RESUMO
Acute kidney injury (AKI) is common in critically ill patients. Diuretics are used without any evidence demonstrating a beneficial effect on renal function. The objective of the present study is to determine the incidence of AKI in an intensive care unit (ICU) and if there is an association between the use of furosemide and the development of AKI. The study involved a hospital cohort in which 344 patients were consecutively enrolled from January 2010 to January 2011. A total of 132 patients (75 females and 57 males, average age 64 years) remained for analysis. Most exclusions were related to ICU discharge in the first 24 h. Laboratory, sociodemographic and clinical data were collected until the development of AKI, medical discharge or patient death. The incidence of AKI was 55% (95%CI = 46-64). The predictors of AKI found by univariate analysis were septic shock: OR = 3.12, 95%CI = 1.36-7.14; use of furosemide: OR = 3.27, 95%CI = 1.57-6.80, and age: OR = 1.02 (95%CI = 1.00-1.04). Analysis of the subgroup of patients with septic shock showed that the odds ratio of furosemide was 5.5 (95%CI = 1.16-26.02) for development of AKI. Age, use of furosemide, and septic shock were predictors of AKI in critically ill patients. Use of furosemide in the subgroup of patients with sepsis/septic shock increased (68.4%) the chance of development of AKI when compared to the sample as a whole (43.9%).
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Injúria Renal Aguda/induzido quimicamente , Diuréticos/efeitos adversos , Furosemida/efeitos adversos , Choque Séptico/complicações , Injúria Renal Aguda/complicações , Estado Terminal , Unidades de Terapia Intensiva , Tempo de Internação , Prognóstico , Fatores de RiscoRESUMO
Acute kidney injury (AKI) is common in critically ill patients. Diuretics are used without any evidence demonstrating a beneficial effect on renal function. The objective of the present study is to determine the incidence of AKI in an intensive care unit (ICU) and if there is an association between the use of furosemide and the development of AKI. The study involved a hospital cohort in which 344 patients were consecutively enrolled from January 2010 to January 2011. A total of 132 patients (75 females and 57 males, average age 64 years) remained for analysis. Most exclusions were related to ICU discharge in the first 24 h. Laboratory, sociodemographic and clinical data were collected until the development of AKI, medical discharge or patient death. The incidence of AKI was 55% (95%CI = 46-64). The predictors of AKI found by univariate analysis were septic shock: OR = 3.12, 95%CI = 1.36-7.14; use of furosemide: OR = 3.27, 95%CI = 1.57-6.80, and age: OR = 1.02 (95%CI = 1.00-1.04). Analysis of the subgroup of patients with septic shock showed that the odds ratio of furosemide was 5.5 (95%CI = 1.16-26.02) for development of AKI. Age, use of furosemide, and septic shock were predictors of AKI in critically ill patients. Use of furosemide in the subgroup of patients with sepsis/septic shock increased (68.4%) the chance of development of AKI when compared to the sample as a whole (43.9%).
Assuntos
Injúria Renal Aguda/induzido quimicamente , Diuréticos/efeitos adversos , Furosemida/efeitos adversos , Choque Séptico/complicações , Injúria Renal Aguda/complicações , Idoso , Estado Terminal , Feminino , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de RiscoRESUMO
The success of peripheral nervous system regeneration has been associated with changes on the microenvironment, particularly on the extracellular matrix (ECM) components. In the present study we analyzed by indirect immunohistochemistry, electron microscopy and Western blotting, the distribution of ECM components, metalloproteinases (MMPs) and their tissue inhibitors (TIMPs), during Wallerian degeneration (WD) and nerve regeneration (2nd, 7th and 21st days after injury) on crushed rat sural nerves. Our results showed that laminin alpha3-chain and alpha2-chain are over expressed during the early stages of degeneration and regeneration respectively, whereas type IV collagen expression increased progressively after crush. On the other hand, the expression of chondroitin sulfate was down regulated during the early stages of degeneration, returning progressively to normal values during nerve regeneration. The expression of MMP-3 was almost normal immediately after lesion, and then reduced progressively achieving the smallest expression at 21 days after crush; on the contrary, the expression of MMP-7 increased significantly immediately after crush (2nd day) returning to normal values afterwards. TIMP-1 and TIMP-2 were over expressed at the beginning of WD, returning progressively to normal values after that. These results indicate that the modifications of ECM components, which are favorable for nerve regeneration, are correlated with changes on the balance between MMPs and TIMPs.
