a diferença de 1% entre a assíntota e o valor estimado pelo modelo ajustado. Essa diferença de duas horas corresponde a 0,28% de água absorvida.
Resumo:
Background. Peritoneal dialysis (PD) is still widely used for acute renal failure (ARF) in developing countries despite concerns about its inadequacy. Continuous PD has been evaluated in ARF by analyzing the resolution of metabolic abnormality and normalization of plasma pH, bicarbonate, and potassium.Methodology: A prospective study was performed on 30 ARF patients who were assigned to high-dose continuous PD (Kt/V = 0.65 per session) via a flexible catheter (Tenckhoff) and automated PD with a cycler. Fluid removal, pH and metabolic control, protein Loss, and patient outcome were evaluated.Results: Patients received 236 continuous PD sessions; 76% were admitted to ICUs. APACHE II score was 32.2 +/- 8.65. BUN concentrations stabilized after 3 sessions, creatinine after 4, and bicarbonate and pH after 2. Fluid removal was 2.1 +/- 0.62 L/day. Creatinine and urea clearances were 15.8 +/- 4.16 and 17.3 +/- 5.01 mL/minute respectively. Normalized creatinine clearance and urea Kt/V values were 110.6 +/- 22.5 L/week/1.73 m(2) body surface area and 3.8 +/- 0.6 respectively. Solute reduction index was 41% +/- 6.5% per session. Serum albumin values remained stable in spite of considerable protein tosses (median 21.7 g/day, interquartile range 9.1 - 29.8 g/day). Regarding ARF outcome, 23% of patients presented renal function recovery, 13% remained on dialysis after 30 days of follow-up, and 57% died.Conclusion: High-dose continuous PD by flexible catheter and cycler was an effective treatment for ARF. It provided high solute removal, allowing appropriate metabolic and pH control, and adequate dialysis dose and fluid removal. Continuous PD can therefore be considered an alternative to other forms of renal replacement therapy in ARF.
Resumo:
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)