[Frequency of footprints alterations in school children from a Mexican community]. / Frecuencia de alteraciones de la huella plantar en escolares de una comunidad mexicana.

INTRODUCTION: Alterations in the plantar footprint in the child are a cause for concern in parents. OBJECTIVE: Determine the frequency of plantar footprint alterations in school children. Determine if there is a relationship between overweight and obesity with the presence of alterations of the plantar footprint. MATERIAL AND METHODS: Observational, transversal and prospective study. 959 schoolchildren aged six to 13 were evaluated. Weight, size, body mass index for age were recorded. The plantar footprint was cataloged on flat foot and cavus foot using the arch index. For statistical analysis and comparison, the SPSS version 24 program was used with the 2 and ANOVA tests. RESULTS: 530 children (55.3%) and 429 girls (44.7%). The median age was 8.97 years. 182 children were found (19%) with alteration of the plantar footprint, 42.3% with flat foot and 57.7% with cavus foot. None of them had foot symptoms. 131 children were overweight and 52 obese, without influencing the presence of any alteration of the plantar footprint (p = 0.20). The flat-foot ratio was higher in men (2.5:1) and standing cavus major in women (1.3:1). CONCLUSIONS: In our study group we find a higher prevalence of the cavus foot compared to the flat foot. Body weight did not influence plantar footprint alterations.

INTRODUCCIÓN: Las alteraciones de la huella plantar en el niño es causa de preocupación en los padres de familia. OBJETIVO: Determinar la frecuencia de alteraciones de la huella plantar en escolares. Determinar si existe relación entre el sobrepeso y la obesidad con la presencia de alteraciones de la huella plantar. MATERIAL Y MÉTODOS: Estudio observacional, transversal y prospectivo. Se evaluaron 959 escolares de seis a 13 años de edad. Se registró peso, talla, índice de masa corporal para la edad. La huella plantar se catalogó en pie plano y pie cavo utilizando el índice del arco. Para el análisis y comparación estadística se utilizó el programa SPSS versión 24 con las pruebas 2 y ANOVA. RESULTADOS: Se revisaron 530 niños (55.3%) y 429 niñas (44.7%). La media de edad fue de 8.97 años. Se observaron 182 niños (19%) con alteración de la huella plantar, 42.3% con pie plano y 57.7% con pie cavo. Ninguno mostró sintomatología del pie. Ciento treinta y un niños tenían sobrepeso y 52 obesidad, sin influir en la presencia de alguna alteración de la huella plantar (p = 0.20). La relación de pie plano fue mayor en los hombres (2.5:1) y de pie cavo fue mayor en las mujeres (1.3:1). CONCLUSIONES: En nuestro grupo de estudio se encontró mayor prevalencia del pie cavo en comparación con el pie plano. El peso corporal no influyó en las alteraciones de la huella plantar.

Factores determinantes de una baja dosis de hemodiálisis establecida por dialisancia iónica en pacientes críticos con insuficiencia renal aguda / Factors determining a low dose of haemodialysis as measured by ionic dialysance in critical patients with acute kidney injury

Introducción: En la insuficiencia renal aguda (IRA), la dosis administrada no suele controlarse y se estima que resulta inferior a la prescrita. Objetivo: Evaluar la diferencia entre la dosis prescrita y la dosis administrada en pacientes con IRA en Unidades de Cuidados Intensivos (UCI), así como los factores que la determinan, utilizando la determinación del Kt por dialisancia iónica. Material y método: Se incluyeron 394 terapias de reemplazo renal (TRR) en 105 pacientes adultos, con IRA oligúrica ingresados en UCI, con requerimiento de TRR , tratados con hemodiálisis intermitente (HDI) y/o extendida (HDE). Las TRR fueron realizadas con un monitor de aclaramiento on line (OCM®, Fresenius) para la determinación del Kt. Se registraron las características de los pacientes, la prescripción y el desarrollo de TRR. Todas estas variables fueron incluidas en un modelo uni y multivariado, teniendo como variable dependiente la incapacidad de lograr la dosis umbral u objetivo (DU). Resultados: Edad 66 ± 15 años, 37% del sexo femenino, etiología más frecuente: sepsis (70%), hipotensión y/o requerimientos de inotrópicos (71%), asistencia respiratoria mecánica (70%); el índice de severidad individualizado promedio fue de 0,7 ± 0,26. Se efectuaron 201 HDI y 193 HDE, la vía de acceso vascular más frecuente fue la femoral (79%). El Kt prescrito fue de 53,5 ± 14 litros, y un 21% de las prescripciones estaban (..) (AU)

