Evaluation of different functionalization methodologies for improving the removal of three target antibiotics from wastewater by a brewery waste activated carbon.

This work aims to increase the efficiency of an activated carbon produced from brewery waste (AC) in the removal of three target antibiotics (sulfamethoxazole (SMX), trimethoprim (TMP), and ciprofloxacin (CIP)) by surface incorporation of oxygen, nitrogen or sulfur groups. AC was produced using spent brewery grains (the most abundant waste from the brewing industry) as raw material, K2CO3 as activating agent and microwave energy for pyrolysis. Then, seven different functionalized AC were prepared, characterized for their physicochemical properties, and tested for adsorption (%) of SMX, TMP and CIP from three different matrices (ultrapure water (pH ~5-6), buffered ultrapure water (pH 8), and effluent from a municipal wastewater treatment plant (WWTP effluent (pH 8)), under batch operation. Based on the obtained results, an oxygen functionalized AC was selected for further characterization and studies on the adsorption of the target antibiotics from the WWTP effluent. Kinetic results fitted the pseudo-second order model and the equilibrium isotherms were adequately described by the Langmuir model, reaching maximum adsorption capacities (qm) of 124 ± 1 µmol g-1, 315 ± 2 µmol g-1 and 201 ± 5 µmol g-1 for SMX, TMP and CIP, respectively. The selected functionalization increased qm by up to 58 % in comparison with the non-functionalized AC. The oxygen modified AC produced from a biomass waste remarkably improved its performance for an efficient application in the removal of antibiotics from wastewater.

Nutricional intake, maternal outcomes and knowledge on preeclampsia prevention: Was there impact during the COVID-19 pandemic among women with hypertension?

AIM: Compare nutritional intake, weight gain, frequency of superimposed pre-eclampsia (SPE) and adequate use/knowledge on preventive interventions for PE, before and during the COVID-19 pandemic among pregnant women with chronic hypertension (CH) METHODS: Prospective cohort of pregnant women with CH. Inclusion between 13 and 25 weeks, with sociodemographic characterization, food frequency questionnaire and 24-hour recall (R24h). Indirect adherence test MEDTAKE was employed to investigate adequate use/understanding of calcium and aspirin. Frequency of SPE, weight gain, food intake, maternal and perinatal outcomes were compared between periods. RESULTS: 58 women were included and 116 R24h considered. Over 80 % used aspirin and calcium for PE prophylaxis. However, less than half understood the meaning of such interventions. There were no differences in sociodemographic characteristics, majority white, 20 to 34 years-old, and multiparous. There were 31 women included before and 27 during the pandemic. Frequency of SPE was respectively 40 % and 44.4 % before and during the pandemic (p = 0.746) and weight gain 8.7Kg before and 7.4Kg during the pandemic. There was no difference in macronutrient intake, average calcium consumption was 444.8 mg before and 402.6 mg during the pandemic; with inadequate use/understanding of preventive interventions for PE. CONCLUSION: The pandemic period did not significantly increase the risk of SPE, without significant increase in weight gain or worsening food quality intake and knowledge on preventive interventions.

Nanoplastics increase the toxicity of a pharmaceutical, at environmentally relevant concentrations - A mixture design with Daphnia magna.

In aquatic environments, nanoplastics (NPls) can adsorb pharmaceuticals. However, throughout the scientific community, there is scarce knowledge about the interactive effects of the mixture nanoplastics (NPls) with pharmaceuticals to aquatic organisms. Therefore, this study aimed to investigate if the pharmaceutical diphenhydramine (DPH) toxicological effects alters when in presence of polystyrene NPls (PSNPls). To achieve this, Daphnia magna immobilization and different biochemical biomarkers (48-hours exposure) were assessed. Synergistic interactions occurred at environmentally relevant concentrations, PSNPls+DPH induced oxidative damage, whereas no effect was observed at single exposures. With the increase of PSNPls concentration, the DPH concentration causing 50% of effect (EC50) for organisms' immobilization decreased to 0.001 mg/L. In silico analysis suggested that the DPH toxicity to D. magna occurs via the sodium-dependent serotonin transporter. The results showed interactive effects between PSNPls and DPH (implying harmful effects on D. magna), allowing more thoughtful decisions by society and policymakers regarding plastics and pharmaceuticals.

