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The treatment of chronic kidney disease (CKD) consists of pharmacological, nutritional, and psychological-social approaches. The dietary therapy of CKD, namely a low-protein low-phosphorus diet, plays a crucial role in contributing to delay the onset of end-stage renal disease (ESRD) and to protect cardiovascular and nutritional status. The protein-free food products represent a very important tool for the implementation of a low-protein diet to ensure adequate energy supply, reducing the production of nitrogenous waste products.

To evaluate the histological changes of tracheal cartilage and epithelium caused by tracheal occlusion at different gestational ages in a fetal rat model.

This work intends to contribute to the planning guidelines in the field of value chain management (VCM). Thus, it develops a model reference proposal supported by the definition of a highly complex environment of knowledge towards on the innovation value chain performance in the product/technology development process (PDP) applied to technology–based companies under uncertainty and restraint. This stage considers a sequence of systematic procedures in the following phases: 1) determining the information needs in two stages; 2) determination of knowledge objects. The results produced are satisfactory, validating the proposed procedure for VCM.

Gastroschisis is a congenital abdominal wall defect with increasing occurrence worldwide over the past 20–30 years. Our aim was to analyze the morbidity of newborns after gastroschisis closure, with emphasis on metabolic and hydroelectrolyte disturbances in patients at three tertiary university centers.

Cleft lip and palate (CLP) is the most common congenital defect of the face. Many animal models have been utilized to study embryogenesis and pathogenesis of CLP, including the development of secondary anomalies and consequent deformities. However, the ideal gestational age for surgical creation of lip or palate defects in rat models has never been determined. The aim of the present study is to improve the experimental model utilizing rat fetuses, defining the most appropriate timing for creation of the lip defect model. The study was composed of three groups of fetuses undergoing surgical creation of a lip defect at the left side of the superior lip at 17.5, 18.5, and 19.5 days of gestation. Fetuses were harvested at 21.5 days of gestation (term = 22 days) and underwent macroscopic and microscopic analyses. We found that the most appropriate moment for lip defect creation was at 19.5 days, given the presence of lip depression at the site of the defect and asymmetry and retraction associated with interruption of the lip and complete reepithelialization of the borders of the defect.

Correction of gastroschisis can be accomplished by primary or staged closure. There is, however, no consensus regarding the best approach or criteria to favor one method over the other has been established.

Background/Purpose: Babies with congenital duodenal obstruction (CDO) have a high incidence of additional anomalies. Downs syndrome (DS) is the most common associated chromosomal defect, affecting up to 20 of these newborns. Morbidity is expected to be higher in DS patients, since it is a major cause of congenital heart disease, immunodeficiency, and other birth defects. We could find only one report concerning the morbidity in the DS newborn, when associated with CDO. The purpose of this report is to compare the postoperative outcome of two groups of newborns with CDO: group I, patients with associated DS and group II, without DS. Methods: A two-center retrospective review of charts of 46 newborns with CDO admitted to the Hospital of “UNICAMP” and the “Hospital das Clinicas da UFMG”, between 1993 and 2001, was undertaken. Results: Sixteen (34,7) of the 46 babies had DS. The groups were homogeneous concerning gestational age, gender, birth weight and nutritional status. There was a higher incidence of cardiopathy (56 x 20) and sepsis (37 x 16) among patients with DS; however we could find statistic difference only for the incidence of cardiopathy. The survival rate was similar for both groups, reaching 94. Conclusions: Despite the associated anomalies, newborns with DS individuals had a similar postoperative course, when compared with babies without DS after surgical correction of CDO. The earlier diagnosis of CDO and other birth defects, associated with intensive care, appropriate surgical procedure and postoperative support can provide an equivalent morbidity for DS patients.

The beneficial effects of statins in reducing cardiovascular events have been attributed predominantly to their lipid-lowering effects, recent studies suggest that these effects might be due to their anti-inflammatory properties. We here investigate the in vivo and in vitro effects of simvastatin on cytokine production in pre-dialysis chronic renal failure patients.

The lack of power exercised by the European Union (EU) in the international security arena explains its relative invisibility in the US. When Americans do recognise the EU, their interpretations of American history shape their responses to it. Whether puzzled by the loss of sovereignty or by the continuing strength of national identity, the American understanding of European integration cannot be divorced from Americans’ own understanding of the American process of nation-building and the exercise of federal power.

As a result of changing market needs and growth in competition, companies' competitiveness is increasingly being determined by their innovation capacity. This study aims at analyzing the characteristics of technological behavior of the Telecom industry in Brazil, specifically of equipment suppliers, which account for most of the sector's technological innovation. This study encompasses quantitative analysis describing the profile of innovative companies and their Research and Development (R&D) efforts, and the results obtained. In order to complement the analysis, a few cases were studied in order to show, among others, the main areas and/or products having R&D carried out in Brazil, factors attracting R&D activities to the country, cooperation with local universities and difficulties faced by companies when carrying R&D locally. Main conclusions and suggestions for public policies of the telecom industry are finally presented.

