949 resultados para PROGNOSTIC INDICATOR


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This study focused on estimating the economic losses resulting from cysticercosis at beef cattle farms that supply an export slaughterhouse located in the state of Sao Paulo, Brazil, and to identify the epidemiological risks factors involved in the disease to ascertain if these farms adopt Good Agricultural Practices (GAP). To this, we used data recorded in 2012 by Brazil's Federal Inspection Service (SIP) on the daily occurrence of the disease, according to the farm from which the animals originated. In addition, the associated risk factors were determined based on a case-control study at 48 farms. Cysticercosis was detected in 2.26% (95% CI 2.2-2.33) of the 190,903 bovines supplied by 556 farms in the following four states: 2.92% (95% CI 2.83-3.03) in Sao Paulo, 1.81% (95% CI 1.71-1.93) in Minas Gerais, 0.71% (95% CI 0.6-0.82) in Goias and 1.11% (95% CI 0.79-1.57) in Mato Grosso do Sul, with significant differences in the epidemiological indices of these states. Cysticercosis was detected at 58.45% (95% CI 54.36-62.55) of the farms of this study, representing estimated economic losses of US$312,194.52 for the farmers. Lower prevalence of this disease were found at the farms qualified for exports to the European Union, indicating a statistically significant difference from those not qualified to export to Europe. The access of cattle to non-controlled water sources, as well as sport fishing activities near the farms, was identified as risk factors. Cysticercosis causes considerable losses in Brazil's beef supply chain, with lower prevalence appearing only at farms qualified to export to the European Union. As for the access of cattle to non-controlled water sources, this is an indication that GAP are not implemented by some farms, demonstrating the violation of international agreements by the industry and the farms. (C) 2015 Elsevier B.V. All rights reserved.

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

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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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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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

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

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To evaluate the usefulness of the Glasgow Prognostic Score (GPS) in patients with esophageal carcinoma (EC). A total of 50 patients with EC were analyzed for GPS, nutritional and clinicopathologic parameters. Patients with CRP ≤ 1.0mg/L and albumin ≥ 3.5mg/L were considered as GPS=0. Patients with only CRP increased or albumin decreased were classified as GPS=1 and patients with CRP > 1.0mg/L and albumin < 3.5mg/L were considered as GPS=2. GPS of 0, 1 and 2 were observed in seven, 23 and 20 patients, respectively. A significant inverse relationship was observed between GPS scores and the survival rate. The survival rate was greatest in patients with GPS= 0 and significantly higher than those from patients with GPS=1 and GPS=2. Minimum 12-month survival was observed in 71% patients with GPS=0 and in 30% patients with GPS=1. None of the patients with GPS=2 survived for 12 months. A significant relationship between CRP or albumin individually and the survival rate was observed. No significant relationship among nutritional, clinic pathological parameters and survival was found. Glasgow Prognostic Score is an useful tool to predict survival in patients with esophageal carcinoma.

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Early diagnosis of hearing loss minimizes its impact on child development. We studied factors that influence the effectiveness of screening programs. To investigate the relationship between gender, weight at birth, gestational age, risk factors for hearing loss, venue for newborn hearing screening and pass and fail results in the retest. Prospective cohort study was carried out in a tertiary referral hospital. The screening was performed in 565 newborns through transient evoked otoacoustic emissions in three admission units before hospital discharge and retest in the outpatient clinic. Gender, weight at birth, gestational age, presence of risk indicators for hearing loss and venue for newborn hearing screening were considered. Full-term infants comprised 86% of the cases, preterm 14%, and risk factors for hearing loss were identified in 11%. Considering the 165 newborns retested, only the venue for screening, Intermediate Care Unit, was related to fail result in the retest. Gender, weight at birth, gestational age and presence of risk factors for hearing loss were not related to pass and/or fail results in the retest. The screening performed in intermediate care units increases the chance of continued fail result in the Transient Otoacoustic Evoked Emissions test.

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

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Background The application and better understanding of traditional and new breast tumor biomarkers and prognostic factors are increasing due to the fact that they are able to identify individuals at high risk of breast cancer, who may benefit from preventive interventions. Also, biomarkers can make possible for physicians to design an individualized treatment for each patient. Previous studies showed that trace elements (TEs) determined by X-Ray Fluorescence (XRF) techniques are found in significantly higher concentrations in neoplastic breast tissues (malignant and benign) when compared with normal tissues. The aim of this work was to evaluate the potential of TEs, determined by the use of the Energy Dispersive X-Ray Fluorescence (EDXRF) technique, as biomarkers and prognostic factors in breast cancer. Methods By using EDXRF, we determined Ca, Fe, Cu, and Zn trace elements concentrations in 106 samples of normal and breast cancer tissues. Cut-off values for each TE were determined through Receiver Operating Characteristic (ROC) analysis from the TEs distributions. These values were used to set the positive or negative expression. This expression was subsequently correlated with clinical prognostic factors through Fisher’s exact test and chi-square test. Kaplan Meier survival curves were also evaluated to assess the effect of the expression of TEs in the overall patient survival. Results Concentrations of TEs are higher in neoplastic tissues (malignant and benign) when compared with normal tissues. Results from ROC analysis showed that TEs can be considered a tumor biomarker because, after establishing a cut-off value, it was possible to classify different tissues as normal or neoplastic, as well as different types of cancer. The expression of TEs was found statistically correlated with age and menstrual status. The survival curves estimated by the Kaplan-Meier method showed that patients with positive expression for Cu presented a poor overall survival (p < 0.001). Conclusions This study suggests that TEs expression has a great potential of application as a tumor biomarker, once it was revealed to be an effective tool to distinguish different types of breast tissues and to identify the difference between malignant and benign tumors. The expressions of all TEs were found statistically correlated with well-known prognostic factors for breast cancer. The element copper also showed statistical correlation with overall survival.

