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Chronic phase of Chagas disease: why should it be treated? A comprehensive review
Coura, José Rodrigues;Borges-Pereira, José;
Memórias do Instituto Oswaldo Cruz , 2011, DOI: 10.1590/S0074-02762011000600001
Abstract: the pathogenesis and evolutive pattern of chagas disease suggests that the chronic phase should be more widely treated in order to (i) eliminate trypanosoma cruzi and prevent new inflammatory foci and the extension of tissue lesions, (ii) promote tissue regeneration to prevent fibrosis, (iii) reverse existing fibrosis, (iv) prevent cardiomyopathy, megaoesophagus and megacolon and (v) reduce or eliminate cardiac block and arrhythmia. all cases of the indeterminate chronic form of chagas disease without contraindications due to other concomitant diseases or pregnancy should be treated and not only cases involving children or recently infected cases. patients with chronic chagas cardiomyopathy grade ii of the new york heart association classification should be treated with specific chemotherapy and grade iii can be treated according to medical-patient decisions. we are proposing the following new strategies for chemotherapeutic treatment of the chronic phase of chagas disease: (i) repeated short-term treatments for 30 consecutive days and interval of 30-60 days for six months to one year and (ii) combinations of drugs with different mechanisms of action, such as benznidazole + nifurtimox, benznidazole or nifurtimox + allopurinol or triazole antifungal agents, inhibition of sterol synthesis.
Chagas disease: What is known and what should be improved: a systemic review
Coura, José Rodrigues;Borges-Pereira, José;
Revista da Sociedade Brasileira de Medicina Tropical , 2012, DOI: 10.1590/S0037-86822012000300002
Abstract: this study consists of a broad review on what is known and what should be improved regarding knowledge of chagas disease, not only through analysis on the main studies published on the topics discussed, but to a large extent based on experience of this subject, acquired over the past 50 years (1961-2011). among the subjects covered, we highlight the pathogenesis and evolution of infection by trypanosoma cruzi, drugs in use and new strategies for treating chagas disease; the serological tests for the diagnosis and the controls of cure the infection; the regional variations in prevalence, morbidity and response to treatment of the disease; the importance of metacyclogenesis of t. cruzi in different species of triatomines and its capacity to transmit chagas infection; the risks of adaptation of wild triatomines to human dwellings; the morbidity and need for a surveillance and control program for chagas disease in the amazon region and the need to prioritize initiatives for controlling chagas disease in latin america and mexico and in non-endemic countries, which is today a major international dilemma. finally, we raise the need for to create a new initiative for controlling chagas disease in the gran chaco, which involves parts of argentina, bolivia and paraguay.
Modelo numérico tri-dimensional linear da plataforma continental do Estado do Maranh?o
Pereira, José Edson Rodrigues;Harari, Joseph;
Boletim do Instituto Oceanográfico , 1995, DOI: 10.1590/S0373-55241995000100002
Abstract: a linear three-dimensional hydrodynamical numerical model, heaps type, was implemented to the continental shelf of maranh?o state, aiming the simulation of the circulation generated by astronomical and meteorological effects in that area. five runs of the model were performed, in order to compute the circulation in the shelf due to the following effects: principal lunar semi-diurnal component (m2), composition of the principal astronomical components in the area, mean summer meteorological conditions, mean winter meteorological conditions and tidal forcing in specific periods of interest. m2 cotidal maps and currents ellipses were obtained, that one being the most important component in the tidal circulation. mean seasonal elevations and currents are generally much smaller than the astronomical ones, allowing the use of tidal forcing only in hydrodynamic predictions.the model simulations were satisfactory in the platform and less precise within bays and internal shallow areas, where significative delays are observed, due to effects of smaller scale than the one adopted by the model.
Modelo numérico tri-dimensional linear da plataforma continental do Estado do Maranh?o
Pereira, José Edson Rodrigues;Harari, Joseph;
Brazilian Journal of Oceanography , 1995, DOI: 10.1590/S1679-87591995000100002
Abstract: a linear three-dimensional hydrodynamical numerical model, heaps type, was implemented to the continental shelf of maranh?o state, aiming the simulation of the circulation generated by astronomical and meteorological effects in that area. five runs of the model were performed, in order to compute the circulation in the shelf due to the following effects: principal lunar semi-diurnal component (m2), composition of the principal astronomical components in the area, mean summer meteorological conditions, mean winter meteorological conditions and tidal forcing in specific periods of interest. m2 cotidal maps and currents ellipses were obtained, that one being the most important component in the tidal circulation. mean seasonal elevations and currents are generally much smaller than the astronomical ones, allowing the use of tidal forcing only in hydrodynamic predictions.the model simulations were satisfactory in the platform and less precise within bays and internal shallow areas, where significative delays are observed, due to effects of smaller scale than the one adopted by the model.
