895 resultados para Cause Of Death


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

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Background and ObjectivesHypokalemia has been consistently associated with high mortality rate in peritoneal dialysis. However, studies investigating if hypokalemia is acting as a surrogate marker of comorbidities or has a direct effect in the risk for mortality have not been studied. Thus, the aim of this study was to analyze the effect of hypokalemia on overall and cause-specific mortality.Design, Setting, Participants and MeasurementsThis is an analysis of BRAZPD II, a nationwide prospective cohort study. All patients on PD for longer than 90 days with measured serum potassium levels were used to verify the association of hypokalemia with overall and cause-specific mortality using a propensity match score to reduce selection bias. In addition, competing risks were also taken into account for the analysis of cause-specific mortality.ResultsThere was a U-shaped relationship between time-averaged serum potassium and all-cause mortality of PD patients. Cardiovascular disease was the main cause of death in the normokalemic group with 133 events (41.8%) followed by PD-non related infections, n=105 (33.0%). Hypokalemia was associated with a 49% increased risk for CV mortality after adjustments for covariates and the presence of competing risks (SHR 1.49; CI95% 1.01-2.21). In contrast, in the group of patients with K < 3.5mEq/L, PD-non related infections were the main cause of death with 43 events (44.3%) followed by cardiovascular disease (n=36; 37.1%). For PD-non related infections the SHR was 2.19 (CI95% 1.52-3.14) while for peritonitis was SHR 1.09 (CI95% 0.47-2.49).ConclusionsHypokalemia had a significant impact on overall, cardiovascular and infectious mortality even after adjustments for competing risks. The causative nature of this association suggested by our study raises the need for intervention studies looking at the effect of potassium supplementation on clinical outcomes of PD patients.

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Pós-graduação em Patologia - FMB

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Pós-graduação em Saúde Coletiva - FMB

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Neoplasm, tumor or cancer generic synonymies are used to designate a group of diseases that affect any part of the body.Their main common feature is the abnormal cell proliferation, usually rapid, uncontrolled and unrestrained. According to World HealthOrganization (WHO) cancer is the leading cause of death worldwide. In 2005, a total of 58 million deaths, 7.6 million (or 13%) of all of them were cancer. Among the factors that favor its development, the tobacco is considered one of the main villains. Therefore, this article, we will discuss the basics and updates about oral cancer and tobacco consumption.

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Diabetes is a chronic disease that currently affects 171 million individuals approximately worldwide, with projection to reach 366 million people in 2030, increasing the prevalence of 2.8% in 2000 to 4.4%. The dyslipidemia is certainly one of the associated metabolic alterations most important, if we consider the main cause of death in Diabetes - the cardiovascular disease (CVD). One of the prevention and help factors in the Diabetes treatment and in the fall of associated complications is the physical exercise, which contributes to a better life quality to the diabetic. The main objective of the work was to evaluate the effect of a mixed physical exercises training program (aerobic/anaerobic with pause-active), including walking exercises, weightlifting and swiss ball, about possible changes in the blood lipid profile of adult individuals type 2 diabetics. The methodology used an experimental model of pre-test and post-test applied to the group. The data were first analyzed in a descriptive way for the normalization and the elaboration of averages and sample diversions. The sample was subdivided in two moments, being one pre and other post then weeks of training. After these procedures, the results of the values of the lipidic profile and glycemia were compared between the pairs pre and post training (test T Student, pair data), non-parametric. With the study, we can conclude that in despite of the low uptake of participants in the search, for reasons already cited, and the great age difference between them, the found results were partially satisfactory, because we achieved significant changes only in the glycemic variables, but we suggest future studies in the molds here proposed.

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Pós-graduação em Fisiopatologia em Clínica Médica - FMB

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Pós-graduação em Enfermagem (mestrado profissional) - FMB

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Pós-graduação em Geografia - IGCE

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In January 1973, large numbers of Mugil cephalus (striped mullet), weighing approximately 250 gm each, died in two freshwater localities in tidewater bayous of Jackson County, Mississippi. Fish identified as Mugil curema, M. cephalus, Megalops atlantica, Dormitator maculatus, and Fundulus grandis were found dead in other low saline estuarine areas. Fish-kills during cold periods are less commonly encountered in Mississippi than in Texas or Florida. This particular incident is attributed to conditions of stress for fishes incompletely acclimated to the encountered low temperatures. The most deleterious stress was the low saline water which probably allowed a breakdown in the fishes' ion-osmoregulatory mechanisms. Striped mullet and other euryhaline fishes in salinities greater than 6 ppt survived, as did freshwater centrarchids and ictalurids in areas with dying mullet. Other stresses thought to contribute to the weakening of striped mullet in Paige Bayou during the period of rapidly decreasing temperatures include starvation and high levels of pesticide residues. In examined fish, the alimentary tracts were devoid of food, the gall bladders were distended and leaking bile, the livers contained excess lipid material and were often stained throughout with bile pigments, and the levels of DDT metabolites and endrin residues in the liver were higher than in control fish. Stress caused by low levels of dissolved oxygen, toxic substances in the water, or disease was discounted as a cause of death.

