scholarly journals HbA1c and Aortic Calcification Index as Noninvasive Predictors of Pre-Existing Histopathological Damages in Living Donor Kidney Transplantation

2020 ◽  
Vol 9 (10) ◽  
pp. 3266
Author(s):  
Kosuke Tanaka ◽  
Shigeyoshi Yamanaga ◽  
Yuji Hidaka ◽  
Sho Nishida ◽  
Kohei Kinoshita ◽  
...  
Keyword(s):  
Interstitial Fibrosis ◽  
Psoas Muscle ◽  
Living Donors ◽  
Aortic Calcification ◽  
Related Factors ◽  
Tubular Atrophy ◽  
Cross Sectional ◽  
Living Kidney Donors ◽  
Significant Difference ◽  
And Control

We previously reported that allografts from living donors may have pre-existing histopathological damages, defined as the combination of interstitial fibrosis (ci), tubular atrophy (ct), and arteriolar hyalinosis (ah) scores of ≧1, according to the Banff classification. We examined preoperative characteristics to identify whether the degree of these damages was related to metabolic syndrome-related factors of donors. We conducted a single-center cross-sectional analysis including 183 living kidney donors. Donors were divided into two groups: chronic change (ci + ct ≧ 1 ∩ ah ≧ 1, n = 27) and control (n = 156). Preoperative characteristics, including age, sex, blood pressure, hemoglobin A1c (HbA1c), aortic calcification index (ACI), and psoas muscle index (PMI), were analyzed. Comparing the groups, the baseline estimated glomerular filtration rate was not significantly different; however, we observed a significant difference for ACI (p = 0.009). HbA1c (p = 0.016) and ACI (p = 0.006) were independent risk factors to predict pre-existing histopathological damages, whereas PMI was not. HbA1c correlated with ct scores (p = 0.035), and ACI correlated with ci (p = 0.005), ct (p = 0.021), and ah (p = 0.017). HbA1c and ACI may serve as preoperative markers for identifying pre-existing damages on the kidneys of living donors.

scholarly journals Kidney Structural Features from Living Donors Predict Graft Failure in the Recipient

2020 ◽  
Vol 31 (2) ◽  
pp. 415-423 ◽  
Author(s):  
Naim Issa ◽  
Camden L. Lopez ◽  
Aleksandar Denic ◽  
Sandra J. Taler ◽  
Joseph J. Larson ◽  
...  
Keyword(s):  
Graft Failure ◽  
Clinical Characteristics ◽  
Interstitial Fibrosis ◽  
Kidney Transplant Recipient ◽  
Structural Features ◽  
Living Donors ◽  
Nephron Number ◽  
Tubular Atrophy ◽  
Cross Sectional ◽  
Arteriolar Hyalinosis

BackgroundNephrosclerosis, nephron size, and nephron number vary among kidneys transplanted from living donors. However, whether these structural features predict kidney transplant recipient outcomes is unclear.MethodsOur study used computed tomography (CT) and implantation biopsy to investigate donated kidney features as predictors of death-censored graft failure at three transplant centers participating in the Aging Kidney Anatomy study. We used global glomerulosclerosis, interstitial fibrosis/tubular atrophy, artery luminal stenosis, and arteriolar hyalinosis to measure nephrosclerosis; mean glomerular volume, cortex volume per glomerulus, and mean cross-sectional tubular area to measure nephron size; and calculations from CT cortical volume and glomerular density on biopsy to assess nephron number. We also determined the death-censored risk of graft failure with each structural feature after adjusting for the predictive clinical characteristics of donor and recipient.ResultsThe analysis involved 2293 donor-recipient pairs. Mean recipient follow-up was 6.3 years, during which 287 death-censored graft failures and 424 deaths occurred. Factors that predicted death-censored graft failure independent of both donor and recipient clinical characteristics included interstitial fibrosis/tubular atrophy, larger cortical nephron size (but not nephron number), and smaller medullary volume. In a subset with 12 biopsy section slides, arteriolar hyalinosis also predicted death-censored graft failure.ConclusionsSubclinical nephrosclerosis, larger cortical nephron size, and smaller medullary volume in healthy donors modestly predict death-censored graft failure in the recipient, independent of donor or recipient clinical characteristics. These findings provide insights into a graft’s “intrinsic quality” at the time of donation, and further support the use of intraoperative biopsies to identify kidney grafts that are at higher risk for failure.

