Cistatina C e taxa de filtração glomerular em cirurgia cardíaca com circulação extracopórea

Pós-graduação em Bases Gerais da Cirurgia - FMB

Avaliação de métodos de estimativa da radiação solar global e da evapotranspiração de referência para o estado de Mato Grosso

Pós-graduação em Agronomia (Irrigação e Drenagem) - FCA

Efeitos renais da dexmedetomidina como adjuvante à anestesia geral combinada à anestesia peridural em pacientes oncológicos submetidos a cirurgias urológicas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos da dexmedetomidina sobre a lesão de isquemia e reperfusão renal em ratos: avaliação pela NGAL, histologia e interleucinas

Pós-graduação em Anestesiologia - FMB

Avalição comparativa das intercorrências dialíticas de pacientes com lesão ranal aguda submetidos a sessões de hemodiálise prolongada de 6 e 10 horas

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Coexistencia de variantes HIV-1 com insercao dipeptidica no gene da transcriptase reversa

O objetivo desta comunicação foi descrever a detecção de coexistência de variantes HIV-1 com inserções de dois aminoácidos entre os códons 69 e 70 da transcriptase reversa. Tais variantes foram isoladas de paciente do sexo masculino, 16 anos de idade, em tratamento no interior do estado de São Paulo. Após confirmação de falha terapêutica, foi realizado teste de resistência a antirretrovirais, a partir do qual foram detectadas duas variantes contendo inserções dos aminoácidos Ser-Gly/Ser-Ala no códon 69 da transcriptase reversa, além da mutação T69S. Tais inserções possuem baixa prevalência, não foram relatadas em caráter de coexistência no Brasil e estão relacionadas com a resistência a múltiplas drogas, tornando o achado relevante do ponto de vista epidemiológico.

Extended Daily Dialysis in Acute Kidney Injury Patients: Metabolic and Fluid Control and Risk Factors for Death

Intermittent hemodialysis (IHD) and continuous renal replacement therapies (CRRT) are used as Acute Kidney Injury (AKI) therapy and have certain advantages and disadvantages. Extended daily dialysis (EDD) has emerged as an alternative to CRRT in the management of hemodynamically unstable AKI patients, mainly in developed countries.Objectives: We hypothesized that EDD is a safe option for AKI treatment and aimed to describe metabolic and fluid control of AKI patients undergoing EDD and identify complications and risk factors associated with death.Study Selection: This is an observational and retrospective study describing introduction of EDD at our institution. A total of 231 hemodynamically unstable AKI patients (noradrenalin dose between 0.3 and 1.0 ucg/kg/min) were assigned to 1367 EDD session. EDD consisted of 6-8 h of HD 6 days a week, with blood flow of 200 ml/min, dialysate flows of 300 ml/min.Data Synthesis: Mean age was 60.6 +/- 15.8 years, 97.4% of patients were in the intensive care unit, and sepsis was the main etiology of AKI (76.2). BUN and creatinine levels stabilized after four sessions at around 38 and 2.4 mg/dl, respectively. Fluid balance decreased progressively and stabilized around zero after five sessions. Weekly delivered Kt/V was 5.94 +/- 0.7. Hypotension and filter clotting occurred in 47.5 and 12.4% of treatment session, respectively. Regarding AKI outcome, 22.5% of patients presented renal function recovery, 5.6% of patients remained on dialysis after 30 days, and 71.9% of patients died. Age and focus abdominal sepsis were identified as risk factors for death. Urine output and negative fluid balance were identified as protective factors.Conclusions: EDD is effective for AKI patients, allowing adequate metabolic and fluid control. Age, focus abdominal sepsis, and lower urine output as well as positive fluid balance after two EDD sessions were associated significantly with death.

METABOLIC IMPLICATIONS OF PERITONEAL DIALYSIS IN PATIENTS WITH ACUTE KIDNEY INJURY

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Intra-abdominal pressure as a predictor of acute kidney injury in postoperative abdominal surgery

Objectives: The purpose of this study was to determine if intra-abdominal pressure (IAP) could predict acute renal injury (AKI) in the postoperative period of abdominal surgeries, and which would be its cutoff value. Patients and methods: A prospective observational study was conducted in the period from January 2010 to March 2011 in the Intensive Care Units (ICUs) of the University Hospital of Botucatu Medical School, UNESP. Consecutive patients undergoing abdominal surgery were included in the study. Initial evaluation, at admission in ICU, was performed in order to obtain demographic, clinical surgical and therapeutic data. Evaluation of IAP was obtained by the intravesical method, four times per day, and renal function was evaluated during the patient's stay in the ICU until discharge, death or occurrence of AKI. Results: A total of 60 patients were evaluated, 16 patients developed intra-abdominal hypertension (IAH), 45 developed an abnormal IAP (>7 mmHg) and 26 developed AKI. The first IAP at the time of admission to the ICU was able to predict the occurrence of AKI (area under the receiver-operating characteristic curve was 0.669; p=0.029) with the best cutoff point (by Youden index method) >= 7.68 mmHg, sensitivity of 87%, specificity of 46% at this point. The serial assessment of this parameter did not added prognostic value to initial evaluation. Conclusion: IAH was frequent in patients undergoing abdominal surgeries during ICU stay, and it predicted the occurrence of AKI. Serial assessments of IAP did not provided better discriminatory power than initial evaluation.

