scholarly journals Association of fibroblast growth factor 23 and α-klotho in hemodialysis patients during administration of ferric citrate hydrate: post hoc analysis of ASTRIO study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kyoko Ito ◽  
Keitaro Yokoyama ◽  
Masaaki Nakayama ◽  
Masafumi Fukagawa ◽  
Hideki Hirakata

Abstract Background Fibroblast growth factor-23 (FGF23) and α-klotho are associated with anemia in patients with chronic kidney disease. In this post hoc analysis of the ASTRIO study (UMIN000019176), we investigated the relationship between FGF23 and α-klotho during treatment with an iron-based phosphate binder, ferric citrate hydrate (FC), compared with non-iron-based phosphate binders in hemodialysis (HD) patients. We examined the effect of iron absorption by FC on the relationship between FGF23 and α-klotho. There have been few clinical studies evaluating these biomarkers simultaneously in HD patients. Methods The ASTRIO study was a 24-week, randomized, open-label, multicenter trial. HD patients taking non-iron-based phosphate binder(s) were randomized at a 1:1 ratio to continue other binder(s) (control group) or switch to FC (FC group). Serum phosphate (P) and hemoglobin (Hb) were maintained within 3.5–6.0 mg/dL and 10–12 g/dL, respectively. Plasma levels of intact FGF23 (i-FGF23), C-terminal FGF23 (c-FGF23), and α-klotho were measured, as were iron-related parameters. Association analyses of FGF23 and α-klotho were conducted. Results Patients were randomized to FC (n = 48) and control (n = 45) groups. Serum ferritin significantly increased from baseline to end-of-treatment (EOT) in the FC group, compared with the control group (adjusted mean difference [95% confidence interval]: 79.5 [44.7, 114.4] ng/mL; p <  0.001). The mean change from baseline to EOT in c-FGF23 was significantly different between the FC and control groups (mean ± standard deviation (SD): − 0.2 ± 0.8 loge pg/mL vs. 0.2 ± 0.8 loge pg/mL, respectively; p = 0.04). The mean change from baseline to EOT in i-FGF23 and α-klotho were not significantly different between the FC and control groups (mean ± SD: − 0.1 ± 0.8 loge pg/mL vs. 0.1 ± 0.9 loge pg/mL; p = 0.33, and 2.0 ± 91.5 pg/mL vs. − 8.9 ± 145.3; p = 0.58, respectively). However, both forms of FGF23 and α-klotho were not significantly associated with each other in both groups. Conclusions Iron absorbed via FC administration in HD patients did not influence the correlation relationship between plasma levels of FGF23 and α-klotho under the condition of serum P and Hb were maintained. Trial registration ASTRIO study (UMIN000019176, registered at UMIN Clinical Trials Registry on October 1, 2015).

Pteridines ◽  
2020 ◽  
Vol 31 (1) ◽  
pp. 55-60
Author(s):  
Haoyu Jiang ◽  
Ying Zheng ◽  
Chang Liu ◽  
Ying Bao

AbstractBackground To evaluate sulfentanyl combined with dexmedetomidine hydrochloride on postoperative analgesia in patients who received video-assisted thoracic surgery (VATS) and its effects on serum norepinephrine (NE), dopamine (DA), 5-hydroxytryptamine (5-HT), and prostaglandin (PGE2).Material and Methods Ninety-nine non-small cell lung cancer (NSCLC) patients who received VATS were included in the study. All the patients received intravenous inhalation compound anesthesia. Of the 99 cases, 49 subjects (control group) received sulfentanyl for patient controlled intravenous analgesia (PICA) and other 50 cases (experiment group) received sulfentanyl combined with dexmedetomidine hydrochloride for PICA after operation of VATS. The analgesic effects of the two groups were evaluated according to Visual Analogue Scales (VAS) and the Bruggrmann Comfort Scale (BCS). The serum pain mediator of NE, DA, 5-HT, and PGE2 were examined and compared between the two groups in the first 24 h post-surgery.Results The VAS scores for the experiment group were significant lower than that of control group on the time points of 8, 16, and 24 h post-surgery (pall<0.05), and the BCS scores of the experiment group in the time points of 8, 16, and 24 h were significantly higher than that of controls (p<0.05). However, the VAS and BCS scores were not statistical differently in the time point of 1, 2, and 4 h post-surgery (pall>0.05). The mean sulfentanyl dosage was 63.01 ± 5.14 μg and 67.12 ± 6.91 μg for the experiment and control groups respectively with significant statistical difference (p<0.05). The mean analgesic pump pressing times were 4.30 ± 1.31 and 5.31 ± 1.46 for experiment and control groups respectively with significant statistical difference (p<0.05). The serum NE, DA, 5-HT, and PGE2 levels were significantly lower in the experimental group compared to that of control group in the time point of 12 h post-surgery (pall<0.05). The side effects of nausea, vomiting, delirium, rash, and hypotension atrial fibrillation were not statistically different between the two groups (pall>0.05).Conclusion Patient controlled intravenous analgesia of sulfentanyl combined with dexmedetomidine hydrochloride was effective in reducing the VAS score and serum pain mediators in NSCLC patients who received VAST.


