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“CUIDADO COM QUEM VOCÊ FALA NA INTERNET”: MEDIAÇÃO PARENTAL PELO OLHAR DE PRÉ-ADOLESCENTES
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Castro, Teresa Sofia

Cadernos CEDES

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apr 2021, Volume 41 N. 113 Pages 4 - 13

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Quando falamos de telas com ligação à Internet, que as crianças usam para lazer e comunicação com seus pares, e da mediação parental, a literatura identifica que, nesse assunto, as crianças ainda são pouco ouvidas. Este artigo resulta de uma tese de doutorado na qual ouvimos as perspectivas críticas de pré-adolescentes portugueses, vindas de famílias de rendas média e média-baixa. Procuramos analisar dois tópicos centrais: o papel influente da mídia nas percepções dos pais e como os pré-adolescentes respondem à mediação parental.

ABSTRACT When talking about devices with Internet connection, which children use for leisure and communication with their peers, and parental mediation, the literature identifies that, on this subject, children are still scarcely heard. This paper is the result of a doctoral dissertation where we listened to the critical perspectives of Portuguese pre-adolescents from middle and lower-middle income families. We aimed at analyzing two central topics: the influential role of the media in parents’ perceptions, and how pre-adolescents respond to parental mediation.

https://doi.org/10.1590/cc231361 1213 downloads

A modified banding technique: experience of a center
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Cerqueira, Sofia S. G.

; Ferreira, Joana M.

; Fructuoso, Mónica R.

; Eusebio, Catarina

; Castro, Rui A.

; Morgado, Teresa M.

Brazilian Journal of Nephrology

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mar 2021, Volume 43 N. 1 Pages 41 - 46

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Introdução: Um acesso vascular em bom funcionamento é vital para pacientes em hemodiálise regular. A bandagem do acesso é indicada na síndrome de roubo associada a alto fluxo. Permite a redução do fluxo de acesso enquanto mantém a perfusão distal do membro. No entanto, este procedimento tem algumas limitações, pois pode causar hemorragia, infecção, formação de aneurisma, trombose de acesso em casos de excesso de bandagem (overbanding) ou, de outra forma, redução insuficiente do fluxo vascular. Outras técnicas cirúrgicas para obter o mesmo benefício seriam úteis. Métodos: Foi realizada uma técnica de bandagem modificada sem colocação endovascular do balão de angioplastia, que é uma alternativa viável às outras técnicas. Esta cirurgia foi realizada em pacientes em diálise crônica com síndrome de roubo. Os fluxos de acesso pré e pós-operatório foram medidos e a resolução dos sintomas foi registrada. A taxa de permeabilidade primária foi definida como a sobrevivência do acesso livre de intervenção desde o tempo operatório. Resultados: Verificamos que essa técnica permitiu redução do fluxo de acesso em todos os nossos seis pacientes, com resolução total dos sintomas em todos os pacientes. A taxa de patência primária em 12 meses foi de 100%. Nenhuma complicação maior foi observada durante nosso acompanhamento. Conclusões: Esta técnica permite a correção de fístulas arteriovenosas de alto fluxo de forma eficiente e segura, podendo ser uma alternativa viável a outros procedimentos de bandagem.

ABSTRACT Background: A well-functioning vascular access is vital to patients on regular hemodialysis. Banding the access is indicated in high-flow-associated steal syndrome. It allows for the reduction of access flow while maintaining distal limb perfusion. Nonetheless, this procedure has some limitations as it can cause hemorrhage, infection, aneurysm formation, thrombosis of access in cases of overbanding, or otherwise insufficient reduction of vascular flow. Other surgical techniques to achieve the same benefit would be useful. Methods: We performed a modified banding technique without endovascular placement of the angioplasty balloon, which is a viable alternative to other techniques. This surgery was performed in patients on chronic dialysis with steal syndrome. Pre- and post-operative access flows were measured and resolution of symptoms was recorded. Primary patency rate was defined as the intervention-free access survival from the operative time. Results: We verified that this technique allowed for access flow reduction in all our six patients, with total resolution of symptoms in all patients. Primary patency rate at 12 months was 100%. No major complications were noted during our follow-up. Conclusions: This technique allows for correction of high-flow arteriovenous fistulas in an efficient and safe way, and can be a viable alternative to other banding procedures.