Multivariate optimization of dispersive liquid-liquid microextraction using ionic liquid for the analysis of ultraviolet filters in natural waters.

In this work, a vortex-assisted dispersive liquid-liquid microextraction method, using an ionic liquid as the extracting solvent was developed, for the simultaneous analysis of three UV filters in different water samples. The extracting and dispersive solvents were selected in a univariate way. Then, the parameters such as the volume of the extracting and dispersive solvents, pH and ionic strength were evaluated using a full experimental design 24, followed by Doehlert matrix. The optimized method consisted of 50 µL of extracting solvent (1-octyl-3-methylimidazolium hexafluorophosphate), 700 µL of dispersive solvent (acetonitrile) and pH of 4.5. When combined with high-performance liquid chromatography, the method limit of detection ranged from 0.3 to 0.6 µg L-1, enrichment factors between 81 and 101%, and the relative standard deviation between 5.8 and 10.0%. The developed method demonstrated effectiveness in concentrating UV filters in both river and seawater samples, being a simple and efficient option for this type of analysis.

Qualidade do sono em pessoas submetidas à hemodiálise com dor crônica / Sleep quality in people with chronic pain undergoing hemodialysis

RESUMO Objetivo avaliar a qualidade do sono em pessoas submetidas ao tratamento hemodialítico com dor crônica. Métodos estudo observacional, prospectivo e transversal, realizado em duas clínicas de hemodiálise. A amostra foi composta por 76 pessoas com doença renal crônica em tratamento hemodialítico e dor crônica. Utilizou-se um formulário sociodemográfico e clínico, a escala visual analógica de dor, o questionário McGill e o Índice de Qualidade do Sono de Pittsburgh. Os dados foram analisados utilizando estatística descritiva e inferencial e testes de correlação. Resultados a maioria dos participantes teve uma qualidade de sono muito ruim. Houve correlação entre a qualidade do sono e a escala visual analógica de dor (p=0,027). Houve correlação negativa entre os descritores da escala de dor McGill e a qualidade do sono (p=0,033). Conclusão o presente estudo mostrou que a maioria dos participantes apresentaram alterações nos níveis de qualidade do sono, que foram classificados como ruins ou muito ruins. Contribuições para a prática o estudo fornece dados sobre a correlação da qualidade do sono em pessoas em hemodiálise com presença de dor crônica, além de fornecer subsídios para o desenvolvimento de intervenções por parte das equipes de enfermagem que ajudem a melhorar a qualidade do sono dessas pessoas.

ABSTRACT Objective to evaluate sleep quality in people with chronic pain undergoing hemodialysis. Methods observational, prospective, and cross-sectional study carried out in two hemodialysis clinics. The sample was formed by 76 people with chronic kidney disease and chronic pain who were undergoing hemodialysis. We used a sociodemopgrahic and clinical form, the visual analogue scale for pain, the McGill questionnaire, and the Pittsburgh Sleep Quality Index. Results were analyzed using descriptive and inferential statistics and correlation tests. Results most participants had very poor sleep quality. There was a correlation between sleep quality and the visual analogue scale for pain (p=0.027). There was a negative correlation between McGill pain scale descriptors and sleep quality (p=0.033). Conclusion the sleep quality levels of most participants suffered alterations and were classified as poor or very poor. Contributions to practice this study provides data on correlations associated with the sleep quality of patients with chronic pain undergoing hemodialysis. It also gives support for nursing teams to develop interventions to improve the sleep quality of these patients.

