Development of a risk score for earlier diagnosis of chronic kidney disease in children

Objective To develop a clinical score for the early identification of chronic kidney disease (CKD) in children and adolescents. The early diagnosis of CKD in childhood allows the adoption of measures to slow the progression of the disease, thereby reducing morbidity and mortality. Nevertheless, the diagnosis is often made too late for proper patient management. Study design We preformed a case-control study of a multicenter Brazilian sample of 752 pediatric patients; the study cases (n = 376) were CKD patients with a median estimated GFR of 37 (IQR = 22 to 57) ml/min/1.73 m(2). The control group (n = 376) comprised age-, gender-and center-matched children who were followed for nonrenal diseases. Potential risk factors were investigated through a standard questionnaire that included symptoms, medical history, and a clinical examination. Two multivariable models (A and B) were fitted to assess predictors of the diagnosis of CKD. Results In model A, 9 variables were associated with CKD diagnosis: antenatal ultrasound with urinary malformation, recurrent urinary tract infection, polyuria, abnormal urine stream, nocturia, growth curve flattening, history of hypertension, foamy urine and edema (c-statistic = 0.938). Model B had the same variables as model A, except for the addition of the history of admission during the neonatal period and the exclusion of antenatal ultrasound variables (c-statistic = 0.927). Conclusions The present scores may serve as a warning sign for CKD diagnosis in children among professionals working in the primary care setting where the symptoms associated with a risk of CKD may be overlooked14

EFEITO DO AMBIENTE SECO E CHUVOSO SOBRE O COMPORTAMENTO E PRODUÇÃO DE VACAS LEITEIRAS

Brazilian milk production is based on crossbred animals, mostly fed on pasture, insolation and other climate challenges. The objective was to evaluate the influence of climatic variations on the production and behavior of animals from genetic groups in DIC in a 2x2 factorial, evaluating the effects of the bioclimatic conditions of the dry period and the ethological responses. It is observed that the rainy season in the region had a significant effect (p<0.05) for production in the summer compared to the spring, in which the primiparous gyr, multiparous gyr and multiparous gyrolando holidays respectively of 20.19; 16.15 and 27.7 liters day -1, while primiparous girolandos did not follow this trend. It was found that the order room with metallized cover is less efficient to reduce thermal stress such as vacancies than the conditions of the rest area, whose insolation protection is based on trees, as recorded by the wet bulb thermometer σ2 of 0.45, in relation to the greater temperature variation by the dry bulb under the shed, σ2 4.23. Therefore, the dry period in the mid-northern region is characterized by the occurrence of high temperatures, where the cows turn turning than the turning ones.La producción de leche brasileña se basa en animales mestizos, en su mayoría alimentados con pasto, insolación y otros desafíos climáticos. El objetivo fue evaluar la influencia de las variaciones climáticas en la producción y comportamiento de animales de grupos genéticos en DIC en un factorial 2x2, evaluando los efectos de las condiciones bioclimáticas del período poco lluvioso y las respuestas etológicas. Se observa que la estación lluviosa en la región tuvo un efecto significativo (p<0.05) para la producción en el verano con respecto a la primavera, en la cual el gyr primíparo, gyr multíparo y gyrolando multíparo festividad respectivamente de 20.19; 16,15 y 27,7 litros día -1, mientras que las primíparas girolandos no siguieron esta tendencia. Se encontró que el cuarto de orden con cubierta metalizada es menos eficiente para reducir el estrés térmico como vacancias que las condiciones del área de descanso, cuya protección de insolación se basa en árboles, según lo registrado por el termómetro de bulbo húmedo σ2 de 0.45, en relación a la mayor variación de temperatura por el bulbo seco debajo del galpón, σ2 4.23. Por lo tanto, el período seco en la región norte media se caracteriza por la ocurrencia de altas temperaturas, donde las vacas giran más que las que giran.Avaliou-se as condições bioclimáticas de produção e as respostas dos animais sob produção na região Meio Norte do Brasil. Vacas leiteiras em lactação, cruzadas (Gir x Holandês) e zebuínas (Gir) durante o período de secas e de chuvas. Coletados dados de temperatura do ar em bulbo seco e húmido, temperatura mínima e máxima, humidade relativa; frequência respiratória (FR), frequência cardíaca (FC) e temperatura retal (TR) convergiram para indicador bioclimático Indice de Temperatura e Umidade (ITU) e o indicador etológico Coeficiente de Tolerância ao Calor (CA). Análise de variância para aferir diferenças significativas acompanhadas de análises de post-hoc indicam efeitos significativo (p-valor ≤ 0,05) dos efeitos de época (Chuvas e Secas) e/ou de grupo genético (Girolanda/Gir). Identificou-se maiores temperaturas (T) e menores humidade relativas (UR) durante as secas: 30,5º e 47,5%; em relação ao período de chuvas: 26,7º C e 86,5%. A condições bioclimáticas estiveram majoritariamente inadequadas à bovinos. As respostas etológicas variaram principalmente em função de raça e somente a FC foi significativamente diferente em função de época. Animais Gir apesar de dispõem de menor perímetro torácico (PT) são mais hábeis em promover a termólise e/ou produzem menos calor endógeno, apresentando CA, FR, FC e TR significativamente (p-valor < 0,05) menores. As condições de produção são desafiadoras com alto ITU e respostas animais que indicam desconforto, principalmente durante os períodos de secas na região meio norte. Palavras-chave: temperatura retal; termólise; ambiência.   Effect of dry and rainy environments on the Ethology of dairy cows   ABSTRACT: Bioclimatic production conditions and the responses of animals under production were evaluated in the Meio Norte region of Brazil. Lactating dairy cows, crossbreeds (Gir x Holstein) and zebu (Gyr) during the dry and rainy season. Collected air temperature data in the dry and wet bulbs, minimum and maximum temperature, relative humidity, respiratory rate (RR), heart rate (HR), and rectal temperature (TR) converged to the bioclimatic indicator Temperature and Humidity Index (THI) and the etiological indicator Heat Tolerance Coefficient (CA). Analysis of variance to assess significant differences accompanied by post-hoc analyses indicate significant effects (p-value ≤ 0.05) of season effects (Rains and Droughts) and/or genetic group (Girolanda/Gir). Higher temperatures (T) and lower relative humidity (RH) were identified during droughts: 30.5º and 47.5%; in relation to the rainy season: 26.7º C and 86.5%. Bioclimatic conditions were mostly unsuitable for cattle. Ethological responses varied mainly depending on breed and only HR significantly differed depending on season. Gir animals, despite having a smaller thoracic perimeter (PT), are more adept at promoting thermolysis and/or producing less endogenous heat, presenting significantly lower AC, RR, HR, and TR (p-value < 0.05). Production conditions are challenging with high THI and animal responses that indicate discomfort, especially during dry periods in the Meio Norte region. Keywords: rectal temperature; thermolysis; ambiance

