Orientadores: Maria Cristina Cintra Gomes Marcondes, Dora Maria Grassi Kassisse / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-27T12:12:43Z (GMT). No. of bitstreams: 1 Camargo_EricaAparecidaMariano_M.pdf: 3544834 bytes, checksum: d9515fe1a07bef154d0bed7c21be4a79 (MD5) Previous issue date: 2015 / Resumo: A importância da validação científica de técnicas coadjuvantes a diversos tratamentos de saúde é inquestionável. Assim a influência da drenagem linfática manual na mobilização hidroeletrolítica, na taxa lipolítica, bem como, no sistema nervoso autonômico ainda precisa ser investigada. O objetivo deste trabalho foi avaliar o efeito da drenagem linfática manual na mobilização hidroeletrolítica, na taxa lipolítica e na modulação autonômica da frequência cardíaca em homens e mulheres. Foram estudados 11 homens; 11 mulheres não usuárias de anticoncepcional oral e 12 mulheres usuárias de anticoncepcional oral, com 21,3 ± 2,9 anos de idade, saudáveis, sedentários e eutróficos. As amostras urinárias foram coletadas em um dia, sem intervenção terapêutica, denominado controle e em outro dia com aplicação da drenagem linfática manual. Na urina, foram analisadas osmolaridade, concentração de sódio, fluxo e concentração de glicerol. A variabilidade da frequência cardíaca foi registrada no início, durante e ao final do experimento, nos dias controle e drenagem linfática manual. Os resultados mostram que a drenagem linfática manual promoveu em homens redução dos eletrólitos urinários e aumento do fluxo e em mulheres não usuárias de anticoncepcional oral houve apenas aumento do fluxo. A técnica induziu diluição urinária em homens e mulheres não usuárias de anticoncepcional, sugerindo que os mecanismos são sexo-dependentes. Para usuárias de anticoncepcional oral, a drenagem linfática manual não diferiu do dia controle, onde houve redução dos eletrólitos e aumento do fluxo urinário. A análise da concentração de glicerol urinário mostrou que a drenagem linfática manual não altera a taxa lipolítica nos voluntários dos grupos estudados. Os resultados da modulação autonômica da frequência cardíaca indicaram que a técnica promoveu predomínio simpático no grupo de homens sem alterações nos grupos das mulheres. Conclui-se que a drenagem linfática manual foi eficaz na diluição urinária de homens e mulheres não usuárias de anticoncepcional oral, assim como, foi eficaz em promover predomínio simpático em homens. A técnica não foi eficaz em promover alterações na taxa lipolítica / Abstract: The importance of scientific validation techniques supporting the various health treatments is unquestionable. Thus, the influence of manual lymphatic drainage in the electrolyte mobilization in lipolytic rate as well as in the autonomic nervous system has to be investigated. The objective of this study was to evaluate the effect of manual lymphatic drainage in the electrolyte mobilization in lipolytic rate and autonomic modulation of heart rate in men and women. 11 male patients; 11 women not using oral contraceptives and 12 women used oral contraceptives, with 21.3 ± 2.9 years old, healthy, sedentary and eutrophic. The urine samples were collected in one day, without therapeutic intervention, denominated as the control and on another day with application of manual lymphatic drainage. In the urine, were analyzed osmolality, sodium concentration, flow, and the concentration of glycerol. The heart rate variability was registered at the outset, during and at the end of the experiment, in the days control and manual lymphatic drainage. The results showed that the manual lymph drainage in men promoted reduction of urinary electrolytes and increased flow and in women non-users oral contraceptives there was only increased flow. The technique induced urinary dilution in men and women non-users oral contraceptives, suggesting that the mechanisms are sex-dependent. For oral contraceptive users, manual lymphatic drainage did not differ from control day where there was a reduction of electrolytes and increased urine flow. The analysis of urinary glycerol concentration showed that manual lymphatic drainage does not change the lipolytic rate in voluntary groups studied. The results of the autonomic modulation of heart rate indicated that the technique promoted sympathetic predominance in men group and without changes in women. We conclude that manual lymphatic drainage was effective in urinary dilution of men and women non-users oral contraceptives, as well as, it was effective in promoting sympathetic predominance in men. The technique was not effective in promoting changes in lipolytic rate / Mestrado / Fisiologia / Mestra em Biologia Funcional e Molecular

