A South African case study of familial membranoproliferative glomerulonephritis

Membranoproliferative glomerulonephritis (MPGN) is an immune-mediated disease that is characterised by mesangial hypercellularity and endocapilliary proliferation with capillary wall remodeling which results in thickening of the glomerular basement membrane. (1) MPGN was traditionally classified on electron microscopy findings into MPGN type I, II, and III. Multiple genetic risk factors have been identified for MPGN II now referred to as dense deposit disease; however, relatively little is known regarding genetic risk factors for MPGN type I and III. A reclassification scheme that better reflects the pathophysiology of MPGN has been implemented. This scheme divides MPGN into immune-complex-mediated and complement-mediated MPGN. Previous descriptions of familial MPGN suggest that this entity falls within the category of complement-mediated MPGN. We describe a South African family with four family members affected with immune-complex-mediated MPGN. All other asymptomatic contactable family members were tested for proteinuria and haematuria and a pedigree for the family was established with an autosomal recessive with incomplete penetrance inheritance pattern or a multigenic inheritance pattern. A systematic review was then performed using the search terms of "inherited MPGN" and "Familial MPGN". In the systematic review of familial MPGN from 1981-2014, nine reports containing twelve families were reviewed totaling thirteen families including the South African family. Six families were found to have immune-complex-mediated MPGN iii and five families had complement-mediated MPGN. The data of two families was limited and thus couldn’t be reclassified

Effects of an occupational safety programme: A comparative study between different training methods involving secondary and vocational school students

Strategies for incorporating proper training in occupational safety at secondary schools are important, since young workers are more likely to be injured at work. However, for a successful educational intervention, an effective Occupational Safety Programme (OSP) with appropriate training methods should be designed and implemented. This study intends to analyze and compare the effects of an OSP in students from diverse school settings, when different training methods are applied. An OSP was designed focusing on the risks related to handling machinery and maintenance tasks and delivered to 301 students from two secondary schools and two vocational schools from the North of Portugal. The sample was divided into three groups, and for each group, a different training method was applied: theory-based; demonstration-based or testimonies-based. To assess its effectiveness, a questionnaire was developed for evaluating the following dimensions: risk acceptance, safety commitment, intended safety behaviors and safety knowledge. The questionnaire was applied two weeks before and after the OSP. A significantly positive effect of the OSP was identified in all dimensions. Comparisons between the three methods showed a greater effect of the testimonies-based intervention in risk acceptance and intended safety behaviors; however, for safety knowledge and safety commitment this was the least effective method. The influence of school type was observed for the safety behaviors and safety commitment dimensions. In conclusion, this study’s results suggested that more engaging methods had larger effects on student risk acceptance and intended safety behaviors, while expositive and demonstrative methods were more suitable to improve safety knowledge and commitment.info:eu-repo/semantics/publishedVersio

COVID-19-related acute kidney injury and dialysis: What are the outcomes in South Africa?

Introduction: Acute kidney injury (AKI) in hospitalized patients infected with COVID-19 is associated with an elevated mortality rate compared to non-infected patients (39% versus 24%). This is despite a lower prevalence of AKI in COVID-19-infected patients (17 vs 22%). The reasons are multifactorial and have been well documented in developed countries, whereas in developing countries there are scant data. Methods: This study aimed to document the mortality in COVID-19-infected South African patients who required dialysis for AKI. Exclusion criteria included any chronic kidney replacement therapy (transplantation or dialysis). A REDCap survey of South African nephrologists and nephrology fellows registered with the South African Nephrology Society was conducted. The primary outcome was all-cause in-hospital mortality, while additional points of interest included comorbidities, dialysis modality and intervention required. Univariate analysis of mortality predictors was performed. Results: The COVID-19-related AKI mortality rate was 58.9%. Significant predictors included continuous veno-venous haemodialysis therapy, invasive ventilation, use of inotropes and the presence of shock. Ischaemic heart disease, heart failure and admission to a private healthcare facility were associated with lower mortality. No significant associations were found with ethnicity, sex, hypertension, diabetes, HIV infection or the use of other modes of dialysis. Conclusions: In South African patients, we report similar outcomes in critically ill patients requiring dialysis for AKI, relative to international data. The predictors of mortality most likely reflect the severity of the illness in our patients. The data suggest that continuous veno-venous haemodiafiltration or slow low efficiency dialysis may be the preferred dialysis modalities in these patients