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Trauma deaths are a result of hemorrhage in 37% of civilians and 47% military personnel and are the primary cause of death for individuals under 44 years of age. Current techniques used to treat hemorrhage are inadequate for severe bleeding. Preliminary research indicates that fibrin sealants (FS) alone or in combination with a dressing may be more effective; however, it has not been economically feasible for widespread use because of prohibitive costs related to procuring the proteins. To meet future demands for hemostatic therapies, FS will likely include recombinant human fibrinogen (rFI) and recombinant human Factor XIII (rFXIII). The underlying hypothesis of the research presented in this dissertation is that a liquid fibrin sealant (LFS) composed of recombinant FI, FXIII and FIIa in optimized proportions can assist hemostasis in the presence and absence of a bioresorbable bandage while using considerably fewer biologics than commercial products currently available. This dissertation characterized rFI produced in the milk of transgenic cows, plasma-derived thrombin (pdFIIa) activated by sodium citrate and rFXIIIa expressed in genetically engineered Pichia pastoris with respect to their capacity to serve as components in a LFS. The ratios of these factors were optimized to yield a LFS with a rapid clot formation rate and high viscoelastic strength. This optimized LFS was preliminarily tested ex vivo and in vivo. The clotting kinetics and viscoelastic strength of our optimized LFS was equivalent to those of a commercially available LFS; however, it uses approximately 75% less fibrinogen and thrombin. Our optimal LFS successfully achieved hemostasis in a significant number of the wounds that included extensive tissue and vascular damage. LFS applied without the assistance of a dressing was able to stop bleeding of oozing wounds or those with small vessels; however, a scaffold was needed when wounds contained large vasculature.

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Background: Cardiovascular disease is an important cause of death in patients on dialysis. Peripheral arterial disease (PAD) is a prognostic factor for cardiovascular disease. The ankle brachial index (ABI) is a noninvasive method used for the diagnosis of PAD. The difference between ABI pre- and post-dialysis had not yet been formally tested, and it was the main objective of this study. Methods:The ABI was assessed using an automated oscillometric device in incident patients on hemodialysis. All blood pressure readings were taken in triplicate pre- and post-dialysis in three consecutive dialysis sessions (times 1, 2, and 3). Results: One hundred and twenty-three patients (85 men) aged 53 +/- 19 years were enrolled. We found no difference in ABI pre- and post-dialysis on the right or left side, and there was no difference in times 1, 2, and 3. In patients with a history of PAD, the ABI pre- versus post-dialysis were of borderline significance on the right side (p = 0.088). Conclusion: ABI measured pre- and post-dialysis presented low variability. The ABI in patients with a history of PAD should be evaluated with caution. The applicability of the current method in predicting mortality among patients on hemodialysis therefore needs further investigation. Copyright (C) 2012 S. Karger AG, Basel

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Breast cancer metastasis is a leading cause of death by malignancy in women worldwide. Efforts are being made to further characterize the rate-limiting steps of cancer metastasis, i.e. extravasation of circulating tumor cells and colonization of secondary organs. In this study, we investigated whether angiotensin II, a major vasoactive peptide both produced locally and released in the bloodstream, may trigger activating signals that contribute to cancer cell extravasation and metastasis. We used an experimental in vivo model of cancer metastasis in which bioluminescent breast tumor cells (D3H2LN) were injected intra-cardiacally into nude mice in order to recapitulate the late and essential steps of metastatic dissemination. Real-time intravital imaging studies revealed that angiotensin II accelerates the formation of metastatic foci at secondary sites. Pre-treatment of cancer cells with the peptide increases the number of mice with metastases, as well as the number and size of metastases per mouse. In vitro, angiotensin II contributes to each sequential step of cancer metastasis by promoting cancer cell adhesion to endothelial cells, trans-endothelial migration and tumor cell migration across extracellular matrix. At the molecular level, a total of 102 genes differentially expressed following angiotensin II pretreatment were identified by comparative DNA microarray. Angiotensin II regulates two groups of connected genes related to its precursor angiotensinogen. Among those, up-regulated MMP2/MMP9 and ICAM1 stand at the crossroad of a network of genes involved in cell adhesion, migration and invasion. Our data suggest that targeting angiotensin II production or action may represent a valuable therapeutic option to prevent metastatic progression of invasive breast tumors.

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Paracoccidioidomycosis (PCM), caused by Paracoccidioides brasiliensis, is the most prevalent invasive fungal disease in South America. Systemic mycoses are the 10th most common cause of death among infectious diseases in Brazil and PCM is responsible for more than 50% of deaths due to fungal infections. PCM is typically treated with sulfonamides, amphotericin B or azoles, although complete eradication of the fungus may not occur and relapsing disease is frequently reported. A 15-mer peptide from the major diagnostic antigen gp43, named P10, can induce a strong T-CD4+ helper-1 immune response in mice. The TEPITOPE algorithm and experimental data have confirmed that most HLA-DR molecules can present P10, which suggests that P10 is a candidate antigen for a PCM vaccine. In the current work, the therapeutic efficacy of plasmid immunization with P10 and/or IL-12 inserts was tested in murine models of PCM. When given prior to or after infection with P. brasiliensis virulent Pb 18 isolate, plasmid-vaccination with P10 and/or IL-12 inserts successfully reduced the fungal burden in lungs of infected mice. In fact, intramuscular administration of a combination of plasmids expressing P10 and IL-12 given weekly for one month, followed by single injections every month for 3 months restored normal lung architecture and eradicated the fungus in mice that were infected one month prior to treatment. The data indicate that immunization with these plasmids is a powerful procedure for prevention and treatment of experimental PCM, with the perspective of being also effective in human patients.