Craniospinal space reduction and malalignment due to atlas assimilation in Basilar Invagination-A case-control study.

Introduction: Type I Basilar invagination is associated with the assimilation of the anterior arch of the atlas. Observation suggests that the assimilation of the atlas does not allow the development of the normal space between the skull and C1 and displaces the high cervical spine towards the neural structures, posteriorly positioned. Purpose: The objective of this work is to evaluate craniospinal alignment in patients with type I Basilar invagination and AOA in comparison with normal subjects (Type I). Methods: Magnetic resonance images and / or CT SCAN with reconstruction in the midline, in acquisitions at t1 and or t2, from 30 normal subjects and 27 patients with type I Basilar invagination were evaluated. The position of Anterior arch of Atlas and odontoid process in relation to the Basion and distances between C1 and C2 to the anterior border of foramen magnum were compared between groups. Results: The distance from C2 to the Basion was significantly higher in the BI group than in the control group (t test: t = 4.18; p = 0) and the space between the skull and Atlas was reduced. All normal subjects had the Atlas anteriorly located in relation to the Basion. In AOA, all patients had Atlas in line with or posteriorly dislocated in relation to the Basion and the Odontoid process occupying the foramen magnum space. Conclusion: data revealed that AOA prevents a normal position of skull in relation to the Atlas and a presumed "slip-back" cranio-spinal displacement during developmental period.

Enhanced enzymatic electrochemical detection of an organophosphate Pesticide: Achieving Wide linearity and femtomolar detection via gold nanoparticles growth within polypyrrole films.

The indiscriminate use of pesticides in agriculture demands the development of devices capable of monitoring contaminations in food supplies, in the environment and biological fluids. Simplicity, easy handling, high sensitivities, and low limits-of-detection (LOD) and quantification are some of the required properties for these devices. In this work, we evaluated the effect of incorporating gold nanoparticles into indigo carmine-doped polypyrrole during the electropolymerization of films for use as an acetylcholinesterase (AChE) enzyme-based biosensor. As proof of concept, the pesticide methyl parathion was tested towards the inhibition of AChE. The enzyme was immobilized simply by drop-casting a solution, eliminating the need for any prior surface modification. The biosensors were characterized with cyclic voltammetry, scanning electron microscopy, transmission electron microscopy, and Raman spectroscopy. The assays for the detection of methyl parathion with films containing polypyrrole, indigo carmine and AChE (PPy-IC-AChE) presented a sensitivity of 5.7 µA cm-2 g-1 mL and a LOD of 12 nmol L-1 (3.0 ng L-1) with a linear range from 1.3 x 10-7 mol L-1 to 1.0 x 10-5 mol L-1. The introduction of gold nanoparticles (AuNP) into the film (PPy-IC-AuNP-AChE) led to remarkable improvements on the overall performance, such as a lower redox potential for the enzymatic reaction, a 145 % increase in sensitivity (14 µA cm-2 g-1 mL), a wider detection dynamic range (from 1.3x10-7 to 1.0x10-3 mol L-1), and a very low LOD of 24 fmol L-1 (64 ag mL-1). These findings underscore the potential of using AuNPs to improve the enzymatic performance of biosensor devices.

Determining prognostic factors in the treatment of primary hemifacial spasm: Clinical outcomes and complications. A literature review.

Objective: Primary Hemifacial Spasm (PHFS) significantly impacts quality of life, necessitating effective treatment like microvascular decompression of the facial nerve. This study aims to identify prognostic factors related to surgical treatment to enhance outcomes and minimize complications. A systematic review of literature from the past five years was conducted. Methods: Following PRISMA guidelines, we systematically searched databases like PubMed, Embase, Scopus, Ovid, EBSCO, and Cochrane using keywords such as 'Hemifacial spasm,' 'Microvascular decompression,' 'Neurovascular conflict,' and 'Surgical techniques.' The search spanned January 2018 to November 2023. The 'Rayyan' program facilitated data compilation. Each author reviewed abstracts, applying inclusion criteria like systematic reviews, clinical trials, observational studies, and case series, while excluding theoretical or non-English articles. Results: Of 26 selected articles, those solely addressing PHFS treatment with botulinum toxin and lacking surgical procedure data were excluded. Thus, our analysis focused on 16 articles, including meta-analyses, systematic reviews, clinical trials, and observational studies. Discussion: Microvascular decompression at the cerebellar pontine angle is the mainstay treatment for hemifacial spasm. Despite limited statistically significant prognostic factors in the literature, overarching recommendations aim to improve outcomes, minimize complications, and prevent recurrences. Key considerations include surgeon expertise, precise techniques, thorough nerve exploration, identifying the conflict's cause, and intraoperative monitoring. Conclusions: PHFS significantly impacts patients' lives, necessitating timely surgical intervention if initial treatments fail. While statistically significant prognostic factors may be lacking, this study highlights crucial considerations for successful treatment.

