Continuous peritoneal dialysis compared with daily hemodialysis in patients with acute kidney injury

Background: In some parts of the world, peritoneal dialysis is widely used for renal replacement therapy (RRT) in acute kidney injury (AKI), despite concerns about its inadequacy. It has been replaced in recent years by hemodialysis and, most recently, by continuous venovenous therapies. We performed a prospective study to determine the effect of continuous peritoneal dialysis (CPD), as compared with daily hemodialysis (dHD), on survival among patients with AKI.Methods: A total of 120 patients with acute tubular necrosis (ATN) were assigned to receive CPD or dHD in a tertiary-care university hospital. The primary endpoint was hospital survival rate; renal function recovery and metabolic, acid-base, and fluid controls were secondary endpoints.Results: of the 120 patients, 60 were treated with CPD (G1) and 60 with dHD (G2). The two groups were similar at the start of RRT with respect to age (64.2 +/- 19.8 years vs 62.5 +/- 21.2 years), sex (men: 72% vs 66%), sepsis (42% vs 47%), shock (61% vs 63%), severity of AKI [Acute Tubular Necrosis Individual Severity Score (ATNISS): 0.68 +/- 0.2 vs 0.66 +/- 0.22; Acute Physiology and Chronic Health Evaluation (APACHE) II: 26.9 +/- 8.9 vs 24.1 +/- 8.2], pre-dialysis blood urea nitrogen [BUN (116.4 +/- 33.6 mg/dL vs 112.6 +/- 36.8 mg/dL)], and creatinine (5.85 +/- 1.9 mg/dL vs 5.95 +/- 1.4 mg/dL). In G1, weekly delivered Kt/V was 3.59 +/- 0.61, and in G2, it was 4.76 +/- 0.65 (p < 0.01). The two groups were similar in metabolic and acid-base control (after 4 sessions, BUN < 55 mg/dL: 46 +/- 18.7 mg/dL vs 52 +/- 18.2 mg/dL; pH: 7.41 vs 7.38; bicarbonate: 22.8 +/- 8.9 mEq/L vs 22.2 +/- 7.1 mEq/L). Duration of therapy was longer in G2 (5.5 days vs 7.5 days; p = 0.02). Despite the delivery of different dialysis methods and doses, the survival rate did not differ between the groups (58% in G1 vs 52% in G2), and recovery of renal function was similar (28% vs 26%).Conclusion: High doses of CPD provided appropriate metabolic and pH control, with a rate of survival and recovery of renal function similar to that seen with dHD. Therefore, CPD can be considered an alternative to other forms of RRT in AKI.

Growth performance and metabolic response of Nile tilapia fed rations supplemented with autolized yeast and zinc

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

Knowledge of firefighters with special paramedic training of the emergency management of avulsed teeth

Immediate replantation into the socket is the ideal procedure in cases of accidental avulsion of permanent teeth. In Brazil, firefighters with special paramedic training are in charge of providing first-aid care to victims of road accidents and might have to deal with tooth avulsions. This study assessed the knowledge of firefighters regarding the emergency management of avulsed teeth. Information was collected from a questionnaire submitted to 110 volunteer firefighters in seven cities in the São Paulo State (Brazil). The results revealed that 70.9% of the respondents did not know what tooth avulsion was; 53.6% did not know what tooth replantation was or defined it incorrectly; 60% would not act properly in tooth avulsion cases; 20.9% did not consider replantation of the avulsed tooth into the socket as a treatment option; the ideal time interval for tooth replantation was unknown to 40% of the interviewees; 90% of the participants answered that they would not be able to perform tooth replantation. Among those who considered themselves unable to perform tooth replantation, 47.3% chose saline as the best storage medium for an avulsed tooth, 21.8% chose milk, 3.6% chose the patient's mouth and 20% reported not knowing where to store the tooth; 81.8% of the firefighters reported not to have ever received any specific directions on tooth replantation and 100% of them considered this knowledge a requirement for first-aid care to accident victims. In conclusion, the knowledge of the surveyed firefighters regarding emergency management after tooth avulsion was unsatisfactory in several aspects that are important for the success of replantation procedures. Firefighters with special paramedic training should be educated on how to proceed in cases of dentoalveolar traumas and tooth avulsions in order to improve treatment prognosis and increase the survival rate of replanted teeth.

