2,838 research outputs found

    Clinical characteristics and outcomes in adult cystic fibrosis patients with severe lung disease in Porto Alegre, southern Brazil

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    Background Advanced lung disease in adult cystic fibrosis (CF) drives most clinical care requirements. The aim was to evaluate outcome (time to death while in the study) in a cohort of adult CF patients with severe lung disease, and to determine the association among baseline patient characteristics and outcome. Methods A retrospective cohort study was performed and clinical records between 2000 and 2015 were reviewed. Severe lung disease was defined as forced expiratory volume in the first second (FEV1) < 30% of predicted. Outcomes of all patients, including their date of death or transplantation, were determined till January 1st, 2016. Clinical data were recorded at the entry date. Results Among 39 subjects included in the study, 20 (51.3%) died, 16 (41.0%) underwent bilateral lung transplantation, and 3 were alive at the end of the study period. Two variables were independently associated with death: body mass index (BMI ≥ 18.5 kg/m2) (HR = 0.78, 95% CI = 0.64–0.96 and p = 0.017) and use of tobramycin inhalation therapy (HR = 3.82, 95% CI = 1.38–10.6 and p = 0.010). Median survival was 37 (95% CI = 16.4–57.6) months. The best cut-off point for BMI was 18.5 kg/m2. Median survival in patients with BMI < 18.5 kg/m2 was 36 months (95% CI = 18.7–53.3). Conclusion Median survival of CF subjects with FEV1 < 30% was 37 months. BMI and tobramycin inhalation therapy were independently associated with death. Median survival in patients with BMI < 18.5 kg/m2 was significantly lower than in patients with BMI ≥ 18.5 kg/m2. The association of tobramycin inhalation with death was interpreted as confounding by severity (use was reserved for advanced lung disease)

    Dental Visit in the Healthcare Program for Kids: Strategies and Challenges in the View of Oral Health Teams in Basic Health Units of Porto Alegre, Brazil

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    Objective: To analyze the perceptions and strategies influencing the achievement of dental visit targets in the Healthcare Program for Kids in the view of the oral health team in basic health units in Porto Alegre, Brazil. Material and Methods: Qualitative study of the descriptive-exploratory type with two focus groups at 12 Health Units in Porto Alegre, RS, with participation of 17 members of oral health teams from different units. Results: The collected data suggest the use of strategies to meet the goals of the Oral Health Program, such as an open schedule, education and health groups, days on which families attend the health unit because of the Bolsa Família Program, vaccination campaign days and home visits. The data also suggest, in order to meet the goals, working jointly with the multiprofessional team and formation of ties, allowing for a greater interaction with patients at the Health Unit, in addition to listening to the life stories of the population and the community. A better understanding of the proposal by health teams for the actions to be carried out horizontally and the greater difficulty in having children at the appointments on days when their mothers work turned out to be challenges. Conclusion: The use of these strategies tends to help and influence the maintenance and implementation of public policies oriented to dental care at an early age and reorient health practices so as to contribute to the strengthening of collectivities

    Influence of Heat Treatments on the Impact Toughness of a Ti-stabilized 12%Cr Supermartensitic Stainless Steel

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    The supermartensitic stainless steels (SMSS) are a relatively new class of corrosion resistant alloys developed to obtain a better combination of weldability, strength, toughness and corrosion resistance than conventional martensitic stainless steels. The final properties of SMSS are strongly influenced by quenching and tempering heat treatments. In this work, different routes of heat treatments were tested in a Ti-stabilized 12%Cr supermartensitic stainless steel with the objective to improve mechanical properties, specially the low temperature (-46ºC) toughness. Double and triple quenching were tested and compared to single quenching heat treatments. Two tempering temperatures (500ºC and 650ºC) were tested. The results obtained with instrumented Charpy impact tests showed that a triple quenching treatment was able to increase the density of fine TiC particles and improve the mechanical properties of specimens heat treated by quenching and tempering at 650ºC

    Semen quality in Peruvian pesticide applicators: association between urinary organophosphate metabolites and semen parameters

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    <p>Abstract</p> <p>Background</p> <p>Organophosphates are broad class of chemicals widely used as pesticides throughout the world. We performed a cross-sectional study of associations between dialkylphosphate metabolites of organophosphates and semen quality among pesticide applicators in Majes (Arequipa), Peru.</p> <p>Methods</p> <p>Thirty-one men exposed to organophosphate (OP) pesticides and 31 non-exposed were recruited (age, 20–60 years). In exposed subjects, semen and a blood sample were obtained one day after the last pesticide application. Subjects were grouped according to levels of OP metabolites in urine. Semen samples were analyzed for sperm concentration, percentage of sperm motility, percentage of normal morphology, semen leucocytes and concentrations of fructose and zinc. Exposure to OP was assessed by measuring six urinary OP metabolites (dimethyl and diethyl phosphates and thiophosphates) by gas chromatography using a single flame photometric detector.</p> <p>Results</p> <p>Diethyldithiophosphate (p = 0.04) and diethylthiophosphate (p = 0.02) better reflected occupational pesticide exposure than other OP metabolites. Semen analysis revealed a significant reduction of semen volume and an increase in semen pH in men with OP metabolites. Multiple regression analysis showed that both occupational exposure to pesticides and the time of exposure to pesticides were more closely related to alterations in semen quality parameters than the single measurement of OP metabolites in urine.</p> <p>Conclusion</p> <p>The study demonstrated that occupational exposure to OP pesticides was more closely related to alterations in semen quality than a single measurement of urine OP metabolites. Current measurement of OP metabolites in urine may not reflect the full risk.</p

    Characterization of mycobacteria and mycobacteriophages isolated from compost at the São Paulo Zoo Park Foundation in Brazil and creation of the new mycobacteriophage Cluster U

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    Background: A large collection of sequenced mycobacteriophages capable of infecting a single host strain of Mycobacterium smegmatis shows considerable genomic diversity with dozens of distinctive types (clusters) and extensive variation within those sharing evident nucleotide sequence similarity. Here we profiled the mycobacterial components of a large composting system at the São Paulo zoo. Results: We isolated and sequenced eight mycobacteriophages using Mycobacterium smegmatis mc2155 as a host. None of these eight phages infected any of mycobacterial strains isolated from the same materials. The phage isolates span considerable genomic diversity, including two phages (Barriga, Nhonho) related to Subcluster A1 phages, two Cluster B phages (Pops, Subcluster B1; Godines, Subcluster B2), three Subcluster F1 phages (Florinda, Girafales, and Quico), and Madruga, a relative of phage Patience with which it constitutes the new Cluster U. Interestingly, the two Subcluster A1 phages and the three Subcluster F1 phages have genomic relationships indicating relatively recent evolution within a geographically isolated niche in the composting system. Conclusions: We predict that composting systems such as those used to obtain these mycobacteriophages will be a rich source for the isolation of additional phages that will expand our view of bacteriophage diversity and evolution
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