Thesis (Ph. D.)--University of Wisconsin--Madison, 1960. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Orientador: Celia Regina Garlip / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-07T12:25:34Z (GMT). No. of bitstreams: 1 Gebrin_AdrianaCeleste_M.pdf: 1300719 bytes, checksum: c4f0ce8c9284378c8180cddf34631ef6 (MD5) Previous issue date: 2006 / Resumo: Proteinuria glomerular está freqüentemente associada à disfunção túbulo-intersticial. O índice de seletividade (IS) da proteinuria é usado para descrever mudanças na permeabilidade glomerular a macromoléculas. O presente estudo tem por objetivo analisar a correlação entre o grau de disfunção tubular (caracterizada pela excreção urinária de alfa 1 microglobulina), os níveis de excreção urinária de IgG e o índice de seletividade glomerular Foram estudadas 84 amostras de urina e soro de 47 pacientes com proteinuria glomerular de diversas etiologias. Albumina urinária, transferrina sérica e urinária, IgG sérica e urinária (IGU) e alfa 1 microglobulina urinária (AIM) foram dosadas por nefelometria. Proteinuria e creatinina urinária foram dosados através de método automatizado (vermelho de pirogalol e Jaffé modificado, respectivamente), sendo a creatinina utilizada para corrigir a excreção urinária de cada uma das proteínas específicas. O índice de seletividade (IS) foi calculado dividindo-se o depuração da transferrina pelo depuração do IgG. Teste de regressão, ANOVA e teste t não pareado foram utilizados para a análise estatística.Baseando-se no (IS), as proteinurias foram classificados em 3 grupos IS<0,10 = seletiva; IS entre 0,10 e 0,20 = seletividade intermediária e IS > 0,20 = não seletiva. Apesar da grande sobreposição de valores, verificamos que os níveis de AIM eram significativamente menores entre aqueles pacientes com proteinuria seletiva e que aumentavam à medida em que a proteinuria se tornava menos seletiva. A análise de regressão mostrou uma correlação significativa entre a excreção urinaria de IgG e AIM (r = 0,74 ; p < 0,05). Nossos dados sugerem que a excreção urinária de alfa 1-microglobulina é um marcador útil da disfunção tubular associada com proteinuria glomerular e que a alfa 1-microglobulina, a IgG e o índice de seletividade podem ter um valor preditivo significativo para a remissão e progressão da proteinuria em pacientes com doenças glomerulares / Abstract: Glomerular proteinuria is often associated with progressive tubulointerstitial dysfunction, which influences the degree of progression of renal failure. Alpha-1-microglobulin (AIM) is considered an indicator of tubular dysfunction. Proteinuria selectivity index (SI) is used to describe changes of the glomerular permeability for macromolecules. The aim of this study was to establish the relationship between SI, alpha-l-microglobulin and IgG urinary excretions. We compare the urinary excretion of AIM, IgG and SI among forty-seven patients with glomerular diseases. Serum and random urine samples were analyzed. Total protein, creatinine, alpha-1-microglobulin, transferrin, and IgG concentrations were determined and the SI was calculated. Based on SI, proteinuria were classified as Group 1: SI<0.10 = highly selective; Group 2: 0.20<SI<0.10 = moderately selective; Group 3: SI>0.20 = nonselective. Alpha-l-microglobulin levels were significantly lower among patients with highly selective proteinuria compared to patients with moderately and nonselective proteinuria. There was a significant relationship between AIM and urinary excretion of IgG (r = 0.74; p<0.05). These data suggest that urinary excretion of AIM is a useful marker of tubular dysfunction associated with glomerular proteinuria. AIM, IgG and SI may have a significant predictive value for both remission and progression of the proteinuria in patients with glomerular diseases / Mestrado / Patologia Clinica / Mestre em Ciências Médicas

