Publications by authors named "Alberto Caldas-Afonso"
Objectives: Type 1 diabetes mellitus is considered a state of chronic low-grade inflammation and activation of the innate immune system, which is regulated by several proinflammatory cytokines and other acute-phase reactants. Arterial stiffness, a dynamic property of the vessels evaluated by the determination of pulse wave velocity (PWV), is increased in diabetic patients and is associated with microvascular and macrovascular complications of diabetes and higher cardiovascular risk. In the present study, we aimed to compare the proinflammatory state and arterial stiffness in diabetic and non-diabetic adolescents, and to characterize the association between these two parameters.
View Article and Find Full Text PDFBackground: Despite their higher risk of developing severe disease, little is known about the burden of influenza in Portugal in children aged < 5 years old. This study aims to cover this gap by estimating the clinical and economic burden of severe influenza in children, in Portugal, during ten consecutive influenza seasons (2008/09-2017/18).
Methods: We reviewed hospitalizations in children aged < 5 years old using anonymized administrative data covering all public hospitals discharges in mainland Portugal.
Objectives: Gender-related differences in oxidative stress, nitric oxide bioavailability, and cardiometabolic risk factors were examined in a cross-sectional study involving 313 prepubertal children (8-9 years old) from the generation XXI birth-cohort.
Methods: Anthropometric measurements, cardiometabolic variables, and redox markers were assessed, including plasma and urinary isoprostanes (P-Isop, U-Isop), plasma total antioxidant status (P-TAS), serum myeloperoxidase (MPO), plasma and urinary nitrates and nitrites (P-NOX, U-NOX), and urinary hydrogen peroxide (U-HO).
Results: Girls showed higher levels of total/non-HDL cholesterol, triglycerides, and insulin resistance (HOMA-IR) compared to boys.
Background: The efficacy of continuous antibiotic prophylaxis in preventing urinary tract infection (UTI) in infants with grade III, IV, or V vesicoureteral reflux is controversial.
Methods: In this investigator-initiated, randomized, open-label trial performed in 39 European centers, we randomly assigned infants 1 to 5 months of age with grade III, IV, or V vesicoureteral reflux and no previous UTIs to receive continuous antibiotic prophylaxis (prophylaxis group) or no treatment (untreated group) for 24 months. The primary outcome was the occurrence of the first UTI during the trial period.
Article Synopsis
- Obesity in prepubertal children may disrupt cardiac rhythms, specifically circadian and ultradian patterns, which has been largely overlooked in research.
- A study involving 316 children showed that overweight/obese kids had a higher frequency of non-dipping blood pressure patterns and lower prevalence of 24-hour mean arterial pressure rhythmicity and heart rate rhythmicity compared to their normal-weight peers.
- The findings indicate potential early signs of cardiovascular issues in obese children, suggesting that further research is necessary to clarify the long-term effects of these disruptions.
Article Synopsis
- The study focuses on urinary tract infections (UTIs) in children and investigates the potential use of soluble Toll-like receptors (sTLR4, sTLR5) and interleukin 8 (IL-8) as biomarkers for diagnosing UTIs.
- It involved 520 children, including those with UTIs, non-UTI infections, and healthy controls, measuring urine and serum levels of the biomarkers before and after treatment.
- Results show that urine sTLR4 levels are higher in UTI patients, with a cut-off level identified to predict UTIs, especially higher in cases of pyelonephritis compared to cystitis, and decreasing post-treatment.
Paediatric obstructive sleep disordered breathing (OSDB) has a considerable impact on cardiovascular physiology, but the consequences on children's basal metabolism and response to exercise are far from being known. The objective was to propose model estimations for paediatric OSDB metabolism at rest and during exercise. A retrospective case-control analysis of data from children submitted to otorhinolaryngology surgery was performed.
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- A new study looked at a special urine test called uHSP70 to help tell if kids have a urinary tract infection (UTI) instead of just using regular tests that might not be very reliable.
- The study involved 802 kids and found that uHSP70 levels were much higher in kids with UTI compared to those with other infections or who were healthy.
- Using uHSP70 could help doctors correctly diagnose UTIs and might stop about 80% of kids from getting unnecessary antibiotics.
Alport syndrome (AS) is the second most common cause of inherited chronic kidney disease. This disorder is caused by genetic variants on , and genes. These genes encode the proteins that constitute collagen type IV of the glomerular basement membrane (GBM).
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- - The study focused on atypical hemolytic uremic syndrome (aHUS) in preschool-aged children, aiming to analyze the clinical profile, treatment, and long-term outcomes of patients with genetic mutations over 20 years in a pediatric nephrology center.
- - A total of five patients with identified genetic mutations were examined; all showed initial symptoms, with most having a complement factor H gene mutation. Treatments included therapeutic plasma exchange, and all patients achieved complete remission despite some experiencing relapses.
- - The findings suggest that genetic background plays a crucial role in the long-term prognosis of kidney function, highlighting the importance of genetic testing in aHUS cases. The study also identified two novel genetic mutations, emphasizing the need for further
Article Synopsis
- Congenital abnormalities of the lower urinary tract lead to severe renal issues in children, often resulting in the need for renal transplants, with this study examining the outcomes of such procedures over a ten-year period.
- The study analyzed 53 renal transplants, finding that 26 were performed on 24 patients with these abnormalities, with a median patient age of 10.5 years, and common conditions including neurogenic bladder and posterior urethral valve.
