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1.
Ciênc. cuid. saúde ; 20: e50308, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1356121

ABSTRACT

RESUMO Objetivo: Analisar a associação entre ultrafiltração e gravidade de pacientes diagnosticados com lesão renal aguda com complicações clínicas decorrentes da hemodiálise. Método: Estudo transversal realizado num hospital universitário do Sul do Brasil. Foram incluídas todas as fichas diárias de sessões de hemodiálise de pacientes com lesão renal aguda submetidos à hemodiálise entre setembro e novembro de 2017. Para obtenção dos dados, elaborou-se um instrumento de coleta. Adotou-se nível de significância inferior a 5%. Resultados: Os 103 pacientes estudados fizeram um total de 519 sessões de hemodiálise. Prevaleceram pacientes do sexo masculino (66,7%) com 60 anos ou mais (51,5%). Cerca de metade dos pacientes apresentou volume médio de ultrafiltração >1501ml (51,5%). A maioria foi considerada grave (72,8%). Dentre as complicações, a mais prevalente foi a hipotensão (69,9%). A realização de um maior volume de ultrafiltração não se associou às complicações estudadas. Pacientes graves apresentaram maior chance para ocorrência de hipotensão (p<0,001 e OR: 33,73). Conclusão: Hipotensão durante a hemodiálise foi uma complicação frequente, ocorrendo em cerca de metade dos pacientes. Como não esteve associada a volumes maiores de ultrafiltração, conclui-se que, possivelmente, a maior gravidade do paciente seja um fator explicativo para o desenvolvimento dessa complicação.


RESUMEN Objetivo: analizar la asociación entre ultrafiltración y gravedad de pacientes diagnosticados con lesión renal aguda con complicaciones clínicas derivadas de la hemodiálisis. Método: estudio transversal realizado en un hospital universitario del Sur de Brasil. Se incluyeron todas las fichas diarias de sesiones de hemodiálisis de pacientes con lesión renal aguda sometidos a hemodiálisis entre septiembre y noviembre de 2017. Para obtener los datos, se elaboró un instrumento de recolección. Se adoptó un nivel de significancia inferior al 5%. Resultados: los 103 pacientes estudiados realizaron un total de 519 sesiones de hemodiálisis. Prevalecieron pacientes varones (66,7%) con 60 años o más (51,5%). Cerca de la mitad de los pacientes presentó volumen medio de ultrafiltración >1501ml (51,5%). La mayoría fue considerada grave (72,8%). Entre las complicaciones, la más prevalente fue la hipotensión (69,9%). La realización de un mayor volumen de ultrafiltración no se asoció a las complicaciones estudiadas. Pacientes graves presentaron mayor predicción de ocurrencia de hipotensión (P0,001 y OR: 33,73). Conclusión: hipotensión durante la hemodiálisis fue una complicación frecuente, ocurriendo en aproximadamente la mitad de los pacientes. Como no estuvo asociada a volúmenes mayores de ultrafiltración, se concluye que, posiblemente, la mayor gravedad del paciente sea un factor explicativo para el desarrollo de esa complicación.


ABSTRACT Objective: To analyze the association between ultrafiltration and severity of patients diagnosed with acute renal injury with clinical complications resulting from hemodialysis. Method: A cross-sectional study was conducted in a teaching hospital in southern Brazil. We included all daily records of hemodialysis sessions of patients with acute kidney injury who underwent hemodialysis between September and November 2017. For data collection, an instrument was developed. A significance level of less than 5% was adopted. Results: The 103 patients under studywent through a total of 519 hemodialysis sessions. Most were male patients (66.7%) aged 60 years or older (51.5%). About half of the patients had mean ultrafiltration volume >1501ml (51.5%). Most were considered critical (72.8%). Among the complications, hypotension (69.9%) was the most prevalent. The performance of a higher volume of ultrafiltration was not associated with the studied complications. Patients with severity showed a higher chance of hypotension (p<0.001 and OR: 33.73). Conclusion: Hypotension during hemodialysis was a frequent complication, presented by nearly half of the patients. As it was not associated with larger ultrafiltration volumes, it is concluded that, possibly, the greater severity of the patient is an explanatory factor for the onset of this complication.


Subject(s)
Humans , Male , Female , Patients , Ultrafiltration , Renal Dialysis , Acute Kidney Injury , Patient Acuity , Hypotension , Intensive Care Units , Kidney
2.
Rev. colomb. nefrol. (En línea) ; 7(1): 84-96, ene.-jun. 2020.
Article in Spanish | LILACS, COLNAL | ID: biblio-1144376