Hongos endofíticos asociados a la planta medicinal Corama (Kalanchoe pinnata [Lam.] Pers.)

No presente estudo, é relatado pioneiramente o isolamento e identificação de fungos endofíticos associados às folhas da planta medicinal Corama (Kalanchoe pinnata [Lam.] Pers.). Coletas de material vegetal foram realizadas na Floresta Nacional do Tapajós, no estado do Pará, em período chuvoso e de estiagem. Após desinfecção da superfície, fragmentos (0,25 mm2) das folhas foram inoculados em meio de cultura Batata Dextrose Ágar (BDA) contendo cloranfenicol (0,1 μg/mL-1). Foram obtidos 86 isolados, que puderam ser agrupados em 33 tipos morfológicos (morfotipos). Por meio de taxonomia clássica, foi possível identificar 73,3% dos morfotipos obtidos: Aspergillus (26,7%), Chrysosporium (12,8%), Fusarium (11,6%), Acremonium (10,5%), Aureobasidium (7,0%), Cladosporium (3,5%) e Penicillium (1,2%). Esses grupos taxonômicos de fungos são os representantes mais frequentes da comunidade endofítica da Corama. Observou-se maior riqueza e diversidade de fungos em período chuvoso em relação ao período de estiagem. Além de contribuir para o conhecimento e preservação da biodiversidade de fungos da Amazônia, os espécimes obtidos neste estudo representam uma valiosa oportunidade para futura prospecção de fungos com atividades biológicas de interesse biotecnológico. Palavras-chave: Interação fungo-planta; Micro-organismos endofíticos; Simbiose.The present study is the first report on the isolation and identification of endophytic fungi associated with the leaves from medicinal plant (Kalanchoe pinnata [Lam.] Pers.). For this, plant material was collected in the Floresta Nacional do Tapajós, in the state of Pará, in the rainy season and in the dry season. After disinfection of the surface, fragments (0.25 mm2) of the leaves were inoculated in Potato Dextrose Agar (PDA) culture medium containing chloramphenicol (0.1 μg.mL-1). A total of 86 different isolates were obtained and grouped into 33 morphological types (morphotypes). By means of classical taxonomy, it was possible to identify 73.3% of the morphotypes obtained: Acremonium (10.5%), Aureobasidium (7.0%), Aspergillus (26.7%), Chrysosporium (12.8%), Cladosporium (3.5%), Fusarium (11.6%) and Penicillium (1.2%). These fungal taxonomic groups are the most frequent representatives of the coroma's endophytic community. It was observed a greater richness and diversity of fungi in rainy season in relation to the dry season. In addition to contributing to the knowledge and preservation of biodiversity of Amazonian fungi, the specimens obtained in this study represent a valuable opportunity for future prospecting of fungi with biological activities of biotechnological interest. Keywords: Fungus-plant interaction; Endophytic micro-organisms; Symbiosis.El presente estudio relata pioneramente el aislamiento e identificación de hongos endofíticos asociados a las hojas de la planta medicinal Corama (Kalanchoe pinnata [Lam.] Pers.). Las colectas de material vegetal se realizaron en el Bosque Nacional del Tapajós, en el estado de Pará, en período lluvioso y de sequía. Después de la desinfección de la superficie, fragmentos (0,25 mm2) de las hojas fueron inoculados en medio de cultivo Patata Dextrosa Agar (BDA) conteniendo cloranfenicol (0,1 μg / ml-1). Se obtuvieron 86 aislados, que pudieron agruparse en 33 tipos morfológicos (morfotipos). En la mayoría de los casos, se observó un aumento de la mortalidad por rotavirus en los últimos años, (7,0%), Cladosporium (3,5%) y Penicillium (1,2%). Estos grupos taxonómicos de hongos son los representantes más frecuentes de la comunidad endofítica de la Corama. Se observó mayor riqueza y diversidad de hongos en período lluvioso en relación al período de sequía. Además de contribuir al conocimiento y preservación de la biodiversidad de los hongos de la Amazonia, los especímenes obtenidos en este estudio representan una valiosa oportunidad para la futura prospección de hongos con actividades biológicas de interés biotecnológico. Descriptores: Interacción fungo-planta; Microorganismos endofíticos; Simbiosis

