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de Andrade CES, Souza KSCD, Galdino OA, de Lima MAF, de Medeiros PJ, Abbott Galvão Ururahy M, Pereira MG, de Almeida JB, de Rezende AA. New-onset diabetes after kidney transplantation: Assessing urinary Wilm's tumor-1 protein to predict renal allograft dysfunction. Adv Med Sci 2024; 69:153-159. [PMID: 38490331 DOI: 10.1016/j.advms.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/21/2023] [Accepted: 03/12/2024] [Indexed: 03/17/2024]
Abstract
PURPOSE New-onset diabetes after transplantation (NODAT) is a frequent metabolic complication associated with podocyte damage and renal allograft dysfunction. Thus, Wilm's tumor-1 (WT-1) protein, as a podocyte marker, holds promise as an option to evaluate renal allograft dysfunction in NODAT. Therefore, the study aimed to investigate urinary WT-1 levels in NODAT patients during the first year after kidney transplantation (KTx). MATERIALS AND METHODS KTx patients were categorized into non-NODAT and NODAT groups. Fasting blood glucose, glycated hemoglobin (HbA1c), urinary albumin/creatinine ratio (ACR), serum creatinine, estimated glomerular filtration rate (eGFR), and urinary WT-1 were measured at 3, 6, 9, and 12-months post-KTx. RESULTS The NODAT group manifested elevated levels of blood glucose and HbA1c during the first year post-KTx. Also, exhibited elevations in ACR and serum creatinine levels at 6, 9, and 12-months post-KTx when compared to non-NODAT group. Conversely, eGFR values in the NODAT group demonstrated significant declines at 3, 6, and 9-months post-KTx relative to non-NODAT. Furthermore, NODAT group exhibited a median annual eGFR of 47 mL/min/1.73 m2. Urinary WT-1 levels at 3, 6, 9, and 12-months post-KTx were significantly higher in the NODAT group compared to non-NODAT. Additionally, noteworthy positive correlations were identified between urinary WT-1 and HbA1c levels, along with significant negative correlations between urinary WT-1 and eGFR at the 3, 6, 9, and 12-months post-KTx. CONCLUSION The increased urinary WT-1 levels from 3-months post-KTx in NODAT patients may indicate the first sign of podocyte injury, predicting a renal allograft dysfunction in these patients.
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Affiliation(s)
| | - Karla Simone Costa de Souza
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ony Araújo Galdino
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | | | - Paulo José de Medeiros
- Division of Nephrology, Department of Integrated Medicine, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | | | - Maurício Galvão Pereira
- Division of Nephrology, Department of Integrated Medicine, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - José Bruno de Almeida
- Division of Nephrology, Department of Integrated Medicine, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Adriana Augusto de Rezende
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
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Lima MAFD, Souza KSCD, Andrade CESD, Ururahy MAG, Medeiros PJD, Pereira MG, Almeida JBD, Evangelista KCMS, Rezende AAD. Vitamin D status and biomarkers of renal graft function after kidney transplantation: a longitudinal study. NUTR HOSP 2023; 40:412-418. [PMID: 36719003 DOI: 10.20960/nh.04024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Introduction Introduction: Low 25-hydroxyvitamin D [25(OH)D] levels occur after kidney transplantation (KTx), and can be associated with increase the risk of graft loss. This longitudinal study aimed to evaluate the vitamin D status and association with biomarkers of the renal graft function after KTx. Methods: this longitudinal study included 42 patients evaluated at baseline, 3 and 6 months after KTx. Biodemographic, clinical, and biochemical parameters such as 25(OH)D and parathyroid hormone (PTH), and biomarkers of renal graft function, such as creatinine, estimated glomerular filtration rate (eGFR), and albumin/creatinine ratio (ACR), were assessed. Sun exposure was also evaluated. Patients were categorized according to their 25(OH)D levels. Results: at baseline, 25(OH)D levels < 30 ng/mL were found in 43 % patients, and 38 % of these patients failed to improve their 25(OH)D levels by 6 months after KTx. Low 25(OH)D levels occurred regardless of sun exposure. Further, 44 % patients developed albuminuria at 6 months. An increased ACR was observed in patients with 25(OH)D levels < 30 ng/mL (p = 0.002) compared to that in patients with 25(OH)D > 30 ng/mL. Additionally, 25(OH)D levels were negatively correlated with ACR at 6 months post-KTx (r = -0.444; p = 0.003). Twelve (28.6 %) patients with 25(OH)D levels < 30 ng/mL showed no eGFR recovery until 6 months after KTx. Conclusion: low vitamin D levels and increased albuminuria were observed at 6 months after KTx, even in a region with high sun exposure. The association between vitamin D status and biomarkers of renal graft function after KTx should be explored in further studies.
