Utilization of peritoneal dialysis in the acute setting

Peritoneal dialysis (PD), although classically described and utilized in the treatment of patients with end-stage renal disease, can also be utilized in the acute setting in different clinical situations. Recent studies showed that, in patients with acute renal failure, it is possible to obtain reasonable dialysis doses with adequate metabolic and etectrolytic control and tow incidence of complications by utilizing continuous PD through a cycler at high volume. In patients with congestive heart failure without end-stage renal disease, PD is capable of promoting clinical improvement with slow removal of liquids, becoming an attractive alternative for situations of rapidly or slowly worsening cardiac function. In patients submitted to chronic hemodialysis but who have vascular access difficulties, PD can also be utilized as a bridge, thereby avoiding the use of central venous catheters, which can be associated with infectious complications such as bacterial endocarditis. New studies must be realized showing other indications for PD.

Emplacement setting of the granite sheeted pluton of Esperanca (Brasiliano orogen, Northeastern Brazil)

Anisotropy of magnetic susceptibility (AMS) and isotopic (U-Pb, Sm-Nd) data were combined to study the emplacement setting of the granite sheets that constitute the Esperanca pluton in the Borborema Province (Northeastern Brazil). The sheets dip moderately to the SE along the contact zone between the Paleoproterozoic basement rocks and Early Neoproterozoic orthogneisses and metasediments. Granite fabrics were determined mainly using AMS in 136 sites distributed within the central and western part of the pluton. The sheets normally have susceptibility lower than 0.35 mSI but, locally, where a Ti-poor magnetite appears with titanite, the susceptibility increases up to 5 mSI. Comparison between the silicate fabric and AMS showed inconsistencies between the shape of mineral and magnetic ellipsoids despite of their orientations that fit fairly well to each other. AMS indicated the deformation was partitioned between the lower (tonalite, syenogranite) and upper (leucogranite and coarse porphyritic granite) sheets. In the lower sheets the curvilinear lineation trajectory is attributed to a dominant heterogeneous pure shear event that flattened laterally the still molten tonalite and syenogranite into the regional foliation. ne associated microstructures are typically magmatic. Zircon U/Pb data of the syenogranite yielded a crystallization age of 592 +/- 5 Ma. In the upper sheets the fabric recorded a component of simple shear deformation that displaced the coarse porphyritic granite and the top gneissic host rocks to the southwest. Microstructures are mostly of post-full crystallization type. T(DM) model ages and epsilon(Nd) (t = 0) values indicate that the magma contaminated by partial melting of the regional host rocks. Sheet propagation at the emplacement level would have exploited the contact zone between crustal blocks of different rheologies when the melt pressures would be able to tensionally fail the anisotropy of the host rocks. (C) 2004 Elsevier B.V. All rights reserved.

Predictors of incorrectness in antimicrobial prescription in the Bauru State Hospital (Bauru city, São Paulo State, Brazil)

The inappropriate use of antimicrobials in hospitals presents a negative impact on patient outcome and is associated with the emergence and spread of multidrug-resistant microorganisms. Antimicrobial stewardship programs (ASPs) have been instituted in order to improve the quality of prescriptions in hospitals. In this setting, the identification of patterns of inappropriate antimicrobial prescription is a valuable tool that allows ASPs to identify priorities for directing educative/restrictive policies. With this purpose, a study was conducted in the Bauru State Hospital, a teaching hospital with 285 beds affiliated to the Botucatu Medical School, São Paulo State University. The hospital maintains an active ASP since it was opened, in 2002. We selected 25% of the requests for parenteral antimicrobials (RPAs) from 2005 for analysis. Prescriptions for prophylactic purposes were excluded. All other RPAs were classified according to a modified Kunin and Jones categories. Univariate and multivariable analyses were performed to identify predictors of general inappropriateness and of specific prescription errors. Prescriptions classified as "appropriate'' or "probably appropriate" were selected as controls in all stages of the study. Among 963 RPAs included in our study, 34.6% were inappropriate. General predictors of inappropriateness were: prescription on weekends/holidays (OR = 1.67, 95% CI = 1.20-2.28, p = 0.002), patient from intensive care unit (OR = 1.57, 95% CI = 1.11-2.23, p = 0.01), peritoneal (OR = 2.15, 95% CI = 1.27-3.65, p = 0.004) or urinary tract infection (OR = 1.89, 95% CI = 1.25-2.87, p = 0.002), combined therapy with two or more antimicrobials (OR = 1.72, 95% CI = 1.15-2.57, p = 0.008) and prescriptions including penicillin (OR = 2.12, 95% CI = 1.39-3.25, p = 0.001) or first-generation cephalosporins (OR = 1.74, 95% CI = 1.01-3.00, p = 0.048). Previous consultation with an infectious diseases (ID) specialist had a protective effect against inappropriate prescription (OR = 0.34, 95% CI = 0.24-0.50, p < 0.001). Factors independently associated with specific prescription errors varied. However, consultation with an ID specialist was protective against both unnecessary antimicrobial use (OR = 0.04, 95% CI = 0.01-0.26, p = 0.001) and requests for agents with insufficient spectrum (OR = 0.14, 95% CI = 0.03-0.30, p = 0.01). In conclusion, the analysis of factors predictive of inappropriateness in antimicrobial prescription allowed us to identify issues requiring intervention. Also, it provided a positive feedback of the ASP efficacy, demonstrating the importance of previous consultation with an ID specialist to assure the quality of antimicrobial prescriptions.

