scholarly journals Evaluation of the Effectiveness of Continuous Venovenous Hemodiafiltration Appli̇ed With Oxiris and AN69 Membranes in Patients With Septic Shock-Related Acute Kidney Injury

2020 ◽  
Author(s):  
Cem Kıvılcım Kaçar ◽  
Osman Uzundere ◽  
Enver Yüksel ◽  
Deniz Kandemir ◽  
Esra Akiz Bıçak ◽  
...  
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Infusion Rate ◽  
Kidney Injury ◽  
The Other ◽  
Noradrenaline Infusion ◽  
Continuous Venovenous Hemodiafiltration ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background and objectives: AN69 and Oxiris are filters used in continuous renal replacement therapy. In this study, we aimed to research the effects of these filters on blood cell counts, blood biochemistry, inflammation indicators, clinical status and mortality of patients diagnosed with septic shock-related acute kidney injury. Method: Between March 2019 and October 2019, 42 adult patients (Group 1: Oxiris (n = 21) or Group 2: AN69 (n=21)) with septic shock-related acute kidney injury and received continuous venovenous hemodiafiltration (CVVHDF) in the intensive care unit were included in the study and their results were prospectively observed and compared. The data at the begining of CVVHDF (pre-CVVHDF) and 24 hours after the onset of CVVHDF (post-CVVHDF) were recorded.Results: In the comparison of the pre- and post-CVVHDF values in Group 1, there was a statistically significant decrease detected in the procalcitonin (p = 0.04) and noradrenaline infusion rate (p = 0.02) levels. In terms of the other data there was no statistically significant difference between pre- and post-CVVHDF values in Group 1. In the comparison of the pre- and post-CVVHDF values in Group 2, there was a statistically significant decrease detected in the urea (p = 0.04), platelet count (p = 0.02) and procalcitonin (p = 0.002) levels. There was no statistically significant difference between pre- and post-CVVHDF values in terms of the other data in Group 2. There was no statistically significant difference between the groups in terms of mortality. Conclusions: CVVHDF with Oxiris filter causes a statistically significant decrease in noradrenaline infusion rate. Therefore, we think that the use of CVVHDF with Oxiris filter applied for septic shock-related acute kidney injury will save us time and increase the improvement in the treatment.

scholarly journals Urinary N-Acetyl-Beta-D-Glucosaminidase Activity in Rat Experimental Ischemic and Toxic Models of Acute Kidney Injury

2017 ◽  
Vol 74 (1) ◽  
pp. 105
Author(s):  
Razvan Andrei CODEA ◽  
Mircea MIRCEAN ◽  
Sidonia Alina BOGDAN ◽  
Andras Laszlo NAGY ◽  
Alexandra BIRIS ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Experimental Model ◽  
Wistar Rats ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Kidney Injury ◽  
Control Group ◽  
Tubular Injury ◽  
Group 2 ◽  
Group 1

The identification of a suitable prevention method which facilitates limiting the deleterious effects of acute kidney injuries is highly required. In order to identify a proper treatment for acute kidney injuries, a suitable experimental model that replicates the structural, metabolic and inflammatory lesions that occur in the natural acute injured kidney is highly necessary. Intense urinary NAG activity can be found in a variety of renal disease such as toxic nephropathies, ischemic renal injury following cardiac surgery or renal transplantation but also in glomerular disease especially in diabetic nephropathy. Rises in urinary NAG enzyme activity strongly suggests tubular cell damage and support NAG enzyme as a biomarker of renal tubular injury. The aim of this paper is to obtain a stable in vivo acute kidney injury experimental model, in Wistar, rats and to evaluate the urinary activity of N-acetyl-β-D-glucosaminidase (NAG) enzyme, blood levels of urea and creatinine and microstructural renal alterations induced by ischemia/reperfusion injury respectively gentamicin nephrotoxicity. For this purpose we have used a rat experimental model. Adult male Wistar rats weighing 250-300 g were randomly divided into 3 groups with 8 rats in each group. Group 1 served as a model for the renal ischemia/reperfusion injury experiment, group 2 served for toxic kidney injury experimental model and group 3 served as control group. All individuals in both groups 1 and 2 presented marked elevations in blood urea and creatinine at the moment of euthanasia (day 3 for group 1 and day 9 for group 2) compared to the control group where biochemical values remained within normal limits. Urine analysis of both group 1 and 2 showed marked urinary NAG index activity which suggests acute tubular injury, suggestion confirmed by histological evaluation of the renal parenchyma sampled from this subjects