Dinamica do potássio nos resíduos vegetais de plantas de cobertura no Cerrado
Torres, José Luiz Rodrigues;Pereira, Marcos Gervasio;
Revista Brasileira de Ciência do Solo , 2008, DOI: 10.1590/S0100-06832008000400025
Abstract: crop residue production, plant residue maintenance and their decomposition are important factors in the understanding of nutrient recycling process. to evaluate k accumulation and release a study with eight cover crops types was developed: pearl millet (pennisetum americanum sin. tiphoydes), brachiaria grass (brachiaria brizantha), sorghum (sorghum bicolor l. moench), pigeonpea (cajanus cajan (l.) millsp), sunn hemp (crotalarea juncea) and black oats (avena strigosa schreb), fallow land and conventional culture (control) in the experimental area of cefet-uberaba-mg, in a cerrado area. the dry mass production, crop residue decomposition in litter bags and k release were evaluated. a mathematical model was used to describe residue decomposition and k release, which calculates the decomposition constant (k) and half-time life. pearl millet, sorghum and the sunn hemp were the cover crops that produced most dry matter while k accumulation was highest in the grasses. k release was highest in pearl millet, oats, brachiaria grass and sunn hemp in the first 42 days after handling. brachiaria grass had the shortest half-time life and the highest k release rate.
Morbidade da doen?a de Chagas: III. Estudo longitudinal, de seis anos, em Virgem da Lapa, MG, Brasil
Pereira, José Borges;Willcox, Henry Percy;Coura, José Rodrigues;
Memórias do Instituto Oswaldo Cruz , 1985, DOI: 10.1590/S0074-02761985000100010
Abstract: in a clinical, radiological and electrocardiographical, follow-up study of the "case control" type performed in virgem da lapa, minas gerais state, brazil, 124 chagasic patients were followed during six years. the results of the patients, the majority in the indeterminate form, did not register any change, in 32.2% there was a progress in the disease and in 5.6% the electrocardiogram returned to normal. these results when compared to that achieved by the control group, composed of pairs of non chagasic persons with the same age and sex, was shown to be 27.4% higher than among patients with positive serology. this factor represents the excess risk or exclusively chagasic component in the development of the disease. no differences were observed by sex related to the development of the disease. it was more premature and seven times more frequent however when related to the cardiopathy than to the megaesophagus. both conditions occurring mainly in slight or moderate degree. in 192 chagasic patients and 188 non chagasic persons observed in that area in the same period, the mortality was 3.6 times higher among the chagasic patients with a letality due to cardiopathy of 8.9% without difference between sexes but more premature among the males. sudden death was more frequent than that one caused by cardiac insufficiency. the prognostic was good for the patients with indeterminate and digestive forms and reserved for patients with the highest degree of cardiopathy.
Avalia o da gera o de microtrincas do a o rápido ABNT M2 no processo EDM com adi o de SiC = Evaluation of microcrack formation of ABNT M2 high speed steel in the EDM process, with addition of silicon carbide powder
Jean Robert Pereira Rodrigues,Claudionor Cruz,Sinésio Domingues Franco,José Roberto Pereira Rodrigues
Acta Scientiarum : Technology , 2008,
Abstract: é sabido que a Usinagem por Descargas Elétricas (EDM) é um processo térmico em que pode haver temperaturas muito elevadas (superiores a 1.200°C) na regi o de usinagem. Consequentemente é fácil de entender o fato de as pe as usinadas por EDM apresentarem camadas superficiais endurecidas, refundidas e com elevado número de microtrincas superficiais. A forma o de microtrincas está associada com o desenvolvimento de altas tens es térmicas que excedem a tens o máxima de resistência do material. Além disso, as microtrincas superficiais penetram em profundidade com extens es que dependem da energia de descarga. O trabalho proposto tem por objetivo estudar o efeito da adi o de pó de SiC em vários fluidos dielétricos, sobre a gera o de microtrincas superficiais, no a o rápido ABNT M2, durante a usinagem por descargas elétricas. Os resultados apresentados mostramredu o da quantidade de microtrincas nas superfícies usinadas, quando se adiciona pó de SiC ao dielétrico, quando comparadas com as usinadas com EDM convencional. It is known that Electrical Discharge Machining (EDM) is a thermal process in which extremely high temperatures (in excess of 1200°C) can occur in the machining area. Consequently, it is easy tounderstand that during each electric discharge, high temperatures are generated, causing local fusion or even evaporation of the machined material. In each discharge, a crater is formed in the material and a small crater is formed in the electrode. Of every meltedmaterial produced in each discharge, only 15% or less is removed using dielectric fluid. The remaining melted material solidifies, forming a wrinkled surface. The characteristics of theobtained surface – overlap of craters, globules of sullage, chimneys, bubbles (formed when the gases arrested are liberated through the resolidified material) – are revealed through an analysis using a scanning electron microscope. The proposed work has as its objective to study the effect of the addition of SiC powder into several dielectric fluids, on microcrack formation of high-speed steel (ABNT M2), during electrical discharge machining. The results show that the samples machined with the addition of SiC powders presentedsignificant reduction in the number of microcracks in the machined surface, when compared with those machined with conventional EDM.
