clearance study
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Author(s):  
Scott A. Hubers ◽  
Siu‐Hin Wan ◽  
Fadi W. Adel ◽  
Sherry L. Benike ◽  
John C. Burnett ◽  
...  

Background Phosphodiesterase V (PDEV) is upregulated in heart failure, leading to increased degradation of cGMP and impaired natriuresis. PDEV inhibition improves the renal response to B‐type natriuretic peptide in animal models. We tested the hypothesis that long‐term PDEV inhibition would improve renal function and cardiorenal response after short‐term volume load in subjects with pre–heart failure. Methods and Results A total of 20 subjects with pre–heart failure (defined as an ejection fraction ≤45% without previous diagnosis of heart failure) and renal impairment were randomized in a 2:1 manner to tadalafil or placebo. Baseline echocardiography and renal clearance study were performed, followed by a short‐term saline load and repeated echocardiography and renal clearance study. Subjects then received either tadalafil at a goal dose of 20 mg daily or placebo, and the study day was repeated after 12 weeks. Long‐term tadalafil did not improve glomerular filtration rate (median increase of 2.0 mL/min in the tadalafil group versus 13.5 mL/min in the placebo group; P =0.54). There was no difference in urinary sodium or cGMP excretion with PDEV inhibition following short‐term saline loading. Conclusions Glomerular filtration rate and urinary sodium/cGMP excretion were not significantly different after 12 weeks of tadalafil compared with placebo. These results do not support the use of PDEV inhibition to improve renal response in patients with pre–heart failure. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01970176.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A426-A426
Author(s):  
J C Andrefsky ◽  
D Cahn-Hidalgo ◽  
R Benabou

Abstract Introduction Chronic sleep deprivation has been associated with cognitive impairment (CI) in multiple studies. Cognivue is an FDA-cleared computerized testing tool that provides adaptive psychophysic evaluation of cognitive functions (CF). A reliable objective method to evaluate CF in patients with sleep disorders could be helpful to optimize long-term treatment. In an FDA clearance study, Cognivue demonstrated good agreement with St. Louis University Mental Status (SLUMS) and other neuropsychological tests, and superior test re-test reliability compared to SLUMS across 2 sessions, 1 to 2 weeks apart (Cognivue regression fit: R2= 0.81, r= 0.90); SLUMS regression fit: R2 = 0.67, r= 0.82). Methods 238 subjects from the FDA clearance study enrolled in the longitudinal study. They underwent Cognivue test and SLUMS at 3 sessions over 18 months (6, 12, 18 months post-FDA study). An analysis of rank linear regression test-retest reliability was performed for both tests. Results Among these 238 patients, Cognivue demonstrated similar linear regression scores across comparisons (test session 1&2: regression fit: R2= 0.76; r = 0.87; test session 1&3: regression fit: R2= 0.72; r = 0.85; test session 1&4: regression fit: R2= 0.73; r = 0.86). The SLUMS test demonstrated greater variability in regression scores across test sessions (test session 1&2: regression fit: R2= 0.63; r = 0.79; test session 1&3: regression fit: R2= 0.43 r = 0.65; test session 1&4: regression fit: R2= 0.64; r = 0.80). Conclusion Cognivue demonstrated maintained superior test re-test reliability compared to SLUMS over a period of 18 months after the FDA clearance study. With that, Cognivue could be beneficial in detecting early stages of multi-domain CI in patients with sleep disorders, providing an opportunity for early intervention strategies and follow-up over time to improve patient outcomes. Support Cognivue, Inc.


Hypertension ◽  
2020 ◽  
Vol 75 (2) ◽  
pp. 439-448
Author(s):  
Li Gu ◽  
JunLin Wang ◽  
Dan-Dan Zhang ◽  
XinXin Meng ◽  
YunHong Zhang ◽  
...  

The inhibition of Type II angiotensin II receptor (AT2R) or BK2R (bradykinin type II receptor) stimulates basolateral Kir4.1/Kir5.1 in the distal convoluted tubule (DCT) and activates thiazide-sensitive NCC (Na-Cl cotransporter). The aim of the present study is to examine the role of AT2R and BK2R in mediating the effect of HK (high dietary K + ) intake on the basolateral K + channels, NCC, and renal K + excretion. Feeding mice (male and female) with HK diet for overnight significantly decreased the basolateral K + conductance, depolarized the DCT membrane, diminished the expression of pNCC (phosphorylated NCC) and tNCC (total NCC), and decreased thiazide-sensitive natriuresis. Overnight HK intake also increased the expression of cleaved ENaC-α and -γ subunits but had no effect on NKCC2 expression. Pretreatment of the mice (male and female) with PD123319 and HOE140 stimulated the expression of tNCC and pNCC, augmented hydrochlorothiazide-induced natriuresis, and increased the negativity of the DCT membrane. The deletion of Kir4.1 not only decreased the NCC activity but also abolished the stimulatory effect of PD123319 and HOE140 perfusion on NCC activity. Moreover, the effect of overnight HK loading on Kir4.1/Kir5.1 in the DCT and NCC expression/activity was compromised in the mice treated with AT2R/BK2R antagonists. Renal clearance study showed that inhibition of AT2R and BK2R impairs renal K + excretion in response to overnight HK loading, and the mice pretreated with PD123319 and HOE140 were hyperkalemic during HK intake. We conclude that synergistic activation of AT2R and BK2R is required for the effect of overnight HK diet on Kir4.1/Kir5.1 in the DCT and NCC activity.


