Associação entre periodontite crônica e marcadores de risco para doença cardiovascular

Pesquisas recentes têm demonstrado que a periodontite pode modificar a concentração sanguínea de uma série de tipos celulares e substâncias bioquímicas, que são considerados fatores de risco para doenças cardiovasculares. Este trabalho tem como objetivo avaliar a associação entre a periodontite crônica e marcadores de risco para doença cardiovascular. No Estudo I foram examinados 100 pacientes aparentemente saudáveis sistemicamente, sendo 66 portadores de periodontite crônica e 34 pacientes controle, sem doença periodontal. Exames periodontais e exames sanguíneos foram realizados, e obtidas as espessuras das camadas íntima-média (IMT) da artéria carótida. No Estudo II, 66 pacientes participantes do Estudo I, diagnosticados com periodontite crônica, foram aleatoriamente submetidos a tratamento periodontal imediato (Grupo Teste, n=33) ou tratamento periodontal retardado (Grupo Controle, n=33). Os dados colhidos no Estudo I foram registrados como pré-tratamento (T0). Novos exames clínicos periodontais e laboratoriais foram realizados no período de 2 meses (T2) e 6 meses (T6) após os exames iniciais (Grupo Controle) ou conclusão do tratamento periodontal (Grupo Teste). Os dados colhidos foram analisados através de testes estatísticos. Os resultados mostraram que pacientes com periodontite crônica quando comparados ao grupo controle, apresentaram valores médios significativamente mais elevados na contagem total de hemácias (p<0,001), hemoglobina (p<0,001), hematócrito (p<0,001), contagem de plaquetas (p=0,019), velocidade de hemossedimentação (p<0,001), proteína C-reativa (p<0,001). Os níveis de HDL-colesterol foram significativamente mais baixos nos pacientes com periodontite crônica quando comparados ao grupo controle (p<0,001). As camadas íntima-média da parede da artéria carótida esquerda foram significativamente mais espessas nos pacientes com periodontite crônica quando comparados ao grupo controle (p=0,049). Os indíviduos com periodontite crônica também apresentaram 3,26 vezes mais chances de possuir Síndrome Metabólica do que aqueles indivíduos que não possuem doença peridontal (IC 95%: 1,8-5,9). No Estudo II, quando comparados os valores médios dos dados hematológicos após tratamento, no grupo teste, foi possível observar melhora estatisticamente significativa, entre T0/T2, dos valores de VHS e triglicerídeos (p=0,002; p=0,004; respectivamente). Redução nos valores médios da contagem total de leucócitos, VHS, CRP, transaminase glutâmico pirúvica, colesterol total e triglicerídeos, entre T0/T6, foi verificada no grupo teste pós-tratamento (p=0,028; p<0,001; p<0,001; p=0,010; p<0,001; p=0,015, respectivamente). Os resultados indicaram que a periodontite crônica severa está associada com níveis elevados de marcadores da inflamação e trombogênese, além de alterações no perfil lipídico em indivíduos sistemicamente saudáveis, podendo atuar como possível fator de risco para as doenças cardiovasculares. O tratamento periodontal não-cirúrgico mostrou-se eficaz na redução dos níveis dos marcadores sistêmicos da inflamação e na melhora do perfil lipídico em indivíduos com doença periodontal severa, consequentemente, reduzindo o risco de doenças cardiovasculares.

Efeitos do estradiol sobre a função endotelial, sensibilidade insulínica e viscosidade sanguínea em mulheres na pós-menopausa com excesso de peso

