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COVID-19 in End-stage Renal Disease (ESRD) Patients Undergoing Hemodialysis: A Close Follow-up of Clinical Findings and Evolutions in Chest CT Imaging: A Retrospective Study 接受血液透析的终末期肾病(ESRD)患者中的新冠肺炎:胸部CT成像临床表现和演变的密切跟踪:回顾性研究
Q4 Medicine Pub Date : 2021-12-18 DOI: 10.5812/numonthly.118090
H. Tayebi Khosroshahi, Armin Zarrintan, Hesam Manaflouyan, Dara Rahmanpour, Ebrahim Farashi, Seyed Ali Mousavi-Aghdas, M. Mirza-Aghazadeh-Attari, M. Tarzamni
Background: Coronavirus disease 2019 (COVID-19) has infected millions and caused tens of thousands of casualties. Epidemiologic studies show that specific individuals with pre-existing conditions are prone to severe disease caused by the virus. Thus, it is necessary to determine clinical signs and symptoms and disease progression course in various pre-existing conditions, namely end-stage renal disease (ESRD) patients undergoing hemodialysis. Methods: The present retrospective study was conducted on 17 ESRD patients undergoing chronic hemodialysis. Clinical signs and symptoms were extracted, and laboratory test results and imaging findings were retrieved using the health information systems of the institute where the study was performed. Results: Of 17 patients in the study, six patients were females, and 11 were males. The mean age of the patients was 62.29 ± 15.6 years (22 - 82). The most common pre-existing conditions were hypertension and diabetes. The most common imaging signs were ground-glass opacities. The most common pattern of involvement was peripheral, bilateral, and multifocal involvement, and interestingly, uncommon imaging signs such as crazy-paving, peribronchovascular involvement, and reticulonodular pattern of involvement. The most common laboratory findings were lymphopenia, lymphocytosis, increased erythrocyte sedimentation rate, and positive C reactive protein. Conclusions: ESRD patients undergoing COVID-19 seem to have higher mortalities than the general public and show more significant lung involvement on chest CT imaging. Furthermore, uncommon imaging signs are more common in this group of patients.
背景:2019冠状病毒病(新冠肺炎)已感染数百万人,造成数万人伤亡。流行病学研究表明,有预先存在疾病的特定个体容易患上由病毒引起的严重疾病。因此,有必要确定各种预先存在的疾病的临床体征、症状和疾病进展过程,即接受血液透析的终末期肾病(ESRD)患者。方法:对17例ESRD慢性血液透析患者进行回顾性研究。提取临床体征和症状,并使用进行研究的研究所的健康信息系统检索实验室检测结果和成像结果。结果:研究中的17名患者中,6名为女性,11名为男性。患者的平均年龄为62.29±15.6岁(22-82岁)。最常见的预先存在的疾病是高血压和糖尿病。最常见的影像学征象是磨玻璃样混浊。最常见的受累模式是外周、双侧和多灶性受累,有趣的是,不常见的影像学体征,如疯狂铺路、支气管血管周围受累和网状结节性受累。最常见的实验室检查结果是淋巴细胞减少、淋巴细胞增多、红细胞沉降率增加和C反应蛋白阳性。结论:接受新冠肺炎治疗的ESRD患者的死亡率似乎高于普通公众,并且在胸部CT成像中显示出更显著的肺部受累。此外,不常见的影像学体征在这组患者中更为常见。
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引用次数: 0
Effect of Cold Dialysis Solution on the Sexual Dysfunction of Patients with Chronic Renal Failure Undergoing Hemodialysis: A Randomized Clinical Trial 冷透析液对血液透析慢性肾功能衰竭患者性功能障碍的影响:一项随机临床试验
Q4 Medicine Pub Date : 2021-12-15 DOI: 10.5812/numonthly.118771
Rahele Hassanpour Moghaddam, F. Nazemian, Sedighe Rastaghi, M. Rad
Background: The present study aimed to evaluate the effect of cold dialysis solution on the sexual dysfunction of patients with chronic renal failure undergoing hemodialysis. Methods: This randomized clinical trial was conducted with a before and after parallel design among 60 hemodialysis patients diagnosed with sexual dysfunction. The selected subjects were randomly allocated to the two groups of experimental and control (30 per each). Patients in the experimental and control groups underwent hemodialysis for one month using 35.5°C and 37°C dialysis solutions, respectively. Following the procedure, male and female sexual function was assessed in the study groups. Data were collected using the International Index of Erectile Functions, the female sexual function index (FSFI), and a demographic questionnaire. Data analysis was performed using Chi-square, Fisher's exact test, Mann-Whitney U test, t-test, paired t-test, and Wilcoxon test at 95% confidence interval. Results: No significant difference was observed between the experimental and control groups regarding male sexual function before and after the intervention (P > 0.05). However, the Mann-Whitney U test indicated a significant difference in the female subjects’ arousal in the experimental group before (3.68 ± 0.38) and after the intervention (3.98 ± 0.46; z = 2.216; P = 0.027). Conclusions: Cold dialysis solution could only increase the sexual arousal of the women in the experimental group, and no changes were observed in other sexual function domains of the male and female patients. Given the short duration of our intervention, it is recommended that further longitudinal studies be performed on larger cohorts of patients in different geographical regions.
