Hepatitis C and nephropathy

OBJETIVOS: Vários estudos associam a infecção crônica pelo vírus da hepatite C a manifestações extra-hepáticas, incluindo glomerulopatias. O objetivo deste artigo é fazer uma breve revisão da literatura sobre as manifestações renais da hepatite C e apresentar os resultados sumarizados de estudo que buscou avaliar a associação de alterações urinárias assintomáticas em doadores de sangue com anticorpos anti- VHCHC positivo. MATERIAIS E MÉTODOS: Realizou-se um estudo transversal, contemporâneo, controlado e aberto no período de julho de 1997 a março de 1998 no Serviço de Nefrologia do HCPA para avaliar a prevalência de alterações urinárias assintomáticas em portadores do vírus da hepatite C. Foram incluídos no estudo os 58 doadores de sangue VHC+ e 128 doadores VHC- (grupo controle) que não apresentavam história de doença hepática ou renal ou outros marcadores virais positivos. Avaliou-se a prevalência de hematúria (> 5 hemácias/campo de grande aumento no E.Q.U), proteinúria [uma (+) no exame por fita do E.Q.U], microalbuminúria (índice microalbuminúria/creatininúria em amostra isolada > 15,6 mg/g), N-acetil-beta-D-glucosaminidase (> 5,6U/g creatinina). RESULTADOS: Não foi constatada anormalidade urinária significativa no grupo VHC+, comparativamente com o grupo controle. A prevalência de hematúria e proteinúria nos grupos VHC+ e VHC- foi respectivamente 12,0% x 9,4% e 5,4% x 5,5% , sem diferença estatística entre os 2 grupos. CONCLUSÃO: A prevalência de hematúria foi semelhante à da população geral, que oscila entre 3-20%.OBJECTIVE: Many studies have associated hepatitis C virus infection with extra-hepatic manifestations, including glomerulopathies. Our objective is to present a brief review of the literature regarding renal manifestations of hepatitis C and the summarized results from a study aimed at evaluating the association of asymptomatic urinary abnormalities in anti-HCV positive blood donors . MATERIALS AND METHODS: We carried out a cross-sectional, contemporary, controlled, open study from July 1997 to March 1998 at the Nephrology Services at Hospital de Clínicas de Porto Alegre in order to evaluate the prevalence of asymptomatic urinary abnormalities in hepatitis-C virus carriers. We included 58 blood donors positive for HCV and 128 donors negative for HCV (control group) without history of hepatic or renal disease and without other positive viral markers. We assessed prevalence of hematuria (> 5 red blood cells per high power field in urinary sediment); proteinuria (1 dipstick positive); microalbuminuria (microalbuminuria/creatinine ratio from an isolated sample >15.6 mg/g); and N-acetyl-beta-glucosaminidase (> 5.6 U/g creatinine). RESULTS: The data showed that the group positive for anti-HCV did not present significant urinary abnormalitiies when compared to a control group. The prevalence of hematuria and proteinuria in the HCV+ e HCV- groups was, respectively, 12.0% x 9.4% and 5.4% x 5.6% with no statistically significant differences. CONCLUSION: The prevalence of hematuria was similar to that found in the general population (3-20%)

Hepatitis C and nephropathy

OBJETIVOS: Vários estudos associam a infecção crônica pelo vírus da hepatite C a manifestações extra-hepáticas, incluindo glomerulopatias. O objetivo deste artigo é fazer uma breve revisão da literatura sobre as manifestações renais da hepatite C e apresentar os resultados sumarizados de estudo que buscou avaliar a associação de alterações urinárias assintomáticas em doadores de sangue com anticorpos anti- VHCHC positivo. MATERIAIS E MÉTODOS: Realizou-se um estudo transversal, contemporâneo, controlado e aberto no período de julho de 1997 a março de 1998 no Serviço de Nefrologia do HCPA para avaliar a prevalência de alterações urinárias assintomáticas em portadores do vírus da hepatite C. Foram incluídos no estudo os 58 doadores de sangue VHC+ e 128 doadores VHC- (grupo controle) que não apresentavam história de doença hepática ou renal ou outros marcadores virais positivos. Avaliou-se a prevalência de hematúria (> 5 hemácias/campo de grande aumento no E.Q.U), proteinúria [uma (+) no exame por fita do E.Q.U], microalbuminúria (índice microalbuminúria/creatininúria em amostra isolada > 15,6 mg/g), N-acetil-beta-D-glucosaminidase (> 5,6U/g creatinina). RESULTADOS: Não foi constatada anormalidade urinária significativa no grupo VHC+, comparativamente com o grupo controle. A prevalência de hematúria e proteinúria nos grupos VHC+ e VHC- foi respectivamente 12,0% x 9,4% e 5,4% x 5,5% , sem diferença estatística entre os 2 grupos. CONCLUSÃO: A prevalência de hematúria foi semelhante à da população geral, que oscila entre 3-20%.OBJECTIVE: Many studies have associated hepatitis C virus infection with extra-hepatic manifestations, including glomerulopathies. Our objective is to present a brief review of the literature regarding renal manifestations of hepatitis C and the summarized results from a study aimed at evaluating the association of asymptomatic urinary abnormalities in anti-HCV positive blood donors . MATERIALS AND METHODS: We carried out a cross-sectional, contemporary, controlled, open study from July 1997 to March 1998 at the Nephrology Services at Hospital de Clínicas de Porto Alegre in order to evaluate the prevalence of asymptomatic urinary abnormalities in hepatitis-C virus carriers. We included 58 blood donors positive for HCV and 128 donors negative for HCV (control group) without history of hepatic or renal disease and without other positive viral markers. We assessed prevalence of hematuria (> 5 red blood cells per high power field in urinary sediment); proteinuria (1 dipstick positive); microalbuminuria (microalbuminuria/creatinine ratio from an isolated sample >15.6 mg/g); and N-acetyl-beta-glucosaminidase (> 5.6 U/g creatinine). RESULTS: The data showed that the group positive for anti-HCV did not present significant urinary abnormalitiies when compared to a control group. The prevalence of hematuria and proteinuria in the HCV+ e HCV- groups was, respectively, 12.0% x 9.4% and 5.4% x 5.6% with no statistically significant differences. CONCLUSION: The prevalence of hematuria was similar to that found in the general population (3-20%)

