O EEG na insuficiencia renal cronica. I. Atividade de fundo em repouso e durante ativacao

We examined the EEG of 88 patients with chronic renal failure (80 adults and 8 children) submitted to different types of treatment such as hemodialysis, peritoneal dialisys, renal transplantation, and ambulatory follow-up. The main alteration observed was diffuse disorganization of background activity. The following features were detected in decreasing order of frequency: low-voltage EEG, triphasic waves, abnormal waking reactions, and paradoxal alpha rhythm. The children showed abnormal alpha rhythm. The alterations induced by intermittent photic stimulation in our patients were minimal, and this was the main difference in relation to data reported by other authors in EEG studies on patients with chronic uremia.

O EEG na insuficiencia renal cronica. III. Valor prognostico

In 1983 and 1984 we performed a longitudinal 1-year follow-up study of 15 patients with chronic renal failure, 8 of whom were on hemodialysis and 7 on peritoneal dialysis. The EEG abnormalities of these patients were catalogued and filed and the patients' medical records were examined 5 years later for an analysis of their clinical evolution. Old age EEG findings were detected in young patients with chronic renal failure who died. We conclude that old age EEG findings in patients of any age with chronic renal failure represent a poor prognosis. In contrast, EEG asynchronies are associated with severe uremic encephalopathy but are reversible, since these phenomena were fully reversed together with all clinical alterations in a patient who later received a renal transplant.

Determinantes da evolução do peso e altura em crianças de 3 meses a 6 anos assistidas em creche: Análise por modelo linear não hierarquizado em ensaio quase-experimental

Objective. To assess factors determining growth in a group of children between 3 months and 6 years old enrolled in a public municipal (i.e., government-supported, not private) day-care center, in comparison to a group of children with similar characteristics but who were not enrolled in the center. Methods. A quasi-experimental study was designed to observe 444 children aged 3 to 72 months from a low-income neighborhood in the city of Sorocaba, in the state of São Paulo, Brazil. Two groups were studied: 164 children enrolled in a local municipal day-care center (intervention group) and 280 not receiving care at the center (nonintervention, comparison group) but instead being cared for at home. Both groups were seen four times over a period of 16 months. At each observation session, the children's weight and height were measured. Information was also collected on the mother's sociodemographic characteristics and the illnesses she had suffered as well as the child's weight and other health characteristics at birth, the child's illnesses in the 15 days before each observation, and any hospitalizations. Results. The children in both groups were from low-income families, with 65% of the families having an average monthly income below US$ 100; 80% of the mothers had received 8 years of schooling or less. Multivariate linear regression analysis showed that at the first observation (just before enrollment in the day-care center), birth weight was the only factor that explained the nutritional differences between the two groups. Subsequent analyses showed that being in day care was the factor that best explained the differences between the groups, especially in terms of the adequacy of weight for age, after controlling for birthweight, sex, age at the beginning of the study, and illnesses in the 15 days before an observation session. The nutritional impact of the intervention was significant as early as 3 months after being enrolled in day care. Conclusions. The nutritional benefits of the care provided at the center outweighed the negative effects sometimes seen in such centers, such as the greater morbidity that children in day-care centers often experience in comparison to children receiving care at home.

Monitoramento sanitário de um sistema integrado de tratamento de águas residuárias da suinocultura

Objective. To assess the potential for contamination of wastewaters from pig farming. Methods. Wastewaters from pig farming were stored in a tank. After 0, 30, 60, 90, and 120 days of hydraulic retention, they were added to lysimeters filled with argillaceous, sandy, or medium soil. Finally, these lysimeters were submitted to simulations of either a rainy season or a dry season. The number of colony-forming units (CFUs) of total coliforms, fecal coliforms, and fecal streptococci was measured in the effluents of the storage tank (for the various periods of hydraulic retention), in the percolate from the lysimeters, and in the three types of soil. The microbiological analyses were carried out using the membrane filter technique. The pH analyses were done potentiometrically. Results. For the three microorganisms, the largest decrease in bacterial counts in the storage tanks occurred with 90 or 120 days of retention. There was a marked decrease in the bacterial count in the percolates of the three soils. For the three soil types the greatest reduction in bacterial counts was found in medium soil, due to its acidity (pH < 7.0). Hydraulic retention was not sufficient to ensure the sanitary adequacy of the wastewaters and their use for irrigation, given that fecal coliform values were above 1 000 CFU per 100 mL. Therefore, adding the residues to the soil was considered a second stage of treatment. Conclusions. The retention of wastewaters followed by adding them to soil was effective in minimizing the contaminating effect of pig farming residues. The storage time for wastewaters from pig farming could be decreased from 120 to 90 days.

