Unexplained pulmonary hypertension in peritoneal dialysis and hemodialysis patients.

OBJECTIVES: To compare the prevalence of unexplained pulmonary artery hypertension (PAH) in hemodialysis (HD) and peritoneal dialysis (PD) patients and to compare laboratory parameters between patients with unexplained PAH and those with normal pulmonary artery pressure (PAP). METHODS: We retrospectively reviewed the medical records of 278 chronic HD and 145 chronic PD patients. Laboratory findings including hemoglobin, calcium, phosphorus, alkaline phosphatase, albumin, parathyroid hormone level, serum iron, total iron binding capacity, ferritin, creatinine and blood urea nitrogen were documented. The results of transthoracic Doppler echocardiography were used to determine the pulmonary artery pressure (PAP). PAH was defined as a systolic pulmonary artery pressure (SPAP) ≥35 mmHg. To rule out secondary PAH, patients with cardiac disease, pulmonary disease, collagen vascular disease, volume overload at the time of echocardiography and positive human immunodeficiency virus test were excluded. RESULTS: Data from 34 patients in group HD and 32 individuals in group PD were analyzed. The median age of the study population was 57 (45-68) years. The median SPAP value in patients with PAH was 37.5 (35-45)mmHg. According to the echocardiographic findings, PAH was found in 14 (41.1%) patients of HD group and in 6 (18.7%) patients of PD group (P=0.04). The median serum iron and hemoglobin was significantly lower in patients with PAH compared to those in patients with normal PAP (P<0.05). CONCLUSION: Unexplained PAH seems to be more frequent in patients undergoing HD than patients in PD group. Moreover, hemoglobin and serum iron levels are lower in patients with PAH compared to those in normal PAP group.

Selection for autochthonous bifidobacteial isolates adapted to simulated gastrointestinal fluid.

BACKGROUND AND THE PURPOSE OF THE STUDY: Bifidobacterial strains are excessively sensitive to acidic conditions and this can affect their living ability in the stomach and fermented foods, and as a result, restrict their use as live probiotic cultures. The aim of the present study was to obtain bifidobacterial isolates with augmented tolerance to simulated gastrointestinal condition using cross-protection method. METHODS: Individual bifidobacterial strains were treated in acidic environment and also in media containing bile salts and NaCl. Viability of the acid and acid-bile-NaCl tolerant isolates was further examined in simulated gastric and small intestine by subsequent incubation of the probiotic bacteria in the corresponding media for 120 min. Antipathogenic activities of the adapted isolates were compared with those of the original strains. RESULTS AND MAJOR CONCLUSION: The acid and acid-bile-NaCl adapted isolates showed improved viabilities significantly (p<0.05) in simulated gastric fluid compared to their parent strains. The levels of reduction in bacterial count (Log cfu/ml) of the acid and acid-bile-NaCl adapted isolates obtained in simulated gastric fluid ranged from 0.64-3.06 and 0.36-2.43 logarithmic units after 120 min of incubation. There was no significant difference between the viability of the acid-bile-NaCl-tolerant isolates and the original strains in simulated small intestinal condition except for Bifidobacterium adolescentis (p<0.05). The presence of 15 ml of supernatants of acid-bile-NaCl-adapted isolates and also those of the initial Bifidobacterium strains inhibited pathogenic bacterial growth for 24 hrs. Probiotic bacteria with improved ability to survive in harsh gastrointestinal environment could be obtained by subsequent treatment of the strains in acid, bile salts and NaCl environments.

Proper names and how they are learned.

Proper names function in our conceptual lives as means for denoting individuals in kinds. Kinds are denoted by common names, more precisely count nouns, and so there are important interrelations between proper names and common nouns. All of this shows up in the way we interpret proper names and employ them in everyday inferences. For example, an airline may count three passengers in relation to a single person Jane, if Jane takes three trips with the airline. Each of the three passengers is Jane, but there is only one Jane. To handle such operations we propose a theory of proper names as part of the theory of kinds. This enables us to specify certain resources (some of them unlearned) that are necessary for the learning of proper names and also a theory of how they are learned. We review the experimental literature on the learning of proper names from the standpoint of the theory. We do not extend the theory to cover recognition or recall.