A ação que o estrogênio desempenha sobre o endotélio depende da integridade deste e consequentemente das características clínicas de cada indivíduo. O uso da terapia hormonal da menopausa (THM) em mulheres com baixo risco cardiovascular geralmente resulta em efeitos benéficos, desde que iniciado em um período próximo da menopausa. Em contrapartida, o seu uso em mulheres com alto risco cardiovascular, como diabéticas ou portadoras de lesões ateroscleróticas já estabelecidas, e ainda naquelas com início da THM em um período superior a dez anos da menopausa geralmente resulta em efeitos maléficos. Nosso objetivo é avaliar os efeitos do estrogênio sobre a função endotelial em mulheres com sobrepeso ou obesidade, ou seja, indivíduos com risco cardiovascular intermediário. Para isso, 44 mulheres na pós-menopausa com idade entre 47 a 55 anos e índice de massa corporal (IMC) de 27,5 a 34,9kg/m, foram randomizadas nos grupos placebo (P) e estrogênio transdérmico (ET). A intervenção consistiu no uso transdérmico de estradiol, 1mg por dia, por um período de três meses. As participantes realizaram avaliação da reatividade endotelial em repouso e após isquemia [pletismografia por oclusão venosa (POV), com medidas do fluxo sanguíneo do antebraço (FSA) e videocapilaroscopia dinâmica do leito periungueal (VCLP), com medidas da velocidade de deslocamento das hemácias (VDH)], dosagens de moléculas de adesão [E-selectina, molécula de adesão intercelular (ICAM-1) e molécula de adesão vascular (VCAM-1)], aferição da sensibilidade insulínica [através do homeostatic model assessment of insulin resistance (HOMA-IR) e área sob a curva (AUC) da insulina durante o teste oral de tolerância à glicose (TOTG)] e mensurações das viscosidades sanguínea e plasmática. As participantes apresentaram idade de 51,77 2,3 anos, IMC de 31,52 2,54 kg/m e tempo de menopausa de 3 [2-5] anos. O grupo P não apresentou nenhuma mudança significativa em qualquer variável. Após a intervenção, o grupo ET comparado ao basal apresentou menor tempo para atingir a VDH máxima durante a hiperemia reativa pós-oclusiva (HRPO) após 1 min de isquemia (4,0 [3,25-5,0] vs. 5,0 [4,0-6,0] s, P<0.05) e maior VDH tanto em repouso (0,316 [0,309-0,326] vs. 0,303 [0,285-0,310] mm/s; P<0,001) quanto na HRPO (0,374 [0,353-0,376] vs. 0,341 [0,334-0,373] mm/s; P<0,001), assim como observamos maior FSA em repouso (2,46 [1,81-3,28] vs. 1,89 [1,46-2,44] ml/min.100ml tecido-1; P<0,01) e durante a HRPO após 3 min de isquemia (6,39 [5,37-9,39] vs. 5,23 [4,62-7,47] ml/min.100ml tecido-1; P<0,001). O grupo ET também apresentou diminuição nos níveis solúveis de E-Selectina (68,95 [50,18-102,8] vs. 58,4 [44,53-94,03] ng/ml; P<0,05), de ICAM-1 (188 [145-212] vs. 175 [130-200] ng/ml; P<0,01), do HOMAIR (3,35 1,67 vs. 2,85 1,60; P<0,05) e da AUC da insulina durante o TOTG (152 [117-186] vs. 115 [85-178]; P<0,01), além de diminuição das viscosidades sanguínea com hematócrito nativo (3,72 0,21 vs. 3,57 0,12 mPa.s; P<0,01) e plasmática (1,49 0,10 vs. 1,45 0,08 mPa.s; P<0,05), comparado ao seu basal. Em conclusão o uso de estradiol transdérmico em mulheres com excesso de peso e menopausa recente, promove melhora da função endotelial, além de oferecer proteção a outros fatores de risco cardiovascular.

Construção de barreiras para diminuir as falhas nas mensurações glicêmicas realizadas pela enfermagem em pacientes críticos com insulina intravenosa