ABSTRACT

Resumen La terapia de acuaféresis ha sido estudiada como una herramienta terapéutica para pacientes con sobrecarga de volumen refractaria al tratamiento con diuréticos de asa. Su objetivo principal es mitigar el impacto clínico de esta sobrecarga en los pacientes con insuficiencia cardiaca descompensada y SCR, reconociendo de esta manera los balances acumulados positivos en los pacientes críticamente enfermos como un factor independiente de mortalidad. Se realizó una búsqueda en las principales bases de datos científicas sobre la terapia de acuaféresis. Se incluyeron guías de manejo, ensayos clínicos controlados, revisiones sistemáticas y metaanálisis. Las bases bibliográficas que arrojaron resultados relevantes fueron Web of Sciences, Scopus, PubMed y SciELO y en total se encontraron 47 referencias bibliográficas publicadas entre 2005 y 2017. La acuaféresis es una terapia de ultrafiltración patentada que mejora la sobrecarga refractaria en pacientes con insuficiencia cardiaca congestiva. Hay brechas en el conocimiento en relación a su costo-efectividad, a los eventos adversos graves que se le atribuyen y a los candidatos que beneficia, por tanto, se requieren más estudios de calidad para llegar a conclusiones sólidas. Hasta el momento no hay evidencia contundente que respalde el uso sistemático y rutinario de la terapia de acuaféresis en las unidades de cuidado intensivo.


Abstract The therapy of Aquapheresis has been studied as a therapeutic tool for patients with volume overload refractory to treatment with ASA diuretics, whose main objective is to mitigate the clinical impact of the same in patients with decompensated heart failure and cardiorenal syndrome, recognizing positive cumulative balances in critically ill patients as a factor regardless of mortality. A search was made in the main scientific databases for review articles, and studies that included the Acuapheresis strategy. Bibliographic references were found in databases from 2005 to 2017. Aquapheresis therapy is a patented ultrafiltration therapy aimed at improving refractory overload in patients with congestive heart failure. There are gaps in knowledge regarding cost-effectiveness therapy, real adverse adverse event relationships attributable to it and candidates will benefit, and we believe that more quality studies are required to reach solid conclusions. So far there is no compelling evidence to support Aquapheresis therapy to implement its routine and routine use of the ICU.


Subject(s)
Humans , Male , Female , Therapeutics , Patients , Ultrafiltration , Colombia , Dialysis , Acute Kidney Injury , Cardio-Renal Syndrome
3.
Article in Chinese | WPRIM | ID: wpr-828368

ABSTRACT

G-quadruplex DNA has become an important target for tumor therapy and anti-tumor development. Modern pharmacology has proved that Macleaya cordata has anti-inflammatory, antibacterial, anti-tumor and other pharmacological effects. Affinity ultrafiltration method can screen active ingredients from compounds rapidly, but G-quadruplex DNA ligands are difficult to dissociate, which is a key step in conventional ultrafiltration method. In this paper, the filtrates after ultrafiltration were determined by HPLC-MS in substitution. The peaks with 20% reduction of MS response from the incubation vs control were considered to be ligand components to G-quadruplex. Two of the peaks with the relative abundance above 30% were identified as sanguinarine(SAN) and chelerine(CHE). Their circular dichroism conformations further proved that SAN and CHE are active ligands of HT4. In addition, another two gradients with high relative abundance were identified as protopine(PRO) and allpcryprotopine(ALL). The binding rate of SAN, CHE, PRO and ALL was calculated according to the HPLC-MS results, and the results showed a consistency with that of the molecular docking method. The proposed method can be used to screen active components from mixture.


Subject(s)
Chromatography, High Pressure Liquid , Chromatography, Liquid , G-Quadruplexes , Ligands , Mass Spectrometry , Molecular Docking Simulation , Ultrafiltration
4.
Insuf. card ; 13(2): 72-86, 01/06/2018. ilus, tab
Article in Spanish | LILACS | ID: biblio-914691

ABSTRACT

Los pacientes con insuficiencia cardíaca descompensada presentan un estado congestivo. La inmensa mayoría de las veces es debido a la activación de mecanismos neurohormonales que provocan la retención de sodio y agua a nivel renal. Esta activación y la congestión pueden devenir en la alteración de la función renal (síndrome cardio-renal). El tratamiento de la congestión se basa en el uso de diuréticos, pero la inmensa mayoría de estos pacientes presentan resistencia a los mismos, además de sufrir diferentes efectos secundarios por su uso, como las alteraciones hidroelectrolíticas. Terapias como la ultrafiltración o la diálisis peritoneal se han valorado en el tratamiento de la insuficiencia cardíaca congestiva. Nuestro objetivo es hacer una aproximación al lector de las alternativas al tratamiento diurético en el paciente congestivo, centrándonos, prioritariamente, en la ultrafiltración.


Patients with decompensated heart failure have a congestive state. Volume overloaded state is due to neurohormonal mechanisms activation that cause the retention of sodium and water by the kidney. This activation and congestion can lead to impaired renal function (cardio-renal syndrome). Congestive treatment is based on use of diuretics but the vast majority of these patients have diuretic resistance, as well as suffering from different side effects due to their use such as hydroelectrolytic alterations. Therapies such ultrafiltration or peritoneal dialysis have been evaluated in the treatment of congestive heart failure. Our objective is to make an approximation of other therapeutic strategies specially on ultrafiltration to resolve congestive state.