2ª Conferência Nacional de Saúde das Mulheres: Saúde e Democracia / 2nd National Conference on Women's Health: Health and Democracy

O trabalho de produção deste Rádio-Livro foi desenvolvido pela leitura e cuidadosa adaptação cultural nas linguagens das diferentes expressões da arte popular sobre a 2ª Conferência Nacional de Saúde das Mulheres, conversando sobre direitos e a responsabilidade do Estado, sobre a produção da saúde e sobre as diferentes inserções que todas as mulheres têm com a saúde e que precisam ser respeitadas e atendidas com integralidade em todas as suas dimensões. O Rádio-Livro é acessado com o pensamento, com o coração e com a vontade de fazer o mundo melhor para todas as pessoas viverem e para que a saúde das pessoas e coletividades se expressem de forma mais plena. Esse material destina-se às Rádios Comunitárias e à população em geral e tem fins exclusivamente educacionais, sendo proibida a compra e a venda em qualquer circunstância.

16ª Conferência Nacional de Saúde: arte e democracia em defesa do SUS / 16th National Health Conference: art and democracy in defense of SUS

O trabalho de produção deste Rádio-Livro foi desenvolvido pela leitura e cuidadosa adaptação cultural nas linguagens das diferentes expressões da arte popular sobre a 16° Conferência Nacional de Saúde, que definiu diretrizes muito importantes para o SUS e para os governos, também sobre a vida e a democracia, nos fazendo lembrar da origem do SUS e da 8ª Conferência Nacional de Saúde. O Rádio-Livro é acessado com o pensamento, com o coração e com a vontade de fazer o mundo melhor para todas as pessoas viverem e para que a saúde das pessoas e coletividades se expressem de forma mais plena. Esse material destina-se às Rádios Comunitárias e à população em geral e tem fins exclusivamente educacionais, sendo proibida a compra e a venda em qualquer circunstância.

O Conselho Nacional de Saúde no enfrentamento à pandemia de COVID-19: a arte como resistência e valorização da vida / The National Health Council in the face of the COVID-19 pandemic: art as resistance and appreciation of life

O trabalho de produção deste Rádio-Livro foi desenvolvido pela leitura e cuidadosa adaptação cultural nas linguagens das diferentes expressões da arte popular sobre as ações do Conselho Nacional de Saúde no enfrentamento à pandemia de COVID-19, mas também à omissão do governo e à negligência à vida das pessoas. O Rádio-Livro é acessado com o pensamento, com o coração e com a vontade de fazer o mundo melhor para todas as pessoas viverem e para que a saúde das pessoas e coletividades se expressem de forma mais plena. Esse material destina-se às Rádios Comunitárias e à população em geral e tem fins exclusivamente educacionais, sendo proibida a compra e a venda em qualquer circunstância.

1ª Conferência Nacional de Vigilância em Saúde: Proteção das vidas, território e democracia / 1st National Conference on Health Surveillance: Protection of lives, territory and democracy

O trabalho de produção deste Rádio-Livro foi desenvolvido pela leitura e cuidadosa adaptação cultural nas linguagens das diferentes expressões da arte popular sobre a 1ª Conferência Nacional de Vigilância em Saúde, uma importante ação do SUS que relaciona as práticas de atenção, promoção de saúde e prevenção de doenças essenciais para o pensar e fazer saúde nos territórios e que tornou-se ainda mais visível durante a pandemia de COVID-19. O Rádio-Livro é acessado com o pensamento, com o coração e com a vontade de fazer o mundo melhor para todas as pessoas viverem e para que a saúde das pessoas e coletividades se expressem de forma mais plena. Esse material destina-se às Rádios Comunitárias e à população em geral e tem fins exclusivamente educacionais, sendo proibida a compra e a venda em qualquer circunstância.

Multivariable optimization of activated carbon production from microwave pyrolysis of brewery wastes - Application in the removal of antibiotics from water.

