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https://www.readbyqxmd.com/read/28223003/treatment-of-metformin-intoxication-complicated-by-lactic-acidosis-and-acute-kidney-injury-the-role-of-prolonged-intermittent-hemodialysis
#1
Giuseppe Regolisti, Riccardo Antoniotti, Filippo Fani, Paolo Greco, Enrico Fiaccadori
Metformin intoxication with lactic acidosis, a potentially lethal condition, may develop in diabetic patients when the drug dose is inappropriate and/or its clearance is reduced. Diagnosis and therapy may be delayed due to nonspecific symptoms at presentation, with severe anion gap metabolic acidosis and elevated serum creatinine values being the most prominent laboratory findings. Confirmation requires measurement of serum metformin by high-performance liquid chromatography-tandem mass spectrometry, but this technique is available only at specialized institutions and cannot be relied on as a guide to immediate treatment...
February 17, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28215414/meta-analysis-of-comparison-of-drug-eluting-stents-and-bare-metal-stents-in-patients-on-dialysis
#2
Shan Li, Dan Ye, Guoping Chen, Weiwei Xu
Coronary artery disease is common in patients with end-stage renal disease who are on hemodialysis. The efficacy and safety of evidence regarding the use of drug-eluting stents (DES) and bare-metal stents (BMS) in patients with dialysis is unclear. We searched MEDLINE, EMBASE, Science Citation Index, CINAHL, and the Cochrane CENTRAL database of controlled clinical trials for controlled trials that compare DES and BMS in dialysis patients up to June 2016. We conducted a meta-analysis across 14 eligible studies (n = 62,250 patients)...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28213179/the-dispersion-releaser-technology-is-an-effective-method-for-testing-drug-release-from-nanosized-drug-carriers
#3
Christine Janas, Marc-Philip Mast, Li Kirsamer, Carlo Angioni, Fiona Gao, Werner Mäntele, Jennifer Dressman, Matthias G Wacker
The dispersion releaser (DR) is a dialysis-based setup for the analysis of the drug release from nanosized drug carriers. It is mounted into dissolution apparatus2 of the United States Pharmacopoeia. The present study evaluated the DR technique investigating the drug release of the model compound flurbiprofen from drug solution and from nanoformulations composed of the drug and the polymer materials poly (lactic acid), poly (lactic-co-glycolic acid) or Eudragit(®)RSPO. The drug loaded nanocarriers ranged in size between 185...
February 14, 2017: European Journal of Pharmaceutics and Biopharmaceutics
https://www.readbyqxmd.com/read/28211787/clinical-factors-influencing-the-decision-to-order-red-blood-cell-transfusions-for-a-sample-of-us-dialysis-patients%C3%A2
#4
J Mark Stephens, John P Caloyeras, John Holmen, Victoria A Kumar, Spiros Tzivelekis, Allan Pollock
AIM: To characterize the clinical context for the decision to order red blood cell (RBC) transfusions in dialysis patients. MATERIALS AND METHODS: Retrospective review of medical records from three integrated health systems serving chronic dialysis patients. Subjects were randomly selected from all patients who received at least one transfusion between January 2009 and December 2013. Data abstracted included transfusion setting, prescribing clinician type, patient demographics and hemoglobin (Hb) concentration prior to transfusion, and cataloguing and prioritizing of clinical factors for their contribution to the decision to transfuse...
February 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28211640/complexation-of-oxethazaine-with-2-hydroxypropyl-%C3%AE-cyclodextrin-increased-drug-solubility-decreased-cytotoxicity-and-analgesia-at-inflamed-tissues
#5
Andressa R Prado, Fabiano Yokaichiya, Margareth Kazuyo Kobayashi Dias Franco, Camila Morais Gonçalves da Silva, Laura Oliveira-Nascimento, Michelle Franz-Montan, Maria C Volpato, Luís F Cabeça, Eneida de Paula
OBJECTIVES: Oxethazaine (OXZ) is one of the few local anaesthetics that provides analgesia at low pH, but presents poor solubility, cytotoxicity and no parenteral formulations. To address these issues, we aimed to prepare OXZ host-guest inclusion complex with hydroxypropyl-beta-cyclodextrin (HP-β-CD). METHODS: The inclusion complex was formed by co-solubilization, followed by a job plot analysis to determine stoichiometry of complexation and dialysis equilibrium analysis (based on UV/VIS absorption and fluorescence profiles of OXZ)...