Assuntos
Matriz Extracelular/metabolismo , Metaloproteases/metabolismo , Degeneração Neural/metabolismo , Regeneração Nervosa/fisiologia , Nervo Sural/metabolismo , Animais , Colágeno Tipo IV/metabolismo , Laminas/metabolismo , Metaloproteinase 3 da Matriz/metabolismo , Metaloproteinase 7 da Matriz/metabolismo , Compressão Nervosa , Ratos , Ratos Wistar , Nervo Sural/lesões , Nervo Sural/ultraestrutura , Fatores de Tempo , Inibidor Tecidual de Metaloproteinase-1/metabolismo , Inibidor Tecidual de Metaloproteinase-2/metabolismo , Cicatrização/fisiologiaRESUMO
Fifty-three rotavirus-positive fecal specimens from children with diarrhea admitted to a Rio de Janeiro, Brazil, children's hospital between January 1997 and December 1998 were characterized for P and G types by using reverse transcription-PCR. Genotype P[4]G2 accounted for 21% of isolates, while uncommon genotypes P[8]G9, P[6]G9, and P[4]G9 accounted for 13% of the isolates.
Assuntos
Antígenos Virais , Proteínas do Capsídeo , Gastroenterite/virologia , Infecções por Rotavirus/virologia , Rotavirus/classificação , Rotavirus/genética , Brasil , Capsídeo/genética , Pré-Escolar , Fezes/virologia , Genes Virais , Genótipo , Hospitalização , Humanos , Lactente , Dados de Sequência Molecular , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Análise de Sequência de DNARESUMO
The levels of polychlorinated dibenzo-p-dioxins (PCDDs) and -furans (PCDFs), polychlorinated biphenyls (PCBs), and other organochlorine compounds were determined in a pooled sample of breast milk from 40 mothers (first lactation: 33; second lactation: 7, age: 15-38 years) living in the urban area of Rio de Janeiro County, Brazil, in 1992. Mothers were breastfeeding only one infant and milk was collected between 4 and 6 weeks after delivery. The results showed a dioxin equivalent concentration of 8.1 pg I-TEq/g milk fat. The levels of other chlorinated compounds (micrograms per gram of milk fat) were as follows: PCBs (total), 0.15; alpha-HCH, 0.001; beta-HCH, 0.27;gamma-HCH, 0.005; HCB, 0.012; DDT (total), 1.7; dieldrin, 0.023, and cis-heptachlor epoxide, 0.008. These results suggest that human background contamination by PCDD/Fs, PCBs, and HCB in Rio de Janeiro is lower than that generally found in industrialized countries.
Assuntos
Benzofuranos/análise , Poluentes Ambientais/análise , Leite Humano/química , Bifenilos Policlorados/análise , Dibenzodioxinas Policloradas/análogos & derivados , Adolescente , Adulto , Brasil , Exposição Ambiental , Feminino , Humanos , Dibenzodioxinas Policloradas/análiseRESUMO
Since the World Health Organization suggested predictive equations for basal metabolic rate (BMR) in 1985 there has been great interest in their validity in different populations worldwide. It has been shown that these equations overestimate BMR in some populations, particularly the ones living in the tropics. There is limited new information on BMR in segments of the Brazilian population. Therefore, the aim of the present study was to compare measured with estimated BMR using some published predictive equations in 50 college students from Rio de Janeiro, Brasil. BMR was measured by indirect calorimetry and the predictive equations used were the ones published by: FAO/WHO/UNU (1985); Harris & Benedict (1919), and Henry & Rees (1991). Estimated BMRs were significantly greater than measured BMR (p < 0.05). Overestimation was greatest with the equation published by Harris & Benedict (18.9%) followed by the ones by FAO/WHO/UNU (12.5%) and Henry & Rees (7.2%). Body composition did not correlate with the overestimation of BMR. More data are necessary so that appropriate predictive equations can be developed for the Brazilian population.
