RESUMO
The objective of this study was to evaluate the salicylic acid applications in attenuating the harmful effects of saline nutrient solution on the physiology and growth of 'Gaúcho' melon cultivated in the NFT hydroponic system. The experiment was conducted in a greenhouse, in Pombal-PB, Brazil. The cultivation system used was the Nutrient Film Technique - NFT hydroponics. A completely randomized split-plot design was used, with the plot referring to four levels of salinity in the nutrient solution - ECns (2.1 control, 3.2, 4.3, and 5.4 dS m-1) and the sub-plot four concentrations of salicylic acid (SA) (0, 1.5, 3.0, and 4.5 mM), applied via foliar spray, with six replications. Nutrient solution of 4.3 and 5.4 dS m-1 electrical conductivity promotes higher maximum and variable fluorescence, respectively. The stomatal conductance, transpiration, stem diameter, main branch length, leaf dry mass, and stem dry mass of 'Gaúcho' melon plants decrease with the increase in salinity of the nutrient solution. Salicylic acid increases the initial fluorescence and the main branch length of 'Gaúcho' melon plants in hydroponic cultivation. Salicylic acid at a concentration of 1.5 to 4.5 mM did not attenuate the effects of salt stress on the internal CO2 concentration, CO2 assimilation rate, and root dry mass of 'Gaúcho' melon plants.
Assuntos
Dióxido de Carbono , Cucurbitaceae , Hidroponia , Ácido Salicílico/farmacologia , Fluorescência , Estresse Salino , ClorofilaRESUMO
The COVID-19 pandemic has challenged the entire world, and patients with diabetes mellitus (DM) have been particularly affected. We aimed to evaluate predictors of mortality during the first 30 days of hospitalization in critically ill patients with COVID-19 and comorbid DM. This prospective study included 110 critically ill patients admitted with COVID-19 infection. Thirty-two (29%) patients had a previous diagnosis of DM. Clinical variables, laboratory tests, and vascular biomarkers, such as VCAM-1, syndecan-1, ICAM-1, angiopoietin-1, and angiopoeitin-2, were evaluated after intensive care unit (ICU) admission. A comparison was made between patients with and without DM. No difference in mortality was observed between the groups (48.7 vs 46.9%, P=0.861). In the multivariate Cox regression analysis, VCAM-1 levels at ICU admission (HR: 1 [1-1.001], P<0.006) were associated with death in patients with DM. Among patients with DM, advanced age (HR 1.063 [1.031-1.096], P<0.001), increased Ang-2/Ang-1 ratio (HR: 4.515 [1.803-11.308] P=0.001), and need for dialysis (HR: 3.489 [1.409-8.642], P=0.007) were independent predictors of death. Higher levels of VCAM-1 in patients with DM was better at predicting death of patients with severe COVID-19 and comorbid DM, and their cut-off values were useful for stratifying patients with a worse prognosis. Vascular biomarkers VCAM-1 and Ang-2/Ang-1 ratio were predictors of death in patients with severe COVID-19 and comorbid DM and those without DM. Additionally, kidney injury was associated with an increased risk of death.
Assuntos
COVID-19 , Diabetes Mellitus , Humanos , Estado Terminal , Estudos Prospectivos , Pandemias , Molécula 1 de Adesão de Célula Vascular , Mortalidade Hospitalar , Unidades de Terapia Intensiva , Biomarcadores , Estudos RetrospectivosRESUMO
Abstract The objective of this study was to evaluate the salicylic acid applications in attenuating the harmful effects of saline nutrient solution on the physiology and growth of 'Gaúcho' melon cultivated in the NFT hydroponic system. The experiment was conducted in a greenhouse, in Pombal-PB, Brazil. The cultivation system used was the Nutrient Film Technique - NFT hydroponics. A completely randomized split-plot design was used, with the plot referring to four levels of salinity in the nutrient solution - ECns (2.1 control, 3.2, 4.3, and 5.4 dS m-1) and the sub-plot four concentrations of salicylic acid (SA) (0, 1.5, 3.0, and 4.5 mM), applied via foliar spray, with six replications. Nutrient solution of 4.3 and 5.4 dS m-1 electrical conductivity promotes higher maximum and variable fluorescence, respectively. The stomatal conductance, transpiration, stem diameter, main branch length, leaf dry mass, and stem dry mass of 'Gaúcho' melon plants decrease with the increase in salinity of the nutrient solution. Salicylic acid increases the initial fluorescence and the main branch length of 'Gaúcho' melon plants in hydroponic cultivation. Salicylic acid at a concentration of 1.5 to 4.5 mM did not attenuate the effects of salt stress on the internal CO2 concentration, CO2 assimilation rate, and root dry mass of 'Gaúcho' melon plants.