Evaluation of the Chetomin effect on histopathological features in a murine acute spinal cord injury model.

Background: Several research studies have been focused on improving the treatment and prognosis of acute spinal cord injury, as part of this initiative we investigated the use of Chetomin to reduce the inflammatory response in this pathology. Methods: An experimental, prospective, cross-sectional study was performed using 42 Wistar rats where we analyzed the effect of Chetomin compared to methylprednisolone administered 1 and 8 h after the spinal cord injury in a murine model. Results: Chetomin administration 8h post-injury decreased IL-6 and VEGF expression; and, and its administration 1h post-injury decreased NF-kB expression. Conclusions: Chetomin has anti-inflammatory effects in acute spinal cord injury, whether these effects are observable with other proinflammatory markers should be investigated.

Recent advances in the development and clinical application of miRNAs in infectious diseases.

In the search for new biomarkers and therapeutic targets for infectious diseases, several molecules have been investigated. Small RNAs, known as microRNAs (miRs), are important regulators of gene expression, and have emerged as promising candidates for these purposes. MiRs are a class of small, endogenous non-coding RNAs that play critical roles in several human diseases, including host-pathogen interaction mechanisms. Recently, miRs signatures have been reported in different infectious diseases, opening new perspectives for molecular diagnosis and therapy. MiR profiles can discriminate between healthy individuals and patients, as well as distinguish different disease stages. Furthermore, the possibility of assessing miRs in biological fluids, such as serum and whole blood, renders these molecules feasible for the development of new non-invasive diagnostic and prognostic tools. In this manuscript, we will comprehensively describe miRs as biomarkers and therapeutic targets in infectious diseases and explore how they can contribute to the advance of existing and new tools. Additionally, we will discuss different miR analysis platforms to understand the obstacles and advances of this molecular approach and propose their potential clinical applications and contributions to public health.

The role of long non-coding RNA NORAD in digestive system tumors.

In recent years, it has been discovered that the expression of long non-coding RNAs is highly deregulated in several types of cancer and contributes to its progression and development. Recently, it has been described that in tumors of the digestive system, such as colorectal cancer, pancreatic cancer, and gastric cancer, DNA damage-activated lncRNA (NORAD) was frequently up-regulated. The purpose of this review is to elucidate the functions of NORAD in tumors of the digestive system, emphasizing its involvement in important cellular processes such as invasion, metastasis, proliferation, and apoptosis. NORAD acts as a ceRNA (competitive endogenous RNA) that sponges microRNAs and regulates the expression of target genes involved in tumorigenesis. Thus, the mechanisms underlying the effects of NORAD are complex and involve multiple signaling pathways. This review consolidates current knowledge on the role of NORAD in digestive cancers and highlights the need for further research to explore its potential as a therapeutic target. Understanding the intricate functions of NORAD could elucidate the way for innovative approaches to cancer treatment.

Enhancing apple postharvest protection: Efficacy of pectin coatings containing Cryptococcus laurentii against Penicillium expansum.

The aim of this work is the application of pectin coatings containing Cryptococcus laurentii as a method of biocontrol of Penicillium expansum for postharvest protection of apples. For this purpose, the yeast was incorporated into a pectin matrix, and its viability and biocontrol activity in vitro and in vivo against P. expansum was evaluated over time. In addition, the influence of the sterilization process on coating thickness was studied. Results showed that pectin coating with C. laurentii enhanced mycelial growth inhibition in vitro studies, while no significant differences were observed in disease incidence and severity reduction in vivo studies. The sterilization process reduced the viscosity of the pectin solution, resulting in coating thicknesses ranging from 0.5 to 1 µm. As a general evaluation, in vitro and in vivo, biocontrol assays were useful in demonstrating better postharvest protection of the yeast at 7 °C concerning 25 °C.

XSIM: A structural similarity index measure optimized for MRI QSM.

