Subcutaneous Epoetin Beta in Renal Anemia: An Open Multicenter Dose Titration Study of Patients on Continuous Peritoneal Dialysis

1995 ◽  
Vol 15 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Peter Bárány ◽  
Naomi Clyne ◽  
Britta Hylander ◽  
Ann-C. Johansson ◽  
Ole Simonsen ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Hemoglobin Concentration ◽  
Dose Titration ◽  
Factors Affecting ◽  
Epoetin Beta ◽  
Moderate Anemia ◽  
Continuous Peritoneal Dialysis ◽  
The Mean ◽  
One Year ◽  
Beta Dose

Objective To establish dose requirements (target hemoglobin >100 g/L) and safety of subcutaneously administered epoetin beta. Design Open multicenter study. Patients Forty-five anemic patients (21 female, 24 male; mean age 55 years; range 20 79 years) who had been on continuous peritoneal dialysis for 1-157 months (mean 24 months). Thirty patients required blood transfusions during the year prior to the study. Mean hemoglobin concentration pretreatment was 75 g/L (range 57 –89 g/L). Intervention After a pretreatment period of two weeks, 60 IU kg-1 week-1 divided into three weekly doses of epoetin beta was administered subcutaneously. The dose was increased by 60 IU kg-1 week-1 after ten weeks, and when necessary, every fourth week in patients with hemoglobin levels below 100 g/L. Main Outcome Measures Hemoglobin concentration. Analysis of factors affecting the response to epoetin beta. Safety of epoetin beta. Results Thirty-eight of the 45 patients completed six months and 21 patients completed one year in the study. Twenty-six patients reached hemoglobin 100 g/L within six months and 8 patients did later on. The mean hemoglobin concentration after three months was 93 g/L (range 64 –144 g/L) and after six months was 99 g/L (range 59 –130 g/L; mean epoetin beta dose 1221U kg-1 week-I). During the second six-month period of the study, hemoglobin levels were stable in most patients. After one year, the mean hemoglobin was 110 g/L (range 84 –153 g/L) and the mean epoetin beta dose was 1071U kg-1 week-l. Prolonged correction time and impaired response to epoetin were observed in patients with infections or hemorrhages and in patients with low hemoglobin concentration before starting epoetin treatment. Iron deficiency was controlled by iron supplementation, either orally or, in 10 patients, intravenously. Increased blood pressure, requiring intensified antihypertensive treatment, was observed in 13 patients. Conclusions Continuous peritoneal dialysis patients with moderate anemia (Hb 75 –90 g/L) and without complicating disorders can be managed with subcutane0usdoses of ep0etin<1201U kg-lweek-l. Theepoetin beta dose should be adjusted after the first month of treatment since most patients required higher doses than the initial 60 IU kg-1 week-l.

Continuous Peritoneal Dialysis in Newborns

1994 ◽  
Vol 14 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Patrizia Zaramella ◽  
Barbara Andreetta ◽  
Giovanni Franco Zanon ◽  
Luisa Murer ◽  
Giovanni Montini ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Neonatal Intensive Care ◽  
Normal Serum ◽  
Tertiary Treatment ◽  
Dialysis Treatment ◽  
Low Weight ◽  
Different Types ◽  
Continuous Peritoneal Dialysis ◽  
The Mean ◽  
The University

Objective To report the complications and outcome of 10 newborns affected by acute renal failure (ARF), treated by continuous peritoneal dialysis (CPD). Design All newborns admitted for tertiary treatment to the Neonatal Intensive Care Unit of the University of Padova, who underwent CPD between February 1986 and December 1990, were analyzed retrospectively. Patients Ten newborns (mean weight 2077 g, range 540–4930 g) received CPD, 6 of whom were preterm. All the survivors completed the study. Interventions A number 9,5 French Tenckhoff catheter was used, and a closed circuit was created by means of a modified continuous ambulatory peritoneal dialysis (CAPD) technique. The mean duration of dialytic therapy was 7 days. Results At the end of the dialytic period, 7 of the 10 patients had normal serum potassium and sodium values. CPD produced two different types of complications: leakage of the dialytic fluid in very low weight newborns and one episode of peritonitis during a chronic dialysis treatment. Six died of severe respiratory failure (in no case, however, was this attributable to ARF or CPD procedure). All but one of the survivors regained normal renal function. The only exception necessitated a kidney trans plant. Conclusion We believe that this technique, although invasive, improves the outcome of both preterm and low birth weight newborns affected by ARF.

