bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum Advanced Glycosylation End-Products in Patients on Hemodialysis and CAPD
Authors: Ateshkadi Arasb , Johnson Curtis A. , Founds Henry W. , Zimmerman Stephen W.
Published: February 2020

Objectives

Part I: To evaluate the long-term effects of daily glucose absorption from the peritoneal dialysis fluid on the formation of low-molecular-weight advanced glycosylation end products (AGE-peptides) in nondiabetic continuous ambulatory peritoneal dialysis (CAPD) patients. Part II: To determine the acute effect of CAPD on serum AGE-peptide concentrations.

Design

Part I: Noninterventional, parallel, cross-sectional clinical trial. Part II: Crossover clinical trial.

Setting

A university-based hospital, and clinics.

Patients

Part I: Sixty nondiabetic subjects recruited into three age-matched (:1:5 years) groups, as follows: 20 healthy volunteers (controls); 20 hemodialysis patients; and 20 CAPD patients. Part II: Eight patients with diabetes mellitus (type lor II) and chronic renal failure who were about to undergo CAPD.

Intervention

Part I: None. Part II: Uninterrupted CAPD, as medically required.

Measurements

Part I: To determine serum AGEpeptide concentrations blood samples were obtained randomly from controls and CAPD patients, and predialysis from hemodialysis patients. Hemoglobin A1c was also measured in all subjects. Part II: To determine serum AGE-peptide concentrations, blood samples were collected within one month prior to initiation of CAPD (predialysis) and, again, one week after initiation of uninterrupted CAPD (postdialysis). Hemoglobin A1c was measured predialysis.

Results

Part I: Mean hemoglobin A1c values for all groups were within the normal range; however, the mean value for CAPD patients was significantly higher than for both hemodialysis patients and healthy controls (controls, 5.21%:1:0.6%; hemodialysis, 5.12%:1:0.5%; CAPD, 5.78%:1:0.6%; p < 0.01). The dialysis patients had a significantly higher mean serum AGE-peptide concentration than the control subjects (controls, 7.02:1:3.4 units/mL; hemodialysis, 11.9:1:3.6 units/mL; CAPD, 11.1:1:4.5 units/mL; p < 0.01). There was no difference in the mean serum AGE-peptide concentration of patients in the hemodialysis and CAPD groups. Part II: The mean hemoglobin A1c value in the diabetic predialysis patients was 9.2%:1:1.9%. There was no difference between the predialysis and postdialysis serum AGE-peptide concentrations (predialysis, 16.9:1:9.6 units/mL; postdialysis, 16.0:1:2.9 units/mL; p = 0.78).

Conclusions

Despite the increased glucose load and the higher hemoglobin A1c values, indicating poor glycemic control, nondiabetic CAPD patients did not have higher serum AGEpeptide concentrations than the nondiabetic hemodialysis patients. In diabetic patients, CAPD did not further increase the serum concentrations of AGEpeptides.
Expected White Blood Cell Counts and Differentials in a Rat Model of Peritoneal Dialysis
Authors: Suzuki Kazuyuki , Khanna Ramesh , Nolph Karl D. , Twardowski Zbylut J. , Moore Harold L.
Published: February 2020

Objective

The purpose of this study was to establish baseline dialysate white blood cell (WBC) counts and differentials in noninfected rats on peritoneal dialysis (PO).

Design

Sixteen male Sprague-Oawley rats underwent PO in the first protocol, and eight from the 16 continued PO in the second through fourth protocols. At the beginning of the experiments, all animals had a PO catheter implanted and were initiated on PO with 1.5% dextrose dialysis solution twice daily. In the first protocol, WBC counts and differentials were assessed from day 4 to day 15 of dialysis in noninfected animals to establish “normal values” for such a rat model. In protocol 2, WBC counts and solute concentrations in small aliquots of dialysate obtained from the catheter were compared to values in well-mixed total drainage. Protocol 3 was designed to assess effects of dwell time on WBC counts. Protocol 4 examined the effect of glucose concentration of dialysis solution on WBC counts.

Results

In the first protocol, the mean dialysate WBC counts were significantly higher on the fourth day of dialysis, but stabilized below 2500 cells/mm3 by the eighth day. The percentage of neutrophils was stable around 20% -25%. In the second protocol, we found aliquots < 1 mL might underestimate the dialysate WBC count compared to the complete drainage. In the third protocol, WBC counts increased as cycle time became longer, but the percentage of neutrophils remained below 50%. In the fourth protocol, we did not find any effects of glucose concentration of instilled solutions on WBC counts and differentials.

Conclusion

This study of WBC counts and differentials in noninfected rats on peritoneal dialysis establishes the range above which infection should be suspected. WBC counts increase with cycle time. Small dialysate aliquots may underestimate WBC counts. Glucose concentration does not effect WBC counts.
Comparison of Peritoneal Catheter Survival with Fistula Survival in Hemodialysis
Authors: Kim Yong-Soo , Yang Chul-Woo , Jin Dong-Chan , Ahn Suk-Joo , Chang Yoon-Sik , Yoon Young-Suk , Bang Byung-Kee
Published: February 2020

Objective

To compare continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) with regard to long-term maintenance of access.

Design

Retrospective study of a four to six-year time period at one center.

Patients

One hundred and twenty-two CAPD patients between December 1988 and December 1992, and 172 HD patients between May 1986 and December 1992.

Main Outcome Measure

Cumulative survival rate of peritoneal catheters and arteriovenous fistulas (AVF) was the main outcome measure. Variables affecting the survival rate including sex, age, presence or absence of diabetes, and type of AVF (autogenous or prosthetic graft) were assessed. The causes of peritoneal catheter failures were analyzed.

