ABSTRACT Introduction: The aim of this study was to analyze the waiting list for kidney transplantation in our hospital according to candidate’s panel reactive antibodies (cPRA) and its outcomes. Methods: One thousand six hundred forty patients who were on the waiting list between 2015 and 2019 were included. For the analysis, hazard ratios (HR) for transplant were estimated by Fine and Gray’s regression model according to panel reactivity and HR for graft loss and death after transplantation. Results: The mean age was 45.39 ± 18.22 years. Male gender was predominant (61.2%), but the proportion decreased linearly with the increase in cPRA (p < 0.001). The distribution of patients according to panels were: 0% (n = 390), 1% – 49% (n = 517), 50% – 84% (n = 269), and ≥ 85% (n = 226). Transplantation was achieved in 85.5% of the sample within a median time of 8 months (CI 95%: 6.9 – 9.1). The estimated HRs for transplantation during the follow-up were 2.84 (95% CI: 2.51 – 3.34), 2.41(95%CI: 2.07 – 2.80), and 2.45(95%CI: 2.08 – 2.90) in the cPRA range of 0%, 1%–49%, and 50%–84%, respectively, compared to cPRA ≥ 85 (p < 0.001). After transplantation, the HR for graft loss was similar in the different cPRA groups, but the HR for death (0.46 95% CI 0.24–0.89 p = 0.022) was lower in the 0% cPRA group when adjusted for age, gender, and presence of donor specific antibodies (DSA). Conclusion: Patients with cPRA below 85% are more than twice as likely to receive a kidney transplantation with a shorter waiting time. The risk of graft loss after transplantation was similar in the different cPRA groups, and the adjusted risk of death was lower in nonsensitized recipients.

RESUMO Introdução: O objetivo foi analisar a lista de espera para transplante renal em nosso hospital segundo o painel de reatividade de anticorpos (PRAc) do candidato e seus desfechos. Métodos: Incluímos 1.640 pacientes em lista de espera entre 2015 e 2019. Para a análise, estimou-se a razão de risco (HR) para transplante pelo modelo de regressão de Fine e Gray conforme o painel de reatividade e HR para perda do enxerto e óbito após o transplante. Resultados: A idade média foi 45,39 ± 18,22 anos. Sexo masculino foi predominante (61,2%), mas a proporção diminuiu linearmente com o aumento do PRAc (p < 0,001). A distribuição de pacientes conforme os painéis foi: 0% (n = 390), 1% – 49% (n = 517), 50% – 84% (n = 269), e ≥85% (n = 226). O transplante foi realizado em 85,5% da amostra em tempo mediano de 8 meses (IC 95%: 6,9 – 9,1). As HRs estimadas para transplante durante o acompanhamento foram 2,84 (IC 95%: 2,51 – 3,34), 2,41 (IC 95%: 2,07 – 2,80) e 2,45 (IC 95%: 2,08 – 2,90) no intervalo de PRAc de 0%, 1%–49% e 50%–84%, respectivamente, comparadas com PRAc ≥ 85 (p < 0,001). Após o transplante, a HR para perda do enxerto foi semelhante nos diferentes grupos de PRAc, mas HR para óbito (0,46 IC 95% 0,24–0,89 p = 0,022) foi menor no grupo PRAc 0% quando ajustada para idade, sexo e presença de anticorpos doador específico (DSA). Conclusão: Pacientes com PRAc abaixo de 85% têm mais que o dobro de probabilidade de receber transplante renal com tempo de espera menor. Risco de perda do enxerto após o transplante foi semelhante nos diferentes grupos PRAc, e risco ajustado de óbito foi menor em receptores não sensibilizados.

Resumo A profissionalização da docência universitária implica amplos esforços dos sistemas educacionais e das próprias instituições de ensino superior para o desenvolvimento de competências docentes naqueles que têm a missão de formar profissionais nas diferentes áreas do conhecimento. Nesse contexto, este trabalho tem como objetivo levantar o perfil das competências do docente a partir de uma revisão sistemática da literatura hispano-americana e anglo-saxã, que contemplou 58 artigos publicados durante os últimos cinco anos. Posteriormente, a análise compreensiva permitiu estabelecer dez categorias emergentes, agrupadas em três dimensões: pedagógica, investigativa e transversal. Este resultado, por um lado, evidencia que existe um grande interesse da comunidade acadêmica pela busca de competências ou qualidades que um formador de formadores deve demonstrar. Por outro, constata-se, nos documentos revisados, que aqueles que atuam na academia coincidem que as duas primeiras dimensões assinaladas anteriormente correspondem ao agenciamento de um formador. Além disso, a dimensão transversal, com ampla presença na literatura consultada, coloca em evidência as competências interpessoais e relacionadas ao uso das TICs e a atenção à diversidade.

