Does Glutamine Concentration Depends on the Type of the Operation?

Glutamine is the main amino acid which is substrate for gluconeogenesis in postoperative period. It is suggested that this leads to a substantial and a long-term decline in glutamine concentration. Glutamine is a source of energy for the synthesis of nucleotides, lymphocytes and cells of gastrointestinal tract. In this study, 79 patients were qualified to a coronary artery bypass surgery (Group I) or a surgery in the large intestine area (Group II). The objectives of this study were: evaluation of the impact of surgical procedures on the serum concentration of glutamine of the operated patients, assessment of gender, weight and BMI impact on glutamine concentration and analysis of the correlation between glutaminę serum concentration and laboratory parameters. The mean concentration of glutamine before surgery, the 3rd and 5th day after surgery was higher in Group I. CRP level in the 3rd and 5th postoperative day was higher in Group II. There were no significant differences betweengroups when it comes to BMI and the concentration of CRP (p <0.05). Glutamine concentration depends on the severity of inflammation, the operated body cavity and the intensified catabolism which results from different pathophysiology of digestive system diseases and coronary arterial disease.

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Impact of Age on Short- and Long-Term Outcomes after Pancreatoduodenectomy for Periampullary Neoplasms

Gastroenterology Research and Practice ◽

10.1155/2020/1793051 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Mario Gruppo ◽

Francesca Tolin ◽

Boris Franzato ◽

Pierluigi Pilati ◽

Ylenia Camilla Spolverato ◽

...

Keyword(s):

Overall Survival ◽

Elderly Patients ◽

Adjuvant Treatment ◽

Long Term Outcomes ◽

Group I ◽

Periampullary Neoplasms ◽

Short And Long Term ◽

Group Ii ◽

The Impact

Background. Although mortality and morbidity of pancreatoduodenectomy (PD) have improved significantly over the past years, the impact of age for patients undergoing PD is still debated. This study is aimed at analyzing short- and long-term outcomes of PD in elderly patients. Methods. 124 consecutive patients who have undergone PD for pancreas neoplasms in our center between 2012 and 2017 were analyzed. Patients were divided into two groups: group I (<75 years) and group II (≥75 years). Demographic features and intraoperative and clinical-pathological data were collected. Primary endpoints were perioperative morbidity and mortality; complications were classified according to the Clavien-Dindo Score. Secondary endpoints included feasibility of adjuvant treatment and overall survival rates. Results. A total of 106 patients were included in this study. There were 73 (68.9%) patients in group I and 33 (31.1%) in group II. Perioperative deceases were 4 (3.6%), and postoperative pancreatic fistulas were 34 (32.1%). Significant difference between two groups was demonstrated for the ASA Score (p=0.004), Karnofsky Score (p=0.025), preoperative jaundice (p=0.004), and pulmonary complications (p=0.034). No significance was shown for diabetes, radicality of resection, stage of disease, operative time, length of stay, postoperative complications according to the Clavien-Dindo Score, postoperative mortality, pancreatic fistula, and reoperation rates. 69.9% of the patients in group I underwent adjuvant treatment vs. 39.4% of the older ones (p=0.012). Mean overall survival was 28.5 months in group I vs. 22 months in group II (p=0.909). Conclusion. PD can be performed safely in elderly patients. Advanced age should not be an absolute contraindication for PD, even if greater frailty should be considered. The outcome of elderly patients who have undergone PD is similar to that of younger patients, even though adjuvant treatment administration is significantly lower, demonstrating that surgery remains the main therapeutic option.

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The impact of long-term biologics/target therapy on bone mineral density in rheumatoid arthritis: a propensity score-matched analysis

Rheumatology ◽

10.1093/rheumatology/kez655 ◽

2020 ◽

Vol 59 (9) ◽

pp. 2471-2480 ◽

Cited By ~ 3

Author(s):

Jia-Feng Chen ◽

Chung-Yuan Hsu ◽

Shan-Fu Yu ◽

Chi-Hua Ko ◽

Wen-Chan Chiu ◽

...

