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Resumen: La glomeruloesclerosis focal y segmentaria (GEFS) es un patrón histológico de lesión que deriva de diversos procesos patológicos que afectan a los podocitos, resultando en pérdida de selectividad del filtrado glomerular, proteinuria y desarrollando insuficiencia renal que progresa a enfermedad renal crónica terminal en un importante número de pacientes. La clasificación propuesta por las guías KDIGO, en 2021, divide la GEFS en cuatro categorías: primaria, secundaria, genética y de causa no determinada, facilitando así su diagnóstico y manejo. Las causas hereditarias de la GEFS presentan una variabilidad clínica significativa, complicando su identificación. El estudio genético es crucial para identificar la GEFS de causa genética. La prevalencia de la GEFS genética es significativa en niños y considerable en adultos, destacando la importancia del diagnóstico temprano para evitar tratamientos innecesarios y facilitar el consejo genético. Las técnicas de secuenciación masiva han revolucionado el diagnóstico genético, permitiendo la identificación de más de 60 genes responsables del daño podocitario. Este documento propone recomendaciones clínicas y patológicas para la realización de estudios genéticos en adultos con GEFS, subrayando la necesidad de una correcta clasificación para la planificación terapéutica adecuada y la mejora de los resultados en ensayos clínicos. Abstract: Focal segmental glomerulosclerosis (FSGS) is a histological pattern of injury that derives from various pathological processes that affect podocytes, resulting in loss of selectivity of the glomerular filtration membrane, proteinuria and the development of renal failure that progresses to end-stage kidney disease in a significant number of patients. The classification proposed by the 2021 KDIGO guidelines divides FSGS into four categories: primary, secondary, genetic, and FSGS of undetermined cause, thus facilitating its diagnosis and management. Genetic causes of FSGS present significant clinical variability, complicating their identification. Genetic testing is crucial to identify FSGS of genetic cause. The prevalence of genetic FSGS is significant in children and considerable in adults, highlighting the importance of early diagnosis to avoid unnecessary treatments and facilitate genetic counselling. Massive sequencing techniques have revolutionized genetic diagnosis, allowing the identification of more than 60 genes responsible for podocyte damage. This document proposes clinical recommendations for carrying out genetic studies in adults with FSGS, highlighting the need for a correct classification for adequate therapeutic planning and improvement of results in clinical trials.

Summary: Background and aims: A growing body of evidence supports the effectiveness of culinary nutrition interventions; however, there is limited research on the analytical techniques, components, and the combined impact of these interventions alongside contextual factors in addressing child growth failure. This paper examines the combined effect of culinary nutrition interventions and contextual factors in reducing child growth failure within mining communities. Methods and materials: This study employed a cross-sectional design, targeting children under the age of five and their caregivers. A total of 706 participants were included, selected using a systematic random sampling technique. Data were collected through structured questionnaires, direct child measurements, and structured interviews. Anthropometric data were analysed using the WHO growth standards. Statistical analysis involved descriptive statistics and logistic regression, with an emphasis on examining interaction effects. Results: The results revealed that 34.7% of the children experienced growth failure while 55% of the caregivers participated in culinary nutrition programs. Children whose caregivers participated in culinary programs had significantly lower odds of experiencing growth failure (OR = 0.69∗∗, P = 0.019, 95% CI). Factorial analysis demonstrated that the impact of culinary interventions on reducing child growth failure was more pronounced in households with adequate food (OR = 0.46∗, P = 0.085, 90% CI), households with vegetable gardens (OR = 0.50∗∗, P = 0.005, 95% CI), children with a good appetite (OR = 0.44∗∗, P = 0.032, 95% CI), households practicing food preservation (OR = 0.52∗, P = 0.054, 90% CI), and those producing their own food (OR = 0.46∗∗, P = 0.016, 95% CI). Conclusion: The findings highlight the synergistic impact of culinary nutrition interventions alongside key factors in addressing child growth failure, particularly in mining communities. It emphasizes the importance of integrating both nutritional programs and the social environment to effectively combat child malnutrition and stunting in these vulnerable populations.

The ability to rapidly respond to wildlife health events is essential. However, such events are often unpredictable, especially with anthropogenic disturbances and climate-related environmental changes driving unforeseen threats. Many events also are short-lived and go undocumented, making it difficult to draw on lessons learned from past investigations. We report on the response to a mortality event observed predominantly in wild passerines in the eastern United States. The event began in May 2021 when wildlife rehabilitators and private citizens reported large numbers of sick and dead juvenile birds, mostly presenting as single cases with neurologic signs and/or ocular and periocular lesions. Early efforts by rehabilitators, veterinarians, state and federal wildlife agencies, and universities helped gather public reports and fuel rapid responses by government agencies. Collective efforts included live bird and carcass collections; submission to diagnostic laboratories and evaluation; information sharing; and coordinated messaging to stakeholders and interested parties. Extensive diagnostic evaluations failed to identify a causative pathogen or other etiology, although congruent results across laboratories have helped drive further investigation into alternative causes, such as nutritional deficiencies. This report highlights the strengths of a multi-agency, interdisciplinary investigation while exposing the need for an operational framework with approaches and resources dedicated to wildlife health.

Simple Summary: In May 2021, wildlife managers in Washington D.C., Maryland, Virginia, West Virginia, and Kentucky began receiving reports of sick, dying, and dead birds with eye swelling and crusty discharge, some of which also exhibited neurological behaviors. The public and licensed wildlife rehabilitators provided initial reports, while additional birds were received in Delaware, New Jersey, Pennsylvania, Ohio, Indiana, Tennessee, and Connecticut. The majority of reports involved fledgling common grackles (Quiscalus quiscula), blue jays (Cyanocitta cristata), European starlings (Sturnus vulgaris), and American robins (Turdus migratorius). Early in the event, the jurisdictions involved indicated a collective desire to work together in a regional response with consistent public messaging and collaboration among diagnostic laboratories. The U.S. Geological Survey National Wildlife Health Center (NWHC) facilitated conversations regarding event response among the affected jurisdictions and coordinated with other responding diagnostic laboratories. However, despite exhaustive collective efforts, no definitive cause(s) of illness or death have been determined, with some analyses still ongoing. This paper provides additional background on the event, outlines approaches taken by agencies to coordinate their response and communications with the public, and summarizes lessons learned that could be used to inform future preparedness and response plans. The ability to rapidly respond to wildlife health events is essential. However, such events are often unpredictable, especially with anthropogenic disturbances and climate-related environmental changes driving unforeseen threats. Many events also are short-lived and go undocumented, making it difficult to draw on lessons learned from past investigations. We report on the response to a mortality event observed predominantly in wild passerines in the eastern United States. The event began in May 2021 when wildlife rehabilitators and private citizens reported large numbers of sick and dead juvenile birds, mostly presenting as single cases with neurologic signs and/or ocular and periocular lesions. Early efforts by rehabilitators, veterinarians, state and federal wildlife agencies, and universities helped gather public reports and fuel rapid responses by government agencies. Collective efforts included live bird and carcass collections; submission to diagnostic laboratories and evaluation; information sharing; and coordinated messaging to stakeholders and interested parties. Extensive diagnostic evaluations failed to identify a causative pathogen or other etiology, although congruent results across laboratories have helped drive further investigation into alternative causes, such as nutritional deficiencies. This report highlights the strengths of a multi-agency, interdisciplinary investigation while exposing the need for an operational framework with approaches and resources dedicated to wildlife health. [ABSTRACT FROM AUTHOR]