Pacientes com insuficiência cardíaca descompensada apresentam um estado congestivo. A grande maioria é devido à ativação de mecanismos neuro-hormonais que causam a retenção de sódio e água nos rins. Essa ativação e congestão podem resultar em comprometimento da função renal (síndrome cardio-renal). O tratamento da congestão baseia-se no uso de diuréticos, mas a grande maioria destes pacientes têm a mesma resistência, e sofrem de diversos efeitos colaterais por utilização, como perturbações electrolíticas. Terapias como ultrafiltração ou diálise peritoneal foram avaliadas no tratamento da insuficiência cardíaca congestiva. Nosso objetivo é aproximar o leitor das alternativas ao tratamento diurético no paciente congestivo, enfocando, principalmente, a ultrafiltração.


Subject(s)
Humans , Diuretics , Heart Failure , Ultrafiltration
5.
Article in English | WPRIM | ID: wpr-718614

ABSTRACT

BACKGROUND: This study compared nutritional parameters in hemodialysis (HD) subjects and controls using bioimpedance analysis (BIA) and investigated how BIA components changed before and after HD. METHODS: This cross-sectional study included 147 subjects on maintenance HD from two hospitals and 298 propensity score-matched controls from one healthcare center. BIA was performed pre- and post-HD at mid-week dialysis sessions. RESULTS: Extracellular water/total body water (ECW/TBW) and waist-hip ratio were higher in the HD patients; the other variables were higher in the control group. The cardiothoracic ratio correlated best with overhydration (r = 0.425, P < 0.01) in HD subjects. Blood pressure, hemoglobin, creatinine, and uric acid positively correlated with the lean tissue index in controls; however, most of these nutritional markers did not show significant correlations in HD subjects. Normal hydrated weight was predicted to be higher in the pre-HD than post-HD measurements. Predicted ultrafiltration (UF) volume difference based on pre- and post-HD ECW/TBW and measured UF volume difference showed a close correlation (r 2 = 0.924, P < 0.01). Remarkably, the leg phase angle increased in the post-HD period. CONCLUSION: The estimated normal hydrated weight using ECW/TBW can be a good marker for determining dry weight. HD subjects had higher ECW/TBW but most nutritional indices were inferior to those of controls. It was possible to predict UF volume differences using BIA, but the post-HD increase in leg phase angle, a nutritional marker, must be interpreted with caution.


Subject(s)
Blood Pressure , Body Water , Creatinine , Cross-Sectional Studies , Delivery of Health Care , Dialysis , Humans , Leg , Nutrition Assessment , Nutritional Status , Renal Dialysis , Ultrafiltration , Uric Acid , Waist-Hip Ratio
6.
Article in English | WPRIM | ID: wpr-739192

ABSTRACT

Non-infectious complications of peritoneal dialysis (PD) are relatively less common than infectious complications but are a potentially serious problem in patients on chronic PD. Here, we present a case of a non-infectious complication of PD in a 13-year-old boy on chronic PD who presented with symptoms such as hypertension, edema, dyspnea, and decreased ultrafiltration. Chest and abdominal radiography showed pleural effusion and migration of the PD catheter tip. Laparoscopic PD catheter reposition was performed because PD catheter malfunction was suspected. However, pleural effusion relapsed whenever the dialysate volume increased. To identify peritoneal leakage, computed tomography (CT) peritoneography was performed, and a defect of the peritoneum in the left lower abdomen with contrast leakage to the left rectus and abdominis muscles was observed. He was treated conservatively by transiently decreasing the volume of night intermittent PD and gradually increasing the volume. At the 2-year follow-up visit, the patient had not experienced similar symptoms. Patients on PD who present with refractory or recurrent pleural effusion that does not respond to therapy should be assessed for the presence of infection, catheter malfunction, and pleuroperitoneal communication. Thoracentesis and CT peritoneography are useful for evaluating pleural effusion, and timely examination is important for identifying the defect or fistula.


Subject(s)
Abdomen , Adolescent , Catheters , Dyspnea , Edema , Fistula , Follow-Up Studies , Humans , Hypertension , Male , Muscles , Peritoneal Dialysis , Peritoneum , Pleural Effusion , Radiography, Abdominal , Thoracentesis , Thorax , Ultrafiltration
7.
Article in English | WPRIM | ID: wpr-644035

ABSTRACT

Injury to podocytes is an early event in diabetic nephropathy leading to proteinuria with possible progression to end-stage renal failure. The podocytes are unique and highly specialized cells that cover the outer layer of kidney ultrafiltration barrier and play an important role in glomerular function. In the past few decades, adult stem cells, such as mesenchymal stem cells (MSCs) with a regenerative and differentiative capacity have been extensively used in cell-based therapies. In addition to their capability for regeneration and differentiation, MSCs contributes to their milieu by paracrine action of a series of growth factors via antiapoptotic, mitogenic and other cytokine actions that actively participate in treatment of podocyte damage through prevention of podocyte effacement, detachment and apoptosis. It is hoped that novel stem cell-based therapies will be developed in the future to prevent podocyte injury, thereby reducing the burden of kidney disease.


