932 resultados para Predictive factors of hospitalization


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The aim of the present study was to examine the benthic fauna in a marginal pond lateral to the Paranapanema River and to identify the main controlling factors of its distribution. Considering the small size of the lacustrine ecosystem, we expected that seasonal variations of the benthic community attributes are more important than spatial variations; Methods: Two samplings, one in March and another in August, were carried out at nine sites in the pond. Sediment samples were obtained through a Van Veen grab for invertebrate sorting, granulometric analysis, and for quantification of organic matter in sediment. Other abiotic factors were measured, such as water transparency, dissolved oxygen, pH, electric conductivity, temperature, and depth of sediment sampling sites. Regarding the comparative analysis at spatial scale, no significant variations in density of the benthic invertebrate community were found. Results: In relation to the studied abiotic factors, only depth presented significant differences among sampling sites; All the measured environmental parameters presented significant differences among sampling months, except depth and the physical and chemical characteristics of the sediment. The abundance of Chaoboridae and Chironomidae was the unique attribute with a significant difference in comparing the two months. A higher abundance of taxa occurred in August, especially for Oligochaeta, Nematoda, Chaoboridae, and Chironomidae; Conclusions: Because of the low structural complexity of the studied pond, we concluded that the changes in benthic macroinvertebrate community attributes were mainly due to seasonal effects.

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A novel strategy to handle divergences typical of perturbative calculations is implemented for the Nambu-Jona-Lasinio model and its phenomenological consequences investigated. The central idea of the method is to avoid the critical step involved in the regularization process, namely, the explicit evaluation of divergent integrals. This goal is achieved by assuming a regularization distribution in an implicit way and making use, in intermediary steps, only of very general properties of such regularization. The finite parts are separated from the divergent ones and integrated free from effects of the regularization. The divergent parts are organized in terms of standard objects, which are independent of the ( arbitrary) momenta running in internal lines of loop graphs. Through the analysis of symmetry relations, a set of properties for the divergent objects are identified, which we denominate consistency relations, reducing the number of divergent objects to only a few. The calculational strategy eliminates unphysical dependencies of the arbitrary choices for the routing of internal momenta, leading to ambiguity-free, and symmetry-preserving physical amplitudes. We show that the imposition of scale properties for the basic divergent objects leads to a critical condition for the constituent quark mass such that the remaining arbitrariness is removed. The model becomes predictive in the sense that its phenomenological consequences do not depend on possible choices made in intermediary steps. Numerical results are obtained for physical quantities at the one-loop level for the pion and sigma masses and pion-quark and sigma-quark coupling constants.

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O objetivo do trabalho foi determinar a ocorrência de fatores de virulência, tais como, a expressão de fímbrias, produção de hemolisina, colicina e aerobactina em 100 cepas de Escherichia coli isoladas de pacientes ambulatoriais e hospitalizados de um hospital universitário de nível de atendimento terciário, entre os meses de julho e agosto de 2000, que apresentavam sinais clínicos e laboratoriais de infecção do trato urinário (ITU). Foram pesquisados os genes pap, afa e sfa responsáveis pela expressão de fímbrias através da técnica de PCR. A freqüência dos fatores de virulência entre as cepas estudadas foi de 96,0%, 76,0% e 24,0% para hemolisina, aerobactina e colicina respectivamente, e a prevalência dos genes para os sistemas de adesinas fimbriais foi de 32,0%, 19,0% e 11,0% para os genes pap, sfa e afa respectivamente. As cepas isoladas dos pacientes ambulatoriais exibiram um número maior de fatores de virulência quando comparadas com aquelas provenientes de indivíduos hospitalizados.

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Objective. To investigate the long-term outcome and prognostic factors of juvenile dermatomyositis (DM) through a multinational, multicenter study.Methods. Patients consisted of inception cohorts seen between 1980 and 2004 in 27 centers in Europe and Latin America. Predictor variables were sex, continent, ethnicity, onset year, onset age, onset type, onset manifestations, course type, disease duration, and active disease duration. Outcomes were muscle strength/endurance, continued disease activity, cumulative damage, muscle damage, cutaneous damage, calcinosis, lipodystrophy, physical function, and health-related quality of life (HRQOL).Results. A total of 490 patients with a mean disease duration of 7.7 years were included. At the cross-sectional visit, 41.2-52.8% of patients, depending on the instrument used, had reduced muscle strength/endurance, but less than 10% had severe impairment. Persistently active disease was recorded in 41.2-60.5% of the patients, depending on the activity measure used. Sixty-nine percent of the patients had cumulative damage. The frequency of calcinosis and lipodystrophy was 23.6% and 9.7%, respectively. A total of 40.7% of the patients had decreased functional ability, but only 6.5% had major impairment. Only a small fraction had decreased HRQOL. A chronic course, either polycyclic or continuous, consistently predicted a poorer outcome. Mortality rate was 3.1%.Conclusion. This study confirms the marked improvement in functional outcome of juvenile DM when compared with earlier literature. However, many patients had continued disease activity and cumulative damage at followup. A chronic course was the strongest predictor of poor prognosis. These findings highlight the need for treatment strategies that enable a better control of disease activity over time and the reduction of nonreversible damage.

