The nutritional programming hypothesis proposes that early life malnutrition is related to an inc... more The nutritional programming hypothesis proposes that early life malnutrition is related to an increase in body fat later in life. Brazilian boys and girls (n = 94; 4-14 y old) were studied. Malnourished children treated in a Nutrition Recovery Center, were followed up and divided into 2 groups: the Outpatient group (recovered after outpatient care, n = 28), and the Day-hospital group (recovered after day-hospital care, n = 38). They were compared with a Control group (healthy individuals without intervention, n = 28). Nutritional recovery was confirmed by anthropometry. Body composition was evaluated by dual-energy X-ray absorptiometry. Both recovered groups had a greater increase in height-for-age Z-scores than in weight-for-age Z-scores after treatment (P < 0.03). Body fat mass (kg) and the percentage of body fat were significantly lower in recovered groups of girls and boys compared with controls. Among boys, lean mass/height (kg/cm), fat-free mass (kg) and the fat-free mass i...
Staphylococcus aureus is the most common cause of peritonitis in patients undergoing peritoneal d... more Staphylococcus aureus is the most common cause of peritonitis in patients undergoing peritoneal dialysis in Brazil. Using restriction endonuclease analysis of plasmid DNA, we investigated the importance of chronic carriage of S. aureus in the development of peritonitis in patients on continuous ambulatory peritoneal dialysis at the Division of Nephrology, Escola Paulista de Medicina, Sao Paulo, Brazil. A total of 117 isolates (30 patients) of S. aureus were available for typing, including 51 isolates (22 patients) from the nares, 58 isolates (27 patients) from pericatheter skin, and 8 isolates (6 patients) from peritoneal fluid, from patients with peritonitis. Restriction endonuclease subtyping showed that although most patients harbored more than one subtype of S. aureus, in the majority of patients nasal and/or pericatheter skin isolates with identical restriction endonuclease digest patterns were recovered on more than one occasion. Furthermore, 95% of patients with both nasal an...
This study was performed to evaluate the effectiveness of surveillance for screening and treatmen... more This study was performed to evaluate the effectiveness of surveillance for screening and treatment of patients with chronic kidney disease undergoing hemodialysis and colonized by Staphylococcus aureus. A systematic review and meta-analysis were performed. The literature search involved the following databases: the Cochrane Controlled Trials Register, Embase, LILACS, CINAHL, SciELO, and PubMed/Medline. The descriptors were "Staphylococcus aureus", "MRSA", "MSSA", "treatment", "decolonization", "nasal carrier", "colonization", "chronic kidney disease", "dialysis", and "haemodialysis" or "hemodialysis". Five randomized controlled trials that exhibited agreement among reviewers as shown by a kappa value of >0.80 were included in the study; methodological quality was evaluated using the STROBE statement. Patients who received various treatments (various treatments group) or t...
RESUMO -OBJETIVO. Avaliar em pacientes com insuficiência renal crônica (IRC), a efetividade e os ... more RESUMO -OBJETIVO. Avaliar em pacientes com insuficiência renal crônica (IRC), a efetividade e os custos do sevelamer, um polímero catiônico livre de alumínio e cálcio, que é um novo quelante de fósforo no trato gastrointestinal.
Vancomycin resistant Enterococci is becoming one of the concerns of public health in recent times... more Vancomycin resistant Enterococci is becoming one of the concerns of public health in recent times. VRE involve those strains of Enterococci that are resistant to the vancomycin which is considered as last drug of choice for the Gram positive bacterial infections. Studies show enterococci to be one of the major food borne diseases and medical consequences of its occurrence in humans. Thus, a crosssectional study was carried out to determine the prevalence of VRE in buffalo meat in Chitwan. A total of 63 retail minced meat samples were collected from different meat shops. These samples were diluted and cultured and subjected to antimicrobial susceptibility test. Of 63 samples, 16 (25.39%) samples were positive for the enterococcus species among which 3 (18.15%), were VRE indicating overall prevalence of VRE to be 4.76%. AST reveled that resistance among them was high for penicillin G and amikacin (75%) followed by tetracycline (43.75%), erythromycin (37.5%), vancomycin(18.75%) levofloxacin ( 12%) and methicillin. Eventhough methicillin revealed no resistance it showed intermediate sensitive to all the samples. Thus, it clarifies the presence of VRE in meat samples suggesting zoonotic disasters that can follow.