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Affiliation(s)
| | - Karla Simone Costa de Souza
- Department of Clinical and Toxicological Analysis. Centro de Ciências da Saúde. Universidade Federal do Rio Grande do Norte
| | - César Endrigo Silva de Andrade
- Division of Nephrology. Department of Integrated Medicine. Centro de Ciências da Saúde. Universidade Federal do Rio Grande do Norte
| | - Marcela Abbott Galvão Ururahy
- Department of Clinical and Toxicological Analysis. Centro de Ciências da Saúde. Universidade Federal do Rio Grande do Norte
| | - Paulo José de Medeiros
- Division of Nephrology. Department of Integrated Medicine. Centro de Ciências da Saúde. Universidade Federal do Rio Grande do Norte
| | - Maurício Galvão Pereira
- Division of Nephrology. Department of Integrated Medicine. Centro de Ciências da Saúde. Universidade Federal do Rio Grande do Norte
| | - José Bruno de Almeida
- Division of Nephrology. Department of Integrated Medicine. Centro de Ciências da Saúde. Universidade Federal do Rio Grande do Norte
| | | | - Adriana Augusto de Rezende
- Department of Clinical and Toxicological Analysis. Centro de Ciências da Saúde. Universidade Federal do Rio Grande do Norte
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Canellas JVDS, Drugos L, Ritto FG, Fischer RG, Medeiros PJD. Xenograft materials in maxillary sinus floor elevation surgery: a systematic review with network meta-analyses. Br J Oral Maxillofac Surg 2021; 59:742-751. [PMID: 34120778 DOI: 10.1016/j.bjoms.2021.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 02/16/2021] [Indexed: 12/12/2022]
Abstract
A systematic review and network meta-analysis was conducted to compare different commercially available xenograft materials used in maxillary sinus floor elevation surgery (MSFES). Embase, PubMed, the Cochrane Library, Web of Science, Scopus, LILACS, and grey literature were searched up to 13 July 2020. Only randomised controlled trials (RCTs) were included. A frequentist network meta-analysis using a random effects model compared different commercially available xenograft materials. The primary outcomes were the percentage of newly-formed bone and residual bone-substitute rate. Both were measured by histomorphometric analysis from bone biopsies obtained during preparation of the implant site. Of the 659 studies initially identified, 11 involving 242 MSFES were included in the quantitative analyses. A total of six bone-substitute materials were analysed (Bio-Oss® (Geistlich Pharma), InduCera® Dual Coat, Lumina-Bone Porous® (Critéria), Osseous® (SIN - Sistema de Implantes Nacional), THE Graft® (Purgo Biologics), and Osteoplant Osteoxenon® (Bioteck)). The P-score estimation showed that Osteoplant Osteoxenon® produced the most newly-formed bone and reabsorbed faster than other xenograft materials after six months. The combination of Bio-Oss® plus bone marrow aspirate concentrate (BMAC) significantly increased the percentage of newly-formed bone compared with Bio-Oss® alone. In contrast, the addition of Emdogain® (Straumann) and leucocyte and platelet-rich fibrin (L-PRF) to Bio-Oss® did not significantly improve the amount of regenerated bone. Study-level data indicated that the percentage of newly-formed bone differs among commercially available xenograft materials. Osteoplant Osteoxenon® seems to result in the highest amount of new bone in MSFES.
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Affiliation(s)
- J V D S Canellas
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil.
