scholarly journals Safety and efficacy of low-dose subcutaneous erythropoietin in hemodialysis patients.

1997 ◽  
Vol 8 (2) ◽  
pp. 288-293
Author(s):  
K P Parker ◽  
W E Mitch ◽  
J C Stivelman ◽  
E J Macon ◽  
J L Bailey ◽  
...  
Keyword(s):  
Low Dose ◽  
Ferritin Level ◽  
Transferrin Saturation ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Dialysis Session ◽  
Phase 2 ◽  
Safety And Efficacy ◽  
Control Subjects ◽  
And Control

Anemia in hemodialysis patients is effectively treated by intravenous (IV) injections of recombinant human erythropoietin (rHuEPO) at each dialysis session. Because the hormone is effective by subcutaneous (SC) administration, it was decided that this study would evaluate low-dose weekly SC rHuEPO therapy. To determine the safety and efficacy of weekly SC rHuEPO administration to hemodialysis patients, only one third the weekly IV dose was given and the effects were compared with those from an age-, gender-, and nephrologic disease-matched control group treated in the standard fashion. Forty-four patients entered the trial and 27 completed the protocol along with 27 control subjects. During Phase 1, experimental and control subjects received standard IV rHuEPO at dialysis for 6 months. During Phase 2, experimental patients received weekly SC rHuEPO at one third the weekly IV dose for 10 months; control subjects continued to receive IV therapy. In Phase 3, both groups were treated for 6 more months with IV rHuEPO. In Phase 2, there was no significant reduction in hematocrit value, reticulocyte count, transferrin saturation, or ferritin level in the experimental group, even with only one third the weekly rHuEPO IV dose over the 10-month period. There were no significant differences between IV and SC rHuEPO administration or between experimental and control subjects in blood pressure, serum chemistries, or parameters of "dialysis adequacy." It was concluded that low-dose weekly SC rHuEPO administration is a safe and effective method for maintaining the hematocrit level of stable hemodialysis patients. This therapy could enhance the efficacy of rHuEPO and substantially reduce costs while preserving patient care outcomes.

scholarly journals Silent infection in clotted hemodialysis access grafts.

1998 ◽  
Vol 9 (7) ◽  
pp. 1314-1317 ◽  
Author(s):  
J C Ayus ◽  
D Sheikh-Hamad
Keyword(s):  
Graft Infection ◽  
Clinical Signs ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Cost Of Care ◽  
Control Group ◽  
Graft Material ◽  
Control Subjects ◽  
Source Of Infection ◽  
And Control

Thrombotic and infectious complications are frequent causes of hemodialysis vascular access failure and contribute considerably to the cost of care for chronic hemodialysis patients. Although there is clear indication for removal of patent grafts in unresolved bacteremia, there are no guidelines for the management of clotted nonfunctioning grafts. To evaluate for the existence and clinical relevance of silent infection in clotted nonfunctioning hemodialysis grafts, a study was conducted with a series of 20 hemodialysis patients who presented with fever (15 patients), or fever and clinical signs of sepsis (five patients), in whom the source of infection was not immediately localized to any organ system. Comparison was made with 21 asymptomatic patients with clotted grafts who served as control subjects. All patients and control subjects came from a pool of 115 chronic hemodialysis patients in an outpatient hemodialysis unit in the Houston metropolitan area, who were on hemodialysis for a period of time ranging from 3 to 15 yr. Indium scans were performed, followed by removal of the clotted grafts in all patients and control subjects. Bacterial cultures of the recovered surgical material and blood were done concomitantly in all study participants. Indium scans showed positive uptake in or around the clotted grafts in all of the patients and in 15 of the control subjects. Purulent material was found in the grafts in all patients and in 13 of 15 indium scan-positive control subjects. When positive, blood culture pathogens were identical to those cultured from the graft material in all instances. The predominant pathogens were Staphylococcus aureus, followed by Staphylococcus epidermidis. There was no evidence of graft infection in the control subjects if indium scan was negative. Chart review dating back to the start of dialysis revealed five past infectious episodes in the patient group, compared with four in the control group. These findings suggest that clotted nonfunctioning grafts are frequent harbingers of infection. They should be suspected as the source of infection in every hemodialysis patient that presents with fever, even in the absence of clinical signs of graft site infection.

