84 research outputs found
NATDATA: integrando dados de recursos naturais dos biomas brasileiros.
RESUMO: A agricultura nacional exige a intensificação das áreas plantadas aliada à manutenção dos recursos naturais dos biomas brasileiros. Respostas rápidas a questões envolvendo temas como solo, recursos hídricos, biodiversidade e clima nesse caso são essenciais. O Brasil dispõe de um grande acervo de dados sobre estes temas, distribuídos em várias instituições de pesquisa. A heterogeneidade de padrões aliada a essa distribuição dificulta o seu uso combinado. Este trabalho apresenta uma iniciativa que vem sendo desenvolvida pela Empresa Brasileira de Pesquisa Agropecuária - Embrapa, que tem como principal objetivo integrar dados de recursos naturais dos diferentes biomas brasileiros, fornecendo aos usuários um ambiente que permita a consulta rápida e integrada a estes dados.SBIAgro 2011
Predictors of first-line treatment persistence in a Portuguese cohort of relapsing-remitting multiple sclerosis
Treatment persistence in first-line injectable disease-modifying therapies (DMT) for relapsing-remitting multiple sclerosis (RRMS) is an important indicator of effectiveness. Identifying predictors of treatment discontinuation is important as there are other therapies currently available and a growing range of emerging drugs. We report a retrospective study of RRMS and clinically isolated syndrome patients followed in a University Hospital during a 13-year period with the objective of identifying predictors of treatment persistence. An evaluation of persistence on the first DMT, rates of DMT discontinuation, and reasons and predictors of discontinuation was performed. A total of 410 patients were included, 69% female, with mean disease duration of 37.8months, mean age of 34.2years and mean follow-up time of 6.1years. The first DMT was glatiramer acetate (GA) in 27.56% of patients, interferon (IFN) β-1a intramuscular in 26.34%, IFNβ-1b in 26.10%, IFNβ-1a22 in 13.66% and IFNβ-1a44 in 6.34%. Treatment was discontinued in 16.34% of patients after 1year of treatment and in 50.24% of patients in the total follow-up time, with a mean time for discontinuation of 39.80months. Higher baseline Expanded Disability Status Scale score was an independent predictor of treatment discontinuation (hazard ratio 1.35, p=0.002). After the first year, treatment persistence was 90.74% for IFNβ-1a-IM, 88.46% for IFNβ-1a44, 83.18% for IFNβ-1b, 83.19% for GA and 69.64% for IFNβ-1a22 (p=0.014). Lower frequency of administration was associated with higher persistence rates. The most common reason for treatment discontinuation was lack of efficacy in all DMT subgroups.info:eu-repo/semantics/publishedVersio
Early Rehospitalization Post-Kidney Transplant Due to Infectious Complications: Can We Predict the Patients at Risk?
INTRODUCTION:
Rehospitalization early post-kidney transplant is common and has a negative impact in morbidity, graft survival, and health costs. Infection is one the most common causes, and identifying the risk factors for early readmission due to infectious complications may guide a preventive program and improve outcome. The aim of this study was to evaluate the incidence, characterize the population, and identify the risk factors associated with early readmission for infectious complications post-kidney transplantation.
METHODS:
We performed a retrospective cohort study of all the kidney transplants performed during 2015. The primary outcome was readmission in the first 3 months post-transplant due to infectious causes defined by clinical and laboratory parameters.
RESULTS:
We evaluated 141 kidney transplants; 71% of subjects were men, with an overall mean age of 50.8 ± 15.4 years. Prior to transplant, 98% of the patients were dialysis dependent and 2% underwent pre-emptive living donor kidney transplant. The global readmission rate was 49%, of which 65% were for infectious complications. The most frequent infection was urinary tract infection (n = 28, 62%) and the most common agent detected by blood and urine cultures was Klebsiella pneumonia (n = 18, 40%). The risk factors significantly associated with readmission were higher body mass index (P = .03), diabetes mellitus (P = .02), older donor (P = .007), and longer cold ischemia time (P = .04). There were 3 graft losses, but none due to infectious complications.