Keyword(s):

Propensity Score ◽

Propensity Score Matching ◽

Target Therapy ◽

Lumbar Vertebra ◽

Mineral Density ◽

Osteoporosis Therapy ◽

Group I ◽

Group Ii ◽

The Impact

Abstract Objectives To investigate changes in BMD in RA patients receiving 3-year biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD) or conventional synthetic DMARD (csDMARD). Methods Patients with RA were recruited from September 2014 until March 2019. Clinical characteristics, BMD and evidence of fragility fractures at enrolment were documented. Participants were treated according to the National Institute for Health and Care Excellence (NICE) guidelines over a 3-year observation period. Repeated BMD was measured at the end of the study period. Participants were grouped into those receiving b/tsDMARD or csDMARD and by propensity score matching (1:2). Results A total of 388 participants completed the 3-year follow-up. After propensity score matching, 92 and 184 participants were allocated to the b/tsDMARD (Group I) and csDMARD (Group II), respectively. After 3 years, BMD remained stable at the femoral neck (FN), hip (total) (TH) and lumbar vertebra (L1-4) (P =0.09, 0.15, 0.87) in Group I. However, BMD decreased significantly in Group II (P=0.045, <0.001, 0.004) at corresponding sites. Participants receiving combined b/tsDMARD and anti-osteoporosis therapy experienced a greater BMD preserving effect than other subgroups. Conclusion Long-term b/tsDMARDs therapy had protective effects on bone loss for patients with RA. Patients receiving concomitant anti-osteoporosis therapy and b/tsDMARDs therapy experienced the greatest BMD preserving effect.

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Semiautomatic Volumetry of Low Attenuation of Thoracic Aortic Plaques on Curved Planar Reformations Using MDCT Angiographic Data with 0.5 mm Collimation

BioMed Research International ◽

10.1155/2018/3563817 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Kenji Mizutani ◽

Izumi Torimoto ◽

Zenjiro Sekikawa ◽

Toshiaki Nishii ◽

Takashi Kawasaki ◽

...

Keyword(s):

Aortic Arch ◽

Correlation Coefficients ◽

Arterial Disease ◽

Plaque Volume ◽

Coronary Arterial Disease ◽

Severe Atherosclerosis ◽

Aortic Plaques ◽

Noncalcified Plaque ◽

The Impact

To evaluate the relationship of aortic low attenuation plaque volume (LAPV) on multidetector computed tomography (MDCT) with the abdominal aortic aneurysm (AAA), the coronary arterial disease (CAD, ≥50% stenosis), severe (≥90% stenosis) CAD, hypertension, and long-term (≥10 years) hypertension. Curved planar reformations (CPR) of three segments (the ascending, the arch, and the upper descending aorta) of the thoracic aorta were generated with attenuation-dependent color codes to measure LAPV with 0~29 HU and total noncalcified plaque volume (TNPV) with 0~150 HU in 95 patients. Correlation coefficients were employed to assess the impact of each LAPV and TNPV on AAA, CAD, severe CAD, hypertension, and long-term hypertension. Each Mean LAPV/cm and TNPV/cm was statistically greater in the aortic arch than the ascending (p<0.001 on each) or the proximal descending segment (p<0.001 on each). LAPV in the aortic arch has moderate correlations with AAA, severe CAD, and long-term hypertension (r=0.643, 0.639, 0.662, resp.). Plaque volumes in each aortic segment can be measured clinically and the increasing LAPV in the arch may be a significant factor associated with the development of severe atherosclerosis underlying AAA, severe CAD, and long-term hypertension.

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The impact of early acute rejection on kidney graft survival after repeat kidney transplantation

Transplantologiya The Russian Journal of Transplantation ◽

10.23873/2074-0506-2021-13-3-260-271 ◽

2021 ◽

Vol 13 (3) ◽

pp. 260-271

Author(s):

A. V. Pinchuk ◽

N. V. Shmarina ◽

I. V. Dmitriev ◽

E. S. Stolyarevich ◽

N. V. Natalya V. Zagorodnikova ◽

...