https://doi.org/10.1590/2175-8239-jbn-2020-0046 340 downloads

Identification of clusters of asthma control: A preliminary analysis of the Inspirers studies
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Jácome, Cristina

; Amaral, Rita

; Almeida, Rute

; Pereira, Ana Margarida

; Couto, Mariana

; Araújo, Luís

; Alves-Correia, Magna

; Pereira, Mariana

; Ferreira-Magalhães, Manuel

; Loureiro, Cláudia Chaves

; Catarata, Maria Joana

; Santos, Lília Maia

; Cabral, Sara

; Pereira, João

; Ramos, Bárbara

; Lopes, Cristina

; Mendes, Ana

; Lopes, Anabela

; Rodrigues, José Carlos Cidrais

; Oliveira, Georgeta

; Aguiar, Ana Paula

; Afonso, Ivete

; Carvalho, Joana

; Arrobas, Ana Maria

; Costa, José

; Valério, Margarida

; Pereira, Marta

; Almeida, Teresa

; Dias, Joana

; Bom, Ana Todo

; Azevedo, João

; Ribeiro, Carmelita

; Alves, Marta

; Pinto, Paula Leiria

; Neuparth, Nuno

; Neves, Ana Castro

; Palhinha, Ana

; Marques, João Gaspar

; Martins, Pedro

; Trincão, David Pina

; Todo-Bom, Filipa

; Santos, Maria Alvarenga

; Branco, Joana

; Costa, Alberto

; Neto, Armandina Silva

; Santalha, Marta

; Lozoya, Carlos

; Santos, Natacha

; Silva, Diana

; Vasconcelos, Maria João

; Barata, Luís Taborda

; Teixeira, Maria Fernanda

; Pinto, Diana

; Alves, Rodrigo Rodrigues

; Moreira, Ana Sofia

; Pinto, Cláudia Sofia

; Silva, Pedro Morais

; Alves, Carlos

; Câmara, Raquel

; Coelho, Didina

; Bordalo, Diana

; Carvalho, Fernanda

; Fernandes, Ricardo

; Ferreira, Rosário

; Oliveira, José Ferraz de

; Menezes, Fernando

; Gomes, Ricardo

; Calix, Maria José

; Marques, Ana

; Cardoso, João

; Emiliano, Madalena

; Gerardo, Rita

; Nunes, Carlos

; Ferreira, José Alberto

; Lopes, Inês

; Alves, Adelaide

; Fonseca, João Almeida

Revista Portuguesa de Imunoalergologia

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dec 2020, Volume 28 N. 4 Pages 231 - 240

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Objetivos: Identificar clusters de controlo da asma baseados no Teste de Controlo da Asma e Rinite Alérgica (CARAT) e comparar as características dos doentes nos diferentes clusters. Métodos: Adultos e adolescentes (≥13 anos) com asma persistente foram recrutados em 29 centros no contexto de 2 estudos observacionais do projeto INSPIRERS. Foram recolhidos dados relativos a características demográficas e clínicas, adesão ao inalador, crenças sobre a medicação, sintomas de ansiedade e depressão, qualidade de vida e controlo da asma (CARAT, >24 bom controlo). Foi efetuada uma análise hierárquica de clusters usando a pontuação total do CARAT (CARAT-T).Resultados: Foram analisados 410 doentes (68% adultos), com uma idade mediana (percentil 25-percentil 75) de 28 (16-46) anos. Foram identificados três clusters [média CARAT-T(min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] e cluster 3 [10(2-13)]. Os doentes no cluster 1 (34%) apresentavam melhor controlo da asma, melhor qualidade de vida, maior adesão aos inaladores e usavam um único inalador. Os doentes nos clusters 2 (50%) e 3 (16%) tinham a asma não controlada, menor adesão aos inaladores, mais sintomas de ansiedade e depressão e mais de metade reportavam pelo menos uma exacerbação no último ano. Adicionalmente, os doentes no cluster 3 eram predominantemente mulheres, tinham mais consultas médicas não agendadas, apresentavam mais sintomas de ansiedade, percebiam uma maior necessidade dos inaladores, mas também uma maior preocupação associada ao seu uso. Não se verificaram diferenças na idade, índice de massa corporal, função pulmonar, hábitos tabágicos, hospitalizações ou tempo de seguimento pelo médico especialista. Conclusões: Um método não supervisionado baseado no CARAT-T, identificou 3 clusters de doentes com diferentes características clínicas. O cluster com melhor controlo apresenta um ponto de corte semelhante ao estabelecido no estudo de validação do CARAT. Este estudo sugere ainda a existência de um ponto de corte adicional para distinguir doença mais grave. Mais investigação é necessária para validar os clusters identificados

Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of the INSPIRERS project. Demographic and clinical characteristics, adherence to inhaled medication, beliefs about inhaled medication, anxiety and depression, quality of life, and asthma control (CARAT, >24 good control) were collected. Hierarchical cluster analysis was performed using CARAT total score (CARAT-T). Results: 410 patients (68% adults), with a median (percentile 25-percentile 75) age of 28 (16-46) years, were analysed. Three clusters were identified [mean CARAT-T (min-max)]: cluster 1 [27(24-30)], cluster 2 [19(14-23)] and cluster 3 [10(2-13)]. Patients in cluster 1 (34%) were characterised by better asthma control, better quality of life, higher inhaler adherence and use of a single inhaler. Patients in clusters 2 (50%) and 3 (16%) had uncontrolled asthma, lower inhaler adherence, more symptoms of anxiety and depression and more than half had at least one exacerbation in the previous year. Furthermore, patients in cluster 3 were predominantly female, had more unscheduled medical visits and more anxiety symptoms, perceived a higher necessity of their prescribed inhalers but also higher levels of concern about taking these inhalers. There were no differences in age, body mass index, lung function, smoking status, hospital admissions or specialist physician follow-up time among the three clusters. Conclusion: An unsupervised method based on CARAT-T, identified 3 clusters of patients with distinct, clinically meaningful characteristics. The cluster with better asthma control had a cut-off similar to the established in the validation study of CARAT and an additional cut-off seems to distinguish more severe disease. Further research is necessary to validate the asthma control clusters identified.

https://doi.org/10.32932/rpia.2020.12.046 633 downloads

Implicados, intermitentes, desengajados?: Estilos de mediação de pais de crianças de 3-8 anos que usam a internet
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Ponte, Cristina

; Simões, José Alberto

; Batista, Susana

; Castro, Teresa Sofia

Sociologia, Problemas e Práticas

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sep 2019, N. 91 Pages 39 - 58

Este artículo presenta los resultados de la primera encuesta nacional sobre como los niños de 3 a 8 años interactúan con las pantallas en el hogar, centrándose en las mediaciones informadas por los padres cuyos hijos usan internet. Teniendo en cuenta la literatura sobre el tema y resultados del contexto portugués, realizamos análises estadísticas de múltiples correspondencias y clusters que consideran los factores relacionados con los niños y los padres en relación con las mediaciones activas y de seguridad. Del análisis surgieron tres tipos de mediadores - involucrados, intermitentes y desconectados - cuyas características se discuten y problematizan.

Este artigo apresenta resultados do primeiro inquérito nacional sobre como crianças (3-8 anos) se relacionam com ecrãs em ambientes familiares, focando-se nas mediações de pais cujos filhos fazem uso da internet. Com base em literatura sobre o tema e em resultados sobre o contexto português, procedeu-se a análises estatísticas de correspondências múltiplas e de clusters que consideraram fatores do lado da criança e do lado dos pais relativamente a mediações ativas e de segurança. Da análise emergiram três tipos de mediadores - implicados, intermitentes e desengajados - cujas características se discutem e se problematizam.

Cet article présente les résultats de la première enquête nationale sur les interactions des enfants âgés de 3 à 8 ans avec les écrans de leur environnement familial, en se concentrant sur les médiations rapportées par les parents dont les enfants utilisent internet. Tenant compte de la littérature sur le sujet et de résultats sur le contexte portugais, nous avons effectué des analyses statistiques de correspondances multiples et de clusters en considérant les facteurs liés aux enfants et aux parents concernant les médiations actives et de sécurité. Trois types de médiateurs ont émergé de l'analyse - impliqués, intermittents et désengagés - dont les caractéristiques sont discutées et problématisées.

