937 resultados para high volume peritoneal dialysis


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The present work resulted from a study about coolant filtration systems in industries with metalworking process in large scale. The filtration and element filter world markets move billions of Reais per year and have a promissory future considering that with the global requirements of sustainable economic development, many companies invest in new filtering technology. Either known as coolant or cutting fluid, it is used to lubricate e cool parts during machining and is necessary due to the high volume demanded in the several machining operations and to the high cost of the product. Therefore, there is the need for recycling the product after its use. The work shows the technology and fundamentals of filtration as well as different filtering elements, filtration systems and scale contamination used in the industry. Also, there is a differentiation between filtration of the surface type (cake) and depth filtration and shows the basic theory of filtration by mathematic models in different operational conditions. Ultimately, project criteria for a coolant filtration system selection is shown followed by technical-operational details of a real vacuum filtration system and a case study aiming the operational cost reduction of the system

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Background. Ideal training methods that could ensure best peritoneal dialysis (PD) outcome have not been defined in previous reports. The aim of the present study was to evaluate the impact of training characteristics on peritonitis rates in a large Brazilian cohort.Methods. Incident patients with valid data on training recruited in the Brazilian Peritoneal Dialysis Multicenter Study (BRAZPD II) from January 2008 to January 2011 were included. Peritonitis was diagnosed according to International Society for Peritoneal Dialysis guidelines; incidence rate of peritonitis (episodes/patient-months) and time to the first peritonitis were used as end points.Results. Two thousand two hundred and forty-three adult patients were included in the analysis: 59 +/- 16 years old, 51.8% female, 64.7% with <= 4 years of education. The median training time was 15 h (IQI 10-20 h). Patients were followed for a median of 11.2 months (range 3-36.5). The overall peritonitis rate was 0.29 per year at risk (1 episode/41 patient-months). The mean number of hours of training per day was 1.8 +/- 2.4. Less than 1 h of training/day was associated with higher incidence rate when compared with the intervals of 1-2 h/day (P = 0.03) and > 2 h/day (P = 0.02). Patients who received a cumulative training of > 15 h had significantly lower incidence of peritonitis compared with < 15 h (0.26 per year at risk versus 0.32 per year at risk, P = 0.01). The presence of a caregiver and the number of people trained were not significantly associated with peritonitis incidence rate. Training in the immediate 10 days after implantation of the catheter was associated with the highest peritonitis rate (0.32 per year), compared with training prior to catheter implantation (0.28 per year) or > 10 days after implantation (0.23 per year). More experienced centers had a lower risk for the first peritonitis (P = 0.003).Conclusions. This is the first study to analyze the association between training characteristics and outcomes in a large cohort of PD patients. Low training time (particularly < 15 h), smaller center size and the timing of training in relation to catheter implantation were associated with a higher incidence of peritonitis. These results support the recommendation of a minimum amount of training hours to reduce peritonitis incidence regardless of the number of hours trained per day.

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Pós-graduação em Engenharia de Produção - FEG

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Pós-graduação em Engenharia de Produção - FEG

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Due to the large use of steel in several processes around the world, there is the increasingly concern to find new materials and/or optimization and improvement of the processes, as the need to reduce the cost and a productivity increase in the primary industry, such as the siderurgy. The rolling is the most used mechanical process in the world and therefore is required the development of new tools in high volume and with optimum characteristics to support the market demand. Forged rolls used are for rolling. These rolls have heat treatment that has the purpose to achieve the appropriated mechanical properties to support the variables of the rolling process. The objective of this work is to analyze the hardness profile and the microstructure a tool steel similar to AISI A2, forged in an opened die process and submitted to heat treatment with water-cooling. The results allowed plotting a hardness profile and performing a microstructure analysis, and whereby to confirm that the heat treatment is not a quenching, but it is a material beneficiation by the hardening of superficial layer, since there is no martensitic microstructure. Therefore, this paper provides the support to future studies about the possibility to perform enhancements in this thermal heat made in the rolls produced at Gerdau Plant in Pindamonhangaba

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Chelydra serpentine serpentine (Common Snapping Turtle). Nesting Behavior and Site Selection. On May 31, 2008, we observed a ca. 36 cm CL Chelydra serpentine serpentine in unexpected nesting circumstances. Observations were made from 0908 to 1027 h on clear day with ambient temp ca 24° C. The nest site near Longmont, Colorado, USA (40.1599528°N, 105.1259861°W; WGS84) was 4.3 m from a seasonal ditch running north-south to connect two lakes, one on either side of a busy road. The intriguing aspect of the nest location was that it was immediately adjacent to a heavily traveled concrete sidewalk that bordered a road with a high volume of traffic. The frequent foot traffic on the sidewalk and virtually constant vehicle traffic on the adjacent road did not deter the turtle from the particular nest location, even though virtually identical soils, gradients, and directional aspects were available equidistant from the ditch, but away from constant human activity.

