Risk factors for non-diabetic renal disease in diabetic patients

Background. Diabetic patients with kidney disease have a high prevalence of non-diabetic renal disease (NDRD). Renal and patient survival regarding the diagnosis of diabetic nephropathy (DN) or NDRD have not been widely studied. The aim of our study is to evaluate the prevalence of NDRD in patients with diabetes and to determine the capacity of clinical and analytical data in the prediction of NDRD. In addition, we will study renal and patient prognosis according to the renal biopsy findings in patients with diabetes. Methods. Retrospective multicentre observational study of renal biopsies performed in patients with diabetes from 2002 to 2014. Results. In total, 832 patients were included: 621 men (74.6%), mean age of 61.7 6 12.8 years, creatinine was 2.8 6 2.2 mg/dL and proteinuria 2.7 (interquartile range: 1.2–5.4) g/24 h. About 39.5% (n ¼ 329) of patients had DN, 49.6% (n ¼ 413) NDRD and 10.8% (n ¼ 90) mixed forms. The most frequent NDRD was nephroangiosclerosis (NAS) (n ¼ 87, 9.3%). In the multivariate logistic regression analysis, older age [odds ratio (OR) ¼ 1.03, 95% CI: 1.02–1.05, P < 0.001], microhaematuria (OR ¼ 1.51, 95% CI: 1.03–2.21, P ¼ 0.033) and absence of diabetic retinopathy (DR) (OR ¼ 0.28, 95% CI: 0.19–0.42, P < 0.001) were independently associated with NDRD. Kaplan–Meier analysis showed that patients with DN or mixed forms presented worse renal prognosis than NDRD (P < 0.001) and higher mortality (P ¼ 0.029). In multivariate Cox analyses, older age (P < 0.001), higher serum creatinine (P < 0.001), higher proteinuria (P < 0.001), DR (P ¼ 0.007) and DN (P < 0.001) were independent risk factors for renal replacement therapy. In addition, older age (P < 0.001), peripheral vascular disease (P ¼ 0.002), higher creatinine (P ¼ 0.01) and DN (P ¼ 0.015) were independent risk factors for mortality. Conclusions. The most frequent cause of NDRD is NAS. Elderly patients with microhaematuria and the absence of DR are the ones at risk for NDRD. Patients with DN presented worse renal prognosis and higher mortality than those with NDRD. These results suggest that in some patients with diabetes, kidney biopsy may be useful for an accurate renal diagnosis and subsequently treatment and prognosis

Uso de plasma rico em plaquetas em úlceras de córnea em cães

This study aims to clinically and macroscopically evaluate the adjuvant therapy withplatelet-rich plasma in the form of eyedrops or clot, for corneal ulcers in dogtreated at the Veterinary Ophthalmology Service. We analyzed 20 eyes diagnosed withulcerative keratitis, divided into two experimental groups. The eyedrop group (GC)was composed of eyes treated topically with eyedrops of autologous platelet-richplasma (PRP), and the clot group (GT) was composed of eyes treated with aplatelet-rich clot and covered with a third eyelid for retention of the clot. Thegroups were evaluated by clinical and macroscopic analysis and by the analysis ofepithelial defect reduction, at different times, at three, five, ten, 15 and 30 days,except for the third day in GT. The coverage of the third eyelid was removed on thefifth day. In both groups the inflammation signs reduced, there was an improvement inocular sensibility and proper repair of epithelial defect. All GT eyes and 70% GCeyes showed complete healing on the fifth day, the remainder of GC completed healingon the tenth day. PRP in the form of eyedrops and clot is an excellent adjuvanttherapy to be instituted in the clinical treatment for corneal ulcer in dogs, becauseit decreases the inflammatory signs and the ocular pain and it potentially assists inhealing epithelial defects.Este trabalho teve por objetivo avaliar, clínica e macroscopicamente, o tratamentoadjuvante com plasma rico em plaquetas na forma de colírio ou tampão, em úlceras decórnea de cães atendidos no Serviço de Oftalmologia Veterinária. Foram analisados 20olhos com diagnóstico de ceratite ulcerativa, distribuídos em dois grupoexperimentais. O grupo colírio (GC) foi constituído por olhos tratados topicamentecom colírio autólogo de plasma rico em plaquetas (PRP), e o grupo tampão (GT) porolhos submetidos ao tratamento à base de tampão sólido de PRP, associado aorecobrimento com terceira pálpebra para retenção deste. Os grupos foram avaliados,por meio de avaliação clínica, macroscópica e análise da redução do defeitoepitelial, em diferentes momentos, aos três, cinco, dez, 15 e 30 dias, com exceção doterceiro dia no GT. O recobrimento da terceira pálpebra foi removido no quinto dia noGT. Em ambos os grupos, houve redução dos sinais de inflamação, melhora nasensibilidade ocular e adequada reparação do defeito epitelial. Todos os olhos do GTapresentaram completa cicatrização no quinto dia e 70% no GC, atingindo a totalidadeno 10º dia. O PRP na forma de colírio ou tampão é uma excelente terapia adjuvante aser instituída no tratamento clínico da úlcera de córnea em cães, pois atua nadiminuição dos sinais inflamatórios, da dor ocular e auxilia potencialmente nacicatrização do defeito epitelial.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Risk factors for non-diabetic renal disease in diabetic patients