背景:本研究旨在评价冷透析液对接受血液透析的慢性肾功能衰竭患者性功能障碍的影响。方法:本随机临床试验采用前后平行设计,对60例诊断为性功能障碍的血液透析患者进行研究。所选受试者被随机分配到实验组和对照组(每组30人)。实验组和对照组的患者分别使用35.5°C和37°C透析溶液进行血液透析一个月。手术后,对研究组的男性和女性性功能进行评估。使用国际勃起功能指数、女性性功能指数(FSFI)和人口统计问卷收集数据。数据分析采用卡方检验、Fisher精确检验、Mann-Whitney U检验、t检验、配对t检验和Wilcoxon检验,置信区间为95%。结果:干预前后实验组与对照组男性性功能差异无统计学意义(P>0.05),Mann-Whitney U检验表明,实验组女性受试者在干预前(3.68±0.38)和干预后(3.98±0.46;z=2.216;P=0.027)的性唤起有显著差异,男性和女性患者的其他性功能领域没有观察到变化。鉴于我们的干预持续时间较短,建议对不同地理区域的较大患者队列进行进一步的纵向研究。
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引用次数: 0
Association of Microalbuminuria and Bevacizumab Therapy Outcomes in Diabetic Retinopathy Patients 糖尿病视网膜病变患者微量白蛋白尿与贝伐单抗治疗结果的相关性
Q4 Medicine Pub Date : 2021-12-15 DOI: 10.5812/numonthly.118972
S. A. Rasoulinejad
Background: Diabetic retinopathy (DR) is a visual impairment-related eye disease developed by long-term hyperglycemic status. Diabetic condition in DR patients leads to diabetic organopathies (e.g., renal failure). Albuminuria, as a hallmark of renal failure, can be correlated with visual indicators in DR patients. Objectives: This study aimed to investigate the role of albuminuria status in visual acuity (VA) and bevacizumab therapy outcomes in DR patients. Methods: In this retrospective study, 48 DR patients were admitted to the Ophthalmology Center of Ayatollah Rouhani Hospital, affiliated with Babol University of Medical Sciences, Babol, Iran. The retinopathy status and VA were identified before and after treatment through 45 days of bevacizumab therapy. In addition, fast blood sugar, hemoglobin A1c, urine albumin, and urine creatinine were evaluated using standard laboratory methods. Results: The VA value before treatment in microalbuminuric DR patients (0.106 ± 0.036) was significantly lower than non-microalbuminuric DR patients (0.347 ± 0.286; P < 0.001). Furthermore, VA value after treatment in microalbuminuric DR patients (0.115 ± 0.071) was significantly lower than non-microalbuminuric DR patients (0.355 ± 0.272; P < 0.001). There was no significant difference in the percentage of VA increase between microalbuminuric and non-microalbuminuric patients. Moreover, the albumin-to-creatinine ratio (ACR) was correlated with a lower VA level before and after treatment (P < 0.001 for both). There was no correlation between the percentage of VA increase with ACR, albumin, and creatinine. Conclusions: The current study results showed that different VA before and after bevacizumab therapy status was correlated with microalbuminuria status. Additionally, microalbuminuria status did not affect the percentage of VA increase in the treatment of DR patients.
