ABSTRACT
BACKGROUND: Although metabolic syndrome traits are risk factors for chronic kidney disease, few studies have examined their association with urinary biomarkers. METHODS: Urinary biomarkers, including A-megalin, C-megalin, podocalyxin, albumin, α1-microglobulin, ß2-microglobulin, and N-acetyl-ß-D-glucosaminidase, were cross-sectionally assessed in 347 individuals (52.7% men) with a urine albumin-to-creatinine ratio (ACR) < 300 mg/g in a health checkup. Metabolic syndrome traits were adopted from the National Cholesterol Education Program (third revision) of the Adult Treatment Panel criteria modified for Asians. RESULTS: Participants had a mean body mass index, estimated glomerular filtration rate (eGFR), and median ACR of 23.0 kg/m2, 74.8 mL/min/1.73 m2, and 7.5 mg/g, respectively. In age- and sex-adjusted logistic regression analysis, A-megalin and albumin were significantly associated with the clustering number of metabolic syndrome traits (3 or more). After further adjustment with eGFR, higher quartiles of A-megalin and albumin were each independently associated with the clustering number of metabolic syndrome traits (adjusted odds ratio for A-megalin: 1.30 per quartile, 95% CI 1.03-1.64; albumin: 1.42 per quartile, 95% CI 1.12-1.79). CONCLUSIONS: Both urinary A-megalin and albumin are associated with the clustering number of metabolic syndrome traits. Further research on urinary A-megalin is warranted to examine its role as a potential marker of kidney damage from metabolic risk factors.
ABSTRACT
The factors affecting the survival of patients with aspiration pneumonia (AP) remain unclear. This study aimed to determine whether factors, including oral status, swallowing function, and oral intake level, were related to survival outcomes in older patients hospitalized for AP. The study enrolled patients with AP who were admitted to our hospital between February 2017 and November 2019. Patients were divided into two groups based on the 90-day mortality after the first swallowing function evaluation: survivors and deceased. The data were compared between the two groups. A total of 29 patients were diagnosed with AP. Of these patients, 13 died within 90 days. The numbers of patients who could not use removable dentures and required sputum suctioning and had cough reflex at rest were significantly higher in the deceased than in the survivors. The salivary pooling and pharyngeal clearance scores evaluated by videoendoscopy, International Dysphagia Diet Standardisation Initiative Functional Diet Scale score determined after swallowing function evaluation, and consciousness level were significantly worse in the deceased than in the survivors. There were significant differences in patients' oral status, swallowing function, oral intake level, and consciousness level between the survivors and deceased.
Subject(s)
Deglutition Disorders , Pneumonia, Aspiration , Aged , Deglutition , Deglutition Disorders/diagnosis , Hospitalization , Humans , Pneumonia, Aspiration/etiologyABSTRACT
OBJECTIVES: Argatroban, a selective thrombin inhibitor, is expected to decrease acute coronary re-occlusion and restenosis via direct suppression of thrombin generation after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction. This study evaluated the effect of argatroban compared with heparin as an adjunctive anticoagulation therapy after PCI in patients with acute myocardial infarction. METHODS: Fifty-four consecutive patients with acute myocardial infarction underwent PCI within 6 hr from the onset and were randomly allocated to receive argatroban (argatroban group: n = 27) or heparin (heparin group: n = 27) after PCI. Each drug was administered intravenously for 72 hr. Coronary angiography was repeated at 1 and 6 months after the onset of acute myocardial infarction. In-hospital cardiac events, bleeding complications, and long-term outcome were surveyed. RESULTS: Baseline clinical and angiographic variables were similar in the two groups. Acute coronary re-occlusion and major hemorrhagic complications did not occur in either group. Minor bleeding complications, such as hematoma of the puncture sites, occurred significantly less frequently in the argatroban group than in the heparin group (4% vs 30%, p < 0.05). After 6 months, there were no significant differences in restenosis rate and target vessel recanalization rate between the two groups. Subgroup analyses revealed no significant differences in restenosis rate between patients treated with only balloon angioplasty and stent implantation. CONCLUSIONS: Argatroban provides similar prevention of acute thrombotic events and restenosis compared with heparin. However, argatroban might reduce bleeding complications in patients with acute myocardial infarction after PCI.