Assuntos
Metabolismo Basal/fisiologia , Adulto , Estatura , Índice de Massa Corporal , Brasil , Feminino , Humanos , Valores de ReferênciaRESUMO
A total of 1397 sera collected from 1095 cases of exanthematic disease notified as measles in ES and RJ states during July 1992 to December 1994 were investigated. These sera were first tested for measles and rubella specific IgM. When they proved negative, they were tested for B19 specific IgM by an enzyme immunoassay. B19 infection was confirmed in 27 (2.5%) of these cases. Sera from 194 negative cases for measles and rubella IgM received from other Brazilian states were also investigated and B19 infection was confirmed for 11 of them. Sera from these 38 IgM positive cases for B19, were tested for anti-B19 IgG by an enzyme immunoassay and for B19 DNA by dot blot hybridization. Anti-B19 IgG antibodies were detected in most of the acute sera. B19 DNA was detected in the acute serum of one patient that had been splenectomized before. As the exanthem caused by human parvovirus infection may be clinically diagnosed as rubella, it could be important to diagnose B19 infection in Brazil since it is becoming prevalent as the cause of rash in countries where rubella is controlled by vaccination.
Assuntos
Anticorpos Antivirais/sangue , Imunoglobulina M/sangue , Sarampo/imunologia , Parvovirus B19 Humano/imunologia , Biomarcadores , Humanos , Sarampo/sangueRESUMO
The latex of 'Crown-of-Thorns' (Euphorbia milii var. hislopii, syn. E. splendens) has been shown to be a potent plant molluscicide that could be used against the snails which are intermediate hosts of Schistosoma trematodes. However, a comprehensive toxicological evaluation of the latex is necessary before its large-scale use in schistosomiasis control becomes possible. In fact, one cause for concern is the presence of tumor-promoting phorbol esters in several plants of the Euphorbiaceae family. Phorbol esters as well as a number of other known tumor promoters share the common property of inhibiting metabolic cooperation (i.e., exchange of low molecular weight molecules via gap junctions) between Chinese hamster V79 cells in monolayer cultures. The present study was undertaken to determine if latex of E. milii presents tumor promoter-like activity is this short-term in vitro assay. Samples of lyophilized E. milii latex were tested at a noncytotoxic concentration range (1, 10, 50 and 100 micrograms/ml) in three independent experiments. 12-O-Tetradecanoylphorbol-13-acetate (10 ng/ml) was used as positive control. In all three assays, E. milii latex consistently inhibited metabolic cooperation between V79 cells at concentrations > or = 10 micrograms/ml. These results that E. milii latex contains tumor-promoting substances. These findings suggest that the use of crude latex as a molluscicide may pose a carcinogenic hazard to people who are continuously exposed to the product.
Assuntos
Carcinógenos/metabolismo , Látex/farmacologia , Moluscocidas/metabolismo , Animais , Plantas , Ensaio Tumoral de Célula-TroncoRESUMO
The latex of 'Crown-of-Thoms'(Euphorbia miliivar. hislopii, syn. E. splendens) has been shown to be a potent plant molluscicide that could be used against the snails which are intermediate hosts of Schistosoma trematodes. However, a comprehensive toxicological evaluation of the latex is necessary before its large-scale use in schistosomiasis control becomes possible. In fact, one cause for concern is the presence of tumor-promoting phorbol esters in several plants of the Euphorbiaceae family. Phorbol esters as well as a number of other known tumor promoters share the common property of inhibiting metabolic cooperation (i.e., exchange of low molecular weight molecules via gap junctions) between Chinese hamster V79 cells in monolayer cultures. The present study was undertaken to determine if latex of E. milii presents tumor promoter-like activity in this shortterm in vitro assay. Samples of lyophilized E. milii latex were tested at a noncytotoxic concentration range (1, 10, 50 and 100 mug/ml) in three independent experiments. 12-0-Tetradecanoylphorbol-13-acetate (10 ng/ml) was used as positive control. In all three assays, E. milii latex consistently inhibited metabolic cooperation between V79 cells at concentrations (10 mug/ml. These results indicate that E. milii latex contains tumor-promoting substances. These findings suggest that the use of crude latex as a molluscicide may pose a carcinogenic hazard to people who are continuously exposed to the product.