Hopelessness, suicide ideation and depression symptoms affect life quality and expectancy of chro... more Hopelessness, suicide ideation and depression symptoms affect life quality and expectancy of chronic kidney disease patients. To verify whether there are differences in hopelessness, suicide ideation and depression symptoms between chronic kidney disease patients on hemodialysis or transplant recipients. We also analyzed the influence of sociodemographic factors in these symptoms. Cross-sectional study in which 50 clinically stable chronic hemodialysis patients and 50 renal transplant patients matched by gender and age. Instruments-Beck Hopelessness Scale (BHS), Beck Scale for Suicide Ideation (BSI) and Beck Depression Inventory (BDI). BHS: 2% of each group scoring &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 8 (p = 1.00). BSI: 4% in hemodialysis and 6% of the transplant patients scoring &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 1 (p = 1.000). BDI: 20% in hemodialysis and 12% of transplant patients scoring &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 14 (p = 0.275). Patients who did not have a labor activity presented more depressive symptoms (average BDI score: 10.5 vs. 7.3, p = 0.027). Transplant patients from deceased donor presented more depressive symptoms compared with those with transplant from living donors (average BDI score: 11.0 vs. 6.7, p = 0.042). There was no difference in the intensity of hopelessness, suicide ideation and depression symptoms between stable hemodialysis and transplant patients. Not performing a labor activity and receiving the transplant from deceased donor lead to more depressive symptoms. The high prevalence of depressive symptoms and the finding of suicide ideation in both modalities of renal replacement therapy point to the need to monitor and care for those patients.
The aim of this study was to investigate the association between urinary 90 kDa N-domain Angioten... more The aim of this study was to investigate the association between urinary 90 kDa N-domain Angiotensin I-converting enzyme (ACE) form with C-reactive protein (CRP) and homocysteine plasma levels (Hcy), urinary nitric oxide (NOu), and endothelial function (EF) in normotensive subjects. Forty healthy subjects were evaluated through brachial Doppler US to test the response to reactive hyperemia and a panel of blood tests to determine CRP and Hcy levels, NOu, and urinary ACE. They were divided into groups according to the presence (ACE90+) or absence (ACE90-) of the 90 kDa ACE, the presence (FH+) or absence (FH-) of family history of hypertension, and the presence or absence of these two variables FH+/ACE90+ and FH-/ACE90-. We found an impaired endothelial dilatation in subjects who presented the 90 kDa N-domain ACE as follows: 11.4% +/- 5.3% in ACE90+ compared with 17.6% +/- 7.1% in ACE90- group and 12.4% +/- 5.6% in FH+/ACE90+ compared with 17.7% +/- 6.2% in FH-/ACE90- group, P < 0.0...
The nutritional programming hypothesis proposes that early life malnutrition is related to an inc... more The nutritional programming hypothesis proposes that early life malnutrition is related to an increase in body fat later in life. Brazilian boys and girls (n = 94; 4-14 y old) were studied. Malnourished children treated in a Nutrition Recovery Center, were followed up and divided into 2 groups: the Outpatient group (recovered after outpatient care, n = 28), and the Day-hospital group (recovered after day-hospital care, n = 38). They were compared with a Control group (healthy individuals without intervention, n = 28). Nutritional recovery was confirmed by anthropometry. Body composition was evaluated by dual-energy X-ray absorptiometry. Both recovered groups had a greater increase in height-for-age Z-scores than in weight-for-age Z-scores after treatment (P < 0.03). Body fat mass (kg) and the percentage of body fat were significantly lower in recovered groups of girls and boys compared with controls. Among boys, lean mass/height (kg/cm), fat-free mass (kg) and the fat-free mass i...
