Inhibition of the P2X7 receptor improves renal function via renin-angiotensin system and nitric oxide on diabetic nephropathy in rats.

AIM: To evaluate the effects of P2X7 receptor blockade on renin-angiotensin system (RAS) in rats with diabetic nephropathy (DN). MAIN METHODS: Wistar rats were unilaterally nephrectomized and received streptozotocin for diabetes mellitus (DM) induction; control animals (CTL) received the drug vehicle. The animals were submitted to P2X7 receptor silencing, forming the group (DM + siRNA). The animals were placed in metabolic cages for data collection and evaluation of renal function; at the end of the protocol, the kidney was removed for analysis of P2X7, renin, angiotensin-converting enzyme (ACE), ACE2, angiotensin, thiobarbituric acid reactive substance levels (TBARS), nitric oxide (NO) and qualitative histological. KEY FINDINGS: The metabolic profile was attenuated in DM + siRNA vs. DM and there was a significant improvement in creatinine, urea and proteinuria levels in the same group. Renin expression was significantly decreased in DM + siRNA vs. DM. ACE and ACE2 were significantly reduced in DM + siRNA vs. DM. TBARS levels were decreased and NO showed an increase in DM + siRNA vs. DM, both significant. All histological alterations were improved in DM + siRNA vs. DM. SIGNIFICANCE: Data have shown that although silencing of the P2X7 receptor did not decrease fasting glucose, it promoted an improvement in the metabolic profile and a significant recovery of renal function, revealing a protective action by the inhibition of this receptor. This effect must have occurred due to the inhibition of RAS and the increase of NO, suggesting that the use of P2X7 receptors inhibitors could be used as adjuvant therapy against DN progression.

Radiation dose in cardiac CT angiography: protocols and image quality.

This paper aims to evaluate the radiation dose exposure of patients submitted to cardiac computed tomography angiography. The effective dose was obtained from the product of dose-length product values and the conversion factor established in the European Working Group for Guidelines on Quality Criteria in CT. The image noise and contrast- and signal-to-noise ratios were obtained for all images. Sixty-four- and 256-slice CT angiographies were used in 211 (68.5 %) and 97 (31.5 %) patients, respectively. The calculated mean effective dose with prospective CT angiography was 6.0±1.0 mSv and the retrospective mode was 8.4±1.2 mSv. The mean image noise values were 38.5±9.5 and 21.4 ± 5.3 for prospective and retrospective modes, respectively. It was observed that the image noise increased by 44.4 % using a prospective mode. Prospective CT angiography reduces radiation dose by ∼29 % compared with the retrospective mode, while maintaining diagnostic image quality and the ability to assess obstructions in patients.

Evaluation of the entrance surface air kerma in mammographic examinations in Rio de Janeiro, Brazil.

The aim of this work was to evaluate the distribution of the entrance surface air kerma (ESAK) and the average glandular dose (D(G)) in four mammography facilities located in the city of Rio de Janeiro. The ESAK values were estimated from the X-ray tube output rate (mGy/mAs) parameters. The image quality was evaluated by the radiologists in each clinic. The ESAK values obtained for a breast thickness of 45 mm were 5.58 mGy in Clinic A, 10.07 mGy in Clinic B, 13.89 mGy in Clinic C and 7.21 mGy in Clinic D. For D(G), it can be seen that, for the same compressed breast thickness (50 mm), the value varied from 0.20 to 3.60 mGy, with a mean value of 1.50 mGy for all the clinics. In image quality evaluation, Clinic D was the only one that presented a very low acceptability for quality criteria and inadequacies in relation to specks, masses and optical density.