Esta pesquisa tem como objeto os fatores que influenciam a mensuração glicêmica realizada pela enfermagem em pacientes que recebem insulina contínua intravenosa utilizando glicosímetros portáteis à beira leito. Vários fatores podem influenciar a mensuração glicêmica, tais como a amostra sanguínea, a calibração do aparelho, a estocagem das fitas-teste, o hematócrito dos pacientes, o uso de vasoaminas e falhas do operador. A partir da Tese de que: A identificação dos fatores que influenciam a mensuração glicêmica realizada pela enfermagem através de glicosímetros é determinante para a eficiência das barreiras de salvaguarda voltadas para a minimização de falhas na sua execução, a fim de garantir resultados glicêmicos confiáveis e, consequentemente, realizar a titulação da insulina com segurança, teve-se como objetivo geral propor ações de enfermagem que funcionem como barreiras para diminuir as falhas nas mensurações glicêmicas realizadas pela enfermagem em pacientes que recebem infusão contínua de insulina. Espera-se contribuir com ações para garantir a adequação e o controle rigoroso da insulina administrada. Estudo observacional, transversal, prospectivo com abordagem quantitativa na análise dos dados, em uma unidade intensiva cirúrgica cardiológica de um hospital público do Rio de Janeiro. As variáveis do estudo foram submetidas a tratamentos estatísticos não paramétricos e às medidas de associação. Foram investigados 42 pacientes com observação de 417 glicemias. Predominaram pacientes do sexo feminino (57,14%), média de idade de 48 (15,85) anos, sem insuficiência renal e sem tratamento dialítico (90,48%). Observou-se PAM com média de 77(10,29) mmHg, uso de vasoaminas (80,95%), PaO2 ≥ 90mmHg em 85,71% e hematócrito <35% em 71,42%. Encontrou-se uma incidência de hipoglicemia de 35,7%, sendo a população dividida em dois grupos, o primeiro (G1) com pacientes que apresentaram hipoglicemia ≤ 60mg/dl (n=15), e o segundo (G2), com pacientes sem hipoglicemia (n=27). O hematócrito baixo foi a característica clínica que apresentou maior associação com a hipoglicemia. Pacientes com esta condição apresentaram 5,60 vezes mais risco de apresentarem hipoglicemia. O uso de vasoaminas elevou 3,3 vezes o risco de hipoglicemia em pacientes com estas medicações. A realização de cirurgias de emergência, a presença de insuficiência renal com tratamento dialítico, e a elevação da PaO2 acima de 90mmHg também apresentaram associação positiva com a hipoglicemia. Das 417 mensurações observadas, predominou o uso de amostra sanguínea de origem arterial. Observou-se que em todas as etapas da técnica de mensuração houve desvio de execução, com exceção de compressão da polpa digital. Os desvios observados que mostraram associação positiva (RR>1) para pacientes com hipoglicemia foram: a falta de calibração do glicosímetro, a falta de verificação da validade/integridade da fita teste, a falta da higienização das mãos e a falta da coleta de até 1 ml de sangue. Construiu-se uma revisão da técnica de mensuração glicêmica com enfoque nos fatores que podem comprometer o resultado glicêmico levando em conta o risco de hipoglicemia. Tornou-se evidente que a compreensão apropriada dos fatores que influenciam a glicemia e a mensuração glicêmica é indispensável para o enfermeiro na obtenção de resultados glicêmicos confiáveis, e assim, evitar erros na titulação das doses de insulina administrada.

Effect of feed quality restriction followed by realimentation on growth, nutrient utilization, biochemical changes and haematological profiles of Indian major carp, rohu (Labeo rohita H.)

