Extended Daily Dialysis in Acute Kidney Injury Patients: Metabolic and Fluid Control and Risk Factors for Death

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.

Multilatinas na global economy. historical characterization, sectorial and space

The successive crises for which has passed in the world economy since the years 1970, together with the United States 'hegemonic crisis, have created the conditions for the reordering and the construction of a multipolar world, with the increasing importance of some peripheral countries into the world economy, particularly with regard to capital flows. This article represents an effort to bring to light the analysis on the decrease of importance of developed countries in world investment flows and corresponding increase in the relevance of some peripheral countries. The objective underlying the text is understanding the expansion of space circuits of production of multinational companies in Latin America (Multilatinas) at different spatial scales, by means of an analysis of the temporal, spatial and sectoral dimensions of the investments. The methodological procedures adopted covered survey, selection and bibliographic data compilation, reading in international organizations (UNCTAD and ECLAC), systematization of data, analysis of data in the light of the theoretical reflections.

Serviço de referência virtual via chat: uma análise comparativa em bibliotecas universitárias norte-americanas e brasileiras

Pós-graduação em Ciência da Informação - FFC

Avaliação de biomarcadores moleculares em mulheres com câncer de ovário

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Transformation of wealth produced into quality of life: analysis of the social efficiency of nation-states with the DEA's triple index approach

Although an essential condition for the occurrence of human development, economic growth is not always efficiently converted into quality of life by nation-states. Accordingly, the objective of this study is to measure the social efficiency-the ability of a nation-state to convert its produced wealth into quality of life-of a set of 101 countries. To achieve this goal, the Data Envelopment Analysis method was used in its standard, cross-multiplicative and inverted form, by means of a new approach called 'triple index'. The main results indicated that the former Soviet republics and Eastern European countries stood out in terms of social efficiency. The developed countries, notwithstanding their high social indicators, did not excel in efficiency; however, the countries of south of Africa, despite having the worst social conditions, were also the most inefficient.

Sistema de cálculo para determinação do tempo de exposição em radioterapia veterinária

Radiotherapy in veterinary practice is already known and widely distributed in large specialized centers of developed countries. In early 2000, there were about 30 radiotherapy equipment specifically designed for the veterinary clinic in the United States. In Brazil, the veterinary radiotherapy is still confined to research in universities, where most of the procedures is radiation therapy performed with superficial x-ray machines, with a voltage between 50 and 150 kVp, focus-distance surface (DFS) between 20,0cm and 40,0cm. As that occurs in human medicine, new research strengthens the development and prospects for the use of radiotherapy as a safe option for treating cancer in animals. This paper presents a methodology for calculating the exposure time for superficial radiotherapy procedures in veterinary medicine for small animals (dogs and cats). The dosimetric parameters of X-rays are determined using a spreadsheet tool for Microsoft Office Excel, developed in this paper for a device Dermopan 2, Veterinary Hospital of UNESP in Araçatuba. Using the worksheet helps the veterinarian to determine the time of exposure to radiation determined for each clinical case, optimize the workflow for professionals in veterinary radiotherapy procedures, which often lack the medical physics in team and at the time of radiotherapy. The correct use of spreadsheet decreases the chances of errors in dose rates of radiation, providing a higher quality of care

Mudou o quê?!: fatos e relatos do crescimento econômico brasileiro no século XXI

The objective of this research is a production of a reporting-book broaching different aspects of the brazilian economic growing, more specifically on the last ten years. These visages surround topics so much discussed by the brazilian and international media. As these medias searched answers for the success of the Brazil's Economy in the 21st century, specially with the good results of the GDP in 2010, the reporting-book also was produced in order to explain better the brazilian scene on the crest of the greatest economic crisis of recent years which has led developed countries to its political and economic degradation

Estudo da deposição de energia das radiofrequências através do método das diferenças finitas dependentes do tempo Monografia

Radiotherapy in veterinary practice is already known and widely distributed in large specialized centers of developed countries. In early 2000, there were about 30 radiotherapy equipment specifically designed for the veterinary clinic in the United States. In Brazil, the veterinary radiotherapy is still confined to research in universities, where most of the procedures is radiation therapy performed with superficial x-ray machines, with a voltage between 50 and 150 kVp, focus-distance surface (DFS) between 20,0cm and 40,0cm. As that occurs in human medicine, new research strengthens the development and prospects for the use of radiotherapy as a safe option for treating cancer in animals. This paper presents a methodology for calculating the exposure time for superficial radiotherapy procedures in veterinary medicine for small animals (dogs and cats). The dosimetric parameters of X-rays are determined using a spreadsheet tool for Microsoft Office Excel, developed in this paper for a device Dermopan 2, Veterinary Hospital of UNESP in Araçatuba. Using the worksheet helps the veterinarian to determine the time of exposure to radiation determined for each clinical case, optimize the workflow for professionals in veterinary radiotherapy procedures, which often lack the medical physics in team and at the time of radiotherapy. The correct use of spreadsheet decreases the chances of errors in dose rates of radiation, providing a higher quality of care

Análise multielementar pela técnica de fluorescência de raios-X de amostras de cólon de roedores com colite e tratados com prednisolona

Pós-graduação em Biologia Geral e Aplicada - IBB

Antidepressivo modula o comportamento e a expressão gênica das cadeias de miosina, serca2 e fosfolambam em ratos com insuficiência aórtica?

