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Sample records for brazilian haemodialysis patients

  1. HBV markers in haemodialysis Brazilian patients: a prospective 12-month follow-up

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    Regina Célia Moreira

    2010-02-01

    Full Text Available The aim of this study was to determine the prevalence and the incidence of hepatitis B virus (HBV among haemodialysis (HD subjects and to evaluate whether testing for serological markers at the time of admission is suitable for HBV screening in this population. One hundred twenty-three patients belonging to two HD centres from São Paulo, Brazil, were tested prospectively. HBV DNA was detected by polymerase chain reaction (PCR in each of the prospective subjects (n = 123 during one year. Additionally, all samples (n = 1,476 were analysed for HBV serological markers. The prevalence of hepatitis B core antibody (anti-HBc, hepatitis B surface antigen (HBsAg and HBV DNA were 34.1%, 15.4% and 8.1%, respectively, while the incidence was null. Fluctuation in HBV serology was observed in one patient. Only 37.8% (17/45 of cases responded to the HBV vaccine. Our results suggest that employing more than one HBV marker and repeated follow-up evaluations may improve HBV screening in HD units.

  2. Secondary haemochromatosis in a haemodialysis patient

    OpenAIRE

    Cheng, Lu; Tang, Xi; Fu, MDPing; Liu, Fang

    2015-01-01

    A 39-year-old woman with end-stage renal disease, which was maintained on haemodialysis, developed secondary haemochromatosis after receiving blood transfusions and intravenous iron supplementation without sufficient serum ferritin concentration monitoring. The patient received intravenous deferoxamine three times a week, combined with high-dose recombinant human erythropoietin therapy and haemodialysis. After three months, improvements in biochemical indicators and iron overload were noted.

  3. Secondary haemochromatosis in a haemodialysis patient.

    Science.gov (United States)

    Cheng, Lu; Tang, Xi; Fu, Ping; Liu, Fang

    2015-07-01

    A 39-year-old woman with end-stage renal disease, which was maintained on haemodialysis, developed secondary haemochromatosis after receiving blood transfusions and intravenous iron supplementation without sufficient serum ferritin concentration monitoring. The patient received intravenous deferoxamine three times a week, combined with high-dose recombinant human erythropoietin therapy and haemodialysis. After three months, improvements in biochemical indicators and iron overload were noted. PMID:26243982

  4. A fatal encephalopathy in chronic haemodialysis patients.

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    Burks, J S; Alfrey, A C; Huddlestone, J; Norenberg, M D; Lewin, E

    1976-04-10

    A distinct neurological syndrome in twelve chronic haemodialysis patients is described. This syndrome is currently the leading cause of death in one Denver dialysis unit. The hallmarks of this syndrome are progressive speech difficulties, mental changes, and a markedly abnormal electroencephalogram which may be present months before the clinical signs appear. Additional clinical features including seizures, myoclonus, asterixis, apraxia, focal neurological signs, and psychiatric symptoms may also be observed. Neuropathological changes are slight and non-specific. The aetiology of this syndrome is unknown but the clinical and pathological features suggest a toxic/metabolic disorder. To date, this disorder has been refractory to several therapeutic measures.

  5. Patients' experiences of safety during haemodialysis treatment--a qualitative study

    NARCIS (Netherlands)

    Lovink, Marleen H; Kars, Marijke C; de Man-van Ginkel, Janneke M; Schoonhoven, Lisette

    2015-01-01

    AIM: To explore the experiences of safety of adult patients during their haemodialysis treatment. BACKGROUND: Haemodialysis is a complex treatment with a risk for harm that causes anxiety among many patients. To date, no in-depth study of haemodialysis patients' emotional responses to conditions of

  6. Intrahepatic haematoma in a patient on long-term haemodialysis.

    Science.gov (United States)

    Lai, K N; Disney, A P; Mathew, T H

    Spontaneous intrahepatic haematoma is an uncommon potentially fatal complication in uraemic patients receiving long-term haemodialysis, particularly in those taking anticoagulant and antiplatelet drugs. Prompt diagnosis, withdrawal of anticoagulant and antiplatelet therapy, cautious transfusion, and careful dialysis with regional heparinisation are essential in the management and may help to avoid surgical intervention in the presence of a tendency to bleed. Noninvasive organ imaging such as ultrasonography and computerised axial tomography are helpful in diagnosis and monitoring of progress. A case of intrahepatic haematoma in a 37-year-old man who had been receiving long-term haemodialysis since 1976 is described.

  7. The mortality risk of overhydration in haemodialysis patients

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    Wizemann, Volker; Wabel, Peter; Chamney, Paul; Zaluska, Wojciech; Moissl, Ulrich; Rode, Christiane; Malecka-Masalska, Teresa; Marcelli, Daniele

    2009-01-01

    Background. While cardiovascular events remain the primary form of mortality in haemodialysis (HD) patients, few centres are aware of the impact of the hydration status (HS). The aim of this study was to investigate how the magnitude of the prevailing overhydration influences long-term survival. Methods. We measured the hydration status in 269 prevalent HD patients (28% diabetics, dialysis vintage = 41.2 ± 70 months) in three European centres with a body composition monitor (BCM) that enables...

  8. Nutritional Risk Screening in Hospitalized and Haemodialysis Patients

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    MIJANDRUŠIĆ SINČIĆ, BRANKICA; Orlić, Lidija; Eržen Jurišić, Dubravka; Kenđel, Gordana; Gombač, Elena; Kvenić, Barbara; Štimac, Davor

    2007-01-01

    Malnutrition is an independent risk factor impacting on higher complications and increased length of hospital stay and costs. The aim of this study was to determine the prevalence of nutritional risk among patients on regular haemodialysis (HD) (Group I, N=105) and among the patients at Gastroenterology, Endocrinology, Hematology and Clinical Immunology (Group II, N=652). Cross-sectional nutritional evaluation was done using Nottingham Hospital Screening Tool (NS). The prevalence ...

  9. Patient satisfaction with in-centre haemodialysis care: an international survey

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    Palmer, Suetonia C; De Berardis, Giorgia; Craig, Jonathan C; Tong, Allison; Tonelli, Marcello; Pellegrini, Fabio; Ruospo, Marinella; Hegbrant, Jörgen; Wollheim, Charlotta; Celia, Eduardo; Gelfman, Ruben; Ferrari, Juan Nin; Törok, Marietta; Murgo, Marco; Leal, Miguel

    2014-01-01

    Objectives To evaluate patient experiences of specific aspects of haemodialysis care across several countries. Design Cross-sectional survey using the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) questionnaire. Setting Haemodialysis clinics within a single provider in Europe and South America. Participants 2748 adults treated in haemodialysis. Primary and secondary outcomes The primary outcome was patient satisfaction with overall care. Secondary outcomes includ...

  10. Immunity to Diphtheria in Haemodialysis Patients

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    Abdolreza S. Jahromi; Mortaza Pourahmd; Sara Azhdari; Gita Manshoori; Abdolhossain Madani; Seyed H. Moosavy

    2011-01-01

    Problem statement: The incidence of infectious diseases is increased in patients with chronic renal failure. Chronic renal failure severely influences the immune functions of the host. Diphtheria is of great epidemiological concern. Although mainly observed during childhood, unvaccinated adults and relatively immunocompromised patients are at increased risk for acquiring diphtheria. Approach: To evaluate the anti-Diphtheria immunity level in southern Iranian patients ...

  11. Immunity to Diphtheria in Haemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Abdolreza S. Jahromi

    2011-01-01

    Full Text Available Problem statement: The incidence of infectious diseases is increased in patients with chronic renal failure. Chronic renal failure severely influences the immune functions of the host. Diphtheria is of great epidemiological concern. Although mainly observed during childhood, unvaccinated adults and relatively immunocompromised patients are at increased risk for acquiring diphtheria. Approach: To evaluate the anti-Diphtheria immunity level in southern Iranian patients with end stage renal disease undergoing hemodialysis and to find its association with sex, age, blood hemoglobin, serum albumin and duration of dialysis. This cross sectional study was carried out on a total of 52 patients, who were on hemodialysis and 52 age and sex matched healthy individuals with without any underlying renal disease as a control group. Subjects in the both groups receiving antidiphtheria toxoid vaccine or immunoglubins a year prior to the study were excluded. The serum antidiphtheria IgG antibody levels were measured by an ELISA method. Results: Diphtheria protected individuals in the patients and the control groups were 34.6 and 63.30% respectively. Of the evaluating factors just hemodialysis duration found to affect on diphtheria immunity. Conclusion: Diphtheria protected individuals in the patients group were significantly less than diphtheria protected individuals in the control group (p = 0.011. Hemodialysis duration has significant effect on anti-diphtheria immunity level.

  12. Association of versican turnover with all-cause mortality in patients on haemodialysis

    DEFF Research Database (Denmark)

    Genovese, Federica; Karsdal, Morten A; Leeming, Diana J;

    2014-01-01

    OBJECTIVE: Cardiovascular diseases are among the most common causes of mortality in renal failure patients undergoing haemodialysis. A high turnover rate of the proteoglycan versican, represented by the increased presence of its fragmentation products in plasma, has previously been associated with...... cardiovascular diseases. The objective of the study was to investigate the association of versican turnover assessed in plasma with survival in haemodialysis patients. METHODS: A specific matrix metalloproteinase-generated neo-epitope fragment of versican (VCANM) was measured in plasma of 364 haemodialysis...

  13. Prosthetic status and treatment needs for lost masticatory function in haemodialysis patients

    OpenAIRE

    Wilczyńska-Borawska, Magdalena; Małyszko, Jolanta; Cylwik-Rokicka, Dorota; Myśliwiec, Michał

    2012-01-01

    Introduction Premature loss of permanent teeth leads to stomatognathic system disability. It is a very serious but underrated problem for patients with chronic renal failure. The aim of study was analyse the degree of loss of masticatory function and number of teeth present for haemodialysis patients, and to define patients’ needs for prosthetic treatment, which could restore correct occlusal condition. Material and methods Sixty-nine haemodialysis patients treated at the Nephrology and Trans...

  14. Quality of life, mental health and health beliefs: comparison between haemodialysis and peritoneal dialysis patients

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    Theofilou P

    2010-01-01

    Aim: The comparative study between in-centre haemodialysis (HD) and continuous ambulatory peritoneal dialysis (PD) patients regarding self-reported quality of life (QoL) as well as some psychological dimensions that may affect and may be affected by the patient’s state of health, like health locus of control beliefs, depression and anxiety. Material and Method: The sample consists of 144 patients in-centre haemodialysis or continuous ambulatory peritoneal dialysis (CAPD). Patient-reported ass...

  15. Effectiveness of muscle stretching exercise on restless leg syndrome among patients undergoing haemodialysis

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    Jasvinder Kaur

    2016-06-01

    Conclusions: The study showed that intervention was effective in Reduction of RLS symptoms whereas continuous reinforcement was needed to lessen the RLS symptoms in haemodialysis patients. [Int J Res Med Sci 2016; 4(6.000: 2164-2169

  16. Hepatitis B and Hepatitis C Infections and Hepatitis B Vaccination in Pediatric Patients on Haemodialysis

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    Bak, Mustafa; Aksu, Nejat; Caner KABASAKAL; Cura, Alphan

    1993-01-01

    This study was performed to determine the prevalence hepatitis B surfage antigen other hepatitis B markers anti HCV antibodies the variations during the course of haemodialysis and immun response to a recombinant hepatitis B vaccine in children with chronic renal failure on haemodialysis nbsp; 54 patients 26 males and 28 females median age 12 1±2 7 years range 5 16 years treated with haemodialysis for median of 12 9±13 9 months were studied All hepatitis markers were detected in serum by an e...

  17. Association between recombinant human erythropoietin and quality of life and exercise capacity of patients receiving haemodialysis. Canadian Erythropoietin Study Group.

    OpenAIRE

    1990-01-01

    OBJECTIVE--To determine whether recombinant human erythropoietin improves the quality of life and exercise capacity of anaemic patients receiving haemodialysis. DESIGN--A double blind, randomised, placebo controlled study. SETTING--Eight Canadian university haemodialysis centres. PATIENTS--118 Patients receiving haemodialysis aged 18-75 with haemoglobin concentrations less than 90 g/l, no causes of anaemia other than erythropoietin deficiency, and no other serious diseases. INTERVENTIONS--Pat...

  18. Does nutrition play a role in the quality of life of patients under chronic haemodialysis?

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    P. Raimundo

    2006-04-01

    Full Text Available Background: In patients with chronic renal failure under haemodialysis, we investigated the inter-relationships and relative contributions of disease, haemodialysis and of nutrition related factors on the patients' Quality of Life. Methods: Collected data in 60 adult patients comprised: co-morbidities (multiple medicines, other chronic diseases, duration of renal failure and of haemodialysis (in months, % weight loss since haemodialysis, nutrient intake derived from diet history analysis (DIETPLAN5 2003, UK. The EuroQoL instrument that includes 5 dimensions, mobility, self-care, activities, pain/discomfort, anxiety/depression, and an overall health visual analogue scale evaluated QoL. Results: Estimates of effect size attributed to each variable included in the general linear model revealed that 47% of patients' mobility/self-care scores were worsened by deficient protein/energy intake and 30% by weight loss=10%. Poor performance of usual activities was attributed in 45% to duration of haemodialysis and of disease, 70% to protein/energy/vitamin B12/zinc/iron deficits, and 20% to weight loss =10%. Pain/discomfort were worsened in 45% by the duration of haemodialysis and of disease,and in 15% by co-morbidities. Higher anxiety/depression were related in 43% to protein/energy/selenium & vitamin C deficits, in 40% to the duration of haemodialysis and of disease, in 10% to weight loss =10%, and in 3% to co-morbidities. Likewise, 47% of poor overall health was determined by protein/energy/vitamin B12/zinc/selenium & vitamin C deficits, 25% by weight loss=10%, 10% by disease duration, and 7% by co-morbidities. Conclusion: Protein, antioxidants and key micronutrients involved in protein metabolism, did exert a major effect on patients' Quality of Life. Given the prevalence of nutrient deficits, the ensuing impaired functional capacity is likely to compromise QoL, timely nutrition is thus warranted.

  19. The effect of reflexology applied on haemodialysis patients with fatigue, pain and cramps.

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    Ozdemir, Gülistan; Ovayolu, Nimet; Ovayolu, Ozlem

    2013-06-01

    The research was conducted to evaluate the effect of foot reflexology on fatigue, pain and cramps in haemodialysis patients. The sample consisted of 80 patients in total, 40 intervention and 40 control patients, receiving treatment in the haemodialysis units of two institutions. Data were collected by using a questionnaire, Piper Fatigue Scale and visual analogue scale for measuring the severity of cramp and pain. The intervention group received reflexology treatment for 1 week in three sessions following haemodialysis, each session lasting approximately 30 min. Parametric and non-parametric tests were used in data analysis. It was determined that reflexology reduced the fatigue subscale scores and total scale scores as well as pain and cramp mean scores in the intervention group. The research results revealed that the severity of fatigue, pain and cramp decreased in patients receiving reflexology. PMID:23730858

  20. Does hepatitis C increase the accumulation of advanced glycation end products in haemodialysis patients?

    NARCIS (Netherlands)

    Arsov, Stefan; Graaff, Reindert; Morariu, Aurora M.; van Oeveren, Wim; Smit, Andries J.; Busletic, Irena; Trajcevska, Lada; Selim, Gjulsen; Dzekova, Pavlina; Stegmayr, Bernd; Sikole, Aleksandar; Rakhorst, Gerhard

    2010-01-01

    Methods. AGE accumulation was measured by means of skin autofluorescence (AF) in 92 haemodialysis (HD) patients and 93 age-matched healthy controls. In the HD patients, CVD-related biochemical variables were also measured. The HD patients were tested for hepatitis C virus (HCV) antibodies and alloca

  1. Copper, zinc and selenium imbalance in Moroccan haemodialysis patients and its correlation to lipid peroxidation

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    Rachid Eljaoudi

    2015-08-01

    Results: The study showed that, plasma Zn and Se concentrations were lower in haemodialysis patients compared to that of healthy controls, while plasma Cu, MDA and Cu/Zn ratio were higher. Plasma Cu/Zn ratios were positively correlated to MDA and weakly correlated to hs-CRP levels whereas plasma Se concentrations were inversely correlated to MDA. In addition, MDA levels increased after haemodialysis session. Conclusions: Based on the results of the present study regarding the imbalance of trace elements in haemodialysis patients, it seems reasonable to periodically assess the trace elements status and consider possible correctional therapy in case of deficiency. [Int J Res Med Sci 2015; 3(8.000: 2079-2085

  2. Efficacy of mupirocin nasal ointment in eradicating Staphylococcus aureus nasal carriage in chronic haemodialysis patients

    NARCIS (Netherlands)

    D. L. Holton; L. E. Nicolle; D. Diley; K. Bernstein

    1991-01-01

    textabstractTopical 2% mupirocin ointment eradicated chronic Staphylococcus aureus nasal carriage immediately post-therapy in 17 (77%) of 22 haemodialysis patients. Mean time to recurrence was 3.8 weeks. Similar pre-therapy and post-therapy phage types occurred in 12 (71%) of 17 patients. Staphyloco

  3. The management of xerostomia in patients on haemodialysis : comparison of artificial saliva and chewing gum

    NARCIS (Netherlands)

    Bots, CP; Brand, HS; Veerman, ECI; Valentijn-Benz, M; Van Amerongen, BM; Amerongen, AVN; Valentijn, RM; Vos, PI; Bijlsma, JA; ter Wee, PM

    2005-01-01

    Many patients on haemodialysis (HD) therapy suffer from a dry mouth and xerostomia. This can be relieved by mechanical and gustatory stimulation or palliative care. The aim of this crossover study was to investigate the effect and preferences of a sugar-free chewing gum (Freedent White(TM)) and a xa

  4. Validation of The Fluid Intake Appraisal Inventory for patients on haemodialysis in Denmark

    DEFF Research Database (Denmark)

    Pahus, Jytte; Ludvigsen, Mette Spliid; Lindberg, Magnus

    2016-01-01

    Background Many haemodialysis patients have problems limiting their fluid intake, which might be influenced by their self-efficacy (SE). Thus interventions to improve patients’ SE could lead to an improvement in their managing of fluid allowance. The Fluid Intake Appraisal Inventory (FIAI...

  5. Comparison of amino acid oxidation and urea metabolism in haemodialysis patients during fasting and meal intake

    NARCIS (Netherlands)

    Veeneman, JM; Kingma, HA; Stellaard, F; de Jong, PE; Reijngoud, DJ; Huisman, RM

    2004-01-01

    Background. The PNA (protein equivalent of nitrogen appearance) is used to calculate protein intake from urea kinetics. One of the essential assumptions in the calculation of PNA is that urea accumulation in haemodialysis (HD) patients is equivalent to amino acid oxidation. However, urea is hydrolys

  6. Incidence of and risk factors for hepatitis B virus and hepatitis C virus infection among haemodialysis and CAPD patients: evidence for environmental transmission.

    Science.gov (United States)

    Cendoroglo Neto, M; Draibe, S A; Silva, A E; Ferraz, M L; Granato, C; Pereira, C A; Sesso, R C; Gaspar, A M; Ajzen, H

    1995-01-01

    Hepatitis B virus (HBV) serum markers (HBsAg, anti-HBs, anti-HBc) and antihepatitis C antibody (anti-HCV) were prospectively followed in haemodialysis and CAPD patients. From January 1987 to January 1990, 185 patients on haemodialysis and 124 on CAPD were analysed. Among patients susceptible to HBV (69 on haemodialysis and 70 on CAPD), there were 17 HBsAg seroconversions on haemodialysis (0.19/patient-year) and 1 on CAPD (0.01/patient-year). A Cox proportional hazards model showed that haemodialysis treatment was the only risk factor significantly associated with HBV infection, thus suggesting transmission through the environment. Regarding hepatitis C, 83 anti-HCV-negative patients on haemodialysis and 46 on CAPD were followed. There were 18 seroconversions on haemodialysis (0.15/patient-year) and two seroconversions on CAPD (0.03/patient-year). Haemodialysis treatment was also the only risk factor significantly associated with a higher risk of HCV infection. The hazard ratio for HCV infection in haemodialysis patients was 5.7 compared to CAPD patients. Nevertheless, for one patient on CAPD treatment transfusions were the only possible source of HCV infection. In conclusion, both viruses were transmitted mainly through the haemodialysis environment, but the role of transfusions could not be excluded. PMID:7538651

  7. Vitamin D deficiency is associated with sudden cardiac death, combined cardiovascular events, and mortality in haemodialysis patients

    OpenAIRE

    Drechsler, Christiane; Pilz, Stefan; Obermayer-Pietsch, Barbara; Verduijn, Marion; Tomaschitz, Andreas; Krane, Vera; Espe, Katharina; Dekker, Friedo; Brandenburg, Vincent; März, Winfried; Ritz, Eberhard; Wanner, Christoph

    2010-01-01

    Aims Dialysis patients experience an excess mortality, predominantly of sudden cardiac death (SCD). Accumulating evidence suggests a role of vitamin D for myocardial and overall health. This study investigated the impact of vitamin D status on cardiovascular outcomes and fatal infections in haemodialysis patients. Methods and results 25-hydroxyvitamin D [25(OH)D] was measured in 1108 diabetic haemodialysis patients who participated in the German Diabetes and Dialysis Study and were followed u...

  8. Multipass haemodialysis

    DEFF Research Database (Denmark)

    Heaf, James Goya; Axelsen, Mette; Pedersen, Robert Smith

    2013-01-01

    INTRODUCTION: Most home haemodialysis (HD) modalities are limited to home use since they are based on a single-pass (SP) technique, which requires preparation of large amounts of dialysate. We present a new dialysis method, which requires minimal dialysate volumes, continuously recycled during tr...... traditional HD and HD 5 × 2.5 h/week. This modality will increase patients' freedom of movement compared with traditional home HD. The new method can also be used in the intensive care unit and for automated peritoneal dialysis.......INTRODUCTION: Most home haemodialysis (HD) modalities are limited to home use since they are based on a single-pass (SP) technique, which requires preparation of large amounts of dialysate. We present a new dialysis method, which requires minimal dialysate volumes, continuously recycled during...

  9. Causes of end stage renal failure among haemodialysis patients in Khartoum State/Sudan

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    Banaga, Amin S. I.; Mohammed, Elaf B.; Siddig, Rania M.; Salama, Diana E.; Elbashir, Sara B.; Khojali, Mohamed O.; Babiker, Rasha A.; Elmusharaf, Khalifa; Homeida, Mamoun M.

    2015-01-01

    Background End stage renal failure (ESRF) has become a major health problem in Sub Saharan Africa (SSA). There were limited data about causes of ESRF in the Sudan. Methods This is a cross sectional hospital based descriptive study. The subjects of the study are ESRF adults’ patients on regular haemodialysis treatment in 15 haemdoialysis centres in Khartoum State—Sudan. Clinical and epidemiological data were obtained from 1583 patients. The medical files of each patient were reviewed to identi...

  10. Restless legs syndrome: an underappreciated and distressing problem for haemodialysis patients.

    Science.gov (United States)

    Chu, L; Chu, E; Dogra, G; Chakera, A

    2014-10-01

    Restless legs syndrome is a distressing condition that is more common in patients with end-stage renal failure. Despite the significant impact it has on quality of life and the documented association between restless legs syndrome and increased mortality, limited data regarding the epidemiology of restless legs syndrome in Australian dialysis patients are available. We report a prospective study that assessed the prevalence and factors associated with restless legs syndrome in an in-centre haemodialysis population.

  11. PERSISTENT AND INTERMITTENT HYPERHYDRATION IN PATIENTS ON PROGRAM HAEMODIALYSIS: METHODS OF EVALUATION AND CORRECTION

    OpenAIRE

    A. G. Strokov; V. A. Terekhov; Y. L. Poz; K.N. Kryshin; Yu. V. Kopylova

    2015-01-01

    Hyperhydration, the sum of persistent (PH) and intermittent (IH) ones is the strong predictor of mortality in patients on program haemodialysis (PHD). The aim of this research was to investigate the complex of methods for minimization of PH as well as IH. Materials and methods. The bioimpedance multifrequency analysis (BIA), relative blood volume (RBV) monitoring and plasma conductivity evaluation by ionic dialysance device were performed in candidates for kidney transplantation. Results. In ...

  12. The role of natriuretic peptides in volume assessment and mortality prediction in Haemodialysis patients

    OpenAIRE

    Sivalingam, Murugan; Vilar, Enric; Mathavakkannan, Suresh; Farrington, Ken

    2015-01-01

    Background Maintaining optimal fluid balance is essential in haemodialysis (HD) patients but clinical evaluation remains problematic. Other technologies such as bioimpedance are emerging as valuable adjuncts. This study was undertaken to explore the potential utility of the natriuretic peptides – atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in the assessment of fluid status and cardiovascular risk in this setting. Methods This was a cross-sectional study carried out i...

  13. Haemodialysis: hospital or home?

    Science.gov (United States)

    Power, Albert; Ashby, Damien

    2014-02-01

    Healthcare costs associated with the provision of dialysis therapy are escalating globally as the number of patients developing end-stage renal disease increases. In this setting, there has been heightened interest in the application and potential benefit of home haemodialysis therapies compared with the conventional approach of thrice weekly, incentre treatments. Increasingly, national healthcare systems are financially incentivising the expansion of home haemodialysis programmes with observational studies demonstrating better patient survival, superior control of circulating volume and blood pressure, greater patient satisfaction and lower running costs compared with incentre dialysis. Nonetheless, increasing the prevalence of home haemodialysis is challenged by the technological complexity of conventional dialysis systems, the need for significant adaptations to the home as well as suboptimal clinician and patient education about the feasibility and availability of this modality. In addition, enthusiasm about frequent as well as nocturnal (extended-hours) haemodialysis has been tempered by results from the recent Frequent Haemodialysis Network randomised controlled trials comparing these schedules with a conventional incentre regime. An increasing emphasis on empowering patient choice and promoting self-management of chronic illness is a powerful driver for the expansion of home haemodialysis programmes in the UK and internationally.

  14. The effects of melatonin on sleep-wake rhythm of daytime haemodialysis patients: A randomized, placebo-controlled, cross-over study (EMSCAP study)

    NARCIS (Netherlands)

    B.C.P. Koch; J.E. Nagtegaal; E.C. Hagen; M.M.L van der Westerlaken; J.B.S. Boringa; G.A. Kerkhof; P.M. ter Wee

    2009-01-01

    AIM: The aim of this study was to investigate the effects of exogenous melatonin on sleep-wake rhythm in haemodialysis patients. METHODS: The study design is a randomized, double-blind, placebo-controlled, cross-over study of 3 ¥ 6 weeks melatonin 3 mg at 22.00 h every night. Haemodialysis patients

  15. Pre-dialysis systolic blood pressure-variability is independently associated with all-cause mortality in incident haemodialysis patients.

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    Viknesh Selvarajah

    Full Text Available Systolic blood pressure variability is an independent risk factor for mortality and cardiovascular events. Standard measures of blood pressure predict outcome poorly in haemodialysis patients. We investigated whether systolic blood pressure variability was associated with mortality in incident haemodialysis patients. We performed a longitudinal observational study of patients commencing haemodialysis between 2005 and 2011 in East Anglia, UK, excluding patients with cardiovascular events within 6 months of starting haemodialysis. The main exposure was variability independent of the mean (VIM of systolic blood pressure from short-gap, pre-dialysis blood pressure readings between 3 and 6 months after commencing haemodialysis, and the outcome was all-cause mortality. Of 203 patients, 37 (18.2% patients died during a mean follow-up of 2.0 (SD 1.3 years. The age and sex-adjusted hazard ratio (HR for mortality was 1.09 (95% confidence interval (CI 1.02-1.17 for a one-unit increase of VIM. This was not altered by adjustment for diabetes, prior cardiovascular disease and mean systolic blood pressure (HR 1.09, 95% CI 1.02-1.16. Patients with VIM of systolic blood pressure above the median were 2.4 (95% CI 1.17-4.74 times more likely to die during follow-up than those below the median. Results were similar for all measures of blood pressure variability and further adjustment for type of dialysis access, use of antihypertensives and absolute or variability of fluid intake did not alter these findings. Diastolic blood pressure variability showed no association with all cause mortality. Our study shows that variability of systolic blood pressure is a strong and independent predictor of all-cause mortality in incident haemodialysis patients. Further research is needed to understand the mechanism as this may form a therapeutic target or focus for management.

  16. Outcomes of AV Fistulas and AV Grafts after Interventional Stent-Graft Deployment in Haemodialysis Patients

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    Schmelter, Christopher, E-mail: christopher.schmelter@klinikum-ingolstadt.de; Raab, Udo, E-mail: udo.raab@klinikum-ingolstadt.de [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany); Lazarus, Friedrich, E-mail: friedrich.lazarus@klinikum-ingolstadt.de [Klinikum Ingolstadt, Department of Nephrology (Germany); Ruppert, Volker, E-mail: volker.ruppert@klinikum-ingolstadt.de [Klinikum Ingolstadt, Department of Vascular Surgery (Germany); Vorwerk, Dierk, E-mail: dierk.vorwerk@klinikum-ingolstadt.de [Klinikum Ingolstadt, Department of Diagnostic and Interventional Radiology (Germany)

    2015-08-15

    PurposeThe study was designed to assess outcomes of arteriovenous (AV) accesses after interventional stent-graft deployment in haemodialysis patients.Materials and Methods63 haemodialysis patients with 66 AV fistulas and AV grafts were treated by interventional stent-graft deployment from 2006 to 2012 at our hospital. Data of these patients were retrospectively analysed for location of deployed stent-grafts, occurrence and location of (re-)stenosis and (re-)thrombosis. Complex stenosis was the most frequent indication for stent-graft deployment (45.5 %), followed by complications of angioplasty with vessel rupture or dissection (31.8 %).ResultsA high rate of procedural success was achieved (98.5 %). The most frequent location of the deployed stent-graft was the draining vein (66.7 %). Stent-graft deployment was more frequent in AV grafts than in AV fistulas. Primary patency was 45.5 % at 6 month, 31.3 % at 12 month and 19.2 % at 24 month. Primary patency was significantly better for AV fistulas than for AV grafts with deployed stent-grafts. Patency of the deployed stent-graft was much better than overall AV access primary patency with deployed stent-graft. Re-stenosis with thrombosis was the most frequent indication for re-intervention. Most frequent location of re-stenosis was the draining vein (37.1 %), followed by stenosis at the AV access (29.5 %) and the deployed stent-graft (23.5 %).ConclusionRe-stenosis and re-thrombosis remain frequent in AV fistulas and AV grafts in haemodialysis patients despite stent-graft deployment. Re-stenosis of the deployed stent-graft is, only in the minority of the cases, responsible for AV access dysfunction.

  17. Non-contrast-enhanced MR angiography for detecting arteriovenous fistula dysfunction in haemodialysis patients

    International Nuclear Information System (INIS)

    Aim: To assess the diagnostic value of non-contrast-enhanced magnetic resonance angiography (NCE-MRA), using time-of-flight and black-blood MRA, in the evaluation of arteriovenous fistulas in haemodialysis patients in comparison to multidetector computed tomography angiography (MDCTA). Material and methods: NCE-MRA and MDCTA were performed on the same day in 21 patients on maintenance haemodialysis with dysfunctional arteriovenous fistulas. The fistulas included three segments: arterial inflow, anastomosis, and venous outflow. Two experienced observers, who were blinded to the results of the NCE-MRA, recorded in consensus the significant stenoses (≥50%) seen on CTA. Two other experienced observers, unaware of the results of CTA, independently recorded significant stenoses (≥50%) in the NCE-MRA. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of NCE-MRA were calculated, with MDCTA as the standard reference. Results: Sixty-three vascular segments in the 21 patients were clearly displayed. For the two observers of NCE-MRA, the accuracy was 98% and 95.4%; sensitivity 96.4% and 96.4%; specificity 97.1% and 94.3%; positive predictive value 96.4% and 93.1%; and, negative predictive value 97.1% and 97.1%. Inter-/intra-observer agreement for detecting stenosis was excellent for NCE-MRA, with a weighted kappa of 0.968 (95% confidence interval [CI], 0.874–1) and 0.936 (95% CI, 0.848–1). Conclusion: Non-contrast-enhanced MRA, using time-of-flight and black-blood MRA, is a reproducible and reliable imaging technique for detecting ≥50% stenosis in dysfunctional haemodialysis arteriovenous fistulas. -- Highlights: •We used 3 points planscan technique to locate the target vessels. •Black-blood MRA applied to detect AVFs in hemodialysis patients. •NCE-MRA is a reliable imaging technique for detecting AVF dysfunction

  18. Quality of life, mental health and health beliefs: comparison between haemodialysis and peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Theofilou P

    2010-10-01

    Full Text Available Aim: The comparative study between in-centre haemodialysis (HD and continuous ambulatory peritoneal dialysis (PD patients regarding self-reported quality of life (QoL as well as some psychological dimensions that may affect and may be affected by the patient’s state of health, like health locus of control beliefs, depression and anxiety. Material and Method: The sample consists of 144 patients in-centre haemodialysis or continuous ambulatory peritoneal dialysis (CAPD. Patient-reported assessments included: a WHOQOL-BREF, b General Health Questionnaire (GHQ-28, c Multidimensional Health Locus of Control Questionnaire (MHLC, d State - Trait Anxiety Inventory (STAI I, II and e Center for Epidemiologic Studies Depression Scale (CES-D.Results: HD patients presented lower scores in WHOQOL-BREF domain of environment. Furthermore, they reported higher scores in the GHQ-28 sub-scales of anxiety/insomnia and severe depression as well as of the total score of the questionnaire. Regarding health beliefs, statistically significant difference was observed in HD patients, who presented higher scores in the internal health locus of control. Conclusions: Patients in HD treatment modality were experiencing a more compromised QoL indicating greater discontent with different aspects of their environment. Further, they reported more symptoms of anxiety, sleeping problems, depression or suicidal thoughts.

  19. Prevalence of occult HBV infection in haemodialysis patients with chronic HCV

    Institute of Scientific and Technical Information of China (English)

    Vedat Goral; Hamza Ozkul; Selahattin Tekes; Dede Sit; Ali Kemal Kadiroglu

    2006-01-01

    AIM: To study the prevalence and clinical effects of occult HBV infection in haemodialysis patients with chronic HCV.METHODS: Fifty chronic hemodialysis patients with negative HbsAg, and positive anti-HCV were included in the study. These patients were divided into two groups:HCV-RNA positive and HCV-RNA negative, based on the results of HCV-RNA PCR. HBV-DNA was studied using the PCR method in both groups.RESULTS: None of the 22 HCV-RNA positive patients and 28 HCV-RNA negative patients revealed HBV-DNA in serum by PCR method. The average age was 47.2 ± 17.0 in the HCV-RNA positive group and 39.6 ± 15.6 in the HCV-RNA negative group.CONCLUSION: The prevalence of occult HBV infection is not high in haemodialysis patients with chronic HCV in our region. This result of our study has to be evaluated in consideration of the interaction between HBsAg positivity (8%-10%) and frequency of HBV mutants in our region.

  20. An outbreak of hepatitis C virus in a haemodialysis unit: molecular evidence of patient-to-patient transmission.

    Science.gov (United States)

    Ansaldi, F; Bruzzone, B; de Florentiis, D; Marasso, P; Gota, F; Mofferdin, A; Campello, C; Crovari, P; Icardi, G

    2003-01-01

    Hepatitis C virus (HCV) infection remains a major problem in haemodialysis units despite the risk decrease provided by anti-HCV screening of blood. The exact mode of transmission of HCV in the dialysis units remains unclear. To identify the route of the virus and the mechanisms of transmission an investigation into the outbreak of HCV infection in a haemodialysis unit on a molecular level was held: 12 newly infected patients and 14 already infected were investigated by sequencing the 5' untranslated region of the viral genome. The results showed that 3 strains infected new cases and these strains matched those sequenced in already infected patients. Transmission occurred between patients treated on the same shift and also between different rooms. Console and blood or blood product contamination was excluded. Our study gave molecular evidence of patient-to-patient transmission of HCV in a haemodialysis unit. Our data underline the importance of the strict enforcement of standard precautions to prevent HCV transmission and failure of the isolation of anti-HCV positive patients as preventive measure.

  1. Central venous stenosis in haemodialysis patients without a previous history of catheter placement

    Energy Technology Data Exchange (ETDEWEB)

    Oguzkurt, Levent [Baskent University, Adana Teaching and Medical Research Centre, Department of Radiology, Adana (Turkey)]. E-mail: loguzkurt@yahoo.com; Tercan, Fahri [Baskent University, Adana Teaching and Medical Research Centre, Department of Radiology, Adana (Turkey); Yildirim, Sedat [Baskent University, Adana Teaching and Medical Research Centre, Department of Surgery, Adana (Turkey); Torun, Dilek [Baskent University, Adana Teaching and Medical Research Centre, Department of Nephrology, Adana (Turkey)

    2005-08-01

    Objective: To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Material and methods: Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Results: Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Conclusion: Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term.

  2. Effect of nocturnal haemodialysis on body composition.

    NARCIS (Netherlands)

    Ipema, K.J.; Westerhuis, R.; Schans, C.P. van der; Jong, P.E. de; Gaillard, C.A.; Krijnen, W.P.; Slart, R.H.; Franssen, C.F.

    2014-01-01

    Background: Haemodialysis patients have a high risk of malnutrition which is associated with increased mortality. Nocturnal haemodialysis (NHD) is associated with a significant increase in protein intake compared with conventional haemodialysis (CHD). It is unclear whether this leads to improved nut

  3. An investigation of the effects of music on anxiety and pain perception in patients undergoing haemodialysis treatment.

    Science.gov (United States)

    Pothoulaki, M; Macdonald, R A R; Flowers, P; Stamataki, E; Filiopoulos, V; Stamatiadis, D; Stathakis, Ch P

    2008-10-01

    This study aimed to investigate the effects of preferred music listening on anxiety and pain perception in patients undergoing haemodialysis. A two group experimental design was used. Sixty people diagnosed with end stage renal failure undergoing haemodialysis treatment participated in this study. Preferred music listening was applied as an intervention. Anxiety and pain were measured pre-test and post-test. The control group scored significantly higher in state anxiety than the experimental group and experienced significantly higher pain intensity in post-test phase. Findings provide experimental evidence to support the effectiveness of preferred music listening in medical settings. PMID:18809642

  4. Relative survival of peritoneal dialysis and haemodialysis patients

    DEFF Research Database (Denmark)

    Heaf, James G; Wehberg, Sonja

    2014-01-01

    INTRODUCTION: Epidemiological studies consistently show an initial survival advantage for PD patients compared to HD. It has recently been suggested that this is due to the fact that many HD patients are referred late, and start dialysis on an acute, in-patient basis. The present study was perfor...

  5. Self-rated health and employment status in chronic haemodialysis patients

    DEFF Research Database (Denmark)

    Molsted, Stig; Aadahl, Mette; Schou, Lone;

    2004-01-01

    OBJECTIVE: Along with survival and other types of clinical outcome, physical, mental and social well-being are important indicators of the effectiveness of the medical care that haemodialysis (HD) patients receive. The present cross-sectional study was designed to assess self-rated health in HD...... obtained from hospital records. RESULTS: A total of 112 patients completed the questionnaire, giving a response rate of 75%. Compared to the general population sample, HD patients scored significantly lower on all eight SF-36 scales (p ... concerning physical functioning. No correlation was found between any of the eight scales and estimates of dialysis adequacy. Of patients aged 18-60 years, 22% were in employment. CONCLUSION: In a large group of Danish HD patients, self-rated health (and especially physical function) was found...

  6. The use of nasal mupirocin ointment to prevent Staphylococcus aureus bacteraemias in haemodialysis patients: an analysis of cost- effectiveness

    NARCIS (Netherlands)

    J.R. Boelaert; M. A. Geernaert; C.A. Godard (Claudine); H.W. van Landuyt; Y.A. de Baere

    1991-01-01

    textabstractNasal carriage of Staphylococcus aureus is a risk factor for the development of infections caused by S. aureus in haemodialysis patients. This study compared the incidence of bacteraemia caused by S. aureus during 6 months of use of nasal 2% calcium mupirocin ('Nasal Bactroban') 3-times

  7. Comparison of interferon gamma release assay & tuberculin skin tests for diagnosis of latent tuberculosis in patients on maintenance haemodialysis

    Directory of Open Access Journals (Sweden)

    Sanjay K Agarwal

    2015-01-01

    Interpretation & conclusions: Our findings showed that more number of patients (36% on haemodialysis were positive for QuantiFERON Gold In-Tube test as compared to TST (17%. There was poor agreement between the two tests. No significant effect of BCG vaccination and history of TB in past was observed on both tests.

  8. Myosin heavy-chain isoform distribution, fibre-type composition and fibre size in skeletal muscle of patients on haemodialysis

    DEFF Research Database (Denmark)

    Molsted, Stig; Eidemak, Inge; Sorensen, Helle Tauby;

    2007-01-01

    and distribution of muscle fibres and the myosin heavy-chain (MHC) isoform composition in patiens on haemodialysis (HD) in order to establish any differences with values for untrained control subjects. Material and methods. Muscle biopsies were obtained from the vastus lateralis muscle of 14 non-diabetic patients...

  9. Relating protein intake to nutritional status in haemodialysis patients : How to normalize the protein equivalent of total nitrogen appearance (PNA)?

    NARCIS (Netherlands)

    Kloppenburg, Wybe; Stegeman, CA; de Jong, PE; Huisman, RM

    1999-01-01

    Background. The protein equivalent of total nitrogen appearance (PNA) is assumed to be a reliable estimate of dietary protein intake in haemodialysis patients. Protein requirements are related to body size. In order to standardize PNA to individual differences in body size, PNA is normalized to vari

  10. The effects of intermittent fasting during the month of Ramadan in chronic haemodialysis patients in a tropical climate country.

    Directory of Open Access Journals (Sweden)

    Wan Ahmad Hafiz Wan Md Adnan

    Full Text Available BACKGROUND: Chronic kidney disease is an emerging problem in the majority Muslim countries. Despite the uncertainties of the risks involved, some Muslim patients undergoing chronic haemodialysis choose to observe intermittent fasting during the month of Ramadan. This study aims to investigate the effect of Ramadan fasting in haemodialysis patients residing in a tropical climate country. METHODS: This prospective cross sectional study recruited Muslim patients on regular haemodialysis from three haemodialysis centres in Kuala Lumpur from 15th July 2011 to 29th August 2011. Patients who fasted for any number of days were included (n = 35, 54% female, age 54±11 years. 89% of patients fasted for more than 15 days and 49% were diabetics. Dialysis parameters and blood samples were obtained one week prior to Ramadan and during the last week of Ramadan. The differences in dialysis parameters and biochemical values pre- and end-Ramadan were examined using paired t-test. RESULTS: Both pre- and post-dialysis weight were significantly decreased during Ramadan fasting compared to the month prior (p = <0.001. There was a significant decrease in the amount of ultrafiltration (p = 0.002. There were no significant differences in dry weight, inter-dialytic weight gain, mean urea reduction ratio or blood pressure measurements comparing pre- and end of Ramadan fasting. There was a significant increase in serum albumin level (p = 0.006 and decrease in serum phosphate level (p = 0.02 at the end of Ramadan. CONCLUSION: Ramadan fasting is associated with reduced weight, improved serum albumin and phosphate level in our population of haemodialysis patients. A larger multi-centre study will allow us to understand more about the effects of fasting in this population.

  11. Influence of blood pressure control on maintenance of residual function in patients treated by haemodialysis

    Directory of Open Access Journals (Sweden)

    Kezić Aleksandra

    2009-01-01

    Full Text Available Introduction. Residual renal function (RRF in the patients treated by haemodialysis (HD is associated not only with better volume and blood pressure control but also with better metabolic control. The condition of the cardiovascular system significantly affects RRF. Objective. The aim of the study was to find if there was any association between blood pressure regulation and the achieved HD ultrafiltration in the first year of haemodialysis treatment and the maintenance of RRF. Methods In this retrospective study, 53 patients were analyzed in the period 1994-2002. Residual clearance of urea (RCU was measured for the first time at the beginning of HD treatment, and for the second time one year later. Laboratory data and values of blood pressure as well as the achieved HD ultrafiltration were taken from the electronic database of the Nephrology Hospital. Results. The value of RCU less than 1ml/min was considered as the loss of RRF and, at the beginning of HD treatment, 14 patients (26.4% had that result. The rise of mean arterial pressure (MAP was associated in linear regression analysis with a drop of residual diuresis volume (β=-0.28; p=0.04, but there was no association with RCU. The patients with MAP>105 mm Hg had RKU less than the patients with MAP<105 mm Hg (t=2.23; p=0.03. The rise of the HD ultrafiiltration significantly affected the loss of RRF obtained by the linear regression analysis (β=-0.44; p=0.0001. Conclusion. The greater HD ultrafiltration is related to a drop of RCU values. Only prospective randomised trials with the use of multiple regression analysis could define a more precise association between hypertension and RKU.

  12. Economic evaluations of interventions to manage hyperphosphataemia in adult haemodialysis patients: A systematic review.

    Science.gov (United States)

    Rizk, Rana; Hiligsmann, Mickaël; Karavetian, Mirey; Evers, Silvia Maa

    2016-03-01

    Managing hyperphosphataemia in haemodialysis patients is resource-intensive. A search for cost-effective interventions in this field is needed to inform decisions on the allocation of healthcare resources. NHSEED, MEDLINE, EMBASE and CINAHL were searched for full economic evaluations of hyperphosphataemia-managing interventions in adult haemodialysis patients, published between 2004 and 2014, in English, French, Dutch or German. Incremental cost-effectiveness ratios of the interventions were up-rated to 2013US$ using Purchasing Power Parity conversion rates and Consumer Price Indices. The quality of included studies was assessed using the Extended Consensus on Health Economic Criteria List. Twelve out of the 1681 retrieved records fulfilled the inclusion criteria. They reported only on one aspect of hyperphosphataemia management, which is the use of phosphate binders (calcium-based and calcium-free, in first-line and sequential use). No economic evaluations of other phosphorus-lowering interventions were found. The included articles derived from five countries and most of them were funded by pharmaceutical companies. The incremental cost-effectiveness ratios of phosphate binders ranged between US$11 461 and US$157 760 per quality-adjusted life-year gained. Calcium-based binders (especially calcium acetate) appear to be the optimal cost-effective first- and second-line therapy in prevalent patients, while the calcium-free binder, lanthanum carbonate, might provide good value for money, as second-line therapy, in incident patients. The studies' overall quality was suboptimal. Drawing firm conclusions was not possible due to the quality heterogeneity and inconsistent results. Future high-quality economic evaluations are needed to confirm the findings of this review and to address other interventions to manage hyperphosphataemia in this population. PMID:26246269

  13. Relationship between renalase and N-terminal pro-B-type Natriuretic Peptide (NT pro-BNP in haemodialysis patients

    Directory of Open Access Journals (Sweden)

    Marcin Dziedzic

    2014-03-01

    Full Text Available Introduction. Our knowledge in the field of cause of deaths in dialysis patients is rapidly expanding, yet we still do not fully understand how renalase regulates the processes of cardiovascular disease developing in end-stage renal disease. Increased sympathetic nerve activity observed in chronic kidney diseases due to raised catecholamines in plasma results from the absence of renalase. Renalase synthesized and secreted by the kidneys participate in the regulation of sympathetic tone and blood pressure. A family of natriuretic peptides has been identified – NT pro-BNP – which seems to be the best predictor of clinical outcome and marker of extracellular fluid overload, as well as predicting mortality, irrespective of renal function. Objective. The aim of the presented study was to investigate renalase concentration and investigate associations between NT-proBNP, as well as analyzed parameters in haemodialysis patients. Materials and method. The study was conducted among residents of the municipality and neighbouring villages in the province of Lublin, central-eastern Poland. 49 male subjects on haemodialysis, aged 65.3 ± 14.2 years, median time on haemodialysis: 37.5 months, were included. All study subjects underwent haemodialysis 3 times a week. The mean concentration of renalase in the entire study population was 126.59 ± 32.63 ng/mL. The circulating levels of NT-proBNP was 813.64 ± 706.96 pg/mL. A significant inverse correlation was found between NT-proBNP and renalase plasma levels (R = –0.3, P = 0.03. Conclusions. Inverse correlation between NT-proBNP and renalase plasma levels in haemodialysis patients were due to impaired kidney function, accompanied by increased sympathetic nerve activity, which have an impact on the development of hypertension and cardiovascular complications.

  14. Uraemic pruritus markedly affects the quality of life and depressive symptoms in haemodialysis patients with end-stage renal disease.

    Science.gov (United States)

    Suseł, Joanna; Batycka-Baran, Aleksandra; Reich, Adam; Szepietowski, Jacek C

    2014-05-01

    Little is known about the influence of uraemic pruritus on patients' wellbeing. The aim of our study was to evaluate the impact of uraemic pruritus on quality of life and depressive symptoms in patients with end-stage renal disease. A total of 200 haemodialysis patients were included into the study. The prevalence of uraemic pruritus was 38%. Patients with uraemic pruritus had significantly lower quality of life according to SF-36 questionnaire compared to the remaining of analysed subjects. Among patients with uraemic pruritus, 64.5% individuals also showed impaired skin-related quality of life evaluated with Dermatology Life Quality Index. The quality of life impairment correlated with uraemic pruritus intensity assessed with VAS and the 4-item itch questionnaire. Depression level significantly correlated with quality of life and severity of depressive symptoms was significantly associated with uraemic pruritus intensity. Our study underscores that uraemic pruritus should be regarded as an important health problem among haemodialysis patients.

  15. A randomized, crossover design study of sevelamer carbonate powder and sevelamer hydrochloride tablets in chronic kidney disease patients on haemodialysis

    OpenAIRE

    Fan, Stanley; Ross, Calum; Mitra, Sandip; Kalra, Philip; Heaton, Jeremy; Hunter, John; Plone, Melissa; Pritchard, Nick

    2009-01-01

    Background. Sevelamer carbonate is an improved, buffered form of sevelamer hydrochloride developed for the treatment of hyperphosphataemia in CKD patients. Sevelamer carbonate formulated as a powder for oral suspension presents a novel, patient-friendly alternative to tablet phosphate binders. This study compared the safety and efficacy of sevelamer carbonate powder with sevelamer hydrochloride tablets in CKD patients on haemodialysis. Methods. This was a multi-centre, open-label, randomized,...

  16. The influence of continuous venovenous haemodialysis on the pharmacokinetics of multiple oral moxifloxacin administration to patients with severe renal dysfunction

    OpenAIRE

    Stass, H; Bührmann, S; Mitchell, A.; Kubitza, D; Möller, J-G; Kribben, A; Wenzel, R R; Schäfers, R F

    2007-01-01

    What is already known about this subjectAlthough renal excretion is one important route of excretion of moxifloxacin and its metabolites, moxifloxacin pharmacokinetics are similar in patients with varying degrees of renal impairment (but not on dialysis) and in healthy subjects.What this study addsThis study showed that moxifloxacin pharmacokinetics are comparable in patients with severe renal failure requiring haemodialysis and in healthy subjects and patients with impaired renal function no...

  17. [Recurrent vascular access trombosis associated with the prothrombin mutation G20210A in a adult patient in haemodialysis].

    Science.gov (United States)

    Quintana, L F; Coll, E; Monteagudo, I; Collado, S; López-Pedret, J; Cases, A

    2005-01-01

    Vascular access-related complications are a frequent cause of morbidity in haemodialysis patients and generate high costs. We present the case of an adult patient with end-stage renal disease and recurrent vascular access thrombosis associated with the prothrombin mutation G20210A and renal graft intolerance. The clinical expression of this heterozygous gene mutation may have been favoured by inflammatory state, frequent in dialysis patients. In this patient, the inflammatory response associated with the renal graft intolerance would have favored the development of recurrent vascular access thrombosis in a adult heterozygous for prothrombin mutation G20210A. In the case of early dysfunction of haemodialysis vascular access and after ruling out technical problems, it is convenient to carry out a screening for thrombophilia.

  18. The treatment of secondary hyperparathyroidism in haemodialysis patients' refractory to alfacalcidol

    Directory of Open Access Journals (Sweden)

    L V Egshatyan

    2012-06-01

    Full Text Available Background. Secondary hyperparathyroidism (sHPT is one of the serious complications in chronic kidney disease and is associated with progressive bone disease and vascular calcification.The objective of the study was to determine the impact of Mimpara (Cinacalcet HCl on mineral disorder, bone turnover and bone mineral density (BMD versus parathyroidectomy (PTx in haemodialysis patients’ refractory to alfacalcidol. Materials and methods. 62 haemodialysis patients with sHPT were enrolled in this 6=months prospective study. All of them had surgical indications for PTx. Surgical indications was established according to clinical or biological assessment. 40 patients underwent Mimpara treatment. Dose of Mimpara was titrated every 4 weeks. Sequential doses included 30–180 (mean 59.1 ± 34.2 mg/day. 22 patients underwent PTx. The surgical technique was depended on quantity of hyperplastic parathyroid glands.Results. In 6 months mean iPTH, Ca, Са×Р, CTx and OC levels significantly decreased by 55.7%, 13.8%,34.3%, 21.4 and 1.4% in the Mimpara group vs. 90.7%, 14%, 55.5%, 58.7% and 26.9% in the PTx group. Median serum iPTH level decreased by 30% after initiation of Mimpara in 94.3% patients, from them by 50%in 74.3%. Achieved the KDOQI treatment targets for PTH in 28.6% patients.In 6 months after PTx median serum iPTH level was <100 pg/ml in 50% patients, achieved the KDOQI treatment targets in 27.3%, <300 pg/ml in 18.2%. Median serum 25(ОНD after PTx significantly increase by 127.3% vs 6.72% in the Mimpara group. In 6 months active restoration of BMD was found in the PTx patients, and patients treated with Cinacalcet showed stabilization of BMD.Mimpara therapy led to a reduction in glandular volume during the course of the study: in both glands with a baseline volume <500 mm3 and with a baseline volume ≥500 mm3. Conclusions. PTx and Cinacalcet therapy improves phosphorus=calcium homeostasis, bone turnover, but bone resorption and formation

  19. A 12-year review of Staphylococcus aureus bloodstream infections in haemodialysis patients: more work to be done.

    LENUS (Irish Health Repository)

    Fitzgerald, S F

    2012-02-01

    Staphylococcus aureus bloodstream infections (BSI) are a significant cause of morbidity and mortality in haemodialysis patients. This study describes a 12-year retrospective review of S. aureus BSI in a large haemodialysis centre in a tertiary referral hospital. The overall rate of S. aureus BSI was 17.9 per 100 patient-years (range 9.7-36.8). The rate of meticillin-resistant S. aureus (MRSA) BSI was 5.6 per 100 patient-years (range 0.9-13.8). Infective complications occurred in 11% of episodes, the most common being infective endocarditis (7.6%). Ten percent of patients died within 30 days of S. aureus being isolated from blood. Most cases of S. aureus BSI (83%) were related to vascular catheters. The provision of lower-risk vascular access, such as arteriovenous fistulae, and reduced use of intravascular catheters should be priorities in all haemodialysis units. Where alternative vascular access cannot be established, interventions to reduce the risk of catheter-related infections should be implemented to reduce morbidity and mortality in this vulnerable patient group.

  20. PERSISTENT AND INTERMITTENT HYPERHYDRATION IN PATIENTS ON PROGRAM HAEMODIALYSIS: METHODS OF EVALUATION AND CORRECTION

    Directory of Open Access Journals (Sweden)

    A. G. Strokov

    2015-04-01

    Full Text Available Hyperhydration, the sum of persistent (PH and intermittent (IH ones is the strong predictor of mortality in patients on program haemodialysis (PHD. The aim of this research was to investigate the complex of methods for minimization of PH as well as IH. Materials and methods. The bioimpedance multifrequency analysis (BIA, relative blood volume (RBV monitoring and plasma conductivity evaluation by ionic dialysance device were performed in candidates for kidney transplantation. Results. In 380 PHD patients, comparing with 26 healthy persons the expansion of extracellular volume was only observed even in the cases of the huge (3.5–15 L overload. PH of more than 15% of extracellular volume was observed in 41% of patients. The deviation of hydration status from reference value was 3.7 ± 1.4 L at first measurement and 1.9 ± 1.2 L at last one in every patient. RBV decreased insignificantly (less than 2.5% / L ultrafiltration during PHD sessions in patients with PH. This value increased after dry weight consummation and it appeared as surrogate of intravascular refueling capacity. The minimization of sodium dialysate – plasma gradient resulted in decrease of IH. Conclusion. The elimination of both PH and IH in PHD patients is the paramount goal; it demands the complex approaches and further investigations. 

  1. Relations between diabetes, blood pressure and aortic pulse wave velocity in haemodialysis patients

    DEFF Research Database (Denmark)

    Peters, Christian Daugaard; Kjærgaard, Krista Dybtved; Dzeko, Mirela;

    Diabetes (DM) is common in haemodialysis (HD) patients and affects both blood pressure (BP) and arterial stiffness. Carotid femoral pulse wave velocity (PWV) reflects the stiffness of the aorta and is regarded as a strong risk factor for cardiovascular (CV) mortality in HD patients. However, PWV...... is highly influenced by the BP-level. Higher PWV-values among HD patients with DM could reflect a higher BP-level rather than increased arterial stiffness. The aim of this study was to investigate the effect of DM on BP and PWV in a group of HD patients. BP and PWV were measured in 66 HD patients without DM...... (HD) and 32 HD patients with DM (HD+DM). The SphygmoCor system was used for estimation of PWV. HD-duration, age, gender and BP medication were similar in the two groups. Mean DM-duration was 23±11 years and 25(78%) had type 2 DM. HD+DM had higher BMI (26±5 vs. 29±5 kg/m2, p=0.02), systolic BP (142...

  2. Thyroid hormone levels in patients with chronic renal failure under haemodialysis

    International Nuclear Information System (INIS)

    This study was conducted with three main objectives, to study thyroid hormones (T 4, T 3) and TSH levels in patients with CRF under haemodialysis and to compare them with normal subjects, to study best means of treatment and to compare these findings with results from other parts of the world. This study was done on 61 patients with renal failure in Khartoum dialysis and kidney transplant centre U of K, 45 males and 16 females with ages ranging from 17-75 years and 42 symptoms-free subjects 14 males and 23 females with age ranging from 16-60 years. The radioimmunoassay (RIA) technique was used for the determination of serum T 4, T 3 and TSH. By using t-test found that the mean concentrations of T 4, T 3 of normal subjects were much higher than those of the patients (p0.05). These results also illustrated that 45.9% of patients with renal failure of low T 4, and 91.8%, 90.26 of patients had T 3 and TSH hormone levels in the normal range, respectively. No significant difference was observed in the mean of thyroid hormones (T 4, T3) and thyroid-stimulating hormones between males and females (p>0.05). The T 3 and T '4 concentrations in patients at all age groups (year) was less than the age groups of the control group, and this decrease was statistically significant (p0.05).(Author)

  3. Studies on kinetics of albumin in uraemic patients on chronic haemodialysis: evidence of interstitial albumin wash-down

    DEFF Research Database (Denmark)

    Hildebrandt, P; Jensen, H A; Henriksen, Jens Henrik Sahl

    1983-01-01

    Albumin-kinetic studies were performed in nine uraemic patients without oedema on chronic haemodialysis and in seven normal controls in order to determine microvascular leakiness and thereby, during steady state, lymph drainage of albumin. Transvascular escape rate of albumin [TERalb i.e. the fra...... considered to be in steady state during the measurements, the increased TERalb indicates increased lymph flux of albumin. The interstitial space protein 'wash-down' and increased lymph drainage probably serve as oedema prevention....

  4. Nutritional status influences generic and disease-specific quality of life measures in haemodialysis patients

    Directory of Open Access Journals (Sweden)

    Ana Catarina Moreira

    2013-06-01

    Full Text Available Background: Poor nutritional status and worse health-related quality of life (QoL have been reported in haemodialysis (HD patients. The utilization of generic and disease specific QoL questionnaires in the same population may provide a better understanding of the significance of nutrition in QoL dimensions. Objective: To assess nutritional status by easy to use parameters and to evaluate the potential relationship with QoL measured by generic and disease specific questionnaires. Methods: Nutritional status was assessed by subjective global assessment adapted to renal patients (SGA, body mass index (BMI, nutritional intake and appetite. QoL was assessed by the generic EuroQoL and disease specific Kidney Disease Quality of Life-Short Form (KDQoL-SF questionnaires. Results: The study comprised 130 patients of both genders, mean age 62.7 ± 14.7 years. The prevalence of undernutrition ranged from 3.1% by BMI 25 also had worse scores in some QoL dimensions, but after adjustment the pattern was maintained only in the symptoms and problems dimension of KDQoL-SF (p = 0.011. Conclusion: Our study reveals that even in mildly undernourished HD patients, nutritional status has a significant impact in several QoL dimensions. The questionnaires used provided different, almost complementary perspectives, yet for daily practice EuroQoL is simpler. Assuring a good nutritional status, may positively influence QoL.

  5. Review: anticoagulation for haemodialysis.

    Science.gov (United States)

    Suranyi, Michael; Chow, Josephine S F

    2010-06-01

    The coagulation cascade is complex but well studied. Dialysis membranes and lines are inherently pro-coagulant and activate both the intrinsic and extrinsic pathways of coagulation, as well as platelets and other circulating cellular elements. To provide safe and effective dialysis, appropriate anticoagulant measures must be applied. Haemodialysis, including anticoagulation, is prescribed by dialysis doctors but delivered by dialysis nurses. The main agents used in clinical practice for anticoagulation during haemodialysis are unfractionated heparin (UF heparin) and low-molecular-weight heparin (LMWH). LMWH has a number of potential advantages, apart from cost. One of the most serious complications of the use of any form of heparin is heparin-induced thrombocytopaenia (HIT) Type II, which occurs more commonly with UF heparin than LMWH. HIT Type II risks severe morbidity and mortality and is challenging to treat successfully in both the acute and chronic phase. In HIT Type II anticoagulation must be delivered without heparin. A wide array of newer anticoagulants are becoming progressively available, each with unique advantages and disadvantages. In maintenance haemodialysis patients with an increased risk of bleeding, a 'no heparin' dialysis may be undertaken, or regional anticoagulation considered. Because this aspect of dialysis is so important to the safe and effective delivery of haemodialysis therapy, dialysis clinicians need to review and update their knowledge of dialysis anticoagulation on a regular basis. PMID:20609088

  6. Hepatitis B and C infection in haemodialysis patients in Libya: prevalence, incidence and risk factors

    Directory of Open Access Journals (Sweden)

    Alashek Wiam A

    2012-10-01

    Full Text Available Abstract Background Patients receiving maintenance haemodialysis (HD are at higher risk for acquiring Hepatitis B Virus (HBV and Hepatitis C Virus (HCV infections than the general population. Strict infection control measures are essential to prevent nosocomial transmission. We aimed to investigate the incidence and prevalence of HBV and HCV infection in the HD population of Libya as well as risk factors for infection. Methods All adult patients receiving maintenance HD (n=2382 in Libyan dialysis centres (n=39 were studied between May 2009 and October 2010. Testing for Hepatitis B surface antigen (HBsAg and anti-HCV antibodies was performed at initiation of dialysis and every 3–6 months thereafter. Patients who were sero-negative for HBV and HCV (n=1160 were followed up for 1 year to detect sero-conversions. Results Participant median age was 49 years and 58% were male. 831 patients (34.9% were sero-positive for HBV and/or HCV (anti-HCV positive 31.1%; HBsAg positive 2.6%; both positive 1.2%. Of the sero-positive patients 4.7% were known to be infected before the initiation of HD. The prevalence of HBV±HCV infection varied widely between HD centres from 0% to 75.9%. Sero-positive patients were younger, had longer time on dialysis and more previous blood transfusions. Prospective follow-up revealed an incidence of sero-conversion of 7.7% during 1 year (7.1% HCV; 0.6% HBV. Wide variation in rates of newly acquired infections was observed between dialysis centres. All new HBV cases were referred from centres already treating HBV infected patients. New HCV infections were reported in most centres but the rate of HCV sero-conversion varied widely from 1.5% to 31%. Duration of dialysis, history of previous renal transplant and history of receiving HD in another centre in Libya were significantly associated with sero-conversion. Conclusion Patients on maintenance HD in Libya have a high incidence and prevalence of HCV infection and lower rates of

  7. Simultaneous bilateral quadriceps tendon rupture in a patient on chronic haemodialysis. (Short-term results of treatment with transpatellar sutures augmented with a quadriceps tendon flap).

    Science.gov (United States)

    Kayali, Cemil; Agus, Haluk; Turgut, Ali; Taskiran, Can

    2008-01-01

    Quadriceps tendon ruptures are rare orthopaedic injuries. Although they are generally seen after the age of 50, they may occur in younger patients with certain underlying conditions, including chronic haemodialysis. Several repair techniques have been proposed but the choice of the best method is still a matter of controversy. This paper presents the case of a renal failure patient with 10 years' history of haemodialysis treatment suffering from bilateral quadriceps tendon rupture. The treatment was with transpatellar sutures augmented with a reverse quadriceps tendon flap. His short-term clinical and radiological results are satisfactory.

  8. Validation of The Fluid Intake Appraisal Inventory; a self-efficacy scale for managing fluid allowance among patients on haemodialysis in Denmark

    DEFF Research Database (Denmark)

    Pahus, Jytte; Ludvigsen, Mette Spliid; Lindberg, Magnus

    2015-01-01

    Background Many haemodialysis patients have problems limiting their fluid intake, and this might be influenced by their self-efficacy (SE). Thus interventions to improve patients’ SE might lead to an improvement in their managing of fluid allowance. The Fluid Intake Appraisal Inventory (FIAI...

  9. Trimestral variations of C-reactive protein, interleukin-6 and tumour necrosis factor-alpha are similarly associated with survival in haemodialysis patients

    NARCIS (Netherlands)

    C.L. Meuwese; S. Snaedal; N. Halbesma; P. Stenvinkel; F.W. Dekker; A.R. Qureshi; P. Barany; O. Heimburger; B. Lindholm; R.T. Krediet; E.W. Boeschoten; J.J. Carrero

    2011-01-01

    Background. The impact of intra-individual changes of inflammatory markers [other than C-reactive protein (CRP)] on mortality in haemodialysis (HD) patients is unknown. We therefore studied survival in relation to trimestral variations of CRP, interleukin-6 (IL-6) and tumour necrosis factor-alpha (T

  10. Prognostic significance of stress myocardial ECG-gated perfusion imaging in asymptomatic patients with diabetic chronic kidney disease on initiation of haemodialysis

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Mitsuru; Kondo, Chisato; Kobayashi, Hideki; Kusakabe, Kiyoko [Tokyo Women' s Medical University, School of Medicine, Department of Radiology, Shinjuku-ku, Tokyo (Japan); Babazono, Tetsuya [Tokyo Women' s Medical University, School of Medicine, Diabetes Centre, Shinjuku-ku, Tokyo (Japan); Nakajima, Takatomo [Tokyo Women' s Medical University, School of Medicine, Department of Cardiology, Shinjuku-ku, Tokyo (Japan)

    2009-08-15

    Diabetic patients with chronic kidney disease (CKD) frequently develop cardiac events within several years of the initiation of haemodialysis. The present study assesses the prognostic significance of stress myocardial ECG-gated perfusion imaging (MPI) in patients with diabetic CKD requiring haemodialysis. Fifty-five asymptomatic patients with diabetic stage V CKD and no history of heart disease scheduled to start haemodialysis were enrolled in this study (56{+-}11 years old; 49 with type 2 diabetes mellitus). All patients underwent {sup 201}Tl stress ECG-gated MPI 1 month before or after the initiation of haemodialysis to assess myocardial involvement. We evaluated SPECT images using 17-segment defect scores graded on a 5-point scale, summed stress score (SSS) and summed difference scores (SDS). The patients were followed up for at least 2 years (42{+-}15 months) to determine coronary intervention (CI) and heart failure (HF) as soft events and acute myocardial infarction (AMI) and all causes of deaths as hard events. The frequencies of myocardial ischaemia, resting perfusion defects, low ejection fraction and left ventricular (LV) dilatation were 24,20,29 and 49%, respectively. Ten events (18%) developed during the follow-up period including four CI, one HF, one AMI and four sudden deaths. Multivariate Cox analysis selected SDS (p=0.0011) and haemoglobin A{sub 1c} (HbA{sub 1c}) (p=0.0076) as independent prognostic indicators for all events. Myocardial ischaemia, in addition to glycaemic control, is a strong prognostic marker for asymptomatic patients with diabetic CKD who are scheduled to start haemodialysis. Stress MPI is highly recommended for the management and therapeutic stratification of such patients. (orig.)

  11. Quality of life, mental health and health beliefs in haemodialysis and peritoneal dialysis patients: Investigating differences in early and later years of current treatment

    OpenAIRE

    Ginieri-Coccossis, M; Theofilou, P; Synodinou, C; Tomaras, V; Soldatos, C

    2008-01-01

    Background The study examines differences regarding quality of life (QoL), mental health and illness beliefs between in-centre haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD/PD) patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment. Methods 144 End-Stage Renal Disease (ESRD) patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Patients con...

  12. Improving compliance with iron infusion therapy in the treatment of chronic anemia in haemodialysis patients with chronic kidney disease

    OpenAIRE

    Nuti, Amith

    2015-01-01

    This quality improvement project was conducted at the haemodialysis unit in the paediatric nephrology department at Noah's Ark Children's Hospital, Cardiff. Stakeholders involved were the medical and nursing staff at the haemodialysis unit, responsible for the care of children with chronic kidney disease CKD. Anaemia is prevalent among children with CKD. Iron infusion is administered to such children with chronic anaemia. Children on haemodialysis attending the Children's Kidney Center receiv...

  13. Effective elimination of dabigatran by haemodialysis. A phase I single-centre study in patients with end-stage renal disease.

    Science.gov (United States)

    Khadzhynov, Dmytro; Wagner, Frank; Formella, Stephan; Wiegert, Erol; Moschetti, Viktoria; Slowinski, Torsten; Neumayer, Hans-H; Liesenfeld, Karl-Heinz; Lehr, Thorsten; Härtter, Sebastian; Friedman, Jeffrey; Peters, Harm; Clemens, Andreas

    2013-04-01

    Dabigatran, a specific, reversible direct thrombin inhibitor, is used to prevent ischaemic and haemorrhagic strokes in patients with atrial fibrillation. As with every anticoagulant, there is a need to rapidly reverse its effects in emergency situations. In an open-label, single-centre phase I study with two fixed multiple dosing periods, we investigated the pharmacokinetics, pharmacodynamics and safety of dabigatran before, during and after 4 hour haemodialysis sessions with either 200 or 400 ml/min targeted blood flow in seven end-stage renal disease patients without atrial fibrillation. Dabigatran was administered over three days in a regimen designed to achieve peak plasma concentrations comparable to those observed in atrial fibrillation patients receiving 150 mg b.i.d. and to attain adequate distribution of dabigatran in the central and peripheral compartments. Plasma concentration-time profiles were similar in both periods on Day 3 (Cmax: 176 and 159 ng/ml). Four hours of haemodialysis removed 48.8% and 59.3% of total dabigatran from the central compartment with 200 and 400 ml/minute targeted blood flow, respectively. The anticoagulant activity of dabigatran was linearly related to its plasma levels. There was a minor redistribution of dabigatran (anticoagulant activity. There was a clinically negligible redistribution of dabigatran after haemodialysis. These results demonstrate that haemodialysis can be a suitable approach to eliminate dabigatran in emergency situations. PMID:23389759

  14. Clearance of glucoregulatory peptide hormones during haemodialysis and haemodiafiltration in non-diabetic end-stage renal disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Morten B; Idorn, Thomas; Knop, Filip K;

    2015-01-01

    BACKGROUND: Patients with end-stage renal disease (ESRD) have increased fasting concentrations and disturbed postprandial responses of several glucoregulatory hormones. We aimed to evaluate the impact of high-flux haemodialysis (HD) and high-volume haemodiafiltration (HDF) on fasting...... and postprandial plasma levels of glucoregulatory pancreatic and gut peptide hormones in ESRD patients. METHODS: Ten non-diabetic HD-treated ESRD patients were included to undergo a 3-h standardized liquid mixed meal test 1 h into an HD and an HDF, respectively. On a third, optional, examination day, the meal test...... during HDF and four completed the optional meal test without dialysis. All plasma hormone concentrations declined significantly during the first fasting hour of dialysis with no differences between HD and HDF. Significant clearance of the investigated hormones was observed for both dialysis modalities...

  15. Quality of life, mental health and health beliefs in haemodialysis and peritoneal dialysis patients: Investigating differences in early and later years of current treatment

    OpenAIRE

    Tomaras V; Synodinou C; Theofilou P; Ginieri-Coccossis M; Soldatos C

    2008-01-01

    Abstract Background The study examines differences regarding quality of life (QoL), mental health and illness beliefs between in-centre haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD/PD) patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment. Methods 144 End-Stage Renal Disease (ESRD) patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Pat...

  16. A Comparative Study of Lipid Profile and Cardiovascular Risk Biomarkers Among Chronic Haemodialysis Patients and Healthy Individuals

    Science.gov (United States)

    Kadavanu, Tony Mathew; Green, Siva Ranganathan; Dutta, Tarun Kumar; Hemachandar, Radhakrishnan; Ramachandrappa, Arun Kumar; Tiwari, Shashank Rakesh; Govindasamy, Ezhumalai

    2016-01-01

    Introduction Lipid abnormalities and increase in inflammatory markers are common among patients with End Stage Renal Disease (ESRD) and it tends to persist/worsen even after initiating Intermittent Haemodialysis (IHD). The cardiovascular mortality and morbidity remains significantly high in this population. Aim The present study was carried out to assess the pattern of lipid abnormality in our population and to find its association with inflammatory markers. Materials and Methods It was a cross-sectional, observational study on ESRD patients undergoing Haemodialysis (HD) in comparison with age and sex matched healthy individuals in a tertiary care hospital. About 40 adult male and female patients aged >18 years, undergoing chronic HD for more than 6 months were enrolled in Group A. Patients who were alcoholics, tobacco consumers and those on steroids and hypolipidemic drugs were excluded. Group B consisted of healthy, age and sex matched controls. Serum lipid profile, lipoprotein A, apolipoprotein A1, apolipoprotein B and apo B/A1 ratio, serum uric acid, homocysteine, hs-CRP and testosterone levels were estimated among patients undergoing intermittent HD and healthy individuals. Chi-square/Fisher’s-exact test was used for comparing ratios. A p-value of <0.05 was considered statistically significant. Results The mean Total Cholesterol (TC), Low Density Lipoprotein (LDL) and Non-HDL High Density Lipoprotein cholesterol was significantly lower in HD patients as compared to control group with all the three parameters attaining statistical significance (p<0.005). The mean lipoprotein A level was significantly higher (p=0.037), while Apo A1 was found to be significantly lower (p=0.001) in patients receiving HD. Inflammatory markers like uric acid was high (p<0.005) and serum testotsterone level in male HD patient was significantly low (p<0.005). Conclusion The mean values of traditional serum lipid profile remained lower in HD patients than the control group. The

  17. Bone histoquantitative findings and histochemical staining reactions for aluminium in chronic renal failure patients treated with haemodialysis fluids containing high and low concentrations of aluminium.