This article presents results from the first national survey on how children aged 3-8 years old interact with screens in the household, focusing on mediations reported by the parents whose children use the internet. Bearing in mind the literature on the topic and the results on the Portuguese context, we conducted a statistical analysis of multiple correspondences and clusters considering factors related to children and related to parents regarding active and security mediations. Three types of mediators emerged from the analysis - involved, intermittent and disengaged - whose characteristics are discussed and problematized.

https://doi.org/10.7458/10.7458/SPP20199112332 716 downloads

The oncogenic effect of hepatitis C lasts beyond the disease's Eradication
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Cerqueira, Sofia

; Teixeira, Catarina

; Afonso, Nuno

; Castro, Rui

; Morgado, Teresa

; Alves, Rui

Portuguese Journal of Nephrology & Hypertension

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sep 2019, Volume 33 N. 3 Pages 182 - 183

Abstract: En | Text: En | PDF: En

ABSTRACT Hepatitis C virus (HCV) is widely prevalent worldwide, with an estimated 180 million people infected. Its manifestations are not limited to hepatic disease, as it has widely known immunomodulator and oncogenic effects. Most HCV associated autoimmune and lymphoproliferative diseases have been shown to subside after successful antiviral treatment. However, viral eradication doesn't always equal lymphoma cure. In some cases, the oncogenic effect lasts well beyond viral elimination. Although the new direct anti-viral agents (DAA) have proved to be safe and effective in treating HCV (with sustained viral responses of 91-95%), this treatment has inherent toxicities. Further, immunologic manifestations of HCV-associated diseases, when present, may require broad immunosuppression in association with the antiviral treatment. We present a case that illustrates the complexities of treating these viral mediated immunologic and lymphoproliferative diseases

https://doi.org/10.32932/pjnh.2019.10.037 329 downloads

Internet dos Brinquedos: vantagens, riscos e desafios de um intrigante cenário de consumo para pais e pesquisadores
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Zaman, Bieke

; Castro, Teresa Sofia

; Miranda, Fernanda Chocron

Intercom: Revista Brasileira de Ciências da Comunicação

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sep 2018, Volume 41 N. 3 Pages 213 - 219

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1809-58442018312 1414 downloads

Percepciones y creencias sobre criopreservación embrionaria en mujeres y hombres que se realizan técnicas de reproducción asistida en Santiago, Chile
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Velarde, Marissa

; Salas, Sofía P.

; Domínguez, Rosario

; López, Teresa

; Céspedes, Pablo

; Furman, Irene

; Godoy, Anita

; Castro, Magdalena

; Zegers-Hochschild, Fernando

Revista chilena de obstetricia y ginecología

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feb 2018, Volume 83 N. 1 Pages 27 - 44

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Background and objetive: Although embryo cryopreservation is frequently used as part of assisted reproductive technology, quantitave information addressing how infertile couples live the experience of having cryopreserved embryos is lacking in Chile. The aim of this study is to examine men and women's perception and beliefs regarding their cryopreserved embryos, as well as their perspective on embryo donation and disposition. Methods: 153 women and men with frozen embryos from a public hospital, Instituto de Investigactiones Materno Infantil, and a private clinic, Clínica Las Condes, in Santiago, Chile, responded between May 2015 and May 2016 to an anonymous online survey addressing their perceptions and beliefs concerning their cryopreserved embryos. Results: Respondents considered their frozen embryos to be equivalent to a child (53.2%) or a potential child (40.7%). Only 8% regard them as an organized group of cells. Over 60% of respondents disagree with destroying surplus embryos or using them for research. Participants from the public hospital are more willing to donate their embryos to another couple than those from the private center (61% vs 40%; P=0.016); 34% of respondents agreed to donate surplus embryos to same sex couples. Conclusion: This study reveals that Chilean couples are emotionally bound to their frozen embryos, and that discarding them is not an option. The results from this survey will help strengthen counseling for couples to enable them to make informed decisions regarding their surplus embryos.

