Inflammation, Diabetes, and Chronic Kidney Disease: Role of Aerobic Capacity

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

Desenvolvimento de um modelo experimental de hemodiálise em cães

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

Relevância do estado de hidratação na interpretação de parâmetros nutricionais em diálise peritoneal

OBJETIVO: Identificar determinantes do estado de hidratação de pacientes em diálise peritoneal crônica, bem como investigar os efeitos da sobrecarga líquida sobre o estado nutricional. MÉTODOS: Foi feito estudo transversal, realizado em 2006, avaliando 27 pacientes em diálise peritoneal crônica, acompanhados no Hospital das Clínicas da Faculdade de Medicina de Botucatu (SP), quanto a parâmetros clínicos, dialíticos, laboratoriais, antropométricos e de bioimpedância elétrica. Para avaliar a influência de parâmetros sobre o estado de hidratação empregou-se modelo de regressão linear múltipla. A amostra foi estratificada quanto ao estado de hidratação pela relação entre água extracelular e água corporal total (0,47 para homens e 0,52 para mulheres), parâmetros obtidos por meio de bioimpedância elétrica. Comparações foram realizadas por análise de covariância, Mann-Whitney, Qui-quadrado ou teste exato de Fisher. Considerou-se significância estatística quando p≤0,05. RESULTADOS: Pacientes com maior volume urinário e em modalidade dialítica automatizada apresentaram melhor estado de hidratação. Pacientes com maior sobrecarga líquida, comparados àqueles com menor sobrecarga, apresentaram menor ângulo de fase (M=4,2, DP=0,9 vs M=5,7, DP=0,7º; p=0,006), menor albumina (M=3,06, DP=0,46 vs M=3,55, DP=0,52g/dL; p=0,05) e maior % prega cutânea tricipital (M=75,3, DP=36,9 vs M=92,1, DP=56,9%; p=0,058), sem outras evidências antropométricas. CONCLUSÃO: Pode-se sugerir que os níveis reduzidos de albumina e ângulo de fase nos pacientes com maior sobrecarga líquida não estiveram relacionados a pior estado nutricional. Para o diagnóstico nutricional em vigência de sobrecarga líquida, deve-se considerar o conjunto de variáveis obtidas por diversos métodos, buscando relacioná-las e interpretá-las de maneira abrangente, possibilitando um diagnóstico nutricional fidedigno.

Prova de Trabalho de Parto Após uma Cesárea Anterior

Objetivo: estudar a validade da prova de trabalho de parto (PTP) em gestantes com uma cesárea anterior. Métodos: estudo retrospectivo, tipo coorte, incluindo 438 gestantes com uma cesárea anterior ao parto em estudo e seus 450 recém-nascidos (RN), divididas em dois grupos - com e sem PTP. O tamanho amostral mínimo foi de 121 gestantes/grupo. Considerou-se variável independente a PTP e as dependentes relacionaram-se à ocorrência de parto vaginal e à freqüência de complicações maternas e perinatais. Foram efetuadas análises uni e multivariada, respectivamente. A comparação entre as freqüências (%) foi analisada pelo teste do qui-quadrado (chi²) com significância de 5% e regressão logística com cálculo do odds ratio (OR) e do intervalo de confiança a 95% (IC95%). Resultados: a PTP associou-se a 59,2% de partos vaginais. Foi menos indicada nas gestantes com mais de 40 anos (2,7% vs 6,5%) e nas portadoras de doenças associadas e complicações da gravidez: síndromes hipertensivas (7,0%) e hemorragias de 3º trimestre (0,3%). A PTP não se relacionou às complicações maternas e perinatais. As gestantes que tiveram o parto por cesárea, independente da PTP, apresentaram maior risco de complicações puerperais (OR = 3,53; IC95% = 1,57-7,93). A taxa de mortalidade perinatal foi dependente do peso do RN e das malformações fetais e não se relacionou à PTP. Ao contrário, as complicações respiratórias foram mais freqüentes nos RN de mães não testadas quanto à PTP (OR = 1,92; IC95% = 1,20-3,07). Conclusões: os resultados comprovaram que a PTP em gestantes com uma cesárea anterior é estratégia segura - favoreceu o parto vaginal em 59,2% dos casos e não interferiu com a morbimortalidade materna e perinatal. Portanto, é recurso que deve ser estimulado.