Safety climate and related factors in rehabilitation nurses of hospitals in Iran

Work ◽  
2021 ◽  
pp. 1-8
Author(s):  
Javad vatani ◽  
Zahra Khanikosarkhizi ◽  
Mohammad Ali Shahabi Rabori ◽  
mohammad khandan ◽  
Mohsen aminizadeh ◽  
...  
Keyword(s):  
Safety Climate ◽  
Cross Sectional Study ◽  
P Value ◽  
Related Factors ◽  
Cross Sectional ◽  
Climate Assessment ◽  
Safety Work ◽  
Significant Difference ◽  
Training Courses ◽  
The Individual

BACKGROUND: Safety climate is a common insight of staff that indicates individuals’ attitudes toward safety and priority of safety at work. OBJECTIVES: Nursing is a risky job where paying attention to safety is crucial. The assessment of the safety climate is one of the methods to measure the safety conditions in this occupation. The aim of this study was to assess the safety climate of rehabilitation nurses working in hospitals in Tehran. METHODS: This is a cross-sectional study which was carried out on 140 rehabilitation nurses selected from all hospitals and clinics in Tehran in 2019. To collect the required data, a two-section questionnaire was used. The first section was related to demographic factors and the second part (22 statements) was to measure the safety climate using nurses’ safety climate assessment questionnaire. The collected data were analyzed by SPSS V16 using independent t-test, ANOVA, Kruskal-Wallis and Mann-Whitney U test at the 5% level. RESULTS: Findings showed that the total mean of safety climate was 3.06±0.56. According to the results, a significant difference was found between the positive and negative satisfaction of nurses with safety climates (P-value = 0.03), communication with nurses (P-value = 0.01) and supervisors’ attitude (P-value = 0.02). Furthermore, a significant difference in safety climate between the individual with the second job and the individual without second could be observed (P-value = 0.01). CONCLUSIONS: The results indicated that the safety climate was not at an acceptable level. Thus, it is essential to introduce safety training courses (e.g. safety, work-rest balance, and so on) and to improve the safety performance at work.

scholarly journals Anolunula in Fingernails among Patients Infected with HIV

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Pratik Gahalaut ◽  
Nitin Mishra ◽  
Sandhya Chauhan ◽  
Mir Mubashir Ali ◽  
Madhur Kant Rastogi ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Cross Sectional Study ◽  
Negative Control ◽  
Hiv Positive ◽  
Control Group ◽  
Cross Sectional ◽  
Significant Difference ◽  
Stage 1 ◽  
And Control ◽  
Hiv Negative

Lunula is the white, half-moon shaped area seen in proximal ends of some nails. Though a few studies have described the nail changes that can occur in association with HIV infection, none of these paid much attention to lunula. Aims and Objectives. To study the lunula in fingernails among HIV infected patients. Materials and Methods. An observational, cross-sectional study to record presence of lunula in 168 HIV-positive patients and compare it with age and sex matched 168 healthy HIV-negative control. Anolunula (absence of lunula) in HIV-positive patients was correlated with CD4 counts, stages of HIV infection, time since patient was diagnosed as HIV-positive, and status of antiretroviral therapy. Results. Anolunula was present in significantly more fingernails in HIV-positive patients compared to HIV-negative controls. There was a highly significant difference for total anolunula (anolunula in all fingernails) in study and control group. Incidence of total anolunula was directly proportional to the stage of HIV infection, increasing progressively as the HIV infection advances from stage 1 to stage 4. Conclusion. Absence of lunula is related to not only HIV infection per se but also the stages of HIV infection.

Weak psoas and spine extensors potentially predispose to hip fracture

2020 ◽  
pp. 112070002090433
Author(s):  
Keong-Hwan Kim ◽  
Jun Hee Lee ◽  
Eic Ju Lim
Keyword(s):  
Hip Fracture ◽  
Lumbar Vertebra ◽  
Psoas Muscle ◽  
Hounsfield Unit ◽  
The Body ◽  
Whole Body ◽  
Cross Sectional ◽  
Fracture Group ◽  
Extensor Muscles ◽  
Significant Difference