Results

The cumulative survival rate of all peritoneal catheters was significantly longer than the AVF survival rate (84% vs 74% at one year; 73% vs 61% at two years; and 63% vs 48% at three years) (p = 0.029). There were no differences in peritoneal catheter survival according to sex, age, or diabetes. Compared with A VF survival, peritoneal catheter survival was significantly longer in male (p = 0.0492), elderly (p = 0.0082), and diabetic (p = 0.0022) patients. Prosthetic graft and old age were risk factors for AVF survival. Of all peritoneal catheter failures, infectious complications were responsible for 75% (33/44) and mechanical complications for 25% (11/44). Peritonitis was the leading infectious complication (21/33) and outflow obstruction was the leading mechanical complication (9/11).

Conclusion

In terms of long-term maintenance of access, CAPD is superior to HD, especially in the elderly or diabetics. Prevention and proper management of peritonitis may prolong the peritoneal catheter survival.
Changes in Biocompatibility of Dialysis Fluid during Its Dwell in the Peritoneal Cavity
Authors: Breborowicz Andrzej , Martis Leo , Oreopoulos Dimitrios G.
Published: February 2020

Objective

To evaluate the changes in biocompatibility of peritoneal dialysis solutions during intraperitoneal dwell.

Design

We studied the effect of the drained dialysates at time 0 and after 30, 60, 120, 240, and 360 minutes of intraperitoneal dwell on the growth of peritoneal mesothelial cells and fibroblasts and the synthesis of proteins by these cells. On one day the patients were dialyzed with glucose-based Dianeal and on alternate days with an amino acid-containing solution based on Travasol.

Patients

Dialysates were collected from 4 patients during continuous ambulatory peritoneal dialysis (CAPD) training.

Results

Unused dialysis solutions containing glucose or amino acids inhibit growth of mesothelial cells and fibroblasts. Dialysates obtained after 30 or 60 minutes of intraperitoneal dwell support the growth of these cells in a way similar to 10% fetal calf serum, but dialysates drained after a longer dwell of 120 360 minutes had a stronger effect on growth of these cells than did serum. All glucose-based dialysates stimulate the synthesis of collagen in mesothelial cells, whereas they reduce the synthesis of non-collagen proteins. All glucose-based dialysates reduce the synthesis of collagen and noncollagen proteins in fibroblasts compared with the production of these proteins in the presence of serum.

Conclusion

Changes in the properties of the dialysis solutions during their intraperitoneal dwells do not seem to increase their biocompatibility. Indeed, excessive mitogenic effect and the stimulation of collagen synthesis of the dialysates may induce pathological changes in the peritoneum.
Phagocytosis and Killing of Suspended and Adhered Bacteria by Peritoneal Cells after Dialysis
Authors: Calame Wim , Afram Charles , Blijleven Nico , Hendrickx Roeland J.B.M. , Namavar Ferry , Beelen Robert H.J.
Published: February 2020

Objective

To determine the effect of dialysis fluid containing various glucose concentrations on the phagocytosis and killing of Staphylococcus aureus by rat peritoneal cells under conditions mimicking the in vivo situation.

Design

Phagocytosis and killing were evaluated by quantitation of the killing capacity of macrophages after in vivo phagocytosis of the bacteria as well as by an in vitro flow cytometric assay of the phagocytosis and killing of adhered bacteria by peritoneal cells.

Animals

Male Wistar rats.

Main Outcome Measure

It was expected that the intraperitoneal administration of dialysis fluid would im pair the capacity of peritoneal cells to eliminate bacteria.

Results

The first test revealed no effects of glucose concentration or dwell time on the killing of phagocytosed bacteria by macrophages, median percentages ranging between 29% and 64%. In the second series of experiments no effect of glucose concentration on the phagocytosis and killing of adhered bacteria was found either; however, longer dwell times significantly enhanced both the phagocytosis (at a dwell time of 1 hour, under 20%; at dwell times of 4 or 18 hours, above 20%, p < 0.02) and the killing (at a dwell time of 1 hour, under 53%; at dwell times of 4 and 18 hours, above 70%, p < 0.01).

Conclusions

Glucose concentration has no effect on the phagocytosis and killing of Staphylococcus aureus, whereas the dwell time significantly enhances both of these functional capacities of peritoneal cells if the bacteria are adhered to surfaces.
Factors Affecting Bicarbonate Transfer with Bicarbonate-Containing CAPD Solution
Authors: Feriani Mariano , Passlick-Deetjen Jutta , La Greca Giuseppe
Published: February 2020

Objective

To evaluate bicarbonate fluxes across the peritoneal membrane and bicarbonate gain in patients treated with continuous ambulatory peritoneal dialysis (CAPD) using dialysis solutions with different bicarbonate concentrations.

Patients and Design

Ninety-seven exchanges, using different dwell times and glucose and bicarbonate concentrations were performed in 43 stable CAPD patients. Dialysate effluent bicarbonate concentration and volumes were measured at different dwell times. Net dialytic bicarbonate gain was calculated. Patients’ acid-base status was determined at the middle of the dwell.

