Comprehensive Overview of Innovative Strategies in Preventing Renal Ischemia-reperfusion Injury: Insights from Bibliometric and In Silico Analyses.

BACKGROUND: Ischemia-Reperfusion Injury (IRI) is a complex pathophysiological process with severe consequences, including irreversible loss of renal function. Various intraoperative prevention methods have been proposed to mitigate the harmful effects of warm ischemia and kidney reperfusion. AIM: This comprehensive analysis provides an overview of pharmacological agents and intraoperative methods for preventing and treating renal IRI. METHODS: Our analysis revealed that eplerenone exhibited the highest binding affinity to crucial targets, including Aldehyde Dehydrogenase (AD), Estrogen Receptor (ER), Klotho protein, Mineralocorticoid Receptor (MR), and Toll-Like Receptor 4 (TLR4). This finding indicates eplerenone's potential as a potent preventive agent against IRI, surpassing other available therapeutics like Benzodioxole, Hydrocortisone, Indoles, Nicotinamide adenine dinucleotide, and Niacinamide. In preventing kidney IRI, our comprehensive analysis emphasizes the significance of eplerenone due to its strong binding affinity to key targets involved in the pathogenesis of IRI. RESULTS: This finding positions eplerenone as a promising candidate for further clinical investigation and consideration for future clinical practice. CONCLUSION: The insights provided in this analysis will assist clinicians and researchers in selecting effective preventive approaches for renal IRI in surgical settings, potentially improving patient outcomes.

Recycling air conditioner-generated condensate water for microalgal biomass production and carbon dioxide sequestration.

Air conditioners alleviate the discomfort of human beings from heat waves that are consequences of climate change caused by anthropogenic activities. With each passing year, the effects of global warming worsen, increasing the growth of air conditioning industry. Air conditioning units produce substantial amounts of non-nutritive and (generally) neglected condensate water and greenhouse gases. Considering this, the study explored the potential of using air conditioner condensate water (ACW) to cultivate Chlorella sorokiniana, producing biomass, and sequestering carbon dioxide (CO2). The maximum biomass production was obtained in the BG11 medium (1.45 g L-1), followed by ACW-50 (1.3 g L-1). Similarly, the highest chlorophyll-a content was observed in the BG11 medium (11 µg mL-1), followed by ACW-50 (9.11 µg mL-1). The ACW-50 cultures proved to be better adapted to physiological stress (Fv/Fm > 0.5) and can be suitable for achieving maximum biomass with adequate lipid, protein, and carbohydrate production. Moreover, C. sorokiniana demonstrated higher lipid and carbohydrate yields in the ACW-50 medium, while biomass production and protein yields were comparable to the BG11 medium. The lipid, protein, and carbohydrate productivity were 23.43, 32.9, and 23.19 mg L-1 d-1, respectively for ACW-50. Estimation of carbon capture potential through this approach equals to 9.5% of the total emissions which is an added advantage The results indicated that ACW could be effectively utilized for microalgae cultivation, reducing the reliance on freshwater for large-scale microalgal biomass production and reduce the carbon footprints of the air conditioning industry.

Microplastics in the environment: Interactions with microbes and chemical contaminants.

Microplastics (MPs) are contaminants of emerging concern that have gained considerable attention during the last few decades due to their adverse impact on living organisms and the environment. Recent studies have shown their ubiquitous presence in the environment including the atmosphere, soil, and water. Though several reviews have focused on the occurrence of microplastics in different habitats, little attention has been paid to their interaction with biological and chemical pollutants in the environment. This review therefore presents the state of knowledge on the interaction of MPs with chemicals and microbes in different environments. The distribution of MPs, the association of toxic chemicals with MPs, microbial association with MPs and the microbial-induced fate of MPs in the environment are discussed. The biodegradation and bioaccumulation of MPs by and in microbes and its potential impact on the food chain are also reviewed. The mechanisms driving these interactions and how these, in turn, affect living organisms however are not yet fully understood and require further attention.

Apolipoproteins A-I and B as predictors of angiographically defined coronary artery disease.

Apolipoprotein A-I and B concentrations were measured in 502 patients undergoing diagnostic cardiac catheterization to assess the predictive power of apolipoproteins B and A-I to discriminate between patients with coronary artery disease and those with normal coronary arteries as defined by coronary arteriography. The strength of the associations was compared with that of the associations between traditional risk factors (eg, smoking status, cholesterol levels) and coronary artery disease. The study population consisted of 154 women (mean age, 62.9 years) and 348 men (mean age, 59.6 years). The apolipoprotein A-I concentration averaged (+/- SD) 124 +/- 25 mg/dL and the apolipoprotein B concentration, 98 +/- 24 mg/dL. In all cases, the apolipoprotein measures showed a larger univariate difference between the "normal" (no coronary artery disease) group (66 patients) and the group with coronary artery disease (436 patients) than did the corresponding standard lipoprotein measures. The variable with the strongest association with coronary artery disease was the ratio of apolipoprotein A-I to apolipoprotein B, followed by apolipoprotein B level. These findings were confirmed using logistic regression, adjusting for other coronary artery disease risk factors. Fasting status did not affect apolipoprotein A-I or B concentrations. We conclude that the use of apolipoprotein A-I and B concentrations gives additional information to that supplied by lipoprotein measures to help predict the presence of coronary artery disease. Since traditional lipid measures may be changed by a meal, apolipoproteins A-I and B might be more useful measures when the fasting status of a patient is in question.