背景:糖尿病视网膜病变(DR)是一种由长期高血糖状态引起的视力损害相关眼病。DR患者的糖尿病状况可导致糖尿病性器官病变(如肾功能衰竭)。蛋白尿作为肾衰竭的标志,可与DR患者的视觉指标相关。目的:本研究旨在探讨蛋白尿状态在DR患者视力(VA)和贝伐单抗治疗结果中的作用。方法:回顾性分析伊朗巴博勒医学大学附属阿亚图拉鲁哈尼医院眼科中心收治的48例DR患者。通过45天的贝伐单抗治疗,在治疗前后确定视网膜病变状态和VA。此外,使用标准实验室方法评估空腹血糖、糖化血红蛋白、尿白蛋白和尿肌酐。结果:微量白蛋白尿DR患者治疗前VA值(0.106±0.036)显著低于非微量白蛋白尿DR患者(0.347±0.286;P < 0.001)。此外,微量白蛋白尿DR患者治疗后VA值(0.115±0.071)显著低于非微量白蛋白尿DR患者(0.355±0.272;P < 0.001)。微量白蛋白尿患者和非微量白蛋白尿患者的VA增加百分比无显著差异。此外,白蛋白与肌酐比值(ACR)与治疗前后较低的VA水平相关(P < 0.001)。VA增加百分比与ACR、白蛋白和肌酐之间没有相关性。结论:目前的研究结果显示,贝伐单抗治疗前后不同的VA与微量白蛋白尿状态相关。此外,微量白蛋白尿状态不影响DR患者治疗中VA增加的百分比。
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引用次数: 0
Evaluation of Factors Affecting Wrist Radio-Cephalic Arteriovenous Fistula Maturation: A Single Institutional Observational Study 影响手腕放射-头侧动静脉瘘成熟的因素评估:一项单一机构观察研究
Q4 Medicine Pub Date : 2021-11-16 DOI: 10.5812/numonthly.118567
Priyeshkumar Patel, V. Prabha, Ritesh Vernekar, Shridhar C. Ghagane, R. Nerli
Background: Chronic renal failure is the most common indication for which arterio-venous (AV) fistula creation surgery is being performed. Various studies have found that native arteriovenous fistulas are the best in long-term patency with lower complications. We conducted this study to find out the role of preprocedural duplex ultrasound (DUS) in predicting outcomes of radio-cephalic fistula in the wrist in the North-Karnataka population. Methods: This prospective study was conducted from May 2019 to July 2020 on 50 patients who were hemodialysis-dependent and underwent AV fistula creation with age from 20 to 70 years. All the patients underwent preoperative DUS and were followed up post-operatively after one, two, and six weeks. Hemodialysis was initiated through the constructed fistula once it was mature, and the maximum blood flow through the fistula was measured. SPSS version 20.0 was used for statistical analysis. Results: Among 50 subjects, the overall cumulative success of AVF maturation was 86% (43), and failure to mature rate was 14% (7). Logistic regression of maturation outcome in the wrist autologous arteriovenous fistula for individual factors showed statistically significant results (P < 0.05) for the diameter of the radial artery > 1.6 mm and the distensibility of the cephalic vein > 0.4 mm. Conclusions: Vein distensibility and radial artery diameter are key factors in predicting successful AVF maturation. The use of intraoperative papaverine instillation directly on vessels can improve arteriovenous fistula outcomes.
背景:慢性肾衰竭是动静脉造瘘手术最常见的适应症。各种研究发现,原生动静脉瘘长期通畅效果最好,并发症少。我们进行了这项研究,以找出术前双工超声(DUS)在预测北卡纳塔克邦人群腕部放射性头瘘预后中的作用。方法:本前瞻性研究于2019年5月至2020年7月对50例血液透析依赖并接受房室瘘造瘘术的患者进行了研究,年龄在20至70岁之间。所有患者术前均行DUS,术后随访1、2、6周。一旦构建的瘘管成熟,血液透析就会开始,并测量通过瘘管的最大血流量。采用SPSS 20.0版本进行统计分析。结果:50例受试者中,AVF成熟的总累计成功率为86%(43例),未成熟率为14%(7例)。腕关节自体动静脉瘘成熟结果的个体因素Logistic回归显示,桡动脉直径> 1.6 mm、头静脉扩张> 0.4 mm的成熟结果均有统计学意义(P < 0.05)。结论:静脉扩张和桡动脉直径是预测AVF成功成熟的关键因素。术中直接在血管上滴注罂粟碱可以改善动静脉瘘的预后。
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引用次数: 0
Remissions in Patients with Idiopathic Membranous Nephropathy Treated with Rituximab in Senegal 塞内加尔特发性膜性肾病患者利妥昔单抗治疗后的缓解
Q4 Medicine Pub Date : 2021-10-02 DOI: 10.5812/numonthly.117467
M. Faye, Fabrice Tiako, A. Lemrabott, B. Ba, N. Keita, M. Ndongo, A. Sy, B. Ndiaye, M. Faye, El Hadji Ka
Objectives: This study aimed to evaluate the efficacy of Rituximab in the management of idiopathic membranous nephropathy (IMN) based on the following criteria: (I) Biological remission at three months (M3) and six months (M6); (II) change in mean proteinuria (24PU), mean serum albumin, and mean serum creatinine at M3 and M6; (III) and side effects. Methods: This retrospective descriptive and analytical study included patients with histologically confirmed IMN with positive plasma anti-PLA2R antibodies who received at least one dose of Rituximab after six months of follow-up without spontaneous remission. Patients with unexplainable records were not included. Results: A total of five patients (P1, P2, P3, P4, and P5), including four males and one female were analyzed. The mean age was 44.20 ± 23.14 years. All patients had IMN type 2. At inclusion, the mean albuminemia, mean creatinine, and mean 24hPU levels were 15.56 ± 5.27 g/L, 6.54 ± 1.13 g/24h, and 17.3 ± 7.60 mg/L, respectively. The median anti-PLA2R antibody titer was 100 IU with extremes of 10 and 800 IU. Partial remission was noted in three patients at M3 (P2, P4, and P5), and it was maintained until M6 in P2. No complete remission was observed. A significant decrease in mean 24hPU at M3 was noted (P < 0.001). Generalized pruritus associated with seizures was noticed in P4 after the first dose of Rituximab. Conclusions: Partial remission was noted in three patients at M3, and one patient maintained this remission at M6. Rituximab significantly reduced 24hPU at M3 after administration. Rituximab administration was well tolerated by the patients.
