scholarly journals Increased Neutrophil Extracellular Trap Formation in Uremia Is Associated with Chronic Inflammation and Prevalent Coronary Artery Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Jwa-Kyung Kim ◽  
Chang-won Hong ◽  
Mi Jin Park ◽  
Young Rim Song ◽  
Hyung Jik Kim ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Acute Infection ◽  
Cross Sectional Study ◽  
Positive Control ◽  
Negative Control ◽  
Neutrophil Extracellular Trap ◽  
Maintenance Hemodialysis ◽  
Cross Sectional ◽  
Extracellular Trap ◽  
Stage Renal Disease

Background.Neutrophils are involved in the pathogenesis of atherosclerosis by neutrophil extracellular trap (NET) formation. We hypothesized that the NET formation of neutrophils might be changed in end-stage renal disease (ESRD) patients, explaining their higher incidence of coronary artery diseases (CAD).Method.A cross-sectional study was performed in 60 maintenance hemodialysis (MHD) patients, 30 age- and sex-matched healthy individuals (HV, negative control), and 30 patients with acute infection (positive control). Neutrophil activation and function were measured with reactive oxygen species (ROS) activity, degranulation, NET formation, and phenotypical changes.Result.Compared with HV, neutrophils extracted from MHD patients displayed significantly increased levels of basal NET formation, ROS production, and degranulation, suggesting spontaneous activation in uremia. Also, an increase in citrullinated histone H3 was detected in this group compared to the HV. And neutrophils from HV were normal CD16bright/CD62Lbrightcells; however, neutrophils from MHD were CD16bright/CD62Ldim, similar to those from patients with acute infections. Interestingly, multivariate analyses identified the prevalent CAD and neutrophil counts as independent determinants of baseline NET formation (β=0.323,p=0.016andβ=0.369,p=0.006, resp.).Conclusions.Uremia-associated-increased NET formation may be a sign of increased burden of atherosclerosis.

scholarly journals Acute Intradialytic Complications in End Stage Renal Disease on Maintenance Hemodialysis

2012 ◽  
Vol 52 (187) ◽  
Author(s):  
R K Agrawal ◽  
S Khakurel ◽  
R Hada ◽  
D Shrestha ◽  
A Baral
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis. Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study. Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%). Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening. Keywords: complications; end stage renal disease; hemodialysis; hypertension; hypotension.

MO864PATIENT MEDICATION ADHERENCE ON HEMODIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Marwa Omrane ◽  
Amel Babchia ◽  
Raja Jaballah ◽  
Afef Mahersia ◽  
Olfa Saidane
Keyword(s):  
Side Effects ◽  
Cross Sectional Study ◽  
Chronic Hemodialysis ◽  
Therapeutic Education ◽  
Maintenance Hemodialysis ◽  
Adherence To Treatment ◽  
Cross Sectional ◽  
Adherence Assessment ◽  
The Mean ◽  
Stage Renal Disease

Abstract Background and Aims Non-adherence to treatment is a major problem in patients with end stage renal disease and contributes to the significant increase in morbidity, mortality and health costs. Method The objective of this work was to assess adherence to treatment prescriptions for hemodialysis patients and to identify the predictive factors of poor compliance. This is a cross-sectional study of 59 patients on chronic hemodialysis. Adherence to treatment was evaluated by the adherence assessment test. Results The mean age of our patients was 51.8 years, with an M/F sex ratio of 1.26. The socio-economic level was considered low in 83% of cases. The mean duration of hemodialysis was 81.6 months [6 months-252 months]. Causal nephropathy was dominated by vascular nephropathy (13 cases). Forty-two patients had high blood pressure. A total of 23.9% of patients were good observers, 59.5% had minimal compliance problems, and 16.7% were poor observers. Statistical analysis has shown that poor adherence to treatment is associated with male gender, low socioeconomic and intellectual level, the presence of comorbidities, increased medication, number of medications taken per day, and less knowledge of the pathology and risks as side effects of drugs. Conclusion Treatment adherence is unsatisfactory in our population of patients on maintenance hemodialysis. Therapeutic education targeting the expected benefit of the treatments, their mode of action, their side effects as well as a simplification of the intake would improve long-term adherence in patients.

scholarly journals Depression in End Stage Renal Disease Patients on Maintenance Hemodialysis at Liaquat University Hospital Hyderabad / Jamshoro

2021 ◽  
Vol 15 (1) ◽  
pp. 60-63
Author(s):  
Rizwan Channa ◽  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Maintenance Hemodialysis ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage ◽  
Hospital Study

