Increased oxidative stress in foam cells obtained from hemodialysis patients.

Premature atherosclerosis represents the main cause of mortality among end-stage renal disease patients (ESRD). Increased inflammation and oxidative stress are involved in initiation and progression of the atherosclerotic plaque. As foam cells are capable of producing significant amounts of inflammatory mediators and free radicals, we hypothesized that foam cells from uremic patients could produce more inflammation and oxidative stress than foam cells from normal people and be, somehow, involved in the accelerated atherosclerosis of uremia. To test this hypothesis, the levels of a few markers of inflammation and oxidative stress: Tumor necrosis factor-α, inducible nitric oxide synthase, malondialdehyde, nitric oxide by-products were measured in the supernatants of macrophage-derived foam cells cultures from 18 hemodialysis patients and 18 apparently healthy individuals controls. Malondialdehyde levels in the supernatant of cell cultures (macrophages stimulated or not with native and oxidized lipoprotein) were significantly increased in uremic patients; no statistically significant difference was found between the supernatant concentrations of nitric oxide by-products, inducible nitric oxide synthase activity, and tumor necrosis factor-α between patients and controls. Our results, obtained with human macrophages and macrophage-derived foam cells, are compatible with the theory that increased cellular oxidative stress and inflammatory activity in ESRD patients could accelerate the atherosclerotic process. The present culture protocol showed it is possible to use human mononuclear cells to evaluate the oxidative metabolism of foam cells, which are considered to be the initial step of atherosclerotic lesions.

Effectiveness of aerobic physical training for treatment of chronic asymptomatic bacteriuria in subjects with spinal cord injury: a randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness and safety of aerobic physical training for treatment of chronic asymptomatic bacteriuria in subjects with spinal cord injury. DESIGN: Randomized controlled trial. SETTING: University hospital. SUBJECTS: Forty-two participants with spinal cord injury between C8 and T12 segments were randomly assigned to intervention or control groups. INTERVENTION: In the intervention group, subjects received a risk evaluation, stress test and urinary culture before the start of the study and after 16 weeks. The study consisted of aerobic physical conditioning with moderate intensity for the intervention group while the control group was asked to maintain their daily life activities. MAIN MEASURES: Increase of estimated peak oxygen consumption and also if there was a decrease in the proportions of positive urinary culture. RESULTS: The intervention group showed an increase of estimated peak oxygen consumption of between 939 (714-1215) and 1154 (1005-1351) mL/min (P = 0.009) and a reduction of chronic asymptomatic bacteria of between 52.3% (29.8-74.3%) and 14.2% (3-36.3%) (P < 0.001). No adverse effects related to physical activity were recorded during the period of training. CONCLUSION: The regular practice of physical activity of moderate intensity applied to patients with spinal cord injury may be an effective and safe method for the treatment of chronic asymptomatic bacteriuria.

The acute-phase proteins serum amyloid A and C reactive protein in transudates and exudates.

The distinction between exudates and transudates is very important in the patient management. Here we evaluate whether the acute-phase protein serum amyloid A (SAA), in comparison with C reactive protein (CRP) and total protein (TP), can be useful in this discrimination. CRP, SAA, and TP were determined in 36 exudate samples (27 pleural and 9 ascitic) and in 12 transudates (9 pleural and 3 ascitic). CRP, SAA, and TP were measured. SAA present in the exudate corresponded to 10% of the amount found in serum, that is, the exudate/serum ratio (E/S) was 0.10 +/- 0.13. For comparison, the exudate/serum ratio for CRP and TP was 0.39 +/- 0.37 and 0.68 +/- 0.15, respectively. There was a strong positive correlation between serum and exudate SAA concentration (r = 0.764; p < 0.0001). The concentration of SAA in transudates was low and did not overlap with that found in exudates (0.02-0.21 versus 0.8-360.5 g/mL). SAA in pleural and ascitic exudates results mainly from leakage of the serum protein via the inflamed membrane. A comparison of the E/S ratio of SAA and CRP points SAA as a very good marker in discriminating between exudates and transudates.

Eficacia del entrenamiento teorico-practico en anatomía palpatoria empleada a los estudiantes de la carrera de fisioterapía / Effectiveness of the theoretical-practical training in palpatory anatomy applied to the physical therapy students

El objetivo del trabajo fue verificar la eficacia del entrenamiento teórico-práctico en Anatomía Palpatoria, estableciendo una interpretación de la Anatomía de Superficie Humana, reconocida por el contacto manual en sujetos normales. Una población de 49 alumnos fueron incluidos por los criterios de inclusión, y randomizados en dos grupos. El grupo A (NA=23) siguió estudiando las disciplinas curriculares y el grupo B (NB= 26) recibió el contenido de la disciplina especial. Fueron aplicadas evaluaciones para ambos los grupos, antes y después de la realización de la disciplina. Durante los períodos pre y post-entrenamiento, la muestra estudiada asumió una distribución normal en los dos grupos. En la comparación entre los grupos y en la intra-grupos se utilizó el test ANOVA del paquete estadístico SPSS. Las medias de las notas de los grupos antes de la disciplina fueron similares, grupo Apre con (MApre)= 5,34 ñ 1,48; grupo Bpre (MBpre)= 5,40 ñ 1,18, y después de la disciplina el grupo Apost (MApost)= 6,02 ñ 1,14 y grupo Bpost (MBpost)= 7,00 ñ 0,78. En el desempe¤o aisló el grupo A antes y después de la disciplina (p= 0,31); y el grupo B antes y después de la disciplina (p= 0,000), por lo tanto, los resultados apresentaram discrepancias significativas, cuando fueron comparadas a las medias de las notas finales entre los grupos (p= 0,001). Los resultados fueron, positivos y estadísticamente significativos cuando los grupos fueron comparados. Por lo tanto, sugerimos que los cursos de graduación en Fisioterapía deben revisar su currículo y proponer una reforma con implantación inmediata de una disciplina específica, Anatomía Palpatoria, proveyendo la necesidad del entrenamiento en habilidades manuales de los estudiantes.