Dual source/dual energy-renal applications

Development of Dual Source Computed Tomography (Definition, Siemens Medical Solutions, Erlanger, Germany) allowed advances in temporal resolution, with the addition of a second X-ray source and an array of detectors to the TCM 64 slices. The ability to run exams on Dual Energy, allows greater differentiation of tissues, showing differences between closer attenuation coefficients. In terms of renal applications, the distinction of kidney stones and masses become one of the main advantages of the use of dual-energy technology. This article pretends to demonstrate operating principles of this equipment, as its main renal applications.

Role of oxidative stress-induced systemic and cavernosal molecular alterations in the progression of diabetic erectile dysfunction

Background Erectile dysfunction (ED) is a prevalent complication of diabetes, and oxidative stress is an important feature of diabetic ED. Oxidative stress-induced damage plays a pivotal role in the development of tissue alterations. However, the deleterious effects of oxidative stress in the corpus cavernosum with the progression of diabetes remain unclear. The aim of this study was to evaluate systemic and penile oxidative stress status in the early and late stages of diabetes. Methods Male Wistar streptozotocin-diabetic rats (and age-matched controls) were examined 2 (early) and 8 weeks (late) after the induction of diabetes. Systemic oxidative stress was evaluated by urinary H2O2 and the ratio of circulating reduced/oxidized glutathione (GSH/GSSG). Penile oxidative status was assessed by H2O2 production and 3-nitrotyrosine (3-NT) formation. Cavernosal endothelial nitric oxide synthase (eNOS) was analyzed by quantitative immunohistochemistry. Dual immunofluorescence was also performed for 3-NT and α-smooth muscle actin (α-SMA) and eNOS–α-SMA. Results There was a significant increase in urinary H2O2 levels in both diabetic groups. The plasma GSH/GSSG ratio was significantly augmented in late diabetes. In cavernosal tissue, H2O2 production was significantly increased in late diabetes. Reactivity for 3-NT was located predominantly in cavernosal smooth muscle (SM) and was significantly reduced in late diabetes. Quantitative immunohistochemistry revealed a significant decrease in eNOS levels in cavernosal SM and endothelium in late diabetes. Conclusions The findings indicate that the noxious effects of oxidative stress are more prominent in late diabetes. Increased penile protein oxidative modifications and decreased eNOS expression may be responsible for structural and/or functional deregulation, contributing to the progression of diabetes-associated ED.

"Participação, um Caminho para a Mudança" Projeto desenvolvido com pessoas com doença renal crónica e cuidadores

O presente relatório reflete a (co)construção e desenvolvimento do projeto de educação e intervenção social “Participação, um Caminho para a Mudança”, que teve como palco a Caledial, uma clínica de hemodiálise em Canelas – Vila Nova de Gaia. Posicionado na metodologia da Investigação-Ação Participativa, este projeto permitiu a criação de espaços coletivos de partilha de experiências e vivências de pessoas com doença crónica, reconhecendo dificuldades e limitações, mas também as potencialidades e recursos existentes. Assim, pelo caminho da participação e da ação, procurou-se dar resposta a algumas das necessidades sentidas, promovendo um cada vez maior envolvimento das pessoas na procura do conhecimento sobre esta doença, no sentido da sua capacitação e empowerment. Teve como ponto de partida o primeiro convívio de Natal das pessoas em hemodiálise, familiares e profissionais da Caledial, e vários grupos de discussão sobre as vivências, perceções e sentimentos face à doença renal crónica. No âmbito deste projeto, resultado do trabalho coletivo de vários participantes, pretendeu-se compreender a realidade enquanto se agia sobre a mesma, num processo contínuo de reflexão-ação-reflexão, que foi capaz de mobilizar esforços individuais e coletivos no sentido da mudança. Surgiu como um desafio e afirmou-se como um dispositivo transformador das relações entre os profissionais de saúde, as pessoas em hemodiálise e as famílias, transformando a clínica num espaço mais aberto e inclusivo, promotor da participação e fértil para o desenvolver de atividades repletas de significado para as pessoas envolvidas.