Melatonin Improves Erythropoietin Hyporesponsiveness via Suppression of Inflammation

2019 ◽  
Vol 14 (3) ◽  
pp. 203-208
Author(s):  
Evan Noori Hameed ◽  
Haydar F. Hadi AL Tukmagi ◽  
Hayder Ch Assad Allami
Keyword(s):  
Iron Status ◽  
Transferrin Saturation ◽  
Control Group ◽  
Base Line ◽  
Inadequate Response ◽  
Inflammatory Parameters ◽  
Tnf Α ◽  
Before And After ◽  
And Control ◽  
Controlled Clinical Study

Background: Inadequate response to Erythropoietin Stimulating Agents (ESA) despite using relatively larger doses regimen represents a potential risk factor of Cardiovascular (CV) related mortality in addition to health-care economic problems in anemic patients with Chronic Kidney Disease (CKD). Erythropoietin (EPO) hyporesponsiveness related to inflammation has been increased progressively. Melatonin is well known as a potent anti-inflammatory agent. Therefore, the current study was designed to evaluate whether melatonin could improve anemic patients response to EPO. Methods: This single controlled clinical study was carried out in 41 CKD patients with hemoglobin (Hb) levels less than 11g/dl divided randomly in a 1:1 ratio into 2 groups; treatment group who received 5mg melatonin plus their regular treatments and control group who received their regular treatments only. Hematological and iron status parameters include Hb level, serum iron (S. iron), Transferrin Saturation Ratio (TSAT) and serum ferritin (S. ferritin) in addition to inflammatory parameters that include tissue necrotic factor alfa (TNF-α), interleukin-1beta (IL-1β) and interleukin-6 (IL-6) determined before and after 12 weeks of treatment. Results: Melatonin remarkably increases the Hb level with a significant increase in S. iron and TSAT compared to baseline. The elevation of S. iron and TSAT was significantly higher in the melatonin group. Additionally, all inflammatory markers estimated were reduced significantly by melatonin compared to base line and control group. Conclusion: The results of the current study showed that melatonin has an advantageous effect on improving EPO response in anemic patients with CKD.

A randomized controlled clinical trial to evaluate safety and efficacy of a Unani formulation in the management of Kalaf (Melasma)

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ifra Abdul Qaiyyum ◽  
Mohammad Nawab ◽  
Munawwar Husain Kazmi
Keyword(s):  
Quality Of Life ◽  
Test Group ◽  
Control Group ◽  
Safety And Efficacy ◽  
Randomized Controlled ◽  
End Point ◽  
Intergroup Comparison ◽  
And Control ◽  
Change In Mean

Abstract Objectives Kalaf (Melasma) is an acquired facial hypermelanism. It has direct impact on patient’s quality of life and leads to development of various personality disorders. Lack of effective treatment and recurrences have drawn the attention of researcher to find alternative treatment. This study aimed to evaluate safety and efficacy of a topical Unani formulation in the management of melasma. Methods We conducted a prospective randomized controlled clinical study on the participants diagnosed with melasma. The participants (n=72) randomized into test (n=36) and control (n=36) groups. Sixty participants (n=30 in each group) completed the duration of therapy. The participants of the test group were treated with a classical Unani formulation and control group with hydroquinone 4%. The primary end point was change in mean MASI score and secondary end point was improvement in quality of life after eight weeks of treatment. Results The Unani formulation reduced 40.5% mean MASI score (17.31 ± 9.58 to 10.28 ± 5.92) in comparison to 32% reduction in mean MASI score (20.58 ± 9.49 to 13.92 ± 7.38) in the control group after eight weeks of treatment. When comparing with baseline the difference in MASI score was found statistically significant in both groups (p<0.05). On intergroup comparison, the change in MASI score between both groups was not statistically significant (p>0.05). In addition, MQOL and DQLI also improved significantly in both groups. Conclusions This study concluded that the Unani formulation and the control drug were equally effective and safer in the management of melasma.

scholarly journals Intermuscular Fat Content in Young Chinese Men With Newly Diagnosed Type 2 Diabetes: Based on MR mDIXON-Quant Quantitative Technique

2021 ◽  
Vol 12 ◽  
Author(s):  
Fuyao Yu ◽  
Bing He ◽  
Li Chen ◽  
Fengzhe Wang ◽  
Haidong Zhu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Skeletal Muscle ◽  
Fat Content ◽  
Control Group ◽  
Diabetic Patients ◽  
Diabetes Group ◽  
Control Subjects ◽  
Intermuscular Fat ◽  
And Control