Although numerous studies suggest an inverse relationship between birth weight and cardiovascular... more Although numerous studies suggest an inverse relationship between birth weight and cardiovascular disease, the mechanistic basis of this phenomenon is not fully understood. Here, we postulate that alterations in plasma concentration of matrix metalloproteinases (MMPs) and growth factors might show different associations between birth weight, blood pressure levels, and vascular function. Concentrations of MMP-2 and its tissue inhibitor 2 (TIMP-2), MMP-9, and insulin-like growth factor-I (IGF-I) and its binding protein IGFBP-3 were measured in 64 children (34 boys, 30 girls). Small-for-gestational-age children exhibited elevated amounts of MMP-2, MMP-9, MMP-2/TIMP-2 ratio, MMP-9/TIMP-2 ratio, as well as lower concentration of IGF-I (P < 0.01), a known regulator of elastin synthesis. Similar findings were observed after adjustment for current age, gender, and race. The changes in the circulating levels of MMP-2, MMP-9, and IGF-I correlated significantly with birth weight, systolic b...
The authors discuss the usefulness of the HLA-B27 test in the diagnosis of ankylosing spondylitis... more The authors discuss the usefulness of the HLA-B27 test in the diagnosis of ankylosing spondylitis (AS). Sensitivity, Specificity, Predictive Value of a Negative Test, Predictive Value of a Positive Test, and Likelihood Ratio are defined and illustrated through the example involving HLA-B27 and AS. The HLA-B27 cannot be used as a screening test for the diagnosis of AS when evaluating an asymptomatic population, however the test is most useful in assisting the diagnosis of AS when used by physicians who understand the principles of probability.
The nutritional programming hypothesis proposes that early life malnutrition is related to an inc... more The nutritional programming hypothesis proposes that early life malnutrition is related to an increase in body fat later in life. Brazilian boys and girls (n = 94; 4-14 y old) were studied. Malnourished children treated in a Nutrition Recovery Center, were followed up and divided into 2 groups: the Outpatient group (recovered after outpatient care, n = 28), and the Day-hospital group (recovered after day-hospital care, n = 38). They were compared with a Control group (healthy individuals without intervention, n = 28). Nutritional recovery was confirmed by anthropometry. Body composition was evaluated by dual-energy X-ray absorptiometry. Both recovered groups had a greater increase in height-for-age Z-scores than in weight-for-age Z-scores after treatment (P < 0.03). Body fat mass (kg) and the percentage of body fat were significantly lower in recovered groups of girls and boys compared with controls. Among boys, lean mass/height (kg/cm), fat-free mass (kg) and the fat-free mass i...
Staphylococcus aureus is the most common cause of peritonitis in patients undergoing peritoneal d... more Staphylococcus aureus is the most common cause of peritonitis in patients undergoing peritoneal dialysis in Brazil. Using restriction endonuclease analysis of plasmid DNA, we investigated the importance of chronic carriage of S. aureus in the development of peritonitis in patients on continuous ambulatory peritoneal dialysis at the Division of Nephrology, Escola Paulista de Medicina, Sao Paulo, Brazil. A total of 117 isolates (30 patients) of S. aureus were available for typing, including 51 isolates (22 patients) from the nares, 58 isolates (27 patients) from pericatheter skin, and 8 isolates (6 patients) from peritoneal fluid, from patients with peritonitis. Restriction endonuclease subtyping showed that although most patients harbored more than one subtype of S. aureus, in the majority of patients nasal and/or pericatheter skin isolates with identical restriction endonuclease digest patterns were recovered on more than one occasion. Furthermore, 95% of patients with both nasal an...