Acquired Antithrombin III (AT III) - Deficiency in Septicaemia

1979 ◽  
Author(s):  
E. Deutsch ◽  
E. Thaler
Keyword(s):  
Septic Shock ◽  
Venous Blood ◽  
Heparin Therapy ◽  
Blood Cultures ◽  
Mean Values ◽  
Negative Results ◽  
Significant Difference ◽  
At Iii ◽  
Group 2 ◽  
Group 1

AT III was measured in 34 patients with clinical and bacteriological evidence of septicaemia using a heparin cofactor assay. Based on the results of positive blood cultures gram-negative septicaemia (G-S) was diagnosed in 10 (group 1) and gram positive septicaemia (G+S) in 9 patients (group 2). From the remaining 15 patients {group 3) blood cultures before onset of antibiotic therapy were not obtained and gave negative results throughout the observation period. Based on bacteria] cultures from other sites than venous blood or bacteriological examination of spinal fluid G-S was assumed in 13 and G+S in 2 patients.In all but one patient of group 1 and one of group 2 AT III activities were decreased below 2 SO of normal controls (n = 91, x = 99.6, SD-8.4) already at the time of the first coagulation screening (patients: n=34, =58.4, SD-16.6). Analysis of var-ance showed no significant difference between the mean values of the three groups at the c per cent (%) level. The minimal AT III activities during the course of the disease were below the norma] range in all patients studied [n=34, =51.2, SD=13.6).Thus AT III deficiency appears to be a constant and early finding in G-S and G+S, causing insufficient inhibition of blood coagulation, and hereby may contribute to irreversible tissue damage caused by microthrombi in septic shock. This deficiency may be an important factor in the failure of heparin therapy to reduce mortality from septic shock.

scholarly journals Evaluation of the concentration of malondialdehyde and nitrite in patients with sickle cell anemia treated or not with hydroxyurea

2010 ◽  
Vol 8 (4) ◽  
pp. 414-418 ◽  
Author(s):  
Darcielle Bruna Dias Elias ◽  
Rivelilson Mendes de Freitas ◽  
Romélia Pinheiro Gonçalves ◽  
Hemerson Yuri Ferreira Magalhães ◽  
Jacqueline Holanda de Sousa ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Serum Levels ◽  
The Other ◽  
Control Group ◽  
Clinical Variables ◽  
Short Period ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

ABSTRACT Objective: To determine the serum levels of malondialdehyde and nitrite in patients with sickle cell anemia treated or not with hydroxyurea in outpatient's setting. Methods: Of the 65 patients with sickle cell anemia selected for the study, 51 were not treated with hydroxyurea (Group 1), 14 made chronic use of hydroxyurea (Group 2) and 20 individuals had no hemoglobinopathies (Control Group). Results: The Control Group had a lower and more homogeneous concentration of malondialdehyde levels as compared to the other groups. The results of Groups 1 and 2 showed increased values of malondialdehyde levels when compared to the Control Group. Considering the values of Groups 1 and 2, there were no significant changes in the malondialdehyde levels. There was no significant difference in the serum levels of nitrite between the groups. Group 2 presented a statistically significant correlation between serum malondialdehyde levels and the clinical variables investigated. In turn, Group 1 showed correlation only with occurrence of three or more vaso-occlusive crises. There was no correlation between nitrite levels and the clinical variables. Conclusion: The results revealed that during the pathogenesis of sickle cell anemia, an increase in lipid peroxidation was observed. On the other hand, no changes in oxidative parameters were detected during treatment with hydroxyurea, probably due to the short period of treatment of the patients studied.