Introduction: Aortic insufficiency (AoI), a volume overload, is characterized by the diastolic reflux of blood from the regurgitating aorta to the left ventricle. This effect results from malfunctioning aortic cusps. The main cause of AoI in developing countries is rheumatic fever, including Brazil, and valvar degeneration in developed countries. There is a strong association between cardiovascular diseases and depression. Selective serotonin reuptake inhibitors (SSRI) are one of the most prescribed antidepressants in the world. Previous studies of our laboratory showed that the utilization of a SSRI, paroxetine, improved cardiac function in rats with sub-chronic AoI and reduced the daily ingestion of hypertonic sodium (NaCl 0,3M). Cardiovascular diseases can determine behavior changes like increase of anxiety, and it is yet unknown if AoI would determine anxiety or anhedonia, incapacity of obtaining pleasure through physical or sensorial experiences. A possible target for SSRI action could be a change in the expression of enzyme isoforms that collaborate in the contractile function of the heart muscle, like the heavy chains of myosine, the sarcoplasmatic reticulum Ca2+/ATPase (SERCA) and its regulator protein, phospholamban (PLB). Objectives: Evaluation of behavior parameters for anxiety and anhedonia state and genic expression of a-myosine, b-myosine, SERCA2a and PLB in the heart tissue of rats with subchronic AoI that received treatment with an SSRI (paroxetine) for 4 weeks. Methods: Surgery to induce AoI was performed on male Wistar rats, anxiety was evaluated by the elevated plus-maze (EPM) and state of anhedonia was tested by ingestion of 2% sucrose solution. After euthanasia the heart tissue was collected and total RNA was extracted to be analyzed by the RT-qPCR method. Results: Heart fractional shortening was preserved in rats with AoI that were treated compared to rats with AoI that were not treated. There was no statistically ...

Investment theory and empirical approach: a discussion on dificulties

In this paper, we analyse several contributions made concerning investment theory in the last decades. The objective of the paper is to discuss the difficulties of the testable theory identified by Chirinko (1983), Fazzari et al. (1988, 2000), Kaplan and Zingales (1997) and Hubbard (1998) to better understand the results of empirical approach. These few authors we worked with provided theoretical arguments and empirical evidences that internal finance variable of the firms may work as an indicator of financial constraint. In several developed countries, financing constraints has been identified as important to understand the investment spending. The principal indicator of financing constraints, that is, cash-flow has been questioned. However, the evidences offer a support to its relevance. We try to justify such evidence based on the few authors listed above, which have been quoted by empirical works. We try to contribute to debate adding aspect of the corporate finance to offer a logical explanation to econometric difficulties.

Trabalhadores hóspedes: herders, borregueros ou peões nas montanhas rochosas dos Estados Unidos e Canadá

In the contemporary world and in the globalized farm labor market, employ temporary immigrants workforce become current in economic developed countries. With governmental support, nations as United States and Canada incite and lawful the foreign entrance for occupy jobs and functions that are not fulfilling by native born, consolidating the displacement of a cheap labor force that stays legally for a certain season in these countries. This article brings up primal subjects about a small and hidden group among farm immigrants, the herders, sheepherders and goat herders in northAmerica Rocky Mountains loneliness. Further to provide an initial theoretical instrumental for the reflections about these workers, we intend to localize them within migration theme and the conflict between capital and labor in these days, in its neoliberal context and struggle forms. For such, we used reflections about labor and migration, also different kind of documents about herders in both countries.

Análise do crescimento das empresas de base tecnológica no Brasil

Technology-Based Firms (TBFs) are companies with intensive innovation dynamics based on technical competences, and for which high growth rates are expected. Nevertheless, even in developed countries, the evidence suggests that significantly high growth rates are more the exception than the rule. In Brazil, most studies on TBFs focus on factors that limit their success, such as managerial experience and capital availability. Based on extensive field research and on a reliable enterprise growth rate indicator, this article aims to evaluate the expansion of those firms, analyzing its relation to key elements such as degree of consolidation, market insertion, and public policy support. We found a growth rate which, although widely varied amongst firms, was significant and was not directly related to the amount of public policy support.

O impacto dos agrotóxicos ao meio ambiente e os reflexos jurídicos à saúde dos trabalhadores rurais

Pós-graduação em Direito - FCHS

Nanoparticles increase the efficacy of cancer chemopreventive agents in cells exposed to cigarette smoke condensate

Lung cancer is a leading cause of death in developed countries. Although smoking cessation is a primary strategy for preventing lung cancer, former smokers remain at high risk of cancer. Accordingly, there is a need to increase the efficacy of lung cancer prevention. Poor bioavailability is the main factor limiting the efficacy of chemopreventive agents. The aim of this study was to increase the efficacy of cancer chemopreventive agents by using lipid nanoparticles (NPs) as a carrier. This study evaluated the ability of lipid NPs to modify the pharmacodynamics of chemopreventive agents including N-acetyl-L-cysteine, phenethyl isothiocyanate and resveratrol (RES). The chemopreventive efficacy of these drugs was determined by evaluating their abilities to counteract cytotoxic damage (DNA fragmentation) induced by cigarette smoke condensate (CSC) and to activate protective apoptosis (annexin-V cytofluorimetric staining) in bronchial epithelial cells both in vitro and in ex vivo experiment in mice. NPs decreased the toxicity of RES and increased its ability to counteract CSC cytotoxicity. NPs significantly increased the ability of phenethyl isothiocyanate to attenuate CSC-induced DNA fragmentation at the highest tested dose. In contrast, this potentiating effect was observed at all tested doses of RES, NPs dramatically increasing RES-induced apoptosis in CSC-treated cells. These results provide evidence that NPs are highly effective at increasing the efficacy of lipophilic drugs (RES) but are not effective towards hydrophilic agents (N-acetyl-L-cysteine), which already possess remarkable bioavailability. Intermediate effects were observed for phenethyl isothiocyanate. These findings are relevant to the identification of cancer chemopreventive agents that would benefit from lipid NP delivery.