Induction of Heme Oxygenase-1 Can Halt and Even Reverse Renal Tubule-Interstitial Fibrosis

Background: The tubule-interstitial fibrosis is the hallmark of progressive renal disease and is strongly associated with inflammation of this compartment. Heme-oxygenase-1 (HO-1) is a cytoprotective molecule that has been shown to be beneficial in various models of renal injury. However, the role of HO-1 in reversing an established renal scar has not yet been addressed. Aim: We explored the ability of HO-1 to halt and reverse the establishment of fibrosis in an experimental model of chronic renal disease. Methods: Sprague-Dawley male rats were subjected to unilateral ureteral obstruction (UUO) and divided into two groups: non-treated and Hemin-treated. To study the prevention of fibrosis, animals were pre-treated with Hemin at days -2 and -1 prior to UUO. To investigate whether HO-1 could reverse established fibrosis, Hemin therapy was given at days 6 and 7 post-surgery. After 7 and/or 14 days, animals were sacrificed and blood, urine and kidney tissue samples were collected for analyses. Renal function was determined by assessing the serum creatinine, inulin clearance, proteinuria/creatininuria ratio and extent of albuminuria. Arterial blood pressure was measured and fibrosis was quantified by Picrosirius staining. Gene and protein expression of pro-inflammatory and pro-fibrotic molecules, as well as HO-1 were performed. Results: Pre-treatment with Hemin upregulated HO-1 expression and significantly reduced proteinuria, albuminuria, inflammation and pro-fibrotic protein and gene expressions in animals subjected to UUO. Interestingly, the delayed treatment with Hemin was also able to reduce renal dysfunction and to decrease the expression of pro-inflammatory molecules, all in association with significantly reduced levels of fibrosis-related molecules and collagen deposition. Finally, TGF-beta protein production was significantly lower in Hemin-treated animals. Conclusion: Treatment with Hemin was able both to prevent the progression of fibrosis and to reverse an established renal scar. Modulation of inflammation appears to be the major mechanism behind HO-1 cytoprotection.Fundacao de Amparo Pesquisa do Estado de Sao Paulo-FAPESP[07/07139-3]Coordenaco de Aperfeioamento de Pessoal de Nivel Superior-CAPESInstituto Nacional de Ciencia e Tecnologia de Complexos Fluidos (INCT)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico-CNP

Compression of the peripheral branches of the sciatic nerve by lipoma

The authors report two female patients with chronic sensitive and motor findings in lower limbs caused by compression of distal branches of sciatic nerve by lipoma. Similar eases were not described on literature. Nerve conduction studies allowed to localize the exact site of compression. At surgery, lipomas compressing the deep peroneal nerve (case 1) and the posterior tibial nerve (case 2) were observed. Histologic studies of tumors confirmed the diagnoses

Política de saúde do trabalhador no Brasil: muitas questões sem respostas National worker's health policy: many questions without answers

Este artigo enfoca a Política Nacional de Saúde do Trabalhador, na perspectiva da expressão do descaso que esta representa frente ao quadro dramático de morbi-mortalidade da classe trabalhadora brasileira. Indica os principais problemas que a política apresenta, destacando questões como a subnotificação das doenças profissionais e dos acidentes de trabalho; a competência das ações, denunciando a fragmentação de responsabilidades a partir da existência de diversas instituições e órgãos com atribuições de intervenção na área; a forma marginal, historicamente estabelecida, como é tratada a Política de Saúde do Trabalhador no contexto da Política Nacional de Saúde; as dificuldades na formação de recursos humanos, entre outras. Aponta para a necessidade de uma política que assegure aos trabalhadores brasileiros a transformação real do grave quadro de mortes e doenças em que encontram-se submetidos, desencadeando processos preventivos de fato, a partir da reestruturação dos processos produtivos e tendo os trabalhadores como condutores desta política. Finalmente, levanta uma série de questões, ainda sem resposta, que possam servir de matéria para investigações, estudos e pesquisas na área.<br>The National Worker's Health Policy is analysed, pointing to such problems as undernotification of occupational diseases and work-related accidents, accountability fragmentation among various organizations, the importance worker's health policy in the context of the National Health Policy, and the lack of trained personnel. This extremely serious situation should be reverted by structural changes in the productive processes, with the active participation of workers both in the stablishment and conduction of this policy. Finally, this paper points to several issues that can contribute to future investigations, research and studies in this area