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Opportunistic Infections in Late Kidney Transplantation with Death Outcome: Case Report

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Open Journal of Nephrology 2021年第2期11卷 171-182页

作者： Miriam Viviane Baron Carina Marangoni Michele Paula dos santos Célia Regina Martins Korzenieski Vitória Pereira Itaquy Tais Michele Werle Gabriela Di Lorenzo Garcia Scherer Joice Nedel Ott Marcus Vinicius de Mello Pinto Janine Koepp Carolina Gonçalves Pinheiro Nathália Ken Pereira Iketani Cristine Brandenburg Aline Ronis Sampaio alexandre Sancho Danielle de Mello Florentino Bartira Ercília Pinheiro da Costa Postgraduate Program in Medicine and Health Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil Coordination for the Improvement of Higher Education Personnel Brazilia Brazil School of Medicine of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil Schoolof Health and Life Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS) Porto Alegre Brazil CelulareInstitute Rio de Janeiro Brazil University of Santa Cruz do Sul (UNISC) Santa Cruz do Sul Brazil Postgraduate Program in Health Sciences of the Faculty of Medicine of ABC (FMABC) S&atilde o Paulo Brazil Hospital Beneficiente Portuguesa of Belém Pará Brazil Dom José Institute of Education and Culture/University of Vale do Acaraú (IDJ/UVA) Ceará Brazil Unigranrio University Rio de Janeiro Brazil Uniredentor University Rio de Janeiro Brazil

Cytomegalovirus (CMV) and Pneumocystis jirovecii fungus are the main opportunistic microorganisms that affect transplanted individuals. Immunosuppressive drugs administered to prevent organ rejection leave the immune system vulnerable to these infections. The present report is about a kidney transplanted patient using immunosuppressants who was diagnosed with cytomegalovirus and pneumocystosis requiring admission to the intensive care unit (ICU). Female patient, 57 years old, a kidney transplanted three years ago, with comorbidities, such as systemic arterial hypertension, hypertriglyceridemia and type 2 diabetes mellitus. She was admitted to the hospital in January 2020 with a history of diarrhea, cough, malaise and weight loss of seven kg in a month. She made continuous use of the immunosuppressants tacrolimus® and mycophenolate sodium (MFS). After five days of hospitalization, she was transferred to the ICU due to refractory diarrhea, worsening renal function and respiratory pattern, requiring mechanical ventilation. Chest tomography showed changes that led to the diagnostic hypothesis of CMV pneumonia or Pneumocystis jirovecii. Treatment with Ganciclovir® and Bactrim® was started. The bronchial lavage polymerase chain reaction test confirmed the infectious condition for CMV and Pneumocystis jirovecii. Despite the drug therapy instituted, there was no improvement in the infectious condition. The patient started to present a general and progressive worsening of the clinical picture with loss of renal graft function, respiratory failure, metabolic acidosis, hemodynamic instability and severe distributive shock, evolving to death. In the present report, it was observed that after late kidney transplantation the fragility of the immune system caused by the use of immunosuppressants contributed to the development of a severe infection with CMV and Pneumocystis jirovecii. Adjusting the doses of immunos

关键词： Renal Transplantation Infections Opportunistic Immunosuppressive Agent Cytomegalovirus Pneumocystis

Accuracy of gestalt perception of acute chest pain in predicting coronary artery disease

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World Journal of Cardiology 2017年第3期9卷 241-247页

作者： Cláudio Marcelo Bittencourt das Virgens Laudenor Lemos Jr Márcia Noya-Rabelo Manuela Campelo Carvalhal Antonio Maurício dos santos Cerqueira Junior Fernanda Oliveira de Andrade Lopes Nicole Cruz de Sá Jéssica Gonzalez Suerdieck Thiago Menezes Barbosa de Souza Vitor Calixto de Almeida Correia Gabriella Sant’Ana Sodré AndréBarcelos da Silva Felipe Kalil Beirao alexandre Felipe Rodrigues Marques Ferreira Luís Cláudio Lemos Correia Department of Cardiology Hospital Sao Rafael Department of Cardiology Hospital Português Bahiana School of Medicine and Public Health