Introduction: We performed a computed tomography analysis of muscle composition characteristics in hip fracture patients and non-hip fracture controls. Methods: In total, 43 patients (9 men, 34 women) were included in the hip fracture group, matched 1 to 1 with non-hip fracture controls. Muscle cross-sectional areas were measured in axial CT scan at the body level of the 4th lumbar vertebra (L4), intervertebral disc level between the 5th lumbar vertebra and the 1st sacral vertebra (L5-S1) and just below level of the lesser trochanter (LT). Attenuation was also evaluated through the mean Hounsfield unit (HU) in these areas. Results: The cross-sectional area per weight (CSA/Wt, mm2/kg) of psoas muscle and extensor muscles of the spine showed a significant difference between the 2 groups at both L4 (9.7 vs. 12.4, p  < 0.001 and 26.3 vs. 29.2, p  = 0.025) and L5-S1 (9.6 vs. 11.5, p  = 0.001 and 8.8 vs. 10.3, p  = 0.041) levels. In addition, the HU of these muscles differed significantly between the 2 groups at both L4 (33.3 vs. 47.6, p  < 0.001 and 13.7 vs. 30.2, p  < 0.001) and L5-S1 (39.7 vs. 52.6, p  < 0.001 and 3.8 vs. 15.1, p  = 0.012) levels. There was no difference in abdominal wall, gluteal, or thigh compartment musculature between the groups. Conclusions: Poorer quantity and quality of psoas muscle and extensor muscles of the spine rather than whole body muscles may contribute to falls and were characteristic features of the hip fracture patients in this series. These findings should be considered when recommending a preventive exercise and rehabilitation protocol.

scholarly journals Knowledge, adherence and control among patients with hypertension attending a peri-urban primary health care clinic, KwaZulu-Natal

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Olumuyiwa A. Olowe ◽  
Andrew J. Ross
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Cross Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Care Clinic ◽  
Primary Health ◽  
Validated Questionnaire ◽  
Study Population ◽  
And Control

Background: Despite hypertension being a common condition among patients attending primary health care (PHC) clinics, blood pressure (BP) control is often poor. Greater insight into patient-related factors that influence the control of hypertension will assist in the development of an intervention to address the issues identified.Aim: The aim of the study was to assess patient-related variables associated with hypertension control among patients attending a peri-urban PHC clinic.Setting: The setting for this study was a peri-urban PHC clinic in KwaZulu-Natal.Method: This was an observational, descriptive and cross-sectional study with 348 patients selected over a 1-month period. A validated questionnaire was used to collect data on patients’ hypertension knowledge and self-reported adherence, and BP recordings from their medical record were recorded to ascertain control.Results: Of the 348 participants, only 49% had good BP control and 44% (152/348) had concurrent diabetes mellitus. The majority of patients had moderate levels of knowledge on hypertension and exhibited moderate adherence. There was a significant relationship between knowledge and reported adherence, between reported adherence and control, but not between reported knowledge and control.Conclusion: Despite over 90% of the study population having moderate knowledge, and 62% with moderate reported adherence, BP was well controlled in only less than 50% of the study population. These findings suggest a need to emphasise adherence and explore new ways of approaching adherence.

scholarly journals Prevalence and Economic Significance of Hydatidosis on Cattle Slaughtered at Nekemte Municipal Abattoir, Western Ethiopia

2020 ◽  
Vol 5 (3) ◽  
pp. 57-63
Author(s):  
Tuge Temesgen ◽  
Keyword(s):  
Risk Factors ◽  
Public Awareness ◽  
Cattle Breed ◽  
Cross Sectional Study ◽  
Hydatid Cysts ◽  
Financial Loss ◽  
Cross Sectional ◽  
Viability Test ◽  
Significant Difference ◽  
And Control

Aim The study was conducted to determine the prevalence of hydatidosis, to identify the association between expected risk factors and occurrence of the disease, to investigate economic importance and to evaluate fertility and viability of the hydatid cyst in cattle slaughtered at the abattoir. Materials and Methods A cross-sectional study, which involves both ante-mortem and post-mortem examination, was conducted at Nekemte municipal abattoir from November 2015 to March 2016. Results A total of 355 local cattle breed was randomly sampled and examined for the presence of hydatid cysts in the organs of the animals using the standard meat inspection procedures, 66 (18.6%) animals were found harboring hydatid cysts. Statistical analysis showed that there was a significant difference (p<0.05) between the prevalence of bovine hydatidosis in all risk factors with exception of sex of the animals. Among 207 hydatid cysts recorded, 93 (44.92%) were from lungs, 65 (31.40%) from livers, 4 (1.93%) from heart, 3 (1.44%) from kidney, 1 (0.48%) from spleen and 41 (19.8%) were in two organs from lung and liver. Fifty-seven (57) of these 207 cysts were randomly selected and subjected to fertility and viability test which revealed 19 (33.33%) as fertile, 25 (43.86 %) sterile and 13 (22.81%) calcified. Viability test proved 7 (12.28%) of 19 fertile cysts as viable and 12 (21.05%) of 19 fertile cysts as non-viable. Viability of cysts in different organs revealed that 5 (16.1%) and 2 (10%) of cysts from lungs and liver, respectively. The estimated financial loss during the study period both due to condemnation of organs and an in direct carcass weight loss from hydatidosis was 2,190,143.52 ETB. Conclusion The results of this study revealed that bovine hydatidosis was an economically important disease of cattle which need serious attention for prevention and control actions in and around Nekemte. Hence, establishment of well-equipped standardized abattoirs, prohibition of backyard slaughter, creation of public awareness, deworming and control of stray dogs are of paramount importance.

