Top PDF The Effect of Antiproteinuric Treatment on Lipid Levels in Patients with Focal Segmental Glomerulosclerosis and Membranous Glomerulopathy

The Effect of Antiproteinuric Treatment on Lipid Levels in Patients with Focal Segmental Glomerulosclerosis and Membranous Glomerulopathy

The Effect of Antiproteinuric Treatment on Lipid Levels in Patients with Focal Segmental Glomerulosclerosis and Membranous Glomerulopathy

Only serum albumin level was found to have a negative correlation with serum total cholesterol level. Age, sex, type of the glomerular disease, serum creatinine, proteinuria and total triglyceride levels, use of statins, steroid, ACEi or ARB were not correlated with LDL cholesterol levels. This may be regarded as indicating that the treatment of hyperlipidemia in nephrotic syndrome should be directed towards increasing serum albumin levels which is possible with the treatment of the underlying glomerular disease. These may show that serum albumin level is a stronger indicator of serum lipid levels than urinary albumin loss in primary glomerular diseases. Furthermore, there may be no need for extra medication to treat hyperlipidemia in the initial period of treatment in those without established cardiovascular risk factors. We showed in the present study the decrease in serum total and LDL cholesterol levels in parallel to proteinuria indirectly due to increased serum albumin levels (Figure 1 and 2).
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Sao Paulo Med. J.  vol.133 número1

Sao Paulo Med. J. vol.133 número1

RESULTS: The study included 168 patients of mean age 37 ± 14 years. The most prevalent glomerular diseases were focal segmental glomerulosclerosis [FSGS] (19.6%), minimal change disease [MCD] (17.9%), membranous nephropathy [MN] (16.7%) and lupus nephritis [LN] (11.9%). The main clinical presenta- tions were nephrotic proteinuria (67.3%) and renal insuiciency (17.9%). The mean proteinuria value de- creased after the treatment began. Regarding 24-hour proteinuria on admission, there was no signiicant diference between patients with a good response and those with no response (7,448 ± 5,056 versus 6,448 ± 4,251 mg/24 h, P = 0.29). The glomerular disease with the highest remission rate was MCD (92%). Absence of interstitial ibrosis presented a strong correlation with remission (remission in patients without ibrosis = 83.4% versus 16.3% in those with ibrosis, P = 0.001).
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Cyclophosphamide in the treatment of focal segmental glomerulosclerosis

Cyclophosphamide in the treatment of focal segmental glomerulosclerosis

vided into two to three doses for 4 to 6 weeks, followed by a single dose of pred- nisone on alternate days for 4 additional weeks, which was then gradually discontin- ued over 2 to 3 months. Remission was defined as the absence of proteinuria (com- plete) or reduction of proteinuria to non- nephrotic levels (partial), and resistance as the persistence of nephrotic range proteinu- ria during the 6 weeks of daily treatment. Relapse was defined as recurrence of the nephrotic range proteinuria after urine had been protein-free for at least 4 weeks. The occurrence of frequent relapse was defined as 3 or more relapses within 12 months in an initially steroid-responsive patient. The clini- cal response to prednisone was classified as: steroid responsive - complete or partial re- mission of proteinuria during the steroid therapy persisting for at least 8 weeks after therapy; steroid dependent - remission of proteinuria during therapy but recurrence when the dosage was reduced below a criti- cal level or relapse of proteinuria within the first month after the end of prednisone thera- py; resistant - no remission of proteinuria during 8 consecutive weeks of daily therapy. All steroid-resistant patients and patients with frequently relapsing nephrotic syndrome (N = 30) received a daily oral dose of 2.0 to 3.0 mg cyclophosphamide/kg body weight for 12 weeks, concurrently with the same steroid regimen. Because the addition of cyclophosphamide to the steroid regimen is a standard treatment for steroid dependent and frequently relapsing nephrotic syndrome
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Therapy of tacrolimus combined with corticosteroids in idiopathic membranous nephropathy

Therapy of tacrolimus combined with corticosteroids in idiopathic membranous nephropathy

