Assessment of Potential Renal Dysfunction in Patients with Congenital Heart Disease after Biventricular Repair

BACKGROUND AND OBJECTIVES: There are few reports on renal dysfunction in the remote period after biventricular repair, and biomarkers for early detection of renal dysfunction are not well understood. We examined whether early fluctuation of biomarkers of renal function occurs in the remote period after biventricular repair in patients with congenital heart disease (CHD). METHODS: Fourteen patients with CHD after biventricular repair were included. The examination values obtained by cardiac catheterization test and renal function indices based on blood and urine sampling were compared. RESULTS: The median estimated glomerular filtration rate (eGFR) of creatinine was 113 mL/min/1.73 m2, and the median eGFR of cystatin C was 117 mL/min/1.73 m2. A urine albumin-to-creatinine ratio (UACR) ≥10 mg/gCr was considered a risk factor for cardiovascular disease in 6 (43%) patients. There was a significant difference in right ventricular ejection fraction and deviation in right ventricular end-diastolic volume from the normal value between the 2 groups divided by UACR. Cyanosis before biventricular repair was noted in 2 (25%) patients with UACR < 10 mg/gCr and in 4 (67%) patients with UACR ≥10 mg/gCr. CONCLUSIONS: Increased UACR was noted in 43% of patients. In patients with UACR ≥10 mg/gCr, right heart system abnormality was observed, and several patients had cyanosis before radical treatment. Measurement for UACR may be able to detect renal dysfunction early in the postoperative remote period.

Assessment of Potential Renal Dysfunction in Patients with Congenital Heart Disease after Biventricular Repair

BACKGROUND AND OBJECTIVES@#There are few reports on renal dysfunction in the remote period after biventricular repair, and biomarkers for early detection of renal dysfunction are not well understood. We examined whether early fluctuation of biomarkers of renal function occurs in the remote period after biventricular repair in patients with congenital heart disease (CHD).@*METHODS@#Fourteen patients with CHD after biventricular repair were included. The examination values obtained by cardiac catheterization test and renal function indices based on blood and urine sampling were compared.@*RESULTS@#The median estimated glomerular filtration rate (eGFR) of creatinine was 113 mL/min/1.73 m2, and the median eGFR of cystatin C was 117 mL/min/1.73 m2. A urine albumin-to-creatinine ratio (UACR) ≥10 mg/gCr was considered a risk factor for cardiovascular disease in 6 (43%) patients. There was a significant difference in right ventricular ejection fraction and deviation in right ventricular end-diastolic volume from the normal value between the 2 groups divided by UACR. Cyanosis before biventricular repair was noted in 2 (25%) patients with UACR < 10 mg/gCr and in 4 (67%) patients with UACR ≥10 mg/gCr.@*CONCLUSIONS@#Increased UACR was noted in 43% of patients. In patients with UACR ≥10 mg/gCr, right heart system abnormality was observed, and several patients had cyanosis before radical treatment. Measurement for UACR may be able to detect renal dysfunction early in the postoperative remote period.

Appearance of Side Effects Related to Non-ionic Iodine Contrast Medium / 医薬品情報学

<b>Objective: </b>We investigated the incidence of side effects related to contrast medium employed in our hospital based on monitoring materials to improve the safety of contrast-enhanced examinations.  Furthermore, we compared the incidence of side effects between the original product and generic drugs to confirm the safety of each preparation.<br><b>Methods: </b>The survey period was from April 2007 until March 2011.  Based on the number of patients who underwent contrast-enhanced examinations and that of patients with side effects, we calculated the incidence of side effects in our hospital, and confirmed its annual changes.  Subsequently, we again collected the incidence of side effects per each manufacturer’s preparation employed, and confirmed the state of side effects of individual preparations.  Furthermore, we evaluated the symptoms as side effects, interval until appearance, and treatment for side effects during the data collection period, as well as the subsequent state, symptoms as side effects, and interval until appearance.  The chi square independence test was employed to compare the results among groups.  <i>p</i><0.05 was regarded as significant (paired test).<br><b>Results: </b>There were no changes in the annual incidence of side effects.  There were also no significant differences in the annual incidence of side effects among the preparations.  Furthermore, there were no marked differences in the symptoms, interval until appearance, treatment for side effects, or subsequent state among the preparations.<br><b>Conclusion: </b>We investigated the appearance of side effects regarding contrast-enhanced examinations for 4 years.  We confirmed that there were no differences in the incidence of side effects among the preparations.

Results of Abdominal Examinations by Sonography at Hokkaido Koseiren-Affiliated Facilities over the Past 10 Years / 日本農村医学会雑誌

  The Association of Radiologists under the umbrella of the Hokkaido Prefectural Federation of Agricultural Cooperatives for Health and Welfare (Hokkaido Koseiren) set up in 2003 a committee with the aim of improving the accuracy of mass health examinations. Recently, the committee reviewed the results of abdominal examinations by sonography performed at the eight hospitals affiliated with the Koseiren during fiscal 2006 that ended March 31, 2007. Of those individuals who underwent thorough health checkups, 91.3% had their abdomen examined by ultrasound. Something anomalous was detected in 68.1% of the examinees and 4.5% needed to undergo closer checkups, the rate of response to which was 74.5%. The detection ratio of cancer by ultrasonography was worked out at 0.048%. The ratio of patients requiring a closer exam to the total and the cancer detection ratio varied widely from hospital to hospital. The wide dispersion was ascribable to the difference in the standard of judgment for indicating closer examinations and the difference in the number of examinees so far as the cancer detection ratio was concerned, from hospital to hospital. A look at the primary findings of anomalies revealed that fatty liver topped the list accounting for 27.4% followed by cholelithiasis with 3.6%. From this, we realized that the abdominal examinations by sonography served to detect cancer and lifestyle-induced health problems as well. Organ-wise, the cancer cases found during the period from 1998 to 2009 broke down as follows: kidney (79 cases), liver (40 cases), pancreas (30 cases), gall bladder (24 cases), others (8 cases) and spleen (none). The cancer detection ratio per year ranged from 0.03 to 0.05% during the period.

High Density Barium Dosage and its Effect on Excretion. A Survey / 日本農村医学会雑誌

Before the introduction of high density barium for contrast studies of the upper gastrointestinal tract, we conducted a survey concerning the adverse reactions to a swallow of barium and barium concentration.<BR>The incidence of side effects rose as the density of barium increased but the effects were transient. There were no cases requiring medical treatment.<BR>Furthermore, the constipation group and the normal group were examined separately.<BR>The ratio of adverse reactions was high in the constipation group even when the barium density was low. In this group stool hardening and delayed excertion were also noticed.<BR>The constancy of barium stool excretion was basically normal, and the barium density had little effect.<BR>The effects of a laxative on the excretion consistency were investigated. The administration of a laxative did not always have a positive affect on excretion. The timing of the administration of the laxative and the amount of water intake should be examined in the future.<BR>We also investigated how the patients feel when they are swallowing barium. We found that whether feel uncomfortable or not depended on the properties of barium rather than its density.<BR>From these results it appears that appropriate guidance is necessary about the use of high density barium, in order to supress the occurrence of side effects, especially in the constipation group.