scholarly journals MO377HOW THE ITALIAN COVID-19 LOCKDOWN AFFECTED NEFROLOGICAL ACTIVITY IN A LOMBARD CENTER

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Paolo Albrizio ◽  
Silvano Costa ◽  
Annalisa Foschi ◽  
Ivo Angelo Antonio Milani ◽  
Stefano Rindi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
First Aid ◽  
The Other ◽  
Renal Diseases ◽  
Significant Difference

Abstract Background and Aims Italy and Lombard hospitals particularly, were hard affected by Covid-19 pandemic, mostly during spring and autumn, seasons characterized by two lockdown periods which were however, partly different as rules. During first lockdown in fact, by hospital decision, all ambulatorial activity was closed, including nephrological one. This did not happen during second lockdown period. How the different choices about hospital activity affected nephrological patients is the aim of this study. Method we evaluated all nephrological advices requested by first aid units of our 3 hospitals, all located in Lombardy, to our Nephrology Unit, splitting out data in 3 periods (I lockdown, summer and II lockdown) and comparing with 2019. Data collected were: number of advices requested by day, age, sex, previous regular nephrological follow-up, Covid-19 diagnosis, nephrological diagnosis after nephrological advice and outcome. Results as shown in table 1, during I lockdown period, with hospital decision of suspending our nephrological ambulatorial activity, we suffered an incremented rate of patients approaching local first aid units compared to 2019 same period with an increased rate of acute kidney injury, mostly for dehydration, and with a higher rate of patients requiring hospitalization. All these differences resulted statistically significant vs 2019 same period (figure 1). On the other side, no statically significant difference was found during the other two examined periods, including the II lockdown, while all our ambulatories were fully operating. Conclusion Covid-19 pandemic affected also the nephrological population with an increased rate of first aid units’ accesses, acute kidney injury events and hospitalization comparing to 2019. However, these differences were detectable only during the I lockdown period characterized by the suspension of all ambulatorial activity, including our Unit. The absence of statistically significant differences during summer and primarily during II lockdown period demonstrates the importance of nephrological ambulatorial activity in management of renal diseases and in prevention of acute events.

scholarly journals Evaluation of Mandibular First Molars’ Axial Inclination and Alveolar Morphology in Different Facial Patterns: A CBCT Study

2020 ◽  
Vol 14 (02) ◽  
pp. 250-259 ◽  
Author(s):  
Marcos Cezar Ferreira ◽  
Karina Maria Salvatore de Freitas ◽  
Francyle Simões Herrera-Sanches ◽  
Patrícia Bittencourt dos Santos ◽  
Daniela Garib ◽  
...  
Keyword(s):  
The Other ◽  
Cone Beam ◽  
Bone Morphology ◽  
Mandibular Molar ◽  
Significant Difference ◽  
Mandibular Body ◽  
Facial Pattern ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Objective The purpose of this study was to evaluate and compare the axial inclination of the mandibular first molars and their respective bone morphology among individuals with different facial patterns. Materials and Methods The sample comprised the cone beam computed tomographies (CBCTs) of 58 subjects divided into three groups according to the facial patterns: 18 brachyfacial (Group 1), with a mean age of 21.58 years; 23 mesofacial (Group 2), with a mean age of 19.14 years; and 17 dolichofacial subjects (Group 3), with a mean age of 19.09 years. Eight variables were evaluated on CBCT scans of each subject: buccal and lingual mandibular height, cervical and middle mandibular width, inclination of mandibular body, inclination of the mandibular molar buccal surface, molar width, molar angulation and tooth/bone angle. Intergroup comparisons were performed with one-way analysis of variance followed by Tukey tests. Results Buccal mandibular height presented statistically significant difference in the three facial patterns. Lingual mandibular height and mandibular inclination showed to be statistically and significantly smaller in brachyfacial subjects than in the other two groups. Mandibular width presented a statistically significant difference between brachyfacial and mesofacial groups. Negative correlations could be observed between the facial pattern and the buccal and lingual mandibular heights and inclination of the mandibular body. Conclusion Buccal mandibular height was significantly and progressively larger in brachyfacial, mesofacial, and dolichofacial subjects. Lingual mandibular height was significantly smaller in brachyfacial than in mesofacial and dolichofacial subjects. Mandibular width was significantly thicker in brachyfacial than in mesofacial subjects. Brachyfacial subjects had smaller mandibular inclination than mesofacial and dolichofacial subjects.

