alpha-Smooth muscle actin and proliferating cell nuclear antigen expression in focal segmental glomerulosclerosis: functional and structural parameters of renal disease progression

The aim of the present study was to investigate the expression of alpha-smooth muscle actin (alpha-SM-actin) and proliferating cell nuclear antigen (PCNA) in renal cortex from patients with focal segmental glomerulosclerosis (FSGS) and their correlations with parameters of renal disease progression. We analyzed renal biopsies from 41 patients with idiopathic FSGS and from 14 control individuals. The alpha-SM-actin immunoreaction was evaluated using a score that reflected the changes in the extent and intensity of staining in the glomerular or cortical area. The PCNA reaction was quantified by counting the labeled cells of the glomeruli or renal cortex. The results, reported as median ± percentile (25th; 75th), showed that the alpha-SM-actin scores in the glomeruli and tubulointerstitium from the renal cortex were 2.0 (2.0; 4.0) and 3.0 (3.0; 4.0), respectively, in patients with FSGS, and 0.5 (0.0; 1.0) and 0.0 (0.0; 0.5) in the controls. The number of PCNA-positive cells per glomerulus and graded field of tubulointerstitium from the renal cortex was 0.2 (0.0; 0.4) and 1.1 (0.3; 2.2), respectively, for patients with FSGS, and 0.0 (0.0; 0.5) and 0.0 (0.0; 0.0) for controls. The present data showed an increase of alpha-SM-actin and PCNA expression in glomeruli and renal cortex from FSGS patients. The extent of immunoreaction for alpha-SM-actin in the tubulointerstitial area was correlated with the intensity of proteinuria. However, there was no correlation between the kidney expression of these proteins and the reciprocal of plasma creatinine level or renal fibrosis. These findings suggest that the immunohistochemical alterations may be reversible

Transforming growth factor beta activity in urine of patients with type 2 diabetes and diabetic nephropathy

Diabetic nephropathy (DN) is characterized structurally by progressive mesangial deposition of extracellular matrix (ECM). Transforming growth factor-ß (TGF-ß) is considered to be one of the major cytokines involved in the regulation of ECM synthesis and degradation. Several studies suggest that an increase in urinary TGF-ß levels may reflect an enhanced production of this polypeptide by the kidney cells. We evaluated TGF-ß in occasional urine samples from 14 normal individuals and 23 patients with type 2 diabetes (13 with persistent proteinuria &gt;500 mg/24 h, DN, 6 with microalbuminuria, DMMA, and 4 with normal urinary albumin excretion, DMN) by enzyme immunoassay. An increase in the rate of urinary TGF-ß excretion (pg/mg UCreat.) was observed in patients with DN (296.07 ± 330.77) (P&lt;0.001) compared to normal individuals (17.04 ± 18.56) (Kruskal-Wallis nonparametric analysis of variance); however, this increase was not observed in patients with DMMA (25.13 ± 11.30) or in DMN (18.16 ± 11.82). There was a positive correlation between the rate of urinary TGF-ß excretion and proteinuria (r = 0.70, <FONT FACE="Symbol">a</font> = 0.05) (Pearson's analysis), one of the parameters of disease progression

Predictive factors of subjective sleep quality and insomnia complaint in patients with stroke: implications for clinical practice

The complaints regarding sleep problems have not been well identified after a stroke. The aim of this study was to investigate the predictive factors of sleep quality and insomnia complaints in patients with stroke. A total of 70 subjects, 40 patients (57 &#177; 7 years) and 30 healthy controls (52 &#177; 6 years) assessed by the Pittsburgh Sleep Quality Index (PSQI) and the Sleep Habits Questionnaire took part in the study. The data were analyzed using the chi-square test, the Student's t-test and logistic regression analysis. On average, the patients showed poor sleep quality (patients: 6.3 &#177; 3.5; controls: 3.9 &#177; 2.2; p= 0.002) and insomnia complaint was the most prevalent (patients: 37.5%; controls: 6.7%; p= 0.007). The absence of insomnia complaint (OR= 0.120; 95%CI= 0.017-0.873; p= 0.036) and the decreased latency of sleep (OR= 0.120; 95%CI= 0.017-0.873; p= 0.036) were the protective factors of sleep quality. Female sex (OR= 11.098; 95%CI= 1.167-105.559; p= 0.036) and fragmented sleep (OR= 32.040; 95%CI= 3.236-317.261; p= 0.003) were the risk factors for insomnia complaint. We suggest that complaints of poor sleep quality and insomnia should be given priority assessment during clinical diagnosis of sleep disorders in stroke

Níveis de ureia em dietas contendo co-produto de vitivinícolas e palma forrageira para ovinos Santa Inês Urea levels in diets containing dried grape byproduct and forage cactus for Santa Inês sheep