    OpenAIRE

    McClure, J; Fazzalari, N L; Fassett, R G; Pugsley, D. J.

    1983-01-01

    A total of 112 undecalcified bone biopsies from 67 patients under treatment for chronic renal failure by maintenance haemodialysis was available for retrospective study. The patients were divided into three groups. Group I (15 cases) had been dialysed for the majority of the time in their own homes with a fluid containing a low concentration of aluminium. Group II (28 cases) had been dialysed exclusively in hospital (prior to 1978) with a fluid containing a high concentration of aluminium and...

  18. Evaluation of the quality of care of a haemodialysis public-private partnership programme for patients with end-stage renal disease

    OpenAIRE

    Julie Y Chen; Wan, Eric Y. F.; Chan, Karina H. Y.; Anca K C Chan; Chan, Frank W.K.; Lam, Cindy L. K.

    2016-01-01

    Background Haemodialysis (HD) is one of the life-saving options for patients with end stage renal disease but demand for this treatment exceeds capacity in publicly funded hospitals. One novel approach to addressing this problem is through a shared-care model whereby government hospitals partner with qualified private HD service providers to increase the accessibility of HD for needy patients. The aim of this study is to evaluate and enhance the quality of care (QOC) provided in such a shared...

  19. Poor value of surveillance cultures for prediction of septicaemia caused by coagulase-negative staphylococci in patients undergoing haemodialysis with central venous catheters

    DEFF Research Database (Denmark)

    Nielsen, J; Kolmos, H J; Rosdahl, V T

    1998-01-01

    Surveillance cultures for the demonstration of coagulase-negative staphylococci in patients on catheter haemodialysis were performed in an attempt to predict dialysis catheter-related septicaemia. In all, 43 patients with 67 haemodialysis catheters were followed for a 1-y period. Once a week, swab...... specimens were obtained from the skin at the insertion site and the hub, and blood cultures were obtained from the catheter. Among coagulase-negative staphylococci, S. epidermidis was the most frequently (80%) isolated species, and two biotypes accounted for 55.7% of the 41 biotypes isolated. 11 septicaemia...... cases due to coagulase-negative staphylococci occurred, all caused by S. epidermidis, and the incidence of S. epidermidis septicaemia was 21% among patients and 16% among catheter periods. S. epidermidis septicaemia occurred in 17%, 31% and 33% of all catheter periods in which S. epidermidis...

  20. Long-term haemodialysis survival

    DEFF Research Database (Denmark)

    Heaf, James; Nielsen, Arne Høj; Hansen, Henrik Post

    2012-01-01

    Haemodialysis (HD) treatment for end-stage renal disease bears a poor prognosis. We present a case of a patient who, apart from two transplant periods lasting 8 months in all, was treated with conventional in-centre HD three times a week and who survived for 41 years. Patients should be aware...... that there is no theoretical upper limit for patient survival on HD....

  1. Simultaneous bilateral quadriceps tendon rupture in a patient with hyperparathyroidism undergoing long-term haemodialysis: a case report and literature review.

    Science.gov (United States)

    Gao, Mao-Feng; Yang, Hui-Lin; Shi, Wei-Dong

    2013-08-01

    Simultaneous bilateral quadriceps tendon rupture is a rare injury that represents quadriceps tendon ruptures. It is generally associated with chronic metabolic disorders and is seen in patients with uraemia undergoing maintenance haemodialysis. The present case was a 46-year-old man who presented with pain and the inability to extend his knees following a minor accident. A physical examination combined with X-radiography and magnetic resonance imaging investigations resulted in a diagnosis of bilateral quadriceps tendon rupture. He had a history of uraemia and had received regular haemodialysis for 7 years. He had high levels of serum parathyroid hormone and he was diagnosed with secondary hyperparathyroidism. Following surgical repair of both quadriceps tendons, in addition to management of the secondary hyperparathyroidism, the patient regained full active mobility of both knee joints and was able to participate in normal activities of daily living.

  2. Speckle tracking determination of mitral tissue annular displacement: comparison with strain and ejection fraction, and association with outcomes in haemodialysis patients.

    Science.gov (United States)

    Chiu, Diana Y Y; Abidin, Nik; Hughes, John; Sinha, Smeeta; Kalra, Philip A; Green, Darren

    2016-10-01

    Abnormal Global longitudinal strain (GLS) and reduced left ventricular ejection fraction (LVEF) are established poor prognostic risk factors in haemodialysis patients. Tissue motion annular displacement of mitral valve annulus (TMAD), determined by speckle tracking echocardiography (STE), can be performed rapidly and is an indicator of systolic dysfunction, but has been less well explored. This study aims to compare TMAD with GLS and LVEF and its association with outcomes in haemodialysis patients. 198 haemodialysis patients (median age 64.2 years, 69 % men) had 2D echocardiography, with STE determined GLS and TMAD. Bland-Altman analysis and linear regression assessed relationship between GLS, LVEF and TMAD. Cox regression analysis investigated association of TMAD with mortality and cardiac events. TMAD had low inter- and intra-observer variability with small biases and narrow limits of agreement (LOA) (bias of -0.01 ± 1.32 (95 % LOA was -2.60 to 2.58) and -0.07 ± 1.27 (95 % LOA -2.55 to 2.41) respectively). There was a moderate negative correlation between GLS and LVEF (r = -0.383, p events (HR 0.91, 95 % CI 0.80-1.02). TMAD is a quick and reproducible alternative to GLS which may be very useful in cardiovascular risk assessment, but does not have the same prognostic value in HD patients as GLS.

  3. Impact of hydration status on body composition as measured by dual energy X-ray absorptiometry in normal volunteers and patients on haemodialysis

    International Nuclear Information System (INIS)

    To evaluate the influence of hydration status on the estimation of body composition using dual-energy X-ray absorptiometry (DXA), six normal volunteers and seven patients on maintenance haemodialysis were investigated using two different DXA machines (Lunar DPX, Hologic QDR 1000/W). Normal volunteers were studied (Hologic QDR 1000/W) before and 1 h after ingestion of breakfast, lunch and dinner (drinking various amounts of liquids at each meal, 0.5-2.4 kg). Whereas bone mineral content and body fat mass did not change, lean body mass of the trunk increased as a consequence of the meals. Conversely in patients on haemodialysis (Lunar DPX), lean body mass decreased in all segments of the body as a consequence of removal of 0.9-4.4 kg of salt-containing fluid by haemodialysis (trunk 61%, legs 30%, arms 5.5% and rest of the body 3.5%), whereas bone mineral content and body fat mass remained unchanged. (author)

  4. Haemodialysis decreases finger pressures independent of artificial kidney blood flow.

    NARCIS (Netherlands)

    Hoek, F. van; Scheltinga, M.R.M.; Houterman, S.; Beerenhout, C.H.

    2010-01-01

    BACKGROUND: During haemodialysis, some patients experience intensification of symptoms of haemodialysis access-induced distal ischaemia. Aim of this study is to compare the effects of two different regimens of arterial blood flow in patients with an arteriovenous access. METHODS: A questionnaire ide

  5. Combining intra-dialytic exercise and nutritional supplementation in malnourished older haemodialysis patients: Towards better quality of life and autonomy.

    Science.gov (United States)

    Hristea, Dan; Deschamps, Thibault; Paris, Anne; Lefrançois, Gaëlle; Collet, Valérie; Savoiu, Corneliu; Ozenne, Sophie; Coupel, Stéphanie; Testa, Angelo; Magnard, Justine

    2016-09-01

    Protein-energy wasting (PEW), defined as a loss of body protein mass and fuel reserves, is a powerful predictor of adverse outcomes in haemodialysis (HD) patients. Robust arguments suggest that intra-dialytic exercise, combined with oral/parenteral nutrition, enhances the effect of nutritional interventions in HD patients. This pilot randomized controlled trial investigated the feasibility and the effects of a 6 month intra-dialytic cycling program combined to a nutritional support on PEW, physical functioning (gait, balance, muscle strength) and quality of life (QoL) in older HD patients (mean age 69.7 ± 14.2 years).Twenty-one patients fulfilling diagnostic criteria of PEW were randomly assigned to Nutrition-Exercise group (GN-Ex , n = 10) or Nutrition group (GN , n = 11). Both groups received nutritional supplements in order to reach recommended protein and energy intake goals. In addition GN-Ex completed a cycling program. No significant difference between groups was found in the number of patients having reached remission of PEW. Likewise, no change was observed in serum-albumin, -prealbumin, C-reactive protein, body mass index, lean- and fat-tissue index, or quadriceps force. Interestingly, we found positive effects of exercise on physical function and QoL for the GN-Ex , as evidenced by a significant improvement in the 6-min walk test (+22%), the absence of decline in balance (unlike the GN ), and a noteworthy increase in QoL (+53%). Combining intra-dialytic exercise and nutrition in HD patients is feasible, and well accepted, improves physical function and QoL but it appears not to have the potential to reverse PEW. PMID:26890997

  6. Association between long-term efficacy of cinacalcet and parathyroid gland volume in haemodialysis patients with secondary hyperparathyroidism.

    Science.gov (United States)

    Tanaka, Motoko; Nakanishi, Shohei; Komaba, Hirotaka; Itoh, Kazuko; Matsushita, Kazutaka; Fukagawa, Masafumi

    2008-08-01

    Purpose. Secondary hyperparathyroidism with nodular hyperplasia is resistant to medical therapies. Cinacalcet is an effective treatment for severe secondary hyperparathyroidism. This multicentre retrospective study was designed to determine the long-term efficacy of cinacalcet in patients with nodular hyperplasia, the advanced type of parathyroid hyperplasia. Subjects and methods. The study subjects were 20 haemodialysis patients with secondary hyperparathyroidism. Patients with ultrasonographically confirmed large parathyroid glands (volume >0.5 cm(3)) were considered to have nodular hyperplasia (n = 8). Cinacalcet was started at the dose of 25 mg/day and titrated up to 100 mg/day to achieve the target intact-parathyroid hormone (iPTH) level of <250 pg/ml. Serum iPTH, corrected calcium, serum phosphorus, calcium × phosphorus product were measured and compared over the 48-week period of treatment with cinacalcet in all 20 patients and over 120 weeks in 6 of the patients (2 with nodular hyperplasia and 4 with non-nodular hyperplasia). We also examined the achievement rate of K/DOQI guideline treatment targets. The dosages of vitamin D preparation, sevelamer hydrochloride and calcium- containing phosphate binder were adjusted for the above target values. Results. iPTH levels were significantly lower at 48 weeks in both groups. However, corrected calcium levels, serum phosphorus levels and calcium phosphorus products were within the target values in the non-nodular hyperplasia group (n = 12), while the target value could not be achieved in the nodular hyperplasia group. In the long-term follow-up group, the levels of iPTH, corrected calcium, serum phosphorus and calcium × phosphorus products were significantly higher in nodular hyperplasia than in non-nodular hyperplasia. Conclusion. Our study suggests that cinacalcet lacks long-term efficacy in nodular hyperplasia, especially for controlling serum calcium and phosphorus levels.

  7. Quality of life, mental health and health beliefs in haemodialysis and peritoneal dialysis patients: Investigating differences in early and later years of current treatment

    Directory of Open Access Journals (Sweden)

    Tomaras V

    2008-11-01

    Full Text Available Abstract Background The study examines differences regarding quality of life (QoL, mental health and illness beliefs between in-centre haemodialysis (HD and continuous ambulatory peritoneal dialysis (CAPD/PD patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment. Methods 144 End-Stage Renal Disease (ESRD patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Patients consisted of: a 77 in-centre haemodialysis (HD and 58 continuous ambulatory peritoneal dialysis (CAPD/PD patients, all currently being treated by dialysis for varied length of time. Patients were compared for differences after being grouped into those who recently commenced treatment ( 4 years. Next, cases were selected as to form two equivalent groups of HD and CAPD/PD patients in terms of length of treatment and sociodemographic variables. The groups consisted of: a 41 in-centre haemodialysis (HD and b 48 continuous ambulatory peritoneal dialysis (CAPD/PD patients, fitting the selection criteria of recent commencement of treatment and similar sociodemographic characteristics. Patient-reported assessments included: WHOQOL-BREF, GHQ-28 and the MHLC, which is a health locus of control inventory. Results Differences in mean scores were mainly observed in the HD patients with > 4 years of treatment, providing lower mean scores in the QoL domains of physical health, social relationships and environment, as well as in overall mental health. Differences in CAPD/PD groups, between those in early and those in later years of treatment, were not found to be large and significant. Concerning the analysis on equivalent groups derived from selection of cases, HD patients indicated significantly lower mean scores in the QoL domain of environment and higher scores in the GHQ-28 subscales of anxiety/insomnia and severe depression, indicating more symptoms in these areas

  8. Effect of Counseling on Health Related Quality of Life on Haemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Ramakrishanan Sivakumar

    2012-09-01

    Full Text Available End stage renal disease affects two million patients worldwide. Health related quality of life (HRQoL has recently become a major indicator of health and well-being of patients with kidney disease. The present goal for the treatment of patients with ESRD is not simply to prolong life, but also to provide a better HRQoL. This goal can be achieved through patient counseling. A simple prospective study was used to examine the effect of patient counseling on HRQoL of hemodialysis patients. In the study, a Short Form-36 (SF-36 questionnaire and clinical parameters were used for 52 hemodialysis patients to assess the HRQoL before and after patient counseling. All the Patients were kept under observation for a period of three months to study the effect of patient counseling. After three months period of counseling a significant (p<0.05 improvement was observed for hemodialysis patients. Also HRQoL score was higher for hemodialysis patients after counseling. This study concluded that knowledge of the disease and its management through patient counseling could improve the HRQoL of hemodialysis patients.

  9. Thrombin-anti-thrombin levels and patency of arterio-venous fistula in patients undergoing haemodialysis compared to healthy volunteers: a prospective analysis.

    Directory of Open Access Journals (Sweden)

    James A Milburn

    Full Text Available BACKGROUND: Patients on haemodialysis (HD are at an increased risk of sustaining thrombotic events especially to their vascular access which is essential for maintenance of HD. OBJECTIVES: To assess whether 1 markers of coagulation, fibrinolysis or endothelial activation are increased in patients on HD compared to controls and 2 if measurement of any of these factors could help to identify patients at increased risk of arteriovenous (AVF access occlusion. PATIENTS/METHODS: Venous blood samples were taken from 70 patients immediately before a session of HD and from 78 resting healthy volunteers. Thrombin-antithrombin (TAT, D-dimer, von Willebrand factor (vWF, plasminogen activator inhibitor-1 antigen (PAI-1 and soluble p-selectin were measured by ELISA. C-reactive protein (hsCRP was measured by an immunonephelometric kinetic assay. Determination of the patency of the AVF was based upon international standards and was prospectively followed up for a minimum of four years or until the AVF was non-functioning. RESULTS: A total of 70 patients were studied with a median follow-up of 740 days (range 72-1788 days. TAT, D-dimer, vWF, p-selectin and hsCRP were elevated in patients on HD compared with controls. At one year follow-up, primary patency was 66% (46 patients. In multivariate analysis TAT was inversely associated with primary assisted patency (r = -0.250, p = 0.044 and secondary patency (r = -0.267, p= 0.031. CONCLUSIONS: The novel finding of this study is that in patients on haemodialysis, TAT levels were increased and inversely correlated with primary assisted patency and secondary patency. Further evaluation is required into the possible role of TAT as a biomarker of AVF occlusion.

  10. STUDY OF LIPID PROFILE IN CHRONIC RENAL FAILURE PATIENTS UNDERGOING HAEMODIALYSIS: A HOSPITAL BASED STUDY

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    Sreenivasulu

    2015-11-01

    Full Text Available INTRODUCTION: Chronic renal failure (CRF is decrease in glomerular filtration rate (GFR to 3 consecut ive months with multiple etiologies. CRF results in profound lipid disorder which stems largely from dysregulation of high density lipoproteins (HDL & triglyceride - rich lipoprotein metabolism. Many a time CRF patients live on hemodialysis on regular basis . Present study was done to know whether hemodialysis has any impact on the lipid profile of the CRF patients. MATERIALS AND METHODS: Study were divided into 7 groups, Group - 1: healthy controls (40, Group - 2: CRF patients who never undergone hemodialysis (40, Group - 3: CRF patients on hemodialysis (40, Group - 4: Healthy males (28, Group - 5: Healthy females (12, Group - 6: males with chronic renal failure (28, Group - 7: females with chronic renal failure (12. Sample analysed for high density lipoproteins (H DL, low density lipoproteins (LDL & very low density lipoproteins (VLDL. RESULTS: Among the various parameters tested triglyceride and VLDL levels were significantly higher in group - 2 and3 as compared to controls (p<0.0001. HDL levels were significant ly lower in group - 2 compared to Group - 1(p <0.0001. HDL level was found reduced in group - 3 as compare to Group - 2(p=0.0035. There was no significant change (p=0.132 observed in total cholesterol between healthy controls and CRF patients with hemodialysis. There is a significant change (p=0.0309 observed in LDL - c between CRF patients and controls and no significant change observed (P=0.6070 between Group - 2 and Group - 3. CONCLUSION: CRF patients are at risk of cardiovascular diseases due to the elevation of various forms of lipids. Prescribing lipid lowering treatment in CRF patients with dyslipidemias for preventing future episode of cardiovascular events and will a lso preserve renal function.

  11. Treatment of secondary hyperparathyroidism in haemodialysis patients: a randomised clinical trial comparing paricalcitol and alfacalcidol

    DEFF Research Database (Denmark)

    Hansen, Ditte; Brandi, Lisbet; Rasmussen, Knud

    2009-01-01

    BACKGROUND: Secondary hyperparathyroidism is a common feature in patients with chronic kidney disease. Its serious clinical consequences include renal osteodystrophy, calcific uremic arteriolopathy, and vascular calcifications that increase morbidity and mortality.Reduced synthesis of active vita...... in the risk of cardiovascular mortality depending on which vitamin D analog that are used. This has potential major importance for this group of patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT00469599.......BACKGROUND: Secondary hyperparathyroidism is a common feature in patients with chronic kidney disease. Its serious clinical consequences include renal osteodystrophy, calcific uremic arteriolopathy, and vascular calcifications that increase morbidity and mortality.Reduced synthesis of active......, may be less prone to induce hypercalcemia and hyperphosphatemia.However, a randomised controlled clinical study comparing alfacalcidol and paricalcitol has never been performed.The primary objective of this study is to compare alfacalcidol and paricalcitol. We evaluate the suppression of the secondary...

  12. Prevalence of occult hepatitis B virus infection in haemodialysis patients from central Greece

    Institute of Scientific and Technical Information of China (English)

    Paraskevi; Mina; Sarah; P; Georgiadou; Christos; Rizos; George; N; Dalekos; Eirini; I; Rigopoulou

    2010-01-01

    AIM:To assess the hepatitis B virus(HBV)-DNA and the prevalence of occult HBV infection in end-stage renal failure(ESRF)patients from Central Greece. METHODS:Sera from 366 ESRF patients attending five out of six dialysis units from Central Greece were investigated for HBV-DNA by real-time polymerase chain reaction.Only serum samples with repeatedly detectable HBV-DNA were considered positive.IgG antibodies to hepatitis C virus(anti-HCV)were tested by a third generation enzyme linked immunosorbent assay(ELIS...

  13. Cerebral metabolic changes in neurologically presymptomatic patients undergoing haemodialysis: in vivo proton MR spectroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Chiu, Ming-Lun; Chiang, I. Chan [Kaohsiung Medical University Hospital, Department of Medical Imaging (China); Li, Chun-Wei [Kaohsiung Medical University, Department of Medical Imaging and Radiological Sciences, College of Health Science (China); Chang, Jer-Ming [Kaohsiung Medical University, Department of Internal Medicine, Kaohsiung Hsiao-Kang Municipal Hospital (China); Kaohsiung Medical University, Department of Nephrology, School of Medicine, College of Medicine (China); Ko, Chih-Hung [Kaohsiung Medical University, Department of Psychiatry, School of Medicine, College of Medicine (China); Kaohsiung Medical University Hospital, Department of Psychiatry (China); Chuang, Hung-Yi [Kaohsiung Medical University, Faculty of Public Health, College of Health Science (China); Kaohsiung Medical University Hospital, Department of Environmental and Occupational Medicine (China); Sheu, Reu-Sheng [Kaohsiung Medical University, Department of Radiology, Kaohsiung Municipal Hsiao-Kang Hospital (China); Kaohsiung Medical University, Department of Radiology, Faculty of Medicine, College of Medicine (China); Lee, Chen-Chang [Kaohsiung Medical University, Department of Medical Imaging and Radiological Sciences, College of Health Science (China); Kaohsiung Medical Centre, Department of Radiology, Chang Gung Memorial Hospital (China); Hsieh, Tsyh-Jyi [Kaohsiung Medical University Hospital, Department of Medical Imaging (China); Kaohsiung Medical University, Department of Radiology, Faculty of Medicine, College of Medicine (China); Kaohsiung Municipal Ta-Tung Hospital, Department of Medical Imaging (China)

    2010-06-15

    To prospectively investigate and detect early cerebral metabolic changes in patients with end-stage renal disease (ESRD) by using in vivo proton MR spectroscopy (MRS). We enrolled 32 patients with ESRD and 32 healthy controls between the ages of 26 and 50 years. Short echo time single-voxel proton MRS was acquired from volumes of interest (VOIs) located in the frontal grey and white matter, temporal white matter and basal ganglia. The choline/phospatidylcholine (Cho), myo-inositol (mI), N-acetylaspartate (NAA) and total creatine (tCr) peaks were measured and the metabolic ratios with respect to tCr were calculated. In the ESRD group, significant elevations of the Cho/tCr and mI/tCr ratios were observed for the frontal grey matter, frontal white matter, temporal white matter and basal ganglia as compared with controls. There was no significant difference in the NAA/tCr ratios at all VOIs between the ESRD patients and the healthy controls. Proton MRS is a useful and non-invasive imaging tool for the detection of early cerebral metabolic changes in neurologically presymptomatic ESRD patients. (orig.)

  14. Anticoagulation in patients with impaired renal function and with haemodialysis. Anticoagulant effects, efficacy, safety, therapeutic options.

    Science.gov (United States)

    Harenberg, J; Hentschel, V A-T; Du, S; Zolfaghari, S; Krämer, R; Weiss, C; Krämer, B K; Wehling, M

    2015-01-01

    Patients with impaired renal function are exposed to an increased risk for bleeding complications depending on the amount of the anticoagulant eliminated by the kidneys. The elimination of unfractionated heparins, vitamin K antagonists and argatroban is only minimally influenced by a reduced renal function. Low-molecular weight heparins, fondaparinux, danaparoid, hirudins and non-vitamin K antagonist oral anticoagulants (NOAC) cause a variably increased bleeding risk in renal impairment. Dose reductions are recommended for all of these anticoagulants in renal impairment, some are even contraindicated at certain levels of renal impairment. Their benefit over the conventional anticoagulants is preserved if renal dosing is employed. For end-stage renal disease patients specific treatment regimens are required. PMID:25405246

  15. How do Patients who are Known to the Renal Units Start Chronic Haemodialysis?

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    Muhammad N RAZA

    2011-09-01

    Full Text Available INTRODUCTION: A significant number of known ESRD patients start dialysis as an emergency. Key factors that determine emergency dialysis initiation have not been well identified. MATERIAL and METHODS: Ninety out of 159 patients studied were known for> 6 months and divided into Emergency dialysis (EmG n=46 and Elective dialysis (EG n=44 groups. RESULTS: Most diabetic patients started dialysis as an emergency (75% vs. 25% p=0.008. At the start, EmG had higher median urea (3.5 vs. 3.8 g/dl p=0.05, a lower bicarbonate (19 vs. 21.5 mEq/L, p=0.04 and haemoglobin (9.4 vs10.5 g/dl p=0.005. Three months pre-dialysis, EmG had a lower serum albumin (3.2 vs. 3.6 g/L, p=0.001 and haemoglobin (10.4 vs. 11, p=0.06, a higher CRP (21 vs. 5, p=0.08 and better preserved eGFR (11 vs. 9, p=0.001. In multivariate analysis, only a diagnosis of diabetes and a CRP >30 were independent risk factors for starting dialysis as an emergency. Having an albumin >3.5 was associated with a reduced risk of having an emergency start to dialysis. CONCLUSION: Apart from having diabetes, it seems difficult to predict emergency start of dialysis in known ESRD patients. Randomised controlled studies can further identify importance of high CRP and low serum albumin in relation to emergency initiation of dialysis.

  16. Continuous venovenous haemodialysis

    DEFF Research Database (Denmark)

    Bistrup, C; Pedersen, R S; Jensen, Dorte Møller

    1996-01-01

    A simple three-pump-based system for the performance of continuous venovenous haemodialysis is described. The method employs access to the circulation via a double-lumen catheter, and by means of a standard extracorporeal peristaltic pump the blood is circulated through a haemofiltration filter. ...

  17. Hereditary fructose intolerance in Brazilian patients

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    Eugênia Ribeiro Valadares

    2015-09-01

    Results and discussion: Age at diagnosis was between 10 and 32 months and the severity of the disease correlated with the increasing of age at diagnosis. The predominant symptoms were vomiting, weight loss, and hepatomegaly. Severe renal tubular acidosis manifested in one child. All patients had remission of symptoms after dietary modification. The sequencing of the ALDOB gene identified one homozygous patient for the mutation c.524C>A (p.A175D, while the others were compound heterozygous for c.360_363delCAAA (p.N120KfsX32, c.178C>T (p.R60X mutations, c.448G>C (p.A150P and c.524C>A (p.A175D. Clinical improvement of patients after dietary treatment is suggestive of the diagnosis, confirmed by molecular analysis. The prevalence of mutations found in our Brazilian patients is different from those of international literature.

  18. Haemodialysis is an effective treatment in acute metabolic decompensation of maple syrup urine disease

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    P.S. Atwal

    2015-09-01

    Full Text Available Acute metabolic decompensation in maple syrup urine disease can occur during intercurrent illness and is a medical emergency. A handful of reports in the medical literature describe the use of peritoneal dialysis and haemodialysis as therapeutic inventions. We report the only patient from our centre to have haemodialysis performed in this setting. Combined with dietary BCAA restriction and calorific support, haemodialysis allows rapid reduction in plasma leucine concentrations considerably faster than conservative methods.

  19. BRCA1 mutations in Brazilian patients

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    Juliano Javert Lourenço

    2004-01-01

    Full Text Available BRCA1 mutations are known to be responsible for the majority of hereditary breast and ovarian cancers in women with early onset and a family history of the disease. In this paper we present a mutational survey conducted in 47 Brazilian patients with breast/ovarian cancer, selected based on age at diagnosis, family history, tumor laterality, and presence of breast cancer in male patients. All 22 coding exons and intron-exon junctions were sequenced. Constitutional mutations were found in seven families, consisting of one insertion (insC5382 in exon 20 (four patients, one four base-pair deletion (3450-3453delCAAG in exon 11 resulting in a premature stop codon (one patient, one transition (IVS17+2T> C in intron 17 affecting a mRNA splicing site (one patient, and a C> T transition resulting in a stop-codon (Q1135X in exon 11 (one patient. The identification of these mutations which are associated to hereditary breast and ovarian cancers will contribute to the characterization of the mutational spectrum of BRCA1 and to the improvement of genetic counseling for familial breast/ovarian cancer patients in Brazil.

  20. Defected red blood cell membranes and direct correlation with the uraemic milieu: the connection with the decreased red blood cell lifespan observed in haemodialysis patients

    International Nuclear Information System (INIS)

    Together with impaired production of erythropoietin and iron deficiency, the decreased lifespan of red blood cells (RBCs) is a main factor contributing to the chronic anaemia observed in haemodialysis (HD) patients. Atomic force microscopy is employed in this work to thoroughly survey the membrane of intact RBCs (iRBCs) of HD patients in comparison to those of healthy donors, aiming to obtain direct information on the structural status of RBCs that can be related to their decreased lifespan. We observed that the iRBC membrane of the HD patients is overpopulated with extended circular defects, termed ‘orifices’, that have typical dimension ranging between 0.2 and 1.0 μm. The ‘orifice’ index—that is, the mean population of ‘orifices’ per top membrane surface—exhibits a pronounced relative increase of order 54 ± 12% for the HD patients as compared to healthy donors. Interestingly, for the HD patients, the ‘orifice’ index, which relates to the structural status of the RBC membrane, correlates strongly with urea concentration, which is a basic index of the uraemic milieu. Thus, these results indicate that the uraemic milieu downgrades the structural status of the RBC membrane, possibly triggering biochemical processes that result in their premature elimination from the circulation. This process could decrease the lifespan of RBCs, as observed in HD patients. (paper)

  1. Anti-inflammatory effects of combined treatment with acetyl salicylic acid and atorvastatin in haemodialysis patients affected by Normal Weight Obese syndrome.

    Science.gov (United States)

    Di Renzo, Laura; Noce, Annalisa; De Angelis, Sandro; Miani, Natascia; Di Daniele, Nicola; Tozzo, Carmela; De Lorenzo, Antonino

    2008-02-01

    Low-grade inflammation is a common feature of chronic kidney disease (CKD) and persistent systemic inflammation is thought to be a strong predictor of cardiovascular events. Inflammation plays a role in determining the serum albumin levels in haemodialysis patients (HD) independently of the nutritional status. Increased cardiovascular mortality in CKD has been associated with the increased incidence of obesity in uremic patients. Ingenbleek suggested a prognostic inflammation and nutritional index (PINI), based on serum albumin, pre-albumin, C-reactive protein, and alpha1 acid glycoprotein, to identify and to follow up acutely ill patients at risk of major complications. The aims of the present study were: to verify the incidence of Normal Weight Obese (NWO) syndrome; to evaluate by PINI the effect of 8 weeks acetyl salicylic (100 mg/die) and atorvastatin (10 mg/die) combined treatment on chronic inflammation in 52 selected HD patients. Laboratory evaluation, anthropometric and body composition measurements were detected. At baseline the 56.25% of non-obese, the 84.21% of pre-obese-obese, and the 41.17% of NWO women showed PINI values >1 (normal status PINI1. Further studies will be necessary to understand the causes of inflammation in non-responder patients. PMID:18262432

  2. Variations in C-reactive protein during a single haemodialysis session do not associate with mortality

    NARCIS (Netherlands)

    C.L. Meuwese; N. Halbesma; P. Stenvinkel; F.W. Dekker; H. Molanaei; A.R. Qureshi; P. Barany; O. Heimburger; B. Lindholm; R.T. Krediet; E.W. Boeschoten; J.J. Carrero

    2010-01-01

    Background. An increase in C-reactive protein (CRP) levels during a single haemodialysis (HD) session has been associated with mortality. These associations, however, are difficult to understand from the current understanding of CRP metabolism. Methods. In 190 Swedish haemodialysis (HD) patients fro

  3. Haemodialysis followed by continuous veno-venous haemodiafiltration in lithium intoxication; a model and a case

    NARCIS (Netherlands)

    Meertens, John H J M; Jagernath, Danny R; Eleveld, Douglas J; Zijlstra, Jan G; Franssen, Casper F M

    2009-01-01

    For severe lithium intoxication haemodialysis is recommended to lower serum lithium levels rapidly. Frequently, serum lithium levels rebound after dialysis and repeated dialysis is needed. This is the first report of an adult patient with severe lithium intoxication who underwent haemodialysis (HD)

  4. Creatinine Index as a Surrogate of Lean Body Mass Derived from Urea Kt/V, Pre-Dialysis Serum Levels and Anthropometric Characteristics of Haemodialysis Patients

    Science.gov (United States)

    Canaud, Bernard; Granger Vallée, Alexandre; Molinari, Nicolas; Chenine, Leila; Leray-Moragues, Hélène; Rodriguez, Annie; Chalabi, Lotfi; Morena, Marion; Cristol, Jean-Paul

    2014-01-01

    Background and Objectives Protein-energy wasting is common in long-term haemodialysis (HD) patients with chronic kidney disease and is associated with increased morbidity and mortality. The creatinine index (CI) is a simple and useful nutritional parameter reflecting the dietary skeletal muscle protein intake and skeletal muscle mass of the patient. Because of the complexity of creatinine kinetic modeling (CKM) to derive CI, we developed a more simplified formula to estimate CI in HD patients. Design, Setting, Participants & Measurements A large database of 549 HD patients followed over more than 20 years including monthly CKM-derived CI values was used to develop a simple equation based on patient demographics, predialysis serum creatinine values and dialysis dose (spKt/V) using mixed regression models. Results The equation to estimate CI was developed based on age, gender, pre-dialysis serum creatinine concentrations and spKt/V urea. The equation-derived CI correlated strongly with the measured CI using CKM (correlation coefficient  = 0.79, p-value <0.001). The mean error of CI prediction using the equation was 13.47%. Preliminary examples of few typical HD patients have been used to illustrate the clinical relevance and potential usefulness of CI. Conclusions The elementary equation used to derive CI using demographic parameters, pre-dialysis serum creatinine concentrations and dialysis dose is a simple and accurate surrogate measure for muscle mass estimation. However, the predictive value of the simplified CI assessment method on mortality deserves further evaluation in large cohorts of HD patients. PMID:24671212

  5. Effect of Membrane Permeability on Cardiovascular Risk Factors and β2m Plasma Levels in Patients on Long-Term Haemodialysis: A Randomised Crossover Trial.

    Science.gov (United States)

    Chazot, Charles; Kirchgessner, Judith; Pham, Jenny; Vo-Van, Cyril; Lorriaux, Christie; Hurot, Jean-Marc; Zaoui, Eric; Grassmann, Aileen; Jean, Guillaume; Marcelli, Daniele

    2015-01-01

    Survival of haemodialysis (HD) patients is influenced by many factors. Mortality is mainly of cardiovascular (CV) origin and related to both traditional and nontraditional CV risk factors. Low plasma Beta2-microglobulin (β2m) levels are associated with improved HD patient survival. HD session times that are longer than the conventional 4 h (i.e., extended dialysis) provide better middle molecule clearance and are also associated with a survival advantage. In this crossover randomised trial, we investigated the effect of membrane flux on CV risk factors and on β2m plasma levels in patients treated with extended dialysis. Dialysis session duration was between 5 and 8 h for all patients. Patients were randomly assigned to the treatment sequences low-flux/high-flux dialysis versus high-flux/low-flux dialysis in a crossover design after a 3-month run-in period, with each phase lasting 9 months. Of the initially enrolled 168 patients, 155 patients started the study after the run-in period, 117 patients completed Phase 1, and 83 patients completed the whole study. Lp(a), homocystein, LDL cholesterol, HDL cholesterol and serum albumin were comparable in the low-flux and high-flux treatments. The average β2m level was 43.3 ± 11.1 mg/l at the end of the low-flux phase. Independent of sequence assignation, average β2m was significantly lower at the end of the high-flux phase (27.5 ± 76.0 mg/l, p < 0.0001 versus end of low-flux phase). Both phosphate and nPNA were significantly lower at the end of the high-flux phase compared to the low-flux phase (p = 0.045 and p = 0.002, respectively). Inclusion of those patients who completed Phase 1 and who dropped out of the study during Phase 2 did not significantly change the results. In conclusion, this study did not find an influence of high-flux filters on several traditional CV risk factors in a population of HD patients treated with extended dialysis. However, high-flux filters are necessary to optimise middle molecule

  6. Rationale and design of the HEALTHY-CATH trial: A randomised controlled trial of Heparin versus EthAnol Lock THerapY for the prevention of Catheter Associated infecTion in Haemodialysis patients

    Directory of Open Access Journals (Sweden)

    Broom Jennifer K

    2009-08-01

    Full Text Available Abstract Background Catheter-related bacteraemias (CRBs contribute significantly to morbidity, mortality and health care costs in dialysis populations. Despite international guidelines recommending avoidance of catheters for haemodialysis access, hospital admissions for CRBs have doubled in the last decade. The primary aim of the study is to determine whether weekly instillation of 70% ethanol prevents CRBs compared with standard heparin saline. Methods/design The study will follow a prospective, open-label, randomized controlled design. Inclusion criteria are adult patients with incident or prevalent tunneled intravenous dialysis catheters on three times weekly haemodialysis, with no current evidence of catheter infection and no personal, cultural or religious objection to ethanol use, who are on adequate contraception and are able to give informed consent. Patients will be randomized 1:1 to receive 3 mL of intravenous-grade 70% ethanol into each lumen of the catheter once a week and standard heparin locks for other dialysis days, or to receive heparin locks only. The primary outcome measure will be time to the first episode of CRB, which will be defined using standard objective criteria. Secondary outcomes will include adverse reactions, incidence of CRB caused by different pathogens, time to infection-related catheter removal, time to exit site infections and costs. Prospective power calculations indicate that the study will have 80% statistical power to detect a clinically significant increase in median infection-free survival from 200 days to 400 days if 56 patients are recruited into each arm. Discussion This investigator-initiated study has been designed to provide evidence to help nephrologists reduce the incidence of CRBs in haemodialysis patients with tunnelled intravenous catheters. Trial Registration Australian New Zealand Clinical Trials Registry Number: ACTRN12609000493246

  7. Composición corporal en pacientes con insuficiencia renal crónica y hemodiálisis Body composition in chronic kidney disease patients and haemodialysis

    Directory of Open Access Journals (Sweden)

    A. M.ª Bravo Ramírez

    2010-04-01

    equiparables a los observados con el DEXA.Background: Nutritional alterations are highly prevalent among patients with chronic kidney diseases stage 5 who receive haemodialysis therapy. Body composition alterations are directly related to an increased morbidity and mortality. Nutritional assessment represents a cardinal intervention oriented to improve the outcome and survival in chronic renal patients. Objective: To evaluate body composition in a mexican population with chronic kidney disease stage 5 and haemodialysis therapy. Methods: Prospective, descriptive and transversal study. Free fatty mass (FFM and fatty mass (FM were evaluated by means of bioelectric impedance (BIE, anthropometrics measures (MPA and dual-energy x-ray absorptiometry (DEXA. Results: 20 patients were evaluated (12 females and 8 males. Mean age was 51.9 ± 19.3 years. Mean weight was 59.5 ± 10.5 kg and mean body mass index was 24.9 ± 3.1 kg/m². Mean FFM valueswere 42.4 ± 8.6 kg (MPA, 43.6 ± 8.9 kg (DEXA y 42.8 ± 10.2 kg (IBE. Mean FM values: 17.2 ± 6.2 kg (MPA, 15.9 ± 6.9 kg (DEXA and 16.9 ± 6.9 kg (IBE. Correlation coefficients between the three methods were: FFM, 0.982 (MPA vs IBE, 0.963 (MPA vs DEXA y 0.947 (IBE vs DEXA. Fatty mass: 0.975 (MPAvs IBE, 0.925 (MPA vs DEXA y 0.898 (IBE vs DEXA. Conclusion: In the studied population, fatty mass was increased and FFM was within the reference ranges. There was not evidence of protein malnutrition. MPA and BIE are practical and useful tools to evaluate body composition in mexican chronic kidney disease patients who receive haemodialysis therapy. The results obtained by means of MPA and BIE correlated with results obtained by DEXA.

  8. Effect of Inflammation on the Relationship of Pulse Pressure and Mortality in Haemodialysis

    OpenAIRE

    Banerjee, Debasish; Collins, Allan J; Herzog, Charles A.

    2012-01-01

    Background/Aim The effect of hypertension on mortality in haemodialysis patients is controversial and can be confounded by non-traditional risk factors like systemic inflammation. This study examined the effect of systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) on mortality in haemodialysis patients, separately with and without markers of systemic inflammation. Methods Data from the United States Renal Data System were analysed for 9,862 patients receivi...

  9. Time of onset in haemodialysis access-induced distal ischaemia (HAIDI) is related to the access type.

    NARCIS (Netherlands)

    Scheltinga, M.R.M.; Hoek, F. van; Bruijninckx, C.M.

    2009-01-01

    BACKGROUND: A small portion of haemodialysis patients develop hand ischaemia (HAIDI, haemodialysis access-induced distal ischaemia) in the presence of an arteriovenous access (AVA). It is unknown if the time of onset of ischaemia is related to the type of AVA. This review aims to investigate if a re

  10. Psychiatric disorders in chronic periodic haemodialysis

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    Paraskevi Theofilou

    2010-10-01

    Full Text Available The progress in Medical and Nursing Science has contributed significantly to the lengthening of life expectancy regarding several categories of ill people with chronic diseases. However, when the quality of life depends on the periodic correction of biological parameters, as with people with chronic renal failure, this situation affects both the patient and the environment. The aim of the present study is the evaluation of psychiatric disorders which are presented in haemodialysis patients as well as the influence of these disorders on their quality of life. Material and method: Review of relative bibliography was made in electronic basis of Medline (1980‐2009 using as key words haemodialysis, chronic renal failure, quality of life, psychiatric disorders. Complementary bibliography was found through other electronic search engines. Results: The chronic character and the frequency of renal failure, the possible dysfunction in the movement as well as the necessary long treatment cause problems, which extend the disease beyond the medical area offering socioeconomic dimensions, which complicate the associated psychiatric disorders. Conclusions: These patients suffer from the disease as well as from the treatment and at the same time they are faced with the number of the accompanying and interrelated problems, which come up in their everyday living and prescribe restrictively their way of life.

  11. Increased risk of mortality among haemodialysis patients with or without prior stroke: A nationwide population-based study in Taiwan

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    Chih-Chiang Chien

    2013-01-01

    Results: Among 5672 HD patients, 650 patients (11.5% had PS. A higher proportion of stroke history at baseline was found in men (52.8% and those aged ≥ 55 yr (80.9%. After adjusting for age, sex and other covariates, the patients with PS were found to have a 36 per cent increased risk of mortality compared to those without PS (HR 1.36, 95% CI: 1.22-1.52. The cumulative survival rates among HD patients without PS were 96.0 per cent at the first year, 68.4 per cent at the fifth year, and 46.7 per cent at the ninth year, and 92.9, 47.3 and 23.6 per cent, respectively, in those with PS (log-rank: P<0.001. Interpretation & conclusions: Our findings showed that PS was an important predictor for all-cause mortality and poor outcome in patients undergoing chronic HD.

  12. Surgery of infrarenal inflammatory aneurysm of abdominal aorta infected with methicillin resistant Staphylococcus aureus in a patient undergoing haemodialysis

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    Babić Srđan

    2008-01-01

    Full Text Available INTRODUCTION Inflammatory abdominal aortic aneurysm accounts for 5% to 10% of all cases of abdominal aortic aneurysm and differs from typical atherosclerotic abdominal aortic aneurysm in many important ways. Although both inflammatory and atherosclerotic abdominal aortic aneurysms most commonly affect the infrarenal portion of the abdominal aorta, patients with the inflammatory variant are younger and usually symptomatic, chiefly from back or abdominal pain. Unlike patients with atherosclerotic abdominal aortic aneurysm, most with the inflammatory variant have an elevated erythrocyte sedimentation rate or abnormalities of other serum inflammatory markers. Computed tomography and magnetic resonance imaging are both sensitive for demonstrating the cuff of soft tissue inflammation surrounding the aneurysm that is characteristic of inflammatory abdominal aortic aneurysm. Inflammatory abdominal aortic aneurysm can be primarily infected by degenaration of an infected artery (in less than 1% of cases, or can become secondary infected in the already existing aneurysm. Secondary infection of the pre-existing aneurysm has big influence on treatment choice, but is also rare. Clinically non-symptomatic infection, also known as bacterial collonisation, can be very frequent, regarding a greatly increased number of positive intraoperative findings (10-15%. Prolonged intravascular catheterization, vascular grafting, repeated punctures with large bore needles, and decreased immune defense mechanism make uraemic patients undergoing hemodialysis more likely to develop Staphylococcus aureus bacteraemia and its complications. CASE OUTLINE The case shows a gigantic inflammatory aneurysm of the abdominal aorta, localized infrarenally, which was solved successfully by resection of the aneurysm of the abdominal aorta, and interposition of Dacron tubular graft 22 mm. Bacterial examination of the aneurysmal sac was positive: methicillin-resistent Staphylococcus aureus was

  13. Biotinidase deficiency: clinical and genetic studies of 38 Brazilian patients

    OpenAIRE

    Borsatto, Taciane; Sperb-Ludwig, Fernanda; Pinto, Louise LC; De Luca, Gisele R; Carvalho, Francisca L; De Souza, Carolina FM; De Medeiros, Paula FV; Charles M. Lourenço; Filho, Reinaldo LO; Neto, Eurico C.; Bernardi, Pricila; Leistner-Segal, Sandra; Schwartz, Ida VD

    2014-01-01

    Background Biotinidase deficiency (BD) is an inborn error of metabolism in which some genetic variants correlate with the level of enzyme activity. Biotinidase activity, however, may be artifactually low due to enzyme lability, premature birth, and jaundice; this hinders both phenotypic classification and the decision to implement therapy. This study sought to characterize the clinical and genetic profile of a sample of Brazilian patients exhibiting reduced biotinidase activity. Methods This ...

  14. Anaphylactoid reactions due to haemodialysis, haemofiltration, or membrane plasma separation.

    OpenAIRE

    Nicholls, A J; Platts, M. M.

    1982-01-01

    A previously undescribed anaphylactoid reaction to haemodialysis, haemofiltration, or membrane plasma separation occurred in 15 patients receiving regular dialysis. The illness varied in severity from urticaria, sneezing, and watering of the eyes to severe bronchospasm and cardiovascular collapse, and began within a minute of blood being returned from the dialyser or filtration device to the patient. Reactions developed only when a dialyser sterilised with ethylene oxide was used for the firs...

  15. Social disability of Brazilian mood disorder patients

    Directory of Open Access Journals (Sweden)

    Tucci A.M.

    2004-01-01

    Full Text Available Mood disorders cause many social problems, often involving family relationships. Few studies are available in the literature comparing patients with bipolar, unipolar, dysthymic, and double depressive disorders concerning these aspects. In the present study, demographic and disease data were collected using a specifically prepared questionnaire. Social adjustment was assessed using the Disability Adjustment Scale and family relationships were evaluated using the Global Assessment of Relational Functioning Scale. One hundred patients under treatment for at least 6 months were evaluated at the Psychiatric Outpatient Clinic of the Botucatu School of Medicine, UNESP. Most patients were women (82% more than 50 (49% years old with at least two years of follow-up, with little schooling (62% had less than 4 years, and of low socioeconomic level. Logistic regression analysis showed that a diagnosis of unipolar disorder (P = 0.003, OR = 0.075, CI = 0.014-0.403 and dysthymia (P = 0.001, OR = 0.040, CI = 0.006-0.275 as well as family relationships (P = 0.002, OR = 0.953, CI = 0914-0.992 played a significant role in social adjustment. Unipolar and dysthymic patients presented better social adjustment than bipolar and double depressive patients (P < 0.001, results that were not due to social class. These patients, treated at a teaching hospital, may represent the severest mood disorder cases. Evaluations were made knowing the diagnosis of the patients, which might also have influenced some of the results. Social disabilities among mood disorder patients are very frequent and intensive.

  16. Flash pulmonary oedema after relief of haemodialysis graft stenosis.

    Science.gov (United States)

    Vélez-Martínez, Mariella; Weinberg, Brent D; Mishkin, Joseph D

    2013-08-01

    Heart failure (HF) and chronic kidney disease (CKD) are undoubtedly very much interrelated, especially in patients with end-stage renal disease (ESRD) who are dependent on renal replacement therapy. Haemodialysis (HD) is of particular interest in cardiovascular patients due to the creation of a haemodialysis vascular access and the haemodynamic changes associated with it. Adequate HD though is very dependent on a properly functioning vascular access. Unfortunately, these surgical vascular accesses are vulnerable to stenoses and occlusions. Percutaneous endovascular treatment of these stenoses is often performed and has been found to be safe and effective. Despite its frequent use, acute medical complications of this percutaneous procedure have not been well-documented. In this report, we describe a patient who developed flash pulmonary oedema after balloon angioplasty treatment of an arteriovenous graft (AVG) stenosis. PMID:23253885

  17. European trial of free light chain removal by extended haemodialysis in cast nephropathy (EuLITE: A randomised control trial

    Directory of Open Access Journals (Sweden)

    Billingham Lucinda

    2008-09-01

    Full Text Available Abstract Background Renal failure is a frequent complication of multiple myeloma and when severe is associated with a greatly increased morbidity and mortality. The principal cause of severe renal failure is cast nephropathy, a direct consequence of high concentrations of monoclonal free light chains (FLCs in patients' sera. FLC removal by extended haemodialysis, using a high cut-off dialyser, has recently been described as a novel therapeutic option. Methods The EUropean trial of free LIght chain removal by exTEnded haemodialysis in cast nephropathy (EuLITE trial is a prospective, randomised, multicentre, open label clinical trial to investigate the clinical benefits of FLC removal haemodialysis in patients with cast nephropathy, dialysis dependent acute renal failure and de novo multiple myeloma. Recruitment commenced in May 2008. In total, 90 patients will be recruited. Participants will be randomised, centrally, upon enrolment, to either trial chemotherapy and FLC removal haemodialysis or trial chemotherapy and standard high flux haemodialysis. Trial chemotherapy consists of bortezomib, doxorubicin and dexamethasone. FLC removal haemodialysis is undertaken with two Gambro HCO 1100 dialysers in series using an intensive treatment schedule. The primary outcome for the study is independence of dialysis at 3 months. Secondary outcomes are: duration of dialysis, reduction in serum FLC concentrations; myeloma response and survival. Hypothesis FLC removal haemodialysis will increase the rate of renal recovery in patients with severe renal failure secondary to cast nephropathy in de novo multiple myeloma. Trial registration ISRCTN45967602

  18. Severe theophylline poisoning: charcoal haemoperfusion or haemodialysis?

    OpenAIRE

    Higgins, R. M.; Hearing, S.; Goldsmith, D.J.; Keevil, B.; Venning, M. C.; Ackrill, P.

    1995-01-01

    Theophylline poisoning with a blood level of 183 mg/l in a 38-year-old man was treated with activated charcoal by mouth, but despite this the blood level of theophylline rose and there was circulatory collapse with rhabdomyolysis, acute renal failure and hyperthermia. Treatment with charcoal haemoperfusion and simultaneous haemodialysis was given, followed by continuous arteriovenous haemodialysis (CAVHD). Mean extraction rates of theophylline were 26% during CAVHD, and 86% during combined di...

  19. Hemochromatosis (HFE gene mutations in Brazilian chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    F.V. Perícole

    2005-09-01

    Full Text Available Patients with chronic renal insufficiency (CRI have reduced hemoglobin levels, mostly as a result of decreased kidney production of erythropoietin, but the relation between renal insufficiency and the magnitude of hemoglobin reduction has not been well defined. Hereditary hemochromatosis is an inherited disorder of iron metabolism. The importance of the association of hemochromatosis with treatment for anemia among patients with CRI has not been well described. We analyzed the frequency of the C282Y and H63D mutations in the HFE gene in 201 Brazilian individuals with CRI undergoing hemodialysis. The analysis of the effects of HFE mutations on iron metabolism and anemia with biochemical parameters was possible in 118 patients of this study (hemoglobin, hematocrit, ferritin levels, transferrin saturation, and serum iron. A C282Y heterozygous mutation was found in 7/201 (3.4% and H63D homozygous and heterozygous mutation were found in 2/201 (1.0% and 46/201 (22.9%, respectively. The allelic frequencies of the HFE mutations (0.017 for C282Y mutation and 0.124 for H63D mutation did not differ between patients with CRI and healthy controls. Regarding the biochemical parameters, no differences were observed between HFE heterozygous and mutation-negative patients, although ferritin levels were not higher among patients with the H63D mutation (P = 0.08. From what we observed in our study, C282Y/H63D HFE gene mutations are not related to degrees of anemia or iron stores in CRI patients receiving intravenous iron supplementation (P > 0.10. Nevertheless, the present data suggest that the H63D mutation may have an important function as a modulating factor of iron overload in these patients.

  20. Design, implementation and preliminary evaluation of a telemedicine system for home haemodialysis.

    Science.gov (United States)

    Skiadas, Marios; Agroyiannis, Basil; Carson, Ewart; Cramp, Derek; Fourtounas, Costas; Darnige, Ann; Morgan, Alastair; Murley, David; Tsavdaris, Harry; Hassomeris, Costas; Skouras, Costas

    2002-01-01

    A telemedicine system for home haemodialysis was designed using a systems approach and a feedback model to produce the hardware and software specifications. Preliminary clinical trials at four European locations involved 29 patients and 305 sessions of haemodialysis. The evaluation included an evaluability assessment and formative evaluation. Central to the methodology was the detailed specification of a stakeholder/evaluation criterion matrix. Preliminary results indicated that the telemedicine system was capable of satisfying the requirements of formative evaluation as a precursor to evaluating its overall worth. PMID:12097177

  1. Central venous access for haemodialysis using the Hickman catheter.

    Science.gov (United States)

    Cappello, M; De Pauw, L; Bastin, G; Prospert, F; Delcour, C; Thaysse, C; Dhaene, M; Vanherweghem, J L; Kinnaert, P

    1989-01-01

    One hundred and seven Hickman catheters for haemodialysis were inserted in 90 end-stage chronic renal failure patients, and were used for 1-448 days (median 45 days). Sixty-nine per cent of the patients were treated without any problem for 1-165 days (median 34 days). Clinically evident complications occurred in 44 catheters inserted in 28 patients, and included outflow obstruction (16.8% of the catheters) and thrombosis (13.1% of the catheters). However, many episodes of clotting or insufficient flow could be corrected by simple manoeuvres. Other less frequent complications were recorded: sepsis, mainly in patients with increased risk factors (4.1% of the catheters), laceration of the catheter (3.7%) and occasional cases of jugular-vein phlebitis, transient palsy of a vocal cord, haematoma of the wound, and bleeding of the cutaneous orifice. No clinical sign of subclavian or innominate-vein thrombosis was observed. Nevertheless, a prospective study conducted in 50 asymptomatic patients demonstrated a 12% rate of anomalies of the venous system, although two-thirds of these alterations were mild and had no consequence. When the present series is compared to the results obtained with currently available percutaneous haemodialysis catheters, it is concluded that the Hickman catheter is a safe, comfortable and efficient vascular access device. PMID:2516892

  2. Existential boredom: the experience of living on haemodialysis therapy.

    Science.gov (United States)

    Moran, A; Scott, P A; Darbyshire, P

    2009-12-01

    Empathy is an essential component of professional nursing practice. In order to empathise appropriately with patients, it is crucial that nurses appreciate, understand and respond to their patients' experience of illness. This study sought to explore the experiences of 16 people with end stage renal disease on haemodialysis therapy in Ireland. A hermeneutical phenomenological methodology was employed incorporating qualitative interviews. The data were analysed using qualitative interpretive analysis. The experience of waiting was significant for the participants in the study. The experience of waiting was constituted by two themes labelled killing time and wasting time. It is suggested that the participants' experience of waiting is reminiscent of Heidegger's existential account of boredom. Moreover, the existential perspective of boredom contained within the participants' accounts is also depicted by Beckett in his play Waiting for Godot. Consequently, the literature of both existential writers is incorporated to provide a more in-depth description of the participants' experience of waiting. It is hoped that the insights provided in this paper will enable practitioners to gain a new awareness and understanding of patients' experiences of end stage renal disease and haemodialysis therapy. This would subsequently enable these professionals to empathise more effectively with their patients' situation and respond more appropriately to their care needs. PMID:23674698

  3. A randomised controlled trial of Heparin versus EthAnol Lock THerapY for the prevention of Catheter Associated infecTion in Haemodialysis patients – the HEALTHY-CATH trial

    Directory of Open Access Journals (Sweden)

    Broom Jennifer K

    2012-11-01

    Full Text Available Abstract Background Tunnelled central venous dialysis catheter use is significantly limited by the occurrence of catheter-related infections. This randomised controlled trial assessed the efficacy of a 48 hour 70% ethanol lock vs heparin locks in prolonging the time to the first episode of catheter related blood stream infection (CRBSI. Methods Patients undergoing haemodialysis (HD via a tunnelled catheter were randomised 1:1 to once per week ethanol locks (with two heparin locks between other dialysis sessions vs thrice per week heparin locks. Results Observed catheter days in the heparin (n=24 and ethanol (n=25 groups were 1814 and 3614 respectively. CRBSI occurred at a rate of 0.85 vs. 0.28 per 1000 catheter days in the heparin vs ethanol group by intention to treat analysis (incident rate ratio (IRR for ethanol vs. heparin 0.17; 95%CI 0.02-1.63; p=0.12. Flow issues requiring catheter removal occurred at a rate of 1.6 vs 1.4 per 1000 catheter days in the heparin and ethanol groups respectively (IRR 0.85; 95% CI 0.20-3.5 p =0.82 (for ethanol vs heparin. Conclusions Catheter survival and catheter-related blood stream infection were not significantly different but there was a trend towards a reduced rate of infection in the ethanol group. This study establishes proof of concept and will inform an adequately powered multicentre trial to definitively examine the efficacy and safety of ethanol locks as an alternative to current therapies used in the prevention of catheter-associated blood stream infections in patients dialysing with tunnelled catheters. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12609000493246

  4. The effects of a low-to-moderate intensity pre-conditioning exercise programme linked with exercise counselling for sedentary haemodialysis patients in The Netherlands : results of a randomized clinical trial

    NARCIS (Netherlands)

    van Vilsteren, MCBA; de Greef, MHG; Huisman, RM

    2005-01-01

    Objectives. The purpose of this study is to determine whether a low-to-moderate intensity pre-conditioning exercise programme linked with exercise counselling could improve behavioural change, physical fitness, physiological condition and health-related quality of life of sedentary haemodialysis pat

  5. Effects of Brazilian Cardioprotective Diet Program on risk factors in patients with coronary heart disease: a Brazilian Cardioprotective Diet randomized pilot trial

    OpenAIRE

    Bernardete Weber; Andrea Polo Galante; Angela Cristine Bersch-Ferreira; Camila Ragne Torreglosa; Vitor Oliveira Carvalho; Elivane da Silva Victor; Jose Amalth do Espírito-Santo; Maria Beatriz Ross-Fernandes; Rafael Marques Soares; Rosana Perim Costa; Enilda de Sousa Lara; Anna Maria Buehler; Otávio Berwanger

    2012-01-01

    OBJECTIVE: To evaluate the effectiveness of the Brazilian Cardioprotective Diet Program in reducing blood pressures, fasting glucose levels and body mass indices in patients with established atherothrombotic disease. METHOD: This randomized controlled pilot trial included outpatients who were over 45 years of age with atherothrombotic cardiovascular disease. Group A, who received the Brazilian Cardioprotective Diet Program, had weekly sessions with dietitians. Groups B and C received the usua...

  6. Japanese haemodialysis anaemia management practices and outcomes (1999–2006): results from the DOPPS

    OpenAIRE

    Akizawa, Tadao; Ronald L Pisoni; Akiba, Takashi; Saito, Akira; Fukuhara, Shunichi; Asano, Yasushi; Hasegawa, Takeshi; Port, Friedrich K; Kurokawa, Kiyoshi

    2008-01-01

    Background. Japanese haemodialysis (HD) patients not only have a very low mortality and hospitalization risk but also low haemoglobin (Hb) levels. Internationally, anaemia is associated with mortality, hospitalization and health-related quality of life (QoL) measures of HD patients. Methods. Longitudinal data collected from 1999 to 2006 from 60 to 64 representative Japanese dialysis units participating in the Dialysis Outcomes and Practice Patterns Study (DOPPS) were used to describe anaemia ...

  7. The impact of rural hospital closures on equity of commuting time for haemodialysis patients: simulation analysis using the capacity-distance model

    Directory of Open Access Journals (Sweden)

    Matsumoto Masatoshi

    2012-07-01

    Full Text Available Abstract Background Frequent and long-term commuting is a requirement for dialysis patients. Accessibility thus affects their quality of lives. In this paper, a new model for accessibility measurement is proposed in which both geographic distance and facility capacity are taken into account. Simulation of closure of rural facilities and that of capacity transfer between urban and rural facilities are conducted to evaluate the impacts of these phenomena on equity of accessibility among dialysis patients. Methods Post code information as of August 2011 of all the 7,374 patients certified by municipalities of Hiroshima prefecture as having first or third grade renal disability were collected. Information on post code and the maximum number of outpatients (capacity of all the 98 dialysis facilities were also collected. Using geographic information systems, patient commuting times were calculated in two models: one that takes into account road distance (distance model, and the other that takes into account both the road distance and facility capacity (capacity-distance model. Simulations of closures of rural and urban facilities were then conducted. Results The median commuting time among rural patients was more than twice as long as that among urban patients (15 versus 7 minutes, p  Conclusions Closures of dialysis facilities in rural areas have a substantially larger impact on equity of commuting times among dialysis patients than closures of urban facilities. The accessibility simulations using thecapacity-distance model will provide an analytic framework upon which rational resource distribution policies might be planned.

  8. Niemann-Pick disease type C: a case series of Brazilian patients

    OpenAIRE

    Paulo José Lorenzoni; Elaine Cardoso; Ana C.S. Crippa; Charles Marques Lourenço; Fernanda Timm Seabra Souza; Roberto Giugliani; Maria Luiza Saraiva-Pereira; Salmo Raskin; Isac Bruck; Cláudia S. K. Kay; Rosana H. Scola; Werneck, Lineu C.; Teive, Hélio A.G.

    2014-01-01

    The aim of the study was to analyze a series of Brazilian patients with Niemann-Pick disease type C (NP-C). Method Correlations between clinical findings, laboratory data, molecular findings and treatment response are presented. Result The sample consisted of 5 patients aged 8 to 26 years. Vertical supranuclear gaze palsy, cerebellar ataxia, dementia, dystonia and dysarthria were present in all cases. Filipin staining showed the “classical” pattern in two patients and a “variant” pattern i...

  9. Identification and characteristics of patients with palliative care needs in Brazilian primary care

    OpenAIRE

    Marcucci, Fernando C. I.; Cabrera, Marcos A. S.; Perilla, Anamaria Baquero; Brun, Marilia Maroneze; de Barros, Eder Marcos L.; Martins, Vanessa M.; Rosenberg, John P.; Yates, Patsy

    2016-01-01

    Background The Brazilian healthcare system offers universal coverage but lacks information about how patients with PC needs are serviced by its primary care program, Estratégia Saúde da Família (ESF). Methods Cross-sectional study in community settings. Patients in ESF program were screened using a Palliative Care Screening Tool (PCST). Included patients were assessed with Karnofsky Performance Scale (KPS), Edmonton Symptom Assessment System (ESAS) and Palliative Care Outcome Scale (POS). Res...

  10. Revascularisation of patients with end-stage renal disease on chronic haemodialysis: bypass surgery versus PCI—analysis of routine statutory health insurance data

    Science.gov (United States)

    Möckel, Martin; Searle, Julia; Baberg, Henning Thomas; Dirschedl, Peter; Levenson, Benny; Malzahn, Jürgen; Mansky, Thomas; Günster, Christian; Jeschke, Elke

    2016-01-01

    Objectives We aimed to analyse the short-term and long-term outcome of patients with end-stage renal disease (ESRD) undergoing percutaneous intervention (PCI) as compared to coronary artery bypass surgery (CABG) to evaluate the optimal coronary revascularisation strategy. Design Retrospective analysis of routine statutory health insurance data between 2010 and 2012. Main outcome measures Primary outcome was adjusted all-cause mortality after 30 days and major adverse cardiovascular and cerebrovascular events at 1 year. Secondary outcomes were repeat revascularisation at 30 days and 1 year and bleeding events within 7 days. Results The total number of cases was n=4123 (PCI; n=3417), median age was 71 (IQR 62–77), 30.4% were women. The adjusted OR for death within 30 days was 0.59 (95% CI 0.43 to 0.81) for patients undergoing PCI versus CABG. At 1 year, the adjusted OR for major adverse cardiac and cerebrovascular events (MACCE) was 1.58 (1.32 to 1.89) for PCI versus CABG and 1.47 (1.23 to 1.75) for all-cause death. In the subgroup of patients with acute myocardial infarction (AMI), adjusted all-cause mortality at 30 days did not differ significantly between both groups (OR 0.75 (0.47 to 1.20)), whereas in patients without AMI the OR for 30-day mortality was 0.44 (0.28 to 0.68) for PCI versus CABG. At 1 year, the adjusted OR for MACCE in patients with AMI was 1.40 (1.06 to 1.85) for PCI versus CABG and 1.47 (1.08 to 1.99) for mortality. Conclusions In this cohort of unselected patients with ESRD undergoing revascularisation, the 1-year outcome was better for CABG in patients with and without AMI. The 30-day mortality was higher in non-AMI patients with CABG reflecting an early hazard with surgery. In cases where the patient's characteristics and risk profile make it difficult to decide on a revascularisation strategy, CABG could be the preferred option.

  11. Effects of angiotensin II blockade on intermediate cardiovascular endpoints in haemodialysis patients: a randomised double-blind placebo-controlled one-year intervention trial (SAFIR study)

    DEFF Research Database (Denmark)

    Peters, Christian Daugaard; Kjærgaard, Krista Dybtved; Jensen, Jens Dam;

    (HD) patients in a double-blind randomised placebo-controlled one year intervention trial using a pre-defined systolic blood pressure (BP) target of 140 mmHg. Patients (41 in each group) did not differ in terms of age, BP, co-morbidity, antihypertensive treatment, dialysis parameters, and residual...... such as central aortic BP, carotid-femoral pulse wave velocity, left ventricular mass index, N-terminal prohormone of brain natriuretic peptide, heart rate variability, and plasma catecholamines were not significantly affected by irbesartan treatment. Changes in systolic BP during the study period...... correlated significantly with changes in left ventricular mass (P=0.02) and changes in arterial stiffness (P<0.001). In conclusion, significant effects of irbesartan on intermediate CV endpoints beyond BP reduction were absent in HD patients....

  12. Enfermedad arterial periférica y pié diabético en pacientes en programa de hemodiálisis Peripheral arterial disease and diabetic foot in patients on haemodialysis programme

    Directory of Open Access Journals (Sweden)

    Azucena García Viejo

    2012-12-01

    and prevention of ulcers and amputations of lower limbs. Material and methods: Transversal descriptive observational study. Carried out with 51 patients included in the haemodialysis programme of the Unit in Segovia. Analyses were carried out of the different risk factors that influence the presence of arteriopathy and diabetic foot, and the different relationships between them as well as a stratification of the risk in the population studied. Results: 45% of the patients present peripheral arterial disease and 58% have sensitivity alterations. Diabetes firstly and cardiovascular diseases are the factors that have the most influence in these problems. Conclusions: Categorizing our patients according to risk will make it possible to plan strategies to prevent the appearance of these complications. The absence of previous examination shows inadequate monitoring. The high prevalence of these pathologies makes protocolized monitoring necessary.

  13. The Impact of Kt/V Urea-Based Dialysis Adequacy on Quality of Life and Adherence in Haemodialysis Patients: A Cross-Sectional Study in Greece.

    Science.gov (United States)

    Theofilou, Paraskevi; Togas, Constantinos; Vasilopoulou, Chrysoula; Minos, Christos; Zyga, Sofia; Tzitzikos, Giorgos

    2015-04-13

    There is clear evidence of a link between dialysis adequacy (as measured by urea kinetic modeling or urea reduction ratio) and such important clinical outcomes as morbidity and mortality. Evidence regarding the relationship between dialysis adequacy and quality of life (QOL) outcomes as well as adherence is less clear. The present paper is a study protocol which is planning to answer the following research question: what is the impact of dialysis adequacy on QOL and adherence in a sample of hemodialysis patients? The final sample size will be around 100 patients undergoing hemodialysis. Each subject's QOL and adherence will be measured using the following instruments: i) the Missoula-VITAS quality of life index 25; ii) the multidimensional scale of perceived social support and iii) the simplified medication adherence questionnaire. Dialysis adequacy is expected to be related to QOL and adherence scores.

  14. EFFECTS OF ANGIOTENSIN II BLOCKADE WITH IRBESARTAN ON INFLAMMATORY MARKERS IN HAEMODIALYSIS PATIENTS: A RANDOMISED DOUBLE BLIND PLACEBO CONTROLLED ONE-YEAR FOLLOW-UP TRIAL (SAFIR STUDY)

    DEFF Research Database (Denmark)

    Peters, Christian Daugaard; Kjærgaard, Krista Dybtved; Nielsen, Claus H.;

    as factors using Stata/IC 12.1. Results Eighty-two patients were randomised (placebo/irbesartan: 41/41) and 56 completed one year of treatment. The groups (placebo/irbesartan) were comparable at baseline (mean±SD): Males 26(63%)/30(73%); age 62±14/61±16 years; systolic blood pressure (BP) 145±19/148±21 mm...

  15. Effect of Inflammation on the Relationship of Pulse Pressure and Mortality in Haemodialysis

    Directory of Open Access Journals (Sweden)

    Debasish Banerjee

    2012-01-01

    Full Text Available Background/Aim: The effect of hypertension on mortality in haemodialysis patients is controversial and can be confounded by non-traditional risk factors like systemic inflammation. This study examined the effect of systolic blood pressure (SBP, diastolic blood pressure (DBP, and pulse pressure (PP on mortality in haemodialysis patients, separately with and without markers of systemic inflammation. Methods:Data from the United States Renal Data System were analysed for 9,862 patients receiving haemodialysis on December 31, 1993, followed through May 2005. Results: In Cox regression analysis, increased age, diabetes, low albumin, high white blood count, low cholesterol, low haemoglobin, high phosphate, low DBP, and cardiovascular comorbidity were associated with high mortality, but SBP was not. Elevated PP adjusted for SBP, age, diabetes, haemoglobin, albumin, cholesterol, calcium, phosphate, parathyroid hormone, and white blood count was associated with higher mortality [adjusted hazard ratio, PP 1.006 (95% confidence interval, CI, 1.002–1.010; SBP 0.993 (95% CI 0.990–0.996]. In dual models, PP adjusted for SBP then DBP was associated with higher mortality [PP 1.029 (95% CI 1.027–1.032; SBP 0.981 (95% CI 0.979–0.983; PP 1.010 (95% CI 1.008–1.011; DBP 0.981 (95% CI 0.979–0.983]. Increasing PP deciles >70 mm Hg were associated with increasing mortality in the absence of markers of systemic inflammation (white blood count >10 × 109/l, albumin Conclusion: PP was a better indicator of adverse outcome than DBP or SBP. Inflammation-associated injury may mask the effect of PP on mortality in haemodialysis patients.

  16. Atypical manifestations in Brazilian patients with neuro-Behçet's disease.

    Science.gov (United States)

    Dutra, Lívia Almeida; Gonçalves, Célio Roberto; Braga-Neto, Pedro; Pedroso, José Luiz; Gabbai, Alberto Alain; Barsottini, Orlando Graziani Povoas; de Souza, Alexandre Wagner Silva

    2012-06-01

    Type and frequency of systemic and neurologic manifestations of Behçet's disease (BD) vary with ethnicity. In Brazil, BD occurs as sporadic cases. We describe clinical and radiological features of 36 Brazilian patients of mixed ethnicity with neuro-Behçet's disease (NBD). Medical records of 178 BD patients were reviewed and 36 (20%) NBD patients were identified. Twenty-one NBD patients (58.3%) were female and 27 (75%) presented with parenchymal manifestations. Brainstem involvement was the most common neurologic syndrome (41.7%). Seizures (27.8%), isolated aseptic meningitis (16.7%), optic neuropathy (ON) (16.7%), cerebral venous thrombosis (CVT) (8.3%), peripheral neuropathy (2.8%), and spinal cord involvement (5.6%) were other neurologic manifestations observed among Brazilian NBD patients. Eighteen (50%) had at least one relapse, and isolated aseptic meningitis was the most common relapsing manifestation. No significant differences concerning the number of relapses between parenchymal and non-parenchymal groups were found. A multivariate model including disease duration, cell count in spinal fluid, cyclosporine use, immunosuppressive use at disease onset, age at NBD onset, and ON did not reveal any significant associations with NBD relapse. There was a low frequency of CVT and an unexpected higher number of isolated aseptic meningitis. Brazilian NBD patients present more parenchymal and atypical manifestations, and relapse more often than NBD patients from other populations. PMID:22169955

  17. Data on HLA class I/II profile in Brazilian pemphigus patients.

    Science.gov (United States)

    Franco Brochado, Maria José; Nascimento, Daniela Francisca; Saloum Deghaide, Neifi Hassan; Donadi, Eduardo Antonio; Roselino, Ana Maria

    2016-09-01

    Pemphigus are blistering autoimmune diseases related with genetic and environmental factors. Here we describe HLA genotyping in pemphigus patients. First, we review the HLA class I/II data on pemphigus reported in Brazilian samples and then present the HLA class I (-A, -B, -C) and class II (-DRB1, -DQA1, -DQB1) alleles related to susceptibility/resistance to pemphigus by comparing 86 patients with pemphigus foliaceus, 83 patients with pemphigus vulgaris, and 1592 controls from the northeastern region of the state of São Paulo, Southeastern Brazil. The data presented here are related to the manuscript "Differential HLA class I and class II associations in Pemphigus Foliaceus and Pemphigus Vulgaris patients from a prevalent Southeastern Brazilian region" Brochado et al. (2016) [1]. PMID:27331116

  18. The use of patient education Roy Adaptation Model haemodialysisRoy Adaptasyon Modelinin hemodiyaliz hasta eğitiminde kullanımı

    Directory of Open Access Journals (Sweden)

    Ayşe Kacaroğlu Vicdan

    2014-07-01

    Full Text Available Chronic diseases are pathological changes which are non-healing, rapidly progressive, often causing disabilities and deficiencies, and individual to experience physical, psychological, social, economical limitations and pain, requiring long-term special care and control. For these reasons, chronic patients are a primary or secondary  stressor for the individual, family and society. Thus, the application of professional nursing models and selection of the accurate model are very important in the treatment of such diseases as they enable the compliance to treatment. The reason for selecting the Roy Adaptation Model as a nursing application in the treatment of patients with chronic renal failure is that this model handles the patient with an “integrated” approach. Because patients with CRF are exposed to a number of physical, psychological and social changes. Hemodialysis that is applied in the treatment of this disease affects the physiological needs, self-concepts, moods, social relations, roles and working lives of individuals. The Adaptation Model that was developed by Roy is a model that was prepared by considering all these needs. This article was written in an attempt to show the benefits of using the Roy Adaptation Model in the hemodialysis patient training. ÖzetKronik hastalıklar tam olarak iyileşmeyen, sürekli ilerleyen, çoğu kez kalıcı sakatlıklara yol açan, bireylerin fiziksel, psikolojik, sosyal, ekonomik sınırlılıklar ve ağrı yaşamasına neden olan, uzun süreli özel bakım ve kontrol gerektiren geriye dönüşsüz patolojik değişikliklerdir. Kronik hastalıklar birey, aile ve toplum için primer ya da sekonder bir stresördür. Bu nedenle, bu tür hastalıkların tedavisinde profesyonel hemşirelik modellerinin uygulanması hastalığa uyumu kolaylaştırdığı için doğru modelin seçilmesi son derece önemlidir. Kronik böbrek yetmezliği olan hastaların tedavisinde bir hemşirelik uygulaması olarak

  19. Influence of Haemodialysis on Susceptibility of Red Blood Cells to Peroxidation

    Directory of Open Access Journals (Sweden)

    Surekha B Khedkar

    2015-01-01

    Full Text Available Background: Uremic anaemia has been the subject of several studies, since it causes serious problems. Decreased RBC production and survival seem to be due to erythropoietin deficiency combined with cell damage. Aims and Objectives: During haemodialysis, complement and leukocyte activation by contact with artificial surfaces promotes the formation of free radicals. However, the cell membrane is protected from this damaging effect by the presence of very efficient antioxidant enzyme defence mechanism. When this protective system is overwhelmed, it leads to cellular damage in the form of decreased RBC survival. It is postulated that antioxidant capacity in uremic patients is reduced, yet the exact mechanism remains unclear. In view of this data a study was undertaken to determine the activities of antioxidant enzymes to assess the oxidant damage to RBC in terms of TBARS (Thiobarbituric Acid Reactive Substances. Materials and Methods:Blood samples were collected from patients (n=40, before and after dialysis. They were compared with age and sex matched normals (n=45, who served as controls. The activities of enzymes glutathione peroxidase (GSH-Px and Catalase (CAT along with glutathione reduced (GSH and malondialdehyde (MDA expressed as TBARS in the RBC of patients on haemodialysis were determined. Results: The results indicated a marginal to moderate decrease in the antioxidant enzyme activities, such as CAT and GSH-Px, and increased TBARS levels before and after dialysis. Conclusion: Our results are suggestive of an increased susceptibility of the RBC to peroxidation on haemodialysis.

