Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 20
Filter
1.
J Affect Disord ; 257: 287-296, 2019 10 01.
Article in English | MEDLINE | ID: mdl-31302517

ABSTRACT

BACKGROUND: Alpha-asymmetry neurofeedback (ALAY) was applied to patients with major depressive disorder (MDD) based on the theory of frontal alpha asymmetry. Neurophysiological studies have found a higher high-beta activity of electroencephalography (EEG) at the posterior cortex among patients with comorbid MDD and anxiety symptoms. The present study examined the effects of ALAY and high-beta down-training (Beta) neurofeedback in symptoms of depression and anxiety and EEG parameters. METHOD: Eighty-seven patients with comorbid MDD and anxiety symptoms were allocated to the ALAY, Beta, or control groups. Both neurofeedback groups received ten-session neurofeedback. All participants completed the Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), and five minutes resting EEG recording at pre-test and post-test. EEG raw signals were transformed into an A1 score [log (F4 alpha) - log (F3 alpha)], P3 and P4 high-beta power. RESULTS: BDI-II and BAI scores decreased at post-test in both ALAY and Beta groups, but no significant difference between the two groups. No significant interaction effect in A1 score at pre-test and post-test between the ALAY, Beta, and control groups. The P3 high-beta was significantly decreased in the Beta group, an increase in the control group, and no change in the ALAY group at post-test compared to the pre-test. CONCLUSIONS: Both neurofeedback groups decreased symptoms of depression and anxiety. The Beta group was more effective in decreasing high-beta power at the parietal cortex compared to other groups. This non-invasive psychological intervention can be used in the future for patients with comorbid MDD and anxiety symptoms.


Subject(s)
Anxiety/therapy , Depressive Disorder, Major/therapy , Neurofeedback/methods , Adult , Anxiety/complications , Biofeedback, Psychology/physiology , Case-Control Studies , Depressive Disorder, Major/complications , Electroencephalography/methods , Female , Humans , Male , Middle Aged , Rest
2.
Clin Psychopharmacol Neurosci ; 17(3): 458, 2019 08 31.
Article in English | MEDLINE | ID: mdl-31352716

ABSTRACT

Clin Psychopharmacol Neurosci 2019;17(2):222-232.

3.
Clin Psychopharmacol Neurosci ; 17(2): 222-232, 2019 May 31.
Article in English | MEDLINE | ID: mdl-30905122

ABSTRACT

OBJECTIVE: Autonomic imbalance is considered a psychopathological mechanism underlying major depressive disorder (MDD). Heart rate variability (HRV) is an index for autonomic activation. Poor sleep quality is common among patients with MDD. HRV biofeedback (BF) has been used for regulating autonomic balance among patients with physical illness and mental disorders. The purpose of present study was to examine the effects of HRV-BF on depressive symptoms, sleep quality, pre-sleep arousal, and HRV indices, in patients with MDD and insomnia. METHODS: In this case-controlled study, patients with MDD and Pittsburgh Sleep Quality Index (PSQI) score higher than 6 were recruited. The HRV-BF group received weekly 60-minute protocol for 6 weeks, and the control group who have matched the age and sex received medical care only. All participants were assessed on Beck Depression Inventory-II, Back Anxiety Inventory, PSQI, and Pre-Sleep Arousal Scale. Breathing rates and electrocardiography were also performed under resting state at pre-testing, and post-testing conditions and for the HRV-BF group, also at 1-month follow-up. RESULTS: In the HRV-BF group, symptoms of depression and anxiety, sleep quality, and pre-sleep arousal were significantly improved, and increased HRV indices, compared with the control group. Moreover, in the HRV-BF group, significantly improved symptoms of depression and anxiety, decreased breathing rates, and increased HRV indices were detected at post-testing and at 1-month follow-up, compared with pre-testing values. CONCLUSION: This study confirmed that HRV-BF is a useful psychosocial intervention for improving autonomic balance, baroreflex, and symptoms of depression and insomnia in MDD patients.