Relevance of classification by size to topographical differences in bronchial smooth muscle response

1993 ◽  
Vol 75 (5) ◽  
pp. 2013-2021 ◽  
Author(s):  
P. Chitano ◽  
S. B. Sigurdsson ◽  
A. J. Halayko ◽  
N. L. Stephens
Keyword(s):  
Smooth Muscle ◽  
Electrical Field Stimulation ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Muscle Response ◽  
Bronchial Responsiveness ◽  
Sixth Generation ◽  
Significant Difference ◽  
And Control

To investigate heterogeneity of airway smooth muscle response, we studied strips of large and small branches from third- to sixth-generation bronchi obtained from ragweed antigen-sensitized and control dogs. The response to electrical field stimulation and carbamylcholine chloride was greater in strips from larger branches of the same generation when expressed as "tissue stress" (force per unit cross-sectional area of the whole tissue), whereas no difference emerged with use of the more appropriate "smooth muscle stress" (force per unit cross-sectional area of the muscle tissue). The response to histamine was significantly higher in small branches than in large ones, and histamine sensitivity [mean effective concentration (EC50)] was 7.79 x 10(-6) [geometric standard error of the mean (GSEM) 1.20] and 1.49 x 10(-5) M (GSEM 1.14), respectively (P < 0.01). Strips from control and sensitized animals at each site and strips from different generations did not show any significant difference. When we clustered our preparations according to dimensions, the response to histamine was significantly higher in small bronchi than in large ones and histamine EC50 was 8.95 x 10(-6) (GSEM 1.17) and 1.57 x 10(-5) M (GSEM 1.18), respectively (P < 0.05). We conclude that evaluation of muscle response in different tissues requires appropriate normalization. Furthermore, classification into generations is inadequate to study bronchial responsiveness, inasmuch as major differences originate from airway size.

Antibiotics and Steroids in the Treatment of Acquired Subglottic Stenosis

1983 ◽  
Vol 92 (4) ◽  
pp. 377-382 ◽  
Author(s):  
John S. Supance
Keyword(s):  
Animal Model ◽  
Subglottic Stenosis ◽  
Control Group ◽  
Cross Sectional ◽  
Procaine Penicillin ◽  
Therapy Animals ◽  
Significant Difference ◽  
Medical Regimens ◽  
And Control ◽  
Systemic Antibiotics

The efficacy of a combination of systemic antibiotics and a steroid in the prevention of acquired subglottic stenosis (ASGS) was evaluated employing a previously developed canine animal model. Thirty-five healthy, postweanling mongrel puppies aged 5 weeks were each intubated for 14 days with an uncuffed polyvinyl endotracheal tube. Twenty puppies received intramuscular dexamethasone (1 mg) daily, and procaine penicillin (100,000 IU) and dihydrostreptomycin (0.125 g) in two divided doses on the day of intubation and each day thereafter until the completion of the study. The remaining 15 puppies served as a control group and received no medical therapy. Animals from both groups were killed at 5, 7, 12, 15, 20, 30, and 56 days following intubation. Comparative examinations of the laryngotracheal complexes of treated and control dogs showed that there was no significant difference between the two groups in the ultimate degree of ASGS attained, as determined by intraluminal cross-sectional area analysis, or in the extent of the lesion as documented by gross and microscopic histology. This investigation showed that the specific systemic combination of two antibiotics and a steroid used in the study was not efficacious in the prevention of ASGS in a canine animal model; for this reason we question the benefit of analogous medical regimens employed to prevent ASGS in infants and children who require long-term endotracheal intubation.