ObjectiveSkeletal muscle fat content is one of the important contributors to insulin resistance (IR), but its diagnostic value remains unknown, especially in the Chinese population. Therefore, we aimed to analyze differences in skeletal muscle fat content and various functional MRI parameters between diabetic patients and control subjects to evaluate the early indicators of diabetes. In addition, we aimed to investigate the associations among skeletal muscle fat content, magnetic resonance parameters of skeletal muscle function and IR in type 2 diabetic patients and control subjects.MethodsWe enrolled 12 patients (age:29-38 years, BMI: 25-28 kg/m2) who were newly diagnosed with type 2 diabetes (intravenous plasma glucose concentration≥11.1mmol/l or fasting blood glucose concentration≥7.0mmol/l) together with 12 control subjects as the control group (age: 26-33 years, BMI: 21-28 kg/m2). Fasting blood samples were collected for the measurement of glucose, insulin, 2-hour postprandial blood glucose (PBG2h), and glycated hemoglobin (HbAlc). The magnetic resonance scan of the lower extremity and abdomen was performed, which can evaluate visceral fat content as well as skeletal muscle metabolism and function through transverse relaxation times (T2), fraction anisotropy (FA) and apparent diffusion coefficient (ADC) values.ResultsWe found a significant difference in intermuscular fat (IMAT) between the diabetes group and the control group (p&lt;0.05), the ratio of IMAT in thigh muscles of diabetes group was higher than that of control group. In the entire cohort, IMAT was positively correlated with HOMA-IR, HbAlc, T2, and FA, and the T2 value was correlated with HOMA-IR, PBG2h and HbAlc (p&lt;0.05). There were also significant differences in T2 and FA values between the diabetes group and the control group (p&lt;0.05). According to the ROC, assuming 8.85% of IMAT as the cutoff value, the sensitivity and specificity of IMAT were 100% and 83.3%, respectively. Assuming 39.25ms as the cutoff value, the sensitivity and specificity of T2 value were 66.7% and 91.7%, respectively. All the statistical analyses were adjusted for age, BMI and visceral fat content.ConclusionDeposition of IMAT in skeletal muscles seems to be an important determinant for IR in type 2 diabetes. The skeletal muscle IMAT value greater than 8.85% and the T2 value greater than 39.25ms are suggestive of IR.

scholarly journals APOPTOSIS INDEX BETWEEN FEMALES AND MALES IN REGULAR HEMODIALYSIS

2016 ◽  
Vol 19 (3) ◽  
pp. 150
Author(s):  
Djoko Santoso
Keyword(s):  
Age Groups ◽  
Microtiter Plate ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Diabetic Patients ◽  
Immunochemical Determination ◽  
Apoptosis Index ◽  
Significant Difference ◽  
And Control ◽  
Esrd Patients

Many reports have documented apoptosis index in hemodialysis patients, but to date, no single study has directly compared the apoptosis index of males to females. Data on mortality rate among hemodialytic patients in the hemodialysis center at the Department of Internal Medicine Dr Soetomo General Hospital, Surabaya, Indonesia show a high number predominated by female patients. Therefore, to answer the question of whether there is a gender difference in apoptosis index, the researcher studied leukocyte responses in male and female hemodialysis patients. The apoptosis index of the sample was measured by indirect immunoassay method. Cell lyses, followed by immunochemical determination of histone-complexed DNA fragments in a microtiter plate wells. The apoptosis quantization was obtained by determining the amount of colored product spectrophotometrically. One hundred and four non-diabetic subjects who received hemodialysis (HD), and 24 normal controls (NC), were evaluated. The apoptosis index in ESRD patients group and control group showed no significant difference (0.6172 vs 0.4008, p=0.114), neither did it vary in both sexes and age groups. When the sex factor was analyzed (after exclusion from the diabetic ESRD patients), females apoptosis index was significantly higher than that of the males (0.7325 vs 0.55175, p<0.05). In conclusion, apoptosis index in females among non-diabetic patients undergoing hemodialysis is higher than that occur in males and controls.