  20. Does nutrition play a role in the quality of life of patients under chronic haemodialysis? ¿Desempeña la nutrición un papel en la calidad de vida de los pacientes con hemodiálisis crónica?

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    P. Raimundo

    2006-04-01

    Full Text Available Background: In patients with chronic renal failure under haemodialysis, we investigated the inter-relationships and relative contributions of disease, haemodialysis and of nutrition related factors on the patients' Quality of Life. Methods: Collected data in 60 adult patients comprised: co-morbidities (multiple medicines, other chronic diseases, duration of renal failure and of haemodialysis (in months, % weight loss since haemodialysis, nutrient intake derived from diet history analysis (DIETPLAN5 2003, UK. The EuroQoL instrument that includes 5 dimensions, mobility, self-care, activities, pain/discomfort, anxiety/depression, and an overall health visual analogue scale evaluated QoL. Results: Estimates of effect size attributed to each variable included in the general linear model revealed that 47% of patients' mobility/self-care scores were worsened by deficient protein/energy intake and 30% by weight loss=10%. Poor performance of usual activities was attributed in 45% to duration of haemodialysis and of disease, 70% to protein/energy/vitamin B12/zinc/iron deficits, and 20% to weight loss =10%. Pain/discomfort were worsened in 45% by the duration of haemodialysis and of disease,and in 15% by co-morbidities. Higher anxiety/depression were related in 43% to protein/energy/selenium & vitamin C deficits, in 40% to the duration of haemodialysis and of disease, in 10% to weight loss =10%, and in 3% to co-morbidities. Likewise, 47% of poor overall health was determined by protein/energy/vitamin B12/zinc/selenium & vitamin C deficits, 25% by weight loss=10%, 10% by disease duration, and 7% by co-morbidities. Conclusion: Protein, antioxidants and key micronutrients involved in protein metabolism, did exert a major effect on patients' Quality of Life. Given the prevalence of nutrient deficits, the ensuing impaired functional capacity is likely to compromise QoL, timely nutrition is thus warranted.Antecedentes: en pacientes con insuficiencia renal cr

  1. 间歇性血液透析中不同浓度肝素封管法的对比研究%Impact of heparin locking concentration on preventing temporary dialysis catheter dysfunction in intermittent haemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    金爱萍; 葛志兰

    2011-01-01

    目的 观察间歇性血液透析(IHD)患者深静脉置管不同浓度肝素封管的效果,探讨合适封管的肝素浓度.方法 将108例维持血液透析患者随机分为3组,每组36例,封管液使用肝素钠和0.9%氯化钠配制,肝素浓度分别为A组1250U/mL,B组3125 U/mL,C组5208 U/mL;监测凝血象、观察3种肝素溶液封管后患者出血并发症、导管堵塞率、导管留置时长、导管相关感染发生率等.结果 3组凝血象指标改变不显著(P>0.05);与A组相比肝素浓度高的两组血透置管留置时间较长,管腔堵塞、导管相关感染(CRI)发生率低,差异均有统计学意义,且C组好于B组.结论 高浓度肝素封管可延长单针双腔深静脉透析管使用寿命,且不增加患者出血的风险,可成为IHD患者维持临时血管通路理想的封管方法.%Objective To compare the effectiveness of three heparin concentrations in preventing catheter malfunction, and to investigate the reasonable concentration of heparin - locking solution. Methods One hundred and eight sustaining haemodialysis patients were randomly divided into three groups, each with 36 patients. The heparin - locking solution was made of heparin sodium and 0.9% sodium chloride solution. The different concentration of heparin - locking solution was used to fill each lumen of the hemodialysis central venous catheter: group A (1 250 U/mL), group B (3 125 U/mL), group C (5 208 U/mL). Blood coagulogram, the venipuncture export bleeding or other bleedings, catheter blocking because of intracatheter thrombosis, the period of dialysis catheter in good function and the rate of catheter - related infections (CRI) were observed. Results There was no significant difference on blood coagulogram and bleeding (P>0.05). The incidence of catheter blocking, CRI in Group B and group C was significant fewer than group A, and the time of using the catheter in Group B and group C was longer than group A. Moreover, the results of group C

  2. The effect of multiple sclerosis on the professional life of a group of Brazilian patients

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    Yára Dadalti Fragoso

    2010-12-01

    Full Text Available OBJECTIVE: To assess the impact of multiple sclerosis (MS on the professional life of Brazilian patients. METHOD: One hundred MS patients were randomly selected from the database of the Brazilian Multiple Sclerosis Association (ABEM. An individual interview was carried out by telephone by a member of ABEM, who collected data on the patients' clinical status, educational level and professional lives. RESULTS: Complete data were obtained from 96 patients (27 males and 69 females aged 55.0±14.1 years, with average disease duration of 4.6±4.0 years. Eighty percent had eleven or more years of schooling. Among the whole group, 66% did not present limitations on walking. The longer the disease duration and the older the patient were, the higher the chances were that the patient was retired or receiving workers' compensation benefits. However, even among patients with MS for less than five years, the rate of non-participation in the workforce was 47.7%. Fatigue, paresthesia, cognitive dysfunction and pain were often cited as the motives for not working. CONCLUSION: MS patients presented high levels of unemployment, retirement and receipt of workers' compensation benefits, despite their high schooling levels. Age, disease duration and disability influenced these results for the whole group. However, even among younger patients with shorter disease duration and low disability, this finding remained.

  3. Pegylated Interferon (Alone or With Ribavirin for Chronic Hepatitis C in Haemodialysis Population

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    Mario Espinosa

    2015-05-01

    Full Text Available Background/Aims: Hepatitis C virus infection remains prevalent among patients undergoing long-term haemodialysis and has a detrimental impact on survival in this population. Antiviral therapy for chronic hepatitis C in haemodialysis patients is still a challenge to clinicians. The aim of the current study is to evaluate the efficacy and safety of therapy with pegylated interferon, alone or combined with ribavirin, for chronic hepatitis C among patients undergoing long-term hemodialysis. Methods: We conducted a retrospective, multicenter cohort trial with monotherapy (pegylated interferon (n=21 or combined antiviral therapy (pegylated interferon plus ribavirin (n=5 for chronic hepatitis C in patients undergoing long-term haemodialysis. Results: Sustained virological response was obtained in eleven (42% patients. Seven (26.9% patients interrupted prematurely the antiviral treatment due to serious side-effects, the most frequent cause of treatment withdrawal being hematological (n=3. HCV RNA load was lower in responder than non-responder patients, 5.44 (3.45; 6.36 vs. 5.86 (4.61; 6.46 log10 copies/mL, even if the difference was not significant (P=0.099. Blood transfusion requirement was greater in patients on combined antiviral therapy than those on pegylated interferon alone, 100% (5/5 vs. 0% (0/21, P=0.0001. No difference in sustained viral response occurred between patients on combined antiviral therapy and those on pegylated interferon monotherapy [40% (2/5 vs. 42.8% (9/21, P=0.90]. Conclusions: Results from this study showed that pegylated interferon alone or with ribavirin is unsatisfactory in terms of efficacy and safety. Prospective trials based on interferon-free regimens (i.e., sofosbuvir plus ribavirin or sofosbuvir plus daclatasvir are under way in patients with hepatitis C receiving long-term hemodialysis.

  4. Development of a quantitative food frequency questionnaire for Brazilian patients with type 2 diabetes

    OpenAIRE

    Sarmento, Roberta Aguiar; Riboldi, Bárbara Pelicioli; da Costa Rodrigues, Ticiana; Mirela Jobim de AZEVEDO; de Almeida, Jussara Carnevale

    2013-01-01

    Background To investigate the association between dietary components and development of chronic diabetic complications, the dietary evaluation should include a long period, months or years. The present manuscript aims to develop a quantitative food frequency questionnaire (FFQ) and a portfolio with food photos to assess the usual intake pattern of Brazilian patients with type 2 diabetes to be used in future studies. Methods Dietary data using 3-day weighed diet records (WDR) from 188 outpatie...

  5. Treatment Outcomes in Tuberculosis Patients with Diabetes: A Polytomous Analysis Using Brazilian Surveillance System

    OpenAIRE

    Reis-Santos, Bárbara; Gomes, Teresa; Locatelli, Rodrigo; de Oliveira, Elizabete R.; Sanchez, Mauro N; Bernardo L Horta; Riley, Lee W.; Maciel, Ethel L

    2014-01-01

    Background The impact of non-communicable diseases on tuberculosis incidence has received significant attention. It has been suggested that the risk of tuberculosis is higher among subjects with diabetes and these subjects also has poor TB treatment outcomes.This study was aimed at assessing the socio-demographic and clinical factors that may influence different outcome of TB in patients with DM (TB-DM) identified in the Brazilian national database from 2001 to 2011. Methods TB-DM cases repor...

  6. Effects of Brazilian Cardioprotective Diet Program on risk factors in patients with coronary heart disease: a Brazilian Cardioprotective Diet randomized pilot trial

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    Bernardete Weber

    2012-12-01

    Full Text Available OBJECTIVE: To evaluate the effectiveness of the Brazilian Cardioprotective Diet Program in reducing blood pressures, fasting glucose levels and body mass indices in patients with established atherothrombotic disease. METHOD: This randomized controlled pilot trial included outpatients who were over 45 years of age with atherothrombotic cardiovascular disease. Group A, who received the Brazilian Cardioprotective Diet Program, had weekly sessions with dietitians. Groups B and C received the usual dietary therapy that is given to patients with cardiovascular diseases as proposed by the Brazilian guidelines. This diet had the same nutrient profile as that given to Group A, but it was customized by the integration of typical Mediterranean foods. The difference between Groups B and C was the number of sessions with the dietitian. Group B received weekly sessions, while group C only had monthly sessions. ClinicalTrials.gov: NCT 01453166. RESULTS: There was a greater reduction in systolic (7.8% and diastolic (10.8% blood pressures in Group A compared with Group B (2.3% and 7.3%, and Group C (3.9% and 4.9%, respectively. Fasting glucose decreased by 5.3% and 2% in Groups A and B, respectively. Fasting glucose increased by 3.7% in Group C. The BMIs decreased by 3.5% and 3.3% in Groups A and B, respectively. Group C did not present with any changes in BMI. However, none of these data showed statistical differences between the groups, which is methodologically acceptable in pilot trials. CONCLUSIONS: The Brazilian Cardioprotective Diet Program seems to be more effective in reducing blood pressures, fasting glucose levels, weights and BMIs in patients with previous cardiovascular disease compared with the diet that has been proposed by the Brazilian guidelines.

  7. Analysis of body composition and nutritional status in Brazilian phenylketonuria patients

    Science.gov (United States)

    Mazzola, Priscila Nicolao; Nalin, Tatiele; Castro, Kamila; van Rijn, Margreet; Derks, Terry G.J.; Perry, Ingrid D.S.; Mainieri, Alberto Scofano; Schwartz, Ida Vanessa D.

    2016-01-01

    Background Phenylketonuria (PKU) is characterized by phenylalanine (Phe) accumulation to toxic levels due to the low activity of phenylalanine-hydroxylase. PKU patients must follow a Phe-restricted diet, which may put them in risk of nutritional disturbances. Therefore, we aimed to characterize body composition parameters and nutritional status in Brazilian PKU patients also considering their metabolic control. Methods Twenty-seven treated PKU patients older than 5 years, and 27 age- and gender-matched controls, were analyzed for anthropometric features and body composition by bioelectrical impedance (BIA). Patients' metabolic control was assessed by historical Phe levels. Results There was no effect of PKU type, time of diagnosis, or metabolic control for any analyzed parameter. About 75% of patients and controls were eutrophic, according to their BMI values. There were no difference between groups regarding body composition and other BIA-derived parameters. Conclusions Brazilian PKU patients do not show differences in body composition and nutritional status in comparison with controls, regardless metabolic control. Although similar to controls, PKU patients may be in risk of disturbed nutritional and metabolic markers as seen for the general population. PMID:27014574

  8. Frequency of Cardiovascular Involvement in Familial Amyloidotic Polyneuropathy in Brazilian Patients

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    Márcia Cavalcanti de Campos Queiroz

    2015-11-01

    Full Text Available Background:Familial amyloidotic polyneuropathy (FAP is a rare disease diagnosed in Brazil and worldwide. The frequency of cardiovascular involvement in Brazilian FAP patients is unknown.Objective:Detect the frequency of cardiovascular involvement and correlate the cardiovascular findings with the modified polyneuropathy disability (PND score.Methods:In a national reference center, 51 patients were evaluated with clinical examination, electrocardiography (ECG, echocardiography (ECHO, and 24-hour Holter. Patients were classified according to the modified PND score and divided into groups: PND 0, PND I, PND II, and PND > II (which included PND IIIa, IIIb, and IV. We chose the classification tree as the statistical method to analyze the association between findings in cardiac tests with the neurological classification (PND.Results:ECG abnormalities were present in almost 2/3 of the FAP patients, whereas ECHO abnormalities occurred in around 1/3 of them. All patients with abnormal ECHO also had abnormal ECG, but the opposite did not apply. The classification tree identified ECG and ECHO as relevant variables (p < 0.001 and p = 0.08, respectively. The probability of a patient to be allocated to the PND 0 group when having a normal ECG was over 80%. When both ECG and ECHO were abnormal, this probability was null.Conclusions:Brazilian patients with FAP have frequent ECG abnormalities. ECG is an appropriate test to discriminate asymptomatic carriers of the mutation from those who develop the disease, whereas ECHO contributes to this discrimination.

  9. Prostatic disorders in acromegalic patients experience of a Brazilian center

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    Livia L. Correa

    2013-06-01

    Full Text Available Introduction Published data suggest that patients with acromegaly have an increased prevalence of prostate disorders. Objective To evaluate prostatic disorders in acromegalic patients comparing these results after one year of treatment of acromegaly and with a group of healthy men. Materials and Methods This study was composed of two parts: sectional study comparing patients with healthy controls (baseline and prospective, longitudinal study (at baseline and after one year of treatment. Forty acromegalic patients were enrolled and evaluated at baseline and after one year with the application of international prostatic symptoms score (IPSS, digital rectal examination, measurements of growth hormone (GH, insulin-like growth factor-I (IGF-I, insulin-like growth factor-binding protein-3 (IGFBP-3, sex hormone-binding globulin (SHBG, prolactin, luteinizing hormone (LH, follicle-stimulating hormone (FSH, total testosterone, total and free prostate-specific antigen (PSA levels and prostate ultrasonography (US. Thirty healthy men were selected as control group. Results We stratified patients and controls according to age, considering 40 years-old as cut off. Healthy controls under 40 had IPSS values lower than acromegalic patients. When considering only older patients and controls prostate hyperplasia and structural abnormalities were more frequent in acromegalics. After one year of treatment there was significant decrease in GH, IGF-I and prostate volume in acromegalics over 40 years-old. Conclusions Acromegalics under 40 have more urinary symptoms according to IPSS and above 40 years-old higher frequency of structural changes and increased prostate volume than healthy men. Significant reduction of GH and IGF-I levels during treatment of acromegaly leads to decrease in the prostate volume.

  10. Moyamoya disease: report of three cases in Brazilian patients

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    FRANCO CLÉLIA MARIA RIBEIRO

    1999-01-01

    Full Text Available Moyamoya disease (MMD is a chronic occlusive cerebrovascular disease of unknown etiology reported mainly in the Japanese. Most cases occur in children. The disease is rare in non-Oriental adults manifesting itself mostly as intracerebral hemorrhages. We describe MMD in 2 non-Oriental young adults and one adolescent that developed cerebral infarctions. The adults were medicated with aspirin and no medication was given to the adolescent. All patients did not deteriorate in a follow-up period from 1 to 4 years. Although rare, MMD is an important cause of stroke in young individuals and may well be underreported: only 18 patients have been reported till 1997 in Brazil. Neurologists should include MMD in differential diagnosis of ischemic and hemorrhagic strokes in young adults.

  11. The costs in provision of haemodialysis in a developing country: A multi-centered study

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    Wijesinghe Aruna

    2011-09-01

    Full Text Available Abstract Background Chronic Kidney Disease is a major public health problem worldwide with enormous cost burdens on health care systems in developing countries. We aimed to provide a detailed analysis of the processes and costs of haemodialysis in Sri Lanka and provide a framework for modeling similar financial audits. Methods This prospective study was conducted at haemodialysis units of three public and two private hospitals in Sri Lanka for two months in June and July 2010. Cost of drugs and consumables for the three public hospitals were obtained from the price list issued by the Medical Supplies Division of the Department of Health Services, while for the two private hospitals they were obtained from financial departments of the respective hospitals. Staff wages were obtained from the hospital chief accountant/chief financial officers. The cost of electricity and water per month was calculated directly with the assistance of expert engineers. An apportion was done from the total hospital costs of administration, cleaning services, security, waste disposal and, laundry and sterilization for each unit. Results The total number of dialysis sessions (hours at the five hospitals for June and July were 3341 (12959 and 3386 (13301 respectively. Drug and consumables costs accounted for 70.4-84.9% of the total costs, followed by the wages of the nursing staff at each unit (7.8-19.7%. The mean cost of a dialysis session in Sri Lanka was LKR 6,377 (US$ 56. The annual cost of haemodialysis for a patient with chronic renal failure undergoing 2-3 dialysis session of four hours duration per week was LKR 663,208-994,812 (US$ 5,869-8,804. At one hospital where facilities are available for the re-use of dialyzers (although not done during study period the cost of consumables would have come down from LKR 5,940,705 to LKR 3,368,785 (43% reduction if the method was adopted, reducing costs of haemodialysis per hour from LKR 1,327 at present to LKR 892 (33

  12. Frequency of islet cell autoantibodies (IA-2 and GAD in young Brazilian type 1 diabetes patients

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    V.C. Pardini

    1999-10-01

    Full Text Available Type 1 diabetes, as an autoimmune disease, presents several islet cell-specific autoantibodies such as islet cell antibody (ICA, anti-insulin, anti-glutamic acid decarboxylase (GAD and the antibody (Ab against tyrosine phosphatase (PTP-like protein known as ICA-512 (IA-2. In order to determine the frequency of the anti-GAD and anti-IA-2 autoantibodies in Brazilian type 1 diabetes patients we studied 35 diabetes mellitus (DM type 1 patients with recent-onset disease (£12 months and 37 type 1 diabetes patients with long-duration diabetes (>12 months who were compared to 12 children with normal fasting glucose. Anti-GAD65 and anti-IA-2 autoantibodies were detected with commercial immunoprecipitation assays. The frequency of positive results in recent-onset DM type 1 patients was 80.0% for GADAb, 62.9% for IA-2Ab and 82.9% for GADAb and/or IA-2Ab. The long-duration type 1 diabetes subjects presented frequencies of 54.1% for GADAb and IA-2Ab, and 67.5% for GAD and/or IA-2 antibodies. The control group showed no positive cases. Anti-GAD and IA-2 assays showed a high frequency of positivity in these Brazilian type 1 diabetes patients, who presented the same prevalence as a Caucasian population.

  13. A survey of oral biopsies in Brazilian pediatric patients.

    Science.gov (United States)

    Maia, D M; Merly, F; Castro, W H; Gomez, R S

    2000-01-01

    This paper presents a review of 1018 oral biopsies in pediatric patients from the Oral Pathology Service, Minas Gerais Federal University, Brazil. The lesions were divided into ten main categories. The most common oral lesions in this study were follicular cyst in the maxillary anterior region, followed by inflammatory fibrous hyperplasia in the same region, and mucocele in the lower lip. Cysts of the jaws and oral soft tissues comprised 26.1 percent of total oral biopsies. The importance of these findings in oral diagnosis is discussed. PMID:10826049

  14. Anemia and functional capacity in elderly Brazilian hospitalized patients.

    Science.gov (United States)

    Bosco, Raquel de Macedo; Assis, Elisa Priscila Souza; Pinheiro, Renata Rosseti; Queiroz, Luiza Cristina Viana de; Pereira, Leani S M; Antunes, Carlos Maurício Figueiredo

    2013-07-01

    This study evaluated the association between anemia and physical functional capacity in a cross-sectional population-based sample of 709 hospitalized elderly patients aged 60 years and over admitted to the Madre Teresa Hospital, Belo Horizonte, State of Minas Gerais, Brazil. The Mann-Whitney or "t" test, and chi-square or Fisher exact test were used for quantitative and categorical variables, respectively, and hierarchical binary logistic regression was used to identify significant predictors. The presence of anemia was found in 30% of participants and was significantly associated with decreased functionality according to the two measures which were used - ADL (activities of daily living) and IADL (instrumental activities of daily living). Anemia was also independently associated with older age. The results of this study demonstrate a strong association between the presence of anemia and lower levels of functional capacity. Further investigations are needed to assess the impact of anemia treatment on the functionality and independence of older people.

  15. Multicenter Brazilian Study of Oral Candida Species Isolated from Aids Patients

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    Priscilla de Laet Sant'Ana

    2002-03-01

    Full Text Available Oropharyngeal candidiasis continues to be considered the most common opportunistic disease in Aids patients. This study was designed to investigate species distribution, serotype and antifungal susceptibility profile among Candida spp. isolated from the oral cavity of Aids patients recruited from six Brazilian university centers. Oral swabs from 130 Aids patients were plated onto CHROMagar Candida medium and 142 isolates were recovered. Yeast isolates were identified by classical methods and serotyped using the Candida Check® system-Iatron. Antifungal susceptibility testing was performed according to the NCCLS microbroth assay. C. albicans was the most frequently isolated species (91%, and 70% of the isolates belonged to serotype A. We detected 12 episodes of co-infection (9%, including co-infection with both serotypes of C. albicans. Non-albicans species were isolated from 12 episodes, 50% of them exhibited DDS or resistance to azoles. Otherwise, only 8 out 130 isolates of C. albicans exhibited DDS or resistance to azoles. Brazilian Aids patients are infected mainly by C. albicans serotype A, most of them susceptible to all antifungal drugs.

  16. Anemia and functional capacity in elderly Brazilian hospitalized patients

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    Raquel de Macedo Bosco

    2013-07-01

    Full Text Available This study evaluated the association between anemia and physical functional capacity in a cross-sectional population-based sample of 709 hospitalized elderly patients aged 60 years and over admitted to the Madre Teresa Hospital, Belo Horizonte, State of Minas Gerais, Brazil. The Mann-Whitney or "t" test, and chi-square or Fisher exact test were used for quantitative and categorical variables, respectively, and hierarchical binary logistic regression was used to identify significant predictors. The presence of anemia was found in 30% of participants and was significantly associated with decreased functionality according to the two measures which were used - ADL (activities of daily living and IADL (instrumental activities of daily living. Anemia was also independently associated with older age. The results of this study demonstrate a strong association between the presence of anemia and lower levels of functional capacity. Further investigations are needed to assess the impact of anemia treatment on the functionality and independence of older people.

  17. Mutations of androgen receptor gene in Brazilian patients with male pseudohermaphroditism

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    D.F. Cabral

    1998-06-01

    Full Text Available We describe the identification of point mutations in the androgen receptor gene in five Brazilian patients with female assignment and behavior. The eight exons of the gene were amplified by the polymerase chain reaction (PCR and analyzed for single-strand conformation polymorphism (SSCP to detect the mutations. Direct sequencing of the mutant PCR products demonstrated single transitions in three of these cases: G®A in case 1, within exon C, changing codon 615 from Arg to His; G®A in case 2, within exon E, changing codon 752 from Arg to Gln, and C®T in case 3, within exon B, but without amino acid change.

  18. BIOIMPEDANCE ANALYSIS IN HAEMODIALYSIS PRACTICE: SHORT REVIEW AND SINGLE CENTER EXPERIENCE

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    A.G. Strokov

    2012-01-01

    Full Text Available Bioimpedance analysis has been widely used to estimate a hydration state, lean and fat mass in haemodialysis patients. The aim of our study was to investigate the validity and usefulness of bioimpedance analysis in routine dialysis practice. Last two years we used the body composition monitoring (BCM, Fresenius Medical Care, method based on whole body multifrequency bioimpedance spectroscopy (BIS, compared with traditional clinical data. For BIS data verification, hydration status of 32 stable HD patients with dialysis vintage more than 3 years and clinically well established dry weight were studied. Only in three cases BIS data seems underestimated in serial measurements. Next step, 28 healthy subjects and 116 dialysis patients were studied. Total body water and extracellular volume (ECV were significantly higher in dialysis group (P<0.01, and there was not any difference in intracellular volume (ICV. Mean AP was similar in patients with moderate (<15% and massive (>15% relative overhydration (RO = overhydration / ECV, at the same time, average number of antihypertensive medications was significantly higher in more overhydrated patients (3.1 vs 1.2. In clinical practice RO is more convenient indicator as compared to standard overhydration volume /dry weight ratio. Mutual application of the BIS and blood volume monitoring allows more rapid and safe dry weight achievement. BIS was useful tool for hydration status monitoring in routine haemodialysis practice, and further work need to be done to clarify BIS validity for nutritional status estimation. 

  19. Cancer Appetite and Symptom Questionnaire (CASQ) for Brazilian Patients: Cross-Cultural Adaptation and Validation Study

    Science.gov (United States)

    Serrano, Sergio Vicente; Halliday, Vanessa; Maroco, João; Campos, Juliana Alvares Duarte Bonini

    2016-01-01

    Background Appetite and symptoms, conditions generally reported by the patients with cancer, are somewhat challenging for professionals to measure directly in clinical routine (latent conditions). Therefore, specific instruments are required for this purpose. This study aimed to perform a cultural adaptation of the Cancer Appetite and Symptom Questionnaire (CASQ), into Portuguese and evaluate its psychometric properties on a sample of Brazilian cancer patients. Methods This is a validation study with Brazilian cancer patients. The face, content, and construct (factorial and convergent) validities of the Cancer Appetite and Symptom Questionnaire, the study tool, were estimated. Further, a confirmatory factor analysis (CFA) was conducted. The ratio of chi-square and degrees of freedom (χ2/df), comparative fit index (CFI), goodness of fit index (GFI) and root mean square error of approximation (RMSEA) were used for fit model assessment. In addition, the reliability of the instrument was estimated using the composite reliability (CR) and Cronbach’s alpha coefficient (α), and the invariance of the model in independent samples was estimated by a multigroup analysis (Δχ2). Results Participants included 1,140 cancer patients with a mean age of 53.95 (SD = 13.25) years; 61.3% were women. After the CFA of the original CASQ structure, 2 items with inadequate factor weights were removed. Four correlations between errors were included to provide adequate fit to the sample (χ2/df = 8.532, CFI = .94, GFI = .95, and RMSEA = .08). The model exhibited a low convergent validity (AVE = .32). The reliability was adequate (CR = .82 α = .82). The refined model showed strong invariance in two independent samples (Δχ2: λ: p = .855; i: p = .824; Res: p = .390). A weak stability was obtained between patients undergoing chemotherapy and radiotherapy (Δχ2: λ: p = .155; i: p < .001; Res: p < .001), and between patients undergoing chemotherapy combined with radiotherapy and

  20. Characterising haemodialysis-associated cardiomyopathy using deformation imaging by cardiovascular magnetic resonance tagging and speckle-tracking echocardiography

    OpenAIRE

    Odudu, Aghogho

    2013-01-01

    Haemodialysis patients represent an extreme phenotype of cardiovascular risk with a pattern of disease distinct from that in the general population. Non-traditional risk factors, specific to chronic kidney disease such as hypervolaemia, arterial stiffness and advanced glycation end-product deposition are increasingly recognised. A previously demonstrated non-traditional risk factor associated with worse outcomes is the presence of uraemic cardiomyopathy. This pattern of cardiac morphology and...

  1. European trial of free light chain removal by extended haemodialysis in cast nephropathy (EuLITE): A randomised control trial

    OpenAIRE

    Billingham Lucinda; Weisel Katja; Heyne Nils; Cook Mark; Hutchison Colin A; Bradwell Arthur; Cockwell Paul

    2008-01-01

    Abstract Background Renal failure is a frequent complication of multiple myeloma and when severe is associated with a greatly increased morbidity and mortality. The principal cause of severe renal failure is cast nephropathy, a direct consequence of high concentrations of monoclonal free light chains (FLCs) in patients' sera. FLC removal by extended haemodialysis, using a high cut-off dialyser, has recently been described as a novel therapeutic option. Methods The EUropean trial of free LIght...

  2. Successful use of combined high cut-off haemodialysis and bortezomib for acute kidney injury associated with myeloma cast nephropathy.

    LENUS (Irish Health Repository)

    Ward, F

    2012-05-01

    We present the case of a 58-year old female with de novo dialysis-dependent acute kidney injury (AKI) secondary to myeloma cast nephropathy. The patient underwent extended high cut-off haemodialysis (HCO-HD), in conjunction with bortezomib-based chemotherapy, and soon became dialysis independent with normal renal function. To our knowledge, this is the first time this treatment strategy has been employed successfully in an Irish centre.

  3. Sunitinib treatment in patients with advanced renal cell cancer: the Brazilian National Cancer Institute (INCA) experience

    Science.gov (United States)

    Coelho, Rafael Corrêa; Reinert, Tomás; Campos, Franz; Peixoto, Fábio Affonso; de Andrade, Carlos Augusto; Castro, Thalita; Herchenhorn, Daniel

    2016-01-01

    ABSTRACT Purpose: The aim of this study was to assess the impact of sunitinib treatment in a non-screened group of patients with metastatic renal cell cancer (mRCC) treated by the Brazilian Unified Health System (SUS) at a single reference institution. Material and Methods: Retrospective cohort study, which evaluated patients with mRCC who received sunitinib between May 2010 and December 2013. Results: Fifty-eight patients were eligible. Most patients were male 41 (71%), with a median age of 58 years. Nephrectomy was performed in 41 (71%) patients with a median interval of 16 months between the surgery and initiation of sunitinib. The most prevalent histological subtype was clear cell carcinoma, present in 52 (91.2%) patients. In 50 patients (86%), sunitinib was the first line of systemic treatment. The main adverse effects were fatigue (57%), hypothyroidism (43%), mucositis (33%) and diarrhea (29%). Grade 3 and 4 adverse effects were infrequent: fatigue (12%), hypertension (12%), thrombocytopenia (7%), neutropenia (5%) and hand-foot syndrome (5%). Forty percent of patients achieved a partial response and 35% stable disease, with a disease control rate of 75%. Median progression free survival was 7.6 months and median overall survival was 14.1 months. Conclusion: Sunitinib treatment was active in the majority of patients, especially those with low and intermediate risk by MSKCC score, with manageable toxicity. Survival rates were inferior in this non-screened population with mRCC treated in the SUS. PMID:27564279

  4. Elbow arteriovenous fistulas for chronic haemodialysis.

    Science.gov (United States)

    Elcheroth, J; de Pauw, L; Kinnaert, P

    1994-07-01

    Arteriovenous fistulas (AVFs) were created at the elbow, rather than using prosthetic grafts, when forearm vessels were inadequate. A total of 272 such fistulas were constructed: 49 between the brachial artery and a forearm vein, 91 between the brachial artery and the elbow perforating vein, 52 between the brachial artery and the cephalic vein and 80 between the brachial artery and the basilic vein. In each case the vein was sutured end to side to the artery. The immediate failure rate was 11.8 per cent. The 1- and 4-year cumulative patency rates were 68.7 and 51.2 per cent for brachial artery-forearm vein AVFs, 80.3 and 68.0 per cent for those between the brachial artery and the elbow perforator, 74.1 and 61.3 per cent for brachial artery-cephalic vein fistulas, and 76.7 and 49.2 per cent for those between the brachial artery and the basilic vein. The elbow AVF is a reliable means of establishing vascular access for haemodialysis. PMID:7922091

  5. Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system

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    Valderilio Feijó Azevedo

    2016-04-01

    Full Text Available ABSTRACT Introduction: Patients with Ankylosing Spondylitis (AS require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact. Objectives: To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public System, establishing approximate values for the direct and indirect costs of treating this illness in Brazil. Material and methods: 93 patients selected from the ambulatory spondyloarthritis clinic at the Hospital de Clínicas of the Federal University of Paraná between September 2011 and September 2012 had their direct costs indirect treatment costs estimation. Results: 70 patients (75.28% were male and 23 (24.72% female. The mean age was 43.95 years. The disease duration was calculated based on the age of diagnosis and the mean was 8.92 years (standard deviation: 7.32; 63.44% were using anti-TNF drugs. Comparing male and female patients the mean BASDAI was 4.64 and 5.49 while the mean BASFI was 5.03 and 6.35 respectively. Conclusions: The Brazilian public health system's spending related to ankylosing spondylitis has increased in recent years. An important part of these costs is due to the introduction of new, more expensive health technologies, as in the case of nuclear magnetic resonance and, mainly, the incorporation of anti-TNF therapy into the therapeutic arsenal. The mean annual direct and indirect cost to the Brazilian public health system to treat a patient with ankylosing spondylitis, according to our findings, is US$ 23,183.56.

  6. Common N-acetylgalactosamine-6-sulfate sulfatase (GALNS exon mutations in Brazilian patients with mucopolysaccharidosis IVA (MPS IVA

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    Tatiana Dieter

    2007-01-01

    Full Text Available Morquio A Syndrome (mucopolysaccharidosis IVA - MPS IVA, OMIM# 253000 is an autosomal recessive inborn error of metabolism caused by the deficiency of N-acetylgalactosamine-6-sulfate sulfatase (GALNS. We investigated five unrelated Brazilian MPS IVA families for mutations in exons 4, 5, 9 and 10 of the GALNS gene. Six out of the 10 mutant alleles were identified. Taken together with a previous study, which included six unrelated families, common mutations among Brazilian patients were p.N164T, p.G116S and p.G301C. Among one hundred control subjects three novel silent mutations were found (p.A107A; GCC -> GCT, p.Y108Y; TAC -> TAT, p.P357P; CCG -> CCA. Screening starting with exons 4, 5, 9, 10 and 11 may be a good strategy for genotyping of Brazilian patients since these exons include 73% of all mutations identified in the current and previous studies.

  7. Merosin-deficient congenital muscular dystrophy (CMD): a study of 25 Brazilian patients using MRI

    International Nuclear Information System (INIS)

    Merosin-deficient congenital muscular dystrophy (CMD) is characterized clinically by hypotonia and muscular weakness and, on imaging studies, by white matter (WM) abnormality. To evaluate MRI findings in Brazilian patients with merosin-deficient CMD. Twenty-five patients were evaluated using MRI. Three patients presented with partial merosin deficiency and 22 with total merosin deficiency. Follow-up examinations were done in 7 cases. T1- and T2-weighted images were performed in all examinations, and fluid-attenuated inversion recovery (FLAIR) was performed in 15. Enhanced images were done in 11 cases. The WM involvement was classified according to location and severity. From 1991 to 2004, 32 MRI examinations were performed. Severe involvement was found in 23 patients in the frontal and temporal lobes, in 18 patients in the parietal lobes, and in 7 patients in the occipital lobes. The brain stem (n=5), cerebellum (n=6), internal capsules (n=1), and external capsules (n=5) were also affected. One patient had occipital pachygyria, and one had cerebellar vermian hypoplasia. No gadolinium enhancement was noted. Follow-up MRI showed no interval change (n=4), progression (n=1), or improvement of the findings (n=2). (orig.)

  8. Merosin-deficient congenital muscular dystrophy (CMD): a study of 25 Brazilian patients using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Claudia C.; Lucato, Leandro T.; Martin, Maria G.M. [School of Medicine of the University of Sao Paulo, Department of Radiology, Sao Paulo, SP (Brazil); Ferreira, Lucio G.; Resende, Maria B.D.; Carvalho, Mary S.; Marie, Suely K.N.; Reed, Umbertina C. [School of Medicine of the University of Sao Paulo, Department of Neurology, Sao Paulo, SP (Brazil); Jinkins, J.Randy [Downstate Medical Center, State University of New York, Department of Radiology, Brooklyn, NY (United States)

    2005-06-01

    Merosin-deficient congenital muscular dystrophy (CMD) is characterized clinically by hypotonia and muscular weakness and, on imaging studies, by white matter (WM) abnormality. To evaluate MRI findings in Brazilian patients with merosin-deficient CMD. Twenty-five patients were evaluated using MRI. Three patients presented with partial merosin deficiency and 22 with total merosin deficiency. Follow-up examinations were done in 7 cases. T1- and T2-weighted images were performed in all examinations, and fluid-attenuated inversion recovery (FLAIR) was performed in 15. Enhanced images were done in 11 cases. The WM involvement was classified according to location and severity. From 1991 to 2004, 32 MRI examinations were performed. Severe involvement was found in 23 patients in the frontal and temporal lobes, in 18 patients in the parietal lobes, and in 7 patients in the occipital lobes. The brain stem (n=5), cerebellum (n=6), internal capsules (n=1), and external capsules (n=5) were also affected. One patient had occipital pachygyria, and one had cerebellar vermian hypoplasia. No gadolinium enhancement was noted. Follow-up MRI showed no interval change (n=4), progression (n=1), or improvement of the findings (n=2). (orig.)

  9. Teratogen exposure and congenital ocular abnormalities in Brazilian patients with Möbius sequence

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    Camila V. Ventura

    2014-10-01

    Full Text Available Purpose: To assess the sociodemographic profiles, teratogen exposures, and ocular congenital abnormalities in Brazilian patients with Möbius sequence. Method: Forty-four patients were recruited from the Brazilian Möbius Sequence Society. This cross-section comprised 41 patients (age, mean ± standard deviation, 9.0 ± 5.5 years who fulfilled the inclusion criteria. The parent or caregiver answered a questionnaire regarding sociodemographic data and pregnancy history. Patients underwent ophthalmological assessments. They were subdivided into groups according to misoprostol exposure during pregnancy, and the two groups were compared. Results: Mothers/caregivers reported unplanned pregnancies in 36 (88% cases. Of these, 19 (53% used misoprostol during their first trimesters. A stable marital status tended to be more frequent in the unexposed group (P=0.051. Incomplete elementary school education was reported by two (11% mothers in the exposed group and by three (14% mothers in the unexposed group (P=0.538. The mothers' gestational exposures to cocaine, marijuana, alcohol, and cigarettes were similar in both groups (P=0.297, P=0.297, P=0.428, and P=0.444, respectively. One (5% case of Rubella infection during pregnancy was found in the unexposed group. The main malformations in the exposed and unexposed groups were the following: strabismus (72% and 77%, respectively, lack of emotional tearing (47% and 36%, respectively, and lagophthalmos (32% and 41%, respectively. Conclusion: Stable marital statuses tended to be more frequent among mothers that did not take misoprostol during pregnancy. Exposures to other teratogens and the main ocular abnormalities were similar in both groups.

  10. Clinical and molecular analysis of human reproductive disorders in Brazilian patients

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    A.C. Latronico

    2004-01-01

    Full Text Available Several genes that influence the development and function of the hypothalamic-pituitary-gonadal-axis (HPG have been identified. These genes encode an array of transcription factors, matrix proteins, hormones, receptors, and enzymes that are expressed at multiple levels of the HPG. We report the experience of a single Endocrinology Unit in the identification and characterization of naturally occurring mutations in families affected by HPG disorders, including forms of precocious puberty, hypogonadism and abnormal sexual development due to impaired gonadotropin function. Eight distinct genes implicated in HPG function were studied: KAL, SF1, DAX1, GnRH, GnRHR, FSHß, FSHR, and LHR. Most mutations identified in our cohort are described for the first time in literature. New mutations in SF1, DAX1 and GnRHR genes were identified in three Brazilian patients with hypogonadism. Eight boys with luteinizing hormone- (LH independent precocious puberty due to testotoxicosis were studied, and all have their LH receptor (LHR defects elucidated. Among the identified LHR molecular defects, three were new activating mutations. In addition, these mutations were frequently associated with new clinical and hormonal aspects, contributing significantly to the knowledge of the molecular basis of reproductive disorders. In conclusion, the naturally occurring genetic mutations described in the Brazilian families studied provide important insights into the regulation of the HPG.

  11. The prevalence of ocular surface complaints in Brazilian patients with glaucoma or ocular hypertension

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    Vital Paulino Costa

    2013-08-01

    Full Text Available PURPOSE: To examine the prevalence of ocular surface complaints in Brazilian patients with glaucoma or ocular hypertension who used topical intraocular pressure (IOP-lowering regimens. METHODS: In this multicenter, noninterventional, single-visit study, adults with glaucoma or ocular hypertension treated with an IOP-lowering regimen were administered the 12-item ocular surface disease index (OSDI questionnaire. Each response was scored on a 5-point scale, with 0 indicating symptom present none of the time and 4 indicating symptom present all of the time. The average of the 12 item responses for each patient was transformed to a scale from 0 to 100, with higher scores representing worse disabilities. OSDI results then were categorized as absence of OSD (scores of 0-12, mild OSD (scores of 13-22, moderate OSD (scores of 23-32, or severe OSD (scores of 33100. RESULTS: The 173 enrolled patients had a mean age of 61.2 years, were women in 65.3% of cases, and had glaucoma in 89.0% of cases and ocular hypertension in 11.0% of cases. OSDI scores for 158 patients using 1 IOP-lowering therapy indicated no OSD in 37.3% of patients (59/158, mild OSD in 20.9% (33/158, moderate OSD in 17.1% (27/158, and severe OSD in 24.7% (39/158. For the 120 patients using 1 IOP-lowering medication and having a known duration of diagnosis of glaucoma or ocular hypertension, mean OSDI scores were numerically higher (worse for the 39 patients with a diagnosis ≥6 years long (score 25 [± 20], indicating moderate OSD than for the 81 patients with a diagnosis lasting <6 years (score 22 [± 20], indicating mild OSD; however, no significant differences in OSDI scores by duration of diagnosis were evident in means (P=0.49, distributions (P≥0.26, or correlation (P=0.77. CONCLUSIONS: A large proportion of Brazilian patients treated with 1 IOP-lowering therapy had some ocular surface complaints.

  12. Occult hepatitis B virus infection in liver transplant patients in a Brazilian referral center

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    T.C.A. Ferrari

    2014-11-01

    Full Text Available Estimates of occult hepatitis B virus (HBV infection prevalence varies among different studies depending on the prevalence of HBV infection in the study population and on the sensitivity of the assay used to detect HBV DNA. We investigated the prevalence of occult HBV infection in cirrhotic patients undergoing liver transplantation in a Brazilian referral center. Frozen liver samples from 68 adults were analyzed using a nested polymerase chain reaction assay for HBV DNA. The specificity of the amplified HBV sequences was confirmed by direct sequencing of the amplicons. The patient population comprised 49 (72.1% males and 19 (27.9% females with a median age of 53 years (range=18-67 years. Occult HBV infection was diagnosed in three (4.4% patients. The etiologies of the underlying chronic liver disease in these cases were alcohol abuse, HBV infection, and cryptogenic cirrhosis. Two of the patients with cryptic HBV infection also presented hepatocellular carcinoma. Markers of previous HBV infection were available in two patients with occult HBV infection and were negative in both. In conclusion, using a sensitive nested polymerase chain reaction assay to detect HBV DNA in frozen liver tissue, we found a low prevalence of occult HBV infection in cirrhotic patients undergoing liver transplant, probably due to the low prevalence of HBV infection in our population.

  13. Clinical and genetic analysis of 29 Brazilian patients with Huntington's disease-like phenotype

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    Guilherme Riccioppo Rodrigues

    2011-06-01

    Full Text Available Huntington's disease (HD is a neurodegenerative disorder characterized by chorea, behavioral disturbances and dementia, caused by a pathological expansion of the CAG trinucleotide in the HTT gene. Several patients have been recognized with the typical HD phenotype without the expected mutation. The objective of this study was to assess the occurrence of diseases such as Huntington's disease-like 2 (HDL2, spinocerebellar ataxia (SCA 1, SCA2, SCA3, SCA7, dentatorubral-pallidoluysian atrophy (DRPLA and chorea-acanthocytosis (ChAc among 29 Brazilian patients with a HD-like phenotype. In the group analyzed, we found 3 patients with HDL2 and 2 patients with ChAc. The diagnosis was not reached in 79.3% of the patients. HDL2 was the main cause of the HD-like phenotype in the group analyzed, and is attributable to the African ancestry of this population. However, the etiology of the disease remains undetermined in the majority of the HD negative patients with HD-like phenotype.

  14. Impact of psychiatric disorders on the quality of life of brazilian HCV-infected patients

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    Susana Batista-Neves

    2009-02-01

    Full Text Available The aim of our study was to determine the impact of psychiatric comorbidities on the health-related quality of life of HCV-infected patients. Assessment of clinical, socio-demographic and quality of life data of the patients followed up at a Hepatology unit was performed by using a standard questionnaire and the SF-36 instrument. Psychiatric diagnoses were confirmed by using the Mini International Neuropsychiatric Interview, Brazilian version 5.0.0 (MINI Plus. Evaluation using the MINI plus demonstrated that 46 (51% patients did not have any psychiatric diagnosis, while 44 (49% had at least one psychiatric diagnosis. Among patients with a psychiatric comorbidity, 26 (59.1% had a current mental disorder, out of which 22 (84.6% had not been previously diagnosed. Patients with psychiatric disorders had lower scores in all dimensions of the SF-36 when compared to those who had no psychiatric diagnosis. Scores of physical functioning and bodily pain domains were lower for those suffering from a current psychiatric disorder when compared to those who had had a psychiatric disorder in the past. Females had lower scores of bodily pain and mental health dimensions when compared to males. Scores for mental health dimension were also lower for patients with advanced fibrosis. The presence of a psychiatric comorbidity was the variable that was most associated with the different scores in the SF-36, compared to other variables such as age, gender, aminotransferase levels, and degree of fibrosis.

  15. Antiendomysium antibodies in brazilian patients with celiac disease and their first-degree relatives

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    KOTZE Lorete Maria da Silva

    2001-01-01

    Full Text Available Background - Literature data have shown high specificity of antiendomysial antibodies (EmA IgA in celiac disease. The scarcity of Brazilian reports concerning this subject motivated the present study. Objectives - To determine the sensitivity and specificity of antiendomysial IgA antibodies in Brazilian celiac patients at diagnosis and after treatment, to confirm patient adherence to a gluten-free diet and to screen first-degree relatives. Methods - An extensive clinical and serological study was performed by investigating the presence of these antibodies in 392 individuals from Southern Brazil. Indirect immunofluorescence using human umbilical cord as substrate was employed and the total levels of IgA were determined by turbidimetry in all groups. The study was conducted on 57 celiac patients (18 at diagnosis, 24 who adhered to a gluten-free diet and 15 with marked or slight transgression of the diet, 115 relatives of celiac patients (39 families, 94 patients with other gastrointestinal diseases, and 126 healthy individuals from the general population. Results - The results demonstrated 100% positivity for the recently diagnosed patients and for those consuming gluten, in contrast to the patients who complied with the diet (0%. In the control group one individual was positive, but refused to undergo a biopsy. In the group of other gastrointestinal diseases, one positive patient presented ulcerative colitis, Down's syndrome and epilepsy, and the intestinal biopsy was diagnostic for celiac disease. These data showed 99.3% specificity for the test. Eighteen relatives were positive for antiendomysial antibodies IgA (15.65%, and comparison with the healthy population revealed a significant difference. An intestinal biopsy was obtained from seven subjects (one with total villous atrophy and six withouth alterations in the mucosal architecture, but all with a high number of intra-epithelial lymphocytes. Conclusions - The method revealed 100

  16. Oxygen status during haemodialysis. The Cord-Group

    DEFF Research Database (Denmark)

    Nielsen, A L; Jensen, H Æ; Hegbrant, J;

    1995-01-01

    Hypoxia during haemodialysis, mainly acetate, has been reported several times. In our study we have monitored oxygen status during 258 bicarbonate haemodialyses. A significant drop below 80 mmHg in mean oxygen tension occurred. Mean oxygen saturation reflected this drop but did not reach levels b...

  17. Haemodialysis related osteomalacia: a staining method to demonstrate aluminium

    OpenAIRE

    Buchanan, Malcolm RC; Ihle, Benno U; Dunn, Cheryl M

    1981-01-01

    A slight modification in tissue processing and staining technique enables a previously described method for staining aluminium to be used to demonstrate aluminium in osteomalacia associated with haemodialysis. The stain appears to be accurate in diagnosing this condition and may assist in establishing the diagnosis before severe osteomalacia develops.

  18. Detection of microsatellite instability but not truncating APC mutations in gastric adenocarcinomas in Brazilian patients

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    Bevilacqua Roberta A.U.

    2000-01-01

    Full Text Available A crucial role for the adenomatous polyposis colonic (APC gene in colorectal carcinogenesis has been conclusively established, but, the role of APC in gastric tumors remains controversial. APC mutations have been detected at a relatively high frequency in gastric tumors of Japanese patients, yet such mutations have been reported to be extremely rare in British patients and patients from north-central-Italy. We here report the analysis of 40 primary sporadic gastric adenocarcinomas and 35 primary sporadic colon adenocarcinomas (from patients resident in São Paulo, Brazil, for mutations in the APC gene between codons 686 and 1693 using the protein truncation test. Although 19 truncating mutations were detected in 35 colon adenocarcinomas (54.2% none were found in any of the gastric adenocarcinomas. As an internal control the tumor samples were also evaluated for microsatellite alterations, which are also common features of both tumor types. Microsatellite instability was present in 1 colon and 7 gastric tumor samples. This suggests that in relation to APC mutations gastric adenocarcinomas from Brazilian patients are similar to those that occur in Europe, and support a fundamental difference both between gastric carcinomas that occur in different geographical regions and between the molecular etiology of gastric and colorectal adenocarcinomas occurring in São Paulo, Brazil.

  19. Niemann-Pick disease type C: a case series of Brazilian patients

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    Paulo José Lorenzoni

    2014-03-01

    Full Text Available The aim of the study was to analyze a series of Brazilian patients with Niemann-Pick disease type C (NP-C. Method Correlations between clinical findings, laboratory data, molecular findings and treatment response are presented. Result The sample consisted of 5 patients aged 8 to 26 years. Vertical supranuclear gaze palsy, cerebellar ataxia, dementia, dystonia and dysarthria were present in all cases. Filipin staining showed the “classical” pattern in two patients and a “variant” pattern in three patients. Molecular analysis found mutations in the NPC1 gene in all alleles. Miglustat treatment was administered to 4 patients. Conclusion Although filipin staining should be used to confirm the diagnosis, bone marrow sea-blue histiocytes often help to diagnosis of NP-C. The p.P1007A mutation seems to be correlated with the “variant” pattern in filipin staining. Miglustat treatment response seems to be correlated with the age at disease onset and disability scale score at diagnosis.

  20. Functional independence in patients with chronic kidney disease being treated with haemodialysis¹ Independencia funcional en pacientes con enfermedad renal crónica en tratamiento de hemodiálisis Independência funcional em pacientes com doença renal crônica em tratamento hemodialítico

    Directory of Open Access Journals (Sweden)

    Graziella Allana Serra Alves de Oliveira Oller

    2012-12-01

    Full Text Available PURPOSE: This study has described and analysed the functional independence of the patients served in the haemodialysis services of a countryside town in the State of São Paulo, Brazil, using the Functional Independence Measure (FIM. METHOD: The population considered was that of 214 patients being treated with haemodialysis, assessed in 2011, by means of a social, demographic and clinical report, a Mini-Mental State Examination (MMSE and also the FIM. RESULTS: The mean age of the population under study was 58.01 years, while the mean FIM point score was 118.38 points, showing a level of complete or modified independence within this population. Even though the level of dependence found has been low, this can be highlighted, within the locomotion domain, in the activity of going up and down stairs (10.28%. Age, complications arising from haemodialysis, and comorbidities show a negative correlation with FIM. CONCLUSION: Awareness of the level of functional independence of the patients being subjected to treatment with haemodialysis is essential in order to back up intervention for the improvement of nursing assistance provided to this population.OBJETIVO: este estudio describió y analizó la independencia funcional de los pacientes atendidos en los servicios de hemodiálisis de una ciudad del interior paulista, según la Medida de Independencia Funcional (MIF. MÉTODO: la población fue de 214 pacientes en tratamiento de hemodiálisis, evaluados en 2011, por medio de un cuestionario sociodemográfico y clínico, Mini examen del Estado Mental y MIF. RESULTADOS: la edad Media de la población del estudio fue de 58,01 años y la media de la MIF fue de 118,38 puntos, evidenciando un nivel de independencia completa o modificada de esa población. Mismo habiendo sido bajo el nivel de dependencia encontrado, se destacó en el dominio locomoción, en la actividad ascender y bajar escaleras (10,28%. La edad, complicaciones relacionadas a la hemodiálisis y

  1. DEVELOPING LIFE SKILLS IN HAEMODIALYSIS USING THE GUIDED SELF-DETERMINATION METHOD

    DEFF Research Database (Denmark)

    Finderup, Jeanette; Bjerre, Tina; Soendergaard, Aase;

    2016-01-01

    analysis. FINDINGS: A process of developing life skills was clearly identified in the changes accomplished by all 13 participants going through the GSD-HD intervention. Six themes showed that the changes involved the patients personally, their relationships with healthcare professionals and relatives...... and their self-management of ESRD: Deeper and more meaningful relationships, self-exploration of self-selected challenges, self-understanding as a condition for meaningful knowledge, ability to act in a self-determined way, feedback from action that accords with daily life skills and decision-making from......BACKGROUND: Studies in patients with diabetes have shown that the guided self determination (GSD) method effectively improves patients' glycaemia control and life skills. As a pilot study in 2011 showed promising results of using parts of GSD adjusted to patients on haemodialysis (HD), we decided...

  2. High frequency of mutation G377S in Brazilian type 3 Gaucher disease patients

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    R. Rozenberg

    2006-09-01

    Full Text Available Gaucher disease (GD, the most prevalent lysosome storage disorder, presents an autosomal recessive mode of inheritance. It is a paradigm for therapeutic intervention in medical genetics due to the existence of effective enzyme replacement therapy. We report here the analysis of GD in 262 unrelated Brazilian patients, carried out in order to establish the frequency of the most common mutations and to provide prognostic information based on genotype-phenotype correlations. Among 247 type 1 GD patients, mutation N370S was detected in 47% of all the alleles, but N370S/N370S homozygosity was found in only 10% of the patients, a much lower frequency than expected, suggesting that most individuals presenting this genotype may not receive medical attention. Recombinant alleles were detected at a high frequency: 44% of the chromosomes bearing mutation L444P had other mutations derived from the pseudogene sequence, present in 25% of patients. Three neuronopathic type 2 patients were homozygous for L444P, all presenting additional mutations (E326K or recombinant alleles that probably lead to the more severe phenotypes. Six children, classified as type 1 GD patients, had a L444P/L444P genotype, showing that neuronopathic symptoms may only manifest later in life. This would indicate the need for a higher treatment dose during enzyme replacement therapy. Finally, mutation G377S was present in 4 homozygous type 1 patients and also in compound heterozygosity in 5 (42% type 3 patients. These findings indicate that G377S cannot be unambiguously classified as mild and suggest an allele-dose effect for this mutation.

  3. Dietary patterns in Brazilian patients with nonalcoholic fatty liver disease: a cross-sectional study

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    Silvia Marinho Ferolla

    2013-01-01

    Full Text Available OBJECTIVE: Recent evidence suggests that non-alcoholic fatty liver disease is associated with diet. Our aim was to investigate the dietary patterns of a Brazilian population with this condition and compare them with the recommended diet. METHODS: A cross-sectional study was conducted on 96 non-alcoholic fatty liver disease patients before any dietetic counseling. All patients underwent abdominal ultrasound, biochemical tests, dietary evaluations, and anthropometric evaluations. Their food intake was assessed by a semi-quantitative food-frequency questionnaire and 24-hour food recall. RESULTS: The median patient age was 53 years, and 77% of the individuals were women. Most (67.7% participants were obese, and a large waist circumference was observed in 80.2% subjects. Almost 70% of the participants had metabolic syndrome, and 62.3% presented evidence of either insulin resistance or overt diabetes. Most patients (51.5, 58.5, and 61.7%, respectively exceeded the recommendations for energy intake, as well as total and saturated fat. All patients consumed less than the amount of recommended monounsaturated fatty acids, and 52.1 and 76.6% of them consumed less polyunsaturated fatty acids and fiber, respectively, than recommended. In most patients, the calcium, sodium, potassium, pyridoxine, and vitamin C intake did not meet the recommendations, and in 10.5-15.5% of individuals, the tolerable upper limit intake for sodium was exceeded. The patients presented a significantly high intake of meats, fats, sugars, legumes (beans, and vegetables and a low consumption of cereals, fruits, and dairy products compared with the recommendations. CONCLUSIONS: Although patients with non-alcoholic fatty liver disease exhibited high energy and lipid consumption, most of them had inadequate intake of some micronutrients. The possible role of nutrient-deficient intake in the development of non-alcoholic fatty liver disease warrants investigation.

  4. Clinical and molecuar characterization of Brazilian patients with growth hormone gene deletions

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    I.J.P. Arnhold

    1998-04-01

    Full Text Available Genomic DNA from 23 patients with isolated growth hormone (GH deficiency (12 males and 11 females: heights -4.9 ± 1.4 SDS was screened for GH gene deletions by restriction endonuclease analysis of polymerase chain reaction amplification products. Three unrelated patients had typical features of severe GH deficiency and deletions (6.7 kb in two and 7.6 kb in one of the GH gene. The two patients with 6.7-kb deletions developed growth-attenuating anti-GH antibodies whereas the patient with the 7.6-kb deletion continued to grow with GH replacement therapy. Our finding that 3/23 (~13% Brazilian subjects had GH gene deletions agrees with previous studies of severe isolated GH deficiency subjects in other populations. Two of three subjects (67% with deletions developed blocking antibodies despite administration of exogenous GH at low doses. Interestingly, only 1/10 of cases with affected relatives or parental consanguinity had GH-1 gene deletions

  5. Nosocomial infections in Brazilian pediatric patients: using a decision tree to identify high mortality groups.

    Science.gov (United States)

    Lopes, Julia M M; Goulart, Eugenio M A; Siqueira, Arminda L; Fonseca, Inara K; Brito, Marcus V S de; Starling, Carlos E F

    2009-04-01

    Nosocomial infections (NI) are frequent events with potentially lethal outcomes. We identified predictive factors for mortality related to NI and developed an algorithm for predicting that risk in order to improve hospital epidemiology and healthcare quality programs. We made a prospective cohort NI surveillance of all acute-care patients according to the National Nosocomial Infections Surveillance System guidelines since 1992, applying the Centers for Disease Control and Prevention 1988 definitions adapted to a Brazilian pediatric hospital. Thirty-eight deaths considered to be related to NI were analyzed as the outcome variable for 754 patients with NI, whose survival time was taken into consideration. The predictive factors for mortality related to NI (p Cox regression model) were: invasive procedures and use of two or more antibiotics. The mean survival time was significantly shorter (p patients who suffered invasive procedures and for those who received two or more antibiotics. Applying a tree-structured survival analysis (TSSA), two groups with high mortality rates were identified: one group with time from admission to the first NI less than 11 days, received two or more antibiotics and suffered invasive procedures; the other group had the first NI between 12 and 22 days after admission and was subjected to invasive procedures. The possible modifiable factors to prevent mortality involve invasive devices and antibiotics. The TSSA approach is helpful to identify combinations of predictors and to guide protective actions to be taken in continuous-quality-improvement programs. PMID:20140354

  6. A homozygous CARD9 mutation in a Brazilian patient with deep dermatophytosis.

    Science.gov (United States)

    Grumach, Anete S; de Queiroz-Telles, Flavio; Migaud, Mélanie; Lanternier, Fanny; Filho, Nelson Rosario; Palma, Sandra M U; Constantino-Silva, Rosemeire Navickas; Casanova, Jean Laurent; Puel, Anne

    2015-07-01

    Deep dermatophytosis has been described in HIV and immunosuppressed patients. Recently, CARD9 (caspase recruitment domain-containing protein 9) deficiency has been reported in individuals with deep dermatophytosis previously classified as "immunocompetent". We report a 24-year-old Brazilian male patient with deep dermatophytosis born to an apparently non-consanguineous family. The symptoms started with oral candidiasis when he was 3 years old, persistent although treated. At 11 years old, well delimited, desquamative and pruriginous skin lesions appeared in the mandibular area; ketoconazole and itraconazole were introduced and maintained for 5 years. At 12 years of age, the lesions, which initially affected the face, started to spread to thoracic and back of the body (15 cm of diameter) and became ulcerative, secretive and painful. Terbinafine was introduced without any improvement. Trichophyton mentagrophytes was isolated from the skin lesions. A novel homozygous mutation in CARD9 (R101L) was identified in the patient, resulting in impaired neutrophil fungal killing. Both parents, one brother (with persistent superficial but not deep dermatophytosis) and one sister were heterozygous for this mutation, while another brother was found to be homozygous for the CARD9 wild-type allele. This is the first report of CARD9 deficiency in Latin America. PMID:26044242

  7. Influence of catechol-O-methyltransferase (COMT) gene polymorphisms in pain sensibility of Brazilian fibromialgia patients.

    Science.gov (United States)

    Barbosa, Flávia Regina; Matsuda, Josie Budag; Mazucato, Mendelson; de Castro França, Suzelei; Zingaretti, Sônia Marli; da Silva, Lucienir Maria; Martinez-Rossi, Nilce Maria; Júnior, Milton Faria; Marins, Mozart; Fachin, Ana Lúcia

    2012-02-01

    Fibromyalgia syndrome (FS) is a rheumatic syndrome affecting to 2-3% of individuals of productive age, mainly women. Neuroendocrine and genetic factors may play a significant role in development of the disease which is characterized by diffuse chronic pain and presence of tender points. Several studies have suggested an association between FS, especially pain sensitivity, and polymorphism of the catechol-O-methyltransferase (COMT) gene. The aim of the present study was to characterize the SNPs rs4680 and rs4818 of the COMT gene and assess its influence in pain sensitivity of patients with fibromyalgia screened by the Fibromyalgia Impact Questionnaire (FIQ). DNA was extracted from peripheral blood of 112 patients with fibromyalgia and 110 healthy individuals and was used as template in PCR for amplification of a 185-bp fragment of the COMT gene. The amplified fragment was sequenced for analyses of the SNPs rs4680 and rs4818. The frequency of mutant genotype AA of SNP rs6860 was 77.67% in patients with FS and 28.18% for the control group. For the SNP rs4818, the frequency of mutant genotype CC was 73.21 and 39.09% for patients with FS and controls, respectively. Moreover, the FIQ score was higher in patients with the homozygous mutant genotype for SNPs rs4680 (87.92 points) and rs4818 (86.14 points). These results suggest that SNPs rs4680 and rs4818 of the COMT gene may be associated with fibromyalgia and pain sensitivity in FS Brazilian patients.

  8. Prevalence of substance use among trauma patients treated in a Brazilian emergency room

    Directory of Open Access Journals (Sweden)

    Reis Alessandra Diehl

    2006-01-01

    Full Text Available OBJECTIVE: Although there is a considerable amount of data in the literature regarding the association between alcohol consumption and injuries treated in emergency rooms, little is known about the relationship between such injury and the use of other substances. The objective of this study was to estimate the prevalence of substance use in patients admitted to the emergency room for non-fatal injuries. METHOD: A prospective cross-sectional study assessing all patients admitted to the emergency room within 6 hours after a non-fatal injury was conducted over a three-month period. The following were used as measures of alcohol and drug use: a standardized World Health Organization questionnaire; a self-administered questionnaire related to drug consumption within the 24 hours preceding contact; the Drug Abuse Screening Test; urine screens for cannabis, cocaine and benzodiazepines; and determination of blood alcohol concentration. Descriptive analyses were performed and the confidence interval used was 95%. RESULTS: A total of 353 patients were included. Cannabis and cocaine screens were conducted for 242 patients and benzodiazepine screens were conducted for 166. Blood alcohol concentrations reached the level of positivity in 11% (n = 39, and 10% (n = 33 presented some degree of intoxication. Among the 242 patients screened, 13.6% (n = 33 tested positive for cannabis, and 3.3% (n = 8 tested positive for cocaine, whereas 4.2% (n = 7 of the 166 patients screened tested positive for benzodiazepines. CONCLUSIONS: Substance use was highly prevalent among these individuals. In this sample, the frequency for the use of cannabis (an illicit drug was comparable to that of alcohol. More studies are needed in order to characterize such use among Brazilians and to develop proper approaches to such cases, with the aim of reducing substance use and its consequences.

  9. FECAL CALPROTECTIN: levels for the ethiological diagnosis in Brazilian patients with gastrointestinal symptoms

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    Lorete Maria da Silva KOTZE

    2015-03-01

    Full Text Available Background Determination of fecal calprotectin can provide an important guidance for the physician, also in primary care, in the differential diagnosis of gastrointestinal disorders, meanly between inflammatory bowel diseases and irritable bowel syndrome. Objectives The aims of the present study were to prospectively investigate, in Brazilian adults with gastrointestinal complaints, the value of fecal calprotectin as a biomarker for the differential diagnosis between functional and organic disorders and to correlate the concentrations with the activity of inflammatory bowel diseases. Methods The study included consecutive patients who had gastrointestinal complaints in which the measurement levels of fecal calprotectin were recommended. Fecal calprotectin was measured using a Bühlmann (Basel, Switzerland ELISA kit Results A total of 279 patients were included in the study, with median age of 39 years (range, 18 to 78 years. After clinical and laboratorial evaluation and considering the final diagnosis, patients were allocated into the following groups: a Irritable Bowel Syndrome: 154 patients (102 female and 52 male subjects. b Inflammatory Bowel Diseases group: 112 patients; 73 with Crohn’s disease; 38 female and 35 male patients; 52.1% (38/73 presented active disease, and 47.9% (35/73 had disease in remission and 39 patients with ulcerative colitis;19 female and 20 male patients; 48.7% (19/39 classified with active disease and 49.3% (20/39 with disease in remission. A significant difference (P<0.001 was observed between the median value of fecal calprotectin in Irritable Bowel Syndrome group that was 50.5 µg/g (IQR=16 - 294 µg/g; 405 µg/g (IQR=29 - 1980 µg/g in Crohn’s disease patients and 457 µg/g (IQR=25 - 1430 µg/g in ulcerative colitis patients. No difference was observed between the values found in the patients with Crohn’s disease and ulcerative colitis. Levels of fecal calprotectin were significantly lower in patients with

  10. Endotoxaemia in haemodialysis: a novel factor in erythropoetin resistance?

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    Laura E A Harrison

    Full Text Available BACKGROUND/OBJECTIVES: Translocated endotoxin derived from intestinal bacteria is a driver of systemic inflammation and oxidative stress. Severe endotoxaemia is an underappreciated, but characteristic finding in haemodialysis (HD patients, and appears to be driven by acute repetitive dialysis induced circulatory stress. Resistance to erythropoietin (EPO has been identified as a predictor of mortality risk, and associated with inflammation and malnutrition. This study aims to explore the potential link between previously unrecognised endotoxaemia and EPO Resistance Index (ERI in HD patients. METHODOLOGY/PRINCIPAL FINDINGS: 50 established HD patients were studied at a routine dialysis session. Data collection included weight, BMI, ultrafiltration volume, weekly EPO dose, and blood sampling pre and post HD. ERI was calculated as ratio of total weekly EPO dose to body weight (U/kg to haemoglobin level (g/dL. Mean haemoglobin (Hb was 11.3±1.3 g/dL with a median EPO dose of 10,000 [IQR 7,500-20,000] u/wk and ERI of 13.7 [IQR 6.9-23.3] ((U/Kg/(g/dL. Mean pre-HD serum ET levels were significantly elevated at 0.69±0.30 EU/ml. Natural logarithm (Ln of ERI correlated to predialysis ET levels (r = 0.324, p = 0.03 with a trend towards association with hsCRP (r = 0.280, p = 0.07. Ln ERI correlated with ultrafiltration volume, a driver of circulatory stress (r = 0.295, p = 0.046, previously identified to be associated with increased intradialytic endotoxin translocation. Both serum ET and ultrafiltration volume corrected for body weight were independently associated with Ln ERI in multivariable analysis. CONCLUSIONS: This study suggests that endotoxaemia is a significant factor in setting levels of EPO requirement. It raises the possibility that elevated EPO doses may in part merely be identifying patients subjected to significant circulatory stress and suffering the myriad of negative biological consequences arising from sustained

  11. Mitochondrial Cardioencephalomyopathy Due to a Novel SCO2 Mutation in a Brazilian Patient

    Science.gov (United States)

    Gurgel-Giannetti, Juliana; Oliveira, Guilherme; Filho, Geraldo Brasileiro; Martins, Poliana; Vainzof, Mariz; Hirano, Michio

    2016-01-01

    Objectives To review all patients with SCO2 mutations and to describe a Brazilian patient with cardioencephalomyopathy carrying compound heterozygous mutations in SCO2, one being the known pathogenic p.E140K mutation and the other a novel 12–base pair (bp) deletion at nucleotides 1519 through 1530 (c.1519_1530del). Design Case report and literature review. Setting University hospital Patient Infant girl presenting with an encephalomyopathy, inspiratory stridor, ventilator failure, progressive hypotonia, and weakness, leading to death. Main Outcome Measures Clinical features, neuro-imaging findings, muscle biopsy with histochemical analysis, and genetic studies. Results This infant girl was the first child of healthy, nonconsanguineous parents. She developed progressive muscular hypotonia and ventilatory failure. At the end of the first month of life, she developed cardiomegaly and signs of cardiac failure. Routine blood tests showed lactic acidosis and mild elevation of the creatine kinase level. Brain magnetic resonance imaging showed increased T2 and fluid-attenuated inversion recovery signals in the putamen bilaterally. Nerve conduction studies showed severe axonal sensorimotor neuropathy. Muscle biopsy revealed a neurogenic pattern with mitochondrial proliferation and total absence of cytochrome-c oxidase histochemical stain. Sequencing of SCO2 showed that the patient had compound heterozygote SCO2 mutations: the previously described c.1541G A (p.E140K) mutation and a novel 12-bp deletion at nucleotides 1519 through 1530 (c.1519_1530del). The patient died at age 45 days. Conclusions Our findings and the literature review indicate that it is important to consider the diagnosis of mitochondrial disease in newborns with hypotonia and cardiomyopathy. In our case, the accurate diagnosis of SCO2 mutations is particularly important for genetic counseling. PMID:23407777

  12. Relevance of apolipoprotein E4 for the lipid profile of Brazilian patients with coronary artery disease

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    D.R.S. Souza

    2007-02-01

    Full Text Available Apolipoprotein E (apoE - e2, e3, e4 alleles plays a role in the regulation of lipid metabolism, with the e4 considered to be a risk factor for coronary artery disease (CAD. We aimed to evaluate the apoE polymorphisms in Brazilians with CAD and their influence on the lipid profile and other risk factors (hypertension, diabetes mellitus, smoking. Two hundred individuals were examined: 100 patients with atherosclerosis confirmed by coronary angiography and 100 controls. Blood samples were drawn to determine apoE polymorphisms and lipid profile. As expected, the e3 allele was prevalent in the CAD (0.87 and non-CAD groups (0.81; P = 0.099, followed by the e4 allele (0.09 and 0.14, respectively; P = 0.158. The e3/3 (76 and 78% and e3/4 (16 and 23% were the most common genotypes for patients and controls, respectively. The lipid profile was altered in patients compared to controls (P < 0.05, independently of the e4 allele. However, in the controls this allele was prevalent in individuals with elevated LDL-cholesterol levels only (odds ratio = 2.531; 95% CI = 1.028-6.232. The frequency of risk factors was higher in the CAD group (P < 0.05, but their association with the lipid profile was not demonstrable in e4 carriers. In conclusion, the e4 allele is not associated with CAD or lipid profile in patients with atherosclerosis. However, its frequency in the non-CAD group is associated with increased levels of LDL-cholesterol, suggesting an independent effect of the e4 allele on lipid profile when the low frequency of other risk factors in this group is taken into account.

  13. Cardiac 123I-MIBG uptake in de novo Brazilian patients with Parkinson's disease without clinically defined dysautonomia

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    Marco Antonio Araujo Leite

    2014-06-01

    Full Text Available Myocardial scintigraphy with meta-iodo-benzyl-guanidine (123I cMIBG has been studied in Parkinson's disease (PD, especially in Asian countries, but not in Latin America. Most of these studies include individuals with PD associated to a defined dysautonomia. Our goal is to report the cardiac sympathetic neurotransmission in de novo Brazilian patients with sporadic PD, without clinically defined dysautonomia. We evaluated retrospectively a series of 21 consecutive cases with PD without symptoms or signs of dysautonomia assessed by the standard bedside tests. This number was reduced to 14 with the application of exclusion criteria. 123I cMIBG SPECT up-take was low or absent in all of them and the heart/mediastinum ratio was low in 12 of 14. We concluded that 123I cMIBG has been able to identify cardiac sympathetic neurotransmission disorder in Brazilian de novo PD patients without clinically defined dysautonomia.

  14. The progression of 102 Brazilian patients with bipolar disorder: outcome of first 12 months of prospective follow-up

    OpenAIRE

    Fernanda Novis; Patricia Cirillo; Rafael de Assis da Silva; Ana Letícia Santos; Luciana Angélica Silva Silveira; Adriana Cardoso; Pedro Coscarelli; Antônio Egidio Nardi; Elie Cheniaux

    2014-01-01

    INTRODUCTION: Prospective studies have shown that the course of bipolar disorder (BD) is characterized by the persistence of symptoms, predominantly depression, along most of the time. However, to our knowledge, no studies in Latin America have investigated it. OBJECTIVES: To replicate international studies using a Brazilian sample to prospectively analyze treatment outcomes in the first year and to determine potential chronicity factors. METHODS: We followed up 102 patients with BD ...

