Estudio longitudinal del peso e índice de masa corporal tras el trasplante renal durante 5 años de evolución.

INTRODUCTION: Gain weight after transplantation is relatively common, also tends to be multifactorial and can be influenced by glucocorticoids and immunosuppressive medications, delayed graft function and cause serious health complications. OBJECTIVES: Assess changes in weight, degree of obesity and body mass index as well as the effect of immunosuppressive treatment over these 5 years after kidney transplantation. METHODS: The samples were 119 kidney transplant recipients, 70 men and 49 women, that attended the query post for five years. All patients were measured Pretransplant and post (from 1st year to the 5th year) weight, height and body mass index calculated by the formula weight/size2 relating it to immunosuppressive treatment taking. RESULTS: There is a considerable increase of body mass index, weight and degree of obesity in the first year after transplantation to increase more slowly in the next four years. The type of immunosuppressive treatment influence the weight and degree of obesity that occurs in this period of time. CONCLUSIONS: A high prevalence there are overweight and obesity after the transplant especially during the first year. A year patients earn an average of 6.6 kg in weight and an average of 2.5 kg/m2 in their BMI. During treatment should minimize doses of steroids and include dietary treatment and adequate physical exercise

Liver safety assessment: required data elements and best practices for data collection and standardization in clinical trials.

A workshop was convened to discuss best practices for the assessment of drug-induced liver injury (DILI) in clinical trials. In a breakout session, workshop attendees discussed necessary data elements and standards for the accurate measurement of DILI risk associated with new therapeutic agents in clinical trials. There was agreement that in order to achieve this goal the systematic acquisition of protocol-specified clinical measures and lab specimens from all study subjects is crucial. In addition, standard DILI terms that address the diverse clinical and pathologic signatures of DILI were considered essential. There was a strong consensus that clinical and lab analyses necessary for the evaluation of cases of acute liver injury should be consistent with the US Food and Drug Administration (FDA) guidance on pre-marketing risk assessment of DILI in clinical trials issued in 2009. A recommendation that liver injury case review and management be guided by clinicians with hepatologic expertise was made. Of note, there was agreement that emerging DILI signals should prompt the systematic collection of candidate pharmacogenomic, proteomic and/or metabonomic biomarkers from all study subjects. The use of emerging standardized clinical terminology, CRFs and graphic tools for data review to enable harmonization across clinical trials was strongly encouraged. Many of the recommendations made in the breakout session are in alignment with those made in the other parallel sessions on methodology to assess clinical liver safety data, causality assessment for suspected DILI, and liver safety assessment in special populations (hepatitis B, C, and oncology trials). Nonetheless, a few outstanding issues remain for future consideration.

Lack of correlation between the optimal glycaemic control and coronary micro vascular dysfunction in patients with diabetes mellitus: a cross sectional study.

Background Coronary microvascular dysfunction (CMD) is associated with cardiovascular events in type 2 diabetes mellitus (T2DM). Optimal glycaemic control does not always preclude future events. We sought to assess the effect of the current target of HBA1c level on the coronary microcirculatory function and identify predictive factors for CMD in T2DM patients. Methods We studied 100 patients with T2DM and 214 patients without T2DM. All of them with a history of chest pain, non-obstructive angiograms and a direct assessment of coronary blood flow increase in response to adenosine and acetylcholine coronary infusion, for evaluation of endothelial independent and dependent CMD. Patients with T2DM were categorized as having optimal (HbA1c < 7 %) vs. suboptimal (HbA1c ≥ 7 %) glycaemic control at the time of catheterization. Results Baseline characteristics and coronary endothelial function parameters differed significantly between T2DM patients and control group. The prevalence of endothelial independent CMD (29.8 vs. 39.6 %, p = 0.40) and dependent CMD (61.7 vs. 62.2 %, p = 1.00) were similar in patients with optimal vs. suboptimal glycaemic control. Age (OR 1.10; CI 95 % 1.04–1.18; p < 0.001) and female gender (OR 3.87; CI 95 % 1.45–11.4; p < 0.01) were significantly associated with endothelial independent CMD whereas glomerular filtrate (OR 0.97; CI 95 % 0.95–0.99; p < 0.05) was significantly associated with endothelial dependent CMD. The optimal glycaemic control was not associated with endothelial independent (OR 0.60, CI 95 % 0.23–1.46; p 0.26) or dependent CMD (OR 0.99, CI 95 % 0.43–2.24; p = 0.98). Conclusions The current target of HBA1c level does not predict a better coronary microcirculatory function in T2DM patients. The appropriate strategy for prevention of CMD in T2DM patients remains to be addressed. Keywords: Endothelial dysfunction; Diabetes mellitus; Coronary microcirculation

Prognosis Relevance of Serum Cytokines in Pancreatic Cancer.

