990 resultados para Roberto Freitas Filho


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

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Pós-graduação em Engenharia Elétrica - FEIS

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Introduction: Peritonitis remains the main cause of peritoneal dialysis (PD) technique failure worldwide, despite significant reductions in infection rates observed over the past decades. Several studies have described risk factors for peritonitis, technique failure and mortality. However, there are scarce data regarding predictors of complications during and after a peritonitis episode. The aim of our study was to analyze predictors of peritonitis-related outcome in the Brazilian Peritoneal Dialysis study (BRAZPD) cohort.Methods: All adult incident patients recruited in the BRAZPD Study between December 2004 and October 2007, who remained at least 90 days on PD and presented their first peritonitis episode (n = 474 patients) were included in the study. The endpoints analyzed were non-resolution, death due to a peritonitis episode and long-term technique survival after a peritonitis episode.Results: In the multivariable regression, non-resolution was independently associated with older age (odds ratio (OR) 1.02; p < 0.01), collagenosis as the primary renal disease (OR 4.6; p < 0.05) and Pseudomonas spp as etiological agent (OR 2.9; p < 0.05). Patients who were transferred from APD to CAPD during peritonitis therapy presented a higher risk of non-response (OR 2.5; p < 0.05). The only factor associated with death during a peritonitis episode was older age (OR 1.04; p < 0.05). Exposure to vancomycin and male gender were the independent predictors of long-term technique failure (OR 2.2; p < 0.01).Conclusion: Apart from confirming previous observations of the negative impact of older age and Pseudomonas spp peritonitis on outcomes, we observed that collagenosis may negatively impact response to treatment and exposure to vancomycin may possibly reduce long-term technique survival. It is important to emphasize that the association of vancomycin with technique failure does not prove causality. These findings shed light on new factors predicting outcome when peritonitis is diagnosed.

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Twelve granulomatous lesions in the thoracic and pelvic limbs of horses from pantaneira breed were evaluated. It was performed suggestive diagnostic of cutaneous pythiosis according to the clinic characteristics of the lesions and histopathological exams using hematoxylin and eosin (HE) and Grocott's methenamine silver (GMS) stains. The confirmation of the diagnoses was performed by the labelled streptavidin biotin (LSAB) method (immunohistochemistry). Extensive focal pyogranulomatous dermatitis associated with pseudo hyphae characteristic of Pythium insidiosum (subcutaneous pythiosis) was the histopathological diagnosis for all 12 horses used in this study. It was confirmed in 100% of the cases by the positive result to Pythium insidiosum in the immunohistochemistry exam, characterized by the visualization of branched and septated structures. It was observed 100% of parity between the techniques. We can conclude that clinical characterization of the granulomatous lesions with pythiosis aspects in horses associated with histopathology suggestive of equine pythiosis constitute a reliable method of diagnostic that can be confirmed by immunohistochemistry technique.

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Background: Chronic kidney disease (CKD) is one of the most serious public health problems. The increasing prevalence of CKD in developed and developing countries has led to a global epidemic. The hypothesis proposed is that patients undergoing dialysis would experience a marked negative influence on physiological variables of sleep and autonomic nervous system activity, compromising quality of life.Methods/Design: A prospective, consecutive, double blind, randomized controlled clinical trial is proposed to address the effect of dialysis on sleep, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life in patients with CKD. The measurement protocol will include body weight (kg); height (cm); body mass index calculated as weight/height(2); circumferences (cm) of the neck, waist, and hip; heart and respiratory rates; blood pressures; Mallampati index; tonsil index; heart rate variability; maximum ventilatory pressures; negative expiratory pressure test, and polysomnography (sleep study), as well as the administration of specific questionnaires addressing sleep apnea, excessive daytime sleepiness, depression, anxiety, stress, and quality of life.Discussion: CKD is a major public health problem worldwide, and its incidence has increased in part by the increased life expectancy and increasing number of cases of diabetes mellitus and hypertension. Sleep disorders are common in patients with renal insufficiency. Our hypothesis is that the weather weight gain due to volume overload observed during interdialytic period will influence the degree of collapsibility of the upper airway due to narrowing and predispose to upper airway occlusion during sleep, and to investigate the negative influences of haemodialysis in the physiological variables of sleep, and autonomic nervous system, and respiratory mechanics and thereby compromise the quality of life of patients.