目的:本研究旨在根据以下标准评估利妥昔单抗治疗特发性膜性肾病(IMN)的疗效:(I)三个月(M3)和六个月(M6)时的生物缓解;(II) M3和M6时平均蛋白尿(24PU)、平均血清白蛋白和平均血清肌酐的变化;(III) 以及副作用。方法:这项回顾性描述性和分析性研究纳入了经组织学证实的IMN患者,这些患者的血浆抗PLA2R抗体呈阳性,在随访六个月后接受了至少一剂利妥昔单抗治疗,但没有自发缓解。记录无法解释的患者不包括在内。结果:共分析了5名患者(P1、P2、P3、P4和P5),包括4名男性和1名女性。平均年龄44.20±23.14岁。所有患者均为IMN 2型。纳入时,平均白蛋白血症、平均肌酐和平均24hPU水平分别为15.56±5.27 g/L、6.54±1.13 g/L和17.3±7.60 mg/L。中位抗PLA2R抗体滴度为100IU,极端值为10和800IU。M3时有三名患者(P2、P4和P5)出现部分缓解,并一直维持到P2的M6。未观察到完全缓解。M3时的平均24hPU显著降低(P<0.001)。第一剂利妥昔单抗后,P4出现与癫痫发作相关的全身瘙痒。结论:M3时有三名患者出现部分缓解,其中一名患者在M6时保持了这种缓解。给药后,利妥昔单抗显著降低M3时的24hPU。患者对利妥昔单抗的给药耐受性良好。
{"title":"Remissions in Patients with Idiopathic Membranous Nephropathy Treated with Rituximab in Senegal","authors":"M. Faye, Fabrice Tiako, A. Lemrabott, B. Ba, N. Keita, M. Ndongo, A. Sy, B. Ndiaye, M. Faye, El Hadji Ka","doi":"10.5812/numonthly.117467","DOIUrl":"https://doi.org/10.5812/numonthly.117467","url":null,"abstract":"Objectives: This study aimed to evaluate the efficacy of Rituximab in the management of idiopathic membranous nephropathy (IMN) based on the following criteria: (I) Biological remission at three months (M3) and six months (M6); (II) change in mean proteinuria (24PU), mean serum albumin, and mean serum creatinine at M3 and M6; (III) and side effects. Methods: This retrospective descriptive and analytical study included patients with histologically confirmed IMN with positive plasma anti-PLA2R antibodies who received at least one dose of Rituximab after six months of follow-up without spontaneous remission. Patients with unexplainable records were not included. Results: A total of five patients (P1, P2, P3, P4, and P5), including four males and one female were analyzed. The mean age was 44.20 ± 23.14 years. All patients had IMN type 2. At inclusion, the mean albuminemia, mean creatinine, and mean 24hPU levels were 15.56 ± 5.27 g/L, 6.54 ± 1.13 g/24h, and 17.3 ± 7.60 mg/L, respectively. The median anti-PLA2R antibody titer was 100 IU with extremes of 10 and 800 IU. Partial remission was noted in three patients at M3 (P2, P4, and P5), and it was maintained until M6 in P2. No complete remission was observed. A significant decrease in mean 24hPU at M3 was noted (P < 0.001). Generalized pruritus associated with seizures was noticed in P4 after the first dose of Rituximab. Conclusions: Partial remission was noted in three patients at M3, and one patient maintained this remission at M6. Rituximab significantly reduced 24hPU at M3 after administration. Rituximab administration was well tolerated by the patients.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45326625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Using Montelukast as an Add-on Treatment in Nephrotic Syndrome Pediatrics: A Randomized Clinical Trial Study 孟鲁司特作为肾病综合征患儿的辅助治疗:一项随机临床试验研究
Q4 Medicine Pub Date : 2021-10-02 DOI: 10.5812/numonthly.116375
Fatemeh Javidi, P. Yousefichaijan, F. Dorreh, A. Arjmand, M. Rezagholizamenjany
Background: Montelukast, as a non-steroidal anti-inflammatory drug, could reduce inflammation in nephrotic syndrome (NS). This study aimed to evaluate the therapeutic effect of montelukast as adjunctive therapy in pediatric NS. Methods: This clinical trial study was conducted on patients with NS. The patients were assigned into two equal groups (N = 25 in each) of intervention (steroid + montelukast) and control and treated for one month. One month later, in the follow-up stage, their proteinuria was measured. The results before and after treatment were statistically analyzed by SPSS software version 21, and the final report of the project was presented. Results: The age of participants in the intervention and control groups was 7.26 ± 4.23 and 6.79 ± 3.91 years, respectively (P = 0.68), and there were 10 female participants in both groups (P = 1.0). Albumin levels in 96% of the control group and 76% of the intervention group were 1.5 - 2.5 μg/dL (P = 0.037). Also, 48% of participants in the control group were corticosteroid dependent, and 60% of participants in the intervention group responded to corticosteroids (P = 0.194). The severity of nephrotic syndrome was moderate in 60% of participants in the control group and mild in 60% of participants in the intervention group (P = 0.138). Conclusions: The results of this study showed that recovery rate was higher in the intervention group, but the difference was not statistically significant.
