scholarly journals Effects of High-Dose Radioactive Iodine Treatment On Renal Function In Patients With Differentiated Thyroid Carcinoma: A Retrospective Study

2021 ◽  
Author(s):  
Liang Yin ◽  
Weilong Li ◽  
Yan Wang ◽  
Yangyang Lin ◽  
Zhichun Lin ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Dysfunction ◽  
Cumulative Dose ◽  
Differentiated Thyroid Carcinoma ◽  
High Dose ◽  
Significant Difference ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Abnormal Renal Function

Abstract Aim: This study aimed to investigate the effects of high-dose radioactive iodine (131I) treatment on the clinical metrics of renal function in patients with differentiated thyroid carcinoma (DTC).Patients and methods: The clinical metrics of renal function were analysed in 850 patients with DTC who received 131I therapy between January 2012 and December 2019. According to the baseline renal function metrics, the patients were divided into normal renal function group (group A) and abnormal renal function group (group B). Each group was further divided into three subgroups (subgroups 1, 2, and 3) based on the cumulative dose of 131I. The clinical metrics of renal function including serum creatinine (SCr) levels, blood urea nitrogen (BUN) levels and estimated glomerular filtration rate (eGFR) were measured within 1 month before the initiation of 131I therapy, 1 year after the last therapy, and 5 years after the initial therapy. The changes in renal function metrics before and after 131I therapy were compared in each group.Result: In group A (588 patients), no significant difference in the mean levels of SCr and BUN and eGFR was observed in the three subgroups (P >0.05), regardless of gender, before the initial 131I therapy and 1 year after the last therapy. A total of 8, 3, and 2 patients presented with abnormal renal function after 131I treatment in subgroups 1, 2, and 3, respectively. No statistically significant difference was observed in the incidence of renal dysfunction among the three subgroups (P = 0.287). The mean age of patients with renal dysfunction was significantly greater than that of patients without renal dysfunction after 131I treatment. In group B, of the 262 patients with abnormal renal function, SCr and BUN levels were elevated in 168 and 155 patients, respectively, and eGFR <60 mL/min/1.73 m2 was found in 87 patients before the initial 131I therapy. No significant difference was observed in the parameters among the three subgroups. However, SCr and BUN levels were found to be increased in all subgroups 5 years after the initial 131I therapy, and they were positively correlated with the cumulative dose of 131I. The difference was statistically significant (P <0.05). Furthermore, eGFR was found to be decreased in all subgroups after 131I therapy, and it was negatively correlated with the cumulative dose of 131I. The difference was statistically significant (P <0.05). A gender bias was not observed in the changing trends of SCr and BUN levels and eGFR.Conclusion: Our findings suggest that the nephrotoxicity of high-dose 131I therapy, regardless of gender, is very low in patients with DTC with normal renal function; however, high-dose 131I therapy may exacerbate the loss of renal function in those with renal dysfunction.

The clinical effect of Chitosan nanoparticles against Helicobacter pylori

2020 ◽  
Vol 10 (7) ◽  
pp. 1116-1121
Author(s):  
Jing Wang ◽  
Xinhong Wang ◽  
Min Li ◽  
Suxiang Fan
Keyword(s):  
Triple Therapy ◽  
Clinical Efficacy ◽  
Adverse Reactions ◽  
Chitosan Nanoparticles ◽  
High Dose ◽  
Significant Difference ◽  
Oral Liquid ◽  
Group A ◽  
The Difference ◽  
Group B