Isolation and multilocus genotyping of Toxoplasma gondii in seronegative rodents in Brazil

Synanthropic rodents, mainly rats and mice, become ecologically associated with men due to changes in their ecosystems caused by human activities. These animals may take part in the epidemiological cycles of several diseases, including toxoplasmosis. The presence of serum antibodies to Toxoplasma gondii in 43 rodents captured in the urban area of Umuarama, PR, Brazil, was verified by modified agglutination test (MAT). Brain and heart samples were also collected and bioassayed in mice for the isolation of the parasite. Isolated samples were analyzed by 12 multilocus genotyping. Although all rodents were seronegative, the parasite was isolated in one mouse (Mus musculus) and one rat (Rattus rattus). Genotyping showed that these samples were similar to those previously isolated from cats in the state of Parana, Brazil. (C) 2010 Elsevier B.V. All rights reserved.

Deuterium Equilibrium Time in Saliva of Newborn Infants

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Identification and antimicrobial susceptibility of Staphylococcus from home-treated peritoneal dialysis patients

Staphylococcus aureus is the main agent of infections during peritoneal dialysis (PD). The presence of S. aureus in the nasal cavity has been extensively studied and suggested as a risk factor of dialysis-related infections, whereas coagulase-negative Staphylococcus (CNS) species are frequently considered part of the normal human microbiota. The aim of this study was to identify Staphylococcus in the nasal cavity, pericatheter skin and peritoneal effluent from PD patients, as well as to evaluate the antimicrobial activity evolution in vitro. Thirty-two chronic PD patients were observed during 12 months and had nasal and pericatheter skin samples collected for culture. When peritonitis was detected, samples were also collected from the peritoneal effluent for culture. The activity of several antimicrobial drugs (penicillin G, oxacillin, cephalothin, ofloxacin, netilmicin and vancomycin) against different Staphylococcus species was measured by using the agar drug diffusion assay (Kirby-Bauer method). Staphylococcus was separated into S. aureus, S. epidermidis and other CNS species in order to determine the in vitro resistance level. S. epidermidis resistance to oxacillin progressively increased during the study period (p < 0.05). Resistance to ofloxacin was inexpressive, whereas resistance to netilmicin and vancomycin was not detected. of the oxacillin-resistant species (n = 74), 83% were S. epidermidis, 13% other CNS and 4% S. aureus (p < 0.05). Regarding multidrug resistant strains (n = 45), 82% were S. epidermidis, 13% other CNS, and 5% S. aureus (p < 0.05). This study shows the relevance of resistance to oxacillin and CNS multi-drug resistance, particularly concerning S. epidermidis, in PD patients.

Stochastic dynamics of Musca domestica (Diptera: Muscidae) and Chrysomya putoria (Diptera: Calliphoridae)

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

Oocysts of Hepatozoon canis in Rhipicephalus (Boophilus) microplus collected from a naturally infected dog

Canine hepatozoonosis is a tick-borne disease caused by protozoans of the genus Hepatozoon. Several tick species have been implicated as potential vectors. Therefore, extensive studies are needed to determine the 'natural' endemic cycle of this parasite. This paper presents the first report of the presence of Hepatozoon canis oocysts in Rhipicephalus (Boophilus) microplus collected from an infected dog. (C) 2011 Elsevier B.V. All rights reserved.

Insects on decomposing carcasses of small rodents in a secondary forest in Southeastern Brazil

The decomposition of small carcasses in the open is frequently neglected although it may provide information of forensic importance. This paper describes an experimental study of arthropod species associated with carcasses of mouse, Mus musculus (Linnaeus, 1758) and rat, Rattus norvegicus (Berkenhout, 1769) (Rodentia: Muridae). Four carcasses were left inside iron cages in sunlit and shady areas in a secondary forest in Southeastern Brazil twice a season for four seasons (n = 16 carcasses of each rodent). The carcasses were removed when arthropods ceased to visit them. The visiting and colonizing invertebrates were collected daily and identified. Immatures were also collected and reared in a laboratory for identification. We collected 6,514 arthropods (820 adults and 5,694 juvenile forms) belonging to 53 species from the families Sarcophagidae, Calliphoridae, Muscidae, Fanniidae, Syrphidae, Richardiidae, Sepsidae, Micropezidae, Otitidae, Drosophilidae, Phoridae, Dolichopodidae, Anthomyiidae, Asilidae and Lauxaniidae (Diptera), Formicidae, Ichneumonidae, Encyrtidae and Apidae (Hymenoptera), Staphylinidae (Coleoptera) and Gonyleptidae (Opiliones). Lucilia eximia (Wiedemann, 1819) (Diptera: Calliphoridae) and Peckia (Pattonella) intermutans (Walker, 1861) (Diptera: Sarcophagidae) deserve special attention because both adult and immature forms were collected in all seasons and in both areas. Our results indicate that the frequency of occurrence of these arthropods was positively associated with carcass size (mouse or rat); no marked insect succession on the carcasses occurred; and the diversity of Calliphoridae and Sarcophagidae was high, irrespective of season.