4.
J Obstet Gynaecol Res ; 39(5): 998-1006, 2013 May.
Article in English | MEDLINE | ID: mdl-23551544

ABSTRACT

AIMS: Patients with premenstrual dysphoric disorder (PMDD) experience moderate to severe physical and mood symptoms during the luteal phase of their menstrual cycle. The purposes of this study were to examine whether there were significant differences in frontal alpha asymmetry between PMDD and non-PMDD women during a depressive induction condition during the luteal and follicular phases and to examine the relations between premenstrual distress and depressive symptoms, and frontal alpha asymmetry. MATERIAL AND METHODS: The participants included 12 college women with PMDD and 12 without PMDD as controls. Frontal electroencephalograms (F3/F4) were measured during the luteal and follicular phases of the menstrual cycle in the following sequence: resting baseline, depressive induction, depressive recall, recovery, and relaxation. Premenstrual distress questionnaires and the Beck Depression Inventory II were administered. RESULTS: The participants with PMDD had higher frontal alpha asymmetry than those without PMDD during the depressive induction and relaxation conditions only during the luteal phase. For PMDD and non-PMDD during the luteal phase, a positive correlation was observed between negative affect (measured by premenstrual distress questionnaires) and frontal alpha asymmetry under the depressive induction stage. In addition, higher Beck Depression Inventory II somatic depression was positively correlated with frontal alpha asymmetry under the depressive induction stage. CONCLUSIONS: This study supports the significant difference between PMDD and non-PMDD on frontal alpha asymmetry, and frontal alpha asymmetry was related to negative affect and somatic depression, while participants with PMDD were in the depressive mood during the luteal phase.


Subject(s)
Alpha Rhythm , Cerebral Small Vessel Diseases/psychology , Depression/etiology , Frontal Lobe/metabolism , Luteal Phase , Neurons/metabolism , Premenstrual Syndrome/psychology , Adolescent , Adult , Cerebral Small Vessel Diseases/metabolism , Cerebral Small Vessel Diseases/physiopathology , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Premenstrual Syndrome/metabolism , Premenstrual Syndrome/physiopathology , Severity of Illness Index , Young Adult
5.
Dis Markers ; 34(4): 229-35, 2013.
Article in English | MEDLINE | ID: mdl-23396289

ABSTRACT

BACKGROUND: Cardiovascular calcification, including arterial intimal and medial calcification (AIC and AMC) and valvular calcification (VC) are important predictors of outcome in chronic dialysis patients. We aimed to compare their prevalence and analyze respective risk factors in hemodialysis (HD) patients. METHODS: A total of 81 HD patients were enrolled. Vascular calcification was assessed by plain film radiography of the pelvis and VC was diagnosed by echocardiography. Demographic data was reviewed and serum levels of calcification-relevant biomarkers were determined. Patients with and without calcification were then compared. RESULTS: The prevalence study indicated that 36 patients had AIC (44.4%), 17 had AMC (21%) and 60 (74.1%) had VC. Patients with vascular calcification were older, and had a higher prevalence of diabetes. Their IL-6, osteoprotegerin, and uric acid levels were higher. Serum fetuin-A was lower in patients with VC. Logistic regression analysis revealed age, uric acid and diabetes to be independently associated with AIC; uric acid, diabetes and osteoprotegerin with AMC. Fetuin-A was the sole associate of VC. CONCLUSIONS: It is concluded that the prevalence of cardiovascular calcification in chronic HD patients was high with cardiac valve involvement more frequent. Factors associated with different type of calcification were not identical. Changes in biomarkers may represent clinical clues for assessment of cardiovascular calcification in HD patients.


Subject(s)
Biomarkers/blood , Blood Vessels/pathology , Calcinosis/diagnosis , Renal Dialysis , Aged , Female , Humans , Logistic Models , Male , Middle Aged
6.
Brain Connect ; 2(4): 177-90, 2012.
Article in English | MEDLINE | ID: mdl-22817652