Keyword(s):

Kidney Transplantation ◽

Acute Rejection ◽

Graft Survival ◽

Postoperative Period ◽

Kidney Graft ◽

Group I ◽

Group Ii ◽

Kidney Transplantations ◽

The Impact

Introduction. Despite the improvements in immunosuppressive therapy, the growing number of repeat kidney transplantations and associated risks of acute rejection make it relevant to assess the impact of early acute rejection on a long-term kidney graft survival.Objective. The aim of the study was to evaluate the rate, the clinical aspects of early acute rejection after repeat kidney transplantation and the outcomes of its treatment, to perform the assessment of the impact of rejection episodes on a long-term kidney graft survival.Material and methods. We carried out the retrospective analysis of kidney graft survival after 121 repeat kidney transplantations performed in N.V. Sklifosovsky Research Institute for Emergency Medicine in the period from 2007 to 2018. Group I included 96 recipients after kidney transplantation without acute rejection in postoperative period. Group II consisted of 25 patients with early acute rejection after kidney transplantation. We performed the assessment of the impact of early acute rejection on the kidney graft survival in comparison with recipients with uncomplicated postoperative period. Statistical processing was carried out by nonparametric methods. Survival was assessed using the Kaplan–Meier curves.Results. 1-year and 3-year kidney graft survival rates amounted to 90.3% (95%, confidence interval 85–95) and 85.4% (95%, CI 79–91), respectively, in recipients of Group I; and 72% (95%, CI 58–86) and 60% (95%, CI 46–76) in patients of Group II. Significant differences in 1-year and 3-year kidney graft survival between patients of Group I and II have been noticed (P=0.0022 and P=0.0065, respectively).Conclusions. Patients with early acute rejection after kidney transplantation had poorer kidney graft survival in comparison with patients without rejection episodes in postoperative period.

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Impact of hemodialysis on the wellbeing of chronic kidney diseases patients: a pre-post analysis

Middle East Current Psychiatry ◽

10.1186/s43045-020-00060-x ◽

2020 ◽

Vol 27 (1) ◽

Author(s):

Um-e-Kalsoom ◽

Sabiha Khan ◽

Israr Ahmad

Keyword(s):

Quality Of Life ◽

Social Support ◽

Perceived Social Support ◽

Kidney Diseases ◽

Chronic Kidney Diseases ◽

Group I ◽

Significant Difference ◽

Group Ii ◽

The Impact

Abstract Background Hemodialysis may have serious psychological impact upon patients suffering from chronic kidney diseases. The aim of the present study is to investigate the impact of hemodialysis on the wellbeing of individuals with chronic kidney diseases (CKD). Result A sample consists of (N = 100) CKD patients referred from neurology ward of Leady Reading Hospital Peshawar. Data was collected from both male (50%) and female (50%) in 2017. Participants were divided into two groups on the basis of pre-set criteria. In group I, individuals with 4–5 stage of CKD referred first time for dialysis treatment were recruited. Group II comprised of CKD patients with 1–3 stage. Demographic data sheet, Pakistan Anxiety and Depression, WHO Quality of Life scale, and Perceived Social support scale (PSS) were used to test the hypotheses. Paired sample t test was use to see the difference between pre- and post-analysis of depression, anxiety, QOL, and PSS in group I (experimental group). Results suggests significant difference on depression (p > .001), anxiety (p > .001), and QOL (p > .001), while no significant difference was reported on perceived social support (p <.673). Findings also indicate no significant difference between group I and group II on QOL depression, anxiety, and PSS. Conclusion The findings concluded that patients under hemodialysis treatment suffered from depression, anxiety, and poor quality of life.

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The Effects of Long-Term Administration of Sodium Nedocromil on Bronchial Hypereactivity

European Journal of Inflammation ◽

10.1177/1721727x0300100305 ◽

2003 ◽

Vol 1 (3) ◽

pp. 119-123 ◽

Cited By ~ 1

Author(s):

G. Ilonidis ◽

G. Anogianakis ◽

CH. Trakatelli ◽

A. Anogeianaki ◽

M. Chomatidis ◽

...

