Nutrition care for chronic kidney disease during pregnancy: an updated review

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Expansion and access to high quality undergraduate courses in Brazil : other quality indicators for higher education

O artigo apresenta resultados parciais de pesquisa com foco na expansão e no acesso a cursos de graduação de alta qualidade avaliados pelo Sistema Nacional de Avaliação da Educação Superior (Sinaes). Discute aspectos que favorecem a compreensão da avaliação da qualidade da educação superior e do debate sobre o Estado avaliador e o Estado regulador. Focaliza as bases epistemológicas e a disputa pela concepção de qualidade no Sinaes capazes de provocar alterações no caráter formativo-emancipatório atribuído à avaliação. A análise de quatro cursos com maior expansão e de alta qualidade, reiterada nos três ciclos avaliativos (2004-2012), evidencia que a ampliação desses cursos não se dá no mesmo ritmo da que ocorre de forma geral. A reflexão mostra também que o Enade se consolida como métrica eficaz de qualidade, mas requer associação a outros indicadores.The article presents partial results of research focused on the expansion and access to high quality undergraduate courses according to Sinaes. It discusses aspects that favor the understanding of the evaluation of quality of higher education and the debate concerning the evaluative state and the regulatory state. It approaches the epistemological basis and the dispute for the conception of quality in the Sinaes that are able to change the formative-emancipatory evaluation of the exam. The analysis of four courses with greater expansion, and the repeated high quality in the three evaluation cycles (2004-2012) indicates that the expansion of high quality courses does not occur the rhythm of the overall expansion. The reflection also demonstrates that the Enade has consolidated itself as an efficient quality metric but its association with other indicators is required

The prognostic association of SPAG5 gene expression in breast cancer patients with systematic therapy

Background: Despite much effort on the treatment of breast cancer over the decades, a great uncertainty regarding the appropriate molecular biomarkers and optimal therapeutic strategy still exists. This research was performed to analyze the association of SPAG5 gene expression with clinicopathological factors and survival outcomes. Methods: We used a breast cancer database including 5667 patients with a mean follow-up of 69 months. Kaplan-Meier survival analyses for relapse free survival (RFS), overall survival (OS), and distant metastasis-free survival (DMFS) were performed. In addition, ROC analysis was performed to validate SPAG5 as a prognostic candidate gene. Results: Mean SPAG5 expression value was significantly higher with some clinicopathological factors that resulted in tumor promotion and progression, including poor differentiated type, HER2 positive or TP53 mutated breast cancer. Based on ROC-analysis SPAG 5 is a suitable prognostic marker of poor survival. In patients who received chemotherapy alone, SPAG5 had only a moderate and not significant predictive impact on survival outcomes. However, in hormonal therapy, high SPAG5 expression could strongly predict prognosis with detrimental RFS (HR = 1.57, 95% CI 1.2-2.06, p = 0.001), OS (HR = 2, 95% CI 1.05-3.8, p = 0.03) and DMFS (HR = 2.36, 95% CI 1.57-3.54, p < 0.001), respectively. In addition, SPAG5 could only serve as a survival predictor in ER+, but not ER- breast cancer patients. Patients might also be at an increased risk of relapse despite being diagnosed with a lower grade cancer (well differentiated type). Conclusions: SPAG5 could be used as an independent prognostic and predictive biomarker that might have clinical utility, especially in ER+ breast cancer patients who received hormonal therapy. © 2019 The Author(s)

Aceites esenciales de plantas nativas del Perú: Efecto del lugar de cultivo en las características fisicoquímicas y actividad antioxidante

Los aceites esenciales (AE) son usados como conservantes en la industria de alimentos, debido a sus características fisicoquímicas y actividad antioxidante. El objetivo de esta investigación fue determinar rendimiento (R), gravedad específica (GE), índice de refracción (IR), actividad antioxidante (AA) y composición química de AE de huacatay (Tagetes minuta), poleo (Minthostachys mollis), romero (Rosmarinus officinalis L.) y sachaculantro (Eryngium foetidum L.), plantas recolectadas de 52 distritos de la región Amazonas, Perú. Para cada AE se usó análisis de varianza de efectos fijos con tres repeticiones y análisis de clúster. La actividad antioxidante se determinó con el método del radical libre 2,2-difenil-1-picrilhidracilo (DPPH) y sus componentes más abundantes fueron identificados con cromatografía de gases acoplada a espectrometría de masas. Las diferencias en R, GE e IR fueron significativas entre distritos. La AA no mostró diferencia significativa entre los distritos, pero entre las plantas sí. Entre los componentes volátiles más abundantes se identificó 1–adamantanol (44,42%) en huacatay, β–felandreno (20,85%) en poleo, β–mirceno (34,59%) en romero y α–pineno (23,41%) en sachaculantro. Se concluye que el lugar geográfico afecta significativamente las propiedades fisicoquímicas de los AE

A randomized two arm phase III study in patients post radical resection of liver metastases of colorectal cancer to investigate bevacizumab in combination with capecitabine plus oxaliplatin (CAPOX) vs CAPOX alone as adjuvant treatment