  15. Cardiac 123I-MIBG uptake in de novo Brazilian patients with Parkinson's disease without clinically defined dysautonomia

    OpenAIRE

    Marco Antonio Araujo Leite; Nascimento, Osvaldo J.M.; João Santos Pereira; Clayton Amaral; Cláudio T. Mesquita; Jader C. Azevedo; Adriana S. X. de Brito; Felipe Villela Pedras

    2014-01-01

    Myocardial scintigraphy with meta-iodo-benzyl-guanidine (123I cMIBG) has been studied in Parkinson's disease (PD), especially in Asian countries, but not in Latin America. Most of these studies include individuals with PD associated to a defined dysautonomia. Our goal is to report the cardiac sympathetic neurotransmission in de novo Brazilian patients with sporadic PD, without clinically defined dysautonomia. We evaluated retrospectively a series of 21 consecutive cases with PD without sympto...

  16. ‘Beats the alternative but it messes up your life’: Aboriginal people's experience of haemodialysis in rural Australia

    Science.gov (United States)

    Rix, Elizabeth F; Barclay, Lesley; Stirling, Janelle; Tong, Allison; Wilson, Shawn

    2014-01-01

    Objectives Australian Aboriginal people have at least eight times the incidence of end-stage kidney disease, requiring dialysis, as the non-Aboriginal population. Provision of health services to rural Aboriginal people with renal disease is challenging due to barriers to access and cultural differences. We aimed to describe the experiences of Aboriginal people receiving haemodialysis in rural Australia, to inform strategies for improving renal services. Design A qualitative design incorporating: Indigenist research methodology and Community Based Participatory Research principles. In-depth interviews used a ‘yarning’ and storytelling approach. Thematic analysis was undertaken and verified by an Aboriginal Community Reference Group. Setting A health district in rural New South Wales, Australia. Participants Snowball sampling recruited 18 Aboriginal haemodialysis recipients. Results Six themes emerged which described the patient journey: ‘The biggest shock of me life,’ expressed the shock of diagnosis and starting the dialysis; ‘Beats the alternative but it messes up your life,’ explained how positive attitudes to treatment develop; ‘Family is everything’, described the motivation and support to continue dialysis; ‘If I had one of them nurses at home to help me’, depicted acute hospital settings as culturally unsafe; ‘Don't use them big jawbreakers’, urged service providers to use simple language and cultural awareness; ‘Stop ‘em following us onto the machine’, emphasised the desire for education for the younger generations about preventing kidney disease. An Aboriginal interpretation of this experience, linked to the analysis, was depicted in the form of an Aboriginal painting. Conclusions Family enables Aboriginal people to endure haemodialysis. Patients believe that priorities for improving services include family-centred and culturally accommodating healthcare systems; and improving access to early screening of kidney disease

  17. Nosocomial infections in brazilian pediatric patients: using a decision tree to identify high mortality groups

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    Julia M.M. Lopes

    2009-04-01

    Full Text Available Nosocomial infections (NI are frequent events with potentially lethal outcomes. We identified predictive factors for mortality related to NI and developed an algorithm for predicting that risk in order to improve hospital epidemiology and healthcare quality programs. We made a prospective cohort NI surveillance of all acute-care patients according to the National Nosocomial Infections Surveillance System guidelines since 1992, applying the Centers for Disease Control and Prevention 1988 definitions adapted to a Brazilian pediatric hospital. Thirty-eight deaths considered to be related to NI were analyzed as the outcome variable for 754 patients with NI, whose survival time was taken into consideration. The predictive factors for mortality related to NI (p < 0.05 in the Cox regression model were: invasive procedures and use of two or more antibiotics. The mean survival time was significantly shorter (p < 0.05 with the Kaplan-Meier method for patients who suffered invasive procedures and for those who received two or more antibiotics. Applying a tree-structured survival analysis (TSSA, two groups with high mortality rates were identified: one group with time from admission to the first NI less than 11 days, received two or more antibiotics and suffered invasive procedures; the other group had the first NI between 12 and 22 days after admission and was subjected to invasive procedures. The possible modifiable factors to prevent mortality involve invasive devices and antibiotics. The TSSA approach is helpful to identify combinations of predictors and to guide protective actions to be taken in continuous-quality-improvement programs.

  18. Comparative study of dental cephalometric patterns of Japanese-Brazilian, Caucasian and Mongoloid patients

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    Renata Sathler

    2014-08-01

    Full Text Available INTRODUCTION: The objective of this study was to identify the patterns of dental variables of adolescent Japanese-Brazilian descents with normal occlusion, and also to compare them with a similar Caucasian and Mongoloid sample. METHODS: Lateral cephalometric radiographs were used to compare the groups: Caucasian (n = 40, Japanese-Brazilian (n = 32 and Mongoloid (n = 33. The statistical tests used were one-way ANOVA and ANCOVA. The cephalometric measurements used followed the analyses of Steiner, Tweed and McNamara Jr. RESULTS: Statistical differences (P < 0.05 indicated a smaller interincisal angle and overbite for the Japanese-Brazilian sample, when compared to the Caucasian sample, although with similar values to the Mongoloid group. CONCLUSION: The dental patterns found for the Japanese-Brazilian descents were, in general, more similar to those of the Mongoloid sample.

  19. The upper arm arterio-venous fistula--an alternative for vascular access in haemodialysis

    DEFF Research Database (Denmark)

    Gade, J; Aabech, J; Hansen, R I

    1995-01-01

    Forty-eight consecutive arteriovenous fistulae of the upper arm constructed in 44 patients between 1983 and 1987 were reviewed. The median observation time was 8.5 months (range 1 day-65 months). The overall patency rate for fistulae used for haemodialysis (early failures excluded) was 50% after...... one year and 38% after two years. However, only six (18.7%) of the used fistulae stopped because of thrombosis. The total number of thromboses was nine (19.6%). The main cause of discontinuance of fistulae was a high number of deaths (n = 22), presumably a result of a high median age of 62 years....... Early failure rate was seven of 46 (15.2%); in three cases (6.5%) this was caused by thrombosis. The results are compared to other alternatives for radiocephalic fistulae and the difficulties of comparisons are discussed. It is concluded that the upper arm arteriovenous fistula can serve as a second...

  20. Severe adverse effects of 5-fluorouracil in S-1 were lessened by haemodialysis due to elimination of the drug.

    Science.gov (United States)

    Inoue, Kazunori; Nagasawa, Yasuyuki; Yamamoto, Ryohei; Omori, Hiroki; Kimura, Tomonori; Tomida, Kodo; Furumatsu, Yoshiyuki; Imai, Enyu; Isaka, Yoshitaka; Rakugi, Hiromi

    2009-04-01

    S-1 and cisplatin are used as one of the first-line chemotherapies for gastric cancer in Japan. The plasma concentration of 5-fluorouracil (5-FU) is increased in patients with renal dysfunction because gimeracil in S-1 inhibits the degradation of 5-FU and about 50% of gimeracil is excreted in the urine. We describe a 35-year-old man with acute kidney injury while taking S-1 and cisplatin for advanced gastric cancer and who presented severe adverse effects of 5-FU. This case report describes the evolution of the plasma concentrations of 5-FU with haemodialysis along with a decrease in the adverse drug effects.

  1. Renal unit practitioners’ knowledge, attitudes and practice regarding the safety of unfractionated heparin for chronic haemodialysis

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    Debra Ockhuis

    2015-02-01

    Full Text Available Background: Chronic haemodialysis for adult patients with end-stage kidney failure requires a patent extracorporeal circuit, maintained by anticoagulants such as unfractionated heparin (UFH. Incorrect administration of UFH has safety implications for patients.Objectives: Firstly, to describe renal practitioners’ self-reported knowledge, attitudes and practice (KAP regarding the safe use of UFH and its effects; secondly, to determine an association between KAP and selected independent variables.Method: A cross-sectional descriptive survey by self-administered questionnaire and non-probability convenience sampling was conducted in two tertiary hospital dialysis units and five private dialysis units in 2013.Results: The mean age of 74/77 respondents (96.1%, was 41.1 years. Most (41/77, 53.2% had 0–5 years of renal experience. The odds of enrolled nurses having poorer knowledge of UFH than registered nurses were 18.7 times higher at a 95% Confidence Interval (CI (1.9–187.4 and statistically significant (P = 0.013. The odds of delivering poor practice having ≤ five years of experience and no in-service education were 4.6 times higher at a 95% CI (1.4–15.6, than for respondents who had ≥ six years of experience (P = 0.014 and 4.3 times higher (95% CI 1.1–16.5 than for respondents who received in-service education (P = 0.032, the difference reaching statistical significance in both cases.Conclusion: Results suggest that the category of the professional influences knowledge and, thus, safe use of UFH, and that there is a direct relationship between years of experience and quality of haemodialysis practice and between having in-service education and quality of practice.

  2. High frequencies of plexiform neurofibromas, mental retardation, learning difficulties, and scoliosis in Brazilian patients with neurofibromatosis type 1

    OpenAIRE

    Trovó-Marqui A.B.; Goloni-Bertollo E.M.; Valério N.I.; Pavarino-Bertelli E.C.; Muniz M.P.; Teixeira M.F.; Antonio J.R.; Tajara E.H.

    2005-01-01

    A clinical study of Brazilian patients with neurofibromatosis type 1 (NF1) was performed in a multidisciplinary Neurofibromatosis Program called CEPAN (Center of Research and Service in Neurofibromatosis). Among 55 patients (60% females, 40% males) who met the NIH criteria for the diagnosis of NF1, 98% had more than six café-au-lait patches, 94.5% had axillary freckling, 45% had inguinal freckling, and 87.5% had Lisch nodules. Cutaneous neurofibromas were observed in 96%, and 40% presented pl...

  3. Multiplex MALDI-TOF MS detection of mitochondrial variants in Brazilian patients with hereditary optic neuropathy

    Science.gov (United States)

    Matilde da Silva-Costa, Sueli; Balieiro, Juliane Cristina; Fernandes, Marcela Scabello Amaral; Alves, Rogério Marins; Guerra, Andrea Trevas Maciel; Marcondes, Ana Maria; Sartorato, Edi Lúcia

    2016-01-01

    Purpose Leber hereditary optic neuropathy (LHON) is a mitochondrial disease characterized by bilateral vision loss. More than 95% of LHON cases are associated with one of the three main mtDNA mutations: G11778A, T14484C, and G3460A. The other 5% of cases are due to other rare mutations related to the disease. The aim of this study was to identify the prevalence and spectrum of LHON mtDNA mutations, including the haplogroup, in a cohort of Brazilian patients with optic neuropathy and to evaluate the usefulness of iPLEX Gold/matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) technology in detecting LHON mutations. Methods We analyzed a total of 101 patients; 67 had a clinical diagnosis of LHON and 34 had optic neuropathy of unknown etiology. Direct sequencing and iPLEX Gold/MALDI-TOF MS were used to screen for the most common pathogenic point mutations in LHON, together with the rare mutations G3733A, C4171A, T10663C, G14459A, C14482G, A14495G, C14568T, and C14482A. Results We identified mutations in 36 patients, of whom 83.3% carried the G11778A mutation and 16.7% carried the T14484C mutation. In individuals with mutations, the haplogroups found were L1/L2, L3, C, R, U, D, and H. Rare mutations were not detected in any of the patients analyzed. Conclusions The frequencies of the main LHON mutations were similar to those previously reported for Latin America. A different frequency was found only for the A3460G mutation. The most frequent haplogroups identified were of African origin. The iPLEX Gold/MALDI-TOF MS technology proved to be highly accurate and efficient for screening mutations and identifying the haplogroups related to LHON. The MassArray platform, combined with other techniques, enabled definitive diagnosis of LHON in 36% (36/101) of the cases studied. PMID:27582625

  4. Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study

    NARCIS (Netherlands)

    Palmer, S.C.; Ruospo, M.; Campbell, K.L.; Garcia Larsen, V.; Saglimbene, V.; Natale, P.; Gargano, L.; Craig, J.C.; Johnson, D.W.; Tonelli, M.; Knight, J.; Bednarek-Skublewska, A.; Celia, E.; Castillo, D. Del; Dulawa, J.; Ecder, T.; Fabricius, E.; Frazao, J.M.; Gelfman, R.; Hoischen, S.H.; Schon, S.; Stroumza, P.; Timofte, D.; Torok, M.; Hegbrant, J.; Wollheim, C.; Frantzen, L.; Strippoli, G.F.; Steiner, K.

    2015-01-01

    INTRODUCTION: Adults with end-stage kidney disease (ESKD) treated with haemodialysis experience mortality of between 15% and 20% each year. Effective interventions that improve health outcomes for long-term dialysis patients remain unproven. Novel and testable determinants of health in dialysis are

  5. Treatment outcomes in tuberculosis patients with diabetes: a polytomous analysis using Brazilian surveillance system.

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    Bárbara Reis-Santos

    Full Text Available The impact of non-communicable diseases on tuberculosis incidence has received significant attention. It has been suggested that the risk of tuberculosis is higher among subjects with diabetes and these subjects also has poor TB treatment outcomes.This study was aimed at assessing the socio-demographic and clinical factors that may influence different outcome of TB in patients with DM (TB-DM identified in the Brazilian national database from 2001 to 2011.TB-DM cases reported in the Brazilian information system were identified and compared.Covariates associated with the outcomes of interest (cure, default, deaths, and development of TB MDR were included in a hierarchical regression model.TB-DM cases increased from 380/100,000/year in 2001 to 6,150/100,000/year in 2011. Some of the main associations found are pointed. The odds of default was higher among those in the age group 20-39 years (OR = 2.07, 95%CI 1.32-3.24; alcoholics (OR = 2.17, 95%CI 1.86-2.54, and HIV/AIDS (OR = 2.16, 95%CI 1.70-2.74;positive monitoring smear (OR = 1.94, 95%CI 1.55-2.43; prior default (OR = 5.41, 95%CI 4.47-6.54, and unknown type of treatment (OR = 3.33, 95%CI 1.54-7.22. The odds of death was greater for subjects ≥60 years old (OR = 2.74, 95%CI 1.74-4.29; institutionalized in shelter (OR = 2.69, 95%CI 1.07-6.77; alcoholics (OR = 2.70, 95%CI 2.27-3.22; HIV/AIDS (OR = 2.87, 95%CI 2.13-3.86; pulmonary+extrapulmonary TB (OR = 2.49, 95%CI 1.79-3.46; with unknown type of treatment (OR = 14.12, 95%CI 7.04-28.32.Development of MDR TB was more related to relapse (OR = 9.60, 95%CI 6.07-15.14;previous default (OR = 17.13, 95%CI 9.58-30.63; and transfer of treatment center (OR = 7.87, 95%CI 4.74-13.07.Older subjects and those with comorbidities and with a previous treatment of TB had poorest outcomes. TB control program in Brazil will need to expand efforts to focus on treatment of TB-DM patients to improve their cure

  6. Nutritional Status Associated to Skipping Breakfast in Brazilian Health Service Patients.

    Science.gov (United States)

    Batista-Jorge, Gislaine Cândida; Barcala-Jorge, Antônio Sérgio; Oliveira Dias, Anderson Frederico; Silveira, Marise Fagundes; de Farias Lelis, Deborah; Oliveira Andrade, João Marcus; Claro, Rafael Moreira; de Paula, Alfredo Mauricio Batista; Guimaraes, Andre Luiz Sena; Ferreira, Adaliene Versiane; Santos, Sérgio Henrique Sousa

    2016-01-01

    Recent studies show that skipping breakfast is associated with an increased risk of obesity, diabetes and cardiovascular diseases. In this context, this study evaluated 400 patients from the Brazilian health service who had their nutritional status defined based on the body mass index and were classified as physically active or insufficient active. The energy intake and macronutrients was also assessed by a 24-hour dietary recall where the association of overweight/obesity with the investigated variables was evaluated using chi-square, Student's t test and multivariate analysis (p < 0.05). The main results showed that more than half of the studied population have the habit of omitting breakfast (55.8%), and among those, 81.2% were overweight/obese (p < 0.0001). Almost three-fourths of these individuals consumed no more than 4 meals a day (73.0%), and regarding this meal frequency/day, 78.8% of the individuals who reported having 4 meals or less a day were overweight/obese compared with 57.8% who reported as having 5-6 meals/day (p < 0.0001). The individuals who reported to omit breakfast had a higher chance of being overweight compared with those who had this habit (OR 2.20; 95% CI 1.40-3.60) and the chance of the physically insufficient active individuals to be overweight/obese was 2.9 times higher when compared to the active individuals (p < 0.0001). Our findings suggest that regular breakfast consumption may decrease overweight and obesity risk.

  7. JAK2 V617F prevalence in Brazilian patients with polycythemia vera, idiopathic myelofibrosis and essential thrombocythemia

    Directory of Open Access Journals (Sweden)

    Bárbara da Costa Reis Monte-Mór

    2007-03-01

    Full Text Available Polycythemia vera (PV, essential thrombocythemia (ET and idiopathic myelofibrosis (IMF are myeloproliferative disorders (MPD that arise from the clonal proliferation of a pluripotent hematopoietic progenitor, leading to the overproduction of one or more myeloid lineages. Recently, a specific mutation in the JAK2 gene, which encodes a tyrosine kinase, has been shown to be associated with the myeloproliferative phenotype observed in PV, ET and IMF. In this study of Brazilian patients, the JAK2 V617F mutation [c.1887G > T was detected in four out of 49 patients with PV (96%, 14 out of 25 patients with IMF (56%, and in eight out of 29 patients with ET, which is in accordance with previous screenings of this mutation in other populations.

  8. Genetic Analysis of PARK2 and PINK1 Genes in Brazilian Patients with Early-Onset Parkinson's Disease

    OpenAIRE

    Karla Cristina Vasconcelos Moura; Mário Campos Junior; Ana Lúcia Zuma de Rosso; Denise Hack Nicaretta; João Santos Pereira; Delson José Silva; Flávia Lima dos Santos; Fabíola da Costa Rodrigues; Cíntia Barros Santos-Rebouças; Márcia Mattos Gonçalves Pimentel

    2013-01-01

    Parkinson's disease is the second most frequent neurodegenerative disorder in the world, affecting 1-2% of individuals over the age of 65. The etiology of Parkinson's disease is complex, with the involvement of gene-environment interactions. Although it is considered a disease of late manifestation, early-onset forms of parkinsonism contribute to 5–10% of all cases. In the present study, we screened mutations in coding regions of PARK2 and PINK1 genes in 136 unrelated Brazilian patients with ...

  9. X-linked adrenoleukodystrophy: clinical and laboratory findings in 15 Brazilian patients

    Directory of Open Access Journals (Sweden)

    Carmen R. Vargas

    2000-06-01

    Full Text Available Adrenoleukodystrophy (X-ALD is an X-linked recessively inherited peroxisomal disorder, phenotypically heterogeneous, characterized by progressive white-matter demyelination of the central nervous system and adrenocortical insufficiency. We investigated 15 male X-ALD patients varying in age from 7 to 39, diagnosed among 108 suspected patients referred for investigation. Plasma levels of very long chain fatty acids (VLCFA were measured at our laboratory using gas chromatography (GC. Eleven cases of childhood X-ALD and four cases of adrenomyeloneuropathy (AMN were diagnosed. Adrenal leukodystrophy insufficiency and limb weakness were the most frequent symptoms, appearing in 12, 8 and 6 of the patients, respectively. Physician awareness of X-ALD seems inadequate to judge by age at diagnosis and lengthy interval between the start of symptoms and diagnosis. This is the first published series of Brazilian patients with X-ALD. We determined signs and symptoms relevant for diagnosis, as early identification seems important for treatment outcome. In addition, diagnosis identifies carriers, who could benefit from genetic counselling and prenatal diagnosis.Adrenoleucodistrofia (X-ALD é uma desordem peroxissomal com padrão de herança ligada ao X, fenotipicamente heterogênea, caracterizada por uma progressiva desmielinização da substância branca do sistema nervoso central e por insuficiência adrenal. Foram investigados por nós 15 pacientes do sexo masculino com sinais clínicos sugestivos de X-ALD, com idade entre 7 e 39 anos, diagnosticados entre 108 pacientes encaminhados para investigação por suspeita clínica. Os níveis plasmáticos dos ácidos graxos de cadeia muito longa (VLCFA foram dosados em nosso laboratório através de cromatografia gasosa (GC. Onze (73% casos da forma infantil de X-ALD (ALD e 4 (27% casos de adrenomieloneuropatia (AMN foram diagnosticados. Insuficiência leucodistrofia adrenal e fraqueza muscular foram os sinais mais

  10. Intensive care management of patients with liver disease: proceedings of a single-topic conference sponsored by the Brazilian Society of Hepatology.

    Science.gov (United States)

    Bittencourt, Paulo Lisboa; Terra, Carlos; Parise, Edison Roberto; Farias, Alberto Queiroz; Arroyo, Vincent; Fernandez, Javier; Pereira, Gustavo; Maubouisson, Luiz Marcelo; Andrade, Guilherme Marques; Costa, Fernando Gomes de Barros; Codes, Liana; Andrade, Antônio Ricardo; Matos, Angelo; Torres, André; Couto, Fernanda; Zyngier, Ivan

    2015-12-01

    Survival rates of critically ill patients with liver disease has sharply increased in recent years due to several improvements in the management of decompensated cirrhosis and acute liver failure. This is ascribed to the incorporation of evidence-based strategies from clinical trials aiming to reduce mortality. In order to discuss the cutting-edge evidence regarding critical care of patients with liver disease, a joint single topic conference was recently sponsored by the Brazilian Society of Hepatology in cooperation with the Brazilian Society of Intensive Care Medicine and the Brazilian Association for Organ Transplantation. This paper summarizes the proceedings of the aforementioned meeting and it is intended to guide intensive care physicians, gastroenterologists and hepatologists in the care management of patients with liver disease.

  11. Genetic Analysis of PARK2 and PINK1 Genes in Brazilian Patients with Early-Onset Parkinson's Disease

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    Karla Cristina Vasconcelos Moura

    2013-01-01

    Full Text Available Parkinson's disease is the second most frequent neurodegenerative disorder in the world, affecting 1-2% of individuals over the age of 65. The etiology of Parkinson's disease is complex, with the involvement of gene-environment interactions. Although it is considered a disease of late manifestation, early-onset forms of parkinsonism contribute to 5–10% of all cases. In the present study, we screened mutations in coding regions of PARK2 and PINK1 genes in 136 unrelated Brazilian patients with early-onset Parkinson's disease through automatic sequencing. We identified six missense variants in PARK2 gene: one known pathogenic mutation, two variants of uncertain role, and three nonpathogenic changes. No pathogenic mutation was identified in PINK1 gene, only benign polymorphisms. All putative pathogenic variants found in this study were in heterozygous state. Our data show that PARK2 point mutations are more common in Brazilian early-onset Parkinson's disease patients (2.9% than PINK1 missense variants (0%, corroborating other studies worldwide.

  12. Nutritional status and food intake of Brazilian patients at various stages of Alzheimer’s disease: A crosssectional study

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    Vanessa Fernanda Goes

    2014-04-01

    Full Text Available Alzheimer’s disease (AD is characterized by disorders that can impair the nutrition of the patient and lead to weight loss and nutritional deficits during the course of the disease. The aim of this study was to assess the nutritional status and food intake of Brazilian patients with Alzheimer’s disease at 3 different stages of the disease. The sample consisted of 30 subjects of both genders, mean age 77 years, with probable AD. Subjects were assessed by collecting anthropometric data, the Mini Nutritional Assessment (MNA, serum albumin content, Mini Mental State Examination and 24-hour records of food and drink. Although a steady decrease in average weight was observed as the disease progressed (CDR1: 70.8±15.9 kg; CDR2: 61.4±15.7 kg; CDR3: 56.1± 8.4 kg, the differences were not significant. MNA and serum albumin both fell during the progression of the disease (p = 0.042; p = 0.047, respectively and, at the severe stage, half the patients were found to be undernourished and the other half at risk of undernutrition. According to their body mass index, 23.3% of patients were overweight. The nutritional value of the food consumed was similar across the stages of AD. In conclusion, the majority of Brazilian patients with AD in this study exhibited cognitive decline and malnutrition. However, food intake was similar among the stages of the disease, thus having no direct association with the progression of AD.

  13. Uremic Toxins and Lipases in Haemodialysis: A Process of Repeated Metabolic Starvation

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    Bernd Stegmayr

    2014-04-01

    Full Text Available Severe kidney disease results in retention of uremic toxins that inhibit key enzymes for lipid breakdown such as lipoprotein lipase (LPL and hepatic lipase (HL. For patients in haemodialysis (HD and peritoneal dialysis (PD the LPL activity is only about half of that of age and gender matched controls. Angiopoietin, like protein 3 and 4, accumulate in the uremic patients. These factors, therefore, can be considered as uremic toxins. In animal experiments it has been shown that these factors inhibit the LPL activity. To avoid clotting of the dialysis circuit during HD, anticoagulation such as heparin or low molecular weight heparin are added to the patient. Such administration will cause a prompt release of the LPL and HL from its binding sites at the endothelial surface. The liver rapidly degrades the release plasma compound of LPL and HL. This results in a lack of enzyme to degrade triglycerides during the later part of the HD and for another 3–4 h. PD patients have a similar baseline level of lipases but are not exposed to the negative effect of anticoagulation.

  14. Occult Hepatitis C Virus Infection in Haemodialysis Unit: A Single-center Experience

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    Abdel Hamid A. Serwah1, Waleed S. Mohamed1, Mohamed Serwah1, Awateif Edreis2, Ahmad El Zaydi3

    2014-07-01

    Full Text Available Background & Aims: Detection of hepatitis C virus RNA in peripheral blood mononuclear cells (PBMC and/or hepatocytes in the absence of HCV RNA in serum, designated as ‘occult HCV infection’, has been a matter of controversy in the recent years. Occult hepatitis C virus (HCV infection has not been investigated in haemodialysis patients. We investigated for the first time the prevalence of occult HCV infection in large cohorts of chronic hemodialysis (CHD patients in a single heamodialysis center at Al-Taif, KSA. Methods: We enrolled 84 CHD patients, whose sera are negative for HCV markers. HCV RNA was tested in PBMC using a sensitive commercial real time assay. In this study, real-time PCR was used to test for the presence of genomic HCV-RNA in peripheral blood mononuclear cells of all of these patients. For comparison, 20 patients on HD with evidence of chronic hepatitis C virus infection were included as a control group. Results: In CHD patients, occult HCV infection, determined by the presence of genomic HCV-RNA in peripheral blood mononuclear cells (PBMNCs, was found in 13.4 % of the patients; 83 % of these patients had ongoing HCV replication, indicated by the presence of HCV-RNA. Patients with occult HCV infection had spent a significantly longer time on heamodialysis and had significantly higher mean alanine aminotransferase levels during the 3 months before study entry. Compared to CHCV patients, those with occult HCV have less elevated bilirubin, AST and ALT. Conclusions: The prevalence of occult HCV infection was moderate in our CHD patients, and it did not appear to be clinically relevant. Further studies in other geographic populations with high HCV endemicity are required to clarify the significance of occult HCV infection in these patient groups. Abbreviations HCV, Hepatitis C Virus ; antibody against HCV; PBMC, peripheral blood mononuclear cells; rRT-PCR, real time reverse transcriptase polymerase chain reaction; CHD, chronic

  15. Continuous non-invasive BP monitoring: service evaluation during induction of anaesthesia and haemodialysis

    OpenAIRE

    Abdel Hakim, Karim A.

    2011-01-01

    Background Routine induction of anaesthesia and maintenance haemodialysis are two examples of clinical procedures that exert a direct effect on the cardiovascular system. The exact incidence of haemodynamic instability during such procedures is not well described, as it would have required invasive intra-arterial monitoring, which is not justified for routine use. As part of two service evaluations, i.e. routine induction of anaesthesia and maintenance haemodialysis, we utilised a non...

  16. Brazilian Portuguese version of the Patient Competency Rating Scale (PCRS-R-BR: semantic adaptation and validity

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    Nicolle Zimmermann

    2014-03-01

    Full Text Available This study describes the adaptation of a revised Brazilian version of the Patient Competency Rating Scale (PCRS-R-BR, which focuses on executive, mnemonic, and attention functions. Evidence of content-based and external validity is also reported. The cross-cultural adaptation was conducted in five phases: 1 translations and back translations; 2 item analysis by authors; 3 classification by experts; 4 revisions and reformulations by authors; 5 pilot study with a sample of patients with mild and moderate/severe traumatic brain injury (TBI. Data were analyzed descriptively, and the PCRS-R-BR scores of groups with mild vs. moderate/severe TBI were compared using the Mann-Whitney test. Patients and their relatives were divided into groups and compared using repeated-measures analysis. The results of the PCRS-R-BR questionnaire for relatives and discrepancy scores of patients with moderate/severe TBI revealed significantly more impairment than that found in the group of patients with mild TBI. There were significant differences between item and total scores of both groups of patients and relatives. Results indicated a high level of item content agreement between experts. This study found initial evidence of PCRS-R-BR content-based and external validity when the questionnaire was applied to patients with mild and moderate/severe TBI and their relatives.

  17. Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised

    OpenAIRE

    Emmanuelle Sobreira; Márcio A. Pena-Pereira; Alan L. Eckeli; Manoel A. Sobreira-Neto; Chagas, Marcos H. N.; Maria P. Foss; Brenna Cholerton; Zabetian, Cyrus P.; Mata, Ignacio F.; Vitor Tumas

    2015-01-01

    ABSTRACTObjective The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) to screen for mild cognitive impairment (PDMCI) and dementia (PDD) in patients with Parkinson's disease (PD).Method Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS,...

  18. Lack of Association between a 3'UTR VNTR Polymorphism of Dopamine Transporter Gene (SLC6A3) and ADHD in a Brazilian Sample of Adult Patients

    Science.gov (United States)

    Aperecida da Silva, Maria; Cordeiro, Quirino; Louza, Mario; Vallada, Homero

    2011-01-01

    Objective: To investigate a possible association between a 3'UTR VNTR polymorphism of the dopamine transporter gene (SLC6A3) and ADHD in a Brazilian sample of adult patients. Method: Study Case-control with 102 ADHD adult outpatients ("DSM-IV" criteria) and 479 healthy controls. The primers' sequence used were: 3'UTR-Forward: 5' TGT GGT GAT GGG…

  19. Alpha-synuclein A53T mutation is not frequent on a sample of Brazilian Parkinson’s disease patients

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    Gabriela S. Longo

    2015-06-01

    Full Text Available Introduction The pathogenesis of Parkinson’s disease (PD involves both genetic susceptibility and environmental factors, with focus on the mutation in the alpha-synuclein gene (SNCA.Objective To analyse the polymorphism SNCA-A53T in patients with familial PD (FPD and sporadic PD (SPD.Method A total of 294 individuals were studied, regardless of sex and with mixed ethnicity. The study group with 154 patients with PD, and the control group included 140 individuals without PD. The genotyping of SNCA-A53T was performed by PCR/RFLP. Significance level was p < 0.05.Results Among all patients, 37 (24% had FPD and 117 (75.9% had SPD. The absence of SNCA-A53T mutation was observed in all individuals.Conclusion SPD is notably observed in patients. However, the SNCA-A53T mutation was absent in all individuals, which does not differ controls from patients. This fact should be confirmed in a Brazilian study case with a more numerous and older population.

  20. Cephalic Arch Stenosis in Autogenous Haemodialysis Fistulas: Treatment With the Viabahn Stent-Graft

    Energy Technology Data Exchange (ETDEWEB)

    Shawyer, Andrew, E-mail: andrew.shawyer@bartsandthelondon.nhs.uk [The Royal London Hospital, Radiology Department (United Kingdom); Fotiadis, Nicos I., E-mail: fotiadis.nicholas@gmail.com [Royal Marsden Hospital, Radiology Department, The Royal Marsden NHS Foundation Trust (United Kingdom); Namagondlu, Girish, E-mail: girish.namagondlu@bartsandthelondon.nhs.uk [The Royal London Hospital, Renal Medicine Department (United Kingdom); Iyer, Arun, E-mail: arun.iyer@bartsandthelondon.nhs.uk [The Royal London Hospital, Radiology Department (United Kingdom); Blunden, Mark, E-mail: mark.blunden@bartsandthelondon.nhs.uk; Raftery, Martin, E-mail: martin.raftery@bartsandthelondon.nhs.uk; Yaqoob, Magdi, E-mail: magdi.yaqoob@bartsandthelondon.nhs.uk [The Royal London Hospital, Renal Medicine Department (United Kingdom)

    2013-02-15

    Cephalic arch stenosis (CAS) is an important and common cause of dysfunction in autogenous haemodialysis fistulas that requires multiple reinterventions and aggressive surveillance. We evaluated the safety and efficacy of the Viabahn stent-graft for the management of CAS. Between April 2005 and October 2011, 11 consecutive patients [four men and seven women (mean age 56.7 years)] with CAS and dysfunctional fistulas were treated with insertion of 11 Viabahn stent-grafts. Six stent-grafts were inserted due to residual stenosis after angioplasty and five for fistuloplasty-induced rupture. No patient was lost to follow-up. The technical and clinical success rate was 100 %. Primary access patency rates were 81.8 % [95 % confidence interval (CI) 0.482-0.977] at 6 months and 72.7 % (95 % CI 0.390-0.939) at 12 months. Secondary access patency rates were 90.9 % at 6 months (95 % CI 0.587-0.997). There were no procedure-related complications. Mean follow-up was 543.8 days (range 156-2,282). The use of the Viabahn stent-graft in the management of CAS is technically feasible and, in this small series, showed patency rates that compare favorably with historical data of angioplasty and bare stents.

  1. Catheter Related Escherichia hermannii Sepsis in a Haemodialysis Patient

    DEFF Research Database (Denmark)

    Rank, Cecilie Utke; Lommer Kristensen, Peter; Schrøder Hansen, Dennis;

    2016-01-01

    Escherichia hermannii is an extremely rare etiological agent of invasive infection, and thus, the bacterium was initially considered non-pathogenic. However, in five previously reported case reports E. hermannii has been implicated as the sole pathogen. Our case report describes blood stream infe...

  2. Molecular epidemiology of a hepatitis C virus epidemic in a haemodialysis unit: outbreak investigation and infection outcome

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    Lanini Simone

    2010-08-01

    Full Text Available Abstract Background HCV is a leading cause of liver chronic diseases all over the world. In developed countries the highest prevalence of infection is reported among intravenous drug users and haemodialysis (HD patients. The present report is to identify the pathway of HCV transmission during an outbreak of HCV infection in a privately run haemodialysis (HD unit in Italy in 2005. Methods Dynamics of the outbreak and infection clinical outcomes were defined through an ambi-directional cohort study. Molecular epidemiology techniques were used to define the relationships between the viral variants infecting the patients and confirm the outbreak. Risk analysis and auditing procedures were carried out to define the transmission pathway(s. Results Of the 50 patients treated in the HD unit 5 were already anti-HCV positive and 13 became positive during the study period (AR = 28.9%. Phylogenic analysis identified that, all the molecularly characterized incident cases (10 out of 13, were infected with the same viral variant of one of the prevalent cases. The multivariate analysis and the auditing procedure disclosed a single event of multi-dose vials heparin contamination as the cause of transmission of the infection in 11 out of the 13 incident cases; 2 additional incident cases occurred possibly as a result of inappropriate risk management. Discussion More than 30% of all HCV infections in developed countries results from poor application of standard precautions during percutaneous procedures. Comprehensive strategy which included: educational programmes, periodical auditing on standard precaution, use of single-dose vials whenever possible, prospective surveillance for blood-borne infections (including a system of prompt notification and risk assessment/management dedicated staff are the cornerstone to contain and prevent outbreaks in HD Conclusions The outbreak described should serve as a reminder to HD providers that patients undergoing dialysis are

  3. Home haemodialysis and uraemic toxin removal: does a happy marriage exist?

    Science.gov (United States)

    Vanholder, Raymond; Eloot, Sunny; Neirynck, Nathalie; Van Biesen, Wim

    2012-10-01

    Home-based methods of haemodialysis are becoming of increasing interest. In this article, we review theoretical and evidence-based aspects of dialysis adequacy in the home setting compared with those of standard in-centre dialysis. Owing to the flexibility it enables, home haemodialysis may allow reduced blood flow rates and the successful use of less-efficient access systems. With home haemodialysis, Kt/V(urea) targets should be pursued as recommended in current guidelines, taking into account that this parameter does not reflect a number of essential elements that affect adequacy, such as dialyser pore size or alternative timeframes-factors that might be applicable to modern home haemodialysis. The use of high-flux, large-pore haemodialysers is associated with improved removal of large uremic toxins and should be considered as standard in home haemodialysis where possible, although dialysis water purity is crucial. Large molecule removal is further enhanced by applying convective strategies (such as haemo[dia]filtration), but these strategies greatly increase technical complexity. Alternate-day haemodialysis is more desirable than the usual thrice-weekly approach to avoid complications at the end of the long weekend interval, and it is easier to implement such a regime at home than in-centre. Frequent, prolonged, and combined frequent and prolonged dialysis regimes are all associated with improved removal and improved outcomes. All three alternative timeframes are easier to apply at home than in-centre. Home haemodialysis offers increased flexibility in adopting dialysis regimes that make it possible to improve solute removal and, therefore, outcomes.

  4. Prognostic factors for survival in patients with colorectal liver metastases: experience of a single brazilian cancer center

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    Héber Salvador de Castro Ribeiro

    2012-12-01

    Full Text Available CONTEXT: Liver metastases are a common event in the clinical outcome of patients with colorectal cancer and account for 2/3 of deaths from this disease. There is considerable controversy among the data in the literature regarding the results of surgical treatment and prognostic factors of survival, and no analysis have been done in a large cohort of patients in Brazil. OBJECTIVES: To characterize the results of surgical treatment of patients with colorectal liver metastases, and to establish prognostic factors of survival in a Brazilian population. METHOD: This was a retrospective study of patients undergoing liver resection for colorectal metastases in a tertiary cancer hospital from 1998 to 2009. We analyzed epidemiologic variables and the clinical characteristics of primary tumors, metastatic disease and its treatment, surgical procedures and follow-up, and survival results. Survival analyzes were done by the Kaplan-Meier method and the log-rank test was applied to determine the influence of variables on overall and disease-free survival. All variables associated with survival with P<0.20 in univariate analysis, were included in multivariate analysis using a Cox proportional hazard regression model. RESULTS: During the period analyzed, 209 procedures were performed on 170 patients. Postope-rative mortality in 90 days was 2.9% and 5-year overall survival was 64.9%. Its independent prognostic factors were the presence of extrahepatic disease at diagnosis of liver metastases, bilateral nodules and the occurrence of major complications after liver surgery. The estimated 5-year disease-free survival was 39.1% and its prognostic factors included R1 resection, extrahepatic disease, bilateral nodules, lymph node involvement in the primary tumor and primary tumors located in the rectum. CONCLUSION: Liver resection for colorectal metastases is safe and effective and the analysis of prognostic factors of survival in a large cohort of Brazilian patients

  5. Validation of the EBMT Risk Score for South Brazilian Patients Submitted to Allogeneic Hematopoietic Stem Cell Transplantation

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    Beatriz Stela Pitombeira

    2013-01-01

    Full Text Available Background. Allogeneic hematopoietic stem cell transplantation (HSCT is still associated with a high transplant-related mortality rate. In 2009, the EBMT risk score was validated as a simple tool to predict the outcome after allogeneic HSCT for acquired hematological disorders. Objectives. The aim of this study was to validate the applicability of the EBMT risk score for allogeneic HSCT on South Brazilian patients. Methods. A retrospective observational study was performed based on patients' records and data base at http://dx.doi.org/10.13039/501100003810 Hospital de Clínicas de Porto Alegre, including all allogeneic transplants for malignant and severe aplastic anemia from 1994 to 2010. Patients were categorized according to EBMT risk score and overall survival (OS. Nonrelapse mortality (NRM and relapse rate (RR were analyzed. Results. There were 278 evaluable patients. OS, NRM, and RR at five years median followup were 48.7%, 40.7%, and 30.7%, respectively. The OS was 81.8% for risk score 0 and 0% for score 6 (P<0.001, and NRM was 13.6% and 80% for risk scores 0 and 6, respectively (P=0.001. Conclusion. The EBMT risk score can be utilized as a tool for clinical decision making before allogeneic HSCT for malignant hematological diseases and severe aplastic anemia at a single center in Brazil.

  6. Regional differences in clinical care among patients with type 1 diabetes in Brazil: Brazilian Type 1 Diabetes Study Group

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    Gomes Marília B

    2012-10-01

    Full Text Available Abstract Background To determine the characteristics of clinical care offered to type 1 diabetic patients across the four distinct regions of Brazil, with geographic and contrasting socioeconomic differences. Glycemic control, prevalence of cardiovascular risk factors, screening for chronic complications and the frequency that the recommended treatment goals were met using the American Diabetes Association guidelines were evaluated. Methods This was a cross-sectional, multicenter study conducted from December 2008 to December 2010 in 28 secondary and tertiary care public clinics in 20 Brazilian cities in north/northeast, mid-west, southeast and south regions. The data were obtained from 3,591 patients (56.0% females and 57.1% Caucasians aged 21.2 ± 11.7 years with a disease duration of 9.6 ± 8.1 years ( Results Overall, 18.4% patients had HbA1c levels Conclusions A majority of patients, mainly in the north/northeast and mid-west regions, did not meet metabolic control goals and were not screened for diabetes-related chronic complications. These results should guide governmental health policy decisions, specific to each geographic region, to improve diabetes care and decrease the negative impact diabetes has on the public health system.

  7. A first-year dornase alfa treatment impact on clinical parameters of patients with cystic fibrosis: the Brazilian cystic fibrosis multicenter study

    OpenAIRE

    Tatiana Rozov; Fernando Antônio A. e Silva; Maria Angélica Santana; Fabíola Villac Adde; Rita Heloisa Mendes

    2013-01-01

    OBJECTIVE: To describe the clinical impact of the first year treatment with dornase alfa, according to age groups, in a cohort of Brazilian Cystic Fibrosis (CF) patients. METHODS: The data on 152 eligible patients, from 16 CF reference centers, that answered the medical questionnaires and performed laboratory tests at baseline (T0), and at six (T2) and 12 (T4) months after dornase alfa initiation, were analyzed. Three age groups were assessed: six to 11, 12 to 13, and >14 years. Pulmonar...

  8. Service providers’ perspectives, attitudes and beliefs on health services delivery for Aboriginal people receiving haemodialysis in rural Australia: a qualitative study

    Science.gov (United States)

    Rix, Elizabeth F; Barclay, Lesley; Wilson, Shawn; Stirling, Janelle; Tong, Allison

    2013-01-01

    Objective Providing services to rural dwelling minority cultural groups with serious chronic disease is challenging due to access to care and cultural differences. This study aimed to describe service providers’ perspectives on health services delivery for Aboriginal people receiving haemodialysis for end-stage kidney disease in rural Australia. Design Semistructured interviews, thematic analysis Setting A health district in rural New South Wales, Australia Participants Using purposive sampling, 29 renal and allied service providers were recruited, including nephrologists, renal nurses, community nurses, Aboriginal health workers, social workers and managers. Six were Aboriginal and 23 non-Aboriginal. Results Improving cultural understanding within the healthcare system was central to five themes identified: rigidity of service design (outreach, inevitable home treatment failures, pressure of system overload, limited efficacy of cultural awareness training and conflicting priorities in acute care); responding to social complexities (respecting but challenged by family obligations, assumptions about socioeconomic status and individualised care); promoting empowerment, trust and rapport (bridging gaps in cultural understanding, acknowledging the relationship between land, people and environment, and being time poor); distress at late diagnosis (lost opportunities and prioritise prevention); and contending with discrimination and racism (inherent judgement of lifestyle choices, inadequate cultural awareness, pervasive multilevel institutionalised racism and managing patient distrust). Conclusions Service providers believe current services are not designed to address cultural needs and Aboriginality, and that caring for Aboriginal patients receiving haemodialysis should be family focused and culturally safer. An Aboriginal-specific predialysis pathway, building staff cultural awareness and enhancing cultural safety within hospitals are the measures recommended

  9. Clinical and molecular characterization of a Brazilian cohort of campomelic dysplasia patients, and identification of seven new SOX9 mutations

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    Eduardo P. Mattos

    2015-03-01

    Full Text Available Campomelic dysplasia (CD is an autosomal, dominantly inherited, skeletal abnormality belonging to the subgroup of bent bone dysplasias. In addition to bowed lower limbs, CD typically includes the following: disproportionate short stature, flat face, micrognathia, cleft palate, bell-shaped thorax, and club feet. Up to three quarters of 46, XY individuals may be sex-reversed. Radiological signs include scapular and pubic hypoplasia, narrow iliac wings, spaced ischia, and bowed femora and tibiae. Lethal CD is usually due to heterozygous mutations in SOX9, a major regulator of chondrocytic development. We present a detailed clinical and molecular characterization of nine Brazilian CD patients. Infants were either stillborn (n = 2 or died shortly after birth and presented similar phenotypes. Sex-reversal was observed in one of three chromosomally male patients. Sequencing of SOX9 revealed new heterozygous mutations in seven individuals. Six patients had mutations that resulted in premature transcriptional termination, while one infant had a single-nucleotide substitution at the conserved splice-site acceptor of intron 1. No clear genotype-phenotype correlations were observed. This study highlights the diversity of SOX9 mutations leading to lethal CD, and expands the group of known genetic alterations associated with this skeletal dysplasia.

  10. High frequencies of plexiform neurofibromas, mental retardation, learning difficulties, and scoliosis in Brazilian patients with neurofibromatosis type 1

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    Trovó-Marqui A.B.

    2005-01-01

    Full Text Available A clinical study of Brazilian patients with neurofibromatosis type 1 (NF1 was performed in a multidisciplinary Neurofibromatosis Program called CEPAN (Center of Research and Service in Neurofibromatosis. Among 55 patients (60% females, 40% males who met the NIH criteria for the diagnosis of NF1, 98% had more than six café-au-lait patches, 94.5% had axillary freckling, 45% had inguinal freckling, and 87.5% had Lisch nodules. Cutaneous neurofibromas were observed in 96%, and 40% presented plexiform neurofibromas. A positive family history of NF1 was found in 60%, and mental retardation occurred in 35%. Some degree of scoliosis was noted in 49%, 51% had macrocephaly, 40% had short stature, 76% had learning difficulties, and 2% had optic gliomas. Unexpectedly high frequencies of plexiform neurofibromas, mental retardation, learning difficulties, and scoliosis were observed, probably reflecting the detailed clinical analysis methods adopted by the Neurofibromatosis Program. These same patients were screened for mutations in the GAP-related domain/GRD (exons 20-27a by single-strand conformation polymorphism. Four different mutations (Q1189X, 3525-3526delAA, E1356G, c.4111-1G>A and four polymorphisms (c.3315-27G>A, V1146I, V1317A, c.4514+11C>G were identified. These data were recently published.

  11. Molecular analysis of the most prevalent mutations of the FANCA and FANCC genes in Brazilian patients with Fanconi anaemia

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    David Enrique Aguilar Rodriguez

    2005-01-01

    Full Text Available Fanconi anaemia (FA is a recessive autosomal disease determined by mutations in genes of at least eleven complementation groups, with distinct distributions in different populations. As far as we know, there are no reports regarding the molecular characterisation of the disease in unselected FA patients in Brazil. OBECTIVE: This study aimed to investigate the most prevalent mutations of FANCA and FANCC genes in Brazilian patients with FA. METHODS: Genomic DNA obtained from 22 racially and ethnically diverse unrelated FA patients (mean age ± SD: 14.0 ± 7.8 years; 10 male, 12 female; 14 white, 8 black was analysed by polymerase chain reaction and restriction site assays for identification of FANCA (delta3788-3790 and FANCC (delta322G, IVS4+4A -> T, W22X, L496R, R548X, Q13X, R185X, and L554P gene mutations. RESULTS: Mutations in FANCA and FANCC genes were identified in 6 (27.3% and 14 (63.6% out of 22 patients, respectively. The disease could not be attributed to the tested mutations in the two remaining patients enrolled in the study (9.1%. The registry of the two most prevalent gene abnormalities (delta3788-3790 and IVS4 + 4 -> T revealed that they were present in 18.2% and 15.9% of the FA alleles, respectively. Additional FANCC gene mutations were found in the study, with the following prevalence: delta322G (11.4%, W22X (9.1%, Q13X (2.3%, L554P (2.3%, and R548X (2.3% of total FA alleles. CONCLUSION: These results suggest that mutations of FANCA and FANCC genes are the most prevalent mutations among FA patients in Brazil.

  12. DEFB1 polymorphisms are involved in susceptibility to human papillomavirus infection in Brazilian gynaecological patients

    Directory of Open Access Journals (Sweden)

    Ludovica Segat

    2014-11-01

    Full Text Available The human beta defensin 1 (hBD-1 antimicrobial peptide is a member of the innate immune system known to act in the first line of defence against microorganisms, including viruses such as human papillomavirus (HPV. In this study, five functional polymorphisms (namely g-52G>A, g-44C>G and g-20G>A in the 5’UTR and c.*5G>A and c.*87A>G in the 3’UTR in the DEFB1 gene encoding for hBD-1 were analysed to investigate the possible involvement of these genetic variants in susceptibility to HPV infection and in the development of HPV-associated lesions in a population of Brazilian women. The DEFB1 g-52G>A and c.*5G>A single-nucleotide polymorphisms (SNPs and the GCAAA haplotype showed associations with HPV-negative status; in particular, the c.*5G>A SNP was significantly associated after multiple test corrections. These findings suggest a possible role for the constitutively expressed beta defensin-1 peptide as a natural defence against HPV in the genital tract mucosa.

  13. Recent advances in the monitoring and control of haemodynamic variables during haemodialysis: a review

    International Nuclear Information System (INIS)

    The human body possesses a unique set of organs that are responsible for providing homeostatic balance to the body's fluids. Of these, the kidneys regulate fluid and electrolyte balance in order to maintain the intracellular and extracellular fluid volumes and ion composition within tight limits. When kidneys fail to function normally, fluid is retained and several ions and solutes accumulate. The consequences may be life threatening. Many kidney failure patients rely on haemodialysis (HD) as a life sustaining therapy to remove the waste products and excess fluid from the circulating blood. HD is based on the principle of diffusion of solutes and ultrafiltration of fluid across a semi-permeable membrane. Fluid removal during HD results in relative hypovolaemia during which the stability of a patient relies on compensatory mechanisms to maintain blood pressure (BP). The major compensatory mechanisms include sympathetic nervous system activation of peripheral vasoconstriction together with modest heart rate acceleration to ensure the haemodynamic stability of the patient. Over the years, many monitoring tools have been developed in the hope of predicting intra-dialytic hypotensive episodes. Similarly many methods have been utilized to prevent dialysis-induced complications: ultrafiltration and dialysate sodium profiling, varying ultrafiltration based on frequent BP measurements, etc. This paper provides a comprehensive review of those monitoring and control tools. It starts with a brief introduction to human kidneys and dialysis for non-specialized readers. The paper then reviews the monitoring tools that have been applied to assess the physiological response of patients during HD. This is followed by control techniques used to prevent dialysis-induced complications. (topical review)

  14. The Influence of Ethanolic Extract of Brazilian Green Propolis Gel on Hygiene and Oral Microbiota in Patients after Mandible Fractures

    Science.gov (United States)

    Niedzielska, Iwona; Niedzielski, Damian; Różanowski, Bartosz; Konopka, Tomasz; Tanasiewicz, Marta; Paluch, Jarosław; Markowski, Jarosław; Orzechowska-Wylęgała, Bogusława; Król, Wojciech

    2016-01-01

    Maintenance of proper oral hygiene by dental plaque elimination is one of the most important factors affecting the healing process in postoperative oral wounds. Propolis is a substance produced by bees. Ethanolic extract of propolis has bactericidal, fungicidal, anti-inflammatory, and antioxidative properties. Moreover, it can scavenge free radicals. The purpose of this paper is to demonstrate the efficacy of a gel containing 3% of ethanolic extract of Brazilian green propolis (EEP-B) when used for maintaining oral hygiene in patients with postoperative oral mucosal wounds. The hygiene was assessed using API, OHI, and SBI followed by microbiological examinations. The patients were divided into two groups. Group 1 consisted of those who used a gel containing EEP-B for oral hygiene, and group 2 consisted of those who used a gel without EEP-B. Although improved oral hygiene was noted in both groups, the improvement was markedly greater in the group using gel containing EEP-B. Summing up the results of microbiological examinations, EEP-B has beneficial effect on mouth microflora in postoperative period. Propolis preparations used for oral hygiene allow eliminating microorganisms of pathogenic character and physiological flora microorganisms considered as being opportunistic, with no harmful influence on physiological microflora in oral ecosystem. PMID:27595110

  15. The Influence of Ethanolic Extract of Brazilian Green Propolis Gel on Hygiene and Oral Microbiota in Patients after Mandible Fractures.

    Science.gov (United States)

    Niedzielska, Iwona; Puszczewicz, Zbigniew; Mertas, Anna; Niedzielski, Damian; Różanowski, Bartosz; Baron, Stefan; Konopka, Tomasz; Machorowska-Pieniążek, Agnieszka; Skucha-Nowak, Małgorzata; Tanasiewicz, Marta; Paluch, Jarosław; Markowski, Jarosław; Orzechowska-Wylęgała, Bogusława; Król, Wojciech; Morawiec, Tadeusz

    2016-01-01

    Maintenance of proper oral hygiene by dental plaque elimination is one of the most important factors affecting the healing process in postoperative oral wounds. Propolis is a substance produced by bees. Ethanolic extract of propolis has bactericidal, fungicidal, anti-inflammatory, and antioxidative properties. Moreover, it can scavenge free radicals. The purpose of this paper is to demonstrate the efficacy of a gel containing 3% of ethanolic extract of Brazilian green propolis (EEP-B) when used for maintaining oral hygiene in patients with postoperative oral mucosal wounds. The hygiene was assessed using API, OHI, and SBI followed by microbiological examinations. The patients were divided into two groups. Group 1 consisted of those who used a gel containing EEP-B for oral hygiene, and group 2 consisted of those who used a gel without EEP-B. Although improved oral hygiene was noted in both groups, the improvement was markedly greater in the group using gel containing EEP-B. Summing up the results of microbiological examinations, EEP-B has beneficial effect on mouth microflora in postoperative period. Propolis preparations used for oral hygiene allow eliminating microorganisms of pathogenic character and physiological flora microorganisms considered as being opportunistic, with no harmful influence on physiological microflora in oral ecosystem. PMID:27595110

  16. The progression of 102 Brazilian patients with bipolar disorder: outcome of first 12 months of prospective follow-up

    Directory of Open Access Journals (Sweden)

    Fernanda Novis

    2014-03-01

    Full Text Available INTRODUCTION: Prospective studies have shown that the course of bipolar disorder (BD is characterized by the persistence of symptoms, predominantly depression, along most of the time. However, to our knowledge, no studies in Latin America have investigated it. OBJECTIVES: To replicate international studies using a Brazilian sample to prospectively analyze treatment outcomes in the first year and to determine potential chronicity factors. METHODS: We followed up 102 patients with BD for 12 months and evaluated the number of months with affective episodes and the intensity of manic and depressive symptoms using the Young Mania Rating Scale (YMRS and the Hamilton Depression Scale (HAM-D17. Sociodemographic and retrospective clinical data were examined to determine possible predictors of outcome. RESULTS: Almost 50% of the patients had symptoms about half of the time, and there was a predominance of depressive episodes. Disease duration and number of depressive episodes were predictors of chronicity. Depressive polarity of the first episode and a higher number of depressive episodes predicted the occurrence of new depressive episodes. CONCLUSION: In general, BD outcome seems to be poor in the first year of monitoring, despite adequate treatment. There is a predominance of depressive symptoms, and previous depressive episodes are a predictor of new depressive episodes and worse outcome.

  17. Health problems among nursing workers in a haemodialysis service.

    Science.gov (United States)

    Prestes, Francine Cassol; Beck, Carmem Lúcia Colomé; Magnago, Tânia Solange Bosi de Souza; Silva, Rosângela Marion da; Coelho, Alexa Pupiara Flores

    2016-03-01

    Objective The aim was to measure work-related health problems among nursing workers at a haemodialysis unit in southern Brazil and associate these issues with the socio-occupational characteristics of the workers. Method This is a qualitative study conducted with 46 nursing workers. Data were collected using a general health questionnaire with socio-occupational information and a work-related health assessment scale. The data were subjected to descriptive, correlational, bivariate analysis with significance levels of 5% using Epi-info® and Predictive Analytics Software. Results Physical, psychological, and social problems were considered bearable, and job satisfaction was associated with current income and work absenteeism for health treatment (pBack pain (3.74 ± 2.04) and leg pain (3.48 ± 2.10) were considered severe. There was a direct correlation between the health issues (r> 0.31, p health assessment among the studied population, the results confirm the need to promote the health of nursing workers. PMID:26982679

  18. Association of single nucleotide polymorphisms in the gene encoding GLUT1 and diabetic nephropathy in Brazilian patients with type 1 diabetes mellitus.

    Science.gov (United States)

    Marques, T; Patente, T A; Monteiro, M B; Cavaleiro, A M; Queiroz, M S; Nery, M; de Azevedo, M J; Canani, L H; Parisi, M C; Moura-Neto, A; Passarelli, M; Giannella-Neto, D; Machado, U F; Corrêa-Giannella, M L

    2015-04-15

    Mesangial cells subject to high extracellular glucose concentrations, as occur in hyperglycaemic states, are unable to down regulate glucose influx, resulting in intracellular activation of deleterious biochemical pathways. A high expression of GLUT1 participates in the development of diabetic glomerulopathy. Variants in the gene encoding GLUT1 (SLC2A1) have been associated to this diabetic complication. The aim of this study was to test whether polymorphisms in SLC2A1 confer susceptibility to diabetic nephropathy (DN) in Brazilian type 1 diabetes patients. Four polymorphisms (rs3820589, rs1385129, rs841847 and rs841848) were genotyped in a Brazilian cohort comprised of 452 patients. A prospective analysis was performed in 155 patients. Mean duration of follow-up was 5.6 ± 2.4 years and the incidence of renal events was 18.0%. The rs3820589 presented an inverse association with the prevalence of incipient DN (OR: 0.36, 95% CI: 0.16 - 0.80, p=0.01) and with progression to renal events (HR: 0.20; 95% CI: 0.03 - 0.70; p=0.009). AGGT and AGAC haplotypes were associated with the prevalence of incipient DN and the AGAC haplotype was also associated with the prevalence of established/advanced DN. In conclusion, rs3820589 in the SLC2A1 gene modulates the risk to DN in Brazilian patients with inadequate type 1 diabetes control.

  19. 不同肝素浓度血液透析临时性导管封管效果的Meta分析%Meta analysis of the sealing effect of temporary integrated catheter by different heparin concentration for patients with haemodialysis

    Institute of Scientific and Technical Information of China (English)

    李莉莉; 史平; 刘明晨; 姚惠萍

    2015-01-01

    Objective To study the proper concentration of heparin lock solution for haemodialysis patients with temporary integrated catheter ,and to apply in the clinical .Method The Pubmed ,the Cochrane Library ,EMBASE , WanFang ,CNKI and CBM databases as well as the related journals ,qualified randomized controlled trials were searched and included in a Meta-analysis using Revman 5 .0 software .The endpoints included catheter related infec-tion ,bleeding complication ,catheter malfunction (included catheter thrombosis) and the APTT .Result Three ran-domized controlled essays and one essays included two trails were included with 288 patients involved ,146 in the ex-perimental team and 142 in the controlled team .Meta analysis results :(1)Time of catheter :the analysis demonstra-ted that low heparin lock concentration can make the catheter a short time (WMD=3 .69 ,95% CI 0 .53~6 .85 ,P=0 .02);(2)APTT :compared with the high heparin lock concentration solution ,the low one can decrease the APTT extend(WMD=7 .0 ,95% CI 0 .30~13 .85 ,P=0 .004);(3)Bleeding :compared with the high heparin lock concen-tration solution there were few patients in low heparin groups suffered bleeding(RR=2 .17 ,95% CI 1 .05~4 .48 ,P=0 .04);(4)Infection:No statistics significance was showed in catheter related infection(RR=0 .64 ,95% CI 0 .31~1 .33 ,P=0 .23);(5)Catheter malfunction:No statistic significance was showed in catheter malfunction(RR=0 .62 , 95% CI 0 .28~1 .37 ,P=0 .24) .Conclusion Compared with the high heparin lock concentration solution ,the low one can decrease the APTT extend ,reduce the bleeding and shorten the time of catheter .%目的 探寻血液透析临时导管肝素封管的合适浓度 ,以指导临床应用.方法 检索 Pubmed、Cochrane Library、EMBASE、万方、CNKI、CBM等数据库和相关杂志中符合纳入标准的随机对照试验 ,并使用Revman 5 .0软件进行Meta分析.研究终点指标包括导管相关感染、出血、导管不畅、

  20. Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

    International Nuclear Information System (INIS)

    Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant

  1. Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

    Energy Technology Data Exchange (ETDEWEB)

    Pasquini, T.A.S. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Neder, H.D. [Instituto de Economia, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Araújo-Junqueira, L. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); De-Souza, D.A. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Departamento de Clínica Médica e Curso de Nutrição, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil)

    2012-12-17

    Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant.

  2. Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

    OpenAIRE

    Pasquini, T.A.S.; H.D. Neder; Araújo-Junqueira, L.; De-Souza, D.A.

    2012-01-01

    Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high c...

  3. Lithium kan anvendes til patienter i hæmodialyse

    DEFF Research Database (Denmark)

    Kancir, Anne Sophie Pinholt; Viftrup, Jens Emil; Pedersen, Erling Bjerregaard

    2015-01-01

    Lithium-induced nephropathy is a known complication of lithium treatment in bipolar disorder. Treatment with lithium should be discontinued, if there is evidence of lithium-induced nephropathy. However, lithium can be given to patients with end-stage-renal-disease on haemodialysis treatment, if...... there is no other way to control the bipolar disorder. We report one patient who was successfully treated with lithium in parallel with haemodialysis....

  4. Off-Pump Triple Coronary Artery Bypass Grafting in a Patient with Situs Inversus Totalis: Case Presentation and a Brief Review of the Brazilian and the International Experiences

    Science.gov (United States)

    Karigyo, Carlos Junior Toshiyuki; Batalini, Felipe; Murakami, Alexandre Noboru; Teruya, Rogério Toshio; Gregori Júnior, Francisco

    2016-01-01

    A 76-year-old man with situs inversus totalis underwent a successful off-pump three-vessel coronary artery bypass surgery. The postoperative course was uneventful, and the patient was discharged 8 days later. At 9-month follow-up a coronary computed tomography angiography confirmed the viability of all of the grafts, and one year after the operation the patient remained asymptomatic. It comprises the fifth Brazilian case of a coronary surgery in a patient with situs inversus totalis and the first one of the country of a coronary artery bypass surgery without the use of the cardiopulmonary bypass in this condition. PMID:27556323

  5. Correlation between ELISA and ML Flow assays applied to 60 Brazilian patients affected by leprosy

    NARCIS (Netherlands)

    R.C. Da Silva; S. Lyon; A.C. Lyon; M.A.F. Grossi; S.H. Lyon; S. Buhrer-Sekula; C.M.F. Antunes

    2010-01-01

    Serological tests can be helpful in classifying leprosy patients as having either the paucibacillary or the multibacillary form. The aim of this study was to evaluate the concordance between two serological assays, i.e. ML Flow and ELISA, in a population of leprosy patients in Brazil. The investigat

  6. Dental needs in Brazilian patients subjected to head and neck radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Rosales, Ana Carolina de Mesquita Netto; Jorge, Jacks; Almeida, Oslei Paes de; Lopes, Marcio Ajudarte [University of Campinas (UNICAMP), Piracicaba, SP (Brazil). Piracicaba Dental School. Dept. of Oral Diagnosis], e-mail: malopes@fop.unicamp.br; Esteves, Sergio Carlos Barros [Center of Oncology, Piracicaba, SP (Brazil)

    2009-07-01

    In spite of its recognized benefits in the treatment of malignant tumors, radiation therapy have several side effects in the head and neck region. The evaluation of oral conditions by a dentist is important to prevent or minimize these problems. The aim of this retrospective review was to analyze the dental needs in 357 patients who received radiotherapy in the head and neck region and were treated at Orocentro/FOP/UNICAMP, between January 1990 and December 2004. Review of patient files showed that dental examination before radiotherapy was not performed in 148 patients (41.5%) and was done in 209 patients (58.5%). From the total of examined patients, 94 (45%) did not require dental procedures at the moment of examination, while 115 (55%) presented some sort of dental need. Following the patients after the radiotherapy, it was observed that the group of patients that was evaluated before radiation presented less need of restorations, root canal filling and dental extractions than those who were not evaluated. The results of this study confirm that the evaluation of oral conditions prior to radiotherapy is essential to minimize the dental needs, emphasizing the importance of the dentist in the multidisciplinary team that treats cancer patients. (author)

  7. Risk Factors of Pulmonary Hypertension in Brazilian Patients with Sickle Cell Anemia.

    Directory of Open Access Journals (Sweden)

    Clarisse Lopes de Castro Lobo

    Full Text Available This study was a prospective cross-sectional cohort study of 125 patients with sickle cell anemia (SS between the ages of 16 to 60 years. Enrolled patients were followed-up prospectively for 15 months. Demographic, clinical, hematological and routine biochemical data were obtained on all patients. Six-minute walk test and Doppler Echocardiography were performed on all patients. A tricuspid regurgitant jet velocity (TRJV 3.0 m/sec, severe. Patients with abnormal TRJV were significantly older and more anemic, had significantly higher lactate dehydrogenase (LDH levels, reticulocyte count and incidence of death. The logistic multimodal model implemented for the 125 patients indicated that age was the covariate that influenced the outcome of normal or abnormal TRJV with a cutoff age of thirty-two years. The survival rate for the group of patients with creatinine (Cr > 1.0 mg/dL was lower than the group with Cr ≤ 1 and normal TRJV. A coefficient matrix showed that the LDH values were weakly correlated with the reticulocyte count but strongly correlated with hemoglobin suggesting that the TRJV values were not correlated with the hemolytic rate but with anemia. Ten patients died during the follow-up of whom 7 had TRJV > 2.5 m/sec. Acute chest syndrome was the most common cause of death followed by sepsis. In conclusion, this study shows that patients with SS older than thirty-two years with high LDH, elevated TRJV, severe anemia and Cr > 1 have poor prognosis and may be at risk of having pulmonary hypertension and should undergo RHC.

  8. Working conditions of Chagas' disease patients in a large Brazilian city

    Directory of Open Access Journals (Sweden)

    Maria Elena Guariento

    1999-04-01

    Full Text Available This study evaluated the working conditions of Chagas' disease patients in the city of Campinas, São Paulo, focusing on two-hundred-fifty patients with steady employment and treated at the University Hospital (HC-FCM/Unicamp: 98% were working-age and 77.6% were men. The origin of the patients reflected the migratory process occurring among this population. Most of the patients had limited professional skills, while 63.6% had not finished primary school and 21.6% were illiterate. However, 63.6% were regularly employed under duly processed work contracts. Their jobs were mainly in general services (21.6% and heavy industry (21.2%. Some 55% of the patients reported a monthly income less than or equal to U$100.00, and 40.4% reported having been fired at least once during the last ten years, in 8.9% of the cases because of a diagnosis of Chagas' disease. Of the patients undergoing pre-hiring physical examinations (57.2%, 9.1% were refused, 92.3% of whom due to positive serology for T. cruzi. Finally, 78.4% reported not belonging to a labor union. The study demonstrated the precarious working conditions and discrimination experienced by workers with Chagas' disease.

  9. Cryptococcosis in non-HIV/non-transplant patients: A Brazilian case series.

    Science.gov (United States)

    Lomes, Naiane Ribeiro; Melhem, Marcia Souza de Carvalho; Szeszs, Maria Walderez; Martins, Marilena Dos Anjos; Buccheri, Renata

    2016-10-01

    Cryptococcosis is a classical systemic opportunistic mycosis, primarily occurring among patients with significant immunologic impairment. However, this disease could also affect patients without any recognized immunologic defects, that is, phenotypically normal patients. The medical records of 29 non-HIV/nontransplant patients with cryptococcal disease during the period 2007-2014 were retrospectively reviewed. The most common site of infection was the central nervous system (n = 25, 86.2%), followed by the pulmonary system (n = 11, 37.9%) and blood (n = 2, 6.8%). Thoracic- and brain-computed tomography demonstrated abnormalities of 81.2% (n = 13) and 62.5% (n = 15), respectively. In sum, 22% (n = 6) of the patients experienced a significant underlying condition. More than one therapeutic regimen was used in 77.8% (n = 21) of the patients. The isolates were identified as being Cryptococcus neoformans species complex (n = 4, 36.4%) and Cryptococcus gattii species complex (n = 7, 63.6%). The overall mortality was 20.7% (n = 6). Herein, we presented the first case series of cryptococcosis in this specific population in São Paulo City, Brazil. The incidence of cryptococcosis in our hospital has not increased in recent years, and 77.8% (n = 21) of cases had no obvious predisposing factor. However, this disease remains associated with high mortality. PMID:27118805

  10. Impact of extracorporeal blood flow rate on blood pressure, pulse rate and cardiac output during haemodialysis

    DEFF Research Database (Denmark)

    Schytz, Philip Andreas; Mace, Maria Lerche; Soja, Anne Merete Boas;

    2015-01-01

    BACKGROUND: If blood pressure (BP) falls during haemodialysis (HD) [intradialytic hypotension (IDH)] a common clinical practice is to reduce the extracorporeal blood flow rate (EBFR). Consequently the efficacy of the HD (Kt/V) is reduced. However, only very limited knowledge on the effect of redu...

  11. Prevalence of the A1555G (12S rRNA and tRNA Ser(UCN mitochondrial mutations in hearing-impaired Brazilian patients

    Directory of Open Access Journals (Sweden)

    Abreu-Silva R.S.

    2006-01-01

    Full Text Available Mitochondrial mutations are responsible for at least 1% of the cases of hereditary deafness, but the contribution of each mutation has not yet been defined in African-derived or native American genetic backgrounds. A total of 203 unselected hearing-impaired patients were screened for the presence of the mitochondrial mutation A1555G in the 12S rRNA gene and mutations in the tRNA Ser(UCN gene in order to assess their frequency in the ethnically admixed Brazilian population. We found four individuals with A1555G mutation (2%, which is a frequency similar to those reported for European-derived populations in unselected samples. On the other hand, complete sequencing of the tRNA Ser(UCN did not reveal reported pathogenic substitutions, namely A7445G, 7472insC, T7510C, or T7511C. Instead, other rare substitutions were found such as T1291C, A7569G, and G7444A. To evaluate the significance of these findings, 110 "European-Brazilians" and 190 "African-Brazilians" unrelated hearing controls were screened. The T1291C, A7569G and G7444A substitutions were each found in about 1% (2/190 of individuals of African ancestry, suggesting that they are probably polymorphic. Our results indicate that screening for the A1555G mutation is recommended among all Brazilian deaf patients, while testing for mutations in the tRNA Ser(UCN gene should be considered only when other frequent deafness-causing mutations have been excluded or in the presence of a maternal transmission pattern.

  12. DISSEMINATED FUNGAL INFECTION WITH ADRENAL INVOLVEMENT: REPORT OF TWO HIV NEGATIVE BRAZILIAN PATIENTS

    OpenAIRE

    PEREIRA, Graziella Hanna; LANZONI, Valéria Pereira Barbosa; Elisa Maria BEIRÃO; TIMERMAN, Artur; Melhem, Marcia Souza Carvalho

    2015-01-01

    Paracoccidioidomycosis and histoplasmosis are systemic fungal infections endemic in Brazil. Disseminated clinical forms are uncommon in immunocompetent individuals. We describe two HIV-negative patients with disseminated fungal infections, paracoccidioidomycosis and histoplasmosis, who were diagnosed by biopsies of suprarenal lesions. Both were treated for a prolonged period with oral antifungal agents, and both showed favorable outcomes.

  13. Response to treatment in Brazilian patients with chronic hepatitis C is associated with a single-nucleotide polymorphism near the interleukin-28B gene

    Directory of Open Access Journals (Sweden)

    Tarciana Grandi

    2013-02-01

    Full Text Available A single-nucleotide polymorphism (SNP upstream of interleukin (IL28B was recently identified as an important predictor of the outcome of chronic hepatitis C patients treated with pegylated interferon plus ribavirin (PEG-IFN/RBV. The aim of this study was to investigate the association between the IL28B gene polymorphism (rs12979860 and virological response in chronic hepatitis C patients. Brazilian patients (n = 263 who were infected with hepatitis C virus (HCV genotype 1 and were receiving PEG-IFN/RBV were genotyped. Early virological response (EVR (12 weeks, end-of-treatment response (EOTR (48 weeks, sustained virological response (SVR (72 weeks and relapse were evaluated using conventional and quantitative polymerase chain reaction (PCR assays. The frequency of the C allele in the population was 39%. Overall, 43% of patients experienced SVR. The IL28B CC genotype was significantly associated with higher treatment response rates and a lower relapse rate compared to the other genotypes [84% vs. 58% EVR, 92% vs. 63% EOTR, 76% vs. 38% SVR and 17% vs. 40% relapse rate in CC vs. other genotypes (CT and TT, respectively]. Thus, the IL28B genotype appears to be a strong predictor of SVR following PEG-IFN/RBV therapy in treatment-naïve Brazilian patients infected with HCV genotype 1. This study, together with similar research examining other SNPs, should help to define adequate protocols for the treatment of patients infected with HCV genotype 1, especially those with a poor prognosis.

  14. Spinocerebellar ataxia type 3: subphenotypes in a cohort of brazilian patients

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    Adriana Moro

    2014-09-01

    Full Text Available Spinocerebellar ataxia type 3 (SCA3 involves cerebellar, pyramidal, extrapyramidal, motor neuron and oculomotor systems with strong phenotypic heterogeneity, that lead us to classify the disorder into different clinical subtypes according to the predominantly affected motor systems. Method The series comprises 167 SCA3 patients belonging to 68 pedigrees, studied from 1989-2013. These patients were categorized into seven different subphenotypes. Results SCA3 cases were clustered according to the predominant clinical features. Three most common forms were subphenotype 2, characterized by ataxia and pyramidal symptom was observed in 67.5%, subphenotype 3 with ataxia and peripheral signs in 13.3%, and subphenotype 6 with pure cerebellar syndrome in 7.2%. Conclusion Our study was the first to systematically classify SCA3 into seven subphenotypes. This classification may be particularly useful for determination of a more specific and direct phenotype/genotype correlation in future studies.