Background: Estimating the dialysis dose is a requirement commonly used to assess the quality of renal replacement therapy (RRT) in patients with chronic kidney disease (CKD). In patients with acute kidney injury (AKI), this value is not always evaluated and it has been estimated that the prescribed dose is seldom obtained. Reports addressing this issue in AKI individuals are scarce and most have not included an adequate number of patients or treatments, nor were patients treated with extended therapies. Kt values obtained by the ionic dialysance method have been validated for the evaluation of the dialysis dose and it has also been shown that, compared with Kt/V, this is the most sensitive strategy for revealing inadequate dialysis treatment in critically ill AKI individuals. The main aim of this study was to assess the difference between the prescribed and the administered dialysis dose in critically ill AKI patients, and to evaluate what factors determine this gap using Kt values assessed through ionic dialisance. Material and Method: Data from 394 sessions of renal replacement therapy in 105 adult haemodialysis (HD) patients with oliguric acute kidney injury and admitted to ICU were included in this analysis. RRT was carried out with Fresenius 4008E dialysis machines equipped with on-line clearance monitoring (OCM® Fresenius), which use non-invasive techniques to monitor the effective ionic dialysance, equivalent to urea clearance. The baseline characteristics of the study population as well as the prescription and outcome of RRT were analysed. These variables were (..) (AU)

Factors determining a low dose of haemodialysis as measured by ionic dialysance in critical patients with acute kidney injury.

BACKGROUND: Estimating the dialysis dose is a requirement commonly used to assess the quality of renal replacement therapy (RRT) in patients with chronic kidney disease (CKD). In patients with acute kidney injury (AKI), this value is not always evaluated and it has been estimated that the prescribed dose is seldom obtained. Reports addressing this issue in AKI individuals are scarce and most have not included an adequate number of patients or treatments, nor were patients treated with extended therapies. Kt values obtained by the ionic dialysance method have been validated for the evaluation of the dialysis dose and it has also been shown that, compared with Kt/V, this is the most sensitive strategy for revealing inadequate dialysis treatment in critically ill AKI individuals. The main aim of this study was to assess the difference between the prescribed and the administered dialysis dose in critically ill AKI patients, and to evaluate what factors determine this gap using Kt values assessed through ionic dialisance. MATERIAL AND METHOD: Data from 394 sessions of renal replacement therapy in 105 adult haemodialysis (HD) patients with oliguric acute kidney injury and admitted to ICU were included in this analysis. RRT was carried out with Fresenius 4008E dialysis machines equipped with on-line clearance monitoring (OCM® Fresenius), which use non-invasive techniques to monitor the effective ionic dialysance, equivalent to urea clearance. The baseline characteristics of the study population as well as the prescription and outcome of RRT were analysed. These variables were included in a multivariate model in which the dependent variable was the failure to obtain the threshold dose (TD). RESULTS: The main baseline characteristics of the study population/treatments were: age 66 ± 15 years, 37% female, most frequent cause of AKI: sepsis (70%). Low BP and/or vasoactive drug requirement (71%), mechanical ventilation (70%) and average individual severity index: 0.7 ± 0.26. Two hundred and one intermittent HD (IHD) and 193 extended HD (EHD) sessions were performed; the most frequently used temporary vascular access was the femoral vein catheter (79%). Prescribed Kt was 53.5 ± 14L and 21% of prescriptions fell below the TD. Sixty-one percent of treatments did not fulfill the TD (31 ± 8L) compared with 56 ± 12L obtained in the subgroup that achieved the target. Compared to IHD, EHD provided a significantly larger Kt (46 ± 16L vs 33L ± 9L). Univariate analysis showed that inadequate compliance was associated with age (>65y), male gender, intra-dialytic hypotension, low Qb, catheter line reversal, and IHD. The same variables with the exception of age and gender were independently associated in the multivariate analysis. CONCLUSIONS: The dialysis dose obtained was significantly lower than that prescribed. EHD achieved values closer to the prescribed KT and significantly higher than in IHD. Ionic Kt measurement facilitates monitoring and allows HD treatments to be extended based upon a previously established TD. Besides the chosen strategy to dispense the dose of dialysis, a well-functioning vascular access allowing for optimal blood flow and other approaches aimed at avoiding hemodynamic instability during RRT are the most important factors to achieve TD, mainly in elderly male patients. The dialysis dose should be prescribed and monitored for all critically ill AKI patients.

