Percutaneous renal graft biopsy: a clinical, laboratory and pathological analysis

CONTEXT: Renal allograft biopsies have been used as a good method for monitoring the evolution of kidney transplants for at least 20 years.1 Histological analysis permits differential diagnosis of the causes of allograft dysfunction to be made. OBJECTIVES: To correlate the data of urinalysis and serum creatinine with histological diagnosis of renal graft in a group of renal transplant patients. DESIGN: Accuracy study, retrospective analysis. SETTING: A university terciary referral center. SAMPLE: 339 percutaneous allograft biopsies obtained from 153 patients. Blood and urine samples were obtained before the graft biopsy. MAIN MEASUREMENTS: Laboratory evaluation and hystological analysis (light microscopy, imunofluorescent eletronic microscopy). RESULTS: Most of the biopsies (58.9%) were performed during the first month post-transplant. An increase in serum creatinine was associated with acute tubular and/or cortical necrosis. Proteinuria and normal serum creatinine were associated with glomerular lesions. Non-nephrotic range proteinuria and an increase in serum creatinine were associated with chronic rejection. CONCLUSIONS: Evaluation of serum creatinine and urinalysis can be useful in suggesting the histological graft diagnosis.CONTEXTO: Biópsia percutânea do rim transplantado tem representado um bom método para monitorização da evolução funcional do enxerto há pelo menos 20 anos. A análise histológica nos permite o diagnóstico deferencial entre as várias causas de disfunção do enxerto. OBJETIVOS: Correlacionar, em pacientes transplantados renais, o exame simples de urina e a creatinina sérica com achados histológicos do enxerto renal. TIPO DE ESTUDO: Estudo da acurácia, análise retrospectiva. LOCAL: Hospital das Clínicas da UNICAMP. AMOSTRA: 339 biopsias renais percutâneas (de 135 pacientes transplantados) no período de janeiro de 1984 a dezembro de 1991. Amostras de sangue e de urina foram coletadas antes da biopsia renal. VARIÁVEIS ESTUDADAS: Avaliação laboratorial e análise histológica. RESULTADOS: Em 94,1% das indicações de biopsia foi obtido material para análise histológica. Em 58,9% das biopsias a indicação ocorreu no primeiro mês de transplante. Elevação da creatinina sérica associou-se a necrose tubular aguda e/ou necrose cortical. Proteinúria com níveis de creatinina sérica dentro da normalidade associou-se a doenças glomerulares. Proteinúria (níveis não nefróticos) e aumento da creatinina estiveram associados a rejeição crônica do transplante. CONCLUSÃO : A análise da creatinina sérica e do exame de urina em pacientes transplantados renais pode sugerir o padrão histológico diferenciado de acometimento.576

Quality of life in renal transplant patients: impact of a functioning graft

Objective measures to evaluate quality of life are gaining importance as an adjuvant in assessing therapeutic interventions. The study purpose was to compare quality of life in renal transplant patients with functioning graft and those who restarted dialysis after graft loss. Quality of life was measured using the World Health Organization Quality of Life questionnaire (WHOQOL-Bref). One hundred and thirty two patients were interviewed, and divided into two groups: group I, 100 patients on regular follow-up in outpatient clinics and stable graft functioning; and group II, 32 patients who restarted dialysis after graft loss. The WHOQOL-Bref showed better quality of life in those renal transplant patients with a functioning graft, especially regarding the physical and psychological domains assessed in the general questions. There were no differences between the groups in the social relationship and environmental domains. WHOQOL-Bref is an efficient tool and can be useful for better approaching these patients, not only on a medical basis.Medidas objetivas de avaliação de qualidade de vida vêm aumentando em importância como adjuvante da análise de intervenções terapêuticas. Com o objetivo de analisar a qualidade de vida em pacientes renais crônicos transplantados, com enxerto funcionante ou que retornaram para tratamento dialítico, foi utilizada a versão em português do World Health Organization Quality of Life (WHOQOL-Bref). Foram estudados 132 pacientes, submetidos ao transplante renal, divididos em dois grupos: grupo I, 100 pacientes com enxerto funcionante e grupo II, 32 pacientes que perderam a função do enxerto e retornaram para tratamento dialítico. A avaliação dos diferentes itens do WHOQOL-Bref mostrou uma melhor qualidade de vida para os pacientes com enxerto funcionante nos domínios físico e psicológico, mas não nos domínios de relações sociais e de meio ambiente, valores estes confirmados pela avaliação das questões gerais. Esse instrumento de avaliação mostrou-se eficaz, pois privilegia a opinião dos pacientes, permitindo uma abordagem multidisciplinar do problema.73273

[quality Of Life In Renal Transplant Patients: Impact Of A Functioning Graft].