<p>Abstract</p> <p>Background</p> <p>About 50% of patients with colorectal cancer are destined to develop hepatic metastases. Radical resection is the most effective treatment for patients with colorectal liver metastases offering five year survival rates between 36-60%. Unfortunately only 20% of patients are resectable at time of presentation. Radiofrequency ablation is an alternative treatment option for irresectable colorectal liver metastases with reported 5 year survival rates of 18-30%. Most patients will develop local or distant recurrences after surgery, possibly due to the outgrowth of micrometastases present at the time of liver surgery. This study aims to achieve an improved disease free survival for patients after resection or resection combined with RFA of colorectal liver metastases by adding the angiogenesis inhibitor bevacizumab to an adjuvant regimen of CAPOX.</p> <p>Methods/design</p> <p>The Hepatica study is a two-arm, multicenter, randomized, comparative efficacy and safety study. Patients are assessed no more than 8 weeks before surgery with CEA measurement and CT scanning of the chest and abdomen. Patients will be randomized after resection or resection combined with RFA to receive CAPOX and Bevacizumab or CAPOX alone. Adjuvant treatment will be initiated between 4 and 8 weeks after metastasectomy or resection in combination with RFA. In both arms patients will be assessed for recurrence/new occurrence of colorectal cancer by chest CT, abdominal CT and CEA measurement. Patients will be assessed after surgery but before randomization, thereafter every three months after surgery in the first two years and every 6 months until 5 years after surgery. In case of a confirmed recurrence/appearance of new colorectal cancer, patients can be treated with surgery or any subsequent line of chemotherapy and will be followed for survival until the end of study follow up period as well. The primary endpoint is disease free survival. Secondary endpoints are overall survival, safety and quality of life.</p> <p>Conclusion</p> <p>The HEPATICA study is designed to demonstrate a disease free survival benefit by adding bevacizumab to an adjuvant regime of CAPOX in patients with colorectal liver metastases undergoing a radical resection or resection in combination with RFA.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov Identifier NCT00394992</p

The Effects of Ash and Black Carbon (Biochar) on Germination of Different Tree Species

Forest fires generate large amounts of ash and biochar, or black carbon (BC), that cover the soil surface, interacting with the soil’s constituents and its seedbank. This study concerns reproductive ecology assessments supported by molecular characterisation to improve our understanding of the effects of fire and fire residues on the germination behaviour of 12 arboreal species with a wide geographic distribution. For this purpose, we analysed the effects of three ash and one BC concentration on the germination of Acacia dealbata Link, A. longifolia (Andrews) Willd., A. mearnsii De Wild., A. melanoxylon R. Br., Pinus nigra Arnold, P. pinaster Aiton, P. radiata D. Don, P. sylvestris L., Quercus ilex L., Q. pyrenaica Willd., Q. robur L., and Q. rubra L. Each tree species was exposed to ash and BC created from its foliage or twigs (except for Q. rubra, which was exposed to ash and BC of Ulex europaeus L.). We monitored germination percentage, the T50 parameter, and tracked the development of germination over time (up to 1 yr). The BC of A. dealbata, P. pinaster, and Q. robur was analysed by pyrolysis-gas chromatography-mass spectrometry (PY-GC-MS) to assess the molecular composition. In six species, ash inhibited the germination, while in another five species, germination was not affected by ash or by BC. In Q. rubra, ash and BC stimulated its germination. This stimulating effect of the BC on Q. rubra is likely to be related to the chemical composition of the ash and BC obtained from Ulex feedstock. The BC of U. europaeus has a very different molecular composition than the other BC samples analysed, which, together with other factors, probably allowed for its germination stimulating effects.This study was carried out within the Project 10MDS200007PR, financed by the Xunta de Galicia; the Project AGL2013-48189-C2-2-R, financed by the Ministerio de Economía y Competitividad, Spain; and FEDERS

Molecular Etiology of Atherogenesis – In Vitro Induction of Lipidosis in Macrophages with a New LDL Model

BACKGROUND: Atherosclerosis starts by lipid accumulation in the arterial intima and progresses into a chronic vascular inflammatory disease. A major atherogenic process is the formation of lipid-loaded macrophages in which a breakdown of the endolysomal pathway results in irreversible accumulation of cargo in the late endocytic compartments with a phenotype similar to several forms of lipidosis. Macrophages exposed to oxidized LDL exihibit this phenomenon in vitro and manifest an impaired degradation of internalized lipids and enhanced inflammatory stimulation. Identification of the specific chemical component(s) causing this phenotype has been elusive because of the chemical complexity of oxidized LDL. METHODOLOGY/PRINCIPAL FINDINGS: Lipid "core aldehydes" are formed in oxidized LDL and exist in atherosclerotic plaques. These aldehydes are slowly oxidized in situ and (much faster) by intracellular aldehyde oxidizing systems to cholesteryl hemiesters. We show that a single cholesteryl hemiester incorporated into native, non-oxidized LDL induces a lipidosis phenotype with subsequent cell death in macrophages. Internalization of the cholesteryl hemiester via the native LDL vehicle induced lipid accumulation in a time- and concentration-dependent manner in "frozen" endolysosomes. Quantitative shotgun lipidomics analysis showed that internalized lipid in cholesteryl hemiester-intoxicated cells remained largely unprocessed in those lipid-rich organelles. CONCLUSIONS/SIGNIFICANCE: The principle elucidated with the present cholesteryl hemiester-containing native-LDL model, extended to other molecular components of oxidized LDL, will help in defining the molecular etiology and etiological hierarchy of atherogenic agents