scholarly journals In Vitro Microbiological Analysis of Bacterial Seal at the Implant-Abutment Interface Using Two Morse Taper Implant Models

2014 ◽  
Vol 25 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Deceles Cristina Costa Alves ◽  
Paulo Sérgio Perri de Carvalho ◽  
Elizabeth Ferreira Martinez
Keyword(s):  
Brain Heart Infusion ◽  
The Other ◽  
Microbiological Analysis ◽  
Torque Wrench ◽  
Significant Difference ◽  
Implant Abutment ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The objective of this study was to evaluate the bacterial seal at the implant-abutment interface using two morse taper implant models, by means of an in vitro microbiological analysis. For that were used 15 implants with mini-abutments tightened by friction, no screws (Group 1); and 30 implants with screw-tightened abutments, of which 15 received 20 N.cm of closing torque (Group 2) and the other 15 received 30 N.cm (Group 3). Microbiological analysis was carried out using colonies of Escherichia coli transported directly from a culture dish to the prosthetic component. Friction implants (Group 1) were activated by tapping and a torque wrench was used for screw-tightened implants (Groups 2 and 3). Each abutment/implant set was immersed in test tubes containing 5 mL of brain-heart infusion broth and incubated at 37 °C for 14 days, observed daily for the presence of contamination. A statistically significant difference was observed regarding the number of contaminated implants. There was greater contamination in Group 2 implants (p<0.05), with no statistically significant difference between the other groups (Group 1 = 20% and Group 3 = 0%). It was concluded that there was no significant difference in in vitro bacterial sealing between implants with mini-abutments tightened by friction without screws and implants with screw-tightened abutments with 30 N.cm of closing torque. The difference in closing torque altered the in vitro sealing ability of the tested abutments, with a greater contamination for components that received a closing torque of 20 N.cm.

scholarly journals Influences of 27-Gauge Vitrectomy on Corneal Topographic Conditions

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Takafumi Hirashima ◽  
Takao Utsumi ◽  
Miou Hirose ◽  
Hideyasu Oh
Keyword(s):  
Diabetic Retinopathy ◽  
Epiretinal Membrane ◽  
Spherical Aberration ◽  
The Other ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
Higher Order Aberration ◽  
Topographic Parameters ◽  
Group 1

Purpose. To evaluate the influences of 27-gauge vitrectomy on corneal topographic conditions. Method. Fifty-six eyes of 56 patients undergoing 27-gauge vitrectomy were retrospectively studied. Twenty-three eyes with epiretinal membrane (ERM), 23 eyes with macular hole (MH), and 10 eyes with proliferative diabetic retinopathy (PDR) were included. Forty-five of the 56 eyes underwent 27-gauge phacovitrectomy (group 1), and the remaining 11 eyes underwent 27-gauge vitrectomy alone (group 2). Corneal topography was obtained with a wave-front analyzer preoperatively and at 1 and 3 months postoperatively. The corneal topographic parameters evaluated were the average corneal power, regular astigmatism, spherical aberration, and higher-order aberration (HOA). Results. In between-group analyses of groups 1 and 2, no significant differences were observed regarding the changes of the 4 parameters from the baseline to 1 and 3 months postoperatively. No significant differences in the changes of all parameters from the baseline to 1 and 3 months postoperatively were also observed between MH group and the other two groups. A significant difference in the change of HOA from the baseline to 1 month postoperatively was observed between ERM and PDR group however, the difference disappeared at 3 months. Conclusion. 27-gauge vitrectomy did not induce substantial changes in the corneal topographic conditions.

scholarly journals Comparison of perioperative parameters in one-handed rotational phacoemulsification versus conventional phacoemulsification and femtosecond laser-assisted cataract surgery

2021 ◽  
Vol 14 (12) ◽  
pp. 1868-1875
Author(s):  
Samuele Gigliola ◽  
◽  
Alfredo Niro ◽  
Carmela Palmisano ◽  
Pasquale Puzo ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
The Other ◽  
Dissipated Energy ◽  
Surgical Time ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