Abstract The professionalization of university teaching has promoted extensive efforts, both by the Educational Systems and Higher Education Institutions themselves, to develop teaching skills in those who have the mission of training professionals in different areas of knowledge. The objective of this work was to build up a profile of a trainer of trainers’ skills. Firstly, a systematic review of Spanish-American and Anglo-Saxon literature, including 58 articles published in the last five years, was carried out. Subsequently, the comprehensive analysis established ten emerging categories, grouped in three dimensions: pedagogical, investigative, and cross-cutting. On the one hand, this result shows academic community’s great interest in searching for skills or qualities that a trainer of trainers must demonstrate. On the other hand, the reviewed documents reveal that those who work in academia agree that the first two dimensions above correspond to the actions of a trainer. Likewise, with a broad presence in the consulted literature, the cross-cutting dimension makes known those interpersonal competencies related to the use of ICT and attention to diversity.

Resumen La profesionalización de la docencia universitaria ha implicado amplios esfuerzos de los sistemas educativos y las propias instituciones de educación superior para desarrollar competencias docentes en quienes tienen la misión de formar profesionales en las distintas áreas del conocimiento. El objetivo de este trabajo consiste en levantar un perfil de competencias docentes mediante una revisión sistemática de literatura hispanoamericana y anglosajona, que contempló 58 artículos publicados durante los últimos cinco años. Posteriormente, el análisis comprensivo permitió establecer diez categorías emergentes, agrupadas en tres dimensiones: pedagógica, investigativa y transversal. Este resultado, por una parte, evidencia que existe un gran interés de la comunidad académica por la búsqueda de las competencias o cualidades que debe demostrar un formador de formadores. Por otra parte, se constata en los documentos revisados que quienes se desempeñan en la academia coinciden en que las dos primeras dimensiones señaladas corresponden al accionar de un formador. La dimensión transversal, con amplia presencia en la literatura consultada, releva aquellas competencias interpersonales y relacionadas con el uso de las TIC y atención a la diversidad.

Resumo Introdução: O ensaio de prova cruzada por citotoxicidade dependente do complemento antiglobulina humana (AHG-CDCXM - do inglês anti-human globulin-enhanced complement-dependent cytotoxicity crossmatch) tem sido usado para avaliar a presença de anticorpos específicos contra o doador (DSA - do inglês donor-specific antibodies) no soro do receptor antes do transplante renal. O ensaio de prova cruzada por citometria de fluxo (CFXM) foi introduzido pela primeira vez como um teste adicional. O objetivo deste estudo foi validar clinicamente o uso único do ensaio CFXM. Métodos: Este estudo comparou os resultados de uma coorte de pacientes de transplante renal que foram submetidos apenas ao CFXM (grupo CFXM) contra uma coorte de pacientes de transplante renal submetidos ao AHG-CDCXM (grupo controle). Resultados: Foram incluídos noventa e sete pacientes no grupo CFXM e 98 controles. Todas as provas cruzadas no grupo controle foram negativas. Um paciente no grupo CFXM teve uma prova cruzada positiva para células B. Um ano após o transplante, não houve diferenças significativas na sobrevida do paciente (p = 0,591) e na sobrevida do enxerto (p = 0,692) entre os grupos. Também não foi encontrada diferença significativa na incidência de episódios de rejeição aguda celular (p = 0,289) segundo critério de Banff ≥ 1A. No entanto, rejeições agudas mediadas por anticorpos ocorreram em 3 controles (p = 0,028). Conclusão: Os resultados mostraram que a interrupção do ensaio AHG-CDCXM não modifica os desfechos clínicos em um acompanhamento de 1 ano.