Resumo O objetivo deste trabalho foi avaliar as aplicações do ácido salicílico como atenuador dos efeitos deletérios da solução nutritiva salina sobre a fisiologia e o crescimento do melão 'Gaúcho' cultivado em sistema hidropônico NFT. O experimento foi conduzido em casa de vegetação, em Pombal - PB, Brasil. O sistema de cultivo utilizado foi a técnica do fluxo laminar de nutrientes - NFT. Foi utilizado um delineamento inteiramente casualizado em parcelas subdivididas, sendo a parcela referente a quatro níveis de salinidade de solução nutritiva - CEsn (2,1 controle, 3,2, 4,3 e 5,4 dS m-1) e a subparcelas quatro concentrações de ácido salicílico - AS (0, 1,5, 3,0 e 4,5 mM), aplicado via pulverização foliar, com seis repetições. A solução nutritiva de 4,3 e 5,4 dS m-1 condutividade elétrica promove maior fluorescência máxima e variável, respectivamente. A condutância estomática, a transpiração, o diâmetro do caule, o comprimento do ramo principal, a massa seca da folha e a massa seca do caule do meloeiro 'Gaúcho' diminuiu com o aumento da salinidade da solução nutritiva. O ácido salicílico aumenta a fluorescência inicial e o comprimento do ramo principal do meloeiro 'Gaúcho' em cultivo hidropônico. O ácido salicílico na concentração de 1,5 a 4,5 mM não atenuou os efeitos do estresse salino sobre a concentração interna de CO2, taxa de assimilação de CO2 e massa seca da raiz do meloeiro 'Gaúcho'.
RESUMO
The COVID-19 pandemic has challenged the entire world, and patients with diabetes mellitus (DM) have been particularly affected. We aimed to evaluate predictors of mortality during the first 30 days of hospitalization in critically ill patients with COVID-19 and comorbid DM. This prospective study included 110 critically ill patients admitted with COVID-19 infection. Thirty-two (29%) patients had a previous diagnosis of DM. Clinical variables, laboratory tests, and vascular biomarkers, such as VCAM-1, syndecan-1, ICAM-1, angiopoietin-1, and angiopoeitin-2, were evaluated after intensive care unit (ICU) admission. A comparison was made between patients with and without DM. No difference in mortality was observed between the groups (48.7 vs 46.9%, P=0.861). In the multivariate Cox regression analysis, VCAM-1 levels at ICU admission (HR: 1 [1-1.001], P<0.006) were associated with death in patients with DM. Among patients with DM, advanced age (HR 1.063 [1.031-1.096], P<0.001), increased Ang-2/Ang-1 ratio (HR: 4.515 [1.803-11.308] P=0.001), and need for dialysis (HR: 3.489 [1.409-8.642], P=0.007) were independent predictors of death. Higher levels of VCAM-1 in patients with DM was better at predicting death of patients with severe COVID-19 and comorbid DM, and their cut-off values were useful for stratifying patients with a worse prognosis. Vascular biomarkers VCAM-1 and Ang-2/Ang-1 ratio were predictors of death in patients with severe COVID-19 and comorbid DM and those without DM. Additionally, kidney injury was associated with an increased risk of death.
RESUMO
Arsenopyrite (FeAsS), the most common arsenic-bearing mineral, is usually found associated with pyrite (FeS2) in gold mining tailings. This work examined the galvanic effect of FeS2 on As release from FeAsS oxidation in circumneutral media under oxygen-depleted and oxygen-saturated conditions. The oxidation experiments were conducted with a flow-through reactor in the absence of FeS2 particles and in the presence of different contents of this sulfide. The results indicated that the permanent, physical contact between FeAsS and FeS2 particles causes an increase in the accumulated As release, mainly under O2-saturated conditions. At 30% wt. FeS2, the increases relatively to FeS2-free conditions were 82% and 117% in O2-depleted and O2-saturated solutions, respectively. At steady-state, the As release rates increased from (4.9 ± 0.5)× 10-4 µmol m-2 s-1 (0% wt. FeS2) to (1.1-1.9)× 10-3 µmol m-2 s-1 (5-30% wt. FeS2) under O2-saturated conditions. Analysis of FeAsS samples after oxidation revealed oxidized particles partially or entirely covered by precipitates with different sizes, shapes and compositions (e.g., As-S-bearing ferrihydrite, elemental sulfur, and As-O phases). A fine (3-4 nm thick) amorphous layer of S-As-bearing ferric oxy-hydroxide was also identified on oxidized FeAsS, with Fe(III) and As(III) species.
