Predictive Factors Of One-year Mortality In A Cohort Of Patients Undergoing Urgent-start Hemodialysis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Chronic kidney disease (CKD) affects 10-15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of Baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality. Patients and methods We studied 424 patients who were admitted to our service between 01/2006 and 12/2012 and were followed for 1 year. We analyzed vascular access, risk factors linked to cardiovascular disease (CVD) and mineral and bone disease associated with CKD (CKD-MBD), and clinical events that occurred during the follow-up period. Factors that influenced patient survival were evaluated by Cox regression analysis. Results The patient mean age was 50 18 years, and 58.7% of them were male. Hypertension was the main cause of primary CKD (31.8%). Major risk factors were smoking (19.6%), dyslipidemia (48.8%), and CVD (41%). Upon admission, most patients had no vascular access for hemodialysis (89.4%). Biochemical results showed that most patients were anemic with high C-reactive protein levels, hypocalcemia, hyperphosphatemia, elevated parathyroid hormone and decreased 25-hydroxy vitamin D. At the end of one year, 60 patients died (14.1%). These patients were significantly older, had a lower percentage of arteriovenous fistula in one year, and low levels of 25-hydroxy vitamin D. Conclusions The combined evaluation of clinical and biochemical parameters and risk factors revealed that the mortality in urgent-start dialysis is associated with older age and low levels of vitamin D deficiency. A lack of a permanent hemodialysis access after one year was also a risk factor for mortality in this population.121Sao Paulo Research Foundation (FAPESP) [2010/03867-7]Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Indisciplina e violência na escola: reflexões no (do) cotidiano

Modern society establishes a disciplinary power that organizes social practices in an hierarchical structure. The so called “moral individual” emerges in this context as an “ideal citizen” according to social standards. The school represents an important mechanism to legitimize these practices by creating a model to classify and determine whether a person will be able to “function” in society accordingly or no. Lack of discipline and violence are types of behavior that put this model into question and usually those who apply them will be punished not with violence but with exclusion. Lack of discipline can be understood as a form of questioning the traditional and the established social order. The school instead of silencing these individuals can use these experiences to promote dialogue and participation searching for alternative forms to integrate different ideas and perceptions. Key words: lack of discipline, violence, school, exclusion.A sociedade moderna funda o poder disciplinar que organiza o funcionamento social em prol da produção de um sujeito homogeneizado e adaptado. O chamado sujeito da moral emerge desse contexto como o cidadão idealizado pelos padrões sociais. A escola é um importante difusor dessa lógica e produz, na sua interioridade, uma classificação dos sujeitos quanto à aptidão para desempenharem sua função na sociedade. Comportamentos indisciplinados e violentos são considerados disruptores e são punidos com o rebaixamento daqueles que dele se servirem, usando-se, nesse sentido, não mais a violência, mas a exclusão. A indisciplina precisa ser vista como um movimento de crítica e questionamento à ordem estabelecida, fato que deve gerar reflexão, em vez de provocar, na escola, o silenciamento. Dessa experiência, a escola pode construir caminhos de diálogos e de participação coletiva e ampliar as leituras possíveis, de modo a favorecer o agenciamento de desejos. Palavras-chave: indisciplina, violência, escola, exclusão

Expressão de leucócitos na circulação sangüínea antes, durante e após miíase por Dermatobia hominis em ratos experimentalmente infectados

A expressão de leucócitos sangüínea foi investigada em ratos (Rattus norvegicus) experimentalmente infectados com larvas de Dermatobia hominis. As células foram contadas antes, durante, aos 6, 10, 15, 20 e 28 dias pós-infestação (dpi), e aos 7, 15, 30 e 60 dias pós-emergência das larvas dos hospedeiros. O total de leucócitos não apresentou marcante diferença entre todos os grupos de animais. Todavia, diferenças significantes foram observadas quanto ao parasitismo pelos estádios larvares, com nível crescente: L1, L2, controle e L3. Na comparação entre grupos: o número de leucócitos foi significativo pró-controle, -15, -20 ou -28 dpi do que aos 6 dpi; e pró-controle, -L2 ou -L3 do que para L1. Neutrófilos, eosinófilos e linfócitos (pequenos e grandes) foram também analisados. Em contraste, o número insuficiente de basófilos e monócitos não permitiram estudos estatísticos. Estes resultados estimulam a continuação dos estudos sobre a relação parasito-hospedeiro nas dermatobioses.Expression of circulating white blood cells was investigated in rats (Rattus norvegicus) experimentally infected with larvae of Dermatobia hominis, the human bot fly. Leucocytes were counted prior to infection (control group) as well as at 6, 10, 15, 20 and 28 days post-infection (dpi) and at 7, 15, 30 and 60 days post-larval emergence (dple). Total leucocyte numbers did not differ markedly among the groups. Significant differences were registered when values from control and animals harboring each larval stage of D. hominis were compared; with crescent rank: L1-, L2-, control and L3-infected groups. Leucocyte numbers were significantly higher in the control, 15, 20 or 28 dpi groups than in the 6 dpi animals. Higher counts were observed in control, L2- or L3-infected rats than L1-infected animals. Neutrophils, eosinophils and both large and small lymphocytes were also counted and analyzed. Basophils and monocytes were insufficient in number to permit statistical studies. These results stimulate the continuity of the studies about the host-parasite relationship in the dermatobiosis

An ex vivo gene therapy approach to treat muscular dystrophy using inducible pluripotent stem cells.