scholarly journals Environmental factors affecting pre-weaning survival of Red Sokoto goats.

2021 ◽  
Vol 32 (2) ◽  
pp. 185-190
Author(s):  
U. K. Oke ◽  
B.B.A. Taiwo ◽  
V. Buvanendran' ◽  
S.A.S. Olorunju ◽  
I.F. Adu
Keyword(s):  
Environmental Factors ◽  
Dry Season ◽  
Animal Production ◽  
Season Of Birth ◽  
Factors Affecting ◽  
Production Research ◽  
The Mean ◽  
One Year ◽  
Birth Type ◽  
Research Institute

Effects of environmental factors viz, hirth year, parity, sex, birth type and season of birth on preweaning survival of Red Sokoto goats (RSG) using production records kept between 1978 - 1985 at the National Animal Production Research Institute (NAPRI), Shika-Zaria were investigated. Birth year, parity and season of birth significantly (P<0.05) affected preweaning survival while birth type and sex of kid did not. The mean survival to weaning at 3 months was 72% and was highest in does with 4 or more parities (77%) and least in primiparous does (66%). Survival was significantly higher during harmattan and worse during the dry season. Losses were more concentrated in the O 7 days of life in primiparous does during the dry season. Overall productivity of does and interac lions between parity and birth cype significantly affected survival. Breeding RSG older than one year to kids preferably during 'harmattan' would improve preweaning survival of the kids.

scholarly journals Adherence to antiretroviral therapy and factors affecting adherence among paediatric HIV patients

2017 ◽  
Vol 4 (6) ◽  
pp. 1962
Author(s):  
Kendre Govind ◽  
Gabhale Yashwant ◽  
Shah Nikita ◽  
Jadhav Vishal ◽  
Nath Kunal ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Cd4 Count ◽  
Fixed Dose ◽  
Factors Affecting ◽  
History Of ◽  
Dose Combination ◽  
The Mean ◽  
And Gender ◽  
One Year ◽  
Adherence Group

Background: Adherence to antiretroviral therapy (ART) is the strongest indicator of successful treatment of Human Immunodeficiency Virus (HIV) among children. The main aim of the present study was to know the prevalence of adherence at our centre and various factors affecting the adherence in children.Methods: It was an observational study done in children less than 15 years of age, affected with HIV.  78 children attending Paediatric Centre of Excellence (PCOE) for HIV L.T.M.G. Hospital, Sion, Mumbai were included in study, Study period was 18 months from January 2012 to June 2013. Complete history of the patients was noted in a pre-designed proforma. Baseline investigations related to HIV were done in all children. Fixed dose combination ART was started in children who fulfilled clinical and/or immunological criteria as per the NACO guidelines. Adherence was estimated using Pill count method..All the data were analysed by using 10.0 version of statistical software SPSS.Results: In this study, male children (57.7%) out numbered the females (42.3%). Majority of study subjects were more than 10 years of age. Overall adherence among subjects was 82.1% at the end of one year and non-adherence was 17.9%. There was no significant association of age and gender of the patients with adherence (p>0.05). Education, employment and knowledge towards medication of care takers was significantly associated with adherence of ART (p<0.05). Adherence of study cases had not showed any significant association with ART treatment regimen (p=0.99). At the end of one year, the mean CD4 count was significantly more as compared to baseline among adherence group and the mean CD4 count was significantly less as compared to baseline among non-adherence group. The most common reason for missed dosage was forgot to take medicine in 29 subjects (37.1 %)..Conclusion: Adherence level in this study was good. Forgot to take the medicine was the main reason given by the patients for non-adherence. Education, employment and knowledge towards medication of care takers was significantly associated with adherence of ART .But further studies are needed to explore various other factors related to adherence in children.

