Age-Related Changes in Clinical and Analytical Variables in Chronic Hemodialyzed Patients.

Worldwide, the number of elderly individuals receiving chronic hemodialysis is rising. The aim of our study was to evaluate several clinical and analytical biomarkers in chronically dialyzed patients and analyze how they change with age. A cross-sectional study was performed by evaluating 289 end-stage renal disease patients undergoing dialysis. We evaluated the hemogram, adipokines, the lipid profile, and several markers related to inflammation, endothelial function/fibrinolysis, nutrition, iron metabolism, and cardiac and renal fibrosis. Clinical data and dialysis efficacy parameters were obtained from all patients. The relationships between studied biomarkers and age were assessed by a statistical comparison between younger (adults with age < 65 years) and older (age ≥ 65 years) patients and by performing regression analysis. Participants presented a mean age of 68.7 years (±13.6), with 66.8% (n = 193) being classified as older. Compared to younger patients, older patients presented the following: (a) significantly lower values of diastolic blood pressure (DBP) and ultrafiltration volume; (b) lower levels of phosphorus, uric acid, creatinine, and albumin; and (c) higher circulating concentrations of tissue-type plasminogen activator (tPA), D-dimer, interleukin-6, leptin, N-terminal pro B-type natriuretic peptide, and tissue inhibitor of metalloproteinase-1. In the multiple linear regression analysis, DBP values, tPA, phosphorus, and D-dimer levels were independently associated with the age of patients (standardized betas: -0.407, 0.272, -0.230, and 0.197, respectively; p < 0.001 for all), demonstrating relevant changes in biomarkers with increasing age at cardiovascular and nutritional levels. These findings seem to result from crosstalk mechanisms between aging and chronic kidney disease.

The 2021 Portuguese Society of Ophthalmology joint guidelines with Paediatric Rheumatology on the screening, monitoring and medical treatment of juvenile idiopathic arthritis-associated uveitis.

AIM: To develop the first Ophthalmology joint guidelines with Paediatric Rheumatology with recommendations on the screening, monitoring and medical treatment of juvenile idiopathic arthritis-associated uveitis (JIA-U), endorsed by the Portuguese Society of Ophthalmology (SPO). METHODS: A systematic literature review was conducted to include publications up to July 14th 2020, with no language restrictions, in order to include all the international position papers/guidelines concerning the medical management of JIA-U and randomised clinical trials assessing the efficacy and safety of medical treatment in this field. We searched through MEDLINE (PubMed), Scopus, Web of Science and Cochrane Library. The Delphi modified technique to generate consensus was used. Preliminary evidence statements were subject to an anonymous agreement assessment and discussion process using an online survey, followed by further discussion and update at a national meeting. A draft of the manuscript with all recommendations was then circulated among all participants and suggestions were incorporated. The final version was again circulated before publication. RESULTS: Twenty-six recommendations were developed focusing on the following topics: general management (3), screening and follow-up of uveitis (4), treatment (17) and health education in JIA-U among patients and families (2). CONCLUSION: These guidelines were designed to support the shared medical management of patients with JIA-U and emphasize the need for a multidisciplinary approach between Ophthalmology and Paediatric Rheumatology regarding the comprehensive care of JIA-U. We acknowledge that updating these recommendations will be warranted in the future, as more evidence becomes available. KEY-WORDS: juvenile idiopathic arthritis, uveitis, biological treatment, conventional immunosuppressive treatment, multidisciplinary management, guidelines, consensus, review, Delphi Technique.

Monitoring recent changes of vegetation in Fildes Peninsula (King George Island, Antarctica) through satellite imagery guided by UAV surveys.

Mapping accurately vegetation surfaces in space and time in the ice-free areas of Antarctica can provide important information to quantitatively describe the evolution of their ecosystems. Spaceborne remote sensing is the adequate way to map and evaluate multitemporal changes on the Antarctic vegetation at large but its nature of occurrence, in relatively small and sparse patches, makes the identification very challenging. The inclusion of an intermediate scale of observation between ground and satellite scales, provided by Unmanned Aerial Vehicles (UAV) imagery, is of great help not only for their effective classification, but also for discriminating their main communities (lichens and mosses). Thus, this paper quantifies accurately recent changes of the vegetated areas in Fildes Peninsula (King George Island, Antarctica) through a novel methodology based on the integration of multiplatform data (satellite and UAV). It consists of multiscale imagery (spatial resolution of 2 m and 2 cm) from the same period to create a robust classifier that, after intensive calibration, is adequately used in other dates, where field reference data is scarce or not available at all. The methodology is developed and tested with UAV and satellite data from 2017 showing overall accuracies of 96% and kappa equal to 0.94 with a SVM classifier. These high performances allow the extrapolation to a pair of previous dates, 2006 and 2013, when atmospherically clear very high-resolution satellite imagery are available. The classification allows verifying a loss of the total area of vegetation of 4.5% during the 11-year time period under analysis, which corresponds to a 10.3% reduction for Usnea sp. and 9.8% for moss formations. Nevertheless, the breakdown analysis by time period shows a distinct behaviour for each vegetation type which are evaluated and discussed, namely for Usnea sp. whose decline is likely to be related to changing snow conditions.