Long-Term Follow-Up of Patients after Acute Kidney Injury: Patterns of Renal Functional Recovery

Background and Objectives: Patients who survive acute kidney injury (AKI), especially those with partial renal recovery, present a higher long-term mortality risk. However, there is no consensus on the best time to assess renal function after an episode of acute kidney injury or agreement on the definition of renal recovery. In addition, only limited data regarding predictors of recovery are available. Design, Setting, Participants, & Measurements: From 1984 to 2009, 84 adult survivors of acute kidney injury were followed by the same nephrologist (RCRMA) for a median time of 4.1 years. Patients were seen at least once each year after discharge until end stage renal disease (ESRD) or death. In each consultation serum creatinine was measured and glomerular filtration rate estimated. Renal recovery was defined as a glomerular filtration rate value >= 60 mL/min/1.73 m2. A multiple logistic regression was performed to evaluate factors independently associated with renal recovery. Results: The median length of follow-up was 50 months (30-90 months). All patients had stabilized their glomerular filtration rates by 18 months and 83% of them stabilized earlier: up to 12 months. Renal recovery occurred in 16 patients (19%) at discharge and in 54 (64%) by 18 months. Six patients died and four patients progressed to ESRD during the follow up period. Age (OR 1.09, p < 0.0001) and serum creatinine at hospital discharge (OR 2.48, p = 0.007) were independent factors associated with non renal recovery. The acute kidney injury severity, evaluated by peak serum creatinine and need for dialysis, was not associated with non renal recovery. Conclusions: Renal recovery must be evaluated no earlier than one year after an acute kidney injury episode. Nephrology referral should be considered mainly for older patients and those with elevated serum creatinine at hospital discharge.

GPR applied to mapping utilities along the route of the Line 4 (yellow) subway tunnel construction in Sao Paulo City, Brazil

The rapid industrial development and disorganized population growth in huge cities bring about various urban problems due to intense use of physical space on and below the surface. Subsurface problems in metropolitan areas are caused by subway line construction, which often follows the routes of utility networks, such as electric and telephone cables, water and gas pipes, storm sewers, etc. Usually, the main problems are related to damage or destruction of preexisting utilities, often putting human lives at risk. With the purpose of minimizing risks. GPR-profiling with 200 MHz antennae was done at two sites, both located in downtown Sao Paulo, Brazil. The objectives of this work were to map utilities or existing infrastructure in the subsurface in order to orient the construction of the Line 4 (yellow) subway tunnel in Sao Paulo. GPR profiles can detect water pipes, utility networks in the subsurface, and concrete foundation columns or pilings in subsoil up to 2 m depth. In addition. the GPR profiles also provided details of the target shapes in the subsurface. GPR interpretations combined with lithological information from boreholes and trenches opened in the study areas were extremely important in mapping of the correct spatial distribution of buried utilities at these two sites in Sao Paulo. This information improves and updates maps of utility placement, serves as a basis for planning of the geotechnical excavation of the Line 4 (yellow) subway tunnel in Sao Paulo, helps minimize problems related to destruction of preexisting utilities in the subsoil, and avoids risk of dangerous accidents. (C) 2012 Elsevier B.V. All rights reserved.

Iodide treatment acutely increases pendrin (SLC26A4) mRNA expression in the rat thyroid and the PCCl3 thyroid cell line by transcriptional mechanisms

Iodine is a critical element involved in thyroid hormone synthesis. Its efflux into the follicular lumen is thought to occur, in part, through pendrin at the apical membrane of thyrocytes. This study attempted to investigate whether iodide administration affects SLC26A4 mRNA expression in rat thyroid and in PCCl3 cells. Rats and cells were treated or not with Nal from 30 min up to 48 h. One group was concomitantly treated with sodium perchlorate. SLC26A4 mRNA expression was also investigated in PCCl3 cells treated with actinomycin D prior to Nal treatment. Iodide administration significantly increased SLC26A4 mRNA content in both models. The simultaneous administration of Nal and perchlorate, as well as the treatment of PCCl3 cells with actinomycin D prevented this effect, indicating that intracellular iodide is essential for this event, which appears to be triggered by transcriptional mechanisms. These data show that intracellular iodide rapidly upregulates SLC26A4 mRNA expression. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Flux-Line-Lattice Melting and Upper Critical Field of Bi1.65Pb0.35Sr2Ca2Cu3O10+delta Ceramic Samples

