873 resultados para non-dialysis management
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P>In livestock genetic resource conservation, decision making about conservation priorities is based on the simultaneous analysis of several different criteria that may contribute to long-term sustainable breeding conditions, such as genetic and demographic characteristics, environmental conditions, and role of the breed in the local or regional economy. Here we address methods to integrate different data sets and highlight problems related to interdisciplinary comparisons. Data integration is based on the use of geographic coordinates and Geographic Information Systems (GIS). In addition to technical problems related to projection systems, GIS have to face the challenging issue of the non homogeneous scale of their data sets. We give examples of the successful use of GIS for data integration and examine the risk of obtaining biased results when integrating datasets that have been captured at different scales.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Background and aims: Staphylococcus epidermidis and other coagulase-negative staphylococci (CoNS) are the most common agents of continuous ambulatory peritoneal dialysis (CAPD) peritonitis. Episodes caused by Staphylococcus aureus evolve with a high method failure rate while CoNS peritonitis is generally benign. The purpose of this study was to compare episodes of peritonitis caused by CoNS species and S. aureus to evaluate the microbiological and host factors that affect outcome. Material and methods: Microbiological and clinical data were retrospectively studied from 86 new episodes of peritonitis caused by staphylococci species between January 1996 and December 2000 in a university dialysis center. The influence of microbiological and host factors (age, sex, diabetes, use of vancomycin, exchange system and treatment time on CAPD) was analyzed by logistic regression model. The clinical outcome was classified into two results (resolution and non-resolution). Results: the odds of peritonitis resolution were not influenced by host factors. Oxacillin susceptibility was present in 30 of 35 S. aureus lineages and 22 of 51 CoNS (p = 0.001). There were 32 of 52 (61.5%) episodes caused by oxacillin-susceptible and 20 of 34 (58.8%) by oxacillin-resistant lineages resolved (p = 0.9713). of the 35 cases caused by S. aureus, 17 (48.6%) resolved and among 51 CoNS episodes 40 (78.4%) resolved. Resolution odds were 7.1 times higher for S. epidermidis than S. aureus (p = 0.0278), while other CoNS had 7.6 times higher odds resolution than S. epidermidis cases (p = 0.052). Episodes caused by S. haemolyticus had similar resolution odds to S. epidermidis (p = 0.859). Conclusions: S. aureus etiology is an independent factor associated with peritonitis non-resolution in CAPD, while S. epidermidis and S. haemolyticus have a lower resolution rate than other CoNS. Possibly the aggressive nature of these agents, particularly S. aureus, can be explained by their recognized pathogenic factors, more than antibiotic resistance.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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An automatic Procedure with a high current-density anodic electrodissolution unit (HDAE) is proposed for the determination of aluminium, copper and zinc in non-ferroalloys by flame atonic absorption spectrometry, based on the direct solid analysis. It consists of solenoid valve-based commutation in a flow-injection system for on-line sample electro-dissolution and calibration with one multi-element standard, an electrolytic cell equipped with two electrodes (a silver needle acts as cathode, and sample as anode), and an intelligent unit. The latter is assembled in a PC-compatible microcomputer for instrument control, and far data acquisition and processing. General management of the process is achieved by use of software written in Pascal. Electrolyte compositions, flow rates, commutation times, applied current and electrolysis time mere investigated. A 0.5 mol l(-1) HNO3 solution was elected as electrolyte and 300 A/cm(2) as the continuous current pulse. The performance of the proposed system was evaluated by analysing aluminium in Al-allay samples, and copper/zinc in brass and bronze samples, respectively. The system handles about 50 samples per hour. Results are precise (R.S.D < 2%) and in agreement with those obtained by ICP-AES and spectrophotometry at a 95% confidence level.
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Includes bibliography
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Soil is an essential resource for life and its properties are susceptible to be modified by tillage systems. The impact of management practices on soil functions can be assessed through a soil quality index. It is interesting to assess soil quality in different soil types. Therefore, the aim of this study was to determine the soil quality index of a Paleudult under different management conditions and sunflower culture. The experiment was carried out in Botucatu (SP, Brazil), in an 11-year non-tilled area used for growing soybean and maize during summer and black oat or triticale in winter. Four management systems were considered: no-tillage with a hoe planter (NTh), no-tillage with a double-disk planter (NTd), reduced tillage (RT) and conventional tillage (CT). Soil samples were taken from the planting lines at harvest time. To determine the soil quality indices, following the methodology proposed by Karlen and Stott (1994), three main soil functions were assessed: soil capacity for root development, water storage capacity of the soil and nutrient supply capacity of the soil. The studied Paleudult was considered a soil with good quality under all the observed management systems. However, the soil quality indices varied between treatments being 0.64, 0.68, 0.86 and 0.79 under NTh, NTd, RT and CT, respectively. Physical attributes such as resistance to penetration and macroporosity increased the soil quality index in RT and CT compared to NTh and NTd. The soil quality indices obtained suggested that the evaluated soil is adequate for sunflower production under our study conditions. In view of the SQI values, RT is the most suitable management for this site since it preserves soil quality and provides an acceptable sunflower yield. © 2011 Elsevier B.V.