The overall survival of patients with pancreatic ductal adenocarcinoma is extremely low. Although gemcitabine is the standard used chemotherapy for this disease, clinical outcomes do not reflect significant improvements, not even when combined with adjuvant treatments. There is an urgent need for prognosis markers to be found. The aim of this study was to analyze the potential value of serum cytokines to find a profile that can predict the clinical outcome in patients with pancreatic cancer and to establish a practical prognosis index that significantly predicts patients' outcomes. We have conducted an extensive analysis of serum prognosis biomarkers using an antibody array comprising 507 human cytokines. Overall survival was estimated using the Kaplan-Meier method. Univariate and multivariate Cox's proportional hazard models were used to analyze prognosis factors. To determine the extent that survival could be predicted based on this index, we used the leave-one-out cross-validation model. The multivariate model showed a better performance and it could represent a novel panel of serum cytokines that correlates to poor prognosis in pancreatic cancer. B7-1/CD80, EG-VEGF/PK1, IL-29, NRG1-beta1/HRG1-beta1, and PD-ECGF expressions portend a poor prognosis for patients with pancreatic cancer and these cytokines could represent novel therapeutic targets for this disease.

Osteoporosis e índice de masa corporal en el trasplantado renal.

INTRODUCTION: frequently after kidney transplantation there is an increase in weight with a resulting high percent of obesity in these recipients. This combined with a rapid loss of bone mass, a higher prevalence of osteoporosis and fractures is evident than in normal populations. OBJECTIVES: to explore the relationship between body mass index (BMI) and prevalence of osteoporosis in a population of renal transplant recipients. METHODS: prospective longitudinal study design. The study was conducted on 306 kidney transplant recipients. The relationship between weigh and body mass index with femoral and lumbar osteopenia and osteoporosis prevalence at the moment of transplant and at 12 months post was explored. RESULTS: there was a high prevalence of overweight (35.6%) and obese (14.1%) recipients after renal transplant and 1 year after (42.2% and 24.2% respectively). Significant differences were found(p = 0.049) between the weight at the time of transplant and the presence of osteopenia or osteoporosis at the lumbar level one year after, the highest weights were in recipients with osteoporosis. The mean BMI was higher (p = 0.028) in osteoporotic patients (26.59 kg/m2) than in patients with osteopenia (24.23 kg/m2). CONCLUSION: results seem to be consistent with recent studies in the general population showing excessive weight as a possible factor detrimental to the bone health.

Valoración del perfil lipídico y de la densidad mineral ósea en pacientes trasplantados renales

INTRODUCTION: Alterations in lipid metabolism and bone mineral metabolism disturbances are common disorders among renal transplant patients, contributing to the apparition of oxidative metabolic and cardiovascular diseases that threaten the integrity of the graft. AIMS: Describe and observe the evolution of alterations in bone mineral density (BMD) and lipid abnormalities in a population of kidney transplant patients. MATERIAL AND METHOD: The samples consisted of 119 kidney transplant patients of both sexes, measurements were performed pretransplant and posttransplant for five years of biochemical parameters, anthropometric measurements and measurement of bone mineral density at the lumbar spine, femur and radioulnar. RESULTS: During the five years after transplantation a significant increase in biochemical parameters, BMI, dyslipidemia, diabetes and hypertension occurs. At six months there is a high percentage of patients with pathologic BMD increase by 4.1% per year of transplantation. CONCLUSIONS: After kidney transplantation, a large increase of hyperlipidemia associated with a characteristic pattern of altered lipid with elevated total cholesterol, low density lipoprotein, high density lipoprotein, and the resulting increase in triglycerides, occurs despite statin therapy, leading to an increase in risk factors for diabetes, hypertension, diseases and cardiovascualres further loss of bone mass which carries a high risk of serious fractures occurs, threatening kidney graft and quality of life of patients.

The human Ia-associated invariant chain is synthesized in Ia-negative B cell variants and is not expressed on the cell surface of both Ia-negative and Ia-positive parental cells.

The expression of Ia-associated human Invariant (In) chain glycoproteins was studied in the Raji B cells as well as in their RJ 2.2.5 Ia-negative derived variant cells by using a specific rabbit anti-human In chain antiserum. Two-dimensional gel electrophoresis of immunoprecipitates from either biosynthetically labeled or surface labeled cells were analyzed. In addition, flow microfluorometric analysis of stained cells was performed. The results indicate that the In chain is constitutively produced in the Ia-negative B cell variant. Moreover, it appears that several forms of In chain-related molecules, with different charges and distinct m.w. are equally expressed in Ia-positive and Ia-negative B cells. Finally, no evidence could be obtained that the In molecular family was expressed on the cell surface of Ia-positive Raji and Ia-negative RJ 2.2.5 cells.