PURPOSE: The structural similarity index measure (SSIM) has become a popular quality metric to evaluate QSM in a way that is closer to human perception than RMS error (RMSE). However, SSIM may overpenalize errors in diamagnetic tissues and underpenalize them in paramagnetic tissues, resulting in biasing. In addition, extreme artifacts may compress the dynamic range, resulting in unrealistically high SSIM scores (hacking). To overcome biasing and hacking, we propose XSIM: SSIM implemented in the native QSM range, and with internal parameters optimized for QSM. METHODS: We used forward simulations from a COSMOS ground-truth brain susceptibility map included in the 2016 QSM Reconstruction Challenge to investigate the effect of QSM reconstruction errors on the SSIM, XSIM, and RMSE metrics. We also used these metrics to optimize QSM reconstructions of the in vivo challenge data set. We repeated this experiment with the QSM abdominal phantom. To validate the use of XSIM instead of SSIM for QSM quality assessment across a range of different reconstruction techniques/algorithms, we analyzed the reconstructions submitted to the 2019 QSM Reconstruction Challenge 2.0. RESULTS: Our experiments confirmed the biasing and hacking effects on the SSIM metric applied to QSM. The XSIM metric was robust to those effects, penalizing the presence of streaking artifacts and reconstruction errors. Using XSIM to optimize QSM reconstruction regularization weights returned less overregularization than SSIM and RMSE. CONCLUSION: XSIM is recommended over traditional SSIM to evaluate QSM reconstructions against a known ground truth, as it avoids biasing and hacking effects and provides a larger dynamic range of scores.

Progressive Acute Lower Extremity Ischemia Resulting From Cardiac Myxoma Embolization: A Case Report.

Cardiac myxomas are the most common primary benign tumors of the heart. The occlusion of peripheral arteries and complete obstruction of the abdominal aorta by a tumor embolus presents with distinct clinical manifestations. Herein, we present the case of a 38-year-old male with acute paresthesia, muscle weakness, erythematous, and violaceous changes in skin color localized to the dorsum of the left forefoot initially treated as cutaneous vasculitis. Further studies revealed the total occlusion of the terminal abdominal aorta by a saddle embolus from a cardiac myxoma. A multidisciplinary team consisting of cardiothoracic and vascular surgeons were involved in treating the patient, which resulted in full resolution of the case. This paper details the progression of acute bilateral limb ischemia to chronic limb threatening ischemia resulting from the total occlusion of the terminal abdominal aorta by a saddle embolus.

Firearms and Extortions in Mexico, 2012 to 2021.

The study of firearm violence in Mexico has primarily focused on homicides and trafficking. Less attention has been given to understanding how firearms affect other crimes and facilitate criminal activity beyond drug markets. By analyzing two questions, this study explores the role of firearms in extortions perpetrated in Mexico from 2012 to 2021. Questions are: What is the likelihood of reporting extortions to the police if offenders exhibited firearms? What is the likelihood of compliance with demands when offenders are armed with firearms? We obtained data from Mexico's National Crime Victimization Surveys and analyzed 2,619 extortions reported from 2012 to 2021. To explore our research questions, we ran two binary logistic regressions. Our dependent variables were dichotomous (reported to police = 1, complied with demands = 1). The independent variables were weapon types (extortions involving firearms as the reference group). We controlled for victim demographics as well as crime characteristics. Our results indicate that 40% of these extortions (n = 1,058) were perpetrated with a firearm. Fifty-two percent of extortions were perpetrated by unarmed offenders (n = 1,348) and 8% (n = 213) were perpetrated with other weapons (no firearms). Models suggest that, when compared to extortions perpetrated by unarmed offenders or those exhibiting other weapons (no firearms), victims of extortions involving firearms are less likely to report these crimes to police, mainly because of fear of reprisal. Similarly, victims are more likely to comply with demands if offenders exhibit firearms. Findings highlight the role of firearms in criminal enterprises and support the need for a comprehensive policy agenda to address firearm violence in Mexico.

Pressurized liquid extraction of oak leaf polyphenols: Solvent selection via Hansen parameters, antioxidant evaluation and monoamine-oxidase-a inhibition analysis.