OBJETIVOS: Determinar la prevalencia de Preeclampsia en gestantes atendidas en el servicio de emergencia del Hospital de Ventanilla en el 2014. MÉTODOS: Estudio Transversal Retrospectivo. LUGAR: Hospital de Ventanilla, entre enero y diciembre 2014. MATERIAL MÉTODOS: Se identificó 102 gestantes a través del registro de las historias clínicas, caracterizadas por edad, estado civil grado de instrucción y trimestre de desarrollo de la Preeclampsia. Se realizó análisis descriptivo mediante tablas de frecuencia y se estudiaron las variables mediante prueba chi cuadrado en SPSS versión 23 y Microsoft Excel. RESULTADOS: Las edad media de 28.46 ± 7,8 (IC 95% 20,66-36,26); 71.6% (73/102) estudios secundarios y 13.7% (14/102) primarios; el estado civil más frecuente fue “conviviente” en un 56.9% (58/102). La Preeclampsia se presentó con mayor frecuencia en el tercer trimestre con un 86.3% (88/102), 71.6% tuvo Preeclampsia leve y 28.4% Preeclampsia severa. La edad (p = 0.052), el estado civil (p = 0.032) no mostraron asociación significativa con el cuadro Leve o Severa clínica de Preeclamsia, contrario a ello el grado de instrucción nivel secundario (p = 0.000) se encuentra asociada al cuadro clínico de Preeclampsia Leve y Severa. CONCLUSIONES: La Preeclampsia está relacionada a una heterogeneidad de factores de riesgo. La prevalencia hospitalaria de Preeclampsia fue de 0.5%. Las gestantes deben ser cuidadosamente controladas durante su embarazo, para reducir la incidencia y complicaciones de este trastorno hipertensivo.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1957. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Ever since the association between altJ.Jminuria and eclampsia was noted by Lever in 1843, the kidney has figured in the forefront in the search for aetiological factors. Lever, who was a contemporary of Bright at Guy's Hospital, observed the close similarity in appearance between many of his eclamptic patients and patients with Bright's disease. Examination of the urine was the logical next step. Having fould albumin in nine out of ten eclamptic patients in whom the urine had been examined, he went on to exanine the urine of fifty "normal 11 controls, and (rather surprisingly, since one would have anticipated a proportion of unrecognised preeclamptic patients amongst these) found albumin to be absent in every case. Lever recognised the "transitory nature 11 of pregnancy proteinuria and concluded that the condition differed from the permanent proteinuria of Bright's disease.In the same month of the same year (1843), Simpson made a similar observation in Edinburgh regarding proteinuria and eclampsia. Whilst also recognising that albuminuria disappeared in those patients who survived, he never theless attributed the syndrome of albuminuria and convulsions to underlying Bright's disease. This was a view that persisted for some time despite its obvious inconsistencies. Carl Braun of Vienna endorsed this concept and the chapter dealing with albuminuria and eclampsia in his "Lerbuch" was translated and run as a series of articles in the Edinburgh Medical Journal (1856 57). In this work, Braun states firmly that eclampsia is a direct result of the uraemia resulting from poorly functioning kidneys. The kidney featured prominently in many subsequent theories on aetiology but the idea of primary renal disease being the origin of the process leading to eclampsia was shortlived.

Doctorat en kinésithérapie et réadaptation / info:eu-repo/semantics/nonPublished

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24084号 / 医博第4860号 / 新制||医||1059(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 柳田 素子, 教授 長船 健二, 教授 黒田 知宏 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

ABSTRACT This study was designed to screen antiretroviral therapy (ART)-naïve human immunodeficiency virus (HIV) infected patients for proteinuria, using urine dipsticks, at the HIV outpatient clinic at Johannesburg Hospital in an attempt to detect and treat early renal disease. In those with persistent proteinuria, a marker of kidney disease, renal biopsy was performed, ART with and without angiotensin-converting enzyme inhibitors (ACE-I) was initiated and patients were followed up for immunological and renal responses. After a minimum period of 12 months, a repeat biopsy was performed, where possible, to determine whether the histological lesions had responded to treatment. During urinary screening, proteinuria, leucocyturia and microscopic haematuria were common. Sterile leucocyturia may be associated with co-morbid sexually transmitted infection or tuberculosis. In the group that underwent renal biopsy with treatment, the renal and immunological response, before and after ART was highly statistically significant. Renal and immunological responses to ART were assessed by reduction in proteinuria with increased GFR, increased CD4 count with reduction in HIV viral load, respectively. On biopsy, HIV-associated immune complex disease was more common than HIVAN, a finding that contradicts international and some local data. Resolution of proteinuria was relatively rapid in comparison to the histological response to treatment, an effect not previously shown. This is the first study of its kind, to the author’s knowledge, that prospectively evaluates the effect of ART with/ ACE-I in ART-naïve HIV infected patients with both clinicopathological and histological criteria. It has shown unequivocally, that renal disease, particularly if detected and treated early in HIV infection, is responsive to treatment. These findings suggest screening for early detection and treatment of HIV-associated renal disease should be mandatory in HIV clinics in South Africa.

Abstract not available

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