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Serhan HA, Gupta PC, Khatib MN, Padhi BK, Gaidhane S, Zahiruddin QS, Gaidhane AM, Kukreti N, Rustagi S, Satapathy P. Effect of Intravenous Mannitol on Intraocular Pressure Changes in Vitrectomized and Non-Vitrectomized Eyes: A Systematic Review and Meta-Analysis. Am J Ophthalmol 2024; 268:45-53. [PMID: 39033830 DOI: 10.1016/j.ajo.2024.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/19/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
PURPOSE Intraocular pressure (IOP) control is paramount during ophthalmic surgeries to ensure successful outcomes and prevent complications. Intravenous mannitol has been explored for its ability to manage IOP fluctuations in both vitrectomized and non-vitrectomized eyes. This meta-analysis aimed to assess the efficacy of mannitol in controlling IOP across these patient groups. DESIGN Systematic review and meta-analysis. METHODS A literature search was conducted across PubMed, EMBASE, Scopus, and Web of Science from inception up to March 1, 2024, focusing on studies investigating mannitol's impact on IOP in vitrectomized and non-vitrectomized eyes. Randomized controlled trials, cohort studies, and case-control studies were included, while case reports and review articles were excluded. The primary outcome was the change in IOP following mannitol administration. Meta-analysis was performed using a random-effects model. R software (V 4.3) was used for statistical analysis. RESULTS Our search included five studies of both vitrectomized (145 eyes) and non-vitrectomized eyes (91 eyes). The meta-analysis demonstrated significant IOP reductions following mannitol administration across multiple time points. Three studies were included at 30 min and 2 studies at all other time points in the analysis. In vitrectomized eyes, notable decreases were observed: at 30 min, the Ratio of Means (ROM) was 0.81 (95% CI: 0.53; 1.24), indicating a 19% reduction; at 60 min, the ROM of 0.833 (95% CI: 0.77; 0.89) showed a 16.7% reduction; at 90 min, the ROM of 0.757 (95% CI: 0.755; 0.758) corresponded to a 24.3% reduction; at 2 h, the ROM of 0.726 (95% CI: 0.642; 0.820) reflected a 27.4% reduction; at 3 h, the ROM of 0.692 (95% CI: 0.600; 0.797) resulted in a 30.8% reduction; and at 4 h, the ROM of 0.700 (95% CI: 0.363; 1.350) indicated a 30% reduction. No significant changes were observed on IOP with mannitol administration when comparing vitrectomized versus non- vitrectomized eyes. CONCLUSION Intravenous mannitol effectively reduces IOP in both vitrectomized and non-vitrectomized eyes, demonstrating its utility in the acute management of elevated IOP during and after ophthalmic surgeries. These findings support the integration of mannitol into perioperative care protocols. However, further research, particularly randomized controlled trials and studies with broader demographic representation, is needed to optimize mannitol's usage and fully understand its long-term safety and efficacy.
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Affiliation(s)
- Hashem Abu Serhan
- From the Department of Ophthalmology, Hamad Medical Corporation (H.A.S.), Doha, Qatar.
| | - Parul Chawla Gupta
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research (P.C.G.), Chandigarh, Punjab, India
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education (M.N.K.), Wardha, Maharashtra, India
| | - Bijaya K Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (B.K.P.), Chandigarh, Punjab, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education (S.G.), Wardha, Maharashtra, India
| | - Quazi Syed Zahiruddin
- South Asia Infant Feeding Research Network (SAIFRN), Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education (Q.S.Z.), Wardha, Maharashtra, India
| | - Abhay M Gaidhane
- Jawaharlal Nehru Medical College, and Global Health Academy, School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education (A.M.G.), Wardha, Maharashtra, India
| | - Neelima Kukreti
- School of Pharmacy, Graphic Era Hill University (N.K.), Dehradun, Uttarakhand, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University (S.R.), Dehradun, Uttarakhand, India
| | - Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University (P.S.), Chennai, Tamil Nadu, India; Medical Laboratories Techniques Department, AL-Mustaqbal University (P.S.), Hillah, Babil, Iraq
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Zhu G, Fu Z, Jin T, Xu X, Wei J, Cai L, Yu W. Dynamic nomogram for predicting acute kidney injury in patients with acute ischemic stroke: A retrospective study. Front Neurol 2022; 13:987684. [PMID: 36176552 PMCID: PMC9513523 DOI: 10.3389/fneur.2022.987684] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/22/2022] [Indexed: 12/02/2022] Open
Abstract
Background This study sought to develop and validate a dynamic nomogram chart to assess the risk of acute kidney injury (AKI) in patients with acute ischemic stroke (AIS). Methods These data were drawn from the Medical Information Mart for Intensive Care III (MIMIC-III) database, which collects 47 clinical indicators of patients after admission to the hospital. The primary outcome indicator was the occurrence of AKI within 48 h of intensive care unit (ICU) admission. Independent risk factors for AKI were screened from the training set using univariate and multifactorial logistic regression analyses. Multiple logistic regression models were developed, and nomograms were plotted and validated in an internal validation set. Based on the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) to estimate the performance of this nomogram. Results Nomogram indicators include blood urea nitrogen (BUN), creatinine, red blood cell distribution width (RDW), heart rate (HR), Oxford Acute Severity of Illness Score (OASIS), the history of congestive heart failure (CHF), the use of vancomycin, contrast agent, and mannitol. The predictive model displayed well discrimination with the area under the ROC curve values of 0.8529 and 0.8598 for the training set and the validator, respectively. Calibration curves revealed favorable concordance between the actual and predicted incidence of AKI (p > 0.05). DCA indicates the excellent net clinical benefit of nomogram in predicting AKI. Conclusion In summary, we explored the incidence of AKI in patients with AIS during ICU stay and developed a predictive model to help clinical decision-making.