CONCLUSION:
There was a high incidence of early rehospitalization due to infectious complications, especially urinary tract infections to nosocomial agents. The risk factors identified were similar to other series.info:eu-repo/semantics/publishedVersio
Benefícios 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
Análise de uso de padrões de metadados em projetos de pesquisa e desenvolvimento na Embrapa Informática Agropecuária.
A Empresa Brasileira de Pesquisa Agropecuária (Embrapa) produz uma grande quantidade de dados como resultado das pesquisa que realiza. Os dados gerados abrangem diferentes domínios: solos, clima, coleções, dados de animais, dados bibliográficos, entre outros. Muitas vezes os projetos trocam ou reúsam a informação produzidas. Apesar disso, muitos deles ainda são armazenados de diferentes formas e usando diferentes formatos, como planilhas, sistemas de banco de dados, papel, entre outros. A necessidade ou possibilidade de integração/compartilhamento de informação entre esses sistemas ou mesmo com outras instituições de pesquisa, desencadeou ações para a incorporação de novas estruturas e conceitos aos sistemas desenvolvidos, no sentido de facilitar a interoperabilidade de dados. Uma abordagem para esse problema é a adoção de padrões de metadados bem estabelecidos para descrição desses dados. Nesse sentindo, a Embrapa Informática Agropecuária estabeleceu um grupo de trabalho cuja missão era identificar a situação de seus projetos de pesquisa quanto à adoção desses padrões. O grupo elaborou um conjunto de perguntas que foram apresentadas à maioria desses projetos, permitindo não apenas identificar a utilização de metadados, mas também descrever as principais observações e recomendações sobre esse tema. Este documento apresenta o trabalho realizado por esse grupo, bem como os resultados obtidos.bitstream/item/57307/1/Livro-BolPesq27-1.pd
Polyomavirus Nephropathy: Ten-Year Experience
BACKGROUND:
Polyomavirus nephropathy (BKVN) is an important cause of chronic allograft dysfunction (CAD). Recipient determinants (male sex, white race, and older age), deceased donation, high-dose immunosuppression, diabetes, delayed graft function (DGF), cytomegalovirus infection, and acute rejection (AR) are risk factors. Reducing immunosuppression is the best strategy in BKVN. The objective of our study was to evaluate CAD progression after therapeutic strategies in BKVN and risk factors for graft loss (GL).
METHODS:
Retrospective analysis of 23 biopsies, from patients with CAD and histological evidence of BKVN, conducted over a period of 10 years. Glomerular filtration rate was <30 mL/min in 16 patients at the time of the BKVN diagnosis.
RESULTS:
BKVN was histologically diagnosed in 23 recipients (19 men, 4 women). All patients were white, with age of 51.2 ± 12.1 years (6 patients, age >60 years), and 22 had a deceased donor. Diabetes affected 4 patients, DGF occurred in 3, cytomegalovirus infection in 2, and AR in 15. All patients were medicated with calcineurin inhibitors (CNI) (95.7% tacrolimus) and corticoids, and 16 also received an antimetabolite. One year after antimetabolite reduction/discontinuation and/or CNI reduction/switching and/or antiviral agents, graft function was decreased in 11 patients, increased/stabilized in 10, and unknown in 2. GL occurred in 9 patients. Older age (hazard ratio, 1.76; 95% confidence interval, 0.94-3.28) and DGF (hazard ratio, 2.60; 95% confidence interval, 0.54-12.64) were the main risk factors for GL. The lower GFR at the time of the BKVN diagnosis was associated with an increased risk of initiation of dialysis.