This study aimed at optimizing the one-step chemical activation and microwave pyrolysis of an agro-industrial waste to obtain a microporous activated carbon (AC) with superior textural and adsorptive properties by a fast, low-reagent and low-energy process. Spent brewery grains were used as precursor, and the antibiotics sulfamethoxazole (SMX), trimethoprim (TMP) and ciprofloxacin (CIP) were considered as target adsorbates. A fractional factorial design was applied to evaluate the effect of the main factors affecting the preparation of AC (activating agent, activating agent:precursor ratio, pyrolysis temperature and residence time) on relevant responses. Under optimized conditions (K2CO3 activation, pyrolysis at 800 °C during 20 min and a K2CO3:precursor ratio of 1:2), a microporous AC with specific surface area of 1405 m2 g-1 and large adsorption of target antibiotics (82-94%) was obtained and selected for further studies. Equilibrium times up to 60 min and maximum Langmuir adsorption capacities of 859 µmol g-1 (SMX), 790 µmol g-1 (TMP) and 621 µmol g-1 (CIP) were obtained. The excellent textural and adsorptive properties of the selected material were achieved with a very fast pyrolysis and low load of activating agent, highlighting the importance of optimization studies to decrease the environmental and economic impact of waste-based AC.

The role of nanoplastics on the toxicity of the herbicide phenmedipham, using Danio rerio embryos as model organisms.

Once in the aquatic ecosystems, nanoplastics (NPls) can interact with other contaminants acting as vectors of transport and altering their toxicological effects towards organisms. Thus, the present study aims to investigate how polystyrene NPls (44 nm) interact with the herbicide phenmedipham (PHE) and affect its toxicity to zebrafish embryos. Single exposures to 0, 0.015, 0.15, 1.5, 15 and 150 mg/L NPls and 0.02, 0.2, 2 and 20 mg/L PHE were performed. Embryos were also exposed to the binominal combinations: 0.015 mg/L NPls + 2 mg/L PHE, 0.015 mg/L NPls + 20 mg/L PHE, 1.5 mg/L NPls + 2 mg/L PHE and 1.5 mg/L NPls + 20 mg/L PHE. Due to the low solubility of PHE in water, a solvent control was performed (0.01% acetone). PHE was quantified. Mortality, heartbeat and hatching rate, malformations appearance, locomotor behavior and biomarkers related to oxidative stress, neurotransmission and energy budgets were analyzed. During 96 h, NPls and PHE single and combined exposures did not affect embryos development. After 120 h, NPls induced hyperactivity and PHE induced hypoactivity. After 96 h, NPls increased catalase activity and PHE increased glutathione S-transferases activity. On the combination 0.015 mg/L NPls + 20 mg/L PHE, hyperactivity behavior was found, similar to 0.015 mg/L NPls, and cholinesterase activity was inhibited. Additionally, the combination 1.5 mg/L NPls + 20 mg/L PHE increased both catalase and glutathione S-transferases activities. The combination NPls with PHE affected more biochemical endpoints than the single exposures, showing the higher effect of the binominal combinations. Dissimilar interactions effects - no interaction, synergism and antagonism - between NPls and PHE were found. The current study shows that the effects of NPls on bioavailability and toxicity of other contaminants (e.g. PHE) cannot be ignored during the assessment of NPls environmental behavior and risks.

Producing Magnetic Nanocomposites from Paper Sludge for the Adsorptive Removal of Pharmaceuticals from Water-A Fractional Factorial Design.

In view of a simple after-use separation, the potentiality of producing magnetic activated carbon (MAC) by intercalation of ferromagnetic metal oxide nanoparticles in the framework of a powder activated carbon (PAC) produced from primary paper sludge was explored in this work. The synthesis conditions to produce cost effective and efficient MACs for the adsorptive removal of pharmaceuticals (amoxicillin, carbamazepine, and diclofenac) from aqueous media were evaluated. For this purpose, a fractional factorial design (FFD) was applied to assess the effect of the most significant variables (Fe3+ to Fe2+ salts ratio, PAC to iron salts ratio, temperature, and pH), on the following responses concerning the resulting MACs: Specific surface area (SBET), saturation magnetization (Ms), and adsorption percentage of amoxicillin, carbamazepine, and diclofenac. The statistical analysis revealed that the PAC to iron salts mass ratio was the main factor affecting the considered responses. A quadratic linear regression model A = f(SBET, Ms) was adjusted to the FFD data, allowing to differentiate four of the eighteen MACs produced. These MACs were distinguished by being easily recovered from aqueous phase using a permanent magnet (Ms of 22-27 emu g-1), and their high SBET (741-795 m2 g-1) were responsible for individual adsorption percentages ranging between 61% and 84% using small MAC doses (35 mg L-1).