To investigate the effect of protein restriction with subsequent re-alimentation on nutrient utilization, hematological and biochemical changes of Indian major carp, Rohu (Labeo rohita H.), 150 acclimatized Rohu fingerlings (average 20.74 ± 0.13 g) divided into five experimental groups (30 fingerlings in each groups with three replications with 10 fingerlings in each) for experimental trial of 90 days using completely randomized design. Control group (T sub(CPR)) was fed with feed having 30% crude protein at 3% of body weight for 90 days trial period. Other experimental groups T sub(1PR) was alternatively 3 days fed with feed having 20% CP and 30% CP at 3% of body weight, T sub(2PR) was alternatively 7 days fed with feed having 20% CP and 30% CP at 3% of body weight, T sub(3PR) was alternatively 15 days fed with feed having 20% CP and 30% CP at 3% of body weight and T sub(4PR) was alternatively 25 days fed with feed having 20% CP and 30% CP at 3% of body weight during 90 days trial period with daily ration in two equal halves at morning and afternoon. It was noticed that retention of different nutrients was almost similar among all treatment groups indicated improvement of digestibility of nutrients might not be the mechanisms for recovery growth in carps. Increased percent feed intake of body weight (hyperphagia) (4.14 ± 0.30 or 4.94 ± 0.46 and 3.33 ± 0.29), improved specific growth rate (1.86 ± 0.09 or 2.26 ± 0.05 and 1.43 ± 0.01), absolute growth rate (1.57 ± 0.08 or 1.84 ± 0.18 and 1.36 ± 0.12), protein efficiency ratio (1.19 ± 0.11 or1.16 ± 0.12 and 1.05 ± 0.09) were the important mechanism showing better performance index (21.60 ± 1.09 or 23.80 ± 0.21 and 19.45 ± 0.37) through which the experimental groups which were protein restricted and re-alimented at 3 or 7 days alternatively during 90 days trial period could able to compensate the growth retardation and to catch up the final body weight of control (128.68 ± 11.53 g/f) but other experimental groups failed to compensate during 90 days trial period. Result of the present study indicated that deprived fish i.e., fish received alternate 3 or 7 days protein restriction and re-alimentation showed recovery growth had still lower values of Hb (10.21 ± 0.02, and 9.88 ± 0.04 g/dl), hematocrit value (30.62 ± 0.05 and 26.64 ± 0.11%), total erythrocytic count (3.40 ± 0.01 and 3.29 ± 0.01 X10super(6) mm³), plasma glucose (126.93 ± 0.20 and 126.67 ± 0.05 mg/dl), total plasma lipid (1.04 ± 0.01 and 1.02 ± 0.01 g/dl) and liver glycogen (290.10 ± 0.80 and 288.99 ± 0.95 mg/kg) in comparison to control (10.56 ± 0.08 g/dl, 31.68 ± 0.24%, 3.52 ± 0.03 X10super(6) mm³, 128.23 ± 0.25 mg/dl, 1.07 ± 0.01g/dl and 292.00 ± 0.23 mg/kg) at the end of 90 days trial but total plasma protein in deprived group was compensated with advancement of trial period. All hematological and biochemical parameters studied were proportionately lowered in the experimental group got higher degree of deprivation. These findings suggested that with the increase of trial length complete compensation of hematological and biochemical profiles of rohu might be achieved. The results indicated that the implementation of alternative 7 days low and high protein diet feeding during aquaculture of carps could make economize the operation through minimizing the feed input cost.

Comparative study of seasonal changes in some blood parameters and genetic polymorphisms of serum antibodies and antigens on red blood cells surface in immature Caspian salmon

Seasonal sampling from 40 immature Caspian salmon were performed in summer, autumn, winter and spring. The maximum ranges of RBC counts, Hct, Hb, WBC count and clotting times were observed in spring, summer, spring, spring and winter, respectively. The minimum amounts of these factors were counted in summer, winter, winter, winter and winter, respectively. Blood Samples were taken from healthy smolt, immature and adult Caspian salmon in spawning time. Hematological determinations and biochemical serum analysis were performed in 101 fish in the three samples. The ranges of hematological values for sample mean were counted. Red blood cell counts were 866600 mm3 and 1259400 mm3 in smolt and adult respectively. Hematocrit was 48.39% in smolt and 44.29% in adult. Hemoglobin was 8.85 gr/dl in smolt and 10.91 gr/dl in adult. White blood cell count was 8781.58 mm3 in smolt and 5217.55 mm3 in adult and mean were differential of WBC, Lymphocyte 90.57%in smolt and73.22% in adult. Neutrophil was 5.12% in smolt and 16.92% in adult, Monocyte were 1.27% in smolt and 4.24% in adult, Clotting time was 282.34 Seconds in smolt and 291.47 seconds in adult MCV, MCH and MCHC also meagered in smolt and adult. Biochemical parameter in immature and mature Caspian salmon meagered .Glucose concentration was 2.97 mmol.l- in immature and 1.99 mmol.l- in mature .Cholesterol concentration was 4.26 mmol.l- in immature and 7.06 mmol.l- in mature. Triglyceride amount was 2.35 mmol.l- in immature and 2.47 mmol.l- in mature and Calcium was 2.47 in immature and 2.61 mmol.l- in mature. An in situ study was made on erythrocytic isoantigens and hetero-antigen and their corresponding iso-and hetero-antibodies of sera by means of hemoagglutination tests on the blood sample, of 450 immature and 50 mature Caspian salmon. The absence of erythrocyte iso-antigens and hetero-antigen and their corresponding iso-and hetero-antibodies were shown by the experimental. It could be indicated an intra-specific variation and differences in species for kelardasht hatchery.