Keyword(s):

Allergic Asthma ◽

Term Treatment ◽

Bronchial Hyperreactivity ◽

Methacholine Challenge ◽

Intrinsic Asthma ◽

Group I ◽

Long Term Treatment ◽

The Mean ◽

Group Ii

The effect of long-term treatment with sodium nedocromil on airway hypereactivity was investigated in two groups of 20 patients each. Group I patients presented with allergic asthma while Group II patients presented with intrinsic asthma. For each subject of the two groups, the base FEV1 was measured and nebulized methacholine was administrated in consecutively higher concentrations until a decrease in FEV1 of >20 % was observed. Following measurement, all patients included in the study were treated with 12 mg of sodium nedocromil per day for 12 months. At the end of the treatment, bronchial hyperreactivity was evaluated for a second time by administering the same dosage of methacholine that originally produced a decline in FEV1 of >20 %. In Group I patients (allergic asthma) mean FEV1 was 3126 ml, before challenge, while after methacholine challenge FEV1 was 2400ml. Following 1-year of sodium nedocromil administration the FEV1 was 2601ml (P<0.05). Before treatment, the mean fall in FEV1, following methacholine challenge, was 23.67% while following a 1-year-long sodium nedocromil administration this value reduced to 15.70% (P<0.05). Correspondingly, PC20 was 5.59 while after sodium nedocromil administration it increased to 11.66 (P<0.05). In Group II patients (intrinsic asthma) mean FEV1 was 2750 ml, before challenge, while after methacholine challenge FEV1 was 2066ml. Following 1-year of sodium nedocromil administration the FEV1 was 2223ml (P<0.05). Before treatment, the mean fall in FEV1, following methacholine challenge, was 27.65 % while following a 1-year-long sodium nedocromil administration this value reduced to 21.92 % (P<0.05). Correspondingly, PC20 was 5.91 while after sodium nedocromil administration it increased to 6.19 (P<0.05). The results suggest a positive effect of long-term sodium nedocromil administration in bronchial hyperreactivity for both groups of patients.

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The impact of ureteral Double-J stent insertion following ureterorenoscopy in patients with ureteral stones accompanied by perirenal fat stranding

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2018.1.15 ◽

2018 ◽

Vol 90 (1) ◽

pp. 15

Author(s):

Ercan Ogreden ◽

Ural Oguz ◽

Erhan Demirelli ◽

Erdal Benli ◽

Özkan Özen

Keyword(s):

Ureteral Stone ◽

Ureteral Stones ◽

Stent Insertion ◽

Female Ratio ◽

Group I ◽

Dj Stent ◽

Group Ii ◽

Fat Stranding ◽

The Impact ◽

Perirenal Fat

Objective: To evaluate the impact of ureteral stent insertion following semirigid ureterorenoscopy (URS) in patients with perirenal fat stranding (PFS) due to ureteral stones. Material and methods: Data of 600 patients who underwent URS were analyzed retrospectively. Seventy-two patients detected to have PFS accompanying ureteral stone were included. Patients who did not undergo double J (DJ) stent insertion following semirigid URS were classified as Group I (n: 52), while those who underwent stent insertion were classified as Group II (n: 20). Side distribution; localization of the stones, stone size, presence of fever, urinary tract infection (UTIs) and urosepsis rates were compared in the two groups. Results: The average age of the patients was 44.4 (20-71) years. Male/female ratio and side of the stone location showed similar distribution in both groups (p > 0.05). Fever occurred in 23 cases (44.2%) in Group I and in 15 cases (75%) in Group II (p = 0.038). UTIs occurred in 15 cases (28.9%) in Group I and in 12 cases (60%) in Group II (p = 0.03). Urosepsis presented in 3 (5.8%) and 5 (25%) of the patients in Group I and II, respectively (p = 0.033). Conclusions: According to our results, ureteral DJ stent insertion following URS in patients with PFS due to ureteral stone caused an increase on postoperative infection related complications.

