2,242 research outputs found
BenefÃcios dos Ativadores Seletivos dos Recetores de Vitamina D em Doentes Transplantados Renais
Severe chronic kidney disease may lead to disturbances, such as hyperphosphatemia, increased secretion
of fibroblast growth factor -23 (FGF -23) and vitamin D deficiency. These may increase plasmatic levels of
parathyroid hormone, and decrease plasmatic levels of calcium. Altogether, these may contribute to the
development of secondary hyperparathyroidism, and to abnormalities in mineral metabolism. Kidney transplantation is the best option to improve longevity and quality of life in end -stage chronic kidney disease
patients. Vitamin D deficiency has been associated with cardiovascular disease, which is the leading cause
of death in chronic kidney disease. Therefore, diagnosing this deficiency may be pivotal for minimizing
mortality in chronic kidney disease, because pharmacological treatments for this deficiency may be prescribed.
Calcitriol is indicated for the treatment of vitamin D deficiency, both in chronic kidney disease and
in kidney transplanted patients. However, calcitriol may increase the plasmatic levels of calcium and phosphorous, which can lead to vascular calcifications, that have been associated with cardiovascular mortality.
Selective vitamin D receptor activators are indicated for the treatment of vitamin D deficiency in chronic
kidney disease. These have the advantage of being associated with lower increases of plasmatic levels of
calcium and phosphorous. These drugs also seem to have additional effects that may minimise patient
morbidity and mortality, especially due to potentially reducing cardiovascular events. Unfortunately, there
are few studies about the use of these drugs in kidney transplanted patients. Here we present a review about the physiology of vitamin D, the consequences of its deficiency in chronic kidney disease and in
kidney transplanted patients, and about the diagnosis and treatment of this deficiency. Finally, we discuss
the new line of research about the efficacy and safety of selective vitamin D receptor activators in kidney
transplanted patients
A MIQE-Compliant Real-Time PCR Assay for Aspergillus Detection
PMCID: PMC3393739This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Emergence of scale-free close-knit friendship structure in online social networks
Despite the structural properties of online social networks have attracted
much attention, the properties of the close-knit friendship structures remain
an important question. Here, we mainly focus on how these mesoscale structures
are affected by the local and global structural properties. Analyzing the data
of four large-scale online social networks reveals several common structural
properties. It is found that not only the local structures given by the
indegree, outdegree, and reciprocal degree distributions follow a similar
scaling behavior, the mesoscale structures represented by the distributions of
close-knit friendship structures also exhibit a similar scaling law. The degree
correlation is very weak over a wide range of the degrees. We propose a simple
directed network model that captures the observed properties. The model
incorporates two mechanisms: reciprocation and preferential attachment. Through
rate equation analysis of our model, the local-scale and mesoscale structural
properties are derived. In the local-scale, the same scaling behavior of
indegree and outdegree distributions stems from indegree and outdegree of nodes
both growing as the same function of the introduction time, and the reciprocal
degree distribution also shows the same power-law due to the linear
relationship between the reciprocal degree and in/outdegree of nodes. In the
mesoscale, the distributions of four closed triples representing close-knit
friendship structures are found to exhibit identical power-laws, a behavior
attributed to the negligible degree correlations. Intriguingly, all the
power-law exponents of the distributions in the local-scale and mesoscale
depend only on one global parameter -- the mean in/outdegree, while both the
mean in/outdegree and the reciprocity together determine the ratio of the
reciprocal degree of a node to its in/outdegree.Comment: 48 pages, 34 figure
VISCERAL LEISHMANIASIS IN PETROLINA, STATE OF PERNAMBUCO, BRAZIL, 2007-2013
Visceral leishmaniasis is a life-threatening disease of great public health relevance in Brazil. The municipality of Petrolina is an endemic area in the State of Pernambuco, Brazil. This study was designed to assess the recent expansion of VL in the municipality ofPetrolina, Pernambuco. Patients data were obtained from the Brazilian National Information System for Notifiable Diseases (SINAN). A total of 111 records from 2007 to 2013 were investigated, of which 69 were residents in Petrolina. The disease has predominantly affected 1-4 year old children (34.8%). Most of the patients were males (59.4%). Co-infection with human immunodeficiency virus occurred in 14.5% of the cases. The criterion most frequently used was the clinical and epidemiological confirmation (59.4%), with clinical cure in 78.3% of cases and one fatal outcome. Visceral leishmaniasis is endemic in Petrolina with transmission levels varying from moderate to high. The present study has shown the precariousness of the use of diagnostic tests in primary healthcare units, and this misuse has interfered with the diagnosis and treatment of cases
Early Relapse After Autologous Hematopoietic Cell Transplantation Remains a Poor Prognostic Factor in Multiple Myeloma but Outcomes Have Improved Over Time
Duration of initial disease response remains a strong prognostic factor in multiple myeloma (MM) particularly for upfront autologous hematopoietic cell transplant (AHCT) recipients. We hypothesized that new drug classes and combinations employed prior to AHCT as well as after post-AHCT relapse may have changed the natural history of MM in this population. We analyzed the Center for International Blood and Marrow Transplant Research database to track overall survival (OS) of MM patients receiving single AHCT within 12 months after diagnosis (N=3256) and relapsing early post-AHCT (\u3c 24 months), and to identify factors predicting for early vs late relapses (24−48 months post-AHCT). Over three periods (2001–2004, 2005–2008, 2009–2013), patient characteristics were balanced except for lower proportion of Stage III, higher likelihood of one induction therapy with novel triplets and higher rates of planned post-AHCT maintenance over time. The proportion of patients relapsing early was stable over time at 35–38%. Factors reducing risk of early relapse included lower stage, chemosensitivity, transplant after 2008 and post-AHCT maintenance. Shorter post-relapse OS was associated with early relapse, IgA MM, Karnofsky \u3c 90, stage III, \u3e 1 line of induction and lack of maintenance. Post-AHCT early relapse remains a poor prognostic factor, even though outcomes have improved over time
Characterization of complex networks: A survey of measurements
Each complex network (or class of networks) presents specific topological
features which characterize its connectivity and highly influence the dynamics
of processes executed on the network. The analysis, discrimination, and
synthesis of complex networks therefore rely on the use of measurements capable
of expressing the most relevant topological features. This article presents a
survey of such measurements. It includes general considerations about complex
network characterization, a brief review of the principal models, and the
presentation of the main existing measurements. Important related issues
covered in this work comprise the representation of the evolution of complex
networks in terms of trajectories in several measurement spaces, the analysis
of the correlations between some of the most traditional measurements,
perturbation analysis, as well as the use of multivariate statistics for
feature selection and network classification. Depending on the network and the
analysis task one has in mind, a specific set of features may be chosen. It is
hoped that the present survey will help the proper application and
interpretation of measurements.Comment: A working manuscript with 78 pages, 32 figures. Suggestions of
measurements for inclusion are welcomed by the author
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