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https://www.readbyqxmd.com/read/29682559/hemodynamic-instability-during-dialysis-the-potential-role-of-intradialytic-exercise
#1
REVIEW
Scott McGuire, Elizabeth Jane Horton, Derek Renshaw, Alofonso Jimenez, Nithya Krishnan, Gordon McGregor
Acute haemodynamic instability is a natural consequence of disordered cardiovascular physiology during haemodialysis (HD). Prevalence of intradialytic hypotension (IDH) can be as high as 20-30%, contributing to subclinical, transient myocardial ischemia. In the long term, this results in progressive, maladaptive cardiac remodeling and impairment of left ventricular function. This is thought to be a major contributor to increased cardiovascular mortality in end stage renal disease (ESRD). Medical strategies to acutely attenuate haemodynamic instability during HD are suboptimal...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29679446/salt-is-not-only-sodium-how-extracellular-fluid-volume-homeostasis-depends-on-chloride-recovery-by-the-kidneys
#2
EDITORIAL
Boye L Jensen
The Acta Physiologica Prize winners Grill et al.1 address a fundamental issue in renal and circulatory physiology, namely how the kidneys accomplish maintenance of extracellular fluid volume (ECV) by conservation of the freely filtered solutes Na+ and Cl-. In an elegant comprehensive investigation in mice, they show that the chloride channel ClC-K2 is necessary for ECV homeostasis. The study sheds light on how the human kidneys regain 20 moles or 0.5 kg of chloride ions per day. Maintenance of ECV is essential for effective circulating volume, constant perfusion pressure and adequate organ perfusion...
April 20, 2018: Acta Physiologica
https://www.readbyqxmd.com/read/29677080/corm-401-reduces-ischemia-reperfusion-injury-in-an-ex-vivo-renal-porcine-model-of-the-donation-after-cardiac-death
#3
Rabindra N Bhattacharjee, Mahms Richard-Mohamed, Qizhi Sun, Aaron Haig, Ghaleb Aboalsamh, Peter Barrett, Richard Mayer, Ibrahim Alhasan, Karen Pineda-Solis, Larry Jiang, Hajed Alharbi, Manujendra Saha, Eric Patterson, Alp Sener, Gediminas Cepinskas, Anthony M Jevnikar, Patrick P W Luke
BACKGROUND: Carbon monoxide (CO) inhalation protects organ by reducing inflammation and cell death during transplantation processes in animal model. However, using CO in clinical transplantation is difficult due to its delivery in a controlled manner. A manganese-containing CORM-401 has recently been synthesized which can efficiently deliver 3 molar equivalents of CO. We report the ability of this anti-inflammatory CORM-401 to reduce ischemia reperfusion injury associated with prolonged cold storage of renal allografts obtained from donation after cardiac death in a porcine model of transplantation...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29675862/hemodialysis-a-model-for-extreme-physiology-in-a-vulnerable-patient-population
#4
REVIEW
Jeroen P Kooman, Krassimir Katzarski, Frank M van der Sande, Karel M Leunissen, Peter Kotanko
Hemodialysis (HD) is a lifesaving treatment for patients with end-stage renal disease, which is very efficient in the correction of abnormalities of the internal environment. However, this efficiency also induces significant hemodynamic, thermal, and respiratory stressors. These have parallels with the extreme physiologic demands which are normally mainly experienced by healthy subjects under adverse environmental conditions, with the difference that they must be endured by a vulnerable patient population. Hemodynamic stress induced by ultrafiltration leads to a decline in circulating blood volume, which may result in intradialytic hypotension (IDH) and changes in tissue perfusion, which may have long-term consequences for the function of vital organs such as the brain and the heart...
April 19, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29671622/changes-in-kidney-tissue-and-effects-of-erythropoietin-after-acute-heart-failure
#5
A Güven Bağla, M Içkin Gülen, F Ercan, F Aşgün, E Ercan, C Bakar
Impairment of cardiac function causes renal damage. Renal failure after heart failure is attributed to hemodynamic derangement including reduced renal perfusion and increased venous pressure. One mechanism involves apoptosis and is defined as cardiorenal syndrome type 1. Erythropoietin (EPO) is a cytokine that induces erythropoiesis under hypoxic conditions. Hypoxia inducible factor 1 alpha (HIF-1α) plays a regulatory role in cellular response to hypoxia. Protective effects of EPO on heart, kidney and nervous system are unrelated to red blood cell production...