A comparative study on effects of Immunoster and Immunowall as immunostimulants on some hematological, biochemical and growth indices of farmed great sturgeon juveniles (Huso huso)

Prebiotics are non-digestible food ingredients that profitably affect the host by selectively stimulating the growth and /or activation of one or a limited number of bacteria in the intestine that can enhance host health status. Immunoster (IS) and Immunowall (IW) are prebiotics and immunostimulants derived from the outer cell wall of brewers yeast, Saccharomyces cerevisiae. These substances contain MOS and �-glucans. After a four-week acclimatization period to rearing conditions and basal diet, 450 farmed great sturgeon juveniles weighing 95.58 ± 9.38 g were randomly distributed into 15 fiberglass tanks (2 × 2 × 0.53 m) in five treatments (Control, IS 1%, IW 1%, IS 3%, and IW 3%) in three replicates (completely randomized design) and kept at a density of 30 fish per tank for a period of 8 weeks at water temperature 20.55 ± 5.11ºC, dissolved oxygen 6.73 ± 0.35 mg L-1 and pH 7.92 ± 0.09. IS and IW were added at two levels of 1% and 3% to the basal diet in place of cellulose, except the control. At the beginning, in the middle and at the end of the trial, carcass analysis was done to determine the moisture, protein, fat, ash, and total carbohydrate. Also, blood samples were collected to measure hematological, biochemical and immune indices. At the end of the trial, final weight, final length, body weight increase (BWI), specific growth rate (SGR), average daily growth (ADG), protein efficiency ratio (PER), feed conversion ratio (FCR), and condition factor (CF) in fish fed on IS and IW in both levels 1% and 3% showed some differences. These differences were significant in IS 3% and IW 1% and 3% compared with the control (P<0.05). HSI showed no significant difference (P>0.05) and survival rate was 100% in all treatments. Crude protein of carcass in fish fed on IS and IW at 1% and 3% showed an increase in comparison with the control. There was significant difference between IS 3% and the control in crude protein of carcass (P<0.05). Fish fed on IS and IW at 1% and 3% showed various results in hematological and biochemical factors. It was observed significant difference in MCV between IW 1% and IS 3% compared with the control (P<0.05). Although there was an increase in values of hematocrit, hemoglobin (except IS 1%), WBC (except IW 3%), MCH, neutrophil, total protein, albumin (except IS 3%), K+, and lysozyme in fish fed on IS and IW compared with the control, it was no significant (P>0.05). The maximum count of WBC and the highest value of Ca2+ were seen in IW 1%. The maximum count of lymphocyte, the highest values of total protein, albumin and IgM were recorded in IW 3%. IS 1% had the maximum count of neutrophil and the highest concentration of lysozyme. Based on obtained results, it can be declared that IS and IW at two levels of 1% and 3% can enhance growth performance and feed efficiency and also improve some hematological, biochemical, and immune indices in farmed great sturgeon juveniles.

The effect of different dietary iron levels on growth and hepatic iron concentration in juvenile gibel carp (Carassius auratus gibelio)

P>An 83-day growth trial was conducted using a flow-through system to examine the effects of different dietary iron levels on growth and hepatic iron concentration in juvenile gibel carp (Carassius auratus gibelio). Six purified diets supplemented with different levels of iron (0, 10, 30, 60, 100 and 200 mg kg(-1)) (as ferrous sulfate) were fed to triplicate groups of fish (initial weight 2.12 +/- 0.00 g per fish). The results showed that the addition of iron to the basal diet did not significantly affect the specific growth rate (SGR), feed efficiency (FE), survival, red blood cell amount (RBC), hemoglobin content (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) or mean corpuscular hemoglobin concentration (MCHC). Hepatic iron concentration and hematocrit (Hct) were significantly influenced by dietary iron level (P < 0.05). On the basis of the iron concentration for the maintenance of optimum hepatic iron concentration and Hct, it was concluded that the dietary iron concentration of juvenile gibel carp should be not less than 202 mg Fe kg(-1) diet.