The intake of sodium, potassium, and phosphorus has important implications for chronic disease risk. Excess sodium intake is shown to be associated with elevated blood pressure, which in turn is a risk factor for cardiovascular disease (CVD) and chronic kidney disease (CKD). Potassium intake, on the other hand, is shown to be beneficial for lowering blood pressure and reducing the risk of CVD and CKD. Once an individual develops CKD, they experience alterations in mineral metabolism, especially phosphorus, and must closely monitor mineral intake and biochemical laboratory values in order to avoid complications. Thus, monitoring mineral intake is important in both healthy and CKD individuals in both research as well as clinical practice settings. It is therefore also important to have a method for estimating mineral intake that is both accurate as well as easy to administer. Two commonly used methods are self-report and 24-hour urinary mineral excretion. however, both methods have pros and cons. An alternative option that has been explored for all three minerals of interest is to collect a spot urine sample, then use one of several published equations to calculate an estimate of 24-hour urinary mineral excretion. While this method is relatively easy to administer, much remains unexplored regarding the accuracy of estimated 24-hour mineral excretion. My aim for my dissertation was to explore how estimated 24-hour sodium (e24hUNa), potassium (e24hUK) and phosphorus (e24hUP) compared to true mineral intake in healthy participants as well as those with CKD. We conducted secondary analyses from two controlled feeding studies, in which true mineral intake was known. Our results show that e24hUNa and e24hUK are not reliable indicators of true sodium and potassium intake, respectively, in healthy participants nor those with CKD, and e24hUP is not a reliable indicator of phosphorus intake in CKD participants. Though these findings should be confirmed by larger studies, these findings suggest that currently available equations may need to be revised and estimated 24-hour mineral excretion from spot urine samples should be interpreted with caution.

Endocrine disrupting chemicals (EDCs) are emerging contaminants that can interfere with the hormone system and may cause cancers, birth defects and reproductive system disorders. Prevalence of endocrine-related dysfunction and disease has increased steadily over the past decades. Although accumulating data suggest that these diseases have fetal origins, associations of EDC exposure during pregnancy and adverse health effects on both mothers and fetuses have not been thoroughly evaluated, particularly at multiple points in time. We firstly developed an analytical method for quantification of 28 EDCs (9 phthalates, 8 bisphenols, 5 parabens, 5 benzophenones and triclosan) in urine samples using ultra high performance liquid chromatography coupled with triple quadrupole mass spectrometer. The method was applied to measure targeted compounds in a total of 5220 urine samples collected from 951 pregnant women at three trimesters and 1501 pregnant women at one or two trimesters in Wuhan, China between 2014 and 2015. Based on the quantification results, exposure patterns and health risks of 28 EDCs on participants were evaluated and discussed in detail below. Among these samples, bisphenol A (BPA), bisphenol S (BPS), bisphenol F (BPF), methylparaben (MeP), ethylparaben (EtP), propylparaben (PrP), 4-hydroxybenzophenone (4-OH-BP), 2,4-dihydroxybenzophenone (BP-1), 2-hydroxy-4-methoxybenzophenone (BP-3), triclosan, mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono(2-ethylhexyl) phthalate (MEHHP), monobenzyl phthalate (MBzP), mono-n-butyl phthalate (MnBP), monoisobutyl phthalate (MiBP) were determined with detection rates exceeding 50%, in which BPA, BP-3, MeP and MnBP were the predominant compounds. We found the U-shaped trends of urinary concentrations of phthalate metabolites over trimesters. Parabens, benzophenones and triclosan displayed a downward trend over three visits. We also found the levels of targeted compounds varied by exposure-related factors, such as sampling seasons, physical activities, computer using time and decoration information. In addition, multiple EDCs were mostly determined at low doses over trimesters, indicating that real-world exposure of pollutants were dominated by low-dose mixtures. We then evaluated the combined health hazards induced by EDC exposure via calculating the estimated daily intakes on the basis of average urinary concentrations at three trimesters. It was found that 24.9% of participants had potential health risks caused by exposure to phthalate mixtures. The most frequency of cumulative risks occurred in women who were exposed to a high dose of one specific phthalate, di-n-butyl phthalate (DnBP) or di(2-ethylhexyl) phthalate (DEHP). We also evaluated the cumulative health risks of BPA and its alternatives and found that about 1.6% of participants were at risks induced by bisphenol exposure. Combined