5'-Nucleotidase activity is decreased in seminal plasma and spermatozoa from varicocele patients.

5'-Nucleotidase is involved in sperm capacitation via the cAMP-adenosine pathway and in sperm motility via direct adenosine production from AMP. Since these functions are reduced in varicocele, the aim of this study was to investigate whether the enzyme levels were altered in sperm from varicocele patients. The mean (SD) international units (IU) of 5'-nucleotidase activity in seminal plasma from 35 varicocele III patients was 0.16(0.09) IU ml(-1) vs 0.35(0.13) IU ml(-1) in 53 controls, this decrease being statistically significant at p < or = 0.001. A significant decrease in activity, expressed as international units per mg of protein concentration in spermatozoa homogenates, was also observed with spermatozoa: 0.0018(0.0017) IU mg(-1) in varicocele III vs 0.0081(0.0060) IU mg(-1) in controls, at p < or = 0.001. Compared to controls, the activity decrease observed both in spermatozoa and seminal plasma from 45 men with varicocele I was not statistically significant at p < or = 0.05. To determine the diagnostic value of 5'-nucleotidase in assessing sperm fertility in varicocele III, we used the likelihood ratios method and best cut-offs were identified in receiver operating characteristic curves. With a prevalence of 36%, the post-test probability of infertility was 91% in spermatozoa and 78% in seminal plasma. The cut-off values of 5'-nucleotidase activity discriminating for fertile/unfertile semen were 0.2 IU ml(-1) in seminal plasma and 0.003 IU mg(-1) of protein in spermatozoa. Overall, determination of 5'-nucleotidase activity, especially in spermatozoa, can be useful to characterize different varicocele degrees as well as the sperm fertility potential.

Normal values of echocardiographic measurements. A population-based study.

OBJECTIVE: To describe echocardiographic measurements and left ventricular mass in a population sample of healthy adults inhabitants of the urban region of Porto Alegre. METHODS: An analytical, observational, population-based, cross-sectional study was done. Through a multi-stage probability sample, 114 individuals were selected to be submitted to a M-mode and two-dimensional echocardiogram with color Doppler. The analyses were restricted to healthy participants. Echocardiographic measurements were described by mean, standard deviation, 95 percentile and 95% confidence limits. RESULTS: A total of 100 healthy participants, with several characteristics similar to those from the original population, had a complete and reliable echocardiographic examination. The measurements of aorta, left atrium, interventricular septum, left ventricle in systole and diastole, left posterior wall and left ventricular mass, adjusted or not for body surface area or height, were significantly higher in males. The right ventricle size was similar among the genders. Several echocardiographic measurements were within standard normal limits. Interventricular septum, left posterior wall and left ventricular mass, adjusted or not for anthropometric measurements, and aortic dimensions had lower mean and range than the reference limits. CONCLUSION: The means and estimates of distribution for the measurements of interventricular septum, left posterior wall and left ventricular mass found in this survey were lower than those indicated by the international literature and accepted as normal limits.