RESUMO
The coal reserves in the south of Brazil were intensely exploited at the time of great demand for such fuel. This resulted in changes in the environment, mainly in the chemical, physical and biological characteristics of the soil. Due to the potential to control erosive processes, increase soil quality and restore biological diversity, revegetation is a promising alternative to recover those impacted areas. In that respect, bracatinga is a pioneering tree species that easily grow in different environments and has being planted as vegetation cover in areas under recovery. Therefore, the objective of this work was to characterize the chemical features and to evaluate the soil microbiological attributes in areas degraded by coal mining and under recovery using bracatinga as cover plant. In the bracatinga canopy projection area, soil samples were collected in the environmental restoration areas that have been, at the time of collecting, under a regime of 2, 4, 6 and 12 years of restoration. In addition an area with natural occurrence of bracatinga was used as control. Microbial biomass nitrogen, microbial biomass carbon and microbial biomass respiration increase in average 281, 230 and 157% respectively, when the 12-year-old areas were compared to the 2-year-old-areas. Likewise, a decrease in qCO2 in the order of 60% was observed for that same comparison. The 12-year-old areas reached the same values of qCO2 found in the reference area. The data suggest an improvement in the microbiological attributes of the soil with the increase in recovery time for the studied areas. SIGNIFICANCE AND IMPACT OF THE STUDY: In coal mining areas under recovery with typically acid soils, the use of the current recovery strategies (revegetation mainly) has been efficient to increase the quality of soils, especially in the environmental restoration areas. Soil microbiological attributes such as microbial biomass nitrogen, microbial biomass carbon, microbial basal respiration and metabolic quotient (qCO2 ) are dynamic and highly sensitive. These parameters have the potential to be adopted together with conventional attributes, such as floristic composition indices and species diversity indices, to evaluate the degree of any particular environmental recovery process being conducted at previously explored mining areas.
Assuntos
Minas de Carvão/métodos , Recuperação e Remediação Ambiental/métodos , Mimosa/crescimento & desenvolvimento , Mimosa/metabolismo , Microbiologia do Solo , Solo/química , Biodiversidade , Biomassa , Brasil , Carbono/análise , Carvão Mineral/análise , Nitrogênio/análise , ÁrvoresRESUMO
INTRODUCTION: Renal cell carcinoma (RCC) is a family of distinct tumors, and a variety of molecules have been evaluated as prognostic markers for RCC. Cyclin D1, a cell cycle regulator, is overexpressed in several primary tumors. OBJECTIVE: To evaluate cyclin D1 expression as a prognostic marker in RCC. METHOD: In total, 109 tumor specimens from patients with RCC were obtained from 2005 to 2010 at Hospital das Clínicas--Ribeirão Preto School of Medicine--USP, Brazil, and submitted to immunohistochemical analysis along with seven normal kidney tissue samples. RESULTS: All of the normal kidney samples lacked cyclin D1 immunohistochemical staining. In addition, there was lower protein expression in the papillary and chromophobe RCC samples. Patients with cyclin D1(low) tumors (≤ 30 % positive cells) showed worse clinical outcome (p = 0.03), lower survival without metastasis and/or death by RCC (p = 0.03), high nuclear grade (p = 0.001), larger tumor size (p = 0.01), presence of symptoms at diagnosis (p = 0.04), necrosis (p = 0.004) and sarcomatoid morphology (p = 0.04). After multivariate analysis, cyclin D1 was not an independent significant factor for worse outcome; however, it improved the accuracy of the adopted prognostic system. The analysis performed for clear cell RCC alone showed similar statistical significance to that of the total cases. CONCLUSIONS: Cyclin D1 protein was overexpressed in RCC. The types of RCC appear to exhibit different immunohistochemical staining patterns for cyclin D1; high protein expression was related to good clinical outcome and to most known favorable prognostic factors. Further investigations are necessary to reveal which mechanisms lead to cyclin D1 accumulation in neoplastic cells.