AIM: To compare perioperative parameters of one-handed rotational phacoemulsification technique (one-handed phaco-roll) with each of other two techniques, “Divide et Conquer” and femtosecond laser-assisted cataract surgery (FLACS) METHODS: In this retrospective and comparative cohort study, eyes with uncomplicated cataract (nuclear density grade 2 to 3) treated routinely with one-handed phaco-roll (n=23; Group 1) or “Divide et Conquer” (n=23; Group 2) or FLACS (n=23; Group 3) were enrolled. Intraoperative parameters including effective phaco-time (EPt), ultrasound time (USt), aspiration time, surgical time, phacoemulsification (phaco)-power, balanced salt solution (BSS) use, cumulative dissipated energy (CDE) were recorded and compared. Clinical outcomes including best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), endothelial cell loss (ECL), central corneal thickness (CCT) and central macular thickness (CMT), were assessed and compared pre-operatively and at 1mo after surgery. RESULTS: Aspiration and surgical time, and BSS used were lower in Group 1 (P<0.01) than other groups. EPt, phaco-power and CDE were lower in Group 1 (P<0.05) than Group 2 but not significantly different from Group 3. In Group 1, USt was lower (P<0.05) than Group 2 but higher (P<0.05) than Group 3. BCVA improved in all groups without significant difference between Group 1 and the other ones. No significant differences regarding all post-operative morphologic outcomes (ECD, ECL, CCT, CMT) were reported. No clinical complications occurred. CONCLUSION: One-handed phaco-roll seems to be less time-consuming than “Divide et Conquer” and FLACS and less energy-consuming than “Divide et Conquer”. Furthermore, one-handed phaco-roll seems to have an equal safety profile compared to the other two techniques.

The Attributable Mortality of Sepsis for Acute Kidney Injury: A Propensity Score Matched Study

2021 ◽  
Author(s):  
Huimiao Jia ◽  
Yijia Jiang ◽  
Xi Zheng ◽  
Wen Li ◽  
Meiping Wang ◽  
...  
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Mortality Rate ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Excess Mortality ◽  
Kidney Injury ◽  
Attributable Mortality ◽  
Hospital Death ◽  
Significant Difference

Abstract Background: Both sepsis and AKI are diseases of major concern in intensive care unit (ICU). This study aimed to evaluate the excess mortality attributable to sepsis for acute kidney injury (AKI).Methods: A propensity score-matched analysis of a prospective cohort study about sepsis epidemiology in 18 Chinese ICUs (January 2014-August 2015) was performed (registration number: ChiCTR-ECH-13003934). Propensity score model was sequentially conducted to match AKI patients with and without sepsis on day 1, day 2, and day 3-5. The primary outcome was hospital death of AKI patients. Propensity score-matched analyses were conducted to estimate the excess mortality attributable to sepsis for AKI. Results: A total of 2008 AKI patients (40.9%) were eligible for the study. Of the 1010 AKI patients with sepsis, 619 (61.3%) were matched to 619 AKI patients in whom sepsis did not develop during the screening period of the study. The hospital mortality rate of matched AKI patients with sepsis was 205 of 619 (33.1%) compared with 150 of 619 (24.0%) for their matched AKI controls without sepsis (p = 0.001). The attributable mortality of total sepsis for AKI patients was 9.1% (95% CI 4.8-13.3%). Matched AKI patients with and without sepsis were subgrouped according to the severity of sepsis (sepsis, septic shock). Of the matched patients with sepsis, 328 (53.0%) diagnosed septic shock. The mortality rate showed remarkably higher in matched AKI patients with septic shock (43.9%) than their controls of patients without sepsis (27.7%). The attributable mortality of septic shock for AKI was 16.2% (95% CI 11.3-20.8%, p < 0.001). Further, the attributable mortality of sepsis for AKI was 1.4% (95% CI 4.1-5.9%, p = 0.825), although there was no significant difference of mortality rate observed between matched AKI patients with and without sepsis (21.0% vs. 19.6%).Conclusions: The attributable hospital mortality of total sepsis for AKI were 9.1%. Septic shock contributes to major excess mortality rate for AKI than sepsis.

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