  15. Clinical and genetic analysis of 29 Brazilian patients with Huntington’s disease-like phenotype

    OpenAIRE

    Guilherme Riccioppo Rodrigues; Walker, Ruth H.; Benedikt Bader; Adrian Danek; Alexis Brice; Cécile Cazeneuve; Odile Russaouen; Iscia Lopes-Cendes; Wilson Marques Jr; Vitor Tumas

    2011-01-01

    Huntington’s disease (HD) is a neurodegenerative disorder characterized by chorea, behavioral disturbances and dementia, caused by a pathological expansion of the CAG trinucleotide in the HTT gene. Several patients have been recognized with the typical HD phenotype without the expected mutation. The objective of this study was to assess the occurrence of diseases such as Huntington’s disease-like 2 (HDL2), spinocerebellar ataxia (SCA) 1, SCA2, SCA3, SCA7, dentatorubral-pallidol...

  16. Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system

    OpenAIRE

    Valderilio Feijó Azevedo; Chayanne N. Rossetto; Lorencetti, Pedro G.; Mariana Y. Tramontin; Bruna Fornazari; Denizar V. Araújo

    2016-01-01

    ABSTRACT Introduction: Patients with Ankylosing Spondylitis (AS) require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact. Objectives: To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public...

  17. Plasma Levels of Middle Molecules to Estimate Residual Kidney Function in Haemodialysis without Urine Collection.

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    Enric Vilar

    Full Text Available Residual Kidney Function (RKF is associated with survival benefits in haemodialysis (HD but is difficult to measure without urine collection. Middle molecules such as Cystatin C and β2-microglobulin accumulate in renal disease and plasma levels have been used to estimate kidney function early in this condition. We investigated their use to estimate RKF in patients on HD.Cystatin C, β2-microglobulin, urea and creatinine levels were studied in patients on incremental high-flux HD or hemodiafiltration(HDF. Over sequential HD sessions, blood was sampled pre- and post-session 1 and pre-session 2, for estimation of these parameters. Urine was collected during the whole interdialytic interval, for estimation of residual GFR (GFRResidual = mean of urea and creatinine clearance. The relationships of plasma Cystatin C and β2-microglobulin levels to GFRResidual and urea clearance were determined.Of the 341 patients studied, 64% had urine output>100 ml/day, 32.6% were on high-flux HD and 67.4% on HDF. Parameters most closely correlated with GFRResidual were 1/β2-micoglobulin (r2 0.67 and 1/Cystatin C (r2 0.50. Both these relationships were weaker at low GFRResidual. The best regression model for GFRResidual, explaining 67% of the variation, was: GFRResidual = 160.3 · (1/β2m - 4.2. Where β2m is the pre-dialysis β2 microglobulin concentration (mg/L. This model was validated in a separate cohort of 50 patients using Bland-Altman analysis. Areas under the curve in Receiver Operating Characteristic analysis aimed at identifying subjects with urea clearance≥2 ml/min/1.73 m2 was 0.91 for β2-microglobulin and 0.86 for Cystatin C. A plasma β2-microglobulin cut-off of ≤19.2 mg/L allowed identification of patients with urea clearance ≥2 ml/min/1.73 m2 with 90% specificity and 65% sensitivity.Plasma pre-dialysis β2-microglobulin levels can provide estimates of RKF which may have clinical utility and appear superior to cystatin C. Use of cut-off levels

  18. Kinetics of Hepatitis B Virus Load During Haemodialysis Sessions and α-Interferon: A Prospective Study

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    Fabrizio Fabrizi

    2013-09-01

    Full Text Available Background: It has been reported a slow progression of hepatitis B in patients undergoing maintenance dialysis, and a role of dialysis session per se has been suggested. The aim of the present study is to evaluate the kinetics of the hepatitis B viral load (HBV DNA in serum during haemodialysis sessions using a highly sensitive technique; the role of interferon-α in lowering HBV viral load in such patients was also investigated. Methods: HBV DNA was determined in 24 HBsAg positive patients on maintenance hemodialysis immediately before and after a 4-hour hemodialysis session, the same measurements were repeated 48 and 72 hours later. HBV DNA quantitation was performed by a novel RealTime PCR assay. Serum IFN-α levels were tested in parallel in a subset of HD sessions (n=40 by ELISA. Results: 20 (83% HBsAg positive patients had detectable HBV DNA in serum. Positive status for HBV DNA in serum was not predicted by demographic, clinical or biochemical parameters. HBV load decreased in many patients after hemodialysis sessions 5.92 log10 IU/mL (95% CI, 5.34 to 6.28 log10 IU/mL vs. 4.79 log10 IU/mL (95% CI, 4.23 to 6.15 log10 IU/mL (P=0.02. A significant relationship between mean HBV DNA levels before dialysis and percentage reduction of HBV DNA during HD sessions occurred [F-test=5.41, rho (least squares=0.307]. Increase of serum IFN-α levels was found in a minority (3/40=7% of HD sessions. Conclusions: Hemodialysis procedure gives reduction of HBV load in HBsAg chronic carriers; no relationship with IFN-α activity during HD sessions was found. The kinetics of HBV viremia in HD procedures could explain the low viral load which is typically observed in these patients. Further studies to identify the mechanisms responsible for reduction of HBV viremia during HD procedures are under way.

  19. Polymorphism in the methylenetetrahydrofolate reductase (C677T) gene and homocysteine levels: a comparison in Brazilian patients with coronary arterial disease, ischemic stroke and peripheral arterial obstructive disease.

    Science.gov (United States)

    Sabino, Adriano; Fernandes, Ana Paula; Lima, Luciana Moreira; Ribeiro, Daniel Dias; Sousa, Marinez Oliveira; de Castro Santos, Maria Elizabeth Rennó; Mota, Ana Paula Lucas; Dusse, Luci Maria Sant'Ana; das Graças Carvalho, Maria

    2009-01-01

    This study aimed to compare plasma levels of total homocysteine (tHcy) in different arterial events as well as to investigate an association between homocysteine levels and C677T polymorphism in Brazilian patients. A total of 145 subjects were enrolled in this study including 43 patients with coronary arterial disease (CAD), 21 with ischemic stroke (IS), 44 with peripheral arterial obstructive disease (PAOD) and 37 control subjects. A preliminary analysis showed significant difference for tHcy plasma levels between patients with CAD (P = 0.003) or PAOD (P = 0.03) compared to controls. However, after adjustment for sex, age, total cholesterol, LDL, diabetes, tabagism or C677T polymorphism, no significant differences were detected in tHcy levels among patients groups and controls. No significant correlation was demonstrated for C677T polymorphism and homocysteine levels. These results indicate that increased Hcy levels may not be considered an independent risk factor for atherothrombotic diseases in Brazilian patients. PMID:18040753

  20. Prevalence and correlates of erectile dysfunction in men on chronic haemodialysis: a multinational cross-sectional study

    NARCIS (Netherlands)

    Vecchio, M.; Palmer, S.; Berardis, G. de; Craig, J.; Johnson, D.; Pellegrini, F.; Nicolucci, A.; Sciancalepore, M.; Saglimbene, V.; Gargano, L.; Bonifati, C.; Ruospo, M.; Navaneethan, S.D.; Montinaro, V.; Stroumza, P.; Zsom, M.; Torok, M.; Celia, E.; Gelfman, R.; Bednarek-Skublewska, A.; Dulawa, J.; Graziano, G.; Lucisano, G.; Gentile, G.; Ferrari, J.N.; Santoro, A.; Zucchelli, A.; Triolo, G.; Maffei, S.; Hegbrant, J.; Wollheim, C.; Cosmo, S. de; Manfreda, V.M.; Strippoli, G.F.; Steiner, K.

    2012-01-01

    BACKGROUND: Factors associated with erectile dysfunction in men on haemodialysis are incompletely identified due to suboptimal existing studies. We determined the prevalence and correlates of erectile dysfunction and identified combinations of clinical characteristics associated with a higher risk o

  1. Reproducibility of peripapillary retinal nerve fiber layer thickness measurements using Spectral Domain OCT in Brazilian patients

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    Daniela Araújo Toscano

    2012-10-01

    Full Text Available PURPOSE: To evaluate the reproducibility of peripapillary retinal nerve fiber layer (RNFL thickness measurements in normal eyes and eyes with glaucoma using spectral domain optical coherence tomography (SDOCT. METHODS: One eye of 79 normal and 72 glaucoma patients was analyzed. All patients underwent a complete ophthalmological examination, including visual acuity testing; intraocular pressure, slit-lamp examination, indirect ophthalmoscopy; and the glaucoma group underwent achromatic perimetry with the 24-2 SITA Fast Humphrey Field Analyzer. All patients' eyes were scanned using the spectral domain optical coherence tomography - Spectralis® and one of them was chosen randomly. Three consecutive circular B-scan centered at the optic disc were performed in one visit. RESULTS: The intraclass correlation coefficient (ICC, coefficient of variation and test-retest variability for the mean retinal nerve fiber layer thickness were respectively: 0.94, 2.56% and 4.85 µm for the normal group and 0.93, 4.65% and 6.61 µm for the glaucomatous group. The intraclass correlation coefficient for retinal nerve fiber layer thickness in all quadrants were all excellent in both groups, with the superior quadrant having the highest ICCs (0.964 in glaucomatous eyes and nasal quadrant measurements having the lowest (0.800, but still excellent in eyes without glaucoma. The coefficient of variation was between 2.56% - 8.74% and between 4.65% - 11.44% in normal and glaucomatous group respectively. The test-retest variability was between 4.85 µm and 11.51 µm in the normal group and between 6.61 µm and 14.24 µm in the glaucomatous group. The measurements in glaucomatous eyes were more variable than normal eyes. CONCLUSIONS: Spectral domain optical coherence tomography showed excellent reproducibility with regard to retinal nerve fiber layer thickness measurements in normal and glaucomatous eyes.

  2. Investigation of the tolerability of oral stevioside in Brazilian hyperlipidemic patients

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    Gisleine Elisa Cavalcante da Silva

    2006-07-01

    Full Text Available The tolerability of stevioside (2.75 mg/kg/day obtained from leaves of Stevia rebaudiana (Bert Bertoni (Compositae was investigated in hyperlipidemic patients. For this purpose a placebo controlled double blind study was performed. The patients were randomized in two groups: the first group received capsules containing placebo and the second group received capsules containing stevioside (50 mg during 90 days. All capsules were ingested twice daily, i.e., 2 capsules before lunch and 2 capsules before dinner. After the selection of the patients and each 30 days body mass index and laboratory tests (alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, total cholesterol, high density lipoprotein, low density lipoprotein, very low density lipoprotein, triglycerides and glucose were performed. Stevioside did not show any clinical relevant modification in all parameters investigated. Moreover the patients did not report severe adverse effect. Thus, we can concluded that stevioside, at least in the doses employed in this study was safe.A tolerabilidade do esteviosideo (2.75 mg/kg/dia obtido a partir de folhas de Stevia rebaudiana (Bert Bertoni (Compositae foi investigada em pacientes hiperlipidêmicos. Para alcançar este objetivo realizamos estudo clínico do tipo duplo cego. Os pacientes foram randomizados em 2 grupos: o primeiro recebeu cápsulas contendo placebo e o segundo recebeu cápsulas contendo esteviosídeo (50 mg. Foram ingeridas duas cápsulas antes do almoço e duas cápsulas antes do jantar durante 90 dias. Após a seleção dos pacientes e a cada 30 dias o índice de massa corpórea e exames laboratoriais (alanina aminotransferase, aspartato aminotransferase, gama-glutamiltransferase, colesterol total, lipoproteína de alta densidade, lipoproteína de baixa densidade, lipoproteína de muito baixa densidade, trigliceridemia e glicemia foram realizados. O esteviosídeo não acarretou qualquer altera

  3. A 3-YEAR FOLLOW-UP OF A BRAZILIAN AIDS PATIENT WITH PROTRACTED DIARRHEA CAUSED BY Enterocytozoon bieneusi

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    Patrícia BRASIL

    1998-07-01

    Full Text Available Enterocytozoon bieneusi is the most prevalent microsporidian parasite that causes gastrointestinal infection in persons with AIDS. Microsporidia are increasingly recognized as important opportunistic pathogens all over the world but in Brazil only few cases have been reported due either to the non awareness of the clinical presentation of the disease or to difficulties in the laboratory diagnosis. We report a 3-year follow-up of a Brazilian HIV-positive patient in whom microsporidial spores were detected in stools and were identified as E. bieneusi using electron microscopy and PCR. The patient presented with chronic diarrhea, CD4 T-lymphocytes count below 100/mm3 and microsporidial spores were consistently detected in stools. Albendazole was given to the patient in several occasions with transient relief of the diarrhea, which reappeared as soon as the drug was discontinued. Nevertheless, a diarrhea-free period with weight gain up to 18 Kg occurred when a combination of nucleoside and protease inhibitors was initiated as part of the antiviral treatment.Enterocytozoon bieneusi é o mais comum microsporídio agente de infecções gastrointestinais que ocorre predominantemente em pessoas com AIDS. Em todo o mundo os microsporídios são reconhecidos como importantes patógenos oportunistas, entretanto poucos casos já foram diagnosticados no Brasil, provavelmente devido ao pouco conhecimento do quadro clínico que os agentes produzem ou a dificuldades no diagnóstico laboratorial. No presente trabalho relatamos o caso de um paciente brasileiro HIV-positivo acompanhado durante 3 anos, em que foram detectados esporos de microsporídios nas fezes, identificados como Enterocytozoon bieneusi por microscopia eletrônica e PCR. O paciente apresentava diarréia crônica, contagem de linfócitos CD4 abaixo de 100/mm3 e fez uso de albendazol em diferentes ocasiões com melhora transitória da diarréia, que reaparecia logo que a droga era suspensa

  4. Cultural adaptation and reproducibility validation of the Brazilian Portuguese version of the Pain Assessment in Advanced Dementia (PAINAD-Brazil) scale in non-verbal adult patients

    Science.gov (United States)

    Pinto, Marcia Carla Morete; Minson, Fabiola Peixoto; Lopes, Ana Carolina Biagioni; Laselva, Claudia Regina

    2015-01-01

    Objective To adapt the Pain Assessment in Advanced Dementia (PAINAD) scale to Brazilian Portuguese with respect to semantic equivalence and cultural aspects, and to evaluate the respective psychometric properties (validity, feasibility, clinical utility and inter-rater agreement). Methods Two-stage descriptive, cross-sectional retrospective study involving cultural and semantic validation of the Brazilian Portuguese version of the scale, and investigation of its psychometric properties (validity, reliability and clinical utility). The sample consisted of 63 inpatients presenting with neurological deficits and unable to self-report pain. Results Semantic and cultural validation of the PAINAD scale was easily achieved. The scale indicators most commonly used by nurses to assess pain were “Facial expression”, “Body language” and “Consolability”. The Brazilian Portuguese version of the scale has proved to be valid and accurate; good levels of inter-rater agreement assured reproducibility. Conclusion The scale has proved to be useful in daily routine care of hospitalized adult and elderly patients in a variety of clinical settings. Short application time, ease of use, clear instructions and the simplicity of training required for application were emphasized. However, interpretation of facial expression and consolability should be given special attention during pain assessment training. PMID:25993063

  5. Chronic symptoms and pulmonary dysfunction in post-tuberculosis Brazilian patients

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    Simone de Sousa Elias Nihues

    2015-10-01

    Full Text Available ABSTRACTBACKGROUND: Questionnaire and spirometry were applied to post-tuberculosis indigenous and non-indigenous individuals from Dourados, Brazil, to investigate the prevalence of chronic respiratory symptoms and pulmonary dysfunction.METHODS:This was a cross-sectional study in cured tuberculosis individuals as reported in the National System on Reportable Diseases (SINAN from 2002 to 2012.RESULTS:One hundred and twenty individuals were included in the study and the prevalence of chronic respiratory symptoms was 45% (95% CI, 34-59%. Respiratory symptoms included cough (28%, sputum (23%, wheezing (22% and dyspnea (8%. These symptoms were associated with alcoholism, AOR: 3.1 (1.2-8.4; less than 4 years of schooling, AOR: 5.0 (1.4-17.7; and previous pulmonary diseases, AOR: 5.4 (1.7-17.3. Forty-one percent (95% CI, 29-56 had pulmonary disorders, of which the most prevalent were obstructive disorders (49%, followed by obstructive disorder with reduced forced vital capacity disorders (46% and restrictive disorders (5%. The lifestyle difference could not explain differences in chronic symptoms and/or the prevalence of pulmonary dysfunction.CONCLUSION:The high prevalence of chronic respiratory symptoms and pulmonary dysfunction in post-tuberculosis patients indicates a need for further interventions to reduce social vulnerability of patients successfully treated for tuberculosis.

  6. Mycobacterium sherrisii Lung Infection in a Brazilian Patient with Silicosis and a History of Pulmonary Tuberculosis

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    Carolina de Oliveira Abrão

    2015-01-01

    Full Text Available Nontuberculous mycobacteria (NTM diseases became relevant with the emergence and spread of HIV and are also related to lung infection in non-HIV individuals with structural lung diseases. Mycobacterium sherrisii is a NTM first characterized in 2004. Only a few cases have been reported. The aim of this case report is to describe the first detailed case of infection with M. sherrisii in a patient with silicosis and history of pulmonary tuberculosis. A 50-year-old HIV-negative white male, previous smoker, with silicosis and a history of treated pulmonary tuberculosis developed a worsening of cough and expectoration pattern, and two sputum samples were positive for acid-fast bacilli. Presumptive treatment for pulmonary tuberculosis was initiated with rifampin, isoniazid, pyrazinamide, and ethambutol, but, at month 5 of treatment, despite correct medication intake and slight improvement of symptoms, sputum bacilloscopy remained positive. Sputum cultures were positive Mycobacterium sherrisii. Treatment regimen was altered to streptomycin (for 2 months, ethambutol, clarithromycin, rifabutin, and trimethoprim-sulfamethoxazole. M. sherrisii should be considered a possible etiological agent of lung infections in patients with pneumoconiosis and history of tuberculosis.

  7. Analysis of HLA-A antigens and C282Y and H63D mutations of the HFE gene in Brazilian patients with hemochromatosis

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    P.L. Bittencourt

    2002-03-01

    Full Text Available The hemochromatosis gene, HFE, is located on chromosome 6 in close proximity to the HLA-A locus. Most Caucasian patients with hereditary hemochromatosis (HH are homozygous for HLA-A3 and for the C282Y mutation of the HFE gene, while a minority are compound heterozygotes for C282Y and H63D. The prevalence of these mutations in non-Caucasian patients with HH is lower than expected. The objective of the present study was to evaluate the frequencies of HLA-A antigens and the C282Y and H63D mutations of the HFE gene in Brazilian patients with HH and to compare clinical and laboratory profiles of C282Y-positive and -negative patients with HH. The frequencies of HLA-A and C282Y and H63D mutations were determined by PCR-based methods in 15 male patients (median age 44 (20-72 years with HH. Eight patients (53% were homozygous and one (7% was heterozygous for the C282Y mutation. None had compound heterozygosity for C282Y and H63D mutations. All but three C282Y homozygotes were positive for HLA-A3 and three other patients without C282Y were shown to be either heterozygous (N = 2 or homozygous (N = 1 for HLA-A3. Patients homozygous for the C282Y mutation had higher ferritin levels and lower age at onset, but the difference was not significant. The presence of C282Y homozygosity in roughly half of the Brazilian patients with HH, together with the findings of HLA-A homozygosity in C282Y-negative subjects, suggest that other mutations in the HFE gene or in other genes involved in iron homeostasis might also be linked to HH in Brazil.

  8. Quality of life of Brazilian and Spanish cancer patients undergoing chemotherapy: an integrative literature review

    Science.gov (United States)

    Sawada, Namie Okino; Nicolussi, Adriana Cristina; de Paula, Juliana Maria; Garcia-Caro, Maria Paz; Marti-Garcia, Celia; Cruz-Quintana, Francisco

    2016-01-01

    Objective: characterize the scientific production of Brazil and Spain in regard to methodological aspects and aspects of health-related quality of life experienced by cancer patients receiving chemotherapy in both countries. Method: integrative literature review was conducted using the following databases: CINAHL, MEDLINE, SCOPUS and CUIDEN and the electronic libraries PubMed and SciELO, conducted in September 2013. Results: a total of 28 papers met the inclusion criteria. The synthesis of knowledge was presented in three categories of analysis: assessment of quality of life in different types of cancer; sociodemographic factors that influenced quality of life; and type of cancer and interventions that improve quality of life. Chemotherapy affects health-related quality of life and the most important factors were: age, sex, chemotherapy protocol, type of surgery, stage of the disease, educational level, and emotional intelligence. Complementary therapies such as acupuncture, guided visualization, prayers and exercise were positive and reduced side effects. Conclusion: the results showed a poor level of evidence, since 86% of the studies were cross-sectional descriptive studies; the instrument most frequently used to measure health-related quality of life was EORTC QLQ C-30 and more studies were conducted in Brazil than in Spain. PMID:27192414

  9. Depressive Symptoms and Dietary Adherence in Patients with End-Stage Renal Disease

    OpenAIRE

    Khalil, Amani A.; Frazier, Susan K; LENNIE, TERRY A.; Sawaya, B. Peter

    2011-01-01

    Depressive symptoms may be associated with fluid and dietary non-adherence which could lead to poorer outcomes. The purpose of this study was to examine the relationship between depressive symptoms and fluid and dietary adherence in 100 patients with end-stage renal disease (ESRD) receiving haemodialysis. A descriptive, cross-sectional design with a convenience sample of 100 patients with ESRD receiving maintenance haemodialysis completed instruments that measured self reported depressive sym...

  10. Multidetector computed tomography angiography in clinically suspected hyperacute ischemic stroke in the anterior circulation: an etiological workup in a cohort of Brazilian patients

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    Felipe Torres Pacheco

    2015-05-01

    Full Text Available Objective The potential of computed tomography angiography (CTA was assessed for early determination of stroke subtypes in a Brazilian cohort of patients with stroke. Method From July 2011 to July 2013, we selected patients with suspected hyperacute stroke (< 6 hours. Intracranial and cervical arteries were scrutinized on CTA and their imaging features were correlated with concurrent subtype of stroke. Results Stroke was documented in 50/106 selected patients (47.2% based on both clinical grounds and imaging follow-up (stroke group, with statistically significant arterial stenosis and vulnerable plaques on CTA. Intracranial large artery disease was demonstrated in 34% of patients in the stroke group. Partial territorial infarct prevailed (86% while artery-to-artery embolization was the most common stroke mechanism (52%. Conclusion Multidetector CTA was useful for the etiologic work-up of hyperacute ischemic stroke and facilitated the knowledge about the topographic pattern of brain infarct in accordance with its causative mechanism.

  11. Investigating the effects of 6 months extended duration, in-centre nocturnal versus conventional haemodialysis treatment: a non-randomised, controlled feasibility study

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    Graham-Brown, Matthew P M; Preston, Robert; Pickering, Warren; McCann, Gerry P

    2016-01-01

    Introduction In-centre nocturnal haemodialysis (INHD) is an underutilised dialysis regimen that can potentially provide patients with better clinical outcomes due to extended treatment times. We have established an INHD programme within our clinical network, fulfilling a previously unmet patient need. This feasibility study aims to gather sufficient data on numerous outcome measures to inform the design of a multicentre randomised controlled trial that will establish the potential benefits of INHD and increase the availability of this service nationally and internationally. Methods and analysis This will be a non-randomised controlled study. Prevalent patients on haemodialysis (HD) will electively change from a conventional in-centre HD regimen of 4 hours thrice weekly to a regimen of extended treatment times (5–8 hours) delivered in-centre overnight thrice weekly. After recruitment of the INHD cohort, a group of patients matched for age, gender and dialysis vintage will be selected from patients remaining on a conventional daytime dialysis programme. Outcome measures will include left ventricular mass as measured by MRI, physical performance measured by the short physical performance battery and physical activity measured by accelerometry. Additionally we will measure quality of life using validated questionnaires, nutritional status by bioimpedance spectroscopy and food diaries, and blood sampling for markers of cardiovascular disease, systemic inflammation. Suitable statistical tests shall be used to analyse the data. We will use omnibus tests to observe changes over the duration of the intervention and between groups. We will also look for associations between outcome measures that may warrant further investigation. These data will be used to inform the power calculation for future studies. Ethics and dissemination A favourable opinion was granted by Northampton Research Ethics Committee (15/EM/0268). It is anticipated that results of this study will be

  12. Profile of patients with rheumatic diseases undergoing treatment with anti-TNF agents in the Brazilian Public Health System (SUS, Belo Horizonte - MG

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    Haliton Alves de Oliveira Junior

    2015-09-01

    Full Text Available The aim of this study was to describe the baseline demographic and clinical characteristics as well as the functional status of a prospective cohort of patients with rheumatic diseases assisted by the Brazilian Public Health System (SUS. Data for 302 patients receiving tumor necrosis factor α inhibitors (anti-TNF agents was collected through a standard form. Among patients, 229 (75.8% were female and 155 (51.3% were Caucasian; the mean age was 50.3 ± 12.8 years, and the mean disease duration was 9.9 ± 8.7 years. Among them 214 patients (70.9% received adalimumab, 72 (23.8% etanercept, and 16 (5.3% infliximab. Mean Health Assessment Questionnaire-Disability Index (HAQ-DI was 1.37 ± 0.67 for all participants. Poor functional response was associated with female gender, married patients and with a score of < 0.6 on the EuroQoL-5 dimensions (EQ-5D. Significant correlation was found between the HAQ-DI values, disease activity and quality of life (QOL. The results obtained in this study contribute to a better understanding of the clinical and demographic characteristics of patients with rheumatic diseases at the beginning of anti-TNF-agent treatment by SUS. Furthermore, our findings are consistent with another Brazilian and foreign cross-sectional investigations. This knowledge can be of great importance for further studies evaluating the effectiveness of biological agents, as well as, to contribute to improve the well-being of the patients with rheumatic diseases.

  13. A review on the diagnosis and treatment of patients with clinically nonfunctioning pituitary adenoma by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism.

    Science.gov (United States)

    Vieira, Leonardo; Boguszewski, Cesar L; Araújo, Luiz Antônio de; Bronstein, Marcello D; Miranda, Paulo Augusto C; Musolino, Nina R de C; Naves, Luciana A; Vilar, Lucio; Ribeiro-Oliveira, Antônio; Gadelha, Mônica R

    2016-08-01

    Clinically nonfunctioning pituitary adenomas (NFPA) are the most common pituitary tumors after prolactinomas. The absence of clinical symptoms of hormonal hypersecretion can contribute to the late diagnosis of the disease. Thus, the majority of patients seek medical attention for signs and symptoms resulting from mass effect, such as neuro-ophthalmologic symptoms and hypopituitarism. Other presentations include pituitary apoplexy or an incidental finding on imaging studies. Mass effect and hypopituitarism impose high morbidity and mortality. However, early diagnosis and effective treatment minimizes morbidity and mortality. In this publication, the goal of the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism is to provide a review of the diagnosis and treatment of patients with NFPA, emphasizing that the treatment should be performed in reference centers. This review is based on data published in the literature and the authors' experience. Arch Endocrinol Metab. 2016;60(4):374-90. PMID:27533614

  14. Effects of Brazilian Propolis on Dental Plaque and Gingiva in Patients with Oral Cleft Malformation Treated with Multibracket and Removable Appliances: A Comparative Study

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    Agnieszka Machorowska-Pieniążek

    2016-01-01

    Full Text Available Orthodontic appliances modify the local environment of the oral cavity, increase the accumulation of dental plaque, and affect the condition of the gingiva. The aim of this study is assessment of Brazilian propolis toothpaste’s effect on plaque index (PLI and gingival index (GI in patients with CL/CLP treated using orthodontic appliances in the 35-day study period. The study population included 96 patients of an Orthodontic Outpatient Clinic, ACSiMS in Bytom. All the patients participated in the active phase of orthodontic treatment using buccal multibracket appliances or removable appliances. During the first examination, each patient was randomly qualified to the propolis group or control group. A statistically significant decrease in GI and PLI in the entire propolis group (P<0.01 was shown during repeated examination. Insignificant change in GI was in the entire control group during the repeated examination compared to the baseline. Similar result was obtained in patients treated with multibracket and removable appliances. The orthodontic appliance type did not affect the final dental plaque amount and gingival condition in patients using the propolis toothpaste. These results may be clinically useful to improve prevention and control oral infectious diseases during orthodontic treatment patients with oral cleft.

  15. Reliability of the Brazilian Portuguese version of the fatigue severity scale and its correlation with pulmonary function, dyspnea, and functional capacity in patients with COPD

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    Silvia Valderramas

    2013-06-01

    Full Text Available OBJECTIVE: To describe the intra-rater and inter-rater reliability of the Brazilian Portuguese version of the fatigue severity scale (FSS in patients with COPD and to identify the presence of its association with parameters of pulmonary function, dyspnea, and functional capacity. METHODS: This was an observational cross-sectional study involving 50 patients with COPD, who completed the FSS in interviews with two researchers in two visits. The FSS scores were correlated with those of the Medical Research Council (MRC scale, as well as with FEV1, FVC, and six-minute walk distance (6MWD. RESULTS: The mean age of the patients was 69.4 ± 8.23 years, whereas the mean FEV1 was 46.5 ± 20.4% of the predicted value. The scale was reliable, with an intraclass correlation coefficient of 0.90 (95% CI, 0.81-0.94; p < 0.01. The FSS scores showed significant correlations with those of MRC scale (r = 0.70; p < 0.01, as well as with 6MWD (r = –0.77; p < 0.01, FEV1 (r = –0.38; p < 0.01, FVC (r = –0.35; p < 0.01, and stage of the disease in accordance with the Global Initiative for Chronic Obstructive Lung Disease criteria (r = 0.37; p < 0.01. CONCLUSIONS: The Brazilian Portuguese version of the FSS proved reliable for use in COPD patients in Brazil and showed significant correlations with sensation of dyspnea, functional capacity, pulmonary function, and stage of the disease.

  16. Molecular findings from influenza A(H1N1pdm09 detected in patients from a Brazilian equatorial region during the pandemic period

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    Maria José Couto Oliveira

    2014-11-01

    Full Text Available After the World Health Organization officially declared the end of the first pandemic of the XXI century in August 2010, the influenza A(H1N1pdm09 virus has been disseminated in the human population. In spite of its sustained circulation, very little on phylogenetic data or oseltamivir (OST resistance is available for the virus in equatorial regions of South America. In order to shed more light on this topic, we analysed the haemagglutinin (HA and neuraminidase (NA genes of influenza A(H1N1pdm09 positive samples collected during the pandemic period in the Pernambuco (PE, a northeastern Brazilian state. Complete HA sequences were compared and amino acid changes were related to clinical outcome. In addition, the H275Y substitution in NA, associated with OST resistance, was investigated by pyrosequencing. Samples from PE were grouped in phylogenetic clades 6 and 7, being clustered together with sequences from South and Southeast Brazil. The D222N/G HA gene mutation, associated with severity, was found in one deceased patient that was pregnant. Additionally, the HA mutation K308E, which appeared in Brazil in 2010 and was only detected worldwide the following year, was identified in samples from hospitalised cases. The resistance marker H275Y was not identified in samples tested. However, broader studies are needed to establish the real frequency of resistance in this Brazilian region.

  17. Frequency of p190 and p210 BCR-ABL rearrangements and survival in Brazilian adult patients with acute lymphoblastic leukemia

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    Ilana de França Azevedo

    2014-10-01

    Full Text Available Objective: This study investigated the occurrence of the p190 and p210 break point clusterregion-Abelson (BCR-ABL rearrangements in adults with acute lymphoblastic leukemia and possible associations with clinical and laboratory characteristics and survival. Methods: Forty-one over 18-year-old patients with acute lymphoblastic leukemia of both genders followed-up between January 2008 and May 2012 were included in this study. Clinical and laboratory data were obtained from the medical charts of the patients. Reverse transcription polymerase chain reaction (RT-PCR using specific primers was employed to identify molecular rearrangements. Results: At diagnosis, the median age was 33 years, and there was a predominance of males (61%. The most common immunophenotype was B lineage (76%. BCR-ABL rearrangements was detected in 14 (34% patients with the following distribution: p190 (28%, p210 (50% and double positive (22%. Overall survival of patients with a mean/median of 331/246 days of follow up was 39%, respectively, negative BCR-ABL (44% and positive BCR-ABL (28%. Conclusion: These results confirm the high frequency of BCR-ABL rearrangements and the low survival rate of adult Brazilian patients with acute lymphoblastic leukemia.

  18. One-week dual therapy with ranitidine bismuth citrate and clarithromycin for the treatment of Helicobacter pylori infection in Brazilian patients with peptic ulcer

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    Maria Aparecida Mesquita; S(o)nia Letícia Silva Lorena; Jazon Romilson Souza Almeida; Ciro Garcia Montes; Fábio Guerrazzi; Luciana T Campos; José Murilo Rubiota Zeitune

    2005-01-01

    AIM: To assess the efficacy and safety of ranitidine bismuth citrate plus clarithromycin given for 1 wk in Brazilian patients with peptic ulcer.METHODS: One hundred and twenty patients with peptic ulcer were randomized in two treatment groups: (1) 1-wk regimen consisting of ranitidine bismuth citrate 400 mg b.i.d. with clarithromycin 500 mg b.i.d. or (2) 2-wk regimen of the same treatment. Eradication of the infection was considered when both the histologic examination and the urease test were negative for the infection 3 mo after treatment.RESULTS: By intention to treat analysis, Helicobacter pylori (H pylori) was eradicated in 73% and 76% of patients, respectively treated for 1 or 2 wk (P>0.05). By per protocol analysis, the eradication rates were 80% and 83%,respectively, in patients treated for 1 or 2 wk (P>0.05). Nine patients (8.2%) reported minor side effects. CONCLUSION: One-week therapy with ranitidine bismuth citrate and clarithromycin is safe, well tolerated and effective for treatment of H pylori infection, andappears to be comparable to the 2-wk regimen in terms of efficacy.

  19. Efficacy of levofloxacin, amoxicillin and a proton pump inhibitor in the eradication of Helicobacter pylori in Brazilian patients with peptic ulcers

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    Fernando Marcuz Silva

    2015-05-01

    Full Text Available OBJECTIVES: The eradication of Helicobacter (H. pylori allows peptic ulcers in patients infected with the bacteria to be cured. Treatment with the classic triple regimen (proton pump inhibitor, amoxicillin and clarithromycin has shown decreased efficacy due to increased bacterial resistance to clarithromycin. In our country, the eradication rate by intention to treat with this regimen is 83%. In Brazil, a commercially available regimen for bacterial eradication that uses levofloxacin and amoxicillin with lansoprazole is available; however, its efficacy is not known. Considering that such a treatment may be an alternative to the classic regimen, we aimed to verify its efficacy in H. pylori eradication. METHODS: Patients with peptic ulcer disease infected with H. pylori who had not received prior treatment were treated with the following regimen: 30 mg lansoprazole bid, 1,000 mg amoxicillin bid and 500 mg levofloxacin, once a day for 7 days. RESULTS: A total of 66 patients were evaluated. The patients’ mean age was 52 years, and women comprised 55% of the sample. Duodenal ulcers were present in 50% of cases, and gastric ulcers were present in 30%. The eradication rate was 74% per protocol and 73% by intention to treat. Adverse effects were reported by 49 patients (74% and were mild to moderate, with a prevalence of diarrhea complaints. CONCLUSIONS: Triple therapy comprising lansoprazole, amoxicillin and levofloxacin for 7 days for the eradication of H. pylori in Brazilian peptic ulcer patients showed a lower efficacy than that of the classic triple regimen.

  20. The C242T polymorphism of the p22-phox gene (CYBA is associated with higher left ventricular mass in Brazilian hypertensive patients

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    Krieger José E

    2011-08-01

    Full Text Available Abstract Background Reactive oxygen species have been implicated in the physiopathogenesis of hypertensive end-organ damage. This study investigated the impact of the C242T polymorphism of the p22-phox gene (CYBA on left ventricular structure in Brazilian hypertensive subjects. Methods We cross-sectionally evaluated 561 patients from 2 independent centers [Campinas (n = 441 and Vitória (n = 120] by clinical history, physical examination, anthropometry, analysis of metabolic and echocardiography parameters as well as p22-phox C242T polymorphism genotyping. In addition, NADPH-oxidase activity was quantified in peripheral mononuclear cells from a subgroup of Campinas sample. Results Genotype frequencies in both samples were consistent with the Hardy- Weinberg equilibrium. Subjects with the T allele presented higher left ventricular mass/height2.7 than those carrying the CC genotype in Campinas (76.8 ± 1.6 vs 70.9 ± 1.4 g/m2.7; p = 0.009, and in Vitória (45.6 ± 1.9 vs 39.9 ± 1.4 g/m2.7; p = 0.023 samples. These results were confirmed by stepwise regression analyses adjusted for age, gender, blood pressure, metabolic variables and use of anti-hypertensive medications. In addition, increased NADPH-oxidase activity was detected in peripheral mononuclear cells from T allele carriers compared with CC genotype carriers (p = 0.03. Conclusions The T allele of the p22-phox C242T polymorphism is associated with higher left ventricular mass/height2.7 and increased NADPH-oxidase activity in Brazilian hypertensive patients. These data suggest that genetic variation within NADPH-oxidase components may modulate left ventricular remodeling in subjects with systemic hypertension.

  1. Survival of patients with operable breast cancer (Stages I-III) at a Brazilian public hospital - a closer look into cause-specific mortality

    International Nuclear Information System (INIS)

    Breast cancer incidence is increasing. The survival rate varies and is longer in high-income countries. In Brazil, lower-income populations rely on the Unified Public Health System (Sistema Único de Saude, SUS) for breast cancer care. The goal of our study is to evaluate the survival of patients with operable breast cancer stages I-III at a Brazilian public hospital that treats mostly patients from the SUS. A cohort study of patients who underwent surgery for breast cancer treatment at the Clinical Hospital of the Federal University of Minas Gerais from 2001 to 2008 was performed, with a population of 897 cases. Information on tumor pathology and staging, as well as patients’ age and type of health coverage (SUS or private system) was collected. A probabilistic record linkage was performed with the database of the Mortality Information System to identify patients who died by December 31th, 2011. The basic cause of death was retrieved, and breast cancer-specific survival rates were estimated with the Kaplan-Meier method. The Cox proportional hazards model was used for univariate and multivariate analysis of factors related to survival. A total of 282 deaths occurred during the study’s period, 228 of them due to breast cancer. Five-year breast cancer-specific survival rates were 95.5% for stage I, 85.1% for stage II and 62.1% for stage III disease. Patients from the SUS had higher stages at diagnosis (42% was in stage III, and from the private system only 17.6% was in this stage), and in the univariate but not multivariate analysis, being treated by the SUS was associated with shorter survival (hazard ratio, HR = 2.22, 95% CI 1.24-3.98). In the multivariate analysis, larger tumor size, higher histologic grade, higher number of positive nodes and age older than 70 years were associated with a shorter breast cancer-specific survival. Five-year breast cancer survival was comparable to other Brazilian cohorts. Patients treated by the SUS, rather than by the private

  2. Predictors of early treatment discontinuation and severe anemia in a Brazilian cohort of hepatitis C patients treated with first-generation protease inhibitors

    Science.gov (United States)

    Miotto, N.; Mendes, L.C.; Zanaga, L.P.; Goncales, E.S.L.; Lazarini, M.S.K.; Pedro, M.N.; Goncales, F.L.; Stucchi, R.S.B.; Vigani, A.G.

    2016-01-01

    The aim of this study was to determine risk factors for adverse events (AE)-related treatment discontinuation and severe anemia among patients with chronic hepatitis C virus (HCV) genotype 1 infection, treated with first-generation protease inhibitor (PI)-based therapy. We included all patients who initiated treatment with PI-based therapy at a Brazilian university hospital between November 2013 and December 2014. We prospectively collected data from medical records using standardized questionnaires and used Epi Info 6.0 for analysis. Severe anemia was defined as hemoglobin ≤8.5 mg/dL. We included 203 patients: 132 treated with telaprevir (TVR) and 71 treated with boceprevir (BOC). AE-related treatment discontinuation rate was 19.2% and anemia was the main reason (38.5%). Risk factors for treatment discontinuation were higher comorbidity index (OR=1.85, CI=1.05-3.25) for BOC, and higher bilirubin count (OR=1.02, CI=1.01-1.04) and lower BMI (OR=0.98, CI=0.96-0.99) for TVR. Severe anemia occurred in 35 (17.2%) patients. Risk factors for this outcome were lower estimated glomerular filtration rate (eGFR; OR=0.95, CI=0.91-0.98) for patients treated with TVR, and higher comorbidity index (OR=2.21, CI=1.04-4.67) and ribavirin dosage (OR=0.84, CI=0.72-0.99) for those treated with BOC. Fifty-five (57.3%) patients treated with TVR and 15 (27.3%) patients treated with BOC achieved sustained virological response (SVR). Among patients who received TVR and interrupted treatment due to AE (n=19), only 26.3% (n=5) achieved SVR (P=0.003). Higher number of comorbidities, lower eGFR and advanced liver disease are associated with severe anemia and early treatment cessation, which may compromise SVR achievement. PMID:27356107

  3. Variables associated with health-related quality of life in a Brazilian sample of patients from a tertiary outpatient clinic for depression and anxiety disorders

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    Bianca Schwab

    2015-12-01

    Full Text Available Introduction: Health-related quality of life (HRQOL assessment tools have been broadly used in the medical context. These tools are used to measure the subjective impact of the disease on patients. The objective of this study was to evaluate the variables associated with HRQOL in a Brazilian sample of patients followed up in a tertiary outpatient clinic for depression and anxiety disorders. Method: Cross-sectional study. Independent variables were those included in a sociodemographic questionnaire and the Hospital Anxiety and Depression Scale (HADS scores. Dependent variables were those included in the short version of the World Health Organization Quality of Life (WHOQOL-BREF and the scores for its subdomains (overall quality of life and general health, physical health, psychological health, social relationships, and environment. A multiple linear regression analysis was used to find the variables independently associated with each outcome. Results: Seventy-five adult patients were evaluated. After multiple linear regression analysis, the HADS scores were associated with all outcomes, except social relationships (p = 0.08. Female gender was associated with poor total scores, as well as psychological health and environment. Unemployment was associated with poor physical health. Conclusion: Identifying the factors associated with HRQOL and recognizing that depression and anxiety are major factors are essential to improve the care of patients.

  4. Omeprazole, Furazolidone, and Tetracycline: an eradication treatment for resistant H. pylori in Brazilian patients with peptic ulcer disease Omeprazol, Tetraciclina e Furazolidona, um tratamento para erradicação do H. pylori resistente em pacientes ulcerosos do Brasil

    OpenAIRE

    Fernando Marcuz Silva; Jaime Natan Eisig; Ethel Zimberg Chehter; Júlio Jovino da Silva; Antonio Atílio Laudanna

    2002-01-01

    OBJECTIVES: To determine the efficacy of a simple, short-term and low-cost eradication treatment for Helicobacter pylori (H. pylori) using omeprazole, tetracycline, and furazolidone in a Brazilian peptic ulcer population, divided into 2 subgroups: untreated and previously treated for the infection. PATIENTS AND METHODS: Patients with peptic ulcer disease diagnosed by endoscopic examination and infected by H. pylori diagnosed by the rapid urease test (RUT) and histological examination, untreat...

  5. Comparison of the Effects of Dialysis Methods (Haemodialysis vs Peritoneal Dialysis) on Diastolic Left Ventricular Function Dialysis Methods and Diastolic Function

    Science.gov (United States)

    Ellouali, Fedoua; Berkchi, Fatimazahra; Bayahia, Rabia; Benamar, Loubna; Cherti, Mohammed

    2016-01-01

    Introduction: In patients undergoing chronic dialysis, several factors appear to influence the occurrence of cardiac abnormalities. The aim of our study was to evaluate the effects of two different methods of renal replacement therapy (chronic haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD)) on left ventricular (LV) diastolic function. Patients and Methods: We enrolled 63 patients: 21 patients on CAPD, and 42 age- and gender-matched patients on HD; 35 patients were men (55.6%). Median of age was 46.4 (35-57) years. The median duration of renal replacement therapy was 3(2-5) years. Results: The two groups (HD vs PD) were similar concerning body mass index, dialysis duration and cardiovascular risk factors. The comparison of echocardiographic parameters showed statistically significant differences between two groups, regarding the presence of calcification, cardiac effusion, severely abnormal left ventricular hypertrophy(LVH) and the ratio of mitral velocity to early diastolic velocity of the mitral annulus (E/e’) >13 (p= 0.001, p= 0.003, p= 0.02, p= 0.004, respectively). In multivariate analysis, an E/e’>13 was higher in PD group ( OR= 5.8, CI [1.3-25.5], p=0.002). Conclusion: The method of dialysis seems to influence LV diastolic function. We observed a higher prevalence of diastolic LV dysfunction in the PD group. Echocardiographic follow up is essential as this could improve the management of cardiovascular complications in dialysis patients. PMID:27583042

  6. Lapatinib in patients with metastatic breast cancer following initial treatment with trastuzumab: an economic analysis from the Brazilian public health care perspective

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    Machado M

    2012-11-01

    Full Text Available Marcio Machado,1 Thomas R Einarson21GlaxoSmithKline Brasil Ltd, Rio de Janeiro, Brazil; 2Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, CanadaObjective: To evaluate, from the perspective of the Brazilian public health care system, the cost-effectiveness of lapatinib plus capecitabine (LAP/CAP versus capecitabine alone (CAP or trastuzumab plus capecitabine (TRAST/CAP in the treatment of women with human epidermal growth factor receptor-2-positive metastatic breast cancer previously treated with trastuzumab.Methods: An economic model was developed to compare costs and clinical outcomes over a 5-year time horizon. Both costs and outcomes were discounted at a 5% rate, in accordance with Brazilian pharmacoeconomic guidelines. Clinical inputs were determined using indirect treatment comparisons. Costs were derived from public reimbursement databases and reported in 2010 Brazilian real (R$1 = USD$0.52. Clinical outcomes included progression-free survival years (PFYs, life-years (LYs and quality-adjusted life-years (QALYs. The economic outcome was the incremental cost per LY, PFY, or QALY gained. The impact of variations in individual inputs (eg, drug cost, drug effectiveness was examined using one-way sensitivity analyses. Overall model robustness was tested using probabilistic sensitivity analyses, varying the ranges of all input parameters within their standard distributions.Results: Expected cost per patient was R$41,195 for CAP, R$95,256 for LAP/CAP, and R$113,686 for TRAST/CAP. Respective LYs were 1.406, 1.695, and 1.465; PFYs were 0.473, 0.711, and 0.612; and QALYS were 0.769, 0.958, and 0.827. LAP/CAP dominated TRAST/CAP for all outcomes. Incremental cost-effectiveness ratios of LAP/CAP over CAP were R$186,563 for LYs, R$226,403 for PFYs, and R$284,864 for QALYs. Results remained unchanged in one-way sensitivity analyses. In probabilistic analyses, LAP/CAP was dominant over TRAST/CAP in 93.5% of simulations.Conclusion: LAP

  7. Intensity modulated radiotherapy (IMRT) for patients of the Brazilian unified health system (SUS): an analysis of 508 treatments two years after the technique implementation

    International Nuclear Information System (INIS)

    Objective: the offering of high-technology radiotherapy to the population assisted by the Brazilian unified health system (SUS) is limited since it is not included in the system’s list of procedures and, many times, because of the insufficient installed capacity and lack of specialized human resources. Thus the access to intensity-modulated radiotherapy (IMRT) is restricted to few centers in Brazil. The present study is aimed at presenting the characteristics of the first 508 cases treated with IMRT during the first years after the technique implementation in a university hospital. Materials and methods: the first consecutive 508 cases of IMRT treatment completed in the period from May/2011 to September/2013 were reviewed. Static multi leaf was the technique employed. Results: amongst 4,233 treated patients, 12.5% were submitted to IMRT. Main indications for the treatment included cancers located in the skull, head and neck and prostate. Intensity modulated radiotherapy was utilized in about 30% of cranial and 50% of prostate treatments. Treatment toxicity was observed in 4% of the patients. Conclusion: because of restricted access to radiotherapy in addition to lack of coverage for the procedure, IMRT indications for SUS patients should be based on institutional clinical protocols, with special attention to the reduction of toxicity. (author)

  8. Intensity modulated radiotherapy (IMRT) for patients of the Brazilian unified health system (SUS): an analysis of 508 treatments two years after the technique implementation

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Harley Francisco de; Trevisan, Felipe Amstalden; Bighetti, Viviane Marques; Guimaraes, Flavio da Silva; Amaral, Leonardo Lira; Barbi, Gustavo Lazaro; Borges, Leandro Federiche; Peria, Fernanda Maris, E-mail: harley@fmrp.usp.br [Universidade de Sao Paulo (FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina

    2014-11-15

    Objective: the offering of high-technology radiotherapy to the population assisted by the Brazilian unified health system (SUS) is limited since it is not included in the system’s list of procedures and, many times, because of the insufficient installed capacity and lack of specialized human resources. Thus the access to intensity-modulated radiotherapy (IMRT) is restricted to few centers in Brazil. The present study is aimed at presenting the characteristics of the first 508 cases treated with IMRT during the first years after the technique implementation in a university hospital. Materials and methods: the first consecutive 508 cases of IMRT treatment completed in the period from May/2011 to September/2013 were reviewed. Static multi leaf was the technique employed. Results: amongst 4,233 treated patients, 12.5% were submitted to IMRT. Main indications for the treatment included cancers located in the skull, head and neck and prostate. Intensity modulated radiotherapy was utilized in about 30% of cranial and 50% of prostate treatments. Treatment toxicity was observed in 4% of the patients. Conclusion: because of restricted access to radiotherapy in addition to lack of coverage for the procedure, IMRT indications for SUS patients should be based on institutional clinical protocols, with special attention to the reduction of toxicity. (author)

  9. Inosine triphosphatase allele frequency and association with ribavirin-induced anaemia in Brazilian patients receiving antiviral therapy for chronic hepatitis C

    Science.gov (United States)

    Delvaux, Nathália; da Costa, Vanessa Duarte; da Costa, Maristella Matos; Villar, Livia Melo; Coelho, Henrique Sérgio Moraes; Esberard, Eliane Bordalo Cathalá; Flores, Priscila Pollo; Brandão-Mello, Carlos Eduardo; Villela-Nogueira, Cristiane Alves; de Almeida, Adilson José; Lampe, Elisabeth

    2015-01-01

    Inosine triphosphatase (ITPA) single nucleotide polymorphisms (SNPs) are strongly associated with protection against ribavirin (RBV)-induced anaemia in European, American and Asian patients; however, there is a paucity of data for Brazilian patients. The aim of this study was to evaluate the ITPA SNP (rs7270101/rs1127354) frequency in healthy and hepatitis C virus (HCV)-infected patients from Brazil and the association with the development of severe anaemia during antiviral therapy. ITPA SNPs were determined in 200 HCV infected patients and 100 healthy individuals by sequencing. Biochemical parameters and haemoglobin (Hb) levels were analysed in 97 patients who underwent antiviral therapy. A combination of AArs7270101+CCrs1127354 (100% ITPase activity) was observed in 236/300 individuals. Anaemia was observed in 87.5% and 86.2% of treated patients with AA (rs7270101) and CC genotypes (rs1127354), respectively. Men with AA (rs7270101) showed a considerable reduction in Hb at week 12 compared to those with AC/CC (p = 0.1475). In women, there was no influence of genotype (p = 0.5295). For rs1127354, men with the CC genotype also showed a sudden reduction in Hb compared to those with AC. Allelic distribution of rs7270101 and rs1127354 shows high rates of the genotypes AA and CC, respectively, suggesting that the study population had a great propensity for developing RBV-induced anaemia. A progressive Hb reduction during treatment was observed; however, this reduction was greater in men at week 12 than in women. PMID:26154744

  10. Inosine triphosphatase allele frequency and association with ribavirin-induced anaemia in Brazilian patients receiving antiviral therapy for chronic hepatitis C

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    Nathália Delvaux

    2015-08-01

    Full Text Available Inosine triphosphatase (ITPA single nucleotide polymorphisms (SNPs are strongly associated with protection against ribavirin (RBV-induced anaemia in European, American and Asian patients; however, there is a paucity of data for Brazilian patients. The aim of this study was to evaluate the ITPA SNP (rs7270101/rs1127354 frequency in healthy and hepatitis C virus (HCV-infected patients from Brazil and the association with the development of severe anaemia during antiviral therapy. ITPA SNPs were determined in 200 HCV infected patients and 100 healthy individuals by sequencing. Biochemical parameters and haemoglobin (Hb levels were analysed in 97 patients who underwent antiviral therapy. A combination of AArs7270101+CCrs1127354 (100% ITPase activity was observed in 236/300 individuals. Anaemia was observed in 87.5% and 86.2% of treated patients with AA (rs7270101 and CC genotypes (rs1127354, respectively. Men with AA (rs7270101 showed a considerable reduction in Hb at week 12 compared to those with AC/CC (p = 0.1475. In women, there was no influence of genotype (p = 0.5295. For rs1127354, men with the CC genotype also showed a sudden reduction in Hb compared to those with AC. Allelic distribution of rs7270101 and rs1127354 shows high rates of the genotypes AA and CC, respectively, suggesting that the study population had a great propensity for developing RBV-induced anaemia. A progressive Hb reduction during treatment was observed; however, this reduction was greater in men at week 12 than in women.

  11. Fabry disease: Evidence for a regional founder effect of the GLA gene mutation 30delG in Brazilian patients

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    Dayse Oliveira de Alencar

    2014-01-01

    Full Text Available The Fabry disease is caused by mutations in the gene (GLA that encodes the enzyme α-galactosidase A (α-Gal A. More than 500 pathologic variants of GLA have already been described, most of them are family-specific. In southern Brazil, a frequent single-base deletion (GLA 30delG was identified among four families that do not recognize any common ancestral. In order to investigate the history of this mutation (investigate the founder effect, estimate the mutation age and the most likely source, six gene-flanking microsatellite markers of the X chromosome on the mutation carriers and their parents, 150 individuals from the same population and 300 individuals that compose the Brazilian parental populations (Europeans, Africans and Native Americans were genotyped. A common haplotype to the four families was identified and characterized as founder. The age was estimated with two statistics software (DMLE 2.2 and ESTIAGE that agreed with 11 to 12 generations old. This result indicates that the mutation GLA 30delG was originated from a single event on the X chromosome of a European immigrant, during the southern Brazil colonization between 1710 and 1740.

  12. Penile primary melanoma: analysis of 6 patients treated at Brazilian national cancer institute in the last eight years

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    Gustavo Ruschi Bechara

    2013-12-01

    Full Text Available Purpose To describe our experience in treating penile melanoma in 06 patients followed at our institution. Materials and Methods Between 2004 and 2012 six consecutive patients with penile melanoma were treated at our Institution. Stage of the disease was classified according to the 2002 AJCC pathologic system. Melanoma in situ (TIS was diagnosed in one patient. One patient was staged as T1b, two patients as T2b and two patients as T4b. The clinical and pathological findings were evaluated. Immunohistochemical tests were performed for Melan-A, HNB-45, S-100 and C-KIT. All histological specimens were examined by the same pathologist (ABSS. The patients with Cis, stages T1b and one patient T2b underwent only local excision. One patient T2b underwent local excision and sentinel lymph node dissection. Two patients with melanoma stage T4b underwent partial penile amputation. One of these last patients had palpable inguinal lymph nodes at diagnosis and underwent bilateral inguinal lymphadenectomy and received systemic chemotherapy (dacarbazine, 30 cycles. Results Mean follow-up was 36.3 months. One patient, with stage T2b, died after 12 months due to disease recurrence with bilateral inguinal involvement. The patient who underwent chemotherapy progressed with lung metastases and died after 14 months of follow up. The disease-free survival at five years was 33.3%. Conclusion: Penile melanoma is a disease with poor prognosis in most cases. Local excision or partial penile amputation may have effective control for stages T1 and T2 lesions. Patients who have clinically proven metastases died despite surgical and adjuvant chemotherapy.

  13. Dental approach in the pediatric oncology patient: characteristics of the population treated at the dentistry unit in a pediatric oncology brazilian teaching hospital

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    Camila Carrillo

    2010-01-01

    Full Text Available OBJECTIVES: The objective of this paper was to characterize the population seen at the dentistry unit of the hematology-oncology service of the Oncology-Hematology Service, Instituto da Criança at the Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo. Oral problems resulting from cancer therapy increase the risk of infection, length of hospital stay, treatment cost and negative impact on the course and prognosis of the disease. METHOD: Of the 367 medical records of cancer patients seen from November 2007 until December 2008: 186 with a cancer diagnosis and complete clinical data were selected, while 20 with a cancer diagnosis and incomplete records were excluded; 161 medical records with only hematological diagnosis were also excluded. The following characteristics were assessed: ethnicity, gender, age, diagnosis and characteristics of the neoplasm, cancer therapy status and performed dental procedures. RESULTS: Review of 1,236 visits indicated that 54% (n=100 of the patients had blood cancers, 46% (n=86 had solid tumors and 63% were undergoing anticancer therapy. The proportion of males (52.7% in the study population was slightly greater. The most common cancer was acute lymphocytic leukemia (32.2%. Cancer occurred more often among those patients aged 5 to 9 years. The most common dental procedures were restorative treatment, preventive treatment and removal of infectious foci. CONCLUSION: The characteristics of the studied population were similar to those of the general Brazilian and global populations, especially regarding gender and diagnosis distributions. The aim of implementation of the dentistry unit was to maintain good oral health and patients' quality of life, which is critical to provide oral care and prevent future oral problems.

  14. Interaction between Smoking and HLA-DRB1*04 Gene Is Associated with a High Cardiovascular Risk in Brazilian Amazon Patients with Rheumatoid Arthritis

    Science.gov (United States)

    Boechat, Narjara de Oliveira; Ogusku, Mauricio Morish; Boechat, Antonio Luiz; Sadahiro, Aya

    2012-01-01

    Background Rheumatoid Arthritis (RA) is an autoimmune disease characterized by chronic inflammation of the joints that affects approximately 1% of the population worldwide. The HLA-DRB1 gene locus plays a major role in genetic susceptibility to RA, a condition that has been associated with a high cardiovascular morbidity and mortality in many studies. Methodology/Principal Findings The aim of this work was to investigate which types of HLA class II genes are associated with RA in patients from the Brazilian Amazon and their influence on high cardiovascular risk status in this population. For this purpose, a case-control study was carried out with a total of 350 non-Indian individuals made up of a cohort of 132 consecutive RA sufferers and 218 healthy controls. A χ2 test showed that HLADRB1*04 (p<0.0016; OR = 1.89; 95% CI = 1.29–2.79) and HLADRB1*10 (p = 0.0377; OR = 3.81; 95% CI = 1.16–12.50) are the major HLA genes associated with susceptibility to RA. A logistic regression model also showed that the interaction between HLADRB1*04 (p = 0.027; OR = 6.02; 95% CI = 1.21–29.7), age (p = 0.0001; OR = 1.26; 95% CI = 1.13–1.39) and smoking (p = 0.0001; OR = 23.6; 95% CI = 4.25–32.1) is associated with a probability of a high cardiovascular risk status at an early age. Conclusions/Significance The results of this study show for the first time that HLA class II type is associated with RA in Brazilian Amazon populations and that a specific interaction between the HLA-DRB1*04 gene and smoking is associated with a high cardiovascular risk status, as initially reported in the European population. This study therefore contributes to an understanding of gene-environment interactions in RA patients. PMID:22912672

  15. Standardised outcomes in nephrology – Haemodialysis (SONG-HD): study protocol for establishing a core outcome set in haemodialysis

    OpenAIRE

    Tong, Allison; Manns, Braden; Hemmelgarn, Brenda; Wheeler, David C; Tugwell, Peter; Winkelmayer, Wolfgang C.; van Biesen, Wim; Crowe, Sally; Kerr, Peter G.; Polkinghorne, Kevan R; Howard, Kirsten; Pollock, Carol; Hawley, Carmel M.; Johnson, David W.; McDonald, Stephen P.

    2015-01-01

    Background: Chronic kidney disease is a significant contributor to mortality and morbidity worldwide, and the number of people who require dialysis or transplantation continues to increase. People on dialysis are 15 times more likely to die than the general population. Dialysis is also costly, intrusive, and time-consuming and imposes an enormous burden on patients and their families. This escalating problem has spurred a proliferation of trials in dialysis, yet health and quality of life rem...

  16. Brazilian blood donation eligibility criteria for dermatologic patients Critérios brasileiros de elegibilidade à doação de sangue para pacientes dermatológicos

    OpenAIRE

    Carlos Gustavo Wambier; Caroline Silva Pereira; Benedito de Pina Almeida Prado Júnior; Norma Tiraboschi Foss

    2012-01-01

    A focused and commented review on the impact of dermatologic diseases and interventions in the solidary act of donating blood is presented to dermatologists to better advise their patients. This is a review of current Brazilian technical regulations on hemotherapeutic procedures as determined by Ministerial Directive #1353/2011 by the Ministry of Health and current internal regulations of the Hemotherapy Center of Ribeirão Preto, a regional reference center in hemotherapeutic procedures. Crit...

  17. Avaliação prospectiva de 11 pacientes brasileiros com mucopolissacaridose II Prospective study of 11 Brazilian patients with mucopolysaccharidosis II

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    Louise L. C. Pinto

    2006-08-01

    Full Text Available OBJETIVO: Avaliar a progressão da mucopolissacaridose II, durante um período de 12 meses, em 11 pacientes brasileiros. MÉTODOS: Onze pacientes brasileiros com mucopolissacaridose II foram avaliados prospectivamente no Serviço de Genética Médica do Hospital de Clínicas de Porto Alegre. As avaliações realizadas na visita inicial e na de 12 meses foram: anamnese, exame físico, ressonância nuclear magnética abdominal, ecocardiograma, teste da caminhada em 6 minutos, audiometria, exames bioquímicos séricos e dosagem uriná- ria de glicosaminoglicanos. RESULTADOS: Os principais achados relativos à comparação entre as duas visitas foram: 1 dois pacientes apresentaram retardo de crescimento; 2 dois pacientes apresentaram variação negativa em relação ao peso; 3 um paciente apresentou variação de obesidade para sobrepeso; 4 três pacientes desenvolveram alargamento do ventrículo esquerdo; destes, dois aumentaram o número de lesões nas valvas cardíacas; 5 não foi encontrada diferença estatística significativa entre a média das distâncias percorridas no teste da caminhada em 6 minutos; 6 houve aumento do volume esplênico; 7 ocorreu aumento dos níveis de gamaglutamiltransferase; 8 não houve alteração dos níveis urinários de glicosaminoglicanos. CONCLUSÕES: De uma maneira geral, a única variável que apresentou, no período estudado, piora com potencial repercussão clínica imediata foram os achados ecocardiográficos. Embora o período de 12 meses seja curto para medir alterações na maioria dos parâmetros comprometidos na mucopolissacaridose II, sua natureza progressiva deve ser levada em conta na avaliação da eficácia dos protocolos de tratamento para essa condição.OBJECTIVE: To assess the progression of mucopolysaccharidosis II in 11 Brazilian patients over a 12-month period. METHODS: Eleven Brazilian patients with mucopolysaccharidosis II were prospectively studied at the Division of Medical Genetics of

  18. Positive effects of football on fitness, lipid profile, and insulin resistance in Brazilian patients with type 2 diabetes

    DEFF Research Database (Denmark)

    de Sousa, M V; Fukui, R; Krustrup, Peter;

    2014-01-01

    We evaluated the effects of recreational football training combined with calorie-restricted diet (football + diet) vs calorie-restricted diet alone (diet) on aerobic fitness, lipid profile, and insulin resistance indicators in type 2 diabetes (T2D) patients. Forty-four T2D patients aged 48-68 years...

  19. Tumour necrosis factor -308 and -238 promoter polymorphisms are predictors of a null virological response in the treatment of Brazilian hepatitis C patients

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    Tarciana Grandi

    2014-06-01

    Full Text Available Certain host single nucleotide polymorphisms (SNPs affect the likelihood of a sustained virological response (SVR to treatment in subjects infected with hepatitis C virus (HCV. SNPs in the promoters of interleukin (IL-10 (-1082 A/G, rs1800896, myxovirus resistance protein 1 (-123 C/A, rs17000900 and -88 G/T, rs2071430 and tumour necrosis factor (TNF (-308 G/A, rs1800629 and -238 G/A, rs361525 genes and the outcome of PEGylated α-interferon plus ribavirin therapy were investigated. This analysis was performed in 114 Brazilian, HCV genotype 1-infected patients who had a SVR and in 85 non-responders and 64 relapsers. A significantly increased risk of having a null virological response was observed in patients carrying at least one A allele at positions -308 [odds ratios (OR = 2.58, 95% confidence intervals (CI = 1.44-4.63, p = 0.001] or -238 (OR = 7.33, 95% CI = 3.59-14.93, p < 0.001 in the TNF promoter. The risk of relapsing was also elevated (-308: OR = 2.87, 95% CI = 1.51-5.44, p = 0.001; -238: OR = 4.20, 95% CI = 1.93-9.10, p < 0.001. Multiple logistic regression of TNF diplotypes showed that patients with at least two copies of the A allele had an even higher risk of having a null virological response (OR = 16.43, 95% CI = 5.70-47.34, p < 0.001 or relapsing (OR = 6.71, 95% CI = 2.18-20.66, p = 0.001. No statistically significant association was found between the other SNPs under study and anti-HCV therapy response.

  20. Gender differences in the perception of asthma and respiratory symptoms in a population sample of asthma patients in four Brazilian cities

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    Laura Russo Zillmer

    2014-12-01

    Full Text Available OBJECTIVE: To evaluate the impact of asthma, by gender, in a population sample of asthma patients in Brazil. METHODS: We conducted face-to-face interviews with 400 subjects (> 12 years of age included in a national probability telephone sample of asthma patients in the Brazilian state capitals of São Paulo, Rio de Janeiro, Curitiba, and Salvador. Each of those 400 subjects completed a 53-item questionnaire that addressed five asthma domains: symptoms; impact of asthma on quality of life; perception of asthma control; exacerbations; and treatment/medication. RESULTS: Of the 400 patients interviewed, 272 (68% were female. In relation to respiratory symptoms, the proportion of women reporting extremely bothersome symptoms (cough with sputum, tightness in the chest, cough/shortness of breath/tightness in the chest during exercise, nocturnal shortness of breath, and nocturnal cough was greater than was that of men. Daytime symptoms, such as cough, shortness of breath, wheezing, and tightness in the chest, were more common among women than among men. Women also more often reported that their asthma interfered with normal physical exertion, social activities, sleep, and life in general. Regarding the impact of asthma on quality of life, the proportion of subjects who reported that asthma caused them to feel that they had no control over their lives and affected the way that they felt about themselves was also greater among women than among men. CONCLUSIONS: Among women, asthma tends to be more symptomatic, as well as having a more pronounced effect on activities of daily living and on quality of life.

  1. Correlation between transverse and vertical measurements in Brazilian growing patients, evaluated by Ricketts-Faltin frontal analysis

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    Regina Helena Lourenço Belluzzo

    2013-02-01

    Full Text Available INTRODUCTION: Currently in orthodontic diagnosis, besides the lateral cephalometric analysis which evaluates the anteroposterior and vertical direction, the frontal analysis may be added, leading us to another important dimension in space: the transverse dimension. OBJECTIVE: Few longitudinal samples with the frontal radiograph were published, so this cephalometric study was designed to correlate the transversal and vertical measures by Ricketts-Faltin frontal analysis into two radiographic times. METHODS: The sample consisted of 45 Brazilian children, 25 girls and 20 boys, all presenting mixed dentition, with balanced facial aesthetics and no previous orthodontic/orthopedic treatment. The initial average age (T1 was 7.7 years and the final (T2 13.3 years. The measurements evaluated were: FTD, MxTD, NTD, LITD, MdTD (transversal, OVD and TVD (vertical. RESULTS: All transversal measures were positively correlated with a medium or high correlation with each other and the vertical measurements; only LITD presented a low correlation with these measurements. CONCLUSION: It was concluded that the face has interdependent regions and that this feature remains with growth.INTRODUÇÃO: atualmente no diagnóstico ortodôntico, além da análise cefalométrica lateral - que avalia os sentidos anteroposterior e vertical -, deve-se acrescentar a análise no sentido frontal, a qual propicia outra dimensão importante no espaço, a transversal. OBJETIVO: poucas são as amostras longitudinais publicadas utilizando telerradiografias frontais; portanto, o presente estudo cefalométrico teve o intuito de correlacionar as medidas transversais e verticais por meio da análise frontal de Ricketts-Faltin, em dois tempos radiográficos. MÉTODOS: a amostra constou de 45 crianças brasileiras, sendo 25 meninas e 20 meninos, todos apresentando dentição mista, com perfil harmonioso e sem nunca terem sido tratadas ortodonticamente e/ou ortopedicamente. A idade m

  2. Incidencia y tipo de efectos adversos durante el procedimiento de hemodiálisis Incidence and type of adverse effects during the haemodialysis procedure

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    Estela María Matarán Robles

    2013-03-01

    organizations. Objective: To describe the incidence and types of adverse effects deriving from haemodialysis in a nephrology unit. Methodology: Design: Transversal study in 28-bed haemodialysis unit. Variables: as a dependent variable, the present of adverse effects and typology was considered, using the International Classification for Patient Safety. Statistical analyses: a description of the sample was carried out, using graphs (histograms, bar diagrams, and dispersion diagrams and also percentages, means, standard deviations, medians, etc. Results: During the period studied a total of 4797 haemodialysis procedures were carried out, with adverse effects arising in a total of 681 sessions, which represents an incidence rate of 141.96 per 1000 dialyses. As far as severity is concerned, 97.5% of the adverse effects were classified as mild, compared to 1.8% and 0.7% which were considered moderate and serious, respectively. Conclusions: Our incidence rate and severity of adverse effects is similar to other centres. This study lets us identify safety problems in our Unit and in a second phase establish a joint protocol which will allow us to reduce the current incident rate. Hypotension was the most common adverse effect.

  3. Psychiatric morbidity among medical in-patients: a standardized assessment (GHQ-12 and CIS-R) using 'lay' interviewers in a Brazilian hospital.

    Science.gov (United States)

    Botega, N J; Pereira, W A; Bio, M R; Garcia Júnior, C; Zomignani, M A

    1995-05-01

    The 12-item General Health Questionnaire (GHQ-12) and the revised Clinical Interview Schedule (CIS-R) were used to estimate the prevalence of psychiatric morbidity among 78 consecutive admissions to a general medical ward in a Brazilian university hospital (43 males and 35 females; mean age = 43.2 years). The CIS-R was administered by three 5th-year medical students after a brief training. A prevalence rate of 36% was found for psychiatric disorders. The most frequent symptoms were sleep disorders (48.7%), worry (35.9%), depression (28.2%) and anxiety (26.9%). The sensitivity and specificity of the GHQ-12 were 71% and 76%, respectively. The CIS-R was simple to administer and acceptable both to patients and interviewers. Misunderstanding was most likely to occur with the poorly educated (20% were illiterate) in questions involving time calculation. Alternative options might be used to specify the length of time in future studies. The findings support the feasibility of the CIS-R and the use of 'lay' interviewers to produce epidemiological information on psychiatric disorders in developing countries at lower costs. PMID:7624806

  4. Thalassemia intermedia as a result of heterozygosis for ß0-thalassemia and aaaanti-3.7/aa genotype in a Brazilian patient

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    E.M. Kimura

    2003-06-01

    Full Text Available We report a case in which the interaction of heterozygosis for both the ß0-IVS-II-1 (G->A mutation and the aaaanti-3.7 allele was the probable cause for the clinical occurrence of thalassemia intermedia. The propositus, a 6-year-old Caucasian Brazilian boy of Portuguese descent, showed a moderately severe chronic anemia in spite of having the ß-thalassemia trait. Investigation of the alpha-globin gene status revealed heterozygosis for alpha-gene triplication (aaa/aa. The patient's father, also presenting mild microcytic and hypochromic anemia, had the same alpha and ß genotypes as his son, while the mother, not related to the father and hematologically normal, was also a carrier of the aaaanti-3.7 allele. The present case emphasizes the need for considering the possibility of alpha-gene triplication in ß-thalassemia heterozygotes who display an unexpected severe phenotype. The ß-thalassemia mutation found here is being described for the first time in Brazil.

  5. Malassezia intra-specific diversity and potentially new species in the skin microbiota from Brazilian healthy subjects and seborrheic dermatitis patients.

    Science.gov (United States)

    Soares, Renan Cardoso; Zani, Marcelo Bergamin; Arruda, Ana Carolina Belini Bazán; Arruda, Lucia Helena Fávaro de; Paulino, Luciana Campos

    2015-01-01

    Malassezia yeasts are part of the resident cutaneous microbiota, and are also associated with skin diseases such as seborrheic dermatitis (SD). The role these fungi play in skin diseases and why they are pathogenic for only some individuals remain unclear. This study aimed to characterize Malassezia microbiota from different body sites in healthy and SD subjects from Brazil. Scalp and forehead samples from healthy, mild SD and severe SD subjects were collected. Non-scalp lesions from severe SD patients were also sampled. 5.8S rDNA/ITS2 amplicons from Malassezia sp. were analyzed by RFLP and sequencing. Results indicate that Malassezia microbiota did not group according to health condition or body area. Phylogenetic analysis revealed that three groups of sequences did not cluster together with any formally described species, suggesting that they might belong to potential new species. One of them was found in high proportions in scalp samples. A large variety of Malassezia subtypes were detected, indicating intra-specific diversity. Higher M. globosa proportions were found in non-scalp lesions from severe SD subjects compared with other areas, suggesting closer association of this species with SD lesions from areas other than scalp. Our results show the first panorama of Malassezia microbiota in Brazilian subjects using molecular techniques and provide new perspectives for further studies to elucidate the association between Malassezia microbiota and skin diseases. PMID:25695430

  6. Malassezia intra-specific diversity and potentially new species in the skin microbiota from Brazilian healthy subjects and seborrheic dermatitis patients.

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    Renan Cardoso Soares

    Full Text Available Malassezia yeasts are part of the resident cutaneous microbiota, and are also associated with skin diseases such as seborrheic dermatitis (SD. The role these fungi play in skin diseases and why they are pathogenic for only some individuals remain unclear. This study aimed to characterize Malassezia microbiota from different body sites in healthy and SD subjects from Brazil. Scalp and forehead samples from healthy, mild SD and severe SD subjects were collected. Non-scalp lesions from severe SD patients were also sampled. 5.8S rDNA/ITS2 amplicons from Malassezia sp. were analyzed by RFLP and sequencing. Results indicate that Malassezia microbiota did not group according to health condition or body area. Phylogenetic analysis revealed that three groups of sequences did not cluster together with any formally described species, suggesting that they might belong to potential new species. One of them was found in high proportions in scalp samples. A large variety of Malassezia subtypes were detected, indicating intra-specific diversity. Higher M. globosa proportions were found in non-scalp lesions from severe SD subjects compared with other areas, suggesting closer association of this species with SD lesions from areas other than scalp. Our results show the first panorama of Malassezia microbiota in Brazilian subjects using molecular techniques and provide new perspectives for further studies to elucidate the association between Malassezia microbiota and skin diseases.