CONCLUSIONS:
GL occurred in 39.1% of patients with BKVN and DGF; older age and lower GFR at the time of diagnosis were important risk factors. Early diagnosis of BKVN is essential to prevent GL.info:eu-repo/semantics/publishedVersio
Multi-criteria evaluation method for freight logistics innovations
The objective of this study is to build up a common approach for the assessment of logistics innovations. Innovations are referred to here as best practices and are considered as existing approaches or solutions providing an answer to a relevant problem or challenge in freight transport. The impact evaluation of logistics innovations takes into account strategic targets, topics covered, transferability and novelty of the best practices. A freight specific multi-criteria analysis approach was designed for the evaluation process
The role of biomass elemental composition and ion-exchange in metal sorption by algae
The use of macroalgae, microalgae and cyanobacteria for metal sorption has been widely reported. Still, there are no studies allowing a direct comparison of the performance of these biomasses, especially while evaluating metal competition. The simultaneous sorption of Co2+, Cu2+, Ni2+ and Zn2+ present in a multi-elemental solution by six macroalgae, two microalgae and three cyanobacteria was evaluated. Brown macroalgae were shown to be the most promising biosorbent, with Undaria pinnatifida having a total metal sorption capacity of 0.6 mmol g-1. Overall, macroalgae performed better than microalgae, followed by cyanobacteria. Carboxyl groups were identified as being the main functional groups involved in metal sorption, and all biomass samples were found to be selective to Cu2+. This was linked not only to its higher complexation constant value with relevant functional groups when compared to the remaining metals, but also the Irving-Williams series. The release of K+ and Ca2+ to the aqueous solution during the metal sorption was followed. The obtained results suggest they are readily exchanged with metals in the solution, indicating the occurrence of an ion-exchange mechanism in metal sorption by most biomass. Red macroalgae are an exception to the reported trends, suggesting that their metal sorption mechanism may differ from the other biomass types.publishe
Nephrotic Range Proteinuria in Renal Transplantation: Clinical and Histologic Correlates in a 10-year Retrospective Study
INTRODUCTION:
There is a high incidence of nephrotic proteinuria in renal transplant recipients, which is an accurate predictor of graft loss. Despite this, its histologic correlates and prognostic implications are still not well characterized. We assessed the clinical and histological correlates of kidney transplantation patients with nephrotic range proteinuria.
METHODS:
We have retrospectively analyzed clinical and histological data from 50 kidney transplantation biopsy specimens from 44 renal transplant recipients with nephrotic range proteinuria between 2006 and 2015. The median follow-up time was 93 months (range, 14 months to 190 months).
RESULTS:
The mean age of the patients was 45.2 ± 13.7 years and our cohort included 86% recipients of deceased-donor grafts. The maintenance immunosuppressive regimen included calcineurin inhibitors in 68% and mammalian target of rapamycin inhibitors in 32% of patients. The average proteinuria was 6.9 ± 3.8 g/d and 52% of patients presented with nephrotic syndrome. The main histological findings were transplant glomerulopathy (22%), de novo glomerular disease (22%), and recurrence of primary disease (22%). Tubular atrophy and interstitial fibrosis was present in 78% of the biopsy specimens. Thirty-one patients (62%) lost the graft at follow-up. There was no statistically significant difference between the histologic diagnosis nor the proteinuria levels and the outcome of the graft.
CONCLUSIONS:
The main causes of nephrotic range proteinuria in patients undergoing biopsy were transplant glomerulopathy, recurrence of the underlying disease, and de novo glomerulonephritis. Nephrotic range proteinuria was related to a high rate of graft loss.info:eu-repo/semantics/publishedVersio
Plataforma Natdata - usando dados de Recursos Naturais do Bioma Pantanal.
Resumo: Este trabalho apresenta um exemplo de uso dos dados disponíveis na plataforma Natdata, uma plataforma para integração de informação de Recursos Naturais dos Biomas Brasileiros. O artigo comenta o processo a adotado no seu desenvolvimento e um exemplo de uso dos dados do Bioma Pantanal, correlacionando as informações existentes. Com isso, mostramos a importância da plataforma, auxiliando na tomada de decisão considerando a preservação e o uso sustentável dos recursos disponíveis no território brasileiro, em especial no Bioma Pantanal, rico em diversidade.Geopantanal 2014
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