ABSTRACT

The function of sleep in humans has been investigated using simultaneous electroencephalography (EEG) and functional magnetic resonance imaging recordings to provide accurate sleep scores with spatial precision. Recent studies have demonstrated that spontaneous brain oscillations and functional connectivity dissociate during nonrapid eye movement (NREM) sleep; this leads to spontaneous cognitive processes, such as memory consolidation and emotional modulation. However, variations in network connectivity across the sleep stages or between sleep/wake transitions require further elucidation. We observed changes in the connectivity of the sensorimotor and default-mode networks (DMN) mediated by midnight sleep among 18 healthy participants. The results indicated that (1) functional connectivity in both networks showed increasing dissociation as NREM sleep deepened, whereas hyperconnectivity occurred during rapid eye movement (REM) sleep; and (2) compared with connectivity before sleep, the DMN presented a comparable connectivity pattern immediately after awakening, whereas the connectivity of the sensorimotor network remained disrupted. These findings showed that connectivity patterns dissociate and reconnect coherently in both cortical networks during NREM and REM sleep, respectively. After the person awakened, the DMN connectivity was re-established before the sensorimotor reconnection. These dynamic sleep-related dissociations and reconnections between sleep/wake conditions might provide the key to understanding cognitive modulations in sleep. If so, connectivity changes might serve as an alternative indicator beyond the EEG signature to unveil the spontaneous processes that occur during sleep.


Subject(s)
Brain/physiology , Nerve Net/physiology , Neural Pathways/physiology , Sleep Stages/physiology , Wakefulness/physiology , Adolescent , Adult , Electroencephalography , Humans , Magnetic Resonance Imaging , Male , Time Factors , Young Adult
7.
Clin Neurophysiol ; 123(5): 960-72, 2012 May.
Article in English | MEDLINE | ID: mdl-21978651

ABSTRACT

OBJECTIVES: The present study examined age-related changes in the flanker effect and the extent to which age interacts with flanker-induced differences in perceptual processing, which contribute to the flanker effect. METHODS: We adopted a modified flanker-task paradigm that incorporates PRO (i.e., hand responses correspond to target arrows) and ANTI (i.e., hand responses do not correspond to target arrows) conditions. Participants from two age groups searched for a centrally presented target flanked on each side by stimuli that were associated with either the same response as the target (congruent), the opposite response (incongruent), or neither response (neutral). Event-related potentials (ERPs), lateralized readiness potentials (LRPs), and behavioral performance were measured. RESULTS: The behavioral-data results showed that a typical flanker effect was present in both age groups in PRO and ANTI conditions, suggesting that flanker-induced differences in perceptual processing contributed to the flanker effect in a similar manner for both age groups. Furthermore, no increase in flanker interference was observed in older adults. LRP profiles also provided convergent evidence showing that perceptually based flanker effects were similar for both age groups. CONCLUSIONS: The present study suggests that aging does not increase flanker interference, nor does it alter perceptually based flanker interference. SIGNIFICANCE: The present study found that older adults could be just as capable as younger adults in resolving flanker interference by adopting different strategies to compensate for their deficiencies.


Subject(s)
Aging/physiology , Attention/physiology , Functional Laterality/physiology , Inhibition, Psychological , Reaction Time/physiology , Adolescent , Adult , Aged , Aging/psychology , Analysis of Variance , Brain Mapping , Electroencephalography , Evoked Potentials/physiology , Female , Humans , Male , Middle Aged , Photic Stimulation , Psychomotor Performance , Time Factors , Young Adult
8.
Nephrology (Carlton) ; 16(7): 663-71, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21777343

ABSTRACT

AIM: The aim of this analysis was to know whether these three cytokine polymorphisms, including interleukin-6 (IL-6; -572 G/C), tumour necrosis factor-α (TNF-α; -308 G/A), and IL-10 (-592 A/C) have an effect on baseline peritoneal transport property and longitudinal evolution of peritoneal function. METHODS: A total of 141 stable peritoneal dialysis (PD) patients with mean treatment duration of 84.4 ± 34.2 months were enrolled. We genotyped these three cytokine polymorphisms, together with clinical parameters that were included as factors affecting longitudinal change of property of peritoneal transport over the first 3 year period after commencing therapy. RESULTS: There was no significant association between genotypes and baseline peritoneal transport property. The -592 A/C polymorphism of IL-10 was associated with longitudinal change of peritoneal transport. The ratio of D/P creatinine was significantly higher in patients with AA than those with CC/CA genotypes at 12 months (0.65 ± 0.11 vs 0.62 ± 0.09, P = 0.048) and 24 months (0.64 ± 0.12 vs 0.59 ± 0.09, P = 0.018). In addition, patients with increased peritoneal transport have greater frequency distribution of AA genotype and A allele. Logistic regression analysis revealed that -592 A allele was an independent predictor for the increase in D/P creatinine over the first 12 month period (odds ratio: 2.482, P = 0.017). There was no correlation between either polymorphism of IL-6 -572 (G/C) or TNF-α-308 (G/A) and longitudinal change of peritoneal function. CONCLUSIONS: Single nucleotide polymorphism of IL-10 -592 (A/C) was associated with longitudinal evolution of peritoneal transport rate in PD patients rather than the baseline peritoneal characteristics.