This study focuses on the extraction of bioactive compounds from Quercus sideroxyla Bonpl., leaves which have been shown to possess health benefits. The extraction process was done using pressurized liquid extraction (PLE), which is efficient and preserves heat-sensitive compounds. Key factors in the process included the choice of solvents, pressure, temperature, and extraction duration. The Hansen solubility parameters analysis aided in selecting effective solvents, such as ethanol and benzyl alcohol. The extracts were found to contain phenolic compounds, flavonoids, and polyphenols with antioxidant properties. The UPLC-PDA-ESI-QqQ was employed for the precise identification and quantification of these compounds, demonstrating superior extraction of quinic acid and gallic acid at elevated temperatures. Notably, the extracts obtained through PLE exhibited significant inhibitory activity of the MAO-A enzyme, linked to neuronal and cognitive health, suggesting potential benefits in these areas.

Extraction, characterization, and use of edible insect oil - A review.

Population growth is driving the search for new food sources, including entomophagy, i.e., a diet based on edible insects. Insect powder are rich in essential fatty acids, minerals, vitamins, and bioactive compounds such as antioxidant phenolics. The technologies for extracting oil from insects must be efficient to guarantee high yields. This oil due to its favorable nutritional profile, and lower cost, can be a viable alternative to vegetable and fish oils. Although common in some cultures, the consumption of insects faces resistance in others due to its association with dirt. Efforts are being made to scientifically demonstrate the safety and nutritional benefits of insects as well as their sustainability as a food source. This first review of insect oils focuses on presenting their different characteristics and encouraging the production and use of these products in the food, pharmaceutical, or cosmetics industries.

Chronoamperometric flow-cell designed to be unaffected by air bubbles.

In this paper, we present a new design for a chronoamperometric flow cell in which air bubbles do not interfere with the control of potential between the working and reference electrodes. The flow-through dual-detection cell consists of two independent parts: an upper compartment containing a quiescent supporting electrolyte solution and a channel that operates under hydrodynamically controlled conditions. In this system, the working and counter electrodes can be placed directly in contact with both compartments, whereas the reference electrode can be assembled to be either isolated or in contact with the flowing stream channel. The design ensures that the potential applied to the working electrode (controlled in the upper compartment) is similar to the potential applied in the flowing channel. The performance of the proposed flow cell in generating accurate results, even in the presence of air bubbles, was evaluated through successive air-analyte-air injections. In both series where the analyte was introduced, suitable reproducibility was achieved. The robustness of the design was definitively proven by performing a series of measurements in analytical applications for the determination of hydrogen peroxide in antiseptic samples, yielding very satisfactory results.

Development of new PDMS in tube extraction microdevice for enhanced monitoring of polycyclic aromatic hydrocarbons and their derivatives in water.

Contamination by polycyclic aromatic hydrocarbons (PAHs) is an urgent environmental concern, given its atmospheric dispersion and deposition in water bodies and soils. These compounds and their nitrated and oxygenated derivatives, which can exhibit high toxicities, are prioritized in environmental analysis contexts. Amid the demand for precise analytical techniques, comprehensive two-dimensional chromatography coupled with mass spectrometry (GCxGC/Q-TOFMS) has emerged as a promising tool, especially in the face of challenges like co-elution. This study introduces an innovation in the pre-concentration and detection of PAHs using an extraction fiber based on polydimethylsiloxane (PDMS), offering greater robustness and versatility. The proposed technique, termed in-tube extraction, was developed and optimized to effectively retain PAHs and their derivatives in aqueous media, followed by GCxGC/Q-TOFMS determination. Fiber characterization, using techniques such as TG, DTG, FTIR, and SEM, confirmed the hydrophobic compounds retention properties of the PDMS. The determination method was validated, pointing to a significant advancement in the detection and analysis of PAHs in the environment, and proved effective even for traces of these compounds. The results showed that the detection limits (LOD) and quantification limits (LOQ) ranged from 0.07 ng L-1 to 1.50 ng L-1 and 0.33 ng L-1 to 6.65 ng L-1, respectively; recovery ranged between 72 % and 117 %; and the precision intraday and interday ranged from 1 % to 20 %. The fibers were calibrated in the laboratory, with exposure times for analysis in the equilibrium region ranging from 3 to 10 days. The partition coefficients between PDMS and water were also evaluated, showing logarithm values ranging from 2.78 to 5.98. The fibers were applied to the analysis of real water samples, demonstrating high capacity. Additionally, given the growing demand for sustainable methods, the approach presented here incorporates green chemistry principles, providing an efficient and eco-friendly solution to the current chemical analysis scenario.

Enhancing mass spectrometry interpretability by ComDim-ICA multi-block analysis: Geographical and varietal traceability of Brazilian Coffea canephora.

