Proteinuria predicts relapse in adolescent and adult minimal change disease

OBJECTIVE: This study sought to outline the clinical and laboratory characteristics of minimal change disease in adolescents and adults and establish the clinical and laboratory characteristics of relapsing and non-relapsing patients. METHODS: We retrospectively evaluated patients with confirmed diagnoses of minimal change disease by renal biopsy from 1979 to 2009; the patients were aged >13 years and had minimum 1-year follow-ups. RESULTS: Sixty-three patients with a median age (at diagnosis) of 34 (23-49) years were studied, including 23 males and 40 females. At diagnosis, eight (12.7%) patients presented with microscopic hematuria, 17 (27%) with hypertension and 17 (27%) with acute kidney injury. After the initial treatment, 55 (87.3%) patients showed complete remission, six (9.5%) showed partial remission and two (3.1%) were nonresponders. Disease relapse was observed in 34 (54%) patients who were initial responders (n = 61). In a comparison between the relapsing patients (n = 34) and the non-relapsing patients (n = 27), only proteinuria at diagnosis showed any significant difference (8.8 (7.1-12.0) vs. 6.0 (3.6-7.3) g/day, respectively, p = 0.001). Proteinuria greater than 7 g/day at the initial screening was associated with relapsing disease. CONCLUSIONS: In conclusion, minimal change disease in adults may sometimes present concurrently with hematuria, hypertension, and acute kidney injury. The relapsing pattern in our patients was associated with basal proteinuria over 7 g/day.

Minimal residual disease in cerebrospinal fluid at diagnosis: a more intensive treatment protocol was able to eliminate the adverse prognosis in children with acute lymphoblastic leukemia

We analyzed cerebrospinal fluid (CSF) samples from 65 consecutive children with acute lymphoblastic leukemia (ALL) treated according to two different treatment protocols (GBTLI-ALL-93 and -99) with no puncture accident for minimal residual disease (MRD) in the central nervous system (CNS). Minimal residual disease was detected by polymerase chain reaction (PCR) with homo/heteroduplex analysis using consensus primers to IgH and TCR genes. MRD in the CSF at diagnosis was detected by PCR in 46.8% of children with no puncture accident or morphological involvement. In patients treated with GBTLI-ALL-93 a significantly lower 5-year event-free survival (EFS) was demonstrated for those with CSF involvement, in univariate (p = 0.01) and multivariate (p = 0.04) analysis. This observation was not true for patients treated with the more intensive protocol GBTLI-ALL-99 (p = 0.81). These findings suggest that MRD detection in the CSF is a common event in children with ALL. Treatment intensification provided by the GBTLI-ALL-99 apparently overcomes the detrimental effect of CNS minimal residual disease at diagnosis.

Minimal processing of jucara's heart palm packed in brine acidified

The jucara's palm (Euterpe edulis), native to the Atlantic Forest is one of the palms most exploited for the removal of heart palm and the tree was removed in large areas. The aim of this study was to examine the feasibility of the methodology of "minimally processed" in jucara's palm. The raw material was obtained by COOPERAGUA, Sete Barras (SP) through a Sustainable Management Plan culminating in a permit issued by IBAMA, Forestry Foundation and DPRN. The process began with the withdrawal of external sheaths and cut, with subsequent immersion in a solution of sodium metabisulphite (Na2S2O5 - 200 ppm), sanitize with a chlorine solution and soak in brine acidified to wait until the filling. The cuttings were placed in polyethylene bags containing acidified solution at concentrations A 0.225%, B 0.375%, C 0.6%, D 0.825% determined by titration curve. The staining became clearer in treatments C and D, due to more acidity, resulting in higher inactivation of enzymes. Even with these positive results, were concluded that minimal processing of jucara is not effective due to the blackout, preventing its commercialization. To stop it requires the bleaching step, which does not characterize it as minimally processed.

Maize and soybeans production in integrated system under no-tillage with different pasture combinations and animal categories

The adoption of no-till system (NTS) combined with crop-livestock integration (CLI) has been a strategy promoted in Brazil, aiming to maximize areas yield and increase agribusiness profitability. This study aimed to evaluate grains yield and phytotechnical attributes from maize and soybean culture by CLI system under NTS after winter annual pure and diversified pastures with the absence or presence of grazing animals. The experiment was installed in Castro (Parana State, Brazil) on in a dystrophic Humic Rhodic Hapludox with a clay texture, using experimental design of randomized complete blocks in 4 x 2 factorial scheme with three replications. Treatments included four pasture combinations (diversified or pure) and animal categories (light and heavy) subjected or not to grazing animals during the winter. During 2008/09 and 2009/10 summers, the area was cultivated with soybeans and maize, respectively, with yield assessment of grains and phytotechnical attributes. Treatments did not alter the yield and weight of a thousand seeds (WTS) of soybeans. In maize culture, the grazing animal during the winter increased the plant population and grains yield, but gave slight decrease in WTS. Pasture combinations (diversified or pure) and animal categories (light and heavy) did not interfere in soybean culture, but benefited the maize crop.