Estabilidade de agregados e distribui o do carbono em Latossolo sob sistema plantio direto em Uberaba, Minas Gerais
Fernando Silva Coutinho,Marcos Gervasio Pereira,Dilson José Rodrigues Junior,José Luiz Rodrigues Torres
Comunicata Scientiae , 2010,
Abstract: The use of no-tillage system (SNT) with cover plants improves soil aggregation. The aim of this studywas to evaluate the stability of aggregates in water and carbon distribution in different aggregatesclass in Oxisol in no-tillage system, Uberaba, MG, Brazil. It was evaluated two areas in SNT: crop ofcorn + brachiaria and corn + crotalaria. An area adjacent to the savanna was taken as a conditionof the original soil. It was collected samples of soil deformability 0-5 and 5-10 cm, soil depths whichwas evaluated the stability of aggregates stable in water, by means of indices of aggregation:mean weight diameter (MWD) and geometric mean diameter (GMD). It was also evaluated thedistribution of the mass of aggregates and carbon per sieve class. It was found that, regardless ofdepth, the area of savanna showed higher values for DMP, DMG and carbon. Among the cultivatedareas, the system of crop corn + brachiaria showed higher values of DMP and carbon of aggregatesin detriment of the area corn + crotalaria. These results indicate that the crop in SNT of corn +brachiaria increases soil aggregation and carbon aggregates when compared to the system ofcorn + crotalaria.
Produ??o de fitomassa por plantas de cobertura e mineraliza??o de seus resíduos em plantio direto
Torres, Jose Luiz Rodrigues;Pereira, Marcos Gervasio;Fabian, Adelar José;
Pesquisa Agropecuária Brasileira , 2008, DOI: 10.1590/S0100-204X2008000300018
Abstract: the objective of this work was to evaluate dry biomass production, decomposition rate and macronutrients release (n, p, ca, mg and s) of cover crops cultural residues, in a no-till savanna soil. the cover crops tested were: pearl millet (pennisetum americanum sin. typhoides), brachiaria grass (brachiaria brizantha cv. marandu), sorghum [sorghum bicolor (l.) moench], pigeon pea [cajanus cajan (l.) millsp.], sunn hemp (crotalaria juncea l.) and black oat (avena strigosa schreb), compared to a fallow plot (control). the experiment was carried out in an oxisol, medium texture. a randomized block design, in a split-plot array in time, with four replications, was used. dry biomass production was evaluated 110 days after sowing. decomposition rate was evaluated by litter bags containing cultural residues. millet and sunn hemp are the cover crops (grass and legume) with the highest dry biomass production and n accumulation, in the two evaluation periods. the highest decomposition rate and nutrient release occurred at 42 days after desiccation. the highest values of half life were observed in dry period.
Incidência de lúpus eritematoso sistêmico em Natal, RN - Brasil
Vilar, Maria José Pereira;Rodrigues, Juliana Martins;Sato, Emilia Inoue;
Revista Brasileira de Reumatologia , 2003, DOI: 10.1590/S0482-50042003000600005
Abstract: objective: to study the incidence of systemic lupus erythematosus (sle) in the city of natal, brazil. methods: only patients living in the city of natal, older than 15 years old, who fulfilled at least 4 of acr criteria between january 1st, 2000 and december 31st, 2000, were included. four sources were used to identify new cases of sle: 1) the university hospital; 2) "health units" and hospitals of the public health network; 3) specialists at private hospitals and outpatient clinics; 4) three laboratories performing antinuclear antibody (ana) determination. physicians were contacted by mail, receiving explanations about the study and directions on how to collaborate. brazilian population census data (2000) was used to calculate incidence rate. the standardized mortality ratio (smr) was used to compare the incidence rates. the 95% confidence intervals (95% ci) were calculated and a p value < 0.05 was considered statistically significant. results: forty three patients were diagnosed as sle new cases in 2000. the calculated incidence was 8.7/100 000/year (95% ci 6.3-11.7). thirty eight patients were female 14.1/100.000/year (95% ci 10.0-19.3) and 5 were male 2.2/100.000/year (95% ci 0.7-5.2). the mean age of sle new cases was 31.8 years old (95% ci 27.8-35.8). the mean age for women was 31.4 years old and for men it was 35.0 years old. the median of disease duration (time between onset of the first acr criterion for sle and diagnosis) was 10 months (1-72 months). conclusions: the incidence of sle in natal is apparently higher than those reported in other regions of the world. the observed differences may be due to ethnical and/or environmental factors.
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