Urinary biomarkers to predict CKD: is the future in multi-marker panels?

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Urinary peptide-based classifier CKD273: towards clinical application in chronic kidney disease

Capillary electrophoresis coupled with mass spectrometry (CE-MS) has been used as a platform for discovery and validation of urinary peptides associated with chronic kidney disease (CKD). CKD affects ∼ 10% of the population, with high associated costs for treatments. A urinary proteome-based classifier (CKD273) has been discovered and validated in cross-sectional and longitudinal studies to assess and predict the progression of CKD. It has been implemented in studies employing cohorts of > 1000 patients. CKD273 is commercially available as an in vitro diagnostic test for early detection of CKD and is currently being used for patient stratification in a multicentre randomized clinical trial (PRIORITY). The validity of the CKD273 classifier has recently been evaluated applying the Oxford Evidence-Based Medicine and Southampton Oxford Retrieval Team guidelines and a letter of support for CKD273 was issued by the US Food and Drug Administration. In this article we review the current evidence published on CKD273 and the challenges associated with implementation. Definition of a possible surrogate early endpoint combined with CKD273 as a biomarker for patient stratification currently appears as the most promising strategy to enable the development of effective drugs to be used at an early time point when intervention can still be effective

Using R via PHP for Teaching Purposes: R-php

This paper deals with the R-php statistical software, that is an environment for statistical analysis, freely accessible and attainable through the World Wide Web, based on R. Indeed, this software uses, as "engine" for statistical analyses, R via PHP and its design has been inspired by a paper of de Leeuw (1997). R-php is based on two modules: a base module and a point-and-click module. R-php base allows the simple editing of R code in a form. R-php point-and-click allows some statistical analyses by means of a graphical user interface (GUI): then, to use this module it is not necessary for the user to know the R environment, but all the allowed analyses can be performed by using the computer mouse. We think that this tool could be particularly useful for teaching purposes: one possible use could be in a University computer laboratory to permit a smooth approach of students to R.

Branqueamento em dentes vitais e não vitais: uma revisão da literatura

Hoje em dia o branqueamento dentário é uma prática bastante difundida nos consultórios dentários, sendo que as técnicas recentemente desenvolvidas trouxeram maior conforto e satisfação para os pacientes. Este trabalho visa abordar os principais agentes branqueadores usados diáriamente e as diferentes técnicas de aplicação destes produtos que podem ser usados tanto em ambulatório como em consultório dependendo do tipo de coloração, da vitalidade do dente e de alguns factores relacionados com os pacientes. Apesar destes agentes apresentarem alguns efeitos adversos, estes não representam um obstáculo que uma técnica bem orientada e correctamente conduzida não permita ultrapassar. Foi realizada uma pesquisa bibliográfica utilizando os motores de busca: PubMed, B-On, e Google Scholar. Foram também escolhidos artigos em revistas da Faculdade de Ciências da Saúde da Universidade Fernando Pessoa publicados entre 1988 e 2016.Nowadays, teeth whitening is a very widespread practice in dental clinics, being that newly developed techniques have brought greater comfort and satisfaction to patients. The aim of this article is to discuss the main bleaching agents used daily in dental practice, as well as the different techniques of application of these products, which can be used both at home and in the dental office, depending on the type of stain, vitality of the tooth, and a number of factors related to patients. Although these agents have some adverse effects, they do not, however, represent an obstacle that a well-oriented and correctly conducted technique would not overcome. A bibliographic research was performed using the search engines: PubMed, B-On, and Google Scholar. Articles were also selected in journals of the Faculty of Health Sciences of the Fernando Pessoa University published between 1988 and 2016

