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Background Coronavirus disease-2019 (COVID-19) has been challenging for patients and medical staff. Radical changes have been needed to prevent disruptions in patient care and medical education. Methods A web-based survey was sent to European Society for Pediatric Nephrology (ESPN) members via the ESPN mailing list to evaluate the effects of the COVID-19 pandemic on delivery of pediatric nephrology (PN) care and educational activities. There were ten questions with subheadings. Results Seventy-six centers from 24 countries completed the survey. The time period was between the beginning of the pandemic and May 30, 2020. The number of patients admitted in PN wards and outpatient clinics were significantly decreased (2.2 and 4.5 times, respectively). Telemedicine tools, electronic prescriptions, online applications for off-label drugs, and remote access to laboratory/imaging results were used in almost half of the centers. Despite staff training and protective measures, 33% of centers reported COVID-19 infected staff, and 29% infected patients. Difficulties in receiving pharmaceuticals were reported in 25% of centers. Sixty percent of centers suspended living-related kidney transplantation, and one-third deceased-donor kidney transplantation. Hands-on education was suspended in 91% of medical schools, and face-to-face teaching was replaced by online systems in 85%. Multidisciplinary training in PN was affected in 54% of the centers. Conclusions This survey showed a sharp decline in patient admissions and a significant decrease in kidney transplantation. Telemedicine and online teaching became essential tools, requiring integration into the current system. The prolonged and fluctuating course of the pandemic may pose additional challenges necessitating urgent and rational solutions. Graphical abstract, Author(s): Burcu Yazicioglu [sup.1] , Sevcan A. Bakkaloglu [sup.1] , M. Abranches, S. Akman, H. Alpay, G. Ariceta, B. Atmis, A. Bael, S. A. Bakkaloglu, U. S. Bayrakçi, R. Bhimma, [...]

Author(s): Burcu Yazicioglu [sup.1] , Sevcan A. Bakkaloglu [sup.1] , M. Abranches, S. Akman, H. Alpay, G. Ariceta, B. Atmis, A. Bael, S. A. Bakkaloglu, U. S. Bayrakçi, R. Bhimma, [...]

Background: Coronavirus disease-2019 (COVID-19) has been challenging for patients and medical staff. Radical changes have been needed to prevent disruptions in patient care and medical education. Methods: A web-based survey was sent to European Society for Pediatric Nephrology (ESPN) members via the ESPN mailing list to evaluate the effects of the COVID-19 pandemic on delivery of pediatric nephrology (PN) care and educational activities. There were ten questions with subheadings. Results: Seventy-six centers from 24 countries completed the survey. The time period was between the beginning of the pandemic and May 30, 2020. The number of patients admitted in PN wards and outpatient clinics were significantly decreased (2.2 and 4.5 times, respectively). Telemedicine tools, electronic prescriptions, online applications for off-label drugs, and remote access to laboratory/imaging results were used in almost half of the centers. Despite staff training and protective measures, 33% of centers reported COVID-19 infected staff, and 29% infected patients. Difficulties in receiving pharmaceuticals were reported in 25% of centers. Sixty percent of centers suspended living-related kidney transplantation, and one-third deceased-donor kidney transplantation. Hands-on education was suspended in 91% of medical schools, and face-to-face teaching was replaced by online systems in 85%. Multidisciplinary training in PN was affected in 54% of the centers. Conclusions: This survey showed a sharp decline in patient admissions and a significant decrease in kidney transplantation. Telemedicine and online teaching became essential tools, requiring integration into the current system. The prolonged and fluctuating course of the pandemic may pose additional challenges necessitating urgent and rational solutions. [ABSTRACT FROM AUTHOR]

A correction is presented to the article "Impact of coronavirus disease‑2019 on pediatric nephrology practice and education: an ESPN survey."

Obesity and the associated metabolic disorders that characterize metabolic syndrome have increased at an alarming rate around the world. It is known that environmental and genetic factors are involved in the genesis of obesity. Peroxisome Proliferator-Activated Receptors (PPARs) stand out among these factors. They compose the nuclear receptor superfamily and there are three isoforms (PPARα, PPARβ/δ and PPARγ), which play an important role in the regulation of the metabolism of carbohydrates, lipids and proteins. The present review aims to understand the relationship between diet, PPARs and the control of blood glucose and body weight, since understanding the mechanisms by which these receptors act may benefit the development of strategies aimed at prevention and the elaboration of therapeutic actions which are more effective for the treatment of obesity and diabetes. [ABSTRACT FROM AUTHOR]