Subject(s)
Interleukin-10/genetics , Kidney Failure, Chronic/therapy , Peritoneal Dialysis , Peritoneum/metabolism , Polymorphism, Single Nucleotide , Adult , Aged , Biological Transport , Chi-Square Distribution , Female , Gene Frequency , Genotype , Humans , Interleukin-6/genetics , Kidney Failure, Chronic/genetics , Kidney Failure, Chronic/immunology , Kidney Failure, Chronic/metabolism , Logistic Models , Male , Middle Aged , Permeability , Phenotype , Promoter Regions, Genetic , Retrospective Studies , Taiwan , Time Factors , Treatment Outcome , Tumor Necrosis Factor-alpha/genetics
9.
Am J Nephrol ; 34(1): 55-63, 2011.
Article in English | MEDLINE | ID: mdl-21659740

ABSTRACT

BACKGROUND: Chronic metabolic acidosis is a common metabolic disturbance and its clinical impact can be severe and extensive. The role and the change of the intrarenal renin-angiotensin system (RAS) during metabolic acidosis are uncertain, and whether acidosis can evoke inflammation remains unclear. METHODS: Male Sprague-Dawley rats were fed with water containing 0.14 M NH(4)Cl to induce metabolic acidosis for 1 and 8 weeks, respectively. They were compared with animals fed with deionized water (control) and equimolar sodium chloride water (NaCl). Gene expression analysis of RAS components included renin, renin/prorenin receptor, angiotensinogen, angiotensin-converting enzyme (ACE), and angiotensin II type 1 and 2 receptors (AT1R and AT2R). Histological examination was also performed to detect morphological change. RESULTS: Acidosis was found in 1-week NH(4)Cl-treated rats but not in the 8-week group. More than twofold proteinuria and a significant decline of glomerular filtration rate (GFR) were observed in acid-loaded rats. Compared to the control and NaCl groups, angiotensinogen, ACE, AT1R and AT2R were significantly increased in the 1-week acidosis group (all p < 0.05). Sustained increase of AT1R expression was found as NH(4)Cl was continued for 8 weeks. There was no significant change in transforming growth factor-ß and nuclear factor-κB. The architecture of tubular epithelial cells was affected during our experiment. CONCLUSION: Metabolic acidosis induced proteinuria and decline of GFR in association with activation of intrarenal RAS.


Subject(s)
Acidosis/metabolism , Renin-Angiotensin System/physiology , Acidosis/chemically induced , Acidosis/pathology , Ammonium Chloride , Angiotensinogen/metabolism , Animals , Gene Expression , Glomerular Filtration Rate , Male , NF-kappa B/metabolism , Peptidyl-Dipeptidase A/metabolism , Proteinuria , Rats , Rats, Sprague-Dawley , Receptor, Angiotensin, Type 1/metabolism , Receptor, Angiotensin, Type 2/metabolism , Renin-Angiotensin System/genetics , Time Factors , Transforming Growth Factor beta/metabolism
10.
Artif Organs ; 34(7): E222-9, 2010 Jul.
Article in English | MEDLINE | ID: mdl-20545663

ABSTRACT

Chronic inflammation is a well-recognized complication in dialysis patients and a potential role of the adipose tissue as an important tissue of origin contributing to inflammation has been proposed. Stable peritoneal dialysis (PD) patients were enrolled to investigate the relationship between serum levels of proinflammatory cytokines and adipokines. Our results revealed that there was a strong association between high sensitivity C-reactive protein and interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-alpha) but not with IL-10 and IL-18. IL-6 correlated with TNF-alpha, IL-10, and IL-18. No association was found between IL-10 and IL-18. Adiponectin was positively correlated with all proinflammatory cytokines, except IL-10. No significant association was found between resistin and proinflammatory cytokines. Hepatocyte growth factor (HGF) was directly related to proinflammatory cytokines but not with adipokines. The presence of residual kidney function (RKF) affected IL-6, TNF-alpha, and HGF levels. The peritoneal transport property did not influence inflammatory cytokine and adipokine levels. In conclusion, there was a close relationship between proinflammatory cytokines and adipokines. HGF correlated with proinflammatory cytokines but not with adipokines. The PD-related factors such as RKF, peritoneal property and dialysis glucose load affected levels of proinflammatory cytokines. Body mass index was an important determinant of leptin and adiponectin in PD patients.


