Morphological changes in eosinophils are reliable markers of the severity of an acute asthma exacerbation in children.

BACKGROUND: Early identification of the severity of asthma exacerbation would be helpful for the management of patients. We aimed to evaluate the correlation of morphological change in activated eosinophils and the severity of an asthma exacerbation. METHODS: Blood was collected from 55 asthmatic children: 40 of whom were having an exacerbation, 15 symptom-free, and 15 healthy controls. The percentage of eosinophils with morphological changes (emission of single or multiple pseudopods, presence of cytoplasmic vacuoles, releasing a small, moderate, or large quantity of granules, spreading, eosinophil death, and presence of cluster of free eosinophil granules) was quantified after the adherence to a slide and compared using the Mann-Whitney test. The correlation between the severity of the asthma exacerbation and the percentage changed eosinophils was tested with Spearman's correlation. RESULTS: The proportion of activated eosinophils was higher in asthmatic symptom-free children than in the control group, and acute asthma exacerbation produced an additional increase in eosinophil activation (P < 0.01). More significantly increased morphological changes were emissions of multiple pseudopods, presence of cytoplasmic vacuoles, spreading, and presence of a cluster of free eosinophil granules (P < 0.001). The following were correlated with the severity of an asthma exacerbation: ≥14% of eosinophils emitting single pseudopod, 8% emitting multiple pseudopods, 17% with vacuoles, 28% eosinophils releasing a large quantity of granules, and 66% of spread eosinophils. CONCLUSIONS: Quantifying the morphological changes in eosinophils is a feasible, easy, and reliable manner to identify the severity of an asthma exacerbation and therefore might improve the clinical management of asthmatic children.

Male Gender and Body Mass Index Are Associated With Hypertension and Reduced Kidney Function 5 or More Years After Living Kidney Donation.

BACKGROUND: The objective of this study was to evaluate renal function and to explore the relationship between some risk factors in kidney donors 12.37 ± 7.60 years after donation. PATIENTS AND METHODS: In a cross-sectional study conducted in a transplant unit, 77 nephrectomized subjects were assessed ≥5 years after donation to evaluate their renal function and the presence or absence of hypertension, dyslipidemia, and microalbuminuria. RESULTS: Twenty donors had an estimated glomerular filtration rate of <60 mL/min/1.73 m(2). Nine donors showed urinary albumin excretion of >20 µg/min (11.68%). Subjects with an EGFR of <60 mL/min were predominantly male and hypertensive and showed higher body mass index (BMI), higher uric acid, higher total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C), and logarithm of triglycerides/HDL-C (log TG/HDL-C) ratios than donors with an EGFR of >60 mL/min. Hypertensive donors were older and had higher BMI, higher UA serum values, higher TC/HDL-C and log TG/HDL-C ratios and microalbuminuria than nonhypertensive donors (P < .005). A multivariate analysis was conducted and, after final adjustment, a filtration rate of <60 mL/min was 3.05 times higher in men than women, increased 10% for each 1-unit increase in BMI and was positively associated with log (TG/HDL-C). The frequency of hypertension increased by 10% for each 1-unit increase in BMI and was positively associated with microalbuminuria. CONCLUSION: In this sample of kidney donors from a single transplant unit, ≥5 years after donation, male sex and high BMI were positively associated with the presence of kidney failure.

Baroreceptor function during natural sleep in rats with mild and severe renal hypertension.

1. Mean arterial pressure (MAP) changes during natural sleep of rats with mild renal hypertension (MAP less than 160 mmHg) were similar to those of normotensive rats. No significant change in MAP was observed in 35 episodes of synchronized sleep (SS) but a significant increase (6.2 +/- 1.4 mmHg) was detected in 23 episodes of desynchronized sleep (DS). 2. Rats with severe renal hypertension (MAP greater than 160 mmHg) behaved more like rats with sinoaortic denervation. MAP increased significantly (6.1 +/- 1.4 mmHg) in 40 episodes of SS studied in 8 rats. In 6 of these rats MAP decreased during DS, while in the other 2 it increased. When all 39 episodes of DS were considered, the decrease in MAP (2.2 +/- 1.5 mmHg) was not statistically significant. 3. Sinoaortic denervation increased the MAP of 3 rats with mild renal hypertension from 154 +/- 4 to 181 +/- 21 mmHg. In 30 episodes of SS MAP increased (19.0 +/- 3.0 mmHg) and in 16 episodes of DS, MAP decreased markedly (27.0 +/- 5.0 mmHg). 4. These data suggest that rats with severe renal hypertension have altered baroreceptor function during natural sleep that is probably due to modification of the central integration of the baroreceptor reflex.