The objective of this study was to observe the clinical effect of Chitosan nanoparticles therapy on Helicobacter pylori (HP) infection. Three treatment groups (A, B, and control group C) were randomly assigned with 60 cases of HP each, making 180 cases. Group C received standard triple therapy (omeprazole + amoxicillin + clarithromycin), group A got a routine dose of Chitosan nanoparticles plus triple therapy, and group B got a high dose of Chitosan nanoparticles plus triple therapy. The course of treatment in each group was 7 days. The eradication rate, clinical efficacy and adverse reactions were observed. Up to 172 patients finished the experiment, with 59 patients in Group A, 57 in Group B and 56 in Group C. In a total analysis set (FAS), the eradication rates of HP in Group A, Group B and Group C were 80.00%, 80.70%, and 71.67%, respectively. There was no significant difference between the two groups (P > 0.05). In accordance with the PPS, the HP eradication rates of group A, B, and C were 81.36%, 80.70% and 76.79%, respectively, and there was no significant difference between the two groups (P > 0.05). The clinical efficacy of group A, B, and C were 91.67%, 91.23%, and 70.00%, respectively. The differences among the three groups were statistically significant (P < 0.05). In accordance with the PPS, the clinical efficacy of group A, B and C was 93.22%, 91.23%, and 75.00%, respectively. With a P-value of less than 0.05, the results indicated that the difference between the two groups was statistically significant. There were 21 adverse reactions in the experiment, including 3 in group A, 6 in group B, and 12 in group C. The difference was statistically significant (P < 0.05) between group A and B compared with group C, the difference was statistically significant (P < 0.05); the difference between group A and group B was statistically significant (P < 0.05). In conclusion the therapeutic effect of Chitosan nanoparticles and oral liquid, combined with triple therapy on HP infection is satisfactory, with less adverse reactions are. However, the findings suggest that it is not desirable to use a high dose Chitosan nanoparticles and oral liquid.

Does body position, age, and heart rate induce IOP’s changes?

2021 ◽  
pp. 112067212110233
Author(s):  
Marcelina Sobczak ◽  
Magdalena Asejczyk ◽  
Malwina Geniusz
Keyword(s):  
Heart Rate ◽  
Body Position ◽  
Age Groups ◽  
Cardiovascular Parameters ◽  
Entire Cohort ◽  
Significant Difference ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Effect Of Age

Objectives: The main goal of this research was to determine the differences between the values of intraocular pressure (IOP) in the supine and sitting positions, and to assess the effect of age and cardiovascular parameters. Methods: Seventy-two healthy adults were enrolled and classified into age groups: 20–30 years (group A), 31–40 years (group B), and 41–71 years (group C). Corneal biometry and cardiovascular parameters, such as heart rate (HR), were measured. IOP measurements were taken in the sitting position (IOPS) and in the supine position (IOPL) using the iCare® Pro tonometer. Results: A significant difference between the IOPS and IOPL in the entire cohort was found ( p < 0.001). Regarding the age subgroups, a significant difference ( p < 0.001) between the IOPS and IOPL was obtained in group A (2.6 ± 1.6 mmHg) and group C (1.5 ± 1.3 mmHg). There were no significant differences in the IOPS between groups. The highest IOP values were obtained for group A. The correlations between HR and IOPS are statistically significant for group A and group B, and for HR and IOPL-S for group B only. Multivariate analysis showed that HR has a significant influence on the difference in IOP in the two body positions. Conclusion: A statistically significant difference between the effect of age and the values of IOPS and IOPL was shown. Cardiovascular parameters showed some relevant statistical dependencies, but with a rather marginal significance in young people. The influence of body position for the measurement of IOP for healthy subjects does not seem to matter, despite the fact that there are some dependencies that are statistically significant.

The association of renal function with safety and efficacy of cisplatin plus S-1 (CS) therapy and docetaxel plus cisplatin plus S-1 (DCS) therapy in patients with advanced gastric cancer (AGC): An additional analysis of JCOG1013.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16035-e16035
Author(s):  
Shuichi Hironaka ◽  
Ryo Sadachi ◽  
Nozomu Machida ◽  
Satoru Iwasa ◽  
Yasuhide Yamada ◽  
...  
Keyword(s):  
Renal Function ◽  
Adverse Events ◽  
Objective Response ◽  
Exploratory Analysis ◽  
Phase Iii ◽  
Fixed Dose ◽  
Hematological Toxicity ◽  
Significant Difference ◽  
Group A ◽  
Group B

