Is Expanded Hemodialysis an Option to Online Hemodiafiltration for Small- and Middle-Sized Molecules Clearance?

2018 ◽  
Vol 47 (1-3) ◽  
pp. 126-131 ◽  
Author(s):  
Javier Reque ◽  
Alejandro Pérez Alba ◽  
Nayara Panizo ◽  
Juan José Sánchez-Canel ◽  
Maria Jose Pascual ◽  
...  
Keyword(s):  
Prospective Study ◽  
Reduction Rate ◽  
Hemodialysis Patients ◽  
Reduction Ratio ◽  
The Other ◽  
Second Phase ◽  
Middle Molecules ◽  
Group 2 ◽  
To Receive ◽  
Group 1

Background: Recent evidence suggests a better reduction rate of some uremic toxins with expanded hemodialysis (HDx). Methods: Prospective study including 8 hemodialysis patients. We divided the study in 2 phases; within the first one, we assigned 4 patients (group 1) to undergo online hemodiafiltration with a PF 210H dialyzer, and the other 4 patients (group 2) to undergo HDx with the high retention onset Theranova 500 dialyzer during 24 sessions. Later, during the second phase and after a washout period, the same patients were switched to receive HDx (group 1) and HDF (group 2). Results: No differences were found in the Urea and β2-microglobulin reduction ratio. However, in the case of myoglobin, the reduction ratio with HDF was 35 vs. 60% with HDx (p < 0.001). Similarly, in the case of prolactin, the reduction ratio with HDF was 45 and 61% with HDx (p < 0.001). Conclusions: We conclude that HDx is not inferior to online hemodiafiltration in the clearance of small and middle molecules and could be superior in the clearance of larger middle molecules.

scholarly journals Analgesic Efficiency of Tramadol Administered Prior to Hysteroscopy Procedure

2016 ◽  
pp. 4
Author(s):  
Pınar Kadiroğulları ◽  
Kerem Doğa Seçkin ◽  
Burak Yücel ◽  
Berna Aslan Çetin ◽  
Sibel Arslan Barut ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Visual Analogue Scale ◽  
Prospective Study ◽  
Analogue Scale ◽  
The Other ◽  
Office Hysteroscopy ◽  
Pain Scores ◽  
Vas Scores ◽  
Group 2 ◽  
Group 1

<p><strong>OBJECTIVE:</strong> In this study, our objective was to assess the pain scores using the Visual Analogue Scale (VAS) in patients who were given tramadol prior to office hysteroscopy in order to demonstrate its analgesic activity when given before this procedure. <br /><strong>STUDY DESIGN:</strong> This prospective study conducted in year 2015 included two group of patients undergoing office hysteroscopy that were defined on the basis of the type of analgesia. Patients in the first group (Group 1, n=44) received oral tramadol prior to the procedure, while patients in the other group (Group 2, n=44) received placebo. VAS scores were determined during (0 minutes) and after (15 minutes) the procedure. <br /><strong>RESULTS:</strong> There were no significant differences between groups in terms of age, parity and body mass index (p&gt;0.05). Comparison of VAS scores at 0 and 15 minutes, lower values were observed in tramadol patients at 0 minutes (p&lt;0.05), while scores at 15 minutes were not significantly different between the groups (p&gt;0.05). <br /><strong>CONCLUSION:</strong> Although oral tramadol given prior to office hysteroscopy was effective and safe in reducing pain during the procedure, it is not useful for the pain that occurs after processing.</p>

The Relationship between Serum Ferritin Levels and 5-Year All-Cause Mortality in Hemodialysis Patients

2021 ◽  
pp. 1-7
Author(s):  
Emre Erdem ◽  
Ahmet Karatas ◽  
Tevfik Ecder
Keyword(s):  
Serum Ferritin ◽  
Hemodialysis Patients ◽  
Rank Test ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Group 3 ◽  
Group 2 ◽  
The Relationship ◽  
Group 1

<b><i>Introduction:</i></b> The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. <b><i>Methods:</i></b> A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin &#x3c;800 ng/mL, group 2: serum ferritin 800–1,500 ng/mL, and group 3: serum ferritin &#x3e;1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. <b><i>Results:</i></b> Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5–60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, <i>p</i> = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05–0.49]; <i>p</i> = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12–0.88]; <i>p</i> = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23–1.04]; <i>p</i> = 0.063). <b><i>Conclusion:</i></b> Time-averaged serum ferritin levels &#x3e;1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.