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Purpose: Malnutrition and fluid overload contribute to the poor cardiovascular prognosis of dialysis patients. Since bioelectrical impedance analysis is an option for the evaluation of body composition and for the monitoring of hydration state, it may assist in the identification of subjects at high cardiovascular risk. The objective of this study was to evaluate the association between bioelectrical impedance parameters and cardiovascular events. Methods: The association between bioelectrical impedance parameters and fatal and non-fatal cardiovascular outcome was evaluated in 145 dialysis patients. Results: The mean age of the population studied was 54.9 ± 15.4 years, 49.7 % were males, and 35.9 % had diabetes. Forty (27.6 %) patients developed cardiovascular events during the 16 months (8; 32) of follow-up. Comparison of patients with and without cardiovascular events revealed higher extracellular mass/body cell mass (ECM/BCM) and extracellular water/total body water ratios and higher C-reactive protein levels in the former. Survival analysis showed that an ECM/BCM ratio >1.2 and a phase angle <6° were associated with poor cardiovascular prognosis. Among nondiabetic patients, these parameters and capacitance were independently associated with cardiovascular events, suggesting that poor nutritional status and fluid overload are associated with the occurrence of these events. Conclusions: Phase angle, capacitance and ECM/BCM ratio are valuable parameters for the evaluation of cardiovascular prognosis, supporting the use of bioelectrical impedance for the clinical assessment of dialysis patients. © 2012 Springer Science+Business Media Dordrecht.
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Includes bibliography
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Background: Acute kidney injury (AKI) requiring dialysis in critically ill patients is associated with an in-hospital mortality rate of 50-80 %. Extended daily hemodialysis (EHD) and high volume peritoneal dialysis (HVPD) have emerged as alternative modalities. Methods: A double-center, randomized, controlled trial was conducted comparing EHD versus HVPD for the treatment for AKI in the intensive care unit (ICU). Four hundred and seven patients were randomized and 143 patients were analyzed. Principal outcome measure was hospital mortality, and secondary end points were recovery of renal function and metabolic and fluid control. Results: There was no difference between the two groups in relation to median ICU stay [11 (5.7-20) vs. 9 (5.7-19)], recovery of kidney function (26.9 vs. 29.6 %, p = 0.11), need for chronic dialysis (9.7 vs. 6.5 %, p = 0.23), and hospital mortality (63.4 vs. 63.9 %, p = 0.94). The groups were different in metabolic and fluid control. Blood urea nitrogen (BUN), creatinine, and bicarbonate levels were stabilized faster in EHD group than in HVPD group. Delivered Kt/V and ultrafiltration were higher in EHD group. Despite randomization, there were significant differences between the groups in some covariates, including age, pre-dialysis BUN, and creatinine levels, biased in favor of the EHD. Using logistic regression to adjust for the imbalances in group assignment, the odds of death associated with HVPD was 1.4 (95 % CI 0.7-2.4, p = 0.19). A detailed investigation of the randomization process failed to explain the marked differences in patient assignment. Conclusions: Despite faster metabolic control and higher dialysis dose and ultrafiltration with EHD, this study provides no evidence of a survival benefit of EHD compared with HVPD. The limitations of this study were that the results were not presented according to the intention to treat and it did not control other supportive management strategies as nutrition support and timing of dialysis initiation that might influence outcomes in AKI. © 2012 Springer Science+Business Media Dordrecht.
