Comparison of dialysis dose through real-time Kt/V by ultraviolet absorbance of spent dialysate, single-pool Daugirdas II, and Kt/BSA according to sex and age

BACKGROUND

Kt/V OnLine (Kt/VOL) avoids inaccuracies associated with the estimation of urea volume distribution (V). The study aimed to compare Kt/VOL, Kt/V Daugirdas II, and Kt/BSA according to sex and age.

METHODS

Urea volume distribution and body surface area were obtained by Watson and Haycock formulas in 47 patients. V/BSA was considered as a conversion factor from Kt/V to Kt/BSA. Dry weight was determined before the study. Kt/VOL was obtained on DIALOG machines.

RESULTS

Pearson correlation between Kt/VOL vs Kt/VII and Kt/VOL vs Kt/BSA was significant for males (r = 0.446, P = 0.012 and r = -0.476 P = 0.007) and individuals < 65 years (0.457, P = 0.019 and -0.549 P = 0.004), but not for females and individuals ≥ 65 years. V/BSA between individuals < 65 and individuals ≥ 65 years were 18.28 ± 0.15 and 18.18 ± 0.16 P = 0.000). No agreement between Kt/VII vs Kt/BSA. Men and individuals > 65 years received a larger dialysis dose than, respectively, females and individuals < 65 years, in the comparison between Kt/VOL versus Kt/VII. V/BSA ratios among men and women were respectively 18.29 ± 0.13 and 18.12 ± 0.15 P = 0.000.

CONCLUSIONS

Kt/VOL allows recognition of real-time dose regardless of sex and age.

Curcumin ameliorates autoimmune diabetes. Evidence in accelerated murine models of type 1 diabetes

Type 1 diabetes (T1DM) is a T cell-mediated autoimmune disease that selectively destroys pancreatic β cells. The only possible cure for T1DM is to control autoimmunity against β cell-specific antigens. We explored whether the natural compound curcumin, with anti-oxidant and anti-inflammatory activities, might down-regulate the T cell response that destroys pancreatic β cells to improve disease outcome in autoimmune diabetes. We employed two accelerated autoimmune diabetes models: (i) cyclophosphamide (CYP) administration to non-obese diabetic (NOD) mice and (ii) adoptive transfer of diabetogenic splenocytes into NODscid mice. Curcumin treatment led to significant delay of disease onset, and in some instances prevented autoimmune diabetes by inhibiting pancreatic leucocyte infiltration and preserving insulin-expressing cells. To investigate the mechanisms of protection we studied the effect of curcumin on key immune cell populations involved in the pathogenesis of the disease. Curcumin modulates the T lymphocyte response impairing proliferation and interferon (IFN)-γ production through modulation of T-box expressed in T cells (T-bet), a key transcription factor for proinflammatory T helper type 1 (Th1) lymphocyte differentiation, both at the transcriptional and translational levels. Also, curcumin reduces nuclear factor (NF)-κB activation in T cell receptor (TCR)-stimulated NOD lymphocytes. In addition, curcumin impairs the T cell stimulatory function of dendritic cells with reduced secretion of proinflammatory cytokines and nitric oxide (NO) and low surface expression of co-stimulatory molecules, leading to an overall diminished antigen-presenting cell activity. These in-vitro effects correlated with ex-vivo analysis of cells obtained from curcumin-treated mice during the course of autoimmune diabetes. These findings reveal an effective therapeutic effect of curcumin in autoimmune diabetes by its actions on key immune cells responsible for β cell death.

Cell-based interventions to halt autoimmunity in type 1 diabetes mellitus

Type 1 diabetes mellitus (T1DM) results from death of insulin-secreting β cells mediated by self-immune cells, and the consequent inability of the body to maintain insulin levels for appropriate glucose homeostasis. Probably initiated by environmental factors, this disease takes place in genetically predisposed individuals. Given the autoimmune nature of T1DM, therapeutics targeting immune cells involved in disease progress have been explored over the last decade. Several high-cost trials have been attempted to prevent and/or reverse T1DM. Although a definitive solution to cure T1DM is not yet available, a large amount of information about its nature and development has contributed greatly to both the improvement of patient's health care and design of new treatments. In this study, we discuss the role of different types of immune cells involved in T1DM pathogenesis and their therapeutic potential as targets and/or modified tools to treat patients. Recently, encouraging results and new approaches to sustain remnant β cell mass and to increase β cell proliferation by different cell-based means have emerged. Results coming from ongoing clinical trials employing cell therapy designed to arrest T1DM will probably proliferate in the next few years. Strategies under consideration include infusion of several types of stem cells, dendritic cells and regulatory T cells, either manipulated genetically ex vivo or non-manipulated. Their use in combination approaches is another therapeutic alternative. Cell-based interventions, without undesirable side effects, directed to block the uncontrollable autoimmune response may become a clinical reality in the next few years for the treatment of patients with T1DM.

The effect of plastering in a house persistently infested with Triatoma infestans (Klug) 1934

The replastering of a house in Mambai-Goias, Brazil, as a measure to wall-in Triatoma infestans, is briefly described. Unfortunately, because the houseowner would not cooperate the roof tiles were not improved and eventually T. infestans reappeared at this site. A brief discussion follows of some aspects of house improvement in the vigilance phase of a Chagas Disease Control Programme. T. infestans appeared in the house described 51 and 258 days after the replastering.

Serum albumin and gamma globulin in Trypanosoma cruzi infections

This paper examines the association between serum protein levels and infection with Trypanosoma cruzi in a region of Central Brazil. 148 people 6 to 78 years of age, were included in this study. There were no statistically significant difference in albumin levels between those with positive T. cruzi serology (2.94 +/- 0.74 g/100 ml) and those with negative serology (3.04 +/- 0.61 g/100 ml). Thus the null hypothesis of no association between infection with T. cruzi and serum albumin is accepted. Gamma-globulin levels were elevated in both groups and were significantly greater (p less than 0.05) in the group with positive T. cruzi serology (1.91 +/- 0.41 g/100 ml) than in the group with negative serology (1.75 +/- 0.41 g/100 ml). The serum albumin levels suggest that malnutrition (either associated with low protein intake or increased loss due to hookworm) is a major problem and unlikely to change if T. cruzi transmission was controlled.

Circulating antigens, immune complexes and C3d levels in human schistosomiasis: relationship with Schistosoma mansoni egg output

Circulating schistosome antigens (CSA), circulating immune complexes (CIC) and C3 breakdown product - C3d - were investigated in human schistosomiasis in comparison to the S. mansoni egg count. A close relationship was observed between the mean number of eggs/g of stool and the detection of CSA (evaluated by the radioimmunoprecipitation-PEG assay - Ripega), CIC (Clq-binding test) and C3d levels (quantitated by radial immunodiffusion). All the patients with more than 500 S. mansoni eggs/g of stool also presented antigen '4', specific of the genus Schistosoma, in the serum. A significant correlation was noticed between levels of CSA and CIC. This suggests the involvement of several schistosome antigens in the detected CIC. No relationship was noted between CIC and C3d levels. In contrast, there was a highly significant correlation between levels of CSA and C3d. The interaction between certain schistosome antigens and the complement system is discussed.