Results

In prolonged dwells (6 –12 hours)thedialysate effluent bicarbonate concentration correlated with arterial plasma bicarbonate concentration (F = 129, p < 0.0001), but not with ultrafiltration rate or dialysis solution bicarbonate concentration. In 4-hour dwells, effluent bicarbonate concentration correlated with both plasma bicarbonate concentration and ultrafiltration rate (F = 32.52, p < 0.0001 and F = 4.4, p < 0.05, respectively). The effluent bicarbonate concentration may be predicted from the patient's plasma bicarbonate concentration and net ultrafiltration rate for either a 4-hour or prolonged (6 –12 hours) dwell time. Net bicarbonate gain by the patient correlated with ultrafiltration rate, plasma bicarbonate, and dialysis solution bicarbonate concentration (F = 100.56, p < 0.0001 at 4 hours and F = 108.08, p < 0.0001 at 6 12 hours), with the ultrafiltration rate being the predominant parameter.

Conclusions

The effluent bicarbonate concentration is related to plasma bicarbonate concentration, with ultrafiltration playing a marginal role only during short dwells. However, the ultrafiltration rate has a profound effect on net patient bicarbonate gain. Multiple linear regression analysis allows the prediction of the effect of acid-base status, ultrafiltration, dwell time, and dialysis solution bicarbonate content on net patient bicarbonate gain. It seems that bicarbonate content in the CAPD dialysis solution should be progressively increased with increasing solution osmolality.
Lipid Parameters Including Lipoprotein (A) in Patients Undergoing CAPD and Hemodialysis
Authors: Siamopoulos Kostas C. , Elisaf Moses S. , Bairaktari Helen T. , Pappas Michael B. , Sferopoulos George D. , Nikolakakis Nick G.
Published: February 2020

Objective

Oyslipidemia possibly contributes to the vascular complications commonly afflicting uremic patients. Lipoprotein (a) [Lp(a)] has been identified as an independent risk factor for atherosclerotic vascular dis ease. The aim of our study was to compare lipidparameters, including Lp(a), between hemodialysis (HO) and continuous ambulatory peritoneal dialysis (CAPO) patients.

Design

A cross-sectional study.

Setting

University Medical Center.

Participants

Forty CAPO and 40 HO patients carefully matched for age, sex, body mass index (BMI), smoking habits, and duration of dialysis were studied. A group of 40 healthy individuals matched for age, sex, BMI, and smoking habits was used as control.

Interventions

None.

Main Outcome Measures

Serum lipid parameters and atherogenic risk ratios were the main outcome measures.

Results

Both groups of dialysis patients had increased serum triglycerides and decreased levels of Apo AI and HOL cholesterol compared to controls. Moreover, the risk ratios total cholesterol/HOL cholesterol and LOL cholesterol/HOL cholesterol were significantly higher, and the ratio ApoA1/ApoB was significantly lower in both groups of patients in comparison to the normal subjects. Both groups of dialysis patients exhibited decreased ratios of LOL cholesterol/ApoB and HOL cholesterol/ApoAI, suggesting the presence of compositional lipoprotein changes. CAPO patients had a more atherogenic lipid profile compared to HO patients, since they exhibited higher levels of total and LOL cholesterol, of ApoB as well as of the ratios total cholesterol/HOL cholesterol and LOL cholesterol/ HOL cholesterol, and lower levels of the ratio ApoA1/ApoB compared to HO patients. Both groups of dialysis patients had increased serum Lp(a) levels. Even though CAPO patients had higher serum Lp(a) levels than HO patients, the differences between these two groups were only marginally statistically significant (p = 0.056 by Mann-Whitney U-test). Uremic dyslipidemia was positively correlated with serum albumin levels in both groups of patients.

Conclusion

CAPO patients exhibit a more atherogenic lipid profile than that of HO patients. The marked disturbances in Lp(a) levels may further increase the vascular risk in both groups of patients.
The Role of Dexa Bone Densitometry in Evaluating Renal Osteodystrophy in Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Johnson David w. , Mclntyre H. David , Brown Alison , Freeman Judy , Rigby Russell J.
Published: February 2020

Objective

The aims of this study were to assess the clinical utility of total and regional bone densitometry in a large continuous ambulatory peritoneal dialysis (CAPD) population and to determine the clinical, biochemical, and radiographic variables that best identified osteopenic CAPD patients.

Design and Patients

A cross-sectional study was performed on 45 CAPD patients (19 males, 26 females), comprising the total CAPD population at the Princess Alexandra Hospital.

Main Outcome Measures

Total body (TB), anteroposterior lumbar spine (APL), femoral neck (FN), Ward's triangle (WT), and skull bone mineral densities (BMDs) were measured using dual-energy x-ray absorptiometry (DEXA) and then correlated with clinical, biochemical, and radiographic indices of uremic osteodystrophy.

Results

BMDs were not significantly different from age and sex-matched reference population data. Considerable regional variation of BMD Z scores were noted between FN (-0.11 ± 0.23), WT (-0.11 ± 0.22), and APL (1.22 ± 0.04) (p = 0.003). APLZ scores were significantly reduced in patients with a previous history of fracture (-1.36 ± 1.07vs0.89 ± 0.31), bonepain(-0.72 ± 1.08vs 1.01 ± 0.31), or steroid treatment (-0.62 ± 0.39 vs 1.16 ± 0.35). Increased BMDZ scores for APL (1.82 ± 0.57 vs0.38 ± 0.29, p < 0.05), FN (0.32 ± 0.36vs-0.38 ± 0.29, p =0.014), and WT (0.45 ± 0.38vs-0.45 ± 0.26, p <0.05) were found in patients with radiographic hyperparathyroid bone disease. Both APL BMD Z scores and skull BMDs were weakly correlated with PTH (r = -0.33, p < 0.05 and r = -0.33, p < 0.05, respectively) and with CAPD duration (r = 0.30, p < 0.05 and r = -0.30, p < 0.05). Generally, however, total body and regional BMDs were poorly related to age, renal disease type, dialysis duration, renal failure duration, serum aluminum, calcium, phosphate, alkaline phosphatase, osteocalcin, and parathyroid hormone.