Intraperitoneal injection of extracted microcystins results in hypovolemia and hypotension in crucian carp (Carassius auratus)

Circulatory responses of crucian carp injected intraperitoneally with extracted micro-cystins (MCs) were studied at sublethal and lethal doses (150 and 600 mu g MC kg(-1) body mass, respectively). Mean arterial blood pressure (MAP), heart rate, hematocrit (Hct), red blood cell (RBC) counts, and circulating blood volume (BV) were assayed at 0, 1, 3, 12, 24, and 48 h post-toxin administration. MAP decreased significantly in a dose-dependent manner over time. Within the 48-h test period, the lethal dose as well as the sublethal dose resulted in a steady decline of MAP without recovery. Heart rate significantly increased within 24 h post-injection as blood pressure significantly dropped, then showed a terminal decline to the control level. The dose-dependent decreases in BV and Hct were directly related to the drop in MAP. Intraperitoneal injection of a lethal dose of MCs led to hepatic and gill hemorrhage. Consequently, crucian carp given MCs suffered from hypovolemic hypotensive shock. (C) 2009 Elsevier Ltd. All rights reserved.

Hematological and plasma biochemical responses of crucian carp (Carassius auratus) to intraperitoneal injection of extracted microcystins with the possible mechanisms of anemia

Alterations in hematological indices such as decreases in blood cell counts (RBC), hematocrit (Ht) and hemoglobin (Hb) concentrations are key symptoms of anemia. However, few experiments were conducted to examine changes in hematological indices of fish exposed to microcystins that are believed to be fatal to circulatory systems of vertebrates. An acute toxicological experiment was designed to study hematological changes of crucian carp injected intraperitoneally (i.p.) with extracted microcystins at two doses, 50 and 200 mu g MC-LReqkg(-1) body weight. After being i.p. injected with microcystins, the fish exhibited behavioral abnormity. There were significant decreases in RBC in the high-dose group, and in Ht and Hb concentrations in both dose groups, while erythrocte sedimentation rate (ESR) significantly increased, indicating the appearance of normocytic anemia. There were no prominent changes in the three red cell indices, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH,), and mean corpuscular hemoglobin concentration (MCHC). Increases in blood urea nitrogen (BUN) and creatinine (CR) in both dose groups suggest the occurrence of kidney impairment. Alteration in blood indices was reversible at the low dose group. Conclusively, anemia induced by kidney impairment was a key factor to cause abnormity of swimming behaviors and high mortality of crucian carp. (c) 2007 Elsevier Ltd. All rights reserved.

Blood-gas properties of plateau zokor (Myospalax baileyi)

Plateau zokor (Myospalax baileyi) is one of the blind subterranean mole rats that spend their life solely underground in scaled burrows. It is one of the special species of the Qinghai-Tibet plateau. In their burrows, oxygen is low and carbon dioxide is high and their contents fluctuate with the change of seasons, soil types, rain and depth of burrows. However, plateau zokors show successful adaptation to that extreme environment. In this study, their adapting mechanisms to the hypoxic hypercapnic environment were analyzed through the comparison of their blood-gas properties with that of pikas (Ochotona curzniae) and Sprague-Dawley rats. The results indicated that plateau zokors had higher red blood corpuscle counts (8.11 +/- 0.59 (10(12)/L)) and hemoglobin concentrations (147 +/- 9.85 g/L), but hematocrit (45.9 +/- 3.29%) and mean corpuscular volume (56.67 +/- 2.57 fL) were lower than the other rodents. Their arterial blood and venous blood pH were 7.46 +/- 0.07 and 7.27 +/- 0.07. Oxygen pressure in arterial blood of plateau zokors was about 1.5 times higher than that of pikas and rats, and it was 0.36 and 0.26 times in their venous blood. Partial pressure for carbon dioxide in arterial and venous blood of plateau zokors was 1.5-fold and 2.0-fold higher, respectively, than in rats and pikas. Oxygen saturation of plateau zokors was 5.7 and 9.3 times lower in venous blood than that of pikas and rats, respectively. As result, the difference of oxygen saturation in arterial blood to venous blood was 2- and 4.5-fold higher in plateau zokors as that of pikas and rats, respectively. In conclusion, plateau zokors had a high tolerance to pH changes in tissues, together with strong capabilities to obtain oxygen from their hypoxic-hypercapnic environment. (c) 2006 Published by Elsevier Inc.

