José Edson Paz da Silva

Evaluation of ischemia‐modified albumin in anemia associated to chronic kidney disease

Chronic kidney disease (CKD) is highly prevalent, with increasing numbers of patients affected by the disease world‐wide, and anemia is a common finding in patients with CKD. Anemia impacts negatively on cardiovascular disease, exercise capacity, and quality of life, resulting in significant mortality and morbidity. The aim of this study was to evaluate the levels of ischemia‐modified albumin and lactate in patients with established anemia associated with CKD and its correlations with hemoglobin levels. Hematocrit, hemoglobin, iron, ferritin, albumin, creatinine, lactate, and ischemia‐modified albumin (IMA) were measured in 17 patients with established anemia associated to CKD and 19 controls by standard methods. The results of hematocrit, hemoglobin, iron, and albumin were lower in the anemia group than in the control group. Ferritin, creatinine, and lactate levels were higher in anemia of the CKD group than the control group. IMA increase in the anemia group (0.8115±0.1304 absorbance units [ABSU]) compared to control (0.4951±0.0393 ABSU). Significant correlations between IMA and lactate, IMA and hemoglobin, IMA and creatinine, and hemoglobin and lactate were observed. IMA and lactate increase during anemia and this elevation could be associated to hypoxia due to low hemoglobin levels. However, our data suggest that lactate is more sensitive to anemia compared to IMA. J. Clin. Lab. Anal. 22:1–5, 2008.

Relation between red blood cell distribution width and mortality after acute myocardial infarction

predictor of impaired peak leg blood flow in patients with chronic heart failure. QJM 1998;91:199–203. [8] Perez-Paramo M, Munoz J, Albillos A, et al. Effect of propranolol on the factors promoting bacterial translocation in cirrhotic rats with ascites. Hepatology 2000;31:43–8. [9] Kincaid EH, Miller PR, Meredith JW, et al. Enalaprilat improves gut perfusion in critically injured patients. Shock 1998;9:79–83. [10] Shewan LG, Coats AJ. Ethics in the authorship and publishing of scientific articles. Int J Cardiol 2010;144:1–2. [11] Coats AJ. Ethical authorship and publishing. Int J Cardiol 2009;131:149–50.

Avaliação da atividade e caracterização de eritropoietina humana recombinante em produtos farmacêuticos

The identification of rhEPO in pharmaceutical products was carried out by polyacrylamide gel electrophoresis and detection with specific antibodies that revealed a typical single broad band similar to that obtained with the European Pharmacopoeia Biological Reference Preparation for erythropoietin. The isoelectric focusing with immunodetection revealed extensive heterogeneity with 5-6 isoforms, characteristic according to the manufacturer. The potency was assessed by the normocythaemic mouse assay with values within 67.6% and 119.4% calculated against the stated potency. The precision evaluated by the weight was within 200 and 389, for the combined assays. The toxicity, bacterial endotoxins, and pH gave variable results according to the batch. In conclusion, we emphasize the importance of the batch-to-batch tests and assays that would guarantee the quality and therapeutic efficacy of the pharmaceutical products.

Ischemia modified albumin and carbonyl protein as potential biomarkers of protein oxidation in hemodialysis

OBJECTIVE The aim of this study was to evaluate the effect of HD on ischemia modified albumin (IMA) and protein carbonyl groups in order to investigate the role of IMA as a marker of protein oxidation. DESIGN AND METHODS This study was conducted with 23 chronic hemodialysis patients. The serum IMA levels and protein carbonyl groups were measured immediately before hemodialysis (pre-HD) and after the end of hemodialysis (post-HD). RESULTS IMA concentrations were significantly higher in post-HD than those of the pre-HD and carbonyl protein concentrations were higher in post-HD in comparison with pre-HD. A significant correlation was observed between IMA and carbonyl protein levels. CONCLUSIONS The increase of IMA levels and protein carbonyl groups post-HD could be attributed to the increase of oxidative stress associated with HD, and IMA appears to be an important biomarker for assessing protein oxidation after HD.

