939 resultados para função renal


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El objetivo de este trabajo de investigación es identificar las organizaciones praxeológicas que permiten la articulación de la noción de función afín con otras nociones tanto en el contexto matemático como extramatemático en la Educación Media en Brasil. Los análisis se apoyan en la Teoría Antropológica de lo didáctico de Chevallard (2001) y los enfoques teóricos en términos de marcos definidos por Douady (1992) y niveles de conocimiento que se esperan de los estudiantes según la definición de Robert (1997). Tres libros de texto que fueron analizados darán una visión general de las relaciones institucionales que sobreviven actualmente en Brasil. Observamos la existencia de diferentes formas de articulación que dependen de las técnicas desarrolladas, necesitando la atención de profesores que deben proponer el mayor número posible de situaciones para que sus estudiantes puedan aplicar la noción de función afín en diferentes tareas, sean ellas escolares o no.

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O objetivo dessa pesquisa é analisar os pontos de vista sobre a noção de derivada de uma função desenvolvida no Ensino Médio e que podem servir de apoio para a disciplina de Cálculo Diferencial e Integral no Ensino Superior. Para isso, escolhemos como referenciais teóricos centrais os pontos de vista de Thurston (1995) e a abordagem teórica em termos de pontos de vista de Rogalski (1995). Para melhor identificar as dificuldades associadas ao ensino e à aprendizagem da noção de derivada na transição Ensino Médio e Superior complementamos as análises utilizando as abordagens teóricas em termos de quadros de Douady (1984) e níveis de conhecimento de Robert(1997) e a teoria antropológica do didático de Bosch e Chevallard (1999). Os resultados encontrados mostram que pouca atenção é dada ao trabalho desenvolvido no Ensino Médio, não se levando em conta os conhecimentos prévios dos estudantes, o que pode justificar as dificuldades encontradas por esses nos primeiros anos do Ensino Superior.

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Centrado na noção de níveis de conhecimento conforme definição de Robert (1997) apresentamos os resultados das análises sobre as possibilidades de articulação de quadros, representações semióticas e pontos de vista quando se consi era a abordagem da noção de função afim no Ensino Médio. Para tal identificamos as relações institucionais esperadas e existentes por meio da análise de documentos oficiais e livros didáticos e a relação pessoal desenvolvida por um grupo de estudantes do Ensino Médio de uma escola pública do estado de São Paulo. Os resultados encontrados colocam em evidência que existe uma preocupação institucional em se considerar a articulação entre os conhecimentos adquiridos no Ensino Fundamental e no decorrer do Ensino Médio. Apesar do trabalho desenvolvido institucionalmente, poucos estudantes do grupo analisado são capazes de desenvolver um trabalho onde essas articulações são necessárias.

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It has been recommended that adult patients with a serum creatinine above 150 µmol/l should be referred to a nephrologist for specialist assessment. This study ascertained all patients in Northern Ireland with creatinine above this concentration in 2001 (n?=?19 286 ) to see if this triggered referral within the subsequent year. After exclusion of those who were already known to a nephrologist and those who had acute renal failure, it was found that younger patients and diabetic patients were more likely to be referred. There was no difference in referral rates between male and female patients. However, only 6.5% of all non-diabetic subjects and 19% of diabetic patients were referred within 12 months after a first increased serum creatinine test.

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Heme oxygenase-1 (HO-1) is a cytoprotective molecule and increased expression in experimental transplant models correlates with reduced graft injury. A functional dinucleotide repeat (GT)n polymorphism, within the HO-1 promoter, regulates gene expression; a short number of repeats (S-allele

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This single center study is the largest series of renal transplant recipients and donors screened for the commonest prothrombotic genotypes. A total of 562 transplant recipients and 457 kidney donors were genotyped for the factor V Leiden and prothrombin G20210A mutations. The prevalence of heterozygous factor V Leiden was 3.4% and 2.6% and prothrombin G20210A was 2.0% and 1.1% in recipients and donors, respectively, similar frequencies to that of the general U.K. population. The 30-day and 1-year graft survival rates in recipients with thrombophilic mutations were 93% and 93%, compared with 88% and 82% in patients without these mutations (log-rank P =0.34). Thrombophilia in recipients (odds ratio 0.55; confidence interval 0.06-2.29; P =0.56) or in donors (odds ratio 1.53; confidence interval 0.27-5.74; P =0.46) did not correlate with graft loss at 30 days after transplantation. In contrast to recent reports, this study did not demonstrate an association between thrombophilia and renal allograft loss, and routine screening is not recommended.

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Objective: Patients with chronic kidney disease (CKD) benefit from specialist interventions to retard progression of renal failure and prevent cardiovascular events. Certain patient groups have poor access to specialist renal services when dialysis is required. This study used a population-based laboratory database to investigate access to and timeliness of referral to renal specialists relatively early in the course of the disease.

Methods: All tests for serum creatinine and haemoglobin (Hb) A1c in Northern Ireland in a two-year period (2001 and 2002) were retrieved for 345,441 adults. Of these, 16,856 patients had at least one serum creatinine level above 150 µmol/L in 2001 not deemed to be due to acute renal failure (crude prevalence 1.42%). This cohort was followed until the end of 2002 and the differences in the time to referral to a specialist were assessed using Cox's proportional hazards regression.

Results: Diabetic patients, older patients and those living in deprived areas were significantly more likely to have serum creatinine testing, compared with non-diabetic, younger and those living in more affluent areas. Delays in referral to renal specialists for patients with raised serum creatinine levels were significantly shorter among diabetic patients, women, younger individuals, those living in rural areas, those living close to renal centres and those living in deprived areas. Overall, only 19% of diabetic patients and 6% of non-diabetic patients who had CKD had seen a renal specialist within 12 months of their index creatinine test.

Conclusion: Contrary to other diseases, disadvantaged patients do not seem to be under-investigated for renal disease compared with their more affluent neighbours and are generally referred earlier for specialist assessment. However, the absolute rate of timely specialist assessment is low. Recent changes in referral criteria for CKD will result in more referrals and will have serious resource implications. Opportunities for health gain among patients with declining renal function are being missed, particularly among the old and those living furthest from specialist centres.