Idiopathic membranous glomerulonephritis in Brazil

Summary: A survey of the medical records and renal biopsy reports of 41 patients with a diagnosis of membranous glomerulonephritis seen at the University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo was undertaken between 1961 and April 1992. Twenty-three of these patients were found to have idiopathic membranous glomerulonephritis (IMG) and 22 of them were treated with corticosteroids and/or immunosuppressants. Data for these 22 patients showed that the age at clinical presentation was 36.3± 17.5 years, white skin colour predominated (14 patients), and 15 were males; nephrotic syndrome was the clinical presentation in 20 patients and proteinuria was accidentally discovered in two patients. On the first hospital visit 11 patients presented proteinuria of up to 3 g/24 h and 16 presented serum creatinine below 1.5 mg/dL, and 14 developed renal hypertension during follow up. Clinicalmorphological correlation permitted us to conclude (in agreement with the literature) that advanced patient age, intensity of proteinuria, serum creatinine levels above 1.5 mg/dL on the occasion of the first hospital visit, and arterial hypertension are clinical-laboratory factors indicating a poor prognosis for IMG. More advanced staging of glomerular damage, presence of segmental mesangial sclerosis and tubulointerstitial involvement are microscopic factors indicating a poor prognosis for IMG.     

Alcohol stimulates the release of dopamine in the ventral pallidum but not in the globus pallidus: a dual-probe microdialysis study.

The mesoaccumbens dopamine system has been hypothesized to be a common neural substrate mediating the actions of various drugs of abuse, including ethanol. However, the involvement of the mesopallidal dopamine system has received very little attention. The present study examined the effects of intraperitoneal (IP) ethanol administration on the extracellular levels of dopamine in the ventral pallidum (VP) and globus pallidus (GP) of Wistar rats. Rats were bilaterally implanted with microdialysis probes aimed at the VP and GP or nucleus accumbens (NAc) and dorsal striatum (dSTR). During microdialysis testing, rats with probes located in the VP and GP were injected IP with sterile saline or 15% (v/v) ethanol in saline at doses of 0.75, 1.5, or 2.25 g/kg. Rats with NAc and dSTR probes were injected with saline or 2.25 g/kg ethanol. The IP administration of 1.5 and 2.25 g/kg ethanol significantly (p <0.05) elevated the extracellular levels of dopamine in the VP (maximal increase: 136 and 182% of baseline, respectively) but not in the GP. No effects on extracellular dopamine levels were observed following the IP injections of 0.75 g/kg ethanol or saline. The IP administration of 2.25 g/kg ethanol significantly (p <0.05) elevated the extracellular levels of dopamine in the NAc (maximal increase: 198% of baseline) and dSTR (maximal increase: 155% of baseline). Analysis of the effects of 2.25 g/kg ethanol on dopamine release revealed greater increases in the VP, NAc, and dSTR compared to the GP. The data suggest that the mesopallidal, mesoaccumbens, and nigrostriatal dopamine systems are more sensitive to the effects of ethanol than the nigropallidal dopamine system.     

Comparative study of the effect of a tube drain in impacted lower third molar surgery.

PURPOSE: Postoperative variables such as pain, swelling, and trismus after surgery of the impacted lower third molars are the main concerns of dental clinicians and surgeons. Many authors claim that the use of a drain could help control these variables. The purpose of this study was to evaluate the effect of the use of a tube drain in impacted lower third molar surgery. MATERIALS AND METHODS: Fifty-three patients of both genders with bilateral impacted lower third molars comprised our comparative study. The patients were divided into 2 groups: in the first the suture procedure was accomplished using a drain, and in the second the suture procedure was accomplished without a drain. The postoperative pain, swelling, and trismus were evaluated at 24 hours, 72 hours, 7 days, and 15 days. RESULTS: In the group in which the drain was used, the control of the swelling variable was statistically significant at 24 and 72 hours (P <.001) in comparison with the group in which the drain was not used. However, pain and trismus were not statistically significant at the evaluation period. CONCLUSION: The use of the drain helps to control swelling. However, it had no effect on pain or trismus.     

Assessment of enamel hypoplasia in autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED)

The features of enamel hypoplasia in a small group of patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) are described. Using a recently developed method, the authors evaluated quantitatively the amount of defect in each tooth by measuring the width of the hypoplastic lesions and dividing the value by the crown height. They then assessed the degree of damage in each tooth type (from central incisors to second premolars) and patient. Canines were the most severely affected among maxillary and mandibular teeth, but all tooth types were involved. Analysing both the differences between patients and their age at the beginning of the defect, the authors observe that hypoparathyroidism is not responsible for the onset of enamel hypoplasia in APECED, although it may contribute to the damage.     

Early increase of oxidative stress and soluble CD40L in children with hypercholesterolemia.

OBJECTIVES: The aim of the study was to analyze the behavior of oxidative stress and its interplay with CD40L, a protein that is implicated in atherosclerosis, in hypercholesterolemic children. BACKGROUND: Oxidative stress has been suggested to play a major role in premature atherosclerosis. METHODS: Forty-one children with hypercholesterolemia (mean age 9.28 +/- 0.5 years) and 40 children with normocholesterolemia (mean age 9.02 +/- 0.69 years) were matched for gender and age. Within each group, children were classified as having or not having a family history of cardiovascular disease. Serum levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG), a marker of oxidative stress, and plasma levels of soluble CD40L (sCD40L) were measured in each child. In a subgroup of children with high (n = 8) or normal (n = 8) levels of serum cholesterol, platelet p38 mitogen-activated protein (MAP) kinase phosphorylation, a protein involved in the activation of nicotinamide adenine dinucleotide phosphate oxidase, was determined. RESULTS: Children with hypercholesterolemia had higher values of 8-OHdG and sCD40L compared with control subjects (0.55 +/- 0.06 ng/ml vs. 0.21 +/- 0.02 ng/ml, p < 0.001 and 0.55 +/- 0.04 ng/ml vs. 0.19 +/- 0.03 ng/ml, p < 0.001, respectively). A significant correlation between 8-OHdG and sCD40L was observed in children with high (r = 0.676, p < 0.001) or normal (r = 0.878, p < 0.001) levels of cholesterol. Children with a family history of cardiovascular disease tended to have higher values of 8-OHdG and sCD40L, but the difference was not significant. Analysis of platelet p38 MAP kinase showed that it was phosphorylated more in children with hypercholesterolemia compared with control subjects (36.8 +/- 5.8 AU vs. 8.0 +/- 4.5 AU, p < 0.001 respectively). CONCLUSIONS: Children with hypercholesterolemia have an early increase of oxidative stress that may be responsible for up-regulation of CD40L and potentially predispose to premature atherosclerosis.