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The exploitation of non-timber forest products is often considered a low-impact activity in tropical forests. However, assessments of the impacts of such activity are mostly focused on the harvested species and not on the plant community, thus limiting our understanding for establishing forest management recommendations. We investigated the consequences of Euterpe edulis palm heart harvesting on the seed rain in the Brazilian Atlantic rainforest. We compared the density of E. edulis individuals, as well as the density of E. edulis seeds, and the density, richness and functional composition of seed rain of the whole plant community, before and after palm heart harvesting in a 10 ha permanent plot. This assessment was carried out in preserved (typical old-growth Atlantic rainforest) and in disturbed (more open habitat dominated by the native bamboo Guadua tagoara) forest patches. Palm harvesting reduced the E. edulis population from 202.16 to 25.67 ind/ha and its seed rain density from 0.362 to 0.3 seeds/m2 and from 2.395 to 0.15 seeds/m2 in preserved and disturbed forest patches, respectively. Seed density of light-dependent climbers, pioneer trees, bamboo and animal-dispersed seeds increased after palm harvesting, especially in the disturbed forest patches, where palm harvesting was more intense and may have changed the light regime of the understory. On the other hand, species richness of the plant community declined by half. We observed a remarkable decline in the number of animal-dispersed species, especially for those with large seeds, suggesting that the activity of seed dispersers, including many species attracted by E. edulis fruits, was reduced. Therefore, harvesting of E. edulis palm heart may change the regeneration dynamics of the Atlantic rainforest, both due to shifts in forest structure, mediated by the removal of individuals from the forest canopy, and in community functioning, mediated by the interference on the activity of seed dispersers. © 2013 Elsevier B.V. All rights reserved.
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In Smart Grids, a variety of new applications are available to users of the electrical system (from consumers to the electric system operators and market operators). Some applications such as the SCADA systems, which control generators or substations, have consequences, for example, with a communication delay. The result of a failure to deliver a control message due to noncompliance of the time constraint can be catastrophic. On the other hand, applications such as smart metering of consumption have fewer restrictions. Since each type of application has different quality of service requirements (importance, delay, and amount of data to transmit) to transmit its messages, the policy to control and share the resources of the data communication network must consider them. In this paper Markov Decision Process Theory is employed to determine optimal policies to explore as much as possible the availability of throughput in order to transmit all kinds of messages, considering the quality of service requirements defined to each kind of message. First a non-preemptive model is formulated and after that a preemptive model is derived. Numerical results are used to compare FIFO, non-preemptive and preemptive policies.
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Intermittent hemodialysis (IHD) and continuous renal replacement therapies (CRRT) are used as Acute Kidney Injury (AKI) therapy and have certain advantages and disadvantages. Extended daily dialysis (EDD) has emerged as an alternative to CRRT in the management of hemodynamically unstable AKI patients, mainly in developed countries.Objectives: We hypothesized that EDD is a safe option for AKI treatment and aimed to describe metabolic and fluid control of AKI patients undergoing EDD and identify complications and risk factors associated with death.Study Selection: This is an observational and retrospective study describing introduction of EDD at our institution. A total of 231 hemodynamically unstable AKI patients (noradrenalin dose between 0.3 and 1.0 ucg/kg/min) were assigned to 1367 EDD session. EDD consisted of 6-8 h of HD 6 days a week, with blood flow of 200 ml/min, dialysate flows of 300 ml/min.Data Synthesis: Mean age was 60.6 +/- 15.8 years, 97.4% of patients were in the intensive care unit, and sepsis was the main etiology of AKI (76.2). BUN and creatinine levels stabilized after four sessions at around 38 and 2.4 mg/dl, respectively. Fluid balance decreased progressively and stabilized around zero after five sessions. Weekly delivered Kt/V was 5.94 +/- 0.7. Hypotension and filter clotting occurred in 47.5 and 12.4% of treatment session, respectively. Regarding AKI outcome, 22.5% of patients presented renal function recovery, 5.6% of patients remained on dialysis after 30 days, and 71.9% of patients died. Age and focus abdominal sepsis were identified as risk factors for death. Urine output and negative fluid balance were identified as protective factors.Conclusions: EDD is effective for AKI patients, allowing adequate metabolic and fluid control. Age, focus abdominal sepsis, and lower urine output as well as positive fluid balance after two EDD sessions were associated significantly with death.
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We study the effects of management of the PT-symmetric part of the potential within the setting of Schrodinger dimer and trimer oligomer systems. This is done by rapidly modulating in time the gain/loss profile. This gives rise to a number of interesting properties of the system, which are explored at the level of an averaged equation approach. Remarkably, this rapid modulation provides for a controllable expansion of the region of exact PT-symmetry, depending on the strength and frequency of the imposed modulation. The resulting averaged models are analysed theoretically and their exact stationary solutions are translated into time-periodic solutions through the averaging reduction. These are, in turn, compared with the exact periodic solutions of the full non-autonomous PT-symmetry managed problem and very good agreement is found between the two.