999 resultados para doença renal crônica terminal


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O presente trabalho investigou a ocorrência de infecção pelos poliomavírus JCV e BKV na população de pacientes com doença renal crônica, no Estado do Acre e em um grupo controle de indivíduos sem doença renal. Foram examinadas 100 amostras de urina do grupo de Pacientes e 99 amostras de urina do grupo Controle. Após a extração do DNA, a PCR foi usada para a amplificação de 173pb do gene que codifica o antígeno-T de ambos os vírus. A diferenciação entre as infecções por JCV e por BKV foi realizada por meio da digestão enzimática do produto amplificado, usando-se endonuclease de restrição. Esse estudo não identificou a presença do BKV nas amostras de urina do grupo de Pacientes e do grupo Controle. O JCV foi identificado em 11,1% (11/99) dos indivíduos do grupo Controle e em 4% (4/100) dos indivíduos do grupo de Pacientes. Foi encontrada diferença estatisticamente significante entre os grupos de Pacientes e Controle quanto à média de Uréia (p < 0,001), onde a média no grupo de Pacientes foi significantemente maior do que a média no grupo Controle. Estes resultados sugerem que os elevados níveis de uréia excretada na urina, a baixa celularidade urinária, a diminuição do “washout” (limpeza) da bexiga e o tempo para a análise das amostras, justifiquem a baixa prevalência de infecção encontrada no grupo de pacientes renais crônicos; pois esses fatores podem diminuir a quantidade de vírus na urina ou podem atuar como inibidores da PCR. Esse estudo sugere a necessidade de aumentar a sensibilidade dos testes para a identificação desses vírus.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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

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Pós-graduação em Geografia - FCT

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Introdução:Doença renal crônica (DRC) é definida pela presença de lesão renal levando à perda lenta e progressiva da função renal.Objetivo:Comparar testes auditivos entre pacientes com DRC submetidos a diferentes método de tratamento.Material e método:Estudo clínico transversal. Os grupos foram divididos de acordo com o método de tratamento: hemodiálise (n = 35), diálise peritoneal (n =15), conservador (n = 51) e 27 pacientes saudáveis (controle). Pacientes com idade superior a 60 anos, perda auditiva congênita, síndromes genéticas, infecções de orelha média e transplante renal foram excluídos da pesquisa. A avaliação audiológica incluiu audiometria tonal, emissões otoacústicas evocadas transientes e Potencial Evocado Auditivo de Tronco Encefálico (PEATE); e as variáveis avaliadas foram: sexo, idade, diagnóstico de hipertensão arterial e diabetes, estádio da DRC, tempo de diagnóstico do diabetes e da hipertensão arterial, duração da DRC e do tratamento.Resultados:A idade, presença de hipertensão arterial e tempo de DRC foram estatisticamente significantes e controlados. O grupo conservador apresentou piores limiares auditivos na audiometria tonal e o intervalo III-V do PEATE significativamente maior que o da hemodiálise.Conclusão:O tratamento conservador mostrou piores resultados na avaliação auditiva, independente de diabetes e de hipertensão, reforçando que os pacientes submetidos a tratamento para DRC devem realizar avaliação auditiva completa para melhor compreensão da doença e de seus efeitos sobre o sistema auditivo.