背景:孟鲁司特作为一种非甾体抗炎药,可减轻肾病综合征(NS)的炎症反应。本研究旨在评价孟鲁司特辅助治疗小儿NS的疗效。方法:对NS患者进行临床试验研究。将患者分为干预组(类固醇+孟鲁司特)和对照组(每组25人),并治疗一个月。一个月后,在随访阶段,测量他们的蛋白尿。采用SPSS软件21版对治疗前后的结果进行统计分析,并给出项目的最终报告。结果:干预组和对照组的参与者年龄分别为7.26±4.23和6.79±3.91岁(P=0.68),两组均有10名女性参与者(P=1.0)。96%的对照组和76%的干预组的白蛋白水平为1.5-2.5μg/dL(P=0.037)。此外,对照组48%的参与者具有皮质类固醇依赖性,干预组60%的参与者对皮质类固醇有反应(P=0.194)。肾病综合征的严重程度在对照组的60%参与者中为中度,在干预组的60%的参与者中为轻度(P=0.138),但差异无统计学意义。
{"title":"Using Montelukast as an Add-on Treatment in Nephrotic Syndrome Pediatrics: A Randomized Clinical Trial Study","authors":"Fatemeh Javidi, P. Yousefichaijan, F. Dorreh, A. Arjmand, M. Rezagholizamenjany","doi":"10.5812/numonthly.116375","DOIUrl":"https://doi.org/10.5812/numonthly.116375","url":null,"abstract":"Background: Montelukast, as a non-steroidal anti-inflammatory drug, could reduce inflammation in nephrotic syndrome (NS). This study aimed to evaluate the therapeutic effect of montelukast as adjunctive therapy in pediatric NS. Methods: This clinical trial study was conducted on patients with NS. The patients were assigned into two equal groups (N = 25 in each) of intervention (steroid + montelukast) and control and treated for one month. One month later, in the follow-up stage, their proteinuria was measured. The results before and after treatment were statistically analyzed by SPSS software version 21, and the final report of the project was presented. Results: The age of participants in the intervention and control groups was 7.26 ± 4.23 and 6.79 ± 3.91 years, respectively (P = 0.68), and there were 10 female participants in both groups (P = 1.0). Albumin levels in 96% of the control group and 76% of the intervention group were 1.5 - 2.5 μg/dL (P = 0.037). Also, 48% of participants in the control group were corticosteroid dependent, and 60% of participants in the intervention group responded to corticosteroids (P = 0.194). The severity of nephrotic syndrome was moderate in 60% of participants in the control group and mild in 60% of participants in the intervention group (P = 0.138). Conclusions: The results of this study showed that recovery rate was higher in the intervention group, but the difference was not statistically significant.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43521623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Investigation on the One-year Rate of Arteriovenous Fistula Failure and Its Related Factors in Patients with End-stage Renal Disease; an Experience in Golestan Province of Iran 终末期肾病患者动静脉瘘一年发生率及相关因素的调查;伊朗戈勒斯坦省的经验
Q4 Medicine Pub Date : 2021-09-19 DOI: 10.5812/numonthly.117420
Fariba Esmaeil Mosharafi, M. Montazeri, Saeid Amirkhanlou
Background: Aortic arch calcification (AAC) is very common in hemodialysis patients and is associated with cardiovascular events and the incidence of arteriovenous fistula (AVF) failure. In order to predict the prognosis of patients, a study was conducted to determine the annual failure rate of AVF and its related factors. Methods: This cross-sectional study was performed on 145 patients with end-stage renal disease (ESRD) who were AVF candidates, visiting a referral center in Golestan province of Iran. After the insertion of intravenous arterial fistulas, posterior-anterior chest x-rays were captured, and the grafts were classified by a radiologist. Patients were followed for one year, and the rates of fistula failure (FF) and cardiovascular mortality were recorded. Finally, the data were entered into SPSS 19 software and analyzed by the Chi-square test. Results: Of 112 patients followed up for one year, 56.2% were men. During the one-year follow-up period, 5.3% of the patients developed arteriovenous FF, and this event was more common in men, but the difference was not statistically significant. The majority of the AVF candidates had a history of diabetes and hypertension, but no association was found between the one-year FF rate and these two diseases. Nearly 7.7% of the patients had grade III calcification, but no significant relationship was observed between the AAC grade and AVF failure rate. Conclusions: The rate of one-year FF was higher among ESRD patients with a history of chronic kidney diseases. Our results also demonstrated that the mortality rate is higher in patients with a high degree of AAC and patients with medical history (cardiovascular disease and diabetes).