Minimal change disease associated with type 1 and type 2 diabetes mellitus

A 19-year-old female with type 1 diabetes for four years, and a 73-year-old female with type 2 diabetes for twenty years developed sudden-onset nephrotic syndrome. Examination by light microscopy, immunofluorescence, and electron microscopy (in one case) identified minimal change disease (MCD) in both cases. There was a potential causative drug (meloxicam) for the 73-year-old patient. Both patients were treated with prednisone and responded with complete remission. The patient with type 1 diabetes showed complete remission without relapse, and the patient with type 2 diabetes had two relapses; complete remission was sustained after associated treatment with cyclophosphamide and prednisone. Both patients had two years of follow-up evaluation after remission. We discuss the outcomes of both patients and emphasize the role of kidney biopsy in diabetic patients with an atypical proteinuric clinical course, because patients with MCD clearly respond to corticotherapy alone or in conjunction with other immunosuppressive agents. Arq Bras Endocrinol Metab. 2012;56(5):331-5

Minimally invasive mastectomy: minimal incisions for better aesthetic quality of breast reconstruction

Background: Women with a family history of breast cancer who develop this disease are confronted with important situations regarding the increased risk for development of a second cancer in the contralateral breast. Prophylactic contralateral mastectomy (PCM) reduces by approximately 95% the risk for contralateral breast cancer. In spite of an increase in indications for PCM, the technical difficulties are many regarding the accomplishment of these procedures. The aim of this study is to describe the technique of mastectomy with preservation of the nipple-areola complex and a small incision, reducing surgical difficulties and complications attributed to this technique, thus allowing better aesthetic results in breast reconstruction. Methods: Forty-six patients with indications for PCM (28 bilateral) were submitted to minimally invasive mastectomy from March 2005 to November 2007. A small incision in the superior pole of the areola, sufficient to pass a liposuction 4 mm cannula is made. With the help of this cannula, detachment of the skin from the gland tissue is performed. Then a 3.5 to 4.5-cm long incision in the inframammary fold is made. Glandular detachment is completed using cautery in the sub,glandular portion and scissors in the upper breast portion cutting the restraints left by the cannula. The mammary gland tissue is removed through this incision. Results: Seventy-four breasts were operated on. The resected breast mass ranged from 285 g to 475 g. All 43 patients were reconstructed with prostheses. There was no necrosis of the nipple-areola complex or of the skin. Conclusions: This technique is an option for cases of patients with indications for PCM.

RELATIONS BETWEEN SOIL SURFACE ROUGHNESS, TORTUOSITY, TILLAGE TREATMENTS, RAINFALL INTENSITY AND SOIL AND WATER LOSSES FROM A RED YELLOW LATOSOL

The soil surface roughness increases water retention and infiltration, reduces the runoff volume and speed and influences soil losses by water erosion. Similarly to other parameters, soil roughness is affected by the tillage system and rainfall volume. Based on these assumptions, the main purpose of this study was to evaluate the effect of tillage treatments on soil surface roughness (RR) and tortuosity (T) and to investigate the relationship with soil and water losses in a series of simulated rainfall events. The field study was carried out at the experimental station of EMBRAPA Southeastern Cattle Research Center in Sao Carlos (Fazenda Canchim), in Sao Paulo State, Brazil. Experimental plots of 33 m(2) were treated with two tillage practices in three replications, consisting of: untilled (no-tillage) soil (NTS) and conventionally tilled (plowing plus double disking) soil (CTS). Three successive simulated rain tests were applied in 24 h intervals. The three tests consisted of a first rain of 30 mm/h, a second of 30 mm/h and a third rain of 70 mm/h. Immediately after tilling and each rain simulation test, the surface roughness was measured, using a laser profile meter. The tillage treatments induced significant changes in soil surface roughness and tortuosity, demonstrating the importance of the tillage system for the physical surface conditions, favoring water retention and infiltration in the soil. The increase in surface roughness by the tillage treatments was considerably greater than its reduction by rain action. The surface roughness and tortuosity had more influence on the soil volume lost by surface runoff than in the conventional treatment. Possibly, other variables influenced soil and water losses from the no-tillage treatments, e. g., soil type, declivity, slope length, among others not analyzed in this study.