Subject(s)
Adipokines/blood , Cytokines/blood , Hepatocyte Growth Factor/blood , Peritoneal Dialysis/adverse effects , Adult , Biological Transport , Body Mass Index , Female , Humans , Inflammation/etiology , Kidney Function Tests , Male , Middle Aged , Peritoneum/metabolism
11.
Perit Dial Int ; 30(4): 456-63, 2010.
Article in English | MEDLINE | ID: mdl-20338972

ABSTRACT

BACKGROUND: Accumulating evidence supports the important role of protein-bound uremic toxins such as indoxyl sulfate and p-cresol in uremic syndrome. They exert direct deleterious effects on a variety of cells and could link to clinical outcome. Factors relevant to indoxyl sulfate and p-cresol levels in peritoneal dialysis (PD) patients have rarely been investigated. We conducted a cross-sectional study to analyze the factors that correlate with both total and free indoxyl sulfate and p-cresol. METHODS: 182 stable PD patients with mean PD therapy duration 38.5 +/- 33.3 months were enrolled. Their mean age was 48.9 +/- 13.5 years; 62.6% (114/182) were female patients. Demographic data, including age, gender, and PD therapy duration, were reviewed and recorded. PD-associated features such as residual kidney function (RKF), peritoneal transport property, and dialysis modality were also recorded. Hemoglobin, blood urea nitrogen (BUN), serum creatinine, C-reactive protein, interleukin (IL)-6, and IL-10 were measured. Levels of total and free indoxyl sulfate and p-cresol were determined. RESULTS: Patients without RKF had lower Kt/V and weekly creatinine clearance and higher serum creatinine and IL-6 levels. These patients also had higher total and free indoxyl sulfate levels. There was no difference in indoxyl sulfate or p-cresol levels compared to patients with different peritoneal transport properties or with different treatment modalities. Multivariate regression analysis revealed that weekly creatinine clearance and serum creatinine were independent associates of total indoxyl sulfate level; IL-6, total indoxyl sulfate, and free p-cresol were associated with free indoxyl sulfate level. Weekly creatinine clearance and free p-cresol level independently correlated with total p-cresol; while gender, total p-cresol, and free indoxyl sulfate were associated with free p-cresol level. CONCLUSION: The free forms of indoxyl sulfate and p-cresol constituted a small portion of their total forms. The presence of RKF affected levels of free and total indoxyl sulfate. IL-6 level was significantly associated with free indoxyl sulfate level. There was a close relationship between indoxyl sulfate and p-cresol levels in their free forms in PD patients.


Subject(s)
Cresols/blood , Indican/blood , Interleukin-6/blood , Peritoneal Dialysis , Uremia/blood , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Uremia/therapy
12.
Ren Fail ; 31(8): 740-2, 2009.
Article in English | MEDLINE | ID: mdl-19814642

ABSTRACT

Residual kidney function (RKF) contributes significantly to solute clearance and fluid removal for dialysis patients, and the presence of RKF is associated with less morbidity and better long-term outcome. Most studies demonstrate that peritoneal dialysis preserves RKF better than hemodialysis (HD). Herein, we report a 55-year-old man with end stage renal failure who had been on chronic HD for 12 years. His RKF is preserved with very slow decline during the past years. Without specific intervention, delicate fluid management, minimal ultrafiltration, and stable hemodynamics during HD may help maintain his RKF. He is currently normotensive with good nutritional status. Although unexpected, we report this HD patient can preserve his RKF for at least 12 years.


