Estudos paleoambientais interdisciplinares: dinâmica da vegetação, do ambiente marinho e inferências climáticas milenares a atuais na Costa Norte do Espírito Santo, Brasil

Estudos paleoambientais desde ~50.000 anos na costa do Brasil e, em particular, no litoral do Espírito Santo, são ainda insuficientes para servir de base a reconstituições da dinâmica da vegetação, de oscilações do nível relativo do mar e de flutuações climáticas e respectivas influências sobre a ação humana milenar. Para obter essas informações, uma equipe interdisciplinar, financiada por projetos temáticos FAPESP e CNPq, desenvolveu pesquisas correlatas na Reserva Natural Vale (RNV) e região. Para a caracterização da dinâmica da vegetação e marinha, com inferências climáticas, em locais de floresta de tabuleiros e campos naturais da RNV e região desde ~16.000 anos, utilizaram-se isótopos do C (12C, 13C e 14C) da matéria orgânica do solo e sedimentar, além de palinologia em sedimentos lacustres e terrestres. No estudo da dinâmica do ecótono floresta – campo, apresentam-se inferências preliminares sobre a evolução pedogenética dos Espodossolos associados ao campo, com ênfase às suas características físico-químicas, e também dos Argissolos, encontrados sob floresta. Finaliza-se com o estágio inicial de uma coleção de referência de fitólitos, bioindicador de vegetação utilizado em estudos paleoambientais, extraídos de plantas da floresta de tabuleiros da RNV.A equipe agradece todo o empenho dos funcionários e apoio logístico da Reserva Natural Vale, Linhares, Espírito Santo; à FAPESP através do projeto Temático 2011/00995-7 (ProjES); e ao CNPq – Universal 2012-5/470210, pelo aporte financeiro e a colaboração dos técnicos do Laboratório 14C, Liz Mary Bueno de Moraes e Thiago Casemiro Barrios de Campos, na preparação de amostras gasosas para a datação 14C.Peer Reviewe

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

The penetration and wettability of varnish in Cryptomeria japonica

Wood products require preservative and finishing treatments to raise their quality and market value, thus making their appearance more pleasing and their strength higher. The objective of this work was to analyze the wettability of the different finishes, as well as the penetration of the products by scanning electron microscopy. The present study used Scanning Electron Microscopy (SEM) with two replicates per sample and a Goniometer to observe the behaviour of the sessile gout with 5 replicates per sample and radial position. It was concluded that the water based varnish presented a diffuse layer when observed in the SEM and the polyurethane varnish formed a film on the substrate thicker than the other treatments. The copal varnish presented a higher contact angle and the nitrocellulose lacquer formed the smallest contact angle. Copal varnish and PU showed higher hydrophobicity and higher resistance to moisture

Early sensory re-education of the hand after peripheral nerve repair based on mirror therapy: a randomized controlled trial

BACKGROUND: Mirror therapy has been used as an alternative stimulus to feed the somatosensory cortex in an attempt to preserve hand cortical representation with better functional results. OBJECTIVE: To analyze the short-term functional outcome of an early re-education program using mirror therapy compared to a late classic sensory program for hand nerve repair. METHOD: This is a randomized controlled trial. We assessed 20 patients with median and ulnar nerve and flexor tendon repair using the Rosen Score combined with the DASH questionnaire. The early phase group using mirror therapy began on the first postoperative week and lasted 5 months. The control group received classic sensory re-education when the protective sensation threshold was restored. All participants received a patient education booklet and were submitted to the modified Duran protocol for flexor tendon repair. The assessments were performed by the same investigator blinded to the allocated treatment. Mann-Whitney Test and Effect Size using Cohen's d score were used for inter-group comparisons at 3 and 6 months after intervention. RESULTS: The primary outcome (Rosen score) values for the Mirror Therapy group and classic therapy control group after 3 and 6 months were 1.68 (SD=0.5); 1.96 (SD=0.56) and 1.65 (SD=0.52); 1.51 (SD=0.62), respectively. No between-group differences were observed. CONCLUSION: Although some clinical improvement was observed, mirror therapy was not shown to be more effective than late sensory re-education in an intermediate phase of nerve repair in the hand. Replication is needed to confirm these findings

Pharmacokinetics and Long-TermSafety and Tolerability of Everolimus in Renal Transplant Recipients Converted From Cyclosporine