RESUMEN Introducción y objetivos: Aunque la criopreservación embrionaria es frecuentemente utilizada como parte de las técnicas de reproducción asistida, no existe información cuantitativa de cómo las parejas infértiles viven la experiencia de tener embriones criopreservados en Chile. El objetivo del estudio fue examinar las percepciones y creencias que tienen mujeres y hombres respecto de sus embriones criopreservados, sus perspectivas respecto de la donación reproductiva y destino de los embriones remanentes. Metodología: 153 mujeres y hombres con embriones criopreservados provenientes de un hospital público, Instituto de Investigaciones Materno Infantil y un centro privado, Clínica Las Condes, en Santiago, Chile, respondieron durante mayo 2015 a mayo 2016 un cuestionario en línea, anónimo, respecto de sus percepciones y creencias sobre criopreservación embrionaria. Resultados: Los encuestados reconocen a sus embriones criopreservados como un hijo (53.2%) o un proyecto de hijo (40.7%). Sólo 8% los considera un grupo organizado de células; sobre el 60% rechaza la opción de descartarlos o usarlos para investigación. Los participantes del hospital público tenían mayor disposición a donar sus embriones remanentes a otras parejas que aquellos del privado (61% vs 40%; P=0.016). Un 34% de las personas encuestadas estuvo de acuerdo con donar embriones a parejas de un mismo sexo. Conclusión: Este estudio muestra que las personas chilenas tienen un vínculo emocional con sus embriones criopreservados y no consideran descartarlos. Los resultados de este estudio pueden servir para dar adecuada consejería a las personas que se realizan técnicas de reproducción asistida, de tal modo de tomar decisiones informadas respecto de la criopreservación.

https://doi.org/10.4067/s0717-75262018000100027 1253 downloads

Lupus nephritis in a patient without evidence of systemic lupus erythematosus
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Cerqueira, Sofia G

; Castro, Rui

; Abreu, Rui M

; Sampaio, Susana

; Rodrigues-Pereira, Pedro

; Nunes, Ana T

; Morgado, Teresa MPR

Portuguese Journal of Nephrology & Hypertension

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mar 2017, Volume 31 N. 1 Pages 59 - 62

Abstract: En | Text: En | PDF: En

Lupus nephritis is a common complication of systemic lupus erythematosus (SLE), usually developing early in the course of the disease. Almost all patients with lupus nephritis present with positive ANA and anti-dsDNA, Hypocomplementaemia and renal manifestations (haematuria, proteinuria and/or renal failure). However, in a small number of patients, the initial presentation is lupus nephritis with absent serology or clinical features of systemic lupus erythematosus

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Rejeição humoral aguda no transplante renal: gravidez como evento sensibilizante?
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Santos, Sofia

; Bessa, Lígia

; Patraquim, Cláudia

; Rocha, Liliana

; Costa, Teresa

; Faria, Maria do Sameiro

; Matos, Paula

; Henriques, Castro

; Mota, Conceição

Nascer e Crescer

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dec 2016, Volume 25 Suppl. 2 Pages 20 - 20

Abstract: Pt | Text: Pt | PDF: Pt

988 downloads

10.

Acute rejection during the first six-months after transplantation: temporal trends regarding risk factors and effects on graft and patient survival
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Costa, Rui

; Malheiro, Jorge

; Santos, Clara

; Fonseca, Isabel

; Martins, La Salete

; Pedroso, Sofia

; Almeida, Manuela

; Dias, Leonidio

; Castro-Henriques, Antonio

; Morgado, Teresa

; Cabrita, Antonio

Portuguese Journal of Nephrology & Hypertension

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mar 2014, Volume 28 N. 1 Pages 40 - 48

