A comparative study of human glomerular basement membrane thickness using direct measurement and orthogonal intercept methods

Introduction Here we report estimates of glomerular basement membrane (GBM) thickness in the Brazilian population performed using direct (DM) and orthogonal interception methods (OIM), and comment on potential sources of variation among estimates made by different laboratories. Methodology A total of 38 patients, ranging from 3 to 78 years of age, 26 (68%) males and 12 (32%) females, were submitted to kidney biopsy procedures for renal disease diagnosis. Glomeruli were diagnosed with minor histological changes by conventional, immunofluorescence and electron microscopy. GBM thickness was estimated using both DM and OIM methods. Results Estimates of GBM thickness obtained using DM were higher than those obtained by OIM. However, the application of a correction for non-perpendicular membrane sectioning to DM estimates yielded similar results to those obtained under OIM. The estimated GMB thickness using DM after correction was 289 + 44 nm, versus 287 + 48 nm by OIM. No statistically significant differences were detected in GMB thickness, nor with respect to patient age or sex. Conclusions GBM thickness in the studied Brazilian population measured approximately 290 nm. The application of criteria for estimating the shortest distance between the endothelial and podocyte cell membranes with correction for non-perpendicular membrane sectioning can increase the accuracy of GBM thickness estimates using DM and OIM.

Evidence on Human Exposure to Pesticides and the Occurrence of Health Hazards in the Brazilian Population: A Systematic Review

Brazil is among the biggest pesticide consumers in the world, with its population severely exposed to tons of such substances, both because of environmental contamination and occupational use. The health consequences of pesticide exposure are well-documented, but still sparse regarding Brazilian population. This study systematically reviewed the Brazilian studies published that address the relationship between exposure to pesticides and health problems in the Brazilian population. Also, information about pesticide use in Brazil is provided. The included studies showed that exposure to pesticides has a relevant impact on the health of the Brazilian population, regardless of age and gender, and on workers in rural areas or not. Most poisoning events seem to result from the continuous use of pesticides, whether occupationally or environmentally, characterizing a public health problem. The major consequences reported in literature were damage to the central nervous system, cancer, deleterious effects on rural workers' health, intoxications, malformations, and endocrine changes. These findings point out the need to understand the impact of chronic exposure to pesticides on severely exposed people and highlight the importance of creating public policies to protect them and avoid disease occurrence.

Early Markers of Cardiovascular Disease Associated With Clinical Data and Autosomal Ancestry in Patients With Type 1 Diabetes: A Cross-sectional Study in an Admixed Brazilian Population.

BackgroundPatients with type 1 diabetes (T1D) have a higher risk of developing cardiovascular disease (CVD), which is a major cause of death in this population. The objective of this study was to investigate early markers of CVD associated with clinical data and autosomal ancestry in T1D patients from an admixed Brazilian population. MethodsA cross-sectional study was conducted with 99 T1D patients. The early markers of CVD included the ankle-brachial index (ABI), coronary artery calcium score (CACS), and carotid Doppler sonography. Demographic, clinical, and serum data were collected. A panel of autosomal informational insertion/deletion ancestry markers was used to estimate the individual proportions of European, African, and Amerindian ancestry.ResultsThe study sample had a mean age of 27.6 years and 14.4 years of duration of T1D. The prevalence of alterations in early CVD markers was: ABI (< 0,9) 19.6%, CACS (> 0 +) 4.1%, and carotid Doppler 5.0%. There was significant agreement between CACS and carotid Doppler, and these were correlated with traditional risk factors for CVD. There was a predominance of European ancestry (47.3%), followed by African (28%) and Ameridian (24.7%). There were no association between early CVD markers and autosomal ancestry proportions.ConclusionThe ABI was useful in the early identification of CVD in asymptomatic young patients with T1D and with a short duration of disease, and showed agreement with the carotid Doppler. Although CACS and carotid Doppler are non-invasive tests, carotid Doppler is more cost-effective, and both have limitations in screening for CVD in young patients with a short duration of T1D. We did not find a statistically significant relationship between autosomal ancestry proportions and early CVD markers in an admixed Brazilian population.

Limitations in Activities of Daily Living in Individuals With Chronic Kidney Disease: Biopsychosocial Factors of the Brazilian Population

This study assesses the relationship between biopsychosocial factors and limitations in activities of daily living (ADL) in individuals with chronic kidney disease (CKD). Individual data from the National Health Survey were analyzed, with a sample size of 839 participants. The outcome was dichotomous, presenting limitations in ADL, and the factors considered were clinical and health characteristics, self-perceived behavior, contextual social support, and housing. Cox regression was applied to control the interaction between factors, using the prevalence ratio as a measure of effect and a significance level of 5%. A total of 839 individuals with CKD were reported, of which 373 (40.7%: 35.4 - 46.1%) reported having limitations in ADL. The presence of limitations in ADL was related to residing in a rural area, as well as to the absence of private health insurance, worse self-perceived health, presence of depressive symptoms, and disabilities, in addition to the use of medications and hemodialysis. Limitations in ADL in individuals with CKD are associated with biopsychosocial factors in the Brazilian population, requiring public policies that enable better therapeutic management and support for behavioral health and contextual needs.

Plutocracy, Platonism and Education in Brazil: Some Reflections on the COVID-19 Pandemic

The Lancet stated in its editorial on the 9th of May 2020 that the situation in Brazil was very problematic insofar as the COVID-19 pandemic was concerned. More than a year later, Brazil already registered more than half a million deaths from complications of COVID-19, which places it in second place in the world ranking of deaths despite having the seventh-largest population in the world. Despite this utterly tragic situation, in July 2021, almost 40% of the Brazilian population approved of the federal government's role in confronting the pandemic, and the Brazilian elites have defended openly the view that the economy was more important than individuals' lives. Given this context, in this article, we reflect on the issue of plutocracy, demonstrating its platonic authoritarian foundations, in order to understand the Brazilian elites' attitude toward the pandemic, which had no proper regard or care for the most vulnerable in society. Through this philosophical inquiry we indicate the importance of education, particularly of philosophy of education, in encouraging educationists and educational systems to reflect on problematic issues and self-reflect so as to identify possible educational deficiencies and shortcomings that created the conditions for individuals' attitudes of indifference to the victims of the pandemic and the vulnerable in society.