Temperature effects on the structural and functional properties of GPI-anchored and anchor-less bull seminal plasma ecto-5'-nucleotidase.

The effects of temperature on the three-dimensional organization and on the secondary structure of GPI-anchored 5'-nucleotidase from bull seminal plasma and of its anchor-less form (solubilized ecto-5'-nucleotidase), obtained after GPI anchor removal by phosphatidylinositol-specific phospholipase C were investigated in parallel by circular dichroism and fluorescence spectroscopy. The structural features of the two enzymes were correlated to their functional properties in the temperature range of 25-90 degrees C. The kinetic data indicated that the enzyme activities were temperature dependent, showing the maximal values at 60 degrees C. The relevant Arrhenius plots were linear in the temperature range of 20-60 degrees C and the activation energies were 44.4 and 51.8 kJ/mol for the solubilized and GPI-anchored 5'-nucleotidase, respectively. The time-course measurements of enzyme activity, in the temperature range of 25-55 degrees C, revealed that the two enzymes were of different thermal stability, the solubilized ectoenzyme showing lower thermal deactivation constants and longer half lives. Fluorescence and near UV circular dichroism spectroscopy showed that temperature increases induced remarkable changes in the protein tertiary structure of the two enzymes, whereas far-UV circular dichroism analysis revealed only a small temperature effect on the protein secondary structure content.

Purification of 5'-nucleotidase from human seminal plasma.

5'-Nucleotidase from human seminal plasma was purified to electrophoretic homogeneity and some of its kinetic and molecular properties compared with those of 5'-nucleotidase from bull seminal plasma. The purification of the enzyme was achieved by using the same affinity chromatography media (Con A-Sepharose and AMP-Agarose or ADP-Agarose) previously used for the purification of bull seminal plasma 5'-nucleotidase (Fini, C., Ipata, P.L., Palmerini, C.A. and Floridi, A. (1983) Biochim. Biophys. Acta 748, 405-412). However, in the present purification procedure no detergent was used as it had been necessary for the purification of the bovine enzyme. The experimental data reveal some main differences between these two enzymes; first, the human enzyme seems to be constituted of a single polypeptide chain of about 71 kDa, while the 5'-nucleotidase of bull seminal plasma, in non denaturing detergent solutions, is a homodimer of about 160 kDa. Another most remarkable difference is that the human enzyme does not seem to contain a phosphatidylinositol anchoring system like the one present in the bovine enzyme and in 5'-nucleotidase of different sources (Low, M.G. (1987) Biochem. J. 244, 1-13). Finally, the AMPase activity of 5'-nucleotidase from human seminal plasma is not affected by dithiothreitol which, on the contrary, is a powerful inhibitor of the bovine enzyme causing the dissociation of its subunits which are held together by disulphide bridges (Fini, C., Minelli, A., Camici, M. and Floridi, A. (1985) Biochem. Biophys. Acta 827, 403-409).

Histology of bronchial carcinoma and regional lymph nodes as putative immune response of the host to the tumor.

Two hundred forty-two patients who had bronchial carcinoma and who underwent radical surgery were studied in order to determine putative host resistance to the tumor at histologic level, i.e., lymphocytic infiltration in the center and around the tumor, together with sinus histiocytosis and follicular hyperplasia in the regional lymph nodes. These features were evaluated in a semiquantitative way, giving rise to three groups of patients: D- (reaction absent or poor), D+ (reaction present), and D++ (strong reaction present). Five-year survival rates and the incidence of metastases in regional nodes were significantly related to the putative host resistance against the tumor, but no clear-cut correlation between grade of malignancy of the tumor and histologic type was evidenced. The significance of these reactive changes is fully discussed.