Objective: To determine the depression in end stage renal disease patients on hemodialysis at Liaquat University Hospital. Study Design: Cross sectional study. Settings: Department of Medicine & Nephrology at Liaquat University Hospital Hyderabad Pakistan. Duration: Six months from February 2015 to January 2016. Methodology: All the Male or Female of age 14-70 years having ESRD patients on maintenance hemodialysis for >3 months period were included. Questionnaire proforma was filled and patient who score 5 or more on depression scale were labeled as positive for depression. An informed written consent for the study was obtained from the patients and their relatives. All the data was recorded on a pre-designed proforma. Data was analyzed by using SPSS version 20. Results: The mean age of patients was 52.21±7.90 years. There were 69.9% males and 30.1% female patients. Out of all 35.8% patients were employed while 64.2% patients were unemployed. Most of the patients 92.3% were married and 7.7% were unmarried. The depression in patients with end stage renal disease was found in 47.2%patients. Conclusion: The frequency of depression in end stage renal disease patients on hemodialysis at Liaquat University Hospital was found to be higher as 47.2%. However, there is need to involve the expert Psychiatrists to cope with this higher problem of depression to improve their quality of life by giving them additional anti-depressant along with hemodialysis.

scholarly journals D ANTIGEN

2016 ◽  
Vol 23 (11) ◽  
pp. 1395-1399
Author(s):  
Nazish Saqlain ◽  
Aatika Ahmed ◽  
Tooba Fateen ◽  
Nisar Ahmed
Keyword(s):  
Cross Sectional Study ◽  
Positive Control ◽  
Negative Control ◽  
Cross Sectional ◽  
Children's Hospital ◽  
Healthy Donors ◽  
Children’S Hospital ◽  
D Antigen ◽  
Study Setting ◽  
Spin Tube

Background: In 1939 Rh antigen was discovered by Levine and Stetson. Rhsystem antigens are very immunogenic, they can produce significant Hemolytic Disease of thefetus and Newborn as well as hemolytic transfusion reactions. There are numerous variants ofD, the most common subtypes are Weak D and Partial D, now called as abnormal D antigens.The incidence of Rh negativity worldwide varies between 3%-25% and that of weak D antigenranges from 0.2%-1%. Objectives: To find out the frequency of Rh negativity and weak Dantigen among the donors coming to the blood bank of The Children’s Hospital & Institute ofChild Health, Lahore and to review the clinical significance of weak D antigen in transfusionperspective especially its role in alloimmunization caused by Weak D antigen when transfusedto Rh negative individuals. Study Design: Cross- sectional study. Setting: The Children’sHospital and Institute of Child Health, Lahore. Period: 1st Jan 2015 to 31st May, 2015. Materialsand Methods: 6320 healthy donors were randomly selected. All samples were grouped forABO and Rh-D factor by immediate spin tube technique. All samples found Rh negative, werefurther processed for weak D antigen with monoclonal anti D sera by using indirect Coomb’stechnique. The presence of macroscopic or microscopic agglutination was recorded as Rhpositive. In case there was no agglutination the mixture was washed 4 times with normalsaline. After the last wash, saline was decanted and 2 drops of monoclonal, polyvalent antihuman globulin was added. Macroscopic and microscopic agglutination was looked for andany agglutination at this stage was recorded as weak D antigen. Positive control (check cellsi.e. washed O positive cells with diluted anti D) and negative control (washed O positive cells)were always put. Results: Among the 6320 healthy donors, 1224(19.4%) were Rh-D negativeand 5096(80.6%) were Rh-D positive. Of the 1224 Rh D negative samples, 3 (0.2%) samplesfound positive for weak D antigen. Conclusion: The frequency of Rh negative blood groupwas 0.2% among the healthy donors at The Children’s Hospital and ICH, Lahore. Although thefrequency is low but it’s proven by literature that weak D antigen can produce alloimmunizationif transfused to Rh-D negative subjects. At the same time the cases of hemolytic reactionsreported previously with Weak D antigen have been scarce.

scholarly journals Frequent neurocognitive deficits after recovery from mild COVID-19

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Marcel S Woo ◽  
Jakob Malsy ◽  
Jana Pöttgen ◽  
Susan Seddiq Zai ◽  
Friederike Ufer ◽  
...  
Keyword(s):  
Short Term Memory ◽  
Telephone Interview ◽  
Acute Infection ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Cognitive Status ◽  
Neurocognitive Deficits ◽  
Cross Sectional ◽  
Neuropsychiatric Complications ◽  
Moderate Disease

Abstract Neuropsychiatric complications associated with coronavirus disease 2019 caused by the Coronavirus SARS-CoV-2 (COVID-19) are increasingly appreciated. While most studies have focussed on severely affected individuals during acute infection, it remains unclear whether mild COVID-19 results in neurocognitive deficits in young patients. Here, we established a screening approach to detect cognitive deficiencies in post-COVID-19 patients. In this cross-sectional study, we recruited 18 mostly young patients 20–105 days (median, 85 days) after recovery from mild to moderate disease who visited our outpatient clinic for post-COVID-19 care. Notably, 14 (78%) patients reported sustained mild cognitive deficits and performed worse in the Modified Telephone Interview for Cognitive Status screening test for mild cognitive impairment compared to 10 age-matched healthy controls. While short-term memory, attention and concentration were particularly affected by COVID-19, screening results did not correlate with hospitalization, treatment, viremia or acute inflammation. Additionally, Modified Telephone Interview for Cognitive Status scores did not correlate with depressed mood or fatigue. In two severely affected patients, we excluded structural or other inflammatory causes by magnetic resonance imaging, serum and cerebrospinal fluid analyses. Together, our results demonstrate that sustained sub-clinical cognitive impairments might be a common complication after recovery from COVID-19 in young adults, regardless of clinical course that were unmasked by our diagnostic approach.