April 19, 2018: Biotechnic & Histochemistry: Official Publication of the Biological Stain Commission
https://www.readbyqxmd.com/read/29671035/-prognostic-relevance-of-tissue-oxygen-saturation-in-patients-in-the-early-stage-of-multiple-organ-dysfunction-syndrome
#6
D Huster, F Härtel, S Nuding, J Schroeder, Y Zhang, K Werdan, H Ebelt
BACKGROUND: Patients in circulatory shock exhibit insufficient peripheral perfusion to ensure adequate oxygenation of vital organs such as the heart and brain. Early detection of reduced tissue oxygen saturation (St O2 ) could be used for rapid therapeutic intervention and thus improve the prognosis of patients in the early stage of multiple organ dysfunction syndrome (MODS). MATERIALS AND METHODS: A total of 60 patients in the early stage of MODS (APACHE [Acute Physiology and Chronic Health Evaluation] II score ≥20) were investigated in a monocentric, prospective, randomized phase II study...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29670546/-in-utero-exposure-to-maternal-diabetes-is-associated-with-early-abnormal-vascular-structure-in-offspring
#7
Abdallah Dib, Cyrielle Payen, Jennifer Bourreau, Mathilde Munier, Linda Grimaud, Ziad Fajloun, Laurent Loufrani, Daniel Henrion, Céline Fassot
Aim/hypothesis: In utero exposure to maternal diabetes increases the risk of developing hypertension and cardiovascular disorders during adulthood. We have previously shown that this is associated with changes in vascular tone in favor of a vasoconstrictor profile, which is involved in the development of hypertension. This excessive constrictor tone has also a strong impact on vascular structure. Our objective was to study the impact of in utero exposure to maternal diabetes on vascular structure and remodeling induced by chronic changes in hemodynamic parameters...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29668344/phenotypic-plasticity-of-mesenchymal-stem-cells-is-crucial-for-mesangial-repair-in-a-model-of-immunoglobulin-light-chain-associated-mesangial-damage
#8
Guillermo A Herrera, Jiamin Teng, Chun Zeng, Hongzhi Xu, Man Liang, J Steven Alexander, Bing Liu, Chris Boyer, Elba A Turbat-Herrera
Mesangiopathies produced by glomerulopathic monoclonal immunoglobulin light chains (GLCs) acting on the glomerular mesangium produce two characteristic lesions: AL-amyloidosis (AL-Am) and light chain deposition disease (LCDD). In both cases, the pathology is centered in the mesangium, where initial and progressive damage occurs. In AL-Am the mesangial matrix is destroyed and replaced by amyloid fibrils and in LCDD, the mesangial matrix is increased and remodeled. The collagen IV rich matrix is replaced by tenascin...
April 18, 2018: Ultrastructural Pathology
https://www.readbyqxmd.com/read/29665289/a-whole-body-physiologically-based-pharmacokinetic-model-for-colistin-and-colistin-methanesulfonate-cms-in-rat
#9
Salim Bouchene, Sandrine Marchand, William Couet, Lena E Friberg, Patrice Gobin, Isabelle Lamarche, Nicolas Grégoire, Sven Björkman, Mats O Karlsson
Colistin is a polymyxin antibiotic used to treat patients infected with multidrug-resistant Gram negative bacteria (MDR-GNB). The objective of this work was to develop a whole-body physiologically based pharmacokinetic (WB-PBPK) model to predict tissue distribution of colistin in rat. The distribution of a drug in a tissue is commonly characterized by its tissue-to-plasma partition coefficient, Kp . Colistin and its prodrug, colistin methanesulfonate (CMS) Kp priors were measured experimentally from rat tissue homogenates or predicted in silico...