Myeloid neoplasms in the setting of chronic lymphocytic leukaemia/chronic lymphocytic leukaemia-like disease: a clinicopathological study of 66 cases comparing cases with prior history of treatment to those without

2021 ◽  
pp. jclinpath-2020-207334
Author(s):  
Catherine Luedke ◽  
Yue Zhao ◽  
Jenna McCracken ◽  
Jake Maule ◽  
Lian-He Yang ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukaemia ◽  
Lymphocytic Leukaemia ◽  
The Other ◽  
Prior History ◽  
Myeloid Neoplasm ◽  
Myeloid Neoplasms ◽  
History Of ◽  
Cytogenetic Profile ◽  
Group 2 ◽  
Group 1

AimsMyeloid neoplasms occur in the setting of chronic lymphocytic leukaemia (CLL)/CLL-like disease. The underlying pathogenesis has not been elucidated.MethodsRetrospectively analysed 66 cases of myeloid neoplasms in patients with CLL/CLL-like disease.ResultsOf these, 33 patients (group 1) had received treatment for CLL/CLL-like disease, while the other 33 patients (group 2) had either concurrent diagnoses or untreated CLL/CLL-like disease before identifying myeloid neoplasms. The two categories had distinct features in clinical presentation, spectrum of myeloid neoplasm, morphology, cytogenetic profile and clinical outcome. Compared with group 2, group 1 demonstrated a younger age at the diagnosis of myeloid neoplasm (median, 65 vs 71 years), a higher fraction of myelodysplastic syndrome (64% vs 36%; OR: 3.1; p<0.05), a higher rate of adverse unbalanced cytogenetic abnormalities, including complex changes, −5/5q- and/or −7/7q- (83% vs 28%; OR: 13.1; p<0.001) and a shorter overall survival (median, 12 vs 44 months; p<0.05).ConclusionsMyeloid neoplasm in the setting of CLL/CLL-like disease can be divided into two categories, one with prior treatment for CLL/CLL-like disease and the other without. CLL-type treatment may accelerate myeloid leukaemogenesis. The risk is estimated to be 13-fold higher in patients with treatment than those without. The causative agent could be attributed to fludarabine in combination with alkylators, based on the latency of myeloid leukaemogenesis and the cytogenetic profile.

scholarly journals The use of an antagonist 5-HT2a/c for depression and motor function in Parkinson' disease

2009 ◽  
Vol 67 (2b) ◽  
pp. 407-412 ◽  
Author(s):  
Antonio Luiz dos Santos Werneck ◽  
Ana Lucia Rosso ◽  
Maurice Borges Vincent
Keyword(s):  
Parkinson Disease ◽  
Motor Function ◽  
Rating Scale ◽  
Statistical Significance ◽  
Psychotic Symptoms ◽  
Initial Moment ◽  
The Mean ◽  
Group 2 ◽  
To Receive ◽  
Group 1