Abstract Introduction: The anti-human globulin-enhanced complement-dependent cytotoxicity crossmatch (AHG-CDCXM) assay has been used to assess the presence of donor-specific antibodies (DSA) in recipient’s serum before kidney transplantation. The flow cytometric crossmatch (FCXM) assay was first introduced as an additional test. The aim of this study was to clinically validate the single use of the FCXM assay. Methods: This study compared the outcomes of a cohort of kidney transplant patients that underwent FCXM only (FCXM group) versus a cohort of kidney transplant patients that underwent AHG-CDCXM (control group). Results: Ninety-seven patients in the FCXM group and 98 controls were included. All crossmatches in the control group were negative. One patient in the FCXM group had a positive B cell crossmatch. One year after transplantation, there were no significant differences in patient survival (p = 0.591) and graft survival (p = 0.692) between the groups. Also, no significant difference was found in the incidence of Banff ≥ 1A acute cellular rejection episodes (p = 0.289). However, acute antibody-mediated rejections occurred in 3 controls (p = 0.028). Conclusion: The results showed that discontinuing the AHG-CDCXM assay does not modify the clinical outcomes in a 1-year follow-up.

Objective: To examine the utility of the Self-Report Psychopathy-Short Form (SRP-SF) to assess psychopathic traits in female offenders and to test gender-based item modifications. Method: A South American sample of female offenders (n=210) was assessed with the Psychopathy Checklist-Revised (PCL-R); 110 subjects also completed the standard SRP-SF, while 109 completed a version with items rewritten to be more relevant for females. The underlying latent structure of the PCL-R and both versions of the SRP-SF were examined. Results: Most of the modified items showed higher average item responses. The PCL-R showed a stronger association with the modified SRP-SF than with the standard SRP-SF. The four-factor model showed very good fit in accounting for the PCL-R data, consistent with previous research. For both SRP-SF versions, the results indicated good model fit. Structural equation models were tested separately, in which a superordinate SRP-SF factor was set to predict a broad factor reflecting chronic misconduct. Both versions showed good model fit, and the SRP-SF superordinate factor significantly predicted a chronic misconduct factor. Conclusions: Both versions of the SRP-SF adequately reflected psychopathic features in this female sample; the modified items added robustness to representation of these features.

RESUMO Introdução: Atualmente não há um protocolo imunossupressor específico para os receptores de transplantes renais portadores de hepatite C (HCV). Assim, o objetivo deste estudo foi avaliar o efeito da conversão a Everolimo (EVR) na HCV em receptores adultos de transplantes renais. Método: Trata-se de um estudo unicêntrico, prospectivo, randomizado, exploratório, controlado, aberto em receptores de aloenxertos renais com sorologia positiva para HCV. Os participantes foram randomizados para conversão a EVR ou manutenção dos inibidores da calcineurina. Resultados: Trinta pacientes foram randomizados e 28 foram acompanhados por um período de 12 meses (grupo de conversão, Grupo 1 = 15 e grupo controle, Grupo 2 =13). Níveis de RT-PCR HCV descritos em valores logarítmicos foram comparáveis entre os grupos e entre pacientes em um mesmo grupo. A análise estatística não mostrou efeitos de interação entre tempo e grupo (valor p G*M= 0,852), ao longo do tempo em cada grupo (valor p M=0,889) e entre grupos (valor p G=0,286). O Grupo 1 apresentou uma maior incidência de eventos de dislipidemia (p=0,03) e proteinúria (p=0,01); não houve diferença na incidência de anemia (p=0,17), diabetes mellitus de início pós-transplante (p=1,00) ou infecção do trato urinário (p=0,60). A TFGe média foi semelhante nos dois grupos. Conclusão: Nosso estudo não mostrou redução da carga viral após conversão a EVR com manutenção do tratamento antiproliferativo.