Application of impedance spectroscopy to evaluate the effect of different setting accelerators on the developed microstructures of calcium phosphate cements

The main goal of the present study was to evaluate the effect of different setting accelerator agents on the developed microstructures of calcium phosphate cements (CPCs) by employing the impedance spectroscopy (IS) technique. Six compositions of CPCs were prepared from mixtures of commercial dicalcium phosphate anhydrous (DCPA) and synthesized tetracalcium phosphate (TTCP) as the solid phases. Two TTCP/DCPA molar ratios (1/1 and 1/2) and three liquid phases (aqueous solutions of Na(2)HPO(4), tartaric acid (TA) and oxalic acid (OA), 5% volume fraction) were employed. Initial (I) and final (F) setting times of the cement pastes were determined with Gillmore needles (ASTM standard C266-99). The hardened samples were characterized by X-ray powder diffraction (XRD), Fourier transformed infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), and apparent density measurements. The IS technique was employed as a non-destructive tool to obtain information related to porosity, tortuosity and homogeneity of the cement microstructures. The formulation prepared from a TTCP/DCPA equimolar mixture and OA as the liquid phase presented the shortest I and F (12 and 20 min, respectively) in comparison to the other studied systems. XRD analyses revealed the formation of low-crystallinity hydroxyapatite (HA) (as the main phase) as well as the presence of little amounts of unreacted DCPA and TTCP after 24 h hardening in 100% relative humidity. This was related to the proposed mechanisms of dissolution of the reactants. The bands observed by FTIR allowed identifying the presence of calcium tartrate and calcium oxalate in the samples prepared from TA and OA, in addition to the characteristic bands of HA. High degree of entanglement of the formed crystals was observed by SEM in samples containing OA. SEM images were also correlated to the apparent densities of the hardened cements. Changes in porosity, tortuosity and microstructural homogeneity were determined in all samples, from IS results, when the TTCP/DCPA ratio was changed from 1/1 to 1/2. The cement formulated from an equimolar mixture of TTCP/DCPA and OA as the liquid phase presented setting times, degree of conversion to low-crystallinity HA and microstructural features suitable to be used as potential bone cement in clinical applications. The IS technique was shown to be a very sensitive and non-destructive tool to relate the paste composition to the developed microstructures. This approach could be very useful to develop calcium phosphate bone cements for specific clinical demands.

Tectonic setting and U/Pb zircon dating of the plutonic Socorro Complex in the Transpressive Rio Paraíba do Sul Shear Belt, SE Brazil