Multichannel 18-test panels: are 60% of panels abnormal by chance?

Current teaching concerning the frequency of abnormal results secondary to chance alone in a multichannel panel is theoretically based on the binomial distribution. However, this distribution can be used only when the probability of an abnormal result (pi) is the same for each test in the panel. In modern-day multichannel testing, pi varies from test to test and most often is less than the usually reported 0.05. On the other hand, a test such as cholesterol may have a pi level as high as 0.55. Theoretically the only distribution that can take this variability into consideration is the Lexis distribution, a form of the binomial distribution that allows for varying pi s. Since no formula is available to calculate this distribution, we wrote a computer program to generate it. We arranged 18-test panels from 203 normal patients in a frequency distribution. This was then compared with the theoretical Lexis and binomial distributions. This analysis showed that although there was a 50% chance of having one abnormality per panel and a 16% chance of having two abnormalities per panel, there was less than 4% chance of having three or more abnormalities per 18-test panel. In addition, most of the abnormalities noted were minor and were thought to be clinically unimportant.

Cerebrospinal fluid monoclonal gammopathy in multiple myeloma and Waldenström's macroglobulinemia.

Serum ratios of monoclonal immunoglobulin (Ig) to total protein, monoclonal immunoglobulin to albumin, CSF/serum Ig-albumin index, and CSF to serum monoclonal immunoglobulin were obtained in 21 patients with multiple myeloma and 2 with Waldenström's macroglobulinemia. Twelve patients (3 with CNS complications) showed CSF monoclonal proteins similar to their serum. CSF IgA levels above 10 mg/dl, IgG levels above 25 mg/dl, CSF-serum IgG ratios above 0.0034 and CSF-serum IgA ratios above 0.0051 were seen in patients with neurologic complications. Our preliminary data may signal early CNS involvement in multiple myeloma.

How should clear cardioplegia be administered? A method of rapid arrest with high flow and pressure.

Most of the currently described methods of administering cardioplegia appear to be less than optimal because of low flows utilized and slow cardiac arrest evolving over a period of several minutes. This may account for some reports of suboptimal protection, namely ventricular dysfunction and elevation of cardiac isoenzymes in the blood following operation. A method of pressurized injection of clear cardioplegic solution with immediate cardiac arrest (6 to 4.1 seconds) is described. The technique utilizes a 16 Fr. cannula under a driving pressure of 300 mm Hg, which gives an aortic root pressure of 80 to 105 mm Hg (mean 98 mm Hg). Monitoring of serum glutamic oxaloacetic transaminase (SGOT), creatine kinase (CK) MB, and lactate dehydrogenase (LDH1 and LDH2) isoenzymes was carried out in 200 consecutive cases of aorta-coronary bypass. Myocardial infarct index (MII), calculated from the CK disappearance value, measured a mean of 5.3. Peak value of CK-MB occurred immediately after operation (2 hours) and ranged from 10.2 +/- 2.6 IU for 30 minutes of ischemia to 13.3 +/- 4.2 IU for 61 minutes, gradually decreasing to less than 2 IU in 48 hours. None of the patients required inotropic agents postoperatively and 89.9% had spontaneous re-establishment of normal cardiac beat following coronary reperfusion. The electrocardiogram (ECG) failed to show any detectable myocardial infarction during this period of time. The system satisfactorily protected the heart for up to 70 minutes of ischemia. The total amount of cardioplegic solution used for 60 minutes measured 1,200 +/- 200 ml. Myocardial temperature dropped to 15 degrees C within 12 +/- 4.3 seconds. The method more closely approximates the ideal flows and pressures for the coronary vascular bed and size of the adult human heart.

Pressurized rapid cardioplegia versus administration of exogenous substrate and topical hypothermia.

Five hundred fifty-nine patients undergoing aortocoronary operation were analyzed retrospectively according to the type of myocardial protection implemented during the period of ischemia. In Group 1 (253 patients), a rapid method of hypothermic cardioplegia alone was utilized. In Group 2 (306 patients), slower infusion of the same solution with topical hypothermia was implemented. Cardiac isoenzymes (CPK-MB, LDH1, LDH2, serum glutamic oxaloacetic transaminase [SGOT]) and myocardial infarct index (MII) were measured postoperatively for 48 hours. Immediately after operation, a significant difference was found between Groups 1 and 2 in the CPK-MB isoenzyme mean value levels--12.1 versus 18.6 IU, p less than 0.01--and MII mean values--5.2 versus 8.1, p less than 0.01. CPK-MB variances between subgroups receiving two, three, and four grafts were significantly different in favor of Group 1. Differences were also found in LDH1, LDH2, total lactic dehydrogenase (LDH), and SGOT: Group 2 levels were significantly higher than in Group 1. There were ten intraoperative infarctions in Group 2 and none in Group 1. In 45% of the patients in Group 2, inotropic agents were necessary in the postoperative period versus none in Group 1. Spontaneous cardiac rhythm following ischemia occurred in 89.7% of the patients in group 1 versus 29% in Group 2. A method of pressurized high-flow rapid cardioplegia with intermittent reperfusions alone, seems to provide adequate protection of the myocardium during ischemia over a slower low-flow method of infusion combined with topical hypothermia.