BANACH SPACES WITHOUT MINIMAL SUBSPACES - EXAMPLES

We analyse several examples of separable Banach spaces, some of them new, and relate them to several dichotomies obtained in [11], by classifying them according to which side of the dichotomies they fall.

Minimal Landau background gauge on the lattice

We present the first numerical implementation of the minimal Landau background gauge for Yang-Mills theory on the lattice. Our approach is a simple generalization of the usual minimal Landau gauge and is formulated for the general SU(N) gauge group. We also report on preliminary tests of the method in the four-dimensional SU(2) case, using different background fields. Our tests show that the convergence of the numerical minimization process is comparable to the case of a null background. The uniqueness of the minimizing functional employed is briefly discussed.

DISTRIBUTION OF NITROGEN AMMONIUM SULFATE (N-15) SOIL-PLANT SYSTEM IN A NO-TILLAGE CROP SUCCESSION

DISTRIBUTION OF NITROGEN AMMONIUM SULFATE (N-15) SOIL-PLANT SYSTEM IN A NO-TILLAGE CROP SUCCESSION The N use by maize (Zea mays, L.) is affected by N-fertilizer levels. This study was conducted using a sandy-clay texture soil (Hapludox) to evaluate the efficiency of N use by maize in a crop succession, based on N-15-labeled ammonium sulfate (5.5 atom %) at different rates, and to assess the residual fertilizer effect in two no-tillage succession crops (signalgrass and corn). Two maize crops were evaluated, the first in the growing season 2006, the second in 2007, and brachiaria in the second growing season. The treatments consisted of N rates of 60, 120 and 180 kg ha(-1) in the form of labeled N-15 ammonium sulfate. This fertilizer was applied in previously defined subplots, only to the first maize crop (growing season 2006). The variables total accumulated N; fertilizer-derived N in corn plants and pasture; fertilizer-derived N in the soil; and recovery of fertilizer-N by plants and soil were evaluated. The highest uptake of fertilizer N by corn was observed after application of 120 kg ha(-1) N and the residual effect of N fertilizer on subsequent corn and Brachiaria was highest after application of 180 kg ha(-1) N. After the crop succession, soil N recovery was 32, 23 and 27 % for the respective applications of 60, 120 and 180 kg ha(-1) N.

Probing neutralino properties in minimal supergravity with bilinear R-parity violation

Supersymmetric models with bilinear R-parity violation can account for the observed neutrino masses and mixing parameters indicated by neutrino oscillation data. We consider minimal supergravity versions of bilinear R-parity violation where the lightest supersymmetric particle is a neutralino. This is unstable, with a large enough decay length to be detected at the CERN Large Hadron Collider. We analyze the Large Hadron Collider potential to determine the lightest supersymmetric particle properties, such as mass, lifetime and branching ratios, and discuss their relation to neutrino properties.

Impact of pretransplant minimal residual disease after cord blood transplantation for childhood acute lymphoblastic leukemia in remission: an Eurocord, PDWP-EBMT analysis

To address the prognostic value of minimal residual disease (MRD) before unrelated cord blood transplantation (UCBT) in children with acute lymphoblastic leukemia (ALL), we analyzed 170 ALL children transplanted in complete remission (CR) after myeloablative conditioning regimen. In all, 72 (43%) were in first CR (CR1), 77 (45%) in second CR (CR2) and 21 (12%) in third CR (CR3). The median interval from MRD quantification to UCBT was 18 days. All patients received single-unit UCBT. Median follow-up was 4 years. Cumulative incidence (CI) of day-60 neutrophil engraftment was 85%. CI of 4 years relapse was 30%, incidence being lower in patients with negative MRD before UCBT (hazard ratio (HR) = 0.4, P = 0.01) and for those transplanted in CR1 and CR2 (HR = 0.3, P = 0.002). Probability of 4 years leukemia-free survival (LFS) was 44%, (56, 44 and 14% for patients transplanted in CR1, CR2 and CR3, respectively (P = 0.0001)). Patients with negative MRD before UCBT had better LFS after UCBT compared with those with positive MRD (54% vs 29%; HR = 2, P = 0.003). MRD assessment before UCBT for children with ALL in remission allows identifying patients at higher risk of relapse after transplantation. Approaches that may decrease relapse incidence in children given UCBT with positive MRD should be investigated to improve final outcomes. Leukemia (2012) 26, 2455-2461; doi:10.1038/leu.2012.123

Minimal alterations on the enamel surface by micro-abrasion: in vitro roughness and wear assessments

