RESUMO
BACKGROUND AND OBJECTIVES: The control of hyperphosphatemia is an unmet need in dialysis care. Compared to conventional hemodialysis (cHD), extended hemodialysis (eHD) appears to more easily control blood phosphate levels in chronically dialyzed patients. Here, we sought to compare eKT/V-matched cHD and eHD procedures in order to quantify the contribution of dialysis prescription and time in the mass removal of phosphate. METHODS: Eight stable hemodialysis patients with negligible residual renal function underwent cHD and eHD sessions adjusted to provide the same eKT/V(urea). Total dialysate, total and hourly partial dialysate and blood samples were collected for comparison of mass extraction of urea, creatinine, and phosphate. RESULTS: Mean eKT/V(urea) was similar in eHD and cHD (1.30 vs. 1.28, p = nonsignificant). Likewise, mass removal of urea and creatinine during cHD and eHD were not significantly different. Conversely, phosphate mass removal was 40% higher with eHD as compared to cHD (1,219 ± 262 vs. 858 ± 186 mg, p = 0.015). Although hourly mass removal of phosphate was higher during cHD, the prolonged period of lesser but continuous removal was responsible for higher total phosphate elimination during eHD. CONCLUSION: In dialysis sessions matched to provide a similar eKT/V(urea), removal of phosphate increases by 40% when time is extended from 4 to 8 h. Urea-based adequacy models cannot be used to predict the amount of phosphorus removal during hemodialysis.
Assuntos
Hiperfosfatemia/terapia , Falência Renal Crônica/terapia , Fosfatos/sangue , Diálise Renal/instrumentação , Diálise Renal/métodos , Adulto , Creatinina/sangue , Soluções para Diálise/uso terapêutico , Feminino , Humanos , Hiperfosfatemia/sangue , Falência Renal Crônica/sangue , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento , Ureia/sangue , Uremia/sangue , Uremia/terapiaRESUMO
Se describe a los dientes supernumerarios o hiperodoncia como el aumento del número de órganos dentarios comparado con la dentición normal. Todos los dientes supernumerarios deben ser extraídos, respetando el momento ideal para su remoción quirúrgica, evaluando siempre el momento oportuno para intervenir. En el presente trabajo las autoras presentan un caso clínico de una paciente de sexo femenino, que tuvo un seguimiento durante cinco años a partir de los 6 meses de edad asistida en el Curso de Extensión Universitaria Bebé Clínica de la Universidad Federal de Río Grande del Sur. Durante sus visitas periódicas de revisión odontológica correspondientes al programa de la Bebé Clínica, se diagnosticó clínicamente la presencia de mordida cruzada anterior, atresia maxilar y radiográficamente la presencia de dos elementos supernumerarios. Frente a ese diagnóstico, es necesario un planeamiento multidisciplinario, o sea, orto-quirúrgico para la realización del tratamiento, destacando una vez más, la importancia de la atención odontológica del bebé y el diagnóstico precoz de posibles alteraciones como en el caso clínico en cuestión: la presencia de elementos supernumerarios y maloclusión dentaria.
Assuntos
Dente Supranumerário/cirurgia , Anormalidades Dentárias , Dente SupranumerárioRESUMO
The lack of Na(+),K(+)-ATPase expression in intercalated cells (IC) is an intriguing condition due to its fundamental role in cellular homeostasis. In order to better understand this question we compared the activities of Na(+),K(+)-ATPase and Na(+)-ATPase in two MDCK cell clones: the C11, with IC characteristics, and the C7, with principal cells (PC) characteristics. The Na(+),K(+)-ATPase activity found in C11 cells is far lower than in C7 cells and the expression of its beta-subunit is similar in both cells. On the other hand, a subset of C11 without alpha-subunit expression has been found. In C11 cells the Na(+)-ATPase activity is higher than that of the Na(+),K(+)-ATPase, and it is increased by medium alkalinization, suggesting that it could account for the cellular Na(+)-homeostasis. Although further studies are necessary for a better understanding of these findings, the presence of Na(+)-ATPase may explain the adequate survival of cells that lack Na(+),K(+)-ATPase.