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Pós-graduação em Engenharia de Produção - FEG

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Due to the large use of steel in several processes around the world, there is the increasingly concern to find new materials and/or optimization and improvement of the processes, as the need to reduce the cost and a productivity increase in the primary industry, such as the siderurgy. The rolling is the most used mechanical process in the world and therefore is required the development of new tools in high volume and with optimum characteristics to support the market demand. Forged rolls used are for rolling. These rolls have heat treatment that has the purpose to achieve the appropriated mechanical properties to support the variables of the rolling process. The objective of this work is to analyze the hardness profile and the microstructure a tool steel similar to AISI A2, forged in an opened die process and submitted to heat treatment with water-cooling. The results allowed plotting a hardness profile and performing a microstructure analysis, and whereby to confirm that the heat treatment is not a quenching, but it is a material beneficiation by the hardening of superficial layer, since there is no martensitic microstructure. Therefore, this paper provides the support to future studies about the possibility to perform enhancements in this thermal heat made in the rolls produced at Gerdau Plant in Pindamonhangaba

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Background Chyle fistulas may occur after left neck dissections that include level IV, due to injury of the thoracic duct or of 1 of its major branches. Despite being unusual, this complication carries substantial postoperative morbidity and even mortality. So far, no effective intraoperative maneuver has been reported to detect this fistula at the end of a neck dissection. In this cohort study, we sought to describe a simple new maneuver, intraoperative abdominal compression, which can effectively help to identify an open major lymphatic duct on level IV at the end of a neck dissection. Patients and Methods From March 1989 to September 2010, 206 patients underwent neck dissections involving left level IV, and underwent intraoperative abdominal compression. There were 119 men and 87 women, with ages ranging from 18 to 81 years (median, 52 years). One hundred forty-four patients had squamous cell carcinomas, 54 had thyroid carcinomas, 5 had malignant melanomas, and 3 had salivary cancers. Distribution by type of left neck dissection was: selective including levels II, III, and IV (73 cases; 35.4%), selective including levels II, III, IV, and V (55 cases; 26.6%), selective including levels I, II, III, and IV (12 cases; 5.8%), modified radical (47 cases; 22.8%), and radical (19 cases; 9.2%). In all cases, at the end of the procedure, the endotracheal tube was temporarily disconnected from the ventilator. Keeping the dissected level IV area under clear visualization, an abdominal compression was performed. At this moment, any detected lymphatic leak was carefully clamped and tied with nonabsorbable sutures. After ventilating the patient, the intraoperative abdominal compression was repeated to reassure complete occlusion of the lymphatic vessel. Results In 13 cases (6.3%), a chyle leak was detected after performing the intraoperative abdominal compression. All leaks except for 2 were successfully controlled after 1 attempt. In these 2 patients, a patch of muscle and fat tissue was applied with fibrin glue on the top. In 1 of these patients, another chyle leak in a different location was detected only at the second intraoperative abdominal compression, and was also effectively closed. Postoperatively, there were 2 (1%) chyle fistulas, both among these 13 cases, and all were successfully managed with clinical measures only. No fistulas occurred among the remaining 193 patients in whom intraoperative abdominal compression did not demonstrate lymphatic leak. Conclusion To our knowledge, this is the first description of a specific maneuver to actively detect a lymphatic fistula at the end of a left neck dissection involving level IV. In this study, intraoperative abdominal compression was able to detect an open lymphatic vessel in 6.3% of the cases, as well as to assure its effective sealing in the remaining 93.7% of the patients. Moreover, no life-threatening high-volume fistula was noted in this study. (C) 2012 Wiley Periodicals, Inc. Head Neck, 2012