Assuntos
Biomarcadores Tumorais/análise , Carcinoma de Células Renais/química , Ciclina D1/análise , Neoplasias Renais/química , Neoplasias Renais/patologia , Rim/química , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Renais/secundário , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Metástase Neoplásica , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Prognóstico , Taxa de Sobrevida , Carga Tumoral , Adulto JovemRESUMO
BACKGROUND/OBJECTIVES: Serum or tissue zinc concentrations are often used to assess body zinc status. However, all of these methods are relatively inaccurate. Thus, we investigated three different kinetic methods for the determination of zinc clearance to establish which of these could detect small changes in the body zinc status of children. SUBJECTS/METHODS: Forty apparently healthy children were studied. Renal handling of zinc was investigated during intravenous zinc administration (0.06537 mg Zn/kg of body weight), both before and after oral zinc supplementation (5 mg Zn/day for 3 months). Three kinetic methods were used to determine zinc clearance: CZn-Formula A and CZn-Formula B were both used to calculate systemic clearance; the first is a general formula and the second is used for the specific analysis of a single-compartment model; CZn-Formula C is widely used in medical practices to analyze kinetic routine. RESULTS: Basal serum zinc values, which were within the reference range for healthy children, increased significantly after oral zinc supplementation. The three formulas used gave different results for zinc clearance both before and after oral zinc supplementation. CZn-Formula B showed a positive correlation with basal serum zinc concentration after oral supplementation (R2=0.1172, P=0.0306). In addition, CZn-Formula B (P=0.0002) was more effective than CZn-Formula A (P=0.6028) and CZn-Formula C (P=0.0732) in detecting small variations in body zinc status. CONCLUSIONS: All three of the formulas used are suitable for studying zinc kinetics; however, CZn-Formula B is particularly effective at detecting small changes in body zinc status in healthy children.
Assuntos
Estado Nutricional , Zinco/farmacocinética , Composição Corporal , Criança , Suplementos Nutricionais , Feminino , Humanos , Masculino , Matemática , Taxa de Depuração Metabólica , Zinco/administração & dosagem , Zinco/sangueRESUMO
This paper aimed to evaluate the improvement of burn wounds healing by sodium alginate/chitosan-based films and laser therapy. Natural polymers with different biological activities are widely used as film dressings to improve wound healing. Lasers arrays accelerate the healing repair of soft tissue injuries. Burn procedures were performed on the backs of 60 male rats assigned into six groups: untreated (CTR), dressed with cellulose films (CL), dressed with sodium alginate/chitosan-based films (SC), laser-irradiated undressed wounds (LT), laser-irradiated wounds with cellulose (CLLT) and sodium alginate/chitosan-based films (SCLT). Laser therapy was applied for 7 days. Animals of each group were euthanised 8 and 14 days after the burn procedures. The inflammatory reaction was significantly more intense in the CTR group than in the irradiated groups after 8 and 14 days. Laser therapy stimulated myofibroblastic differentiation in 8 days, with or without dressing films. Combined laser therapy and both dressings improved epithelisation, blood vessels formation and collagenization, promoted rapid replacement of type III for type I collagen and favored the better arrangement of the newly formed collagen fibres. The combination of laser therapy and sodium alginate/chitosan-based dressing improves burn healing, apparently by modulating the epithelisation, blood vessels formation and collagenization processes.
Assuntos
Alginatos/farmacologia , Queimaduras/radioterapia , Quitosana/farmacologia , Terapia com Luz de Baixa Intensidade , Actinas/metabolismo , Animais , Queimaduras/patologia , Colágeno Tipo I/análise , Fibroblastos/metabolismo , Ácido Glucurônico/farmacologia , Ácidos Hexurônicos/farmacologia , Masculino , Neovascularização Fisiológica/efeitos dos fármacos , Neovascularização Fisiológica/efeitos da radiação , Ratos , Cicatrização/efeitos dos fármacos , Cicatrização/efeitos da radiaçãoRESUMO
Some studies have demonstrated the involvement of nuclear factor-kappa B (NF-kB) in the pathogenesis of glomerulonephritis. The aim of our study was twofold: (1) to analyze the prognostic value of NF-kB expression in primary IgA nephropathy (IgAN) and (2) to compare the results of NF-kB expression by immunohistochemistry (IHC) and southwestern histochemistry (SWH). We analyzed 62 patients diagnosed with IgAN from 1987 to 2003. We used monoclonal antibodies to CD68 and mast cell tryptase and polyclonal antibodies to TGF-ß1, α-SMA and NF-kB p65. We used SWH for the in situ detection of activated NF-kB. The results showed that NF-kB expression (mainly by SWH) correlated with clinical and histological parameters. An unfavorable clinical course of IgAN was significantly related to tubular NF-kB expression by SWH, but not by IHC. The Kaplan-Meier curves demonstrated that increased NF-kB expression, which was measured by IHC and SWH, decreased renal survival. In conclusion, the increased expression of NF-kB in the tubular area may be a predictive factor for the poor prognosis of patients with IgAN. Compared with IHC, NF-kB expression determined by SWH was correlated with a larger number of parameters of poor disease outcome.
