SummaryBackground and objectives With the advent of fetal screening ultrasonography, the detection of congenital anomalies of the kidney and urinary tract (CAKUT) in utero has permitted early management of these conditions. This study aims to describe the clinical course of a large cohort of patients with prenatally detected nephrouropathies.Design, setting, participants, & measurements In this retrospective cohort study, 822 patients were prenatally diagnosed with CAKUT and systematically followed up at a tertiary Renal Unit for a median time of 43 months. Variables included in the analysis were sex, laterality, fetal ultrasonography (isolated versus associated hydronephrosis), and presence/absence of nephrouropathies. The events of interest were urinary tract infection, surgical interventions, hypertension, CKD, and death. Survival analyses were performed to evaluate time until occurrence of the events of interest.Results Urinary tract infection occurred in 245 (29.8%) children, with higher risk in females (hazard ratio=1.30, 95% confidence interval=1.02-1.70, P=0.05); 22 patients (2.7%) had hypertension, and 49 (6%) patients developed CKD. The risk of CKD was greater in patients with associated hydronephrosis (hazard ratio=5.20, 95% confidence interval=2.90-9.30, P,0.001). Twelve patients (1.5%) died during follow-up. Death was significantly associated with being born during the first period of the study (hazard ratio=6.00, 95% confidence interval=1.60-22.50, P,0.001), associated hydronephrosis (hazard ratio=9.30, 95% confidence interval=2.90-29.30, P,0.001), and CKD (hazard ratio=170.00, 95% confidence interval=41.00-228.00, P,0.001).Conclusions In our series, the clinical course of prenatally detected CAKUT was heterogeneous, and those infants with associated hydronephrosis at baseline were identified as a high-risk subgroup.
Summary objectIve. To assess the profile and scientific output of medical researchers supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) grants. Methods. Data were extracted from the Lattes curricula of 411 medical researchers with active grants for the 2006-2008 period. The variables of interest were gender, institutional affiliation, scientific output, and advisership of undergraduate research fellows and master's and doctoral candidates. results. Researchers were predominantly male (68%) and recipients of category 2 grants (55.7%). Four Brazilian states (São Paulo, Rio de Janeiro, Rio Grande do Sul, and Minas Gerais) accounted for 90% of all researchers. Eight institutions accounted for roughly 80% of researchers in the sample, particularly USP (30.7%) and UNIFESP (17%). The study identified 30 areas of expertise for researchers. Median scientific output was 4.13 published articles per year (interquartile range, IQ, 2.9-5.8), or 2.23 per year (IQ, 1.4-3.2) after adjusting for articles published in Web of Scienceindexed journals. The most productive areas in terms of indexed articles were Neuroscience (3.16 articles/year; IQ, 1.8-4.7) and Psychiatry (2.92; IQ, 1.73-4.5). conclusIon. Medical researchers are concentrated in the Southeast region of Brazil. The scientific output of most Brazilian researchers has increased over the past five years. An understanding of the profile of medical researchers in the country may aid development of effective strategies for qualitative improvement of scientific output.
Our findings suggest that the combination of fetal and postnatal renal pelvic dilatation is able to increase the diagnostic accuracy for detecting infants who need a more comprehensive postnatal investigation for upper urinary tract obstruction.
Quantifying the relative performance of individual scholars has become an integral part of decision-making in research policy. The objective of the present study was to evaluate if the scholarship rank of Brazilian Council for Scientific and Technological Development (CNPq) researchers in Medicine is consistent with their scientific productivity. The Lattes curricula of 411 researchers (2006)(2007)(2008) were included in the study. Scholarship category was the variable of interest. Other variables analyzed were: time since receiving the doctorate, teaching activity (undergraduate, master's and doctoral students), number of articles published, and number of papers indexed by the Institute for Scientific Information (ISI) and Scopus databases. Additional performance indicators included were: citations, h-index, and m-index. There was a significant difference among scholarship categories regarding number of papers per year, considering the entire scientific career (P \ 0.001) or the last 5 years (P \ 0.001). There was no significant difference among scholarship categories regarding the number of citations per article in the ISI (Thomson Reuters) database (P = 0.23). There was a significant difference in h-index among scholarship categories in both databases, i.e. (P \ 0.001) and Scopus (P \ 0.001). Regarding the m-index, there was a significant difference among categories only in the ISI database (P = 0.012). According to our findings, a better instrument for qualitative and quantitative indicators is needed to identify researchers with outstanding scientific output.
Childhood hypertension has classically been recognized as a secondary disease. However, primary hypertension also occurs in children. The aim of this study was to compare clinical features of pediatric patients with elevated blood pressure, which were referred to an outpatient tertiary unit, and to detect variables associated with the identification of primary hypertension. The records of 220 patients with hypertension followed between 1996 and 2006 were analyzed. The variable of interest was primary hypertension. Logistic regression analysis was applied to identify clinical variables that were independently associated with primary hypertension. Of 220 patients, 33 (15%) had primary hypertension, and 187 (85%) exhibited secondary hypertension. No statistically significant differences were detected in gender, race, age at diagnosis, and systolic/diastolic blood pressure levels between both groups. After adjustment, four variables at baseline remained independently associated with primary hypertension: absence of signs/symptoms (OR 18.87, 95% CI 6.32-56.29), normal serum creatinine (OR 0.02, 95% CI 0.00-0.27), family history of hypertension (OR 3.03, 95% CI 1.04-8.79), and elevated body weight (OR 1.06, 95% CI 1.02-1.10). The absence of signs/symptoms, normal serum creatinine, family history of hypertension, and overweight/obesity at admission are clues to diagnose primary hypertension in childhood.
Objective: This study aimed at evaluating the profile and scientific production of researchers in Nephrology and Urology, receiving grants in the area of Clinical Medicine from the Brazilian National Research Council. Methods: The standardized online curriculum vitae (Curriculum Lattes) of 39 researchers in Medicine receiving grants in the 2006-2008 triennium were included in the analysis. The variables analyzed were: gender, affiliation, time from completion of the PhD program, scientific production, and supervision of undergraduate students, and master's and PhD programs. Results: Males (74.4%) and category 2 grants (56.4%) predominated. The following three Brazilian states are responsible for 90% of the researchers: São Paulo (28; 71.8%); Rio Grande do Sul (4; 10.3%); and Minas Gerais (3; 7.7%). Four institutions are responsible for 70% of the researchers: UNIFESP (14; 36%); USP (8; 20.5%); UFMG (3, 7.7%); and UNICAMP (3; 7.7%). Considering the academic career, the assessed researchers published 3,195 articles in medical journals, with a median of 75 articles per researcher (QI = 52-100). The researchers received a total of 25,923 citations at the database Web of Science ® , with a median of 452 citations per researcher (QI = 161-927). The average number of citations per article was 13.8 citations (SD = 11.6). Conclusions: The Southeastern region of Brazil concentrates researchers in Nephrology and Urology. Our study has shown an increase in the scientific production of most researchers in the last five years. By knowing the profile of researchers in Nephrology and Urology, more effective strategies to encourage the scientific production and the demand for resources to finance research projects can be defined.
Our study has shown that researchers in the field of cardiology have a relevant scientific production. The knowledge of the profile of researchers in the field of Cardiology will probably enable effective strategies to qualitatively improve the scientific output of Brazilian researchers.
Our findings support the idea that ultrasound and dimercapto-succinic acid scan used in combination are reliable predictors of dilating vesicoureteral reflux.
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