背景:主动脉弓钙化(AAC)在血液透析患者中非常常见,与心血管事件和动静脉瘘(AVF)衰竭的发生率有关。为了预测患者的预后,进行了一项研究,以确定AVF的年失败率及其相关因素。方法:这项横断面研究对145名终末期肾病(ESRD)患者进行,他们是AVF候选人,访问了伊朗戈勒斯坦省的转诊中心。在插入静脉动脉瘘后,采集胸部前后部的x光片,并由放射科医生对移植物进行分类。对患者进行了一年的随访,并记录瘘管衰竭(FF)的发生率和心血管死亡率。最后,将数据输入SPSS 19软件,通过卡方检验进行分析。结果:112例随访1年的患者中,男性占56.2%。在一年的随访期内,5.3%的患者出现动静脉FF,这种情况在男性中更常见,但差异无统计学意义。大多数AVF候选人有糖尿病和高血压病史,但一年的FF发病率与这两种疾病之间没有关联。近7.7%的患者有III级钙化,但AAC分级与AVF失败率之间没有显著关系。结论:有慢性肾脏病史的ESRD患者一年FF发生率较高。我们的研究结果还表明,高度AAC患者和有病史(心血管疾病和糖尿病)的患者的死亡率更高。
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引用次数: 0
Prevalence of Sexually Transmitted Diseases in Men of 25 - 60 Years in Iran 伊朗25-60岁男性性传播疾病的患病率
Q4 Medicine Pub Date : 2021-09-19 DOI: 10.5812/numonthly.117767
Fereshte Aliakbari, M. Emadeddin, Neda Taghizabet, Fatemeh Rezaei-Tazangi, Zahra Sadeghzadeh, S. J. Hosseini
Background: Sexually transmitted diseases (STDs), especially in men, can lead to multiple morbidities and facilitate the transmission of serious pathogens, such as the human immunodeficiency virus. The present study used the data from a nationwide survey on male morbidities to estimate the prevalence of STDs among men in Iran. Methods: This cross-sectional study used the data from a nationwide project on male reproductive morbidities in 2007. A total of 2296 men within the age range of 25 - 60 years were recruited by systematic cluster sampling from four provinces (i.e., Golestan, Hormozgan, Kermanshah, and Isfahan, Iran). The data on the symptoms of STDs, including genital secretion, pushing out, itching or genital ulcers, and lymphadenopathy of the inguinal area after sexual contact, were collected by trained urologists. Data analysis was carried out using SPSS software (version18.0, Chicago, IL, USA). The independent samples t-test and chi-square test were used for data analysis. Results: A total of 2296 men with a mean age value of 39.95 ± 10.3 years were interviewed in this study. Two-thirds of all the subjects (75%) were aware of using condoms in suspected sexual relationships; however, only 69% of the aforementioned subjects used condoms in those circumstances. Overall, 14 subjects (0.6%) had one type of STDs at the study time. Moreover, 110 subjects (4.7%) answered “yes” to the question of whether they were referred to a physician for sexual problems. Conclusions: The prevalence of STDs is still low among the male population in Iran. Careful and well-designed surveillance systems to monitor the incidence of STDs and proper preventive measures to restrict the spread of sexually transmitted pathogens are among the proposed recommendations.