Assuntos
Glomerulonefrite por IGA/metabolismo , NF-kappa B/metabolismo , Humanos , Imuno-Histoquímica , Avaliação de Resultados em Cuidados de SaúdeRESUMO
PURPOSE: To compare the efficacy of conjunctival autograft surgery with the attachment to the scleral bed using fibrin tissue adhesive or mononylon 10-0 suture after resection of primary pterygium. METHODS: A comparative, prospective and randomized clinical trial was performed in 47 eyes of 47 patients with primary medial located pterygium. Group 1 (adhesive) was composed by 21 patients that underwent conjunctival autograft closure with fibrin tissue adhesive (Quixil™) and Group 2 (suture) was composed by 26 patients that underwent pterygium surgery with mononylon 10-0 (Ethicon(®)) suture (suture group) after pterygium excision. All surgeries were performed by the same surgeon. Patients were assessed on the preoperative period and on the 1(st), 14(th) and 21(st) postoperative days. They were followed-up with a questionnaire of ocular discomfort and by the surgical time spent, ocular hyperemia, complications and recurrence signals, being the recurrence also evaluated at the 6th postoperative month. Data were submitted to statistical analysis. A value of p<0.005 was considered statistically significant. RESULTS: The average surgical time was 19.05 ± 6.12 minutes in group 1 (glue) and 48.15 ± 7.13 minutes in the group 2 (suture) (p<0.001). The ocular discomfort scale analysis showed a lower score in the 1(st) (p<0.005), 7(th) (p<0.001) and 21(th) (p<0.001) postoperative days in group 1. Ocular hyperemia was less intense in all periods of this study in group 1 (p<0.001). Complications were one in each group and both were managed with clinical treatment until the 21(th) postoperative day. There was one recurrence in group 1 and two in group 2 until the 6(th) postoperative month. CONCLUSION: In the surgical management of primary pterygium, fibrin tissue adhesive attached the conjunctival autograft, decreased the surgical time and diminished the conjunctival hyperemia and ocular discomfort with similar recurrences on the postoperative period, compared to fixation with mononylon 10.0 suture, proving to be an excellent option for conjunctival autograft attachment in primary pterygium surgery.
Assuntos
Túnica Conjuntiva/transplante , Adesivo Tecidual de Fibrina/uso terapêutico , Pterígio/cirurgia , Técnicas de Sutura , Adolescente , Adulto , Idoso , Humanos , Hiperemia , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Período Pós-Operatório , Estudos Prospectivos , Estatísticas não Paramétricas , Fatores de Tempo , Transplante Autólogo/métodos , Resultado do Tratamento , Adulto JovemRESUMO
OBJETIVO: Comparar a eficácia da fixação do enxerto autógeno de conjuntiva ao leito escleral após exérese de pterígio primário, utilizando-se adesivo tecidual de fibrina ou sutura de monofilamento de nylon 10-0. MÉTODOS: Estudo comparativo, prospectivo e aleatório foi realizado em 47 olhos de 47 pacientes com pterígio primário de localização medial. O grupo 1 (adesivo) foi constituído de 21 pacientes submetidos à fixação do enxerto conjuntival com adesivo tecidual de fibrina (QuixilTM); enquanto que o grupo 2 (sutura), foi constituído de 26 pacientes, cuja fixação do enxerto foi feita com sutura em pontos separados de monofilamento de nylon 10-0 (Ethicon®) após a excisão do pterígio feita pelo mesmo cirurgião. Os pacientes foram avaliados antes da cirurgia, no 1º, 14º e 21º dia após a cirurgia. Utilizou-se uma escala visual de desconforto ocular e verificou-se o tempo cirúrgico, hiperemia ocular e presença de complicações, além de sinais de recidiva, sendo sua presença também avaliada no 6º mês após a cirurgia. As variáveis foram submetidas à análise estatística. Valores de p<0,05 indicaram significância estatística. RESULTADOS: O tempo cirúrgico médio foi de 19,05 ± 6,12 minutos para o grupo 1 e 48,15 ± 7,13 minutos para o grupo sutura (p<0,001). A escala referente ao desconforto ocular demonstrou um menor escore no 1º (p<0,005), 7º (p<0,001) e 21º (p<0,001) dia após a cirurgia com a utilização do adesivo tecidual. A hiperemia ocular mostrou-se menor em todos os períodos do estudo após a cirurgia (p<0,001) no grupo cola. As complicações encontradas, uma em cada grupo, resolveram-se com tratamento clínico até o 21º dia após a cirurgia. Houve uma recidiva no grupo 1 e duas no grupo 2 até o 6 º mês após a cirurgia. CONCLUSÃO: Em cirurgia de fixação de enxerto autógeno de conjuntiva para tratamento de pterígio primário, adesivo tecidual de fibrina reduziu o tempo do ato cirúrgico, desencadeou menor hiperemia conjuntival e desconforto no período pósoperatório, com índice de recidiva semelhante em comparação com o uso de sutura de mononylon 10.0, demonstrando ser uma excelente opção para a fixação do enxerto conjuntival no tratamento cirúrgico do pterígio primário.
