DOES TYPE 2 DIABETES MELLITUS DELAY RENAL FAILURE IN AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE?

Dengue infection is a major public health problem. When acute renal failure complicates dengue infection, it is usually associated with severe disease as in dengue hemorrhagic fever or dengue shock syndrome. The role of immune complex in development of renal failure in dengue infection is still unclear. Here, the author used a computational medicine technology to study the property of the dengue virus-immunoglobulin complex. According to this study, the diameter of derived complex is much smaller, compared with the diameter of glomerulus. Entrapment of the immune complex is believed to occur when a previous glomerular lesion causes narrowing of the glomerulus's diameter. Therefore, the immune complex should not have a significant role in pathogenesis of renal failure in dengue infection.     

Effect of Immune Complex on the Biomechanics of Blood Flow in Common Glomerulonephritis Diseases

Glomerulonephritis (GN) is a common nephrological disorder. The correlation between degree of glomerular damage, severity of GN, and development of hypertension is an interesting topic in present research on GN. Although the progression of GN is proved to associate with hypertension, no clear pathogenesis is reported. In this study, the author assesses the effect of various sizes of immune complex in three common GN diseases on the biomechanics of blood flow in the renal vascular. Further discussion on the impact on hypertension is also provided.     

Angiotensin-Converting Enzyme Gene Polymorphism Is Correlated to the Progression of Disease in Patients with IgA Nephropathy: A Metaanalysis

Angiotensin-converting enzyme (ACE) displays potent vasoconstrictive effects, attenuation of fibrinolysis, and platelet activation and aggregation. Recently it was mentioned that the insertion/deletion polymorphism of the ACE gene is associated with ESRD. The lengthy course of IgA Nephropathy (IgAN) and the possibility of good outcomes without therapy suggest nontoxic therapies such as ACE inhibitors and angiotensin receptor blockers (ARBs). However, the correlation between the ACE gene polymorphism and progression of IgAN still requires further approval. Here, the author performs a summative analysis on the recent previous reports on the ACE gene polymorphism and its correlation to progression of IgAN. The meta-analysis was performed to assess the correlation between the pattern of ACE gene polymorphism and progression of IgAN. From five available studies, 346 and 555 patients with (group 1) and without (group 2) the progression of disease are evaluated. According to this study, the frequency of DD genotype in group 1 is significant higher than group 2 (p < 0.05). In addition, the author first reports a non-significant correlation between the ethnicity and the ACE gene polymorphism.     

Prevalence and genotypes of hepatitis C virus infection among drug addicts and blood donors in Thailand

Hepatitis C virus (HCV) is an infectious agent that has the potential to cause chronic liver disease, cirrhosis and hepatocellular carcinoma. We determined the prevalence and genotypes of HCV infection among groups of drug addicts: intravenous drug users (n = 134), methamphetamine users (n = 100), inhaled-drugs users (n = 19) and alcoholics (n = 50); a group of blood donors acted as a control. The control group consisted of 179 randomly-selected anti-HCV positive samples: these were subjected to HCV RNA screening and genotyping. The anti-HCV test was performed by ELISA: HCV RNA screening was by nested RT-PCR that employed primers from the 5' noncoding region. The genotype assay was based upon analysis of the 5' NCR amplified sequences and RFLP. Hepatitis C virus was highly prevalent among all groups of drug addicts (12-70%). In 2000. among the new blood donors (n = 66,340) at the National Blood Center, Thai Red Cross, anti-HCV prevalence amounted to 0.98%. The HCV genotype distribution showed that the most prevalent genotype was 3a, followed by 1b and 6a. Our data demonstrated the very high prevalence of HCV infection in IVDUs, a finding that is consistent with the blood-borne nature of the virus. In order to curb HCV infection, a determined effort to educate both the general population and high-risk groups is required; such a program of education would address both general and particular methods of transmission, especially the use of non-sterile needles etc.     

Screening for syphilis in pregnancy: which is the proper method?

Background Consequences of syphilis in mother, pregnancy, fetus and child are considerable, but preventable. Serological screening must be offered at the first prenatal visit. Presently, the diagnosis of syphilis is dependent mainly on serological tests. The most widely used screening tests for syphilis are the VDRL and the rapid plasma reagin (RPR) and for confirmation the fluorescent treponemal antibody (FTA) and the treponema pallidum hemagglutination (TPHA) tests. Method The four alternative nodes for diagnosis of can be a) VDRL + FTA, b) VDRL + TPHA, c) RPR + FTA and d) RPR + TPHA. Here the author reports an evaluation of cost utility of those tests in obstetrical practice. According to this study, it can be shown that the cost per accurate diagnosis for VDRL + TPHA is the least expensive choice and for RPR + FTA is the most expensive choice. Conclusion Therefore, this alternative is the best method for serological diagnosis of syphilis, based on medical laboratory economics principles.