The Precambrian Rio Paraíba do Sul Shear Belt comprises a 200-km-wide anastomosing network of NE-SW trending ductile shear zones extending over 1000 km of the southeastern coast of Brazil. Granulitic, gneissic-migmatitic, and granitoid terrains as well as low- to medium-grade metavolcanosedimentary sequences are included within it. These rocks were affected by strong contractional, tangential tectonics, due to west-northwestward oblique convergence of continental blocks. Subsequent transpressional tectonics accomodated large dextral, orogen-parallel movements and shortening. The plutonic Socorro Complex is one of many deformed granites with a foliation subparallel to that of the shear belt and exposes crosscutting relationships between its tectonic, magmatic, and metamorphic structures. These relationships point to a continuous magmatic evolution related to regional thrusts and strike slip, ductile shear zones. The tectonic and magmatic structural features of the Serra do Lopo Granite provide a model of emplacement by sheeting along shear zones during coeval strike-slip and cross shortening of country rocks. Geochronological data indicate that the main igneous activity of Socorro Complex spanned at least 55 million years, from the late stage of the northwestward ductile thrusting (650 Ma), through right-lateral strike slip (595 Ma) deformation. The country rocks yield discordant age data, which reflect a strong imprint of the Transamazonian tectono-metamorphic event (1.9 to 2.0 Ma). We propose a model for the origin of calcalkaline granites of the Ribeira Belt by partial melting of the lower crust with small contributions of the lithospheric mantle during transpressional thickening of plate margins, which were bounded by deep shear zones. The transpressional regime also seems to have focused granite migration from deeper into higher crustal levels along these shear zones.

Genetic control of fruit-setting percentage of tomatoes tolerant to high temperatures

The aim of present work was to study, through means and variances of generations, the genetic control of fruit-set percentage in tomatoes, in a biparental cross between line Jab-95 (resistant to fruit-set) and 'Caribe' cultivar (susceptible to fruit-set) after being subjected to high temperatures. F1, F2, and backcross generations for both parents (P 1, P2) were produced in a greenhouse at FCAVUNESP, Jaboticabal-SP, Brazil. A randomized complete block experimental design with four replications was used to evaluate the different generations. Estimates of genetic parameters were obtained according to Mather and Jinks (1982). An additive-dominant model was fitted to explain the variation observed. The mean degree of dominance (0.54), indicated incomplete dominance in the direction of increasing fruit-set percentage at high temperatures. The genetic control of fruit-set percentage, at high temperatures, for tomato was found to be oligogenic or polygenic (3.54 genes). The heritability in a limited sense was 83.91%, suggesting that the selection of individuals based on the characteristic evaluated can be efficient.

Intervenções benéficas no pré-natal para prevenção da mortalidade materna

Maternal mortality rate (MM) is a health quality indicator that is directly influenced by the economic, cultural and technological level of a country. Official data of MM in Brazil, although underestimated, point to the lack of quality in pregnancy, childbirth and puerperium care services. This characteristic is common in developing countries, where poorer pregnant women as well as those facing greater difficulty to quality care access are found. Prenatal care cannot prevent major childbirth complications, which are important causes of MM; however, some interventions during the prenatal period can favor maternal prognosis and prevent MM. In this setting, this study brings a scientifically based update concerning effective interventions for maternal mortality prevention during the prenatal period. The most important strategies consist of a tripod with specific interventions related to maternal health promotion, risk prevention and assurance of nutritional support during gestation, in addition to criteria to investigate gestational risk and inclusion of the pregnant woman in the basic component of the prenatal care model. It ends with the definition of priorities in the prevention of MM related to eclampsia/preeclampsia and reinforces the importance of normalization of reference systems for obstetric emergency cases.

Setting the preheating process of electronic ballasts for hot-cathode fluorescent lamps, considering the Rh/Rc ratio

This paper presents a new model for the representation of the electrodes filaments of fluorescent lamps, during their preheating, and an analysis capable to guide the design of the preheating process in electronic ballasts. The main improvement obtained with the lamp model is the accurate theoretical reproduction of the behavior of the Rh/Rc ratio during the preheating process. In addition, using the proposed methodology based on the lamp model, it is possible to set a proper preheating process to the electrodes filaments, without the necessity of exhaustive empirical adjustments in the prototype, reducing time and costs involved in the design of ballasts with preheating capabilities. © 2006 IEEE.

