Sepsis and AKI in clinical emergency room patients: the role of urinary NGAL

Few studies have investigated the predictive properties of urinary (u) NGAL as an AKI marker in septic population. This study evaluated the efficacy of uNGAL as predictor of AKI and death in septic patients admitted to the clinical emergency room (ER). We prospectively studied patients with sepsis admitted to the ER. Urine was analyzed for NGAL within the first 24 hours after admission (classified as NGAL1), between 24 and 48 h (NGAL2), and at moment of AKI diagnosis (NGAL3). Among 168 septic patients admitted to ER, 72% developed AKI. The uNGAL and its relationship with creatinine (Cr) were high in septic patients but statistically higher in those with sepsis and AKI. The uNGAL1 and uNGAL2, as well as uNGAL1/uCr1 and uNGAL2/uCr2, were good predictors for AKI (AUC-ROC 0.73, 0.70, 0.77, and 0.84, resp.). The uNGAL1 and uNGAL1/uCr1 were poor predictors for death (AUC-ROC 0.66 and 0.68, resp.), whereas uNGAL2 and uNGAL2/uCr2 were better predictors (AUC-ROC 0.70 and 0.81, resp.). The uNGAL is highly sensitive but nonspecific predictor of AKI and death in septic patients admitted into ER.

Modulação autonômica, pressão arterial, aptidão funcional e qualidade de vida em mulheres com hipertensão arterial submetidas a um programa de Hatha Yoga

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Perfil antropométrico e força de membros superiores em competidores de montaria em touros

A força de preensão manual tem sido relatada como determinante no desempenho de empunhadura em modalidades como lutas e escalada. Este estudo teve por propósito avaliar a aptidão de força isotônica máxima e de preensão manual em praticantes e não praticantes de montaria em touros, a fim de obter parâmetros de referência desta população. Foram avaliados 20 sujeitos em dois grupos, sendo 10 classificados como atletas de montaria e 10 não-atletas. A avaliação da força de preensão manual foi realizada em dinamômetro em posição convencional (DP) e específica (DE), com ambas as mãos (D e E). A força isotônica máxima foi determinada pelo teste de uma repetição máxima (1RM) e também foram obtidas medidas de circunferência dos segmentos, bem como a composição corporal por protocolo de dobras cutâneas. Os valores das variáveis foram comparados pelo teste-t (ρ ≤ 0,05) para dados independentes. As relações entre os valores de força e características antropométricas foram traçadas pelo coeficiente de Pearson. Os resultados para AMT em DPD (43.8±6.8 kgf), DPE (39.4±7.7 kgf), DED (44.9±5.6 kgf) e DEE (39.8±8.3 kgf) comparados aos apresentados por n-AMT em DPD (47.0±3.0 kgf), DPE (42.2±6.1 kgf), DED (49.2±1.5 kgf) e DEE (46.2±4.1 kgf) apresentaram diferenças apenas para DED e DEE. A força nos testes de 1RM (supino reto: 73.2±12.0 kg e 82.0±12.0 kg; rosca direta: 45.2±8.9 kg e 43.8±8.9 kg; tríceps pulley: 67.0±6.3 kg e 72.0±6.3 kg; e puxada posterior: 73.5±8.5 kg e 73.7±7.5 kg) não mostram diferenças entre os grupos. A influência sobre a dinamometria apresenta-se diferente entre os grupos, sendo relevante a força de flexão do cotovelo em AMT e a antropometria e força isotônica para n-AMT. Conclui-se que as características morfo-funcionais de membros superiores não demandam especificidade à montaria em touros.