Mass spectrometry can gain analytical interpretability by studying complementarity and synergy between the data obtained by the same technique. To explore its potential in an untargeted metabolomic application, the objective of this work was to obtain organic and aqueous coffee extracts of three coffee Canephora groups produced in Brazil with distinctive aspects: geographical origin and botanical variety. Aqueous and organic extracts of roasted coffee beans were analyzed by direct infusion electrospray ionization mass spectrometry. Due to the large number of samples, the injector of the liquid chromatography system was used to automate the analysis. The column was removed, and a peak tube was added to connect the system directly to the mass spectrometer to inject both polar and nonpolar fractions of the coffee extracts individually. The technique provided characteristic fingerprinting mass spectra that not only allowed for differentiation of geographical origins but also between robusta and conilon botanical varieties. The mass spectra of the organic and water extracts represented two separate data blocks to be analyzed by the ComDim-ICA multi-block data analysis method. While the classical ComDim is based on applying PCA to the iteratively reweighted concatenated matrices, in the ComDim-ICA, the factorization is done using independent components analysis, which promotes specific improvements since it is based on extracting components that are statistically independent of one another. The results highlighted by ComDim-ICA show that both water and organic extracts contributed with important ions to the characterization of the coffee composition. However, the results revealed a high variability of metabolomic composition within each botanical variety (Robusta Amazônico and Conilon Capixaba) and geographical provenance (Rondônia indigenous-1, Rondônia non-indigenous-2 and Espírito Santo-3). Even so, water mass spectra differentiated the botanical variety Conilon from Robusta based on significant ions related to trigonelline, caffeic acid, caffeoylquinic acid, and methylpyridinium; both water and organic mass spectra differentiated Rondônia indigenous from Rondônia non-indigenous and Espírito Santo Conilon based on significant ions related to benzoic acid, pentose, coumaric acid, caffeine in the organic extract and malonic acid, pentose, caffeoylquinic acid, methyl pyridinium, caffeine, and sucrose present in the water extract. With the proposed approach acquiring ion fingerprints of different coffee extracts and their subsequent analysis by ComDim-ICA, new complementary chemical aspects of Brazilian Coffea canephora were put in evidence.

Establishing an autogenous vascular access program in a Guatemalan comprehensive pediatric nephrology center.

BACKGROUND: The Guatemalan Foundation for Children with Kidney Diseases collaborated with Bridge of Life, a not-for-profit charitable organization, to establish a vascular access program. We reviewed our experience with graded surgical responsibility and structured didactic training, creating arteriovenous fistulas (AVF) for Guatemalan children. METHODS: Pediatric vascular access missions were completed from 2015 to 2023 and analyzed retrospectively. Follow-up was completed by the Guatemalan pediatric surgeons, nephrologists, and nursing staff. AVF patency and patient survival were evaluated by Kaplan-Meier life-table analysis with univariate and multivariable association between patient demographic variables by Cox proportional hazards models. RESULTS: Among a total of 153 vascular access operations, there were 139 new patient procedures, forming the study group for this review. The mean age was 13.6 years, 42.6% were female, and the mean BMI was 17.3. Radial or ulnar artery-based direct AVFs were established in 100 patients (71.9%) and ten of the 25 transposition procedures. Brachial artery inflow was required in 29 direct AVFs (20.9%). Two patients underwent femoral vein transpositions. Access-related distal ischemia was not encountered. Seven of the AVF patients later required access banding for arm edema; all had previous dialysis catheters (mean = 9, range 4-12). Primary and cumulative patency rates were 84% and 86% at 12 months and 64% and 81% at 24 months, respectively. The median follow-up was 12 months. Overall patient survival was 84% and 67% at 12 and 24 months, respectively. There were no deaths related to AVF access. CONCLUSIONS: Safe and functional AVFs were established in a teaching environment within a Guatemalan comprehensive pediatric nephrology center.

Prevalence and Correlates of Intimate Partner Violence Among Women and Men in Mexico: A Systematic Review and Meta-analysis.