Subject(s)
Adult Stem Cells , Apoptosis , Diabetic Nephropathies , Hope , Intercellular Signaling Peptides and Proteins , Kidney , Kidney Diseases , Kidney Failure, Chronic , Mesenchymal Stem Cells , Podocytes , Proteinuria , Regeneration , Ultrafiltration
8.
Article in English | WPRIM | ID: wpr-57412

ABSTRACT

Clinical examination, bronchoalveolar lavage fluid (BALF) cytology, acute-phase protein, and pulmonary hemostasis and fibrinolysis marker (fibrinogen, serum amyloid A [SAA], and D-dimer) results were compared between control and respiratory disease-affected horses. Using a clinical scoring system, horses (n = 58) were classified as respiratory disease-free (Controls, n = 15) or with recurrent airway obstruction (RAO; n = 18), inflammatory airway disease (n = 14) or chronic interstitial pneumopathy (n = 11). There were no significant differences in fibrinogen concentrations among groups, but there was a trend toward a lower value in controls (median 0.0024 g/L) than in horses with chronic pneumopathies (median 0.0052 g/L), in particular, those with RAO (median 0.0062 g/L). Fibrinogen concentration was positively correlated with percentage of neutrophils in BALF (r(s) = 0.377, p = 0.004). SAA concentrations were low; 65.5% of samples were below the detection limit. D-dimer concentrations were also low and quantifiable concentrations were only obtained after ultrafiltration and only in RAO (median 0.1 mg/L). In conclusion, there was limited evidence of increased coagulatory activity in chronic pneumopathies, apart from RAO. It is uncertain whether fibrinogen and D-dimer concentrations increased due to their role as acute-phase proteins or as a misbalance of coagulation and fibrinolysis.


Subject(s)
Acute-Phase Proteins , Airway Obstruction , Bronchoalveolar Lavage Fluid , Fibrinogen , Fibrinolysis , Hemostasis , Horses , Limit of Detection , Neutrophils , Serum Amyloid A Protein , Ultrafiltration
9.
Article in English | WPRIM | ID: wpr-812132

ABSTRACT

Ultrafiltration is one of the most fascinating technologies, which makes it possible to improve the quality of traditional medicines for application in the pharmaceutical industry. However, researchers have paid little attention to the effect of ultrafiltration membrane on traditional medicines chemical constituents. In this work, Ophiopogon japonicus (L.f) Ker-Gawl. was used as an example to illuminate the influence of ultrafiltration with different material and molecular weight cut-off (MWCO) membrane on natural chemical constituents as measured by ultra-fast liquid chromatography coupled with ion trap time-of-flight mass spectrometry (UFLC-IT-TOF/MS). Our results indicated that ultrafiltration membrane significantly impacted homoisoflavonoids, especially homoisoflavonoids that were almost completely retained on the polyethersulfone (PES) membrane. We also found that the larger number of aglycone hydroxy and sugar moiety in steroid saponins, the higher the transmittance. Furthermore, the passage rate (%) of ophiogenin type saponins was higher than that of others. The possible adsorptive mechanisms were hydrogen bonding, hydrophobic interactions, and benzene ring interaction by π-π stacking. In conclusion, it is crucial to choose appropriate ultrafiltration membrane based on the characteristics of produce products for application of ultrafiltration technique.


Subject(s)
Chromatography, High Pressure Liquid , Methods , Chromatography, Liquid , Methods , Drugs, Chinese Herbal , Isoflavones , Molecular Structure , Molecular Weight , Ophiopogon , Chemistry , Plant Extracts , Chemistry , Polymers , Saponins , Spectrometry, Mass, Electrospray Ionization , Methods , Sulfones , Ultrafiltration , Methods
10.
Int. j. med. surg. sci. (Print) ; 3(4): 1025-1030, dic. 2016. tab, graf
Article in English | LILACS | ID: biblio-1095252

ABSTRACT

One of the goals of hemodialysis is to maintain normal hydration status in ESRD patients.Pre hemodialysis systolic blood pressure is usually used as a clinical parameter of hydration status and to set ultrafiltration rate before Hd. It is unclear how much pre-Hd SBP correlated with hydration status. The aimwas to determine correlation between pre-Hd SBP and hydration status before Hd. An observational correlation study was performed in two dialysis centers in Santiago, Chile, from January-June, 2011. Adult patients inHd for at least three months, who gave their informed consent were included. Patients with pacemaker,amputee, hospitalized and metallic prostheses were excluded. Total-body water and over hydrated were assessed with bioimpedance spectroscopy before the first and third dialysis session of the week. Pre-Hd SBP,pre-Hd body weight, pre-Hd TBW and pre-Hd OH, were analyzed using Pearson correlation and linear regressionmodel. 96 measurements were assessed, 52 % were male with median age 59.5 years. The correlationbetween pre-Hd SBP and pre-Hd overhydration was r=0.33, and total body water r=0.15, with a predictedvalue, R2=0.10 and R2 =0.14 respectively. Pre-Hd SBP had low correlation with pre-Hd hydration status and by itself, is not a reliable parameter to set ultrafiltration rate before Hd. Nevertheless Pre-Hd body weight predicted in 70 % the pre-Hd TBW.