  7. Effect of all-trans retinoic acid on newly diagnosed acute promyelocytic leukemia patients: results of a Brazilian center

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    B.C. de-Medeiros

    1998-12-01

    Full Text Available Thirty-seven patients with acute promyelocytic leukemia (APL were treated with all-trans retinoic acid (ATRA. Patients received 45 mg m-2 day-1 po of ATRA until complete remission (CR was achieved, defined as: a presence of less than 5% blasts in the bone marrow, with b white blood cells >103/mm3, c platelets >105/mm3 and d hemoglobin concentration >8 g/dl, with no blood or platelet transfusions. Thirty-one (83.7% patients achieved CR by day 50, and 75% of these before day 30. Correction of the coagulopathy, achieved between days 2 and 10 (mean, 3 days, was the first evidence of response to treatment. Only one patient had been previously treated with chemotherapy and three had the microgranular variant M3 form. Dryness of skin and mucosae was the most common side effect observed in 82% of the patients. Thrombosis, hepatotoxicity and retinoid acid syndrome (RAS were observed in 7 (19%, 6 (16% and 4 (11% patients, respectively. Thirteen (35% patients had to be submitted to chemotherapy due to hyperleukocytosis (above 40 x 103/mm3 and six of these presented with new signs of coagulopathy after chemotherapy. Four (11% patients died secondarily to intracerebral hemorrhage (IH and two (5.4% dropped out of the protocol due to severe ATRA side effects (one RAS and one hepatotoxicity. RAS and IH were related strictly to hyperleukocytosis. The reduced use of platelets and fresh frozen plasma probably lowered the total cost of treatment. We conclude that ATRA is an effective agent for inducing complete remission in APL patients.

  8. Detection of Zika virus in Brazilian patients during the first five days of infection - urine versus plasma.

    Science.gov (United States)

    Pessôa, Rodrigo; Patriota, João Veras; de Souza, Maria de Lourdes; Abd El Wahed, Ahmed; Sanabani, Sabri Saeed

    2016-07-28

    Advantages of testing for Zika virus (ZIKV) in urine have been reported, such as the persistence of ZIKV in this type of specimen for up to 20 days after ZIKV disease onset. We investigate 61 patients in the first 5 days post-symptom onset and find more patients testing positive for ZIKV in plasma samples (n=46), than in corresponding urine samples (n=37). For patients respectively testing positive in both plasma and urine (n=28), respective viral loads appeared similar. PMID:27494130

  9. Effect of hepatitis C serology on C-reactive protein in a cohort of Brazilian hemodialysis patients

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    Nascimento M.M.

    2005-01-01

    Full Text Available Hepatitis C (HCV is not an uncommon feature in hemodialysis (HD patients and may be a cause of systemic inflammation. Plasma cytokine interleukin-6 (IL-6 is mainly produced by circulating and peripheral cells and induces the hepatic synthesis of C-reactive protein (CRP, which is the main acute phase reactant. The aim of this study was to investigate the influence of HCV on two markers of systemic inflammation, serum CRP and IL-6, in HD patients. The study included 118 HD patients (47% males, age 47 ± 13 years, 9% diabetics who had been treated by standard HD for at least 6 months. The patients were divided into two groups depending on the presence (HCV+ or absence (HCV- of serum antibodies against HCV. Serum albumin (S-Alb, plasma high sensitivity CRP (hsCRP, IL-6, and alanine aminotransferase (ALT were measured and the values were compared with those for 22 healthy controls. Median hsCRP and IL-6 values and hsCRP/IL-6 ratio were: 3.5 vs 2.1 mg/l, P < 0.05; 4.3 vs 0.9 pg/ml, P < 0.0001, and 0.8 vs 2.7, P < 0.0001, for patients and controls, respectively. Age, gender, S-Alb, IL-6 and hsCRP did not differ between the HCV+ and HCV- patients. However, HCV+ patients had higher ALT (29 ± 21 vs 21 ± 25 IU/l and had been on HD for a longer time (6.1 ± 3.0 vs 4.0 ± 2.0 years, P < 0.0001. Moreover, HCV+ patients had a significantly lower median hsCRP/IL-6 ratio (0.7 vs 0.9, P < 0.05 compared to the HCV- group. The lower hsCRP/IL-6 ratio in HCV+ patients than in HCV- patients suggests that hsCRP may be a less useful marker of inflammation in HCV+ patients and that a different cut-off value for hsCRP for this population of patients on HD may be required to define inflammation.

  10. Loss to follow-up in anti-HCV-positive patients in a Brazilian regional outpatient clinic

    Science.gov (United States)

    Mendes, L.C.; Ralla, S.M.; Vigani, A.G.

    2016-01-01

    Loss to follow-up (LF), which refers to patients who started care but voluntary stopped it, is a problem for patients with chronic disease. We aimed to estimate the rate of LF among patients seropositive for hepatitis C virus (HCV) and identify possible demographic and lifestyle risk factors associated with LF. From January 2009 through December 2012, 1010 anti-HCV-positive patients were included in the study. Among participants, 223 (22.1%) met the case definition for LF (more than 1-year elapsed since the last clinical appointment). Among 787 patients who remained in follow-up, 372 (47.2%) were discharged after undetectable HCV RNA, 88 (11.1%) were transferred (and remained on regular follow-up at the destination), and 25 (3.1%) died. According to univariate analysis, male gender, absence of a life partner, black race, psychiatric illness, previous alcohol abuse, previous or current recreational drug use, and previous or current smoking were significantly associated with LF. In multivariate analysis, absence of a life partner (adjusted odds ratio (AOR)=1.44; 95% confidence interval (95%CI)=1.03–2.02), black race (AOR=1.81, 95%CI=1.12–2.89), psychiatric illness (AOR=1.77, 95%CI=1.14–2.73), and the presence of at least one lifestyle risk factor (pertaining to substance abuse) (AOR=1.95, 95%CI=1.29–2.94) were independently associated with LF. Our study provides an estimate of the incidence of LF among anti-HCV-positive patients and identifies risk factors associated with this outcome. In addition, these results can help clinicians recognize patients at risk for LF, who require additional support for the continuity of care. PMID:27580006

  11. RASSF1A and DOK1 Promoter Methylation Levels in Hepatocellular Carcinoma, Cirrhotic and Non-Cirrhotic Liver, and Correlation with Liver Cancer in Brazilian Patients

    Science.gov (United States)

    Araújo, Oscar C.; Rosa, Agatha S.; Fernandes, Arlete; Niel, Christian; Villela-Nogueira, Cristiane A.; Pannain, Vera; Araujo, Natalia M.

    2016-01-01

    Hepatocellular carcinoma (HCC) is the second most common cause of cancer mortality worldwide. Most cases of HCC are associated with cirrhosis related to chronic hepatitis B virus or hepatitis C virus infections. Hypermethylation of promoter regions is the main epigenetic mechanism of gene silencing and has been involved in HCC development. The aim of this study was to determine whether aberrant methylation of RASSF1A and DOK1 gene promoters is associated with the progression of liver disease in Brazilian patients. Methylation levels were measured by pyrosequencing in 41 (20 HCC, 9 cirrhotic, and 12 non-cirrhotic) liver tissue samples. Mean rates of methylation in RASSF1A and DOK1 were 16.2% and 12.0% in non-cirrhotic, 26.1% and 19.6% in cirrhotic, and 59.1% and 56.0% in HCC tissues, respectively, showing a gradual increase according to the progression of the disease, with significantly higher levels in tumor tissues. In addition, hypermethylation of RASSF1A and DOK1 was found in the vast majority (88%) of the HCC cases. Interestingly, DOK1 methylation levels in HCC samples were significantly higher in the group of younger (<40 years) patients, and higher in moderately differentiated than in poorly differentiated tumors (p < 0.05). Our results reinforce the hypothesis that hypermethylation of RASSF1A and DOK1 contributes to hepatocarcinogenesis and is associated to clinicopathological characteristics. RASSF1A and DOK1 promoter hypermethylation may be a valuable biomarker for early diagnosis of HCC and a potential molecular target for epigenetic-based therapy. PMID:27078152

  12. Sight-dependent quality of life and ophthalmic findings in a group of Brazilian patients with multiple sclerosis

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    Yára Dadalti Fragoso

    2011-10-01

    Full Text Available OBJECTIVE: To assess the visual quality of life in patients with multiple sclerosis (MS, and to observe whether this parameter could be correlated to the findings of the ophthalmologic examination. METHOD: The translated and validated 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25 was used to assess the visual quality of life. Clinical data on MS, visual acuity, visual fields, optic coherence tomography (OCT and disc cupping were used for assessing correlation with VFQ-25. RESULTS: The mean VFQ-25 value was 78.6±18.2% in 27 patients. VFQ-25 did not correlate with patients' ages, with disability (EDSS, disease duration or medication use. Visual acuity showed a relatively poor (<60% correlation to VFQ-25, while no correlation could be established between visual fields, OCT and disc cupping with VFQ-25. CONCLUSION: MS patients present several alterations in their eyes and sight that cannot be assessed by isolated measures. Ophthalmological examination of these patients must include many parameters not usually used in standard ophthalmologic consultations.

  13. Cognitive impairment in a Brazilian sample of patients with bipolar disorder Prejuízo cognitivo em uma amostra brasileira de pacientes com transtorno do humor bipolar

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    Júlia J Schneider

    2008-09-01

    Full Text Available OBJECTIVE: Persistent neurocognitive deficits have been described in bipolar mood disorder. As far as we are aware, no study have examined whether the cognitive impairment is presented in the same way in a Brazilian sample. METHOD: Cognitive function of 66 patients with bipolar disorder (32 with depressive symptoms and 34 euthymic and 28 healthy subjects was examined using a complete cognitive battery. RESULTS: Patients with bipolar disorder presented a significantly poorer performance in eight of the 12 subtests when compared to healthy subjects. There was no significant difference between the subgroups of patients. These patients showed impairment in both verbal and non-verbal cognitive function. CONCLUSION: Cognitive impairment was found in both groups of patients with bipolar disorder. The findings described here suggest an overall impairment of cognitive function, independent of mood symptoms. This is in line with data showing that cognitive deficits may be a persistent characteristic of bipolar disorder.OBJETIVO: Déficits neurocognitivos persistentes têm sido descritos no transtorno do humor bipolar; entretanto, não há estudos em amostras brasileiras para avaliar se o prejuízo se apresenta da mesma forma. MÉTODO: Foi realizada uma avaliação cognitiva em 66 pacientes bipolares (32 com sintomas depressivos e 34 eutímicos e 28 controles, utilizando-se uma bateria cognitiva completa. RESULTADOS: Em oito dos 12 subtestes avaliados os pacientes apresentaram desempenho significativamente inferior em relação aos controles. Não houve diferença significativa entre os grupos de pacientes. Foram encontrados prejuízos cognitivos tanto na área verbal como na área não verbal da cognição. CONCLUSÃO: Foi observada uma performance inferior em ambos os grupos de pacientes com transtorno bipolar. As dificuldades cognitivas encontradas apontam para um prejuízo global no funcionamento cognitivo, independente da presença de sintomas

  14. Active human Cytomegalovirus infection and Glycoprotein B genotypes in Brazilian pediatric renal or hematopoietic stem cell transplantation patients

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    Débora de Campos Dieamant

    2010-03-01

    Full Text Available A prospective analysis of active Human Cytomegalovirus infection (HCMV was conducted on 33 pediatric renal or hematopoietic stem cell post-transplant patients. The HCMV-DNA positive samples were evaluated for the prevalence of different gB subtypes and their subsequent correlation with clinical signs. The surveillance of HCMV active infection was based on the monitoring of antigenemia (AGM and on a nested polymerase chain reaction (N-PCR for the detection of HCMV in the patients studied. Using restriction analysis of the gB gene sequence by PCR-RFLP (Restriction Fragment Length Polymorphism, different HCMV strains could be detected and classified in at least four HCMV genotypes. Thirty-three pediatric recipients of renal or bone marrow transplantation were monitored. Twenty out of thirty-three (60.6% patients demonstrated active HCMV infection. gB1 and gB2 genotypes were more frequent in this population. In this study, we observed that gB2 had correlation with reactivation of HCMV infection and that patients with mixture of genotypes did not show any symptoms of HCMV disease. Future studies has been made to confirm this.

  15. Candida in saliva of Brazilian hemophilic patients Candida na saliva de pacientes hemofílicos brasileiros

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    Claudio Maranhão Pereira

    2004-12-01

    Full Text Available Hemophilia is a common hereditary hemorrhagic disorder, however little is known about the oral microflora of hemophilic patients. The aim of this study was to quantify the Candida and identify its species in non-stimulated saliva of hemophilic patients, and consider its relationship with clinical factors influencing Candida carriage. This study comprised evaluation of 86 hemophilic patients of the Hematology Center/UNICAMP and 43 healthy subjects as controls. All patients were submitted to anamnesis, intraoral examination and unstimulated saliva collection. Candida counts and species identification were performed in salivary samples. Candida was present in 64% of the hemophilic patients and in 44% of the healthy controls. C. albicans represented 65% and 68% of the isolated species, in hemophiliacs and control group respectively, and C. tropicalis was the second most common species in both groups. These results indicate that hemophilic patients carry Candida more frequently and in higher counts than healthy controls, independently of oral clinical parameter considered, as viral infections, complete dentures, transfusions of hemoderivatives, and salivary flow.Hemofilia é uma alteração hemorrágica hereditária comum, entretanto pouco se sabe a respeito da microbiota oral destes indivíduos. O objetivo deste estudo foi quantificar a presença de Candida e identificar as suas espécies na saliva de hemofílicos, correlacionando os resultados com fatores clínicos que possam influenciar a presença deste fungo. Foram avaliados 86 hemofílicos do Hemocentro/UNICAMP e 43 indivíduos saudáveis. Todos os pacientes foram submetidos a anamnese, exame clínico intra-oral e coleta de saliva de forma não estimulada. A quantificação e identificação das espécies de Candida foram realizadas nas amostras de saliva. Candida estava presente em 64% dos hemofílicos e em 44% dos indivíduos saudáveis. C. albicans representou 65% e 68% das esp

  16. Schistosomiasis haematobia in Brazilian patients: clinical and renal functional evaluation with {sup 99m}Tc-DTPA

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    DAlmeida, J.; Maliska, C.I.; Pellegrini, P.M.; Collares, R.A.I [Army Central Hospital, Rio de Janeiro, RJ (Brazil). Nuclear Medicine Service]. E-mail: joaquimjdalmeida@yahoo.com.br; Penas, M.E.; Cruz, M.G.A. [Clementino Fraga Filho School Hospital, (UFRJ), Rio de Janeiro, RJ (Brazil). Nuclear Medicine Service

    2007-07-01

    The present study was carried out at the Army Central Hospital, Rio de Janeiro, Brazil, from September 2000 to December 2001, employing diethylenetriamine penta-acetic acid labeled with technetium-99m ({sup 99m}Tc-DTPA) to evaluate the renal function of nineteen symptomatic patients infected with S. haematobium during a peace mission in Mozambique. Results evidenced that the most frequent clinical manifestations were hematuria (68.4%) and low back pain (68.4%) and 73.7% patients had altered dynamic renal scintigraphy expressed by an increase in the excretory phase independently of the symptoms duration; furthermore, none of them had mechanical obstructive pattern. Schistosoma haematobium glomerulopathy could be considered a pathological finding without correlation with the disease clinical manifestations. (author)

  17. Correlation between TH1 response standard cytokines as biomarkers in patients with the delta virus in the western Brazilian Amazon

    Science.gov (United States)

    Nicolete, Larissa Deadame de Figueiredo; Borzacov, Lourdes Maria Pinheiro; Vieira, Deusilene Souza; Nicolete, Roberto; Salcedo, Juan Miguel Villalobos

    2016-01-01

    Hepatitis D virus (HDV) is endemic in the Amazon Region and its pathophysiology is the most severe among viral hepatitis. Treatment is performed with pegylated interferon and the immune response appears to be important for infection control. HDV patients were studied: untreated and polymerase chain reaction (PCR) positive (n = 9), anti-HDV positive and PCR negative (n = 8), and responders to treatment (n = 12). The cytokines, interleukin (IL)-2 (p = 0.0008) and IL-12 (p = 0.02) were differentially expressed among the groups and were also correlated (p = 0.0143). Future studies will be conducted with patients at different stages of treatment, associating the viral load with serum cytokines produced, thereby attempting to establish a prognostic indicator of the infection. PMID:27074258

  18. Modulatory effect of BclI GR gene polymorphisms on the obesity phenotype in Brazilian patients with Cushing's disease

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    Ricardo P.P. Moreira

    2013-05-01

    Full Text Available OBJECTIVES: Patients with Cushing's disease exhibit wide phenotypic variability in the severity of obesity, diabetes and hypertension. In the general population, several glucocorticoid receptor genes (NR3C1 and HSD11B1 polymorphisms are associated with altered glucocorticoid sensitivity and/or metabolism, resulting in an increased or reduced risk of an adverse metabolic profile. Our aim was to analyze the association of NR3C1 and HSD11B1 gene variants with the severity of some clinical and hormonal features of Cushing's disease. METHODS: Sixty-four patients presenting with Cushing's disease were diagnosed based on adrenocorticotrophic hormone levels, high-dose dexamethasone suppression tests and/or inferior petrosal sinus sampling and magnetic resonance imaging. The A3669G, ER22/23EK, N363S BclI-NR3C1 and HSD11B1-rs12086634 variants were screened. RESULTS: The BclI, HSD11B1-rs12086634 and A3669G variants were found in 36%, 19.5% and 14% of alleles, respectively. The N363S and ER22/23EK polymorphisms were identified in heterozygosis once in only two patients (1.5% of alleles. There were no differences in the weight gain or prevalence of diabetes and hypertension in the patients carrying the abovementioned alleles compared to the wild-type carriers. Interestingly, the mean body mass index (BMI of the BclI carriers was significantly higher than the non-carriers (34.4±7 kg/m2 vs. 29.6±4.7 kg/m2, respectively. None of the polymorphisms were associated with the basal adrenocorticotrophic hormone, FU levels or F level after dexamethasone suppression testing. CONCLUSION: Although Cushing's disease results from increased glucocorticoid secretion, we observed that interindividual variability in the peripheral glucocorticoid sensitivity, mediated by the glucocorticoid receptor, could modulate the obesity phenotype.

  19. Hospital surface contamination in wards occupied by patients infected with MRSA or MSSA in a Brazilian university hospital

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    K. S. Carvalho

    2009-01-01

    Full Text Available

    The hospital environment, especially surfaces, represents a secondary reservoir for pathogens such as Staphylococcus aureus. The present study was carried out at the Hospital de Clínicas da Universidade Federal de Uberlândia (HC-UFU in Brazil, from January to August 2004, with the aim of qualitatively and quantitatively assessing the presence of S. aureus on surfaces touched by hands (bed rail, bedside table and door handle, on the floor and in the air, in wards where the patients were infected or not infected with this organism. Twenty-six wards with at least one infected patient and 26 wards with uninfected patients were investigated. Surfaces and air were sampled during bed making, by means of sterile 10cm2 adhesive tapes and 90mm-diameter exposed culture plates, respectively. Cultures were carried out on Egg Yolk Salt Agar, containing 7.5% NaCl and 1% egg yolk, and colonies identified by lecithinase and coagulase tests and Gram stain. About 50% of the wards were S. aureus contaminated, without significant differences between the groups (46.1% in the infected patient wards versus 53.8% in controls; the correlation between counts of the pathogen on the surfaces and in the air was 66.7%. In spite of the fact that these bacteria were frequently present in the assessed wards, the microbial density was low (less than 1 CFU/cm2. The association between environmental contamination and the epidemiology of S. aureus nosocomial infections is complex and thus further investigations are needed to reach a better understanding of this relationship. Keywords: environmental contamination; nosocomial infections; Staphylococcus aureus.

  20. Restless legs syndrome in patients on chronic hemodialysis in a Brazilian city: frequency, biochemical findings and comorbidities

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    Goffredo Filho Gilberto S.

    2003-01-01

    Full Text Available OBJECTIVE: To evaluate the frequency of restless legs syndrome (RLS in patients with chronic renal failure (CRF in Petrópolis, Brazil, and investigate associations between the syndrome and: demographic characteristics, biochemical variables and comorbidities. METHOD: A cross-sectional study in which we interviewed 176 patients on dialytic therapy based on criteria elaborated by the International Restless Legs Syndrome Study Group, and compared data of patients with and without RLS. RESULTS: The frequency was 14.8 %. There were no significant differences between the two groups in demographic and biochemical variables investigated (iron, creatinine, intact parathyroid hormone, hemoglobin, calcium, phosphate. We found no association between RLS and the most common comorbidities, except for chronic glomerulonephritis (CGN (OR = 3.84, p < 0.01. CONCLUSION: In the studied population RLS is a common disorder, and is not associated with the investigated biochemical abnormalities. A higher frequency of RLS in subjects with CGN is a finding that needs further investigation.

  1. Brazilian version of the Berg balance scale

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    Miyamoto S.T.

    2004-01-01

    Full Text Available The purpose of the present study was to translate and adapt the Berg balance scale, an instrument for functional balance assessment, to Brazilian-Portuguese and to determine the reliability of scores obtained with the Brazilian adaptation. Two persons proficient in English independently translated the original scale into Brazilian-Portuguese and a consensus version was generated. Two translators performed a back translation. Discrepancies were discussed and solved by a panel. Forty patients older than 65 years and 40 therapists were included in the cultural adaptation phase. If more than 15% of therapists or patients reported difficulty in understanding an item, that item was reformulated and reapplied. The final Brazilian version was then tested on 36 elderly patients (over age 65. The average age was 72 years. Reliability of the measure was assessed twice by one physical therapist (1-week interval between assessments and once by one independent physical therapist. Descriptive analysis was used to characterize the patients. The intraclass correlation coefficient (ICC and Pearson's correlation coefficient were computed to assess intra- and interobserver reliability. Six questions were modified during the translation stage and cultural adaptation phase. The ICC for intra- and interobserver reliability was 0.99 (P < 0.001 and 0.98 (P < 0.001, respectively. The Pearson correlation coefficient for intra- and interobserver reliability was 0.98 (P < 0.001 and 0.97 (P < 0.001, respectively. We conclude that the Brazilian version of the Berg balance scale is a reliable instrument to be used in balance assessment of elderly Brazilian patients.

  2. Brazilian version of the Berg balance scale

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    S.T. Miyamoto

    2004-09-01

    Full Text Available The purpose of the present study was to translate and adapt the Berg balance scale, an instrument for functional balance assessment, to Brazilian-Portuguese and to determine the reliability of scores obtained with the Brazilian adaptation. Two persons proficient in English independently translated the original scale into Brazilian-Portuguese and a consensus version was generated. Two translators performed a back translation. Discrepancies were discussed and solved by a panel. Forty patients older than 65 years and 40 therapists were included in the cultural adaptation phase. If more than 15% of therapists or patients reported difficulty in understanding an item, that item was reformulated and reapplied. The final Brazilian version was then tested on 36 elderly patients (over age 65. The average age was 72 years. Reliability of the measure was assessed twice by one physical therapist (1-week interval between assessments and once by one independent physical therapist. Descriptive analysis was used to characterize the patients. The intraclass correlation coefficient (ICC and Pearson's correlation coefficient were computed to assess intra- and interobserver reliability. Six questions were modified during the translation stage and cultural adaptation phase. The ICC for intra- and interobserver reliability was 0.99 (P < 0.001 and 0.98 (P < 0.001, respectively. The Pearson correlation coefficient for intra- and interobserver reliability was 0.98 (P < 0.001 and 0.97 (P < 0.001, respectively. We conclude that the Brazilian version of the Berg balance scale is a reliable instrument to be used in balance assessment of elderly Brazilian patients.

  3. Relato de um paciente brasileiro com síndrome de Wolfram Report of a Brazilian patient with Wolfram syndrome

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    Paulo R.G. Zen

    2002-12-01

    Full Text Available Objetivos: relatar o caso de um paciente com diagnóstico de síndrome de Wolfram (SW e braquidactilia do tipo E. A síndrome de Wolfram é caracterizada pela presença de diabetes melito, diabetes insípido, atrofia do nervo óptico, alterações do trato urinário, surdez e distúrbios neurológicos e psiquiátricos. No entanto, nem todas as manifestações estarão presentes no momento do diagnóstico, indicando a necessidade de acompanhamento a longo prazo destes pacientes. Este acompanhamento deve ser estendido aos familiares diretos, tendo em vista o risco aumentado da ocorrência de distúrbios psiquiátricos e diabetes melito entre os portadores heterozigotos da síndrome de Wolfram. Descrição: menino, branco, filho de pais não consangüíneos, era hígido até os 4 anos, quando iniciou com polidipsia e poliúria, sendo diagnosticada diabetes melito tipo I. Desde então, faz uso irregular de insulina e segue mal a dieta por problemas socioeconômicos. Foi avaliado pelo serviço de Genética aos 11 anos de idade. Ao exame físico, chamou a atenção a presença de braquidactilia. Durante a investigação complementar, constatou-se atrofia bilateral do nervo óptico, com potencial evocado visual e eletrorretinograma compatíveis com lesão grave de nervo. Ambas retinas eram normais. A presença de diabetes melito insulino-dependente e atrofia do nervo óptico são critérios suficientes para o diagnóstico de síndrome de Wolfram. A investigação molecular confirmou o diagnóstico. Comentários: o presente relato tem o objetivo de alertar os profissionais da área médica para a associação entre o diabetes melito e síndromes monogênicas, como a SW.ABSTRACT Objective: to report a case of a patient diagnosed with Wolfram Syndrome and brachydactyly type E. Wolfram Syndrome is characterized by the presence of diabetes mellitus, diabetes insipidus, atrophy of the optic nerve, alterations of the urinary tract, deafness and neurologic and

  4. Mutational analysis of the GAP-related domain of the neurofibromatosis type 1 gene in Brazilian NF1 patients

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    Alessandra B. Trovó

    2004-01-01

    Full Text Available Neurofibromatosis type 1 (NF1 is a common autosomal dominant disorder caused by mutations in the NF1 gene. In the present study, a total of 55 unrelated NF1 patients were screened for mutations in the GAP-related domain/GRD (exons 20-27a by single-strand conformation polymorphism (SSCP. Four different mutations were identified and, taken together, they comprise one nonsense substitution (Q1189X, one deletion (3525-3526delAA, one missense substitution (E1356G and one mutation in the splice acceptor site (c.4111-1G>A. One novel polymorphism (c.4514+11C>G and other three putative polymorphisms were also found (c.3315-27G>A, V1146I and V1317A. Genotype-phenotype correlations were investigated, but no particular association was detected.

  5. Promoter region sequence differences in the A and G gamma globin genes of Brazilian sickle cell anemia patients

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    C.G. Barbosa

    2010-08-01

    Full Text Available Fetal hemoglobin (HbF, encoded by the HBG2 and HBG1 genes, is the best-known genetic modulator of sickle cell anemia, varying dramatically in concentration in the blood of these patients. This variation is partially associated with polymorphisms located in the promoter region of the HBG2 and HBG1 genes. In order to explore known and unknown polymorphisms in these genes, the sequences of their promoter regions were screened in sickle cell anemia patients and correlated with both their HbF levels and their βS-globin haplotypes. Additionally, the sequences were compared with genes from 2 healthy groups, a reference one (N = 104 and an Afro-descendant one (N = 98, to identify polymorphisms linked to the ethnic background.The reference group was composed by healthy individuals from the general population. Four polymorphisms were identified in the promoter region of HBG2 and 8 in the promoter region of HBG1 among the studied groups. Four novel single nucleotide polymorphisms (SNP located at positions -324, -317, -309 and -307 were identified in the reference group. A deletion located between -396 and -391 in the HBG2 promoter region and the SNP -271 C→T in the HBG1 promoter region were associated with the Central African Republic βS-globin haplotype. In contrast, the -369 C→G and 309 A→G SNPs in the HBG2 promoter region were correlated to the Benin haplotype. The polymorphisms -396_-391 del HBG2, -369 SNP HBG2 and -271 SNP HBG1 correlated with HbF levels. Hence, we suggest an important role of HBG2 and HBG1 gene polymorphisms on the HbF synthesis.

  6. 249 TP53 mutation has high prevalence and is correlated with larger and poorly differentiated HCC in Brazilian patients

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    Paranaguá-Vezozzo Denise C

    2009-06-01

    Full Text Available Abstract Background Ser-249 TP53 mutation (249Ser is a molecular evidence for aflatoxin-related carcinogenesis in Hepatocellular Carcinoma (HCC and it is frequent in some African and Asian regions, but it is unusual in Western countries. HBV has been claimed to add a synergic effect on genesis of this particular mutation with aflatoxin. The aim of this study was to investigate the frequency of 249Ser mutation in HCC from patients in Brazil. Methods We studied 74 HCC formalin fixed paraffin blocks samples of patients whom underwent surgical resection in Brazil. 249Ser mutation was analyzed by RFLP and DNA sequencing. HBV DNA presence was determined by Real-Time PCR. Results 249Ser mutation was found in 21/74 (28% samples while HBV DNA was detected in 13/74 (16%. 249Ser mutation was detected in 21/74 samples by RFLP assay, of which 14 were confirmed by 249Ser mutant-specific PCR, and 12 by nucleic acid sequencing. All HCC cases with p53-249ser mutation displayed also wild-type p53 sequences. Poorly differentiated HCC was more likely to have 249Ser mutation (OR = 2.415, 95% CI = 1.001 – 5.824, p = 0.05. The mean size of 249Ser HCC tumor was 9.4 cm versus 5.5 cm on wild type HCC (p = 0.012. HBV DNA detection was not related to 249Ser mutation. Conclusion Our results indicate that 249Ser mutation is a HCC important factor of carcinogenesis in Brazil and it is associated to large and poorly differentiated tumors.

  7. Pneumoconiosis and liver cirrhosis are not risk factors for tuberculosis in patients with pulmonary infection

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    Wu, H.P.; Pan, Y.H.; Hua, C.C.; Shieh, H.B.; Jiang, B.Y.; Yu, T.J. [Chang Gung Memorial Hospital, Chilung (Taiwan)

    2007-05-15

    It is unclear whether patients with liver cirrhosis and coal miners with pneumoconiosis are at increased risk of developing pulmonary tuberculosis (TB). Furthermore, little is known of the likelihood of pneumonia in patients with bronchiectasis, haemodialysis, diabetes mellitus or advanced lung cancer being due to TB. To answer these questions, patients with these clinical comorbidities were analysed. The study was retrospective and included 264 TB patients, 478 non-TB pneumonia patients, and as negative controls, 438 subjects without pneumonia. The parameters analysed were age, gender and the presence of pneumoconiosis, bronchiectasis, liver cirrhosis, haemodialysis, diabetes mellitus and advanced lung cancer. Male gender was the only significant factor increasing the risk of pulmonary TB. When compared with non-TB pneumonia and control patients, the odds ratios were 1.862 and 2.182, respectively. Patients with liver cirrhosis did not show an increased risk of pulmonary TB after regression analysis. Pneumoconiosis resulted in a 2.260 (P = 0.003) odds ratio for pulmonary TB, compared with the controls. However, there was no difference in pneurmoconiosis between TB and non-TB pneumonia patients. Patients with bronchiectasis, lung cancer and those receiving haemodialysis had a lower risk for pulmonary TB in lower respiratory tract infection, with odds ratios of 0.342, 0.311 and 0.182, respectively. Physicians should first consider non-TB bacterial infection rather than Mycobacterium tuberculosis infection in pneumonia in patients with bronchiectasis, lung cancer or those receiving haemodialysis.

  8. A first-year dornase alfa treatment impact on clinical parameters of patients with cystic fibrosis: the Brazilian cystic fibrosis multicenter study

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    Tatiana Rozov

    2013-12-01

    Full Text Available OBJECTIVE: To describe the clinical impact of the first year treatment with dornase alfa, according to age groups, in a cohort of Brazilian Cystic Fibrosis (CF patients. METHODS: The data on 152 eligible patients, from 16 CF reference centers, that answered the medical questionnaires and performed laboratory tests at baseline (T0, and at six (T2 and 12 (T4 months after dornase alfa initiation, were analyzed. Three age groups were assessed: six to 11, 12 to 13, and >14 years. Pulmonary tests, airway microbiology, emergency room visits, hospitalizations, emergency and routine treatments were evaluated. Student's t-test, chi-square test and analysis of variance were used when appropriated. RESULTS: Routine treatments were based on respiratory physical therapy, regular exercises, pancreatic enzymes, vitamins, bronchodilators, corticosteroids, and antibiotics. In the six months prior the study (T0 phase, hospitalizations for pulmonary exacerbations occurred in 38.0, 10.0 and 61.4% in the three age groups, respectively. After one year of intervention, there was a significant reduction in the number of emergency room visits in the six to 11 years group. There were no significant changes in forced expiratory volume in one second (VEF1, in forced vital capacity (FVC, in oxygen saturation (SpO2, and in Tiffenau index for all age groups. A significant improvement in Shwachman-Kulczychi score was observed in the older group. In the last six months of therapy, chronic or intermittent colonization by P. aeruginosa was detected in 75.0, 71.4 and 62.5% of the studied groups, respectively, while S. aureus colonization was identified in 68.6, 66.6 and 41.9% of the cases. CONCLUSIONS: The treatment with dornase alfa promoted the maintenance of pulmonary function parameters and was associated with a significant reduction of emergency room visits due to pulmonary exacerbations in the six to 11 years age group, with better clinical scores in the >14 age group, one

  9. Manifestações orais em pacientes com AIDS em uma população brasileira Oral manifestations in HIV - infected patients in a Brazilian population

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    Lélia Batista de SOUZA

    2000-03-01

    Full Text Available Foram analisados l00 pacientes HIV+/AIDS no Hospital Giselda Trigueiro - Natal/RN, Brasil no período de l996-97 quanto a presença de manifestações orais nestes pacientes. Setenta e quatro pacientes eram do sexo masculino e 26 do feminino. A idade média dos pacientes do sexo masculino foi 40 anos, variando de 24 a 67 anos e no feminino 29,8 anos variando de 17 a 48 anos. As manifestações orais mais freqüentes foram candidíase (homens - 79,7%; mulheres - 80,7%, gengivite e periodontite (homens - 79,7%; mulheres - 73,0%, leucoplasia pilosa (homens - 6,7%; mulheres - 3,8%, herpes labial (homens - 5,4%; mulheres - 7,6%, sarcoma de Kaposi (homens - 6,7%.Verificou-se que 62,2% dos homens eram homo- ou bissexuais e 100% das mulheres eram heterossexuais. Nossos resultados revelam semelhanças com outros trabalhos realizados em pacientes de outras regiões do mundo.One hundred HIV+/AIDS Brazilian patients (74 men and 26 women were examined in the Giselda Trigueiro Hospital, in Natal, Rio Grande do Norte, Brazil in the period from l996 to 1997. The men’s mean age was 40 years, ranging from 24 to 67 years and the women’s was 29.8 years, ranging from 17 to 48 years. One or more oral findings were observed in theses patients. The most common oral lesions were candidiasis (men - 97.2%; women - 80.7%, gingivitis and periodontitis (men - 79.7%; women - 7.3%, hairy leukoplakia (men - 6.7%; women - 3.8%, herpes simplex (men - 5.4%; women - 2.7%, and Kaposi’s sarcoma (men - 6.7%. From the men, 62.1% were homo-/bisexual, and 100% of the women were heterosexual.

  10. A first-year dornase alfa treatment impact on clinical parameters of patients with cystic fibrosis: the Brazilian cystic fibrosis multicenter study

    Science.gov (United States)

    Rozov, Tatiana; Silva, Fernando Antônio A. e; Santana, Maria Angélica; Adde, Fabíola Villac; Mendes, Rita Heloisa

    2013-01-01

    OBJECTIVE: To describe the clinical impact of the first year treatment with dornase alfa, according to age groups, in a cohort of Brazilian Cystic Fibrosis (CF) patients. METHODS: The data on 152 eligible patients, from 16 CF reference centers, that answered the medical questionnaires and performed laboratory tests at baseline (T0), and at six (T2) and 12 (T4) months after dornase alfa initiation, were analyzed. Three age groups were assessed: six to 11, 12 to 13, and >14 years. Pulmonary tests, airway microbiology, emergency room visits, hospitalizations, emergency and routine treatments were evaluated. Student's t-test, chi-square test and analysis of variance were used when appropriated. RESULTS: Routine treatments were based on respiratory physical therapy, regular exercises, pancreatic enzymes, vitamins, bronchodilators, corticosteroids, and antibiotics. In the six months prior the study (T0 phase), hospitalizations for pulmonary exacerbations occurred in 38.0, 10.0 and 61.4% in the three age groups, respectively. After one year of intervention, there was a significant reduction in the number of emergency room visits in the six to 11 years group. There were no significant changes in forced expiratory volume in one second (VEF1), in forced vital capacity (FVC), in oxygen saturation (SpO2), and in Tiffenau index for all age groups. A significant improvement in Shwachman-Kulczychi score was observed in the older group. In the last six months of therapy, chronic or intermittent colonization by P. aeruginosa was detected in 75.0, 71.4 and 62.5% of the studied groups, respectively, while S. aureus colonization was identified in 68.6, 66.6 and 41.9% of the cases. CONCLUSIONS: The treatment with dornase alfa promoted the maintenance of pulmonary function parameters and was associated with a significant reduction of emergency room visits due to pulmonary exacerbations in the six to 11 years age group, with better clinical scores in the >14 age group, one year after the

  11. Kaposi’s sarcoma in Brazilian AIDS patients: a study of 144 cases Sarcoma de Kaposi em pacientes com AIDS: estudo de 144 casos

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    Esther G. BIRMAN

    2000-12-01

    Full Text Available One hundred and forty-four Brazilian AIDS patients presenting with Kaposi’s sarcoma (KS were evaluated with respect to the frequency of oral neoplasms and their clinical features. The majority of the patients were young male adults (age range: 21-40 years old, from which 11.1 % presented with oral KS (OKS exclusively. Oral and skin lesions were associated in 25% of the cases, while only four patients showed association between oral and visceral KS; 49.3% of the cases were exclusively dermatological. The hard palate was the main site affected, followed by the oropharynx. The localization of KS was found to be similarly frequent in the tongue, gingiva and other sites of the oral mucosa. Candidosis was the prevailing fungal disease; in 20% of the cases it was restricted to the oral mucosa and in 80% it was systemic. No high frequency of paracoccidioidomicosis and cryptococcosis was detected. The prevailing bacterial disease was Tuberculosis and there was only one case of syphilis. Among the viral diseases, the most frequently detected was herpes simplex, followed by molusco contagiosum, condiloma acuminatum and cytomegaloviroses at lower frequencies. Pneumonia caused by Pneumocystes carinii and toxoplasmosis were also identified. The authors emphasise the importance of oral examination in HIV-infected patients bearing in mind several aspects related especially to KS, and stress the need for an interdisciplinary team in the management of these patients, in order to provide better quality of life as well as rapid diagnosis and treatment.Foram estudados pacientes brasileiros portadores de SIDA apresentando sarcoma de Kaposi (SK. O perfil de idade mostrou um grupo com média de idade entre 21 e 40 anos, sendo que 11,1% da amostra apresentava SK exclusivamente na cavidade bucal, observando-se em 25% da amostra uma associação de lesões bucais e na pele. Somente quatro pacientes apresentaram associação de lesões bucais e viscerais, enquanto 49

  12. Are Diuretics Underutilized in Dialysis Patients?

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    Trinh, Emilie; Bargman, Joanne M

    2016-09-01

    While oral diuretics are commonly used in patients with chronic kidney disease for the management of volume and blood pressure, they are often discontinued upon initiation of dialysis. We suggest that diuretics are considerably underutilized in peritoneal dialysis and haemodialysis patients despite numerous potential benefits and few side effects. Moreover, when diuretics are used, optimal doses are not always prescribed. In peritoneal dialysis, the use of diuretics can improve volume status and minimize the need for higher glucose-containing solutions. In patients on haemodialysis, diuretics can help lessen interdialytic weight gain, resulting in decreased ultrafiltration rates and fewer episodes of intradialytic hypotension. This paper will review the mechanism of action of diuretics in patients with renal insufficiency, quantify the risk of side effects and elaborate on the potential advantages of diuretic use in peritoneal dialysis and hemodialysis patients with residual kidney function.

  13. Incidencia de las demencias en hemodiálisis: Apoyo al cuidador principal Incidence of dementia in haemodialysis: Support for the main carer

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    Mª Ángeles Sánchez Lamolda

    2013-03-01

    Full Text Available Las demencias, aparecen cada día con más frecuencia en pacientes con tratamiento de hemodiálisis; la edad de entrada al tratamiento dialítico ha aumentado en los últimos años, influenciada por el aumento de la esperanza de vida. El deterioro en el estilo de vida del paciente afecta tanto a familiares como cuidadores, presentándose una situación compleja y difícil de manejar. En la actualidad, constituye un serio problema de salud con una repercusión social y económica a gran escala, por la pérdida de independencia del paciente y la carga física y psicológica que sufre la familia. Objetivo: Conocer la incidencia de las demencias y su relación con la edad, sexo, nivel de estudios, patologías asociadas. Material y método: Estudio descriptivo y transversal. Para conocer la incidencia de las demencias utilizamos el cuestionario: (short portable mental status questionarire Pfeiffer. Variables: sexo, edad, nivel de estudios, Convivencia, Hipertensión arterial, Diabetes. Resultados: el 28% de los pacientes presentan demencia, 36% se encuentra entre 75-79 años, afectando considerablemente al sexo femenino. El 58% no han terminado los estudios primarios. Hipertensión arterial no es estadísticamente significativa, Diabetes Mellitus aparece en el 48% de los pacientes que presentan demencia. Conclusión: La edad de los pacientes en hemodiálisis ha aumentado considerablemente, dando lugar a la aparición de las demencias, de ahí la necesidad de establecer las intervenciones de enfermería adecuadas para mejorar la calidad asistencial, ofrecer la información adecuada a familiares y cuidadores sobre las medidas a tener en cuenta en cada situación.Dementia appears with increasing frequency in patients undergoing haemodialysis: the age of starting dialysis treatment has increased in recent years, influenced by the increase in life expectancy. The deterioration in the patient's lifestyle affects both relatives and carers, creating a

  14. Oral candidiasis treatment with Brazilian ethanol propolis extract.

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    Santos, V R; Pimenta, F J G S; Aguiar, M C F; do Carmo, M A V; Naves, M D; Mesquita, R A

    2005-07-01

    The Brazilian commercial ethanol propolis extract, also formulated to ensure physical and chemical stability, was found to inhibit oral candidiasis in 12 denture-bearing patients with prosthesis stomatitis candidiasis association.

  15. Brazilian recommendations of mechanical ventilation 2013. Part I

    OpenAIRE

    Barbas, Carmen Sílvia Valente; Ísola, Alexandre Marini; Farias, Augusto Manoel de Carvalho; Cavalcanti, Alexandre Biasi; Gama, Ana Maria Casati; Duarte, Antonio Carlos Magalhães; Vianna, Arthur; Serpa, Ary; Bravim, Bruno de Arruda; Pinheiro, Bruno do Valle; Mazza, Bruno Franco; Carvalho, Carlos Roberto Ribeiro; Toufen, Carlos; David, Cid Marcos Nascimento; Taniguchi, Corine

    2014-01-01

    Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented b...

  16. Brazilian recommendations of mechanical ventilation 2013. Part 2

    OpenAIRE

    Barbas, Carmen Sílvia Valente; Ísola, Alexandre Marini; Farias, Augusto Manoel de Carvalho; Cavalcanti, Alexandre Biasi; Gama, Ana Maria Casati; Duarte, Antonio Carlos Magalhães; Vianna, Arthur; Serpa Neto, Ary; Bravim, Bruno de Arruda; Pinheiro, Bruno do Valle; Mazza, Bruno Franco; Carvalho, Carlos Roberto Ribeiro; Toufen Júnior, Carlos; David, Cid Marcos Nascimento; Taniguchi, Corine

    2014-01-01

    Perspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associação de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented b...

  17. Conicity index as a contributor marker of inflammation in haemodialysis patients.

    Science.gov (United States)

    Ruperto, Mar; Barril, Guillermina; Sánchez-Muniz, Francisco J

    2013-01-01

    Introducción: El depósito de grasa abdominal es un reconocido factor de riesgo de inflamación tanto en la población general como en pacientes en hemodiálisis (HD). El objetivo del estudio fue investigar la asociación de la adiposidad abdominal utilizando el índice de conicidad (Ci) con marcadores nutricionales y de inflamación, y analizar si estos factores se relacionaban con el pronóstico clínico en pacientes en HD. Método: Estudio observacional transversal en 80 pacientes en HD (52 hombres, edad media, 68,2 ± 14,2). El depósito de grasa abdominal fue evaluada por la mediana del Ci con respecto a marcadores inflamatorios, antropomórficos y nutricionales. Aplicación del análisis de regresión lineal para identificar si la proteína C-reactiva (PCR) como biomarcador inflamatorio era uno de los factores predictivos de Ci en la muestra de pacientes en HD. Resultados: La media del Ci era significativamente mayor en hombres que en mujeres (p = 0,001). Correlaciones directas fueron observadas entre el Ci y los triglicéridos séricos (r = 0,23; p hombres ≥?1,39 y mujeres ≥?1,33) presentaban sobrepeso e inflamación (p < 0,05). La PCR como biomarcador de inflamación era un predictor significativo del Ci, aunque el poder predictivo desaparecía cuando se ajustaba por la mediana de conicidad. Conclusión: La aposición de masa grasa abdominal estimada por el Ci está directamente relacionada con el perfil inflamatorio en pacientes en diálisis. Los resultados sustentan la hipótesis de que la inflamación en pacientes en HD tiene efectos pleiotrópicos en función de la adiposidad corporal.

  18. Changes in the volume status of haemodialysis patients are reflected in sublingual microvascular perfusion

    NARCIS (Netherlands)

    R.H.H. Bemelmans; E.C. Boerma; J. Barendregt; C. Ince; J.H. Rommes; P.E. Spronk

    2009-01-01

    Background. After the introduction of sidestream darkfield imaging (SDF) of the microcirculation, it has become clear that in sepsis, microcirculatory alterations can exist in the absence of systemic haemodynamic abnormalities. However, it is unclear whether this phenomenon also occurs in the treatm

  19. Políticas públicas brasileñas para las personas mayores Brazilian public policies for elderly patients

    Directory of Open Access Journals (Sweden)

    Marcia Regina Martins Alvarenga

    2009-06-01

    Full Text Available Diferentes estudios recientes demuestran que el envejecimiento de la población brasileña es irreversible. Evaluar las necesidades de salud de este segmento poblacional para gestionar los recursos disponibles es imprescindible para los profesionales de la salud. Ese artículo tiene como objetivo presentar el Sistema único de Salud en Brasil y las políticas públicas para las personas mayores. El país brasileño no dispone de una red de servicios articulados y dedicados a la asistencia de las necesidades específicas de las personas mayores, a pesar de que la legislación brasileña está avanzando en cuanto a la promoción y la protección de la salud de estas personas.Recent different studies show that Brazilian population aging is irreversible. Evaluation of the elderly health care needs by health professionals is essential to the management of the available resources. The aim of this article is to describe the Brazilian Unified Health Care System and the public policies for elderly. In spite of the lack of an integrated health care network to provide health care to meet the needs of the elderly population, Brazilian legislation is improving, foreseeing the health promotion and protection of older people.

  20. Quality Change in Brazilian Automobiles

    OpenAIRE

    Renato Fonseca

    2015-01-01

    In this paper I investigate the quality evolution of Brazilian autos. To measure the quality evolution of Brazilian autos, I have assembled a data set for Brazilian passenger cars for the period 1960/94, to which I have applied the hedonic pricing methodology. To the best of my knowledge, this is the first time an index of quality change has been constructed for the Brazilian automobile industry. The results presented here have two major implications. They allow a better understanding of prod...

  1. Stpahylococcus aureus biofilms on central venous haemodialysis catheters Biofilmes de Staphylococcus aureus em cateter venoso central em hemodiálise

    Directory of Open Access Journals (Sweden)

    Elisabeth Eyko Aoki

    2005-12-01

    Full Text Available Biofilm bacterial infections are common in patients undergoing treatment with haemodialysis. This study involved 16 patients (7 males, 9 females; ages from 22 to 81 with an average age of 50 who had had a total of 25 temporary haemodialysis polyurethane catheter insertions into the subclavian vein (22 dual-lumen and 3 triple-lumen. The catheters remained in place from 3 to 91 days, on an average of 47 days. The reasons for catheter removal were: bad functioning (44%, suspicion of catheter-related infection (20%, availability of permanent access (16%, accidental removal (12%, signs and symptoms of infection at the site of catheter insertion (4%, and exogenous contamination (4%. Positive tip cultures were observed on seven of the catheters (28%, showing three positive blood cultures. The Staphylococcus aureus were identified in 12% of the blood cultures and isolated from one of the hubs, and biofilms were observed on all catheter tips. The S. aureus retrieved from both blood and catheters (tips and hubs were resistant to penicillin and susceptible to azithromycin, ciprofloxacin, clindamycin, chloramphenicol, gentamicin, oxacillin, rifampin, sulfamethoxazole, tetracycline, and vancomycin. The S. aureus strains isolated from both blood and catheters (tips and hubs were considered to be identical based on antibiotic susceptibility patterns and genetic similarity assessed using an automated ribotyping system.As infecções devido a biofilmes bacterianos são comuns em pacientes sob tratamento em hemodiálise. Neste estudo, 16 pacientes (7 homens, 9 mulheres, de 22 a 81 anos, média 50 anos de idade, com um total de 25 cateteres de hemodiálise (3 de triplo-lúmen e 22 de duplo-lúmen de poliuretano inseridos em veia subclávia foram estudados. Os cateteres permaneceram no local de 3 a 91 dias (média de 47 dias. Os cateteres foram removidos devido ao: mau funcionamento (44%, suspeita de infecção relacionada ao cateter (20%, viabilidade de um acesso

  2. The Brazilian Nuclear Energy Program

    International Nuclear Information System (INIS)

    A survey is initially of the international-and national situation regarding energetic resources. The Brazilian Nuclear Energy Policy and the Brazilian Nuclear Program are dealt with, as well as the Nuclear Cooperation agreement signed with the Federal Republic of Germany. The situation of Brazil regarding Uranium and the main activities of the Brazilian Nuclear Energy Commission are also discussed

  3. Behaviorial inhibition and history of childhood anxiety disorders in Brazilian adult patients with panic disorder and social anxiety disorder Comportamento inibido e história de transtornos de ansiedade na infância em pacientes brasileiros adultos com transtorno do pânico e transtorno de ansiedade social

    OpenAIRE

    Luciano Rassier Isolan; Cristian Patrick Zeni; Kelin Mezzomo; Carolina Blaya; Leticia Kipper; Elizeth Heldt; Gisele Gus Manfro

    2005-01-01

    PURPOSE: To evaluate the presence of behavioral inhibition and anxiety disorders during childhood in Brazilian adult patients with panic disorder and social anxiety disorder compared to a control group. METHODS: Fifty patients with panic disorder, 50 patients with social anxiety disorder, and 50 control subjects were included in the study. To assess the history of childhood anxiety, the Schedule for Affective Disorders and Schizophrenia for School Age Children, Epidemiologic Version (K-SADS-E...

  4. Low frequency of bipolar disorder, dopamine dysregulation syndrome, and punding in Brazilian patients with Parkinson's disease Baixa frequência de transtorno bipolar, síndrome de desregulação dopaminérgica e punding em pacientes brasileiros com doença de Parkinson

    OpenAIRE

    Arthur Kummer; Dias, Fernando M. V.; Francisco Cardoso; Antonio L. Teixeira

    2010-01-01

    OBJECTIVE: To investigate the frequency of bipolar disorder, dopamine dysregulation syndrome and punding in Parkinson's disease patients from a Brazilian movement disorders clinic. METHOD: One hundred patients underwent a comprehensive psychiatric examination composed of MINI-plus and specific questionnaires to investigate dopamine dysregulation syndrome and punding. RESULTS: We identified, respectively, one and five Parkinson's disease patients with bipolar disorder type I and type II. All m...

  5. Increased Pro-inflammatory Cytokines (TNF-a and IL-6 and Anti-inflammatory Compounds (sTNFRp55 and sTNFRp75 in Brazilian Patients during Exanthematic Dengue Fever

    Directory of Open Access Journals (Sweden)

    Luzia MO Pinto

    1999-05-01

    Full Text Available Pro-inflammatory cytokines, tumor necrosis factor (TNF-a, interleukin-6 (IL-6 and interleukin-1b (IL-1b as well as anti-inflammatory compounds, soluble TNF-Receptor p55 (sTNFRp55, sTNFRp75 and IL-1 receptor antagonist (sIL-1Ra, were investigated in 34 Brazilian cases of dengue fever (DF originated from a study of exanthematic virosis. The presence of pro-inflammatory cytokines was detected in sera from these patients by ELISA. TNF-a and IL-6 levels were significantly higher than control subjects in 32% and 52% patients, respectively. To our knowledge this was the first time a receptor antagonist and soluble receptors for cytokines were detected in sera obtained during exanthematic DF without hemorrhagic manifestations. Both sTNFRp55 and sTNFRp75 were consistently elevated in 42% and 84% patients, respectively. Most patients had IL-1b levels not different from those of normal subjects, except for one case. Only 16% patients had altered levels of IL-1Ra. Previous studies in dengue hemorrhagic fever patients demonstrated production of these soluble factors; here we observed that they are found in absence of hemorrhagic manifestations. The possible role of these anti-inflammatory compounds in immune cell activation and in regulating cytokine-mediated pathogenesis during dengue infection is discussed.

  6. Genetic polymorphisms of NAT2, CYP2E1 and GST enzymes and the occurrence of antituberculosis drug-induced hepatitis in Brazilian TB patients

    OpenAIRE

    Raquel Lima de Figueiredo Teixeira; Renata Gomes Morato; Pedro Hernan Cabello; Ligia Mayumi Kitada Muniz; Adriana da Silva Rezende Moreira; Afrânio Lineu Kritski; Fernanda Carvalho Queiroz Mello; Philip Noel Suffys; Antonio Basilio de Miranda; Adalberto Rezende Santos

    2011-01-01

    Isoniazid (INH), one of the most important drugs used in antituberculosis (anti-TB) treatment, is also the major drug involved in hepatotoxicity. Differences in INH-induced toxicity have been attributed to genetic variability at several loci, such as NAT2, CYP2E1, GSTM1 and GSTT1, that code for drug-metabolising enzymes. Our goal was to examine the polymorphisms in these enzymes as susceptibility factors to anti-TB drug-induced hepatitis in Brazilian individuals. In a case-control design, 167...

  7. Illness perceptions in dialysis patients and their association with quality of life.

    NARCIS (Netherlands)

    Timmers, L.; Thong, M.; Dekker, F.W.; Boeschoten, E.W.; Heijmans, M.; Rijken, M.; Weinman, J.; Kaptein, A.

    2008-01-01

    The present study explored illness perceptions of end stage renal disease (ESRD) patients on both haemodialysis (HD) and peritoneal dialysis (PD) treatment, and their associations with quality of life. Leventhal's self-regulation model (SRM) was used as a theoretical framework. Illness perceptions a

  8. EPIDEMIOLOGY AND ETIOLOGICAL FACTORS OF ERECTILE DYSFUNCTION IN PATIENTS ON DIALYSIS AND AFTER RENAL TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    E. A. Efremov

    2011-01-01

    Full Text Available Today the problem of better life quality of patients with end stage renal disease and after renal transplantation and their sexual adaptation is considered to be more impotent. The clinical part of the investigation is the obser- vation of 205 patients – men with terminal stage renal disease. Erectile dysfunction is represented in 91,4% (64 of patients getting haemodialysis, 92,3% (24 of patients getting peritoneal dialysis, 61,5% (67 of patients after renal transplantation. According to International Index of Erectile Function the mean score of erectile function is 16,7 ± 5,2 in haemodialysis patients, 19,46 ± 3,6 in peritoneal dialysis patients, 21,9 ± 5,6 in patients after renal transplantation. The analysis revealed great prevalence of erectile dysfunction and interest in improvement among the patients with end stage renal disease and after renal transplantation. 

  9. Transcultural Diabetes Nutrition Algorithm: Brazilian Application.

    Science.gov (United States)

    Moura, Fabio; Salles, João; Hamdy, Osama; Coutinho, Walmir; Baptista, Deise Regina; Benchimol, Alexander; Marchetti, Albert; Hegazi, Refaat A; Mechanick, Jeffrey I

    2015-09-01

    The prevalence of obesity, pre-diabetes, and type 2 diabetes (T2D) is increasing worldwide, especially in the developing nations of South America. Brazil has experienced an exponential increase in the prevalence of these chronic non-communicable diseases. The rising prevalence is probably due to changing eating patterns, sedentary living, and a progressive aging of the population. These trends and their underlying causes carry untoward consequences for all Brazilians and the future of Brazilian public health and the healthcare system. Lifestyle changes that include healthy eating (nutrition therapy) and regular physical activity (structured exercise) represent efficient inexpensive measures to prevent and/or treat the aforementioned disorders and are recommended for all afflicted patients. Regrettably, the implementation of lifestyle changes is fraught with clinical and personal challenges in real life. The transcultural Diabetes Nutrition Algorithm (tDNA) is a therapeutic tool intended to foster implementation of lifestyle recommendations and to improve disease-related outcomes in common clinical settings. It is evidence-based and amenable to cultural adaptation. The Brazilian Diabetes Association, Society of Cardiology and Ministry of Health guidelines for nutrition therapy and physical exercise were considered for the Brazilian adaptation. The resultant tDNA-Brazil and its underlying recommendations are presented and explained.

  10. Transcultural Diabetes Nutrition Algorithm: Brazilian Application

    Directory of Open Access Journals (Sweden)

    Fabio Moura

    2015-09-01

    Full Text Available The prevalence of obesity, pre-diabetes, and type 2 diabetes (T2D is increasing worldwide, especially in the developing nations of South America. Brazil has experienced an exponential increase in the prevalence of these chronic non-communicable diseases. The rising prevalence is probably due to changing eating patterns, sedentary living, and a progressive aging of the population. These trends and their underlying causes carry untoward consequences for all Brazilians and the future of Brazilian public health and the healthcare system. Lifestyle changes that include healthy eating (nutrition therapy and regular physical activity (structured exercise represent efficient inexpensive measures to prevent and/or treat the aforementioned disorders and are recommended for all afflicted patients. Regrettably, the implementation of lifestyle changes is fraught with clinical and personal challenges in real life. The transcultural Diabetes Nutrition Algorithm (tDNA is a therapeutic tool intended to foster implementation of lifestyle recommendations and to improve disease-related outcomes in common clinical settings. It is evidence-based and amenable to cultural adaptation. The Brazilian Diabetes Association, Society of Cardiology and Ministry of Health guidelines for nutrition therapy and physical exercise were considered for the Brazilian adaptation. The resultant tDNA-Brazil and its underlying recommendations are presented and explained.

  11. Translation and cross-cultural adaptation into Brazilian Portuguese of the Vanderbilt Head and Neck Symptom Survey version 2.0 (VHNSS 2.0 for the assessment of oral symptoms in head and neck cancer patients submitted to radiotherapy

    Directory of Open Access Journals (Sweden)

    Eliane Marçon Barroso

    2015-12-01

    Full Text Available ABSTRACT INTRODUCTION: Patients submitted to radiotherapy for the treatment of head and neck cancer have several symptoms, predominantly oral. The Vanderbilt Head and Neck Symptom Survey version 2.0 is an American tool developed to evaluate oral symptoms in head and neck cancer patients submitted to radiotherapy. OBJECTIVE: The aim of the present study was to translate the Vanderbilt Head and Neck Symptom Survey version 2.0 into Brazilian Portuguese and cross-culturally adapt this tool for subsequent validation and application in Brazil. METHODS: A method used for the translation and cultural adaptation of tools, which included independent translations, synthesis of the translations, back-translations, expert committee, and pre-test, was used. The pre-test was performed with 37 head and neck cancer patients, who were divided into four groups, to assess the relevance and understanding of the assessed items. Data were submitted to descriptive statistical analysis. RESULTS: The overall mean of the content validity index was 0.79 for semantic and idiomatic equivalence, and it was higher than 0.8 for cultural and conceptual equivalence. The cognitive interview showed that patients were able to paraphrase the items, and considered them relevant and easily understood. CONCLUSION: The tool was translated and cross-culturally adapted to be used in Brazil. The authors believe this translation is suited for validation.

  12. Kala-azar in a Brazilian child

    Directory of Open Access Journals (Sweden)

    Michael K. Hole

    2011-04-01

    Full Text Available We report the case of a six-year-old Brazilian girl referred for splenomegaly who first presented with fever, asthenia, and weight loss. Geographical location, clinical exam, and blood laboratories suggested kalaazar. Serology confirmed kala-azar diagnosis, but direct evidence of the parasites was not made. A treatment by meglumine antimoniate is given under hospital surveillance for two weeks. Thereupon, the patient is asymptomatic and all tests are normal.

  13. Say syndrome: A new Brazilian case

    OpenAIRE

    Guion-Almeida M.L.; Kokitsu-Nakata N.M.; Zechi R.M.

    1998-01-01

    We report on a Brazilian boy, born to nonconsanguineous parents, who presented short stature, microcephaly, large ears, Robin sequence, hand anomalies, delayed bone age, and developmental delay. Major signs found in this patient are related to the Say syndrome.Os autores descrevem um menino, filho de pais normais e não-consanguíneos, apresentando baixa estatura, microcefalia, orelhas grandes, seqüência de Robin, anomalias digitais, atraso na idade óssea e atraso no desenvolvimento neuropsicom...

  14. Rett syndrome: clinical and molecular characterization of two Brazilian patients Síndrome de Rett: caracterização clínica e molecular de dois casos brasileiros

    Directory of Open Access Journals (Sweden)

    Andrea Stachon

    2007-03-01

    Full Text Available BACKGROUND: Rett syndrome (RS is recognized as a pan-ethnic condition. Since the identification of mutations in the MECP2 gene, more patients have been diagnosed, and a broad spectrum of phenotypes has been reported. There is a lack of phenotype-genotype studies. OBJECTIVE: To describe two cases of Brazilian patients with identified MECP2 mutations. METHOD: We present two female Brazilian patients with RS. RESULTS: Both patients presented with regression at 2-3 years of age, when stereotypic hand movements, social withdrawal and postnatal deceleration of head growth rate were observed. Both patients presented verbal communication impairment. Case 1 had loss of purposeful hand movements, and severe seizure episodes. Case 2 had milder impairment of purposeful hand movements, and no seizures. They had different mutations, D97Y and R294X, found in exons 3 and 4 of MECP2 gene, respectively. CONCLUSION: Testing for MECP2 mutations is important to confirm diagnosis and to establish genotype/phenotype correlations, and improve genetic counseling.CONTEXTO: Síndrome de Rett (RS é doença pan-étnica de fenótipo bastante variado desde que foram identificadas mutações no gene MECP2 e um número maior de pacientes tem sido diagnosticadas. Existe uma demanda por estudos que investiguem a relação genótipo-fenotipo. OBJETIVO: Descrever dois casos brasileiros de RS com mutações identificadas. MÉTODO: Duas pacientes brasileiras com diagnóstico clínico-molecular de RS foram descritas buscando-se correlacionar genótipo-fenótipo. RESULTADOS: Ambas pacientes apresentaram regressão aos 2-3 anos de idade, movimentos esteriotipados de mãos, retraimento social e desaceleração do crescimento encefálico. Ambas apresentaram déficit de comunicação verbal. Caso 1 também apresentou perda dos movimentos manuais intencionados e crises convulsivas graves. Caso 2 apresentou-se com comprometimento parcial dos movimentos manuais e sem história de crise

  15. Full loss of residual renal function causes higher mortality in dialysis patients; findings from a marginal structural model.

    NARCIS (Netherlands)

    Wal, W.M. van der; Noordzij, M.; Dekker, F.W.; Boeschoten, E.W.; Krediet, R.T.; Korevaar, J.C.; Geskus, R.B.

    2011-01-01

    BACKGROUND: Declining residual renal function, as indicated by the glomerular filtration rate (GFR), is associated with an increased mortality risk in patients with end-stage renal disease (ESRD) on dialysis. METHODS: We monitored GFR and mortality in 1800 haemodialysis (HD) and peritoneal dialysis

  16. Gastric metaplasia and Campylobacter pylori infection of duodenum in patients with chronic renal failure.

    OpenAIRE

    Shousha, S; Keen, C; Parkins, R A

    1989-01-01

    Duodenal biopsy specimens from 80 patients with chronic renal failure, who were undergoing haemodialysis, were examined by light microscopy for evidence of inflammation, gastric metaplasia, and Campylobacter pylori infection. Chronic duodenitis was present in 47 (59%) of patients, of whom only seven (9%) showed evidence of active inflammation. Gastric metaplasia was present in 50 (62.5%) of patients, yet Campylobacter pylori was identified in only two patients (2.5%). It is suggested that the...

  17. Drug-resistant reverse transcriptase genotyping and phenotyping of B and non-B subtypes (F and A) of human immunodeficiency virus type I found in Brazilian patients failing HAART.

    Science.gov (United States)

    Caride, E; Brindeiro, R; Hertogs, K; Larder, B; Dehertogh, P; Machado, E; de Sá, C A; Eyer-Silva, W A; Sion, F S; Passioni, L F; Menezes, J A; Calazans, A R; Tanuri, A

    2000-09-15

    Development of drug resistance is the inevitable consequence of incomplete suppression of virus plasma levels in HIV-1-infected patients treated with highly active antiretroviral therapy. Resistance mutations previously characterized have been found in B subtype viruses of developed countries. Moreover, mutation profiles for non-B and more divergent B subtype viruses found in developing countries shall be analyzed together with their ex vivo phenotyping in order to establish an exact correlation between the genotyping data and the clinical management counseling for those uncommon virus subtypes. In the present study, we evaluated the mutation profile for individuals infected with B subtype and non-B subtype viruses. Viral DNA fragments corresponding to the RT gene were amplified, sequenced, and subtyped. Phenotyping analysis for reverse transcriptase nucleoside (NRTI) and nonnucleoside inhibitor susceptibility was performed using the recombinant virus assay technology. Brazilian non-B subtypes (subtype F, n = 4, and subtype A, n = 1) isolates showed essentially the same B subtype mutation profile, presenting an NRTI drug resistance with similar MIC50% and MIC90% values for all drugs analyzed regardless of their subtypes. A strong cross-resistance phenotype among AZT, 3TC, and abacavir could be seen in all isolates analyzed. A novel result was that some RT sequences not only revealed the presence of G333D/E mutations but also correlated to the presence of mutation T386I that could abrogate the M184V-surpassing effect of L210W or L210W plus G333D/E. These findings suggest that Brazilian non-B subtype HIV-1 strains use an identical RT drug resistance mutation pattern when compared to B isolates and will contribute to the validation of the genotypic and phenotypic tests in these predominant worldwide-spread viral variants. PMID:11017792

  18. Brazilian Trichoptera Checklist II

    Science.gov (United States)

    2014-01-01

    Abstract A second assessment of Brazilian Trichoptera species records is presented here. A total of 625 species were recorded for Brazil. This represents an increase of 65.34% new species recorded during the last decade. The Hydropsychidae (124 spp.), followed by the Hydroptilidae (102 spp.) and Polycentropodidae (97 spp.), are the families with the greatest richness recorded for Brazil. The knowledge on Trichoptera biodiversity in Brazil is geographically unequal. The majority of the species is recorded for the southeastern region. PMID:25349524

  19. BRAZILIAN NEWS PORTALS CHARACTERISTICS

    Directory of Open Access Journals (Sweden)

    Heloiza G. Herckovitz

    2011-02-01

    Full Text Available A content analysis of four Brazilian news media portals found that economic news dominated the top headlines with little attention paid to education, the environment and welfare. Other trends included a focus on local events and national news sources, reliance on few sources, mostly official ones, and a low percentage of news that fitted the concept of newsworthiness (a combination of both social significance and deviance concepts. Other findings of a study of 432 top news stories published by UOL, Estadão, iG and Terra during a 15-day period between February and March 2008 indicate that the top portions of the portals’ front pages carry news that lacks story depth, editorial branding, and multimedia applications. The results suggest that online news portals are in their infancy although Brazil has the largest online population of Latin America. This study hopes to shed light on the gatekeeping process in Brazilian news portals. Brazilian media portals have yet to become a significant editorial force able to provide knowledge about social issues and public affairs in a socially responsible fashione.

  20. Service providers’ perspectives, attitudes and beliefs on health services delivery for Aboriginal people receiving haemodialysis in rural Australia: a qualitative study

    OpenAIRE

    Rix, Elizabeth F; Barclay, Lesley; Wilson, Shawn; Stirling, Janelle; Tong, Allison

    2013-01-01

    Objective Providing services to rural dwelling minority cultural groups with serious chronic disease is challenging due to access to care and cultural differences. This study aimed to describe service providers’ perspectives on health services delivery for Aboriginal people receiving haemodialysis for end-stage kidney disease in rural Australia. Design Semistructured interviews, thematic analysis Setting A health district in rural New South Wales, Australia Participants Using purposive sampli...

  1. Brazilian Version of the Functional Assessment Measure: Cross-Cultural Adaptation and Reliability Evaluation

    Science.gov (United States)

    Lourenco Jorge, Liliana; Garcia Marchi, Flavia Helena; Portela Hara, Ana Clara; Battistella, Linamara R.

    2011-01-01

    The objective of this prospective study was to perform a cross-cultural adaptation of the Functional Assessment Measure (FAM) into Brazilian Portuguese, and to assess the test-retest reliability. The instrument was translated, back-translated, pretested, and reviewed by a committee. The Brazilian version was assessed in 61 brain-injury patients.…

  2. Managing Migration: The Brazilian Case

    OpenAIRE

    Eduardo L. G. Rios-Neto

    2005-01-01

    The objective of this paper is to present the Brazilian migration experience and its relationship with migration management. The article is divided into three parts. First, it reviews some basic facts regarding Brazilian immigration and emigration processes. Second, it focuses on some policy and legal issues related to migration. Finally, it addresses five issues regarding migration management in Brazil.

  3. Test-retest reliability and discriminant validity for the Brazilian version of “The Interstitial Cystitis Symptom Index and Problem Index” and “Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale” instruments

    Science.gov (United States)

    D’Ancona, Carlos Arturo Levi; Junqueira, Roberto Gomes; Carlos da Silva, Daniel; Oliveira, Henrique Ceretta; de Moraes Lopes, Maria Helena Baena

    2015-01-01

    Background The purpose is to evaluate the psychometric properties of reliability and discriminant validity of the Brazilian Portuguese versions of two instruments used in the diagnosis of interstitial cystitis (IC): “The Interstitial Cystitis Symptom Index and Problem Index” (The O’Leary-Sant), and “Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale”. Methods Three groups of patients were examined: a study group (subjects with IC), control group 1 (individuals with at least one IC symptom), and control group 2 (subjects without IC symptoms). Test-retest stability was evaluated at intervals of 3 to 7 days in the study group. Discriminant validity was examined in all three groups. Results The intraclass correlation coefficient (ICC) [95% confidence interval (CI)] results were 0.56 (range, 0.21-0.78) for The O’Leary-Sant Symptom Index, 0.48 (range, 0.10-0.73) for The O’Leary-Sant Problem Index, and 0.49 (range, 0.12-0.74) for the PUF. To analyze discriminant validity between groups, we used Fisher’s exact test and odd ratio (OR) to identify differences. We obtained a P value<0.0001, which indicated that the null hypothesis was rejected; in other words, there was evidence that at least two different groups were compared to the proportion of patients with IC. Conclusions The analyzed instruments did not reach appropriate values for reliability. Future studies are needed to analyze the psychometric measures of these instruments on a larger sample of patients with IC. PMID:26813711

  4. Aspergillus niger peritonitis in a patient on continuous ambulatory peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Usha Kalawat

    2013-07-01

    Full Text Available Fungal peritonitis is an uncommon condition which is associated with high morbidity and mortality in patients on continuous ambulatory peritoneal dialysis (CAPD. It is associated with several complications and many of the patients who develop this condition are unable to resume CAPD treatment and have to shift to haemodialysis. Here we report the rare occurrence of fungal peritonitis due to Aspergillus niger in a patient on CAPD.

  5. Vitamin D Binding Protein Is Not Involved in Vitamin D Deficiency in Patients with Chronic Kidney Disease

    OpenAIRE

    2015-01-01

    Objective. This study was designed to evaluate vitamin D status with separate determination of 25-OH D2 and 25-OH D3 and its relationship to vitamin D binding protein (VDBP) in patients with chronic kidney disease (CKD) and long-term haemodialysis patients (HD). Methods. 45 CKD patients, 103 HD patients, and 25 controls (C) were included. Plasma vitamin D concentrations were determined using chromatography and VDBP in serum and urine in CKD using enzyme immunoassay. Results. Plasma vitamin D ...

  6. Brazilian energy overview

    International Nuclear Information System (INIS)

    The Brazilian energy overview compared with the rest of the world is presented, as well as the current situation and prospects for the future. In a first part, the evalution from the past through the present time is considered, and in a second part, attention is given on the future prospects for Brazil and the different countries in connection with the energy field. It is expected that the current per capita energy consumption in Brazil, in all of its various forms, now totalling 6 million kcal/inh, will reach at least 22 million kcal/inh toward the end of this century

  7. The Brazilian Bolsa Escola

    Directory of Open Access Journals (Sweden)

    Rachel Cassidy

    2008-12-01

    Full Text Available The Bolsa Escola (‘school stipend’ and its successor the Bolsa Familia (‘family stipend’ schemes have formed a crucial and successful part of Brazil’s welfare program. Bolsa Escola provided aid to Brazil’s poorest families on the condition that their children attended school, and Bolsa Familia has extended this idea, giving aid on the condition that children both attend school and receive vaccinations. Bolsa Familia is currently the largest Conditional Cash Transfer Program (CCTP in the world, costing roughly 0.5% of Brazilian GDP and helping around 11.2 million families (around 44 million Brazilians, constituting roughly one fifth of the population. Multilateral institutions have praised the schemes, and they are setting a leading example to other developing nations. In 2005, Paul Wolfowitz (former president of the World Bank said, ‘Bolsa Familia has already become a highly praised model of effective social policy. Countries around the world are drawing lessons from Brazil’s experience and are trying to produce the same results for their own people’.