April 17, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29659397/scintigraphic-and-sonographic-findings-of-subcapsular-cortical-necrosis-in-a-transplanted-kidney
#10
Bulent Yazici, Emrah Gunay, Aysegül Akgün, Sait Sen, Suha Sureyya Ozbek
Renal transplant scintigraphy, performed in a 23-year-old man who had renal graft from a living donor, showed nearly normal perfusion and moderately low function of the graft. But the margins of the graft were blurred, and it was interestingly appearing enlarged late in the study. Ultrasound demonstrated a hypoechoic rim surrounding the whole kidney. Biopsy revealed necrosis besides normal cortical tissue. Necrosis was thought to be limited to the subcapsular cortical area. It should be considered that these scintigraphic findings could be due to greatly reduced and delayed perfusion of edematous subcapsular necrotic area of the graft even in normal perfusion images...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29657196/atypical-hemolytic-uremic-syndrome-a-monocentric-adult-tunisian-study-and-review-of-literature
#11
R Kherder-Elfekih, M Hajji, L Ben Fatma, H Jebali, I Mami, W Smaoui, M Krid, L Rais, S Beji, K Zouaghi, M Sellami-Kallel
Atypical hemolytic uremic syndrome (aHUS) is characterized by microvascular thrombosis resulting in thrombocytopenia, hemolytic anemia, and multiorgan dysfunction. It is associated with genetic or acquired disorders of regulatory components of the complement system. For our study, we collected data from 16 patients diagnosed with aHUS between January 2010 and January 2014. The mean age was 33.6 years. The female-to-male ratio was 3. The median follow-up duration was 27 ± 3.5 months. The most common clinical presentation was hypertension...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29655601/placental-disposition-of-the-immunosuppressive-drug-tacrolimus-in-renal-transplant-recipients-and-in-ex-vivo-perfused-placental-tissue
#12
J J M Freriksen, D Feyaerts, P H H van den Broek, O W H van der Heijden, J van Drongelen, H W van Hamersvelt, F G M Russel, R G van der Molen, R Greupink
Currently, tacrolimus is the most potent immunosuppressive agent for renal transplant recipients and is commonly prescribed during pregnancy. As data on placental exposure and transfer are limited, we studied tacrolimus placental handling in samples obtained from renal transplant recipients. We found transfer to venous umbilical cord blood, but particularly noted a strong placental accumulation. In patient samples, tissue concentrations in a range of 55-82 ng/g were found. More detailed ex vivo dual-side perfusions of term placentas from healthy women revealed a tissue-to-maternal perfusate concentration ratio of 113 ± 49 (mean ± SEM), underlining the placental accumulation found in vivo...
April 12, 2018: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29651581/single-15-min-protocol-yields-the-same-cryoablation-size-and-margin-as-the-conventional-10-8-10-min-protocol-results-of-kidney-and-liver-swine-experiment
#13
John D Werner, Aline C Tregnago, George J Netto, Constantine Frangakis, Christos S Georgiades
INTRODUCTION: The objective was to determine the ablation size of a single 15-min freeze and compare it with the conventional 10-min freeze-8-min thaw-10-min freeze protocol. Secondary objectives were to determine the ablation margin and to ascertain whether islands of viable tissue remain within the ablation zone. MATERIALS AND METHODS: Five adult swine under general anesthesia were used. After surgical abdominal exposure, two ablations were performed in liver and two in kidney...
April 12, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29649954/anatomical-considerations-and-open-surgery-to-treat-juxtarenal-abdominal-aortic-aneurysms
#14
Georgiana Samoila, Ian Michael Williams
INTRODUCTION: Historically, the open approach to the abdominal aorta has been transperitoneal (TP). In comparison, a retroperitoneal (RP) incision exposes the lateral wall of the suprarenal aorta for clamp application and midline structures such as the duodenum and pancreas are not encountered. Proximal clamp position for open repair of juxtarenal abdominal aortic aneurysm (JR-AAA) is suprarenal, supra-superior mesenteric, or supraceliac. While RP and TP approaches have previously been compared for physiological reasons, there are currently no randomized controlled trials comparing these methods from an anatomical perspective...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29649824/end-organ-saturation-differences-in-early-neonatal-transition-for-left-versus-right-sided-congenital-heart-disease
#15
Gabriel Altit, Shazia Bhombal, Theresa A Tacy, Valerie Y Chock
BACKGROUND: For neonates with congenital heart disease (CHD), left-sided (LL) and right-sided (RL) single ventricular physiologies (LL, hypoplastic left heart syndrome; RL, tricuspid atresia or pulmonary atresia with intact ventricular septum) may demonstrate distinct changes in tissue saturation in the first 72 h of life. Near-infrared spectroscopy (NIRS) can measure regional cerebral saturation (Csat) and renal saturation (Rsat) to clarify differences between LL and RL over time. OBJECTIVES: Our primary objective was to measure changes in Csat and Rsat in the first 72 h of life using NIRS between CHD infants with LL compared to RL...