Avaliou-se o efeito da inclusão de níveis crescentes de ureia sobre o consumo e a digestibilidade aparente dos nutrientes de dietas contendo coproduto de vitivinícolas desidratado (CVD) e palma forrageira in natura. Foram utilizados 16 ovinos da raça Santa Inês machos, não castrados, com peso médio de 37kg e média de idade de 11 meses. As dietas continham 60% de CVD e 40% de palma forrageira, e níveis crescentes de ureia, 0, 1, 2 e 3%, na matéria seca (MS). O delineamento experimental foi o inteiramente ao acaso, e o experimento foi desenvolvido em dois períodos, com 15 dias de adaptação e cinco dias de coleta cada. Os consumos da MS, fibra em detergente neutro (FDN), carboidratos não fibrosos (CNF) e nutrientes digestíveis totais (NDT) apresentaram comportamento quadrático com valores máximos de 2,04; 0,66; 0,74; 1,50kg/dia, respectivamente. No consumo de proteína bruta (PB), a cada acréscimo de uma unidade percentual de ureia ocorreu aumento de 20 gramas no consumo de PB. Os coeficientes de digestibilidade da MS, PB, FDN e CNF apresentaram comportamento quadrático com valores máximos de 62,5; 85,0; 81,0; e 97,8%, respectivamente. A inclusão de ureia até 2% nas dietas contendo coproduto de vitivinícolas desidratado e palma forrageira in natura possibilitou incrementos no consumo e no coeficiente de digestibilidade dos nutrientes.<br>The effect of urea levels on intake and apparent digestibility of nutrients in diets containing dried wine grape byproduct and fresh forage cactus was evaluated. Sixteen male, non-castrated, Santa Inês sheep, averaging 37kg and 11-month-old were used. The diets had 60% of dried grape byproduct (DGB) and 40% of forage cactus, and increasing levels of urea - 0, 1, 2, and 3% in dry matter. Completely randomized designs with two periods with 15 adjust days and five days for samples collection was carried out. Dry matter (DM), neuter detergent fiber (NDF), non-fibrous carbohydrates (NFC), and total digestive nutrients (TDN) intakes presented quadratic behavior with maximum values of 2.04; 0.66; 0.74; and 1.50kg/day, respectively. For each increase of an unit percentage of urea an increase of 20 grams in the CP intake occurred. The digestibility coefficients of DM, CP, NDF, and NFC presented quadratic behavior with maximum values of 62.5, 85.0, 81.0, and 97.8%, respectively. The inclusion of urea up to 2% in the diets containing dried grape byproduct and fresh forage cactus made possible increases in nutrient intake and coefficient of digestibility of nutrients

Qualidade de vida: abordagens, conceitos e avaliação Calidad de vida: abordajes, conceptos y evaluaciíon Quality of life: approaches, concepts and assessment

Apesar da grande relevância social, o tema qualidade de vida apresenta imprecisões teórico/metodológicas o que dificulta a investigação, o diálogo entre as diferentes áreas que trabalham com o tema e, principalmente, a aplicação do conhecimento produzido na melhoria da qualidade de vida da população. Buscando contribuir para a clarificação do conceito este estudo teve como objetivo, a partir da leitura, discussão e análise da literatura especializada, apresentar as principais abordagens, conceitos e propostas de classificação e avaliação da qualidade de vida. Verificou-se que as abordagens e conceitualizações sobre a qualidade de vida se apresentam na literatura de forma diversificada, e, por vezes, divergentes. A falta de consenso teórico leva muitas pesquisas a utilizarem conceitos como saúde, bem estar e estilo de vida como sinônimos de qualidade de vida. Novas abordagens epistemológicas no estudo do tema são necessárias bem como estudos que analisem a qualidade de vida em situações de intervenção.<br>A pesar de la gran relevancia social, el tema calidad de vida presenta imprecisiones teórico/metodológicas, rasgo que dificulta la investigación, el diálogo entre las diferentes áreas que trabajan con el tema, principalmente, en la aplicación del conocimiento producido para mejorar la calidad de vida de la población. En la búsqueda para contribuir para aclarar el concepto, este estudio tuvo como objetivo, a partir de la lectura, discusión y análisis de la literatura especializada, presentar los principales abordajes, conceptos y propuestas de clasificación y evaluación de la calidad de vida. Se observó que los abordajes y conceptos sobre la calidad de vida se presentan en la literatura de forma diversificada y, por veces, divergentes. La falta de consenso teórico lleva muchas pesquisas a utilizaren conceptos como salud, bienestar y estilo de vida como sinónimos para calidad de vida. Nuevos abordajes epistemológicos en el estudio del tema son necesarios, así como estudios que investiguen la calidad de vida en situaciones de intervención.<br>Despite the great social relevance, the theme quality of life presents theoretical/methodological inaccuracies, fact that makes difficult the investigation, the dialogue among the different areas that deal with the theme, and mainly, the application of the knowledge produced in the improvement of the population's quality of life. In order to contribute for a clarification of the concept, this study had as objective, through the reading, discussion and analysis of the specialized literature, to present the main approaches, concepts and proposals of classification and assessment of quality of life. It was verified that the approaches and conceptualizations about quality of life are presented in the literature in a varied way and, many times, divergent. The lack of theoretical consensus makes many researches to use concepts as health, well-being and life style, as synonyms for quality of life. New approaches in epistemological study of the topic are necessary as well as studies analyzing the quality of life in times of intervention are needed