Peritubular Capillaries C4d Deposits in Renal Allograft Biopsies and Anti HLA I/II Alloantibodies Screening. Incidence and Clinical Importance

Aim: To characterise clinically the patients with C4d in peritubular capillaries deposits (C4dPTCD) and/or circulating anti-HLA class I/II alloantibodies. To determine the correlation between positive C4dPTCD and circulating anti-HLA class I/II alloantibodies during episodes of graft dysfunction. Subjects and Methods: C4d staining was performed in biopsies with available frozen tissue obtained between January 2004 and December 2006. The study was prospective from March 2005, when a serum sample was obtained at the time of biopsy to detect circulating anti-HLA class I/II alloantibodies. Results: We studied 109 biopsies in 86 cadaver renal transplant patients. Sixteen of these (14.7%) presented diffuse positive C4dPTCD. There was a 13.5% rate of +C4dPTCD incidence within the first six months of transplantation and 16% after six months (p>0.05). Half of the +C4dPTCD in the first six months was associated with acute humoral rejection. After six months, the majority of +C4dPTCD (n=7/8) was present in biopsies with evidence of interstitial fibrosis/tubular atrophy and/or transplant glomerulopathy. The C4dPTCD was more frequent in patients with positive anti-HCV antibodies(p<0.0001), a previous renal transplant (p=0.007), and with a panel reactivity antibody (PRA) ≥ 50%(p=0.0098). The anti-HCV+ patients had longer time on dialysis (p=0.0019) and higher PRA(p=0.005). Circulating anti-HLA I/II alloantibodies were screened in 46 serum samples. They were positive in 10.9% of samples, all obtained after six months post transplant. Circulating alloantibodies were absent in 92.5% of the C4d negative biopsies. Conclusion: We found an association between the presence of C4dPTCD and 2nd transplant recipients,higher PRA and the presence of anti-HCV antibodies. The presence of HCV antibodies is not a risk factor for C4dPTCD per se, but appears to reflect longer time on dialysis and presensitisation. In renal dysfunction a negative alloantibody screening is associated with a reduced risk of C4dPTCD (<10%)

Does Warm-Up Have a Beneficial Effect on 100-m Freestyle?

To investigate the effect of warm-up on 100-m swimming performance. Twenty competitive swimmers (with a training frequency of 8.0 ± 1.0 sessions/wk) performed 2 maximal 100-m freestyle trials on separate days, with and without prior warm-up, in a counterbalanced and randomized design. The warm-up distance totaled 1000 m and replicated the swimmers' usual precompetition warm-up strategy. Performance (time), physiological (capillary blood lactate concentrations), psychophysiological (perceived exertion), and biomechanical variables (distance per stroke, stroke frequency, and stroke index) were assessed on both trials. Performance in the 100-m was fastest in the warm-up condition (67.15 ± 5.60 vs 68.10 ± 5.14 s; P = .01), although 3 swimmers swam faster without warm-up. Critical to this was the 1st 50-m lap (32.10 ± 2.59 vs 32.78 ± 2.33 s; P < .01), where the swimmers presented higher distance per stroke (2.06 ± 0.19 vs. 1.98 ± 0.16 m; P = .04) and swimming efficiency compared with the no-warm-up condition (stroke index 3.46 ± 0.53 vs 3.14 ± 0.44 m2 · c1 · s1; P < .01). Notwithstanding this better stroke-kinematic pattern, blood lactate concentrations and perceived exertion were similar between trials. These results suggest that swimmers' usual warm-up routines lead to faster 100-m freestyle swimming performance, a factor that appears to be related to better swimming efficiency in the 1st lap of the race. This study highlights the importance of performing swimming drills (for higher distance per stroke) before a maximal 100-m freestyle effort in similar groups of swimmers.UBI/FCSH/Santander/2010info:eu-repo/semantics/publishedVersio

Warm-up for Sprint Swimming: Race-Pace or Aerobic Stimulation? A Randomized Study

The aim of this study was to compare the effects of 2 different warm-up intensities on 100-m swimming performance in a randomized controlled trial. Thirteen competitive swimmers performed two 100-m freestyle time-trials on separate days after either control or experimental warm-up in a randomized design. The control warm-up included a typical race-pace set (4 × 25 m), whereas the experimental warm-up included an aerobic set (8 × 50 m at 98-102% of critical velocity). Cortisol, testosterone, blood lactate ([La]), oxygen uptake (V[Combining Dot Above]O2), heart rate, core (Tcore and Tcorenet) and tympanic temperatures, and rating of perceived exertion (RPE) were monitored. Stroke length (SL), stroke frequency (SF), stroke index (SI), and propelling efficiency (ηp) were assessed for each 50-m lap. We found that V[Combining Dot Above]O2, heart rate, and Tcorenet were higher after experimental warm-up (d > 0.73), but only the positive effect for Tcorenet was maintained until the trial. Performance was not different between conditions (d = 0.07). Experimental warm-up was found to slow SF (mean change ±90% CL = 2.06 ± 1.48%) and increase SL (1.65 ± 1.40%) and ηp (1.87 ± 1.33%) in the first lap. After the time-trials, this warm-up had a positive effect on Tcorenet (d = 0.69) and a negative effect on [La] (d = 0.56). Although the warm-ups had similar outcomes in the 100-m freestyle, performance was achieved through different biomechanical strategies. Stroke length and efficiency were higher in the first lap after the experimental warm-up, whereas SF was higher after control warm-up. Physiological adaptations were observed mainly through an increased Tcore after experimental warm-up. In this condition, the lower [La] after the trial suggests lower dependency on anaerobic metabolism.UBI/FCSH/Santander/2010info:eu-repo/semantics/publishedVersio

