RESUMO
This study aimed to describe the community food environment surrounding schools and its association with territorial socio-environmental vulnerability in the city with the highest intraurban social inequity index in Brazil. METHODS: this ecological observational study includes data on the presence and type of food retail in a 400 m buffer surrounding public and private schools in Recife. We have also described the Health Vulnerability Index (HVI) of census tracts and conducted multivariate analyses. RESULTS: through factor analysis, we observed two grouping patterns of food retail. The "diverse food outlets" pattern was positively associated with middle HVI (ß 0.14, 95% confidence interval [CI] - 0.11; 0.16) and higher HVI areas (ß 0.15, 95%CI - 0.11; 0.17), while "the large food retail chains" pattern was inversely associated with middle HVI (ß -0.42, 95% CI - 0.53; -0.30) and high HVI areas (ß -0.32, 95%CI - 0.45; -0.18) and positively associated with private schools (ß 0.15, 95%CI - 0.030; 0.27). CONCLUSION: the greatest variety in food retail is in high HVI areas, and large food retail chains prevail around private schools, especially in low HVI areas.
Assuntos
Alimentos , Instituições Acadêmicas , Humanos , Brasil , Análise Fatorial , MarketingRESUMO
Abstract This study aimed to describe the community food environment surrounding schools and its association with territorial socio-environmental vulnerability in the city with the highest intraurban social inequity index in Brazil. Methods: this ecological observational study includes data on the presence and type of food retail in a 400 m buffer surrounding public and private schools in Recife. We have also described the Health Vulnerability Index (HVI) of census tracts and conducted multivariate analyses. Results: through factor analysis, we observed two grouping patterns of food retail. The "diverse food outlets" pattern was positively associated with middle HVI (β 0.14, 95% confidence interval [CI] - 0.11; 0.16) and higher HVI areas (β 0.15, 95%CI - 0.11; 0.17), while "the large food retail chains" pattern was inversely associated with middle HVI (β -0.42, 95% CI - 0.53; -0.30) and high HVI areas (β -0.32, 95%CI - 0.45; -0.18) and positively associated with private schools (β 0.15, 95%CI - 0.030; 0.27). Conclusion: the greatest variety in food retail is in high HVI areas, and large food retail chains prevail around private schools, especially in low HVI areas.
Resumo Este trabalho objetivou descrever o ambiente alimentar comunitário no entorno das escolas e sua associação com a vulnerabilidade socioambiental territorial na cidade com maior índice de desigualdade social intraurbana do Brasil. Métodos: estudo ecológico observacional, inclui dados sobre a presença e o tipo de varejo de alimentos em uma área de 400 m no entorno de escolas públicas e privadas de Recife. Descrevemos o Índice de Vulnerabilidade à Saúde (IVS) dos setores censitários e realizamos análises multivariadas. Resultados: por meio da análise fatorial, observamos dois padrões de agrupamento de estabelecimentos. O padrão "Diversos pontos de venda de alimentos" foi associado positivamente com IVS médio (β 0,14; intervalo de confiança [IC] 95% - 0,11; 0,16) e áreas de IVS mais alto (β 0,15; IC95% - 0,11; 0,17), enquanto o padrão "Grandes redes varejistas de alimentos" foi inversamente associado às áreas de IVS médio (β -0,42; IC95% - 0,53; -0,30) e alto IVS (β -0,32; IC95% - 0,45; -0,18) e positivamente associado com escolas particulares (β 0,15; IC95% - 0,030; 0,27). Conclusão: a maior variedade de estabelecimentos está em áreas de alto IVS, e grandes redes varejistas de alimentos predominam no entorno de escolas particulares, especialmente em áreas de baixo IVS.
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Digitization has enhanced the utility of cytology in private practice by allowing for rapid sample receipt and analysis, leading to better informed real-time patient care. Despite many advantages of digital cytology, understanding its limitations is required to avoid common pitfalls. A strong foundation in sample preparation and imaging techniques is also required to obtain high-quality diagnostic samples. By optimizing these factors, the benefits of digital cytology are maximized, allowing for the practice of high-quality point-of-care medicine that best addresses the needs of the patient and pet owner in a rapid time frame.