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Affiliation(s)
- Ganggui Zhu
- Department of Neurosurgery, Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zaixiang Fu
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Taian Jin
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaohui Xu
- Department of Neurosurgery, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, China
| | - Jie Wei
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lingxin Cai
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wenhua Yu
- Department of Neurosurgery, Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Wenhua Yu
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Hashimoto H, Yamada H, Murata M, Watanabe N. Diuretics for preventing and treating acute kidney injury. Hippokratia 2022. [DOI: 10.1002/14651858.cd014937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Hiroyuki Yamada
- Department of Primary Care and Emergency Medicine; Kyoto University Hospital; Kyoto Japan
- Department of Nephrology; Kyoto University Hospital; Kyoto Japan
| | - Maki Murata
- Department of Emergency Medicine and Critical Care; National Hospital Organization Kyoto Medical Center; Kyoto Japan
| | - Norio Watanabe
- Department of Psychiatry; Soseikai General Hospital; Kyoto Japan
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Ortona S, Barisione C, Ferrari PF, Palombo D, Pratesi G. PCSK9 and Other Metabolic Targets to Counteract Ischemia/Reperfusion Injury in Acute Myocardial Infarction and Visceral Vascular Surgery. J Clin Med 2022; 11:jcm11133638. [PMID: 35806921 PMCID: PMC9267902 DOI: 10.3390/jcm11133638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 12/13/2022] Open
Abstract
Ischemia/reperfusion (I/R) injury complicates both unpredictable events (myocardial infarction and stroke) as well as surgically-induced ones when transient clampage of major vessels is needed. Although the main cause of damage is attributed to mitochondrial dysfunction and oxidative stress, the use of antioxidant compounds for protection gave poor results when challenged in clinics. More recently, there is an assumption that, in humans, profound metabolic changes may prevail in driving I/R injury. In the present work, we narrowed the field of search to I/R injury in the heart/brain/kidney axis in acute myocardial infarction, major vascular surgery, and to the current practice of protection in both settings; then, to help the definition of novel strategies to be translated clinically, the most promising metabolic targets with their modulatory compounds—when available—and new preclinical strategies against I/R injury are described. The consideration arisen from the broad range of studies we have reviewed will help to define novel therapeutic approaches to ensure mitochondrial protection, when I/R events are predictable, and to cope with I/R injury, when it occurs unexpectedly.
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Affiliation(s)
- Silvia Ortona
- Vascular and Endovascular Surgery Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132 Genoa, Italy; (S.O.); (D.P.); (G.P.)
| | - Chiara Barisione
- Department of Surgical and Integrated Diagnostic Sciences, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy
- Correspondence: ; Tel.: +39-010-555-7881
| | - Pier Francesco Ferrari
- Department of Civil, Chemical and Environmental Engineering, University of Genoa, Via Opera Pia, 15, 16145 Genoa, Italy;
| | - Domenico Palombo
- Vascular and Endovascular Surgery Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132 Genoa, Italy; (S.O.); (D.P.); (G.P.)