e16035 Background: A phase III study, JCOG1013, did not show the superiority of docetaxel plus cisplatin plus S-1 (DCS) to cisplatin plus S-1 (CS) in overall survival (OS) (Yamada Y, Lancet GH 2019). It is known that cisplatin and gimeracil (an inhibitor of dihydropyrimidine dehydrogenase contained in S-1) are excreted in urine. We previously reported (abstr 197, ASCO-GI 2021) exploratory analysis of JCOG1013 which showed creatinine clearance (CrCl) was associated with safety (Grade [G]4 hematological toxicity for CS, and G3-4 non-hematological toxicity for CS and DCS), but not with efficacy in either group. Here, we report the additional detail results of this exploratory analysis. Methods: Among 741 participants in JCOG1013, patients with serum creatinine level < 1.2 mg/dL were included in this analysis and categorized by CrCl and treatment into A1 (CrCl ≥ 80 mL/min, CS), A2 (60 < CrCl < 80, CS), A3 (CrCl < 60, CS), B1 (CrCl > 80, DCS), B2 (60 < CrCl < 80, DCS), and B3 (CrCl < 60, DCS). The dose (mg/m2) of C/S was 60/80 regardless renal function in group A (A1, A2 and A3), and that of D/C/S was adjusted in group B as follows: 40/60/80 in B1, 40/50/80 in B2, and 40/40/65 in B3. Adverse events, OS, progression-free survival (PFS), and objective response rate (ORR) were compared by CrCl in group A (A1 vs. A2 vs. A3) and group B (B1 vs B2 vs B3), respectively. Results: Of 723 pts (169/136/57 in A1/A2/A3 and 170/138/53 in B1/B2/B3), the median CrCl (mL/min) was 94.1/71.9/53.4 in A1/A2/A3 and 98.2/70.0/55.6 in B1/B2/B3. The relative dose intensity of C/S was 90.4/75.3%, 87.8/74.9% and 85.7/72.8% in A1, A2 and A3, and that of D/C/S was 87.5/77.7/74.9%, 85.8/61.2/72.7% and 87.8/49.4/58.3% in B1, B2 and B3. The incidence of G4 white blood cell decreased, G4 neutrophil count decreased, and G3-4 anorexia were 1.2/4.4/9.3% (P < 0.01), 4.8/11.1/18.5% (P < 0.01), 14.4/28.1/28.6% (P < 0.01) in A1/A2/A3, and 1.8/3.0/4.0% (P = 0.36), 27.3/24.8/20.0% (P = 0.28), 22.4/29.3/32.0% (P = 0.11) in B1/B2/B3, respectively. No significant association between CrCl and other adverse events was observed either in CS or in DCS group. The median OS was 15.4/15.5/15.4 months in A1/A2/A3 (P = 0.89) and 15.3/13.7/13.7 months in B1/B2/B3 (P = 0.72). The median PFS was comparable among A1/A2/A3 (7.1/6.8/6.2 months, P = 0.88) and B1/B2/B3 groups (7.5/7.2/7.8 months, P = 0.85). ORR showed no significant difference in A1/A2/A3 (58.9/57.8/46.9%, P = 0.31) and B1/B2/B3 groups (62.0/61.5/51.5%, P = 0.36). Conclusions: Dose modification according to renal function in the DCS arm could control the increase of severe toxicities, which were observed frequently in patients with low renal function in patients receiving fixed dose of CS. Clinical trial information: 000007652.

Reversibility of Renal Failure in Newly Diagnosed Patients with Multiple Myeloma and the Role of Novel Agents.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 955-955 ◽  
Author(s):  
Maria Roussou ◽  
Efstathios Kastritis ◽  
Dimitrios Christoulas ◽  
Magdalini Migkou ◽  
Maria Gavriatopoulou ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Renal Function ◽  
Renal Impairment ◽  
High Dose ◽  
Newly Diagnosed ◽  
Agent Based ◽  
Renal Response ◽  
Group A ◽  
Group B ◽  
Novel Agent