Assuntos
Animais Exóticos , Técnicas Citológicas , Animais , Animais Exóticos/citologia , Técnicas Citológicas/veterináriaRESUMO
This research aimed to investigate the occurrence of clusters of cardiovascular risk behaviors and their association with social demographic and occupational characteristics in a population of industrial workers in the metropolitan area of Recife, Brazil. It was a transversal study with 727 workers of both genders. We identified cluster distribution from the variables: smoking, alcohol consumption, physical activity and waist circumference, by a combination of hierarchical and non-hierarchical analysis. We later tested the association with the social demographic and occupational variables with a multi-varied analysis. We have identified a protection cluster (sufficient physical activity, moderate alcohol consumption) and a risk cluster (high waist circumference, sedentarism, smoking, excessive alcohol consumption). The protection cluster was positively associated with night shift or variable shift work (RP: 1.66, IC95%: 1.26-2.17), and the risk cluster was associated with women (RP: 1.15, IC95%: 1.01-1.31). Cluster analysis allowed to identify that, for day shift workers and women, the shortest daytime outside the work environment can influence the adoption of cardiovascular risk behaviors.
Assuntos
Doenças Cardiovasculares , Brasil/epidemiologia , Doenças Cardiovasculares/epidemiologia , Análise por Conglomerados , Estudos Transversais , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Fatores de Risco , Tolerância ao Trabalho ProgramadoRESUMO
Abstract This research aimed to investigate the occurrence of clusters of cardiovascular risk behaviors and their association with social demographic and occupational characteristics in a population of industrial workers in the metropolitan area of Recife, Brazil. It was a transversal study with 727 workers of both genders. We identified cluster distribution from the variables: smoking, alcohol consumption, physical activity and waist circumference, by a combination of hierarchical and non-hierarchical analysis. We later tested the association with the social demographic and occupational variables with a multi-varied analysis. We have identified a protection cluster (sufficient physical activity, moderate alcohol consumption) and a risk cluster (high waist circumference, sedentarism, smoking, excessive alcohol consumption). The protection cluster was positively associated with night shift or variable shift work (RP: 1.66, IC95%: 1.26-2.17), and the risk cluster was associated with women (RP: 1.15, IC95%: 1.01-1.31). Cluster analysis allowed to identify that, for day shift workers and women, the shortest daytime outside the work environment can influence the adoption of cardiovascular risk behaviors.
Resumo Esta pesquisa teve como objetivo investigar a ocorrência de clusters de comportamentos de risco cardiovascular e sua associação com características sociodemográficas e ocupacionais em uma população de trabalhadores da indústria da região metropolitana de Recife, Brasil. Trata-se de um estudo transversal com 727 trabalhadores de ambos os gêneros. Identificou-se a distribuição do cluster a partir das variáveis: tabagismo, etilismo, atividade física e circunferência da cintura, por meio de uma combinação de análise hierárquica e não hierárquica. Posteriormente, testamos a associação às variáveis sociodemográficas e ocupacionais com uma análise multivariada. Identificamos a formação consistente de um cluster de proteção (atividade física suficiente, consumo moderado de álcool) e de um cluster de risco (circunferência da cintura elevada, sedentarismo, tabagismo, consumo excessivo de álcool). O cluster de proteção associou-se positivamente ao turno noturno ou turnos variáveis (RP: 1,66, IC95%: 1,26-2,17) e o cluster de risco esteve associado às mulheres (RP: 1,15, IC95%: 1,01-1,31). A análise de cluster permitiu identificar que, para trabalhadores diurnos e mulheres, a menor jornada diurna fora do trabalho pode influenciar na adoção de comportamentos de risco cardiovascular.
RESUMO
Evidências reforçam que a abreviação do jejum perioperatório reduz complicações e desconfortos evitáveis. No entanto, a realidade do jejum prolongado persiste e compromete a segurança alimentar e nutricional do paciente cirúrgico em hospitais brasileiros. O presente estudo teve como objetivo investigar as características de jejum alimentar e hídrico de pacientes oncológicos no período perioperatório. Participaram sessenta pacientes admitidos para cirurgias eletivas no tratamento de canceres do trato gastrointestinal. À beira do leito, um questionário foi aplicado e complementado por registros do bloco cirúrgico e prontuários. Durante o jejum, cerca de 1 hora antes e 4 horas após a cirurgia, os pacientes relataram a última e a primeira refeição e ingestão de água, intercorrências alimentares, fome e sede. Foi conduzida análise estatística descritiva e inferencial. Houve grande variação de duração com mediana de 17 horas (mín. 5 máx. 330) do jejum pré-operatório alimentar e 14,1 horas (mín. 2,25 máx. 417) do jejum hídrico. No pós-operatório a mediana do jejum alimentar e hídrico foi de 19,2 horas (mín. 2,42 máx. 200) e 21 horas (mín. 2,5 máx. 201) respectivamente. O jejum alimentar e hídrico foi demasiadamente prolongado e alheio à características determinantes de risco nutricional como a faixa etária, a oferta dietética pré e pós-jejum, as intercorrências alimentares e o desconforto por fome e sede.