Heat shrink sleeves for MB/BacTtm Bottles

Organon Teknika Corporation markets a diagnostic test system that detects mycobacteria. The test media is sold in a tubing glass bottle which may break if dropped or weakened in shipment to the laboratory. Because mycobacteria is a very infectious airborne agent, there is concern in the marketplace that the potential for breakage of glass bottles places the laboratory technician and environment at risk. While tests are under way to identify a plastic bottle suitable for this application, Organon Teknika is pursuing the use of a heat shrink sleeve as an option to improve the safety of this product. This study addresses the feasibility of using a heat shrink sleeve as a safety mechanism by comparing bottles with sleeves to bottles without sleeves. While the PVC sleeve will not eliminate bottle breakage, tests have shown that this sleeve can reduce the likelihood of glass and liquid scatter in the case of bottle breakage. In light of these results, Organon Teknika has implemented the use of the heat shrink sleeve on the MB/BacT Process Bottles

The efficacy of Radiofrequency Ablation in the treatment of benign thyroid nodules and recurrent well-differentiated thyroid carcinomas.

Purpose: The aim of our study was to evaluate, in our experience, the effectiveness of the Radiofrequency Ablation (RFA)in the treatment of benign thyroid nodules and thyroid malignancies. Materials and methods: The study included 23 patients, 15 with nodular goiter (NG) with contraindication or refusing surgery and 8 with inoperable recurrent well-differentiated thyroid cancers (RTC). RFA was performed in a single session under ultrasound guidance, under local anesthesia and mild sedation using 18- or 19-gauge internally cooled, single tipped electrode with 7- and 10-mm active tips. The pre- and post-treatment evaluations included: contrast-enhanced ultrasound (CEUS) and unenhanced Computed Tomography (CT) study for the NGs, completed with contrast media in patients with RTCs. Of each lesion the initial volume (V), the vascularity and the proportion of solid component were assessed; for NGs we also evaluated thyroid function, local symptoms (according to a score of 0-10 severity) and a cosmetic score defined by the radiologist according to a 1-4 scale (not palpable, palpable but not visible, visible only during swallowing and visible in any position). The follow-up in 21/23 patients ranged between 6 and 18 months; 2/8 patients with RTCs did not undergo 6-months follow-up, respectively for systemic progression of disease and onset of severe comorbidity. Volume Reduction Rate was assessed during the follow-up and therapeutic success was defined as a> 50% VRR. Residual vital tissue was also assessed by using CEUS or post-contrastographic CT examinations. Complications were also evaluated. For NGs we also tried whether there was a correlation between VRR at 6 months follow-up and some parameters such as age, gender, mean energy per millilitre of pre-treatment nodule volume, nodule initial volume, initial nodule solidity and initial nodule vascularity. Results: Mean V of lesions before treatment was 29.5 ± 24.7 mL for NGs (range: 5.5-90ml), and 4.7 ± 3.5 ml (range: 0.8 to 8.8 ml) for RTCs. The mean VRR at 6, 12 and 18 months were respectively 74.3%, 79.8% and 82.3% for NGs. At last follow-up, the therapeutic success rate of NGs was 100% (15/15). The overall recurrence rate was 0% (0/15). We found that volume, residual vital tissue, cosmetic score and symptom score of NGs were significantly lower at last follow-up than before treatment (P <0.0005 for all comparison). Initial nodule volume, vascularity and energy delivered per millilitre of pre-treatment nodule volume demonstrated to be significantly related to 6-months VRR (P < 0.0001 for all analysis). The VRR of RTCs was 68.4%, 66.4% and 64.4% during the follow-up at 6, 12 and 18 months. At last follow-up, the therapeutic success rate for RTCs was 83% (5/6) with overall regrowth and/or recurrence rate of 0% (0/6). In no case of NGs dysphonia was observed; 3/6 patients with paratracheal RCT, closely adjacent to the danger triangle of the recurrent laryngeal nerve, have reported dysphonia (permanent in 2 cases and transient in 1 patient). Conclusions: RFA demonstrated in our experience to be an effective and safe interventional technique and may represent a viable alternative to surgery in selected patients