scholarly journals Incomplete Kawasaki disease - a diagnostic and therapeutic challenge

2014 ◽  
Vol 9 (4) ◽  
pp. 30-35
Author(s):  
S Datta ◽  
S Maiti ◽  
G Das ◽  
A Chatterjee ◽  
P Ghosh
Keyword(s):  
Kawasaki Disease ◽  
Intravenous Immunoglobulin ◽  
Incomplete Kawasaki Disease ◽  
Duration Of Symptoms ◽  
Clinical Criteria ◽  
Echocardiographic Finding ◽  
2D Echocardiography ◽  
Acquired Heart Disease ◽  
The Mean ◽  
One Year

Background The diagnosis of classical Kawasaki Disease was based on clinical criteria. The conventional criteria is particularly useful in preventing over diagnosis, but at the same time it may result in failure to recognize the incomplete form of Kawasaki Disease. Objective To suspect incomplete Kawasaki Disease, because early diagnosis and proper treatment may reduce substantial risk of developing coronary artery abnormality which is one of the leading causes of acquired heart disease in children. Method Nine cases of incomplete Kawasaki Disease were diagnosed over a period of one year. The diagnosis of incomplete Kawasaki Disease was based on fever for five days with less than four classical clinical features and cardiac abnormality detected by 2D- echocardiography. A repeat echocardiography was done after 6 weeks of onset of illness. The patients were treated with Intravenous Immunoglobulin and/or aspirin. Result The mean age of the patients was 3.83 years and the mean duration of symptoms before diagnosis was 12.1 days. Apart from other criteria all of our patients had edema and extreme irritability. All the patients had abnormal echocardiographic finding. Five patients received only aspirin due to nonaffordability of Intravenous Immunoglobulin and four patients received both aspirin and Intravenous Immunoglobulin, but the outcome was excellent in all the cases. Conclusion Incomplete Kawasaki Disease can be diagnosed with more awareness and aspirin alone may be used as a second line therapy in case of non affordability of Intravenous Immunoglobulin. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 30-35 DOI: http://dx.doi.org/10.3126/jcmsn.v9i4.10234

Coronary endarterectomy in coronary artery disease: Factors affecting graft patency and survival

2021 ◽  
pp. 021849232110068
Author(s):  
Simon CY Chow ◽  
Jacky YK Ho ◽  
Micky WT Kwok ◽  
Takuya Fujikawa ◽  
Kevin Lim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Graft Patency ◽  
Complete Revascularization ◽  
Coronary Endarterectomy ◽  
Factors Affecting ◽  
Early Results ◽  
Cerebrovascular Events ◽  
Obtuse Marginal ◽  
One Year