This article presents the first systematic review and meta-analysis of the prevalence and correlates of different forms of intimate partner violence (IPV) among women and men in Mexico. To identify studies, a comprehensive search strategy was developed and executed across 11 databases (Academic Search Complete, APA PsycInfo, CINAHL, Cochrane CENTRAL, Embase, International Bibliography of the Social Sciences, LILACS, MEDLINE, SciELO, Sociological Abstracts, Web of Science). From the 1,746 studies screened, 155 full-text articles were reviewed, and this systematic review included 27 studies involving 249,557 participants to determine the prevalence of physical, psychological, sexual, threats, and other forms of IPV, according to gender and other sociodemographic characteristics. Overall IPV prevalence was 16.4%, with significant differences across pregnant and non-pregnant women. Physical IPV prevalence was 14.7%, revealing higher rates in men (29.5%) compared to women (14.2%). Psychological IPV prevalence was 27.3% and sexual IPV was at 6.6%, with differences across evaluation periods. Threats and other IPV forms showed a prevalence rate of 14.2% and 21.5%. Meta-regression analyses included gender, education, marital status, rural residency, pregnancy, age, and evaluation period. This study demonstrates that IPV is a critical public health concern in Mexico, impacting both women and men. It shows the vulnerability of rural residents, youth, and pregnant women. However, understanding IPV complexities in Mexico requires nuanced considerations of demographic and situational contexts. Urgent initiatives from municipal, state, and federal governments are needed to combat IPV, focusing on prevention and support for affected individuals.

Birth order moderates the association between adverse childhood experiences and externalizing behavior symptoms in adolescence.

Adverse childhood experiences (ACEs) are associated with externalizing behaviors. Whereas some ACEs affect individual children (i.e., child-specific; e.g., failing a grade), others affect the family unit (i.e., family-wide; e.g., parent losing a job); effects of ACEs on externalizing behavior may manifest differently across groupings of ACEs. Moreover, birth order may modify the association between child-specific and family-wide ACEs and externalizing behavior due to differences in the experience of being a younger versus older sibling. This study examined the externalizing behavior of siblings in relation to their experiences of child-specific and family-wide ACEs to test the hypothesis that younger siblings are at greater risk for developing externalizing symptoms following familial ACE exposure. Participants were 61 sibling pairs (younger sibling Mage = 11.37 years, 44.1% male; older sibling Mage = 13.1 years, 52.5% male) recruited from six schools in the northeastern United States. Parents rated each child's externalizing behaviors (e.g., bullying, meanness) and retrospectively reported on each child's experience of 34 ACEs; two raters categorized ACEs as child-specific (n = 10) or family-wide (n = 24). Multilevel modeling revealed that both child-specific and family-wide ACEs were associated with increased externalizing behaviors. Birth order moderated the effect of family-wide (but not child-specific) ACEs on externalizing behaviors, independent of sex and age. Externalizing behavior was higher for younger siblings as compared with older siblings, particularly when a high number of ACEs (6+) were reported. This research should prompt future exploration of mechanistic theories of the impact of family-wide and child-specific ACEs and the role of birth order.

Dynamic evolution of kidney function in patients with STEC-hemolytic uremic syndrome followed for more than 15 years: unexpected changes.

BACKGROUND: Most studies regarding kidney outcomes in patients with Shiga toxin-producing Escherichia coli-hemolytic uremic syndrome (STEC-HUS) focus on kidney status at last assessment. We aimed to describe patterns of changes in kidney function during follow-up and investigate associations between kidney function at 1st, 5th, and 10th year after onset and long-term kidney outcomes. METHODS: Data of patients with STEC-HUS followed for at least 15 years were analyzed. Kidney function patterns were constructed considering kidney status at 1st, 5th, 10th, and ≥ 15 years and defined as (1) progressive, if patients changed from complete recovery to any chronic kidney disease (CKD) stage or if CKD worsened; (2) improvement, if they shifted from any CKD stage to complete recovery or to a milder stage; and (3) stable, if remained unchanged. RESULTS: Of 152 patients included, after 1 year of follow-up, 47% had complete recovery, 22% CKD1, and 32% CKD2-5. At last assessment, 46% had complete recovery, 34% CKD1, and 19% CKD2-5. Despite percentages seeming similar, patients differed: 48% were stable, 27% improved, and 25% worsened. Further, 62% of patients with CKD2-4 in the 1st year normalized their glomerular filtration rate (GFR) thereafter. Comparison of kidney function between 1st, 5th, and 10th year to last assessment shows a stable pattern in 48, 59, and 69% respectively. CONCLUSIONS: Changes in kidney function showed a dynamic and complex behavior, with patients moving from one group to another. Consistently, kidney function neither at the 1st, 5th, or 10th year was representative of final outcome. Unexpectedly, two-thirds of patients with CKD2-4 after 1 year achieved normal eGFR later during follow-up.