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DA SILVA, N. D. JR, T. FERNANDES, U. P. R. SOCI, A. W. A. MONTEIRO, M. I. PHILLIPS, and E. M. DE OLIVEIRA. Swimming Training in Rats Increases Cardiac MicroRNA-126 Expression and Angiogenesis. Med. Sci. Sports Exerc., Vol. 44, No. 8, pp. 1453-1462, 2012. Purpose: MicroRNA (miRNA)-126 is angiogenic and has two validated targets: Sprouty-related protein 1 (Spred-1) and phosphoinositol-3 kinase regulatory subunit 2 (PI3KR2), negative regulators of angiogenesis by VEGF pathway inhibition. We investigated the role of swimming training on cardiac miRNA-126 expression related to angiogenesis. Methods: Female Wistar rats were assigned to three groups: sedentary (S), training 1 (T1, moderate volume), and training 2 (T2, high volume). T1 consisted of 60 min.d(-1) of swimming, five times per week for 10 wk with 5% body overload. T2 consisted of the same protocol of T1 until the eighth week; in the ninth week, rats trained for two times a day, and in the 10th week, rats trained for three times a day. MiRNA and PI3KR2 gene expression analysis was performed by real-time polymerase chain reaction in heart muscle. We assessed markers of training, the cardiac capillary-fiber ratio, cardiac protein expression of VEGF, Spred-1, Raf-1/ERK 1/2, and PI3K/Akt/eNOS. Results: The cardiac capillary-fiber ratio increased in T1 (58%) and T2 (101%) compared with S. VEGF protein expression was increased 42% in T1 and 108% in T2. Cardiac miRNA-126 expression increased 26% (T1) and 42% (T2) compared with S, correlated with angiogenesis. The miRNA-126 target Spred-1 protein level decreased 41% (T1) and 39% (T2), which consequently favored an increase in angiogenic signaling pathway Raf-1/ERK 1/2. On the other hand, the gene expression of PI3KR2, the other miRNA-126 target, was reduced 39% (T1) and 78% (T2), and there was an increase in protein expression of components of the PI3K/Akt/eNOS signaling pathway in the trained groups. Conclusions: This study showed that aerobic training promotes an increase in the expression of miRNA-126 and that this may be related to exercise-induced cardiac angiogenesis, by indirect regulation of the VEGF pathway and direct regulation of its targets that converged in an increase in angiogenic pathways, such as MAPK and PI3K/Akt/eNOS.

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Abstract Introduction In acute lung injury (ALI), elevation of procollagen type III (PC III) occurs early and has an adverse impact on outcome. We examined whether different high-inflation strategies of mechanical ventilation (MV) in oleic acid (OA) ALI alter regional expression of PC III. Methods We designed an experimental, randomized, and controlled protocol in which rats were allocated to two control groups (no injury, recruited [alveolar recruitment maneuver after tracheotomy without MV; n = 4 rats] and control [n = 5 rats]) or four injured groups (one exposed to OA only [n = 10 rats] and three OA-injured and ventilated). The three OA-injured groups were ventilated for 1 hour according to the following strategies: LVHP-S (low volume-high positive end-expiratory pressure [PEEP], supine; n = 10 rats, tidal volume [VT] = 8 ml/kg, PEEP = 12 cm H2O), HVLP-S (high volume-low PEEP, supine; n = 10 rats, VT = 20 ml/kg, PEEP = 5 cm H2O), and HVLP-P (high volume-low PEEP, prone; n = 10 rats). Northern blot analysis for PC III and interleukin-1-beta (IL-1β) and polymorphonuclear infiltration index (PMI) counting were performed in nondependent and dependent regions. Regional differences between groups were assessed by two-way analysis of variance after logarithmic transformation and post hoc tests. Results A significant interaction for group and region effects was observed for PC III (p = 0.012) with higher expression in the nondependent region for HVLP-S and LVHP-S, intermediate for OA and HVLP-P, and lower for control (group effect, p < 0.00001, partial η2 = 0.767; region effect, p = 0.0007, partial η2 = 0.091). We found high expression of IL-1β (group effect, p < 0.00001, partial η2 = 0.944) in the OA, HVLP-S, and HVLP-P groups without regional differences (p = 0.16). PMI behaved similarly (group effect, p < 0.00001, partial η2 = 0.832). Conclusion PC III expression is higher in nondependent regions and in ventilatory strategies that caused overdistension. This response was partially attenuated by prone positioning.

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The purpose of this study was to assess the composition of the rainwater in Araraquara City, Brazil, a region strongly influenced by pre-harvest burning of sugar cane crops. Chemical and mineralogical variables were measured in rainwater collected during the harvest, dry period of 2009 and the non-harvest, wet period of 2010. Ca2+ and NH4+ were responsible for 55% of cations and NO3- for 45% of anions in rainwater. Al and Fe along with K were the most abundant among trace elements in both soluble and insoluble fractions. High volume weighted mean concentration (VWM) for most of the analyzed species were observed in the harvest, dry period, mainly due to agricultural activities and meteorological conditions. The chemistry of the Araraquara rainwater and principal component analysis (PCA) quantification clearly indicate the concurrence of a diversity of sources from natural to anthropogenic especially related to agricultural activities.

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[ES]El spam, o correo no deseado enviado masivamente, es una amenaza que afecta al correo electrónico y otros medios de comunicación telemática. Su alto volumen de circulación genera pérdidas temporales y económicas considerables. Se presenta una solución a este problema: un sistema inteligente híbrido de filtrado antispam, basado en redes neuronales artificiales (RNA) no supervisadas. Consta de una etapa de preprocesado y de otra de procesado, basadas en distintos modelos de computación: programada (con 2 fases: manual y computacional) y neuronal (mediante mapas autoorganizados de Kohonen, SOM), respectivamente. Este sistema ha sido optimizado usando, como cuerpo de datos, ham de “Enron Email” y spam de dos fuentes diferentes. Se analiza la calidad y el rendimiento del mismo mediante diferentes métricas.