Method for the evaluation of insecticidal activity over time in Atta sexdens rubropilosa workers (Hymenoptera: Formicidae)

The active ingredients used in the formulation of toxic baits for leaf-cutting ants (Hymenoptera: Formicidae) should possess a delayed action defined as an insecticidal activity whereby worker mortality is ≤15% at 24 hours and ≥90% at 21 days. Serious shortcomings have occurred in the search for new active ingredients, such as the initial selection of fenoxycarb, copper oxychloride and diflubenzuron, compounds considered very promising but whose inefficiency was verified only later, indicating methodological problems. In view of this situation, we developed a classification method for insecticidal activity over time using workers of the leaf-cutting ant Atta sexdens rubropilosa Forel. The insecticides used were fipronil, sulfluramid GX071HB and sulfluramid GX439, vehicled in an attractive pasty formulation prepared based on citrus pulp. The results obtained were consistent from a toxicological viewpoint and agreed with the literature in terms of the control of colonies. Sulfluramids were found to possess a delayed action at a broad range of concentrations, in agreement with the fact that these substances are highly effective in the control of all leaf-cutting ant species. The smaller range of concentrations of fipronil with delayed action is probably related to its lower efficacy for species more difficult to control such as Atta capiguara (Forti et al. 2003). We discuss the importance of relating behavioral particularities to the specific feeding habits of leaf-cutting ants, with methodological adequacy of the assessment of insecticides aimed at toxic baits.

Erosão hídrica de Latossolo Vermelho muito argiloso relevo ondulado em área de pós-plantio de eucalipto no Vale do Rio Doce, região Centro Leste do Estado de Minas Gerais

The erosion caused by running water constitutes important cause of environmental degradation and productivity reduction, which justifies its evaluation in areas of eucalypt commercial plantations, mainly in ondulated slope conditions. The present study was intended to evaluate the influence of different management systems, in an undulated eucalypt pos-planting area, upon soil and water losses by erosion. The experiment was installed in a very clayey Red Latosol (Oxisol) under three eucalypt management systems (downhill planting with burning of crop residues - EDq; downhill planting with maintenance of crop residues on soil surface - ED; level planting with maintenance of crop residues on soil surface - EN), native forest (FN), bare soil (SD), and native pasture (PN). The soil and water losses evaluations were performed in standard plots installed in the field. All eucalypt systems presented very low values of soil losses in relation to the established tolerance limit, indicating the adequacy of these management systems concerning water erosion. The sustainability of these environments regarding erosion is indicated by the fact that soil losses in eucalipt were very close to those observed in native forest (reference).

Papel da eritropoetina recombinante humana sobre o metabolismo dos carboidratos, paratormônio, cálcio iônico, zinco, prolactina e níveis pressóricos em renais crônicos tratados com hemodiálise

Objective: To evaluate the influence of recombinant human erythropoietin (Epho) on carbohydrate metabolism, parathyroid hormone, calcium ionic, zinc, prolactin and blood pressure (BP) in chronic renal failure treated by hemodialysis. Methods: Ten patients in hemodialysis were followed during 24 weeks in two phases: 12 weeks pre-Epho (BP was measured pre and post hemodialysis sessions) and 12 weeks post-Epho (BP was measured as above and also the blood levels of glucose, insulin, parathyroid hormone, calcium ionic, prolactin, and zinc). Results: Patients were 39.8±8.5 y, 50% males. Hematocrit and hemoglobin presented a significant increase four weeks after Epho (22.3±2.3 to 28.1±2.6% and 7.4±0.8 to 9.4±0.9 g/dL, p<0.05). BP (mmHg) and weight pre-Epho: 158±99 and 59±13 (before hemodialysis), 147±96 and 55±13 (after hemo) and post-Epho: 161±100 and 59±13 (before hemo) 155±101 and 56±12 (after hemo) were all not statistically different in any moment. There are also no difference pre and post-Epho in fast glucose (91.8±6.5 and 90.8±6.1 mg/dL, p>0.05), parathyroid hormone (341.4±249.3 and 515.7±310 pg/ mL), calcium ionic (3,66±0.63 and 3.76±0.45 mmol/L), prolactin (males: 327±144.1 and 298.1 ±145.2 μg/mL; females: 666.2±426.6 and 659±395.3 μg/mL) and zinc (median of 0.73 and 0.71 μg\L). Basal insulin was lower after Epho (median of 9.1 to 3.8 μg/mL, p<0.05). Conclusion: These data suggest that recombinant human erythropoietin was effective to improve the anemia and the carbohydrate metabolism in patients with chronic renal failure treated by hemodialysis. © Copyright Moreira Jr. Editors. Todos os direitos reservados.