Evidence has reinforced the idea that shortening perioperative fasting reduces avoidable complications and discomfort. However, the reality of prolonged fasting persists and compromises the food and nutritional safety of surgical patients in Brazilian hospitals. The present study aimed to investigate the characteristics of food and water fasting in cancer patients in the perioperative period. Sixty patients admitted for elective surgeries in the treatment of cancers of the gastrointestinal tract participated. At the bedside, a questionnaire was applied and complemented by records from the operating room and medical records. During fasting, approximately 1 hour before and 4 hours after surgery, patients reported their last and first meal as well as water intake, food complications, hunger, and thirst. A descriptive and inferential statistical analysis was conducted. There was a wide variation concerning duration with a median of 17 hours (min. 5hr max. 330hr) of preoperative food fasting and 14.1 hours (min. 2.25hr max. 417hr) of water fasting. Postoperatively, the median time of food and water fasting was 19.2 hours (min. 2.42hr max. 200hr) and 21 hours (min. 2.5hr max. 201hr), respectively. Food and water fasting was excessively prolonged, and their application did not take into consideration determinant characteristics of nutritional risk such as age, pre- and post-fasting dietary offer, food complications, and discomfort due to hunger and thirst.
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Resumo Objetivo deste artigo é avaliar o Programa de Alimentação do Trabalhador sob a ótica de gestores, nutricionistas e a alimentação oferecida em indústrias da Região Metropolitana do Recife. Trata-se de um estudo transversal. Foi aplicado questionário estruturado com 40 gestores e 40 nutricionistas acerca dos seus conhecimentos sobre o programa e o cumprimento das atribuições exigidas por ele. Também foi avaliada a qualidade nutricional dos cardápios. Entre os gestores e os nutricionistas, 22,5% e 72,5% não sabiam do cadastro no programa e das suas exigências nutricionais, respectivamente. Grande parte dos nutricionistas e gestores relacionou o programa a uma exigência da legislação trabalhista. Nenhum respondente conhecia a obrigatoriedade de ações de educação alimentar e nutricional, mesmo assim, 55% dos serviços realizavam ações educativas e 25% realiza avaliação nutricional dos trabalhadores. Observou-se que apesar da oferta de bebidas naturais, frutas e folhosos diariamente, também há oferta diária de diversos produtos ultraprocessados, principalmente doces e bebidas artificiais. O estudo evidenciou o pouco conhecimento dos gestores e dos nutricionistas sobre os objetivos do programa bem como a sua insipiente execução.
Abstract The scope of this article is to evaluate the Worker Food Program from the viewpoint of managers, nutritionists and the food offered in industries of the Metropolitan Region of Recife. It consisted of a cross-sectional study. A structured questionnaire was filled out by 40 managers and 40 nutritionists regarding their knowledge about the program and compliance with the tasks required by it. The nutritional quality of the menus was also evaluated. Among the managers and nutritionists, 22.5% and 72.5%, respectively, did not know about the enrolment in the program and the nutritional requirements involved. Most nutritionists and managers related the program to a labor law requirement. None of the respondents knew about the mandatory food and nutritional education actions, even though 55% of the services involved educational actions and 25% performed nutritional assessment of the workers. It was found that, despite the daily supply of natural beverages, fruit and leafy vegetables, there is also a daily supply of various ultra-processed products, especially sweet foods and artificial beverages. The study revealed the lack of knowledge of managers and nutritionists about the objectives of the program as well as its incipient execution.