Anthropometric profile and upper-limbs strength of bull rider s competitors

A força de preensão manual tem sido relatada como determinante no desempenho de empunhadura em modalidades como lutas e escalada. Este estudo teve por propósito avaliar a aptidão de força isotônica máxima e de preensão manual em praticantes e não praticantes de montaria em touros, a fim de obter parâmetros de referência desta população. Foram avaliados 20 sujeitos em dois grupos, sendo 10 classificados como atletas de montaria e 10 não-atletas. A avaliação da força de preensão manual foi realizada em dinamômetro em posição convencional (DP) e específica (DE), com ambas as mãos (D e E). A força isotônica máxima foi determinada pelo teste de uma repetição máxima (1RM) e também foram obtidas medidas de circunferência dos segmentos, bem como a composição corporal por protocolo de dobras cutâneas. Os valores das variáveis foram comparados pelo teste-t (ρ ≤ 0,05) para dados independentes. As relações entre os valores de força e características antropométricas foram traçadas pelo coeficiente de Pearson. Os resultados para AMT em DPD (43.8±6.8 kgf), DPE (39.4±7.7 kgf), DED (44.9±5.6 kgf) e DEE (39.8±8.3 kgf) comparados aos apresentados por n-AMT em DPD (47.0±3.0 kgf), DPE (42.2±6.1 kgf), DED (49.2±1.5 kgf) e DEE (46.2±4.1 kgf) apresentaram diferenças apenas para DED e DEE. A força nos testes de 1RM (supino reto: 73.2±12.0 kg e 82.0±12.0 kg; rosca direta: 45.2±8.9 kg e 43.8±8.9 kg; tríceps pulley: 67.0±6.3 kg e 72.0±6.3 kg; e puxada posterior: 73.5±8.5 kg e 73.7±7.5 kg) não mostram diferenças entre os grupos. A influência sobre a dinamometria apresenta-se diferente entre os grupos, sendo relevante a força de flexão do cotovelo em AMT e a antropometria e força isotônica para n-AMT. Conclui-se que as características morfo-funcionais de membros superiores não demandam especificidade à montaria em touros.

Relaxamento progressivo, stress, enfrentamento e qualidade de vida em pessoas com apneia obstrutiva do sono

Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

Unesp Informa, 2015, número 72

Boletim elaborado pela Assessoria de Comunicação e Imprensa da Reitoria da UNESP

Unesp Informa, 2016, número 77

Boletim elaborado pela Assessoria de Comunicação e Imprensa da Reitoria da UNESP

Unesp Ciência, 2016, ano 7, número 72

Revista elaborada pela Assessoria de Comunicação e Imprensa da Reitoria da UNESP

Comparison of Gross Pathology, Histopathology, and Mycobacterial Culture for the Diagnosis of Tuberculosis in Elk (Cervus elaphus)

Using the isolation of Mycobacterium bovis as the reference standard, this study evaluated the sensitivity, specificity and kappa statistic of gross pathology (abattoir postmortem inspection), histopathology, and parallel or series combinations of the two for the diagnosis of tuberculosis in 430 elk and red deer. Two histopathology interpretations were evaluated: histopathology I, where the presence of lesions compatible with tuberculosis was considered positive, and histopathology II, where lesions compatible with tuberculosis or a select group of additional possible diagnoses were considered positive. In the 73 animals from which M. bovis was isolated, gross lesions of tuberculosis were most often in the lung (48), the retropharyngeal lymph nodes (36), the mesenteric lymph nodes (35), and the mediastinal lymph nodes (16). Other mycobacterial isolates included: 11 M. paratuberculosis, 11 M. avium, and 28 rapidly growing species or M. terrae complex. The sensitivity estimates of gross pathology and histopathology I were 93% (95% confidence limits [CL] 84,97%) and 88% [CL 77,94%], respectively, and the specificity of both was 89% [CL 85,92%]). The sensitivity and specificity of histopathology II were 89% (CL 79,95%) and 77% (CL 72,81%), respectively. The highest sensitivity estimates (93- 95% [CL 84,98%]) were obtained by interpreting gross pathology and histopathology in parallel (where an animal had to be positive on at least one of the two, to be classified as combination positive). The highest specificity estimates (94-95% [CL 91-97%]) were generated when the two tests were interpreted in series (an animal had to be positive on both tests to be classified as combination positive). The presence of gross or microscopic lesions showed moderate to good agreement with the isolation of M. bovis (Kappa = 65-69%). The results show that post-mortem inspection, histopathology and culture do not necessarily recognize the same infected animals and that the spectra of animals identified by the tests overlaps.