Solidified floating organic drop microextraction (SFODME) for the simultaneous analysis of three non-steroidal anti-inflammatory drugs in aqueous samples by HPLC.

In this work, a liquid-liquid microextraction methodology using solidified floating organic drop (SFODME) was combined with liquid chromatography and UV/Vis detection to determine non-steroidal anti-inflammatory drugs (NSAIDs) naproxen (NPX), diclofenac (DCF), and mefenamic acid (MFN) in tap water, surface water, and seawater samples. Parameters that can influence the efficiency of the process were evaluated, such as the type and volume of the extractor and dispersive solvents, effect of pH, agitation type, and ionic strength. The optimized method showed low detection limits (0.09 to 0.25 µg L-1), satisfactory recovery rates (90 to 116%), and enrichment factors in the range between 149 and 199. SFODME showed simplicity, low cost, speed, and high concentration capacity of the analytes under study. Its use in real samples did not demonstrate a matrix effect that would compromise the effectiveness of the method, being possible to apply it successfully in water samples with different characteristics.

Optimizing microwave-assisted production of waste-based activated carbons for the removal of antibiotics from water.

This work aimed at the microwave-assisted production of activated carbon (AC) from primary paper mill sludge (PS) for the adsorption of antibiotics from water. Production conditions, namely pyrolysis temperature, pyrolysis time and activating agent (KOH):PS ratio, were optimized as a function of product yield, specific surface area (SBET), total organic carbon (TOC) content and adsorptive removal percentage of two target antibiotics (amoxicillin (AMX) and sulfamethoxazole (SMX)). Under the optimized conditions (pyrolysis at 800 °C during 20 min and a KOH:PS ratio of 1:5), a microporous AC (MW800-20-1:5, with SBET = 1196 m2 g-1, TOC = 56.2% and removal of AMX and SMX = 85% and 72%, respectively) was produced and selected for further kinetic and equilibrium adsorption studies. The obtained results were properly described by the Elovich reaction-based kinetic model and the Langmuir equilibrium isotherm, with maximum adsorption capacities of 204 ± 5 mg g-1 and 217 ± 8 mg g-1 for AMX and SMX, respectively. Considering the satisfactory comparison of these results with the performance of commercial and alternative AC produced by conventional pyrolysis, this work demonstrated the feasibility of the microwave-assisted production of environmentally and energetically sustainable waste-based AC to be applied in the efficient removal of antibiotics from water.

IgA Nephropathy Recurrence after Kidney Transplantation: Role of Recipient Age and Human Leukocyte Antigen-B Mismatch.

BACKGROUND: Recurrence of immunoglobulin (Ig)A nephropathy (rIgAN) is a growing cause of kidney allograft dysfunction. This study was aimed at investigating factors associated with rIgAN and the subsequent progression to end-stage renal disease (ESRD). METHODS: Retrospective study including consecutive patients with IgA nephropathy (IgAN) who received a kidney transplant in our center between 1992 and 2016 and had a renal biopsy by clinical indication. The date of detection of chronic kidney disease (CKD) 5 was used as renal outcome. RESULTS: Eighty-six kidney transplants were performed in patients with IgAN, 38 (44%) were from living donors (related n = 26). rIgAN was diagnosed in 23 allografts (27%). Renal function and proteinuria at the end of the follow-up period were worst in the rIgAN patients compared to those without rIgAN (2.2 vs. 1.4 mg/dL, p = 0.014, and 1.16 vs. 0.49 g/day, p = 0.005, respectively). Risk of rIgAN and progression to CKD 5 decreased with patient's age (hazard ratio [HR] 0.95, 95% CI 0.92-0.98, p = 0.002, and HR 0.97, 95% CI 0.83-0.97, p = 0.008 per year, respectively). Patients with rIgAN had a higher risk of progression to CKD 5 (HR 6.7, 95% CI 1.3-35.7, p = 0.025). Full donor-recipient mismatch in the human leukocyte antigen (HLA)-B loci decreased the risk of rIgAN (HR 0.22, 95% CI 0.06-0.76, p = 0.017). CONCLUSIONS: rIgAN was an independent risk factor for ESRD after renal allograft. Younger age increased the risk of rIgAN and CKD 5. Conversely, HLA-B mismatching was a potential protective factor for rIgAN of this glomerular disease.