This study was performed to evaluate the effectiveness of surveillance for screening and treatmen... more This study was performed to evaluate the effectiveness of surveillance for screening and treatment of patients with chronic kidney disease undergoing hemodialysis and colonized by Staphylococcus aureus. A systematic review and meta-analysis were performed. The literature search involved the following databases: the Cochrane Controlled Trials Register, Embase, LILACS, CINAHL, SciELO, and PubMed/Medline. The descriptors were "Staphylococcus aureus", "MRSA", "MSSA", "treatment", "decolonization", "nasal carrier", "colonization", "chronic kidney disease", "dialysis", and "haemodialysis" or "hemodialysis". Five randomized controlled trials that exhibited agreement among reviewers as shown by a kappa value of >0.80 were included in the study; methodological quality was evaluated using the STROBE statement. Patients who received various treatments (various treatments group) or t...
RESUMO -OBJETIVO. Avaliar em pacientes com insuficiência renal crônica (IRC), a efetividade e os ... more RESUMO -OBJETIVO. Avaliar em pacientes com insuficiência renal crônica (IRC), a efetividade e os custos do sevelamer, um polímero catiônico livre de alumínio e cálcio, que é um novo quelante de fósforo no trato gastrointestinal.
Vancomycin resistant Enterococci is becoming one of the concerns of public health in recent times... more Vancomycin resistant Enterococci is becoming one of the concerns of public health in recent times. VRE involve those strains of Enterococci that are resistant to the vancomycin which is considered as last drug of choice for the Gram positive bacterial infections. Studies show enterococci to be one of the major food borne diseases and medical consequences of its occurrence in humans. Thus, a crosssectional study was carried out to determine the prevalence of VRE in buffalo meat in Chitwan. A total of 63 retail minced meat samples were collected from different meat shops. These samples were diluted and cultured and subjected to antimicrobial susceptibility test. Of 63 samples, 16 (25.39%) samples were positive for the enterococcus species among which 3 (18.15%), were VRE indicating overall prevalence of VRE to be 4.76%. AST reveled that resistance among them was high for penicillin G and amikacin (75%) followed by tetracycline (43.75%), erythromycin (37.5%), vancomycin(18.75%) levofloxacin ( 12%) and methicillin. Eventhough methicillin revealed no resistance it showed intermediate sensitive to all the samples. Thus, it clarifies the presence of VRE in meat samples suggesting zoonotic disasters that can follow.
Hopelessness, suicide ideation and depression symptoms affect life quality and expectancy of chro... more Hopelessness, suicide ideation and depression symptoms affect life quality and expectancy of chronic kidney disease patients. To verify whether there are differences in hopelessness, suicide ideation and depression symptoms between chronic kidney disease patients on hemodialysis or transplant recipients. We also analyzed the influence of sociodemographic factors in these symptoms. Cross-sectional study in which 50 clinically stable chronic hemodialysis patients and 50 renal transplant patients matched by gender and age. Instruments-Beck Hopelessness Scale (BHS), Beck Scale for Suicide Ideation (BSI) and Beck Depression Inventory (BDI). BHS: 2% of each group scoring &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 8 (p = 1.00). BSI: 4% in hemodialysis and 6% of the transplant patients scoring &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 1 (p = 1.000). BDI: 20% in hemodialysis and 12% of transplant patients scoring &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 14 (p = 0.275). Patients who did not have a labor activity presented more depressive symptoms (average BDI score: 10.5 vs. 7.3, p = 0.027). Transplant patients from deceased donor presented more depressive symptoms compared with those with transplant from living donors (average BDI score: 11.0 vs. 6.7, p = 0.042). There was no difference in the intensity of hopelessness, suicide ideation and depression symptoms between stable hemodialysis and transplant patients. Not performing a labor activity and receiving the transplant from deceased donor lead to more depressive symptoms. The high prevalence of depressive symptoms and the finding of suicide ideation in both modalities of renal replacement therapy point to the need to monitor and care for those patients.