Abstract Abstract 955 Renal impairment (RI) is a common complication of multiple myeloma (MM) and is associated with increased mortality. High dose dexamethasone-based regimens have been extensively used for the initial management of patients with MM presenting with RI. Recently, novel agent-based regimens have been introduced in the frontline management of MM. The purpose of our analysis was to assess the effect of novel agent-based regimens on the rate of RI improvement and compare their efficacy with conventional chemotherapy (CC) plus dexamethasone (Dexa) in newly diagnosed MM patients. Over the last decade, 82 patients with newly diagnosed MM and RI, defined as creatinine clearance (CrCI) <50ml/min, received frontline treatment in our Center. Patients were divided into three groups: group A: 28 patients who received CC plus Dexa-based regimens (VAD, VAD-like regimens, melphalan plus Dexa); group B: 38 patients who received IMiDs-based regimens (thalidomide or lenalidomide with high dose Dexa and/or cyclophosphamide or melphalan) and group C: 16 patients who received bortezomib-based regimens with Dexa. Renal complete response (RCR) was defined as a sustained increase of baseline CrCI to >60ml/min. Renal partial response (RPR) was defined as an increase of CrCI from<15 to 30-50ml/min. Renal minor response (RMR) was defined as sustained improvement of baseline CrCI of<15ml/min to 15-29 ml/min, or, if baseline CrCI was 15-29 ml/min, improvement to 30-59 ml/min. Patients in group B were older than those of groups A and C (p=0.01) while more patient in group C had light chain only MM than in groups A and B (p=0.04). There were no significant differences in the severity of RI, Bence Jones proteinuria, hypercalcemia or ISS stage among the three groups. Improvement of renal function, recorded as RMR or better, was achieved more frequently in patients treated with novel agents (group B: 87% and in group C: 94%) than in patients treated with CC plus Dexa-based regimens (64%, p=0.024). Among 9 patients who required renal dialysis 3 became independent of this procedure after treatment. We subsequently focused our analysis in major renal responses (RPR or RCR), because this endpoint is clinically more relevant. RCR was achieved in 43% of patients in group A, in 50% in group B and in 69% of patients in group C (p=0.2) and RCR+RPR rates were 50% and 57% and 81% for groups A, B and C respectively (p=0.1). Creatinine clearance <30 ml/min was associated with a significantly lower probability of RCR or RPR only in patients treated with CC plus Dexa- or with IMiDs-based regimens (p<0.01), but not in patients treated with bortezomib (p=0.529). The probability of RPR+RCR was similar for patients treated with IMiDs compared to CC plus Dexa-based regimens (p=0.619). In multivariate analysis bortezomib–based regimens (p=0.02, OR: 7, 95% CI 1.5-25) and CrCl>30 ml/min (p=0.002, OR: 6.1, 95% CI 2.5-22.5) were independently associated with a higher probability of RCR+RPR. The median time to RPR was similar for patients treated with IMiDs compared to CC plus Dexa-based regimens (2.2 months for Group A, 1.5 months for Group B, p=0.587) but it was significantly shorter for Group C (0.7 months, p=0.017). Other factors associated with a shorter time to ≥RPR included CrCl>30 ml/min (p=0.039) and age<75 (p=0.089). In multivariate analysis bortezomib–based regimens (p=0.004, OR: 3 95% CI 1.6-6.7) and CrCl>30 ml/min (p=0.006, OR: 2.5 95% CI 1.3-4.5) were independently associated with a shorter time to ≥RPR. In landmark analysis (time was one month in order to reduce bias due to early deaths), rapid improvement of renal function (≤1 month) was associated with a trend for a longer survival compared to patients who achieved renal response later (>1 month) (47 vs. 21 months, p=0.19). Myeloma response to treatment was 58%, 68% and 79% for the three treatment groups respectively and was associated with renal response (p=0.024), though less strongly with a major renal response (p=0.061). Our data indicate that novel agent-based regimens can improve renal function in most patients; furthermore bortezomib-based regimens improve renal function to a higher degree and significantly more rapidly than CC plus Dexa-based or IMiD-based regimens even in patients with severe renal impairment. We conclude that bortezomib-based regimens may be the preferred treatment for newly diagnosed myeloma patients who present with renal impairment. Disclosures: Dimopoulos: JANSSEN-CILAG: Honoraria; CELGENE: Honoraria.

scholarly journals Postoperative Sore Throat, Nausea and Vomiting in Routine Nasal Surgery: Influence of Pharyngeal Packing

2012 ◽  
Vol 1 (1) ◽  
pp. 24-28
Author(s):  
Mehrdad Naderian ◽  
Ehsan Jangholi ◽  
Taraneh Kharaz Tavakol
Keyword(s):  
Sore Throat ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Nasal Surgery ◽  
Significant Difference ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Pharyngeal Packing