Permian bivalves of the Taciba Formation, Itarare group, Parana basin, and their biostratigraphic significance

A small and poorly diversified bivalve fauna from Taciba Formation, Itarare Group, Parana Basin (State of Santa Catarina, Mafra Municipality), is described in this paper for the first time, based on new findings. The fauna is recorded in a 30 cm thick interval of fine sandstone locally at the top of Taciba Formation, in the Butia quarry. The studied fossil-bearing sand-stone bed is a marine intercalation recording a brief eustatic rise in sea-level, probably following glacier retreat and climate amelioration at the end of a broad glacial scenario. The fauna is mainly dominated by productid brachiopods, which are not described here, and rare mollusk shells (bivalves and gastropods). Two bivalve species were identified: Myonia argentinensis (Harrington, 1955), and Aviculopecten multiscalptus (Thomas, 1928). The presence of Myonia argentinensis is note-worthy since this species is also present in the Baitaca assemblage found in marine siltstones (Baitaca assemblage) of the Rio do Sul Formation, cropping out at the Teixeira Soares region, Parana State. This species is also recorded in the bivalve fauna from the Bonete Formation, Pillahinco Group, Sauce Grande Basin, Buenos Aires Province, in Argentina. Hence, the marine bivalves of the Taciba Formation are associated with the transgressive event that characterizes the Eurydesma fauna, indicating a Late Asselian-Sakmarian age for the bivalve fauna. Presence of the Myonia argentinensis megadesmid species reinforces the Gondwanic nature of the studied fauna.

Tafonomia de tempestitos conchíferos amalgamados da formação Teresina em Rio Preto (Estado do Paraná, permiano médio, bacia do Paraná) e suas implicações paleoambientais

The deposits of the Permian Teresina Formation are mainly characterized by fi ne-grained siliciclastic rocks and centimetric intercalations of tempestites (bioclastic sandstones and coquinas). Despite the relevance of the bivalve-rich carbonate beds of the Teresina Formation to paleoenvironmental studies, their taphonomy is still poorly studied. The fossil concentration studied in this work was found in a quarry in the city of Irati, Rio Preto district, Parana State. The fossil concentration is located in the middle/upper portion of the unit, far from the top. The studied bed is a bioclastic, intraclastic, peloidal, grainstone/ packstone, with abundant bivalve shell fragments, pelitic and micritic intraclasts, peloids, rare ooids and oncoids, as well as permineralized of Lycophyta microphylles and fish scales. The grains of this carbonate concentration show: high degree of time-averaging, variable degree of packing (dense to disperse), no sorting and chaotic orientation. Notably, the concentration includes a mixture of elements which are indicative of: a) restrictive, low energy, carbonate environment (peloids, ooids and oncoids); b) subaerial environment surrounding the main body of water (Lycophyta microphylles) and c) quiet-water environment punctuated by storm events, where the suspension-feeding bivalves thrived. At least four depositional events caused by storm fl ows were recorded. The amalgamated nature of the bed is a result of storm events in an intracratonic basin with very low seafl oor slope and low rates of sedimentation and subsidence.