health hazards were mainly driven by one specific bisphenol (BPS or BPA). Our findings suggested that regional interventions of DnBP, DEHP, BPA and BPS in application and production should be tighten and/or taken. Considering the low-dose effects of BPA, we further investigated the associations of BPA and three major natural estrogens, including estrone (E1), estradiol (E2) and estriol (E3), at three trimesters of pregnancy. We observed non-monotonic dose-response relationships of BPA to E1, E2 and E3 over trimesters even when BPA concentrations were below the current safety thresholds. In the gender-stratified models, we found significant negative relationships (β < 0, p < 0.05) between BPA and E2 among mothers with male fetuses in the first trimester. However, we found that no significant relationship between BPA and E2 among mothers with female fetuses over three trimesters. Significant non-monotonic associations (from significant negative to positive associations) between BPA and E3 were observed among mothers with female fetuses in the second trimester. The above mentioned findings suggested the gender-specific and trimester-specific effects of BPA on estrogens. Our findings also indicated that the current tolerance daily intake value maybe not safe enough to evaluate the potential health risks induced by BPA exposure. We next investigated the effects of maternal exposure to phthalates on both mothers and fetuses. Associations of phthalate exposure with the risks of gestational diabetes mellitus (GDM) and plasma glucose levels were evaluated based on a nested case-control study design. It was found that the levels of phthalate metabolites in women with GDM were significantly higher than those without GDM. Meanwhile, positive associations between urinary concentrations of phthalate metabolites and the risks of GDM were obvious, indicating that phthalate exposure may be a risk factor for GDM. In addition, phthalate levels were related to the increased plasma glucose levels after 75 g oral glucose tolerance test. Our findings suggested that phthalates might disturb the glucose homeostasis and increase GDM risks. Furthermore, we assessed the trimester-specific and gender-specific effects of DEHP exposure on fetal growth, birth size and postnatal growth at 6, 12 and 24 months. We found that among male offspring, 1st-trimester DEHP was negatively related to fetal growth (β < 0, p < 0.05), but positively related to 24-month body mass index (BMI). 2nd-trimester DEHP was negatively related to fetal growth, birth weight and birth length, but positively related to the weight gain rates from birth to 12 months old. 3rd-trimester DEHP was positively (β > 0, p < 0.05) associated with birth weight, BMI at 6 and 12 months. However, among females, 1st-trimester DEHP was associated with increased birth length, while 2nd-trimester DEHP was negatively associated with BMI at 6 and 12 months. A negative association between DEHP and weight gain rates at 6 months was noted among females. Our findings indicated the second trimester maybe the sensitive window of DEHP exposure for offspring growth since 2nd-trimester DEHP levels were related to the decreased fetal growth, decreased birth size, but increased weight gain rates in early childhood age among male offspring. To investigate the mechanism underlying the associations of DEHP exposure with glucose and lipid metabolism, we investigated the biotransformation of DEHP and the disturbed metabolisms induced by MEHP, the putative toxic metabolite of DEHP, in human normal liver cell L02 using metabolomics and lipidomics. We found that MEHP was the major metabolite of DEHP. Decreased uptake of glucose and accumulation of glucose in liver cells were obvious after MEHP exposure. Phospholipid remodeling, incomplete fatty acid β-oxidation, inhibition of purine metabolism and glycolysis, and increased oxidative stress were noted in MEHP-exposed L02 cells, which were related to insulin resistance. In this work, we measured 28 EDCs in a total of 5220 urine samples provided by 951 pregnant women (three trimesters) and 1501 pregnant women (one or two trimesters) and then evaluated the exposure levels, exposure patterns (variations, variability and correlations), health risks and health effects of these compounds on pregnant women and fetuses. Our data suggested that participants had potential health risks induced by exposure to phthalates or bisphenols. Phthalate exposure was related with the increased plasma glucose levels and risks of GDM. Prenatal DEHP exposure may induce the intrauterine growth restriction and catch-up growth among males, which supported the evidence of fetal origin. To explore the underlying mechanisms of MEHP on glucose and lipid metabolic disorders, we exposed the human normal hepatic L02 cells with MEHP, and applied metabolomic and lipidomic approaches for finding potential biomarkers and disturbed pathways. We found that MEHP exposure inhibited glucose uptake, caused phospholipid remodeling and increased oxidative stress in L02. These findings suggest that the usage of products containing EDCs, particularly phthalates, in pregnant women should be limited in China, intervention of BPS should be considered, and threshold values of BPA are called for reevaluation.