Uno de los objetivos de la hemodiálisis es mantener la hidratación normal en pacientes ESRD. La presión arterial sistólica pre hemodiálisis, es usualmente utilizada como parámetro clínico del estado de hidratación y para fijar la velocidad de ultrafiltración antes de la hemodialisis. No está claro cuanto se correlacionan la presión arterial sistólica prehemodialysis con el estado de hidratación. El objetivo fue determinar la correlación entre la PAS prehemodiálisis y el estado de hidratación antes de Hd. Se realizó un estudio de correlación observacional en dos centros de diálisis de Santiago de Chile, de Enero a Junio de 2011. Se incluyeron pacientes adultos en HD durante al me-nos tres meses que dieran su consentimiento informado. Se excluyeron los pacientes con marcapasos, amputados, hospitalizados y pró-tesis metálicas. El agua corporal total y el exceso de hidratación se evaluaron con espectroscopia 1030 de bioimpedancia antes de la primera y tercera sesión de diálisis de la semana. Pre-Hd PAS, pre-Hd peso corporal, pre-Hd ACT y pre-Hd OH, se analizaron utilizando el modelo de correlación y regresión lineal de Pearson. Se evaluaron 96 mediciones, 52% eran hombres con edad media 59, 5 años. La correlación entre la PAS pre-Hd y la sobrehidratación pre-Hd fue r=0, 33 y agua corporal total r=0, 15, con un valor predicho, R2= 0, 10 y R2 = 0, 14 respectivamente. Existe baja correlación entre la PAS Pre-Hd con el esta-do de hidratación pre-Hd y por lo mismo, no es un parámetro confiable para establecer la tasa de ultrafiltración antes de Hd. Sin embargo, el peso corporal Pre-Hd predijo en un 70% el agua corporal total pre-Hd.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Water-Electrolyte Balance/physiology , Blood Pressure/physiology , Renal Dialysis/methods , Spectrum Analysis , Systole , Body Fluids/physiology , Ultrafiltration , Linear Models , Electric Impedance , Correlation of Data
11.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 26(1): 34-38, jan.-mar.2016.
Article in Portuguese | SES-SP, LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: lil-789774

ABSTRACT

A otimização das medidas para controle volêmico tem papel preponderante naabordagem de pacientes com disfunção cardíaca e renal combinada, uma vez quealterações crônicas ou agudas em um desses órgãos, em geral, induzem ou perpetuam anormalidades (funcionais e/ou estruturais) no outro. Esta revisão de literatura propõe uma análise sobre as principais medidas terapêuticas no cardiopata com disfunção renal...


Optimizing the methods used in the control of volemia is very important in the treatment of patients with combined heart and renal dysfunction, as chronic or acute changes in either of these organs generally induces or perpetuates abnormalities (functional and/orstructural) in the other. This literature review analyzes the main therapeutic methods used in heart disease with renal dysfunction...


Subject(s)
Humans , Male , Female , Heart Failure/complications , Heart Failure/therapy , Renal Insufficiency/complications , Renal Insufficiency/therapy , Cardio-Renal Syndrome/diagnosis , Cardio-Renal Syndrome/therapy , Heart Diseases/complications , Heart Diseases/diagnosis , Shock, Cardiogenic , Peritoneal Dialysis/methods , Risk Factors , Ultrafiltration/methods
12.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 26(1): 39-45, jan.-mar.2016.
Article in Portuguese | LILACS | ID: lil-789775

ABSTRACT

A congestão pulmonar aguda no paciente com doença cardíaca é uma manifestação clínica de extrema gravidade, ocorrendo em aproximadamente 25% dos casosde insuficiência cardíaca aguda. O diagnóstico é essencialmente clínico, baseado na anamnese e exame físico. Os exames complementares não devem retardar o início do tratamento na sala de emergência. Descontrole pressórico, progressão da doença valvar, infarto do miocárdio e arritmias são fatores desencadeantes frequentes paraedema agudo de pulmão. O tratamento inicial fundamenta-se na suplementação de oxigênio e suporte ventilatório, administração de opioides, diuréticos e vasodilatadores endovenosos. Inotrópicos estão indicados na presença de instabilidade hemodinâmicacom disfunção orgânica...


Acute pulmonary congestion in patients with cardiac disease is a clinical manifestation of extreme severity, occurring in approximately 25% of cases of acute heart failure. Diagnosis is essentially clinical, based on history and physical examination. Complementarytests should not delay the start of treatment in the emergency room. Uncontrolled blood pressure, progression of valvular disease, myocardial infarction, and arrhythmias are common triggers for acute pulmonary edema. Initial treatment is based on supplemental oxygen and ventilatory support, administration of opioids, intravenous diuretics, andvasodilators. Inotropic agents are indicated in the presence of hemodynamic instability with organ dysfunction...


