In situ assessment of Mindin as a biomarker of podocyte lesions in diabetic nephropathy.

Diabetic nephropathy (DN) is the leading cause of chronic kidney disease and end-stage renal failure worldwide. Several mechanisms are involved in the pathogenesis of this disease, which culminate in morphological changes such as podocyte injury. Despite the complex diagnosis and pathogenesis, limited attempts have been made to establish new biomarkers for DN. The higher concentration of Mindin protein in the urine of patients with type 2 diabetes mellitus suggests that it plays a role in DN. Therefore, this study investigated whether in situ protein expression of Mindin can be considered a potential DN biomarker. Fifty renal biopsies from patients diagnosed with DN, 57 with nondiabetic glomerular diseases, including 17 with focal segmental glomerulosclerosis (FSGS), 14 with minimal lesion disease (MLD) and 27 with immunoglobulin A nephropathy (IgAN), and 23 adult kidney samples from autopsies (control group) were evaluated for Mindin expression by immunohistochemistry. Podocyte density was inferred by Wilms' tumor 1 (WT1) immunostaining, while foot process effacement was assessed by transmission electron microscopy. Receiver operative characteristic (ROC) analysis was performed to determine the biomarker sensitivity/specificity. Low podocyte density and increased Mindin expression were observed in all cases of DN, regardless of their class. In the DN group, Mindin expression was significantly higher than that in the FSGS, MCD, IgAN and control groups. Higher Mindin expression was significantly positively correlated with foot process effacement only in class III DN cases. Furthermore, Mindin protein presented high specificity in the biopsies of patients with DN (p < 0.0001). Our data suggest that Mindin may play a role in DN pathogenesis and is a promising biomarker of podocyte lesions.

Knowledge about sexually transmitted infections among users of a testing and counseling center / Conhecimento sobre as infecções sexualmente transmissíveis em usuários de um centro de testagem e aconselhamento

Introduction: Sexually Transmitted Infections (STI) are configured as a public health problem, carrying a stigma, and often making the individual more vulnerable to other diseases. The perception of vulnerability does not motivate a preventive behavior towards STIs. Objective: To evaluate knowledge about STIs in relation to sociodemographic aspects and sexual and reproductive behaviors. Methods: This descriptive study was conducted in 2018 with 772 users of the voluntary Testing and Counseling Center (TCC) of Uberaba/MG, and included a questionnaire on their knowledge regarding STIs, addressing specific aspects of HIV, HPV, herpes, gonorrhea, chlamydia, hepatitis B and syphilis. Furthermore, data on the sexual and reproductive behavior of users was collected. Results: The study included 201 men and 571 women, of which 334 were pregnant. Less knowledge about STIs was observed among pregnant women, adolescents and the elderly people. Questions about chlamydia represented the highest rate of errors (75.9%) among respondents, while syphilis was the STI with greater knowledge (79.5% of the correct answers). Most participants reported they had never used condoms (60.5%) and identified "will not get any STI" as the main reason for not using them (52.7%). There were no significant associations between the degree of knowledge of STIs and sexual behavior. Conclusion: Among the population, especially teenagers and elderly people, there is a relevant lack of knowledge when it comes to STIs. Promoting universal access to diagnosis and prevention of STIs, as well as holistic care for vulnerable and at-risk populations, remain as challenges to be overcome

Introdução: Infecções Sexualmente Transmissíveis (IST) se configuram como um problema de saúde pública, pois carregam consigo estigma e tornam as pessoas mais vulneráveis a outras doenças. A percepção de vulnerabilidade não motiva o comportamento preventivo às IST. Objetivo: Avaliar o conhecimento sobre as IST em relação aos fatores sociodemográficos e o comportamento sexual e reprodutivo. Métodos: Estudo descritivo conduzido em 2018 com 772 usuários do Centro de Testagem e Aconselhamento (CTA) da cidade de Uberaba, estado de Minas Gerais, Brasil. Os participantes responderam a um questionário sobre conhecimento das IST, abordando questões específicas sobre vírus da imunodeficiência humana (HIV), papilomavírus humano (HPV), herpes, gonorreia, clamídia, hepatite B e sífilis. Foram coletados também dados sobre o comportamento sexual e reprodutivo dos usuários. Resultados: O estudo contou com 201 homens e 571 mulheres, das quais 334 estavam gestantes. Menor conhecimento sobre IST foi observado entre gestantes, adolescentes e idosos. As perguntas sobre clamídia representaram o maior índice de erros (75,9%), ao passo que a sífilis se mostrou uma IST de maior conhecimento (79,5% de acerto). A maioria dos participantes afirmou nunca usar preservativos (60,5%) e identificou como principal motivo para esse não uso uma percepção da impossibilidade de contrair uma IST (52,7%). Não foram observadas associações significativas entre o grau de conhecimento de IST e o comportamento sexual. Conclusão: Há, entre a população, especialmente adolescentes e idosos, um desconhecimento relevante acerca das principais IST. A promoção do acesso universal ao diagnóstico e à prevenção das IST, bem como a integralidade no cuidado da população vulnerável e de risco permanecem enquanto desafios a superar.