OBJECTIVE: To test the ability of a 5HT2a/c (trazodone) antagonist, to improve depression and motor function in Parkinson' disease (PD). METHOD: Twenty PD patients with and without depression were randomly assigned to receive trazodone (group 1) or not (group 2). They were evaluated through UPDRS and Hamilton Depression Rating Scale (HAM-D). RESULTS: For the UPDRS the mean score of group 2 was 33.1 ± 19.7 and 37.1 ± 18.0 at the end. For the group 1, the corresponding scores were 31.4 ± 11.3 and 25.9 ± 13.7. The variations in the Mann-Whitney test were 0.734 at the initial moment and 0.208 at the final moment. The variation in the comparison of the initial moment with the final moment was 0.005 providing statistical significance. For the HAM-D, the mean score went up 4 points in group 2, contrary to a 5.5 points decrease in group 1. CONCLUSION: Data analysis shows that this agent significantly improves depression, but the motor function improved only in the depressed patients. Because of the known anti-dopaminergic property of the 5-HT2c receptors, a possible approach for depression in PD could be the use of 5-HT2c antagonists, similarly to the use of atypical neuroleptics in case of psychotic symptoms.

scholarly journals Comparison of peribulbar anesthesia and topical anesthesia on outcome of phacoemulsification

2017 ◽  
Vol 5 (6) ◽  
pp. 2608 ◽  
Author(s):  
Rishi Mehta ◽  
Sharda Punjabi ◽  
Nutan Bedi ◽  
Chandra Kant Nagar
Keyword(s):  
Intraoperative Complications ◽  
Visual Outcome ◽  
Topical Anesthesia ◽  
Satisfaction Score ◽  
The Other ◽  
Patients Satisfaction ◽  
Peribulbar Anesthesia ◽  
Group 2 ◽  
A Prospective Study ◽  
Group 1

Background: Due to advancement in phacoemulsification techniques, there has been growing shift from peribulbar anesthesia (PA) to topical anesthesia (TA). But dilemma exists regarding the supremacy of one over the other as both types have certain advantages and disadvantages.Methods: A prospective study was conducted. Patients were divided into two groups. Group-1 underwent PA while group-2 underwent TA. Satisfaction score of patients and surgeons and incidence of complications were noted. The data was analyzed.Results: Lowest patients’ satisfaction score among group-1 vs. group-2 was 160 (87.9%) vs.82 (45.81%). Highest surgeons satisfaction score among group-1 and group-2 was 74(40.65%) vs. 2(1.1%). Intraoperative complications among the group-1 and group-2 were 35 (19.2%) vs. 86(48.0%).Conclusions: While TA provides initial painless phase of surgical procedure, PA results in lesser intraoperative complications resulting in better visual outcome.

Detection Of Potentially Embolic Intracardiac Thrombus In Patients With Cerebral Ischaemia

1981 ◽  
Author(s):  
R M Donaldson ◽  
C Humphrey ◽  
R W Emanuel ◽  
C Earl
Keyword(s):  
Cerebral Ischaemia ◽  
Clinical Evidence ◽  
The Other ◽  
Intracardiac Thrombus ◽  
Cardiac Assessment ◽  
Patients At Risk ◽  
Group 2 ◽  
Histological Confirmation ◽  
A Prospective Study ◽  
Group 1

In a prospective study, 5 8 consecutive patients presenting clinically with transient or permanent focal cerebral ischaemia underwent cardiac assessment which included twodimensional echocardiography (2DE). All had been referred after neurological investigations failed to establish the underlying cause of the neurological event. 5 0 of these patients had no evidence of heart disease (Group 1); the other 28 patients had clinical evidence of an underlying cardiac abnormality or arrhythmia (Group 2). One of the patients in Group 1 had echocardiographic evidence of mitral valve prolapse; no cardiac pathology was visualised in the other 29 patients in this group. In 5 of the 28 patients from Group 2, intracardiac thrombus presumed responsible for the neurological manifestations was demonstrated by 2DE and histological confirmation obtained following surgery or at necropsy in 4 of these cases. No abnormality was found on 2DE in the other 23 patients. All acoustically dense thrombi were larger than 1.5 cm and had some degree of organisation. Two were recent, histologically showing red blood cells and mplatelet-fibrin columnation. The accoustical similarity of small thrombi to the surrounding blood or endocardium may hinder the sensitivity of the method.The technique may help to define patients at risk from embolisation. As intracardiac thrombi are a common and potentially an easily prevented cause of stroke,a 2DE screen should be undertaken in patients with arrhythmias or clinical evidence of cardiac disease who have experienced one or more episodes of cerebral ischaemia.