February 17, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28187052/renal-transplant-recipients-the-factors-related-to-immunosuppressive-medication-adherence-based-on-the-health-belief-model
#6
Pen-Chen Kung, Mei Chang Yeh, Ming-Kuen Lai, Hsueh-Erh Liu
BACKGROUND: Kidney transplant failures are caused primarily by lack of adherence to immunosuppressive medication regimens by patients after transplantation. A number of studies have indicated that health-related beliefs are an effective predictor of health-related behavior. PURPOSE: The aim of this study is to understand the influence of the personal characteristics and health-related beliefs of patients on adherence to treatment with immunosuppressive medication based on the Health Belief Model...
February 9, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28185616/tuberculous-peritonitis
#7
Urvashi Vaid, Gregory C Kane
Tuberculous peritonitis is rare in the United States but continues to be reported to occur in certain high-risk populations, which include patients with AIDS or cirrhosis, patients on continuous ambulatory peritoneal dialysis, recent immigrants from areas of high endemicity, and those who are immunosuppressed. The diagnosis of this disease requires a high clinical index of suspicion and should be considered in the differential of ascites with a lymphocyte predominance and serum-ascitic albumin gradient of <1...
January 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28181316/an-improved-method-for-purification-and-refolding-of-recombinant-hiv-vif-expressed-in-e-coli
#8
Carlos A Duarte, Mickel Palomino
Virion infectivity factor (Vif) is a 23 KDa protein which protects HIV-1 from deamination of its proviral DNA by APOBEC3G. The active form of Vif is a multimer that interacts simultaneously with CBF-beta, the Elongin B and C subunits, Cullin 5 and APOBEC3G to form a ubiquitin ligase complex targeting the latter for degradation. Vif clearly represents an attractive target for developing novel antiviral drugs for the therapy of HIV/AIDS, and this goal requires a source of well folded, readily available protein...
February 8, 2017: Biotechnology and Applied Biochemistry
https://www.readbyqxmd.com/read/28179099/hydrophobically-modified-polysaccharide-based-on-polysialic-acid-nanoparticles-as-carriers-for-anticancer-drugs
#9
Bom Jung, Man-Kyu Shim, Min-Ju Park, Eun Hyang Jang, Hong Yeol Yoon, Kwangmeyung Kim, Jong-Ho Kim
This study presented the development of hydrophobically modified polysialic acid (HPSA) nanoparticles, a novel anticancer drug nanocarrier that increases therapeutic efficacy without causing nonspecific toxicity towards normal cells. HPSA nanoparticles were prepared by 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide (EDC)/N-hydroxysuccinimide (NHS) coupling between N-deacetylated polysialic acid (PSA) and 5β-cholanic acid. The physicochemical characteristics of HPSA nanoparticles (zeta-potential, morphology and size) were measured, and in vitro cytotoxicity and cellular uptake of PSA and HPSA nanoparticles were tested in A549 cells...
February 4, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28178698/dipeptidyl-peptidase-4-inhibitors-in-chronic-kidney-disease-a-systematic-review-of-randomized-clinical-trials
#10
Simon R Walker, Paul Komenda, Suhail Khojah, Wafa Al-Tuwaijri, Kerry MacDonald, Brett Hiebert, Neil Tangri, Stewart W D Nadurak, Thomas W Ferguson, Claudio Rigatto, Navdeep Tangri
BACKGROUND: Chronic kidney disease (CKD) is common in patients with type 2 diabetes mellitus (T2DM) and limits therapeutic options. Dipeptidyl peptidase-4 (DPP-4) inhibitors represent a novel class of oral glucose-lowering agents and are known to be safe and effective in the general population. METHODS: We searched Cochrane, EMBASE, and PubMed from the time of their inception until March 2015. We included randomized controlled trials analyzing the efficacy (change in hemoglobin A1C [HbA1C]) and safety of DPP-4 agents in individuals with reduced kidney function (estimated glomerular filtration rate <60 mL/min/1...
