Evaluation of anxiety, depression and urinary protein excretion among the family caregivers of advanced cancer patients.

Caregiving to a family member with advanced cancer can be stressful. Stress leads to psychological changes, oxidative stress and increased glomerular permeability to proteins. To find out their association with stress, we assessed anxiety and depression by the hospital anxiety and depression scale (HADS), urinary malondialdehyde:creatinine ratio (UMDA:Cr), urinary protein:creatinine ratio (UP:Cr) and SDS-polyacrylamide gel electrophoresis (SDS-PAGE) profile of urinary proteins in 31 family caregivers of advanced cancer patients and 31 matched controls. HADS, UMDA:Cr and UP:Cr were significantly higher in the caregivers as compared to the controls. These parameters were significantly correlated. Besides an increase in albumin excretion, a few higher and lower molecular weight proteins were detected in the urine of caregivers. These results indicate that the family caregivers of advanced cancer patients undergo anxiety and depression associated with stress leading to increased oxidative stress and glomerular permeability to proteins. These changes might have health implications, warranting appropriate stress management counseling for them.

Can urinary excretion rate of malondialdehyde, uric acid and protein predict the severity and impending death in perinatal asphyxia?

BACKGROUND: Perinatal asphyxia (PA) associated with multi-organ damage is a leading cause of neonatal mortality and morbidity. We evaluated if urinary malondialdehyde:creatinine (UMDA:Cr), uric acid:creatinine (UUA:Cr) and protein:creatinine (UP:Cr) vary with the severity of PA and if these parameters can predict the impending death in PA. METHODS: Study included 20 asphyxiated and 20 healthy newborn males. Hypoxic-ischemic encephalopathy (HIE) staging, APGAR (activity, pulse, grimace, appearance and respiration) score and urinary protein, uric acid, creatinine and MDA were evaluated. RESULTS: UMDA:Cr, UUA:Cr and UP:Cr were significantly higher and correlated with APGAR and HIE in PA. By regression analysis also, urinary parameters were found to have significant association with HIE stage and APGAR in PA. Receiver operating characteristics (ROC) curve of UP:Cr, UUA:Cr and UMDA:Cr showed area under curve of 0.896 (p=0.003), 0.859 (p=0.008) and 0.849 (p=0.010) with cut-off value of 9.04 mg, 2.34 mg and 3.49 microg/mg of creatinine respectively that can optimally predict the impending death in PA. SDS-PAGE of unconcentrated urine detected both high (73 kDa and 68 kDa) and low molecular weight proteins (52 kDa, 47 kDa, 25 kDa and 20 kDa) in PA but not in controls. CONCLUSION: Urinary excretion rate of uric acid, MDA and proteins is higher and has potential to act as biochemical markers for severity evaluation and death prediction in PA.

Altered malondialdehyde, protein carbonyl and sialic acid levels in seminal plasma of microscopically abnormal semen.

Microscopically abnormal (n = 26) semen showed significantly higher levels of malondialdehyde (MDA), protein carbonyl (PC) and protein-bound sialic acid (SA) in seminal plasma as compared with normal semen (n = 24). The percentage of nonmotile spermatozoa showed significant (P < 0.01) positive correlation with MDA (r = 0.5) and PC (r = 0.49). Sperm counts showed a significant negative correlation with MDA (r = -0.63, P < 0.001) level of seminal plasma. SA correlated (r = 0.56, P < 0.01) with MDA. The receiver operating characteristic (ROC) curve of MDA and SA showed that MDA of 3.15 micromol l(-1) and SA of 3.85 micromol l(-1) were optimum cut-off limits to discriminate abnormal semen from normal. In conclusion, high SA might be a protective response against prevailed oxidative stress in abnormal semen. Seminal plasma MDA and SA may act as potential markers of abnormal semen.