No description available.

IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide with a very severe prognosis, causing kidney failure in up to 50 % of patients in a period of 30 years. For the diagnosis of IgAN it is necessary to perform a renal biopsy, this is an invasive examination that carries number of risks for the patients (the most common is bleeding and others). The aim of our work was to identify markers that could facilitate diagnosis and might help in determining the disease activity with an estimate of prognosis and consequently optimal use of effective therapy. In the pilot project on 19 patients with different types of glomerulonephritides (IgAN, diabetic nephropathy, membranous glomerulonephritis, lupus nephritis, ANCA associated vasculitis) and 19 healthy subjects we demonstrated a panel of 7 biomarkers (8-hydroxyguanosine, dodecanal, leukotriene C4, alpha1-antitrypsin, heparan sulfate , IgA-uromodulin, Gd-IgA1) that were able to completely differentiate patients with IgAN from other types of glomerulonephritides or healthy controls. In a group of 93 Czech patients with IgAN we confirmed the influence of clinical factors (PU, HT, eGFR) on the progression of renal function. Using LDA and logistic regression modelling we found that serum Gd-IgA1 (native without pre-treatment with...

Bakgrund: Det förekommer att personer är beroende av en kvarliggande urinkateter för att kunna miktera. Den urinuppsamlingspåsen som kopplas till urinkatetern kan se olika ut. En vanlig komplikation är kateterassocierad urinvägsinfektion vilket kan leda till döden. För att undvika komplikationer ska sjuksköterskan informera personerna om egenvård av urinkatetern.  Syfte: Syftet var att beskriva vuxna personers upplevelser av att leva med en kvarliggande urinrörskateter eller en suprapubiskateter i vardagen. Metod: Litteraturöversikten som genomfördes utgick från 12 artiklar med kvalitativ design där resultaten utgår från ett patientperspektiv. Data samlades in från 2 olika databaser. Fribergs analysmetod för kvalitativa artiklar användes.   Resultat: I resultatet framkom tre huvudteman; förändrad självbild, känslan av okunskap och känslor kopplade till komplikationer. Åtta subtema identifierades; acceptansen av urinkatetern och urinuppsamlingspåsen, påverkan på det sexuella samlivet, behovet av planering, osäkerheten till behovet av urinkatetern, behovet av information, oro för flödeshinder, oro för infektioner och smärta.  Slutsats: Urinkatetern kan upplevas som besvärlig eller som en lättsamhet beroende på om den orsakar problem om den löser problemen i vardagen. Urinuppsamlingspåsen upplevs som en begränsning i vardagen och mycket planering behövs när personen ska lämna hemmet. Det finns en känsla av okunskap då personen inte fått tillräckligt med information om urinkatetern. / Background: It occurs that some people are in need of an indwelling urinary catheter to micturate. The urine-collection bag that is connected to the urinary catheter has different appearances.  A common complication is a catheter associated urinary tract infection that can lead to death. The nurse should inform the person about self-care of the urinary catheter, to avoid complications.   Aim: The aim was to describe adult peoples’ experiences of living with an indwelling urinary catheter or a suprapubic catheter in the daily life.  Method: This literature review has its origin within 12 articles with a qualitative design where the results were written from the patients' perspective. Data was collected from two different databases. The method of Friberg was used to analyse the data.  Results: The results were based on three major themes; altered self-image, the feeling of ignorance and feelings related to complications. Eight sub themes were identified; acceptance of the urinary catheter and the urine-collection bag, impact on the sexual intercourse, the need of planning, the uncertainty of the needs for the urinary catheter, the need for information, worries for blockage, worries for infections and pain.  Conclusion: The urinary catheter can be experienced as difficulty or as a lightness depending on if it causes troubles or solves problems in the daily life. The urine collection bag experiences as a limitation in daily life and much planning is needed when the person should leave the home. A feeling of ignorance occurs when the person has not received enough information about the urinary catheter.