As one of the calcineurin inhibitors, tacrolimus (TAC) has been used in primary glomerulopathy for many years because it can inhibit the protein phosphatase activity of calcineurin, leading to suppression of the nuclear translo- cation of various genes and to inhibition of T cell activa- tion (6). Our previous study showed that a low dose of TAC in combination of corticosteroids was effective for mild mesangial proliferative glomerulonephritis (7). Addi- tionally, the efficacy of TAC in the treatment of focal segmental glomerulosclerosis was also reported (8). The therapeutic effect of TAC on membranous glomerulone- phritis was initially investigated in rats (9); then the first randomized controlled trial, where TAC monotherapy was studied in IMN patients, was carried out in 2007 (10). Praga et al. (10) found a significantly larger number of remissions in TAC-treated patients compared with placebo patients during the 18-month follow-up, suggesting that TAC was a very useful therapy for IMN patients. One year later, a prospective non-randomized cohort study comparing two regimens, TAC plus prednisone and CYC plus predni- sone, was performed for treating IMN (11). Li et al. (11) concluded that both regimens were effective for IMN
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Effect of standard tuberculosis treatment on plasma cytokine levels in patients with active pulmonary tuberculosis.

Effect of standard tuberculosis treatment on plasma cytokine levels in patients with active pulmonary tuberculosis.

VEGF, endowed with potent angiogenic, lymphangiogenic and vascular permeability activities in endothelial cells, is up-regulated in response to tissue inflammation, hypoxia and pro-inflammatory cytokines (reviewed in [40,41]). Thus, VEGF may influence leukocyte trafficking by playing a role in blood and lymphatic vessel function during inflammation [42]. Indeed, VEGF is chemoattractant for monocytes [40] and its over-expression in mouse models leads to abundant angiogenesis and inflammation [43]. Serum VEGF and angioprotein-2 levels have been shown to be associated with the severity of systemic inflammation in patients with inflammatory lung disease [44]. Although the specific role of VEGF in the pathogenesis of TB is unclear, it has been suggested that VEGF may participate in the neovascularization in granu- lomatous tissue [45], favoring the progression of chronic inflammation in association with pulmonary damage. In active TB, elevated plasma VEGF levels have been reported in several publications [46,47,48]; activated macrophages are the most likely source of VEGF in TB lesions [48]. In the present report, we observed that plasma VEGF concentrations decrease upon TB therapy with comparable rates in both TB+HIV2 and TB+HIV+ individuals. Importantly, in HIV uninfected subjects, plasma VEGF concentrations, measured as early as 2 weeks after treatment initiation, positively associated with the time of culture sputum conversion. This suggests that as the bacillary load is controlled in the lungs, inflammation-induced VEGF production is reduced. Indeed, angiogenesis and chronic inflammation have been described as inter-dependent events [49]. The lack of association between VEGF and the time to sputum conversion in TB+HIV+ individuals may be due to chronic HIV-driven hyper- immune activation.
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Etofibrate but not controlled-release niacin decreases LDL cholesterol and lipoprotein (a) in type IIb dyslipidemic subjects

Etofibrate but not controlled-release niacin decreases LDL cholesterol and lipoprotein (a) in type IIb dyslipidemic subjects

Inc., Minneapolis, MN, USA) administered twice a day for a 16-week period. Etofibrate and niacin were placed in new vials labeled with the patient number and the vials were given directly to the patients by a research assistant. During the 4-week evaluation one patient in the etofibrate group and 4 in the niacin group did not return for study evalua- tion and were lost to follow-up. Thus, the final etofibrate group consisted of 14 sub- jects (12 males), mean age 56 ± 5 years, and the niacin group consisted of 11 subjects (8 males), mean age 57 ± 7 years. The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki and was approved by the Ethics Committee of the Heart Institute and all subjects gave informed consent to participate in the study.
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Influence of tungsten and titanium on the structure of chromium cast iron

Influence of tungsten and titanium on the structure of chromium cast iron

The paper analyses the as-cast state structure of chromium cast iron designed for operation under harsh impact-abrasive conditions. In the process of chromium iron castings manufacture, very strong influence on the structure of this material have the parameters of the technological process. Among others, adding to the Fe-Cr-C alloy the alloying elements like tungsten and titanium leads to the formation of additional carbides in the structure of this cast iron, which may favourably affect the casting properties, including the resistance to abrasive wear.
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Distinct metabolic profile of primary focal segmental glomerulosclerosis revealed by NMR-based metabolomics.

Distinct metabolic profile of primary focal segmental glomerulosclerosis revealed by NMR-based metabolomics.