NanoImpact ◽  
2020 ◽  
Vol 17 ◽  
pp. 100213 ◽  
Author(s):  
Shanshan Liang ◽  
Bing Wang ◽  
Xue Li ◽  
Runxuan Chu ◽  
Hongyang Yu ◽  
...  

2019 ◽  
Vol 26 (08) ◽  
pp. 1296-1299
Author(s):  
Qazi Adil Inam ◽  
Furqan Arshad ◽  
Nabeel Naeem Baig ◽  
Khadijah Abid

To decide the adequacy of ureterorenoscope by utilizing lithoclast for distal ureteric stone clearance. Study Design: Longitudinal study. Setting: Department of urology Aziz Bhatti Shaheed Teaching Hospital. Period: Feb 2014 to Dec 2016. Materials and Methods: 32 patients from medical record who underwent for stone clearance with ureteroscopy followed by lithoclast. The patients with larger upper ureteral stones were enrolled in the study though patients with stone size<1cm and co-morbidities were not included in the study. The characteristic of patients and stone, treatment modality & outcome i.e. efficacy in terms of “successful stone clearance” were determined. Results: The average age of 32 patients was 34.28±10.11 years. 18 (56.3%) of the patients were females whereas 14 (43.7%) were males. Ureteric stones were present on both right and left sides in 17 (54%) and 15(46%) patients. Bilateral ureteric stone was present in 2 (6.25%) patients. The efficacy was reported as 96% for the stone size of 1-1.5cm and 92% for the stone size of 1.6-3cm. Conclusions: We concluded that Ureterorenoscope followed by Lithoclast is the useful and safest procedure for stone clearance.


2018 ◽  
Vol 315 (2) ◽  
pp. F223-F230 ◽  
Author(s):  
Peng Wu ◽  
Zhong-Xiuzi Gao ◽  
Xiao-Tong Su ◽  
David H. Ellison ◽  
Juliette Hadchouel ◽  
...  

With-no-lysine kinase 4 (WNK4) and kidney-specific (KS)-WNK1 regulate ROMK (Kir1.1) channels in a variety of cell models. We now explore the role of WNK4 and KS-WNK1 in regulating ROMK in the native distal convoluted tubule (DCT)/connecting tubule (CNT) by measuring tertiapin-Q (TPNQ; ROMK inhibitor)-sensitive K+ currents with whole cell recording. TPNQ-sensitive K+ currents in DCT2/CNT of KS- WNK1−/− and WNK4−/− mice were significantly smaller than that of WT mice. In contrast, the basolateral K+ channels (a Kir4.1/5.1 heterotetramer) in the DCT were not inhibited. Moreover, WNK4−/− mice were hypokalemic, while KS- WNK1−/− mice had normal plasma K+ levels. High K+ (HK) intake significantly increased TPNQ-sensitive K+ currents in DCT2/CNT of WT and WNK4−/− mice but not in KS- WNK1−/− mice. However, TPNQ-sensitive K+ currents in the cortical collecting duct (CCD) were normal not only under control conditions but also significantly increased in response to HK in KS- WNK1−/− mice. This suggests that the deletion of KS-WNK1-induced inhibition of ROMK occurs only in the DCT2/CNT. Renal clearance study further demonstrated that the deletion of KS-WNK1 did not affect the renal ability of K+ excretion under control conditions and during increasing K+ intake. Also, HK intake did not cause hyperkalemia in KS- WNK1−/− mice. We conclude that KS-WNK1 but not WNK4 is required for HK intake-induced stimulation of ROMK activity in DCT2/CNT. However, KS-WNK1 is not essential for HK-induced stimulation of ROMK in the CCD, and the lack of KS-WNK1 does not affect net renal K+ excretion.


Author(s):  
Qiang Wu ◽  
LiQinDu Wang ◽  
Chen Jiang ◽  
GuangLai Zhou

Clearance is an effective method to control radioactive waste, but some assessment of types of pollutants may need to be done before clearance in some situation. In fact, there is large volume very low level radioactive materials in nuclear wastes in nuclear power plant, a reasonable method should be built based on both of potential clearance study and clearance method optimization. Some suggestions are presented about the work of radioactive waste disposal for its present condition and development in China.


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