Stability of cp-Ti and Ti-6Al-4V alloy for dental implants as a function of saliva pH - an electrochemical study

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Implication of RNA-Binding Protein La in Proliferation, Migration and Invasion of Lymph Node-Metastasized Hypopharyngeal SCC Cells

The 5-year survival rate for oral cavity cancer is poorer than for breast, colon or prostate cancer, and has improved only slightly in the last three decades. Hence, new therapeutic strategies are urgently needed. Here we demonstrate by tissue micro array analysis for the first time that RNA-binding protein La is significantly overexpressed in oral squamous cell carcinoma (SCC). Within this study we therefore addressed the question whether siRNA-mediated depletion of the La protein may interfere with known tumor-promoting characteristics of head and neck SCC cells. Our studies demonstrate that the La protein promotes cell proliferation, migration and invasion of lymph node-metastasized hypopharyngeal SCC cells. We also reveal that La is required for the expression of beta-catenin as well as matrix metalloproteinase type 2 (MMP-2) within these cells. Taken together these data suggest a so far unknown function of the RNA-binding protein La in promoting tumor progression of head and neck SCC.

Fetal Pulmonary Response After Fetoscopic Tracheal Occlusion for Severe Isolated Congenital Diaphragmatic Hernia

OBJECTIVE: To estimate the response in lung growth and vascularity after fetal endoscopic tracheal occlusion for severe congenital diaphragmatic hernia in the prediction of neonatal survival.METHODS: Between January 2006 and December 2010, fetal lung parameters (observed-to-expected lung-to-head ratio; observed-to-expected lung volume; and contralateral lung vascularization index) were evaluated before fetal tracheal occlusion and were evaluated longitudinally every 2 weeks in 72 fetuses with severe isolated congenital diaphragmatic hernia. Thirty-five fetuses underwent fetal endoscopic tracheal occlusion and 37 cases did not.RESULTS: Survival rate was significantly higher in the fetal endoscopic tracheal occlusion group (54.3%) than in the no fetal endoscopic tracheal occlusion group (5.4%, P<.01). Fetal endoscopic tracheal occlusion resulted in a significant improvement in fetal lung size and pulmonary vascularity when compared with fetuses that did not go to the fetal intervention (increase of the observed-to-expected lung-to-head ratio, observed-to-expected total lung volume, and contralateral pulmonary vascularization index 56.2% compared with 0.3%, 37.9% compared with 0.1%, and 98.6% compared with 0.0%, respectively; P<.01). Receiver operating characteristic curves indicated that the observed-to-expected total fetal lung volume was the single best predictor of neonatal survival before fetal endoscopic tracheal occlusion (cutoff 0.23, area under the curve [AUC] 0.88, relative risk 5.3, 95% confidence interval [CI] 1.4-19.7). However, the contralateral lung vascularization index at 4 weeks after fetal endoscopic tracheal occlusion was more accurate in the prediction of neonatal outcome (cutoff 24.0%, AUC 0.98, relative risk 9.9, 95% CI 1.5-66.9) with the combination of observed-to-expected lung volumes and contralateral lung vascularization index at 4 weeks being the best predictor of outcome (AUC 0.98, relative risk 16.6, 95% CI 2.5-112.3).CONCLUSION: Fetal endoscopic tracheal occlusion improves survival rate by increasing the lung size and pulmonary vascularity in fetuses with severe congenital diaphragmatic hernia. The pulmonary response after fetal endoscopic tracheal occlusion can be used to predict neonatal survival. (Obstet Gynecol 2012; 119: 93-101) DOI: 10.1097/AOG.0b013e31823d3aea

Effects of Food Deprivation on the Development of Coleomegilla maculata (De Geer) (Coleoptera: Coccinellidae)

The lady beetle Coleomegilla maculata (De Geer) is a natural enemy of several insect pests and feeds on pollen and nectar to survive periods when prey is scarce. The effect of the feeding interval on the development, survival, fecundity, and longevity of C. maculata was determined. Newly hatched larvae of C. maculata were reared individually and fed with eggs of the Mediterranean flour moth Anagasta kuehniella (Zeller) at intervals of one, two, and three days under controlled conditions (23 ± 1ºC; 60 ± 10% RH; 12 h phtophase). The duration of larval instars and the total larval stage was prolonged as the feeding interval increased. The larval period lasted on average 9.2 ± 0.19 days when the larvae were fed daily with prey, and 14.6 ± 0.48 days when food was offered at three-day intervals. There was an inverse relationship between food intervals, survival, and weight of larvae and adults of the coccinellid. Survival rate of larvae fed daily was 76.8%, while the rate was 50.0% and 23.4% for larvae fed every two and three days, respectively. Coleomegilla maculata showed fecundity of 781.1 ± 149.02, 563.4 ± 80.81 and 109.0 ± 103.0 eggs when fed daily and at intervals of two and three days, respectively.

Subterranean termites (Isoptera: Rhinotermitidae): Exploitation of equivalent food resources with different forms of placement

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

Biomonitoring of substrates containing sewage sludge: assessment of the feasibility in using the diplopod Rhinocricus padbergi.