Assuntos
Humanos , Assistência Alimentar , Serviços de Alimentação , Brasil , Estado Nutricional , Estudos TransversaisRESUMO
The scope of this article is to evaluate the Worker Food Program from the viewpoint of managers, nutritionists and the food offered in industries of the Metropolitan Region of Recife. It consisted of a cross-sectional study. A structured questionnaire was filled out by 40 managers and 40 nutritionists regarding their knowledge about the program and compliance with the tasks required by it. The nutritional quality of the menus was also evaluated. Among the managers and nutritionists, 22.5% and 72.5%, respectively, did not know about the enrolment in the program and the nutritional requirements involved. Most nutritionists and managers related the program to a labor law requirement. None of the respondents knew about the mandatory food and nutritional education actions, even though 55% of the services involved educational actions and 25% performed nutritional assessment of the workers. It was found that, despite the daily supply of natural beverages, fruit and leafy vegetables, there is also a daily supply of various ultra-processed products, especially sweet foods and artificial beverages. The study revealed the lack of knowledge of managers and nutritionists about the objectives of the program as well as its incipient execution.
Objetivo deste artigo é avaliar o Programa de Alimentação do Trabalhador sob a ótica de gestores, nutricionistas e a alimentação oferecida em indústrias da Região Metropolitana do Recife. Trata-se de um estudo transversal. Foi aplicado questionário estruturado com 40 gestores e 40 nutricionistas acerca dos seus conhecimentos sobre o programa e o cumprimento das atribuições exigidas por ele. Também foi avaliada a qualidade nutricional dos cardápios. Entre os gestores e os nutricionistas, 22,5% e 72,5% não sabiam do cadastro no programa e das suas exigências nutricionais, respectivamente. Grande parte dos nutricionistas e gestores relacionou o programa a uma exigência da legislação trabalhista. Nenhum respondente conhecia a obrigatoriedade de ações de educação alimentar e nutricional, mesmo assim, 55% dos serviços realizavam ações educativas e 25% realiza avaliação nutricional dos trabalhadores. Observou-se que apesar da oferta de bebidas naturais, frutas e folhosos diariamente, também há oferta diária de diversos produtos ultraprocessados, principalmente doces e bebidas artificiais. O estudo evidenciou o pouco conhecimento dos gestores e dos nutricionistas sobre os objetivos do programa bem como a sua insipiente execução.
Assuntos
Assistência Alimentar , Serviços de Alimentação , Brasil , Estudos Transversais , Humanos , Estado NutricionalRESUMO
The Xanthomonas genus includes many Gram-negative plant-associated bacteria. Here, we report a virulent Xanthomonas siphophage called Samson. A siphophage isolated from sewage, Samson contains a 43,314-bp genome with 58 predicted genes. Samson has high nucleotide identity with Pseudomonas phage PaMx42.
RESUMO
Following treatment for pneumonia, a 1-y-old female Nubian goat was presented because of a persistent fever for 3 mo and peripheral lymphadenopathy for 1 mo. Cytology and histology of the superficial cervical and prefemoral lymph nodes demonstrated a moderate-to-marked "left-shifted" lymphoid population, suggestive of lymphoma, and extremely rare extracellular, 2-4 µm, oval, basophilic yeast, consistent with Histoplasma capsulatum. On immunohistochemistry, >95% of the lymphocytes demonstrated positive cytoplasmic and membranous immunoreactivity for CD3. Histoplasma spp. urine antigen and serum antibody testing were positive and negative, respectively. Panfungal PCR and sequencing of DNA extracted from scrolls of formalin-fixed, paraffin-embedded tissue yielded matches to H. capsulatum with 99-100% identity. Given the poor prognosis and persistent pyrexia, the animal was euthanized. Postmortem examination confirmed concurrent multicentric, intermediate-size, T-cell, lymphoblastic lymphoma and histoplasmosis; lesions consistent with intestinal coccidiosis and suspected pulmonary Rhodococcus equi were also noted. Although dimorphic fungi have been described previously in goats, lesions of Histoplasma spp. had not been documented in this species, to our knowledge. Given the low disease burden, it is suspected that the lymphoma was primary, leading to an immunocompromised state and development of secondary, opportunistic infections.