Assessment of Oxidative, Inflammatory, and Fibrinolytic Biomarkers and DNA Strand Breakage in Hypercholesterolemia

The aim of this study was to assess the levels of oxidative, inflammatory, and fibrinolytic biomarkers as well as DNA strand breakage in hypercholesterolemic subjects. Fasting glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, uric acid, total protein, albumin, apolipoprotein (Apo) A, Apo B, advanced oxidation protein products (AOPP), increased ischemia-modified albumin (IMA), ―SH, NOx, IL-6, and D-dimer levels were assessed, and DNA strand breakage was evaluated using comet assay in 38 patients with hypercholesterolemia and 20 healthy controls. Total cholesterol, triglycerides, LDL cholesterol, Apo A, Apo B, AOPP, IMA, IL-6, and D-dimer concentrations were significantly higher in subjects with hypercholesterolemia. However, NOx and plasma ―SH group concentrations were lower in hypercholesterolemic subjects, while no significant differences were observed with respect to DNA strand breakage between the two groups. Hypercholesterolemia is related to oxidative stress and inflammation. Accordingly, AOPP concentration was higher in subjects with hypercholesterolemia, and we speculate that AOPP can reflect the enhancement of protein oxidation and inflammation.

Carbonyl iron reduces anemia and improves effectiveness of treatment in under six-year-old children

O tratamento da anemia ferropriva de criancas consiste, em sua maioria, no uso de solucao de sulfato ferroso e este tratamento nem sempre apresenta a efetividade desejada. O objetivo deste estudo foi avaliar a efetividade do ferro carbonila, na forma de comprimidos mastigaveis, como uma alternativa de tratamento para anemia ferropriva de criancas menores de seis anos de idade. Foram incluidas no estudo 73 criancas atendidas em PSFs de Santa Maria, RS. Um grupo recebeu comprimidos mastigaveis de ferro carbonila (CI) e o grupo controle recebeu solucao de sulfato ferroso (FS), ambos a dose de 5mg/Kg/dia por 90 dias. Amostras de sangue foram coletadas nos dias zero, 30 e 90 do tratamento para avaliacao de hemograma, ferritina, ferro serico e capacidade total de ligacao do ferro. Tambem foi avaliada a aceitacao e aderencia ao tratamento e relato de efeitos colaterais durante o tratamento. A hemoglobina teve um incremento de 1,3g/dL no grupo CI e 1,2g/dL no grupo FS aos 30 dias de tratamento. Apos 90 dias de tratamento, o grupo CI apresentou resultados significativamente melhores para hematocrito, VCM, HCM, CTLF e ferritina. A ferritina do grupo CI teve um importante aumento ao final do tratamento (9,51ng/mL para 26,16ng/mL). O grupo CI apresentou melhor aceitacao do tratamento e menos efeitos colaterais. Comprimidos mastigaveis de ferro carbonila poderiam ser considerados uma importante opcao terapeutica para tratamento da anemia ferropriva de criancas menores de seis anos de idade.

Frequency of suspected cases of neurocysticercosis detected by computed skull tomography in Santa Maria, RS, Brazil

Due to the lack of studies about neurocysticercosis in the South of Brazil, an investigation was conducted to determine the percentage of suspected cases of neurocysticercosis in computed tomography diagnoses in Santa Maria, RS, from January 1997 to December 1998. Of 6300 computed tomographies (CT) of the skull performed at the private Hospital de Caridade Astrogildo de Azevedo, 80, i.e., 1.27% were suspected of neurocysticercosis. Fifty were women (62.5%) and 30 were men (37.5%). The most frequent radiological manifestation indicating neurocysticercosis was the presence of calcifications (isolated or associated), with a 95% rate (76 cases), while the presence of hypodense lesions reached a 5% rate (4 cases). After routine analysis, each CT was evaluated again and the suspected cases were confirmed. The percentage of suspected cases of neurocysticercosis detected by CT in the present study carried out in Santa Maria was considered low (1.27%). This can be explained by the fact that tomography is not accessible to the economically underprivileged population of Santa Maria. We hope that the present study can alert the population and the professionals to the fact that neurocysticercosis is a more frequent disease than indicated by the few diagnoses made.

