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.
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