- Department of Surgical and Integrated Diagnostic Sciences, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy
- Research Center for Biologically Inspired Engineering in Vascular Medicine and Longevity, University of Genoa, Via Montallegro, 1, 16145 Genoa, Italy
| | - Giovanni Pratesi
- Vascular and Endovascular Surgery Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132 Genoa, Italy; (S.O.); (D.P.); (G.P.)
- Department of Surgical and Integrated Diagnostic Sciences, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy
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Diuretics and the kidney. BJA Educ 2022; 22:216-223. [DOI: 10.1016/j.bjae.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/22/2022] Open
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Fujii Y, Abe T, Ikegami K. Diabetic Pathophysiology Enhances Inflammation during Extracorporeal Membrane Oxygenation in a Rat Model. MEMBRANES 2021; 11:membranes11040283. [PMID: 33920465 PMCID: PMC8068986 DOI: 10.3390/membranes11040283] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 12/17/2022]
Abstract
Systemic inflammatory responses in patients undergoing extracorporeal membrane oxygenation (ECMO) contribute significantly to ECMO-associated morbidity and mortality. In recent years, the number of type 2 diabetes mellitus patients has increased, and the number of these patients undergoing ECMO has also increased. Type 2 diabetes mellitus is a high-risk factor for complications during ECMO. We studied the effects of ECMO on inflammatory response in a diabetic rat ECMO model. Twenty-eight rats were divided into 4 groups: normal SHAM group (normal rats: n = 7), diabetic SHAM group (diabetic rats: n = 7), normal ECMO group (normal rats: n = 7), and diabetic ECMO group (diabetic rats: n = 7). We measured the plasma levels of cytokines, tumor necrosis factor-α, and interleukin-6. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), blood urea nitrogen (BUN), creatinine (Cr), and liver-type fatty acid binding protein (L-FABP) were examined in the rat cardiopulmonary bypass model to ascertain organ damage. In addition, the lung wet-to-dry weight (W/D) ratio was measured as an index of pulmonary tissue edema. A pathologic evaluation of kidneys was conducted by hematoxylin-eosin (HE) and periodic-acid-methenamine-silver (PAM) staining. In the diabetic ECMO group, levels of cytokines, AST, ALT, LDH, and L-FABP increased significantly, reaching a maximum at the end of ECMO in comparison with other groups (p < 0.05). In addition, hematoxylin-eosin and periodic acid-methenamine-silver staining of renal tissues showed marked injury in the ECMO group (normal ECMO and diabetic ECMO groups). Furthermore, when the normal ECMO and diabetic ECMO groups were compared, severe organ injury was seen in the diabetic ECMO group. There was remarkable organ injury in the diabetic ECMO group. These data demonstrate that diabetes enhances proinflammatory cytokine release, renal damage, and pulmonary edema during ECMO in an animal model.
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Affiliation(s)
- Yutaka Fujii
- Department of Clinical Engineering and Medical Technology, Niigata University of Health and Welfare, Niigata 950-3198, Japan;
- Correspondence:
| | - Takuya Abe
- Department of Clinical Engineering and Medical Technology, Niigata University of Health and Welfare, Niigata 950-3198, Japan;
| | - Kikuo Ikegami
- Department of Health and Medical Sciences, Chiba Institute of Science, Choshi 288-0025, Japan;
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Fernandes M, Majoni M, Garg AX, Dubois L. Systematic Review and Meta-Analysis of Preventative Strategies for Acute Kidney Injury in Patients Undergoing Abdominal Aortic Aneurysm Repair. Ann Vasc Surg 2021; 74:419-430. [PMID: 33548402 DOI: 10.1016/j.avsg.2020.12.061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/09/2020] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
BACKGOUND To assess the effect of various preventative interventions for reducing the incidence of postoperative acute kidney injury (AKI) in patients undergoing elective abdominal aortic aneurysm (AAA) repair. METHODS We included randomized controlled trials of 10 patients or more which tested a preventative intervention versus standard therapy or placebo in patients undergoing elective AAA repair using the open or endovascular approach. Studies including mixed patient populations such as those with aortic occlusive disease, thoracoabdominal aneurysms or ruptured aneurysms were ineligible for review. We searched Medline (1966-2019), EMBASE (1947-2019), CINAHL (1961-2019), Web of Science (1945-2019), Scopus (1966-2019), and The Cochrane Library (1996-2019) for trials available as published manuscripts in English. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Where possible we pooled the results of similar interventions using random effects meta-analysis. RESULTS We included 17 trials involving 1443 participants. Most trials were small, single-center studies, with varying definitions of AKI and a high or moderate risk of bias. The preventative strategies with possible protective effects were mannitol, a composite of antioxidant supplements, an open extraperitoneal approach, and human atrial natriuretic peptide (hANP). Curcumin, methylprednisolone, carbon dioxide contrast medium, hemodynamic monitoring and N-acetylcysteine were found to be ineffective. Six trials with a total of 355 participants reported on remote ischemic preconditioning (RIPC) and our meta-analysis showed no statistically significant difference between RIPC and standard treatment (OR 1.20, 95% CI 0.37, 3.89); although the results should be interpreted with caution due to considerable statistical heterogeneity (I2 = 70%). None of the interventions studied significantly reduced receipt of renal replacement therapy (RRT). CONCLUSIONS Interventions that have shown some potential to reduce AKI after AAA repair include mannitol, a composite of antioxidant supplements, an open extraperitoneal approach and hANP. These conclusions are limited by the small size, high risk of bias and inconsistency of the included trials. Large, high quality, multi-center randomized trials will help determine which interventions are effective in reducing the incidence of postoperative AKI among patients undergoing elective AAA repair.
