Prevalence and Clinical Characteristics of Asymptomatic Pyuria in Chronic Kidney Disease

BACKGROUND: Pyuria seems to be common in chronic kidney disease (CKD), irrespective of urinary tract infection (UTI). It has been hypothesized that sterile pyuria occurs in CKD because of chronic renal parenchymal inflammation. However, there are limited data on whether CKD increases the rate of pyuria or how pyuria in CKD should be interpreted. We investigated the prevalence and characteristics of asymptomatic pyuria (ASP) in CKD via urinary white blood cell (WBC) analysis.METHODS: Urine examination was performed for all stable hemodialysis (HD) and non-dialysis CKD patients of the outpatient clinic (total N=298). Patients with infection symptoms or recent history of antibiotic use were excluded. Urine culture and WBC analysis were performed when urinalysis revealed pyuria.RESULTS: The prevalence of ASP was 30.5% (24.1% in non-dialysis CKD and 51.4% in HD patients). Over 70% of the pyuria cases were sterile. The majority of urinary WBCs were neutrophils, even in sterile pyuria. However, the percentage of neutrophils was significantly lower in sterile pyuria. In multivariate logistic regression analysis, the degree of pyuria, percentage of neutrophils, and presence of urinary nitrites remained independently associated with sterile pyuria.CONCLUSIONS: The prevalence of ASP was higher in CKD patients and increased according to CKD stage. Most ASP in CKD was sterile. Ascertaining the number and distribution of urinary WBCs may be helpful for interpreting ASP in CKD.

Evaluation of hypoxia/reoxygenation injury of H9C2 myocardial cells and intervention effect of notoginsenoside R1 based on RTCA technology / 中国药理学通报

Aim: To establish the standard hypoxia/reoxygenation (H/R) injury model of H9c2 myocardial cells and evaluate the intervention effect of notoginsenoside R, based on RTCA technology. Methods: H9c2 myocardial cells were inoculated into the E-Plate board, 3 wells by a group, then the growth curve and cell index of different hypoxia time, different reoxygenation time and notoginsenoside R, intervention were determined respectively, with the growth status of H9c2 myocardial cells reflected by cell index. Results: Cell survival rate was (48.82 ±5.32)% after hypoxia treatment for 4h and reoxygenation treatment for 16h with replacement of serum-free, glucose-free DMEM medium before hypoxia, and no significant difference was found between the results measured with MTT method. Notoginsenoside R, could protect the hypoxia/reoxygenation injury of H9c2 myocardial cells without time dependence. Conclusions: RTCA technology is an effective means to establish the standard H/R injury model of H9c2 myocardial cells, which also has some guiding significance in discovering new drug targets and mechanisms.

Estudo comparativo da ação anti-inflamatória do óleo-resina da Copaifera reticulata em modelos farmacológicos experimentais em camundongos / Comparative study of oleoresin of copaiba species Copaifera reticulata as antiinflammatory in experimental models in mice

Na Região Amazônica o uso do óleo das árvores copaibeiras é tão extenso, que a copaíba se destaca como a planta medicinal mais utilizada e conhecida pela população amazônica. Existem diversas indicações para a utilização do óleo-resina de copaíba com pouco respaldo científico. Avaliar a ação do óleo-resina de copaíba da espécie Copaifera reticulata como antiinflamatório em modelos experimentais de reação inflamatória aguda foi o objetivo desta pesquisa. Para isso, foram utilizados 4 grupos de 7 camundongos da linhagem Swiss Webster, que receberam tratamento veiculado com o ultrassom, e o óleo-resina extraído de árvore da espécie Copaífera reticulata. O modelo de inflamação aguda bolsa de ar (air pouch) induzida por carragenina foi utilizado para avaliar o efeito anti-inflamatório do óleo-resina de copaíba (in natura). As análises ocorreram no exsudato que foi avaliado quanto ao conteúdo total de proteínas, número total de leucócitos e análise celular. Para análise estatística foi eleito o teste de Kruskal-Wallis com nível de significância alfa = 0,05. As células totais e as mononucleares não mostraram diferenças estatisticamente significantes entre si nem em relação ao grupo copaíba. A comparação do nível de proteínas apresentou diferença significativa (p-valor < 0,01) entre o grupo controle (0,2608 ± 0,1557) e o grupo tratado por carragenina (0,597 ± 0,152). Foi observada diferença real (1,4 neutrófilos) entre os grupos carragenina (2,0079 ± 1,5231) e o grupo copaíba (0,6063 ± 0,32). Conclui-se que a atividade anti-inflamatória do óleo-resina é potencialmente importante como fonte de princípios ativos e que o ultrassom proporcionou a facilitação e aceleração da penetração transcutânea do óleo-resina de copaíba, favorecendo o seu uso tópico. (AU)