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The aim of this study was evaluate the response of two coffee cultivars (tolerant and sensitive to aluminum - Al), inoculated or not by two arbuscular mycorriza fungi (AMF), Gigaspora margarita and Glomus etunicatum, in cerrado Oxisol, with different base saturation. This experiment was conducted under greenhouse conditions, with a complete randomized design, in a 2x3x2 factorial scheme, consisting of 2 cultivars (tolerante and sensitive to Al), 3 treatments with mycorrhizal (inoculated with two species of AMF and without inoculation) and 3 levels of soil base saturation (30, 45 and 53 V%), with five replicates per treatment. The variables were: plant height, stem diameter, leaf area, shoot dry weight, root fresh weight, nitrate reductase activity, chlorophyll concentration, root colonization and number of AMF spores. Mycorrhizae isolates promoted greater response of coffee plants, in acid soil with high concentration of Al, but this response was observed for both cultivars when plants were colonized by G. margarita. The cultivars evaluated showed no differences in Al tolerance when non inoculated.

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Aims and background. The study was undertaken to investigate CCL2/MCP-1, CCL3/MIP-l alpha, CCL4/MIP-1 beta, CCL5/RANTES and CXCL8/IL-8 women with epithelial ovarian cancer.Methods and study design. Sixteen patients diagnosed with epithelial ovarian cancer and 18 healthy women with no evidence of malign neoplasia (control group) aged from 23 to 89 years (mean +/- SEM, 58.7 +/- 2.3) were included. The epithelial ovarian cancer patients underwent laparotomy and debulking surgery Chemokines serum levels were measured by cytometric bead array. Statistical analysis was performed using Mann-Whitney and Kendall's tau. P <0.05 was considered statistically significant for all analyses.Results. The tumor staging (FIGO) was classified into: I in 4 cases (25%), III in 5 cases (31.3%) and stage IV in 7 cases (43.8%). Sera chemokine dosages of CCL2 /MCP-1 and CCL4/MIP-1 beta were lower in epithelial ovarian cancer patients than in the control group (P = 0.021 and P = 0.030, respectively). No significant difference between groups was observed in the levels of CCL3/MIP-l alpha, CCL5/RANTES and CXCL8/IL-8. No association between the chemokines analyzed and tumor stage was found. The serum level of CCL4/MIP-1 beta was correlated with CA-125.Conclusions. The study of serum levels of CCL2/MCP-1, CCL3/MIP-l alpha, CCL4/MIP-1 beta, CCL5/RANTES and CXCL8/IL-8 chemokines in epithelial ovarian cancer patients identified a down-regulation in CCL2/MCP-1 and CCL4/MIP-1 beta, which suggests that the two chemokines may play an important role in the pathophysiology of ovarian cancer.

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The research aimed to estimate body contents of protein and energy and net requirements of energy for maintenance of buffaloes, slaughtered at different stages of maturity. There were used 14 Mediterranean intact males with initial average body weight of 352.2 +/- 24.3 kg and average age of 24 months. The animais were randomly divided into four experimental groups. One group was designed to slaughter at the beginning of the experimental period (IS). The animals of another group were restricting fed, receiving, individually, levels of protein and energy 15% above maintenance (RF). The animals of the two remaining groups were individually fed ad libitum (SW450 and SW500) to reach weights corresponding to 100 and 110 percent of the mature weight of the buffalo cows (respectively 450 and 550 kg). The ration contained ground-corn cobs, soybean meal, urea, minerals, and signal-grass (Brachiaria decumbens) hay, with a concentrate: roughage ratio of 50: 50 and 13% of crude protein on a dry matter basis. To estimate changes in body composition inside the range of weights included in the trial, linear regression equations of log protein (kg), fat (kg) and energy (Mcal) as a function of log empty-body-weight (EBW), in kg, were fitted. Energy requirements for maintenance were obtained as estimated heat production at zero level of energy intake. Buffaloes submitted to fattening in feedlot presented early body fat deposition, and had with the same live weight lower protein content and higher fat content and energy per unit weight than european-zebu crossbred cattle.

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

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Because the biomechanical behavior of dental implants is different from that of natural tooth, clinical problems may occur. The mechanism of stress distribution and load transfer to the implant/bone interface is a critical issue affecting the success rate of implants. Therefore, the aim of this study was to conduct a brief literature review of the available stress analysis methods to study implant-supported prosthesis loading and to discuss their contributions in the biomechanical evaluation of oral rehabilitation with implants. Several studies have used experimental, analytical, and computational models by means of finite element models (FEM), photoelasticity, strain gauges and associations of these methods to evaluate the biomechanical behavior of dental implants. The FEM has been used to evaluate new components, configurations, materials, and shapes of implants. The greatest advantage of the photoelastic method is the ability to visualize the stresses in complex structures, such as oral structures, and to observe the stress patterns in the whole model, allowing the researcher to localize and quantify the stress magnitude. Strain gauges can be used to assess in vivo and in vitro stress in prostheses, implants, and teeth. Some authors use the strain gauge technique with photoelasticity or FEM techniques. These methodologies can be widely applied in dentistry, mainly in the research field. Therefore, they can guide further research and clinical studies by predicting some disadvantages and streamlining clinical time.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Pós-graduação em Educação - FFC

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Pós-graduação em Engenharia Mecânica - FEIS