Evapotranspiração e eficiência do uso da água no primeiro ciclo produtivo da figueira 'Roxo de valinhos' submetida a cobertura morta

Evaluated the evapotranspiration (ETc) and the efficiency of water use (USA) by the fig tree 'Purple Valinhos' submitted to irrigation and mulching (bagacilho of sugar cane crushed) in the first production cycle, at conditions of Botucatu, St. Paul. We used the method of soil water balance and to obtain the reference evapotranspiration method was used Montheit FAO Penman 56. For the assessment of crop coefficients (kc) we adopted the following phenological distribution: phase 1 - between transplanting and 20% of the vegetative (DV), ii) phase 2 - 20 to 80% DV, and iii) phase 3 - fruiting. Observe the cumulative ETc 409.4 and 465.8 mm in 254 days after transplanting (DAT) and averages of 1.47 and 1.67 mm day(-1), with and without mulching (CC and SC). The crop coefficients (kc) mediums were 0.16, 0.43 and 0.49 for SC and 0.18, 0.44 and 0.50 for CC, in phases 1 and 3, respectively. The EUA values decrease with increasing the volume of water received and ranged between 1.65 and 3.32 kg of green figs per m(3) of water for irrigated SC and CC.

Estimativas da área da folha de figueiras 'Roxo de Valinhos' usando dimensões lineares do limbo foliar

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

Detecção dos genes de Biofilme, da leucocidina Panton-Valentine e da resistência a Meticilina em amostras de Staphylococcus aureus e Estafilococos Coagulase-Negativa

Uma coleção de 57 amostras de Staphylococcus aureus e 30 de estafilococos coagulasenegativa isoladas de recém-nascidos (RN) foram estudadas em relação à presença dos genes pvl, mecA e ica. Das 57 amostras de S. aureus, 31,6% apresentaram o gene mecA e 17,5% os genes pvl, sendo que dentre estas somente uma amostra foi mecA e pvl positiva. Os ECN apresentaram 36,7% de amostras mecA positivas, 93,3% ica positivas e nenhuma amostra pvl. Foi observada uma queda no número de amostras resistentes à meticilina no período de 1991-2005 para os S. aureus e também no período de 1990- 1996 para os ECN, porém a diferença não foi significativa. Também foram estudadas dez amostras de S. aureus isoladas de fossa nasal e nenhuma apresentou o gene mecA ou pvl. Já entre as dez amostras de ECN isoladas de fossa nasal, todas apresentaram o gene 11 ica, porém nenhuma foi resistente à meticilina. A análise dos dados clínicos dos RN revelou que o uso de cateter e outros corpos estranhos aumentam o risco de infecção por S. aureus e ECN. Assim, a produção de biofilme por ECN foi um importante fator de virulência presente em mais de 90% das amostras, confirmando a importância deste na ocorrência de infecções relacionadas com cateteres, e, apesar dos genes mecA e pvl estarem presentes concomitantemente em apenas uma amostra de S. aureus, esta revelou ter importância significativa

Avaliação do balanço nitrogenado e aparecimento de nitrogênio uréico como marcadores de catabolismo, infecção e mortalidade em pacientes com lesão renal aguda em diálise

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

O papel do NGAL urinário como preditor diagnóstico e prognóstico da lesão aguda associada a sepse em pacientes admitidos na emergência clínica

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

The long-term outcome after acute kidney injury: a narrative review

This review will focus on long-term outcomes after acute kidney injury (AKI). Surviving AKI patients have a higher late mortality compared with those admitted without AKI. Recent studies have claimed that long-term mortality in patients after AKI varied from 15% to 74% and older age, presence of previous co-morbidities, and the incomplete recovery of renal function have been identified as risk factors for reduced survival. AKI is also associated with progression to chronic kidney (CKD) disease and the decline of renal function at hospital discharge and the number and severity of AKI episodes have been associated with progression to CKD. IN the most studies, recovery of renal function is defined as non-dependence on renal replacement therapy which is probably too simplistic and it is expected in 60-70% of survivors by 90 days. Further studies are needed to explore the long-term prognosis of AKI patients.