Associação entre gordura corporal, inflamação e estresse oxidativo na hemodiálise / Association between body fat, inflammation and oxidative stress in hemodialysis

A presença de desnutrição tem sido associada a inflamação e estresse oxidativo (EO) em pacientes em hemodiálise (HD) crônica. Objetivo: Verificar a associação entre marcadores do estado nutricional, incluindo a gordura corporal (GC), marcadores inflamatórios e de EO em pacientes HD. Métodos: Estudo transversal, realizado em 40 pacientes em HD. O estado nutricional foi avaliado por avaliação subjetiva global modificada (SGAm), equivalente protéico do aparecimento de nitrogênio total normalizado (PNAn), albumina sérica (Alb-s), índice de massa corporal (IMC), GC e massa corporal magra (MCM), inflamação e EO foram avaliadas através da proteína C- reativa de (IL-6), produtos protéicos de oxidação avançada (PPOA), 8-hidroxideoxiguanosina (8OHdG) e pentosidina, respectivamente. Resultados: Trinta e sete por cento dos pacientes apresentavam algum grau de desnutrição avaliada pela SGAm. A mediana e variação da GC (Kg) foram de 16,2 (5,3 - 36,7). Com relação aos marcadores inflamatóriose de EO, houve uma correlação positiva e significativa entre IMC e PCRas (R= 0,37; p= 0,02), GC e PCRas (R= 0,32; p= 0,04) e entre PCRas e IL-6 (R= 0,51; p= 0,0007). Correlação negativa foi encontrada entre Alb-s e PCRas (R= -0,31; p= 0,05). Apenas no sexo masculino, a PCRas apresentou relação com IMC (R=0,54; p=0,01) e com a GC (R=0,52; p=0,01). Nenhuma associação foi encontrada entre marcadores inflamatórios e de EO. Conclusão: Marcadores de desnutrição e de excesso de peso não foram correlacionados com EO. A associação da PCRas com IMC e GC somente no sexo masculino pode sugerir diferenças na resposta inflamatória entre os sexos.

The presence of malnutrition has been associated with inflammation and oxidative stress (OS) in patients on hemodialysis (HD) disease. Objective: To investigate the association between markers of nutritional status, including body fat (BF), inflammatory markers and EO in HD patients. Methods: Cross-sectional study in 40 HD patients. Nutritional status was assessed by subjective global assessment modified (SGAM), protein equivalent of total nitrogen appearance normalized (PNAN), albumin (Alb-s), body mass index (BMI), GC and lean body mass (LBM) , inflammation and EO were evaluated by C-reactive protein (IL-6), advanced oxidation protein products (PPOA), 8-hidroxideoxiguanosina (8OHdG) and pentosidine, respectively. Results: Thirty-seven percent of patients had some degree of malnutrition assessed by SGAM. The median and range of the GC (kg) were 16.2 (5.3 to 36.7). Regarding markers inflamatóriose EO, there was a significant positive correlation between BMI and hsCRP level (R = 0.37, p = 0.02), GC and hsCRP level (R = 0.32, p = 0.04) and between hsCRP level and IL-6 (R = 0.51, p = 0.0007). Negative correlation was found between s-Alb and hsCRP level (R = -0.31, p = 0.05). Only in males, the hsCRP level was correlated with BMI (R = 0.54, p = 0.01) and BA (R = 0.52, p = 0.01). No association was found between inflammatory markers and EO. Conclusion: Markers of malnutrition and overweight were not associated with EO. The association of hsCRP level with BMI and BF only in males may suggest differences in inflammatory response between the sexes.

Etiology and occurrence of acute bacterial meningitis in children in Benghazi Libyan Arab Jamahiriya

Over a 14-month period, 77 children with a presumptive diagnosis of acute bacterial meningitis were investigated. The incidence of acute bacterial meningitis was 0.8%, with a case fatality rate of 13.0%. Children pound 1 year of age were more affected [64.9%]. The total male to female ratio was 1.2:1. Gram stain detected more cases [85.7%] than culture [66.2%]. A total of 48 isolates were identified by culture and their antibiotic sensitivity was determined. Haemophilus influenzae [33.8%] was the predominant organism identified, followed by Streptococcus pneumoniae [26.0%], Klebsiella spp. [6.5%] and Neisseria meningitidis [2.6%]. Many of the bacterial isolates were sensitive to gentamicin, cefotaxime and ceftriaxone and least sensitive to tetracycline and ampicillin