The Effects of Different Warm-up Volumes on the 100-m Swimming Performance: A Randomized Crossover Study

The aim of this study was to compare the effect of 3 different warm-up (WU) volumes on 100-m swimming performance. Eleven male swimmers at the national level completed 3 time trials of 100-m freestyle on separate days and after a standard WU, a short WU (SWU), or a long WU (LWU) in a randomized sequence. All of them replicated some usual sets and drills, and the WU totaled 1,200 m, the SWU totaled 600 m, and the LWU totaled 1,800 m. The swimmers were faster after the WU (59.29 seconds; confidence interval [CI] 95%, 57.98-60.61) and after the SWU (59.38 seconds; CI 95%, 57.92-60.84) compared with the LWU (60.18 seconds; CI 95%, 58.53-61.83). The second 50-m lap after the WU was performed with a higher stroke length (effect size [ES] = 0.77), stroke index (ES = 1.26), and propelling efficiency (ES = 0.78) than that after the SWU. Both WU and SWU resulted in higher pretrial values of blood lactate concentrations [La] compared with LWU (ES = 1.58 and 0.74, respectively), and the testosterone:cortisol levels were increased in WU compared with LWU (ES = 0.86). In addition, the trial after WU caused higher [La] (ES ≥ 0.68) and testosterone:cortisol values compared with the LWU (ES = 0.93). These results suggest that an LWU could impair 100-m freestyle performance. The swimmers showed higher efficiency during the race after a 1200-m WU, suggesting a favorable situation. It highlighted the importance of the [La] and hormonal responses to each particular WU, possibly influencing performance and biomechanical responses during a 100-m race.Santander Totta bank (UBI/FCSH/Santander/2010). COP/Millenium BCPSport Sciences 2014info:eu-repo/semantics/publishedVersio

Controlling the pandemic during the SARS-CoV-2 vaccination rollout

© The Author(s) 2021. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.There is a consensus that mass vaccination against SARS-CoV-2 will ultimately end the COVID-19 pandemic. However, it is not clear when and which control measures can be relaxed during the rollout of vaccination programmes. We investigate relaxation scenarios using an age-structured transmission model that has been fitted to age-specific seroprevalence data, hospital admissions, and projected vaccination coverage for Portugal. Our analyses suggest that the pressing need to restart socioeconomic activities could lead to new pandemic waves, and that substantial control efforts prove necessary throughout 2021. Using knowledge on control measures introduced in 2020, we anticipate that relaxing measures completely or to the extent as in autumn 2020 could launch a wave starting in April 2021. Additional waves could be prevented altogether if measures are relaxed as in summer 2020 or in a step-wise manner throughout 2021. We discuss at which point the control of COVID-19 would be achieved for each scenario.G.R., J.V., A.N., M.C.G. were supported by Fundação para a Ciência e a Tecnologia (FCT) project reference 131_596787873, awarded to G.R. M.V. was supported by the European Union H2020 ERA project (No. 667824 - EXCELLtoINNOV). The contribution of C.H.v.D. was under the auspices of the US Department of Energy (contract number 89233218CNA000001) and supported by the National Institutes of Health (grant number R01-OD011095). MK acknowledges support from the Netherlands Organization for Health Research and Development (ZonMw) Grant no. 10430022010001.info:eu-repo/semantics/publishedVersio

A New Anatomo-Clinical Approach to an Old Disease

info:eu-repo/semantics/publishedVersio

A FORMAÇÃO DO ENFERMEIRO PARA A ASSISTÊNCIA DE PORTADORES DE NECESSIDADES ESPECIAIS, COM PARALISIA CEREBRAL, SUBMETIDOS À INTERNAÇÃO DOMICILIAR