The aim of this study was to investigate the association between urinary 90 kDa N-domain Angioten... more The aim of this study was to investigate the association between urinary 90 kDa N-domain Angiotensin I-converting enzyme (ACE) form with C-reactive protein (CRP) and homocysteine plasma levels (Hcy), urinary nitric oxide (NOu), and endothelial function (EF) in normotensive subjects. Forty healthy subjects were evaluated through brachial Doppler US to test the response to reactive hyperemia and a panel of blood tests to determine CRP and Hcy levels, NOu, and urinary ACE. They were divided into groups according to the presence (ACE90+) or absence (ACE90-) of the 90 kDa ACE, the presence (FH+) or absence (FH-) of family history of hypertension, and the presence or absence of these two variables FH+/ACE90+ and FH-/ACE90-. We found an impaired endothelial dilatation in subjects who presented the 90 kDa N-domain ACE as follows: 11.4% +/- 5.3% in ACE90+ compared with 17.6% +/- 7.1% in ACE90- group and 12.4% +/- 5.6% in FH+/ACE90+ compared with 17.7% +/- 6.2% in FH-/ACE90- group, P < 0.0...
The nutritional programming hypothesis proposes that early life malnutrition is related to an inc... more The nutritional programming hypothesis proposes that early life malnutrition is related to an increase in body fat later in life. Brazilian boys and girls (n = 94; 4-14 y old) were studied. Malnourished children treated in a Nutrition Recovery Center, were followed up and divided into 2 groups: the Outpatient group (recovered after outpatient care, n = 28), and the Day-hospital group (recovered after day-hospital care, n = 38). They were compared with a Control group (healthy individuals without intervention, n = 28). Nutritional recovery was confirmed by anthropometry. Body composition was evaluated by dual-energy X-ray absorptiometry. Both recovered groups had a greater increase in height-for-age Z-scores than in weight-for-age Z-scores after treatment (P < 0.03). Body fat mass (kg) and the percentage of body fat were significantly lower in recovered groups of girls and boys compared with controls. Among boys, lean mass/height (kg/cm), fat-free mass (kg) and the fat-free mass i...
Although numerous studies suggest an inverse relationship between birth weight and cardiovascular... more Although numerous studies suggest an inverse relationship between birth weight and cardiovascular disease, the mechanistic basis of this phenomenon is not fully understood. Here, we postulate that alterations in plasma concentration of matrix metalloproteinases (MMPs) and growth factors might show different associations between birth weight, blood pressure levels, and vascular function. Concentrations of MMP-2 and its tissue inhibitor 2 (TIMP-2), MMP-9, and insulin-like growth factor-I (IGF-I) and its binding protein IGFBP-3 were measured in 64 children (34 boys, 30 girls). Small-for-gestational-age children exhibited elevated amounts of MMP-2, MMP-9, MMP-2/TIMP-2 ratio, MMP-9/TIMP-2 ratio, as well as lower concentration of IGF-I (P < 0.01), a known regulator of elastin synthesis. Similar findings were observed after adjustment for current age, gender, and race. The changes in the circulating levels of MMP-2, MMP-9, and IGF-I correlated significantly with birth weight, systolic b...
The authors discuss the usefulness of the HLA-B27 test in the diagnosis of ankylosing spondylitis... more The authors discuss the usefulness of the HLA-B27 test in the diagnosis of ankylosing spondylitis (AS). Sensitivity, Specificity, Predictive Value of a Negative Test, Predictive Value of a Positive Test, and Likelihood Ratio are defined and illustrated through the example involving HLA-B27 and AS. The HLA-B27 cannot be used as a screening test for the diagnosis of AS when evaluating an asymptomatic population, however the test is most useful in assisting the diagnosis of AS when used by physicians who understand the principles of probability.
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