Chronic allograft nephropathy

Chronic allograft nephropathy (CAN) is the leading cause of renal allograft loss in paediatric renal transplant recipients. CAN is the result of immunological and nonimmunological injury, including acute rejection episodes, hypoperfusion, ischaemia reperfusion, calcineurin toxicity, infection and recurrent disease. The development of CAN is often insidious and may be preceded by subclinical rejection in a well-functioning allograft. Classification of CAN is histological using the Banff classification of renal allograft pathology with classic findings of interstitial fibrosis, tubular atrophy, glomerulosclerosis, fibrointimal hyperplasia and arteriolar hyalinosis. Although improvement in immunosuppression has led to greater 1-year graft survival rates, chronic graft loss remains relatively unchanged and opportunistic infectious complications remain a problem. Protocol biopsy monitoring is not current practice in paediatric transplantation for CAN monitoring but may have a place if new treatment options become available. Newer immunosuppression regimens, closer monitoring of the renal allograft and management of subclinical rejection may lead to reduced immune injury leading to CAN in the paediatric population but must be weighed against the risk of increased immunosuppression and calcineurin inhibitor nephrotoxicity

Analysis of protein carbonylation - pitfalls and promise in commonly used methods

Abstract Oxidation of proteins has received a lot of attention in the last decades due to the fact that they have been shown to accumulate and to be implicated in the progression and the patho-physiology of several diseases such as Alzheimer, coronary heart diseases, etc. This has also resulted in the fact that research scientist became more eager to be able to measure accurately the level of oxidized protein in biological materials, and to determine the precise site of the oxidative attack on the protein, in order to get insights into the molecular mechanisms involved in the progression of diseases. Several methods for measuring protein carbonylation have been implemented in different laboratories around the world. However, to date no methods prevail as the most accurate, reliable and robust. The present paper aims at giving an overview of the common methods used to determine protein carbonylation in biological material as well as to highlight the limitations and the potential. The ultimate goal is to give quick tips for a rapid decision making when a method has to be selected and taking into consideration the advantage and drawback of the methods

Modelagem e análise de serviços de saúde baseados em Redes de Petri interpretadas

Este trabalho introduz as Redes de Petri para modelagem e análise de sistemas de saúde que além da complexidade de suas atividades, envolve na sua concepção, implementação, operação e tomada de decisões, vários e diferentes profissionais. Os modelos são desenvolvidos em PFS (Production Flow Schema) e MFG (Mark Flow Graph) que são interpretações de redes de Petri, explicitando os recursos envolvidos e o fluxo de itens (pessoas, equipamentos, informações). Os serviços do Ambulatório do Hospital das Clínicas da Universidade de São Paulo são utilizados como estudo de caso para comprovar as vantagens da presente proposta.<br>This paper introduces the Petri net for modelling and analysis of health systems where beyond the complexity of they activities, involves in its conception, implementation, operation and decision making several and differents professionals. The models are developed in PFS (Production Flow Schema) and MFC (Mark Flow Graph) that are interpretations of Peri nets aiming the explicit identification of resources and flow of itens (material and information). The services of the ambulatory of Clinic Hospital of University of São Paulo is considered in a case study to confirm the advantages of the proposal

Cisto enterógeno intrarraquiano: relato de caso Intraspinal enterogenous cyst: case report

Os autores relatam o caso de um paciente de 7 anos de idade, com quadro de dor cervical e tetraparesia progressiva há 2 meses, que apresentava lesão cística intrarraquiana de C4 a C6. Foi submetido a exerese da lesão por via anterior, através de corporectomia de C5-C6 e reconstrução com enxerto de crista ilíaca e placa metálica. O diagnóstico anátomo-patológico da lesão foi de cisto enterógeno. Aspectos relacionados a apresentação clínica, embriologiae tratamento dessa lesão são discutidos.<br>The authors report the case of a 7 years old boy with cervical pain and tetraparesis progressing by two months. He presented an intraspinal cystic lesion from C4 to C6. Exeresis of the lesion was undergone by anterior way through a corpectomy of C5-C6 followed by reconstruction with bone graft of the iliac crest and metallic plaque. Anatomic diagnosis of the lesion was enterogenous cyst. Aspects of clinical presentation, embryology and treatment of these cysts are discussed