Conclusions

We conclude that the prevalence of osteopenia is not increased in CAPD patients. Clinical and biochemical parameters do not reliably predict BMD measurements, but prior steroids and bone symptoms are major risk factors for important bone loss. Although DEXA can reliably detect osteopenia in different skeletal regions, its usefulness in detecting osteodystrophy is limited by the confounding effects of superimposed hyperparathyroid osteosclerosis, which increases BMD.
Estimation of Total Creatinine Clearance is Unreliable in Children on Peritoneal Dialysis
Authors: Aufricht Christoph , Kitzmüller Erwin , Lothaller Maria-Anna , Müller Thomas , Birnbacher Robert , Balzar Egon , Greenbaum Laurence
Published: February 2020

Objective

To test the reliability of creatinine clearance in children on peritoneal dialysis (PD).

Design

Longitudinal, case-controlled.

Setting

Routine clinic visits at the pediatric dialysis unit of the Universitätskinderklinik of Vienna. Patients: Eleven children (2 -13 years, 10 -55 kg) with end-stage renal disease on PD.

Interventions

Creatinine clearance (CCr) was determined by measuring creatinine excretion (ECr) over 24 hours in both dialysate and urine. Each child had three to five separate measurements of their CCr. At the same time we also calculated the schwartz formula clearance from the patient's height and serum creatinine, using a modified correlate.

Main Outcome Measures

Reliability of CCr was assessed by two approaches. First, we compared each serial measurement with the mean value for each patient and thereby assessed the “intramethodical” variability. Second, we compared each CCr with the simultaneous formula clearance and assessed the “intermethodical” disagreement.

Results

Twenty-seven percent of the measurements of CCr were classified as unreliable based on a comparison with the mean value for each patient. Reliability was closely correlated with residual renal function (p < 0.01); only 12% of the measurements in the an uric patients were classified as unreliable (vs 31% in the patients with residual renal function). The simultaneous formula clearance was less variable than the CCr. The formula clearance had a sensitivity of 93% and a specificity of 60% for detecting unreliable values of CCr.

Conclusion

Estimation of total CCr is unreliable in pediatric patients on PD. A simultaneous formula clearance can be used to detect which values are unreliable.
Characteristics of Long Term Peritoneal Dialysis Survivors: 18 Years Experience in One Center
Authors: Abdel-Rahman Emaad M. , Wakeen Maureen , Zimmerman Stephen W.
Published: February 2020

Objectives

Long-term experience of patients on peritoneal dialysis (PD) in general, and in diabetic patients specifically, is limited. Few patients have been followed on PD for over 8 years. Our aim was to evaluate and characterize long-term survivors (L TS) on PD for more than 100 months. A retrospective analysis of 20 patients who survived on PD for more than 100 months was performed. Data on long-term survivors was compared to data of 103 patients who died or switched to hemodialysis (HD) in less than 100 months.

Design

The study included all patients starting PD prior to 1 January 1986. Demographic, biochemical, dialysis prescription, and morbidity data were obtained on these patients. Characteristics of long-term survivors on PD (more than 100 months), was compared with those who died or switched to HD in less than 100 months, using Student t-test.

Setting

An experienced single center, university-based dialysis program.

Patients

165 patients started PD at the University of Wisconsin prior to 1 January 1986. Forty three had type I diabetes mellitus and 24 had type II diabetes mellitus as the cause of their renal failure.

Results

Twenty patients survived on PD more than 100 months (L TS). Long-term survival of type I diabetic patients was seen in 7 of 43 patients at risk. Seventeen type I diabetics received renal transplants and ten died. 103 patients either died or switched to HD in less than 100 months. Long-term survivors were significantly younger, weighed less, had fewer episodes of peritonitis, fewer hospital days, and were prescribed more dialysis per kg body weight, than those who died or switched to HD prior to 100 months.

Conclusions

Long-term survival on CAPD for longer than 100 months is possible with survival periods up to 18 years in both males and females and in nondiabetics as well as patients with type I diabetes mellitus. No patient with type II diabetes mellitus survived longer than 100 months on CAPD. In comparison to short-term survivors, long-term survivors were characterized by being younger, weighing less, having fewer episodes of peritonitis, fewer hospital days, and were prescribed more dialysis/kg body weight.
Oxidative Metabolism of Polymorphonuclear Leukocytes in Continuous Ambulatory Peritoneal Dialysis
Authors: Nagai Tsukasa , Kuriyama Manabu , Kawada Yukimichi
Published: February 2020

Objective

To evaluate the oxidative metabolism of polymorphonuclear leukocytes (PMNL) in continuous ambulatory peritoneal dialysis (CAPD) patients compared with those of hemodialysis (HD) patients, chronic renal failure (CRF) patients not yet on dialysis, and healthy controls; and to discover factors contributing to the oxidative function in CAPD patients.

Patients

Thirty-five CAPD, 22 HD, 11 CRF patients were assessed; all were free from infections at the time of examination. Thirty-one healthy volunteers served as controls.

Methods

The oxidative metabolism was estimated by the production of superoxide anion, which was detected by luminol-dependent zymosan stimulated chemiluminescence (CL) with whole blood assessment. The volume of superoxide production equivalent to 1 mL of circulating blood (T-CL), that equivalent to 104 neutrophils (CL/N) and the velocity of superoxide production (V-CL), were measured as parameters for the oxidative function of PMNL.