This is an end of course work that has as its subject nurse training in the home care of special needs patients, particularly, of patients with cerebral paralysis. Its aim is to sensitize the nurse to the peculiarities of Attention Services at home and for patients with cerebral palsy. To direct the course of this work, we present as a study the problem of the identification of the main necessities of the patients with cerebral palsy in Attention Services at home. The general objective of this research will be to describe the training process of specialist nurses in home care and the specific objectives will be: To identify the main requirements of patients with special needs and cerebral palsy, and to describe how nurses are prepared for this type of care of patients and their family. It was opted to carry out a bibliographical research, contemplating a qualitative focus, of explorative nature, descriptive and explanatory, resulting in the following thematic categories: The perception of the importance of "being a nurse in home care" and the relevance of the knowledge of the needs of patients with cerebral palsy and their family, in regards to home internment. From its development, it was possible to perceive that the academic focus given to this type of service and to this type of patient is limited, and that a specific specialization for the peculiarities of the service of home care and the peculiarities of a patient with cerebral palsy is still restricted. We conclude that greater assessment and study of the service of home care, as well as the patient with cerebral palsy, is necessary. As much during study as after graduation because this is a service in expansion and the patient needs complete care. We hope that this study contributes to a greater interest in the subject, facilitating the assistance of patients in home care, particularly those with special needs.Este es un trabajo de finalización de curso, que tiene como tema la formación de enfermeras en la atención domiciliaria con una necesidad especial, más concretamente, para el cliente con parálisis cerebral; quiere aumentar la sensibilización, especialmente a la enfermera acerca de las peculiaridades del Servicio de Atención a domicilio y al paciente con parálisis cerebral. Para dirigir el progreso de este trabajo, se presenta como problema el estudio de la identificación de las principales necesidades presentadas por el cliente con parálisis cerebral en el servicio de cuidados en el hogar. El objetivo general de esta investigación es describir el proceso de formación de la enfermera especialista en cuidados en el hogar y los objetivos específicos: identificar las principales necesidades de la atención al cliente con necesidades especiales, con parálisis cerebral; describir cómo las enfermeras están preparadas para este tipo de asistencia a estos clientes y de su familia. Nuestra opción es realizar una búsqueda bibliográfica, se contempla un enfoque cualitativo, el carácter exploratorio, descriptivo y explicativo, por lo que en las siguientes categorías temáticas: La percepción de la importancia de "ser calificadas enfermeras en la atención a domicilio" y la importancia del conocimiento de las necesidades del cliente y de la familia del neuropata, frente al episodio de hospitalización en domicilio. A partir de su desarrollo, es posible percibir que el enfoque académico dispensado a este tipo de servicio y a ese tipo de cliente es limitada, y que está todavía limitada una especialización especifica tanto para las peculiaridades del servicio de atención domiciliaria, como las peculiaridades de un paciente neuropata. Llegamos a la conclusión de que necesitamos una mayor valoración y estudio del servicio de atención domiciliaria, así como a los clientes con parálisis cerebral, tanto durante como en la postgraduación, por el hecho de que este es un servicio en expansión y el cliente es un usuario que necesita toda la atención. Esperamos que este estudio contribuya a un mayor interés en el tema, facilitar la asistencia de los clientes sometidos a atención domiciliaria, especialmente los que tienen necesidades especiales.Trata-se de um trabalho de conclusão de curso, que tem como tema a formação do enfermeiro no atendimento domiciliar ao portador de necessidade especial, mais especificamente, ao cliente com paralisia cerebral, pretende sensibilizar, em especial ao enfermeiro quanto às peculiaridades do serviço de atendimento domiciliar e do paciente com paralisia cerebral. Para direcionar o andamento deste trabalho, apresentamos como problema de estudo a identificação das principais necessidades apresentadas pelo cliente com paralisia cerebral no serviço de atendimento domiciliar. O objetivo geral desta pesquisa foi descrever o processo de formação do enfermeiro especialista em atendimento domiciliar e os objetivos específicos: identificar as principais necessidades assistenciais do cliente portador de necessidades especiais com paralisia cerebral; descrever como o enfermeiro é preparado para essa assistência a esses clientes e sua família. Optou-se por realizar uma pesquisa bibliográfica, contemplando-se uma abordagem qualitativa, de natureza exploratória, descritiva e explicativa, resultando nas seguintes categorias temáticas: A percepção da importância do “ser enfermeiro capacitado em home care” e A relevância do conhecimento das necessidades do cliente e da família do neuropata, frente ao episodio de internação domiciliar. A partir do seu desenvolvimento, foi possível perceber que a abordagem acadêmica dispensada a esse tipo de serviço e a esse tipo de cliente é restrita, e que ainda é restrita também uma especialização especifica, tanto para as peculiaridades do serviço de atendimento domiciliar, como às peculiaridades de um paciente neuropata. Concluímos que é necessário maior valorização e estudo quanto ao serviço de atendimento domiciliar, assim como também ao cliente com paralisia cerebral, tanto no intra como na pós-graduação, pelo fato de que este é um serviço em expansão e esse cliente é um usuário em potencial, por ser um cliente que necessita de atenção integral. Desejamos que este estudo contribua de forma a impulsionar um maior interesse sobre o tema, facilitando a assistência de clientes submetidos à internação domiciliar, em especial àqueles que possuem necessidades especiais