Muusika retseptiivses muusikateraapias: Eesti muusikaterapeutide praktikad

Eesti Arst 2023; 102(6–7):366–37

Kaasasündinud südamerikete geneetilised põhjused

Kaasasündinud südamerike (KSSR) on üks levinum kaasasündinud arengurike, mille tekkes on oluline roll geneetilistel teguritel. Pärilikud KSSRid jaotatakse sündroomseteks ja mittesündroomseteks. Põhjused võivad olla nii kromosomaalsed (nt Downi sündroom, Williamsi sündroom), ühe geeni häired (nt Allagille’i sündroom) kui ka mitmetegurilised (pärilik eelsoodumus). Diagnostikaks on võimalik kasutada tsütogeneetilist uuringut, FISH-analüüsi, molekulaarseid teste geenimutatsioonide tuvastamiseks ning ka fenotüübi uuringut. Mittesündroomsed KSSRid on geneetiliselt väga heterogeensed. Seoses südamerikete esinemisega on avastatud umbes 20 erinevat geeni. KSSRi ravis võib rikke geneetilisest põhjusest sõltuda selle prognoos ja kliiniline kulg, hinnang kordusriskile, samuti vajadus perekonna teiste liikmete testimiseks ning sünnieelseks diagnostikaks. Eesti Arst 2008; 87(5):367−37

Use of Water Immersion to Ameliorate the Progression of Chronic Experimental Kidney Disease

The possible benefits of aquatic environment to kidney function in renal failure stages not much been investigated.  It is known that water environment could influence renal function positively: plasma renin activity  is reduced, contributing to renal vascular pressure and sodium excretion. Water immersion causes increase  in renal blood flow and contributes to the lowering in renal sympathetic nerve activity, renal vascular pressure  and decrease in plasma renin activity. Non-swimming aerobic aquatic exercises have shown a beneficial  effect to chronic kidney disease patients. We hypothesized that the aquatic environment could improve  renal functioning and even slow the progression rate of chronic kidney disease (CKD). The aim of our study  was to investigate the effects of regular water immersion and voluntary swimming to the rate of progression  of experimental CKD. Wistar rats were divided into matched groups 2 weeks after 5/6 nephrectomy  (5/6NPX) and studied during 18 weeks. One group was subjected to water immersion with water temperature  38o and swimming without exhaustion 30 min daily for 12 weeks. Control groups remained sedentary.  Chronic studies of systolic blood pressure and urinary protein excretion rate (mg/24h) were performed.  Renal morphology was studied and MCP-1 gene expression level was investigated in kidney tissue samples  at the end of the study. The main systolic blood pressure was significantly lower and proteinuria was reduced  significantly in the swimming-immersion group compared to control 5/6NPX animals. The degree  of glomerulosclerosis and interstitial fibrosis was significantly less prominent in the water-therapy group.  Expression of mRNA for chemokine MCP-1 in glomeruli of CKD animals differs significantly between the  water-therapy group and control 5/6NPX group and was closely associated with effects on proteinuria and  systolic blood pressure. These results point to the additional renoprotective properties of long-term water  immersion and daily aquatic therapy in rats with CKD.