Redução da morbi-mortalidade na síndrome de hellp completa com o uso de altas doses de dexametasona

Objective: To determine the clinical maternal and neonatal outcomes in HELLP syndrome patients treated with dexamethasone who either developed renal injury or renal insufficiency and to identify predictive values of urea and creatinine for the identification of subjects with HELLP syndrome at risk of developing renal insufficiency. Methods: Non-radomized intervention study of dexamethasone use in HELLP syndrome. A total of 62 patients were enrolled at Maternidade Escola Januário Cicco (MEJC). Patients received a total of 30 mg of dexamethasone IV, in three doses of 10 mg every 12 hours. A clinical and laboratory follow up were performed at 24, 48 and 72 hours. Patients were followed up to 6 months after delivery. Patients were grouped in accordance to renal function, i.e, normal and some type of renal lesion. Renal lesion was considered when creatinine was equal or greater than 1.3 mg/dl and diuresis less than 100 ml in 4 hours period and renal insufficiency was defined when dialysis was needed. Results: A total of 1230 patients with preeclampsia were admitted at MEJC. Of those 62 (5%) developed HELLP syndrome. There was no statistical difference in the groups with renal involvement or normal renal function with respect to the demographics, type of anesthesia used and delivery, and weight of the newborn. An improvement in the AST, ALT, LDH, haptoglobine, antithrombine, fibrinogenen and platelets was observed within 72 hours after dexamethosone use. There was a significant increase in the diuresis within the interval of 6 hours before the delivery and 24 hours after it. Of the 62 patients, 46 (74. 2%) had normal renal function and 16 (25.8%) evolved with renal lesion, with 5 (8.1%) needing dialysis. These 5 patients who received dialysis recovered the xi renal function. The delay in administering dexamethasone increased in 4.6% the risk of development of renal insufficiency. Patients with renal insufficiency had received significantly more blood products than subjects without renal lesion (p=0.03). Diuresis, leukocytes, uric acid, urea, creatinine were significantly different between the groups with normal renal function, renal lesion and renal insufficiency. The levels of creatinine 1.2mg/dl and uric acid 51mg/dl, at admission are predictive of subjects who will evolve with renal lesion (p<0.001). Maternal mortality was 3.2%. None of the subjects with renal insufficiency evolved with chronic renal disease. Conclusions: Dexamethasone in patients with HELLP syndrome seems to reduce significantly the hepatic microthrombosis and normalize hemostasis as seen by improvement of liver function. Renal injury can be considered, in HELLP syndrome, when creatinine levels are greater than 1.3 mg/dl and diuresis less than 100 ml/h in interval of 4 hours. The level of creatinine greater than 1.2 mg/dl and urea greater than 51mg/dl are predictive of subjects with HELLP syndrome who will develop renal injury. Patients who receive more red cell packs develop renal insufficiency. Finally, the delay in administering dexamethasone increases the risk of developing renal insufficiency

Avaliação da genotoxicidade e da qualidade das águas do açude de Lucrécia/RN

The occurrence of human cancer in the municipality of Lucrécia (RN, Brazil) has shown high frequencies (INCA, 2007). Tests of micronucleus (MN) and nuclear abnormalities (NA) were performed to assess the genotoxic potential of water from the Lucrécia dam, which is located in a semi-arid region under the influence of crop irrigation and irregular rainfall. Water samples were collected in this source for analyzing the concentration of cyanobacteria, metals and radioactivity. Erythrocytes of Nile tilapia (Oreochromis niloticus) were collected in dam and cells of human oral mucosa in the urban area of this municipality for the bioassays of MN and NA. In fish were also analyzed concentrations of metals in samples of liver and gills. The genotoxicity tests with biological samples of fish and humans have shown significant increases in the frequencies of MN and NA (p ≤ 0.05) and are indicative of increased DNA damage in relation to the control groups. In conclusion, the results obtained from water samples and biological municipality of Lucrécia indicates that the presence of chemical and microbiological pollutants, and increase of genotoxic in human of this municipality. We suggest the implementation of advanced water treatment, to prevent further degradation of the aquatic environment and decrease in the life quality. This research of environmental quality assessment was performed in order to contemplate a multi and interdisciplinary character of this water resource and that can induce genotoxic damage in the organisms in this study region