背景:性传播疾病(STDs),特别是男性,可导致多种疾病,并促进严重病原体的传播,如人类免疫缺陷病毒。目前的研究使用了一项关于男性发病率的全国性调查的数据来估计伊朗男性中性传播疾病的流行程度。方法:这项横断面研究使用了2007年全国男性生殖疾病项目的数据。采用系统整群抽样方法,从4个省(即Golestan、Hormozgan、Kermanshah和伊朗伊斯法罕)共招募了2296名年龄在25 - 60岁之间的男性。性传播疾病症状的数据,包括生殖器分泌、外泄、瘙痒或生殖器溃疡,以及性接触后腹股沟区淋巴结病,由训练有素的泌尿科医生收集。采用SPSS软件(version18.0, Chicago, IL, USA)进行数据分析。数据分析采用独立样本t检验和卡方检验。结果:共访谈男性2296例,平均年龄39.95±10.3岁。三分之二的受试者(75%)知道在可疑的性关系中使用避孕套;然而,在上述情况下,只有69%的受试者使用避孕套。总体而言,14名受试者(0.6%)在研究期间患有一种性传播疾病。此外,110名受试者(4.7%)在是否因性问题被转诊给医生的问题上回答“是”。结论:伊朗男性人群中性传播疾病的患病率仍然较低。拟议的建议包括建立精心设计的监测系统来监测性传播疾病的发病率,以及采取适当的预防措施来限制性传播病原体的传播。
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引用次数: 0
Correlation of Intravesical Prostatic Protrusion in Benign Prostate Hyperplasia and Residual Lower Urinary Tract Symptoms After Surgery: A Systematic Review 良性前列腺增生患者膀胱内前列腺突出与术后残留下尿路症状的相关性:系统综述
Q4 Medicine Pub Date : 2021-09-05 DOI: 10.5812/numonthly.113614
H. Rahardjo, Bayu Gemilang
Context: Intravesical prostatic protrusion (IPP) is a potential candidate for the initial evaluation of patients with lower urinary tract symptoms (LUTS). Intravesical prostatic protrusion is also known to predict the outcome of trials without a catheter and medical treatment outcomes and to determine bladder outlet obstructions. Objectives: This study aimed to determine whether IPP influences the residual LUTS after surgery in patients with benign prostate hyperplasia who have undergone prostate surgery. Evidence Acquisition: An online database search was conducted regarding the prognosis of postoperative benign prostate hyperplasia patients with intravesical prostatic protrusions. The selected databases comprised PubMed, ScienceDirect, EBSCO, and Cochrane Library. Randomized controlled trial, cohort, or case control studies that were written in English or Bahasa and published up until November 2020 were included. We reviewed postoperative outcomes, including subjective symptoms, based on the International Prostate Symptom Score and objective signs, such as Qmax and post voiding residue. Results: Our initial database search yielded 143 papers. After exclusion from abstract screening, seven papers were considered for full-text analysis. Five of these studies showed higher preoperative intravesical prostatic protrusion within successful postoperative outcomes. Some studies showed that patients with significant intravesical prostatic protrusions had more significant International Prostate Symptom Score decrements. However, two studies demonstrated that intravesical prostatic protrusion was not a significant prognostic factor. Conclusions: Most studies suggested that intravesical prostatic protrusion can predict better post-surgery lower urinary tract symptom outcomes. Further research using information about the risk of bias in ultrasound examination and more homogeneous surgical techniques and considering the duration of patients’ illness before they receive surgical management is needed.
背景:膀胱内前列腺增生症(IPP)是下尿路症状(LUTS)患者初步评估的潜在候选者。众所周知,膀胱内前列腺增生可以预测无导管试验的结果和药物治疗结果,并确定膀胱出口阻塞。目的:本研究旨在确定IPP是否影响接受前列腺手术的良性前列腺增生患者术后残余LUTS。证据收集:对膀胱内前列腺突出的良性前列腺增生术后患者的预后进行了在线数据库搜索。选定的数据库包括PubMed、ScienceDirect、EBSCO和Cochrane Library。包括用英语或巴哈萨语撰写并在2020年11月之前发表的随机对照试验、队列或病例对照研究。我们根据国际前列腺症状评分和客观体征,如Qmax和排尿后残留物,回顾了术后结果,包括主观症状。结果:我们最初的数据库搜索产生了143篇论文。在从摘要筛选中排除后,考虑对七篇论文进行全文分析。其中5项研究显示,在成功的术后结果范围内,术前膀胱内前列腺增生较高。一些研究表明,膀胱内前列腺突出的患者的国际前列腺症状评分下降更为显著。然而,两项研究表明,膀胱内前列腺增生不是一个重要的预后因素。结论:大多数研究表明,膀胱内前列腺增生可以预测更好的术后下尿路症状结果。需要进一步研究超声检查中的偏倚风险和更同质的手术技术,并考虑患者在接受手术治疗前的患病时间。
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引用次数: 0
The Association Between Uric Acid and Symmetric Dimethylarginine Levels in the Patients Undergoing Twice-weekly Hemodialysis 每周两次血液透析患者尿酸与对称二甲基精氨酸水平的关系
Q4 Medicine Pub Date : 2021-08-18 DOI: 10.5812/numonthly.117476
A. Lydia, Yassir A. Yassir, R. Hidayat, S. Suwarto