Background. Diabetic patients with kidney disease have a high prevalence of non-diabetic renal disease (NDRD). Renal and patient survival regarding the diagnosis of diabetic nephropathy (DN) or NDRD have not been widely studied. The aim of our study is to evaluate the prevalence of NDRD in patients with diabetes and to determine the capacity of clinical and analytical data in the prediction of NDRD. In addition, we will study renal and patient prognosis according to the renal biopsy findings in patients with diabetes. Methods. Retrospective multicentre observational study of renal biopsies performed in patients with diabetes from 2002 to 2014. Results. In total, 832 patients were included: 621 men (74.6%), mean age of 61.7 6 12.8 years, creatinine was 2.8 6 2.2 mg/dL and proteinuria 2.7 (interquartile range: 1.2–5.4) g/24 h. About 39.5% (n ¼ 329) of patients had DN, 49.6% (n ¼ 413) NDRD and 10.8% (n ¼ 90) mixed forms. The most frequent NDRD was nephroangiosclerosis (NAS) (n ¼ 87, 9.3%). In the multivariate logistic regression analysis, older age [odds ratio (OR) ¼ 1.03, 95% CI: 1.02–1.05, P < 0.001], microhaematuria (OR ¼ 1.51, 95% CI: 1.03–2.21, P ¼ 0.033) and absence of diabetic retinopathy (DR) (OR ¼ 0.28, 95% CI: 0.19–0.42, P < 0.001) were independently associated with NDRD. Kaplan–Meier analysis showed that patients with DN or mixed forms presented worse renal prognosis than NDRD (P < 0.001) and higher mortality (P ¼ 0.029). In multivariate Cox analyses, older age (P < 0.001), higher serum creatinine (P < 0.001), higher proteinuria (P < 0.001), DR (P ¼ 0.007) and DN (P < 0.001) were independent risk factors for renal replacement therapy. In addition, older age (P < 0.001), peripheral vascular disease (P ¼ 0.002), higher creatinine (P ¼ 0.01) and DN (P ¼ 0.015) were independent risk factors for mortality. Conclusions. The most frequent cause of NDRD is NAS. Elderly patients with microhaematuria and the absence of DR are the ones at risk for NDRD. Patients with DN presented worse renal prognosis and higher mortality than those with NDRD. These results suggest that in some patients with diabetes, kidney biopsy may be useful for an accurate renal diagnosis and subsequently treatment and prognosis

The Present and Future of QCD

International audienceThis White Paper presents the community inputs and scientific conclusions from the Hot and Cold QCD Town Meeting that took place September 23-25, 2022 at MIT, as part of the Nuclear Science Advisory Committee (NSAC) 2023 Long Range Planning process. A total of 424 physicists registered for the meeting. The meeting highlighted progress in Quantum Chromodynamics (QCD) nuclear physics since the 2015 LRP (LRP15) and identified key questions and plausible paths to obtaining answers to those questions, defining priorities for our research over the coming decade. In defining the priority of outstanding physics opportunities for the future, both prospects for the short (~ 5 years) and longer term (5-10 years and beyond) are identified together with the facilities, personnel and other resources needed to maximize the discovery potential and maintain United States leadership in QCD physics worldwide. This White Paper is organized as follows: In the Executive Summary, we detail the Recommendations and Initiatives that were presented and discussed at the Town Meeting, and their supporting rationales. Section 2 highlights major progress and accomplishments of the past seven years. It is followed, in Section 3, by an overview of the physics opportunities for the immediate future, and in relation with the next QCD frontier: the EIC. Section 4 provides an overview of the physics motivations and goals associated with the EIC. Section 5 is devoted to the workforce development and support of diversity, equity and inclusion. This is followed by a dedicated section on computing in Section 6. Section 7 describes the national need for nuclear data science and the relevance to QCD research

The Present and Future of QCD

This White Paper presents the community inputs and scientific conclusions from the Hot and Cold QCD Town Meeting that took place September 23-25, 2022 at MIT, as part of the Nuclear Science Advisory Committee (NSAC) 2023 Long Range Planning process. A total of 424 physicists registered for the meeting. The meeting highlighted progress in Quantum Chromodynamics (QCD) nuclear physics since the 2015 LRP (LRP15) and identified key questions and plausible paths to obtaining answers to those questions, defining priorities for our research over the coming decade. In defining the priority of outstanding physics opportunities for the future, both prospects for the short (~ 5 years) and longer term (5-10 years and beyond) are identified together with the facilities, personnel and other resources needed to maximize the discovery potential and maintain United States leadership in QCD physics worldwide. This White Paper is organized as follows: In the Executive Summary, we detail the Recommendations and Initiatives that were presented and discussed at the Town Meeting, and their supporting rationales. Section 2 highlights major progress and accomplishments of the past seven years. It is followed, in Section 3, by an overview of the physics opportunities for the immediate future, and in relation with the next QCD frontier: the EIC. Section 4 provides an overview of the physics motivations and goals associated with the EIC. Section 5 is devoted to the workforce development and support of diversity, equity and inclusion. This is followed by a dedicated section on computing in Section 6. Section 7 describes the national need for nuclear data science and the relevance to QCD research

The present and future of QCD

International audienceThis White Paper presents an overview of the current status and future perspective of QCD research, based on the community inputs and scientific conclusions from the 2022 Hot and Cold QCD Town Meeting. We present the progress made in the last decade toward a deep understanding of both the fundamental structure of the sub-atomic matter of nucleon and nucleus in cold QCD, and the hot QCD matter in heavy ion collisions. We identify key questions of QCD research and plausible paths to obtaining answers to those questions in the near future, hence defining priorities of our research over the coming decades