| | - L Drugos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil
| | - F G Ritto
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil
| | - R G Fischer
- Department of Periodontology, Faculty of Dentistry, Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil
| | - P J D Medeiros
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil
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Otranto de Britto Teixeira A, Almeida MADO, Almeida RCDC, Maués CP, Pimentel T, Ribeiro DPB, Medeiros PJD, Quintão CCA, Carvalho FDAR. Three-dimensional accuracy of virtual planning in orthognathic surgery. Am J Orthod Dentofacial Orthop 2020; 158:674-683. [PMID: 33008712 DOI: 10.1016/j.ajodo.2019.09.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 08/01/2019] [Accepted: 09/01/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study aimed to assess the accuracy of virtual surgical planning (VSP) performed by Dolphin Imaging software (version 11.9; Dolphin Imaging and Management Solutions, Chatsworth, Calif). METHODS Ten people requiring bimaxillary surgery and genioplasty were followed up prospectively. All patients had preoperative cone-beam computed tomography, plaster models, and photographs allowing for VSP. Interocclusal intermediate surgical splints were produced using a 3-dimensional (3D) printer. Postoperative images were acquired 15 days after surgery using cone-beam computed tomography. ITK-Snap (version 3.6; Cognitica, Philadelphia, Pa) allowed the segmentation of reliable 3D models. Geomagic Qualify 2013 (3D Systems, Rock Hill, SC) and MeshValmet (version 3.0) were used to identify the differences between VSP and actual surgical results through the root mean square values and the 3D translational displacement (3-axes) of the 3D centroid of each model. RESULTS Discrepancies between the VSP and the actual result were found at the mandible (P = 0.013) and the chin (P = 0.013) when considering the root mean square values. In addition, 3D centroid differences were found in the transverse and sagittal direction of the right ramus (P = 0.034 and P = 0.005, respectively) and the sagittal aspect of the left ramus (P = 0.025). Considering 2 mm as a threshold of clinical relevance, almost all the bone fragments (maxilla, proximal, and distal mandibular segments) were accurately corrected by surgery, although not in the chin. CONCLUSIONS On the basis of the obtained values, it is possible to consider the Dolphin Imaging software as clinically acceptable for performing virtual orthognathic surgical planning.
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Affiliation(s)
| | | | | | - Caroline Pelagio Maués
- Department of Orthodontics, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thais Pimentel
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Danilo Passeado Branco Ribeiro
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paulo José de Medeiros
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Catia Cardoso Abdo Quintão
- Department of Orthodontics, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Canellas JVDS, Ritto FG, Figueredo CMDS, Fischer RG, de Oliveira GP, Thole AA, Medeiros PJD. Histomorphometric evaluation of different grafting materials used for alveolar ridge preservation: a systematic review and network meta-analysis. Int J Oral Maxillofac Surg 2019; 49:797-810. [PMID: 31699633 DOI: 10.1016/j.ijom.2019.10.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 08/29/2019] [Accepted: 10/09/2019] [Indexed: 02/08/2023]
Abstract
In this systematic review and network meta-analysis including only randomized clinical trials (RCTs), different grafting materials used in alveolar ridge preservation after tooth extraction were analysed, focusing on histomorphometric new bone formation (NBF) in core biopsies obtained during implant placement. The PubMed, Embase, Cochrane Library, Web of Science, Scopus, and LILACS databases, as well as the grey literature, were searched for published and unpublished trials (from database inception to January 14, 2019). The primary outcome was the percentage of NBF. The secondary outcomes were the percentage of residual biomaterial and the percentage of soft tissue. An arm-based network meta-analysis was performed. The rank of intervention efficacy was obtained to measure the probability of each biomaterial being ranked first across all interventions. A total of 1526 studies were found, of which 38 were included for quantitative analysis. Three trials were rated as having a high risk of bias and 35 trials as having an unclear risk of bias. The network meta-analysis showed that nine grafting materials decreased NBF and 25 did not decrease NBF. The grafting material with the highest amount of NBF was plasma rich in growth factors. Due to the lack of studies with a low risk of bias, further RCTs are needed for definitive conclusions.
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Affiliation(s)
- J V D S Canellas
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil.
| | - F G Ritto
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - C M D S Figueredo
- Department of Periodontology, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - R G Fischer
- Department of Periodontology, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - G P de Oliveira
- Department of Histology and Embryology, Biology Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - A A Thole
- Department of Histology and Embryology, Biology Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - P J D Medeiros
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Canellas JVDS, Medeiros PJD, Figueredo CMDS, Fischer RG, Ritto FG. Platelet-rich fibrin in oral surgical procedures: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2018; 48:395-414. [PMID: 30072300 DOI: 10.1016/j.ijom.2018.07.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/21/2018] [Accepted: 07/10/2018] [Indexed: 12/21/2022]
Abstract
The effect of platelet-rich fibrin (PRF) in enhancing the healing after oral surgical interventions is still a matter of debate. The purpose of this study was to identify instances where PRF has been shown to be effective in oral surgical procedures. A comprehensive literature search was performed up to 2017 on PubMed/MEDLINE, Cochrane Library, Web of Science, Scopus and LILACS databases and grey literature. The full-text of potentially relevant studies were reviewed and only randomized clinical trials (RCTs) were included. A total of 559 studies were found, of which 30 were included for qualitative analysis and 13 for quantitative analysis. Three review authors assessed the risk of bias independently. The available literature suggests that PRF has a positive effect in improving alveolar preservation on extraction sockets and around dental implants. The qualitative analysis showed a significantly better effect of PRF in promoting bone regeneration for alveolar cleft reconstruction. The meta-analysis for third molar surgery showed a decrease in prevalence of alveolar osteitis. PRF increased implant stability 1 week and 1 month after surgery (P=0.0005 and 0.0003). Due to the lack of studies with low risk of bias and a limited number of patients available, further RCTs are needed to confirm these results.
