Dulce Carvalho

OBJECTIVE: To investigate the ability of anti-endothelial cell antibodies (AECA) to modulate endothelial cell function. METHODS: The effects of purified IgG from 11 patients with systemic lupus erythematosus (SLE) and 4 patients with systemic vasculitis on the expression of adhesion molecules (intercellular adhesion molecule 1, vascular cell adhesion molecule 1, E-selectin) by human umbilical vein endothelial cells and on the adhesion of the human promyelocytic cell line U937 were examined in vitro. RESULTS: IgG from 6 of 8 AECA-positive SLE patients and 3 of 3 AECA-positive systemic vasculitis patients up-regulated adhesion molecule expression and leukocyte adhesion to endothelial cells. The 4 AECA-negative samples had no effect. Transfer experiments demonstrated that at later time points (2-8 hours) after AECA addition, endothelium-derived interleukin-1 (IL-1) accounted for the ability of AECA to increase leukocyte adhesion. However, even within very short times after addition of AECA (<30 minutes), endothelial cells released a distinct transferable mediator with similar effects. CONCLUSION: AECA in patients with SLE or systemic vasculitis may contribute to pathogenesis by increasing leukocyte adhesion to endothelial cells. AECA act by inducing the release of at least two endothelium-derived mediators, one (as-yet-unidentified) rapidly and another (IL-1) more slowly, both of which stimulate endothelial cells in an autocrine manner.

Ferreira AC, Nolasco F, Carvalho D, Sampaio S, Baptista A, Pessegueiro P, Monteiro E, Mourão L, Barroso E. Impact of RIFLE classification in liver transplantation. Clin Transplant 2010: 24: 394–400. © 2009 John Wiley &amp; Sons A/S. Abstract: Acute renal failure (ARF) is common after orthotopic liver transplantation (OLT). The aim of this study was to evaluate the prognostic value of RIFLE classification in the development of CKD, hemodialysis requirement, and mortality. Patients were categorized as risk (R), injury (I) or failure (F) according to renal function at day 1, 7 and 21. Final renal function was classified according to K/DIGO guidelines. We studied 708 OLT recipients, transplanted between September 1992 and March 2007; mean age 44 ± 12.6 yr, mean follow‐up 3.6 yr (28.8%≥5 yr). Renal dysfunction before OLT was known in 21.6%. According to the RIFLE classification, ARF occurred in 33.2%: 16.8% were R class, 8.5% I class and 7.9% F class. CKD developed in 45.6%, with stages 4 or 5d in 11.3%. Mortality for R, I and F classes were, respectively, 10.9%, 13.3% and 39.3%. Severity of ARF correlated with development of CKD: stage 3 was associated with all classes of ARF, stages 4 and 5d only with severe ARF. Hemodialysis requirement (23%) and mortality were only correlated with the most severe form of ARF (F class). In conclusion, RIFLE classification is a useful tool to stratify the severity of early ARF providing a prognostic indicator for the risk of CKD occurrence and death.

O trauma é um importante problema de saúde pública mundial devido às altas taxas de morbidade e mortalidade. O trabalho em questão considerou os traumas em pacientes com idade inferior a 18 anos e exclusivamente músculo-esqueléticos, atendidos num serviço de emergência ortopédica de um hospital metropolitano, no período de outubro de 2000 a junho de 2001, totalizando 340 protocolos. O objetivo foi permitir melhor conhecimento das características do trauma, proporcionando um planejamento adequado do atendimento, redução dos custos e estabelecimento de medidas preventivas. As lesões encontradas foram diferenciadas em leves ou graves. A faixa etária de escolares foi a mais acometida, totalizando 40% dos atendimentos realizados, destacando-se a queda como o principal mecanismo de trauma encontrado. O ambiente mais propício a acidentes foi o domiciliar e as extremidades foram a parte do corpo mais acometidas, tanto nas lesões leves quanto graves. Cerca de 64% dos casos foram leves. Os tipos de trauma mais freqüentes foram a contusão, seguida de fratura e entorse. Já os lactentes apresentam como importantes mecanismos de trauma a tração, pressão e a agressão, em sua maioria pelos familiares. Foi constatado que o fato da criança estar acompanhada de algum adulto não impede a ocorrência de acidentes, nem interfere na gravidade.

The COVID-19 pandemic had a strong impact on increasing anxiety in adolescents. This systematic review aims to identify the most effective psychoeducational interventions for reducing anxiety in adolescents following the guidelines of the Joanna Briggs Institute (JBI). The inclusion and exclusion criteria have been defined, and the search strategy has been planned. The search strategy will aim to locate both published and unpublished studies using, among other databases: CINAHL Plus with Full Text; PubMed; the Cochrane Central Register of Controlled Trials; and the JBI Database of Systematic Reviews. Following the search, all identified citations will be collated and uploaded into Endnote, and duplicates removed. Titles and abstracts will then be screened by two independent reviewers and by a third reviewer if a disagreement occurs. The results of the search will be reported in full in the final systematic review and presented in the PRISMA flow diagram. Eligible studies will be critically appraised for methodological quality using standardized critical appraisal instruments from the JBI. Data will be extracted from the studies included using the standardized JBI data extraction tool. For data synthesis, studies will be pooled using JBI SUMARI. The GRADE approach for grading the certainty of evidence will be followed, and a summary of findings will be created using GRADEPro GDT software. The results from this systematic review are expected to provide an overview of the most effective psychoeducational interventions for reducing anxiety in adolescents, allowing researchers to design and propose a new multicomponent psychoeducational intervention that will be validated and tested in the future. PROSPERO protocol registration number: CRD42020204356.