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Abstract Background Frailty among older adults undergoing hemodialysis is increasingly prevalent, significantly impacting cognitive function, mobility, and social engagement. This study focuses on the clinical profiles of very older adults in hemodialysis, particularly examining the interplay of dependency and frailty, and their influence on dialysis regimens. Methods In this observational, descriptive study, 107 patients aged over 75 from four outpatient centers and one hospital unit were examined over a year. Patient data encompassed sociodemographic factors, dialysis specifics, analytical outcomes, lifestyle elements, and self-reported post-treatment fatigue. Malnutrition-inflammation scale was used to measure the Nutritional status; MIS scale for malnutrition-inflammation, Barthel index for dependency, Charlson comorbidity index; FRIED scale for frailty and the SF12 quality of life measure. Results The study unveiled that a substantial number of older adults on hemodialysis faced malnutrition (55%), dependency (21%), frailty (46%), and diminished quality of life (57%). Patients with dependency were distinctively marked by higher comorbidity, severe malnutrition, enhanced frailty, nursing home residency, dependency on ambulance transportation, and significantly limited mobility, with 77% unable to walk. Notably, 56% of participants experienced considerable post-dialysis fatigue, correlating with higher comorbidity, increased dependency, and poorer quality of life. Despite varying clinical conditions, dialysis patterns were consistent across the patient cohort. Conclusions The older adult cohort, averaging over four years on hemodialysis, exhibited high rates of comorbidity, frailty, and dependency, necessitating substantial support in transport and living arrangements. A third of these patients lacked residual urine output, yet their dialysis regimen mirrored those with preserved output. The study underscores the imperative for tailored therapeutic strategies to mitigate dependency, preserve residual renal function, and alleviate post-dialysis fatigue, ultimately enhancing the physical quality of life for these patients.

This systematic review explores the intersection of race, gender, and social class in the context of internationalization of higher education (IHE) research in Brazil. Historically, the development of the Brazilian educational system has responded to the elite's demands and reproduced Western-European values and knowledge. The exponential growth of IHE has led to increased scholarly interest in various interdisciplinary research areas, with a possible move in studies and practices from a neoliberal to a more critical, decolonial, and diverse perspective. This article aims to investigate to what extent Brazilian researchers have investigated the intersectionality of gender, race, and class in IHE. Using two scientific databases, the published between 2015 and 2022. The theoretical framework of intersectionality (Crenshaw, 2002; Collins & Bilge, 2021; Akotirene, 2019) is presented to help recognize the interaction of different social markers of inequalities in IHE. The results pointed to a small number of publications related to this theme and continuous interest in the Science without Borders (SwB) mobility program. A particularly privileged profile of participants in academic mobility programs across various higher education institutions (HEI) in Brazil demonstrated the need for planning and actions to understand the social, historical, and political aspects that perpetuate exclusions. Moreover, this review indicates the importance of addressing colonialism in social dynamics and recognizing the coloniality of power in language policies in IHE. It calls for further investigations that explore the intersections of social markers in IHE processes from a more politically engaged perspective.

Abstract Liquid-liquid phase separation (LLPS) in living cells provides innovative pathways for synthetic compartmentalized catalytic systems. While LLPS has been explored for enhancing enzyme catalysis, its potential application to catalytic peptides remains unexplored. Here, we demonstrate the use of coacervation, a key LLPS feature, to constrain the conformational flexibility of catalytic peptides, resulting in structured domains that enhance peptide catalysis. Using the flexible catalytic peptide P7 as a model, we induce reversible biomolecular coacervates with structured peptide domains proficient in hydrolyzing phosphate ester molecules and selectively sequestering phosphorylated proteins. Remarkably, these coacervate-based microreactors exhibit a 15,000-fold increase in catalytic efficiency compared to soluble peptides. Our findings highlight the potential of a single peptide to induce coacervate formation, selectively recruit substrates, and mediate catalysis, enabling a simple design for low-complexity, single peptide-based compartments with broad implications. Moreover, LLPS emerges as a fundamental mechanism in the evolution of chemical functions, effectively managing conformational heterogeneity in short peptides and providing valuable insights into the evolution of enzyme activity and catalysis in prebiotic chemistry.