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Affiliation(s)
- Michaela Fernandes
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Melissa Majoni
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Amit X Garg
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Division of Nephrology, London Health Sciences Centre, London, Ontario, Canada; Institute for Clinical Evaluative Sciences, London, Ontario, Canada
| | - Luc Dubois
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Institute for Clinical Evaluative Sciences, London, Ontario, Canada; Division of Vascular Surgery, London Health Sciences Centre, London, Ontario, Canada.
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Waskowski J, Pfortmueller CA, Schenk N, Buehlmann R, Schmidli J, Erdoes G, Schefold JC. (TIMP2) x (IGFBP7) as early renal biomarker for the prediction of acute kidney injury in aortic surgery (TIGER). A single center observational study. PLoS One 2021; 16:e0244658. [PMID: 33411755 PMCID: PMC7790407 DOI: 10.1371/journal.pone.0244658] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/13/2020] [Indexed: 12/13/2022] Open
Abstract
Objective Postoperative acute kidney injury (po-AKI) is frequently observed after major vascular surgery and impacts on mortality rates. Early identification of po-AKI patients using the novel urinary biomarkers insulin-like growth factor-binding-protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases-2 (TIMP-2) might help in early identification of individuals at risk of AKI and enable timely introduction of preventative or therapeutic interventions with the aim of reducing the incidence of po-AKI. We investigated whether biomarker-based monitoring would allow for early detection of po-AKI in patients undergoing abdominal aortic interventions. Methods In an investigator-initiated prospective single-center observational study in a tertiary care academic center, adult patients with emergency/ elective abdominal aortic repair were included. Patients were tested for concentrations of urinary (TIMP-2) x (IGFBP7) at baseline, after surgical interventions (PO), and in the mornings of the first postoperative day (POD1). The primary endpoint was a difference in urinary (TIMP-2) x (IGFBP7) levels at POD1 in patients with/ without po-AKI (all KDIGO stages, po-AKI until seven days after surgery). Secondary endpoints included sensitivity/ specificity analyses of previously proposed cut-off levels and clinical outcome measures (e.g. need for renal replacement therapy). Results 93 patients (n = 71 open surgery) were included. Po-AKI was observed in 33% (31/93) of patients. Urinary (TIMP-2) x (IGFBP7) levels at POD1 did not differ between patients with/ without AKI (median 0.39, interquartile range [IQR] 0.13–1.05 and median 0.23, IQR 0.14–0.53, p = .11, respectively) and PO (median 0.2, IQR 0.08–0.42, 0.18, IQR 0.09–0.46; p = .79). Higher median (TIMP-2) x (IGFBP7) levels were noted in KDIGO stage 3 pAKI patients at POD1 (3.75, IQR 1.97–6.92; p = .003). Previously proposed cutoff levels (0.3, 2) showed moderate sensitivity/ specificity (0.58/0.58 and 0.16/0.98, respectively). Conclusion In a prospective monocentric observational study in patients after abdominal aortic repair, early assessment of urinary (TIMP-2) x (IGFBP7) did not appear to have adequate sensitivity/ specificity to identify patients that later developed postoperative AKI. Clinicaltrials.gov NCT03469765, registered March 19, 2018.