A Instalação do Campus Universitário Alaor de Queiroz Araújo e as Consequências sobre o Manguezal do Entorno

Pretende-se mostrar como ocorreu o processo de ocupação da área onde foi instalado o Campus Universitário Alaor de Queiroz Araújo, mais conhecido como “Campus de Goiabeiras” – Universidade Federal do Espírito Santo (UFES) e as consequências sobre o manguezal do entorno. O Campus possui dimensão atual equivalente a 1.567.545 m² e se encontra localizado na região norte do município de Vitória/ES, entre o canal da Passagem e a Avenida Fernando Ferrari. A pesquisa realizada indicou que a ocupação da área resultou na perda de 211.250 m² de manguezal, decorrente dos aterros efetuados inicialmente para adequar o espaço físico destinado à construção do referido Campus e depois para a ampliação da Avenida Fernando Ferrari, finalizada em 2010. Visa também esse artigo apresentar a problemática da entrada de substâncias nocivas oriundas do lançamento de efluentes em diversos pontos existentes no entorno imediato da área

A Instalação do Campus Universitário Alaor de Queiroz Araújo e as Consequências sobre o Manguezal do Entorno

Pretende-se mostrar como ocorreu o processo de ocupação da área onde foi instalado o Campus Universitário Alaor de Queiroz Araújo, mais conhecido como “Campus de Goiabeiras” – Universidade Federal do Espírito Santo (UFES) e as consequências sobre o manguezal do entorno. O Campus possui dimensão atual equivalente a 1.567.545 m² e se encontra localizado na região norte do município de Vitória/ES, entre o canal da Passagem e a Avenida Fernando Ferrari. A pesquisa realizada indicou que a ocupação da área resultou na perda de 211.250 m² de manguezal, decorrente dos aterros efetuados inicialmente para adequar o espaço físico destinado à construção do referido Campus e depois para a ampliação da Avenida Fernando Ferrari, finalizada em 2010. Visa também esse artigo apresentar a problemática da entrada de substâncias nocivas oriundas do lançamento de efluentes em diversos pontos existentes no entorno imediato da área

A Compartimentação do Parque Natural Municipal de Jacarenema Segundo a Hierarquia da Paisagem Proposta por Bertrand

The coastal zone receive serious environmental, social and economic damages due to its intense occupation. Coastal areas, which are extremely valuable for their resources and logistics, are densely populated. The Jacarenema Municipal Natural Park (PNMJ) is located on the east coast of the municipality of Vila Velha and has been under heavy pressure from the urbanization process. The lack of more relevant data on the importance of the maintenance of this park and the absence of information that inserts it within a systemic approach were the main reasons that inspired this article. The focus here will be to describe the distribution and the current state of conservation of the geofácies (level of the hierarchy of the landscape proposed by Bertrand) taking also into account the evolution of the occupation of the area around the Park, that is, what should be its buffer zone.A zona costeira sofre com graves prejuízos ambientais, sociais e econômicos devido a sua intensa ocupação. As faixas de terras costeiras, extremamente valiosas por seus recursos e logísticas, são densamente povoadas. O Parque Natural Municipal de Jacarenema (PNMJ) localizado na costa leste do município de Vila Velha vem sendo submetido a forte pressão do processo de urbanização. A falta de dados mais relevantes sobre a importância da manutenção deste parque e a carência de informações que o insiram dentro de uma visão sistêmica foram os principais motivos que inspiraram este artigo. O enfoque aqui será o de descrever a distribuição e o atual estado de conservação dos geofácies (nível da hierarquização da paisagem proposta por Bertrand) levando em consideração também a evolução da ocupação da área do entorno do Parque, isto é, o que deveria ser a zona de amortecimento.

Belém’s built form and its developments to the formation of a system of open spaces accessible to population