维持性血液透析患者认知功能特点研究

Objective: To study the episodic memory, semantic memory, cognitive planning ability and inhibition ability in MHD patients. Method: Neuropsychological research methods such as Action memory of verb-object phrase, Trail Making Test (A and B), Verbal Fluency Test, Go-No/Go test and Stroop Color Naming Task were used to investigate Episodic Memory 、Semantic Memory、Executive Function of 40 MHD and 40 NC. Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale(SDS), Social Support Scale, Life Satisfaction Scale, and biochemical examination were applied and their relationships with cognitive function were analized. The mean age and education level of MHD group and NC group have no significant difference. Result: 1.Action memory of verb-object phrase differed significantly between MHD group and NC group. 2.Two tests of Verbal Fluency differed significantly between MHD group and NC group. 3.Trail Making Test A, Trail Making Test B, the baseline condition of Go-No/Go Test and Stroop Color Naming Test differed significantly between MHD group and NC group. 4.There is no significant difference between MHD group and NC group on the correct rate of No/Go Test and the baseline condition. Both groups showed Stroop Effect in Go-No/Go test, but MHD group performed significantly worse. 5.In Stroop Color Naming Task Test, NC group showed Stroop Effect, significant Repeated Distraction Promotion Effect and significant Negative Priming Effect,while MHD group showed only Stroop Effect and no Repeated Distraction Promotion Effect and no Negative Priming Effect. There is significant difference in Stroop Effect between MHD group and NC group. Conclusion: 1.Comparing with NC group, episodic memory, semantic memory, cognitive planning ability, and inhibition ability of MHD group were impaired significantly. 2.The pathological aging of Executive Function in MHD group showed: executive Function should be a unitary system. 3.Cognitive impairment is negatively correlated with serum creatinine, blood pressure and anxiety score in MHD patients; and is related with hemoglobin, hematocrit, social support and life satisfaction. Keyword: maintenance hemodialysis, episodic memory, semantic memory, cognitive planning, inhibition ability.

HIF pathway mutations and erythrocytosis

Erythrocytosis is present when there is an increase in the red cell mass, usually accompanied by an elevated hemoglobin and hematocrit. This occurs when there is an intrinsic defect in the erythroid component of the bone marrow or for secondary reasons when an increase in erythropoietin production drives red cell production. In normoxic conditions, HIF-alpha interacts with the other proteins in the HIF pathway and is destroyed, but in hypoxic conditions, HIF-alpha binds to HIF-beta. and alters the expression of downstream genes, including the erythropoietin gene. The end result is an increase in erythropoietin production. Mutations in any of the genes in the HIF pathway could lead to changed proteins, abnormalities in the degradation of HIF-alpha and, ultimately, result in increased erythropoietin levels. A number of mutations in the VHL, PHD2, and HIF2A genes have been identified in individuals. These mutations lead to erythrocytosis. The clinical results of these mutations may include some major thromboembolic events in young patients.

Intervention With an Erythropoietin-Derived Peptide Protects Against Neuroglial and Vascular Degeneration During Diabetic Retinopathy.

