Comment on Bress et al. Effect of Intensive Versus Standard Blood Pressure Treatment According to Baseline Prediabetes Status: A Post Hoc Analysis of a Randomized Trial. Diabetes Care 2017;40:1401-1408.

info:eu-repo/semantics/publishedVersio

Comportamento celular e resposta antioxidante diferenciados de Saccharomyces cerevisiae e Saccaromyces chevalieri ao metavanadato de amónio

A fermentação do vinho é um processo microbiológico complexo que requere a presença de leveduras adaptadas a condições de stresse. No ambiente celular de organismos aeróbios ocorrem naturalmente espécies reactivas de oxigénio (ROS) como subprodutos da respiração mitocondrial. A elevada reactividade destas espécies químicas pode gerar danos moleculares que, em alguns casos, levam à morte celular. Em condições fisiológicas normais ou como resposta ao stresse oxidativo, a célula pode desencadear respostas adaptativas que envolvem mecanismos antioxidantes como os enzimas glutationo redutase (GR; EC 1.6.4.2) e catalases T (CAT T; EC 1.11.1.6) e A (CAT A; EC 1.11.1.6). O vanádio, um metal pesado presente em alguns fitofármacos, pode também comportar- se como um gerador de ROS, alterando o estado redox intracelular e exercendo efeitos nocivos em leveduras expostas a quantidade excessiva deste elemento. O principal objectivo deste trabalho foi comparar o efeito do metavanadato de amónio (NH4VO3), um sal pentavalente de vanádio, na viabilidade celular e nas actividades enzimáticas GR, CAT T e CAT A das leveduras vínicas Saccharomyces cerevisiae UE-ME3 e Saccharomyces chevalieri UE-ME1. Os resultados obtidos mostram que S. chevalieri UE-ME1 revelou menor tolerância ao NH4VO3 do que S. cerevisiae UE-ME3, uma vez que culturas de S. chevalieri não sobreviveram para valores de concentração do sal de vanádio superiores a 7,5 mM enquanto que células de S. cerevisiae mantiveram-se viáveis em presença de metavanadato de amónio 75 mM. As actividades enzimáticas estudadas apresentaram em S. chevalieri valores muito inferiores aos que foram determinados em S. cerevisiae embora em ambas as espécies de levedura o NH4VO3 pareça comportarse como um indutor de stresse oxidativo ao provocar um decréscimo significativo da actividade GR (P<0,01) e um aumento significativo da actividade CAT A (P<0,01). Observou-se, ainda, nas duas espécies de levedura, um aumento da actividade enzimática CAT T, tida como resposta adaptativa protectora ao stresse oxidativo. O comportamento diferenciado de adaptação à presença de metavanadato de amónio pelas duas espécies de Saccharomyces pode ser parcialmente justificado pela presença de sistemas antioxidantes mais eficientes em S. cerevisiae UE-ME3

Adenovirus Infection in a Kidney–Pancreatic Transplant Recipient: Case Report

Adenovirus infection in transplant recipients may present from asymptomatic viremia to multisystemic involvement. Most frequently, it occurs in the first year after a kidney transplant, and it is secondary to the reactivation of latent disease. However, primary infection may occur, and disseminated disease is more common when related to primary infection. Kidney involvement may be confirmed by biopsy, although diagnosis may be presumptive. Reduction of immunosuppression and supportive care are important components of therapy. CASE DESCRIPTION: A 41-year-old female renal-pancreatic recipient 12 years before with chronic renal graft dysfunction and a functional pancreatic graft had a history of cytomegalovirus and polyoma virus infection 2 years after transplantation. She was taking tacrolimus, mycophenolate mofetil, and prednisolone. The patient was admitted after persistent uncharacteristic diarrhea 3 weeks before hospitalization without any relevant epidemiologic context. She was dehydrated, and the lab results showed worsened kidney function and leucocytosis. The viral culture revealed adenovirus. Vigorous hydration was implemented, and the mycophenolate mofetil dose was reduced. The patient was discharged, and renal function returned to previous values. DISCUSSION AND CONCLUSION: Adenovirus infection has a wide clinical presentation, and multisystemic involvement may occur in transplant recipients. Supportive care is paramount. The clinical features and viral culture confirm the diagnosis, although tissue samples and quantitative polymerase chain reaction may be required in more severe cases.info:eu-repo/semantics/publishedVersio

Implications for patients waiting for a kidney transplant of using the calculated panel reactive antibody (cPRA)

Introduction: Kidney transplant improves survival even in highly‑sensitized (HS) patients. To overcome their disadvantage in accessing transplantation, those with high Complement Dependent Cytotoxic PRA (CDC‑PRA) receive additional points during allocation. Whether this strategy reaches all HS patients and how long they wait for a transplant is largely undetermined. Methods: Patients on our unit’s active wait‑list for kidney transplantation in the year 2014 were analyzed. CDC‑PRA and calculated PRA (cPRA) were recorded. To obtain cPRA, antibodies in the last serum available specific for HLA‑A, ‑B or –DR with an intensity > 1000 MFI were considered. Results: The cPRA values in the population (N=551) were 0% (N=312), 1‑79% (N=118) and ≥ 80% (22%; N=121). Among these groups, the proportion of women (29.5, 55.9 and 61.2%, P 50%. Moreover, only 30% of HS by cPRA patients received the extra points designed to improve their transplantability. We consider that both CDC‑PRA and cPRA should be taken into account when defining HS status.info:eu-repo/semantics/publishedVersio