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

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Introduction: The pulmonary rehabilitation (PR) is composed of aerobic and resisted exercises that improve the functional capacity to the exercise, life quality and decrease respiratory symptoms in subjects with chronic pulmonary disease. Objective: Assess the effects of a combined PR program in the cardiorespiratory function and peripheral muscle strength in subjects with chronic pulmonary disease. Method: Patients with chronic pulmonary disease were submitted to the PR program, which was developed on 24 sessions of 60 minutes (three times per week). The program was composed of aerobic exercises (two times per week) and resisted exercises (once a week). Before and after the PR the patients were submitted to manovacuometry in order to measure the maximum inspiratory pressure (MIP) and the maximum expiratory pressure (MEP), ventilometry, peek expiratory flow (PEF), six minute walking test (6MWT) and one maximum repetition (1RM). The data are presented in absolute frequency, percentage and mean±standard deviation. The t Student test was used to compare data before and after the PR and the ANOVA test to compare before, after and predicted distances in the 6MWT (p<0.05). Results: Seven patients were part of this study, 85.70% of women, 71.40% with pulmonary emphysema diagnosis. The mean age was 69.43±5.59 years old, the height was 1.61±0.07 m, the mean weight was 66.20±8.40 kg and the body mass index mean was 25.50±2.48 kg/m². From the variables assessed, the MEP increased from 79.71±13.69 to 84.42±12.83 cmH2O (p=0,03), the PEF increase from 255.71±66.3 to 320.00±93.63 l/min (p=0,03) and the distance in the 6MWT from 415.28±47.90 to 483,79±79,77 m (p=0,02). The load in the 1RM test in the reverse peck deck exercise (before - - 17.10±8.10kg; after – 210.40±9.00kg), knee in leg extension machine (before – 17.10±9.50kg; after – 26.40±13.10kg) and hip extensors (right before – 48.60±22.10kg; after – 62.90±19.30kg; and left before – 46.40±20.10kg; after – 62.10±18.20kg) increased significantly (p<0,05). Conclusion: After the PR program there was improvement in the expiratory muscular strength, in the lower limbs strength and in the functional capacity. Besides that, there was a reduction in the airflow obstruction of the subjects with chronic pulmonary disease.

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The kidneys, for his anatomical and functional characteristics, are sensitive to affections that take the liberation of renal toxins or the blood supply, causing irreversible injuries to his renoparenchymal tissue that is substituted by fibrous tissue. Even after the resolution of the basic cause, there will be the loss of a significant number of his functional unity, renal adaptations will take place in the attempt of maintaining the renal function. These adaptations produce additional injuries, perpetuating to loss of renoparenchymal tissue and the reduction of the renal function. The renal insufficiency (IR) takes place after the loss of 3/4 of the number of his functional unities. Before the progression to the phase of IR, the animal shows up practically without symptoms, but for the gradual increase of the urinary and of the ingestion of water. The reduction of the degree of renal function leads to alterations system compensatory for the accumulation of substances that would suffer renal excretion. The progression of IR leads to the phase of the syndrome urêmica. In this phase the animal presents innumerable clinical signs that can take it to the death. The treatment is symptomatic and dietetic, but depending on the phase not much efficient. Because of being progressive and insidious, the IRC demands the preparation of campaigns and programs of explanation for the veterinary doctors who aim for the consciousness and/or sensibility of the owners to carry out periodic examinations of selection that precociously detect the renal dysfunction. The diagnosis in the beginning IR enables the efficiency of the treatment in stop or slowing his progression, extending the time and quality of life of the patient

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Pós-graduação em Fonoaudiologia - FFC

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

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To evaluate the prevalence of hypertension and its correlation with the severity of renal injury and proteinuria in dogs with leishmaniosis, sixty-six dogs were divided into two groups. Group 1 (G1) was composed of 54 dogs included in stage 1 of chronic kidney disease (CKD), and group 2 (G2) of twelve dogs in stages 2 and 3 of CKD. Prevalence of hypertension was 28.8%, comprising 22.2% of the dogs from G1 and 58.3% from G2 (P=0.011). The mean arterial blood pressure (BP) of dogs from G1 (135.7 +/- 20.5) was lower than from G2 (170.0 +/- 26.3) (P <0.001). Urine proteincreatinine ratio (UP/C) revealed values above 0.5 in 75.7% of the dogs, with 34% presenting hypertension. All dogs with hypertension had histopathological and laboratory evidence of glomerular disease. Although there was no statistically significant correlation between elevated BP and the severity of glomerular lesions (P=0.408), there was a statistically significant correlation between elevated BP and increased UP/C in the studied population (P=0.002). Thus, dogs with leishmaniosis and renal disease must be screened for the presence of hypertension so that treatment may be instituted as early as possible, in countries where treatment is allowed, to prevent the progression of renal damage.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Pós-graduação em Fisiopatologia em Clínica Médica - FMB