We have conducted magnetoresistance measurements rho(T,H) in applied magnetic fields up to 18 T in Bi1.65Pb0.35Sr2Ca2Cu3O10+delta ceramic samples which were subjected to different uniaxial compacting pressures. The anisotropic upper critical fields H (c2)(T) were extracted from the rho(T,H) data, yielding and the out-of-plane superconducting coherence length xi (c) (0)similar to 3 . We have also estimated and xi (ab) (0) similar to 90 . In addition to this, a flux-line-lattice (FLL) melting temperature T (m) has been identified as a second peak in the derivative of the magnetoresistance d rho/dT data close to the superconducting transition temperature. An H (m) vs. T phase diagram was constructed and the FLL boundary lines were found to obey a temperature dependence H (m) ae(T (c) /T-1) (alpha) , where alpha similar to 2 for the sample subjected to the higher compacting pressure. A reasonable value of the Lindemann parameter c (L) similar to 0.29 has been found for all samples studied.

Compact and autonomous multiwavelength microanalyzer for in-line and in situ colorimetric determinations

Nowadays, the attainment of microsystems that integrate most of the stages involved in an analytical process has raised an enormous interest in several research fields. This approach provides experimental set-ups of increased robustness and reliability, which simplify their application to in-line and continuous biomedical and environmental monitoring. In this work, a novel, compact and autonomous microanalyzer aimed at multiwavelength colorimetric determinations is presented. It integrates the microfluidics (a three-dimensional mixer and a 25 mm length "Z-shape" optical flow-cell), a highly versatile multiwavelength optical detection system and the associated electronics for signal processing and drive, all in the same device. The flexibility provided by its design allows the microanalyzer to be operated either in single fixed mode to provide a dedicated photometer or in multiple wavelength mode to obtain discrete pseudospectra. To increase its reliability, automate its operation and allow it to work under unattended conditions, a multicommutation sub-system was developed and integrated with the experimental set-up. The device was initially evaluated in the absence of chemical reactions using four acidochromic dyes and later applied to determine some key environmental parameters such as phenol index, chromium(VI) and nitrite ions. Results were comparable with those obtained with commercial instrumentation and allowed to demonstrate the versatility of the proposed microanalyzer as an autonomous and portable device able to be applied to other analytical methodologies based on colorimetric determinations.

Variable rotational line broadening in the Be star Achernar

Aims. The main theoretical problem for the formation of a Keplerian disk around Be stars is how angular momentum is supplied from the star to the disk, even more so since Be stars probably rotate somewhat subcritically. For instance, nonradial pulsation may transport angular momentum to the stellar surface until (part of) this excess supports the disk-formation/replenishment. The nearby Be star Achernar is presently building a new disk and o ers an excellent opportunity to observe this process from relatively close-up. Methods. Spectra from various sources and epochs are scrutinized to identify the salient stellar parameters characterizing the disk life cycle as defined by H emission. The variable strength of the non-radial pulsation is confirmed, but does not a ect the other results. Results. For the first time it is demonstrated that the photospheric line width does vary in a Be star, by as much as v sin i . 35 km However, unlike assumptions in which a photospheric spin-up accumulates during the diskless phase and then is released into the disk as it is fed, the apparent photospheric spin-up is positively correlated with the appearance of H line emission. The photospheric line widths and circumstellar emission increase together, and the apparent stellar rotation declines to the value at quiescence after the H line emission becomes undetectable