Background:Conversion from cyclosporine (CsA) to everolimus (EVR) in kidney transplant recipients receiving mycophenolate sodium (MPS) and corticosteroids has been used to reduce CsA associated toxicities. Nevertheless, exposures produced by the initial EVR dose, the steady state pharmacokinetic and long-term safety and tolerability have not been explored in detail.Methods:Twenty-four stable kidney transplant recipients receiving CSA, MPS, and corticosteroids were converted from CSA to EVR. The initial EVR dose was 3 mg BID. Weekly monitoring of EVR blood concentrations was followed by a full 12 hour pharmacokinetic profile 28 days after conversion. Therapeutic drug monitoring, safety, and tolerability were analyzed during 5 years of follow-up.Results:The study population was relatively young (mean of 42 years) with a predominance of males (62%) and White (67%) recipients of kidneys from living (54%) or deceased (46%) donors. Mean time of the conversion was 61 months after transplantation. In the first 7 patients, the initial EVR dose of 3 mg BID resulted in mean EVR trough blood concentration of 14.7 3.7 ng/mL at day 7. The initial EVR dose was then reduced to 2 mg BID for the following 17 patients. Four weeks after conversion, mean EVR dose was 1.7 +/- 0.5 mg BID (7 patients were receiving 1 mg BID and 17 were receiving 2 mg BID) resulting in mean EVR trough blood concentration of 4.0 +/- 1.4 ng/mL. Whereas mean maximum concentration (13.4 +/- 2.8 versus 22.9 +/- 7.4 ng/mL, P = 0.003) and mean apparent clearance (232 +/- 79 versus 366 +/- 173 mL/min, P = 0.016) were higher, mean area under the curve (78.2 +/- 22.1 versus 102.5 +/- 38.5 ng.h/mL, P = 0.067) and mean C-0 (3.7 +/- 1.3 versus 4.1 +/- 1.5 ng/mL, P = 0.852) were no different comparing patients receiving 1 mg and 2 mg EVR BID. Mean inter-subject variability of area under the curve, trough concentration, and maximum concentration was 38%, 36%, and 38%. EVR treatment was discontinued in 29% of patients due to proteinuria (N = 2), pneumonia (N = 2), dyslipidemia (N = 2), and anemia (N = 1) and MPS dose was reduced in 58% of patients.Conclusions:The initial 3 mg BID dose produced high EVR trough blood concentrations. The 2 mg BID dose appears to be the appropriate initial dose to provide therapeutic concentrations but still requires initial intensive therapeutic monitoring to achieve and maintain blood concentrations within the therapeutic target concentration. The combination of EVR and full dose MPS has limited long-term tolerability and safety.NovartisUniv Fed Sao Paulo, Div Nephrol, Hosp Rim, Rua Borges Lagoa,960 11 Andar, BR-04038002 Sao Paulo, BrazilUniv Fed Sao Paulo, Div Nephrol, Hosp Rim, Rua Borges Lagoa,960 11 Andar, BR-04038002 Sao Paulo, BrazilWeb of Scienc

Effect of Donor Age on Endocrine Function of and Immune Response to Ovarian Grafts

Premature loss of ovarian function (POI) is associated with numerous negative side effects, including vasomotor symptoms, sleep and mood disturbances, disrupted urinary function, and increased risks for osteoporosis and heart disease. Hormone replacement therapy (HRT), the standard of care for POI, delivers only a subset of ovarian hormones and fails to mimic the monthly cyclicity and daily pulsatility characteristic of healthy ovarian tissue in reproductive-aged individuals whose ovarian tissue contains thousands of ovarian follicles. Ovarian tissue allografts have the potential to serve as an alternative, cell-based HRT, capable of producing the full panel of ovarian hormones at physiologically relevant doses and intervals. However, the risks associated with systemic immune suppression (IS) required to prevent allograft rejection outweigh the potential benefits of comprehensive and dynamic hormone therapy. This work investigates whether the age of ovarian tissue donor animals affects the function of, and immune response to, subcutaneous ovarian grafts. We performed syngeneic and semi-allogeneic ovarian transplants using tissue from mice aged 6–8 (D7) or 20–22 (D21) days and evaluated ovarian endocrine function and immune response in a mouse model of POI. Our results revealed that tissue derived from D7 donors, containing an ample and homogeneous primordial follicle reserve, was more effective in fully restoring hypothalamic–pituitary–ovarian feedback. In contrast, tissue derived from D21 donors elicited anti-donor antibodies with higher avidity compared to tissue from younger donors, suggesting that greater immunogenicity may be a trade-off of using mature donors. This work contributes to our understanding of the criteria donor tissue must meet to effectively function as a cell-based HRT and explores the importance of donor age as a factor in ovarian allograft rejection

Expanding the use of expanded criteria donors in kidney transplantation

Although the use of kidney allografts from expanded criteria donors (ECD) has increased in recent years, the reported discard rates are also growing. the influence of ECD characteristics on transplant outcomes is still underevaluated.This retrospective study investigated the influence of preimplantation biopsy findings and delayed graft function (DGF) on patient and graft survivals and renal function at 36 months in a cohort of 372 ECD kidney transplant recipients.Patient and graft survivals were 91.6 and 68.9 %. the incidence of biopsy-proven acute rejection was 31 %. There were no differences in patient (88.6 vs. 91.1 vs. 94.7 vs. 78.6 %, p = 0.10) or graft (78.1 vs. 72.2 vs. 60.5 vs. 62.6 %, p = 0.14) survivals and renal function (41.7 +/- A 25.6 vs. 39.9 +/- A 29.9 vs. 38.1 +/- A 30.6 vs. 37.4 +/- A 29.2 mL/min, p = 0.79) comparing ECD kidneys with mild, moderate, and severe histological changes or with no preimplantation biopsy, respectively. However, severe scored transplants had the worst death-censored graft survival (OR 3.1, 95 % CI 1.4-6.9, p = 0.007). No significant differences in patient (86.2 vs. 83.4 %, p = 0.17) or graft (73.7 vs. 65.9 %, p = 0.06) survivals and renal function (38.9 +/- A 28.6 vs. 39.9 +/- A 28.4 mL/min, p = 0.72) were observed comparing patients with or without DGF. Multivariable analysis found diabetes history as the only independent risk factor for graft loss (OR 2.1, 95 % CI 1.3-3.3, p = 0.003) or patient death (OR 3.1, 95 % CI 1.5-5.8, p < 0.001).Within the limitations of sample size and short follow-up time, in this cohort of ECD kidney transplant recipients the severity of histological changes observed in preimplantation biopsies was independently associated with graft loss.Universidade Federal de São Paulo, Transplant Div, Hosp Rim & Hipertensao, BR-04038002 São Paulo, BrazilUniversidade Federal de São Paulo, Div Nephrol, Hosp Rim, BR-04038002 São Paulo, BrazilUniversidade Federal de São Paulo, Transplant Div, Hosp Rim & Hipertensao, BR-04038002 São Paulo, BrazilUniversidade Federal de São Paulo, Div Nephrol, Hosp Rim, BR-04038002 São Paulo, BrazilWeb of Scienc