Redução no consumo de efluente gerado em abatedouro de tilápia do nilo através da implantação de conceitos de produção mais limpa (p+l)

the nourishing industry is a segment that makes use of high water consumption due to necessity of the hygienic cleaning of the establishments and the maintenance of the good quality of the food. It enters the nourishing industries with bigger water consumption we have the fishery industry which generates effluent around 5.4 m(3). t(-1) of processed fish. This work had as objective the reduction in the water consumption of the processing of Nile tilapia through the implantation of P+L techniques, for had been in such a way carried through hydraulical alterations in the filleting tables aiming at the minimum possible water consumption for two methods of filleting, eviscerated and not eviscerated, as well as the comment of the alterations in the generated quality of the effluent one. In the present study, the reduction in the water consumption in the filleting process corresponded 98.16% for method EV considering an average time of processing of 3 hours for 32.99 kg of fish, and for method NEV the reduction was of 97.97% with average time of processing of 2.1 hours for 34.96 kg of fish, thus demonstrating that the P+L techniques are efficient for the reduction of the water consumption.

Efeitos da aplicação de herbicidas sobre a eficiência fotoquímica em plantas de soja convencional e geneticamente modificada

Objetivou-se, neste trabalho, avaliar o efeito da aplicação de herbicidas em pós-emergência sobre a eficiência fotoquímica de duas cultivares de soja (M-SOY 7908 RR e M-SOY 8001). O delineamento experimental utilizado foi em blocos ao acaso, com quatro repetições. Os tratamentos constaram da aplicação de herbicidas isolados e em misturas: lactofen, glyphosate, lactofen + chlorimuron-ethyl, chlorimuron-ethyl + imazethapyr, chlorimuron-ethyl + bentazon, glyphosate + imazethapyr, lactofen + chlorimuron-ethyl + imazethapyr e lactofen + chlorimuron-ethyl + imazethapyr/haloxyfop-methyl. Além disso, foram mantidas duas testemunhas sem aplicação de herbicida. As avaliações foram realizadas aos 4; 11; 18; 25 e 32 dias após aplicação dos herbicidas (DAA) no primeiro ano, e aos 6, 14, 21, 28 e 35 DAA, no segundo. A cultivar M-SOY 8001 foi suscetível à aplicação dos herbicidas, principalmente às misturas contendo lactofen + chlorimuron-ethyl e lactofen + chlorimuron-ethyl + imazethapyr + haloxifop-methyl, os quais provocaram redução no rendimento quântico máximo do PSII (Fv/Fm). As duas cultivares apresentaram suscetibilidade aos herbicidas quando tratados com lactofen aplicado isolado e nas misturas lactofen + chlorimuron-ethyl, chlorimuron-ethyl + imazethapyr, lactofen + chlorimuron-ethyl + imazethapyr e lactofen + chlorimuron-ethyl + imazethapyr + haloxifop-methyl com redução nos teores de clorofila, estimados pelo Medidor Portátil de Clorofilas. Os danos foram reversíveis, desaparecendo gradativamente com a idade das plantas.

Desbaste da limeira-ácida-'Tahiti' (Citrus latifolia Tanaka) com TPA e efeitos na produção

Foram avaliadas concentrações de 0; 10; 20; 40 e 80 mg/L do 3,5,6-TPA (Ácid 3,5,6-tricloro-2-piridil- oxiacético), em sua formulação éster, para desbaste de frutos novos da limeira-ácida-'Tahiti' (Citrus latifolia Tanaka), nas condições ecológicas do Estado de São Paulo. O 3,5,6-TPA, na concentração 10mg/L, foi o tratamento mais eficaz para uso na cultura. Concentrações maiores causaram severos danos às plantas. Essa concentração, aplicada logo após a florada de outubro, reduziu em 65% a produção do mês de fevereiro seguinte. Todavia, as produções dos meses subseqüentes não diferiram entre si. A concentração de 10mg/L causou alongamento dos frutos, aumento da espessura da casca e redução do Brix, na época da colheita.