Asma aguda em adultos na sala de emergência : o manejo clínico na primeira hora

Asma é doença com alta prevalência em nosso meio e ao redor do mundo. Embora novas opções terapêuticas tenham sido recentemente desenvolvidas, parece haver aumento mundial na sua morbidade e mortalidade. Em muitas instituições, as exacerbações asmáticas ainda constituem emergência médica muito comum. As evidências têm demonstrado que a primeira hora no manejo da asma aguda na sala de emergência concentra decisões cruciais que podem determinar o desfecho desta situação clínica. Nesta revisão não-sistemática, os autores enfocaram a primeira hora da avaliação e tratamento do paciente com asma aguda na sala de emergência, descrevendo uma estratégia apropriada para o seu manejo. São consideradas as seguintes etapas: diagnóstico, avaliação da gravidade, tratamento farmacológico, avaliação das complicações e decisão sobre onde se realizará o tratamento adicional. Espera-se que estas recomendações contribuam para que o médico clínico tome a decisão apropriada na primeira hora do manejo da asma aguda.Asthma is a disease with high prevalence in our country and around the world. Although new therapeutic approaches have been recently developed, there appears to be a worldwide increase in morbidity and mortality from asthma. In many institutions, asthma exacerbation is still a common medical emergency. Clinical evidence demonstrates that the first hour of management of acute asthma in the emergency room entails crucial decisions that could be determinant in the clinical outcome. In this non-systematic review, the authors focus on the first hour assessment and treatment of patients with acute asthma and outline an appropriate strategy for their management. Diagnosis, severity assessment, pharmacological treatment, complications, and the decision regarding the place where additional treatment will take place will be considered. It is reasonable to expect that these recommendations will help physicians make appropriate decisions about the first hour care of acute asthma in the emergency room

Lipid peroxidation and total radical-trapping potential of the lungs of rats submitted to chronic and sub-chronic stress

Exposure to stress induces a cluster of physiological and behavioral changes in an effort to maintain the homeostasis of the organism. Long-term exposure to stress, however, has detrimental effects on several cell functions such as the impairment of antioxidant defenses leading to oxidative damage. Oxidative stress is a central feature of many diseases. The lungs are particularly susceptible to lesions by free radicals and pulmonary antioxidant defenses are extensively distributed and include both enzymatic and non-enzymatic systems. The aim of the present study was to determine lipid peroxidation and total radical-trapping potential (TRAP) changes in lungs of rats submitted to different models of chronic stress. Adult male Wistar rats weighing 180-230 g were submitted to different stressors (variable stress, N = 7) or repeated restraint stress for 15 (N = 10) or 40 days (N = 6) and compared to control groups (N = 10 each). Lipid peroxidation levels were assessed by thiobarbituric acid reactive substances (TBARS), and TRAP was measured by the decrease in luminescence using the 2- 2'-azo-bis(2-amidinopropane)-luminol system. Chronic variable stress induced a 51% increase in oxidative stress in lungs (control group: 0.037 ± 0.002; variable stress: 0.056 ± 0.007, P < 0.01). No difference in TBARS was observed after chronic restraint stress, but a significant 57% increase in TRAP was presented by the group repeatedly restrained for 15 days (control group: 2.48 ± 0.42; stressed: 3.65 ± 0.16, P < 0.05). We conclude that different stressors induce different effects on the oxidative status of the organism

Análise do polimorfismo de inserção/deleção do gene da enzima conversora da angiotensina e presença de complicações crônicas em pacientes com diabete melito tipo 2

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Lipid peroxidation and total radical-trapping potential of the lungs of rats submitted to chronic and sub-chronic stress

Exposure to stress induces a cluster of physiological and behavioral changes in an effort to maintain the homeostasis of the organism. Long-term exposure to stress, however, has detrimental effects on several cell functions such as the impairment of antioxidant defenses leading to oxidative damage. Oxidative stress is a central feature of many diseases. The lungs are particularly susceptible to lesions by free radicals and pulmonary antioxidant defenses are extensively distributed and include both enzymatic and non-enzymatic systems. The aim of the present study was to determine lipid peroxidation and total radical-trapping potential (TRAP) changes in lungs of rats submitted to different models of chronic stress. Adult male Wistar rats weighing 180-230 g were submitted to different stressors (variable stress, N = 7) or repeated restraint stress for 15 (N = 10) or 40 days (N = 6) and compared to control groups (N = 10 each). Lipid peroxidation levels were assessed by thiobarbituric acid reactive substances (TBARS), and TRAP was measured by the decrease in luminescence using the 2- 2'-azo-bis(2-amidinopropane)-luminol system. Chronic variable stress induced a 51% increase in oxidative stress in lungs (control group: 0.037 ± 0.002; variable stress: 0.056 ± 0.007, P < 0.01). No difference in TBARS was observed after chronic restraint stress, but a significant 57% increase in TRAP was presented by the group repeatedly restrained for 15 days (control group: 2.48 ± 0.42; stressed: 3.65 ± 0.16, P < 0.05). We conclude that different stressors induce different effects on the oxidative status of the organism