Correlation of cystatin-C with glomerular filtration rate by inulin clearance in pregnancy

OBJECTIVE

To test utility of cystatin-C as a marker of glomerular filtration rate during pregnancy, we performed serial correlations with inulin clearance during pregnancy and postpartum.

METHODS

Twelve subjects received inulin infusions and serum cystatin-C at three time points. Pearson's correlation coefficient was calculated.

RESULTS

Cystatin-C levels ranged 0.66-1.48 mg/L during pregnancy, and 0.72-1.26 mg/L postpartum. Inulin clearance ranged 130-188 mL/min during pregnancy, and 110-167 mL/min postpartum. Cystatin-C did not correlate with inulin clearance at any time point.

CONCLUSION

Serum cystatin-C did not correlate with inulin clearance during pregnancy or postpartum.

Predictors of plasma and urinary catecholamine levels in normotensive and hypertensive men and women

Age, sex, hypertension and dietary sodium are proposed to affect plasma and urinary catecholamines. Yet no prior study has examined the simultaneous effects of these factors within the same study population, so results may have been confounded by factors not determined. We investigate, for the first time, the impact of simultaneously determined predictors of plasma and urinary catecholamines, and the relationship of catecholamines with the diagnosis of hypertension. Hypertensive and normotensive subjects (n=308) were studied off antihypertensives in liberal and low sodium balance. Twenty-four hour urinary catecholamines (norepinephrine and epinephrine) were measured. Plasma catecholamines were measured supine after overnight fast. Repeated measures multivariate linear regression models examined effect of sex, race, age, body mass index, dietary salt (liberal salt vs. low salt), hypertension status, and mean arterial pressure on plasma and urinary catecholamines. Logistic regression determined the relationship of catecholamines with diagnosis of hypertension. Dietary sodium restriction and increasing age predicted increased plasma and urinary norepinephrine, with sodium restriction having greatest effect. Female sex predicted lower urinary and plasma epinephrine. Neither plasma nor urinary catecholamines predicted the diagnosis of hypertension. In summary, specific demographic factors variably impact catecholamines and should be considered when assessing catecholamines in research and clinical settings.

Cardiovascular risk factors and menstrual cycle phase in pre-menopausal women

BACKGROUND

Exogenous estrogens have been shown to affect markers of cardiovascular risk in women.

AIM

The objective of this study was to determine the effect of menstrual cycle phase on markers of cardiovascular risk in young, healthy women with regular menstrual cycles.

SUBJECTS AND METHODS

This prospective cohort study examined 20 healthy pre-menopausal women at 2 time-points in the menstrual cycle, in early follicular phase and early luteal phase.

RESULTS

In the early luteal phase, levels of estrogen, progesterone, LH, total cholesterol, and HDL were significantly higher, compared with the early follicular phase. In contrast, there were no significant differences in LDL or triglyceride levels between the 2 phases. Furthermore, there were no significant effects of menstrual cycle phase on glycemic indices (fasting blood glucose, glycohemoglobin or homeostatic model assessment of insulin resistance), markers of inflammation (C-reactive protein, soluble CD40 ligand, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, or adiponectin), or vascular function, as measured by brachial artery reactivity.

CONCLUSIONS

Although menstrual cycle phase affects total cholesterol and HDL levels, it does not affect other markers of cardiovascular risk in young women with regular menstrual cycles.

The Value of Lymphadenectomy Post-Neoadjuvant Therapy in Carcinoma Esophagus: a Review

Lymph nodal metastasis is one of the most important prognostic factors determining survival in patients with carcinoma esophagus. Radical esophagectomy, with the resection of surrounding lymph nodes, is considered the prime treatment of carcinoma esophagus. An extensive lymphadenectomy improves the accuracy of staging and betters locoregional control, but its effect on survival is still not apparent and carries the disadvantage of increased morbidity. The extent of lymphadenectomy during esophagectomy also remains debatable, with many studies revealing contradictory results, especially in the era of neoadjuvant therapy. The pattern of distribution and the number of nodal metastasis are modified by neoadjuvant therapy. The paper reviews the existing evidence to determine whether increased lymph node yield improves oncological outcomes in patients undergoing esophagectomy with particular attention to those patients receiving neoadjuvant therapy.

Evaluation of the Hunter-Sessions self-retaining aortic cannula

A report of our experience with a new self-retaining aortic cannula is presented. We have used this cannula in more than 30 patients and found it to be very secure and convenient for rapid cannulation since no pursestring sutures are required for initial placement.