Effect of different restorative procedures on the fracture resistance of teeth submitted to internal bleaching

The aim of this study was to evaluate the influence of different restorative procedures on the fracture resistance of endodontically treated teeth submitted to intracoronal bleaching. Fifty upper central incisors were distributed into 5 groups: GI - healthy teeth; GII - endodontically treated teeth sealed with Coltosol; GIII - endodontically treated teeth bleached and sealed with Coltosol; GIV - endodontically treated teeth bleached and restored with composite resin; and GV - endodontically treated teeth bleached and restored with a fiberglass post and composite resin. In the bleached specimens, a cervical seal was made prior to bleaching with 38% hydrogen peroxide. The gel was applied on the buccal surface and in the pulp chamber, and was then light-activated for 45 s. This procedure was repeated three times per session for four sessions, and each group was submitted to the restorative procedures described above. The specimens were submitted to fracture resistance testing in a universal testing machine. There were statistically significant differences among the groups (p < 0.05). The mean value found for GIII was the lowest (0.32 kN) and was significantly different from the values found for GI (0.75 kN), GII (0.67 kN), GIV (0.70 kN), and GV (0.72 kN), which were not significantly different from each other (p > 0.05). The restorative procedures using composite resin were found to successfully restore the fracture resistance of endodontically treated and bleached teeth.

Quantitative coronary arterial stenosis assessment by multidetector CT and invasive coronary angiography for identifying patients with myocardial perfusion abnormalities

Semi-quantitative stenosis assessment by coronary CT angiography only modestly predicts stress-induced myocardial perfusion abnormalities. The performance of quantitative CT angiography (QCTA) for identifying patients with myocardial perfusion defects remains unclear. CorE-64 is a multicenter, international study to assess the accuracy of 64-slice QCTA for detecting a parts per thousand yen50% coronary arterial stenoses by quantitative coronary angiography (QCA). Patients referred for cardiac catheterization with suspected or known coronary artery disease were enrolled. Area under the receiver-operating-characteristic curve (AUC) was used to evaluate the diagnostic accuracy of the most severe coronary artery stenosis in a subset of 63 patients assessed by QCTA and QCA for detecting myocardial perfusion abnormalities on exercise or pharmacologic stress SPECT. Diagnostic accuracy of QCTA for identifying patients with myocardial perfusion abnormalities by SPECT revealed an AUC of 0.71, compared to 0.72 by QCA (P = .75). AUC did not improve after excluding studies with fixed myocardial perfusion abnormalities and total coronary arterial occlusions. Optimal stenosis threshold for QCTA was 43% yielding a sensitivity of 0.81 and specificity of 0.50, respectively, compared to 0.75 and 0.69 by QCA at a threshold of 59%. Sensitivity and specificity of QCTA to identify patients with both obstructive lesions and myocardial perfusion defects were 0.94 and 0.77, respectively. Coronary artery stenosis assessment by QCTA or QCA only modestly predicts the presence and the absence of myocardial perfusion abnormalities by SPECT. Confounding variables affecting the relationship between coronary anatomy and myocardial perfusion likely account for some of the observed discrepancies between coronary angiography and SPECT results.

A cross-sectional study on canine Leishmania (L.) infantum chagasi infection in Amazonian Brazil ratifies a higher prevalence of specific IgG-antibody response than delayed-type hypersensitivity in symptomatic and asymptomatic dogs