Radiopacity of restorative materials using digital images

The radiopacity of esthetic restorative materials has been established as an important requirement, improving the radiographic diagnosis. The aim of this study was to evaluate the radiopacity of six restorative materials using a direct digital image system, comparing them to the dental tissues (enamel-dentin), expressed as equivalent thickness of aluminum (millimeters of aluminum). Five specimens of each material were made. Three 2-mm thick longitudinal sections were cut from an intact extracted permanent molar tooth (including enamel and dentin). An aluminum step wedge with 9 steps was used. The samples of different materials were placed on a phosphor plate together with a tooth section, aluminum step wedge and metal code letter, and were exposed using a dental x-ray unit. Five measurements of radiographic density were obtained from each image of each item assessed (restorative material, enamel, dentin, each step of the aluminum step wedge) and the mean of these values was calculated. Radiopacity values were subsequently calculated as equivalents of aluminum thickness. Analysis of variance (ANOVA) indicated significant differences in radiopacity values among the materials (P<0.0001). The radiopacity values of the restorative materials evaluated were, in decreasing order: TPH, F2000, Synergy, Prisma Flow, Degufill, Luxat. Only Luxat had significantly lower radiopacity values than dentin. One material (Degufill) had similar radiopacity values to enamel and four (TPH, F2000, Synergy and Prisma Flow) had significantly higher radiopacity values than enamel. In conclusion, to assess the adequacy of posterior composite restorations it is important that the restorative material to be used has enough radiopacity, in order to be easily distinguished from the tooth structure in the radiographic image. Knowledge on the radiopacity of different materials helps professionals to select the most suitable material, along with other properties such as biocompatibility, adhesion and esthetic.

Risk of peritonitis during peritoneal dialysis in carriers of Staphylococcus aureus and coagulase-negative staphylococci

The presence of Staphylococcus aureus in the nasal cavities and pericatheter skin of peritoneal dialysis patients put them at high risk of developing peritonitis. However, it is not clear whether the presence of coagulase-negative staphylococci (CNS) in the nasal passages and skin of patients is related to subsequent occurrence of peritoneal infection. The aim of the present study was to verify the relationship between endogenous sources of S. aureus and CNS and occurrence of peritonitis in patients undergoing peritoneal dialysis. Thirty-two patients on peritoneal hemodialysis were observed for 18 months. Staphylococcus species present in their nasal passage, pericatheter skin and peritoneal effluent were identified and compared based on drug susceptibility tests and dendrograms, which were drawn to better visualize the similarity among strains from extraperitoneal sites as well as their involvement in the causes of infection. Out of 288 Staphylococcus strains isolated, 155 (53.8%) were detected in the nasal cavity, 122 (42.4%) on the skin, and 11 (3.8%) in the peritoneal effluent of patients who developed peritonitis during the study. The most frequent Staphylococcus species were CNS (78.1%), compared with S. aureus (21.9%). Among CNS, S. epidermidis was predominant (64.4%), followed by S. warneri (15.1%), S. haemolyticus (10.7%), and other species (9.8%). Seven (64%) out of 11 cases of peritonitis analyzed presented similar strains. The same strain was isolated from different sites in two (66%) out of three S. aureus infection cases. In the six cases of S. epidermidis peritonitis, the species that caused infection was also found in the normal flora. From these, two cases (33%) presented highly similar strains and in three cases (50%), it was difficult to group strains as to similarity. Patients colonized with multidrug-resistant S. epidermidis strains were more predisposed to infection. Results demonstrated that an endogenous source of S. epidermidis could cause peritonitis in peritoneal dialysis patients, similarly to what has been observed with S. aureus.

Usage of enterprise modeling processes and information systems design to forecast demand

Managing the great complexity of enterprise system, due to entities numbers, decision and process varieties involved to be controlled results in a very hard task because deals with the integration of its operations and its information systems. Moreover, the enterprises find themselves in a constant changing process, reacting in a dynamic and competitive environment where their business processes are constantly altered. The transformation of business processes into models allows to analyze and redefine them. Through computing tools usage it is possible to minimize the cost and risks of an enterprise integration design. This article claims for the necessity of modeling the processes in order to define more precisely the enterprise business requirements and the adequate usage of the modeling methodologies. Following these patterns, the paper concerns the process modeling relative to the domain of demand forecasting as a practical example. The domain of demand forecasting was built based on a theoretical review. The resulting models considered as reference model are transformed into information systems and have the aim to introduce a generic solution and be start point of better practical forecasting. The proposal is to promote the adequacy of the information system to the real needs of an enterprise in order to enable it to obtain and accompany better results, minimizing design errors, time, money and effort. The enterprise processes modeling are obtained with the usage of CIMOSA language and to the support information system it was used the UML language.