Studier har tidigare visat surgörning urinprover inför analys av kalcium, fosfat och magnesium inte är nödvändigt. Dessa analyter är viktiga att analysera vid njursjukdomar och det görs med instrumentet Advia Chemistry XPT (Siemens AG, München, Tyskland) på Universitetssjukhuset Örebro. Syftet med arbetet var att se om samma resultat erhölls för kalcium, fosfat och magnesium beroende på om urinen var surgjord eller inte inför analys. Tre metoder utvärderades beträffande behov av surgörning av urin: Metod 1; den nuvarande metoden, urinen surgjordes till pH 3-4. Metod 2; utan surgörning, urinen rumstempererades i 30 min före mätning. Metod 3; utan surgörning, urinen värmdes till 36ºC före varje mätning för att lösa upp eventuella saltkristaller. Alla metoderna utfördes på 30 prover och testades efter 0h, 24h, 3 dagar och 7 dagar. Resultaten sammanställdes i ett linjärt regressionsdiagram och ett Bland Altmann-diagram. Ett förutbestämt acceptansmål var att de genomsnittliga analysresultaten inte skulle ha en större skillnad än 10% vid jämförelse mellan metod 1 och metod 2 respektive metod 1 och metod 3, samt att eventuella avvikande enskilda prover skulle undersökas närmare. Fem av proverna höll inte den förutbestämda 10%-gränsen och mikroskoperades för att se om saltkristaller förekom och surgjordes för att se om provsvaren skulle förändras. I tre av fem prover kunde saltkristaller observeras. Detta gav slutsatsen att alla prover fortsatt måste surgöras eftersom det inte går att avgöra i förväg om provet måste surgöras eller inte eftersom ett tydligt samband inte kunde ses mellan proverna som inte höll 10%-gränsen och de som gjorde det. / Studies have previously shown that acidification of urine samples before analysis for calcium, phosphate and magnesium may not be necessary. These analytes are important to monitor during kidney disease and are, at USÖ, detected using the instrument Advia Chemistry XPT (Siemens AG, München, Germany). The aim of this study was to examine whether the results from analyzing previously mentioned mineral levels would differ depending on whether the urine had been acidified prior to analysis or not. To examine this, three methods were used. Method 1; the current method, where urine is acidified to pH 3-4. Method 2; without acidification, the urine was warmed at room temperature before analysis. Method 3; without acidification, the urine was heated to 36°C before analysis. All methods were assayed on 30 samples which were all examined after 0h, 24h, 3 days and 7 days. Results were compiled using a linear regression diagram and a Bland Altmann diagram. The predetermined acceptance criterion was a maximum 10% difference between mean analyte levels found using methods 2 or 3, in comparison to using method 1. Five samples deviated from the remainder by breaking the 10% limit and were therefore scrutinized under microscope to search for salt crystals, before acidification and reanalysis. Crystals were detected in three of the five samples. As there was no clear connection between the deviating samples, there is no way of knowing prior to analysis whether acidification will be necessary or not, and it is therefore deemed a necessity to acidify all urine samples.