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In some operational circumstances a fast evaluation of landfill leachate anaerobic treatability is necessary, and neither Biochemical Methane Potential nor BOD/COD ratio are fast enough. Looking for a fast indicator, this work evaluated the anaerobic treatability of landfill leachate from São Carlos-SP (Brazil) in a pilot scale Anaerobic Sequence Batch Biofilm Reactor (AnSBBR). The experiment was conducted at ambient temperature in the landfill area. After the acclimation, at a second stage of operation, the AnSBBR presented efficiency above 70%, in terms of COD removal, utilizing landfill leachate without water dilution, with an inlet COD of about 11,000 mg.L-1, a TVA/COD ratio of approximately 0.6 and reaction time equal to 7 days. To evaluate the landfill leachate biodegradability variation over time, temporal profiles of concentration were performed in the AnSBBR. The landfill leachate anaerobic biodegradability was verified to have a direct and strong relationship to the TVA/COD ratio. For a TVA/CODTotal ratio lower than 0.20, the biodegradability was considered low, for ratios between 0.20 and 0.40 it was considered medium, and above 0.40 it was considered high.

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Characterization of the polygenic and polymorphic features of the Steller sea lion major histocompatibility complex (MHC) provides an ideal window for evaluating immunologic vigor of the population and identifying emergence of new genotypes that reflect ecosystem pressures. MHC genotyping can be used to measure the potential immunologic vigor of a population. However, since ecosystem-induced changes to MHC genotype can be slow to emerge, measurement of differential expression of these genes can potentially provide real-time evidence of immunologic perturbations. MHC DRB genes were cloned and sequenced using peripheral blood mononuclear leukocytes derived from 10 Steller sea lions from Southeast Alaska, Prince William Sound, and the Aleutian Islands. Nine unique DRB gene sequences were represented in each of 10 animals. MHC DRB gene expression was measured in a subset of six sea lions. Although DRB in genomic DNA was identical in all individuals, relative levels of expressed DRB mRNA was highly variable. Selective suppression of MHC DRB genes could be indicative of geographically disparate environmental pressures, thereby serving as an immediate and sensitive indicator of population and ecosystem health.

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Imposex is the development of male sexual characteristics, i.e., penis and/or vas deferens in females of dioecious gastropods. This phenomenon has been associated to the use of the organotin based marine antifouling paints and used worldwide as a bioindicator of pollution by the TBT (antifouling agent) as well as to evaluate the related ecological impact. This study reports imposex in Stramonita haemastoma at south coast of Rio de Janeiro State (Brazil), specifically at Sepetiba and Ilha Grande Bays. All the stations where snails were found have shown imposex. Ilha Grande Bay presented the highest values of imposex indices when compared to Sepetiba Bay. The results suggest that high concentration of shipping activities and coastal morphology are the principal causes at the most polluted sites.

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Background. The aim of this paper was to clarify if previously established prognostic factors explain the different mortality, rates observed in ICU septic patients around the world. Methods. This is a sub-study from the PROGRESS study, which was an international, prospective, observational registry of ICU patients with severe sepsis. For this study we included 10930 patients from 24 countries that enrolled more than 100 patients in the PROGRESS. The effect of potential prognostic factors on in-hospital mortality was examined using univariate and multivariate logistic regression. The complete set of data was available for 7022 patients, who were considered in the multivariate analysis. Countries were classified according to country, income, development status, and in-hospital mortality terciles. The relationship between countries' characteristics and hospital mortality mortality was evaluated using linear regression. Results. Mean in-hospital mortality was 49.2%. Severe sepsis in-hospital mortality varied widely in different countries, ranging from 30.6% in New Zealand to 80.4% in Algeria. Classification as developed or developing country was not associated with in-hospital mortality (P=0.16), nor were levels of gross national product per capita (P=0.15). Patients in the group of countries with higher in-hospital mortality, had a crude OR for in-hospital death of 2.8 (95% CI 2.5-3.1) in comparison to those in the lower risk group. After adjustments were made for all other independent variables, the OR changed to 2.9 (95% CI 2.5-3.3). Conclusion. Severe sepsis mortality varies widely, in different countries. All known markers of disease severity and prognosis do not fully, explain the international differences in mortality,. Country, income does not explain this disparity, either. Further studies should be developed to verify if other organizational or structural factors account for disparities in patient care and outcomes. (Minerva Anestesiol 2012;78:1215-25)