The ambulatory surgery includes those surgical procedures that require a small period of post-operative recovery so that the patients will be discharged from the hospital in the same day of the surgical intervention. In Urology, the vast amount of pathology that allows the cure with medium and low complexity surgical procedures makes this specialty a privileged one in which ambulatory surgery is concerned. In this paper the authors propose to describe how their Urology group works in the ambulatory field. 472 patients where reviewed in an evaluation period from January 2006 to April 2008. The medical appointment protocol is summarized as well as the most common surgical procedures and complications. Annually we operate an average of 200 ambulatory patients and this represents about 22% of the hole surgical activity of the Urology group. The majority of the surgeries are circumcisions and vasectomies (always associated with other small procedures). There is a 5 hours weakly period where a total of 5 to 6 patients are operated. Surgical complications represented 1.6% of total procedures, all of them late ones. With this specific ambulatory program our service managed to reduce drastically the waiting time for this kind of procedures (now-a-days is about 3-4 weeks), with a satisfaction rate of about 95%. According to the great outcomes, low complications rate and great acceptance of the patients, the development of this unit is without doubt a winning project in patients care.

To evaluate importance of homocysteinemia as risk factor of thrombotic cerebrovascular disease, in terms of age and homocysteinemia levels.A group of patients under 55 years old (n = 35, 21 males) that had suffered a stroke 3 months to 1 year before the study, defined by clinical criteria and the presence of cerebral infarction confirmed by tomography, without history or predisponents to embolic disease. The patients were matched with a group of controls without vascular pathology of a check-up program, in terms of age and sex. Patients and controls with history of alcoholism, signs or laboratory of renal or hepatic insufficiency or with history of recent ingestion of vitamins of the group B were excluded since these conditions could influence homocysteinemia levels. We measured to patients and controls the plasmatic basal homocysteinemia and homocysteinemia 6 hours after methionine overload of 0.1 g/Kg body weigh. We estimated case-control odds ratio of hyperhomocysteinemia globally and by age groups, and odd ratio of different levels of homocysteinemia.Hyperhomocysteinemia case-control global odds ratio was 5.7, being higher in younger patients (8.8 below and 3.5 after the age of 45 years). Homocysteinemia as a risk factor of cerebrovascular disease presented as a continuous effect: low homocysteinemia was protective, and the higher the homocysteinemia, the higher the cerebrovascular risk proved to be. In these circumstances, heterozygozyty of cysthationine beta synthase deficiency, refered as the more important cause of hyperhomocysteinemia, cannot account for most of the cases of hyperhomocysteinemia.

To determine whether hyperhomocysteinemia represents a risk factor of early thrombotic cerebrovascular disease.In a group of patients under 55 years of age (n = 33, 19 males) which had suffered a stroke from 3 months to 1 year before the study, defined by clinical criteria and presence of cerebral infarction confirmed by tomography, without history or predisposition to embolic disease. The patients were matched with a group of normal controls of checkup program, in terms of age, and sex. Patients and controls with a history of alcoholism, clinical or laboratory signs of renal or hepatic insufficiency or with a history of recent ingestion of Group B vitamins were excluded since these conditions would influence homocysteinemia levels. We measured the plasmatic basal homocysteinemia of patients and controls (HC) and 6 hours later a methionine overload of 0.1 g/Kg body weight (LOAD HC).Patients; Controls; Signific.; Age 46.0 +/- 7.7; 45.9 +/- 7.8; NS; Basal HC. 10.1 +/- 3.4; 8.5 +/- 1.7; p < 0.05; Load HC 28.0 +/- 7.6; 22.7 +/- 5.5; p < 0.01.In this study hyperhomocysteinemia appears as a risk factor for thrombotic cerebrovascular disease before the age of 55;-The measurement of homocysteinemia after the methionine loading test was more discriminative than the basal measurement;-A larger number of patients and controls will be necessary to establish the relative importance of homocysteinemia among other vascular risk factors in cerebrovascular disease.

The authors present a case of abdominal aorta dissection--type B. The diagnosis was made by Doppler ultrasound and computerized tomography (CT). The use of Doppler ultrasound in the diagnosis and assessment of abdominal aorta dissection and visceral arterial involvement is discussed. Doppler ultrasound is also a useful imaging technique in follow-up evaluation if conservative treatment is employed.

We report a case of duodenal primary non-Hodgkin lymphoma classified as a polymorphic B lymphoma with a low degree of malignancy. It was studied by ultrasound, computed tomography and simple contrast study. We review the radiologic appearance, sites of origin, and the role of Imagiology in staging and differential diagnosis.