Reliability assessment of energy limited systems using sequential montecarlo simulation

This paper explains why the reliability assessment of energy limited systems requires more detailed models for primary generating resources availability, internal and external generating dispatch and customer demand than the ones commonly used for large power systems and presents a methodology based on the full sequential Montecarlo simulation technique with AC power flow for their long term reliability assessment which can properly include these detailed models. By means of a real example, it is shown how the simplified modeling traditionally used for large power systems leads to pessimistic predictions if it is applied to an energy limited system and also that it cannot predict all the load point adequacy problems. © 2006 IEEE.

Dual path: A concept to improve the esthetic replacement of missing anterior teeth with a removable partial denture

The dual path of insertion concept for removable partial denture (RPD) design may be used in esthetically demanding situations. When compared to conventional RPDs, the main advantage of this design is the minimal use of clasps. This clinical report describes the treatment of a patient with an anterior maxillary edentulous area using a dual path RPD. The diagnostic cast was surveyed to ensure the adequacy of the undercuts on the mesial surfaces of the anterior abutments, where rigid minor connectors were placed. Inverted V-shaped canine cingulum rest seats were prepared to provide resistance to tooth movement during function. The dual path RPD concept allows excellent esthetic results, minimizes tooth preparation, and reduces the tendency toward plaque accumulation in a Kennedy class IV partially edentulous arch. © 2008 by The American College of Prosthodontists.

Planejamento agrícola e implantação de sistema de cultivo de cana-de-açúcar com auxílio de técnicas geoestatísticas

Sugarcane is one of the most important crops of the Brazilian agribusiness and this importance justifies the use of techniques that allow the implementation of cultivation systems capable of reducing the variability of soil characteristics and the establishment of efficient agricultural planning. The aim of the present work was the planning and implementation of cultivation systems for sugarcane using geostatistical techniques, in the Pereira Barreto region, SP. An area of 505 ha was mapped using the global positioning system (GPS) and a Digital Elevation Model was elaborated (MDE). Soil samples were collected for 0-0.25 m depth, in each 7 ha, for their chemical attributes and texture characterization. Data were analyzed by descriptive statistics and geostatistics. The determination of the spatial distribution of soil granulometric and chemical attributes allowed the allocation of the studied sugarcane varieties according to soil fertility and clay content. The kriging maps of soil granulometric and chemical attributes brought useful information to the establishment of production environments with different soil and crop managements. The identification of different environments by means of geostatistical techniques allowed the precise planning of the sugarcane cultivation, as well as the adequacy of fertilization practices and the allocation of suitable sugarcane varieties adapted to the conditions imposed by differences in the soil attributes.

Influência da aplicação de vinhaça na capacidade de Infiltração de um solo de textura franco arenosa

The objective of this study was to analyze effects in different depth in soil water infiltration and to verify the Horton and Kostiakov-Lewis models adequacy in infiltration rate estimate. The treatments were five doses of vinasse (0, 200, 250, 300 and 350 m3?ha1?. The vinasse application reduced the soil erosion risk increasing the possibility of runoff. The Horton model had the best adjustment on the observed data, and the Kostiakov-Lewis model overestimated the infiltration rate values.

Comparação entre as necessidades energéticas prescritas e administradas a pacientes em terapia nutricional enteral

Objective: evaluating the adequacy, prescription and energy supply of enteral nutrition therapy in hospitalized patients. Methods: was performed a retrospective survey of the evolution of TNE protocol of 59 patients hospitalized in a general hospital in Marília / SP / BR. Data collected included gender, age, clinical diagnosis, anthropometric and dietary data related to the prescribed dietary formula, route and method of administration of the enteral nutrition, the daily volume prescribed and administered, the daily amount of energy required and offered in the diet, as well as possible complications. Body mass index (BMI), triceps skinfold (TSF) and arm muscle circumference (AMC) were used to establish the nutritional status of the patients. The adequacy of ENT was done according to the daily energy requirement compared to the average energy received during the daily use of ENT. Results: The average found to the BMI was 21.4 kg/m 2, and no differences were found comparing male and female. The data for TSF and AMC were different between genders (p<0.05) and suggest a more severe muscle mass in relation to adipose tissue. The averaged to the energy requirements was 1642 kcal/day but the average of energy prescribed was 1045 kcal/day and the amount offered was 1035 kcal/day. There was a significant difference between the necessity and the supplied energy offered through enteral nutrition (p=0.00) as well between the energy required and prescribed (p =0.00), both were shorter than the necessity. There was no significant difference (p>0.05) in energy supply, volume of enteral nutrition prescribed and administered among eutrophic, underweight or overweight patients. Conclusion: The results of this study indicate that the prescription and energy supply were not based on the needs of these patients, causing a significant energy deficit, which can lead to worsening of the nutritional status of the same. In hospitalized patients in use of ENT, the energy requirement must be made by a qualified professional within the multidisciplinary team, based on the needs of each patient.