PURPOSE: To compare the efficacy of conjunctival autograft surgery with the attachment to the scleral bed using fibrin tissue adhesive or mononylon 10-0 suture after resection of primary pterygium. METHODS: A comparative, prospective and randomized clinical trial was performed in 47 eyes of 47 patients with primary medial located pterygium. Group 1 (adhesive) was composed by 21 patients that underwent conjunctival autograft closure with fibrin tissue adhesive (QuixilTM) and Group 2 (suture) was composed by 26 patients that underwent pterygium surgery with mononylon 10-0 (Ethicon®) suture (suture group) after pterygium excision. All surgeries were performed by the same surgeon. Patients were assessed on the preoperative period and on the 1st, 14th and 21st postoperative days. They were followed-up with a questionnaire of ocular discomfort and by the surgical time spent, ocular hyperemia, complications and recurrence signals, being the recurrence also evaluated at the 6th postoperative month. Data were submitted to statistical analysis. A value of p<0.005 was considered statistically significant. RESULTS: The average surgical time was 19.05 ± 6.12 minutes in group 1 (glue) and 48.15 ± 7.13 minutes in the group 2 (suture) (p<0.001). The ocular discomfort scale analysis showed a lower score in the 1st (p<0.005), 7th (p<0.001) and 21th (p<0.001) postoperative days in group 1. Ocular hyperemia was less intense in all periods of this study in group 1 (p<0.001). Complications were one in each group and both were managed with clinical treatment until the 21th postoperative day. There was one recurrence in group 1 and two in group 2 until the 6th postoperative month. CONCLUSION: In the surgical management of primary pterygium, fibrin tissue adhesive attached the conjunctival autograft, decreased the surgical time and diminished the conjunctival hyperemia and ocular discomfort with similar recurrences on the postoperative period, compared to fixation with mononylon 10.0 suture, proving to be an excellent option for conjunctival autograft attachment in primary pterygium surgery.
Assuntos
Adolescente , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Túnica Conjuntiva/transplante , Adesivo Tecidual de Fibrina/uso terapêutico , Pterígio/cirurgia , Técnicas de Sutura , Hiperemia , Complicações Pós-Operatórias , Período Pós-Operatório , Estudos Prospectivos , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento , Transplante Autólogo/métodosRESUMO
BACKGROUND: An epidemic of acute gastroenteritis occurred in Rio Branco City, Acre State, in Brazil's Amazon region in 2005. An investigation was conducted to confirm the etiology and identify possible risk factors for death. METHODS: Rio Branco municipality surveillance data for the period May to October 2005 were reviewed. In a case-control study, children who died following acute gastroenteritis were compared to age-matched controls with acute gastroenteritis who survived. Rotavirus A (RV-A) was investigated in 799 stool samples and genotyped by reverse transcription polymerase chain reaction (RT-PCR). RESULTS: The cumulative incidence of diarrhea in children aged <5 years was 21%. A fatal outcome was significantly associated with uncovered household water storage containers. RV-A was identified in 88% of samples and G9 was the prevalent genotype (71%). CONCLUSIONS: Oral rehydration solution and boiling or chlorinating drinking water likely limited mortality. This epidemic was caused by RV-A genotype G9. After the outbreak, a rotavirus vaccine was introduced into the official childhood immunization schedule in Brazil.
Assuntos
Surtos de Doenças , Gastroenterite/epidemiologia , Infecções por Rotavirus/epidemiologia , Rotavirus/isolamento & purificação , Doença Aguda , Brasil/epidemiologia , Estudos de Casos e Controles , Pré-Escolar , Gastroenterite/mortalidade , Gastroenterite/virologia , Genótipo , Humanos , Lactente , Fatores de Risco , Rotavirus/genética , Infecções por Rotavirus/mortalidade , Infecções por Rotavirus/virologiaRESUMO
AIMS: The protein alpha1-microglobulin (alpha1-microg) is filtered by the glomeruli and fully reabsorbed by the proximal tubules, and tubulointerstitial injury compromises its reabsorption. The aim of this study was to determine which functional, morphological and inflammatory renal disorders associated with tubulointerstitial damage interfere with urinary excretion of alpha1-microg in patients with glomerulopathies. PATIENTS AND METHODS: 38 patients (33.6 +/- 11.3 years) with primary or secondary glomerulopathies diagnosed by renal biopsies were studied. The urinary fractional excretion of alpha1-microg (FEalpha1-microg), the urinary monocyte chemoattractant protein-1/urinary creatinine (UMCP-1) index and 24-h proteinuria were determined. In the cortex of renal biopsies, the number of macrophages/104 microm2 of glomerular tuft (GT) and tubulointerstitial (TI) areas, the relative interstitial area (RCIA), and the relative interstitial fibrosis area (CIF) were measured. Results are reported as median and range and the Spearman non-parametric test was used to determine the correlations. RESULTS: FEalpha1-microg was 0.165% (0.008% - 14,790.0%) in patients with glomerulopathies and 0.065% (0.010% - 0.150%) in the control group (p < 0.05; Mann-Whitney U-Test). FEalpha1-microg was correlated with creatinine clearance (r = -0.4396; p = 0.0358), UMCP-1 index (r = 0.5978; p < 0.0001), number of macrophages/TI area (r = 0.5634; p = 0.0034) and RCIA (r = 0.7436; p < 0.0001). However, FEa1-microg was not correlated with proteinuria (r = 0.1465; p = 0.5153) or with CIF (r = 0.0039; p = 0.98). CONCLUSIONS: renal MCP-1 and the expansion and number of macrophages of the tubulointerstitial area participate in the increase of urinary excretion of alpha1-microg in patients with glomerulopathies. Although proteinuria and interstitial fibrosis have not been associated with this effect, the present study does not exclude some of these disorders in the pathophysiology of urinary excretion of alpha1-microg.