O cotidiano do enfermeiro em pesquisa clínica: um relato de experiência

O presente artigo consiste no relato de experiência das autoras como enfermeiras de um ensaio clínico randomizado, cego, de fase III, realizado na Escola Nacional de Saúde Pública Sérgio Arouca / FIOCRUZ / RJ. Relata as atividades do enfermeiro na operacionalização de uma pesquisa clínica e destaca a sua importância neste novo campo de trabalho. Menciona a rigorosa implementação do protocolo clínico pelo enfermeiro, visando prevenir desvios, falhas e vieses, assim como o compromisso com a autenticidade dos registros, a atenção e o respeito aos direitos e bem-estar dos sujeitos. O enfermeiro pode exercer com qualidade atividades não somente assistenciais, como também de pesquisa, em áreas da saúde, como por exemplo os ensaios clínicos, através de monitoramento, supervisão e capacitação profissional.

Ocorrência de multiparasitismo em larvas de terceiro ínstar e pupas de Chrysomya megacephala (Fabricius) em condições de campo

Durante experimento de pesquisa envolvendo o parasitismo de larvas de terceiro ínstar e pupas de Chrysomya megacephala (Fabricius, 1794) em dois locais da cidade do Rio de Janeiro, RJ, observou-se a ocorrência de multiparasitismo em 1,83% das pupas expostas no Instituto Oswaldo Cruz (IOC) e em 2,16% expostas no Jardim Zoológico (ZOO). O experimento foi conduzido semanalmente de agosto de 1999 a julho de 2000. Em ambos os locais, houve a co-ocorrência de duas espécies por pupa e os parasitóides encontrados foram os himenópteros Tachinaephagus zealandicus Ashmead, 1904, Pachycrepoideus vindemiae (Rondani, 1875) e Nasonia vitripennis (Walker, 1836). 72,73% do multiparasitismo ocorreu no ZOO em julho de 2000. Em condições de multiparasitismo, T. zealandicus e P. vindemiae mantiveram seu hábito gregário e solitário, respectivamente, mas N. vitripennis foi encontrado solitário em algumas pupas.

Uma Metodologia para a Seleção de Sistemas de Cogeração em Plataformas Offshore

As reservas mundiais provadas de gás natural totalizavam 143 trilhões de m3 em 1999. Deste total, 403 bilhões estão no território brasileiro, sendo 151 bilhões de m3 em terra e 252 bilhões no mar. A Figura 1 mostra a distribuição da produção nacional, sendo quase metade do total extraído na Bacia de Campos, RJ. Pode-se dizer que a cogeração aplicada a plataformas de petróleo não representa uma novidade, já há alguns anos até mesmo os navios utilizam a produção conjunta de trabalho mecânico e calor a partir da queima de um mesmo combustível. Entretanto, existem múltiplas configurações possíveis para atendimento de certas demandas térmicas e elétricas e a escolha da mais adequada pode representar uma sensível diferença em termos de aproveitamento energético.

Predação de sementes de Allagoptera arenaria (Gomes) O'Kuntze (Arecaceae) por Pachymerus nucleorum Fabricius (Coleoptera, Chrysomelidae, Bruchinae)

A predação de sementes da palmeira Allagoptera arenaria (Gomes) O'Kuntze, 1891(Arecaceae) por Pachymerus nucleorum Fabricius, 1972 foi avaliada de setembro de 2003 a setembro de 2005 no Parque Nacional da Restinga de Jurubatiba (RJ). A biologia e o comportamento de P. nucleorum em A. arenaria e as taxas de predação de sementes foram descritas. Frutos encontrados sob 50 palmeiras foram coletados, mensalmente, em cada uma das duas áreas amostradas no PNRJ (mata de cordão arenoso e formação arbustiva aberta de Clusia Sclthdl, Clusiaceae). A avaliação dos cocos predados foi feita a partir da contagem dos orifícios de saída dos bruquíneos no campo, da emergência dos insetos no laboratório e da abertura dos frutos remanescentes. Através de observações e experimentos em 60 infrutescências, verificou-se que a oviposição de Pachymerus nucleorum em A. arenaria ocorre na infrutescência ainda em desenvolvimento diferentemente de registros na literatura em outras espécies de palmeiras, onde a oviposição ocorre nos frutos no chão. A predação dos frutos por P. nucleorum foi de 29,3% na área de mata de cordão arenoso e 20,6% na formação arbustiva aberta de Clusia. O ciclo de vida de P. nucleorum foi bastante longo e com amplitudes bem grandes dentro de uma mesma amostra, o que sugere uma possível diapausa em alguma fase do seu ciclo de vida.