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Affiliation(s)
- Jan Waskowski
- Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- * E-mail:
| | - Carmen A. Pfortmueller
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Noelle Schenk
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Roman Buehlmann
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Juerg Schmidli
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Gabor Erdoes
- Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Joerg C. Schefold
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Qian Z, Wu Z, Li C, Yao C, Tan G, Li W, Guo DA. Rapid Determination of 3 Components With Different Polarities in Medicinal Mushrooms by Multistep Matrix Solid-Phase Dispersion and High-Performance Liquid Chromatography Analysis. Nat Prod Commun 2021. [DOI: 10.1177/1934578x20987784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In this study, a multistep matrix solid-phase dispersion (MSPD) combining with a high-performance liquid chromatography method was developed for assaying 3 components of different polarities (mannitol, adenosine, and ergosterol) from mushroom samples. MSPD extraction was carried out using 1 g octadecyl-bonded silica as the sorbent material, 9% methanol, 20% methanol, and 100% methanol as eluting solvents for the elution of mannitol, adenosine, and ergosterol, respectively. Mannitol was separated on an NH2P-50 4E column and detected using an evaporative light scattering detector. Adenosine and ergosterol were separated on a Poroshell 120 SB-C18 column and measured at 260 nm and 283 nm, respectively. The developed method showed good linearity ( R ≥ 0.9986) within the test range. The relative SD (RSD) of precisions were less than 1.4%, and the recoveries were 95.6%-97.0% (RSD ≤3.0%). Compared with the reported methods, the developed procedure could rapidly prepare components with different polarities (mannitol, adenosine, and ergosterol) from medical mushroom samples with less organic solvent and sample. The method is rapid and eco-friendly, which is helpful to improve the quality evaluation of medicinal mushrooms.
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Affiliation(s)
- Zhengming Qian
- Key Laboratory of State Administration of Traditional Chinese Medicine, Dongguan HEC Cordyceps R&D Co., Ltd, Guangdong, P. R. China
- Department of Rehabilitation, Xiangnan University, Hunan, P. R. China
| | - Zi Wu
- Key Laboratory of State Administration of Traditional Chinese Medicine, Dongguan HEC Cordyceps R&D Co., Ltd, Guangdong, P. R. China
| | - Chunhong Li
- Key Laboratory of State Administration of Traditional Chinese Medicine, Dongguan HEC Cordyceps R&D Co., Ltd, Guangdong, P. R. China
| | - ChangLiang Yao
- Shanghai Research Center for Modernization of Traditional Chinese Medicine, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, P. R. China
| | - Guoying Tan
- Key Laboratory of State Administration of Traditional Chinese Medicine, Dongguan HEC Cordyceps R&D Co., Ltd, Guangdong, P. R. China
| | - Wenjia Li
- Key Laboratory of State Administration of Traditional Chinese Medicine, Dongguan HEC Cordyceps R&D Co., Ltd, Guangdong, P. R. China
| | - De-an Guo
- Shanghai Research Center for Modernization of Traditional Chinese Medicine, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, P. R. China
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Cui R, Li F, Shao J, Wang Y, Yue C, Zheng Y, Li X. Postoperative anemia is a risk factor for acute kidney injury after open aorta and vena cava surgeries. PLoS One 2020; 15:e0240243. [PMID: 33048948 PMCID: PMC7553320 DOI: 10.1371/journal.pone.0240243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 09/22/2020] [Indexed: 12/13/2022] Open
Abstract
Open aorta and vena cava surgeries are usually associated with substantial blood loss which may result in postoperative acute kidney injury (AKI). The present study is designed to investigate the prevalence, outcome and risk factors of postoperative AKI associated with open aorta and vena cava surgeries, with a focus on the role of anemia in these conditions. A retrospective review of medical records of Peking Union Medical College Hospital was conducted. Patients who underwent open aorta and vena cava surgeries during January 1, 2010 and June 30, 2014 were included in this study. The primary analysis was between patients underwent open aorta and vena cava surgeryies, with or without postoperative AKI. Multivariable logistic regression models were used to determine risk factors of postoperative AKI. The study included 79 patients (63.3% male) with a mean age of 52.5±17.3 years (range, 17–81 years). Postoperative AKI occurred in 23/79 (29.1%) of the patients. Anemia was present in 11/79 (16%) at baseline, and increased to 45/79 (52%) postoperatively. After adjustment for various risk factors, postoperative anemia (OR, 5.202; 95% CI 1.403–19.285) was independently associated with postoperative AKI. AKI is a common complication in patients who undergo open aorta and vena cava surgeries, and postoperative anemia was the most relevant predictive factor of AKI. Strategies to minimize bleeding and anemia for all patients may be advisable. Further studies are needed to assess the impact of AKI on long term outcome and to examine preventive strategies to address potentially modifiable risk factors.