Assuntos
alfa-Globulinas/urina , Glomerulonefrite/urina , Túbulos Renais Proximais/metabolismo , Proteinúria/urina , Adulto , Biomarcadores/sangue , Biomarcadores/urina , Biópsia , Quimiocina CCL2/urina , Creatinina/metabolismo , Progressão da Doença , Feminino , Glomerulonefrite/complicações , Glomerulonefrite/fisiopatologia , Humanos , Imuno-Histoquímica , Túbulos Renais Proximais/patologia , Masculino , Nefelometria e Turbidimetria , Prognóstico , Proteinúria/etiologia , Proteinúria/fisiopatologiaRESUMO
IgA nephropathy (IgAN) is a kidney disease with a varying renal prognosis. Recently, many studies have demonstrated that renal alpha-smooth muscle actin (alpha-SMA) and transforming growth factor (TGF-beta1) expression, as well interstitial mast cell infiltrates could represent a prognostic marker in several renal diseases. The aim of our study was to analyze the prognostic value of mast cell, TGF-beta1 and alpha-SMA expression in IgAN. A survey of the medical records and renal biopsy reports of 62 patients with a diagnosis of IgAN followed-up from 1987 to 2003 was performed. The mean follow-up time was 74.7 +/- 50.0 months. The immunohistochemical studies were performed using a monoclonal antibody anti-human mast cell tryptase, a polyclonal antibody anti-human TGF-beta1, and a monoclonal antibody anti-human alpha-SMA. An unfavorable clinical course of IgAN was related to interstitial mast cell infiltrates and alpha-SMA expression in the tubulointerstitial area. Expression of glomerular TGF-beta1 and alpha-SMA, and interstitial TGF-beta1 is not correlated with clinical course in IgAN. In conclusion, the increased number of mast cells and higher alpha-SMA expression in the tubulointerstitial area may be predictive factors for the poor prognosis of patients with IgAN.
Assuntos
Actinas/metabolismo , Glomerulonefrite por IGA/metabolismo , Mastócitos/citologia , Fator de Crescimento Transformador beta1/metabolismo , Adolescente , Adulto , Feminino , Glomerulonefrite por IGA/patologia , Humanos , Imuno-Histoquímica , MasculinoRESUMO
PURPOSE: To evaluate excimer laser fluence after experimentally induced changes in room temperature and relative air humidity. METHODS: Excimer laser fluence was analyzed with a specific power meter under three different gradients of room temperature and relative air humidity as well as the reproducibility of myopic correction of -3.00 diopters in a polymethylmethacrylate plate test. RESULTS: Under the simulated environmental conditions, no significant difference in laser energy fluence and reproduction of myopic correction was observed. CONCLUSIONS: In a setting with controlled temperature and relative air humidity, subtle changes in environmental factors do not appear to influence laser fluence and efficacy.
Assuntos
Ambiente Controlado , Umidade , Ceratomileuse Assistida por Excimer Laser In Situ , Modelos Anatômicos , Temperatura , Humanos , Miopia/cirurgia , Polimetil MetacrilatoRESUMO
OBJECTIVE: To evaluate the accuracy of Amsel's criteria individually or in combinations of two for the clinical diagnosis of bacterial vaginosis. METHODS: This cross-sectional study enrolled 135 women at UNICAMP, and evaluated Amsel's four clinical criteria. Sensitivity, specificity, positive and negative predictive values were calculated for each criterion individually, in combinations of two, and for the classic test with at least three criteria present. The Nugent method was used as gold standard. RESULTS: The most sensitive individual criteria were pH and vaginal discharge (97%), the latter having lowest specificity (26%). The criterion with highest specificity was the presence of clue cells (86%). The combination of two criteria showed sensitivity of 83% to 93%, and specificity of 82% to 94%. CONCLUSION: The accuracy of Amsel's clinical criteria individually or in combinations of two was as accurate as the presence of at least three criteria for the diagnosis of bacterial vaginosis.