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Background: Decreased heart rate variability (HRV) is related to higher morbidity and mortality. In this study we evaluated the linear and nonlinear indices of the HRV in stable angina patients submitted to coronary angiography. Methods. We studied 77 unselected patients for elective coronary angiography, which were divided into two groups: coronary artery disease (CAD) and non-CAD groups. For analysis of HRV indices, HRV was recorded beat by beat with the volunteers in the supine position for 40 minutes. We analyzed the linear indices in the time (SDNN [standard deviation of normal to normal], NN50 [total number of adjacent RR intervals with a difference of duration greater than 50ms] and RMSSD [root-mean square of differences]) and frequency domains ultra-low frequency (ULF) ≤ 0,003 Hz, very low frequency (VLF) 0,003 - 0,04 Hz, low frequency (LF) (0.04-0.15 Hz), and high frequency (HF) (0.15-0.40 Hz) as well as the ratio between LF and HF components (LF/HF). In relation to the nonlinear indices we evaluated SD1, SD2, SD1/SD2, approximate entropy (-ApEn), α1, α2, Lyapunov Exponent, Hurst Exponent, autocorrelation and dimension correlation. The definition of the cutoff point of the variables for predictive tests was obtained by the Receiver Operating Characteristic curve (ROC). The area under the ROC curve was calculated by the extended trapezoidal rule, assuming as relevant areas under the curve ≥ 0.650. Results: Coronary arterial disease patients presented reduced values of SDNN, RMSSD, NN50, HF, SD1, SD2 and -ApEn. HF ≤ 66 ms§ssup§2§esup§, RMSSD ≤ 23.9 ms, ApEn ≤-0.296 and NN50 ≤ 16 presented the best discriminatory power for the presence of significant coronary obstruction. Conclusion: We suggest the use of Heart Rate Variability Analysis in linear and nonlinear domains, for prognostic purposes in patients with stable angina pectoris, in view of their overall impairment. © 2012 Pivatelli et al.; licensee BioMed Central Ltd.

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Chronic cardiomyopathy is the most important clinical form of Chagas disease, and it is characterised by myocarditis that is associated with fibrosis and organ dysfunction. Alternative treatment options are important tools to modulate host immune responses. The main goal of this work was to evaluate the anti-inflammatory actions of melatonin during the chronic phase of Chagas disease. TNF-α, IL-10 and nitrite concentrations were evaluated as predictive factors of immune modulation. Creatine phosphokinase-MB (CK-MB), cardiac inflammatory foci and heart weight were assessed to evaluate the efficacy of the melatonin treatment. Male Wistar rats were infected with 1 × 105 blood trypomastigotes of the Y strain of Trypanosoma cruzi and kept untreated for 60 days to mimic chronic infection. After this period, the rats were orally treated with melatonin 50 mg/kg/day, and the experiments were performed 90, 120, and 180 days post-infection. Melatonin treatment significantly increased the concentration of IL-10 and reduced the concentrations of NO and TNF-α produced by cardiomyocytes. Furthermore, it led to decreased heart weight, serum CK-MB levels and inflammatory foci when compared to the untreated and infected control groups. We conclude that melatonin therapy is effective at protecting animals against the harmful cardiac inflammatory response that is characteristic of chronic T. cruzi infection. © 2013 Elsevier B.V. All rights reserved.

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This study uses some backward-looking versions of Phillips curves, estimated from both revised and real-time data, to explore the existence, robustness and size of the contribution that a variety of activity measures may make to the task of predicting inflation in Chile. The main results confirm the findings of the recent international literature: the predictive power of the activity measures considered here is episodic, unstable and of moderate size. This weak predictive contribution is robust to the use of final and real-time data.

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