ABSTRACT Introduction: Currently, there is no specific immunosuppressive protocol for hepatitis C (HCV)-positive renal transplants recipients. Thus, the aim of this study was to evaluate the conversion effect to everolimus (EVR) on HCV in adult kidney recipients. Method: This is an exploratory single-center, prospective, randomized, open label controlled trial with renal allograft recipients with HCV-positive serology. Participants were randomized for conversion to EVR or maintenance of calcineurin inhibitors. Results: Thirty patients were randomized and 28 were followed-up for 12 months (conversion group, Group 1 =15 and control group, Group 2 =13). RT-PCR HCV levels reported in log values were comparable in both groups and among patients in the same group. The statistical analysis showed no interaction effect between time and group (p value G*M= 0.852), overtime intra-groups (p-value M=0.889) and between group (p-value G=0.286). Group 1 showed a higher incidence of dyslipidemia (p=0.03) and proteinuria events (p=0.01), while no difference was observed in the incidence of anemia (p=0.17), new onset of post-transplant diabetes mellitus (p=1.00) or urinary tract infection (p=0.60). The mean eGFR was similar in both groups. Conclusion: Our study did not show viral load decrease after conversion to EVR with maintenance of antiproliferative therapy.

Resumo: O objetivo deste estudo foi avaliar o efeito de um programa de educação estruturado em grupo, aplicado por enfermeira de cuidados primários a pacientes com diabetes mellitus tipo 2. A amostra contou com 137 pacientes com diabetes mellitus tipo 2, randomizados em dois grupos: intervenção, (curso educativo de cinco semanas e reforços a cada 4 meses, durante um ano) e grupo controle (sem educação estruturada) com avaliação do controle metabólico, peso, pressão arterial, escores de estresse e conhecimento relacionados ao diabetes. Não houve diferenças entre os grupos na HbA1c em 4, 8 ou 12 meses, quando comparado aos valores basais. Foi observado um incremento na HbA1c no grupo controle após ajustes para HbA1c no basal e dose de insulina (p = 0,044 entre grupos). Os escores de conhecimento e estresse relacionados ao diabetes melhoraram após a intervenção. Um programa educacional estruturado ministrado à pacientes com diabetes mellitus tipo 2 atendidos em atenção primaria melhorou o conhecimento e estresse associados à doença. Além disso, nossos resultados sugerem uma prevenção de elevação da HbA1c.

Abstract: The aim of the study was to evaluate the effect of a structured group education program administered by a primary care nurse in patients with type 2 diabetes mellitus. The sample included 137 patients with type 2 diabetes mellitus, randomized into two groups: intervention (5-week educational course and reinforcements every 4 months for one year) and control (with no structured diabetes mellitus education) with an evaluation of metabolic control, weight, blood pressure, distress scores, and knowledge on diabetes. There were no differences between the two groups in HbA1c at 4, 8, or 12 months when compared to baseline values. An increase in HbA1c was observed in the control group after adjusting for baseline HbA1c and insulin dose (p = 0.044 between groups). Knowledge scores and diabetes-related distress improved after the intervention. A structured educational program administered to type 2 diabetes mellitus patients seen at a primary care unit improved the knowledge and distress associated with the disease. The results also suggest the prevention of an increase in HbA1c.

Resumen: El objetivo de este estudio fue evaluar el efecto de un programa de educación estructurada en grupo, aplicado por la enfermera de atención primaria para pacientes con diabetes mellitus tipo 2. La muestra incluyó a 137 pacientes con diabetes mellitus tipo 2, aleatorizados en dos grupos: intervención (curso de formación de 5 semanas, com refuerzos cada 4 meses durante un año) y el grupo de control (sin educación estructurada) para evaluar el control metabólico, peso, presión arterial, niveles de estrés y conocimientos relacionados con la diabetes. No hubo diferencias entre los grupos en HbA1c en 4, 8 ó 12 meses en comparación con los valores basales. Se observó un aumento de HbA1c en el grupo de control después del ajuste de HbA1c en la línea de base y a la dosis de la insulina (p = 0,044 entre grupos). Las puntuaciones de los conocimientos y del estrés relacionadas con la diabetes mejoraron después de la intervención. Un programa educativo estructurado ofrecido a los pacientes con diabetes mellitus tipo 2 tratados en la atención primaria mejoró el conocimiento y el estrés asociado con la enfermedad. Por otra parte, nuestros resultados sugieren una prevención elevada de la HbA1c.