AIM To test accuracy and reproducibility of gestalt to predict obstructive coronary artery disease(CAD)in patients with acute chest *** We studied individuals who were consecutively admitted to our Chest Pain *** admission,investigators performed a standardized interview and recorded14 chest pain *** on these features,a cardiologist who was blind to other clinical characteristics made unstructured judgment of CAD probability,both numerically and *** the reference standard for testing the accuracy of gestalt,angiography was required to rule-in CAD,while either angiography or non-invasive test could be used to *** order to assess reproducibility,a second cardiologist did the same *** In a sample of 330 patients,the prevalence of obstructive CAD was 48%.Gestalt’s numerical probability was associated with CAD,but the area under the curve of0.61(95%CI:0.55-0.67)indicated low level of ***,categorical definition of typical chest pain had a sensitivity of 48%(95%CI:40%-55%)and specificity of 66%(95%CI:59%-73%),yielding a negligible positive likelihood ratio of 1.4(95%CI:0.65-2.0)and negative likelihood ratio of 0.79(95%CI:0.62-1.02).Agreement between the two cardiologists was poor in the numerical classification(95%limits of agreement=-71%to 51%)and categorical definition of typical pain(Kappa=0.29;95%CI:0.21-0.37).CONCLUSION Clinical judgment based on a combination of chest pain features is neither accurate nor reproducible in predicting obstructive CAD in the acute setting.

关键词： Acute chest pain Clinical judgment Gestalt Coronary artery disease Acute coronary syndrome

Feasibility Study for Power Generation during Peak Hours with a Hybrid System in a Recycled Paper Mill

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Computational Water, Energy, and Environmental Engineering 2013年第2期2卷 43-53页

作者： Adriano Beluco Clodomiro P.Colvara Luis E.Teixeira alexandre Beluco Universidade Ritter dos Reis Porto AlegreBrazil Genesys Participacoes Ltd. Porto AlegreBrazil Institution Pesquisas Hidráulicas Universidade Federal do Rio Grande do SulPorto AlegreBrazil

The differential pricing for peak hours encourages industrial consumers to look for independent power supplies for the period from 19 to 22 hours. This paper presents a study to identify the optimal solution for a recycled paper mill that also intends to work in that period. The factory is located in Rio Grande do Sul, in southern Brazil, and considers the use of a diesel gen set, a micro hydro power plant and possibly PV modules. Two micro hydro power plants were considered in the study, an old plant to be renewed and another to be fully implemented. The software Homer was used as a tool to determine the most feasible combination of components considered in the study. The sale of surplus power to the energy system appears as a key to viability of alternatives that are not based solely on diesel generators. The optimal solution consists of a combination of diesel generators and micro hydro power plant, in one case, and only on hydroelectric power plant in another, with a significant penetration of PV modules if its cost is reduced to 12% of the current price, selling an amount of energy equal to that which is bought. The annual water availability in one of the sites requires diesel supplement, while the other, more abundant, this supplement is not necessary.

关键词： Hybrid Energy Systems Micro Hydro Power PV Modules Energetic Complementarity Feasibility Study Computational Simulation Software Homer

Interaction between Equatorial Plasma Bubbles and a Medium-Scale Traveling Ionospheric Disturbance,observed by OI 630 nm airglow imaging at Bom Jesus de Lapa,Brazil

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Earth and Planetary Physics 2021年第5期5卷 397-406页

作者： Cristiano Max Wrasse Cosme alexandre Oliveira Barros Figueiredo Diego Barros Hisao Takahashi Alexander JoséCarrasco Luiz Fillip Rodrigues Vital Láysa Cristina Araujo Resende Fábio Egito Geângelo de Matos Rosa Antonio Hélder Rodrigues Sampaio Space Weather Division National Institute for Space Research(INPE)São Josédos CamposBrazil University of Los Andes(ULA) MéridaVenezuela State Key Laboratory of Space Weather Beijing 100190China Federal University of Campina Grande(UFCG) Campina GrandeBrazil Federal Institute for Education Science and Technology Baiano(IF Baiano)Bom Jesus da LapaBrazil

OI 630.0 nm airglow observations,from a new observatory at Bom Jesus de Lapa,were used to study the interaction between EPBs(Equatorial Plasma Bubbles)and the MSTID(Medium-Scale Traveling Ionospheric Disturbance)over the Northeast region in *** the night of September 16 to 17,2020,an EPB was observed propagating eastward,in an apparent fossil stage,until it interacted with a dark band electrified MSTID(e MSTID).After the interaction,four EPBs merged,followed by an abrupt southward development and *** of the data suggests that an eastward polarization electric field,induced by the dark band e MSTID,forced the EPB into an upward drift,growing latitudinally along the magnetic field lines and then bifurcating.