Results

There were no differences in all CL parameters between CAPD and HD patients. T -CL and CL/N of dialysis patients were equal to controls but those of CRF patients were significantly decreased. V-CL of dialysis patients, as well as CRF patients, was smaller than that of controls but the difference was not significant. Among nutritional status, degree of anemia, dialytic efficacy and duration of dialysis in CAPD patients, only serum albumin concentration (Alb) correlated well to all CL parameters. Hypoalbuminemic patients(Alb <3.6 gldL, n=20) had significantly decreased T -CL and CL/N compared to normoalbuminemic patients(Alb ?: 3.6 g/dL, n=15), and decreased CL/N and V-CL compared to controls. No differences in CL parameters were observed between the patients with a history of peritonitis (n=15) and without a history of peritonitis (n=20).

Conclusions

Oxidative metabolism of PMNL in CAPD patients was maintained with respect to superoxide productive volume, while the oxidative velocity was relatively impaired. Furthermore, it seems that albumin has a great influence on the oxidative metabolism of PMNL in CAPD patients.
The Effect of Dialysate Glucose on Phagocyte Superoxide Generation in Capd Patients
Authors: Kashem Abul , Nomoto Yasuo , Tanabe Ryoji , Nishina Makoto , Endoh Haruko , Nakajima Keiko , Endoh Masayuki , Sakai Hideto , Nakazawa Hiroe
Published: February 2020

Objective

In the present study, we investigated the influence of dialysate glucose on superoxide (02) generation by peripheral and peritoneal phagocytes in continuous ambulatory peritoneal dialysis (CAPD) patients.

Design

Peripheral polymorphonuclear leukocytes (PMNL) and mononuclear leukocytes (MNL), and peritoneal cells were isolated from peripheral blood and peritoneal effluents, respectively, and their oxidative metabolism was assessed by measuring 02 generation after stimulation with a soluble stimulant [phorbol myristate acetate (PMA), 1 mg/mL, Sigma Chemical, St. Louis, MO, U.S.A.] using the chemiluminescence method. Dialysate glucose effect on 02 generation was also studied in vitro by exposing peripheral PMNL and MNL from healthy controls to peritoneal dialysis fluid (PDF) containing glucose or amino acids at a neutral pH for different time periods.

Results

The amount of 02 generation by both peripheral and peritoneal phagocytes in CAPD patients was significantly higher than that in the control, and the response was greater in patients who were dialyzed with high glucose dialysate than those using low glucose dialysate. In an in vitro study, all incubated cells, except the control, showed suppression of 02 generation in the early dwell time (2 hr), and subsequently showed increased responses (peaking at 6 hr), although lower in degree than those observed in vivo. In contrast, amino acid-based PDF exhibited no such effect on 02 generation at identical pH with similar or lower osmolality. Furthermore, the respective increased or decreased oxidative responses with the increased or decreased PDF glucose concentrations in the same patient confirmed the positive effect of PDF glucose on phagocyte 02 generation.

Conclusion

It is suggested that increased 02 generation by peritoneal and circulating phagocytes in CAPD patients is at least partly due to the enhancement of hexose monophosphate shunt activity by increasing glucose metabolism in phagocytes, and the increased 02 generation might be involved in long-term complications of CAPD. Therefore, a suitable alternative osmotic agent is needed to provide a more physiological environment to minimize the adverse effects of glucose on cell functions.
2-NDC from dithiocarbamates improves ATRA efficiency and ROS-induced apoptosis via downregulation of Bcl2 and Survivin in human acute promyelocytic NB4 cells
Authors: Samarkhazan NS , Yekta R , Sayadi M , Tackallou SH , Safaralizadeh R , Mahdavi M
Published: February 2020

Although it has been widely considered that all-trans retinoic acid (ATRA) is an efficient therapeutic agent for acute promyelocytic leukemia (APL), there is an urgent need for extending and examining new therapeutics in medicine. Dithiocarbamates (DTCs) are one of the recent important chemical synthetic compounds used in cancer therapy. The aim of this study was to evaluate the apoptosis-inducing effect of 2-nitro-1-phenylethylpiperidine-1-carbodithioate (2-NDC) as an active derivative from DTCs, in combination with ATRA on human APL NB4 cells. The viability of treated NB4 cells was measured by 3-(4,5-dimethyltiazol-2-yl)-2,5-diphenyltetrazolium bromide assay in various concentrations (10–120 µM). The proapoptotic effects of 2-NDC were investigated by acridine orange/ethidium bromide staining, DNA ladder formation, and flow cytometry. We also assessed the oxidative stress-inducing effect of 2-NDC and in combination with ATRA on the NB4 cells. The alteration in gene expression levels of Bax, Bcl2, and Survivin was measured through a real-time polymerase chain reaction. Furthermore, we redetected the interaction between 2-NDC and antiapoptotic proteins Bcl2 and Survivin via molecular docking. We found that 2-NDC induced apoptosis in NB4 cells in a time–dosage-dependent manner. Also, 2-NDC triggered apoptosis by expanding intracellular reactive oxygen species, combined with ATRA. Bax/Bcl2 ratio was modulated and Survivin was downregulated in NB4 cells upon 2-NDC treatment. Molecular docking studies indicated that 2-NDC binds to the baculovirus inhibitor of apoptosis protein repeat domain of Survivin and Bcl homology 3 domain of Bcl2 with various affinities. Based on the present observations, it seems that this derivative can be estimated as an appropriate candidate for future pharmaceutical evaluations.
Using accelerometer as a diagnostic tool to detect drug-induced parkinsonism (DIP) secondary to first-generation anti-psychotic medications
Authors: Trisno Roth , Nair Parvathy , Martin Daniel , Baghini Maryam S , Chung Hoam , Pendharkar Gita , Kulkarni Jayashri
Published: February 2020

Objective:

The objective of this study is to examine the effectiveness of an accelerometer-based compact system in detecting and quantifying drug-induced parkinsonism (DIP) in patients with schizophrenia.