Introduction: Pharyngeal packs are commonly used to prevent of postoperative nausea and vomiting (PONV) and Sore throat during nasal surgery following tracheal intubation. the aim of this study is evaluation of effectiveness of pharyngeal packing in the prevention of PONV. Materials and methods: This study with random sampling performed on 120 adult patients scheduled for routine nasal surgery referred Boo – Ali hospital in Tehran, Iran from March 2011 to March 2012. the study was approved in the ethical committee of Azad University and written informed consent to participate in the study. All subjects randomly allocated to Group A or Group B to have and not to have pharyngeal packing during surgery, Respectively.The incidence of PONV and sore throat in the recovery room,at 2 and 6 h were recorded by a 100 mm long visual analogue scale (VAS). Data were analysed using non-parametric tests in SPSS 18. Significant difference was set at p<0.05. Results: The average age of patients was 27.6 ± 7.1 years. The average of age in Group A was 29.2 ± 2.8 years and in Group B was 27.4 ± 3.2 years. The difference in throat pain scores in the two groups at each assessment time was statistically significant. The difference in PONV scores were not statistically significant. Conclusion: The usage of pharyngeal packing during nasal surgery leads to decreased incidence of sore throat in experiment group compared with the control group. Also has no effect on the incidence of PONV. [GMJ. 2012;1(1):24-28]

scholarly journals The influence of balanced complex chromosomal rearrangements on preimplantation embryonic development potential and molecular karyotype

2020 ◽  
Author(s):  
Gang Li ◽  
Weiyi Shi ◽  
Wenbin Niu ◽  
Jiawei Xu ◽  
Yihong Guo ◽  
...  
Keyword(s):  
Embryonic Development ◽  
High Quality ◽  
Preimplantation Genetic Testing ◽  
Abnormal Embryo ◽  
Significant Difference ◽  
Molecular Karyotype ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Euploid Embryo

Abstract Background: Balanced complex chromosome rearrangements (BCCR) are balanced chromosomal structural aberrations that involve two or more chromosomes and at least three breakpoints. It is very rare in the population.The objective is to explore the difference of influence of three types of BCCR on early embryonic development and molecular karyotype.Results:Twelve couples were recruited including four couples of three-way rearrangements carriers (group A), three couples of double two-way translocations carriers (group B) and five couples of exceptional CCR carriers (group C). A total of 243 oocytes were retrievedin the seventeen preimplantation genetic testing (PGT) cycles, and 207 of these were available for fertilization.After intracytoplasmic sperm injection, 181oocytes normally fertilized. The rates of embryos forming on day3 in three groups were 87.88%, 97.78% and77.14%, which was significantly different (P=0.01). Compared with group B, the rate of embryo formation was statistically significantly lower in group C(P=0.01).Furthermore, the rates of high-quality blastocysts in three group were 14.71%, 48.15% and 62.96%, respectively, which was significantly different (P=0.00). Compared with group B andC, the rate of high-quality blastocysts in group A was statistically significantly lower (P=0.00;P=0.00). Comprehensive chromosome analysis was performed on 83 embryos, including 75 trophectodermcellsand 8 blastomeres. Except 7 embryos failed to amplify, 9.01%embryos were diagnosed as euploidy, and 90.91% were diagnosed as abnormal. As for group A, the euploid embryo rate was 10.71%and the abnormal embryo rate was 89.29%. In group B,the euploid embryo rate was 3.85%, the abnormal embryo rate was 96.15%. The euploid embryo rate was 13.04%, the abnormal embryo rate was 86.96% in group C.There were no significant differences among the three groups (P = 0.55).Conclusions:The lowest rate of high quality blastocysts has been for three-way rearrangements and the lowest rate of euploidy has been for double two-way translocations, although no significant difference. Different types of BCCR maybe have little effect on the embryonic molecular karyotype. The difference of influence of BCCR on early embryonic developmentandmolecular karyotypeshould be further studied.