Objective: To evaluate the in vitro changes on the enamel surface after a micro-abrasion treatment promoted by different products. Material and Methods: Fifty (50) fragments of bovine enamel (15 mm × 5 mm) were randomly assigned to five groups (n=10) according to the product utilized: G1 (control)= silicone polisher (TDV), G2= 37% phosphoric acid (3M/ESPE) + pumice stone (SS White), G3= Micropol (DMC Equipment), G4= Opalustre (Ultradent) and G5= Whiteness RM (FGM Dental Products). Roughness and wear were the responsible variables used to analyze these surfaces in four stages: baseline, 60 s and 120 s after the micro-abrasion and after polishing, using a Hommel Tester T1000 device. After the tests, a normal distribution of data was verified, with repeated ANOVA analyses (p?0.05) which were used to compare each product in different stages. One-way ANOVA and Tukey tests were applied for individual comparisons between the products in each stage (p?0.05). Results: Means and standard deviations of roughness and wear (µm) after all the promoted stages were: G1=7.26(1.81)/13.16(2.67), G2=2.02(0.62)/37.44(3.33), G3=1.81(0.91)/34.93(6.92), G4=1.92(0.29)/38.42(0.65) and G5=1.98(0.53)/33.45(2.66). At 60 seconds, all products tended to produce less surface roughness with a variable gradual decrease over time. After polishing, there were no statistically significant differences between the groups, except for G1. Independent of the product utilized, the enamel wear occurred after the micro-abrasion. Conclusions: In this in vitro study, enamel micro-abrasion presented itself as a conservative approach, regardless of the type of the paste compound utilized. These products promoted minor roughness alterations and minimal wear. The use of phosphoric acid and pumice stone showed similar results to commercial products for the micro-abrasion with regard to the surface roughness and wear.

Temporary effect of chiseling on the compaction of a Rhodic Hapludox under no-tillage

Mechanical chiseling has been used to alleviate the effects of compaction in soils under no-tillage (NT). However, its effect on the soil physical properties does not seem to have a defined duration period. The purpose of this study was to evaluate the behavior of the bulk density (BD) and degree of compaction (DC) at different soil depths, after chiseling in no-tillage, for one year. The experiment was performed in Ponta Grossa, Paraná State, Brazil, using an Oxisol (Rhodic Hapludox). Bulk density and DC were previously measured in an area under NT for 16 years, then immediately after chiseling (CHI) in May 2009, six months after chiseling (CHI6M) in October 2009 and one year after chiseling (CHI12M) in May 2010. In the layers 0.0-0.10, 0.10-0.20 and 0.20-0.30 m, there was a significant BD reduction CHI and a marked increase CHI6M. The BD values measured CHI12M were similar to those before tillage. Chiseling reduced the DC in the layers 0.0-0.10 m and 0.10-0.20 m, but returned to the initial values one year later. During the evaluation periods CHI, CHI6M and CHI12M, the BD increased in the layer 0.30-0.40 m, compared with NT. The highest DC values were observed six months after chiseling; nevertheless the structural recovery of the soil was considerable, possibly due to the high degree of soil resilience and the influence of the wetting and drying cycles detected in the study period. The chiseling effects, evaluated by BD and DC, lasted less than one year, i.e., the beneficial short-term effects of chiseling on the reduction of the surface BD increased the risk of compaction in deeper soil layers.

Relations between soil surface roughness, tortuosity, tillage treatments, rainfall intensity and soil and water losses from a red yellow latosol

The soil surface roughness increases water retention and infiltration, reduces the runoff volume and speed and influences soil losses by water erosion. Similarly to other parameters, soil roughness is affected by the tillage system and rainfall volume. Based on these assumptions, the main purpose of this study was to evaluate the effect of tillage treatments on soil surface roughness (RR) and tortuosity (T) and to investigate the relationship with soil and water losses in a series of simulated rainfall events. The field study was carried out at the experimental station of EMBRAPA Southeastern Cattle Research Center in São Carlos (Fazenda Canchim), in São Paulo State, Brazil. Experimental plots of 33 m² were treated with two tillage practices in three replications, consisting of: untilled (no-tillage) soil (NTS) and conventionally tilled (plowing plus double disking) soil (CTS). Three successive simulated rain tests were applied in 24 h intervals. The three tests consisted of a first rain of 30 mm/h, a second of 30 mm/h and a third rain of 70 mm/h. Immediately after tilling and each rain simulation test, the surface roughness was measured, using a laser profile meter. The tillage treatments induced significant changes in soil surface roughness and tortuosity, demonstrating the importance of the tillage system for the physical surface conditions, favoring water retention and infiltration in the soil. The increase in surface roughness by the tillage treatments was considerably greater than its reduction by rain action. The surface roughness and tortuosity had more influence on the soil volume lost by surface runoff than in the conventional treatment. Possibly, other variables influenced soil and water losses from the no-tillage treatments, e.g., soil type, declivity, slope length, among others not analyzed in this study.