Subject(s)
Kidney Failure, Chronic/therapy , Kidney/physiopathology , Renal Dialysis , Humans , Kidney Function Tests , Male , Middle Aged , Recovery of Function
14.
Tohoku J Exp Med ; 218(1): 17-24, 2009 May.
Article in English | MEDLINE | ID: mdl-19398869

ABSTRACT

Primary aldosteronism is an important cause of secondary hypertension, because it is potentially curable, especially in case of unilateral aldosterone-producing adrenal adenoma (APA). However, the information is limited concerning the cardiovascular and renal outcomes in this patient population. We studied 52 patients with APA in order to determine the pre-operative and post-operative factors predicting cardiovascular and renal outcomes. All 52 patients were hypertensive before the operation. Among 35 patients who underwent pre-operative electrocardiogram, 23 patients had left ventricular hypertrophy (LVH). Patients with LVH had lower estimated glomerular filtration rate (eGFR). Adrenalectomy successfully normalized or improved hypertension, hypokalemia, and aldosterone excess. One month after the adrenalectomy, 32 patients (62%) became normotensive, but 20 patients (38%) remained hypertensive. However, after an average follow-up period of 51 months, only 18 patients remained normotensive, while 34 patients were hypertensive. Thus, the rate of recurrent hypertension after adrenalectomy was high (14/32, 43%). Pre-operative systolic blood pressure (BP), diastolic BP, and post-operative plasma aldosterone concentrations were the only variables significantly different between the hypertensive and normotensive patients. Using pre-operative BP 165/110 mmHg as a cutoff has good positive predictive values (73-92%) for post-operative long-term hypertension. Patients whose renal function worsened after adrenalectomy had significantly higher pre-operative plasma active renin levels. Thus, in patients with APA, the presence of LVH is correlated with impaired renal function (lower eGFR). In conclusion, pre-operative BP and post-operative plasma aldosterone are important in predicting post-adrenalectomy hypertension, and a lower pre-operative plasma renin predicts the improvement in renal function after adrenalectomy.


Subject(s)
Adrenal Cortex Neoplasms , Adrenalectomy , Adrenocortical Adenoma , Aldosterone/blood , Cardiovascular System/metabolism , Hypertension , Kidney , Adrenal Cortex Neoplasms/complications , Adrenal Cortex Neoplasms/metabolism , Adrenal Cortex Neoplasms/surgery , Adrenocortical Adenoma/complications , Adrenocortical Adenoma/metabolism , Adrenocortical Adenoma/surgery , Adult , Aged , Female , Humans , Hypertension/etiology , Hypertension/surgery , Kidney/pathology , Kidney/physiology , Male , Middle Aged , ROC Curve , Treatment Outcome , Young Adult
15.
Nephron Clin Pract ; 111(4): c247-52, 2009.
Article in English | MEDLINE | ID: mdl-19293593

ABSTRACT

BACKGROUND: Iron deficiency is the most common factor associated with erythropoietin (EPO) hyporesponsiveness. Current iron indices are inadequate to demonstrate the status or utility of iron in erythropoiesis. The aims of this study are to investigate the value of the reticulocyte hemoglobin content, RET-Y, in hemodialysis (HD) patients and compare the levels with conventional iron indices. METHODS: HD patients (n = 289) were divided into 4 groups according to serum ferritin (cutoff value 100 ng/ml) and transferrin saturation (TSAT, cutoff value 20%). The RET-Y value, hemogram and biochemical data were determined and compared between groups. Factors associated with RET-Y were examined. RESULTS: The mean RET-Y value was 1,716 +/- 125 AU. Patients with absolute iron deficiency had lower RET-Y levels and mean corpuscular volume (MCV). Patients with functional iron deficiency had a lower reticulocyte production index and serum albumin levels. MCV, mean corpuscular hemoglobin concentration (MCHC) and albumin were independently correlated with the RET-Y level (all p < 0.001). EPO-independent patients had low iron indices and low RET-Y levels, but a higher reticulocyte production index and albumin levels were noted. CONCLUSION: RET-Y levels in HD patients were close to that of the normal population. Low RET-Y levels were observed in patients with absolute iron deficiency and also in EPO-independent patients with low ferritin and low TSAT. There was a strong association between the serum albumin and RET-Y levels in chronic HD patients.