April 12, 2018: Neonatology
https://www.readbyqxmd.com/read/29642690/impella-protected-pci-the-clinical-results-achieved-so-far
#16
Gabriele Pesarini, Andrea Gratta, Giulia Dolci, Mattia Lunardi, Flavio L Ribichini
The ability of interventional cardiologists to identify high-risk percutaneous coronary interventions (PCI) patients, requires the integration of different features belonging to medical history, organ damage, coronary anatomy and the nature of the acute event. The selection of a subgroup of patients that could benefit from mechanical support during interventions is a key feature to success. The introduction of the Impella percutaneous axial pump have added an easy to set-up, less-invasive and time consuming active-support device to the interventional toolbox...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29627741/effects-of-renal-sympathetic-denervation-on-myocardial-structure-function-and-perfusion-a-serial-cmr-study
#17
Sinny Delacroix, Ramesh G Chokka, Adam J Nelson, Dennis T Wong, Stephen Pederson, Joanne Nimmo, Adil Rajwani, Kerry Williams, Karen S Teo, Stephen G Worthley
BACKGROUND AND AIMS: Echocardiographic studies have shown improvements in cardiac indices associated with renal sympathetic denervation (RDN), however, the benefits on myocardial perfusion have never been assessed. This trial was designed to study the effects of RDN on myocardial perfusion using cardiac magnetic resonance (CMR) imaging. METHODS: A total of 14 patients with resistant hypertension were recruited for RDN and myocardial perfusion, alongside other CMR indices, was assessed at baseline and at 6 months...
March 10, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29625107/cephalosporin-antibiotics-are-weak-blockers-of-gabaa-receptor-mediated-synaptic-transmission-in-rat-brain-slices
#18
Dmitry V Amakhin, Elena B Soboleva, Aleksey V Zaitsev
Cephalosporins are beta-lactam antibiotics that are extensively used in medical practice and are reported to cause epileptic seizures in some patients. The primary cause of cephalosporin-induced convulsions is believed to be their ability to block GABAa receptors. However, direct evidence for the involvement of this mechanism has not yet been provided. The present study aims to investigate the ability of two cephalosporins - cefepime and ceftriaxone - to block inhibitory synaptic transmission in entorhinal cortex slices of rats...
April 3, 2018: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29623045/relaxin-deficiency-leads-to-uterine-artery-dysfunction-during-pregnancy-in-mice
#19
Sarah A Marshall, Sevvandi N Senadheera, Maria Jelinic, Kelly O'Sullivan, Laura J Parry, Marianne Tare
The uterine vasculature undergoes profound adaptations in response to pregnancy. Augmentation of endothelial vasodilator function and reduced smooth muscle reactivity are factors contributing to uterine artery adaptation and are critical for adequate placental perfusion. The peptide hormone relaxin has an important role in mediating the normal maternal renal vascular adaptations during pregnancy through a reduction in myogenic tone and an increase in flow-mediated vasodilation. Little is known however about the influence of endogenous relaxin on the uterine artery during pregnancy...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29614507/renoprotective-postoperative-monitoring-what-is-the-best-method-for-computing-renal-perfusion-pressure-an-observational-prospective-multicentre-study
#20
Csaba Kopitko, Laszlo Medve, Tibor Gondos
BACKGROUND: Low mean arterial pressure (MAP) is a well-known risk factor for postoperative acute kidney injury (AKI), but probably it is not the sole hemodynamic parameter that can influence the development of renal failure. There are data in cardiac patients supporting the role of renal venous congestion in the development of AKI. The aim of our study was to determine a combination of factors best predicting the development of AKI. METHODS: Data were collected prospectively for adult patients admitted after major abdominal surgery to 9 Hungarian intensive care units...
April 3, 2018: Nephron
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