关键词： Equatorial Plasma Bubbles Medium-Scale Traveling Ionospheric Disturbance ionosphere thermosphere EPB and MSTID interaction

Circulating leptin and its muscle gene expression in Nellore cattle with divergent feed efficiency

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Journal of Animal Science and Biotechnology 2018年第1期9卷 228-232页

作者： Lúcio Flávio Macedo Mota Cristina Moreira Bonafé Pamela Almeida alexandre Miguel Henrique Santana Francisco JoséNovais Erika Toriyama Aldrin Vieira Pires Saulo da Luz Silva Paulo Roberto Leme JoséBento Sterman Ferraz Heidge Fukumasu Departmento de Zootecnia Universidade Federal dos Vales do Jequitinhonha e MucuriDiamantinaMG 39100 000Brazil Faculdade de Ciencias Agrarias e Veterinarias Universidade Estadual Paulista JaboticabalSP 14884 900Brazil Departamento de Medicina Veterinaria Faculdade de Zootecnia e Encjenharia de AlimentosUniversidade de Sao PauloAM.Duque de Caxias Norte n225Pirassununcja 13635 900SPBrazil Departmento de Zootecnia e Desenvolvimento Acjrossocioambiental Sustentavel Faculdade de VeterinariaUniversidade Federal FluminenseNiteroiRJ 24230 340Brazil Departamento de Zootecnia Faculdade de Zootecnia e Engenharia de AlimentosUniversidade de Sao PauloPirassununga 13635-900SPBrazil

Background： Leptin has a strong relation to important traits in animal production, such as carcass composition,feed intake, and reproduction. It is mainly produced by adipose cells and acts predominantly in the *** this study, circulating leptin and its gene expression in muscle were evaluated in two groups of young Nellore bulls with divergent feed efficiency. Individual dry matter intake（DMI） and average daily gain（ADG） of 98 Nellore bulls were evaluated in feedlot for 70 d to determinate the residual feed intake（RFI） and select 20 animals for the high feed efficient（LRFI） and 20 for the low feed efficient（HRFI） groups. Blood samples were collected on d 56 and at slaughter（80 d） to determine circulating plasma leptin. Samples of Longissimus dorsi were taken at slaughter for leptin gene expression ***： DMI and RFI were different between groups and LRFI animals showed less back fat and rump fat thickness,as well as less pelvic and kidney fat weight. Circulating leptin increased over time in all animals. Plasma leptin was greater in LRFI on 56 d and at slaughter（P = 0.0049）. Gene expression of leptin were greater in LRFI animals（P = 0.0022） in accordance with the plasma levels. The animals of the LRFI group were leaner, ate less, and had more circulating leptin and its gene ***： These findings demonstrated that leptin plays its physiological role in young Nellore bulls, probably controlling food intake because feed efficient animals have more leptin and lower residual feed intake.

关键词： Beef cattle Energy homeostasis Fat depositon Residual feed intake

Femoral Tunnels in Anatomical ACL Reconstruction: Techniques Inside Out X Outside In

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Open Journal of Orthopedics 2018年第10期8卷 373-380页

作者： alexandre Pagotto Pacheco Luiz Guilherme Hartmann Roberto Freire da Mota e Albuquerque Oswaldo Taglietta Filho Hospital dos Fornecedores de Cana de Piracicaba Piracicaba Brazil Institute of Orthopaedics and Traumatology Hospital das Clínicas da Faculdade de Medicina da Universidade de S&atilde o Paulo S&atilde o Paulo Brazil

Objective: To observe the accuracy and the advantages and disadvantages of the femoral tunnels made by the two techniques. Materials and Methods: We randomly summoned nineteen patients undergoing anatomic ACL reconstruction in a single band technique by the same surgeon: Ten by group II (GII) and nine by Group I (GI). GI: drilling in the technical in-out. GII: drilling the technique out-in. The patients underwent a CT scan with three-dimensional reconstruction of the distal femur. Was applied the technique of quadrants described by Bernard and Hertel and optimized for position by Forsythe and observed in the femoral tunnel: the accuracy of the joint entry;posterior cortical thickness in that point;emergency lateral distance to the lateral epicondyle and the overall length. Results: The coordinates of the distances obtained average was very close, with no statistical difference comparable to that obtained by Bernard and Hertel and Forsythe. The distance from the tunnel exit to the lateral epicondyle obtained average 1.46 cm in GI and 0.47 cm in GII, with a significant statistical difference. The thickness of the posterior cortex was 3.9 mm in GI and 5.4 mm in GII, with no statistical difference. The length averaged was 3.07 cm in GI and GII in 2.94 cm, with no statistical difference. Conclusions: Both techniques allow well placed tunnels, with no statistical difference. In the technique in-out the tunnel exit is closer to the lateral epicondyle. The thickness of the posterior cortex is similar. The length of the femoral tunnel is similar and around 3 cm.