Tafonomia de biválvios em calcários oolíticos da formação Teresina (Bacia do Paraná, Permiano Médio, Prudentópolis, PR)

Herein, it is presented the first detailed taphonomic study on bivalve mollusk shells preserved in the oolitic limestones of the Teresina Formation (probably Kungurian-Roadian, Lower-Middle Permian) in the eastern margin of the Parana basin. The selected beds are located in two quarries (informally named PRU 1 and PRU 2) in Prudentopolis municipality (Center-South Parana State), and positioned approximately in the middle of the formation and probably in the Pinzonella illusa Zone. The PRU 1 limestone ([approximately]30 cm thick), which is partially silicified and intercalated with predominantly pelitic rocks, is classified as a bivalve oolitic grainstone. The basal contact is erosive and the top shows symmetrical ripple marks, which are draped by shale with mud cracks. There are two fining-upwards successions characterized by dense to dispersed packing of the shells, which are usually disarticulated, randomly oriented (many nested/stacked) and mixed with some Formapelitic intraclasts. Microhummocky cross-stratification occurs a little below the top of the bed. The PRU2 bed is classified as ooidbivalve rudstone[approximately] (~5 cm thick), where all shells are disarticulated and fragmented, showing dense packing. The bivalves probably inhabited a muddy substrate and were mixed (as parautochtonous and allochthonous bioclasts) with ooids during high-energy storm events, including posterior shell displacement as a result of bioturbation. Thus, the calcareous beds represent amalgamated proximal tempestites with a complex taphonomic history, strong temporal/spatial mixing of bioclasts and limited paleoecological resolution. They are a typical example of shell beds generated in a huge epeiric sea, which was not necessarily connected to the ocean and where very low depositional-slope gradient, very slow subsidence and minimum sediment accommodation space caused frequent sediment reworking by storm related processes.

Prevalence and risk factors for Toxoplasma gondii infection in certified and non-certified pig breeding farms in the Toledo microregion, PR, Brazil

A infecção pelo Toxoplasma gondii tem sido diagnosticada em suínos em todo o mundo. Perdas econômicas geralmente estão relacionadas a distúrbios reprodutivos. A infecção pelo Toxoplasma tem também importância em saúde pública, já que cistos teciduais do parasito podem persistir na carne e subprodutos oriundos de suínos, que servirão de fontes de infecção para o ser humano. O objetivo deste trabalho foi verificar a frequência e os fatores de risco associados à infecção pelo Toxoplasma em granjas de reprodutores suídeos certificados ou não da microrregião de Toledo, no Paraná, que inclui os municípios de Toledo, Nova Santa Rosa, São José das Palmeiras e São Pedro do Iguaçú. A frequência relativa de infecção foi 13,4%, sem diferença com o tipo de granja. A análise de regressão logística demonstrou os seguintes fatores associados à infecção: não utilização de funcionários separados por área da granja, o acesso de animais ao cocho de ração e ao reservatório de água, a não utilização de tampa neste reservatório, a não prevenção de roedores, o número e peso médio de leitões ao desmame por porca.

High volume peritoneal dialysis for acute renal failure

Background. Peritoneal dialysis (PD) is still widely used for acute renal failure (ARF) in developing countries despite concerns about its inadequacy. Continuous PD has been evaluated in ARF by analyzing the resolution of metabolic abnormality and normalization of plasma pH, bicarbonate, and potassium.Methodology: A prospective study was performed on 30 ARF patients who were assigned to high-dose continuous PD (Kt/V = 0.65 per session) via a flexible catheter (Tenckhoff) and automated PD with a cycler. Fluid removal, pH and metabolic control, protein Loss, and patient outcome were evaluated.Results: Patients received 236 continuous PD sessions; 76% were admitted to ICUs. APACHE II score was 32.2 +/- 8.65. BUN concentrations stabilized after 3 sessions, creatinine after 4, and bicarbonate and pH after 2. Fluid removal was 2.1 +/- 0.62 L/day. Creatinine and urea clearances were 15.8 +/- 4.16 and 17.3 +/- 5.01 mL/minute respectively. Normalized creatinine clearance and urea Kt/V values were 110.6 +/- 22.5 L/week/1.73 m(2) body surface area and 3.8 +/- 0.6 respectively. Solute reduction index was 41% +/- 6.5% per session. Serum albumin values remained stable in spite of considerable protein tosses (median 21.7 g/day, interquartile range 9.1 - 29.8 g/day). Regarding ARF outcome, 23% of patients presented renal function recovery, 13% remained on dialysis after 30 days of follow-up, and 57% died.Conclusion: High-dose continuous PD by flexible catheter and cycler was an effective treatment for ARF. It provided high solute removal, allowing appropriate metabolic and pH control, and adequate dialysis dose and fluid removal. Continuous PD can therefore be considered an alternative to other forms of renal replacement therapy in ARF.