Resumo: O objetivo deste estudo foi avaliar o efeito de um programa de educação estruturado em grupo, aplicado por enfermeira de cuidados primários a pacientes com diabetes mellitus tipo 2. A amostra contou com 137 pacientes com diabetes mellitus tipo 2, randomizados em dois grupos: intervenção, (curso educativo de cinco semanas e reforços a cada 4 meses, durante um ano) e grupo controle (sem educação estruturada) com avaliação do controle metabólico, peso, pressão arterial, escores de estresse e conhecimento relacionados ao diabetes. Não houve diferenças entre os grupos na HbA1c em 4, 8 ou 12 meses, quando comparado aos valores basais. Foi observado um incremento na HbA1c no grupo controle após ajustes para HbA1c no basal e dose de insulina (p = 0,044 entre grupos). Os escores de conhecimento e estresse relacionados ao diabetes melhoraram após a intervenção. Um programa educacional estruturado ministrado à pacientes com diabetes mellitus tipo 2 atendidos em atenção primaria melhorou o conhecimento e estresse associados à doença. Além disso, nossos resultados sugerem uma prevenção de elevação da HbA1c.

Abstract: The aim of the study was to evaluate the effect of a structured group education program administered by a primary care nurse in patients with type 2 diabetes mellitus. The sample included 137 patients with type 2 diabetes mellitus, randomized into two groups: intervention (5-week educational course and reinforcements every 4 months for one year) and control (with no structured diabetes mellitus education) with an evaluation of metabolic control, weight, blood pressure, distress scores, and knowledge on diabetes. There were no differences between the two groups in HbA1c at 4, 8, or 12 months when compared to baseline values. An increase in HbA1c was observed in the control group after adjusting for baseline HbA1c and insulin dose (p = 0.044 between groups). Knowledge scores and diabetes-related distress improved after the intervention. A structured educational program administered to type 2 diabetes mellitus patients seen at a primary care unit improved the knowledge and distress associated with the disease. The results also suggest the prevention of an increase in HbA1c.

Resumen: El objetivo de este estudio fue evaluar el efecto de un programa de educación estructurada en grupo, aplicado por la enfermera de atención primaria para pacientes con diabetes mellitus tipo 2. La muestra incluyó a 137 pacientes con diabetes mellitus tipo 2, aleatorizados en dos grupos: intervención (curso de formación de 5 semanas, com refuerzos cada 4 meses durante un año) y el grupo de control (sin educación estructurada) para evaluar el control metabólico, peso, presión arterial, niveles de estrés y conocimientos relacionados con la diabetes. No hubo diferencias entre los grupos en HbA1c en 4, 8 ó 12 meses en comparación con los valores basales. Se observó un aumento de HbA1c en el grupo de control después del ajuste de HbA1c en la línea de base y a la dosis de la insulina (p = 0,044 entre grupos). Las puntuaciones de los conocimientos y del estrés relacionadas con la diabetes mejoraron después de la intervención. Un programa educativo estructurado ofrecido a los pacientes con diabetes mellitus tipo 2 tratados en la atención primaria mejoró el conocimiento y el estrés asociado con la enfermedad. Por otra parte, nuestros resultados sugieren una prevención elevada de la HbA1c.

Objective: To test the four-factor model of the Hare Psychopathy Checklist - Revised (PCL-R) empirical construct of psychopathy in a Chilean prison population by using instruments that supply different types of data. Methods: Two hundred and nine male inmates of the Prison of Los Andes, Chile, were evaluated. Confirmatory factor analysis was carried out with the PCL-R and the Self-Report of Psychopathy - III - Short Form (SRP-III-SF). Results: The distributions of total PCL-R and SRP-III-SF scores were normal (Kolmorogov-Smirnov [K-S] = 1.04, p = 0.230; K-S = 0.812, p = 0.525, respectively), with means of 20.9±6.8 for the former and 61.6±15.2 for the latter. Model fit was good for the PCL-R (Tucker Lewis index [TLI] = 0.96; root mean square error of approximation [RMSEA] = 0.04) and for the SRP-SF (TLI = 0.94, RMSEA = 0.04). Conclusions: The results obtained with the PCL-R and the SRP-SF showed adequate fit to the empirical four-factor model of psychopathy and support this model. As foreseeable, fit was better for the PCL-R, which combines several sources of information.