Thyroid Nodules in Patients with Acromegaly: Frequency According to the ACR TI-RADS Classification and its Relationship with Disease Activity

2021 ◽  
Author(s):  
Mustafa Can ◽  
Muhammet Kocabaş ◽  
Melia Karakose ◽  
Hatice Caliskan Burgucu ◽  
Zeliha Yarar ◽  
...  
Keyword(s):  
Disease Activity ◽  
Thyroid Nodules ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Control Group ◽  
Control Subjects ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Mean ◽  
And Control

Abstract Purpose: In our study, we aimed to determine the frequency of thyroid nodules in patients with acromegaly according to the American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS) classification and its relationship with acromegaly disease activity. Methods: A total of 56 patients with acromegaly and age, sex, and body mass index matched with 56 healthy control subjects were included in our study. Thyroid-stimulating hormone, free thyroxine, and anti-thyroperoxidase antibody levels of patients and control subjects were measured. In addition, patients and healthy controls were evaluated by ultrasonography to determine thyroid structure, thyroid volume, and thyroid nodules and to make ACR TI-RADS classification. Results: Thyroid nodules were present in 31 (55.4%) of 56 patients in the acromegaly group and 20 (35.7%) of 56 subjects in the control group, and the frequency of thyroid nodules was significantly higher in the acromegaly group (p=0.038). The mean number of nodules in the acromegaly group and control group was 1.27±1.43 and 0.48±0.73, respectively, and the mean number of nodules was significantly higher in the acromegaly group (p=0.003). The number of patients with TI-RADS 1, TI-RADS 2, and TI-RADS 4 nodules in the acromegaly group was higher than the control group (p=0.026, p=0.049, p=0.007, respectively). No difference was found in terms of cytological findings between those who have undergone FNAB in the acromegaly group and control group. Conclusion: In our study, we found that the frequency of thyroid nodules, the number of thyroid nodules, and the number of TI-RADS 1, TI-RADS 2, and TI-RADS 4 nodules increased in patients with acromegaly. There was no significant difference between acromegaly disease activity and thyroid nodule frequency, number of thyroid nodules, and TI-RADS classifications.

scholarly journals Effect of Astragalus membranaceus Oral Solution on Lifespan and Learning and Memory Ability of Honey Bees

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Tao Hong ◽  
Long-Xue Li ◽  
Xiao-ping Han ◽  
Jing-liang Shi ◽  
Cai-yun Dan ◽  
...  
Keyword(s):  
Learning And Memory ◽  
Honey Bees ◽  
Dose Group ◽  
Low Dose ◽  
Oral Solution ◽  
Astragalus Membranaceus ◽  
Control Group ◽  
High Dose ◽  
The Mean ◽  
And Control

In this study, the effects of Astragalus membranaceus oral solution on lifespan and learning and memory abilities of honey bees were evaluated. Two groups of bees were fed with sucrose syrup (50%) containing low dose (1.33%) and high dose (13.3%) of A. membranaceus oral solution, respectively. The proboscis extension response (PER) analysis was applied to examine the learning and memory capabilities of bees. Two genes related to memory formation in honey bees were determined by real-time PCR. High dose (13.3%) of A. membranaceus significantly decreased the mean lifespan of bees compared to the bees fed with low dose (1.33%) and control bees. No significant differences in lifespan of bees were found between low-dose-fed bees and control bees. The results of PER experiments showed apparent improvement in the memorizing ability of the high-dose group (in comparison with the control group). Moreover, the relative expression levels of Nmdar1 in the low-dose group and control group were significantly lower than those in the high-dose group. It is preliminarily concluded that A. membranaceus has an adverse effect on the mean lifespan of honey bees but might be helpful in strengthening memories.

Effect of Recombinant Human Erythropoietin (R-Huepo) Therapy on Plasma Ft3, FT4, TSH, FSH, LH, free Testosterone and Prolactin Levels in Hemodialysis Patients

1992 ◽  
Vol 15 (10) ◽  
pp. 585-589 ◽  
Author(s):  
M. Yeksan ◽  
N. Tamer ◽  
M. Cirit ◽  
S. Türk ◽  
G. Akhan ◽  
...  
Keyword(s):  
Free Testosterone ◽  
Hemodialysis Patients ◽  
Thyroid Stimulating Hormone ◽  
Sexual Disorders ◽  
Serum Prolactin ◽  
Control Group ◽  
Dialysis Session ◽  
Free Triiodothyronine ◽  
Human Erythropoietin ◽  
Stimulating Hormone

