Obesity may be erythropoietin dose-saving in hemodialysis patients

BACKGROUND: In dialysis patients, the obesity-survival paradox still requires an explanation. Anemia and high doses of erythropoiesis-stimulating agents (ESAs) are associated with worse outcomes in the hemodialysis (HD) population. In the present study, we explored the relation between obesity and anemia control in a sample of maintenance HD patients in Egypt. METHODS: This multicenter observational study included 733 patients on maintenance HD from 9 hemodialysis centers in Egypt. Clinical and laboratory data as well as average doses of ESAs and parenteral iron were recorded. The erythropoietin resistance index (ERI) was calculated. RESULTS: Obesity, defined as a body mass index (BMI) ≥ 30 kg/m2, was present in 22.6% of the studied population. The target hemoglobin level (10.0–11.5 g/dL) was achieved in 27.3% of non-obese and 25.3% of obese patients, with no significant difference. The median serum ferritin and the values of transferrin saturation index did not differ significantly between these two groups. The weekly ESA dose was significantly lower in obese than in non-obese patients (P = 0.0001). A trend toward higher ESA doses and ERI values was observed in patients with lower BMIs (P < 0.0001). Multiple linear regression revealed that the BMI and urea reduction ratio were the strongest predictors of the ERI. CONCLUSION: Our study adds more evidence to obesity-associated advantages in HD patients. BMI may determine ESA response, with better responses observed in patients with higher BMIs.

Incidence of cryptosporidiosis in immunodeficient cancer patients in Egypt

A coproprotozoal study was carried out on 63 patients suffering from malignancy. The majority had cancer of the hemopoietic system. All patients were under chemotherapy and classified into two groups: Group A [33 children] and group B [30 adults], of whom 20 immunocompetent diarrheic patients of matched age and sex were considered as controls. Stool samples were examined by merthiolate iodine-formaldehyde concentration technique [MIF]. Modified Zeihl- Neelsen [ZN] stain was performed for Cryptosporidium oocysts. The detection of Cryptosporidium coproantigen by enzyme-linked immunoassay test [Ridascreen test] was used. Immunoglobulins [IgG, IgM, IgE and IgA], C3, C4 and CD4:CD8 ratio were measured. According to their levels, 25 out of 63 patients had both humoral and cellular immunodeficiency. The incidence of Cryptosporidium in cancer patients was 23.8%, while it was 37.7% and 91% in children and adults immunodeficient patients, respectively. ZN stain was able to diagnose Cryptosporidium in 13 out of 35 immunodeficient cases, while ELISA detected only 11 cases. Cryptosporidium infection in immunodeficient cancer patients had significantly more frequent and prolonged duration of diarrhea than in negative ones

effect of high ceiling diuretic [lasix] on the periodontium of albino rats

This study was designed to investigate the effect of high dose of furosemide on the periodontium of albino rats. The animals received an intramascular injection equal to 1.6 ml of the ampul of furosemide [represents 80 mg of the drug] day after day for 8 weeks. The rats were sacrificed by cervical dislocation 2,4,6,8,10,12,14 and 16 weeks from the beginning of the experiment. The histopathological results revealed severe degenerative and destructive changes in the gingival tissues and the periodontal ligament as well as apparant bone resorption at the 8th week of the experiment, while cementum was more resistant to resorption than bone. However, such changes were only temporary and reversible

Evaluation of using potassium pyroantimonate in retention of 45Ca in enamel and dentine forming cells

To evaluate the effect of potassium pyroantimonate [PPA] on the retention and localization of [45]Ca in both ameloblasts and odontoblasts, six frogs were injected with 5uci/gm body weight of [45]CaCl[2]. Pairs of the animals were sacrificed 5 min, 1 h and 24 hs post injection. Blocks of the developing teeth were dissected and fixed in 4% glutaraldehyete with and without PPA [control] and processed for autoradiographic examination. Sections of 36 teeth in the same stage of development were selected and the means of net silver grain counts /Um[2] of PPA treated and control tissues of similar time interval were compared for statistical significance. Counts in PPA specimens were consistently higher for both types of cells and in all time intervals with statistical significance in differences between experimental and control mean counts. These findings suggest the formation of PPA complexes with calcium allowing its retention without interfering with its distribution either in ameloblasts or odontoblasts

Reversibility of Iatrogenic effect of furosemide on the rat submandibular salivary gland

This study was undertaken to investigate histologically the effect of multiple intramuscular injections of furosemide on the rat submandibular salivary gland. The animals were sacrificed by cervical dislocation 2,4,6 and 8 weeks after administration of the last dosage. The histo pathological results revealed severe degenerative changes in all structures of salivary gland after 2 weeks and the serous portions were more sensitive to furosemide than mucous acini or duct system. However, the degeneration proved to be temporary and reversible