Background Coronary endarterectomy aims to improve completeness of revascularization in patients with occluded coronary vessels. The benefits of coronary endarterectomy remain uncertain. The aim of this study was to evaluate short-term surgical outcomes and factors affecting graft patency post-coronary endarterectomy. Methods Between 2009 and 2019, 81 consecutive patients who had coronary endarterectomy done were evaluated for their perioperative and early results. A total of 36 patients with follow-up coronary studies were included in patency analysis. Mortality rates, major adverse cardiac and cerebrovascular events, and graft patency were outcomes of interest. Survival and risk factor analysis were performed with Kaplan–Meier and logistic regression analysis. Results The average age of the cohort was 61.9 ± 9.29 years. Complete revascularization rate was 95.4% post-coronary endarterectomy. The 30-day and 1-year mortality was 2.5 and 6.2%, respectively. One-year major adverse cardiac and cerebrovascular events rate was 11.1%. Periprocedural myocardial infarction rate was 7.4%. Three patients required repeat revascularization within a mean follow-up duration of 49.6 ± 36.5 months. Overall graft patency was 89.2% at 20.2 months and graft patency post-coronary endarterectomy was 85.4%. Arterial grafts showed 100% patency. Vein grafts to endarterectomized obtuse marginal branch had patency rates of 33.3%. Multiple endarterectomies were associated with worse one-year major adverse cardiac and cerebrovascular events (OR: 28.6 ± 1.16; P = 0.003). Conclusions Coronary endarterectomy facilitates completeness of revascularization and does not increase early mortality. Graft patency post-coronary endarterectomy on obtuse marginal artery was suboptimal. Judicious use of coronary endarterectomy should be practiced to balance the need of completeness of revascularization against the risk of myocardial infarction.

scholarly journals Development of Perceptual Inhibition in Adolescents—a Critical Period?

Symmetry ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 457
Author(s):  
Isabel María Introzzi ◽  
María Marta Richard’s ◽  
Yesica Aydmune ◽  
Eliana Vanesa Zamora ◽  
Florencia Stelzer ◽  
...  
Keyword(s):  
Response Time ◽  
Executive Functions ◽  
Critical Period ◽  
Search Task ◽  
Probability Distributions ◽  
Linear Trajectory ◽  
Gaussian Functions ◽  
Mean Response Time ◽  
The Mean ◽  
One Year

Recent studies suggest that the developmental curves in adolescence, related to the development of executive functions, could be fitted to a non-linear trajectory of development with progressions and retrogressions. Therefore, the present study proposes to analyze the pattern of development in Perceptual Inhibition (PI), considering all stages of adolescence (early, middle, and late) in intervals of one year. To this aim, we worked with a sample of 275 participants between 10 and 25 years, who performed a joint visual and search task (to measure PI). We have fitted ex-Gaussian functions to the probability distributions of the mean response time across the sample and performed a covariance analysis (ANCOVA). The results showed that the 10- to 13-year-old groups performed similarly in the task and differ from the 14- to 19-year-old participants. We found significant differences between the older group and all the rest of the groups. We discuss the important changes that can be observed in relation to the nonlinear trajectory of development that would show the PI during adolescence.

Analysis of Single-Vehicle Crash Injury Severities in Urban River-Crossing Road Tunnels

2015 ◽  
Vol 743 ◽  
pp. 526-532 ◽  
Author(s):  
C.M. Jiang ◽  
J.J. Lu ◽  
L.J. Lu
Keyword(s):  
Heavy Vehicles ◽  
Probit Regression ◽  
Factors Affecting ◽  
Explanatory Variables ◽  
Urban Road ◽  
Road Tunnels ◽  
Negative Effect ◽  
Single Vehicle ◽  
Injury Severities ◽  
One Year

Based on the originally unprocessed data from the Official Platform of“110”Alarming Receiving Center (OP110ARC) of Shanghai Public Security Bureau (SPSB), 529 single-vehicle crashes reported during one year and a half which happened at the thirteen urban road tunnels going across the Huangpu River are used in this study. To investigate the factors affecting the crash influence severity levels, ordered probit regression is established. Several categories of factors are considered as explanatory variables in the models. The study finds that the entrance of the tunnels is the site where severe injury crashes trend to occur. Rainy and snowy days impose vehicles and motorists driving via the tunnel sections in danger. Tunnels with a low speed limit (40 km/h in this study) may be not as safe as we thought before. Two-wheel vehicles without sufficient physical protection for its drivers and heavy vehicles also show a negative effect on the operation safety of single-vehicle at these studied tunnels. Alcohol involved drivers are more likely to suffer from a severe crashes and gets badly hurt.