scholarly journals Prevalence of cigarette smoking in schizophrenic patients compared to other hospital admitted psychiatric patients

2011 ◽  
Vol 26 (S2) ◽  
pp. 1417-1417
Author(s):  
A. Kheradmand ◽  
H. Ziaaddini ◽  
M. Vahabi
Keyword(s):  
Cigarette Smoking ◽  
Psychiatric Patients ◽  
Normal Population ◽  
Demographic Data ◽  
Related Factors ◽  
Cross Sectional ◽  
Significant Difference ◽  
Other Substances ◽  
Schizophrenic Patients ◽  
The Difference

Introduction & aimsEstimate the prevalence of cigarette smoking and some of the related factors among schizophrenic and other hospitalized psychiatric patients.MethodsThis was a cross-sectional study on 120 patients hospitalized in Shahid Beheshti hospital in Kerman in 2005. Patients were equally devided in two groups of schizophrenia and other psychiatric disorders. Sampling was based on statistical census and data were collected using a questionnaire including 27 questions on demographic data, psychiatric disorder, smoking cigarettes and other substances, and Fagerstrom test. Data were analyzed by Chi-square and ANOVA tests using SPSS software.ResultsPrevalence and severity of cigarette smoking was 71.6% and 6.47% among schizophrenic and 51.6% and 6.40% among other psychiatric patients, respectively and the difference was not significant. History of withdrawal was 25.6% and 58.1% in the schizophrenia and other disorders respectively and the difference was significant (P < 0.05). Addiction to other substances was 51.6% in schizophrenic and 45% in the other patients and the most prevalent substances in both groups were opium and alcohol. The severity of smoking cigarettes was 6.9 along with other drug abuses and 5.1 in cases with just smoking based on Fagerstrom test and the difference was significant (P < 0.05).ConclusionsThe prevalence of cigarette smoking in both schizophrenia and other psychiatric patients is higher than normal population, but there is no significant difference between these two groups. Schizophrenic patients need persistent supportive and supervising programs for cigarette smoking abuse treatment because of their cognitive, motivate and social problems.

scholarly journals Sepsis Is Associated with a Preferential Diaphragmatic Atrophy

2014 ◽  
Vol 120 (5) ◽  
pp. 1182-1191 ◽  
Author(s):  
Boris Jung ◽  
Stephanie Nougaret ◽  
Matthieu Conseil ◽  
Yannaël Coisel ◽  
Emmanuel Futier ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Secondary Analysis ◽  
Lumbar Vertebra ◽  
Psoas Muscle ◽  
Cross Sectional ◽  
Icu Admission ◽  
Icu Stay ◽  
Peripheral Muscle ◽  
And Control

Abstract Background: Diaphragm and psoas are affected during sepsis in animal models. Whether diaphragm or limb muscle is preferentially affected during sepsis in the critically ill remains unclear. Methods: Retrospective secondary analysis study including 40 patients, comparing control (n = 17) and critically ill patients, with (n = 14) or without sepsis (n = 9). Diaphragm volume, psoas volume, and cross-sectional area of the skeletal muscles at the third lumbar vertebra were measured during intensive care unit (ICU) stay using tridimensional computed tomography scan volumetry. Diaphragm strength was evaluated using magnetic phrenic nerve stimulation. The primary endpoint was the comparison between diaphragm and peripheral muscle volume kinetics during the ICU stay among critically ill patients, with or without sepsis. Results: Upon ICU admission, neither diaphragm nor psoas muscle volumes were significantly different between critically ill and control patients (163 ± 53 cm3vs. 197 ± 82 cm3 for the diaphragm, P = 0.36, and 272 ± 116 cm3vs. to 329 ± 166 cm3 for the psoas, P = 0.31). Twenty-five (15 to 36) days after admission, diaphragm volume decreased by 11 ± 13% in nonseptic and by 27 ± 12% in septic patients, P = 0.01. Psoas volume decreased by 11 ± 10% in nonseptic and by 19 ± 13% in septic patients, P = 0.09. Upon ICU admission, diaphragm strength was correlated with diaphragm volume and was lower in septic (6.2 cm H2O [5.6 to 9.3]) than that in nonseptic patients (13.2 cm H2O [12.3 to 15.6]), P = 0.01. Conclusions: During the ICU stay, both diaphragm and psoas volumes decreased. In septic patients, the authors report for the first time in humans preferential diaphragm atrophy compared with peripheral muscles.

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