Composition of stingless bee honey: Setting quality standards

Compositional data from 152 stingless bee (Meliponini) honey samples were compiled from studies since 1964, and evaluated to propose a quality standard for this product. Since stingless bee honey has a different composition than Apis mellifera honey, some physicochemical parameters are presented according to stingless bee species. The entomological origin of the honey was known for 17 species of Meliponini from Brazil, one from Costa Rica, six from Mexico, 27 from Panama, one from Surinam, two from Trinidad & Tobago, and seven from Venezuela, most from the genus Melipona. The results varied as follows: moisture (19.9-41.9g/100g), pH (3.15-4.66), free acidity (5.9-109.0meq/Kg), ash (0.01-1.18g/100g), diastase activity (0.9-23.0DN), electrical conductivity (0.49-8.77mS/cm), HMF (0.4-78.4mg/Kg), invertase activity (19.8-90.1IU), nitrogen (14.34-144.00mg/100g), reducing sugars (58.0-75.7g/100g) and sucrose (1.1-4.8g/100g). Moisture content of stingless bee honey is generally higher than the 20% maximum established for A. mellifera honey. Guidelines for further contributions would help make the physicochemical database of meliponine honey more objective, in order to use such data to set quality standards. Pollen analysis should be directed towards the recognition of unifloral honeys produced by stingless bees, in order to obtain standard products from botanical species. A honey quality control campaign directed to both stingless beekeepers and stingless bee honey hunters is needed, as is harmonization of analytical methods. © 2007 Asociación Interciencia.

Cytotoxic effects of hard-setting cements applied on the odontoblast cell line MDPC-23

Objective: The present study evaluated the cytotoxic effects of hard setting applied on the odontoblastlike cells MDPC-23. Study design: Eighty round-shaped samples were prepared with the following experimental materials: calcium hydroxide, Vitrebond, RelyX Luting, and RelyX Unicem. The samples were placed in serum-free culture medium and incubated for 24 hours or 7 days at 37°C with 5% CO 2 and 95% air. The odontoblast cells were plated in the wells and incubated for 72 hours. After this period, the complete culture medium was replaced by the extracts obtained from every sample, and the methyltetrazolium assay was carried out to evaluate the cell metabolism. Results: For the 24-hour period, the experimental materials calcium hydroxide, Vitrebond, RelyX Luting, and RelyX Unicem decreased the cell metabolic activity by 91.52%, 81.14%, 78.17%, and 2.64%, respectively. For the 7-day period, calcium hydroxide, Vitrebond, RelyX Luting, and RelyX Unicem decreased the metabolic activity of the MDPC-23 cells by 91.13%, 87.27%, 79.04%, and 10.51%, respectively. Conclusion: RelyX Unicem presented the lowest cytopathic effects to the cultured odontoblast cell line. © 2007 Mosby, Inc. All rights reserved.

Usefulness of Mycobacterium tuberculosis molecular typing in a tuberculosis low-endemic agro-industrial setting of Brazil

To highlight the transmission and major phylogenetic clades of Mycobacterium tuberculosis, a retrospective study was carried out at two health facilities in a small agro-industrial area in São Paulo, Brazil, that has a low tuberculosis incidence rate. IS6110-RFLP and spoligotyping were performed on the isolates, with the former revealing that 31.3% (35/112) of strains were clustered. Epidemiological links were found in 16 of the 35 clustered patients and were associated with transmission among patients living in public housing. Spoligotyping grouped 62.8% of the strains. The T genetic family predominated among the isolates. Of interest is that five strains had a pattern characteristic of African or Asian origin (ST535), and two others were of the rare localized type ST1888 (BRA, VEN). In addition, three new types-1889, 1890, and 1891-were identified. Spoligotyping showed that some ST may be circulating to or from Brazil, and RFLP revealed ongoing transmission in inadequately ventilated public-housing buildings. This may point to a failure in tuberculosis control policy.

How the delphi and AHP methods are aiding to define the critical success factors priorities in a digital factory project implementation

Digital factory is a concept that offers a collaborative approach to enhance product and production engineering processes through simulation. Products, processes and resources are modeled to be used to develop and test the product conception and manufacturing processes, before their use in the real factory. The purpose of this paper is to present the steps to identify the Critical Success Factors (CSF) priorities in a digital factory project implementation in a Brazilian company and how the Delphi and AHP Methods are aiding to identify these CSF priorities. Copyright © 2008 SAE International.

Climate Change and Development in Latin America and the Caribbean. Overview 2009

Includes bibliography

Tax performance and reform in the Organization of Eastern Caribbean States (OECS)

Includes bibliography

Female human resources development: growth and equity as priorities

Includes bibliography