2020 ◽  
pp. bmjstel-2020-000657
Author(s):  
Rebecca Singer ◽  
Grace Leo ◽  
Tessa Davis ◽  
Ben Lawton ◽  
Henry Goldstein ◽  
...  

Previous research has examined the utilisation of musical cues to improve the performance of cardiopulmonary resuscitation (CPR) delivered in training environments. We postulated a musical cue that is both contemporary and transcends cultures may improve CPR performance. Our aim was to establish whether chest compressions are performed with improved rate and depth if a song of a fixed beat (PinkFong’s ‘Baby Shark’ with a tempo of 115 beats per minute (bpm) and 15 beats in each verse) is played to a healthcare professional immediately before undertaking CPR compared to whale noises (a non-metronomic rhythm). 58 Participants of a paediatric conference (majority doctors) were randomly assigned to listen to a minute of Baby Shark (28) or whale song (30) and then undertake a minute of CPR. There was no significant difference in the mean compression rate between the Baby Shark and control groups, with the groups achieving 121 and 125 bpm, respectively (p=0.18). In relation to compression depth within the target zone, the Baby Shark group had more compressions completed within the target zone (55%) than the control group (39%) although this difference was not significant (p=0.08). Listening to Baby Shark prior to undertaking simulated CPR does not improve overall performance, but there is a potential tendency to improve adequate compression depth which may be beneficial in training exercises.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Fatima M Ezzeddine ◽  
Antoine N Saliba ◽  
Vaibhav Jain ◽  
Hector R Villarraga ◽  
Joerg Herrmann ◽  
...  

Introduction: Several chemotherapy agents, especially anthracyclines, are associated with the development of non-ischemic cardiomyopathy. When chemotherapy-induced cardiomyopathy (CHIC) is associated with left bundle branch block (QRS >150 ms) and a left ventricular ejection fraction (LVEF) of 35% or lower, cardiac resynchronization therapy (CRT) is often utilized to improve cardiac function and relieve symptoms. Hypothesis: CRT is associated with improvement in left ventricular strain in patients with CHIC. Methods: The study included 22 patients with CHIC and 44 age- and gender-matched controls with other types of NIC who underwent CRT implantation between 2004 and 2017. LVEF, left ventricular global longitudinal strain (GLS), systolic strain rate (SRS), and early diastolic strain rate (SRE) were assessed at baseline and 6-18 months after CRT. CRT response was defined as LVEF improvement by >5% after CRT. Results: CRT responders had a significant improvement in left ventricular GLS as compared to CRT non-responders in the control group, but not in the CHIC group (Table 1). The mean change in LVEF after CRT was similar between the CHIC and control groups (10 ± 10% versus 11 ± 11%, p= 0.67). The mean change in GLS after CRT was also similar between the two groups (-2.15 ± 4.32 versus -3.57 ± 4.02, p= 0.19). The proportion of patients whose LVEF increased by more than 5% was similar between the two groups (59% in the CHIC group versus 68% in the control group, p= 0.46). The mean changes in LV myocardial systolic and early diastolic strain rates were similar between the CHIC and control groups. Mean SRS decreased by 0.13 ± 0.14 in the CHIC group and by 0.34 ± 1.28 in the control group (p=0.45). Mean SRE increased by 0.06 ± 0.18 in the CHIC group and by 0.07 ± 0.22 in the control group (p=0.86). Conclusions: CRT is associated with improvement in left ventricular strain in patients with CHIC. Prospective studies are needed to further evaluate the echocardiographic strain outcomes of CRT in CHIC.


Author(s):  
Mohammed bin Majed bin Shariah al - Shammari

The aim of this study was to identify the effectiveness of teaching role playing strategy in developing dialogue skills in the immortal language of the intermediate third grade students. To achieve the objectives of the study, the researcher used the semi-experimental method by designing the two equal groups. The sample contains 51 students, 26 students for the control group and 25 students for the experimental group. The researcher used the statistical treatments using the SPSS program, The study has resulted in The results showed that the level of dialogue skills on the student scale among the average third-grade students in the experimental and control groups was medium. The mean of the two groups was on all dialogue skills (2.23). The skill of expressing the opinion is one of the most common dialogue skills, (2.25), while the skill of listening and listening is second, with an average of (2.24), followed by self-esteem in third place with an average of 2.23. Finally, ). In addition, there were statistically significant differences at the level of α 0.05 0.05 in post-performance in all dialogue skills (self-esteem, good listening and listening, respect for others, expression of opinion). In the light of its findings, the researcher made a number of recommendations.