This was a cross-sectional study which analyzed the prevalence and the clinical and immunological spectrum of canine Leishmania (L.) infantum chagasi infection in a cohort of 320 mongrel dogs living in an endemic area of American visceral leishmaniasis in the Amazonian Brazil by using, mainly, the indirect fluorescence antibody test (IFAT-IgG) and the delayed-type hypersensitivity (DTH), and the parasite research by the popliteal lymph node aspiration. The IFAT and DTH reactivity recognized three different immune response profiles: (1) IFAT((+))/DTH(-) (107 dogs), (2) IFAT((-))/DTH(+) (18 dogs), and (3) IFAT((+))/DTH(+) (13 dogs), providing an overall prevalence of infection of 43 % (138/320). Thus, the specific prevalence of IFAT ((+)) /DTH ((-)) 33.4 % (107/320) was higher than those of IFAT ((-)) /DTH ((+)) 5.6 % (18/320) and IFAT ((+)) /DTH ((+)) 4.0 % (13/320). Moreover, the frequency of these profiles among 138 infected dogs showed that the IFAT ((+)) /DTH ((-)) rate of 77.5 % (107/138) was also higher than those of 13.0 % (18/138) of IFAT ((-)) /DTH ((+)) and 9.5 % (13/138) of IFAT ((+)) /DTH ((+)) rates. The frequency of asymptomatic dogs (76 %-105) was higher than those of symptomatic (16.6 %-23) and oligosymptomatic ones (7.4 %-10). A total of 16 (11.6 %) L. (L.) i. chagasi isolates were obtained from infected dogs, all from the IFAT ((+)) /DTH ((-)) profile: 41 % (9/22) from symptomatic, 33.3 % (3/9) from oligosymptomatic, and 5.2 % (4/76) from asymptomatic dogs. These findings strongly suggested that despite the higher frequency of asymptomatic dogs (76 %-105), the majority (72.4 %-76) was characterized by the IFAT ((+)) /DTH ((-)) profile with a doubtful immunogenetic resistance against infection.

Bactericidal effects of two parameters of Er:YAG laser intracanal irradiation: ex-vivo study

The success of endodontic treatment depends on the complete elimination of microorganisms from the root canal system, thus the search for new procedures to eliminate them is justified. The aim of this study was to assess bacterial reduction after intracanal irradiation with the Er:YAG laser. The canals of 70 extracted human maxillary canines were prepared up to file #40 using 1% NaOCl, irrigated with 17% EDTA, and then washed with physiological solution activated by ultrasound. The roots were sterilized by autoclaving, inoculated with 10 mu l of a suspension containing 1.5 x 10(8) CFU/ml of Enterococcus faecalis ATCC 29212 and incubated at 37A degrees C for 72 h. The canals were irradiated with the Er:YAG laser using two energy settings: 60 mJ and 15 Hz, and 100 mJ and 10 Hz. The remaining bacteria were counted immediately and 48 h after laser irradiation. The results showed a high bacterial reduction at both time points. With 60 mJ and 15 Hz there was an immediate reduction of 99.73% and the reduction was 77.02% after 48 h, and with 100 mJ and 10 Hz there was an immediate reduction of 99.95% and the reduction was 84.52% after 48 h. Although the best results were observed with 100 mJ of energy, the difference between the two settings was not statistically significant. The count performed 48 h after irradiation showed that E. faecalis were able to survive, and can grow even from small numbers.

Caracterização de uma floresta estacional semidecidual em Varginha, MG. E comparação com remanescentes da região.

Foi realizado o levantamento florístico e fitossociológico na porção mais extensa de mata no Parque Florestal Municipal São Francisco de Assis, na cidade de Varginha, sul de Minas Gerais. A área tem cerca de 10 ha e é cortada por um pequeno córrego. Foram lançadas 25 parcelas de 20m x 20m e medidos e cadastrados todos os indivíduos arbóreos com DAP > 5cm. Foram encontrados 1568 indivíduos que, juntos, somaram área basal de 23,65 m2, sendo registrados 102 espécies, 72 gêneros e 42 famílias no levantamento fitossociológico e 111 espécies, 77 gêneros e 43 famílias no levantamento florístico. As famílias com maior número de espécies foram Myrtaceae, Fabaceae e Melastomataceae. As espécies de maior valor de importância foram Casearia arborea, Copaifera langsdorffii, Tachigali rugosa e Myrcia splendens. Os resultados encontrados são os esperados para as Florestas Estacionais Semideciduais da região.