Method:

A pilot study controlled clinical trial comprising 6 people with schizophrenia and 11 control subjects was conducted at Alfred Health, Melbourne. Participants had their movements assessed using Barnes Akathisia Rating Scale (BARS), Simpson Angus Scale (SAS) and Movement Disorder Society Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III) followed by an assessment of gait using three triaxial accelerometers.

Results:

Median BARS, SAS, MDS-UPDRS III and accelerometer scores were significantly higher for patients with schizophrenia than controls. Accelerometers detected three times more rest tremor than clinical rating scales. Patients with schizophrenia had 70% of their dynamic acceleration at frequencies between 4 and 10 Hz, which is almost twice that observed in the control population (38%). Accelerometer scores were significantly correlated with BARS scores.

Conclusion:

Accelerometers were able to accurately detect patients with DIP better than some clinical rating scale including the SAS. Further larger-scale studies must be conducted to further demonstrate the accuracy of accelerometers in detecting DIP.
Clinical- and cost-effectiveness of intensive short-term dynamic psychotherapy for chronic pain in a tertiary psychotherapy service
Authors: Lilliengren Peter , Cooper Angela , Town Joel M , Kisely Steve , Abbass Allan
Published: February 2020

Objective:

The objective of this study is to assess the clinical- and cost-effectiveness of intensive short-term dynamic psychotherapy (ISTDP) for patients with chronic pain.

Method:

A sample of 228 pain patients was drawn from a larger naturalistic study of ISTDP. They received an average of 6.1 sessions delivered by 31 therapists. Psychiatric symptoms and interpersonal problems were assessed at three time points. Healthcare data from baseline year and three years following treatment came from independent governmental databases.

Results:

Multilevel models indicated significant reductions in symptoms and interpersonal problems during treatment, including a moderate to large pre-post effect size ( d = 0.76) for somatization. Further, the sample had successive reductions in yearly healthcare costs, reaching the normal population mean two years post-treatment.

Conclusion:

Within the limitations of the uncontrolled design, our study suggests that ISTDP may be both clinically effective and cost-effective for patients with chronic pain.
Model predictive control method of a parallel electromagnetic isolation system based on the improved genetic algorithm
Authors: Zhang Lei , Zhuan Xiangtao
Published: February 2020

To improve the vibration isolation performance for a parallel electromagnetic isolation system, an improved genetic algorithm to optimize the Q and R matrices in the control objective function for a model predictive control approach is proposed. In this study, a parallel electromagnetic isolation system with two electromagnetic isolation units is designed to expand the vibration isolation range to isolate the large object. The dynamical equation and state equation of the parallel electromagnetic isolation system are built. The nonlinear relationship among electromagnetic force, coil current, and gap is calculated by COMSOL Multiphysics to design the model predictive control controller. Meanwhile, an improved genetic algorithm by the variable chromosome length coevolutionary method is presented to tackle two issues. The first issue is that the parameters of Q and R matrices in the control objective function are mainly selected by trial and error. The other issue is that the model predictive control approach needs to determine prediction steps which may lead to the model predictive control approach suffering from heavy computation or an inaccurate prediction model. Simulation and experimental results demonstrate that the parallel electromagnetic isolation system with model predictive control method based on the improved genetic algorithm can achieve better vibration isolation performance in comparison with the passive isolation system.
High-quality, high-volume spay–neuter: Access to care and the challenge to private practitioners
Authors: Bushby Philip A
Published: February 2020

Impact:

Low-cost spay–neuter clinics were first established nearly 50 years ago in response to the numbers of dogs and cats euthanized in animal shelters. Since then, high-quality, high-volume spay–neuter (HQHVSN) clinics have been established throughout the USA and have contributed to a significant reduction in animal euthanasia in shelters. These clinics, specializing in efficient systems and surgical techniques, provide an avenue for clients who cannot afford surgery to sterilize their pets. These clinics have also helped animal shelters with limited financial resources implement spay–neuter prior to adoption policies.

Response:

The veterinary profession’s reaction to HQHVSN clinics has been mixed; some practitioners question the quality of care provided or fear the loss of clientele, while others recognize the need for such clinics and support their development.

Challenges:

As veterinary education has become more expensive and veterinary care more sophisticated, the cost of veterinary care, including spay–neuter surgery, has risen. With increasing costs, the numbers of pets that receive little or no veterinary care has increased. Indeed, a 2018 survey by the Access to Veterinary Care Coalition documented that more than 25% of pet-owning households in the USA experienced difficulties obtaining veterinary care for their pets and the most frequent barrier was financial.

Aim:

This review looks at the reality of HQHVSN clinics and what this means for the private practitioner. By adopting similar systems and techniques that lower the cost of spay–neuter surgery, practitioners could potentially pass on cost savings to clients. Moreover, the same principles may be applied to other aspects of basic care to further address access to care issues.
Leptospirosis in cats: Current literature review to guide diagnosis and management
Authors: Murillo Andrea , Goris Marga , Ahmed Ahmed , Cuenca Rafaela , Pastor Josep
Published: February 2020

Global importance:

Leptospirosis is the most widespread zoonosis worldwide. Mammals (eg, rats, horses, cows, pigs, dogs, cats and aquatic species, such as sea lions and northern elephant seals) can all be infected by leptospires. Infection in animals occurs through contact with urine or water contaminated with the bacteria. In people, the disease is acquired mainly from animal sources or through recreational activities in contaminated water.