Alternatives For Reducing Relapse Rate When Switching From Natalizumab To Fingolimod In Multiple Sclerosis.

Natalizumab is a therapeutic option for treating multiple sclerosis (MS) and is particularly efficacious for patients with highly active disease. A long washout period has been recommended between withdrawal of natalizumab and start of fingolimod (another option for treating MS). This long washout period has been associated with a significant increase in MS activity. In the present study, a group of 96 patients who were switched from natalizumab to fingolimod had short washout periods between drugs, or monthly corticosteroid pulse therapy if longer washout periods were recommended. This therapeutic approach led to the lowest reported relapse rate so far, among patients with MS switching from natalizumab to fingolimod (8.3%). No complications from short withdrawal were observed in this group of patients.

No correlation was observed between vitamin D levels and disability of patients with multiple sclerosis between latitudes 18° and 30° South

ABSTRACT Objective: Vitamin D has taken center stage in research and treatment of multiple sclerosis (MS). The objective of the present study was to assess the serum vitamin D levels of a large population of patients with MS and controls living in a restricted tropical area. Methods: Data from 535 patients with MS and 350 control subjects were obtained from 14 cities around the Tropic of Capricorn. Results: The mean serum 25-OH vitamin D level was 26.07 ± 10.27 ng/mL for the control subjects, and 28.03 ± 12.19 ng/mL for patients with MS. No correlation was observed between vitamin D levels and the disability of patients over the disease duration. Conclusion: At least for the region around the Tropic of Capricorn, serum levels of vitamin D typically are within the range of 20 to 30 ng/mL for controls and patients with MS

Comemoração dos 100 anos de Paulo Freire

Em 2021 celebramos o Centenário de Paulo Freire, ilustre educador, com atuação e reconhecimento internacionais e cuja trajetória deixa um legado para o mundo, de modo especial para a construção de saberes no diálogo entre o conhecimento acadêmico e o popular. A PROEC, no propósito de reconhecer e ressaltar a importante contribuição de Paulo Freire, abriu o Concurso “Comemoração dos 100 anos de Paulo Freire” que buscou valorizar, incentivar e dar visibilidade às ações de ensino, pesquisa, extensão e cultura da UNIFESP inspiradas no referencial teórico-metodológico freireano e realizadas por estudantes, docentes, técnicos(as) e terceirizados(as)

Núcleos de Ensino da Unesp: artigos 2010: volume 2: formação de professores

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Resumos concluídos - Medicina

Resumos concluídos - Medicin

Resumos concluídos - Saúde Coletiva

Resumos concluídos - Saúde Coletiv