Duchenne muscular dystrophy is a progressive and incurable neuromuscular disease caused by genetic and biochemical defects of the dystrophin-glycoprotein complex. Here we show the regenerative potential of myogenic progenitors derived from corrected dystrophic induced pluripotent stem cells generated from fibroblasts of mice lacking both dystrophin and utrophin. We correct the phenotype of dystrophic induced pluripotent stem cells using a Sleeping Beauty transposon system carrying the micro-utrophin gene, differentiate these cells into skeletal muscle progenitors and transplant them back into dystrophic mice. Engrafted muscles displayed large numbers of micro-utrophin-positive myofibers, with biochemically restored dystrophin-glycoprotein complex and improved contractile strength. The transplanted cells seed the satellite cell compartment, responded properly to injury and exhibit neuromuscular synapses. We also detect muscle engraftment after systemic delivery of these corrected progenitors. These results represent an important advance towards the future treatment of muscular dystrophies using genetically corrected autologous induced pluripotent stem cells

Bioremediation of Polluted Waters Using Microorganisms

Water pollution is an issue of great concern worldwide, and it can be broadly divided into three main categories, that is, contamination by organic compounds, inorganic compounds (e.g., heavy metals), and microorganisms. In recent years, the number of research studies concerning the use of efficient processes to clean up and minimize the pollution of water bodies has been increasing. In this context, the use of bioremediation processes for the removal of toxic metals from aqueous solutions is gaining considerable attention. Bioremediation can be defined as the ability of certain biomolecules or types of biomass to bind and concentrate selected ions or other molecules present in aqueous solutions. Bioremediation using microorganisms shows great potential for future development due to its environmental compatibility and possible cost-effectiveness. A wide range of microorganisms, including bacteria, fungi, yeasts, and algae, can act as biologically active methylators, which are able to at least modify toxic species. Many microbial detoxification processes involve the efflux or exclusion of metal ions from the cell, which in some cases can result in high local concentrations of metals at the cell surface, where they can react with biogenic ligands and precipitate. Although microorganisms cannot destroy metals, they can alter their chemical properties via a surprising array of mechanisms. The main purpose of this chapter is to provide an update on the recent literature concerning the strategies available for the remediation of metal-contaminated water bodies using microorganisms and to critically discuss their main advantages and weaknesses. The focus is on the heavy metals associated with environmental contamination, for instance, lead (Pb), cadmium (Cd), and chromium (Cr), which are potentially hazardous to ecosystems. The types of microorganisms that are used in bioremediation processes due to their natural capacity to biosorb toxic heavy metal ions are discussed in detail. This chapter summarizes existing knowledge on various aspects of the fundamentals and applications of bioremediation and critically reviews the obstacles to its commercial success and future perspectives

Chimerism 47,XY,+21/46,XX in a female infant with anencephaly and other congenital defects

Chimerism is rare in humans and is usually discovered accidentally when a 46,XX and 46,XY karyotype is found in a same individual. We describe a malformed female infant with neural tube defect (NTD) and a 47,XY,+21[5]/46,XX[30] karyotype.3637Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Apoptosis of non-parasitized red blood cells in malaria: a putative mechanism involved in the pathogenesis of anaemia

<p>Abstract</p> <p>Background</p> <p>Severe anaemia is a common complication of <it>Plasmodium falciparum </it>malaria in hyperendemic regions. Premature elimination of non-parasitized red blood cells (nRBC) has been considered as one mechanism involved in the genesis of severe malaria anaemia. It has been reported that apoptosis can occur in RBC and, consequently, this cell death process could contribute to anaemia. This study was performed to evaluate the susceptibility of nRBC to apoptosis in a malaria anaemia murine model.</p> <p>Methods</p> <p>Balb/c mice were intraperitonially inoculated with 1 × 10⁶<it>P. yoelii </it>17XL parasitized RBC (pRBC) and, then, parasitaemia and anaemia were monitored. Apoptosis in both pRBC and nRBC was assessed during early and late phases of infection by flow cytometry using Syto 16 and annexin V-PE double staining and forward scatter measurement.</p> <p>Results</p> <p>As expected, experimental infection of Balb/c mice with <it>Plasmodium yoelii </it>17XL parasites was characterized by progressive increase of parasitaemia and acute anaemia, leading to death. Flow cytometry analysis showed that a number of pRBC was in the apoptotic process. It was noteworthy that the increase of nRBC apoptosis levels occurred in the late phase of infection, when anaemia degree was notably accentuated, while no significant alteration was observed in the early phase.</p> <p>Conclusion</p> <p>The increased levels of nRBC apoptosis herein firstly reported, in malaria infection could represent a putative mechanism worsening the severity of malarial anaemia.</p