Author(s):  
Salim Ahmed Saif Al-rashdi

    The present study aimed at uncovering the effectiveness of employing the enrichment activities for mental thinking on the development of mathematical thinking and achievement among Grade 7 students. To achieve the research objectives, the researcher used the semi experimental design known as the design of the control group with the tribal and remote tests. In light of the experimental design, the average Grade 7 students tested the sample of the study in the second semester of 30 students who were divided into 15 students for the experimental group and 15 students for the control group after checking the validity and stability of the tools. The results showed that there was a statistically significant difference at (0.05) between the mean scores of the experimental and control groups in the cognitive achievement test related to the unit of Engineering in the second semester and the mathematical thinking test for the average of the experimental group. The results also showed a statistically significant difference) between the average scores of the experimental group students in the tribal and remote applications in the cognitive achievement test and the mathematical thinking test, and in favor of the average post-implementation. In the light of these results, the study presented a number of recommendations and suggestions.   ، ، ، ،


Nutrition is one of the main problems in the world, where the number of malnourished patients reaches less than 104 million children and one third of all causes of child mortality worldwide are still caused by malnutrition. Nutrition knowledge in school-aged children is one of the factors determining patterns food consumption and nutritional status. Nutrition education in school-aged children can improve children's nutritional knowledge and play a role in food selection and eating habits. Nutrition education should start from an early age. Nutrition and health education began to be directed at kindergarten and elementary school students, since this age group has a habit of attitude that is relatively easy to be formed. This study aims to determine the effect of nutrition education by story’s telling with pirzi doll media to increase knowledge and attitude of children about balanced nutrition. This study used quasi-experimental design with two group pre and post-test design sampling was carried out with a systematic random sampling. Sample of research were children enrolled in Kindergarten IT Rabbani and IT Menara Fitrah in Ogan Ilir District. There were 37 samples on control group dan 39 samples on experimental group. The results of statistical analysis using Mann-Whitney test. The mean score of knowledge after being given a nutritional education was 26.15 ± 3.10 in the experimental group and in the control group was 26.05± 3.16 (p-value=0.817). The mean score of attitudes after being given a nutritional education was 13.69 ± 1.97 in the experimental group and in the control group was 11.24 ± 3.67 (p-value=0.002). There was no difference in mean score of knowledge between the experimental and control groups after being given a nutritional education. There was a difference in mean values of attitudes between the experimental and control groups after being given a nutritional education.


Author(s):  
Merdan Serin ◽  
Mehmet Bayramiçli ◽  
Özlem Tuğçe Çilingir Kaya ◽  
Hilal Nişva Levent ◽  
Zeynep Deniz Akdeniz Doğan ◽  
...  

Abstract Introduction Vasospasm is a major problem following microsurgical reconstruction which can result in the partial or complete loss of the flap tissue. The aim of this study was to investigate the efficiency of hydrodilatation for the prevention of vasospasm. Material and Methods Thirty male Wistar rats were used for this experimental study. Femoral arteries of were exposed, photographed, and transected. In group 1, group 2, and group 3 papaverine solution, hydrodilatation, and minimal mechanical dilatation (control group) was performed, respectively. The anastomosis was completed and the arteries were photographed again 10 minutes after completion of the anastomosis. Following 7-day period samples for transmission electron microscopy (TEM) and light microscopy were obtained. Results The mean vessel diameters prior to transection were 0.43, 0.45, and 0.52 mm in the papaverine, hydrodilatation, and control groups, respectively. The mean vessel diameter 10 minutes following the completion of anastomosis was 0.76, 0.75, and 0.51 mm in the papaverine, hydrodilatation, and control groups, respectively. Median score for papaverine group regarding histological parameters of regular endothelial lining and lumen, neutrophil infiltration, vascular congestion, and edema in tunica adventitia was 2, 3, 2, and 3 positive, respectively. Median score for the papaverine group regarding histological parameters of regular endothelial lining and lumen, neutrophil infiltration, vascular congestion, and edema in tunica adventitia was 3, 3, 3, and 3 positive, respectively. All the histological scores were negative in the control group. The difference between the control group and the experiment groups 1 and 2 was significant regarding all four histological parameters (p < 0.05). Conclusion Hydrodilatation and papaverine application were both effective in preventing vasospasm following microsurgical intervention but papaverine caused slightly less damage to the endothelial lining and less edema in the tunica adventitia when compared with the hydrodilatation. Hydrodilatation group showed a vasodilatory effect that was statistically similar to that of papaverine, which has a proven efficacy.


