ABSTRACT C3 glomerulopathies are a rare group of glomerular diseases resulting from excessive activation of the alternative complement pathway. The pathogenesis involves genetic, acquired, or immunologic defects in regulators of the alternative complement pathway. Currently, these diseases have a chronic course with progression to end-stage renal disease in up to 50% of adult patients. We report a case of a young woman who presented with nephrotic syndrome and renal disfunction. During follow-up, the diagnosis of C3 glomerulopathy associated with complement factor I deficiency was established. After relapse of nephrotic proteinuria, immunosuppressive therapy with mycophenolate mofetil and glucocorticoid was added to supportive care. There is no disease-specific therapy for C3 glomerulopathies, and treatment is focused on reducing proteinuria and renal inflammation. Supportive treatment with ACE inhibitors or angiotensin receptor blockers is the first-line therapy. Immunosuppressive therapy with mycophenolate mofetil plus corticosteroids is associated with higher chances of clinical remission and lower risk of kidney failure. Complement targeting therapies, such as eculizumab, avacopan, danicopan, iptacopan, and pegcetacoplan, are being studied as potential new therapeutic options. This article highlights the need for more clinical trials to test new therapeutic agents, as well as to better understand the heterogeneity of the disease and its long-term outcomes.

ABSTRACT Older to older living kidney transplantation is an acceptable alternative to avoid dialysis, improve quality of life and maintain favorable long-term outcomes of patients with end-stage kidney disease. However, the management of these patients is complex and the acceptance of older donors and recipients to kidney transplantation remains controversial. The older recipients usually have several comorbidities that may complicate the postoperative course and increase the risk of end-stage kidney disease. We present a clinical case of living kidney transplantation between an older donor and recipient, both over 70 years old, who evolved to a stage 3 chronic kidney disease, without proteinuria, hypertension, or other complications, three years after transplantation. Our case reinforces favorable outcomes in older living transplantation, both for recipient and donor, as has been demonstrated in several published studies.

RESUMO As aulas de Educação Física representam uma oportunidade única de desenvolver competências motoras, habilidades esportivas e promover uma vida saudável. A prática esportiva no meio aquático, fornecem um local alternativo de alta qualidade para experiências educacionais ao ar livre. O surfe é um desporto aquático praticado ao ar livre, que se realiza em ambiente natural, revelando-se como uma importante forma de aprendizagem e terapia. O objetivo desta pesquisa foi analisar quantitativa e qualitativamente a importância do surfe nas aulas de Educação Física (EF) como suporte ao bem-estar de crianças e adolescentes. Um total de 190 alunos (80 meninas) participaram deste estudo e foram inicialmente avaliados antes e após 6 semanas de prática de surfe, como parte de um currículo de EF, quanto aos impactos no bem-estar e na socialização. Analisando os dois momentos, as questões mais valorizadas foram Q5 (4,39 ± 0,827; 4,52 ± 0,791) e Q14 (4,60 ± 0,716; 4,47 ± 0,808). A análise fatorial exploratória resultou em 3 categorias (Expectativas Individuais; Autoconfiança; Socialização no Surfe), que explicam 62,79% da variância total. O fator Expectativa Individual foi o mais significativo e a Autoconfiança teve o aumento mais significativo. O surfe no currículo de EF pode ser considerado uma atividade segura, um importante mediador para fazer novos amigos e fazer parte de um grupo, com importantes efeitos de curto prazo na autoconfiança, principalmente em adolescentes.

ABSTRACT Physical Educations classes represent a unique opportunity to develop motor competence, sports skills and foster healthy life. Blue spaces environments provide an alternative location for high-quality outdoor educational experiences. Throughout, surfing is an aquatic outdoor sport, that takes place in the natural setting, proved as an important learning and therapeutic approach. The aim of this research was to analyze the importance of surfing in Physical Education (PE) classes as a support of children and adolescent’s well-being. A total of 190 students (80 girls) participated in this study and were assessed at baseline and after 6 weeks of surfing practice as part of a PE curriculum, regarding the impacts on well-being and socialization. Analyzing the two moments, the most valued questions were Q5(4.39±0.827; 4.52±0.791) and Q14(4.60±0.716; 4.47±0.808). The exploratory factor analysis results in 3 categories (Individual Expectations; Self-Confidence; Socialization in Surfing), which explain 62.79% of the total variance. The factor Individual Expectation was the most significant and Self-Confidence had the most significant increase. Surfing as part of the PE curriculum can be considered a safe activity, an important mediator for making new friends and being part of a group with important short-term effects on self-confidence, especially in adolescents.