In the Amazon region the use of oil of copaibeira trees is so extensive that the copal stands out as the most known medicinal plant used by Amazonian population. There are several indications for the use oleoresin of copaiba with little scientific backing. The aim of this study was to evaluate the effects of oleoresin of copaiba species Copaifera reticulata as antiinflammatory in experimental models of acute inflammatory reaction. For this, we used 28 mice of Swiss Webster strain, who received treatment with ultrasound aired, and oleoresin extracted from Copaifera reticulata. The model of acute inflammation air pouch induced by carrageenan was used to evaluate the anti-inflammatory effect of oleoresin of copaiba (fresh). The analysis occurred in the exudate analyzed for total protein content, total number of leukocytes and cell analysis. For statistical analysis was elected the Kruskal-Wallis test with significance level alpha = 0.05. Total cells and mononuclear cells showed no statistically significant differences among themselves or in relation to the group copal. The comparison of protein level showed a significant difference (p-value < 0.01 *), saline was lower (0.2608 ± 0.1557) than carrageenan (0.597 ± 0.152). Real difference was observed (1.4 neutrophils) between groups carrageenan (2.0079 ± 1.5231) and the group copaíba (0.6063 ± 0:32). We concluded that the antiinflammatory activity of the oleoresin is potentially important as a source of active ingredients and provided that ultrasound facilitation and acceleration of transcutaneous penetration of the copaiba oil, favoring its topical use. (AU)

Research on Detecting Doubling Time of Human and Rat Airway Smooth Muscle Cells with A Real Time Cellular Analyzer / 现代检验医学杂志

Objective To detect the doubling time of airway smooth muscle cells of human and rat by the xCELLigence in-strument,a real time cellular analyzer.Methods The airway smooth muscle cells were separated by collagenase-pancreatin digestion from the rat airway.Then,added to the different holes of E-plate of xCELLigence instrument with the planting destiny of 3 000 cells/well.and so were the human airway smooth muscle cells.The E-plate was then placed on the xCELLi-gence instrument to monitor cell proliferation for 100 hours to calculate the doubling time by using the RTCA Software Package 2.0 software.Results The doubling time of human airway smooth muscle cell calculated by the real time cellular analyzer was 23.96±0.47 h,which was consistent with the data provided by the reference.The doubling time of rat airway smooth muscle cell was 18.62±0.15 h,and the computational process was simple,time-saving and also effective.Conclusion The xCELLigence instrument can be used to calculate doubling time of airway smooth muscle cells of human and rat, which provides experimental methods and reference data for the basic respiratory disease research.

Evaluation of RDW-CV, RDW-SD, and MATH-1SD for the detection of erythrocyte anisocytosis observed by optical microscopy / Avaliação de RDW-CV, RDW-SD e MATH-1SD na detecção da anisocitose dos eritrócitos visualizados na microscopia óptica

INTRODUCTION AND OBJECTIVE: To evaluate the performance of red cell distribution width reported statistically as coefficient of variation (RDW-CV), standard deviation (RDW-SD), and mathematical deduction of 1 standard deviation (SD) around mean corpuscular volume (MATH-1SD) in identifying anisocytosis in automated blood counts when compared with the manual quantification of erythrocyte anisocytosis in peripheral blood smears. MATERIAL AND METHODS: 806 routine samples obtained from the hematology laboratory of Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR) were analyzed. Performance evaluations were carried out by dividing samples into microcytic, normocytic and macrocytic mean corpuscular volume (MCV). For each MCV range, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and efficiency were calculated. In addition, the Youden index (Y) was obtained and a comparative analysis with receiver operating characteristic (ROC) curves was done to evaluate the performance of RDW-SD, RDW-CV, and MATH-1SD on different MCV ranges. RESULTS AND DISCUSSION: RDW-CV had the best sensitivity (86.8%) and efficiency (86.8%) in detecting anisocytosis in microcytic MCV ranges. RDW-SD and MATH-1SD were more sensitive and efficient in normocytic (82.9% and 83.3%; 92.1% and 92.3%, respectively) and macrocytic (90.2% and 90.2%; 95.1% and 95.1%, respectively) MCV ranges. A ROC curve analysis indicated that RDW-CV was more efficient in detecting anisocytosis in microcytic MCV ranges (p < 0.05 vs. RDW-SD and MATH-1SD). In normocytic and macrocytic MCV ranges, RDW-SD and MATH-1SD showed similar efficiency in detecting anisocytosis (p < 0.05 vs. RDW-CV). CONCLUSION: RDW-SD, RDW-CV, and MATH-1SD deliver different performances in detecting blood smear anisocytosis according to MCV values. They are parameters that complement each other and should be used together to identify erythrocyte size heterogeneity.