Subject(s)
Anemia, Iron-Deficiency/complications , Anemia, Iron-Deficiency/diagnosis , Hemoglobins/analysis , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/diagnosis , Renal Dialysis , Reticulocytes/metabolism , Anemia, Iron-Deficiency/blood , Female , Humans , Kidney Failure, Chronic/blood , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity
16.
Ren Fail ; 31(2): 167-70, 2009.
Article in English | MEDLINE | ID: mdl-19212917

ABSTRACT

Emphysematous pyelonephritis (EPN) is a severe and complicated renal infection characterized by gas formation within the infected kidney and its surrounding tissues. Early diagnosis with a high index of suspicion and aggressive treatment are important for improving outcome. Bilateral involvement is rare, and surgical intervention is usually required because of its high mortality rate. A literature review found that EPN has rarely been noted in chronic dialysis patients, and those who show bilateral EPN have demonstrated no survival at all until now. Herein, we presented a 51-year-old diabetic uremic woman who developed right emphysematous pyelitis initially and then progressed to bilateral EPN when hospitalized. Percutaneous drainage (PCD) with simultaneous antibiotic therapy successfully eradicated her renal infection. In this study, all reported cases of EPN in chronic dialysis patients were also reviewed.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Drainage , Emphysema/therapy , Pyelonephritis/therapy , Uremia/complications , Emphysema/complications , Female , Humans , Kidney Failure, Chronic/complications , Middle Aged , Pyelonephritis/complications
17.
J Ren Nutr ; 19(3): 220-7, 2009 May.
Article in English | MEDLINE | ID: mdl-19243976

ABSTRACT

OBJECTIVE: Both chronic inflammation and dysregulation of bone and mineral metabolism are closely related with long-term outcomes of dialysis patients. Our objective was to investigate the relationship between these two abnormalities. DESIGN: This was a cross-sectional study. SETTING: This study was performed at a hospital-based hemodialysis center. PATIENTS: We enrolled 448 (male, 198; female, 250) clinically stable hemodialysis patients. Patients with chronic inflammatory disease, malignancy, or viral hepatitis were excluded. Their age (mean +/- SD) was 57.4 +/- 12.5 years. MAIN OUTCOME MEASURES: Biomarkers, including high-sensitivity C-reactive protein (hsCRP), total calcium, phosphate, and intact parathyroid hormone levels, were measured and compared with the recommended range in the K/DOQI guidelines. Correlations between these parameters were analyzed, and factors independently associated with hsCRP and the calcium phosphate product (Ca x P) were identified by regression analysis. RESULTS: Most patients did not achieve the K/DOQI recommended therapeutic range in the four parameters, and only 50 patients (11%) met their treatment goals. The hsCRP level was directly related to calcium, phosphate, and Ca x P. Patients who achieved the guidelines' range had lower hsCRP levels (1.97 mg/L vs. 2.71 mg/L, P < .05). A high hsCRP level (> or = 10 mg/L) was associated with higher calcium, phosphate, and Ca x P levels, and lower albumin levels. Serum albumin, Ca x P, alkaline phosphatase, and diabetes independently predicted hsCRP levels. CONCLUSION: There is a strong association between chronic inflammation and the disturbance of bone mineral metabolism in chronic hemodialysis patients.


Subject(s)
Bone and Bones/metabolism , C-Reactive Protein/metabolism , Kidney Failure, Chronic/blood , Kidney Failure, Chronic/therapy , Minerals/blood , Renal Dialysis , Biomarkers/blood , Calcium/blood , Chronic Disease , Cross-Sectional Studies , Female , Humans , Inflammation/blood , Inflammation/complications , Kidney Failure, Chronic/complications , Male , Middle Aged , Phosphates/blood
18.
Med Princ Pract ; 16(4): 321-3, 2007.
Article in English | MEDLINE | ID: mdl-17541301