Ovarian Reserve Reduction With Surgery Is Not Correlated With the Amount of Ovarian Tissue Inadvertently Excised at Laparoscopic Surgery for Endometriomas

2019 ◽  
Vol 26 (11) ◽  
pp. 1493-1498 ◽  
Author(s):  
Ludovico Muzii ◽  
Chiara Di Tucci ◽  
Mara Di Feliciantonio ◽  
Giulia Galati ◽  
Irene Pecorella ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Ovarian Tissue ◽  
Reduction Rate ◽  
Surgical Excision ◽  
Significant Difference ◽  
Laparoscopic Cystectomy ◽  
Group 2 ◽  
Ovarian Endometriomas ◽  
Serial Measurements ◽  
Group 1

The aim of the present study was to evaluate the effect of laparoscopic cystectomy on ovarian reserve by means of anti-Müllerian hormone (AMH) serial measurements and to compare AMH values with the number of inadvertently removed follicles in histological specimens. Fifty-two women were enrolled: 34 patients with endometriomas (group 1) and 18 patients with other benign ovarian cysts (group 2). All patients underwent laparoscopic cystectomy performed by a single experienced surgeon. The AMH was measured before, and 1, 3, and 6 months after cystectomy in group 1, and before and 6 months after surgery in group 2. Preoperative AMH levels (mean [standard deviation, SD]) in group 1 (3.39 [2.43] ng/mL) were not significantly different from group 2 (3.74 [2.57] ng/mL; P = .68). In group 1, a significant decrease in AMH levels of 43.4% was observed at 1 month (1.93 [1.36]; P = .003), and of 63.1% at 3 months (1.25 [1.00]; P = .007) postoperatively. The AMH increased not significantly between the third and sixth months in group 1 (+9.4%). Six months after surgery, AMH was reduced by 59.3% compared to baseline values in group 1 ( P = .012), and by 29.5% in group 2 ( P = .200). A significant difference in the AMH decrease was present between bilateral and monolateral endometriomas ( P = .006). There was no correlation between the reduction rate of AMH and the number of follicles inadvertently removed in patients with endometriomas ( P = .669). In conclusion, AMH decreases significantly after surgical excision of ovarian endometriomas. The postoperative decrease does not appear to correlate with the amount of ovarian tissue inadvertently excised with the endometrioma wall.

Hyaluronan affects extravascular water in lungs of unanesthetized rabbits

1989 ◽  
Vol 66 (6) ◽  
pp. 2595-2599 ◽  
Author(s):  
J. Bhattacharya ◽  
T. Cruz ◽  
S. Bhattacharya ◽  
B. A. Bray
Keyword(s):  
Body Weight ◽  
Water Content ◽  
Extravascular Lung Water ◽  
Volume Expansion ◽  
The Other ◽  
Lung Water ◽  
Intravenous Saline ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

We have determined whether changes in lung hyaluronan content affect extravascular water in lungs of unanesthetized rabbits. Three groups of experiments were performed. In group 1 (n = 12), no infusions were given; in group 2, nine pairs of rabbits received either intravenous hyaluronidase (750 U.kg-1.min-1) or an equivalent volume of saline; in group 3, nine pairs of rabbits received either hyaluronidase or saline, followed by intravenous saline infusion amounting to 24% of body weight. At the end of each experiment, one lung was analyzed for extravascular lung water by the wet-dry method. Except for group 3, in all animals the other lung was analyzed for hyaluronan content by a method that involved hydrolyzing lung hyaluronan with fungal hyaluronidase to release reducing N-acetyl glucosamine groups, which were quantified. In group 1, lung hyaluronan, which varied from 50 to 159 micrograms/g dry wt (mean 106 +/- 35 micrograms/g dry wt), significantly correlated with variation in extravascular lung water (mean 4.2 +/- 0.3 g/g dry wt). In group 2 rabbits given hyaluronidase, lung hyaluronan was 40% lower and extravascular lung water was 14.6% lower than in paired controls (P less than 0.01). In group 3, volume expansion did not affect lung water, except after hyaluronidase when lung water was 47% higher than paired controls. We conclude that in the lung the content of hyaluronan is one of the determinants of extravascular water content.