With changes in lifestyle of the population and changes in women reproductive patterns in the last century, the profile of mortality among women has changed, today the prevailing non-infectious chronic diseases, like cancer, including breast cancer. This paper is a case- control population-based, with the objective of evaluating the risk factors and their association with breast cancer in a population of women seen in Odete Valadares Maternity, in the Hospital Foundation of the State of Minas Gerais, in Belo Horizonte, between January and July 2006. Inclusion criteria were age over 18 years and referral for mammography service. Women with abnormal mammography and confirmation of malignancy of the breast were invited to participate in the study, and those with normal mammography were invited to compose the control group. We evaluated 710 women and 456 selected to participate in the study, 261 with breast cancer and 195 healthy controls. The participants were interviewed, answered a questionnaire on reproductive aspects and lifestyle habits (smoking, alcohol consumption, physical activity, children, age at menarche and menopause, oral contraceptive use and hormone replacement therapy and breast- feeding) and was measured anthropometric data. The association between several independent variables and the presence of breast cancer was evaluated by Student's t test, Mann-Whitney and chi square test. We estimated odds ratio and their respective confidence intervals. This study found a positive association between physical inactivity, menopause, nulliparity, lack of breastfeeding and family history of breast cancer and the diagnosis of breast cancer, and alcohol conferred a protective effect in this population. [ABSTRACT FROM AUTHOR]

Phosphopenic rickets may be caused by mutations in the PHEX gene (phosphate regulating endopeptidase homolog X-linked). Presently, more than 500 mutations in the PHEX gene have been found to cause hypophosphatemic rickets. The authors report a clinical case of a 4-year-old girl with unremarkable family history, who presented with failure to thrive and bowing of the legs. Laboratory tests showed hypophosphatemia, elevated alkaline phosphatase, normal calcium, mildly elevated PTH and normal levels of 25(OH)D and 1.25(OH)D. The radiological study showed bone deformities of the radius and femur. Clinical diagnosis of phosphopenic rickets was made and the genetic study detected a heterozygous likely pathogenic variant of the PHEX gene: c.767_768del (p.Thr256Serfs*7). This variant was not previously described in the literature or databases. Knowledge about new mutations can improve patient's outcome. Genetic analysis can help to establish a genotype-phenotype correlation.

Objectives: To measure waist circumference (WC) and supine abdominal height (SAH) at different anatomic sites and to assess the relationship with cardiometabolic risk factors in women aged >60 years., Methods: The present study included 113 women from Viçosa, Minas Gerais, Brazil. The evaluations comprised anthropometric, biochemical and haemodynamic measurements. Different anatomical sites were used to measure WC: (i) the midpoint between the last rib and iliac crest; (ii) umbilical level; (iii) immediately above the iliac crests; and (iv) the narrowest point between the last rib and the iliac crest. Measurements were also taken at different anatomic sites for SAH: (i) the midpoint between the iliac crests; (ii) umbilical level; (iii) higher abdominal diameter; and (iv) the narrowest point between the last rib and the iliac crest., Results: It was found that 35.4% of women were overweight, and the area (SE) body mass index was 25.8 (4.2) kg/m(2). WC at the umbilical level [area (SE) area under the curve (AUC) = 0.694 (0.079)] and SAH at the midpoint between the iliac crests [AUC = 0.747 (0.076)] showed the largest areas under the receiver operating characteristic curve (P < 0.05) with respect to the identification of cardiometabolic risk factors associated with the metabolic syndrome (MS) where, of the two measures, SAH showed the greatest predictive potential., Conclusions: The results obtained in the present study suggest that, for the assessment of older women, the umbilical level and the midpoint between the iliac crests should used to measure WC and SAH, respectively. SAH showed the greatest predictive power for cardiometabolic risk factors associated with the MS in older women., (© 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.)

The obesity and the metabolic disorders associated characterize the metabolic syndrome, which has increased at an alarming rate around the world. It is known that environmental and genetic factors are involved in the genesis of obesity. Peroxisome Proliferator-Activated Receptors (PPARs) stand out among these factors. They compose the nuclear receptor superfamily and there are in three isoforms (PPARα,PPARβ/δ and PPARγ), which play an important role in the regulation of the metabolism of carbohydrates, lipids and proteins. The present review aims to understand the relationship between the diet, the PPARs and the control of the blood glucose and body weight, since the understanding about the mechanisms by which these receptors act may benefit the development of the strategies aiming at prevention and elaboration of therapeutics actions which are more effective for the treatment of obesity and diabetes.

A 5-year-old female developed, after a 7-month period of fever, anorexia, weight loss, and a transitory cutaneous erythematous eruption, a severe acute transverse myelopathy, with a partial recovery of motor and sensory function. She had positive antinuclear and antidouble-stranded DNA antibodies but no antiphospholipid antibodies. Six months later she had massive proteinuria and restarted treatment with steroids and cyclophosphamide. Our patient is one of the youngest reported with lupus myelopathy. We discuss the clinical presentation, the magnetic resonance imaging findings, and other relevant laboratory studies of this rare but serious complication of systemic lupus erythematosus.