Evaluation of the changes in Tei-index (myocardial performance index) in Doppler echocardiography before and after treating with anthracycline combinations in children with malignancy

2021 ◽  
Author(s):  
Majid Naderi ◽  
Maryam Judi ◽  
Maryam Yazdanparast ◽  
Sima SavadKuhi ◽  
Saeedeh Yaghoubi
Keyword(s):  
Performance Index ◽  
Myocardial Performance Index ◽  
P Value ◽  
High Dose ◽  
Healthy Children ◽  
Myocardial Performance ◽  
Tei Index ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Cardiomyopathy usually causes a cardiac dysfunction resistant to treatment due to anthracycline. This study aimed to evaluate the changes in Tei-Index (myocardial performance index) in patients with malignancies treated with anthracycline. Material and Methods: This case-control study was done on 15 children who were treated with low-dose anthracycline (1-199mg/kg) called group A and 15 children who were treated with high dose (>200mg/kg) anthracycline called group B after acquiring consent from their parents. Children with no abnormality in Echo-Doppler results were included in this study. The patients’ age range between 1- 17 years with a mean age of 6.57 years. Another group of healthy children were assigned to group C as a control group who had not received chemotherapy. The first echo was performed right before the treatment and the second one, two weeks after completing chemotherapy.  Data were analyzed by the SPSS statistical software. Results: Changes in mean Tei-index in group A were 0.36 ± 0.04 before treatment and 0.43 ± 0.11 after treatment. Changes in mean Tei-index in group B were 0.37 ± 0.04 before treatment and 0.45 ± 0.06 after treatment. There was no significant difference between the two groups using the independent T-test. (p-value= 0.57). No significant correlation between the changes in mean ejection fraction (EF) and treatment was found in the three groups (p-value=0.45). Conclusion: This study showed a change in the Tei-index (MPI) in patients receiving anthracycline; regardless of the dosage, they got in their regimen. Given the use of anthracycline, any abnormal cardiac finding can alert the physicians to the possibility of cardiomyopathy, hence scheduling routine follow-ups are necessary.

scholarly journals A Postmortem Study on the Volume of the Human Thyroid Gland

2012 ◽  
Vol 38 (1) ◽  
pp. 6-8 ◽  
Author(s):  
ASM Nurunnabi ◽  
S Ara ◽  
MU Jahan
Keyword(s):  
Thyroid Gland ◽  
Age Groups ◽  
Human Thyroid ◽  
Cross Sectional ◽  
Fluid Displacement ◽  
Medical College ◽  
Significant Difference ◽  
Group A ◽  
The Difference ◽  
Group B

The present study was designed to find out the difference in volume of the thyroid gland of Bangladeshi people in relation to age and sex and to compare with previous local and foreign studies. It was a Cross-sectional descriptive type of study. The hospital based study was conducted in the Department of Anatomy, Dhaka Medical College, Dhaka, from January to December 2008. The present study was performed on 60 post mortem human thyroid gland (39 of male and 21 of female) collected from unclaimed dead bodies which were in the morgue under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age-groups including group A (10-20 years), group B (21-50 years) & group C (>50 years) and the volume of the thyroid glands were measured by fluid displacement method and recorded. No difference was found in mean volume of the thyroid gland between male and female. However, significant difference was found in between age groups. The volume of the gland was found to increase from early childhood and puberty up to 50 years of age and then decreased.  DOI: http://dx.doi.org/10.3329/bmrcb.v38i1.10444  Bangladesh Med Res Counc Bull 2012; 38: 6-8

scholarly journals Early Evaluation of Renal Function in High-Risk Patients after Off-Pump Coronary Artery Bypass Grafting

2016 ◽  
Vol 9 (1) ◽  
pp. 23-30
Author(s):  
Istiaq Ahmed ◽  
AM Asif Rahim ◽  
Khawaja Nasir Uddin Mahmood ◽  
Manzil Ahmad
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
High Risk ◽  
Renal Dysfunction ◽  
Artery Bypass ◽  
Off Pump ◽  
High Risk Patients ◽  
Significant Difference ◽  
Risk Patients ◽  
Group B