Objective measures to evaluate quality of life are gaining importance as an adjuvant in assessing therapeutic interventions. The study purpose was to compare quality of life in renal transplant patients with functioning graft and those who restarted dialysis after graft loss. Quality of life was measured using the World Health Organization Quality of Life questionnaire (WHOQOL-Bref). One hundred and thirty two patients were interviewed, and divided into two groups: group I, 100 patients on regular follow-up in outpatient clinics and stable graft functioning; and group II, 32 patients who restarted dialysis after graft loss. The WHOQOL-Bref showed better quality of life in those renal transplant patients with a functioning graft, especially regarding the physical and psychological domains assessed in the general questions. There were no differences between the groups in the social relationship and environmental domains. WHOQOL-Bref is an efficient tool and can be useful for better approaching these patients, not only on a medical basis.38732-

USE OF MUSIC DURING PHYSICAL THERAPY INTERVENTION IN A NEONATAL INTENSIVE CARE UNIT: A RANDOMIZED CONTROLLED TRIAL

Introduction: Previous studies have shown music therapy as a way to improve the clinical status of premature infants, improving vital signs and decreasing crying episodes. Objective: Compare the effects of music on vital signs of premature infants undergoing respiratory physiotherapy. Methods: We performed a randomized clinical trial consisting of 26 premature infants, divided into control group (N=12) and study group (N=14), carried out in a Neonatal Intensive Care Unit. All newborn infants undergone standard practice physiotherapy for 15 minutes: vibration and aspiration. On the study group they were exposed to classical music three minutes before the standard physiotherapy, and finished three minutes after the end of these procedures. A recorder was placed inside the incubator with an intensity of 25 decibels. Measurements of heart and respiratory rate and oxygen saturation were measured before, during and after each sessions of respiratory physiotherapy for two groups. Results: When comparing control and study groups regarding heart rate frequency and oxygen saturation, there was no statistically significant difference, but the inclusion of music determined clinically the variability of these data and 30% of the variation in respiratory rate was due to the inclusion of music during and after the physiotherapy, and the neonatal noninvasive ventilation showed less variation in their respiratory rate when compared to the neonatal on oxygen therapy. Conclusion: The results have showed a beneficial effect of music, showing lower respiratory rate in newborn infants during and after respiratory physiotherapy procedure

PERFIL DO PROFISSIONAL CONTÁBIL DO SETOR PÚBLICO: UMA ANÁLISE DAS CAPITAIS BRASILEIRAS E DISTRITO FEDERAL

Este trabalho tem como objetivo verificar o perfil do profissional contábil do setor público, atuante na administração das capitais brasileiras e Distrito Federal. O interesse por saber quem são esses profissionais e a sua valorização salarial, surge pela sua importância na gestão de recursos públicos, sendo responsável por orientar a administração desses recursos. Inicialmente buscou-se identificar o responsável pela prestação de contas municipais, para montar o perfil desse profissional e identificar a remuneração bruta por capital e por região. É importante ressaltar que os resultados e conclusões obtidos neste estudo foi restrita aos profissionais que assinaram as prestações de contas das capitais e do Distrito Federal do ano de 2015. A pesquisa mostrou que o perfil dos profissionais contábeis públicos é formado por indivíduos com nível superior, do sexo masculino. A maioria são servidores de carreira e assume função comissionada, o que eleva sua remuneração. Notou-se grande variação salarial entre os profissionais e a maior remuneração encontra-se na região Nordeste. A média salarial dos homens é 15% maior que a das mulhere

Thermal and cardiorespiratory newborn adaptations during hot tub bath

Objective: To evaluate thermal and cardiorespiratory adaptation during hot tub bath and shower in healthy newborns in the first hours of life. Study design: This is a randomized blind controlled trial, registered in ReBEC (No. RBR-4z26f3) with 184 newborns divided into hot tub group (n=84) and shower (n=100). Newborns from intervention group were immersed in a hot tub with warm water up to the neck, without exposure to air flow, and control group received traditional shower. Heart rate, respiratory rate and temperature were measured before and immediately after bath by an investigator blinded to the type of bath. Results: Groups were similar in gender, gestational age, birth weight, Apgar score at 5th minute and hours of life, p => 0.05. To analyze thermal and cardiorespiratory adjustments, difference between post-bath variables and pre-bath was calculated. In this analysis, it was found statistically significant difference between two types of bath regarding heart rate, respiratory rate and temperature. Hot tub bath decreases heart and respiratory rates and increases temperature, whereas shower provides the opposite effect (0.0001). Conclusion: This study demonstrates that hot tub baths and shower, in healthy newborns, promote thermal and cardiorespiratory adaptations, reflecting thermal, cardiac and respiratory positive reactions after hot tub bath

