Renal injury induced by rheumatoid arthritis is not clear and may be related to the angiotensin II. We aim to investigate the adjuvant‐induced arthritis (AIA) injury in rat kidney, focusing the angiotensin II/AT1 pathway. Male Wistar rats were allocated in to three groups: Control, AIA and AIA plus losartan. The AIA was induced by injection of 100 µL of an emulsion of dissected Mycobacterium tuberculosis (50 mg/mL) on the paw. Treatment with losartan was initiated on the first day of immunization (daily subcutaneous injection, 1 mg/kg). After 60 days post immunization, we evaluated kidney function by plasma creatinine, urea and uric acid levels and creatinine depuration; kidney injury by apoptosis analysis and inflammation markers such as macrophages, transforming growth factor beta (TGF‐β) and inducible nitric oxide synthase (iNOS) expression; oxidative stress by plasma thiobarbituric acid reactive substances (TBARS); renal expression of angiotensin receptors subtype 1 (AT1) and 2 (AT2) and plasma concentration of angiotensin II. AIA rats showed elevated plasma levels of creatinine, urea, uric acid, TBARS and Ang II and reduced creatinine depuration, and enhanced kidney macrophage number, TGF‐β, caspase‐3, iNOS and AT1/AT2 receptors expression. The losartan reduced plasma creatinine and its clearance, reduced macrophages and the expression of TGF‐β and iNOS in renal tissues, and reduced plasma TBARS. We conclude that AIA causes kidney injury by a physiopathological mechanism that involves AT1 stimulation in renal tissue, elevating the presence of macrophages, the expression of TGF‐β and iNOS, as well the local oxidative stress, which contribute to renal function deterioration.
Incisional hernia results from inadequate healing in the area of an operative incision and its diagnosis is clinical or imaging. Complex incisional hernias are difficult to treat and have complications, especially compartment syndrome. Thus, technical care in closing incisions in primary surgeries reduces the risk of developing an incisional hernia. Therefore, the study aimed to present a case report of a patient who performed the present correction of a giant incisional hernia with a double-sided mesh.
Diverticular disease is a benign disease, with a good response to clinical treatment, based on changes in eating habits, greater fiber consumption, potent antibiotic therapy in the simplest inflammatory processes, and the use of interventional radiology in abscesses. A surgical indication is restricted to failure of clinical therapy and more severe forms of the disease, such as strictures, abscesses, and perforations. The present study aimed to present a clinical case report on acute diverticulosis of the left colon that progressed to a reconstruction of the intestinal transit.
Hirschsprung's disease (HD) is a congenital anomaly of innervation of the lower intestine, limited to the colon, resulting from partial or total obstruction. The main symptom is the inability of a newborn to evacuate within 48 hours after birth, which can cause intestinal obstruction in the neonate and megacolon in children and adults. Therefore, this study reported the case of a 30-year-old female patient with HD affecting the entire colon, where we opted for surgical treatment. In the present study, it was emphasized the medical need to have a better understanding of the clinical picture of HD, as well as its complications and the importance of early diagnosis. In the report presented, it was discussed a late diagnosis of HD and how it affects the patient's life. It presented the improvement in the quality of life that can be obtained by offering an accurate diagnosis and adequate treatment for the patient.
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