Subject(s)
Humans , Pulmonary Edema/complications , Pulmonary Edema/therapy , Heart Failure/diagnosis , Heart Failure/therapy , Heart Atria , Cardiotonic Agents , Dyspnea/complications , Diuretics/administration & dosage , Echocardiography, Doppler/methods , Electrocardiography/methods , Risk Factors , Morphine/administration & dosage , Ultrafiltration/methods , Vasodilator Agents/administration & dosage
13.
Singapore medical journal ; : 378-383, 2016.
Article in English | WPRIM | ID: wpr-276711

ABSTRACT

<p><b>INTRODUCTION</b>Diuretics are the mainstay of therapy for restoring the euvolaemic state in patients with decompensated heart failure. However, diuretic resistance remains a challenge.</p><p><b>METHODS</b>We conducted a retrospective cohort study to examine the efficacy and safety of ultrafiltration (UF) in 44 hospitalised patients who had decompensated heart failure and diuretic resistance between October 2011 and July 2013.</p><p><b>RESULTS</b>Among the 44 patients, 18 received UF (i.e. UF group), while 26 received diuretics (i.e. standard care group). After 48 hours, the UF group achieved lower urine output (1,355 mL vs. 3,815 mL, p = 0.0003), greater fluid loss (5,058 mL vs. 1,915 mL, p < 0.0001) and greater weight loss (5.0 kg vs. 1.0 kg, p < 0.0001) than the standard care group. The UF group also had a shorter duration of hospitalisation (5.0 days vs. 9.5 days, p = 0.0010). There were no differences in the incidence of 30-day emergency department visits and rehospitalisations for heart failure between the two groups. At 90 days, the UF group had fewer emergency department visits (0.2 vs. 0.8, p = 0.0500) and fewer rehospitalisations for heart failure (0.3 vs. 1.0, p = 0.0442). Reduction in EQ-5D™ scores was greater in the UF group, both at discharge (2.7 vs. 1.4, p = 0.0283) and 30 days (2.5 vs. 0.3, p = 0.0033). No adverse events were reported with UF.</p><p><b>CONCLUSION</b>UF is an effective and safe treatment that can improve the health outcomes of Asian patients with decompensated heart failure and diuretic resistance.</p>


Subject(s)
Aged , Diuretics , Therapeutic Uses , Drug Resistance , Emergency Service, Hospital , Female , Heart Failure , Therapeutics , Hospitalization , Humans , Male , Middle Aged , Patient Readmission , Retrospective Studies , Treatment Outcome , Ultrafiltration
14.
Article in English | WPRIM | ID: wpr-77742

ABSTRACT

Erectile dysfunction (ED) is a highly prevalent disorder that affects millions of men and considered to be an early symptom of atherosclerosis and a precursor of various systemic vascular disorders. The aim of the present study was to prepare ginsenoside Re enriched fraction (GS-F3K1, ginsenoside Re 10%, w/w) from ginseng berries flesh and to investigate the enhanced activities of GS-F3K1 on alcohol-induced ED. GS-F3K1 was prepared by the continuous liquid and solid separating centrifugation and circulatory ultrafiltration from ginseng berries flesh. GS-F3K1 was administered for 5 weeks in ethanol-induced ED rat by oral administration of 20% ethanol. To investigate the effects of GS-F3K1 on ED model, the levels of nitrite expression, cyclic guanosine monophosphate (cGMP) and erectile response of the penile corpus cavernosum of rat were measured. The erectile response of the corpus cavernosum was restored after GS-F3K1 administration, to a level similar to the normal group. The level of nitrite and cGMP expression in the corpus cavernosum of GS-F3K1-administered male rats was increased significantly compared to positive control group. GS-F3K1 from ginseng berries should effectively restore ethanol-induced ED in male rats and could be developed as a new functional food for the elderly men.


Subject(s)
Administration, Oral , Aged , Animals , Atherosclerosis , Centrifugation , Erectile Dysfunction , Ethanol , Fruit , Functional Food , Guanosine Monophosphate , Humans , Male , Panax , Rats , Ultrafiltration
15.
Article in English | WPRIM | ID: wpr-67996

ABSTRACT

BACKGROUND: Successful pregnancy outcomes in patients with advanced chronic kidney disease (CKD) are increasingly common in Western countries. However, in Korea, the available literature addressing this clinical issue is scarce. METHODS: We reviewed 5 successful parturitions [1 patient with Stage 5 CKD and 4 with maintenance hemodialysis (HD)] at Seoul St. Mary's Hospital over 3 years and investigated changes in dialysis prescription, anemia management, and the incidence of maternal and neonatal complications. RESULTS: There were no maternal or neonatal deaths in this cohort. The mean age at the time of conception and delivery was 35.8 ± 3.7 and 36.2 ± 3.5 years, respectively. Dialysis patients received more frequent and intensified HD during pregnancy, 20.0 ± 5.7 h/wk of HD over 5 visits with the ultrafiltration dose maintained between 1 and 2 kg per session. All patients received erythropoietin-stimulating agents and iron replacement therapy during pregnancy. The mean hematocrit was 33.1 ± 1.9% before pregnancy and was well maintained during gestation (33.9 ± 3.8% at the first trimester, 29.2 ± 4.2% at the second trimester, and 33.6 ± 8.7% at delivery). The mean gestation period was 32.7 ± 4.7 weeks, with 60% of patients experiencing premature delivery. The primary maternal complication was pre-eclampsia; 3 women developed pre-eclampsia and underwent emergency cesarean sections. Most neonatal complications were related to preterm birth. CONCLUSION: Dialysis-related care and general clinical management improved the clinical outcome of pregnancy for patients with advanced CKD.