Distribuição espacial de Phytophthora nicotianae e reação de cultivares de cebola ao fungo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito do ácido alfa-lipóico sobre biomarcadores de estresse oxidativo, inflamação e fatores de risco cardiovascular em hipertensos

Alpha-lipoic acid (ALA) is a potent antioxidant with favourable anti-inflammatory, metabolic and endothelial effects, and has been widely investigated due to its potential against cardiovascular risk factors. This study aimed to evaluate the effect of oral ALA supplementation on oxidative stress biomarkers, inflammation and cardiovascular risk factors in patients with hypertension. This is a double-blind placebo-controlled randomized clinical trial, where the intervention was evaluated prospectively comparing results in both groups. The sample consisted of 64 hypertensive patients who were randomly distributed into ALA group (n = 32), receiving 600 mg / day ALA for twelve weeks and control group (n = 32), receiving placebo for the same period. The following parameters were evaluated before and after intervention: lipid peroxidation, content of reduced glutathione (GSH), enzymatic activities of glutathione peroxidase (GPx) and superoxide dismustase, ultrasensitive C-reactive protein (hs-CRP), triglycerides, total cholesterol and fractions, fasting glucose and anthropometric indicators. There was a statistically significant reduction (p <0.05) in serum concentrations of total cholesterol, very low density lipoprotein (VLDL), high density lipoprotein (HDL), triglycerides and blood glucose. There was a reduction in body weight and waist, abdominal and hip circumferences in the group that received ALA. In addition, there was a statistically significant increase (p <0.05) in the contents of reduced glutathione (GSH) and glutathione peroxidase (GPx) in the group receiving ALA. Oral administration of ALA appears to be a valuable adjuvant therapy, which may contribute to decrease the damage caused by oxidative stress and other risk factors associated with the atherosclerotic process

Normas tributárias indutoras na concretização do princípio constitucional da redução das desigualdades sociais e regionais

The Federal Constitution states that the reduction of social and regional inequalities is one of the goals to be achieved by the Brasilian State. The economic constitution states that the national economy must be developed so as to achieve, amongst other objectives, the reduction of those inequalities. In this paper, we aim to demonstrate the duty, imposed by the Constitution to the State, of acting in the national economy so as to promote the achievement of the constitutional goals, among wich we highlight the reduction of inequalities. One of the instruments that can be used by the State to achieve this objective is its fiscal policy. It is also an aim in this paper to demonstrate that inducing tax norms can be used by the State, because it can encourage the economic agents to bring about the reduction of social and regional inequalities. Therefore, after bibliographic and jurisprudential research, we conclude that the duty, imposed to the State, of acting in the national economy so as to promote the achievement of the constitutional goals exists. We also conclude that this acting must be planed and constant, because the consequences are slow and that, within the limits of the constitution, the inducing tax norms can be an instrument for the State in order to reduct the social and regional inequalities

Gesso sintético e pinos transcorticais na redução de fratura de tíbia em uma bezerra

Relata-se um caso de fratura de tíbia em uma bezerra de sete meses de idade, 200kg de peso, apresentando fratura fechada, cominutiva em diáfise. A fixação externa foi preferida como método de imobilização óssea, utilizando-se pinos transcorticais e gesso sintético. Obteve-se eficiente imobilização da fratura, com rápida recuperação do animal, dispendendo-se pouco tempo para o pós-operatório (52 dias). A técnica demonstrou ser de fácil realização e passível de ser executada a campo.