Introducción: Dada la relevancia clínica y social que tiene la psicopatía, resulta útil contar con instrumentos autoinformados para la aproximación diagnóstica a la psicopatía. Objetivos: Evaluar la congruencia interna y la validez convergente del Self Report of Psychopathy-Short Form. Material y métodos: Se evaluaron 208 personas condenadas, alojadas en el Centro de Cumplimiento Penal de la Provincia de Los Andes, Chile. Se utilizaron el SRP-III-SF, el PCL-R y la HCR-20. Resultados: La distribución de valores del SRP-III-SF tuvo una media de 61,6 y fue normal. El Coeficiente de Alfa de Cronbach para el total fue 0,8 y para los factores 1, 2, 3 y 4 fue 0,7, 0, 4, 0,7 y 0,5, respectivamente. La correlación del SRP-III-SF con el PCL-R fue 0,4 (p = 0,01) y con HCR 20, 0,5 (p < 0,001). El riesgo de diagnóstico de psicopatía con el PCL-R aumentó en forma lineal para cada cuartil de la distribución del SRP-SF. El área bajo la curva ROC fue 0,66 (p = 0,05; 95% IC 0,5; 0,8).

Introduction: Given the clinical and social relevance of psychopathy, it is desirable to have self-report instruments for a proper diagnostic approach. Objectives: Assess the internal congruence and convergent validity of the Self Report of Psychopathy Scale III-Short Form. Material and Methods: 208 convicts housed at the "Centro de Cumplimiento Penal" detention center in the Province of Los Andes, Chile, were evaluated using the SRP-III-SF, PCL-R, and HCR-20 schemes. Results: the SRP-III-SF distribution was normal, with a mean of 61.6. The Cronbach's Alpha Coefficient for the total was 0.8, and 0.7, 0.4, 0.7 and 0.5 for the 1, 2, 3, and 4 factors respectively, while the correlations of SRP-III-SF with PCL-R and HCR 20 were, respectively, 0.4 (p = 0.01) and 0.5 (p < 0,001). The scores of the PCL-R diagnosed psychopathy were linearly higher for each quartile of the SRP-SF distribution. The area under the ROC curve was 0.66 (p = 0.05; 95% IC 0.5; 0.8).

Introdução: Dada a relevância clínica e social que tem a psicopatia, é útil contar com instrumentos autoinformados para a aproximação diagnóstica à psicopatia. Objetivos: Avaliar a congruência interna e a validez convergente do Self Report of Psychopathy-Short Form. Material e métodos: Avaliaram-se 208 pessoas condenadas, alojadas no Centro de Cumprimento Penal da Província dos Andes, Chile. SRP-III-SF, PCL-R e HCR-20 foram usados. Resultados: A distribuição dos valores do SRP-III-SF teve uma média de 61.6 e foi normal. O Coeficiente do Alfa de Cronbach para o total foi 0.8 e para os fatores 1, 2, 3 e 4 foi 0.7, 0.4, 0.7 e 0.5, respectivamente. A correlação do SRP-III-SF com PCL-R foi 0.4 (p = 0.01) e com HCR 20, 0.5 (p < 0.001). O risco do diagnóstico de psicopatia com o PCL-R aumentou em forma linear para cada quartil da distribuição do SRP-SF. A área sob a curva ROC foi 0.66 (p = 0.05; 95% IC 0.5; 0.8).

A educação é parte importante do tratamento do diabetes melito (DM), e é por meio dela que os pacientes são capacitados para realizar o gerenciamento da sua doença. Existe uma gama variada de intervenções educativas já testadas nos pacientes com DM, não havendo, até o momento, um modelo universal definido que possa ser padronizado e reconhecido como eficaz para todos os indivíduos com a doença. Este artigo tem por objetivo revisar o efeito das diferentes modalidades de intervenções educativas para o autocuidado no controle glicêmico de pacientes com DM tipo 2, além de definir recomendações gerais para a utilização desta estratégia de tratamento.

Education plays an important role in diabetes mellitus (DM) treatment, as it enables patients to manage their disease. There is a wide range of tested educational interventions, and, to date, no universal model that can be standardized and recognized as effective for all individuals with the disease has been defined. This article aims to review the effect of different types of educational interventions for self-management of glycemic control in patients with DM type 2, in addition to define general recommendations for this treatment strategy.