Recent advances on the development and application of magnetic activated carbon and char for the removal of pharmaceutical compounds from waters: A review.

The adsorption of pharmaceutical substances using carbonaceous materials, such as activated carbon (AC), biochar (BC) and hydrochar (HC), has received substantial attention by researchers working on water treatment, due to the simplicity, low-cost and high performance of this process. In order to widen the potentiality of these carbonaceous materials and to overcome some of their limitations, particularly the inefficient separation of powdered formulations from treated water, the incorporation of magnetic nanoparticles has been explored. The recovery of magnetic carbon materials (MCM) from the treated water can be attained by applying an external magnetic field, avoiding inefficient and costly filtration and centrifugation processes, typically applied in the case of non-magnetic carbonaceous adsorbents. In the last ten years, some work has been devoted to the preparation of MCM specifically from AC (MCACM), biochar (MCBCM) and hydrochar (MCHCM). This review aims to present the different aspects of using MCM in water treatment, namely in the removal of pharmaceutical compounds. The synthesis routes used to produce MCM, their physical, morphologic and chemical features, and their application in the removal of these micro-organic contaminants from water will be assessed. The advantages and disadvantages of using MCM in water treatment, and their comparative performance with the carbonaceous non-magnetic precursors will be also discussed in this review.

Análise da funcionalidade em idosos após a prática de exercícios resistidos em ambiente aquático / Analysis of functionality in elderly after the practice of resistance exercises in aquatic environment

Introdução: O envelhecimento é um fenômeno natural da vida humana que ocasiona mudanças fisiológicas. A senescência provoca alterações que vão interferir no equilíbrio. O exercício é reconhecido como aliado no processo de envelhecimento, assim, exercícios de resistência muscular podem ser realizados em ambiente aquático e terrestre, porém exercícios aquáticos criam situações de instabilidade, fornecendo mais informações sensoriais. Objetivo: Analisar a utilização dos exercícios resistidos no ambiente aquático na melhora do equilíbrio de idosos por meio da análise da plataforma de força e com a eletromiografia de superfície. Métodos: A pesquisa contemplou 13 idosos do município de Parnaíba/PI. O programa de exercícios resistidos em ambiente aquático constituiu-se de exercícios de resistência muscular, equilíbrio e relaxamento, executados durante uma hora, duas vezes por semana em dias alternados, durante seis semanas. Resultados: Em relação à análise estabilométrica houve melhoria do centro de gravidade e controle motor dos integrantes. Ao inferir os dados da eletromiografia dos músculos estudados, obteve-se significância estatística para cada variável, apontando eficácia do protocolo no controle motor destes músculos. Conclusão: O protocolo proposto é eficaz no controle motor e equilíbrio de idosos, reduzindo o risco de quedas e promovendo melhoria da capacidade funcional. (AU)

Introduction: Aging is a natural phenomenon of human life that causes physiological changes. Senescence causes changes that will interfere with balance. The exercise is recognized as an ally in the aging process, thus, muscular endurance exercises can be performed in the aquatic and terrestrial environment, however, aquatic exercises create situations of instability, providing more sensory information. Objective: To analyze the use of resistance exercises in the aquatic environment in improving the balance of the elderly through the analysis of the force platform and the surface electromyography. Methods: The study included 13 elders from the municipality of Parnaiba/PI. The water-resistive exercise program consisted resistance of exercises, balance and relaxation, performed for one hour, twice a week on alternate days, for six weeks. Results: In relation to the stabilometric analysis there was improvement of the center of gravity and motor control of the members. By inferring the electromyography data of the studied muscles, statistical significance was obtained for each variable, indicating protocol efficacy in the motor control of these muscles. Conclusion: The proposed protocol is effective in motor control and balance of the elderly, reducing the risk of falls and promoting improvement of functional capacity. (AU)

Early outcomes of kidney transplantation from elderly donors after circulatory death (GEODAS study).