OBJECTIVE:
Erythropoietin (EPO) may be protective for early stage diabetic retinopathy, although there are concerns that it could exacerbate retinal angiogenesis and thrombosis. A peptide based on the EPO helix-B domain (helix B-surface peptide [pHBSP]) is nonerythrogenic but retains tissue-protective properties, and this study evaluates its therapeutic potential in diabetic retinopathy.
RESEARCH DESIGN AND METHODS:
After 6 months of streptozotocin-induced diabetes, rats (n = 12) and age-matched nondiabetic controls (n = 12) were evenly split into pHBSP and scrambled peptide groups and injected daily (10 µg/kg per day) for 1 month. The retina was investigated for glial dysfunction, microglial activation, and neuronal DNA damage. The vasculature was dual stained with isolectin and collagen IV. Retinal cytokine expression was quantified using real-time RT-PCR. In parallel, oxygen-induced retinopathy (OIR) was used to evaluate the effects of pHBSP on retinal ischemia and neovascularization (1-30 µg/kg pHBSP or control peptide).
RESULTS:
pHBSP or scrambled peptide treatment did not alter hematocrit. In the diabetic retina, Müller glial expression of glial fibrillary acidic protein was increased when compared with nondiabetic controls, but pHBSP significantly reduced this stress-related response (P < 0.001). CD11b+ microglia and proinflammatory cytokines were elevated in diabetic retina responses, and some of these responses were attenuated by pHBSP (P < 0.01-0.001). pHBSP significantly reduced diabetes-linked DNA damage as determined by 8-hydroxydeoxyguanosine and transferase-mediated dUTP nick-end labeling positivity and also prevented acellular capillary formation (P < 0.05). In OIR, pHBSP had no effect on preretinal neovascularization at any dose.
CONCLUSIONS:
Treatment with an EPO-derived peptide after diabetes is fully established can significantly protect against neuroglial and vascular degenerative pathology without altering hematocrit or exacerbating neovascularization. These findings have therapeutic implications for disorders such as diabetic retinopathy.

Erythropoietin receptor and hematological disease

This review will discuss evidence for the role of the erythropoietin (Epo) receptor in the development of erythrocytosis and other hematological disorders, The possible causative role of mutations of other genes in the pathogenesis of idiopathic erythrocytosis will be considered, Polycythemia vera (PV) is a myeloproliferative disorder that is caused by an undefined stem cell abnormality, characterized by a significant erythrocytosis, leukocytosis, and thrombocytosis. However, erythrocytosis may arise from apparent (or relative) polycythemia in which the hematocrit is raised due to a low plasma volume. In such cases the red cell mass is normal. A group of disorders with increased red cell mass caused by stimulation of erythrocyte production is known as secondary polycythemia, Investigation of such patients may reveal a congenital abnormality such as high affinity hemoglobin or an acquired abnormality caused, for example, by smoking, renal Vascular impairment, or an Epo-producing tumor. Even after thorough examination there remains a cohort of patients for whom no definite cause for the erythrocytosis can be established, A careful clinical history may reveal whether this idiopathic erythrocytosis is likely to be congenital and/or familial, in which case the term

Hemostatic alterations with exercise conditioning in NIDDM

Various parameters of coagulation and fibrinolysis were measured in 13 men (aged 54 +/- 3 yr) with non-insulin-dependent diabetes mellitus (NIDDM) before and after 12-14 wk of exercise training. Subjects exercised for 30 min 3 times/wk at 70% of maximum O2 consumption (VO2max). Training increased VO2max by 12.5% but did not alter body weight, relative body fat, blood pressure, cholesterol, triglycerides, or high-density lipoprotein cholesterol. Slight downward trends were apparent for fasting glucose and insulin, but glycosylated hemoglobin was unchanged. There were no changes in coagulation parameters of plasminogen, hematocrit, or alpha 2-antiplasmin. Plasma fibrinogen (303 +/- 24.2 vs. 256 +/- 12.3 mg/dl) and fibronectin (380 +/- 41.9 vs. 301 +/- 22.2 micrograms/ml) were significantly reduced (P less than 0.02) by exercise conditioning. Three assays of fibrinolytic activity (tissue plasminogen activator, euglobulin lysis time, and an isotopic measure of fibrinolysis) confirmed that neither basal fibrinolysis nor the fibrinolytic responses to venous occlusion and maximal exercise were significantly altered. Exercise conditioning may have antithrombotic effects in NIDDM by reducing plasma fibrinogen and fibronectin. Although the significance of the fall in fibronectin awaits further studies, the reduction in plasma fibrinogen gives a rationale for the use of exercise training in men with NIDDM.