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Objetivo: Avaliar na década de 90 e 2000 os fatores preditores de rejeição aguda (RA) aos 6 meses pós transplante renal (TR) e o seu efeito na sobrevida censurada do enxerto e do doente. Material e Métodos: Análise retrospetiva dos casos de RA efetuada separadamente em dois períodos: 1990-1999 e 2000-2009. Na avaliação dos fatores de risco para RA foi utilizado um modelo de regressão logística multivariada. Procedemos à construção de curvas comparativas de sobrevivência do enxerto entre paciente com e sem RA pelo método de Kaplan-Meier em cada período. A regressão de Cox multivariada permitiu identificar os preditores de sobrevivência censurada do enxerto e doente, usando como modelo: rejeição aguda, idade (< 40 vs ≥ 40 anos) e sexo do recetor, tempo em HD/DP (< 36 vs. ≥ 36meses), dador vivo vs. cadavérico (apenas na década de 2000), incompatibilidades HLA (0-3 vs. 4-6), PRA (≤ 15 vs. > 15%), número de TR prévios (< 2 vs. ≥ 2), status de hepatite B/C, idade (< 38 vs. ≥ 38 anos) e sexo do dador, episódio de necrose tubular aguda (NTA), uso de ATG na imunossupressão (IS) de indução, uso de MMF ou Tacrolimus (apenas na década de 2000) na IS de indução/manutenção. Resultados: Num total de 1299 transplantes renais, 644 (49.5%) foram realizados na década de 90 e 655 (50.5%) na década de 2000. A RA foi mais frequente na década de 90 (26.2% vs. 11.1%, p < 0.001). Nesta década, os fatores de risco para RA foram o não-uso de ATG (OR 1.88, p = 0.025) e a idade do recetor < 40 anos (OR 2.39, p = 0.001). Na década de 2000, NTA (OR 1.895, p = 0.046) e PRA > 15% (OR 3.519, p = 0.001) foram os fatores de risco identificados. A sobrevivência censurada do enxerto aos 5 anos foi inferior nos casos de RA na década de 90 (81% vs. 94%, p < 0.001) e 2000 (81% vs. 91%, log rank p = 0.004). Na análise de regressão Cox, os preditores de menor sobrevivência do enxerto na década de 90 foram a RA (HR 2,436, p < 0.001), idade do recetor < 40 anos (HR 1.984, p = 0.002) e idade do dador ≥ 38 anos (HR 1.961, p = 0.002). Na década de 2000 foram identificadas a NTA (HR 3.247, p < 0.001) e idade de dador ≥ 38 anos (HR 2.32, p = 0.017). Não encontramos diferenças na sobrevida do doente aos 5 anos em ambos períodos. Apenas o status de Hepatite B/C (HR 1.714, p = 0.023) foi preditor independente de morte do doente na década de 90, enquanto que na década de 2000, os preditores significativos foram TR prévio (HR 2,718, p = 0.049) e RA (HR 2,619, p = 0.023). Conclusão: A partir de 2000, a RA aos 6 meses deixou de ser um preditor independente de sobrevivência do enxerto. Inversamente, passou a ter um efeito negativo independente na sobrevivência do doente. Os avanços na IS permitiu o TR em recetores cada vez mais sensibilizados, com melhoria na sobrevida do enxerto nestes casos mas com possível efeito desfavorável na sobrevida do doente.