Background: Cardiopulmonary bypass (CPB) is an unphysiological state and widely regarded as an important contributor to renal failure. Despite improvement in cardiopulmonary bypass technique, anesthesia and intensive care, perioperative renal dysfunction still represents a significant and potentially lethal complication after coronary artery bypass graft surgery (CABG). Renal dysfunction is a serious complication of coronary revascularization with CPB and results in increased morbidity, mortality and prolonged hospital stay. We compared the incidence of perioperative renal dysfunction in patients who underwent CABG, on-pump and off-pump (OPCAB) Methods: A total of 60 high -risk patients with ischaemic heart diseases were included in the study who underwent CABG. Out of the total 60 patients, 30 were in the Off-pump group (Group A) and the rest 30 were in the On-pump group (Group B). They were diagnosed as high-risk patients considering serum creatinine level>1.7mg/dl with age ?60 years, ejection fraction 30-40%. Renal function was evaluated in both groups preoperatively and postoperatively (on 1st, 2nd and 7th postoperative day) and compared between two groups.Results: One patient in the On-pump group died on 6th postoperative day. Preoperative renal parameters were also similar and showed no statistically significant difference. So both groups were comparable. Comparison of renal parameter in OPCAB and on-pump CABG between preoperative and 7th day postoperatively found in this study were blood urea 50.33±6.29, 39.87±4.8 vs 52.67±9.05 , 66.21±6.91 ; S. Creatinine (mg/dl) 1.94±0.19 , 1.28±0.19 vs 2.07±0.31 , 2.82±0.47; Creatinine Clearance Rate(ml/min) 46.61±4.1, 71.51±12.3 vs 46.53±4.6, 34.02±4.49 ; Urine output (ml/24 hrs)1692.7±71.53, 1755.7±82.91 vs 1591.2±78.76, 1492.1±196.29 all are statistically significant(p<0.05). Mean period of mechanical ventilation, ICU stay and total postoperative hospital stay were significantly greater in On-pump group. One patient of Group –B died due to multi organ failure including acute renal failure on 6th postoperative day (3.3%) (p>0.05). Statistically significant difference of renal parameters in different postoperative days showed evidence of well preservation of renal function in OPCAB.Conclusion: Adaptation of OPCAB offers better preservation of renal function as well as better early postoperative outcome specially in high-risk CABG patients.Cardiovasc. j. 2016; 9(1): 23-30

scholarly journals The influence of balanced complex chromosomal rearrangements on preimplantation embryonic development potential and molecular karyotype

2020 ◽  
Author(s):  
Gang Li ◽  
Weiyi Shi ◽  
Wenbin Niu ◽  
Jiawei Xu ◽  
Yihong Guo ◽  
...  
Keyword(s):  
Embryonic Development ◽  
High Quality ◽  
Preimplantation Genetic Testing ◽  
Abnormal Embryo ◽  
Significant Difference ◽  
Molecular Karyotype ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Euploid Embryo

Abstract Background: Balanced complex chromosome rearrangements (BCCR) are balanced chromosomal structural aberrations that involve two or more chromosomes and at least three breakpoints. It is very rare in the population.The objective is to explore the difference of influence of three types of BCCR on early embryonic development and molecular karyotype.Results:Twelve couples were recruited including four couples of three-way rearrangements carriers (group A), three couples of double two-way translocations carriers (group B) and five couples of exceptional CCR carriers (group C). A total of 243 oocytes were retrievedin the seventeen preimplantation genetic testing (PGT) cycles, and 207 of these were available for fertilization.After intracytoplasmic sperm injection, 181oocytes normally fertilized. The rates of embryos forming on day3 in three groups were 87.88%, 97.78% and77.14%, which was significantly different (P=0.01). Compared with group B, the rate of embryo formation was statistically significantly lower in group C(P=0.01).Furthermore, the rates of high-quality blastocysts in three group were 14.71%, 48.15% and 62.96%, respectively, which was significantly different (P=0.00). Compared with group B andC, the rate of high-quality blastocysts in group A was statistically significantly lower (P=0.00;P=0.00). Comprehensive chromosome analysis was performed on 83 embryos, including 75 trophectodermcellsand 8 blastomeres. Except 7 embryos failed to amplify, 9.01%embryos were diagnosed as euploidy, and 90.91% were diagnosed as abnormal. As for group A, the euploid embryo rate was 10.71%and the abnormal embryo rate was 89.29%. In group B,the euploid embryo rate was 3.85%, the abnormal embryo rate was 96.15%. The euploid embryo rate was 13.04%, the abnormal embryo rate was 86.96% in group C.There were no significant differences among the three groups (P = 0.55).Conclusions:The lowest rate of high quality blastocysts has been for three-way rearrangements and the lowest rate of euploidy has been for double two-way translocations, although no significant difference. Different types of BCCR maybe have little effect on the embryonic molecular karyotype. The difference of influence of BCCR on early embryonic developmentandmolecular karyotypeshould be further studied.

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