O princípio constitucional da redução das desigualdades regionais e o transporte de gás natural

In a country of continental dimensions as Brazil, one of the top challenges to its economic growth is the logistic related to energetical demand supply. We live now in the era of environmental protection and, in this new context of priorizations, it passes trough the search for alternative energies for the energetic matrix, due the petroleum elevated costs in the global market (and its finitude), but also due its pollution over the environment. This attempt of substitution needs solutions related to the national reality, into a national long term developing plan and based at a juridical-economic analysis of its realization. This study will look for, also based in an economical analysis, the juridical legitimity of choosing natural gas as the new protagonist of national economic growth (as a substitute of petroleum) and the necessary boost that must be done by law, based on an economic policy focused strictly for that fact, as a modifying agent of this reality. This study, therefore, will always be turned to a constitutional aspect, respecting the principles of economic order and the goal of reducing regional inequalities, which must influence the making off of a developing plan. At the end, it will try to demonstrate the juridical viability of such undertaking, tuned in jus-economical criteria. Another goal is related to the analysis of the natural gas industry, due the regulation of its transport has a major importance for national energetic integration, not only because this activity be characterized as a net industry, still under control of a natural monopoly, but also because the competitive or cooperative profile that should be priorized at the beginning of the economic planning for this activity (such as investment policies and its own rules that will submit private agents)

O princípio constitucional da redução das desigualdades regionais e os campos maduro-marginais de petróleo: aspectos regulatórios e fiscais

Under the circumstances of the desestatization that penetrate Brazilian economy in the 90‟s, new features in the monopoly of oil by the Union were designed by the constitutional amendment number 9. of 1995. This deep change in the legal regime of oil sector brought the possibility of entrance to small and medium size producers in this industry, especially through the production activities developed in mature and marginal fields of oil, which are located mainly in northeast region of Brazil. Considering that the intervention of state over the economy finds its guidelines and limits in Federal Constitution disposals, the present work investigated in which way states regulation, mainly through taxation rules, has obeyed the constitutional regime in force, and specially, the reduction of regional inequalities principle. By mean, firstly, of an analysis of central concepts (mature fields, marginal fields, small and medium size producers) we observed that the imprecision over the conceptual aspect has constituted an obstacle to a specific states‟ regulation, directed to this newborn class of producers, whose growth has been pursuit by the state. That is verified in the case of concession procedures, and also, concerning the taxation system applied to small and medium size producers. Examining the main constitutional principles related to this universe which are the legality, equality, privileged treatment to small enterprises, contributive capacity, and reduction of regional inequalities we conclude that it is legally possible, a truly specific regulation, including a special taxation regime, to the small and medium size producers whose activities are concentrate over mature-marginal fields, aiming the concretization of the Brazilian state main goals

As zonas de processamento de exportação como instrumento de desenvolvimento e redução das desigualdades regionais

The existence of inequalities among the Brazilian regions is an indeed fact along the country s history. Before this reality the constitutional legislator inserted into the Federal Constitution of 1988, as a purpose of the Federative Republic of Brazil, the reduction of regional inequalities. The development has also been included as a purpose from the State, because there is an straight relation with the reduction of regional inequalities. In both situations is searched the improvement of people s living conditions. . In pursuit of this achievement, the State must implement public policy, and, for this to happen, it needs the ingress of income inside of the public coffers and support of economic agents, therefore the importance of constitucionalization of the economic policy. The 1988 s Constitution adopted a rational capitalism regime consentaneous with current legal and social conceptions, that s why it enabled the State s intervention into economy to correct the so-called market failures or to make the established objectives fulfilled. About this last one, the intervention may happen by induction through the adoption of regulatory Standards of incentive or disincentive of economic activity. Among the possible inductive ways there are the tax assessments that aim to stimulate the economic agents behavior in view of finding that the development doesn t occur with the same intensity in all of the country s regions. Inside this context there are the Export Processing Zones (EPZs) which are special areas with different customs regime by the granting of benefits to the companies that are installed there. The EPZs have been used, by several countries, in order to develop certain regions, and economic indicators show that they promoted economic and social changes in the places where they are installed, especially because, by attracting companies, they provide job creation, industrialization and increased exports. In Brazil, they can contribute decisively to overcome major obstacles or decrease the attraction of economic agents and economic development of the country. In the case of an instrument known to be effective to achieve the goals established by the Constitution, it is duty of the Executive to push for the law that governs this customs regime is effectively applied. If the Executive doesn t fulfill this duty, incurs into unjustifiable omission, correction likely by the Judiciary, whose mission is to prevent acts or omissions contrary to constitutional order