  8. Health service quality scale: Brazilian Portuguese translation, reliability and validity

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    Rocha Luiz Roberto Martins

    2013-01-01

    Full Text Available Abstract Background The Health Service Quality Scale is a multidimensional hierarchical scale that is based on interdisciplinary approach. This instrument was specifically created for measuring health service quality based on marketing and health care concepts. The aim of this study was to translate and culturally adapt the Health Service Quality Scale into Brazilian Portuguese and to assess the validity and reliability of the Brazilian Portuguese version of the instrument. Methods We conducted a cross-sectional, observational study, with public health system patients in a Brazilian university hospital. Validity was assessed using Pearson’s correlation coefficient to measure the strength of the association between the Brazilian Portuguese version of the instrument and the SERVQUAL scale. Internal consistency was evaluated using Cronbach’s alpha coefficient; the intraclass (ICC and Pearson’s correlation coefficients were used for test-retest reliability. Results One hundred and sixteen consecutive postoperative patients completed the questionnaire. Pearson’s correlation coefficient for validity was 0.20. Cronbach's alpha for the first and second administrations of the final version of the instrument were 0.982 and 0.986, respectively. For test-retest reliability, Pearson’s correlation coefficient was 0.89 and ICC was 0.90. Conclusions The culturally adapted, Brazilian Portuguese version of the Health Service Quality Scale is a valid and reliable instrument to measure health service quality.

  9. Comparison of self-report and interview administration methods based on the Brazilian versions of the Western Ontario Rotator Cuff Index and Disabilities of the Arm, Shoulder and Hand Questionnaire in patients with rotator cuff disorders

    Directory of Open Access Journals (Sweden)

    Andréa Diniz Lopes

    2009-02-01

    Full Text Available OBJECTIVE: The purpose of the present study was to compare self-report and interview administration methods using the Western Ontario Rotator Cuff Index (WORC and Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH in patients with rotator cuff disorders. METHODS: Thirty male and female patients over 18 years of age with rotator cuff disorders (tendinopathy or rotator cuff tear and Brazilian Portuguese as their primary language were recruited for assessment via administration of the Western Ontario Rotator Cuff Index and and Disabilities of the Arm, Shoulder and Hand Questionnaire. A randomization method was used to determine whether the questionnaires would be self-reported (n=15 or administered by an interviewer (n=15. Pearson correlation coefficients were used to evaluate the correlation between the Western Ontario Rotator Cuff Index and and Disabilities of the Arm, Shoulder and Hand Questionnaire in each group. The t-test was used to determine whether the difference in mean questionnaire scores and administration time was statistically significant. For statistical analysis, the level of significance was set at 5%. RESULTS: The mean subject age was 55.07 years, ranging from 27 to 74 years. Most patients had a diagnosis of tendinopathy (n=21. With regard to level of schooling, the majority (n=26 of subjects had completed a college degree or higher. The mean questionnaire scores and administration times did not significantly differ between the two groups (p>0.05. There were statistically significant correlations (p<0.05 between Western Ontario Rotator Cuff Index and and Disabilities of the Arm, Shoulder and Hand Questionnaire, and strong correlations were found between the questionnaires in both groups. CONCLUSION: There are no differences between the Western Ontario Rotator Cuff Index and Disabilities of the Arm, Shoulder and Hand Questionnaire administration methods with regard to administration time or correlations between the

  10. Adaptação e validação do Cardiac Patients Learnings Needs Inventory para pacientes brasileiros Adaptación y validación del Cardiac Patients Learnings Needs Inventory para pacientes brasileños Adaptation and validation of Cardiac Patients' Learning Needs Inventory for Brazilian patients

    Directory of Open Access Journals (Sweden)

    Luzia Elaine Galdeano

    2012-01-01

    presentó mejor consistencia interna fue Factores de Riesgo (α= 0,91. CONCLUSIÓN: La versión adaptada mantuvo las equivalencias conceptuales, semánticasOBJECTIVES: To culturally adapt the Cardiac Patients' Learning Needs Inventory for use in Brazil and to test its reliability (internal consistency and stability in Brazilian patients with coronary artery disease. METHODS: The study included 65 patients with acute myocardial infarction, hospitalized in a public hospital in the state of São Paulo. For data collection, we used an instrument for sociodemographics characteristics and the Portuguese version of the Cardiac Patients' Learning Needs Inventory. Internal consistency was estimated based on Cronbach's alpha. The stability was established using the test-retest method and calculated using the Student's t-test. The level of significance was 0.05. RESULTS: We identified high internal consistency (0.96 in the first step, and 0.78 in the second. The domain that presented better internal consistency was Risk Factors (α = 0.91. CONCLUSION: The adapted version maintained conceptual equivalence, semantics and language of the original version, and presented adequate reliability and stability.

  11. Patterns of hepatitis B virus infection in Brazilian human immunodeficiency virus infected patients: high prevalence of occult infection and low frequency of lamivudine resistant mutations

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    Michel VF Sucupira

    2006-09-01

    Full Text Available Hepatitis B virus (HBV molecular profiles were determined for 44 patients who were infected with human immunodeficiency virus (HIV type 1 and had antibodies to the hepatitis B core antigen (anti-HBc, with and without other HBV serological markers. In this population, 70% of the patients were under lamivudine treatment as a component of antiretroviral therapy. HBV DNA was detected in 14 (32% patients. Eight out of 12 (67% HBsAg positive samples, 3/10 (30% anti-HBc only samples, and 3/22 (14% anti-HBs positive samples were HBV DNA positive. HBV DNA loads, measured by real time polymerase chain reaction, were much higher in the HBsAg positive patients (mean, 2.5 × 10(9 copies/ml than in the negative ones (HBV occult infection; mean, 2.7 × 10(5 copies/ml. Nine out of the 14 HBV DNA positive patients were under lamivudine treatment. Lamivudine resistant mutations in the polymerase gene were detected in only three patients, all of them belonging to the subgroup of five HBsAg positive, HBV DNA positive patients. A low mean HBV load (2.7 × 10(5 copies/ml and an absence of lamivudine resistant mutations were observed among the cases of HBV occult infection.

  12. Incidence of active mycobacterial infections in Brazilian patients with chronic inflammatory arthritis and negative evaluation for latent tuberculosis infection at baseline - A longitudinal analysis after using TNFα blockers

    Science.gov (United States)

    Gomes, Carina Mori Frade; Terreri, Maria Teresa; de Moraes-Pinto, Maria Isabel; Barbosa, Cássia; Machado, Natália Pereira; Melo, Maria Roberta; Pinheiro, Marcelo Medeiros

    2015-01-01

    Several studies point to the increased risk of reactivation of latent tuberculosis infection (LTBI) in patients with chronic inflammatory arthritis (CIAs) after using tumour necrosis factor (TNF)α blockers. To study the incidence of active mycobacterial infections (aMI) in patients starting TNF α blockers, 262 patients were included in this study: 109 with rheumatoid arthritis (RA), 93 with ankylosing spondylitis (AS), 44 with juvenile idiopathic arthritis (JIA) and 16 with psoriatic arthritis (PsA). All patients had indication for anti-TNF α therapy. Epidemiologic and clinical data were evaluated and a simple X-ray and tuberculin skin test (TST) were performed. The control group included 215 healthy individuals. The follow-up was 48 months to identify cases of aMI. TST positivity was higher in patients with AS (37.6%) than in RA (12.8%), PsA (18.8%) and JIA (6.8%) (p < 0.001). In the control group, TST positivity was 32.7%. Nine (3.43%) patients were diagnosed with aMI. The overall incidence rate of aMI was 86.93/100,000 person-years [95% confidence interval (CI) 23.6-217.9] for patients and 35.79/100,000 person-years (95% CI 12.4-69.6) for control group (p < 0.001). All patients who developed aMI had no evidence of LTBI at the baseline evaluation. Patients with CIA starting TNF α blockers and no evidence of LTBI at baseline, particularly with nonreactive TST, may have higher risk of aMI. PMID:26560983

  13. Pharmacogenetics in the Brazilian population

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    Guilherme eSuarez-Kurtz

    2010-10-01

    Full Text Available Brazil is the 5th largest country in the world and its present population, in excess of 190 million, is highly heterogeneous, as a result of centuries of admixture between Amerindians, Europeans and Sub-Saharan Africans. The estimated individual proportions of biogeographical ancestry vary widely and continuously among Brazilians, most individuals - irrespective of self-identification as White, Brown or Black, the major categories of the Brazilian Census race/color system - having significant degrees of European and African ancestry, while a sizeable number display also Amerindian ancestry. These features have important pharmacogenetic (PGx implications: first, extrapolation of PGx data from relatively well-defined ethnic groups is clearly not applicable to the majority of Brazilians; second, the frequency distribution of polymorphisms in pharmacogenes (e.g. CYP3A5, CYP2C9, GSTM1, ABCB1, GSTM3, VKORC, etc varies continuously among Brazilians and is not captured by race/color self-identification; third, the intrinsic heterogeneity of the Brazilian population must be acknowledged in the design and interpretation of PGx studies in order to avoid spurious conclusions based on improper matching of study cohorts. The peculiarities of PGx in Brazilians are illustrated with data for different therapeutic groups, such as anticoagulants, HIV-protease inhibitors and nonsteroidal antinflammatory drugs, and the challenges and advantages created by population admixture for the study and implementation of PGx are discussed. PGx data for Amerindian groups and Brazilian-born, first generation Japanese are presented to illustrate the rich diversity of the Brazilian population. Finally, I introduce the reader to the Brazilian Pharmacogenetic Network or Refargen (www.refargen.org.br, a nationwide consortium of research groups, with the mission to provide leadership in PGx research and education in Brazil, with a population health impact.

  14. Pharmacogenetics in the brazilian population.

    Science.gov (United States)

    Suarez-Kurtz, Guilherme

    2010-01-01

    Brazil is the fifth largest country in the world and its present population, in excess of 190;million, is highly heterogeneous, as a result of centuries of admixture between Amerindians, Europeans, and Sub-Saharan Africans. The estimated individual proportions of biogeographical ancestry vary widely and continuously among Brazilians: most individuals, irrespective of self-identification as White, Brown or Black - the major categories of the Brazilian Census "race/color" system - have significant degrees of European and African ancestry, while a sizeable number display also Amerindian ancestry. These features have important pharmacogenetic (PGx) implications: first, extrapolation of PGx data from relatively well-defined ethnic groups is clearly not applicable to the majority of Brazilians; second, the frequency distribution of polymorphisms in pharmacogenes (e.g., CYP3A5, CYP2C9, GSTM1, ABCB1, GSTM3, VKORC, etc) varies continuously among Brazilians and is not captured by race/color self-identification; third, the intrinsic heterogeneity of the Brazilian population must be acknowledged in the design and interpretation of PGx studies in order to avoid spurious conclusions based on improper matching of study cohorts. The peculiarities of PGx in Brazilians are illustrated with data for different therapeutic groups, such as anticoagulants, HIV protease inhibitors and non-steroidal antinflammatory drugs, and the challenges and advantages created by population admixture for the study and implementation of PGx are discussed. PGx data for Amerindian groups and Brazilian-born, first-generation Japanese are presented to illustrate the rich diversity of the Brazilian population. Finally, I introduce the reader to the Brazilian Pharmacogenetic Network or Refargen, a nation-wide consortium of research groups, with the mission to provide leadership in PGx research and education in Brazil, with a population health impact. PMID:21833165

  15. Assessment of cognition using the Rao's Brief Repeatable Battery of Neuropsychological Tests on a group of Brazilian patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Joseph Bruno Bidin Brooks

    2011-12-01

    Full Text Available To assess the cognition of patients with multiple sclerosis (MS using the Rao's Brief Repeatable Battery of Neuropsychological Tests (BRB-N. METHOD: BRB-N was translated and adapted for control subjects. Subsequently, it was applied to a group of patients with relapsing-remitting (RR MS. RESULTS: The assessment on the healthy controls (n=47 showed that the correlation between tests on the same cognitive domain was high and that there was a five-factor solution that explained 90% of the total variance. Except for the Word List Generation subset of tests, the performance of patients with RRMS (n=39 was worse than that of the healthy controls. CONCLUSION: BRB-N is a relatively simple method to assess cognition of patients with MS in the daily clinic. It does not take long to apply and does not require special skills or equipment.

  16. Characteristics of co-infections by HCV and HBV among Brazilian patients infected by HIV-1 and/or HTLV-1

    Directory of Open Access Journals (Sweden)

    Marcia Moreira

    2013-12-01

    Full Text Available BACKGROUND: The human retroviruses HIV-1 and HTLV-1 share the routes of infection with hepatitis viruses B and C. Co-infection by these agents are a common event, but we have scarce knowledge on co-infection by two or more of these agents. OBJECTIVE: To evaluate the characteristics and risk factors for co-infections by HBV and HCV in patients infected by HIV-1 or/and HTLV-1, in Salvador, Brazil. METHODS: In a case-control study we evaluated patients followed in the AIDS and HTLV clinics of Federal University of Bahia Hospital. Clinical and epidemiological characteristics were reviewed, and patients were tested for the presence of serological markers of HBV and HCV infections. HCV-infected patients were tested by PCR to evaluate the presence of viremia. RESULTS: A total of 200 HIV-1, 213 HTLV-1-infected, and 38 HIV-HTLV-co-infected individuals were included. HIV-infected patients were more likely to have had more sexual partners in the lifetime than other patients' groups. HIV-HTLV-co-infected subjects were predominantly male. Patients infected by HTLV or co-infected had a significantly higher frequency of previous syphilis or gonorrhea, while HIV infection was mainly associated with HPV infection. Co-infection was significantly associated to intravenous drug use (IVDU. HBV and/or HCV markers were more frequently found among co-infected patients. HBV markers were more frequently detected among HIV-infected patients, while HCV was clearly associated with IVDU across all groups. AgHBs was strongly associated with co-infection by HIV-HTLV (OR = 22.03, 95% CI: 2.69-469.7, as well as confirmed HCV infection (p = 0.001. Concomitant HCV and HBV infection was also associated with retroviral co-infection. Patients infected by HTLV-1 had a lower chance of detectable HCV viremia (OR = 0.04, 95% CI: 0.002-0.85. CONCLUSIONS: Infection by HCV and/or HBV is frequent among patients presenting retroviral infection, but risk factors and prevalence for each

  17. The rise of Brazilian agriculture

    DEFF Research Database (Denmark)

    Jensen, Hans Grinsted; Vink, Nick; Sandrey, Ron

    2014-01-01

    The purpose of this article is to explore some of the possible lessons for South African agriculture from the Brazilian experience. To this end, the article discusses the performance of Brazilian agriculture in terms of land and labour use, production, and exports. This is followed by aspects...... of Brazilian agricultural policies, namely farmer support, the research and technology transfer system and land issues. The implications for South African agriculture can be summarized as the recognition that history, geography, the development path and agricultural policies all matter. The article...... then identifies five important lessons for agricultural development in South Africa....

  18. Detection of circulant tumor necrosis factor-alpha , soluble tumor necrosis factor p75 and interferon-gamma in Brazilian patients with dengue fever and dengue hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Elzinandes LA Braga

    2001-02-01

    Full Text Available Pro-inflammatory cytokines are believed to play an important role in the pathogenesis of dengue infection. This study reports cytokine levels in a total of 54 patients examined in Recife, State of Pernambuco, Brazil. Five out of eight patients who had hemorrhagic manifestations presented tumor necrosis factor-alpha (TNF-alpha levels in sera which were statistically higher than those recorded for controls. In contrast, only one out of 16 patients with mild manifestations had elevated TNF-alpha levels. The levels of interleukin-6 (IL, IL-1beta tested in 24 samples and IL-12 in 30 samples were not significantly increased. Interferon-g was present in 10 out of 30 patients with dengue. The data support the concept that the increased level of TNF-alpha is related to the severity of the disease. Soluble TNF receptor p75 was found in most patients but it is unlikely to be related to severity since it was found with an equivalent frequency and levels in 15 patients with dengue fever and another 15 with dengue hemorrhagic fever.

  19. Integrating peritoneal and home haemodialysis: a nurse’s perspective from a single centre

    Science.gov (United States)

    Rhodes, Carol; Beech, Nicola; Chesterton, Lindsay; Fluck, Richard

    2011-01-01

    Home based dialytic therapy is underutilized in most renal centres. This article describes a nurse led and delivered approach to problem solving from a patient perspective, resulting in an increase in prevalent and incident patient numbers on home HD and peritoneal dialysis. Overall, between 2004 and 2010 home-based therapies have risen from 61 to 119 prevalent patients, with a fall in in-centre patient numbers. PMID:25949509

  20. Integrating peritoneal and home haemodialysis: a nurse's perspective from a single centre.

    Science.gov (United States)

    Rhodes, Carol; Beech, Nicola; Chesterton, Lindsay; Fluck, Richard

    2011-12-01

    Home based dialytic therapy is underutilized in most renal centres. This article describes a nurse led and delivered approach to problem solving from a patient perspective, resulting in an increase in prevalent and incident patient numbers on home HD and peritoneal dialysis. Overall, between 2004 and 2010 home-based therapies have risen from 61 to 119 prevalent patients, with a fall in in-centre patient numbers.

  1. Freqüência de sintomas digestivos em pacientes brasileiros com Diabetes Mellitus Digestive symptoms in Brazilian patients with Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    L.E. DE A. TRONCON

    2001-06-01

    Full Text Available Sintomas sugestivos do comprometimento do tubo digestivo são comuns em pacientes diabéticos, mas estudos comparando as freqüências destes sintomas com as da população geral são escassos e não existem trabalhos dessa natureza com diabéticos brasileiros. OBJETIVO: Determinar as freqüências de diferentes sintomas digestivos em amostra não selecionada de pacientes diabéticos, em comparação às encontradas em pessoas da comunidade. MÉTODOS: A ocorrência de 13 diferentes sintomas digestivos foi investigada por meio da aplicação de um questionário padronizado, especificamente estruturado, em 153 diabéticos dos tipos 1 e 2 e em 50 pessoas aparentemente sadias, tomadas como controles. RESULTADOS: A freqüência de diabéticos com pelo menos um sintoma digestivo foi significativamente superior à verificada no grupo controle (70% vs 36%, p = 0,01. Freqüências elevadas de plenitude gástrica (30% vs 36%, pirose (30% vs 34% e de constipação (17% vs 12%, foram observadas tanto entre os diabéticos como nos controles. No entanto, somente a freqüência de um único sintoma, a disfagia, foi significativamente maior entre os diabéticos, em relação ao grupo controle (13% vs 2%, p = 0,02. CONCLUSÃO: Estes resultados indicam que a freqüência de sintomas digestivos em diabéticos, apesar de elevada, não difere da verificada na população geral, exceto para a disfagia. As freqüências dos diferentes sintomas estiveram próximas das faixas relatadas em estudos do hemisfério Norte, o que não apóia a hipótese de que fatores inerentes ao meio afetam a ocorrência de queixas digestivas em diabéticos.PURPOSE: To determine the frequencies of digestive symptoms in an unselected sample of Brazilian diabetics, in comparison to those verified in the general population. METHODS: The frequencies of 13 digestive symptoms were determined in 153 type 1 and type 2 diabetics and in 50 apparently healthy controls, utilizing a structured

  2. Xeroderma Pigmentosum: Low Prevalence of Germline XPA Mutations in a Brazilian XP Population

    Directory of Open Access Journals (Sweden)

    Karina Miranda Santiago

    2015-04-01

    Full Text Available Xeroderma pigmentosum (XP is a rare autosomal recessive disorder characterized by DNA repair defects that cause photophobia, sunlight-induced cancers, and neurodegeneration. Prevalence of germline mutations in the nucleotide excision repair gene XPA vary significantly in different populations. No Brazilian patients have been reported to carry a germline mutation in this gene. In this study, the germline mutational status of XPA was determined in Brazilian patients exhibiting major clinical features of XP syndrome. The study was conducted on 27 unrelated patients from select Brazilian families. A biallelic inactivating transition mutation c.619C>T (p.Arg207Ter was identified in only one patient with a history of neurological impairment and mild skin abnormalities. These findings suggest that XP syndrome is rarely associated with inherited disease-causing XPA mutations in the Brazilian population. Additionally, this report demonstrates the effectiveness of genotype-phenotype correlation as a valuable tool to guide direct genetic screening.

  3. brazilian subsidiaries of multinationals

    Directory of Open Access Journals (Sweden)

    Felipe Mendes Borini

    2012-01-01

    Full Text Available The theme of corporate social responsibility (CSR has not been widely examined in the context of multinationals. This dearth is even greater with respect to subsidiaries, particularly the subject of reverse transfer of practices, that is, the transfer of practices developed in subsidiaries back to the parent company. Because of this theoretical gap, the present article investigates the factors involved on reverse transfer of CSR practices. The research hypotheses test the importance of developing nonlocation-bound capabilities, of integration between subsidiaries and parent and of institutional distance. The data were obtained by a survey of the main foreign subsidiaries in Brazil. All told, we analyzed 150 Brazilian subsidiaries of multinationals, by applying multiple linear regression. The results indicate that the reverse transfer of CSR depends on the development of nonlocation-bound capabilities of the subsidiaries and integration between the parent company and its foreign subsidiaries.

  4. Traditional risk factors are more relevant than HIV-specific ones for carotid intima-media thickness (cIMT in a Brazilian cohort of HIV-infected patients.

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    Antonio G Pacheco

    Full Text Available Combination antiretroviral therapy (cART had a dramatic impact on the mortality profile in human immunodeficiency virus (HIV infected individuals and increased their life-expectancy. Conditions associated with the aging process have been diagnosed more frequently among HIV-infected patients, particularly, cardiovascular diseases.Patients followed in the Instituto de Pesquisa Clínica Evandro Chagas (IPEC prospective cohort in Rio de Janeiro were submitted to the general procedures from the Brazilian Longitudinal Study of Adult Health, comprising several anthropometric, laboratory and imaging data. Carotid intima-media thickness (cIMT was measured by ultrasonography, following the Mannheim protocol. Linear regression and proportional odds models were used to compare groups and covariables in respect to cIMT. The best model was chosen with the adaptive lasso procedure.A valid cIMT exam was available for 591 patients. Median cIMT was significantly larger for men than women (0.56mm vs. 0.53mm; p = 0.002; overall = 0.54mm. In univariable linear regression analysis, both traditional risk factors for cardiovascular diseases (CVD and HIV-specific characteristics were significantly associated with cIMT values, but the best multivariable model chosen included only traditional characteristics. Hypertension presented the strongest association with higher cIMT terciles (OR = 2.51; 95%CI = 1.69-3.73, followed by current smoking (OR = 1,82; 95%CI = 1.19-2.79, family history of acute myocardial infarction or stroke (OR = 1.60; 95%CI = 1.10-2.32 and age (OR per year = 1.12; 95%CI = 1.10-1.14.Our results show that traditional cardiovascular disease (CVD risk factors are the major players in determining increased cIMT among HIV infected patients in Brazil. This finding reinforces the need for thorough assessment of those risk factors in these patients to guarantee the incidence of CVD events remain under control.

  5. Brazilian Eratosthenes Project

    Science.gov (United States)

    Langhi, R.; Vilaça, J.

    2014-10-01

    The objective of Brazilian Eratosthenes Project is the development and application of teaching training actions according the ``docent autonomy" concept to basic Astronomy Education. Argentina coordinates the project in South America, but Brazil works in this project since 2010 with the theme ``Projeto Eratóstenes Brasil" in the homepage: http://sites.google.com/site/projetoerato. Two schools measure a sticks shadow and communicate their results. After, they calculate an average radius of Earth. The stick (gnomon) should stay in vertical position in the leveled ground. Since 2010, the project received hundreds of Brazilian schools with different experiments that were constructed with autonomy, because our site doesn't show some itinerary pre-ready to elaborate the experiments. To collect data for our research, we will use interviews via Skype with the teachers. These data are useful to researches about Science Education area and the Teaching Formation. Teaching professional practice could change and we see modifications in the teachers work, what depends of their realities and context. This project intents to respect the docent autonomy. This autonomy to responsible modifications during continued formation is called ``activist formative model" according Langhi & Nardi (Educação em Astronomia: repensando a formação de professores. São Paulo: Escrituras Editora, 2012). This project discusses about researches in Astronomy Education - still extreme rare in Brazil, when we compare with other areas in Science Education. We believe that actions like this could motivate the students to learn more Astronomy. Furthermore, this national action can be a rich source of data to investigations about teaching formation and scientific divulgation.

  6. The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital

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    Luciana Takata Pontes

    2015-11-01

    Full Text Available OBJECTIVE: Mohs micrographic surgery is a specialized surgical procedure used to treat skin cancer. The purpose of this study was to better understand the profile of the patients who underwent the procedure and to determine how histology might be related to complications and the number of stages required for complete removal. METHODS: The records of patients who underwent Mohs micrographic surgery from October 2008 to November 2013 at the Dermatology Division of the Hospital of the Campinas University were assessed. The variables included were gender, age, anatomical location, histology, number of stages required and complications. RESULTS: Contingency tables were used to compare the number of stages with the histological diagnosis. The analysis showed that patients with superficial basal cell carcinoma were 9.03 times more likely to require more than one stage. A comparison between complications and histological diagnosis showed that patients with superficial basal cell carcinoma were 6.5 times more likely to experience complications. CONCLUSION: Although superficial basal cell carcinoma is typically thought to represent a less-aggressive variant of these tumors, its propensity for demonstrating “skip areas” and clinically indistinct borders make it a challenge to treat. Its particular nature may result in the higher number of surgery stages required, which may, as a consequence, result in more complications, including recurrence. Recurrence likely occurs due to the inadequate excision of the tumors despite their clear margins. Further research on this subtype of basal cell carcinoma is needed to optimize treatments and decrease morbidity.

  7. Xeroderma Pigmentosum: Low Prevalence of Germline XPA Mutations in a Brazilian XP Population

    OpenAIRE

    Karina Miranda Santiago; Amanda França de Nóbrega; Rafael Malagoli Rocha; Silvia Regina Rogatto; Maria Isabel Achatz

    2015-01-01

    Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder characterized by DNA repair defects that cause photophobia, sunlight-induced cancers, and neurodegeneration. Prevalence of germline mutations in the nucleotide excision repair gene XPA vary significantly in different populations. No Brazilian patients have been reported to carry a germline mutation in this gene. In this study, the germline mutational status of XPA was determined in Brazilian patients exhibiting major clinical...

  8. The Brazilian Nuclear Energy Commission and the health

    International Nuclear Information System (INIS)

    The Program of Health Section / Brazilian Cnen, which was elaborated to promote the use of ionizing radiations (nuclear and x-ray techniques) in benefit of Brazilian health, with safety assurance of patients, personnels, population and environment, is presented. The Ministry of Health, industries, Medical and Physicist Associations, Universities and Research Centers are participants of this program. The activities involved in the program are: production of isotopes and radiopharmaceuticals; radiation detectors and nuclear instrumentation; radiation protection and dosimetry; education and training of human resources; applied research and new technologies. The guiding and actions that the section will adopt to attend the growing necessities of Brazilian society, considering technological powers, management, available substructure and associated difficulties are defined. (M.C.K.)

  9. Improving survival among Brazilian children with perinatally-acquired AIDS

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    Luiza Harunari Matida

    2004-12-01

    Full Text Available Brazil was the first developing country to provide free, universal access to antiretroviral treatment for AIDS patients. The Brazilian experience thus provides the first evidence regarding the impact of such treatment on the survival of perinatally acquired AIDS cases in the developing world. MATERIAL AND METHODS: This retrospective cohort study used medical record reviews to examine characteristics and trends in the survival of a representative sample of 914 perinatally acquired AIDS cases in 10 Brazilian cities diagnosed between 1983 and 1998. RESULTS: Survival time increased steadily and substantially. Whereas half of the children died within 20 months of diagnosis at the beginning of the epidemic, 75% of children diagnosed in 1997 and 1998 were still alive after four years of follow-up. CONCLUSIONS: Advances in management and treatment have made a great difference in the survival of Brazilian children with AIDS. These results argue strongly for making such treatment available to children in the entire developing world.

  10. The Low Prevalence of Y Chromosomal Microdeletions is Observed in the Oligozoospermic Men in the Area of Mato Grosso State and Amazonian Region of Brazilian Patients

    OpenAIRE

    Gleice Cristina dos Santos Godoy; Bianca Borsatto Galera; Claudinéia Araujo; Jacklyne Silva Barbosa; Max Fernando de Pinho; Marcial Francis Galera; Sebastião Freitas de Medeiros

    2014-01-01

    OBJECTIVE To determine the prevalence of chromosomal abnormalities and microdeletions on Y chromosome in infertile patients with oligozoospermia or azoospermia in Mato Grosso state, Brazil. METHODS This cross-sectional study enrolled 94 men from infertile couples. Karyotype analysis was performed by lymphocyte culture technique. DNA from each sample was extracted using non-enzymatic method. Microdeletions were investigated by polymerase chain reaction (PCR). RESULTS With the use of cytogeneti...

  11. Evaluation of the Pattern of EPIYA Motifs in the Helicobacter pylori cagA Gene of Patients with Gastritis and Gastric Adenocarcinoma from the Brazilian Amazon Region.

    Science.gov (United States)

    Vilar E Silva, Adenielson; Junior, Mario Ribeiro da Silva; Vinagre, Ruth Maria Dias Ferreira; Santos, Kemper Nunes; da Costa, Renata Aparecida Andrade; Fecury, Amanda Alves; Quaresma, Juarez Antônio Simões; Martins, Luisa Caricio

    2014-01-01

    The Helicobacter pylori is associated with the development of different diseases. The clinical outcome of infection may be associated with the cagA bacterial genotype. The aim of this study was to determine the EPIYA patterns of strains isolated from patients with gastritis and gastric adenocarcinoma and correlate these patterns with the histopathological features. Gastric biopsy samples were selected from 384 patients infected with H. pylori, including 194 with chronic gastritis and 190 with gastric adenocarcinoma. The presence of the cagA gene and the EPIYA motif was determined by PCR. The cagA gene was more prevalent in patients with gastric cancer and was associated with a higher degree of inflammation, neutrophil activity, and development of intestinal metaplasia. The number of EPIYA-C repeats showed a significant association with an increased risk of gastric carcinoma (OR = 3.79, 95% CI = 1.92-7.46, and P = 0.002). A larger number of EPIYA-C motifs were also associated with intestinal metaplasia. In the present study, infection with H. pylori strains harboring more than one EPIYA-C motif in the cagA gene was associated with the development of intestinal metaplasia and gastric adenocarcinoma but not with neutrophil activity or degree of inflammation. PMID:26904732

  12. Evaluation of the Pattern of EPIYA Motifs in the Helicobacter pylori cagA Gene of Patients with Gastritis and Gastric Adenocarcinoma from the Brazilian Amazon Region

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    Adenielson Vilar e Silva

    2014-01-01

    Full Text Available The Helicobacter pylori is associated with the development of different diseases. The clinical outcome of infection may be associated with the cagA bacterial genotype. The aim of this study was to determine the EPIYA patterns of strains isolated from patients with gastritis and gastric adenocarcinoma and correlate these patterns with the histopathological features. Gastric biopsy samples were selected from 384 patients infected with H. pylori, including 194 with chronic gastritis and 190 with gastric adenocarcinoma. The presence of the cagA gene and the EPIYA motif was determined by PCR. The cagA gene was more prevalent in patients with gastric cancer and was associated with a higher degree of inflammation, neutrophil activity, and development of intestinal metaplasia. The number of EPIYA-C repeats showed a significant association with an increased risk of gastric carcinoma (OR = 3.79, 95% CI = 1.92–7.46, and P=0.002. A larger number of EPIYA-C motifs were also associated with intestinal metaplasia. In the present study, infection with H. pylori strains harboring more than one EPIYA-C motif in the cagA gene was associated with the development of intestinal metaplasia and gastric adenocarcinoma but not with neutrophil activity or degree of inflammation.

  13. Omeprazole, Furazolidone, and Tetracycline: an eradication treatment for resistant H. pylori in Brazilian patients with peptic ulcer disease Omeprazol, Tetraciclina e Furazolidona, um tratamento para erradicação do H. pylori resistente em pacientes ulcerosos do Brasil

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    Fernando Marcuz Silva

    2002-09-01

    Full Text Available OBJECTIVES: To determine the efficacy of a simple, short-term and low-cost eradication treatment for Helicobacter pylori (H. pylori using omeprazole, tetracycline, and furazolidone in a Brazilian peptic ulcer population, divided into 2 subgroups: untreated and previously treated for the infection. PATIENTS AND METHODS: Patients with peptic ulcer disease diagnosed by endoscopic examination and infected by H. pylori diagnosed by the rapid urease test (RUT and histological examination, untreated and previously unsuccessfully treated by macrolides and nitroimidazole, were medicated with omeprazole 20 mg daily dose and tetracycline 500 mg and furazolidone 200 mg given 3 times a day for 7 days. Another endoscopy or a breath test was performed 12 weeks after the end of treatment. Patients were considered cured of the infection if a RUT and histologic examination proved negative or a breath test was negative for the bacterium. RESULTS: Sixty-four patients were included in the study. The women were the predominant sex (58%; the mean age was 46 years. Thirty-three percent of the patients were tobacco users, and duodenal ulcer was identified in 80% of patients. For the 59 patients that underwent follow-up examinations, eradication was verified in 44 (75%. The eradication rate for the intention-to-treat group was 69%. The incidence of severe adverse effects was 15%. CONCLUSION: The treatment provides good efficacy for H. pylori eradication in patients who were previously treated without success, but it causes severe adverse effects that prevented adequate use of the medications in 15% of the patients.OBJETIVO: Testar a eficácia de um esquema simplificado e de baixo custo para erradicação do H. pylori utilizando omeprazol, tetraciclina e furazolidona, em uma população de ulcerosos do Brasil, já tratados e não tratados previamente para a infecção. PACIENTES E MÉTODOS: Pacientes portadores de úlcera péptica, documentada por exame endoscópico e

  14. Consenso 2012 da Sociedade Brasileira de Reumatologia sobre vacinação em pacientes com artrite reumatoide 2012 Brazilian Society of Rheumatology Consensus on vaccination of patients with rheumatoid arthritis

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    Claiton Viegas Brenol

    2013-02-01

    Full Text Available OBJETIVO: Elaborar recomendações para a vacinação em pacientes com artrite reumatoide (AR no Brasil. MÉTODO: Revisão da literatura e opinião de especialistas membros da Comissão de AR da Sociedade Brasileira de Reumatologia e um pediatra reumatologista. RESULTADOS E CONCLUSÕES: Foram estabelecidas 12 recomendações: 1 Antes de iniciar drogas modificadoras do curso de doença, deve-se revisar e atualizar o cartão vacinal; 2 As vacinas contra influenza sazonal e contra H1N1 estão indicadas anualmente para pacientes portadores de AR; 3 A vacina antipneumocócica deve ser indicada para todos os pacientes; 4 A vacina contra varicela deve ser indicada para pacientes com história negativa ou duvidosa de infecção prévia por varicela; 5 A vacina contra HPV deve ser considerada em adolescentes e mulheres jovens; 6 A vacina antimeningocócica é indicada para pacientes portadores de AR apenas em casos de asplenia ou deficiência de complemento; 7 Existe orientação de imunização contra o Haemophilus influenzae tipo B de pacientes adultos asplênicos; 8 Não há indicação de uma vacina adicional contra BCG em pacientes com AR; 9 A vacina contra hepatite B é indicada para pacientes com anticorpos contra HBsAg negativos; considerar a vacina contra hepatite A em combinação com a hepatite B; 10 Pacientes com grande risco de contrair tétano que receberam rituximabe nas últimas 24 semanas devem utilizar imunização passiva com imunoglobulina antitetânica; 11 A vacina contra febre amarela é contraindicada nos pacientes com AR em uso de imunossupressores; 12 As recomendações acima descritas devem ser revisadas ao longo da evolução da AR.OBJECTIVE: To elaborate recommendations to the vaccination of patients with rheumatoid arthritis (RA in Brazil. METHOD: Literature review and opinion of expert members of the Brazilian Society of Rheumatology Committee of Rheumatoid Arthritis and of an invited pediatric rheumatologist. RESULTS AND

  15. Assessing Brazilian educational inequalities

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    Benoit Lorel

    2008-03-01

    Full Text Available This paper provides an evaluation of schooling inequality in Brazil using different indicators such as the Education Gini coefficient, the Education Standard Deviation and the Average number of Years of Schooling. We draw up a statistical description of Brazilian human capital dispersion in time over the last half century, across regions and states. Our analysis suggests several conclusions: 1 Strong reduction of educational inequalities measured by Education Gini index. 2 A three parts picture of Brazil seems to emerge, reflecting initial conditions. 3 High increase of the Average number of Years of Schooling. 4 A significant link between Education Gini and the average education length. 5 Education Standard Deviation leads to inverted results compared to Education Gini. 6 Brazilian data are consistent with an Education Kuznets curve if we consider Education Standard Deviation.Esse trababalho busca avaliar o grau de desigualdade educacional no Brasil baseado-se em diferentes indicatores tais como: o índice de Gini educacional, os anos médios de escolaridade e no desvio padrão educacional. Tenta-se colocar uma descrição estatistica da distribuição do capital humano no Brasil, incluindo as diferenças estaduais e regionais observadas durante a ultima metade do século. As conclusões da nossa análise são as seguintes: 1 Forte reduç ão das desigualdades educativas calculadas com o Gini educacional. 2 Um retrato tripartido do Brasil parece se formar refletindo as condições iniciais. 3 Um forte aumento dos níveis de escolarização. 4 Uma relação significativa entre o Gini educacional e os anos médios de estudos. 5 O desvio padrão educacional leva aos resultados inversos do Gini educacional. 6 Os dados brasileiros admitem uma curva de Kuznets educacional se considerarmos o desvio padrão educacional.

  16. A Rare Case of Fatal Endocarditis and Sepsis Caused by Pseudomonas aeruginosa in a Patient with Chronic Renal Failure.

    Science.gov (United States)

    Aggarwal, Manav; Vijan, Vikrant; Vupputuri, Anjith; Nandakumar, Sandya; Mathew, Navin

    2016-07-01

    Nosocomial catheter-related and Arteriovenous fistula (AV)-related infections are significant concern in patients undergoing haemodialysis. These infections are associated with multiple complications as well as mortality and demands immediate and appropriate management. While coagulase-negative staphylococci, S.aureus, and Escherichia coli are the most common causes of catheter-related infections in haemodialysis patients, such infections caused by Pseudomonas aeruginosa are relatively rare. Here, we present an unusual case of 36-year-old male patient with chronic renal failure, who developed endocarditis and sepsis from Pseudomonas aeruginosa infection of the left hand arteriovenous fistula. The bacteraemia in the present case caused multiple complications including dry gangrene of bilateral lower limbs, stroke, endophthalmitis, left brachial artery thrombosis and vegetations on the interventricular septum and aortic wall. Despite antibiotic treatment, the patient suffered a cardiac arrest and could not be revived. PMID:27630891

  17. Detection of Herpesvirus, Enterovirus, and Arbovirus infection in patients with suspected central nervous system viral infection in the Western Brazilian Amazon.

    Science.gov (United States)

    Bastos, Michele S; Lessa, Natália; Naveca, Felipe G; Monte, Rossicléia L; Braga, Wornei S; Figueiredo, Luiz Tadeu M; Ramasawmy, Rajendranath; Mourão, Maria Paula G

    2014-09-01

    Acute infections of the central nervous system (CNS) can be caused by various pathogens. In this study, the presence of herpesviruses (HHV), enteroviruses (EVs), and arboviruses were investigated in CSF samples from 165 patients with suspected CNS viral infection through polymerase chain reaction (PCR) and reverse transcriptase PCR. The genomes of one or more viral agents were detected in 29.7% (49/165) of the CSF samples. EVs were predominant (16/49; 32.6%) followed by Epstein-Barr virus (EBV) (22.4%), Varicella-Zoster virus (VZV) (20.4%), Cytomegalovirus (CMV) (18.4%), herpes simplex virus (HSV-1) (4.1%), (HSV-2) (4.1%), and the arboviruses (14.3%). Four of the arboviruses were of dengue virus (DENV) and three of oropouche virus (OROV). The detection of different viruses in the CNS of patients with meningitis or encephalitis highlight the importance of maintaining an active laboratory monitoring diagnostics with rapid methodology of high sensitivity in areas of viral hyperendemicity that may assist in clinical decisions and in the choice of antiviral therapy.

  18. Analysis of the DF508 mutation in a Brazilian cystic fibrosis population: comparison of pulmonary status of homozygotes with other patients

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    Maróstica P.J.C.

    1998-01-01

    Full Text Available Sixty-one cystic fibrosis patients admitted for check-up or antibiotic treatment were enrolled for genetic and clinical evaluation. Genetic analysis was performed on blood samples stored on neonatal screening cards using PCR techniques to determine the presence of DF508 mutations. Clinical evaluation included Shwachman and Chrispin-Norman scores, age at onset of symptoms and diagnosis, spirometry, awake and sleep pulse oximetry, hyponychial angle measurement and presence of chronic Pseudomonas aeruginosa colonization. Eighteen patients (29.5% were homozygous for the DF508 mutation, 26 (42.6% had one DF508 mutation and 17 (27.9% were noncarriers, corresponding to a 50.8% prevalence of the mutation in the whole population. Analysis by the Kruskal-Wallis test for comparison of genetic status with continuous variables or by the chi-square test and logistic regression for dichotomous variables showed no significant differences between any two groups for a = 0.05. We conclude that genetic status in relation to the DF508 mutation is not associated with pulmonary status as evaluated by the above variables

  19. Occurrence of severe and moderate traumatic brain injury in patients attended in a Brazilian Teaching Hospital: epidemiology and dosage of alcoholemy

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    José Weber Vieira de Faria

    2008-03-01

    Full Text Available This study aimed at observing aspects of epidemiology in order to investigate the use of alcohol in patients older than 18 with severe and moderate traumatic brain injury, which were attended in the Clinics Hospital of the University of Uberlândia. Positive alcoholemy was found in 39.3% of the patients. Of the 33 positive exams alcoholemy was found higher than 60 mg/dL in 28 (84.6%. There was not significant relation between alcoholemy levels and trauma severity. The major prevalence occurred on Saturdays nights. The most frequent types of external causes were transportation accidents (64.74 followed by accidental falls (17.27% and physical aggression (16.55%. 93.9% of the patients with positive alcoholemy were men aged 20-29. 24.2% of the ones with positive alcoholemy died yet no significant difference was found in the study of the ones with negative alcoholemy (n=51 (p=0.93; RR= 0.9; IC95%=0.40-2.08.Os objetivos deste estudo são investigar aspectos da epidemiologia e identificar o uso de álcool em pacientes com traumatismo craniencefálico grave e moderado em maiores de 18 anos atendidos no Hospital de Clínicas da Universidade Federal de Uberlândia. Encontrou-se alcoolemia positiva em 39,3% dos pacientes. Nos 33 exames positivos, foram observadas alcoolemias superiores a 60 mg/dL em 28 (84,6%. Não houve relação significativa entre os níveis de alcoolemia e a gravidade do trauma. Maior prevalência ocorreu aos sábados, no período noturno. Os tipos de causa externa mais frequentes foram os acidentes de transporte (64,74%, seguidos de quedas acidentais (17,27% e de agressões (16,55%. Dos pacientes com alcoolemia positiva, 93,9% eram do sexo masculino, com maior prevalência dos 20 aos 29 anos. Dentre aqueles com alcoolemia positiva, 24,2% vieram a falecer, não havendo diferença significante com os pacientes com alcoolemia negativa (n=51 (p=0,93; RR= 0,9; IC95%=0,40-2,08.

  20. Avaliação comparativa do padrão de normalidade do perfil facial em pacientes Brasileiros leucodermas e em Norte-Americanos Comparative evaluation of the facial profile normality standards in Brazilian Caucasian patients and in North American patients

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    Eduardo Sant'Ana

    2009-02-01

    Full Text Available OBJETIVO: ciente de que a cirurgia ortognática moderna se preocupa em planejar e diagnosticar os casos clínicos utilizando medidas obtidas de grandezas do perfil tegumentar dos pacientes - com o auxílio de imagens digitais empregadas em softwares de planejamento -, no presente estudo foi proposto aferir as medidas de brasileiros leucodermas de descendência européia e compará-las com as medidas já padronizadas por Arnett, com o intuito de criar novas medidas a serem seguidas por brasileiros que utilizam o software de predição cirúrgica Dolphin Imaging 9.0. MÉTODOS: foram utilizadas radiografias cefalométricas de 31 pacientes com oclusão Classe I de Angle e harmonia facial. Todas as radiografias foram digitalizadas e inseridas no software Dolphin 9.0 e 16 pontos de tecido mole e 22 pontos do esqueleto facial foram marcados, seguindo-se exatamente as marcações da análise de Arnett e McLaughlin presentes no programa. RESULTADOS: os resultados obtidos foram avaliados estatisticamente e mostram que o perfil do brasileiro é quase totalmente diferente do perfil norte-americano, exceção feita a apenas quatro pontos para os homens e outros quatro para as mulheres. Os brasileiros apresentam uma face menos protruída, um perfil mais convexo e menor proeminência do queixo do que o grupo controle. CONCLUSÃO: esses dados mostram a necessidade de se realizar algumas mudanças nas grandezas numéricas para que um perfeito diagnóstico e planejamento possam ser realizados em brasileiros, criando assim o padrão do perfil facial do brasileiro leucoderma de descendência européia.AIM: Considering that modern orthognathic surgery is mainly concerned in planning and diagnosing clinical cases by the use of patients' soft tissue measurements obtained from digital images used in planning software, the aim of this study is to establish Caucasian Brazilians measures and to compare them to the standard North American measures. METHODS: For this, a

  1. Supplementation and therapeutic use of vitamin D in patients with multiple sclerosis: Consensus of the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology

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    Doralina Guimarães Brum

    2014-02-01

    Full Text Available Multiple sclerosis (MS is an inflammatory, autoimmune, demyelinating, and degenerative central nervous system disease. Even though the etiology of MS has not yet been fully elucidated, there is evidence that genetic and environmental factors interact to cause the disease. Among the main environmental factors studied, those more likely associated with MS include certain viruses, smoking, and hypovitaminosis D. This review aimed to determine whether there is evidence to recommend the use of vitamin D as monotherapy or as adjunct therapy in patients with MS. We searched PUBMED, EMBASE, COCHRANNE, and LILACS databases for studies published until September 9 th , 2013, using the keywords “multiple sclerosis”, “vitamin D”, and “clinical trial”. There is no scientific evidence up to the production of this consensus for the use of vitamin D as monotherapy for MS in clinical practice.

  2. Determining mutations in G6PC and SLC37A4 genes in a sample of Brazilian patients with glycogen storage disease types Ia and Ib

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    Marcelo Paschoalete Carlin

    2013-01-01

    Full Text Available Glycogen storage disease (GSD comprises a group of autosomal recessive disorders characterized by deficiency of the enzymes that regulate the synthesis or degradation of glycogen. Types Ia and Ib are the most prevalent; while the former is caused by deficiency of glucose-6-phosphatase (G6Pase, the latter is associated with impaired glucose-6-phosphate transporter, where the catalytic unit of G6Pase is located. Over 85 mutations have been reported since the cloning of G6PC and SLC37A4 genes. In this study, twelve unrelated patients with clinical symptoms suggestive of GSDIa and Ib were investigated by using genetic sequencing of G6PC and SLC37A4 genes, being three confirmed as having GSD Ia, and two with GSD Ib. In seven of these patients no mutations were detected in any of the genes. Five changes were detected in G6PC, including three known point mutations (p.G68R, p.R83C and p.Q347X and two neutral mutations (c.432G > A and c.1176T > C. Four changes were found in SLC37A4: a known point mutation (p.G149E, a novel frameshift insertion (c.1338_1339insT, and two neutral mutations (c.1287G > A and c.1076-28C > T. The frequency of mutations in our population was similar to that observed in the literature, in which the mutation p.R83C is also the most frequent one. Analysis of both genes should be considered in the investigation of this condition. An alternative explanation to the negative results in this molecular study is the possibility of a misdiagnosis. Even with a careful evaluation based on laboratory and clinical findings, overlap with other types of GSD is possible, and further molecular studies should be indicated.

  3. Evaluation of Hepcidin Isoforms in Hemodialysis Patients by a Proteomic Approach Based on SELDI-TOF MS

    OpenAIRE

    Oliviero Olivieri; Antonio Lupo; Nicola Martinelli; Albino Poli; Nicola Tessitore; Valeria Bedogna; Annalisa Castagna; Federica Zaninotto; Domenico Girelli; Natascia Campostrini

    2010-01-01

    The hepatic iron regulator hormone hepcidin consists, in its mature form, of 25 amino acids, but two other isoforms, hepcidin-20 and hepcidin-22, have been reported, whose biological meaning remains poorly understood. We evaluated hepcidin isoforms in sera from 57 control and 54 chronic haemodialysis patients using a quantitative proteomic approach based on SELDI-TOF-MS. Patients had elevated serum levels of both hepcidin-25 and hepcidin-20 as compared to controls (geometric means: 7.52 versu...

  4. Candidíase oral e leucoplasia pilosa como marcadores de progressão da infecção pelo HIV em pacientes brasileiros Oral candidiasis and hairy leukoplakia as progression markers of HIV infection in Brazilian patients

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    Ivan Dieb Miziara

    2004-06-01

    Full Text Available Candidíase oral (CO e leucoplasia pilosa (LP são importantes indicadores da progressão da infecção pelo vírus da imunodeficiência humana (HIV para o quadro de AIDS, principalmente em locais onde exames específicos são inacessíveis. OBJETO: Relacionar CO e LP ao número de células CD4+ e à carga viral (CV em pacientes brasileiros HIV-positivos, confirmando-as como marcadores clínicos confiáveis de progressão da doença. FORMA DE ESTUDO: Coorte longitudinal. CASUÍSTICA E MÉTODO: Avaliamos prospectivamente 124 pacientes HIV-positivos, isentos de terapia antiretroviral. Todos foram submetidos a exame ORL, dosagem de células CD4+ e CV, sendo divididos em dois grupos: P e A, de acordo com a presença ou ausência de CO e LP. Depois de seis meses, os pacientes do grupo A foram subdivididos nos subgrupos P6 (presença de lesões e A6. Dosamos novamente CD4+ e carga viral. Os resultados foram analisados estatisticamente. RESULTADOS: No grupo P (43 pacientes, 28 CO e 15 LP a contagem de células CD4+ foi menor e a carga viral maior em relação ao grupo A (pOral candidiasis (OC and hairy leukoplakia (HL are important markers of HIV (Human Imunodeficiency syndrome infection progression for AIDS, mainly in locals where specific tests are inacessible. AIM: to intertwine OC and HL to CD4+ counting and to viral charge (VC on HIV positive brazilian patients, confirming them as trustworthy clinical markers of the disease progression. STUDY DESIGN: Longitudinal cohort. MATERIAL AND METHOD: we have prospectively evaluated 124 HIV+ patients not in use of antiretroviral therapy. All of them have undertaken otorrhinolaringologic examination and CD4+ and VC counting, being divided in two groups: P and A, accordingly to presence or absence of OC and HL. After six months, patients belonging to the A group were re-divided on groups P6 (presence of lesions and A6 (absence of lesions. Again, CD4+ and VC were counted. The results were statistically

  5. European Association of Cardiovascular Imaging/Cardiovascular Imaging Department of the Brazilian Society of Cardiology recommendations for the use of cardiac imaging to assess and follow patients after heart transplantation.

    Science.gov (United States)

    Badano, Luigi P; Miglioranza, Marcelo H; Edvardsen, Thor; Colafranceschi, Alexandre Siciliano; Muraru, Denisa; Bacal, Fernando; Nieman, Koen; Zoppellaro, Giacomo; Marcondes Braga, Fabiana G; Binder, Thomas; Habib, Gilbert; Lancellotti, Patrizio

    2015-09-01

    The cohort of long-term survivors of heart transplant is expanding, and the assessment of these patients requires specific knowledge of the surgical techniques employed to implant the donor heart, the physiology of the transplanted heart, complications of invasive tests routinely performed to detect graft rejection (GR), and the specific pathologies that may affect the transplanted heart. A joint EACVI/Brazilian cardiovascular imaging writing group committee has prepared these recommendations to provide a practical guide to echocardiographers involved in the follow-up of heart transplant patients and a framework for standardized and efficient use of cardiovascular imaging after heart transplant. Since the transplanted heart is smaller than the recipient's dilated heart, the former is usually located more medially in the mediastinum and tends to be rotated clockwise. Therefore, standard views with conventional two-dimensional (2D) echocardiography are often difficult to obtain generating a large variability from patient to patient. Therefore, in echocardiography laboratories equipped with three-dimensional echocardiography (3DE) scanners and specific expertise with the technique, 3DE may be a suitable alternative to conventional 2D echocardiography to assess the size and the function of cardiac chambers. 3DE measurement of left (LV) and right ventricular (RV) size and function are more accurate and reproducible than conventional 2D calculations. However, clinicians should be aware that cardiac chamber volumes obtained with 3DE cannot be compared with those obtained with 2D echocardiography. To assess cardiac chamber morphology and function during follow-up studies, it is recommended to obtain a comprehensive echocardiographic study at 6 months from the cardiac transplantation as a baseline and make a careful quantitation of cardiac chamber size, RV systolic function, both systolic and diastolic parameters of LV function, and pulmonary artery pressure. Subsequent

  6. The role of TMPRSS2:ERG in molecular stratification of PCa and its association with tumor aggressiveness: a study in Brazilian patients.

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    Eguchi, Flávia C; Faria, Eliney F; Scapulatempo Neto, Cristovam; Longatto-Filho, Adhemar; Zanardo-Oliveira, Cleyton; Taboga, Sebastião R; Campos, Silvana G P

    2014-07-10

    Recurrent gene fusions between the genes TMPRSS2 and ERG have been described in prostate cancer (PCa) and are found in 27% to 79% of radical prostatectomy. This fusion transcription results in ERG overexpression, which can be detected by immunohistochemistry (IHC) and provide a potential diagnostic marker for PCa. Three tissue microarrays (TMAs) containing samples from 98 patients with PCa and one TMA of 27 samples from individuals without PCa were tested for ERG immunostaining, and the presence of TMPRSS2:ERG transcripts was confirmed by quantitative real time PCR (qRT-PCR). The results showed that 46.9% of tumors tested positive for ERG immunostaining, and this finding was consistent with the results of qRT-PCR testing (k = 0.694, p tools in detecting TMPRSS2:ERG fusions. A correlation between ERG expression and clinical and pathological parameters was not found, but the frequency, specificity and recurrence of ERG in PCa suggests that it may be a potential adjunct diagnostic tool.

  7. Multiple sclerosis outcome and morbi-mortality of a Brazilian cohort patients Caracteristicas clínico-evolutivas e morbi-mortalidade de uma coorte de pacientes brasileiros com esclerose múltipla

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    Soniza Vieira Alves-Leon

    2008-01-01

    Full Text Available We studied the clinical and evolution characteristics of multiple sclerosis (MS patients followed since the onset of HUCFF/UFRJ in 1978. The diagnosis of MS was based on Poser's et al. and MC Donald's et al. criteria. From 188 patients, 122 were included. Eighty-five were females. The mean age onset was 32.2 years-old (range 6.0 to 61.0±10.3, mainly Caucasians (82/67%. The relapsing-remitting course (MSRR was more frequent (106/86.8%. Monosymptomatic onset was significantly more frequent in Caucasians than in Afro-Brazilians (pEstudamos as características clínico-evolutivas de pacientes com esclerose múltipla (EM acompanhados no HUCFF-UFRJ desde 1978. Foram usados critérios de Poser et al. e MC Donald et al. para o diagnóstico de EM. De 188, 122 foram incluídos. Oitenta e cinco eram mulheres. A média de idade de início foi 32,2 anos (6,0-61,0±10,3, predominando caucasianos (n=82/67%. A forma recorrente-remitente (EMRR foi mais freqüente (n=106/86,8%. Formas mono-sintomáticas no primeiro surto foram significativamente mais freqüentes em caucasianos do que em afro-brasileiros (p<0,05. Dezessete pacientes apresentavam a forma benigna (13,9% e 43 a grave (35,2%. A forma benigna foi associada com a EMRR (p=0,01. A taxa de letalidade 2,12% (4 óbitos. Nossos resultados são semelhantes aos de outras séries brasileiras no que se refere ao sexo e idade, e falta de correlação entre EDSS e número de surtos; confirmamos gradiente sul-sudeste de distribuição afro-descendente, associação significativa entre primeiro surto mono-sintomático e caucasianos e menor freqüência de formas benignas.

  8. A prospective study of hepatitis B virus markers in patients with chronic HBV infection from Brazilian families of Western and Asian origin

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    F.J. Carrilho

    2005-09-01

    Full Text Available The purpose of the present study was to determine the frequency of hepatitis B virus (HBV markers in families of HBsAg-positive patients with chronic liver disease. Serum anti-HBc, HBsAg and anti-HBs were determined by enzyme immunoassay and four subpopulations were considered: genetically related (consanguineous and non-genetically related (non-consanguineous Asian subjects and genetically related and non-genetically related Western subjects. A total of 165 and 186 relatives of Asian and Western origin were enrolled, respectively. The occurrence of HBsAg and anti-HBs antibodies was significantly higher (P < 0.0001 in family members of Asian origin (81.8% than in family members of Western origin (36.5%. HBsAg was also more frequent among brothers (79.6 vs 8.5%; P < 0.0001, children (37.9 vs 3.3%; P < 0.0001 and other family members (33.9 vs 16.7%; P < 0.0007 of Asian than Western origin, respectivelly. No difference between groups was found for anti-HBs, which was more frequently observed in fathers, spouses and other non-genetic relatives. HBV infection was significantly higher in children of Asian than Western mothers (P < 0.0004. In both ethnic groups, the mothers contributed more to their children's infection than the fathers (P < 0.0001. Furthermore, HBsAg was more frequent among consanguineous members and anti-HBs among non-consanguineous members. These results suggest the occurrence of vertical transmission of HBV among consanguineous members and probably horizontal sexual transmission among non-consanguineous members of a family cluster. Thus, the high occurrence of dissemination of HBV infection characterizes family members as a high-risk group that calls for immunoprophylaxis. Finally, the study showed a high familial aggregation rate for both ethnic groups, 18/19 (94.7% and 23/26 (88.5% of the Asian and Western origin, respectively.

  9. Mineral inadequacy of oral diets offered to patients in a Brazilian hospital Grado de inadecuación en minerales de dietas orales ofrecidas a pacientes en hospital brasileño

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    D. C. F. Moreira

    2012-02-01

    Full Text Available Introduction: While enteral diets for hospitalized patients normally follow nutrient composition guidelines, more than 90% of hospitalized patients receive oral diets with unknown mineral composition. Objective: To evaluate the mineral contents and adequacy of three types of oral diets (regular, blend and soft and complementary snacks offered to patients of a Brazilian hospital. Methods: The amount of minerals was determined in two non-consecutive days in duplicate samples of breakfast, collation, lunch, snack, dinner, supper and a complementary snack meal. Dietary Reference Intakes (DRIs were used to determine the adequacy of the daily amounts served to patients. Results and discussion: The regular diet met the RDA (Recommended Dietary Allowances requirements only for Mn, P and Se, while the blend diet was deficient in Ca, K and Mg, and the soft diet met RDA requirements only for P and Zn. Iron was below the RDA requirement in all diets for women in fertile age, and Na was above the safe limit of intake (UL in all the diets. The use of complementary snack was effective in meeting RDA requirements for Cu in the regular diet, and Mn and Se in the soft diet, but promoted overconsumption of Na. Conclusions: Evident nutritional imbalances have been detected at a key interphase between nutrition and public health services, but a solution does not appear to be insurmountable. A permanent nutritional evaluation of hospital oral diets should be an integral part of routine health care in order to speed the recovery of the hospitalized patient and dispel eventual risks due to critical mineral imbalances.Introducción: Mientras las dietas enterales para pacientes hospitalizados siguen normas de composición nutricional, más del 90% de los pacientes internados en Latinoamérica reciben dietas orales de composición mineral desconocida. Objetivo: Evaluar el contenido mineral y la adecuación de tres tipos de dietas orales (regular, blanda y fluida y

  10. Brazilian Congress structural balance analysis

    CERN Document Server

    Levorato, Mario

    2016-01-01

    In this work, we study the behavior of Brazilian politicians and political parties with the help of clustering algorithms for signed social networks. For this purpose, we extract and analyze a collection of signed networks representing voting sessions of the lower house of Brazilian National Congress. We process all available voting data for the period between 2011 and 2016, by considering voting similarities between members of the Congress to define weighted signed links. The solutions obtained by solving Correlation Clustering (CC) problems are the basis for investigating deputies voting networks as well as questions about loyalty, leadership, coalitions, political crisis, and social phenomena such as mediation and polarization.

  11. Cost benefits of low dose subcutaneous erythropoietin in patients with anaemia of end stage renal disease.

    OpenAIRE

    Stevens, M E; Summerfield, G P; Hall, A.A.; Beck, C. A.; Harding, A.J.; Cove-Smith, J.R.; Paterson, A. D.

    1992-01-01

    OBJECTIVE--To assess the cost benefits of low dose subcutaneous recombinant human erythropoietin in correcting the anaemia of end stage renal disease. DESIGN--Three year retrospective study. SETTING--Subregional nephrology service serving a mixed urban and rural population of 800,000. SUBJECTS--60 patients with symptoms of anaemic end stage renal disease treated with erythropoietin (43 receiving haemodialysis; 11 receiving continuous ambulatory peritoneal dialysis; two with predialysis end st...

  12. Brazilian Mothers' Socialization Goals: Intracultural Differences in Seven Brazilian Cities

    Science.gov (United States)

    Seidl-de-Moura, Maria Lucia; Lordelo, Eulina; Vieira, Mauro Luis; Piccinini, Cesar Augusto; Siqueira, Jose de Oliveira; Magalhaes, Celina Maria Colino; Pontes, Fernando Augusto Ramos; Salomao, Nadia Maria; Rimoli, Adriana

    2008-01-01

    The present study aimed to investigate Brazilian mothers' socialization goals. The participants in the study were 349 primiparous mothers, whose ages ranged from 17 to 47 years (mean = 26.6 years), who had children aged between 1 and 48 months (mean = 16.4 months). The families were living in seven different cities representing each of the five…

  13. Scorpion envenoming caused by Tityus cf. silvestris evolving with severe muscle spasms in the Brazilian Amazon.

    Science.gov (United States)

    Monteiro, Wuelton Marcelo; de Oliveira, Sâmella Silva; Pivoto, Guilherme; Alves, Eliane Campos; de Almeida Gonçalves Sachett, Jacqueline; Alexandre, Cleber Nunes; Fé, Nelson Ferreira; Barbosa Guerra, Maria das Graças Vale; da Silva, Iran Mendonça; Tavares, Antonio Magela; Ferreira, Luiz Carlos de Lima; Lacerda, Marcus Vinícius Guimarães

    2016-09-01

    Scorpion stings are a public health problem in the Brazilian Amazon. However, detailed clinical characterization with the proper animal identification is scarce. Here we report a confirmed case of envenoming by Tityus cf. silvestris in the Brazilian Amazon. The case evolved with generalized muscle spasms and was treated with antivenom and supportive therapy, requiring intensive care unit admission. The patient evolved favourably and was discharged after 9 days of hospitalization. PMID:27368713

  14. Cross-cultural adaptation of the dysfunctional voiding score symptom (DVSS) questionnaire for Brazilian children

    OpenAIRE

    Adriano A. Calado; Eleazar M. Araujo; Ubirajara Barroso Jr; Jose M. Bastos Netto; Miguel Zerati Filho; Antonio Macedo Jr; Darius Bagli; Walid Farhat

    2010-01-01

    PURPOSE: To translate and culturally adapt the Dysfunctional Voiding Symptom Score (DVSS), questionnaire into Brazilian Portuguese. MATERIALS AND METHODS: The 10-item Dysfunctional Voiding Symptom Score (DVSS) was translated into Brazilian Portuguese according to a standard methodology: translation, synthesis, back-translation, Expert Committee, and pre-testing. After the translation process the final version was pre-tested and patient responses were analyzed to identify necessary modificatio...

  15. Remote hearing aid fitting: Tele-audiology in the context of Brazilian Public Policy

    OpenAIRE

    Penteado, Silvio Pires; Ramos, Sueli de Lima; Battistella, Linamara Rizzo; Marone, Silvio Antonio Monteiro; Bento, Ricardo Ferreira

    2012-01-01

    Summary Introduction: Currently, the Brazilian government has certificated nearly 140 specialized centers in hearing aid fittings through the Brazilian National Health System (SUS). Remote fitting through the Internet can allow a broader and more efficient coverage with a higher likelihood of success for patients covered by the SUS, as they can receive fittings from their own homes instead of going to the few and distant specialized centers. Aim: To describe a case of remote fitting between 2...

  16. Acute effects of haemodialysis on central venous and arterial pressure characteristics

    OpenAIRE

    Thalhammer, Christoph; Segerer, Stephan; Augustoni, Marlene; Jacomella, Vincenzo; Clemens, Robert K; Wüthrich, Rudolf P.; Amann-Vesti, Beatrice R; Husmann, Marc

    2015-01-01

    BACKGROUND Hemodynamic stability of patients during dialysis sessions is of pivotal importance in daily practice and accurate determination of dry weight (DW) remains a challenge. Little information is available about central venous and aortic pressure during dialysis. In this pilot study we used a new non-invasive technique to describe the changes in central venous pressure (CVP) during dialysis. METHODS An ultrasound-assisted silicon-based pressure-manometer was used at the contralateral...

  17. Evaluation of the factors interfering with drug treatment compliance among Brazilian patients with schizophrenia Avaliação dos fatores de aderência ao tratamento medicamentoso entre pacientes brasileiros com esquizofrenia

    Directory of Open Access Journals (Sweden)

    Moacyr Alexandro Rosa

    2005-09-01

    Full Text Available BACKGROUND: Treatment noncompliance among schizophrenic patients is as high as 50%. In order to rate compliance and assess the most significant differences between compliant and noncompliant patients, a Brazilian population of schizophrenic outpatients was followed for one year. METHODS: Fifty outpatients were selected. Clinical interview, the Brief Psychiatric Rating Scale - Anchored version (BPRS-A and an expanded version of the Rating of Medical Influences (ROMI scale (used to rate patient attitudes toward compliance were applied at baseline. The BPRS-A was used in the follow-up visits (approximately once a month. Missing two consecutive appointments without explanation or taking less than 75% of the medication (by written family report was considered noncompliance. RESULTS: Noncompliance was 48% over one year. Patients in the noncompliant group presented initial worsening of psychotic symptoms (pINTRODUÇÃO: A não aderência ao tratamento em pacientes com esquizofrenia chega a 50%. Com a finalidade de avaliar a taxa de aderência e as principais diferenças entre pacientes aderentes e não aderentes, uma população de pacientes esquizofrênicos em tratamento ambulatorial foi acompanhada por um ano. MÉTODOS: Cinqüenta pacientes foram selecionados. Foi realizada uma entrevista clínica e aplicadas as escalas BPRS-A (Escala Breve de Avaliação Psiquiátrica - Versão Ancorada e uma versão expandida da ROMI (Escala de Influências Medicamentosas na avaliação basal. A BPRS-A foi utilizada nas visitas seguintes (cerca de uma vez por mês. A falta consecutiva a duas consultas sem explicação ou a ingestão de menos de 75% (segundo relato familiar escrito da medicação foram consideradas não aderência ao tratamento. RESULTADOS: A taxa de não aderência encontrada foi de 48% em um ano. O grupo não aderente teve uma piora na sintomatologia psicótica inicial (p < 0,05 e havia estado em tratamento por um tempo mais curto (p = 0,007. A

  18. Deforestation in the Brazilian Amazon

    NARCIS (Netherlands)

    Boekhout van Solinge, T.

    2015-01-01

    This essay takes a (green) criminological and multidisciplinary perspective on deforestation in the Brazilian Amazon, by focusing on the crimes and damages that are associated with Amazonian deforestation. The analysis and results are partly based on longer ethnographic stays in North Brazil (Amazon

  19. Jorge de Lima: Brazilian Poet

    Science.gov (United States)

    Kennedy, James H.

    1973-01-01

    Discusses Jorge de Lima--born in Uniao dos Palmares, Brazil on April 23, 1893, died in Rio de Janeiro on November 15, 1953--who during the Twenties became an important member of the literary movement known as Modernism and wrote both religious and regional poetry constituting the beginnings of a Afro-Brazilian poetry. (Author/JM)

  20. BRAZILIAN EXPORTS OF MANUFACTURED WOOD

    Directory of Open Access Journals (Sweden)

    Rafael de Azevedo Calderon

    2010-08-01

    Full Text Available The present work deals with the Brazilian exports of sawnwood of non-coniferous, veneer sheets and plywood, from 1961 to 2002. The data regarding the three studied products, sawnwood of non-coniferous, veneer sheets and plywood, were joined through the method of Fisher so that an econometric evaluation of the market of the three products could be carried out. Supply and demand models of the Brazilian exports were specified. The results were satisfactory and they match with the literature. The supply of exports presented a positive answer in relation to the exporter's remuneration, to the production, to the use of the installed capacity (cycles of domestic economical activity and to the tendency, and negative in relation to the internal demand. The demand for the Brazilian exports was influenced positively by the world income, participation index and tendency, and negatively for the relative price. The low elasticity-price of the found demand can have implications in the conservation of the Brazilian forest resources because the exporters can increase the prices, reduce the amounts and still increase the incomes.

  1. The Brazilian nuclear power programme

    International Nuclear Information System (INIS)

    The booklet contains survey articles on the nuclear power problems of Brazil, the German-Brazilian nuclear power agreement, the application of international safety measures, and 'Brazil and the non-proliferation of nuclear weapons'. The agreement is given in full wording. (HP)

  2. Gramscian Thought and Brazilian Education

    Science.gov (United States)

    Dore, Rosemary

    2009-01-01

    In the history of Brazilian education, it is only since the 1980s, during the redemocratization of Brazil, that proposals for public education in a socialist perspective have been presented. The past two decades have been marked by a growing interest in Gramscian thought, mainly in the educational field, making possible the elaboration of…

  3. Water for haemodialysis and related therapies: recent standards and emerging issues.

    Science.gov (United States)

    Hoenich, Nicholas A; Levin, Robert; Ronco, Claudio

    2010-01-01

    Dialysis is a well-established and widely used procedure. For a number of years, the focus has been on ensuring that water used in the preparation of dialysis fluid meets the required chemical and microbiological quality and complies with national or international standards which have recently been updated. Continued vigilance is required, in particular when new chemicals such as silver-stabilized hydrogen peroxide and chlorine dioxide are used to prevent growth of Legionella bacteria in hospital water systems, since residues are harmful to patients receiving dialysis. To achieve the required quality, large volumes of water are processed, and a substantial portion is sent to waste via the municipal sewer systems with little attempt to reuse such water on site. In view of concern about global warming and climate change, there is a need to adopt a more environmentally conscious attitude requiring dialysis providers to focus on this aspect of water usage. PMID:20093808

  4. Hereditary fructose intolerance in Brazilian patients

    OpenAIRE

    Eugênia Ribeiro Valadares; Ana Facury da Cruz; Talita Emile Ribeiro Adelino; Viviane de Cássia Kanufre; Maria do Carmo Ribeiro; Maria Goretti Moreira Guimarães Penido; Luciano Amedee Peret Filho; Valadares, Laís Maria Santos Valadares e

    2015-01-01

    Introduction: Hereditary fructose intolerance (HFI) is a rare inborn error of carbohydrate metabolism, autosomal recessive, caused by mutations in the gene ALDOB, leading to deficiency of aldolase B. Symptoms begin in the first months of life with the introduction of complementary foods containing fructose, sucrose or sorbitol, often with vomiting, feeding problems and failure to thrive. Prolonged exposure may cause liver and kidney failure, which can lead to death. Treatment consists in remo...

  5. Say syndrome: A new Brazilian case

    Directory of Open Access Journals (Sweden)

    M.L. Guion-Almeida

    1998-12-01

    Full Text Available We report on a Brazilian boy, born to nonconsanguineous parents, who presented short stature, microcephaly, large ears, Robin sequence, hand anomalies, delayed bone age, and developmental delay. Major signs found in this patient are related to the Say syndrome.Os autores descrevem um menino, filho de pais normais e não-consanguíneos, apresentando baixa estatura, microcefalia, orelhas grandes, seqüência de Robin, anomalias digitais, atraso na idade óssea e atraso no desenvolvimento neuropsicomotor. Estudo cromossômico mostrou cariótipo normal, 46,XY. Os achados são compatíveis com a síndrome de Say.

  6. Brazilian blood donation eligibility criteria for dermatologic patients Critérios brasileiros de elegibilidade à doação de sangue para pacientes dermatológicos

    Directory of Open Access Journals (Sweden)

    Carlos Gustavo Wambier

    2012-08-01

    Full Text Available A focused and commented review on the impact of dermatologic diseases and interventions in the solidary act of donating blood is presented to dermatologists to better advise their patients. This is a review of current Brazilian technical regulations on hemotherapeutic procedures as determined by Ministerial Directive #1353/2011 by the Ministry of Health and current internal regulations of the Hemotherapy Center of Ribeirão Preto, a regional reference center in hemotherapeutic procedures. Criteria for permanent inaptitude: autoimmune diseases (>1 organ involved, personal history of cancer other than basal cell carcinoma, severe atopic dermatitis or psoriasis, pemphigus foliaceus, porphyrias, filariasis, leprosy, extra pulmonary tuberculosis or paracoccidioidomycosis, and previous use of etretinate. Drugs that impose temporary ineligibility: other systemic retinoids, systemic corticosteroids, 5-alpha-reductase inhibitors, vaccines, methotrexate, beta-blockers, minoxidil, anti-epileptic, and anti-psychotic drugs. Other conditions that impose temporary ineligibility: occupational accident with biologic material, piercing, tattoo, sexually transmitted diseases, herpes, and bacterial infections, among others. Discussion: Thalidomide is currently missing in the teratogenic drugs list. Although finasteride was previously considered a drug that imposed permanent inaptitude, according to its short halflife current restriction of 1 month is still too long. Dermatologists should be able to advise their patients about proper timing to donate blood, and discuss the impact of drug withdrawal on treatment outcomes and to respect the designated washout periods.Uma revisão centrada no impacto de doenças e intervenções dermatológicas no ato solidário de doar sangue é apresentada aos dermatologistas para melhor aconselhamento dos seus pacientes. Esta é uma revisão das atuais normas técnicas brasileiras sobre procedimentos hemoterápicos conforme

  7. Respiratory complications in Brazilian patients infected with human immunodeficiency virus Complicações respiratórias em pacientes brasileiros infectados pelo vírus da imunodeficiência humana

    Directory of Open Access Journals (Sweden)

    Adriana Weinberg

    1993-04-01

    Full Text Available PURPOSE: To determine how often and by what means an indentifiable pulmonary pathogen can be recognized in human immunodeficiency virus (HIV infected patients with respiratory disorders in Brazil, which are the most frequently observed microorganisms and what impact specific therapy has on these agents. PATIENTS AND METHODS: Thirty-five HIV seroposiüve subjects with respiratory complaints were studied. All patients had a complete history, physical examination and blood counts. The pulmonary assessment included chest radiograms; sputum examination for bacterial and fungal pathogens; bronchoscopy with bronchoalveolar lavage and transbronchial biopsy. Patients with treatable complications received standard antimicrobial therapy. RESULTS: One or more microorganisms were found in 24 subjects and another 3 individuals showed nonspecific interstitial pneumonitis. The sputum examination identified the pulmonary pathogens in 7 cases. The bronchoalveolar lavage and the histopathologic examination were diagnostic in 14% and 83%, respectively, of the 28 individuals that were submitted to bronchoscopy. The most frequently identified microorganism was P. carinii (55%, followed by M. tuberculosis (41% and cytomegalovirus (8%. The clinical, laboratory and radiographic findings failed to distinguish the specific pulmonary pathogens. Twenty-three individuals with P. carinii pneumonitis and/or tuberculosis received specific therapy; among the evaluable patients the therapeutic response rates were 79% for PCP and 100% for TB. CONCLUSIONS: We have determined that tuberculosis, P. carinii and cytomegalovirus pneumonitis are the most common respiratory opportunistic diseases in Brazilian patients infected with HIV. The histologic evaluation was crucial in order to identify the pulmonary pathogens. Tuberculosis in AIDS individuals displayed clinical and radiographic findings atypical for reactivation disease. However, most of the features observed in HIV infected

  8. Cardiovascular risk factors in outpatients with bipolar disorder: a report from the Brazilian Research Network in Bipolar Disorder

    OpenAIRE

    Fabiano A. Gomes; Karla M. Almeida; Pedro V. Magalhães; Caetano, Sheila C.; Márcia Kauer-Sant'Anna; Beny Lafer; Flávio Kapczinski

    2013-01-01

    Objective: Bipolar disorder (BD) is associated with significant morbidity and mortality due to comorbid general medical conditions, particularly cardiovascular disease. This study is the first report of the Brazilian Research Network in Bipolar Disorder (BRN-BD) that aims to evaluate the prevalence and clinical correlates of cardiovascular risk factors among Brazilian patients with BD. Methods: A cross-sectional study of 159 patients with DSM-IV BD, 18 years or older, consecutively recruited ...