- Despite the prevalence of infections like pyelonephritis in these patients, the results showed a high graft survival rate of 92.3% throughout the follow-up period, indicating renal transplant as a viable treatment option without significantly worse outcomes.
Nutritional status might contribute to variations induced by physical activity (PA) in redox status biomarkers. We investigated the influence of PA on redox status and nitric oxide (NO) production/metabolism biomarkers in nonoverweight and overweight/obese prepubertal children. We performed a cross-sectional evaluation of 313 children aged 8-9 years (163 nonoverweight, 150 overweight/obese) followed since birth in a cohort study (Generation XXI, Porto, Portugal).
View Article and Find Full Text PDFBackground: Prenatal ethanol exposure has been shown to reduce nephron endowment in animal models, but the effect of alcohol during human pregnancy on postnatal kidney function has not been explored. We aim to investigate the potential association of maternal alcohol consumption during pregnancy with the offspring renal function, considering potential confounding by intrauterine growth and children's current nutritional status.
Methods: Prospective longitudinal study in a random sample of 1093 children from a population-based birth cohort.
Article Synopsis
- * Over 900 pediatric patients receive dialysis annually, with peritoneal dialysis (PD) and continuous renal replacement therapy (CRRT) being the most common methods used.
- * Dialysis practices vary across centers based on disease causes and local economic conditions, with plans for a European AKI registry to enhance understanding of management and outcomes. *
Obesity is known to be associated with a myriad of cardiovascular and metabolic comorbidities. In children, several longitudinal studies have shown that obesity consequences start early in life and accompany the obese child into adulthood, implying a higher risk of adverse cardiovascular events. More recently, data related to the possible role of obesity in the risk of kidney disease in adults, independently of diabetes, has started to become more available.
View Article and Find Full Text PDFBackground And Objectives: Autosomal dominant polycystic kidney disease is the most common inheritable kidney disease, frequently thought to become symptomatic in adulthood. However, patients with autosomal dominant polycystic kidney disease may develop signs or symptoms during childhood, in particular hypertension. Although ambulatory BP monitoring is the preferred method to diagnose hypertension in pediatrics, data in children with autosomal dominant polycystic kidney disease are limited.
View Article and Find Full Text PDFImportance: Conventional methods to diagnose and monitor chronic kidney disease (CKD) in children, such as creatinine level and cystatin C-derived estimated glomerular filtration rate (eGFR) and assessment of proteinuria in spot or timed urine samples, are of limited value in identifying patients at risk of progressive kidney function loss. Serum soluble urokinase receptor (suPAR) levels strongly predict incident CKD stage 3 in adults.
Objective: To determine whether elevated suPAR levels are associated with renal disease progression in children with CKD.
Background: We aimed to study the impact of obesity on urinary excretion of angiotensinogen (U-AGT) in prepubertal children, focusing on the duration of obesity and gender. Also, we aimed to evaluate whether plasma angiotensinogen (P-AGT) and hydrogen peroxide (HO) play a role in the putative association.
Methods: Cross-sectional evaluation of 305 children aged 8-9 years (160 normal weight, 86 overweight, and 59 obese).
Background: Dedicated pediatricians in emergency departments (EDs) may be beneficial, though no previous studies have assessed the related costs and benefits/harms. We aimed to evaluate the net benefits and costs of dedicated emergency pediatricians in a pediatric ED.
Methods: Cost-consequences analysis of visits to a pediatric ED of a tertiary hospital.
Background: Pulse wave velocity (PWV) is a noninvasive technique to evaluate arterial stiffness, a dynamic property of the vessels, reflecting their structure and function. Childhood obesity is associated with several cardiovascular comorbidities and to the progression of atherosclerosis. We aimed to compare carotid-femoral PWV between normal weight and overweight/obese prepubertal children and to quantify its association with other cardiovascular risk factors.
View Article and Find Full Text PDFBackground: Glomerular filtration rate (GFR) is conventionally indexed to body surface area (BSA), but this may lead to biased results when applied to subjects of abnormal body size. The aim of our study was to examine the impact of normalization to the BSA and alternative body size descriptors on measured and estimated GFR in overweight and obese children.
Methods: This was a cross-sectional study of 313 children aged 8-9 years old.
Introduction: Myeloperoxidase (MPO), an enzyme linking obesity and cardiovascular (CV) risk in adults, has rarely been studied in young children and no studies assessed its association with renal function. We sought to explore a possible association between serum MPO levels, obesity, CV risk factors and renal function in prepubertal children.
Materials/methods: Cross-sectional evaluation of 309 children aged 8-9 years (161 normal weight, 148 overweight/obese), members of the birth cohort Generation I (Portugal).
Background: Fibrogenic cytokines are recognized as putative drivers of disease activity and histopathological deterioration in various kidney diseases. We compared urinary transforming growth factor β1 (U-TGF-β1) and endothelin 1 (U-ET-1) levels across body mass index classes and assessed their association with the level of urinary angiotensinogen (U-AGT), a biomarker of intrarenal renin-angiotensin-aldosterone system (RAAS).
Methods: The was a cross-sectional evaluation of 302 children aged 8-9 years.
Background: Most modifiable risk factors for high blood pressure (BP), such as obesity and salt intake, are imprinted in childhood and persist into adulthood. The aim of our study was to evaluate the intake of salt in children and to assess its impact on BP taking into account gender and nutritional status.
Methods: A total of 298 children aged 8-9 years were evaluated in a cross-sectional study.