1991 ◽  
Vol 62 (2) ◽  
pp. 60-61
Author(s):  
T. L. Taljaard ◽  
S. J. Terblanche ◽  
H. J. Bertschinger ◽  
L. J. Van Vuuren

This investigation was designed to determine whether or not the technique of intrauterine insemination affects the length of the subsequent oestrous cycle. Dorper ewes (n=31) were divided into treatment and control groups. All the ewes were synchronised using 40 mg fluorogestone acetate intravaginal sponges for 14 d and 300 IU pregnant mare serum gonadotrophin on the day of sponge removal. A standard semen diluent was deposited laparoscopically in each uterine horn of ewes in the treatment, group. Teaser rams were used to detect oestrus. Progesterone profiles were used to confirm oestrus. The mean oestrous cycle length of 17,83 ± 0,69 d for the group in which the diluent was deposited by laparoscopy did not differ significantly (P0,l) from the 18,36±2,11 d of the control group. The technique of laparoscopic insemination did not influence the length of subsequent oestrous cycles.


Author(s):  
Erdal Kurnaz ◽  
Yaşar Şen ◽  
Süleyman Aydın

AbstractBackground:The aim of this study was to determine the serum levels of kisspeptin and ghrelin (GAH), as well as the relationship of these two peptides with each other in premature thelarche (PT) and premature adrenarche (PA) cases and to investigate the possibility of using these peptides as markers in the differentiation of puberty disorders.Methods:A PT group aged 1–8 years (n = 40), a PA group aged 1–9 years (n = 23, female/male = 20/3) and control groups consistent with each of the previous groups in terms of age and gender were created for the study. Kisspeptin and ghrelin levels were measured with ELISA methods from blood samples drawn while fasting in the morning.Results:When the PT group was compared with the controls, the plasma kisspeptin levels of the cases were significantly higher than the control group (165.47 ± 15.45 pmol/L, 96.82 ± 12.33 pmol/L, p = 0.005, respectively). Kisspeptin levels in the PA group did not show a difference with the control group (121.36 ± 17.99 pmol/L, 95.52 ± 11.54 pmol/L, p = 0.249, respectively). No significant difference could be found when GAH levels in the PT and PA groups were compared with controls. No significant correlation was found between kisspeptin and GAH levels in the PT and PA groups.Conclusions:Our results indicate that kisspeptin plays an important role in the PT, but GAH is not associated with puberty disorders.


2000 ◽  
Vol 84 (5) ◽  
pp. 775-779 ◽  
Author(s):  
Ramendra N. Mazumder ◽  
Hassan Ashraf ◽  
Syed S. Hoque ◽  
Iqbal Kabir ◽  
Naseha Majid ◽  
...  

To date there have been few reports on the impact of dietary intervention on the clinical course of acute shigellosis. Current management of acute shigellosis is primarily focused on antibiotic therapy with less emphasis on nutritional management. In a randomised clinical trial, we examined the role of an energy-dense diet on the clinical outcome in malnourished children with acute dysentery due to shigellosis. Seventy-five children aged 12–48 months with acute dysentery randomly received either a milk–cereal formula with an energy density of 4960 kJ/l (test group) or a milk–cereal formula with energy of 2480 kJ/l (control group) for 10 d in hospital. In both milk–cereal formulas, protein provided 11 % energy. In addition, the standard hospital diet was offered to all children and all children received an appropriate antibiotic for 5 d. The mean food intakes (g/kg per d) in the test and control groups were: 112 (SE 2·28) AND 116 (se 3·48) (P=0·16) on day 1; 118 (se 2·72) and 107 (se 3·13) (P=0·04) on day 5; 120 (se 2·25) and 100 (se 3·83) (P=0·04) on day 10. The mean energy intakes (kJ/kg per d) in the test and control groups respectively were: 622 (se 13·2) and 315 (se 11·3) (P<0·05) on day 1; 655 (se 15·1) and 311 (se 7·98) (P<0·05) on day 5; 672 (se 14·7) and 294 (se 11·1) (P<0·05) on day 10. The food and energy intakes were mostly from the milk–cereal diet. There was no difference between two groups in resolution of fever, dysenteric (bloody and or mucoid) stools, stool frequency and tenesmus. However, vomiting was more frequently observed among the test-group children during the first 5 d of intervention (67 % v. 41 %, P=0·04). There was an increase in the mean weight-for-age (%) in the test group compared with the control group after the 10 d of dietary intervention (6·2 (se 0·6) v. 2·7 (se 0·4), P<0·01). In addition, resolution of rectal prolapse was better (26 % v. 8 %, P=0·04) in the test group v. control group after 5 d, and 13 % v. 6 %, (P=0·08) after 10 d of dietary intervention. Supplementation with a high-energy diet does not have any adverse effect on clinical course of acute shigellosis and reduces the incidence of rectal prolapse in malnourished children.


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