Human herpesvirus type 6-(HHV-6) has been associated with morbidity after liver transplantation. OBJECTIVE: The aim of this study was to determine the HHV-6 seroprevalence among donor-recipient pairs, analyze the incidence of early active infection, its clinical manifestation, interaction with CMV, and the related morbidity in the first year after kidney transplantation. METHODS: 46 donor-recipient pairs had IgG evaluated by ELISA before transplantation: HHV-6(Pambio - USA) and CMV-(Roche - USA). A frozen whole blood sample collected weekly (from the 1st to the 6th week) was retrospectively tested for HHV-6 viral load (VL) determination by real time quantitative PCR (qPCR, Nanogen - Italy). Patients were preemptively surveyed for CMV by pp65 antigenemia (Ag, APAAP, immunohistochemistry, Biotest - Germany) from the 4th to the 12th week after transplantation. Active infection was defined as qPCR-HHV6+ (viral-load/mL-VL) and Ag+ (+cells/100.000 granulocytes), for HHV-6 and CMV, respectively. DCMV was defined as simultaneous positive antigenemia and suggestive signs/symptoms. Concerning +qPCR-HHV6, associated factors, clinical manifestation, interaction with CMV and morbidity were searched. RESULTS: Pre-transplant HHV-6 seroprevalence was significantly higher among kidney recipients compared to their donors (82.6x54.8%; p = 0.005 [3.9 (1.4-10.4)]). Active infection by this virus occurred in 26.1% (12/46), with no association with previous IgG (p = 0.412). Median VL was 125 copies/mL (53-11.264), and the median Ag was 21 +cells (2-740). There was no association between HHV-6 and CMV activation after transplantation (p = 0.441), neither concerning DCMV (p = 0.596). Median highest Ag+ and days of ganciclovir treatment were similar between qPCR-HHV6 + or - (p = 0.206 and p = 0.124, respectively). qPCR-HHV6+ was associated with higher incidence of bacterial (p = 0.009) and fungal (p = 0.001) infections, and higher number (p = 0.001) of hospital admission and longer duration of hospitalization over the first 6 and 12 months post-transplantation (p = 0.033 and p = 0.001). CONCLUSION: Latent HHV-6 infection is more common among recipients than donors before transplantation. Early active infection by this pathogen after transplantation does not increase DCMV incidence or severity during the first 3 months of follow-up. However, early HHV-6 replication is associated with other infections and hospitalizations in the first year.

INTRODUCTION: BKV nephropathy (BKN) causes kidney graft loss, whose specific diagnosis is invasive and might be predicted by the early detection of active viral infection. OBJECTIVE: Determine the BKV-infection prevalence in late kidney graft dysfunction by urinary decoy cell (DC) and viral DNA detection in urine (viruria) and blood (viremia; active infection). METHODS: Kidney recipients with >1 month follow-up and creatinine >1.5 mg/dL and/or recent increasing >20% (n = 120) had their urine and blood tested for BKV by semi-nested PCR, DC searching, and graft biopsy. PCR-positive patients were classified as 1+, 2+, 3+. DC, viruria and viremia prevalence, sensitivity, specificity, and likelihood ratio (LR) were determined (Table 2x2). Diagnosis efficacy of DC and viruria were compared to viremia. RESULTS: DC prevalence was 25%, viruria 61.7%, and viremia 42.5%. Positive and negative patients in each test had similar clinical, immunossupressive, and histopathological characteristics. There was no case of viremia with chronic allograft nephropathy and, under treatment with sirolimus, patients had a lower viruria prevalence (p = 0.043). Intense viruria was the single predictive test for active infection (3+; LR = 2.8).1,6-4,9 CONCLUSION: DC, BKV-viruria and -viremia are commun findings under late kidney graft dysfunction. Viremia could only be predicted by intense viruria. These results should be considered under the context of BKN confirmation.

Guindilia trinervis is a native Chilean shrub that bears seeds with a high content of oil suitable for biodiesel production. It was tested for its capacity to form roots in cuttings of juvenile and adult plants in ex vitro as well as in vitro conditions. Variables such as type of cutting, exogenous application of IBA¹ and time of collection were studied. For adult plants, the best ex vitro rooting (79 %) was obtained with distal polynodal cuttings collected in late summer and treated with 100 mg L-1 IBA, but rooting was also achieved in the presence of water alone (up to 69 %). Juvenile plants displayed the best rooting (84 %) with single node cuttings and 50 mg L-1 IBA, as well as in the presence of Seradix (72 %). This treatment also showed the highest number of roots per explant. In vitro rooting of shoot tips took place on modified MS media supplemented with 1.0 mg L-1 IBA yielding roots up to 82 %, compared to nodal sections that rooted scantily. Rooted material could be acclimated and adapted well to greenhouse and nursery conditions. Controls of adult and juvenile cuttings treated with water exhibited spontaneous rooting in most of the treatments. Cuttings from adult plants harvested in late summer rooted better than those harvested in winter. Spring cuttings collected during flowering and fructification did not root. Results indicate that by means of adventitious root initiation G. trinervis can be effectively propagated by distal cuttings, collected in summer or winter. This may allow large-scale production of plant material with desired traits.