Lower Free Triiodothyronine Levels Within the Reference Range Are Associated with Higher Cardiovascular Mortality: an Analysis of the NHANES

Thyroid hormones play a central role in cardiovascular homeostasis. Lower free triiodothyronine (FT3) levels have been associated with worse prognosis in several conditions. However, contrary to thyrotropin (TSH) and free thyroxine (FT4), the role of FT3 in morbidity and mortality in the general population remains uncertain. Our objective was to evaluate the association between within the normal range FT3 levels and mortality in the general population.info:eu-repo/semantics/publishedVersio

Predicting Function Delay with a Machine Learning Model: Improve the Long-term Survival of Pancreatic Grafts

The impact of delayed graft function on outcomes following various solid organ transplants is well documented and addressed in the literature. Delayed graft function following various solid organ transplants is associated with both short- and long-term graft survival issues. In a retrospective cohort study including 106 patients we evaluated whether pancreas graft survival differs according to moment of insulin therapy following simultaneous pancreaskidney transplant. As a result, we aimed to identify possible risk factors and build a machine-learning-based model that predicts the likelihood of dysfunction following SPK transplant patients based on day zero data after transplant, allowing to enhance pancreatic graft survival. Feature selection by Relief algorithm yielded donor features, age, cause of death, hemoglobin, gender, ventilation days, days in ICU, length of cardiac respiratory arrest and recipient features, gender, long-term insulin, dialysis type, time of diabetes mellitus, vPRA pre-Tx, number of HLA-A mismatches and PRDI, all contributed to the models' strength.info:eu-repo/semantics/publishedVersio

Caffeine consumption and mortality in chronic kidney disease: a nationally representative analysis

BACKGROUND: An inverse relationship between coffee consumption and mortality has been reported in the general population. However, the association between caffeine consumption and mortality in patients with chronic kidney disease (CKD) remains uncertain. METHODS: We analysed 4863 non-institutionalized USA adults with CKD [defined by an estimated glomerular filtration rate (eGFR) of 15-60 mL/min/1.73 m2 and/or a urinary albumin:creatinine ratio >30 mg/g] in a nationwide study using the National Health and Nutrition Examination Survey (NHANES) 1999-2010. Caffeine consumption was evaluated by 24-h dietary recalls at baseline and all-cause, cardiovascular and cancer mortality were evaluated until 31 December 2011. We also performed an analysis of caffeine consumption according to its source (coffee, tea and soft drinks). Quartiles of caffeine consumption were 213.5 (Q4). RESULTS: During a median follow-up of 60 months, 1283 participants died. Comparing with Q1 of caffeine consumption, the adjusted hazard ratio for all-cause mortality was 0.74 [95% confidence interval (CI) 0.60-0.91] for Q2, 0.74 (95% CI 0.62-0.89) for Q3 and 0.78 (95% CI 0.62-0.98) for Q4 (P = 0.02 for trend across quartiles). There were no significant interactions between caffeine consumption quartiles and CKD stages or urinary albumin:creatinine ratio categories regarding all-cause mortality.info:eu-repo/semantics/publishedVersio

Canaliculite Lacrimal Crónica - a Resposta para uma História de Olho Vermelho com 3 Anos de Evolução

Chronic lacrimal canaliculitis is a rare infection of the lacrimal system, and can lead to misdiagnosis due to its overlapping presentation to other common entities. The authors report a case of lacrimal canaliculitis with a three-year history of recurrent unilateral red eye and mucopurulent discharge. Here, we describe the clinical course, surgical details, and microbial analysis of canaliculitis infection.info:eu-repo/semantics/publishedVersio

Risk-benefit profile of intensive blood pressure treatment

info:eu-repo/semantics/publishedVersio

Caffeine consumption and mortality in chronic kidney disease: a nationally representative analysis

BACKGROUND: An inverse relationship between coffee consumption and mortality has been reported in the general population. However, the association between caffeine consumption and mortality in patients with chronic kidney disease (CKD) remains uncertain. METHODS: We analysed 4863 non-institutionalized USA adults with CKD [defined by an estimated glomerular filtration rate (eGFR) of 15-60 mL/min/1.73 m2 and/or a urinary albumin:creatinine ratio >30 mg/g] in a nationwide study using the National Health and Nutrition Examination Survey (NHANES) 1999-2010. Caffeine consumption was evaluated by 24-h dietary recalls at baseline and all-cause, cardiovascular and cancer mortality were evaluated until 31 December 2011. We also performed an analysis of caffeine consumption according to its source (coffee, tea and soft drinks). Quartiles of caffeine consumption were 213.5 (Q4). RESULTS: During a median follow-up of 60 months, 1283 participants died. Comparing with Q1 of caffeine consumption, the adjusted hazard ratio for all-cause mortality was 0.74 [95% confidence interval (CI) 0.60-0.91] for Q2, 0.74 (95% CI 0.62-0.89) for Q3 and 0.78 (95% CI 0.62-0.98) for Q4 (P = 0.02 for trend across quartiles). There were no significant interactions between caffeine consumption quartiles and CKD stages or urinary albumin:creatinine ratio categories regarding all-cause mortality.info:eu-repo/semantics/publishedVersio