All the participants with primary glomerulopathies (FSGS, MN, IgAN and MCD) and healthy volunteers were recruited in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Two experienced pathologists reviewed all the kidney biopsies. The inclusion criteria are as follows: 1) Biopsy-proven primary glomerulopathy; 2) Patients with new-diagnosed primary glomer- ulopathy and haven’t received any drug therapy (ACE-I/ARB, steroids, immunosuppressants, etc.); 3) Patients at CKD stages 1 to 4. The diagnosis and CKD stage were determined based on the criteria of the National Kidney Foundation (NKF). The glomer- ular filtration rate (GFR) was estimated by the equation from the study ‘‘Modification of Diet in Renal Disease’’ (MDRD) [11]. The exclusion criteria are as follows: 1) Obesity; 2) Reflux nephrop- athy; 3) HIV-associated nephropathy; 4) Malignant cancers; 5) Autoimmune diseases; 6) Infection; 7) Hereditary kidney diseases; 8) History of alcoholism and continued smoking.
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Arq. NeuroPsiquiatr.  vol.72 número10

Arq. NeuroPsiquiatr. vol.72 número10

A total of 88 patients (56 female) with dystonia with cervical involvement who attended the Botulinum Toxin and Movement Disorders Outpatient Unit in the Neurology Service, Hospital de Clínicas, Universidade Federal do Paraná, from June 2008 to June 2009, were selected for the study. Two movement disor- ders specialists examined all patients (C.H.C and H.A.T). Patients were submitted to brain computed tomography (CT scan) and cervical-spine radiography. Additional tests included complete blood count (CBC), TSH, VDRL, blood glu- cose test, ESR, electrolyte levels and liver and kidney function. Cervical spine CT scan and magnetic resonance imaging (MRI) and brain MRI as well as other laboratory tests were requested according to the clinical assessment of each patient. We selected all dystonic patients ( focal, segmental, multifocal or generalized) without etiological diagnosis.
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The effects of a new plant mixture on lipid levels in patients with metabolic syndrome

The effects of a new plant mixture on lipid levels in patients with metabolic syndrome

In order to investigate the glucose- and lipid- lowering effects of the HM5 extract, a pilot study was conducted on a small number of patients (n=11) with high sugar and/or lipid levels. A control group consisting of 10 healthy subjects with normal biochemical parameters was included in the study. 62% of the patients finished the study (n=13). The patients received 30 HM5 drops 3

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Statistical Assessment of the Effect of Chemical Composition on Mechanical Properties of Hypereutectic AlSi17CuNiMg Silumin

Statistical Assessment of the Effect of Chemical Composition on Mechanical Properties of Hypereutectic AlSi17CuNiMg Silumin

The paper presents a statistical assessment of the effect of chemical composition on mechanical properties of hypereutectic AlSi17 silumin, which is expected to act as a counterpart of alloys used by automotive industry and aviation for casting of high-duty engine parts in West European countries and USA. The studies on the choice of chemical composition of silumins were preceded by analysis of the reference literature to state what effect some selected alloying elements and manufacturing technology may have on the mechanical properties (HB, R m and A 5 ) of these alloys. As alloying additives, Cu, Ni and Mg in proper combinations were used. The alloy after
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The Effects of Gender Segregation at the Occupation, Industry, Establishment, and Job-Cell Levels on the Male-Female Wage Gap

The Effects of Gender Segregation at the Occupation, Industry, Establishment, and Job-Cell Levels on the Male-Female Wage Gap

On the firms’ side, the fixed effects absorb unobserved heterogeneity in a large set of factors such as their management productivity, discrimination practices, technologies, job attributes, work conditions, and compensation policies. All these dimensions can affect gender sorting across establishments. If females are more frequently hired to work at es- tablishments that pay lower wages, unless establishment fixed effects are controlled for, a negative relationship between wages and female segregation is likely to appear in the data. In one specification of the model, we use a job-match fixed effect which is intended to capture unobserved heterogeneity in worker-firm matches. This specification is quite rich in that it captures the “quality” of the match between the unobserved characteristics of the workers (job preferences, abilities/skills, etc.) and firms (job characteristics, work conditions, etc.). In addition, job match quality also captures the production complementarities between the worker and the firm (Woodcock, 2007). As shown by Woodcock (2008), the quality of job matches is important for wage determination. If the sorting process of workers in the labor market is correlated with differences in job characteristics and match-specific productivity, “good” and “bad” matches can influence not only gender segregation across firms but also across industries and even occupations. 7 Thus, controlling for match-specific fixed effects
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J. Bras. Nefrol.  vol.38 número1