This paper presents a characterization of the built space of Belém highlighting, its estuarine condition, physical geography and its economic, social and spacial development. It is based on Quapá-SEL Workshop conclusions held in Belém, in May 2015, in which teachers and students from São Paulo and Pará Federal Universities assessed the conditions of urban open spaces of the city. The results highlight a disarticulation between real estate agents strategies and of urban management towards structuring an Open Spaces System (SEL in Portuguese), as well as its limited appropriation by the population. There is a remarkable differentiation between the landscapes of central area in opposition / contraposition to that at the city’s expansion area. This debate showed how much permanent preservation areas on the banks of inland rivers and islands (the main green spaces of the city and main linkage with the Amazonian biome), with its landscape potentials, have been unevenly appropriated in the city, through gentrification.Este texto apresenta uma caracterização do espaço construído de Belém, destacando sua condição estuarina, fisiografia e evolução socioespacial, mas iluminando elementos de desarticulação nas estratégias de operação dos agentes envolvidos na produção da cidade e da gestão urbanística para a estruturação de um Sistema de Espaços Livres e a forma limitada como os mesmos são apropriados pela população. O artigo baseia-se nas conclusões da Oficina Quapá SEL realizada em Belém em maio de 2015, na qual professores e estudantes da Universidade Federal do Pará e a equipe de professores e bolsistas da Universidade de São Paulo realizaram a avaliação dos espaços públicos da cidade. Observou-se que há notável diferenciação da paisagem da área central em oposição/contraposição à área de expansão da cidade e comprometimento de Áreas de Preservação Permanente (APPs) nas margens dos rios internos e das ilhas, principais espaços verdes do município e elementos de conexão com o bioma amazônico que, embora possua potencial paisagístico, vem sendo apropriado de forma socialmente desigual.

Belém’s built form and its developments to the formation of a system of open spaces accessible to population

This paper presents a characterization of the built space of Belém highlighting, its estuarine condition, physical geography and its economic, social and spacial development. It is based on Quapá-SEL Workshop conclusions held in Belém, in May 2015, in which teachers and students from São Paulo and Pará Federal Universities assessed the conditions of urban open spaces of the city. The results highlight a disarticulation between real estate agents strategies and of urban management towards structuring an Open Spaces System (SEL in Portuguese), as well as its limited appropriation by the population. There is a remarkable differentiation between the landscapes of central area in opposition / contraposition to that at the city’s expansion area. This debate showed how much permanent preservation areas on the banks of inland rivers and islands (the main green spaces of the city and main linkage with the Amazonian biome), with its landscape potentials, have been unevenly appropriated in the city, through gentrification.Este texto apresenta uma caracterização do espaço construído de Belém, destacando sua condição estuarina, fisiografia e evolução socioespacial, mas iluminando elementos de desarticulação nas estratégias de operação dos agentes envolvidos na produção da cidade e da gestão urbanística para a estruturação de um Sistema de Espaços Livres e a forma limitada como os mesmos são apropriados pela população. O artigo baseia-se nas conclusões da Oficina Quapá SEL realizada em Belém em maio de 2015, na qual professores e estudantes da Universidade Federal do Pará e a equipe de professores e bolsistas da Universidade de São Paulo realizaram a avaliação dos espaços públicos da cidade. Observou-se que há notável diferenciação da paisagem da área central em oposição/contraposição à área de expansão da cidade e comprometimento de Áreas de Preservação Permanente (APPs) nas margens dos rios internos e das ilhas, principais espaços verdes do município e elementos de conexão com o bioma amazônico que, embora possua potencial paisagístico, vem sendo apropriado de forma socialmente desigual.

Pulmonary Inflammation Is Regulated by the Levels of the Vesicular Acetylcholine Transporter

Acetylcholine (ACh) plays a crucial role in physiological responses of both the central and the peripheral nervous system. Moreover, ACh was described as an anti-inflammatory mediator involved in the suppression of exacerbated innate response and cytokine release in various organs. However, the specific contributions of endogenous release ACh for inflammatory responses in the lung are not well understood. To address this question we have used mice with reduced levels of the vesicular acetylcholine transporter (VAChT), a protein required for ACh storage in secretory vesicles. VAChT deficiency induced airway inflammation with enhanced TNF-alpha and IL-4 content, but not IL-6, IL-13 and IL-10 quantified by ELISA. Mice with decreased levels of VAChT presented increased collagen and elastic fibers deposition in airway walls which was consistent with an increase in inflammatory cells positive to MMP-9 and TIMP-1 in the lung. In vivo lung function evaluation showed airway hyperresponsiveness to methacholine in mutant mice. The expression of nuclear factor-kappa B (p65-NF-kappa B) in lung of VAChT-deficient mice were higher than in wild-type mice, whereas a decreased expression of janus-kinase 2 (JAK2) was observed in the lung of mutant animals. Our findings show the first evidence that cholinergic deficiency impaired lung function and produce local inflammation. Our data supports the notion that cholinergic system modulates airway inflammation by modulation of JAK2 and NF-kappa B pathway. We proposed that intact cholinergic pathway is necessary to maintain the lung homeostasis