Cryptosporidium-induced acute kidney injury in a patient with acquired immunodeficiency syndrome.

Cryptosporidium is a pathogen that can cause infectious enteritis especially in immunocompromised patients. Acute kidney injury, electrolyte imbalance, and acid-base disorders may occur as a result of high volumes of intestinal fluid loss, which has not been previously reported to be a common manifestation of cryptosporidiosis. Numerous antigen detection methods can be used to ensure early diagnosis of Cryptosporidium infection, which is crucial to prevent morbidities. We report a unique case of cryptosporidiosis in a 33-year-old male patient with acute kidney injury and profound hypokalemia, hyponatremia, hypocalcemia, hypophosphatemia, hypomagnesemia, and metabolic acidosis. Following the initiation of antiretroviral therapy to human immunodeficiency virus, the patient's symptoms improved and he recovered fully from kidney injury and electrolyte imbalance, highlighting the importance of early antiretroviral therapy.

Baseline Peritoneal Membrane Transport Characteristics Are Associated with Peritonitis Risk in Incident Peritoneal Dialysis Patients.

The peritoneal equilibration test (PET) is a semi-quantitative measurement that characterizes the rate of transfer of solutes and the water transfer rate across the peritoneum in patients treated with peritoneal dialysis (PD). The results of the PET are used to maximize daily peritoneal ultrafiltration and solute clearances. Previous studies have shown that high transport status is associated with ultrafiltration failure, malnutrition, and reduced survival; however, the way in which peritoneum transport characteristics affect peritonitis risk is unknown. In the current cohort study, we recruited 898 incident-PD patients and used intention-to-treat analysis to test if baseline PET affected the subsequent 3-year peritonitis rate. Among all recruited PD patients, 308 (34.2%) developed peritonitis within three years. Multivariate Cox regression analysis showed that the high-transport group has the greatest peritonitis risk (HR 1.98, 95% CI: 1.08-3.62) even after an adjustment for demographics, comorbid diseases, and biochemical measurements. We concluded that a baseline high peritoneal membrane transport rate is an independent risk factor for peritonitis in incident PD patients.

The Effect of Far-Infrared Therapy on the Peritoneal Membrane Transport Characteristics of Uremic Patients Undergoing Peritoneal Dialysis: An Open-Prospective Proof-of-Concept Study.

Long-term peritoneal dialysis (PD) can lead to detrimental changes in peritoneal membrane function, which may be related to the accumulation of glucose degradation products. A previous study demonstrated that 6 months of far-infrared (FIR) therapy may decrease glucose degradation products in PD dialysate. Due to limited literature on this matter, this study aims to investigate the effect of FIR therapy on the peritoneal membrane transport characteristics of PD patients. Patients were grouped according to baseline peritoneal transport status: lower transporters (low and low-average) and higher transporters (high-average and high). Both groups underwent 40 min of FIR therapy twice daily for 1 year. In lower transporters, FIR therapy increased weekly dialysate creatinine clearance (6.91 L/wk/1.73 m2; p = 0.04) and D/P creatinine (0.05; p = 0.01). In higher transporters, FIR therapy decreased D/P creatinine (-0.05; p = 0.01) and increased D/D0 glucose (0.05; p = 0.006). Fifty percent of high transporter patients shifted to high-average status after FIR therapy. FIR therapy may decrease D/P creatinine for patients in the higher transporter group and cause high transporters to shift to high-average status, which suggests the potential of FIR therapy in improving peritoneal membrane function in PD patients.

Hemorrhagic pericardial tamponade in a peritoneal dialysis patient.

Uremic pericarditis and pericardial effusion are possible complications among patients with end-stage renal disease. The accumulation of toxic metabolites may contribute to the pathogenesis of uremic pericarditis. Bleeding diathesis in peritoneal dialysis patients raises the risk of hemorrhagic pericardial tamponade, which is a fatal complication of peritoneal dialysis. We report a case of hemorrhagic pericardial tamponade who was nonadherent to peritoneal dialysis with initial presentation of hypotension and syncope. Transthoracic echocardiogram revealed septated, fibrinoid pericardial effusion and right ventricular diastolic compression. A massive bloody pericardial effusion was drained when he underwent the pericardial window procedure. There was a significant improvement both in his clinical condition and in the echocardiogram images after the procedure. Hemorrhagic pericardial tamponade occurs in uremic patients but is rarely seen in those undergoing peritoneal dialysis. Early diagnosis, immediate surgical drainage, and regular follow-up with echocardiography are crucial to achieve better prognoses in future similar clinical scenarios.

Risk factors and clinical features for post-transplant thoracic air-leak syndrome in adult patients receiving allogeneic haematopoietic stem cell transplantation.

Post-transplant thoracic air-leak syndrome (ALS) is rare but potentially life-threatening in patients receiving allogeneic haematopoietic stem cell transplantation (HSCT). Nevertheless, papers on thoracic ALS are limited, and this complication remains largely unknown. We reviewed 423 adult patients undergoing allogeneic HSCT from 2003 to 2014. Risk factors, clinical features and survival for thoracic ALS were collected and analysed. Thirteen out of 423 patients (3.1%) developed post-transplant thoracic ALS, including two ALS patients in the early phase. The median age at HSCT was 33 years among 13 patients with thoracic ALS. Male patients were predominant (69%). The median onset time was 253 days (range: 40-2680) after HSCT. Multivariate analysis revealed that grade III-IV acute graft-versus-host disease (GVHD) (p = 0.017), extensive chronic GVHD (cGVHD) (p = 0.019) and prior history of pulmonary invasive fungal infection (p = 0.007) were significant risk factors for thoracic ALS. In patients with cGVHD, those with thoracic ALS had a significantly worse survival than those without thoracic ALS (p = 0.04). Currently, published data analysing and exploring post-transplant thoracic ALS are limited. Our study employed a large patient cohort and determined the risk factors and clinical features for post-transplant thoracic ALS.