Subject(s)
Anemia , Cesarean Section , Cohort Studies , Dialysis , Emergencies , Female , Fertilization , Hematocrit , Humans , Incidence , Iron , Korea , Parturition , Perinatal Death , Pre-Eclampsia , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, First , Pregnancy Trimester, Second , Pregnant Women , Premature Birth , Prescriptions , Renal Dialysis , Renal Insufficiency, Chronic , Seoul , Ultrafiltration
16.
Braz. j. microbiol ; 46(1): 251-260, 05/2015. tab, graf
Article in English | LILACS | ID: lil-748253

ABSTRACT

An Aspergillus niger UFV-1 phytase was characterized and made available for industrial application. The enzyme was purified via ultrafiltration followed by acid precipitation, ion exchange and gel filtration chromatography. This protein exhibited a molecular mass of 161 kDa in gel filtration and 81 kDa in sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), indicating that it may be a dimer. It presented an optimum temperature of 60 °C and optimum pH of 2.0. The KM for sodium phytate hydrolysis was 30.9 mM, while the kcat and kcat/KM were 1.46 ×105 s−1 and 4.7 × 106 s−1.M−1, respectively. The purified phytase exhibited broad specificity on a range of phosphorylated compounds, presenting activity on sodium phytate, p-NPP, 2- naphthylphosphate, 1- naphthylphosphate, ATP, phenyl-phosphate, glucose-6-phosphate, calcium phytate and other substrates. Enzymatic activity was slightly inhibited by Mg2+, Cd2+, K+ and Ca2+, and it was drastically inhibited by F−. The enzyme displayed high thermostability, retaining more than 90% activity at 60 °C during 120 h and displayed a t1/2 of 94.5 h and 6.2 h at 70 °C and 80 °C, respectively. The enzyme demonstrated strong resistance toward pepsin and trypsin, and it retained more than 90% residual activity for both enzymes after 1 h treatment. Additionally, the enzyme efficiently hydrolyzed phytate in livestock feed, liberating 15.3 μmol phosphate/mL after 2.5 h of treatment.


Subject(s)
/isolation & purification , /metabolism , Aspergillus niger/enzymology , /chemistry , Chemical Precipitation , Chromatography, Gel , Chromatography, Ion Exchange , Electrophoresis, Polyacrylamide Gel , Enzyme Stability , Enzyme Inhibitors/analysis , Hydrogen-Ion Concentration , Hydrolysis , Kinetics , Molecular Weight , Protein Multimerization , Proteolysis , Peptide Hydrolases/metabolism , Phytic Acid/metabolism , Substrate Specificity , Temperature , Ultrafiltration
17.
Article in Chinese | WPRIM | ID: wpr-297408

ABSTRACT

<p><b>OBJECTIVE</b>To study the effect of ultrafiltration-membrane extracts of Radix Rehmanniae Praeparata (UMERRP) on theproliferation and genetic stability of bone marrow-derived mesenchymal stem cells (BMSCs) induced by cadmium chloride (CdCl2).</p><p><b>METHODS</b>Protective effects on the proliferation, micronuclear rates, chromosome aberration rates, and apoptosis rates were observed by micronuclei test, karyotype analysis, and flow cytometry.</p><p><b>RESULTS</b>Compared with the CdCl2 group, UMERRP with different molecular weights at 0. 8 g/L could obviously promote the proliferation (P <0. 05). Compared with the control group, micronuclear rates, chromosome aberration rates, and apoptosis rates were obviously enhanced in the CdCl2 group (P <0. 05). Compared with the CdCl2 group, UMERRP with different molecular weights could obviously decreased CdCl2 induced micronuclear rates, chromosome aberration rates, and apoptosis rates (P <0. 05). Of them, BMSC micronuclear rates and chromosome aberration rates decreased most obvious in UMERRP groups with molecular weight below 10 000 (P <0. 05). The apoptosis rate decreased most obviously in UMERRP groups with molecular weight ranging 100 000 and 200 000 (P <0. 05).</p><p><b>CONCLUSION</b>UMERRP could reduce CdCl2 induced micronuclear rates, chromosome aberration rates, and apoptosis rates.</p>


Subject(s)
Apoptosis , Bone Marrow , Cadmium Chloride , Toxicity , Drugs, Chinese Herbal , Pharmacology , Flow Cytometry , Hematopoietic Stem Cells , Humans , Mesenchymal Stem Cells , Ultrafiltration
18.
Article in Chinese | WPRIM | ID: wpr-243400