Practical relevance:

Literature on the clinical presentation of leptospirosis in cats is scarce, although it has been demonstrated that cats are susceptible to infection and are capable of developing antibodies. The prevalence of antileptospiral antibodies in cats varies from 4% to 33.3% depending on the geographical location. Urinary shedding of leptospires in naturally infected cats has been reported, with a prevalence of up to 68%. Infection in cats has been associated with the consumption of infected prey, especially rodents. Thus, outdoor cats have a higher risk of becoming infected.

Clinical challenges:

Clinical presentation of this disease in cats is rare and it is not known what role cats have in the transmission of leptospirosis. Ongoing work is needed to characterise feline leptospirosis.

Audience:

This review is aimed at all veterinarians, both general practitioners who deal with cats on a daily basis in private practice, as well as feline practitioners, since both groups face the challenge of diagnosing and treating infectious and zoonotic diseases.

Evidence base:

The current literature on leptospirosis in cats is reviewed. To date, few case reports have been published in the field, and information has mostly been extrapolated from infections in people and dogs. This review is expected to serve as a guide for the diagnosis and management of the disease in cats.
The incidence and pattern of iliopsoas tendinitis following hip arthroscopy
Authors: Campbell Abigail , Thompson Kamali , Pham Hien , Pickell Michael , Begly John , Wolfson Theodore , Youm Thomas
Published: February 2020

Background:

Iliopsoas tendinitis is a known source of extra-articular hip pain and it has been shown to be a common cause of continued hip pain following total hip arthroplasty. While iliopsoas tendinitis after hip arthroscopy is a well-known phenomenon amongst hip arthroscopists, its presentation, course, and treatment has yet to be elucidated.

Methods:

An IRB-approved chart review was performed of patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) between March 2015 and July 2017. No cases of dysplasia were included. All patients had combined cam/pincer impingement as well as labral pathology. Tendinitis patients were identified. Patient demographics, surgical data, time to onset/diagnosis of iliopsoas tendinitis, treatment (oral anti-inflammatories, corticosteroid injection, physical therapy), and resolution of symptoms were recorded. These cases were age- and sex-matched to a control group that did not develop postoperative iliopsoas tendinitis for comparison. Patient outcomes were measured with the modified Harris Hip Score (mHHS) and Nonarthritic Hip Score (NAHS) recorded from the preoperative and 1-year postoperative visits.

Results:

Of 258 hip arthroscopy cases, 18 cases (7.0%) of postoperative iliopsoas tendinitis were diagnosed under high resolution ultrasound. On average, iliopsoas tendinitis was diagnosed 2.8 ± 1.8 months after surgery. There were no significant differences in age, sex, and BMI between patients that developed IP tendinitis compared to those that did not. No specific procedures were found to be significantly associated with incidence of postoperative IP tendinitis, including capsular closure. 18 patients were treated with corticosteroid injection, which provided mild to moderate improvement for 5 (27.8%) patients and completely resolved symptoms for 13 patients (72.2%). Of all 18 patients with postoperative iliopsoas tendinitis confirmed by response to a diagnostic injection, 10 (55.6%) had symptoms improve within 3 months of diagnosis, 2 (11.1%) between 3 and 6 months, 4 (22.2%) between 6 and 12 months, and 2 (11.1%) after 1 year. No patients went on to have surgery for this problem. Patients with iliopsoas tendinitis had lower MHHS ( p  = 0.04) and NAHS ( p = 0.09) scores at their 1-year postoperative visits.

Conclusions:

Iliopsoas tendinitis is a common source of pain following arthroscopic hip surgery and can be effectively diagnosed and treated with ultrasound-guided injection. Therefore, surgeons performing arthroscopic procedures of the hip must remain aware of and include it in their differential when encountering patients with hip flexion pain after surgery. Research should be continued to further evaluate the long-term outcomes and return to sport rates of these patients.
Wound Care With a Porcine Extracellular Matrix After Surgical Treatment of Rhinophyma
Authors: Schmitz Lutz , Hessam Schapoor , Scholl Lisa , Reitenbach Sarah , Segert Marc H. , Bechara Falk G.
Published: February 2020

Background

Rhinophyma surgery is commonly associated with prolonged wound healing and the need for multiple wound dressings.

Objectives

To evaluate clinical outcome with a porcine extracellular matrix (ECM) after shave excision of rhinophyma compared with common wound care procedure.

Materials and methods

Retrospective analysis of patients with common dressings (CD) compared with patients with additional ECM (OASIS) application. Clinical findings were assessed prior to treatment and at follow-up visit using the Patient and Observer Scar Assessment Scale (POSAS), Vancouver Scar Scale (VSS), and Rhinophyma Severity Index (RHISI).

Results

Overall, 28 patients (67.5 ±9.0 years) with a mean wound area of 33.9 (±8.5) cm² were included. After a mean follow-up period of 132 (±73) days, scales of POSAS, VSS, and RHISI showed significant ( P< .0001) reductions of 47.0% (±11.1), 56.0% (±12.0), and 62.3% (±14.3), respectively. Subgroup analysis showed no significant differences of aforementioned parameters between the ECM group ( n= 17) and CD group ( n= 11). In contrast, the number of dressing changes were significantly ( P< .006) less in the ECM group (1.4 ±0.8) compared with CD group (4.1 ±2.6). The ECM group showed a significant ( P< .017) shorter time to re-epithelization (10.5 ±1.7 days) than the CD group (13.1 ±2.2 days).