J. Bras. Nefrol. vol.38 número1

Introduction: The glomerulopathies are the most common biopsy-proven kidney disea- ses. The epidemiological investigation of glomerulopathies allows the identification of their distribution and main causes and ena- bles the development of prevention and treat- ment strategies. Objective: This study aims to identify the frequency and clinical-pathologi- cal correlation of glomerular diseases diag- nosed at the HC-UFPR over the period of 5 years. Methods: 131 biopsies were perfor- med between January 1, 2008 and Decem- ber 31, 2012 and were analysed by light and immunofluorescence microscopy. Histopa- thological slides were reviewed by a patholo- gist. Clinical and laboratory data and the im- munofluorescence microscopy results were extracted from medical records. The findings were tabulated and analysed. Results: 128 of 131 cases were reanalysed. 46.5% were obtained from men. Patients´ age averaged 43 years for men and 38 for women. In 99 cases, the indication of biopsy was identified; 49.5% cases presented nephrotic syndrome, 17.17%, acute renal failure and 15.15%, chronic renal failure; 8.08%, nephritic syn- drome; 6.06%, isolated proteinuria and 4.04% isolated hematuria. In 61.21% an underlying disease related to the glomeru- lopathy could be identified; 33.62% corres- ponded to primary disease and in 5.17% of cases the nature of the glomerulopathy could not be determined. Among seconda- ry glomerulopathies, the most frequent was Lupus Nephritis (49.29%), and among the primary, Focal Segmental Glomerulosclerosis (30.77%) and Membranous Nephropathy (25.64%). Conclusion: The average patient with glomerulopathy in this service is an adult with nephrotic syndrome. Unlike other reports, secondary glomerulopathies were predominant. These findings may reflect the tertiary characteristic of the assistance at HC-UFPR.
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NPHS2 mutations in late-onset focal segmental glomerulosclerosis: R229Q is a common disease-associated allele

NPHS2 mutations in late-onset focal segmental glomerulosclerosis: R229Q is a common disease-associated allele

In contrast to the NPHS2 mutations reported in the severe childhood form of steroid-resistant nephrotic syndrome (9), the NPHS2 mutations we report display some distinct characteristics that appear to be associ- ated with later onset of disease. The NPHS2 mutations we report are either missense mutations or nucleotide deletions. The absence of obvious null mutations in our report suggests that the encoded peptide may retain some function and thus result in a milder phe- notype. Second, we found that these mutations clus- ter in the C-terminal part of podocin. By contrast, mutations associated with severe childhood-onset are dispersed throughout the encoded protein but, in general, are more N-terminal in location than the mutations reported here. This raises the possibility that such N-terminal mutations may represent par- ticular alleles causing protein misfolding or altered protein processing, thereby causing a more severe clinical phenotype. The presence of common variants such as R229Q will improve carrier detection and genetic counseling, as well as identification of appro- priate therapy and elimination of corticosteroids as a therapeutic option (10). The G→A substitution abol- ishes a ClaI restriction site, which allows rapid screen- ing for this mutation. Further investigation is required to determine whether a mild phenotype may be associated with heterozygosity for NPHS2 variants, as well as whether homozygotes for the common R229Q variant have any kidney dysfunction. The severity of clinical disease associated with NPHS2 alterations is highly variable. This suggests that other factors (genetic and environmental) are involved in the development of FSGS. Identification of such fac- tors will improve diagnosis and treatment of nephrot- ic syndrome. Common NPHS2 polymorphisms may be among those factors that alter the susceptibility to various forms of secondary renal injury.
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J. Bras. Nefrol.  vol.39 número4

J. Bras. Nefrol. vol.39 número4

in a patient with NS. The patient did not present the classical clinical signs. Bilateral RVT was suspected due to anuria and sudden worsening of renal func- tion. The venogram, gold standard, was performed to obtain the diagnosis, as well as the therapeutic inter- vention, with bilateral thrombectomy and thromboly- sis located in the left renal vein. There was modest improvement in renal flow immediately and complete recovery of renal function after two weeks of the event.
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The Effect of Chlorella vulgaris Supplementation on Liver Enzymes, Serum Glucose and Lipid Profile in Patients with Non-Alcoholic Fatty Liver Disease

The Effect of Chlorella vulgaris Supplementation on Liver Enzymes, Serum Glucose and Lipid Profile in Patients with Non-Alcoholic Fatty Liver Disease