  9. Consenso 2012 da Sociedade Brasileira de Reumatologia sobre o manejo de comorbidades em pacientes com artrite reumatoide 2012 Brazilian Society of Rheumatology Consensus on the management of comorbidities in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Ivânio Alves Pereira

    2012-08-01

    Full Text Available OBJETIVO: Elaborar recomendações da Comissão de Artrite Reumatoide da Sociedade Brasileira de Reumatologia (SBR para o manuseio das comorbidades em artrite reumatoide (AR. MÉTODOS: Revisão da literatura e opinião de especialistas da Comissão de AR da SBR. RESULTADOS E CONCLUSÕES: Recomendações: 1 Diagnosticar e tratar precoce e adequadamente as comorbidades; 2 O tratamento específico da AR deve ser adaptado às comorbidades; 3 Inibidores da enzima conversora da angiotensina (IECA ou bloqueadores dos receptores de angiotensina II (BRA são preferidos no tratamento da hipertensão arterial sistêmica; 4 Em pacientes com AR e diabetes mellitus, deve-se evitar o uso contínuo de dose cumulativa alta de corticoides; 5 Sugere-se o uso de estatinas para manter níveis de LDL menor que 100 mg/dL e índice aterosclerótico menor que 3,5 em pacientes com AR e comorbidades; 6 A síndrome metabólica deve ser tratada; 7 Recomenda-se a realização de exames para a investigação de aterosclerose subclínica; 8 Maior vigilância para um diagnóstico precoce de neoplasia oculta; 9 Medidas de prevenção para trombose venosa são sugeridas; 10 Recomenda-se a realização de densitometria óssea em pacientes com AR acima de 50 anos, e naqueles com idade menor com corticoide maior que 7,5 mg por mais de três meses; 11 Pacientes com AR e osteoporose devem evitar quedas, e devem ser aconselhados a aumentarem a ingestão de cálcio, aumentarem a exposição solar e fazerem atividade física; 12 Suplementação de cálcio e vitamina D é sugerida.Autilização de bisfosfonatos é sugerida para pacientes com escore T menor que -2,5 na densidade mineral óssea; 13 Recomenda-se equipe multidisciplinar, com participação ativa do médico reumatologista no tratamento das comorbidades.OBJECTIVE: To elaborate recommendations of the Rheumatoid Arthritis Committee of the Brazilian Society of Rheumatology (SBR to manage comorbidities in rheumatoid arthritis (RA

  10. A brief overview of Sino-Brazilian relations

    Institute of Scientific and Technical Information of China (English)

    Hinia Lan Wan

    2011-01-01

    This paper reviews the Sino-Brazilian relations approaching a Brazilian perspective and outlines bilateral trade features,challenges and opportunities.It is basically a reflection after analyzes on the existing literature related to Brazilian foreign rela

  11. IPO Determinants of Brazilian Companies

    Directory of Open Access Journals (Sweden)

    Bruno Cals de Oliveira

    2014-10-01

    Full Text Available The literature on Initial Public Offerings (IPO is still little explored in Brazil, since the significant growth in the stock market occurred only recently. The purpose of this study is to identify the determining factors for the IPO of Brazilian companies, based on logistic regression methods and using a sample with private and public Brazilian companies. The results indicate that firms that undertook their IPO in the period were those that had been making significant investments, those that had the highest level of profitability and/or those that increased their level of indebtedness. The IPO was an alternative to improve the capital structure and/or raise funds to continue investing in their growth. The companies that went public were those that seized the opportunity offered in the period and the size of the companies was not significant for the IPO.

  12. Pulmonary Valve Infective Endocarditis in an Adult Patient with Severe Congenital Pulmonary Stenosis and Ostium Secundum Atrial Septal Defect

    Directory of Open Access Journals (Sweden)

    Juan Lacalzada

    2010-01-01

    Full Text Available A hypertensive 76-year-old man with severe pulmonary valve stenosis (PVS and recent initiation of haemodialysis was referred with fever, chills, and asthenia. One month prior, he had been admitted with similar symptoms. Transthoracic echocardiography (TTE had shown a PVS and no valve vegetations were observed. Following discharge, he was readmitted with fever and blood cultures positive for Staphylococcus haemolyticus. A new TTE revealed two pulmonary valve vegetations and a previously undetected ostium secundum-type atrial septal defect (ASD, confirmed by transesophageal echocardiography. The clinical course was uneventful with intravenous antibiotic treatment and the patient was safely discharged. This is a case of pulmonary valve infective endocarditis (IE. The incidence of right-sided IE is on the rise due to the increased number of patients using central venous lines, pacing, haemodialysis and other intravascular devices. Pulmonary valve IE is extremely rare, especially in structurally normal hearts. The case reported here, presents a combination of predisposing factors, such as severe congenital PVS, the presence of a central venous catheter, and haemodialysis. The fact that it was an older patient with severe congenital PVS and associated with a previously undiagnosed ASD, is also an unusual feature of this case, making it even more interesting.

  13. The competitiveness of Brazilian tourist destinations

    OpenAIRE

    Barbosa, Luiz Gustavo Medeiros

    2013-01-01

    This thesis proposes a construct to measure the competitiveness of Brazilian tourist destinations and orient the actions of public and private tourism managers. The model of this study is based on a relevant literature review, a panel with specialists that have expertise in Brazilian tourism and field research. The investigation was carried out in 15 Brazilian tourist cities, representative of the socioeconomic diversity that characterises the heterogeneity of a developing country. The result...

  14. Pathways to Internationalize Brazilian Journals of Psychology

    OpenAIRE

    Estêvão C. Gamba; Abel Laerte Packer; Rogerio Meneghini

    2015-01-01

    AbstractThe science of psychology has been developing in the country of Brazil over the last 50 years. Nonetheless, most of the science in this field is published only in Brazilian journals. Overall, Brazil has yet to share its science with the international community. The potential to internationalize the science generated by Brazilian psychologists exists, though. One way would be to scale up the publication of Brazilian psychologists in international journals. Another way would be to inter...

  15. Permeability measuremens of brazilian Eucalyptus

    OpenAIRE

    Marcio Rogério da Silva; Gilmara de Oliveira Machado; Jay Deiner; Carlito Calil Junior

    2010-01-01

    The permeability of Brazilian Eucalyptus grandis and Eucalyptus citriodora wood was measured in a custom build gas analysis chamber in order to determine which species could be successfully treated with preservatives. Liquid permeability was tested using an emulsion of Neen oil and a control of distillated water. Air was used to test the gas phase permeability. For both Eucalyptus grandis and Eucalyptus citriodora, the longitudinal permeability of gas was shown to be about twice as great as t...

  16. Brazilian Studies Then and Now

    Directory of Open Access Journals (Sweden)

    Anthony Pereira

    2012-09-01

    Full Text Available In 1912 the Brazilian diplomat and scholar Manuel de Oliveira Lima gave six lectures at Stanford University that encapsulated his views of what we now call Brazilian Studies. This article summarizes Oliveira Lima’s lectures. It then points out three aspects of Oliveira Lima’s worldview that are problematic from the perspective of the twenty-first century: his Eurocentrism; the unproblematic nature of the nation-state in his thinking; and his largely negative view of Brazil’s racial heritage. The third part of the essay analyzes three aspects of Oliveira Lima’s lectures that are still contemporary. These are the need to establish an adequate comparative context for the study of Brazil; the difficulty of justifying an academic discipline that revolves around the study of a single country; and the challenge of uniting disparate and specialized disciplines in order to appreciate Brazil’s complexity and trajectory in the modern world. In the conclusion, some guidelines for maintaining Brazilian Studies as a vibrant field are suggested.

  17. Alternative fuels: a Brazilian outlook

    International Nuclear Information System (INIS)

    This paper focuses on studies and information related to the use of alternative fuels in Brazil. The first part of this paper deals with the economics of different biomass technologies. The analysis consists of a careful costing of all operations involved. The study deals with wood, sugar cane and cassava, since these crops are exploited for commercial purposes in Brazil. Corn, although a useful raw material for producing ethanol in the United States, is not used for this purpose in Brazil. The second part deals with the industrial technologies used to convert biomass into energy. We consider several forms of energy derived from biomass and evaluate the economics of the processes. When opportune, we compare costs with those of the North American market. Market analysis and displacement of conventional energy are the subject of the third part of the paper. While the cost of each product is evaluated in most cases; in others the current market price is used. Finally, we raise the issues of institutional problems and planning and offer some conclusions on the future of biomass as an alternative energy source. The technological discussion in this paper is based on the Brazilian experience in producing ethanol and other fuels from biomass. It is possible to extrapolate the Brazilian experience to other developing countries. The observations made in this chapter are based on the conditions prevalent in the Brazilian south-central agricultural region, specifically the state of Sao Paulo. (author). 91 refs., 16 figs., 11 tabs

  18. Novel CFTR missense mutations in Brazilian patients with congenital absence of vas deferens: counseling issues Mutações novas no gene CFTR de pacientes brasileiros portadores de agenesia dos vasos deferentes: dificuldades no aconselhamento

    Directory of Open Access Journals (Sweden)

    Patricia de Campos Pieri

    2007-01-01

    Full Text Available PURPOSE: Screening for mutations in the entire Cystic Fibrosis gene (CFTR of Brazilian infertile men with congenital absence of vas deferens, in order to prevent transmission of CFTR mutations to offspring with the use of assisted reproductive technologies. METHOD: Specific polymerase chain reaction (PCR primers were designed to each of the 27 exons and splicing sites of interest followed by single strand conformational polymorphism and Heteroduplex Analysis (SSCP-HA in precast 12.5% polyacrylamide gels at 7ºC and 20ºC. Fragments with abnormal SSCP migration pattern were sequenced. RESULTS: Two novel missense mutations (S753R and G149W were found in three patients (two brothers together with the IVS8-5T allele in hetrozygosis. CONCLUSION: The available screenings for CF mutations do not include the atypical mutations associated to absence of vas deferens and thus, when these tests fail to find mutations, there is still a genetic risk of affected children with the help of assisted reproduction. We recommend the screening of the whole CFTR gene for these infertile couples, as part of the work-up before assisted reproduction.OBJETIVO: Pesquisar mutações em toda a extensão do gene que causa a Fibrose Cística (CFTR de homens brasileiros inférteis por agenesia congênita dos vasos deferentes, com a finalidade de prevenir a transmissão de mutações em CFTR à prole com o uso das tecnologias de reprodução assistida. MÉTODOS: Foram desenhados oligonucleotídeos específicos para realização de reação de polimerização em cadeia (PCR para cada um dos 27 exons e sítios de processamento de interesse no gene CFTR. O PCR foi seguido pela técnica de SSCP-HA (polimorfismos de conformação no DNA de fita simples e na formação de heteroduplexes em géis pré-fabricados de poliacrilamida a 12,5% em duas temperaturas, 7ºC e 20ºC. Os fragmentos com padrão alterado na migração do SSCP foram submetidos a seqüenciamento automatizado

  19. Exploratory factor analysis of the Brazilian OHIP for edentulous subjects.

    Science.gov (United States)

    Souza, R F; Leles, C R; Guyatt, G H; Pontes, C B; Della Vecchia, M P; Neves, F D

    2010-03-01

    The use of seven domains for the Oral Health Impact Profile (OHIP)-EDENT was not supported for its Brazilian version, making data interpretation in clinical settings difficult. Thus, the aim of this study was to assess patients' responses for the translated OHIP-EDENT in a group of edentulous subjects and to develop factor scales for application in future studies. Data from 103 conventional and implant-retained complete denture wearers (36 men, mean age of 69.1 +/- 10.3 years) were assessed using the Brazilian version of the OHIP-EDENT. Oral health-related quality of life domains were identified by factor analysis using principal component analysis as the extraction method, followed by varimax rotation. Factor analysis identified four factors that accounted for 63% of the 19 items total variance, named masticatory discomfort and disability (four items), psychological discomfort and disability (five items), social disability (five items) and oral pain and discomfort (five items). Four factors/domains of the Brazilian OHIP-EDENT version represent patient-important aspects of oral health-related quality of life.

  20. Perfil da incidência e da sobrevida de pacientes com carcinoma epidermóide oral em uma população brasileira Incidence and survival profile of patients with oral squamous cell carcinoma in a Brazilian population

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    Lucinei Roberto de Oliveira

    2006-10-01

    Full Text Available INTRODUÇÃO: A incidência do câncer bucal no Brasil é uma das mais altas do mundo. OBJETIVOS: Avaliar o perfil, os fatores de risco e a sobrevida de pacientes diagnosticados com carcinoma epidermóide oral entre 1982 e 2002 em uma população brasileira. MATERIAL E MÉTODO: Idade, gênero, local da lesão, história pregressa, consumo de tabaco e bebidas alcoólicas, exposição actínica, traumatismo por prótese, recidivas, metástases e sobrevida foram obtidos dos prontuários. RESULTADOS: Dos 340 pacientes 84,4% eram homens e 15,6%, mulheres (5,4:1. As lesões linguais foram as mais freqüentes (27,9%. Vinte por cento dos pacientes relataram traumatismo por prótese e em 73,8% das lesões em lábio inferior foi relatada exposição actínica desprotegida. Não houve diferença entre as regiões anatômicas e o consumo de tabaco em relação a recidivas, metástases regionais e metástases à distância. O tempo médio de história pregressa foi de 13 meses, havendo diferença entre as regiões anatômicas. A sobrevida em cinco anos foi de 24%. A sobrevida dos pacientes com recidivas e/ou metástases variou conforme a idade analisada ( 60 anos, mas não houve diferença quanto à história pregressa e às regiões anatômicas. A discrepância homem/mulher encontrada foi alta, diminuindo conforme o aumento da idade. O consumo de tabaco e álcool é elevado nessa população, mas não influenciou as recidivas e as metástases da doença. Foi grande o tempo de evolução das lesões até a procura pelo serviço. CONCLUSÕES: Os baixos índices de sobrevida refletem a necessidade de uma maior atenção ao câncer bucal nessa população.BACKGROUND: The buccal cancer incidence in Brazil is one of the highest in the world. OBJECTIVES: To evaluate profile, risk factors and survival in patients with oral squamous cell carcinoma between 1982 and 2002 in a Brazilian population. MATERIAL AND METHOD: Age, gender, tumor site, previous clinical history

  1. Competitiveness in the Brazilian oil industry. The Brazilian 'oil diamond'

    International Nuclear Information System (INIS)

    It is recognized the economic benefits that might follow the opening process of the Brazilian oil and natural gas industry, which shall experience a fast expansion with the arrival of national and international private investors. However, we should not neglect the broader impact of this process on the future development of all that cluster of national agents that lived around and served the former national oil monopoly, managed by the Brazilian National Oil Company, Petrobras. This work focuses on this larger perspective, discussing about the capacity of Brazil to sustain and expand its competitiveness in the oil business as well as to obtain the maximum economic development from the exploration of its oil and gas reserves. We adopt the work of Michael Porter, from the University of Harvard, about the Competitive Advantage of Nations, as a theoretical model to analyze the Competitive Advantage of Brazil in the global oil industry. By introducing the concept of ''oil diamond'', adapted from the notion introduced by this author, we develop a new understanding of national competitiveness in the oil sector. In this paper, we present the general model as well as a brief characterization of the results found for Brazil Subsequently, we focus on just one leg of the model, for which we discuss, with more detail, about the competitive condition of the country in the opening-up scenario. This leg regards the so-called supporting and supplementary industries that constitute what is denominated in the French tradition the ''para petroleum'' industry. We analyze the conditions for the Brazilian domestic ''para petroleum industry'' to survive and grow in the new competitive environment. (authors)

  2. Recirculación de la sangre durante la sesión de hemodiálisis en el catéter tunelizado PalindromeTM Blood recirculation during the haemodialysis session in the tunnelled catheter PalindromeTM

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    Isabel Crehuet Rodríguez

    2012-03-01

    catheter currently used with our patients; because of this and the scarcity of studies published on these new catheters with regard to this matter, we carried out a study to calculate the percentage recirculation of these catheters, both with circuit lines in normal position and in inverted position. We calculated this percentage by analysing the determination of urea in serum, in 4 blood samples drawn weekly, with the haemodialysis circuit lines in both positions, and we applied the recirculation formula: R = (BUN A2-BUNA1/BUN A2-BUN Vx100 Based on the results obtained we can conclude that the percentage of blood recirculation in these catheters is practically the same with the circuit lines in each position, and the figures obtained were more than acceptable to achieve a good quality of haemodialysis, according to the parameters recommended by the spanish nefrology society vascular access guidelines.

  3. Perception of health-related quality of life in children with chronic kidney disease by the patients and their caregivers: Multicentre national study results

    OpenAIRE

    Kiliś-Pstrusińska, Katarzyna; Medyńska, Anna; Chmielewska, Irena Bałasz; Grenda, Ryszard; Kluska-Jóźwiak, Agnieszka; Leszczyńska, Beata; Niedomagała, Julita; Olszak-Szot, Ilona; Miklaszewska, Monika; Szczepańska, Maria; Tkaczyk, Marcin; Urzykowska, Agnieszka; Wasilewska, Anna; Zachwieja, Katarzyna; Zajączkowska, Maria

    2013-01-01

    Objective The aim of the study was to analyse the health-related quality of life (HRQoL) in Polish children with chronic kidney disease (CKD) dependant on the CKD stage, treatment modality and selected social life elements in families of the patients. Furthermore, potential differences between self-report and parent/proxy reports and the factors influencing them were assessed. Methods A total of 203 CKD children (on haemodialysis (HD), peritoneal dialysis (PD) and conservative treatment (CT))...

  4. HIV risk behavior of psychiatric patients with mental illness: a sample of Brazilian patients Comportamento de risco para o HIV de pacientes psiquiátricos: uma amostra de pacientes brasileiros

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    Mark Drew Crosland Guimarães

    2010-12-01

    Full Text Available OBJECTIVE: The prevalence of HIV among psychiatric patients is higher than general population rates worldwide. Many risk behaviors have been identified in studies from both developing and developed countries, though sampling limitations restrict the generalizability of their results. The objective of this study was to report findings from the first national sample of psychiatric patients about lifetime practice of unsafe sex and associated factors. METHOD: A national multicenter sample of adults with mental illness was randomly selected from 26 public mental health institutions throughout Brazil. Sociodemographic, sexual behavior and clinical data were obtained from person-to-person interviews and blood was collected for serology testing. Logistic regression was used for analysis. RESULTS: The overall prevalence of lifetime unprotected sex was 80.3%. Married, older, female patients, those with multiple partners and living with children or partners only and those with less severe psychiatric diagnosis more often practised unsafe sex. DISCUSSION: Risk behavior assessment is a critical tool for clinicians to be able to determine needed HIV-related services for their clients and ensure appropriate follow-through with care and prevention. Interventions that address situational risks in psychiatric patients' lives-institutional and individual- and increase their ability to make informed decisions about their sexual health are urgently needed.OBJETIVO: A prevalência do HIV em pacientes psiquiátricos é maior do que na população geral em diversos países. Diversos comportamentos de risco têm sido identificados em estudos em países desenvolvidos e em desenvolvimento. Entretanto, limitações amostrais restringem a generalização dos resultados em sua grande maioria. O objetivo deste trabalho foi apresentar resultados do primeiro estudo representativo de uma amostra nacional de pacientes psiquiátricos sobre a prática do sexo desprotegido e seus

  5. 36th Brazilian Workshop on Nuclear Physics

    CERN Document Server

    Brandão de Oliveira, José Roberto; Barbosa Shorto, Julian Marco; Higa, Renato

    2014-01-01

    The Brazilian Workshop on Nuclear Physics (RTFNB, acronym in Portuguese) is organized annually by the Brazilian Physics Society since 1978, in order to: promote Nuclear Physics research in the country; stimulate and reinforce collaborations among nuclear physicists from around the country; disseminate advances in nuclear physics research and its applications; disseminate, disclose and evaluate the scientific production in this field.

  6. The first Brazilian Dinosaur Symposium

    Science.gov (United States)

    dos Anjos Candeiro, Carlos Roberto; da Silva Marinho, Thiago

    2015-08-01

    The 1st Brazilian Dinosaur Symposium gathered paleontologists, geologists, and paleoartists in the city of Ituiutaba, Minas Gerais State, Brazil, from April 21st to 24th, 2013. The Dinosaur Symposium in the Pontal Campus of the Universidade Federal de Uberlândia, Minas Gerais State, Brazil provided an opportunity to share many new results of dinosaur research being conducted around the world. The symposium coincided with a new dawn of scientific advances in dinosaur paleontology further expanding its importance, interest and credibility worldwide.

  7. Dementia in Parkinson's disease: a Brazilian sample

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    Beatriz Baldivia

    2011-10-01

    Full Text Available To determine the prevalence of dementia associated with Parkinson's disease (PD-D in a Brazilian sample adopting clinical and diagnostic procedures recommended by the Movement Disorders Society (MDS. Sixty-seven patients were consecutively submitted to neurological, neuropsychological and functional examinations. PD-D was established according to MDS clinical criteria (Level II and clinical procedures for PD-D (Level I and prevalence rate was compared between the levels adopted. Ten patients (14.9% were diagnosed as demented by Level I criteria whereas sixteen (23.8% were diagnosed based on Level II criteria. Level I criteria had low sensitivity in detecting PD-D (31.25%, but greater specificity (90.19. The PD-D group had significantly worse performance on all neuropsychological tests, were older (p<0.001, had an older age of onset ofdisease (p<0.01, had lower educational level (p<0.02 and had higher scores on functional scales. Current age (p=0.046 and Hoehn & Yahr score (p=0.048 were predictors for developing PD-D.

  8. PANDORA - Survey of Brazilian cardiologists about cholesterol reduction

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    Santos Raul D.

    2000-01-01

    Full Text Available OBJECTIVE: To report about a group of physicians' understanding of the recommendations of the II Brazilian Guidelines Conference on Dyslipidemias, and about the state of the art of primary and secondary prevention of atherosclerosis. METHODS: Through the use of a questionnaire on dyslipidemia, atherosclerosis prevention, and recommendations for lipid targets established by the II Brazilian Guidelines Conference on Dyslipidemias, 746 physicians, 98% cardiologists, were evaluated. RESULTS:Eighty-seven percent of the respondents stated that the treatment of dyslipidemia changes the natural history of coronary disease. Although most of the participants followed the total cholesterol recommendations (<200mg/dL for atherosclerosis prevention, only 55.8% would adopt the target of LDL-C <100 mg/dL for secondary prevention. Between 30.5 and 36.7% answered, in different questions, that the recommended level for HDL-C should be <35mg/dL. Only 32.7% would treat their patients indefinitely with lipid- lowering drugs. If the drug treatment did not reach the proposed target, only 35.5% would increase the dosage, and 29.4% would change the medication. Participants did not know the targets proposed for diabetics. CONCLUSION: Although the participating physicians valued the role played by lipids in the prevention of atherosclerosis, serious deficiencies exist in their knowledge of the recommendations given during the II Brazilian Guidelines Conference on Dyslipidemias.

  9. Comparison of postmenopausal endogenous sex hormones among Japanese, Japanese Brazilians, and non-Japanese Brazilians

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    Maciel Maria

    2011-02-01

    Full Text Available Abstract Background Differences in sex hormone levels among populations might contribute to the variation in breast cancer incidence across countries. Previous studies have shown higher breast cancer incidence and mortality among Japanese Brazilians than among Japanese. To clarify the difference in hormone levels among populations, we compared postmenopausal endogenous sex hormone levels among Japanese living in Japan, Japanese Brazilians living in the state of São Paulo, and non-Japanese Brazilians living in the state of São Paulo. Methods A cross-sectional study was conducted using a control group of case-control studies in Nagano, Japan, and São Paulo, Brazil. Participants were postmenopausal women older than 55 years of age who provided blood samples. We measured estradiol, estrone, androstenedione, dehydroepiandrosterone sulfate (DHEAS, testosterone and free testosterone by radioimmunoassay; bioavailable estradiol by the ammonium sulfate precipitation method; and sex hormone-binding globulin (SHBG by immunoradiometric assay. A total of 363 women were included for the present analyses, comprising 185 Japanese, 44 Japanese Brazilians and 134 non-Japanese Brazilians. Results Japanese Brazilians had significantly higher levels of estradiol, bioavailable estradiol, estrone, testosterone and free testosterone levels, and lower SHBG levels, than Japanese. Japanese Brazilians also had significantly higher levels of bioavailable estradiol, estrone and DHEAS and lower levels of SHBG and androstenedione than non-Japanese Brazilians. Levels of estradiol, testosterone and free testosterone, however, did not differ between Japanese Brazilians and non-Japanese Brazilians. These differences were observed even after adjustment for known breast cancer risk factors. We also found an increase in estrogen and androgen levels with increasing body mass index, but no association for most of the other known risk factors. Conclusions We found higher levels of

  10. Bioimpedancia vectorial y espectroscópica: valoración del estado de hidratación con ambos métodos en hemodiálisis Bioimpedance vector and spectroscopic analysis: assessing hydration status using both methods in haemodialysis

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    Ruth Ros Nogales

    2013-03-01

    de hiperhidratación prediálisis tienen una equivalencia aceptable y sus resultados pueden ser intercambiables.Bioimpedance analysis is a useful tool for determining the nutritional and hydration status of haemodialysis patients. The two most commonly used systems are bioimpedance vector single frequency analysis and bioimpedance spectroscopic multiple frequency analysis, which use different criteria to classify the hydration status of the dialysed patient. The single frequency bioimpedance vector system uses a scale of 7 points ranging from a value of 3 (most hydration to a value of -3 (most dehydration, defining hyperhydration when the vector is on the hydration axis below the tolerance ellipse of 75% (values 3 and 2 on the scale. Multi-frequency spectroscopy uses two criteria to define the pre-dialysis state of hyperhydration: OH more than 2.5 litres or more than 15% of the extracellular water volume. The aim of this study was to analyse the degree of concordance between the two systems of bioimpedance in defining the state of hyperhydration of haemodialysis patients. A transversal study was carried out on 54 patients undergoing haemodialysis, performing a bioimpedance analysis with single frequency vector and multi-frequency spectroscopic monitors immediately before a haemodialysis session. The degree of equivalence in the definition of hyperhydration between the two monitors was greater when the criterion of OH>15% of extracellular water was used in the multi-frequency monitor (kappa index 0.81, excellent concordance than when the criterion of OH>2.5 litres was used (kappa index 0.71, acceptable concordance. Conclusions: There is a good relationship between the hydration vector scale and OH value (excess hydration. The criteria used by the single-frequency vector and multi-frequency spectroscopic monitors show acceptable equivalence and their results can be interchangeable.

  11. Type I allergic hypersensitivity reactions due to ethylene oxide sterilised leucocyte filters in patients with thalassaemia: report of four cases.

    Science.gov (United States)

    Belen, Burcu; Polat, Meltem

    2015-01-01

    Ethylene oxide (EO) is a highly reactive gas used in sterilisation of heat sensitive medical devices, such as infusion sets, cannulae, intubation materials, ventriculoperitoneal shunts, dialysis catheters and stents. Allergic reactions due to EO have been reported in haemodialysis patients, patients undergoing extracorporeal photopheresis and donors of plasmapheresis. Clinical manifestations vary considerably and generally do not allow differentiation between IgE-mediated anaphylaxis and anaphylactoid reactions. We report four patients with thalassaemia who experienced anaphylaxis during transfusion due to ethylene oxide sterilised leucocyte filters. The aim of this report is to highlight the fact that frequently transfused patients can have allergic reactions due to EO particles left in leucocyte filters. PMID:25725028

  12. Low frequency of bipolar disorder, dopamine dysregulation syndrome, and punding in Brazilian patients with Parkinson's disease Baixa frequência de transtorno bipolar, síndrome de desregulação dopaminérgica e punding em pacientes brasileiros com doença de Parkinson

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    Arthur Kummer

    2010-03-01

    Full Text Available OBJECTIVE: To investigate the frequency of bipolar disorder, dopamine dysregulation syndrome and punding in Parkinson's disease patients from a Brazilian movement disorders clinic. METHOD: One hundred patients underwent a comprehensive psychiatric examination composed of MINI-plus and specific questionnaires to investigate dopamine dysregulation syndrome and punding. RESULTS: We identified, respectively, one and five Parkinson's disease patients with bipolar disorder type I and type II. All manic/hypomanic episodes occurred before Parkinson's disease onset. No patient was identified with dopamine dysregulation syndrome or punding. CONCLUSION: The frequency of manic/hypomanic episodes seems to decrease with Parkinson's disease onset, and local environmental factors (e.g. drug availability may be responsible for the low frequency of dopamine dysregulation syndrome and punding in Brazilian Parkinson's disease patients.OBJETIVO: Investigar a frequência de transtorno bipolar, síndrome de desregulação dopaminérgica e punding em pacientes com doença de Parkinson de uma clínica de movimentos anormais no Brasil. MÉTODO: Cem pacientes foram submetidos à avaliação psiquiátrica composta pelo MINI-Plus e questionários específicos para investigar síndrome de desregulação dopaminérgica e punding. RESULTADOS: Identificamos, respectivamente, um e cinco pacientes com transtorno bipolar tipo I e tipo II. Todos os episódios maníacos/hipomaníacos ocorreram antes do início da doença de Parkinson. Nenhum paciente foi identificado com síndrome de desregulação dopaminérgica ou punding. CONCLUSÃO: A frequência de episódios maníacos/ hipomaníacos parece declinar com o início da doença de Parkinson. Fatores ambientais locais (p.ex.: disponibilidade de drogas podem ser responsáveis pela baixa frequência de síndrome de desregulação dopaminérgica e punding em pacientes brasileiros com doença de Parkinson.

  13. Scientometrics: Nature Index and Brazilian science.

    Science.gov (United States)

    Silva, Valter

    2016-09-01

    A recent published newspaper article commented on the (lack of) quality of Brazilian science and its (in) efficiency. The newspaper article was based on a special issue of Nature and on a new resource for scientometrics called Nature Index. I show here arguments and sources of bias that, under the light of the principle in dubio pro reo, it is questionable to dispute the quality and efficiency of the Brazilian science on these grounds, as it was commented on the referred article. A brief overview of Brazilian science is provided for readers to make their own judgment.

  14. Scientometrics: Nature Index and Brazilian science.

    Science.gov (United States)

    Silva, Valter

    2016-09-01

    A recent published newspaper article commented on the (lack of) quality of Brazilian science and its (in) efficiency. The newspaper article was based on a special issue of Nature and on a new resource for scientometrics called Nature Index. I show here arguments and sources of bias that, under the light of the principle in dubio pro reo, it is questionable to dispute the quality and efficiency of the Brazilian science on these grounds, as it was commented on the referred article. A brief overview of Brazilian science is provided for readers to make their own judgment. PMID:27627071

  15. I RBH - First Brazilian Hypertension Registry

    Science.gov (United States)

    Jardim, Paulo César Brandão Veiga; de Souza, Weimar Kunz Sebba Barroso; Lopes, Renato Delascio; Brandão, Andréa Araújo; Malachias, Marcus V. Bolívar; Gomes, Marco Mota; Moreno Júnior, Heitor; Barbosa, Eduardo Costa Duarte; Póvoa, Rui Manoel dos Santos

    2016-01-01

    Background: A registry assessing the care of hypertensive patients in daily clinical practice in public and private centers in various Brazilian regions has not been conducted to date. Such analysis is important to elucidate the effectiveness of this care. Objective: To document the current clinical practice for the treatment of hypertension with identification of the profile of requested tests, type of administered treatment, level of blood pressure (BP) control, and adherence to treatment. Methods: National, observational, prospective, and multicenter study that will include patients older than 18 years with hypertension for at least 4 weeks, following up in public and private centers and after signing a consent form. The study will exclude patients undergoing dialysis, hospitalized in the previous 30 days, with class III or IV heart failure, pregnant or nursing, with severe liver disease, stroke or acute myocardial infarction in the past 30 days, or with diseases with a survival prognosis < 1 year. Evaluations will be performed at baseline and after 1 year of follow-up. The parameters that will be evaluated include anthropometric data, lifestyle habits, BP levels, lipid profile, metabolic syndrome, and adherence to treatment. The primary outcomes will be hospitalization due to hypertensive crisis, cardiocirculatory events, and cardiovascular death, while secondary outcomes will be hospitalization for heart failure and requirement of dialysis. A subgroup analysis of 15% of the sample will include noninvasive central pressure evaluation at baseline and study end. The estimated sample size is 3,000 individuals for a prevalence of 5%, sample error of 2%, and 95% confidence interval. Results: The results will be presented after the final evaluation, which will occur at the end of a 1-year follow-up. Conclusion: The analysis of this registry will improve the knowledge and optimize the treatment of hypertension in Brazil, as a way of modifying the prognosis of

  16. Essays on the history of Brazilian dipterology: II. notices about Brazilian Diptera (17th century)

    OpenAIRE

    Nelson Papavero; Márcia Souto Couri

    2012-01-01

    Essays on the history of Brazilian dipterology. II. Notices about Brazilian Diptera (17th century). Notices from the Brazilian Diptera from the 17th century come mainly from two foreign invasions occurred in Brazil, the first one by the French in Maranhão and the second by the Dutch in northeastern Brazil. This paper includes reports of Fathers Claude d'Abbeville and Yves d'Evreux and from Piso and Marcgrave, the last two presenting the first illustrations of Brazilian Diptera. The paper also...

  17. Essays on the history of Brazilian dipterology: II. notices about Brazilian Diptera (17th century

    Directory of Open Access Journals (Sweden)

    Nelson Papavero

    2012-06-01

    Full Text Available Essays on the history of Brazilian dipterology. II. Notices about Brazilian Diptera (17th century. Notices from the Brazilian Diptera from the 17th century come mainly from two foreign invasions occurred in Brazil, the first one by the French in Maranhão and the second by the Dutch in northeastern Brazil. This paper includes reports of Fathers Claude d'Abbeville and Yves d'Evreux and from Piso and Marcgrave, the last two presenting the first illustrations of Brazilian Diptera. The paper also includes reports of Friar Laureano de la Cruz, Father João de Sotto Mayor and Maurício de Heriarte.

  18. Implementing the Brazilian Database on Orofacial Clefts

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    Isabella Lopes Monlleó

    2013-01-01

    Full Text Available Background. High-quality clinical and genetic descriptions are crucial to improve knowledge of orofacial clefts and support specific healthcare polices. The objective of this study is to discuss the potential and perspectives of the Brazilian Database on Orofacial Clefts. Methods. From 2008 to 2010, clinical and familial information on 370 subjects was collected by geneticists in eight different services. Data was centrally processed using an international system for case classification and coding. Results. Cleft lip with cleft palate amounted to 198 (53.5%, cleft palate to 99 (26.8%, and cleft lip to 73 (19.7% cases. Parental consanguinity was present in 5.7% and familial history of cleft was present in 26.3% subjects. Rate of associated major plus minor defects was 48% and syndromic cases amounted to 25% of the samples. Conclusions. Overall results corroborate the literature. Adopted tools are user friendly and could be incorporated into routine patient care. The BDOC exemplifies a network for clinical and genetic research. The data may be useful to develop and improve personalized treatment, family planning, and healthcare policies. This experience should be of interest for geneticists, laboratory-based researchers, and clinicians entrusted with OC worldwide.

  19. Exploring professionalization among Brazilian oral health technicians

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    Sanglard-Oliveira Carla

    2012-07-01

    Full Text Available Abstract Professional dental auxiliaries emerged in the early 20th century in the United States of America and quickly spread to Europe and other regions of the world. In Brazil, however, oral health technicians (OHTs, who occupy a similar role as dental hygienists, had a long journey before the occupation achieved legal recognition: Brazilian Law 11.889, which regulates this occupation in the country, was only enacted in 2008. The aim of this paper is to review the literature on the professionalization of OHTs, highlighting the triggering, limiting and conflicting aspects that exerted an influence on the historical progress of these professionals in Brazil. We have tested Abbott’s and Larson’s theory on professionalization, against the history of OHTs. A number of different dental corporative interests exerted an influence over professionalization, especially in discussions regarding the permissible activities of these professionals in the oral cavity of patients. With primary health care advances in Brazil, the importance of these professionals has once again come to the forefront. This seems to be a key point in the consolidation of OHTs in the area of human resources for health in Brazil.

  20. Functional health literacy and healthy eating: Understanding the brazilian food guide recommendations

    OpenAIRE

    Maria Auristela Magalhães Coelho; Helena Alves de Carvalho Sampaio; Maria da Penha Baião Passamai; Lissidna Almeida Cabral; Tatiana Uchôa Passos; Gláucia Posso Lima

    2014-01-01

    Objective: To assess the relationship between the functional health literacy of Unified Heath System users and the understanding of food servings in the pocket version of the Brazilian Food Guide. Methods: Functional health literacy was assessed by the Brief Test of functional health literacy. Two dialogue rounds were conducted with patients with...

  1. Paracoccidioidomycosis of the male genital tract. Report of eleven cases and a review of Brazilian literature

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    SEVERO Luiz Carlos

    2000-01-01

    Full Text Available Eleven cases of involvement of the genital tract in paracoccidioidomycosis were collected in a retrospective study of the clinical records of 683 patients seen in Porto Alegre, Rio Grande do Sul, Brazil. These cases are herein summarily reported. Eighteen similar cases were gathered in review of the Brazilian literature. Obtained data are discussed.

  2. Neymar, defender of brazilian tradition

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    Francisca Islandia Cardoso da Silva

    2016-09-01

    Full Text Available The purpose of this article is to analyze how university students of Teresina-PI appropriate of the message of a report of the television show Esporte Espetacular. There was use of the technique of focus groups and analytical-descriptive method for collecting and analyzing data. The sample consisted of 24 university students, aged between 18 and 24 years. The report features Neymar as responsible to follow the "tradition" of Brazilians and to be crowned as the best player in the world. The subjects of research said that the speech conveyed by the report can reproduce and create a reality sometimes dreamlike, because objective to confer to Neymar great importance with regard to national identity.

  3. Zipf Law for Brazilian Cities

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    Moura, N J; Jr., Newton J. Moura; Ribeiro, Marcelo B.

    2006-01-01

    This work studies the Zipf Law for cities in Brazil. Data from censuses of 1970, 1980, 1991 and 2000 were used to select a sample containing only cities with 30,000 inhabitants or more. The results show that the population distribution in Brazilian cities does follow a power law similar to the ones found in other countries. Estimates of the power law exponent were found to be 2.22 +/- 0.34 for the 1970 and 1980 censuses, and 2.26 +/- 0.11 for censuses of 1991 and 2000. More accurate results were obtained with the maximum likelihood estimator, showing an exponent equal to 2.41 for 1970 and 2.36 for the other three years.

  4. Free-living amoebae (FLA: detection, morphological and molecular identification of Acanthamoeba genus in the hydraulic system of an haemodialysis unit in Tunisia

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    Dendana F.

    2008-06-01

    Full Text Available The free-living amoebae (FLA are ubiquitous and opportunistic protozoa. They can induce human and animal diseases. The aim of our study was to detect the FLA and Acanthamoeba genus in the hydraulic system of an hemodialysis unit. It was a prospective study of 46 water samples. The first collect (23 was before cleaning and after the haemodialysis sessions and the second (23 after cleaning and before the hemodialysis sessions. Results: the morphological study enabled us to detect morphotypic diversity. The predominant morphotypes were the acanthopodial forms (29%. At the entrance of hemodialysis unit there were acanthopodial (44% and monotactic (25% forms; at the outlet, acanthopodial and fan-shaped forms (25% each. In addition, Acanthamoeba genus was present in 39% (1st collect and 18% (2nd collect. The amplification of the FLA 18S rDNA gene was negative in only one sample localized in the last stage of water treatment unit (WTU. The amplification of the 18S rDNA (ASA.A1 Acanthamoeba gene was positive in15 samples. Conclusions: we noted that, in the hemodialysis unit, the purification techniques used in the WTU were effective, but there is a problem of water stagnation in the drain, which constitutes an appropriate condition for the biofilms formation. It is then necessary to use a filter with a low porosity (0.2 μm at the entrance of the hemodialysis unit and if possible to change the drain

  5. Trends in breastfeeding research by Brazilian nurses

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    Mônica Oliveira B. Oriá

    2005-02-01

    Full Text Available Exclusive breastfeeding is acknowledged as important for survival, optimal growth, and development of infants. The current review presents a synthesis of research output by Brazilian nurses on breastfeeding over the last 20 years, analyzes the theoretical and methodological issues emerging from studies on breastfeeding in Brazil, and provides directions for future research and practice by nurses in the area breastfeeding. Studies included in this review were identified through LILACS searches of Portuguese-language sources. Articles were organized and analyzed chronologically by comparing the evolution of the Brazilian Breastfeeding Program. The incomplete research output of the Brazilian nursing profession in regard to breastfeeding research needs to be addressed. In addition, specific cultural, sociological, and anthropological characteristics of Brazilian regional settings remain to be explored. Emphasis on potential confounders and critical interrelations is warranted.

  6. Cerebrotendinous xanthomatosis: report of two Brazilian brothers.

    NARCIS (Netherlands)

    Lange, M.C.; Zetola, V.F.; Teive, H.; Scola, R.H.; Trentin, A.P.; Zavala, J.A.; Pereira, E.R.; Raskin, S.; Werneck, L.C.; Sistermans, E.A.

    2004-01-01

    Cerebrotendinous xanthomatosis is a treatable rare autossomal recessive disease characterized by lipid storage secondary to a sterol 27-hydroxylase deficiency in the formation of cholic and chenodeoxycholic acids. We describe two Brazilian brothers with cognitive impairement and chronic diarrhea. On

  7. Brazilians sentenced to sewage-related diseases

    OpenAIRE

    Édison Carlos

    2016-01-01

    There is no furthest behind infrastructure in Brazil than the lack of sewage disposal, particularly the shortage of services for treating water, and for collecting and treating waste. The scarcity of these essential services to human dignity has been plaguing millions of Brazilians, as indicated by the data of the National Sanitation Information System 2014. We have 35 million Brazilians without access to services for treating water, where half the population has no sewage collection an...

  8. Ethics and science in brazilian legal discourse

    OpenAIRE

    Cota Marçal, Antônio; Nasser Cury, Paula Maria

    2012-01-01

    The Brazilian Constitution of 1988 declares Brazil as a Democratic State of Law. This formally democratic legal status has been facing difficulties when it comes to its material implementation. Brazilian legal procedures are still greatly influenced by the catholic heritage from Portugal in the times of colonization, translated in the present times into a strong moral set of dogmas that still reflects upon the legal production and interpretation in the country. Recently in Brazil, a debate br...

  9. Myths and truths about Brazilian hospitality

    OpenAIRE

    Ferraz, Valéria de Souza

    2012-01-01

    The Brazilians image is often associated with sympathy and joy. However these characteristics do not necessarily make them hospitable. To be hospitable it´s not just have a smile or be helpful, you must have hospitability, that is, the ability to offer hospitality. Hospitality is a social phenomenon that manifests in the domestic, commercial or public context. It is believed that the Brazilian has a natural talent for the domestic hospitality, which extends somehow into the ...

  10. [Theater in Brazilian science museums and centers].

    Science.gov (United States)

    Moreira, Leonardo Maciel; Marandino, Martha

    2015-12-01

    This qualitative research, based on a descriptive and exploratory study, examines how theater is used as a science communication strategy by Brazilian science museums and centers. Data was collected through a survey emailed to 24 Brazilian institutions identified as science museums and centers. Content analysis was performed, using cross-sectional thematic analysis. It was found that respondents' activities could be classified as approaching theater as an educational support.

  11. Cross-cultural adaptation of the Brazilian version of the Eating Assessment Tool - EAT-10.

    Science.gov (United States)

    Gonçalves, Maria Inês Rebelo; Remaili, Carla Bogossian; Behlau, Mara

    2013-12-16

    The Eating Assessment Tool (EAT-10) was conceptually developed in the United States from data collected from 482 patients, for use as a self-administered survey regarding risk identification of dysphagia and symptoms related to clinical response to treatment. The purpose of this study is to present the cultural equivalence of the Brazilian version of the EAT-10. The process followed the Scientific Advisory Committee of Medical Outcome Trust (SACMOT). The questionnaire was translated by two Brazilian bilingual speech-language pathologists, aware of the purpose of this study. A back translation was performed by a third Brazilian speech-language pathologist, bilingual and English teacher that had not participated in the previous stage. After comparing both translations, a final version of the questionnaire was produced and called Instrumento de Autoavaliação da Alimentação (EAT-10). It was administered to 107 adult inpatients of the Hospital São Paulo, cwith request for bedside clinical evaluation of swallow. During the process of translation and cultural adaptation, no item was modified and/or suppressed. The EAT-10 maintained the same structure as the original American English version with ten questions, of which three of functional domain, three of emotional domain and four of physical symptoms domain. The cultural equivalence of the Brazilian version of the EAT-10 was demonstrated, being a score of three points or above it the cutoff for dysphagia risk, also for the Brazilian population.

  12. The outcomes and prognostic factors of patients requiring prolonged mechanical ventilation.

    Science.gov (United States)

    Lai, Chih-Cheng; Shieh, Jiunn-Min; Chiang, Shyh-Ren; Chiang, Kuo-Hwa; Weng, Shih-Feng; Ho, Chung-Han; Tseng, Kuei-Ling; Cheng, Kuo-Chen

    2016-01-01

    The aims of this study were to investigate the outcomes of patients requiring prolonged mechanical ventilation (PMV) and to identify risk factors associated with its mortality rate. All patients admitted to the respiratory care centre (RCC) who required PMV (the use of MV ≥21 days) between January 2006 and December 2014 were enrolled. A total of 1,821 patients were identified; their mean age was 69.8 ± 14.2 years, and 521 patients (28.6%) were aged >80 years. Upon RCC admission, the APACHE II scores were 16.5 ± 6.3, and 1,311 (72.0%) patients had at least one comorbidity. Pulmonary infection was the most common diagnosis (n = 770, 42.3%). A total of 320 patients died during hospitalization, and the in-hospital mortality rate was 17.6%. A multivariate stepwise logistic regression analysis indicated that patients were more likely to die if they who were >80 years of age, had lower albumin levels (<2 g/dl) and higher APACHE II scores (≥15), required haemodialysis, or had a comorbidity. In conclusion, the in-hospital mortality for patients requiring PMV in our study was 17%, and mortality was associated with disease severity, hypoalbuminaemia, haemodialysis, and an older age. PMID:27296248

  13. Futebol mulato: racial constructs in Brazilian football

    Directory of Open Access Journals (Sweden)

    Tiago Fernandes Maranhao

    2011-05-01

    Full Text Available The aim of this paper is to review Gilberto Freyre’s ideas about futebol mulato and the way these ideas have spread the notion of the Brazilian mulatto as a symbol of a ‘racial democracy’, unique in Brazil, around the world. The notion first appeared in 1938 in an article by Freyre for the Diários Associados, an important Brazilian newspaper. Football (soccer was employed by Freyre as the special arena where the multiracial Brazilian nation could shine and show the world a different way of being, opposed to the white and ‘rational’ way of European football. In Freyre’s work, the so-called ‘football-art’ was compared to poetry, while the European style was equated with prose. This essay argues that Freyre’s ideas were useful in constructing the Brazilian identity, a nation of harmony in all its aspects, including the area of race, and how the idea of the mulatto has been used to minimise social disparities within Brazilian society. Freyre’s ideas remain contemporary; many Brazilian intellectuals still refer to these concepts. As well, the press in this huge country, and especially in World Cup years, uses the concepts of mulatto and football-art to characterize Brazil and differentiate it from other countries.

  14. 3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Luiz Gonzaga Coelho

    2013-04-01

    Full Text Available Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

  15. NMO-DBr: the Brazilian Neuromyelitis Optica Database System

    Directory of Open Access Journals (Sweden)

    Marco A. Lana-Peixoto

    2011-08-01

    Full Text Available OBJECTIVE: To present the Brazilian Neuromyelitis Optica Database System (NMO-DBr, a database system which collects, stores, retrieves, and analyzes information from patients with NMO and NMO-related disorders. METHOD: NMO-DBr uses Flux, a LIMS (Laboratory Information Management Systems for data management. We used information from medical records of patients with NMO spectrum disorders, and NMO variants, the latter defined by the presence of neurological symptoms associated with typical lesions on brain magnetic resonance imaging (MRI or aquaporin-4 antibody seropositivity. RESULTS: NMO-DBr contains data related to patient's identification, symptoms, associated conditions, index events, recurrences, family history, visual and spinal cord evaluation, disability, cerebrospinal fluid and blood tests, MRI, optic coherence tomography, diagnosis and treatment. It guarantees confidentiality, performs cross-checking and statistical analysis. CONCLUSION: NMO-DBr is a tool which guides professionals to take the history, record and analyze information making medical practice more consistent and improving research in the area.

  16. Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus.

    Science.gov (United States)

    Rosário, Pedro Weslley; Ward, Laura S; Carvalho, Gisah A; Graf, Hans; Maciel, Rui M B; Maciel, Léa Maria Z; Maia, Ana Luiza; Vaisman, Mário

    2013-06-01

    Thyroid nodules are frequent findings, especially when sensitive imaging methods are used. Although thyroid cancer is relatively rare, its incidence is increasing, particularly in terms of small tumors, which have an uncertain clinical relevance. Most patients with differentiated thyroid cancer exhibit satisfactory clinical outcomes when treatment is appropriate, and their mortality rate is similar to that of the overall population. However, relapse occurs in a considerable fraction of these patients, and some patients stop responding to conventional treatment and eventually die from their disease. Therefore, the challenge is how to identify the individuals who require more aggressive disease management while sparing the majority of patients from unnecessary treatments and procedures. We have updated the Brazilian Consensus that was published in 2007, emphasizing the diagnostic and therapeutic advances that the participants, representing several Brazilian university centers, consider most relevant in clinical practice. The formulation of the present guidelines was based on the participants' experience and a review of the relevant literature.

  17. Insights from Brazilian medical journals

    Directory of Open Access Journals (Sweden)

    Bruno Caramelli

    2009-01-01

    Full Text Available This brand-new series of articles aims at delivering to national and international readers some of the cutting-edge contributions from the Brazilian medical literature. Recently papers published in the main Brazilian medical journals are carefully selected and analyzed by skilled medical editors. In addition we asked editors to choose keywords to be highlighted in order to claim for reader's attention. Articles are organized by area of interest to facilitate reading. To get the most of the limited available editorial space we did not include the names of the authors of the related articles in the text itself but a complete reference guide is provided at the end of the article. The result carries the most important messages from the original paper accompanied by a personal interpretation. Directed to the busy medical doctor we hope that this initiative may help in the successful translation of knowledge from scientific evidence to clinical practice.Esta nova série de artigos tem por objetivo levar aos leitores nacionais e internacionais algumas das mais importantes contribuições provenientes da literatura médica brasileira recente. Os artigos originais mais relevantes são selecionados por experientes editores a quem solicitamos que escolham palavras- chaves para que sejam destacadas para chamar a atenção do leitor. Para facilitar a leitura, os artigos são organizados por área de interesse. Para aproveitar ao máximo o limitado espaço editorial não são incluídos os nomes dos autores dos artigos. Entretanto, a referência completa é oferecida ao final do artigo. O resultado final traz o que há de melhor do artigo, seguido de uma sintética interpretação pessoal. Endereçado ao médico ocupado, esperamos que esta inciativa possa contribuir para o sucesso da translação do conhecimento da evidência científica para a prática clínica.

  18. Serum amylase activity and renal amylase activity clearance in patients with severely impaired renal function and in patients treated with renal allotransplantation.

    Science.gov (United States)

    Pedersen, E B; Brock, A; Kornerup, H J

    1976-03-01

    Serum amylase activity was measured in 29 nondialysed patients with severe renal failure, in 24 uraemic patients treated with chronic haemodialysis, and in 29 patients treated with renal allotransplantation. Simultaneous measurement of renal amylase activity clearance (CAm) and creatinine clearance (CCr) was performed in 25 patients with severe renal failure and in 19 transplanted patients. Serum amylase activity was elevated in all three groups. CAm was significantly correlated to CCr both in the group with severe renal failure and in the transplanted group. Unlike in the group of transplanted patients, the ratio CAm/CCr was significantly increased in patients with severe impaired renal function. It is concluded that the elevation of serum amylase activity in patients with impaired renal function is primarily due to decreased glomerular filtration rate. The value of CAm/CCr for diagnosing acute pancreatitis is doubtful in patients with severe renal disease.

  19. Estudo brasileiro de validação para localização e lista de qualidade formal do Rorschach-SC: não-pacientes psiquiátricos Estudio brasileño de validación para localización y lista de calidad formal del Rorschach-SC: no-pacientes psiquiátricos Brazilian validation study to locate and list of formal quality of the Rorschach-CS: non-psychiatric patients

    Directory of Open Access Journals (Sweden)

    Juliana de Cassia Leonel

    2012-04-01

    resultados indicaron validez para el atlas brasileño.This study aimed at validating the Atlas Rorschach-CS Location Areas and Formal Quality List from a Brazilian sample. 46 adults, non-patients psychiatric cases, both genders and different educational levels and social status were selected. The instruments used were the SRQ-20 and the Rorschach method. The Rorschach responses were scoredaccording to the areas and the North-American and Brazilian Lists of formal quality . The comparative analyzes performed by ANOVA did not established differences between the two groups regarding the Location Areas W, D, Dd in both North-American and Brazilian areas, proving the validity of the Brazilian areas. Differences were not found as regarding the Formal Quality FQo and X+% both using the North-American and Brazilian lists, proving the validity of the Brazilian list for these two variables.. The results indicate validity to the Brazilian Atlas.

  20. Educating Brazilian workers about AIDS.

    Science.gov (United States)

    1991-12-01

    This article contains a the script for a slide-tape presentation entitled Working Against AIDS, a presentation developed by the Brazil Family Planning Association (BEMFAM) which is designed to debunk common misconceptions about the disease. This audio-visual, which targets Brazilian workers, can be used during talks, seminars, and meetings. A discussion of the issues involved usually follows the presentation of Working Against AIDS. The presentation contains 30 illustrated slides (these are included in the article). The presentation begins by explaining that much of the information concerning AIDS is prejudicial and misleading. The next few slides point out some of the common misconceptions about AIDS, such as claims denying the existence of the disease, or suggestions that only homosexuals and prostitutes are at risk. The presentation then goes on to explain the ways in which the virus can and cannot be transmitted. Then it discusses how the virus destroys the body's natural defenses and explains the ensuing symptoms. Slides 14 and 15 point out that no cure yet exists for AIDS, making prevention essential. Slides 16-23 explain what actions are considered to be high risk and which ones do not entail risk. Noting that AIDS can be prevented, slide 24 says that the disease should not present an obstacle to spontaneous manifestations of human relations. The next slide explains that condoms should always be used when having sex with someone who could be infected with AIDS. Finally slides 26-30 demonstrate the proper way to use and dispose of a condom.

  1. Permeability measuremens of brazilian Eucalyptus

    Directory of Open Access Journals (Sweden)

    Marcio Rogério da Silva

    2010-09-01

    Full Text Available The permeability of Brazilian Eucalyptus grandis and Eucalyptus citriodora wood was measured in a custom build gas analysis chamber in order to determine which species could be successfully treated with preservatives. Liquid permeability was tested using an emulsion of Neen oil and a control of distillated water. Air was used to test the gas phase permeability. For both Eucalyptus grandis and Eucalyptus citriodora, the longitudinal permeability of gas was shown to be about twice as great as the liquid phase permeability. No radial permeability was observed for either wood. The permeability of air and water through the sapwood of Eucalyptus grandis was greater than that through the sapwood of Eucalyptus citriodora. The permeability of neen oil preservative through the sapwood of Eucalyptus grandis was also greater than through the sapwood of E. Citradora, but the difference was not statistically significant. Scanning Electron Microscopy images showed that the distribution and obstruction in the vessels could be correlated with observed permeability properties. Irrespective of the causes of differences in permeability between the species, the fluid phase flux through the sapwood of both species was significant, indicating that both Eucalyptus grandis and Eucalyptus citriodora could be successfully treated with wood preservative.

  2. Brazilian Portuguese Validated Version of the Cardiac Anxiety Questionnaire

    International Nuclear Information System (INIS)

    Cardiac Anxiety (CA) is the fear of cardiac sensations, characterized by recurrent anxiety symptoms, in patients with or without cardiovascular disease. The Cardiac Anxiety Questionnaire (CAQ) is a tool to assess CA, already adapted but not validated to Portuguese. This paper presents the three phases of the validation studies of the Brazilian CAQ. To extract the factor structure and assess the reliability of the CAQ (phase 1), 98 patients with coronary artery disease were recruited. The aim of phase 2 was to explore the convergent and divergent validity. Fifty-six patients completed the CAQ, along with the Body Sensations Questionnaire (BSQ) and the Social Phobia Inventory (SPIN). To determine the discriminative validity (phase 3), we compared the CAQ scores of two subgroups formed with patients from phase 1 (n = 98), according to the diagnoses of panic disorder and agoraphobia, obtained with the MINI - Mini International Neuropsychiatric Interview. A 2-factor solution was the most interpretable (46.4% of the variance). Subscales were named 'Fear and Hypervigilance' (n = 9; alpha = 0.88), and 'Avoidance', (n = 5; alpha = 0.82). Significant correlation was found between factor 1 and the BSQ total score (p < 0.01), but not with factor 2. SPIN factors showed significant correlations with CAQ subscales (p < 0.01). In phase 3, 'Cardiac with panic' patients scored significantly higher in CAQ factor 1 (t = -3.42; p < 0.01, CI = -1.02 to -0.27), and higher, but not significantly different, in factor 2 (t = -1.98; p = 0.51, CI = -0.87 to 0.00). These results provide a definite Brazilian validated version of the CAQ, adequate to clinical and research settings

  3. Brazilian Portuguese Validated Version of the Cardiac Anxiety Questionnaire

    Energy Technology Data Exchange (ETDEWEB)

    Sardinha, Aline, E-mail: alinesardinhapsi@gmail.com; Nardi, Antonio Egidio [Laboratório de Pânico e Respiração do Programa de Pós-Graduação em Psiquiatria e Saúde Mental do Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro (Brazil); Instituto Nacional de Ciência e Tecnologia - Translational Medicine (INCT-TM, CNPq), Rio de Janeiro (Brazil); Araújo, Claudio Gil Soares de [Programa de Pós-Graduação em Ciências do Exercício e do Esporte da Universidade Gama Filho, Rio de Janeiro (Brazil); CLINIMEX - Clínica de Medicina do Exercício, Rio de Janeiro (Brazil); Ferreira, Maria Cristina [Programa de Pós-Graduação em Psicologia da Universidade Salgado de Oliveira, Rio de Janeiro (Brazil); Eifert, Georg H. [Schmid College of Science and Technology Psychology, Crean School of Health and Life Sciences -Chapman University (United States)

    2013-12-15

    Cardiac Anxiety (CA) is the fear of cardiac sensations, characterized by recurrent anxiety symptoms, in patients with or without cardiovascular disease. The Cardiac Anxiety Questionnaire (CAQ) is a tool to assess CA, already adapted but not validated to Portuguese. This paper presents the three phases of the validation studies of the Brazilian CAQ. To extract the factor structure and assess the reliability of the CAQ (phase 1), 98 patients with coronary artery disease were recruited. The aim of phase 2 was to explore the convergent and divergent validity. Fifty-six patients completed the CAQ, along with the Body Sensations Questionnaire (BSQ) and the Social Phobia Inventory (SPIN). To determine the discriminative validity (phase 3), we compared the CAQ scores of two subgroups formed with patients from phase 1 (n = 98), according to the diagnoses of panic disorder and agoraphobia, obtained with the MINI - Mini International Neuropsychiatric Interview. A 2-factor solution was the most interpretable (46.4% of the variance). Subscales were named 'Fear and Hypervigilance' (n = 9; alpha = 0.88), and 'Avoidance', (n = 5; alpha = 0.82). Significant correlation was found between factor 1 and the BSQ total score (p < 0.01), but not with factor 2. SPIN factors showed significant correlations with CAQ subscales (p < 0.01). In phase 3, 'Cardiac with panic' patients scored significantly higher in CAQ factor 1 (t = -3.42; p < 0.01, CI = -1.02 to -0.27), and higher, but not significantly different, in factor 2 (t = -1.98; p = 0.51, CI = -0.87 to 0.00). These results provide a definite Brazilian validated version of the CAQ, adequate to clinical and research settings.

  4. Citizenship and decoloniality in Brazilian education

    Directory of Open Access Journals (Sweden)

    Viviane Conceição Antunes

    2014-08-01

    Full Text Available Reflecting on the importance of multiculturalism in teaching process and observing the otherness are primarily a challenge. This enables us to rethink what we have within ourselves, also to reconstitute memories involving discriminatory and unethical attitudes, which takes place in social fellowship. Based on the studies of Walsh (2007, 2009, Gomes (2007 and Tavares (2011, this work relies on decoloniality studies, mainly on the relevance of the history of Africa and Africanness in Brazilian education. Our corpus of analysis is found in the "Diretrizes Curriculares Nacionais para a Educação Básica" (DCN, 2013, the Brazilian Legislative Syllabus for Basic Education. Our focus is on the chapters concerning the Native-Brazilian and Quilomboa Education and ethnic-racial relations. Our most important aims are: to show the intercultural theoretical framework in which they are based on; to understand the immediate link established between the Native-Brazilian education and intercultural perspective; to clarify how the African diaspora was carried out in this particular case. Based on some Excel resources we were able to: 1 stablish the predominance of functional framework of interculturalism throughout these chapters, along with some critical features of interculturalism, as the issue of curricular decoloniality; 2 observe the established relationship between bilingualism and multiculturalism in the guidelines of Native-Brazilian education; and 3 identify a search for an effective inclusion of Africanness in curricula supported by the historical recognition and visibility of their sociocultural contribution.

  5. Brazilian Review of Finance 2013 Editorial Report

    Directory of Open Access Journals (Sweden)

    Ricardo Pereira Câmara Leal

    2014-06-01

    Full Text Available RBFin is the main Brazilian publication outlet of academic papers about finance. The contents of the Review are open and online with a printed version distributed to members of the Brazilian Finance Society. Using the Open Journals System to manage the editorial process, publication of RBFin adheres to a strict publication schedule. The Review is indexed by EconLit, RedALyC, Google Scholar, Gale, Proquest and Ebsco and is listed in the JEL, DOAJ, Latindex, OpenJGate, and Cabell's directories. RBFin is rated B1 in the business area of the Brazilian classification system and B2 in Economics. The editorial board undergoes partial turnover every year and comprises 19 individuals from four countries, the Brazilian members being affiliated with universities in five different Brazilian states. The acceptance rate was 27% for papers submitted in 2012, the most recent year in which all submissions have already received a final decision. The average number of days between receipt and acceptance for articles submitted in 2013 was 203. The worst case was 361 days. The average number of days between receipt and publication was 294. The worst case was 575 days. Fifty-three individuals served as reviewers in 2013.

  6. Implementation of the Brazilian national repository

    Energy Technology Data Exchange (ETDEWEB)

    Tello, Cledola Cassia Oliveira de, E-mail: tellocc@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2013-07-01

    Ionizing radiation in Brazil is used in electricity generation, medicine, industry, agriculture and for research and development purposes. All these activities can generate radioactive waste. At this point, in Brazil, the use of nuclear energy and radioisotopes justifies the construction of a national repository for radioactive wastes of low and intermediate-level. According to Federal Law No. 10308, Brazilian National Commission for Nuclear Energy (CNEN) is responsible for designing and constructing the intermediate and final storages for radioactive wastes. Additionally, a restriction on the construction of Angra 3 is that the repository is under construction until its operation start, attaining some requirements of the Brazilian Environmental Regulator (IBAMA). The RBMN Project (Repository for Low and Intermediate-Level Radioactive Wastes) aims at the implantation of a National Repository for disposal of low and intermediate-level of radiation wastes. This Project has some aspects that are unique in the Brazilian context, especially referring to the time between its construction and the end of its institutional period. This time is about 360 years, when the area will be released for unrestricted uses. It means that the Repository must be safe and secure for more than three hundred years, which is longer than half of the whole of Brazilian history. This aspect is very new for the Brazilian people, bringing a new dimension to public acceptance. Another point is this will be the first repository in South America, bringing a real challenge for the continent. The current status of the Project is summarized. (author)

  7. Effect Of Haemodialysis On Intra Dialytic Calcium, Phosphorus,Magnesium, Levels In Relation To AutonomicNervous System Activity

    OpenAIRE

    Mona Hosny, Sahar Shawky, Ahmed Ramadan , Hany Refaat

    2004-01-01

    Autonomic nervous system dysfunction is common in uremia and in patients under hemodialysis. Changes in serum calcium, serum phosphorus and serum magnesuim always occur during hemodialysis. The relation between these changes and autonomic nervous system activity during hemodialysis has not been fully studied. This study was carried out on 30 patients with chronic renal failure on regular hemo-dialysis with nearly similar age group. We measured serum calcium, serum phosphorus and serum magnesi...

  8. The Effectiveness of Cognitive-Existential Group Therapy on Increasing Hope and Decreasing Depression in Women-Treated with Haemodialysis

    OpenAIRE

    Bahmani, Bahman; Najjar, Maryam Motamed; Sayyah, Mansour; Shafi-Abadi, Abdollah; Kashani, Hamed Haddad

    2015-01-01

    Introduction: Hopefulness is one of the most significant predictors of adaptation in hemodialysis patients, and plays a vital role in the recovery process. In contrast to hopefulness, depression is a frequent psychological reaction of the hemodialysis treatment with many negative consequences. The current research was designed to examine the effect of cognitive-existential treatment on the level of hopefulness and depression in hemodialysis patients. Materials & Methods: This quasi-experiment...

  9. The Corporate Governance of Privately Controlled Brazilian Firms

    OpenAIRE

    Érica C. R. Gorga; Antonio Gledson de Carvalho; Bernard S. Black

    2009-01-01

    We provide an overview of the corporate governance practices of Brazilian public companies, based primarily on an extensive 2005 survey of 116 companies. We focus on the 88 responding Brazilian private firms which are not majority owned by the state or a foreign company. We identify areas where Brazilian corporate governance is relatively strong and weak. Board independence is an area of weakness: The boards of most Brazilian private firms are comprised entirely or almost entirely of insiders...

  10. Multicystic transformation of the kidneys in dialysis patients

    DEFF Research Database (Denmark)

    Frifelt, J J; Larsen, C; Elle, Birgitte;

    1989-01-01

    In a dialysis population patients who had been treated merely with haemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) were examined with ultrasound. The occurrence of multicystic transformation of the kidney was 4/15 in HD patients and 8/25 in CAPD patients with no significant...... difference between the two groups. There was a significant association between the occurrence of multicystic transformation and the patient age while there was no significant association to the duration of dialysis or the duration of the uraemic state. No tumour or any other complication to cystic...... transformation was found. In 582 persons without renal disease examined as controls we found 44 with cystic change. This material does not support the recommendation of regular ultrasound examination of our dialysis patients. However, until these results can be confirmed by prospective studies we must recommend...

  11. Trends in water balance components across the Brazilian Cerrado

    Science.gov (United States)

    The Brazilian Cerrado (Savanna) is considered one of the most important biomes for Brazilian water resources; however, little is known about the components of the water balance in this biome. In this study, we reviewed the available literature on the water balance components in the Brazilian Cerrado...

  12. Directions and deviations in the Brazilian nuclear policy

    International Nuclear Information System (INIS)

    The emergence of the Brazilian nuclear policy as a subject of interest to the Brazilian society, the conflicts characterizing its formulation and implementation between 1945 and 1958 and the political criteria for executing a Brazilian nuclear program are presented. (M.C.K.)

  13. Evaluation of dental material series from patients with dental prostheses and suspicion of delayed hypersensitivity*

    OpenAIRE

    Yoshimura, Fernanda Cortinhas; Cunha, Victor do Espirito Santo; Hahnstadt, Ruppert Ludwig; Pires, Mário Cezar

    2016-01-01

    BACKGROUND Patients with oral sensitivity are common in our practice. Allergic contact dermatitis is one of the most frequent etiologies. OBJECTIVES Evaluate oral contact dermatitis using the Brazilian standard series and complementary dental series in patients using dental prostheses, with or without oral complaints. Determine specific dental Brazilian series. METHODS Patients using dental prostheses with or without oral complaints realized patch tests. Brazilian standard series and compleme...

  14. Brazilian Congress, 2014 elections and governability challenges

    Directory of Open Access Journals (Sweden)

    Fabiano Santos

    2015-04-01

    Full Text Available This research note examines the results of the 2014 elections focusing on the National Congress. Its main objective is to ponder over common claims and predictions regarding the future of Brazilian politics. Beyond agreements and alliances involved in the electoral dispute, President Dilma Rousseff once again shall face the political challenges and dilemmas of Brazilian presidentialism, namely, how to create and manage government coalitions capable of implementing a coherent political program with a fragmented and heterogeneous Congress. The critical examination of the current hypotheses on the latest elections, especially concerning parliamentary fragmentation and a shift towards the right-wing, will serve as a compass attempting to formulate possible answers to such a fundamental problem in Brazilian politics.

  15. Cross-cultural adaptation and validation of the episodic autobiographic memory interview for Brazilian Portuguese

    Directory of Open Access Journals (Sweden)

    Guilherme R. Rodrigues

    2015-08-01

    Full Text Available Episodic memory enables the storage of personal events with specific temporal and spatial details, and their retrieval through a sensory experience, usually visual, which is called autonoetic consciousness. While, in Brazil, several scales for the evaluation of anterograde episodic memory have been validated, there is not yet an instrument to assess the episodic autobiographical memory. The aim of this study is thus to make a cross-cultural adaptation and validation of the Episodic Autobiographic Memory Interview (EAMI for Brazilian Portuguese. Altogether, 11 patients with Alzheimer’s disease (AD and 10 healthy controls (CTs were evaluated. EAMI scores for AD patients were lower than those of CTs, and these scores also correlated positively with the Remember-Know coefficient. The intraclass correlation coefficient indicated a good inter-rater reliability. The Portuguese version of EAMI showed a good reliability and validity, which suggests that it is a useful tool for evaluation of autobiographical memory in Brazilian patients.

  16. Trends on Brazilian book market – fiction best sellers by Brazilian writers (2000-2009

    Directory of Open Access Journals (Sweden)

    Sandra Reimão

    2011-12-01

    Full Text Available The first part of this paper describes Brazilian general book market quantitative data on the period from 2000 to 2009; the second part analyzes the list of best sellers in Brazil on that period, focusing on the presence of Brazilian fiction writers on it. Our analysis points to the conclusion that there is an undeniable quantitative increase on such market but it is not accompanied by innovation. Most titles are world wide best sellers from Anglo-Saxon culture that receive massive publishing campaign and issuing, and represent very little risk to the publishing industry. As for Brazilian writers, they were already well known, especially from TV.

  17. Brazilian methodology adopted about lightning rods

    Energy Technology Data Exchange (ETDEWEB)

    Esposito, Felipe [Comissao Nacional de Enegia Nuclear, Rio de Janeiro, RJ (Brazil). Div. de Rejeitos Radioativos]. E-mail: felipe@cnen.gov.br

    2005-07-01

    This paper describes the Brazilian experience concerning the suspension of the authorization for the production and installation of lightning rods containing radioactive material in the country and the main measures put into practice in order to safely remove and transport to temporary storage facilities all the existing devices Brazil that would be put out of use after the suspension. It is also presented the procedure established by the National Regulatory Body namely the Brazilian National Commission of Nuclear Energy- CNEN to be accomplished by the owners of this kind of devices. (author)

  18. Climate change in the Brazilian northeast

    Science.gov (United States)

    Rodrigues, Regina R.; Haarsma, Reindert J.; Hoelzemann, Judith J.

    2012-10-01

    Climate Change, Impacts and Vulnerabilities in Brazil: Preparing the Brazilian Northeast for the Future; Natal, Brazil, 27 May to 01 June 2012 The variability of the semiarid climate of the Brazilian northeast has enormous environmental and social implications. Because most of the population in this area depends on subsistence agriculture, periods of severe drought in the past have caused extreme poverty and subsequent migration to urban centers. From the ecological point of view, frequent and prolonged droughts can lead to the desertification of large areas. Understanding the causes of rainfall variability, in particular periods of severe drought, is crucial for accurate forecasting, mitigation, and adaptation in this important region of Brazil.

  19. THE INDIGENOUS GROUPS AND THE BRAZILIAN SWEETS

    Directory of Open Access Journals (Sweden)

    Mártin César Tempass

    2008-12-01

    Full Text Available In the books of Gilberto Freyre and Câmara Cascudo, that influencied so much the literature about brazilian alimentation, the participation of indigenous groups in the national sweets formation process is negligencied. However, is possible to find in book´s “interlineations” of these two authors valuables informations about indigenous contributions to this process. Starting from these two authors and based in the culinary system notion, this paper quests to situate the role of indigenous groups in the brazilian sweets formation and numbers the possibles causes to invisibility of sweets by indigenous at the culinary formation process.

  20. Brazilians sentenced to sewage-related diseases

    Directory of Open Access Journals (Sweden)

    Édison Carlos

    2016-06-01

    Full Text Available There is no furthest behind infrastructure in Brazil than the lack of sewage disposal, particularly the shortage of services for treating water, and for collecting and treating waste. The scarcity of these essential services to human dignity has been plaguing millions of Brazilians, as indicated by the data of the National Sanitation Information System 2014. We have 35 million Brazilians without access to services for treating water, where half the population has no sewage collection and only 40% of the waste collected in this country is treated. The shortage of sewage disposal affects all of us.