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the influences of ultrafiltration and alcohol sedimentation on protective effects of Radix Astragali and Radix Hedyseri against rat's cerebral ischemia.</p><p><b>METHODS</b>Using dexamethasone (im.) and ligating common carotid artery, the rat stasis model combined transient cerebral ischemia was established to evaluate the effects of the ultrafiltration and alcohol sedimentation through detecting antioxidant system and other indexes in brain tissue.</p><p><b>RESULTS</b>The results showed that the 6 g/kg water extract(crude drug), ultrafiltration and alcohol sedimentation of Radix Astragali and Radix Hedyseri could upgrade adenosine-triphosphate (ATP), superoxide dismutase (SOD) and catalase (CAT), and degrade malondialdehyde(MDA) and water content of brain tissue in rat stasis model combined transient cerebral ischemia, the water extract and ultrafiltration of them could degrade lactic acid (LD) of brain tissue, and the effects of alcohol sedimentation of Radix Astragali and Radix Hedyseri become weaker than water extract of them.</p><p><b>CONCLUSION</b>The water extract, ultrafiltration and alcohol sedimentation of Radix Astragali and Radix Hedyseri have some protective effects on cerebral ischemia in rats, the effective differences of the extract through the same extraction method are not remarkable, and alcohol precipitation method has obvious influences effect on Radix Astragali and Radix Hedyseri.</p>


Subject(s)
Alcohols , Chemistry , Animals , Antioxidants , Metabolism , Astragalus Plant , Chemistry , Brain , Catalase , Metabolism , Cerebral Infarction , Drug Therapy , Drugs, Chinese Herbal , Pharmacology , Malondialdehyde , Metabolism , Plant Roots , Chemistry , Rats , Superoxide Dismutase , Metabolism , Ultrafiltration
19.
Acta Pharmaceutica Sinica ; (12): 755-759, 2015.
Article in Chinese | WPRIM | ID: wpr-257071

ABSTRACT

With development of bio-technique, more and more proteins were applied as clinical approaches. However, the protein homogeneity, especially the N-glycosylation limited the further research and application of these protein drugs. The analysis method for N-glycans is believed to be critical in protein drugs development. To enhance the N-glycans isolation efficiency and accelerate the pretreatment, a new strategy was built on ultrafiltration-devices. New methods increased the isolation efficiency of N-glycans containing N-acetylglucosa mine with 10%-20%. The degrading of N-glycans containing sialic acids was also minimized with this method. 20%-100% more N-glycans with sialic acids were isolated. The pretreatment was finished within 30 min. Coupled with HPLC-HRMS, an effective and reliable strategy designed for protein drugs N-glycans analysis were developed.


Subject(s)
Glycoproteins , Chemistry , Glycosylation , Polysaccharides , Chemistry , Ultrafiltration
20.
Article in English | WPRIM | ID: wpr-72727

ABSTRACT

BACKGROUND/OBJECTIVES: In this study, potential anti-inflammatory effect of enzymatic hydrolysates from Styela clava flesh tissue was assessed via nitric oxide (NO) production in lipopolysaccahride (LPS) induced RAW 264.7 macrophages and in vivo zebrafish model. MATERIALS/METHODS: We investigated the ability of enzymatic hydrolysates from Styela clava flesh tissue to inhibit LPS-induced expression of pro-inflammatory mediators in RAW 264.7 macrophages, and the molecular mechanism through which this inhibition occurred. In addition, we evaluated anti-inflammatory effect of enzymatic hydrolysates against a LPS-exposed in in vivo zebrafish model. RESULTS: Among the enzymatic hydrolysates, Protamex-proteolytic hydrolysate exhibited the highest NO inhibitory effect and was fractionated into three ranges of molecular weight by using ultrafiltration (UF) membranes (MWCO 5 kDa and 10 kDa). The above 10 kDa fraction down-regulated LPS-induced expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2), thereby reducing production of NO and prostaglandin E2 (PGE2) in LPS-activated RAW 264.7 macrophages. The above 10 kDa fraction suppressed LPS-induced production of pro-inflammatory cytokines, including interleukin (IL)-1beta, IL-6, and tumor necrosis factor (TNF)-alpha. In addition, the above 10 kDa fraction inhibited LPS-induced phosphorylation of extracellular signal-regulated kinases (ERKs), c-Jun N-terminal kinase (JNK), and p38. Furthermore, NO production in live zebrafish induced by LPS was reduced by addition of the above 10 kDa fraction from S. clava enzymatic hydrolysate. CONCLUSION: The results of this study suggested that hydrolysates derived from S. clava flesh tissue would be new anti-inflammation materials in functional resources.


Subject(s)
Cyclooxygenase 2 , Cytokines , Dinoprostone , Extracellular Signal-Regulated MAP Kinases , Interleukin-6 , Interleukins , JNK Mitogen-Activated Protein Kinases , Macrophages , Membranes , Molecular Weight , Nitric Oxide , Nitric Oxide Synthase Type II , Phosphorylation , Tumor Necrosis Factor-alpha , Ultrafiltration , Zebrafish
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