BACKGROUND: Spain has dramatically increased the number of controlled circulatory death donors (cDCD). The initial selection criteria for considering cDCD for kidney transplantation (KT) have been expanded progressively, with practically no limits in donor age during the last years. We aimed to analyze the early clinical outcomes using expanded (> 65 years) cDCD in comparison with standard ones. METHODS: Observational multicenter study including 19 transplant centers in Spain. We performed a systematic inclusion in a central database of every KT from expanded cDCD at each participant unit from January-2012 to January-2017. Surgical procedures and immunosuppressive protocols were based on local practices. Data was analyzed in the central office using logistic and Cox regression or competitive-risk models for multivariate analysis. Median time of follow-up was 18.1 months. RESULTS: 561 KT were performed with kidneys from cDCD, 135 from donors older than 65 years. As expected, recipients from older cDCD were also older (65.8 (SD 8.8) vs 53.7 (SD 11.4) years; p < 0.001) and with higher comorbidity. At 1 year, no differences were found amongst older and younger cDCD KT recipients in terms of serum creatinine (1.6 (SD 0.7) vs 1.5 (SD 0.8) mg/dl; p = 0.29). Non-death censored graft survival was inferior, but death-censored graft survival was not different (95.5 vs 98.2% respectively; p = 0.481). They also presented a trend towards higher delayed graft function (55.4 vs 46.7%; p = 0.09) but a similar rate of primary non-function (3.7 vs 3.1%; p = 0.71), and acute rejection (3.0 vs 6.3%; p = 0.135). In the multivariate analysis, in short follow-up, donor age was not related with worse survival or poor kidney function (eGFR < 30 ml/min). CONCLUSIONS: The use of kidneys from expanded cDCD is increasing for older and comorbid patients. Short-term graft outcomes are similar for expanded and standard cDCD, so they constitute a good-enough source of kidneys to improve the options of KT wait-listed patients.

Meningite aguda bacteriana na população infantojuvenil: principais agentes e métodos para diagnóstico - uma revisão da literatura / Acute bacterial meningitis in children and young population: main agents and methods for diagnosis - a literature review

A meningite bacteriana é uma afecção de grande significância devido a sua relação com alta mortalidade e morbidade na população neonatal a jovem. Devido a este fato é importante o conhecimento sobre esta doença e os seus principais agentes etiológicos. Com o objetivo de relatar os principais métodos de diagnóstico, assim como os principais agentes etiológicos envolvidos na fisiopatologia da meningite bacteriana em população jovem foi realizada uma busca por artigos publicados nos últimos 5 anos nas bases de dados Pubmed, Scielo, Bireme e Lilacs. A literatura atual aponta como microrganismos predominantes na incidência dessa doença a N. meningitidis S. pneumoniae, sendo as mais recorrentes na população de faixa etária entre 29 dias e 17 anos. Os fatores relacionados ao prognóstico estão intimamente relacionados com a distinção da classificação do agente etiológico em bacteriano ou viral, importante para a determinação da terapia adequada.

Bacterial meningitis is a highly significant disease due to its relationship with high mortality and morbidity in neonatal and young population. Due to this is important to know about this disease and its main etiological agents. In purpose to report the main diagnostic methods, as well as the main etiological agents involved in the pathophysiology of bacterial meningitis was conducted a search for articles published in the last five years in Pubmed, Scielo, Bireme and Lilacs. The current literature indicates N. meningitidis S. pneumoniae the most predominant microorganisms in the incidence of this disease between population aged between 29 days and 17 years. Factors related to prognosis are closely related to the classification distinction of the etiologic agent in bacterial or viral, important to determine the ap- propriate therapy.