Nest distribution and nesting habits of Xylocopa ordinaria Smith (Hymenoptera, Apidae) in a restinga area in the northern Rio de Janeiro State, Brazil

This paper aims to study the distribution of natural nests of Xylocopa ordinaria and characterize its nesting habits in the restinga of Grussai/Iquipari (RJ), supporting future studies on the pollinators management in the northern Rio de Janeiro state. The data obtained from Aug/2003 to Dec/2004, in an area of 11.6ha, were related to the nest distribution, substrate identification and dimensions, emergence, sex ratio, nest structure (n= 23 nests) and pollen content analysis of provisioning masses and feces. X. ordinaria nests were abundant and presented a clustered distribution. These bees do not present taxonomical affinity for nesting substrates, but preferences for wood availability and characteristics, being Pera glabrata the main substrate. X. ordinaria is a multivoltine species that tolerates co-specifics in their nests. These bees were generalist on their nectar and pollen consumption, but presented floral constancy while provisioning brood cells. These behaviors, activity along the year, flights throughout the day, and legitimate visits to flowers indicate the importance of X. ordinaria on the pollination of plants in the restinga.

Local distribution of blackfly (Diptera, Simuliidae) larvae in two adjacent streams: the role of water current velocity in the diversity of blackfly larvae

This study aimed to evaluate the influence of water velocity speed on the local distribution and taxocenosis structure of blackfly larvae. The larvae were collected from two adjacent streams located in the municipality of Angra dos Reis (RJ): Caputera River and one of its tributaries. Riffle litter patches were sampled randomly using a 30 x 30 cm quadrat. Four blackfly species were found: Simulium incrustatum s. l. Lutz, 1910; Simulium (Inaequalium) sp. ; Simulium pertinax s. l. Kollar, 1832 and Simulium subpallidum s. l. Lutz, 1909. Among these species, Simulium pertinax s. l. was clearly associated with higher water current speeds, while Simulium subpallidum s. l. showed association with lower water velocities, and Simulium (Inaequalium) sp. had a relatively constant distribution along the water current gradient.

Revision of the genus Harpasus Mulsant (Coleoptera, Coccinellidae, Chilocorini)

Harpasus Mulsant, 1850 was studied based on the morphology of the exoskeleton and genitalia. The type material of Harpasus aureus Almeida & Carvalho, 2006, H. quadrifolium González, Corrêa & Almeida, 2008 and a homotype of H. zonatus (Mulsant, 1850) were examined. The lectotype of H. eversmanni (Mulsant, 1850) was designated and two new species were described, Harpasus unifasciatus sp. nov. (Teresópolis, RJ, Brazil) and Harpasus ferrugineus sp. nov. (Puerto Carreño, Vichada, Colombia). Herein a diagnosis for the genus and its seven species, identification key and information about biological aspects are presented.

Transferência de nitrogênio entre plantas interconectadas por fungos micorrízicos arbusculares (FMAS)

Este trabalho, desenvolvido em casa de vegetação da Universidade Estadual do Norte Fluminense (UENF), em Campos (RJ), no primeiro semestre de 1996, objetivou avaliar a importância dos fungos micorrízicos arbusculares (FMAS) no processo de transferência de N do feijão para o milho, utilizando o isótopo 15N. Foram construídos três tipos de vasos especiais, divididos em três seções, A, B e C, com 2 dm³ de capacidade: sem barreira, com tela de nylon de 40 ∝m (permitiu a passagem de hifas fúngicas, mas não a de raízes) e com tela de nylon de 1 ∝m (não permitiu a passagem de hifas e raízes) entre as seções B e C. Adicionaram-se 25 mg kg-1 de N somente na seção A de cada vaso, utilizando-se, como fonte (15NH4)2SO4. Duas plantas de feijão pré-germinadas e inoculadas com Rhizobium tropici foram plantadas com suas raízes divididas entre as seções A e B. Após 10 dias, efetuou-se o plantio do milho, diretamente, na seção C dos vasos, e a inoculação micorrízica nos tratamentos com o FMA foi feita pela adição de propágulos de Glomus etunicatum somente na seção C. O experimento foi coletado 35 dias após o transplantio do feijão, e os resultados demonstraram que a colonização micorrízica se mostrou satisfatória, tanto no milho quanto no feijão. A presença da micorriza aumentou a produção de matéria seca, conteúdo de 15N e P da parte aérea das plantas de milho. A transferência direta de 15N do feijão para o milho através do micélio fúngico foi de 16,6%; a transferência indireta envolvendo o FMA - ou seja, a absorção do 15N excretado pelas raízes do feijão na solução do solo que foi absorvido e transferido através do micélio do FMA para o milho - foi de 34,1%; e a transferência indireta não envolvendo o FMA - ou seja, a absorção de 15N pelas raízes de milho da solução do solo sem envolvimento do FMA - foi de 49,3%.