Objective: To determine risk factors for acute rejection in the first 6 months post- transplant and their effect on death-censored graft and patient survival in the 990-1999 and 2000-2009 periods. Patients and Methods: Retrospective analysis of acute rejection episodes was performed separately in two periods: 1990-1999 and 2000-2009. Multivariate logistic regression analysis was performed in order to identify risk factors for acute rejection. Death-censored graft and patient survival comparison between patients with or without acute rejection occurrence was performed by Kaplan-Meier analysis. Multivariate Cox regression analysis identified independent predictors for death-censored graft and patient survival, assuming the following model: acute rejection, patient’s age (< 40 vs. ≥ 40 years) and gender, time on haemodialysis / peritoneal dialysis (< 36 vs. ≥ 36 months), live vs. deceased donor (only after the year 2000), HLA mismatches (0-3 vs. 4-6), PRA (≤ 15 vs. > 15%), number of previous kidney transplants (< 2 vs. ≥ 2), status of hepatitis B/C, donor´s age (< 38 vs. ≥ 38 years) and gender, delayed graft function (DGF), ATG use in induction immunosuppression (IS), MMF or Tacrolimus use in induction / maintenance IS (after 2000). Results: A total of 1299 kidney transplants were analyzed. Acute rejection was more frequently diagnosed in the 1990s (26.2% vs. 11.1%, p < 0.001). Over this period, ATG non-use (OR 1.88, p = 0.025) and patients’ age < 40 years (OR 2.39, p = 0.001) were risk factors for AR while, after 2000, DGF (OR 1.895, p = 0.046) and PRA > 15% (OR 3.519, p = 0.001) were identified. Five years death-censored graft survival was lower in AR cases in the 1990s (81% vs. 94%, p < 0.001) and after 2000 (81% vs. 91%, log rank p = 0.004). Independent predictors for worse death-censored graft survival in 1990-1999 patients were AR (HR 2,436, p < 0.001), patient´s age < 40 years (HR 1.984, p = 0.002) and donor´s age ≥ 38 years (HR 1.961, p = 0.002), while after 2000, DGF (HR 3.247, p < 0.001) and donor´s age ≥ 38 years (HR 2.32, p = 0.017) were identified. No difference was found at five-year patient survival in both groups. Only hepatitis B/C (HR 1.714, p = 0.023) was identified as an independent predictor for patient death in the 1990-1999 period, while after 2000, retransplantation (HR 2,718, p = 0.049) and AR (HR 2,619, p = 0.023) were determinant. Conclusion: After the year 2000, AR was no longer an independent predictor for poor graft survival. Inversely, AR began to play a deleterious effect on patient survival. Advances on immunosuppressive drugs allowed the increase of kidney transplant on hypersensitized patients, with improvement of graft survival in those patients but also with a possible deleterious effect on patient survival.

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11.

Cutaneous mucinosis in mixed connective tissue disease*
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Favarato, Maria Helena Sampaio

; Miranda, Sofia Silveira de Castro

; Caleiro, Maria Teresa Correia

; Assad, Ana Paula Luppino

; Halpern, Ilana

; Fuller, Ricardo

Anais Brasileiros de Dermatologia

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aug 2013, Volume 88 N. 4 Pages 635 - 638

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A mucinose cutânea é um grupo de condições em que há um acúmulo de mucina ou glicosaminoglicanos na pele e seus anexos. É descrita em algumas doenças do tecido conjuntivo, porem nunca em associação com doença mista do tecido conjuntivo. Relatamos dois casos de mucinose cutânea em pacientes com doença mista do tecido conjuntivo em remissão, um apresentava-se sob a forma papular e outro sob a forma reticular eritematosa de mucinose. Estes são os primeiros casos de mucinose descritos na doença mista do tecido conjuntivo. Ambos os casos apresentaram o quadro cutâneo de modo isolado, sem nenhuma outra manifestação clínico-laboratorial, havendo resposta à azatioprina em um e à cloroquina associada a prednisona no outro.

Cutaneous mucinosis is a group of conditions involving an accumulation of mucin or glycosaminoglycan in the skin and its annexes. It is described in some connective tissue diseases but never in association with mixed connective tissue disease. This report concerns two cases of cutaneous mucinosis in patients with mixed connective tissue disease in remission; one patient presented the papular form, and the other reticular erythematous mucinosis. These are the first cases of mucinosis described in mixed connective tissue disease. Both cases had skin lesions with no other clinical or laboratorial manifestations, with clinical response to azathioprine in one, and to an association of chloroquine and prednisone in the other.

https://doi.org/10.1590/abd1806-4841.20131948 3486 downloads

12.

Tacrolimus: a forgotten agent in kidney transplant leukopenia
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Azevedo, Pedro

; Freitas, Cristina

; Silva, Hugo

; Aguiar, Pedro

; Santos, Teresa

; Cabral, João

; Rocha, Guilherme

; Almeida, Manuela

; Pedroso, Sofia

; Martins, La Salete

; Dias, Leonídio

; Henriques, António Castro

; Cabrita, António

Portuguese Journal of Nephrology & Hypertension

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jan 2013, Volume 27 N. 1 Pages 55 - 60

