Is serum phosphorus control related to parathyroid hormone control in dialysis patients with secondary hyperparathyroidism?

Background Elevated serum phosphorus (P) levels have been linked to increased morbidity and mortality in dialysis patients with secondary hyperparathyroidism (SHPT) but may be difficult to control if parathyroid hormone (PTH) is persistently elevated. We conducted a post hoc analysis of data from an earlier interventional study (OPTIMA) to explore the relationship between PTH control and serum P. Methods The OPTIMA study randomized dialysis patients with intact PTH (iPTH) 300–799 pg/mL to receive conventional care alone (vitamin D and/or phosphate binders [PB]; n = 184) or a cinacalcet-based regimen (n = 368). For patients randomized to conventional care, investigators were allowed flexibility in using a non-cinacalcet regimen (with no specific criteria for vitamin D analogue dosage) to attain KDOQI™ targets for iPTH, P, Ca and Ca x P. For those assigned to the cinacalcet-based regimen, dosages of cinacalcet, vitamin D sterols, and PB were optimized over the first 16 weeks of the study, using a predefined treatment algorithm. The present analysis examined achievement of serum P targets (≤4.5 and ≤5.5 mg/dL) in relation to achievement of iPTH ≤300 pg/mL during the efficacy assessment phase (EAP; weeks 17–23). Results Patients who achieved iPTH ≤ 300 pg/mL (or a reduction of ≥30% from baseline) were more likely to achieve serum P targets than those who did not, regardless of treatment group. Of those who did achieve iPTH ≤ 300 pg/mL, 43% achieved P ≤4.5 mg/dL and 70% achieved P ≤5.5 mg/dL, versus 21% and 46% of those who did not achieve iPTH ≤ 300 pg/mL. Doses of PB tended to be higher in patients not achieving serum P targets. Patients receiving cinacalcet were more likely to achieve iPTH ≤300 pg/mL than those receiving conventional care (73% vs 23% of patients). Logistic regression analysis identified lower baseline P, no PB use at baseline and cinacalcet treatment to be predictors of achieving P ≤4.5 mg/dL during EAP in patients above this threshold at baseline. Conclusions This post hoc analysis found that control of serum P in dialysis patients was better when serum PTH levels were lowered effectively, regardless of treatment received

Matemática, Literatura & Aulas

A aprendizagem da Matemática não ocorre por mera transmissão de saberes do professor para os alunos. A ideia de que o conhecimento pode passar linearmente de uma cabeça – daquele que sabe – para outra(s) cabeça(s) – para aqueles que querem saber –, pelas palavras ditas e escritas, não tem qualquer correspondência com a realidade. A aprendizagem é um processo adaptativo, simultaneamente individual e coletivo, baseado na ação e na reflexão, no qual a comunicação tem um papel fundamental, na medida que permite estabelecer ligação entre as pessoas

Characterization of natural occurrence of Oenocarpus distichus in the state of Maranhão, Brazil.

In Maranhão States Amazon, bacaba stands out as an important resource to local populations. It is employed in human and animal feeding, building houses, traditional medicine and manufacturer goods. The economically viable part of this species is the processed pulp known as bacaba, sold in natura or frozen. Considering the great potential of sustainable economic exploitation of native fruit trees, such as the bacaba, occurrence areas of natural populations of O. distichus in three municipalities of the Gurupi micro region and two of the Chapada das Mangabeiras were mapped in order to subsidize future researches regarding conservation and use of the germplasm. Bacaba populations were mapped in cities of the two microregions: 1) Gurupi where soils, in general, are of low natural fertility with predominance of dystrophic plinthudults and red-yellow dystrophic and plinthic soils and; 2) Chapada das Mangabeiras, where yellow dystrophic hapludox soils are found; and in the escarpments the litholic dystrophic neosoils are common. In these micro regions, bacaba populations are reduced to individuals found in backyards

Avaliação do efeito da adubação NPK no crescimento de gravioleira no município de São Francisco do Pará.

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Avaliação do efeito da adubação NPK no crescimento de gravioleira (Annona muricata L.) nas condições edafoclimáticas do município de São Francisco do Pará.

In: FRAZÃO, D. A. C.; HOMMA, A. K. O; VIÉGAS, I. de J. M. (Ed.). Contribuição ao desenvolvimento da fruticultura na Amazônia. Belém, PA: Embrapa Amazônia Oriental, 2006. p. 557-561

Biolistic co-transformation of Metarhizium anisopliae var. acridum strain CG423 with green fluorescent protein and resistance to glufosinate ammonium.

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Manejo e tratos culturais da melancia irrigada.

No cultivo de melancia, quando submetido às boas práticas de manejo e tratos culturais, a produtividade e a qualidade dos frutos tendem a se elevar aos patamares que atendem às exigências do mercado consumidor. Tanto para o bom desenvolvimento das plantas, quanto para obter boas produtividades da melancia, é necessária a execução de um conjunto de práticas de manejo durante todo o ciclo da cultura, em qualquer que seja o sistema de cultivo adotado