Due to the constant release of potentially harmful substances in the environment, it is necessary the use of biomonitoring as a form to assess the impact of these substances on animals that inhabit this environment. Therefore, there is a better understanding of the possible effects that these exogenous substances may cause in the organisms present there. In the present study it was verified the feasibility of the use of the diplopod Rhinocricus padbergi as bioindicator of impacted soils by their exposition to substrates containing different concentrations of sewage sludge from different Sewage Treatment Stations (STSs). It was observed animals' behavior and the survival rate was analyzed by log-rank test (p=0,05). The analysis showed that the animals exposed to pure sewage sludge presented higher mortality index than the specimens exposed to different concentrations of the sludge mixed with soil. In general, the survival rate and the analysis of the behavior of the diplopod R. padbergi showed efficiency of this species in biomonitoring impacted soils.

The Ultrastructural Study of Tumorigenic Cells Using Nanobiomarkers

Despite recent advances, patients with malignant brain tumors still have a poor prognosis. Glioblastoma (WHO grade 4 astrocytoma), the most malignant brain tumor, represents 50% of all astrocytomas, with a median survival rate of <1 year. It is, therefore, extremely important to search for new diagnostic and therapeutic approaches for patients with glioblastoma. This study describes the application of superparamagnetic nano-particles of iron oxide, as well as monoclonal antibodies, of immunophenotypic significance, conjoined to quantum dots for the ultrastructural assessment of glioblastoma cells. For this proposal, an immunophenotypic study by flow cytometry was carried out, followed by transmission electron microscopy analysis. The process of tumor cell labeling using nanoparticles can successfully contribute to the identification of tumorigenic cells and consequently for better understanding of glioblastoma genesis and recurrence. In addition, this method may help further studies in tumor imaging, diagnosis, and prognostic markers detection.

Studies on the electrochemical disinfection of water containing Escherichia coli using a Dimensionally Stable Anode

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

Experimental systemic virulence of oral Candida dubliniensis isolates in comparison with Candida albicans, Candida tropicalis and Candida krusei

There are no previous studies on the comparative virulence of Candida dubliniensis with other non-albicans species. The aim of this study was to compare the virulence and infection kinetics of C. dubliniensis and other species. Candida albicans, C. dubliniensis, Candida tropicalis and Candida krusei (reference strains) were inoculated intravenously in mice. For infection kinetics evaluation, a group of five animals were sacrificed after 6 h, 3, 7, 14 and 21 days. Microbiological evaluations (liver, spleen, kidneys, lungs and brain) and histopathological examination of the kidney were performed. The results of virulence evaluation were analysed using Kaplan-Meier survival analysis (5%). Candida dubliniensis-inoculated mice survived for longer periods compared with those with C. albicans (P = 0.005). No differences were detected in relation to C. tropicalis (P = 0.326) and C. krusei (P = 0.317). Most of the organs were persistently colonised by C. albicans and C. dubliniensis even by day 21. Tendency of C. krusei clearance was observed in all organs. Fungal masses and renal lesions were observed after inoculation of C. albicans, C. dubliniensis and C. tropicalis. Within the limits of the study, data on survival rate and dissemination capacity suggest that C. dubliniensis is less virulent than C. albicans.

Searching for molecular markers in head and neck squamous cell carcinomas (HNSCC) by statistical and bioinformatic analysis of larynx-derived SAGE libraries

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

BONE SPREADER TECHNIQUE: A PRELIMINARY 3-YEAR STUDY

The purpose of this study was to observe the clinical outcome of bone spreading and standardized dilation of horizontally resorbed bone during immediate implant placement using a "screw-type" configuration of expansion and threadformers. Fifty-three patients were included in this study, and 41 edentulous areas in anterior and posterior maxillas were treated. Sixty-eight implants were placed using an insertion torque of at least 40 Ncm. Abutments were delivered 4 to 6 months after implant placement. The overall failure percentage was 4.41% (3 failures). A retrieved analysis of I implant removed at 3 years after placement demonstrated bone resorption down to the level of the third thread. The bone spreader technique is different from Summers' osteotome, both in clinical use and in armamentarium. The main advantage of the crest-expanding technique is that it is a less invasive procedure; the facial wall expands after the medullary bone is compressed against the cortical wall. Within the limits of this preliminary study, the cumulative survival rate for this method of implant placement is 95.58% at 3 years. This study confirms that a bone spreader used in the maxilla shows an unusually low failure rate after 3 years.

Cytotoxicity and Genotoxicity of Root Canal Sealers Based on Mineral Trioxide Aggregate

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)