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Affiliation(s)
| | | | | | - R G Fischer
- Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - F G Ritto
- Rio de Janeiro State University, Rio de Janeiro, Brazil
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Gama ZADS, Saturno-Hernández PJ, Ribeiro DNC, Freitas MRD, Medeiros PJD, Batista AM, Barreto AFG, Lira BF, Medeiros CADS, Vasconcelos CCCDS, Silva EMMD, Faria EDBD, Dantas JF, Neto JG, Medeiros LCLD, Sicolo MA, Fonseca PDCB, Costa RMMD, Monte FS, Melo VD. [Development and validation of indicators for best patient safety practices: the ISEP-Brazil Project]. CAD SAUDE PUBLICA 2016; 32:e00026215. [PMID: 27653192 DOI: 10.1590/0102-311x00026215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 12/10/2015] [Indexed: 11/22/2022] Open
Abstract
Efficacious patient safety monitoring should focus on the implementation of evidence-based practices that avoid unnecessary harm related to healthcare. The ISEP-Brazil project aimed to develop and validate indicators for best patient safety practices in Brazil. The basis was the translation and adaptation of the indicators validated in the ISEP-Spain project and the document Safe Practices for Better Healthcare (U.S. National Quality Forum), recommending 34 best practices. A 25-member expert panel validated the indicators. Reliability and feasibility were based on a pilot study in three hospitals with different management formats (state, federal, and private). Seventy-five best practice indicators were approved (39 structure; 36 process) for 31 of the 34 recommendations. The indicators were considered valid, reliable, and useful for monitoring patient safety in Brazilian hospitals.
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Affiliation(s)
| | | | | | | | | | - Almária Mariz Batista
- Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Brasil
| | | | - Benize Fernandes Lira
- Subcoordenadoria de Vigilância Sanitária, Secretaria da Saúde Pública, Natal, Brasil
| | | | | | | | | | | | | | | | | | | | | | - Francisca Sueli Monte
- Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Brasil
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Medeiros PJD, Villarim Neto A, Lima FP, Azevedo IM, Leão LRDS, Medeiros AC. Effect of sildenafil in renal ischemia/reperfusion injury in rats. Acta Cir Bras 2011; 25:490-5. [PMID: 21120279 DOI: 10.1590/s0102-86502010000600006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Accepted: 06/16/2010] [Indexed: 01/16/2023] Open
Abstract
PURPOSE To evaluate the effect of sildenafil, administered prior to renal ischemia/reperfusion (I/R), by scintigraphy and histopathological evaluation in rats. METHODS Twenty-four rats were divided randomly into two groups. They received 0.1 ml of 99mTechnetium-etilenodicisteine intravenous, and a baseline (initial) renal scintigraphy was performed. The rats underwent 60 minutes of ischemia by left renal artery clamping. The right kidney was not manipulated. The sildenafil group (n=12) received orally 1 mg/kg of sildenafil suspension 60 minutes before ischemia. Treatment with saline 0.9% in the control group (n=12). Half of the rats was assessed after 24 hours and half after seven days I/R, with new renal scintigraphy to study differential function. After euthanasia, kidneys were removed and subjected to histopathological examination. For statistical evaluation, Student t and Mann-Whitney tests were used. RESULTS In the control group rats, the left kidneys had significant functional deficit, seven days after I/R, whose scintigraphic pattern was consistent with acute tubular necrosis, compared with the initial scintigraphy (p<0.05). Sildenafil treatment resulted in better differential function of the left kidneys 24h after reperfusion, compared with controls. Histopathologically, the left kidney of control rats (24 hours after I/R) showed a higher degree of cellular necrosis when compared with the sildenafil treated rats (p<0.05). CONCLUSION Sildenafil had a protective effect in rat kidneys subjected to normothermic I/R, demonstrated by scintigraphy and histomorphometry.
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