关键词： ACL Reconstruction Knee ACL Surgery

Instruments for the assessment of social anxiety disorder: Validation studies

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World Journal of Psychiatry 2012年第5期2卷 83-85页

作者： Flávia de Lima Osório José alexandre de Souza Crippa Sonia Regina Loureiro Department of Neuroscience and Behavior Faculty of Medicine of Ribeirao Preto University of Sao Paulo INCT Translational Medicine Hospital das Clínicas FMRP-USP Avenida dos Bandeirantes 3900 Ribeirao Preto SP CEP 14049-900 Brazil

Great progress has been observed in the literature over the last decade regarding the validation of instruments for the assessment of Social Anxiety Disorder in the Brazilian context. Particularly outstanding in this respect is the production of a group of Brazilian investigators regarding the psychometric study of the following instruments: Liebowitz Social Anxiety Scale, Social Phobia Inventory, Brief Social Phobia Scale, Disability Profile, Liebowitz Self-Rated Disability Scale, Social Phobia Safety Behaviors Scale and Self-Statements During Public Speaking Scale, which have proved to be appropriate and valid for use in the adult Brazilian population, representing resources for the assessment of social anxiety in clinical and experimental situations.

关键词： Social anxiety Social phobia,Instruments Validation Scale

Biotechnological Potential of Endophytic Bacteria to Improve the Micropropagated Seedling of Variety RB92579 Sugarcane(Saccharum officinarum L.)

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Advances in Microbiology 2018年第11期8卷 859-873页

作者： Maria do Carmo Silva Barreto Márcia do Vale Barreto Figueiredo Márcia Vanusa da Silva Arnóbio Gon?alves de Andrade José de Paula de Oliveira Clébia Maria Alves Almeida Livia Caroline alexandre de Araújo Odemar Vicente dos Reis Junior Manoel Urbano Ferreira Junior Antonio Félix da Costa Vera Lucia de Menezes Lima Departamento de Bioquímica Centro de Biociências Universidade Federal de Pernambuco Recife Brazil Laboratório de Biologia do Solo Instituto Agron&#244 mico de Pernambuco Recife Brazil Departamento de Química Universidade Federal Rural de Pernambuco Recife Brazil Centro de Tecnologias Estratégicas do Nordeste Recife Brazil

Endophytic bacteria may influence agricultural production in several ways, including promoting plant growth. Two experiments were conducted in order to evaluate the combination of endophytic bacteria from the Brazilian Northeast region aims at the commercial introduction of the inoculation of these bacteria in micropropagated sugarcane plants using a temporary immersion bioreactor. One experiment was done in tubes with sterile commercial substrate, and the other was done in pots with soil;both were installed in a greenhouse. A mixed inoculation was performed in six inoculated endophytic diazotrophic bacteria in micropropagated sugarcane plants, variety RB92579. In the experiment with soil, the mixed inoculation significantly increased the shoot dry matter of plants without the addition of nitrogen fertilizer. However, the accumulation of total-N in the tissues showed no significant differences between treatments with and without nitrogen fertilization. The evaluation of micropropagated seedlings showed no increases in the parameters tested. The results showed that the response of inoculation in temporary immersion bioreactor micropropagation is possible, and that the application of homologous strains may have contributed to a better response by the interaction of endophytic bacteria with sugarcane RB92579. Further studies should be conducted to improve the methodology, which indicates a great potential to optimize this process on a commercial scale.

关键词： Biological Nitrogen Fixation Meristem Culture Diazotrophic Bacteria Endophytes Micropropagation

Emergence of Conilon Coffee Seedlings Originating from Seeds Treated with a Sodium Hypochlorite Solution

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American Journal of Plant Sciences 2014年第13期5卷 1819-1830页

作者： Raquel Fialho Rubim Henrique Duarte Vieira Eduardo Fontes Araújo Anna Christina Sanazário de Oliveira alexandre Pio Viana Center of Agricultural Sciences and Technologies State University of North Fluminense Darcy RibeiroCampos dos GoytacazesBrazil Department of Plant Science Federal University of VicosaVicosaBrazil

The coffee seeds are problematic for the physiologycal quality, featuring low speed of seedling emergence. In this sense, this work was developed with the objective of evaluating the effect of sodium hypochlorite in the removal of the parchment and in the emergence and seedlings development of conilon coffee in nursery conditions. Coffee seeds of the variety Victoria were used, which were harvested in the cherry stage and pulped by hand. Seeds were dried in an oven with forced ventilation until reaching moisture contents of 35%, 30% and 25% wet basis. Then, the seeds with parchment were soaked in a sodium hypochlorite solution with concentrations of 4%, 5%, 6% and 7% active chlorine for 3 and 6 hours. For each moisture content, two additional treatments were added consisting of seeds with parchment and seeds in which the structure was removed manually. The characteristics evaluated were: emergence speed index, total emergence, dry mass of the shoots and root system. Utilization of sodium hypochlorite promoted an acceleration in seedling emergence speed similar to the method for manual removal of the parchment when using concentrations of 4%, 5%, 6% and 7% for 3 hours, at all moisture contents.

关键词： Coffea canephora Soaking Seeds Parchment