February 9, 2017: Nephron
https://www.readbyqxmd.com/read/28177093/-pharmacological-and-nutritional-problems-in-pregnant-patient-on-chronic-dialysis
#11
Michele Giannattasio, Federica Giannattasio, Giuseppe Gernone
Many of information on the safety of drugs during pregnancy were obtained many years ago, before the pregnant women were excluded from the study protocols for possible fetal risks. Because randomized trials in pregnancy are complex and considered unethical. For the same reasons, there are no randomized controlled trials in pregnant women on dialysis. Moreover Compared to the normal subject, the pharmacokinetics and pharmacodynamics in these patients are influenced or by pregnancy or from dialysis techniques or from chronic uremia...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28176477/absence-of-thrombocytopaenia-and-or-microangiopathic-haemolytic-anaemia-does-not-reliably-exclude-recurrence-of-atypical-haemolytic-uraemic-syndrome-after-kidney-transplantation
#12
REVIEW
Anoushka R Krishnan, Brian Siva, Aron Chakera, Germaine Wong, Daniel Wong, Wai H Lim
A 54-year-old man was diagnosed with atypical haemolytic uraemic syndrome (aHUS) with confirmed complement H mutation in 2012, requiring ongoing dialysis. He was commenced on eculizumab in 2014 once the pharmaceutical board approved this drug. After 4 months, he received a live unrelated donor renal transplant from his wife and continued eculizumab post-transplant. Three months later, there was a rise in his creatinine with no laboratory features of haemolysis and a kidney biopsy confirmed rejection, which was treated with increased immunosuppression...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28165804/improved-oral-absorption-and-anti-lung-cancer-activity-of-paclitaxel-loaded-mixed-micelles
#13
Jian Hou, E Sun, Zhen-Hai Zhang, Jing Wang, Lei Yang, Li Cui, Zhong-Cheng Ke, Xiao-Bin Tan, Xiao-Bin Jia, Huixia Lv
The aim of this study was to establish a paclitaxel (PTX)-loaded mixed micelle delivery system (PTX-TP-M) with vitamin E-TPGS (TPGS) and Plasdone®S-630 Copovidone (PVPS630) as carriers to improve the solubility, oral absorption, and anti-tumor activity of PTX against lung cancer. In this study, PTX-TP-M was prepared using the ethanol thin-film dispersion method followed by characterization of the binary mixed micelles system. The average size of the PTX-TP-M was 83.5 ± 1.8 nm with a polydispersity index of 0...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28160765/the-use-of-complementary-and-alternative-medicine-among-dialysis-patients
#14
Ronit Koren, Hadas Zafrir Danieli, Keren Doenyas-Barak, Tomer Ziv-Baran, Ahuva Golik
Context • The use of complementary and alternative medicine (CAM) has been on the rise in the last decade. Subpopulations of patients with chronic diseases are at risk for adverse events and potential drug-herb interactions, among them dialysis patients. Objective • The study aimed to evaluate the prevalence of CAM consumption among dialysis patients and to search for potential interactions. Design • The study was cross-sectional, based on questionnaires. Setting • The study occurred in the hemodialysis unit at Assaf Harofeh Medical Center (Zeriffin, Israel)...
January 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28157814/hypertension-in-dialysis-patients-a-consensus-document-by-the-european-renal-and-cardiovascular-medicine-eureca-m-working-group-of-the-european-renal-association-european-dialysis-and-transplant-association-era-edta-and-the-hypertension-and-the-kidney-working
#15
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles Ferro, Jean-Michel Halimi, Gunnar Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verharr, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease treated with hemodialysis or peritoneal dialysis, hypertension is very common and often poorly controlled. Blood pressure (BP) recordings obtained before or after hemodialysis display a J-shaped or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar hemodynamic setting related with dialysis treatment. Elevated BP by home or ambulatory BP monitoring is clearly associated with shorter survival...