Background:Several studies have provided convincing evidence that in apparently healthy subjects elevated serum levels of plasma C-reactive protein (CRP) are associated with an increased risk of experiencing myocardial infarction and sudden cardiac death. It has been claimed that, in dialytic patients, the hepatic synthesis of this ‘acute phase response’ plasma protein is primarily induced by the macrophage-derived interleukin 6 (IL-6). Little information is available, however, regarding CRP and IL-6 plasma levels in pre-dialytic renal failure. Methods:Plasma CRP by a modification of the laser nephelometry technique, IL-6 and serum albumin were determined in 103 chronic pre-dialytic patients (mean age 50 ± 6.3 years; creatinine clearance (Cr.cl.) 36.3 ± 23.1 ml/min). Results:CRP was >5 mg/l (normal upper range) in 42% of the global population. CRP and IL-6 were significantly related (r = 0.35, p < 0.0004). CRP and IL-6 were related to renal function (CRP vs. Cr.cl., r = –0.56, p < 0.0001; IL-6 vs. Cr.cl., r = –0.55, p < 0.0001, Spearman correlation coefficient). When patients were divided in tertiles according to renal function, CRP median value resulted 7.9 mg/l (interquartile interval: 5–12) in the first tertile (Cr.cl. <18.5 ml/min), 4.0 mg/l (3–6) in the second tertile (Cr.cl. 18.5–45 ml/min) and 3.2 mg/l (2.7–4.0) in the last tertile (Cr.cl. >45 ml/min) (p < 0.0001). A negative correlation between CRP and S-albumin was also found (r = –0.52, p < 0.0001, Spearman correlation coefficient). Conclusions:IL-6 and CRP were increased and were inversely related to creatinine clearance in our population of 103 chronic predialytic patients. The possibility of a decreased renal clearance of CRP and/or cytokines as a cause of an activated acute-phase response is discussed. A negative correlation between CRP and S-albumin was found confirming the link between chronic inflammation and malnutrition in chronic renal patients.

The process of local government borrowing to finance the capital needs of social services has an impact on both central-local relations and the type of service which can be offered to the citizen-consumer. Based on an examination of these relationships in the United States, the United Kingdom, France, and Italy, it is postulated that different types of central-local relations are dependent on the nature of relations between central government and the investment community. Further, through use of material from a case study of public housing politics in Italy, it is shown how the investment criteria of the so-called “private” sector are transferred to the operations of the public sector through the mechanism of local borrowing. This transferal affects the manner in which social services are conceived and delivered.

The article is concerned with the control procedures of a IV generation Uninterruptible Power Supply (U.P.S.) system.

The matrix structure recommends itself as a convenient framework for implementing cross‐disciplinary projects. However, this structure tends to generate conflict between project and disciplinary managements. In excess, conflict can reduce performance. The aim of the work described in this paper was to see whether conflict could be controlled by better definition of the respective roles of project and functional managers.

Eight patients with chronic thromboembolic pulmonary hypertension (CTPH) that had been demonstrated by perfusion lung scan, pulmonary arteriography, and right heart catheterization had their pulmonary circulation evaluated by CT. Eight subjects without lung pathology were also studied for comparison. High resolution CT from apex to base with 1 cm thick sections after intravenous injection of contrast medium was performed in each individual. Emboli lodged in main pulmonary arteries on arteriography were regularly shown by CT, whereas those in segmental or smaller arteries were not detected. Diameters of the main pulmonary arteries measured on CT correlated with systolic pulmonary artery pressure (p < 0.001). The ratio between diameters of segmental arteries and the corresponding bronchi (A/B ratio) on CT was > 1 in 72 of 144 examined pulmonary segments (18 segments for each patient) in patients with CTPH. The ratio was > 1 in only 10 of 144 examined segments in normal control subjects. Dilatation of bronchial arteries was present in four of eight patients with CTPH. The parenchymal density in patients with CTPH was significantly higher in the axial than in the middle or peripheral lung compartments. In conclusion, CT may help with the diagnosis of CTPH by detecting thrombi of main arteries and by showing characteristic findings; moreover, it is accurate in estimating pulmonary arterial pressure secondary to thromboembolic obstruction.

Administration of extracellular vesicles derived from amniotic fluid stem cells regenerates underdeveloped fetal lungs in rodents.

The article addresses the nine myths regarding the Chinese People's Liberation Army (PLA) and People's Liberation Army Navy (PLAN) that could affect the China-U.S. military relations. It clarifies that China has an army-subordinate navy and two brigades of marines that are subordinate to the South Sea Fleet of the PLAN. According to the authors, PLAN understands the U.S. Navy better than the other way around. They add that the U.S. tends to be more inclined to history than China.