Effect of Chlorhexidine Cleansing of Umbilical Cord for Prevention of Infection

2018 ◽  
Vol 4 (2) ◽  
pp. 35-39
Author(s):  
Md Khairuzzaman ◽  
MA Mannan ◽  
Abdul Matin ◽  
Mst Monjuman Ara Sarker ◽  
Nihar Ranjan Sarker ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Controlled Trial ◽  
Care Group ◽  
Cord Care ◽  
Randomized Controlled ◽  
Group 3 ◽  
Group 2 ◽  
To Receive ◽  
Level Hospital ◽  
Group 1

Background: Chlorhexidine cleansing of the cord can reduce neonatal mortality among newborns.Objective: The aim of study was to determine the effect of cord cleansing with chlorhexidine in reduction of umbilical infection among newborns in hospital settings.Methodology: This randomized controlled trial was carried out between April 2013 to July 2014 and 510 newborns were randomly assigned within a tertiary level hospital in Bangladesh to receive 1 of 3 cord care regimens single cord cleansing with 4% chlorhexidine(Group-1), multiple cord cleansing with 4% chlorhexidine (Group-2)  and clean and dry cord care (Group-3 : control).Results: The risk of umbilical cord infection (omphalitis) was significantly reduced in both the single (Relative risk [RR] 0.15 [95% CI] 0.008-0.93) and multiple chlorhexidine cleansing group (RR 0.37 [95% CI] 0.04- 0.99) compared to the dry cord care group.  The risk of omphalitis was not significantly different between multiple and single chlorhexidine cleansing group (RR 3.14 [0.13-76.54]). Conclusion: Chlorhexidine significantly reduce the risk of umbilical infection in both single and multiple cord cleansing neonates.Bangladesh Journal of Infectious Diseases 2017;4(2):35-39

scholarly journals Evaluation of the concentration of malondialdehyde and nitrite in patients with sickle cell anemia treated or not with hydroxyurea

2010 ◽  
Vol 8 (4) ◽  
pp. 414-418 ◽  
Author(s):  
Darcielle Bruna Dias Elias ◽  
Rivelilson Mendes de Freitas ◽  
Romélia Pinheiro Gonçalves ◽  
Hemerson Yuri Ferreira Magalhães ◽  
Jacqueline Holanda de Sousa ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Serum Levels ◽  
The Other ◽  
Control Group ◽  
Clinical Variables ◽  
Short Period ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

ABSTRACT Objective: To determine the serum levels of malondialdehyde and nitrite in patients with sickle cell anemia treated or not with hydroxyurea in outpatient's setting. Methods: Of the 65 patients with sickle cell anemia selected for the study, 51 were not treated with hydroxyurea (Group 1), 14 made chronic use of hydroxyurea (Group 2) and 20 individuals had no hemoglobinopathies (Control Group). Results: The Control Group had a lower and more homogeneous concentration of malondialdehyde levels as compared to the other groups. The results of Groups 1 and 2 showed increased values of malondialdehyde levels when compared to the Control Group. Considering the values of Groups 1 and 2, there were no significant changes in the malondialdehyde levels. There was no significant difference in the serum levels of nitrite between the groups. Group 2 presented a statistically significant correlation between serum malondialdehyde levels and the clinical variables investigated. In turn, Group 1 showed correlation only with occurrence of three or more vaso-occlusive crises. There was no correlation between nitrite levels and the clinical variables. Conclusion: The results revealed that during the pathogenesis of sickle cell anemia, an increase in lipid peroxidation was observed. On the other hand, no changes in oxidative parameters were detected during treatment with hydroxyurea, probably due to the short period of treatment of the patients studied.

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