A second new species for the rare dipsadid genus Caaeteboia Zaher et al., 2009 (Serpentes: Dipsadidae) from the Atlantic Forest of northeastern Brazil

Caaeteboia is a rare and elusive monotypic genus of Neotropical snake, being one of the least known dipsadids of the Brazilian Atlantic Forest. Here, we assess the morphological and genetic diversity of this genus, comparing these results with several other genera of Xenodontinae. Our combined results revealed the presence of an unknown species from the northeastern portion of the Atlantic Forest. The new species is distributed throughout the enclaves of coastal open forests mixed with savanna-like habitat, locally known as “Floresta de Tabuleiro”, and submontane ombrophilous forests in the Brazilian states of Paraíba and Pernambuco. This new species is easily distinguished from C. amarali by its lower number of dorsal, ventral, and subcaudal scales, and a remarkable dark lateral stripe from the nostril up to the anterior third of the body. The new species extends the distribution of the genus in approximately 700 kilometers northwards, reinforcing the importance of the conservation of small remnants of Atlantic Forest in northeastern Brazil, which still harbor high levels of endemicity and diversity.Caaeteboia é um gênero de serpente raro e monotípico da região Neotropical, sendo um dos dipsadídeos menos conhecidos da Floresta Atlântica brasileira. Neste trabalho, avaliamos a diversidade morfológica e genética desse gênero, comparando-o com outros gêneros de Xenodontinae. Nossos resultados combinados revelaram a presença de uma espécie desconhecida da porção nordeste da Floresta Atlântica. A nova espécie se distribui ao longo dos enclaves de florestas abertas costeiras misturadas com habitats savânicos, conhecidos localmente por “Florestas de Tabuleiro”, e florestas ombrófilas submontanas nos estados da Paraíba e de Pernambuco. Essa nova espécie é distinguida de C. amarali pelo menor número de escamas dorsais, ventrais e subcaudais, e por uma evidente linha escura lateral desde o focinho até o terço anterior do corpo. A nova espécie amplia a distribuição do gênero para aproximadamente 700 quilômetros ao norte, e reforça a importância da conservação dos pequenos remanescentes de Floresta Atlântica no nordeste do Brasil, os quais ainda abrigam altos níveis de endemismo e diversidade.Asociación Herpetológica Argentin

A second new species for the rare dipsadid genus Caaeteboia Zaher et al., 2009 (Serpentes: Dipsadidae) from the Atlantic Forest of northeastern Brazil

Caaeteboia is a rare and elusive monotypic genus of Neotropical snake, being one of the least known dipsadids of the Brazilian Atlantic Forest. Here, we assess the morphological and genetic diversity of this genus, comparing these results with several other genera of Xenodontinae. Our combined results revealed the presence of an unknown species from the northeastern portion of the Atlantic Forest. The new species is distributed throughout the enclaves of coastal open forests mixed with savanna-like habitat, locally known as “Floresta de Tabuleiro”, and submontane ombrophilous forests in the Brazilian states of Paraíba and Pernambuco. This new species is easily distinguished from C. amarali by its lower number of dorsal, ventral, and subcaudal scales, and a remarkable dark lateral stripe from the nostril up to the anterior third of the body. The new species extends the distribution of the genus in approximately 700 kilometers northwards, reinforcing the importance of the conservation of small remnants of Atlantic Forest in northeastern Brazil, which still harbor high levels of endemicity and diversity.Caaeteboia é um gênero de serpente raro e monotípico da região Neotropical, sendo um dos dipsadídeos menos conhecidos da Floresta Atlântica brasileira. Neste trabalho, avaliamos a diversidade morfológica e genética desse gênero, comparando-o com outros gêneros de Xenodontinae. Nossos resultados combinados revelaram a presença de uma espécie desconhecida da porção nordeste da Floresta Atlântica. A nova espécie se distribui ao longo dos enclaves de florestas abertas costeiras misturadas com habitats savânicos, conhecidos localmente por “Florestas de Tabuleiro”, e florestas ombrófilas submontanas nos estados da Paraíba e de Pernambuco. Essa nova espécie é distinguida de C. amarali pelo menor número de escamas dorsais, ventrais e subcaudais, e por uma evidente linha escura lateral desde o focinho até o terço anterior do corpo. A nova espécie amplia a distribuição do gênero para aproximadamente 700 quilômetros ao norte, e reforça a importância da conservação dos pequenos remanescentes de Floresta Atlântica no nordeste do Brasil, os quais ainda abrigam altos níveis de endemismo e diversidade.Asociación Herpetológica Argentin