Assuntos
Vaginose Bacteriana/diagnóstico , Adolescente , Adulto , Líquidos Corporais/citologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Esfregaço VaginalRESUMO
The objective of the present study was to determine the frequency of the most common clinical features in patients with autosomal dominant polycystic kidney disease in a sample of the Brazilian population. The medical records of 92 patients with autosomal dominant polycystic kidney disease attended during the period from 1985 to 2003 were reviewed. The following data were recorded: age at diagnosis, gender, associated clinical manifestations, occurrence of stroke, age at loss of renal function (beginning of dialysis), and presence of a family history. The involvement of abdominal viscera was investigated by ultrasonography. Intracranial alterations were prospectively investigated by magnetic resonance angiography in 42 asymptomatic patients, and complemented with digital subtraction arteriography when indicated. Mean age at diagnosis was 35.1 +/- 14.9 years, and mean serum creatinine at referral was 2.4 +/- 2.8 mg/dL. The most frequent clinical manifestations during the disease were arterial hypertension (63.3%), lumbar pain (55.4%), an abdominal mass (47.8%), and urinary infection (35.8%). Loss of renal function occurred in 27 patients (mean age: 45.4 +/- 9.5 years). The liver was the second organ most frequently affected (39.1%). Stroke occurred in 7.6% of the patients. Asymptomatic intracranial aneurysm was detected in 3 patients and arachnoid cysts in 3 other patients. In conclusion, the most common clinical features were lumbar pain, arterial hypertension, abdominal mass, and urinary infection, and the most serious complications were chronic renal failure and stroke. Both intracranial aneurysms and arachnoid cysts occurred in asymptomatic patients at a frequency of 7.14%.
Assuntos
Rim Policístico Autossômico Dominante/complicações , Adulto , Angiografia Digital , Transtornos Cerebrovasculares/diagnóstico , Transtornos Cerebrovasculares/etiologia , Cistos/diagnóstico , Cistos/etiologia , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/etiologia , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/etiologia , Hepatopatias/diagnóstico , Hepatopatias/etiologia , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Infecções Urinárias/diagnóstico , Infecções Urinárias/etiologiaRESUMO
We report a 3-year-old boy with isolated 3-methylcrotonyl-coenzyme A deficiency with unexpectedly severe presentation, seizures and history of cerebral ischae-mic episode.
Assuntos
Erros Inatos do Metabolismo dos Aminoácidos/complicações , Erros Inatos do Metabolismo dos Aminoácidos/diagnóstico , Carbono-Carbono Ligases/deficiência , Acidente Vascular Cerebral/complicações , Erros Inatos do Metabolismo dos Aminoácidos/terapia , Pré-Escolar , Glicina/análogos & derivados , Glicina/urina , Humanos , Masculino , Fenótipo , Valeratos/urinaRESUMO
The objective of the present study was to determine the frequency of the most common clinical features in patients with autosomal dominant polycystic kidney disease in a sample of the Brazilian population. The medical records of 92 patients with autosomal dominant polycystic kidney disease attended during the period from 1985 to 2003 were reviewed. The following data were recorded: age at diagnosis, gender, associated clinical manifestations, occurrence of stroke, age at loss of renal function (beginning of dialysis), and presence of a family history. The involvement of abdominal viscera was investigated by ultrasonography. Intracranial alterations were prospectively investigated by magnetic resonance angiography in 42 asymptomatic patients, and complemented with digital subtraction arteriography when indicated. Mean age at diagnosis was 35.1 ± 14.9 years, and mean serum creatinine at referral was 2.4 ± 2.8 mg/dL. The most frequent clinical manifestations during the disease were arterial hypertension (63.3 percent), lumbar pain (55.4 percent), an abdominal mass (47.8 percent), and urinary infection (35.8 percent). Loss of renal function occurred in 27 patients (mean age: 45.4 ± 9.5 years). The liver was the second organ most frequently affected (39.1 percent). Stroke occurred in 7.6 percent of the patients. Asymptomatic intracranial aneurysm was detected in 3 patients and arachnoid cysts in 3 other patients. In conclusion, the most common clinical features were lumbar pain, arterial hypertension, abdominal mass, and urinary infection, and the most serious complications were chronic renal failure and stroke. Both intracranial aneurysms and arachnoid cysts occurred in asymptomatic patients at a frequency of 7.14 percent.