Guindilia trinervis es un arbusto silvestre nativo de Chile productor de semillas con alto contenido de aceite y aptitudes para producción de biodiésel. En este estudio se investigó la capacidad de propagar vegetativamente esta especie evaluando el enraizamiento de estacas de plantas juveniles y adultas. Las variables estudiadas fueron el tipo de estaca, niveles exógenos de IBA² y la época de colecta. Para plantas adultas el mejor enraizamiento (79 %) ocurrió en estacas polinodales (distales) colectadas a fines de verano y tratadas con 100 mg L-1 de IBA, y en presencia de agua sola (hasta 69 %). En plantas juveniles el mejor enraizamiento (84 %) ocurrió en estacas uninodales con 50 mg L-1 de IBA y también con Seradix (72 %); este tratamiento indujo el máximo número de raíces por explante. Ápices provenientes de plantas juveniles cultivados in vitro enraizaron hasta un 82 %, en medio MS modificado, suplementado con 1.0 mg L-1 de IBA. Las secciones nodales enraizaron escasamente. Las plántulas de todos los tratamientos se aclimataron y adaptaron bien en invernadero y vivero. El control con agua en estacas adultas y juveniles originó raíces en casi todos los ensayos. En verano las respuestas rizogénicas fueron superiores que en invierno. Las estacas colectadas en época de floración o fructificación no enraizaron. Los resultados indican que G. trinervis puede ser propagada en forma eficiente mediante la inducción de raíces adventicias preferentemente en estacas distales colectadas a fines de verano. Esta respuesta permitiría la propagación de plantas con caracteres deseados en programas de producción masiva.

The use of umbilical cord blood stem cells is an efficient alternative for the transplantation of hematopoietic progenitor cells. A number of factors can influence the volume and amount of CD34+ cells, which are considered as immature and capable of proliferation. Quantification of CD34+ cells, evaluation of CD38 and c-kit molecules on these cells, as well as correlations of such factors as maternal age, gestational age, newborn sex and weight, umbilical cord length, placental weight with increased volume and concentration of immature cells, among others, were performed in 70 blood samples from term newborns. The mean volume of umbilical cord blood collected was 53.8±33.6 mL, where 30.96±18.9 CD34+/mL UCB cells were found, of which 16.66±8.32% were CD34+CD38- cells, and 47.23±24.0% were CD34+CD117cells. Newborn weight and placental weight were positively correlated with increased volume of collected UCB. The volume of collected blood was found to affect the absolute count of CD34+ cells and the relative value of these among total nucleated cells, as well as the percentage of CD34+CD117+ and CD34+CD117cells. CD34+ cells were positively correlated with leukocytes, and gestational age was negatively correlated with the number of CD34+ cells. Our results confirm the importance of the accurate quantification of CD34+ cells and their subsets, and that many factors may be related to the higher number of hematopoietic stem cells, which are crucial for successful transplantation.

The best strategy for control of cytomegalovirus (CMV) infection in lung transplant patients is still not determined. The aim of this study was to document the incidence of CMV infection in a cohort of lung transplant recipients under universal prophylaxis with intravenous ganciclovir. All patients received immunosuppressive regimens consisting of cyclosporine, azathioprine, and prednisone. Regardless of CMV serostatus, intravenous ganciclovir was prescribed for every patient in the first 3 months post-transplantation. CMV infection was defined as the detection of CMV pp65 in leukocytes. Eighty-two lung transplant patients were included over a 5-year period. The incidence of CMV infection in the first year post-transplantation was 68.3%, occurring after a median length of 114 days (range, 26-343 days). This study revealed a high incidence of CMV infection in the first year following lung transplantation despite prolonged universal ganciclovir prophylaxis.