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A leucopenia no doente transplantado renal é comum, causa complicações com potencial risco de vida, mas é muitas vezes mal caracterizada. As infecções por agentes oportunistas, distúrbios imunológicos e toxicidade secundária a fármacos são as principais causas de citopenias de uma ou várias linhas. A leucopenia induzida pelo tacrolimus é uma complicação frequente, mas pouco reconhecida. Descrevemos um doente com início de leucopenia sete meses pós-transplante renal. Após excluir outras potenciais causas, o tacrolimus foi substituído pela ciclosporina, com recuperação da contagem leucocitária. Baseado no caso clínico, os autores fizeram uma revisão das causas de leucopenia pós-transplante e sua investigação. O diagnóstico e tratamento precoces são fundamentais na melhoria do prognóstico.

Leukopenia in kidney transplant patients is frequent, it causes potentially life-threatening complications, but it is often poorly characterized. Opportunistic infections, immunologic disturbances and drug-related toxicity are principal causes of single or multilineage cytopenias. Tacrolimus-induced leukopenia is a less recognized but frequent complication. We describe one patient with leukopenia developing within seven months after renal transplant. After excluding other potential causes, tacrolimus was switched to cyclosporine, with recovery of white blood cell count. Based on the clinical report, the authors reviewed causes of post-transplant leukopenia, focusing on the diagnostic investigation. Early diagnosis and interventions are fundamental to improve prognosis.

1467 downloads

13.

Susceptibilidad antifúngica en dermatofitos
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Colella, María Teresa

; Castro, María

; Montiel, Marvia

; Vásquez, Erika

; Mata-Essayag, Sofía

; Magaldi, Sylvia

; Hartung de Capriles, Claudia

; Pérez, Celina

; Olaizola, Carolina

; Arántza, Roselló

Kasmera

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dec 2006, Volume 34 N. 2 Pages 85 - 92

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

No existe hasta los momentos una prueba estandarizada para realizar la susceptibilidad antifúngica de los dermatofitos. El objetivo de este estudio fue implementar la técnica de los pozos de difusión para el estudio de la susceptibilidad de los dermatofitos. Se utilizaron un total de 100 aislados de dermatofitos (74 Trichophyton rubrum, 18 Trichophyton mentagrophytes, 1 Trichophyton tonsurans, 5 Microsporum canis y 2 Epidermophyton floccosum) provenientes de muestras clínicas aisladas e identificadas en la Sección de Micología Médica, IMT. Se empleó la técnica de los pozos de difusión con los siguientes antimicóticos: Griseofulvina, Terbinafina, Fluconazol e Itraconazol. Se aplicaron los criterios de interpretación acordados por la NCCLS. El inóculo, se estandarizó utilizando el peso como unidad. El medio Agar Staib demostró ser el más adecuado, al obtenerse un mejor crecimiento de los aislados en un 97 %. Esta es la primera vez, que se utiliza el peso como medida para cuantificar el inóculo en los dermatofitos. La mayor sensibilidad se evidenció ante Terbinafina seguido de Griseofulvina e Itraconazol. No se demostró sensibilidad alguna ante el Fluconazol. Sin embargo se requieren más estudios en los cuales se relacione la susceptibilidad “in vitro” con los resultados “in vivo”.

There are no test standarizaded for the antifungal susceptibility of dermatophytes. The aim of this study is to probe the well diffusion technique as antifungal susceptibility test for dermatophites. One hundred species of dermatophytes were isolated and identified (74 Trichophyton rubrum, 18 Trichophyton mentagrophytes, 1 Trichophyton tonsurans, 5 Microsporum canis and 2 Epidermophyton floccosum).in the Medical Micology Departament of TMI. The antifungal sensitivity of the isolates of the dermatophytes to the drugs was carried out using the well diffusion technique. The antifungal agents tested were griseofulvin, terbinafine, itraconazole and fluconazole. Results were interpreted according to NCCLS breakpoints. The inoculum suspension was standardized by weight measurement. Agar Staib was considered the most suitable, because 97% of the isolates grew on it. This is the first time the inoculum suspension of dermatophytes is standardized by weight measurement. Terbinafine was found to be the most effective drug, followed by Griseofulvin and Itraconazole. Fluconazole were not found to be effective.

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