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The Effects of Long-Term Treatment by Immunotherapy and Fluticazone on Broncial Hyperreactivity

European Journal of Inflammation ◽

10.1177/1721727x0300100104 ◽

2003 ◽

Vol 1 (1) ◽

pp. 13-16

Author(s):

G. Ilonidis ◽

G. Anogianakis ◽

Chr. Trakatelli ◽

A. Anogeianaki ◽

J. Giavazis ◽

...

Keyword(s):

Provocation Test ◽

Term Treatment ◽

Provocation Tests ◽

Group I ◽

Long Term Treatment ◽

Group Ii ◽

Male Subjects

Thirty subjects (20 female and 10 male), all allergic to the mites D. Pteronyssinus and D. Farinae, participated in the present study which covered a period of four years. The subjects were randomly divided in two groups. Group I included 10 female and 5 male subjects, with an average age of 25.8 (+/− 3.5) years who received immunotherapy only. Group II had an average age of 31.5 (+/− 4) years and they received immunotherapy along with fluticazone propionate (1000mcg/day). The protocol for immunotherapy was the same for both groups. The basis FEV1 was determined for each subject of both Groups I and II and afterwards they were subjected to provocation tests of nebulized methacholine solution administered in consecutively larger concentrations until a drop in FEV1 >20 % (PC20), was observed. Three years later, when their therapy was completed, all subjects were subjected to the same provocation test and a significant reduction in bronchial hyperactivity was documented for both groups. In particular, for Group I, the percentage of change in FEV1 values was 27.25 +/- 5.23 % and PC20 5.11 +/− 2.64 mg/ml before immunotherapy, while after immunotherapy the same indicators were 22.22 +/- 7.08 % (P<0.05) and 6.85 +/− 4.03 mg/ml, (P<0.05) respectively. For Group II, the percentage of change in FEV1 values was 26.28 +/− 2.5 % and PC20 5.42 +/− 2.5 mg/ml before immunotherapy, while after immunotherapy the same indicators were 12.27 +/- 2.49 % (P<0.01)and 11.64 +/− 5.14 mg/ml, P<0.01 respectively. It is concluded that although significant reduction in hyperreactivity can be achieved through immunotherapy, the combination of immunotherapy with daily fluticazone propionate administration shows the most promising results.

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Psychosocial profile of encopretic children and their caregivers in relation to parenting style

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1297 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S362-S362 ◽

Cited By ~ 1

Author(s):

E. Zaky ◽

M. Rashad ◽

H. Elsafoury ◽

E. Ismail

Keyword(s):

Parenting Style ◽

Parenting Styles ◽

Healthy Controls ◽

Psychosocial Profile ◽

Group I ◽

Egyptian Children ◽

Paternal Anxiety ◽

Group Ii ◽

Anxiety Depression ◽

The Impact

BackgroundThe role of psychological factors in the development and maintenance of encopresis is controversial.ObjectivesAssessment of the psychosocial profile of encopretic children and their caregivers in relation to parenting style compared to controls.MethodologyThe current cross sectional study comprised 90 Egyptian children classified into three groups: group I (encopresis without constipation and overflow incontinence), group II (encopresis with constipation and overflow incontinence), and group III (clinically healthy controls); each group included 30 children. Thorough clinical evaluation and psychometric assessment were carried out for all enrolled children while caregivers were evaluated for their parenting styles, anxiety, depression, and introversion scores.ResultsHardness, undue blaming, and indecisive parenting styles were significantly more prevalent among caregivers of group I. Encopretic children of group I & II had poorer self-esteem and higher prevalence of clinically manifest depression compared to healthy controls. Furthermore, there was a higher prevalence of clinically manifest paternal anxiety, depression, and introversion and maternal depression among caregivers of group II and higher prevalence of clinically manifest paternal anxiety and depression among fathers of group I.ConclusionThe approach of toilet training, not the time of its initiation, seems to be the factor that really matters in predisposing to and perpetuating encopresis. Further exploration is needed to determine if the documented association of psychological disorders of enrolled encopretic children and their caregivers was causal or being just the impact of the child's encopresis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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