The aim of this study was to evaluate the effect of r-HuEPO treatment on free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), free testosterone and prolactin levels in uremic hemodialysis patients. Twenty-four uremic hemodialysis patients were given r-HuEPO with a dose 60 U/kg as intravenous bolus injection at the end of each dialysis session. Once the hematocrit value of the patient had reached a range of 30-35%, the dose was adjusted so as to keep the hematocrit levels constant. Twenty uremic dialysis patients were taken as control group. The above-mentioned hormone levels of patients and control group were determined before and 4 months after r-HuEPO treatment. After the treatment, serum prolactin levels significantly decreased in both sexes (36.8 ± 7.8 vs 22.9 ± 6.3 ng/ml and 78.3 ±13.3 vs 37.4 ± 10.4 ng/ml male and female, respectively). FT3 and FT4 significantly increased (1.17 vs 1.67 pg/ml, p<0.05, and 0.64 vs 0.084 ng/dl, p<0.05, respectively). TSH levels increased but those changes were not significant. There was no change in the level of any hormone in the control group. Also, the sexual functions of eight male patients treated with r-HuEPO improved and menstruation started again in four female patients. We concluded that r-HuEPO treatment especially decreases prolactin level in uremic hemodialysis patients. It is conceivable that correction of elevated prolactin levels could improve sexual disorders in these patients.

scholarly journals A comparative study of low dose magnesium sulphate therapy with Pritchard’s regime in management of Eclampsia

2019 ◽  
Vol 8 (10) ◽  
pp. 3907
Author(s):  
Vijay M. Kansara ◽  
Payal Sureshkumar Patel ◽  
Ajesh N. Desai
Keyword(s):  
Perinatal Mortality ◽  
Magnesium Sulphate ◽  
Low Dose ◽  
Fetal Outcome ◽  
Control Group ◽  
Average Weight ◽  
Indian Women ◽  
Mortality And Morbidity ◽  
Labour Room ◽  
And Control

Background: Eclampsia is one of the most common causes of maternal and perinatal mortality and morbidity in India. Amongst the principles of management of eclampsia, the first is the control of convulsions. Magnesium sulphate is the main stay of treatment in eclampsia and imminent eclampsia. Average weight of Indian women is less than the western women due to which lower dose of magnesium sulphate can be used.  The aim of the study was to compare the efficacy of low dose magnesium sulphate regimen with standard Pritchard regimen in control of eclampsia.Methods: The study was carried out at emergency labour room, GMERS Sola Civil Hospital Ahmedabad. 120 patients of eclampsia were divided randomly into study group (n=60) receiving low dose MgSO4 and control group (n=60) receiving Pritchard regimen. The recurrence of convulsion, toxicity of MgSO4 and maternal and fetal outcome was studied.Results: It was observed that with low dose MgSO4 regime, convulsions were controlled in 91.7% of the cases. With standard Pritchard’s regime convulsions were controlled in 95% of patients. The maternal and perinatal mortality and morbidity were comparable in both groups.Conclusions: Low dose magnesium sulphate therapy is as effective as Pritchard’s regime for controlling convulsions in eclampsia and can be safely given in Indian women. 

scholarly journals The Effects of Group Discussion Based Education on the Promotion of Self-Management Behaviors in Hemodialysis Patients

2018 ◽  
Vol 7 (4) ◽  
pp. 225-232 ◽  
Author(s):  
Azam Mahjubian ◽  
Nasrin Bahraminejad ◽  
Koorosh Kamali
Keyword(s):  
Group Discussion ◽  
Hemodialysis Patients ◽  
Wilcoxon Test ◽  
Self Management ◽  
Control Group ◽  
Control Groups ◽  
Educational Method ◽  
Management Interventions ◽  
And Control ◽  
Management Behaviors

Introduction: Improving self-management of the patients undergoing hemodialysis is an effective way to reduce complications and to improve the quality of life of them. The current study aims to assess the effects of group discussion on the promotion of self-management behaviors in hemodialysis patients. Methods: In this quasi -experimental clinical trial study (with experimental and control groups) 60 patients were arranged in two experimental and control groups through using convenience sampling with random allocation. Self-management interventions were conducted on the experimental group during 3 to 4 sessions of group discussion. The control group received routine interventions. The data were collected through Li and colleagues' self-management standard questionnaire before and 3 months after the intervention. The data were analyzed via SPSS software version 13 and chi-square, t-test, Mann-Whitney, and Wilcoxon test. Results: The results showed that the mean scores of four dimension of self-management including participation with the medical team, problem solving, self-care and emotional management after the implementation of group were significantly different between the experimental and control groups. Conclusion: Based on the findings, group discussion was an effective educational method to promote self-management of chronic hemodialysis patients. Therefore, holding group discussion to reinforce the self- management behaviors in patients undergoing hemodialysis is recommended.

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