Platelet aggregation and serum adenosine deaminase (ADA) activity in pregnancy associated with diabetes, hypertension and HIV

Platelet aggregation and adenosine deaminase (ADA) activity were evaluated in pregnant women living with some disease conditions including hypertension, diabetes mellitus and human immunodeficiency virus infection. The subject population is consisted of 15 non‐pregnant healthy women [control group (CG)], 15 women with normal pregnancy (NP), 7 women with hypertensive pregnancy (HP), 10 women with gestational diabetes mellitus (GDM) and 12 women with human immunodeficiency virus‐infected pregnancy (HIP) groups. The aggregation of platelets was checked using an optical aggregometer, and serum ADA activity was determined using the colorimetric method. After the addition of 5 µM of agonist adenosine diphosphate, the percentage of platelet aggregation was significantly (p < 0·05) increased in NP, HP, GDM and HIP groups when compared with the CG, while the addition of 10 µM of the same agonist caused significant (p < 0·05) elevations in HP, GDM and HIP groups when compared with CG. Furthermore, ADA activity was significantly (p < 0·05) enhanced in NP, HP, GDM and HIP groups when compared with CG. In this study, the increased platelet aggregation and ADA activity in pregnancy and pregnancy‐associated diseases suggest that platelet aggregation and ADA activity could serve as peripheral markers for the development of effective therapy in the maintenance of homeostasis and some inflammatory process in these pathophysiological conditions. Copyright

In vitro oxidation of fibrinogen promotes functional alterations and formation of advanced oxidation protein products, an inflammation mediator.

Fibrinogen (FB) is a soluble blood plasma protein and is a key molecule involved in coagulation. Oxidative modification of proteins, such as the formation of advanced oxidation protein products (AOPP), a heterogeneous family of protein compounds structurally modified and derived from oxidative stress, may be associated with the pathophysiology of a number of chronic inflammatory diseases. Therefore, the aim of this study was to determine whether the formation of this mediator of inflammation occurs from FB and whether its generation is associated with structural changes. Results of the present study suggest that the oxidation of FB may provoke the formation of AOPP, which in turn, may promote functional alterations in FB, thus causing changes in its structural domains and increasing its procoagulant activity.

Estudo comparativo entre metodologias de triagem para detecção de hemoglobina S em bancos de sangue

INTRODUCTION: The sickle cell trait is the presence of hemoglobin S (HbS) in heterozygosity. According to RDC regulation 153/04, abnormal hemoglobin screening has become mandatory in blood donation samples since June 2004. OBJECTIVE: The aim of this study was to compare different screening methods used in blood banks for HbS detection. Material and method: From April 2007 to April 2008, three HbS detection methods were applied in 4,108 suitable blood samples from the blood bank of the University Hospital of Santa Maria (HUSM). The comparative study among the methods comprised solubility tests and gel-centrifuge (ID-HbS). Furthermore, the positivity reference was the presence of HbS on hemoglobin electrophoresis. RESULTS: Twenty-three (0.56%) out of 4,108 samples showed positivity for HbS and two (0.05%) showed positivity for HbC. Twenty-two (95.6%) out of 23 HbS positive samples determined through qualitative electrophoresis were detected by solubility test and 20 (86.9%) were detected by gel-centrifugation test. CONCLUSION: Hemoglobin electrophoresis proved the best method in the identification of hemoglobin variants and, therefore, worthwhile when it comes to diagnostic screening in blood banks due to its high sensitivity, which keeps false-negative results to a minimum and ensures blood quality.