Municipal wastewater contains a significant amount of nutrients such as phosphorus (P) and nitrogen (N). Therefore have the interest of recovering these nutrients at wastewater treatment plants (WWTP) increased. Nutrient recovery would generate revenue for the WWTP, as it is possible to sell the products as fertiliser. Today, there are several techniques on the market to recover P as magnesium ammonium phosphate (MAP) and N as ammonium sulphate (AMS). Urine is the fraction contributing with the highest concentration of nutrients. Techniques to separate urine from the rest of the wastewater have been developed. These techniques enable the possibility to recover nutrients from the urine fraction separately; this is beneficial since the nutrient concentration would be higher. The purpose with this study was to examine the possibility for increased nutrient recovery at centralised WWTPs through urine separation.   Different techniques for nutrient recovery were compared by their recovery efficiency, chemical demand, and hydraulic retention time (HRT). A WWTP with enhanced biological P removal was modelled with Danish Hydraulic Institute’s (DHI) software WEST. Eight scenarios, with different percentage of the population equivalents using urine separation techniques, were simulated. The P recovery was calculated from phosphate (PO4) in the hydrolysed excess sludge and the separated urine. The N recovery was calculated from the ammonium (NH4) in the supernatant from the anaerobe digester. The theoretical biogas production was also calculated, from the modelled sludge.    The comparison of P recovery techniques showed no substantial differences in their recovery efficiency, chemical demand, and HRT. The comparison of N recovery techniques showed three techniques with a higher efficiency than the other methods. Ekobalans Fenix AB, CMI Europe Environment, and Organics developed these techniques. To determine which method to use, requests for proposal from different providers are recommended. As the urine separation increased, the influent P and N load decreased. When the urine separation increased and the operational parameters were kept constant, the effluent concentration of P and N decreased. The ratio of total Kjeldahl nitrogen (TKN) and total nitrogen (TN) however increased as the urine separation increased. The total MAP production calculated from the modelled hydrolysis showed that the production increased as the urine separation increased. On the other hand, the total MAP production from calculated hydrolysis showed a decrease in production as the urine separation increased. The difference in these results could be because of the performance of the modelled hydrolysis was better with a smaller nutrient load, resulting in a larger release of PO4 as the urine separation increased. The total AMS production increased as the urine separation increased. This, due to the increase of the TKN:TN ratio. The biogas production was not substantially affected by the increased urine separation.

No description available.

Background: Urinary tract infection (UTI) is a common bacterial infection that is usually diagnosed by symptoms such as dysuria and frequency, and the golden standard is to take a urine culture to identify bacteria that may cause UTI. This method was founded with the idea that normal urine is sterile, but this is now being questioned because of growing evidence of a urinary microbiota thus giving a new approach to methods for UTI diagnosis. Aim: To identify and re-evaluate findings of bacteria from urine cultures in the ongoing paradigm shift of a potential urinary microbiome, and dysbiosis as a cause for UTI. Materials and Methods: This study used MALDI-TOF MS to identify approximately 250 bacteria isolates that had been cultured by Expanded Quantitative Urine Culture (EQUC) from 162 women with symptoms of cystitis. EQUC had allowed the bacteria to grow in both CO2 and anaerobic conditions, which differs from standard techniques.   Results and Conclusion: Escherichia coli and Enterococcus faecalis dominated the results of most frequently identified bacteria. However, other bacteria were commonly present within the same culture which is traditionally considered as contamination but may now indicate a urinary flora. Anaerobic bacteria – such as Porphyromonas sp. – were also identified, but their connection to UTI is unclear. Lactobacillus sp. – which are associated with a healthy flora in women – were found in urine cultures and often in smaller quantities which could suggest dysbiosis. More research on Lactobacillus sp. and their correlation with UTI is suggested for a more accurate indication of urinary dysbiosis in women.