Assuntos
Adenosina Trifosfatases/metabolismo , Proteínas de Transporte de Cátions/metabolismo , Néfrons/citologia , ATPase Trocadora de Sódio-Potássio/metabolismo , Animais , Linhagem Celular , Cães , Corantes Fluorescentes/metabolismo , Homeostase , Imuno-Histoquímica , Subunidades Proteicas/metabolismo , Sódio/metabolismoRESUMO
The levels of IgG, IgG subclasses, IgM and IgA were determined in serum from 17 patients with IgA deficiency and severe or frequent infections, allergy and/or autoimmunity (median age 7 years, range 2-19), 11 healthy IgA-deficient adults and 35 controls (median age 7 years, range 2-19). In serum from all groups IgG, IgM and IgA antibodies were determined against beta-lactoglobulin, E. coli O antigens and poliovirus type 1 antigen. In saliva of 15 IgA-deficient patients and 12 of the controls IgG, IgM and secretory component-carrying antibodies against E. coli O antigens and poliovirus type 1 were determined. The majority of the studied individuals lived under poor socio-economic conditions in Brazil, with consequent heavy microbial exposure. One IgA-deficient patient with rheumatoid arthritis also had IgG2 deficiency but no infectious problems. Four out of the 35 controls without any obvious infectious problems were found with IgA or IgG subclass deficiency. One of the 11 healthy IgA-deficient adults was low in the IgG2 subclass, one in IgG1 and one in IgG3. Those with symptomatic IgA deficiency had significantly higher serum IgG than the controls, especially in the age group 6-11 years. This latter group also had significantly increased serum IgG1 and IgG2 levels when compared with the age-matched controls. Salivary IgM antibodies to E. coli and poliovirus antigens were significantly higher among the symptomatic IgA-deficient individuals than among the controls. It is not clear at present whether these increased Ig levels are secondary to frequent infections and/or part of mechanisms that may compensate for the IgA deficiency.
Assuntos
Deficiência de IgA/epidemiologia , Deficiência de IgG/epidemiologia , Adolescente , Adulto , Antígenos de Bactérias/imunologia , Antígenos Virais/imunologia , Brasil , Criança , Pré-Escolar , Países em Desenvolvimento , Escherichia coli/imunologia , Feminino , Humanos , Imunoglobulina M/imunologia , Lactoglobulinas/imunologia , Masculino , Poliovirus/imunologia , PobrezaRESUMO
The causes of high morbidity due to infection among children with sickle-cell disease (SD) are unknown. Immunlogical studies have focused on spleen function, on the alternative complement pathway, and recently on phagocytic activity. We evaluated Fc recptor-mediated phagocytic activity. We evaluated Fc receptor-mediated phagocytosis (sheep red cells opsonized with rabbit anti-E IgG, EA) and C3b receptor-mediated phagocytosis (zymosan particles incubated with fresh serum) in 27 children with SD. The control group consisted of 28 normal children matched by age and sex. The phagocytic indices obtained for cells from patients with SD were significantly lower than those for the controls (P < 0.001), both when EA and zymosan were used independent of whether the zymosan particles were incubated with patient serum or with a pool of normal sera. The results suggest the absence of abnormalities in the alternative complement pathway but do indicate an intrinsic cellular defect
Assuntos
Lactente , Pré-Escolar , Criança , Adolescente , Humanos , Anemia Falciforme/sangue , Monócitos/fisiologia , Fagocitose , Receptores de Complemento/fisiologia , Receptores Fc/fisiologiaRESUMO
The causes of high morbidity due to infection among children with sickle-cell disease (SD) are unknown. Immunological studies have focused on spleen function, on the alternative complement pathway, and recently on phagocytic activity. We evaluated Fc receptor-mediated phagocytosis (sheep red cells opsonized with rabbit anti-E IgG, EA) and C3b receptor-mediated phagocytosis (zymosan particles incubated with fresh serum) in 27 children with SD. The control group consisted of 28 normal children matched by age and sex. The phagocytic indices obtained for cells from patients with SD were significantly lower than those for the controls (P less than 0.001), both when EA and zymosan were used and independent of whether the zymosan particles were incubated with patient serum or with a pool of normal sera. The results suggest the absence of abnormalities in the alternative complement pathway but do indicate an intrinsic cellular defect.