Methods: This double-blind randomized placebo-controlled clinical trial was conducted on 60 NAFLD patients from specialized clinics of Tabriz University of Medical Sciences from December 2011 to July 2012. The subjects were randomly allocated into 2 groups: 1) “intervention” (n=30) received 400 mg/day vitamin E plus four 300 mg tablets of Chlorella vulgaris and, 2) “placebo” (n=30) received 400 mg/day vitamin E and four placebo tablets per day for 8 weeks. Weight, liver enzymes and metabolic factors were assessed in fasting serum and dietary data was collected at baseline and end of the study.
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Effect of Multipoint Sequential Water Mist Cooling of Casting Die on Microstructure and Mechanical Properties of AlSi11 Alloy

Effect of Multipoint Sequential Water Mist Cooling of Casting Die on Microstructure and Mechanical Properties of AlSi11 Alloy

The control program starts the cooling process in the 1. zone as soon as possible after filling the mold with the liquid metal, and at the latest at the beginning of crystallization of silumin, i.e. 330 C. Then, after the silumin crystallization is finished, the program begins with the cooling of the other zones, which will no longer supply the zone 1 with the liquid metal,, but instead accelerate the process of cooling of the entire cast. The program ends cooling of the chill after reaching the temperature of 60 C for casting. The program also contains a condition of water pulsation after temperature reduction by mold below 150 C and then 100 C. This condition reduces the amount of water in a mist along with the decreasing ability of the evaporation on the cooled wall of the pre-chill and thereby reduces the possibility of water gathering at the casting station.. Moreover, research shows that reducing the amount of water at this stage did not affect the cooling rate and the total time of casting. The cooling process ends when they reach the permanent molds temperature below 60 ° C.
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Rev. Bras. Reumatol.  vol.51 número4 en v51n4a09

Rev. Bras. Reumatol. vol.51 número4 en v51n4a09

A benefi cial infl uence of antimalarials on lipid profi le of systemic lupus erythematosus (SLE) patients has been recently claimed. In this cross-sectional study, we evaluated the effect of chloroquine on cholesterol levels of a Brazilian popu- lation with SLE. Sixty patients were studied, 95% females. Mean age was 48.7 years (SD 13.3 years). Overweight or obesity was documented in 27 cases (45%). Thirty-four patients (56.6%) were using chloroquine in standard dosage, while 33 (55%) were on corticosteroids. Hypercholesterolemia was present in 26 patients (43.3%), while low HDL- cholesterol levels were seen in 18 cases (30%). Normal cholesterolemia was documented equally in users and non-users of antimalarials (P > 0.20). After adjustment for statin and corticosteroid intake by multivariate analysis, cholesterol and HDL-cholesterol levels did not signifi cantly differ in users or non-users of chloroquine (P > 0.05). There was no association of chloroquine intake with low body mass index (P = 0.314). Our fi ndings suggest that antimalarial intake by itself does not distinguish cholesterol profi les in SLE patients.
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SOCIAL ECONOMY – A FORM OF INCLUSION AND OF ''REACTIVATING'' OF LABOR IN THE CONTEXT OF THE CURRENT CRISIS

SOCIAL ECONOMY – A FORM OF INCLUSION AND OF ''REACTIVATING'' OF LABOR IN THE CONTEXT OF THE CURRENT CRISIS

than they produce, which means over the real incomes obtained through social work. Văduva, . We are talking about New Zeeland. Most countries present important sovereign debts , an increasing deficit between incomes and expenses, practical risks of making new loans that bring them close to the insolvency area or to bankruptcy The European Commission, . Such a process is explained by the confusion between the exigencies of social economy – based on work – and the passive social protection policies, which ignore or place labor between brackets . )nstead of the minimum guaranteed salary, some irrational social policies have promoted the minimum guaranteed income, independent from the work resources of the beneficiaries, poverty is perceived as a state characterizing the majority Vîrjan , p. . Successes, but also limits recorded in the labor market today are similar to those defining the reform of the Romanian economy as a whole Aceleanu and Cretu , p. , marked by a public‐private partnership are organizationally weak and frail, the tensions between labor market structures and mechanisms that interfere with legislative‐institutional tensions.
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On The Impact Of Pressure Drop On Human Body With Mathematical Models

On The Impact Of Pressure Drop On Human Body With Mathematical Models

Here 1013.25 is the pressure at sea level in mil/bar, z is the altitude in meters. Knowing p 0 ( z ) and the relation for resistance to flow, the pressure variation on the human body have been computed by the following method. We have

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