Enhanced photocatalytic hydrogen generation using polymorphic macroporous TaON.

Macroporous TaON (mac-TaON) is prepared using polymer sphere templating and controlled ammonolysis. In contrast to typical powder synthesis, which gives the ß polymorph, mac-TaON is a mixture of ß and γ polymorphs. mac-TaON shows twice the activity for photocatalytic hydrogen generation in comparison to mac-TaON when normalised for surface area.

Microwave plasma synthesis of lanthanide zirconates from microwave transparent oxides.

Lanthanide zirconate phases Ln(2)Zr(2)O(7) and Ln(4)Zr(3)O(12) (Ln = Y, La, Gd, Dy, Ho, Yb) have been prepared using a microwave induced plasma methodology, which allows rapid synthesis using materials which do not couple directly with microwaves at room temperature. We describe the measurement of heating profiles of the precursor binary metal oxides which can be used to identify conditions conducive to the synthesis of more complex oxides. Uncontrolled heating which can be a feature of microwave synthesis of ceramics is not observed, allowing reproducible synthesis. Conventionally these phases are prepared at >1400 °C over hours or days and are being investigated for applications including the immobilisation of nuclear waste where rapid processing is important. Using the microwave plasma method, phase-pure materials have been prepared in minutes. Furthermore, it is clear that Ln(2)Zr(2)O(7) and Ln(4)Zr(3)O(12) also exhibit significant plasma-promoted dielectric heating (e.g. >2200 °C for Dy(4)Zr(3)O(12)) which is typically greater than either of the respective precursors, thus providing a driving force to rapidly complete the reaction.

Microwave-induced plasma heating and synthesis: in situ temperature measurement of metal oxides and reactions to form ternary oxides.

Direct microwave synthesis between solids is limited by the restricted number of materials that exhibit microwave heating at room temperature. The dielectric properties of most materials dictate that microwave heating can occur at higher temperatures, primarily due to increasing conduction losses. Microwave-induced plasma promoted microwave heating circumvents the requirement for room temperature microwave heating allowing microwave methods to be applied to a greater range of materials. For example, MgO heats to >1700 degrees C using an O(2) plasma and 900 W magnetron power. Here we demonstrate that in situ temperature measurements can be used to identify binary oxides that exhibit significant plasma promoted heating. Furthermore, reactions to form ternary oxides can be monitored to determine if reactions are driven by the dielectric properties of the precursor(s) or product.

Development of an aminocarboxylic acid-modified infrared chemical sensor for selective determination of copper ions in aqueous solutions.

An evanescent wave infrared chemical sensor for the sensitive and selective detection of copper ions in aqueous solutions is described. Because copper ions have no vibrational features, a band-shifting technique was utilized to produce the analytical signal. To enhance the sensitivity of the detection process, a three-step procedure was employed to prepare acidified tris(2-aminoethyl)amine (ATAA) phase on an evanescent wave sensing element. This sensing phase has a chemical structure similar to that of ethylenediamine tetraacetic acid (EDTA), a common chelating agent for metal ions. After formation of complex with copper ions, the shifts in the absorption bands of the ATAA phase were used for quantitation. An additional four sensing phases having chemical structures related to that of EDTA were synthesized to compare their performances for detection of copper ions. The synthetic sensing phases are highly stable in water and insensitive to changes in solutions at pH greater than 4. ATAA was the most sensitive of the phases tested, probably because of the accessibility and flexibility of the functional groups in the ATAA phase. To explore these systems in greater detail and to optimize detection, the effects of parameters such as the buffer concentration, the pH of the sample solution, and the matrix effect on response time and linearity of detection were examined. The analytical signals for copper ions were similar - and highly selective - when the pH of the solution was between 5 and 6.5. For a detection time of 5min, these signals were linear for concentrations up to 200microM with a detection limit ca. 3microM.

Development of an aminocarboxylic acid-modified infrared chemical sensor for selective determination of tyrosine in urine.

An infrared (IR) chemical sensor based on immobilization of an acidified tris(2-aminoethyl)amine (ATAA) for the detection of tyrosine in urine is described. The sensing phase (i.e., coating) was saturated with nickel ions so that it would interact with tyrosine molecules in aqueous solution through the formation of stable ATAA-Ni2+-tyrosine complexes. Investigation of the signals of nine amino acids shows that only the three containing phenyl groups could be detected by this sensor system. A unique spectral feature located at 1515 cm(-1) allowed tyrosine to be discriminated from the other two amino acids. To examine the performance of the ATAA sensing phase in the quantitative analysis of tyrosine, the effects of several factors were examined. pH affected the ability of tyrosine to form complexes; the optimal signal occurred at ca. pH 8. The concentration of ammonia buffer also affected the analytical signals through a competition effect; lower concentrations of ammonia buffer provided higher intensity signals. It was found that nickel ions are the most useful for detection of tyrosine. Although the concentration of nickel ions had less influence on the analytical signal than did the concentration of the ammonia buffer, the signal intensity was optimal when the nickel ions and the target molecule had similar concentrations. The detected time profiles indicated that the ATAA sensor phase functioned via a surface adsorption mechanism. The linear range of signal intensities was up to 600 microM with a detection limit of 30 microM.