scholarly journals The association between early vascular aging and cyclothymic affective temperament

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
M Vecsey-Nagy ◽  
B Szilveszter ◽  
M Kolossvary ◽  
X Gonda ◽  
Z Rihmer ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Linear Regression Analysis ◽  
Suspected Coronary Artery Disease ◽  
Cross Sectional Study ◽  
Vascular Aging ◽  
Cross Sectional ◽  
Entire Cohort ◽  
Affective Temperaments ◽  
Affective Temperament ◽  
Vascular Age

Abstract Funding Acknowledgements Type of funding sources: None. onbehalf Cardiovascular Imaging Research Group Background Affective temperaments (depressive, anxious, irritable, hyperthymic, cyclothymic) are regarded as the biologically stable core of personality, and accumulating data implies their relationship with cardiovascular diseases. There are currently limited data on the association of affective temperaments and early vascular aging. Purpose The aim of our study was to assess the potential relationship of affective temperaments and vascular age, as assessed by coronary CT. Methods In our current cross-sectional study, 209 patients referred to coronary computed tomography angiography (CCTA) due to suspected coronary artery disease (CAD), were included. After the evaluation of medical history and demographic parameters, all patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) and the Beck Depression Inventory (BDI). Vascular age was estimated using coronary artery calcium (CAC) score and we calculated its difference from chronological age for each patient. Linear regression analysis was applied to identify predictors of early vascular aging in the entire cohort and in male and female sub-populations, separately. Results The independent predictors of early vascular aging were female sex (B = -10.82 [95%CI: -15.30 – -6.33]), diabetes mellitus (B = 7.16 [95%CI: 1.20 – 13.12]) and dyslipidemia (B = -8.28 [95%CI: 3.94 – 12.62]). Further assessing gender differences, cyclothymic temperament score proved to be an independent predictor of early vascular aging in women (B = 0.89 [95%CI: 0.04 – 1.75]), while this association was absent in men. Conclusion Our results suggest that cyclothymic affective temperament contribute to early vascular aging in women.

scholarly journals Effect of redundant clinical trials from mainland China evaluating statins in patients with coronary artery disease: cross sectional study

BMJ ◽  
2021 ◽  
pp. n48
Author(s):  
Yuanxi Jia ◽  
Jiajun Wen ◽  
Riaz Qureshi ◽  
Stephan Ehrhardt ◽  
David D Celentano ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Clinical Trials ◽  
Coronary Artery ◽  
Confidence Interval ◽  
Randomized Clinical Trials ◽  
Mainland China ◽  
Statin Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Artery Disease

Abstract Objective To identify redundant clinical trials evaluating statin treatment in patients with coronary artery disease from mainland China, and to estimate the number of extra major adverse cardiac events (MACEs) experienced by participants not treated with statins in those trials. Design Cross sectional study. Setting 2577 randomized clinical trials comparing statin treatment with placebo or no treatment in patients with coronary artery disease from mainland China, searched from bibliographic databases to December 2019. Participants 250 810 patients with any type of coronary artery disease who were enrolled in the 2577 randomized clinical trials. Main outcome measures Redundant clinical trials were defined as randomized clinical trials that initiated or continued recruiting after 2008 (ie, one year after statin treatment was strongly recommended by clinical practice guidelines). The primary outcome is the number of extra MACEs that were attributable to the deprivation of statins among patients in the control groups of redundant clinical trials—that is, the number of extra MACEs that could have been prevented if patients were given statins. Cumulative meta-analyses were also conducted to establish the time points when statins were shown to have a statistically significant effect on coronary artery disease. Results 2045 redundant clinical trials were identified published between 2008 and 2019, comprising 101 486 patients in the control groups not treated with statins for 24 638 person years. 3470 (95% confidence interval 3230 to 3619) extra MACEs were reported, including 559 (95% confidence interval 506 to 612) deaths, 973 (95% confidence interval 897 to 1052) patients with new or recurrent myocardial infarction, 161 (132 to 190) patients with stroke, 83 (58 to 105) patients requiring revascularization, 398 (352 to 448) patients with heart failure, 1197 (1110 to 1282) patients with recurrent or deteriorated angina pectoris, and 99 (95% confidence interval 69 to 129) unspecified MACEs. Conclusions Of more than 2000 redundant clinical trials on statins in patients with coronary artery disease identified from mainland China, an extra 3000 MACEs, including nearly 600 deaths, were experienced by participants not treated with statins in these trials. The scale of redundancy necessitates urgent reform to protect patients.

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