February 2, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28151871/antihypertensive-medications-and-risk-of-death-and-hospitalizations-in-us-hemodialysis-patients-evidence-from-a-cohort-study-to-inform-hypertension-treatment-practices
#16
Tariq Shafi, Stephen M Sozio, Jason Luly, Karen J Bandeen-Roche, Wendy L St Peter, Patti L Ephraim, Aidan McDermott, Charles A Herzog, Deidra C Crews, Julia J Scialla, Navdeep Tangri, Dana C Miskulin, Wieneke M Michels, Bernard G Jaar, Philip G Zager, Klemens B Meyer, Albert W Wu, L Ebony Boulware
Antihypertensive medications are commonly prescribed to hemodialysis patients but the optimal regimens to prevent morbidity and mortality are unknown. The goal of our study was to compare the association of routinely prescribed antihypertensive regimens with outcomes in US hemodialysis patients.We used 2 datasets for our analysis. Our primary cohort (US Renal Data System [USRDS]) included adult patients initiating in-center hemodialysis from July 1, 2006 to June 30, 2008 (n = 33,005) with follow-up through December 31, 2009...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28147927/a-case-report-of-enzalutamide-administration-in-a-dialysis-dependent-patient-with-castration-resistant-prostate-cancer
#17
Erica S Tsang, Marie de Haan, Bernhard J Eigl
Enzalutamide, an androgen receptor signaling inhibitor, is a standard of care treatment for metastatic castration-resistant prostate cancer. We present the first reported case of enzalutamide in a patient with end-stage renal disease, on dialysis. While there were no significant toxicities, a sustained increase in systolic blood pressure was maintained after starting enzalutamide, suggestive of a degree of drug accumulation. Further evaluation of novel hormonal agents in end-stage renal disease patients should be encouraged as this population is typically excluded from clinical trials...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28145625/pediatric-renal-transplant-practices-in-india
#18
Sidharth Kumar Sethi, Rajiv Sinha, Smriti Rohatgi, Vijay Kher, Arpana Iyengar, Arvind Bagga
Limited access to tertiary-level health care, limited trained pediatric nephrologists and transplant physicians, lack of facilities for dialysis, lack of an effective deceased donor program, non-affordability, and non-adherence to immunosuppressant drugs poses a major challenge to universal availability of pediatric transplantation in developing countries. We present the results of a survey which, to the best of our knowledge, is the first such published attempt at understanding the current state of pediatric renal transplantation in India...
February 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28145436/anticancer-drug-camptothecin-test-in-3d-hydrogel-networks-with-hela-cells
#19
Jun Liang, Xiuzhi Susan Sun, Zhilong Yang, Shuai Cao
Development of a biomimetic 3D culture system for drug screening is necessary to fully understand the in vivo environment. Previously, a self-assembling peptide hydrogel has been reported; the hydrogel exhibited physiological properties superior to a 3D cell culture matrix. In this work, further research using H9e hydrogel with HeLa cells was carried out considering H9e hydrogel's interaction with camptothecin, a hydrophobic drug. According to AFM images, a PGworks solution triggered H9e hydrogel fiber aggregation and forms a 3D matrix suitable for cell culture...
February 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28143438/medication-adherence-in-randomized-controlled-trials-evaluating-cardiovascular-or-mortality-outcomes-in-dialysis-patients-a-systematic-review
#20
Karumathil M Murali, Judy Mullan, Jenny H C Chen, Steven Roodenrys, Maureen Lonergan
BACKGROUND: Medication non-adherence is common among renal dialysis patients. High degrees of non-adherence in randomized controlled trials (RCTs) can lead to failure to detect a true treatment effect. Cardio-protective pharmacological interventions have shown no consistent benefit in RCTs involving dialysis patients. Whether non-adherence contributes to this lack of efficacy is unknown. We aimed to investigate how medication adherence and drug discontinuation were assessed, reported and addressed in RCTs, evaluating cardiovascular or mortality outcomes in dialysis patients...
January 31, 2017: BMC Nephrology
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