Assuntos
Doenças das Cabras/diagnóstico , Histoplasma/isolamento & purificação , Histoplasmose/veterinária , Linfoma/veterinária , Animais , DNA de Protozoário/análise , Evolução Fatal , Feminino , Doenças das Cabras/parasitologia , Doenças das Cabras/patologia , Cabras , Histoplasmose/diagnóstico , Histoplasmose/parasitologia , Histoplasmose/patologia , Linfoma/diagnóstico , Linfoma/patologia , Reação em Cadeia da Polimerase/veterinária , Análise de Sequência de DNA/veterináriaRESUMO
A 2-year-old female spayed Boxer dog was presented for a 1-month history of progressive hemorrhagic diarrhea with tenesmus and weight loss despite trial courses of antibiotics and diet change. Abdominal ultrasound revealed severe, focal thickening, and loss of normal architecture of the colonic wall with abdominal lymphadenomegaly. Dry-mount fecal cytology, performed on several consecutive days, consistently revealed numerous, round, 16-20 µm structures with basophilic, granular content, and a thin cell wall. Transmission electron microscopy identified these structures as fungi. Culture, polymerase chain reaction (PCR), and sequencing of the internal transcribed spacer, D1/D2 regions, and DNA-directed RNA polymerase II core subunit (RPB2) confirmed the presence of Basidiobolus microsporus in the feces. Biopsies collected via ileocolonoscopy revealed marked, multifocal, chronic, neutrophilic, and eosinophilic ileitis and colitis with ulceration, granulation tissue, and intralesional hyphae (identified with Gomori methenamine silver stain). A Pythium enzyme-linked immunosorbent assay and Pythium-specific PCR performed on the formalin-fixed paraffin-embedded biopsy specimens were positive while Basidiobolus-specific PCR was negative, thus confirming a diagnosis of pythiosis. This report describes a fatal case of colonic and intestinal pythiosis with the presence of fecal Basidiobolus sp. spores, suggestive of concurrent gastrointestinal basidiobolomycosis.
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Coinfecção/veterinária , Doenças do Cão/microbiologia , Entomophthorales , Gastroenteropatias/veterinária , Pitiose/diagnóstico , Pythium , Zigomicose/veterinária , Animais , Coinfecção/diagnóstico , Coinfecção/microbiologia , Coinfecção/patologia , Doenças do Cão/diagnóstico , Doenças do Cão/patologia , Cães , Feminino , Gastroenteropatias/diagnóstico , Gastroenteropatias/microbiologia , Gastroenteropatias/patologia , Pitiose/complicações , Pitiose/microbiologia , Pitiose/patologia , Zigomicose/complicações , Zigomicose/diagnóstico , Zigomicose/patologiaRESUMO
MicroRNAs (miRNAs) are a group of small noncoding RNAs that act as regulators of posttranslational gene/protein expression and are known to play a key role in physiological and pathological processes. The objective of our study was to compare expression of miR-21 in renal tissue from dogs affected with chronic kidney disease (CKD) caused by X-linked hereditary nephropathy (XLHN), a disease equivalent to human Alport syndrome, to that from unaffected dogs. Additionally, we sought to characterize changes in relative mRNA expression of various genes associated with miR-21 function. miRNA was isolated from kidney tissue collected from both affected dogs and unaffected, age-matched littermates at defined milestones of disease progression, including end-stage renal disease (ESRD). Additionally, autopsy samples from affected dogs at ESRD and corresponding unaffected dogs were evaluated. Samples were scored based on histological changes, and relative expression of miR-21 and kidney disease-related genes was determined using quantitative real-time polymerase chain reaction. In affected dogs, significant upregulation of kidney miR-21 was first detected at the milestone corresponding with increased serum creatinine. Furthermore, miR-21 expression correlated significantly with urine protein: urine creatinine ratio, serum creatinine concentration, glomerular filtration rate, and histologic lesions (glomerular damage, tubular damage, chronic inflammation, and fibrosis). At end-stage disease, COL1A1, TGFB1 and its receptor, TGFB2, and Serpine1 were upregulated, while PPARA, PPARGC1A, ACADM, SOD1, and EGF were downregulated. In conclusion, miR-21 is abnormally upregulated in the kidneys of dogs with CKD caused by XLHN, which may play an important pathologic role in the progression of disease by dysregulating multiple pathways.