Open-wedge high tibial osteotomy in patients with discoid lateral meniscus

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110173
Author(s):  
Hee-June Kim ◽  
Ji-Yeon Shin ◽  
Hyun-Joo Lee ◽  
Chul-Hee Jung ◽  
Kyeong-Hyeon Park ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Lateral Meniscus ◽  
Lateral Compartment ◽  
Clinical Results ◽  
Discoid Lateral Meniscus ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Factors Affecting ◽  
The Mean ◽  
Open Wedge Hto

Background: There are concerns about the progression of the lateral osteoarthritis (OA) should be taken into account when high tibial osteotomy (HTO) is performed in patients with discoid lateral meniscus (LM). This study evaluated the clinical results of HTO in patients with discoid LM and elucidated factors affecting the results. Methods: This study evaluated 32 female patients with varus deformity and medial OA. Patients with discoid LM (8 patients) or without discoid LM (24 patients) underwent open-wedge HTO. The mean age was 53.5 years and the mean follow-up period was 35 months. Clinical results, including the Hospital for Special Surgery (HSS) score, Knee Society knee score (KS) and function score (FS), were evaluated. The progression of OA in the lateral compartment was also evaluated. Finally, we evaluated the factors affecting the clinical results and OA progression in the lateral compartment. Results: Between two groups, all clinical scores were not different (p = 0.964, 0.963, and 0.559, respectively). Three of eight patients (37.5%) in the discoid group developed OA in the lateral compartment, whereas 2 of 24 patients (8.3%) in the control group developed such; however, this was not significantly different (p = 0.085). In discoid group, patients with undercorrection has higher KS relative to patients with acceptable correction (p = 0.044). Other clinical results and OA change in the lateral compartment were not affected by evaluated factors. Conclusions: Patients who underwent open-wedge HTO showed the satisfactory clinical results and lateral OA progression regardless of the presence or absence discoid LM. However, when discoid LM was present, patients with undercorrection showed higher KS in comparison with patients with acceptable correction.

scholarly journals The features of the coastal fronts in the Eastern Guangdong coastal waters during the downwelling-favorable wind period

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chaoyu Yang ◽  
Haibin Ye
Keyword(s):  
Coastal Waters ◽  
Meteorological Data ◽  
Pearson Correlation ◽  
Ocean Model ◽  
Ekman Pumping ◽  
Zonal Distribution ◽  
Factors Affecting ◽  
China Sea ◽  
Hybrid Coordinate Ocean Model ◽  
The Mean

AbstractA coastal front was detected in the eastern Guangdong (EGD) coastal waters during a downwelling-favorable wind period by using the diffuse attenuation coefficient at 490 nm (Kd(490)). Long-term satellite data, meteorological data and hydrographic data collected from 2003 to 2017 were jointly utilized to analyze the environmental factors affecting coastal fronts. The intensities of the coastal fronts were found to be associated with the downwelling intensity. The monthly mean Kd(490) anomalies in shallow coastal waters less than 25 m deep along the EGD coast and the monthly mean Ekman pumping velocities retrieved by the ERA5 dataset were negatively correlated, with a Pearson correlation of − 0.71. The fronts started in October, became weaker and gradually disappeared after January, extending southwestward from the southeastern coast of Guangdong Province to the Wanshan Archipelago in the South China Sea (SCS). The cross-frontal differences in the mean Kd(490) values could reach 3.7 m−1. Noticeable peaks were found in the meridional distribution of the mean Kd(490) values at 22.5°N and 22.2°N and in the zonal distribution of the mean Kd(490) values at 114.7°E and 114.4°E. The peaks tended to narrow as the latitude increased. The average coastal surface currents obtained from the global Hybrid Coordinate Ocean Model (HYCOM) showed that waters with high nutrient and sediment contents in the Fujian and Zhejiang coastal areas in the southern part of the East China Sea could flow into the SCS. The directions and lengths of the fronts were found to be associated with the flow advection.

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