ABSTRACT

OBJECTIVE: This study describes a patient with nephrotic syndrome who experienced recurrent pulmonary emboli as renal disease relapsed frequently. CLINICAL PRESENTATION: A 30-year-old male, who was diagnosed as having nephrotic syndrome at 12, presented with general edema, ascites and hypoalbuminemia. Although the patient responded well to steroid therapy, a common cold frequently caused flare-up of nephrotic syndrome. Histopathological examination of renal tissue revealed minimal disease change. At 17, the patient had a first pulmonary embolism attack with concurrent upper respiratory tract infection. Full-blown manifestations of nephrotic syndrome with low antithrombin III levels were identified at that time. Anticoagulant therapy was administered to treat the pulmonary embolism. Since the first attack, several episodes of pulmonary emboli occurred, which, combined with kidney disease, triggered refractory nephrotic syndrome. The nephrotic syndrome did not remit, and a secondary renal biopsy identified glomerular pathological changes similar to previous biopsy results. To prevent recurrent pulmonary emboli, a Greenfield inferior vena cava filter was implanted in April 2002. No further pulmonary embolism events occurred after interventional filter deployment. CONCLUSION: The results of this study suggest that inferior vena cava filter implantation can be effective for preventing recurrent pulmonary embolism complicating refractory nephrotic syndrome.


Subject(s)
Nephrotic Syndrome/complications , Pulmonary Embolism/complications , Pulmonary Embolism/prevention & control , Vena Cava Filters , Adult , Anticoagulants/therapeutic use , Humans , Male , Recurrence
19.
Mediators Inflamm ; 2007: 19891, 2007.
Article in English | MEDLINE | ID: mdl-18288267

ABSTRACT

AIMS: chronic inflammation contributes significantly to the morbidity and mortality of chronic hemodialysis patients. A recent research has shown that adipokines were associated with inflammation in these patients. We aim to investigate whether biomarkers of inflammation, adipokines, and clinical features can predict the outcome of hemodialysis patients. MATERIALS AND METHODS: we enrolled 181 hemodialysis patients (men: 97, mean age: 56.3+/-13.6) and analyzed predictors of long-term outcomes. RESULTS: during the 3-year followup period, 41 patients died; the main causes of death were infection and cardiovascular disease. Elevated serum levels of hsCRP and albumin and advanced age were highly associated with death (all P<.001). Leptin and adiponectin levels were not significantly different between deceased patients and survivors. Cox-regression analysis indicated that age, diabetes, albumin level, and hsCRP were independent factors predicting mortality. CONCLUSION: the presence of underlying disease, advanced age, and markers of chronic inflammation is strongly related to survival rate in long-term hemodialysis patients.


Subject(s)
Adipokines/metabolism , Inflammation/metabolism , Kidney Diseases/blood , Kidney Diseases/mortality , Renal Dialysis/methods , Adult , Aged , Biomarkers/metabolism , Female , Humans , Hypoalbuminemia/metabolism , Kidney Diseases/complications , Male , Middle Aged , Regression Analysis , Time Factors , Treatment Outcome
20.
Am J Physiol Endocrinol Metab ; 289(2): E212-7, 2005 Aug.
Article in English | MEDLINE | ID: mdl-15741238

ABSTRACT

This study is aimed at verifying the causal relationship of chronic circadian desynchronization and changes in body weight control. Eight male albino F344 rats aged between 12-15 wk were subjected to twice weekly 12-h shifts of the daily light-dark (LD) cycle for 13 wk (3 mo). Continuous circadian phase shifts consisting of intermittent phase delay and advance and reduced circadian amplitudes were consistently displayed in all five experimental rats implanted intraperitoneally with heart rate, body temperature, and activity transponders. The experimental rat maintained a greater body weight during LD shifts and even after 10 days of recovery than that of the age-matched control rat, which was maintained on a regular LD cycle. Body weight gain was greater in the first 2 mo of LD shifts in the experimental rat than in the control rat. Relative to the baseline, food intake and activity percentages were increased and reduced, respectively, for the experimental rats. Features of these results, such as increased body weight gain and food intake, and reduced activity, suggest a causal relationship of chronic circadian desynchronization and changes in body weight control in male albino F344 rats.


Subject(s)
Eating/physiology , Energy Metabolism/physiology , Photoperiod , Weight Gain/physiology , Analysis of Variance , Animals , Body Temperature/physiology , Body Temperature/radiation effects , Circadian Rhythm/physiology , Circadian Rhythm/radiation effects , Darkness , Eating/radiation effects , Energy Metabolism/radiation effects , Heart Rate/physiology , Heart Rate/radiation effects , Light , Male , Motor Activity/physiology , Motor Activity/radiation effects , Rats , Rats, Inbred F344 , Weight Gain/radiation effects
SELECTION OF CITATIONS
SEARCH DETAIL
...