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Affiliation(s)
- Rui Cui
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Department of Nephrology, Beijing Haidian Hospital and Beijing Haidian section of Peking University Third Hospital, Beijing, China
| | - Fangda Li
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiang Shao
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuzhu Wang
- Department of Nephrology, Beijing Haidian Hospital and Beijing Haidian section of Peking University Third Hospital, Beijing, China
| | - Cai Yue
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- * E-mail: (CY); (YZ)
| | - Yuehong Zheng
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- * E-mail: (CY); (YZ)
| | - Xuemei Li
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Ischemic Renal Injury: Can Renal Anatomy and Associated Vascular Congestion Explain Why the Medulla and Not the Cortex Is Where the Trouble Starts? Semin Nephrol 2020; 39:520-529. [PMID: 31836035 DOI: 10.1016/j.semnephrol.2019.10.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The kidneys receive approximately 20% of cardiac output and have a low fractional oxygen extraction. Quite paradoxically, however, the kidneys are highly susceptible to ischemic injury (injury associated with inadequate blood supply), which is most evident in the renal medulla. The predominant proposal to explain this susceptibility has been a mismatch between oxygen supply and metabolic demand. It has been proposed that unlike the well-perfused renal cortex, the renal medulla normally operates just above the threshold for hypoxia and that further reductions in renal perfusion cause hypoxic injury in this metabolically active region. An alternative proposal is that the true cause of ischemic injury is not a simple mismatch between medullary metabolic demand and oxygen supply, but rather the susceptibility of the outer medulla to vascular congestion. The capillary plexus of the renal outer medullary region is especially prone to vascular congestion during periods of ischemia. It is the failure to restore the circulation to the outer medulla that mediates complete and prolonged ischemia to much of this region, leading to injury and tubular cell death. We suggest that greater emphasis on developing clinically useful methods to help prevent or reverse the congestion of the renal medullary vasculature may provide a means to reduce the incidence and cost of acute kidney injury.
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Xiao H, Wang Q, Bang-Berthelsen CH, Jensen PR, Solem C. Harnessing Adaptive Evolution to Achieve Superior Mannitol Production by Lactococcus lactis Using Its Native Metabolism. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2020; 68:4912-4921. [PMID: 32233405 DOI: 10.1021/acs.jafc.0c00532] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Mannitol can be obtained as a by-product of certain heterolactic lactic acid bacteria, when grown on substrates containing fructose. Lactococcus lactis, a homolactic lactic acid bacterium, normally does not form mannitol but can be persuaded into doing so by expressing certain foreign enzyme activities. In this study, we find that L. lactis has an inherent capacity to form mannitol from glucose. By adaptively evolving L. lactis or derivatives blocked in NAD+ regenerating pathways, we manage to accelerate growth on mannitol. When cells of the adapted strains are resuspended in buffer containing glucose, 4-58% of the glucose metabolized is converted into mannitol, in contrast to nonadapted strains. The highest conversion was obtained for a strain lacking all major NAD+ regenerating pathways. Mannitol had an inhibitory effect on the conversion, which we speculated was due to the mannitol uptake system. After its inactivation, 60% of the glucose was converted into mannitol by cells suspended in glucose buffer. Using a two-stage setup, where biomass first was accumulated by aerated culturing, followed by a nonaerated phase (static conditions), it was possible to obtain 6.1 g/L mannitol, where 60% of the glucose had been converted into mannitol, which is the highest yield reported for L. lactis.
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Affiliation(s)
- Hang Xiao
- National Food Institute, Technical University of Denmark, DK-2800 Kongens Lyngby, Denmark
| | - Qi Wang
- National Food Institute, Technical University of Denmark, DK-2800 Kongens Lyngby, Denmark
- College of Food Science and Engineering, Northwest A&F University, Yangling 712100, China
| | | | - Peter Ruhdal Jensen
- National Food Institute, Technical University of Denmark, DK-2800 Kongens Lyngby, Denmark
| | - Christian Solem
- National Food Institute, Technical University of Denmark, DK-2800 Kongens Lyngby, Denmark
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Ferraris VA. Acute kidey injury risks during cardiac operations are too numerous to count? Could a single actionable variable be the answer? J Thorac Cardiovasc Surg 2019; 159:e70-e71. [PMID: 31301894 DOI: 10.1016/j.jtcvs.2019.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 06/05/2019] [Indexed: 10/26/2022]
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