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Doenças do Cão/genética , Doenças Genéticas Ligadas ao Cromossomo X/veterinária , MicroRNAs/metabolismo , Nefrite Hereditária/veterinária , Insuficiência Renal Crônica/veterinária , Animais , Cães , Regulação da Expressão Gênica , MicroRNAs/genética , Nefrite Hereditária/genética , Insuficiência Renal Crônica/genéticaRESUMO
Carbon dioxide is an important environmental cue for many insects, regulating many behaviors including some that have direct human impacts. To further improve our understanding of how this system varies among closely related insect species, we examined both the behavioral response to CO2 as well as the transcriptional profile of key developmental regulators of CO2 sensory neurons in the olfactory system across the Drosophila genus. We found that CO2 generally evokes repulsive behavior across most of the Drosophilids we examined, but this behavior has been lost or reduced in several lineages. Comparisons of transcriptional profiles from the developing and adult antennae for subset these species suggest that behavioral differences in some species may be due to differences in the expression of the CO2 co-receptor Gr63a. Furthermore, these differences in Gr63a expression are correlated with changes in the expression of a few genes known to be involved in the development of the CO2 circuit, namely dac, an important regulator of sensilla fate for sensilla that house CO2 ORNs, and mip120, a member of the MMB/dREAM epigenetic regulatory complex that regulates CO2 receptor expression. In contrast, most of the other known structural, molecular, and developmental components of the peripheral Drosophila CO2 olfactory system seem to be well-conserved across all examined lineages. These findings suggest that certain components of CO2 sensory ORN development may be more evolutionarily labile, and may contribute to differences in CO2-evoked behavioral responses across species.
Assuntos
Antenas de Artrópodes/metabolismo , Comportamento Animal/efeitos dos fármacos , Dióxido de Carbono/farmacologia , Drosophila melanogaster/crescimento & desenvolvimento , Drosophila melanogaster/fisiologia , Regulação da Expressão Gênica/efeitos dos fármacos , Células Receptoras Sensoriais/fisiologia , Animais , Antenas de Artrópodes/efeitos dos fármacos , Antenas de Artrópodes/crescimento & desenvolvimento , Proteínas de Drosophila/genética , Drosophila melanogaster/efeitos dos fármacos , Proteínas Nucleares/genética , Células Receptoras Sensoriais/citologia , Células Receptoras Sensoriais/efeitos dos fármacos , Fatores de Transcrição/genéticaRESUMO
Neoplasia is usually encountered in the African pygmy hedgehog at a mean age of 3.5 y, and malignancy is common. Myelogenous leukemias are rarely reported in hedgehogs. We describe 3 cases of eosinophilic leukemia in adult, middle-aged (mean age: 2.3 y) hedgehogs, for which prognosis appears grave. In 1 case, attempted treatment was unsuccessful, and in all 3 cases, the disease course was rapid and all died soon after diagnosis. Blood smear evaluation, along with complete blood count, was critical in making the diagnosis in all cases. Luna stain was validated and used to better visualize eosinophils in cytologic and histologic sections. Electron microscopy confirmed the presence of specific granules in hedgehog eosinophils.
Assuntos
Eosinófilos/citologia , Ouriços , Síndrome Hipereosinofílica/veterinária , Animais , Corantes , Diagnóstico Diferencial , Síndrome Hipereosinofílica/diagnóstico , Masculino , Microscopia Eletrônica/veterinária , Reprodutibilidade dos TestesRESUMO
BACKGROUND: X-linked Alport syndrome (XLAS), caused by mutations in the type IV collagen COL4A5 gene, accounts for approximately 80% of human Alport syndrome. Dogs with XLAS have a similar clinical progression. Prior studies in autosomal recessive Alport mice demonstrated early mesangial cell invasion as the source of laminin 211 in the glomerular basement membrane (GBM), leading to proinflammatory signaling. The objective of this study was to verify this process in XLAS dogs. METHODS: XLAS dogs and WT littermates were monitored with serial clinicopathologic data and kidney biopsies. Biopsies were obtained at set milestones defined by the onset of microalbuminuria (MA), overt proteinuria, onset of azotemia, moderate azotemia, and euthanasia. Kidney biopsies were analyzed by histopathology, immunohistochemistry, and electron microscopy. RESULTS: XLAS dogs showed progressive decrease in renal function and progressive increase in interstitial fibrosis and glomerulosclerosis (based on light microscopy and immunostaining for fibronectin). The only identifiable structural abnormality at the time of microalbuminuria was ultrastructural evidence of mild segmental GBM multilamination, which was more extensive when overt proteinuria developed. Co-localization studies showed that mesangial laminin 211 and integrin α8ß1 accumulated in the GBM at the onset of overt proteinuria and coincided with ultrastructural evidence of mild cellular interpositioning, consistent with invasion of the capillary loops by mesangial cell processes. CONCLUSION: In a large animal model, the induction of mesangial filopodial invasion of the glomerular capillary loop leading to the irregular deposition of laminin 211 is an early initiating event in Alport glomerular pathology.