INTRODUÇÃO E OBJETIVO: Avaliar o desempenho do red cell distribution width expresso em coeficiente de variação (RDW-CV) e desvio padrão (RDW-SD) e da dedução matemática de 1 desvio padrão (DP) ao redor do volume corpuscular médio (MATH-1SD) ao identificar anisocitose nos hemogramas automatizados, quando comparados com o método manual de quantificação da anisocitose eritrocitária em lâmina. MATERIAL E MÉTODOS: Foram analisadas 806 amostras obtidas da rotina laboratorial da Seção de Hematologia do Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR). As avaliações de desempenho foram realizadas dividindo-se as amostras em volume corpuscular médio (VCM) microcítico, VCM normocítico e VCM macrocítico. Para cada faixa de VCM, sensibilidade, especificidade, valor preditivo positivo (VPP), valor preditivo negativo (VPN) e eficiência foram determinados. Além disso, o índice de Youden foi calculado e uma análise comparativa de curvas de características de operação do receptor (curvas ROC [receiver operating characteristic]) foi realizada para verificar o desempenho de RDW-CV, RDW-SD e MATH-1SD em diferentes faixas de VCM. RESULTADOS E DISCUSSÃO: O RDW-CV obteve a melhor sensibilidade (86,8%) e eficiência (86,8%) ao detectar anisocitose em faixas de VCM microcítico. O RDW-SD e o MATH 1SD foram mais sensíveis e eficientes em VCM normocítico (82,9% e 83,3%; 92,1% e 92,3%, respectivamente) e macrocítico (90,2% e 90,2%; 95,1% e 95,1%, respectivamente). A comparação de curvas ROC demonstrou que o RDW-CV foi mais eficiente ao detectar anisocitose em VCM microcítico (p < 0,05 vs. RDW-SD e MATH-1SD). Em VCM normocítico e macrocítico, o RDW-SD e o MATH-1SD mostraram eficiência semelhante ao detectar anisocitose (p < 0,05 vs. RDW-CV). CONCLUSÃO: RDW-CV, RDW-SD e MATH-1SD possuem desempenhos diferentes ao detectar anisocitose em lâmina conforme a faixa de VCM. São parâmetros que se complementam e que devem ser utilizados em conjunto na identificação de heterogeneidade dos tamanhos eritrocitários.

Valor del estudio celular del esputo en el seguimiento de las enfermedades inflamatorias de la vía aérea / Value of sputum analysis in the management of inflammatory airway diseases

El análisis celular del esputo, espontáneo u obtenido mediante la técnica de esputo inducido, se ha transformado en una herramienta ampliamente difundida para la evaluación y orientación del tratamiento de las enfermedades inflamatorias de la vía aérea, principalmente asma, enfermedad pulmonar obstructiva crónica y bronquitis eosinofílica. Se han aportado evidencias sobre la utilidad de la técnica del esputo inducido, validada y estandarizada, para ser empleada en pacientes con dificultades para expectorar. Numerosas investigaciones dieron cuenta de la efectividad de basar las decisiones terapéuticas en el componente inflamatorio de la vía aérea mediante el recuento de células en el esputo. Varios estudios mostraron que, en pacientes con asma el análisis celular de esputo guía en la determinación de estrategias para disminuir las exacerbaciones y para mejorar la función pulmonar, aun en pacientes con asma grave, para disminuir el remodelamiento; también se ha descrito su utilidad en pacientes con EPOC, para la disminución de las exacerbaciones.

Cellular analysis of sputum either spontaneous or by induced sputum technique, has become a widespread tool for the evaluation and guidance of treatment of inflammatory diseases of the airway, primarily asthma, COPD and eosinophilic bronchitis. Induced sputum method is a validated, standardized and non-invasive technique, useful in patients with difficulties to expectorate. Its implementation is simple and cost effective. Numerous investigations have shown the effectiveness of basing treatment decisions on the inflammatory component of the airway by counting cells in sputum. Several studies have demonstrated that in patients with asthma, results of this analysis can guide in defining strategies to reduce exacerbations and to improve lung function even in patients with severe asthma, as well as to decrease the remodeling; in addition, a reduction in exacerbations in COPD patients, monitored by this sputum examination, has also been described.