Redução na população de plantas sobre a produtividade e a qualidade fisiológica da semente de soja

O objetivo deste trabalho foi avaliar os efeitos de reduções na população de plantas sobre a produtividade e a qualidade fisiológica da semente de soja. Duas cultivares de soja (BRSMG 68 Vencedora e M-SOY 8001) foram cultivadas em áreas com e sem o controle de plantas daninhas. As populações estudadas foram: 400.000, 340.000, 280.000, 220.000 e 160.000 pl.ha-1, em um espaçamento entrelinhas de 0,43m. de maneira geral, a presença de plantas daninhas causa decréscimos na produtividade e no tamanho da semente produzida. Entretanto, variações na população não interferem na qualidade fisiológica, no tamanho e na massa de 100 sementes. A cultura da soja é capaz de suportar grandes reduções de população sem perdas significativas de produtividade. Essa capacidade é grandemente influenciável pela cultivar: a Vencedora suporta reduções de até 45% e a M-SOY 8001 de até 30%, em relação à população de 400.000 pl.ha-1.

Manutenção de tratores agrícolas e condição técnica dos operadores

A manutenção dos tratores agrícolas pode ser considerada um conjunto de procedimentos que visa a manter o equipamento nas melhores condições de funcionamento, propiciando aumento da vida útil, evitando danos prematuros, eliminando os já observados e concorrendo para maior segurança no trabalho. Essa conduta, apesar de simples, exige atenção e cuidado semelhante ou até maior quando comparado a outro veículo automotor. O presente trabalho teve por objetivo analisar a regularidade e a qualidade da manutenção dos tratores da Fazenda de Ensino, Pesquisa e Produção da UNESP - Jaboticabal, utilizados para os mais variados tipos de trabalho, como aração, gradagem, pulverização e jardinagem, e avaliar a condição técnica dos operadores responsáveis pelas máquinas. Os resultados indicam que a manutenção diária não foi eficiente, o que pode resultar em redução da vida útil das máquinas. Quanto aos operadores, notou-se baixo grau de conhecimento técnico com relação à manutenção dos tratores e falta de treinamento específico.

Integração de práticas culturais e redução da dose do bentazon na cultura da soja: I - efeitos sobre o crescimento da cultura

O trabalho foi desenvolvido no município de Jaboticabal, SP, no ano agrícola de 1990/91, onde testou-se a integração de práticas culturais e menor dose de herbicida aplicado em pósemergência na cultura da soja, cultivar Paraná. O delineamento experimental utilizado foi o de blocos ao acaso, com dezesseis tratamentos e quatro repetições, no esquema fatorial 4x2x2, sendo quatro tipos de manejos de plantas daninhas: testemunha infestada, 50% da dose recomendada (360 g ia/ha) do herbicida bentazon, dose recomendada do herbicida bentazon (720 g ia/ha) e testemunha capinada; dois espaçamentos entre-linhas: 30 cm e 60 cm; e duas densidades: normal e reduzida (média de 20 e 10 plantas por metro, respectivamente). Observou-se que a quantidade de matéria seca das plantas daninhas por época da colheita da soja, foi significativamente maior nos tratamentos com espaçamento maior e densidade reduzida. O arranjo proporcionado pela densidade normal (média de 20 plantas /m) e menor espaçamento (30 cm) entre-linhas, proporcionou sombreamento mais precoce do solo e foi a melhor opção de controle cultural das plantas daninhas em todos os tratamentos testados. Não foi observado sintomas de intoxicação e nem efeitos negativos sobre a nodulação das plantas de soja, por parte do herbicida aplicado, em ambas as doses testadas.