Background: Uric acid (UA) levels are associated with increased risk of cardiovascular events and mortality in hemodialysis patients. However, there are still conflicting data on the mechanism of increased risks related to uric acid levels. Objectives: This study assessed the association between uric acid levels and symmetric dimethylarginine (SDMA), as a marker of cardiovascular disease, in the subjects undergoing hemodialysis twice weekly. Methods: This was a cross-sectional study conducted in a tertiary hospital in Jakarta, Indonesia. We included all the adults who underwent hemodialysis twice weekly for at least three months in our hospital. Subjects already on uric acid lowering therapy, pregnant or lactating women and those with a history of malignancy were excluded. Uric acid and SDMA levels were measured at the same time in pre-dialysis venous blood samples. Bivariate analysis was performed using the Mann-Whitney U test or one-way ANOVA. Results: A total of 126 subjects were included. The median level of UA was 8.4 mg/dL (IQR: 2.6, min: 4.1, max: 13.6), and 72 subjects (57.14%) had UA levels of 8 mg/dL or higher. The median SDMA level was 535.5 (312.7) mmol/dL (min: 119.7, max: 1895.5). Subjects with UA levels > 8 mg/dL had significantly higher SDMA levels compared to subjects with UA levels < 8 mg/dL (550.1 (IQR: 357.25) vs 491.35 (IQR: 181.1), P: 0.0475). Conclusions: In twice-weekly hemodialysis patients, UA levels above 8 mg/dL were associated with increased SDMA levels.
背景:血液透析患者的尿酸水平与心血管事件和死亡率的增加有关。然而,关于与尿酸水平相关的风险增加的机制,仍有相互矛盾的数据。目的:本研究评估了每周两次接受血液透析的受试者的尿酸水平与作为心血管疾病标志的对称二甲基精氨酸(SDMA)之间的关系。方法:这是一项在印度尼西亚雅加达一家三级医院进行的横断面研究。我们纳入了所有在我们医院每周接受两次血液透析至少三个月的成年人。已经接受降尿酸治疗的受试者、孕妇或哺乳期妇女以及有恶性肿瘤病史的受试对象被排除在外。在透析前静脉血液样本中同时测量尿酸和SDMA水平。使用Mann-Whitney U检验或单因素方差分析进行双变量分析。结果:共纳入126名受试者。UA的中位水平为8.4 mg/dL(IQR:2.6,最小值:4.1,最大值:13.6),72名受试者(57.14%)的UA水平为8 mg/dL或更高。SDMA水平中位数为535.5(312.7)mmol/dL(最小值:119.7,最大值:1895.5)。UA水平>8 mg/dL的受试者的SDMA水平显著高于UA水平<8 mg/dL[550.1(IQR:357.25)vs 491.35(IQR:181.1),P:0.0475]。
{"title":"The Association Between Uric Acid and Symmetric Dimethylarginine Levels in the Patients Undergoing Twice-weekly Hemodialysis","authors":"A. Lydia, Yassir A. Yassir, R. Hidayat, S. Suwarto","doi":"10.5812/numonthly.117476","DOIUrl":"https://doi.org/10.5812/numonthly.117476","url":null,"abstract":"Background: Uric acid (UA) levels are associated with increased risk of cardiovascular events and mortality in hemodialysis patients. However, there are still conflicting data on the mechanism of increased risks related to uric acid levels. Objectives: This study assessed the association between uric acid levels and symmetric dimethylarginine (SDMA), as a marker of cardiovascular disease, in the subjects undergoing hemodialysis twice weekly. Methods: This was a cross-sectional study conducted in a tertiary hospital in Jakarta, Indonesia. We included all the adults who underwent hemodialysis twice weekly for at least three months in our hospital. Subjects already on uric acid lowering therapy, pregnant or lactating women and those with a history of malignancy were excluded. Uric acid and SDMA levels were measured at the same time in pre-dialysis venous blood samples. Bivariate analysis was performed using the Mann-Whitney U test or one-way ANOVA. Results: A total of 126 subjects were included. The median level of UA was 8.4 mg/dL (IQR: 2.6, min: 4.1, max: 13.6), and 72 subjects (57.14%) had UA levels of 8 mg/dL or higher. The median SDMA level was 535.5 (312.7) mmol/dL (min: 119.7, max: 1895.5). Subjects with UA levels > 8 mg/dL had significantly higher SDMA levels compared to subjects with UA levels < 8 mg/dL (550.1 (IQR: 357.25) vs 491.35 (IQR: 181.1), P: 0.0475). Conclusions: In twice-weekly hemodialysis patients, UA levels above 8 mg/dL were associated with increased SDMA levels.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42484541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Nephro-urology Monthly
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