Conclusions

The application of porcine ECM is practicable and reduces the number of dressing changes and time to re-epithelization clearly. Crusts are scaling off spontaneously without any aggressive action needed. Our findings indicate that ECM application is a promising approach for rhinophyma wound care.
Fans as e-participants? Utopia/dystopia visions for the future of digital sport fandom
Authors: Sturm Damion
Published: February 2020

Media technologies and digital practices are reshaping and redefining the future of sport fandom. This article points to some of the utopian and dystopic transformations for fandom presented by (post)television, digital/social media and the anticipated virtual technologies of the future. Specifically, three distinct phases of fan participation are charted around existing and futuristic visions of technology-as-sport. First are the current televisual technologies that attempt to engage and retain traditionally “passive” viewers as spectators through pseudo-participatory perspectives that will carry over to new screens and technologies. Second, the assumed interactive participation afforded by social and digital media is considered, positing the future amplification of connectivity, personalisation and networking across digital fan communities, albeit undercut by further impositions of corporatisation and datafication through illusory forms of “interactivity”. Finally, the fusion, intensification and continual evolution of technology-as-sport is explored, asserting that forms of immersive participation will be significant for future virtual technologies and may ultimately re-position fans as e-participants in their own media-tech sport spectacles. Collectively, it is anticipated that the creation of new virtual worlds, spaces and experiences will amplify and operationalise forms of immersive participation around augmented spectatorship, virtual athletic replication and potentially constitute the sport itself. Indeed, a new model of the fan-as-immersed-e-participant is advanced as such futuristic virtual sporting realms may not only integrate fans into the spectacle but also project them into the event as participant and as the spectacle.
Rational Adaptation: Contextual Effects in Medical Decision Making
Authors: Robinson Frank Eric , Feufel Markus A. , Shalin Valerie L. , Steele-Johnson Debra , Springer Brian
Published: February 2020

Research and practice in medical decision making value consistency with standardized intervention, potentially neglecting the impact of various environmental features such as workload or the constraints of local work practice. This study presents both qualitative and quantitative analyses of emergency physicians’ decision-making processes in their natural work setting to examine the impact of contextual features. We study contextual effects on two separable decision-making processes identified in quantified observational data: goal enactment and goal establishment. Whereas goal enactment responds to hospital differences and patient difficulty as main effects, goal establishment responds to their interaction. Our emphasis on goal establishment expands the scope of a medical decision-making literature focused on diagnosis, and extends to other professions and the more general conceptualization of expertise. From a theoretical perspective, we emphasize the importance of accounting for contextual variability within the bounds of expert behavior. Practically, we provide real-world examples of context effects that bear on the standardization of care, cost differences between hospitals, and the conceptualization of quality medical care.
Development of submarine cable hydrodynamic loads calculation program using MATLAB
Authors: Bayoumi Seif , Hamdy Mohamed , Abo Elazm Mohamed M , Shehadeh Mohamed Fahmy M
Published: February 2020

A MATLAB program was developed to estimate the hydrodynamic forces due to wave and current on an un-trenched submarine cable of diameter 9 in resting at the bottom of a 14-m depth sea, utilizing the Fourier decomposition method. The aim of this part of the research is to provide an accurate estimation of the hydrodynamic forces acting on the cable and to present a comparison between the Morison force model and Fourier decomposition force model. In addition, investigating the methods of fixation for submarine pipes and cables as the commonly used methods is of high cost for both manufacturing and installation and maintenance processes has many drawbacks. This research is concerned with the ability of the cable to be stable on the seabed using its own weight and, if required, estimating extra chain weight to be added helping stabilize the cable on the seabed. A validation of the developed program with UWAHYDRO program developed in the Western Australia University is introduced in this article.
Chemical Characterization and Biological Properties of Royal Jelly Samples From the Mediterranean Area
Authors: El-Guendouz Soukaïna , Machado Alexandra M. , Aazza Smail , Lyoussi Badiaâ , Miguel Maria G. , Mateus Maria C. , Figueiredo A. Cristina
Published: February 2020

Royal jelly (RJ) is a bee product that has high nutritional value and is beneficial for the human health, earning importance as a functional food. Thus, the characterization of its main biological properties is with high importance. In this work, 6 RJ samples obtained in Morocco, Portugal, and Spain were evaluated in terms of total phenol and flavone/flavonol contents; total protein; 10-hydroxy-2-decenoic acid (10-HDA); volatiles composition; antioxidant and anti-inflammatory properties; and inhibition of tyrosinase, xanthine oxidase (XO), and acetylcholinesterase (AChE) activities. Total phenolic content ranged from 3 to 9 mg gallic acid equivalent/g RJ, and flavone/flavonol content from 0.1 to 0.5 mg quercetin equivalent/g RJ. 10-Hydroxy-2-decenoic acid content varied from 0.9% to 1.2% and total protein from 5.5% to 29.7%. Gas chromatography-flame ionization detector and gas chromatography-mass spectrometry analysis showed RJ volatiles dominated by linolenic acid, 2-decenoic acid, and octanoic acid in variable amounts. The antioxidant activity was monitored through nitric oxide (NO) scavenging activity and hydrogen peroxide (H2O2) scavenging capacity, where the IC50 ranged from 2.3 to 3.4 and 0.2 to 1.5 mg/mL, respectively. Anti-AChE activity IC50 ranged from 0.7 to 4.6 mg/mL, while XO inhibition IC50 ranged from 3.3 to 11.9 mg/mL. The results showed that phenols and flavonoids highly contributed to the RJ biological properties in contrast to 10-HDA and proteins.