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Association of objective measures of volume status with blood pressure, cardiac structure, and cardiac function among patients receiving maintenance hemodialysis
No full textBackground Intradialytic hypertension, defined as an increase in BP from pre- to post-hemodialysis (HD), affects
5%–15% of patients receiving maintenance HD and is associated with cardiovascular and all-cause mortality.
Hypervolemia is believed to be a major etiological factor, yet the association of more objective biomarkers of
volume status with intradialytic hypertension is not well described.
Methods In a post hoc analysis of the Frequent Hemodialysis Network Daily Trial (n5234), using data from
baseline, 1-, 4-, and 12-month visits (n5800), we used random-effects regression to assess the association of
bioimpedance estimates of volume (vector length) with post-HD systolic BP (continuous) and any increase in
systolic BP (categorical) from pre- to post-HD. We adjusted models for randomized group; age; sex; self-reported
race; Quételet (body mass) index; vascular access; HD vintage; hypertension; history of heart failure; diabetes;
residual kidney function (urea clearance); pre-HD systolic BP; ultrafiltration rate; serum-dialysate sodium
gradient; and baseline values of hemoglobin, phosphate, and equilibrated Kt/V urea.
Results The mean age of participants was 50614 years, 39% were female, and 43% were Black. In adjusted
models, shorter vector length (per 50 V/m) was associated with higher post-HD systolic BP (2.9 mm Hg; 95%
confidence interval [CI], 1.6 to 4.3) and higher odds of intradialytic hypertension (odds ratio 1.66; 95% CI, 1.07 to
2.55). Similar patterns of association were noted with a more stringent definition of intradialytic hypertension
(.10 mm Hg increase from pre- to post-HD systolic BP), where shorter vector length (per 50 V/m) was
associated with a higher odds of intradialytic hypertension (odds ratio 2.17; 95% CI, 0.88 to 5.36).
Conclusions Shorter vector length, a bioimpedance-derived proxy of hypervolemia, was independently associated with higher post-HD systolic BP and risk of intradialytic hypertension
The Association of Serum Bicarbonate with Psychological and Physical Health-Related Quality of Life in Patients Receiving Maintenance Hemodialysis: A Secondary Analysis of the Frequent Hemodialysis Network (FHN) Daily Trial
No full textHydrolyzable tannins (ellagitannins), flavonoids, pentacyclic triterpenes and their glycosides in antimycobacterial extracts of the ethnopharmacologically selected Sudanese medicinal plant Combretum hartmannianum Schweinf
No full textIn Sudanese traditional medicine, decoctions, macerations, and tonics of the stem and root of Combretum hart-mannianum are used for the treatment of persistent cough, a symptom that could be related to tuberculosis (TB). To verify these traditional uses, extracts from the stem wood, stem bark, and roots of C. hartmannianum were screened for their growth inhibitory effects against Mycobacterium smegmatis ATCC 14468. Methanol Soxhlet and ethyl acetate extracts of the root gave the strongest effects (MIC 312.5 and 625 mu g/ml, respectively). HPLC-UV/DAD and UHPLC/QTOF-MS analysis of the ethyl acetate extract of the root led to the detection of 54 compounds, of which most were polyphenols and many characterized for the first time in C. hartmannianum. Among the major compounds were terflavin B and its two isomers, castalagin, corilagin, tellimagrandin I and its derivative, (S)-flavogallonic acid dilactone, punicalagin, and methyl-ellagic acid xylopyranoside. In addition, di-, tri- and tetragalloyl glucose, combregenin, terminolic acid, cordifoliside D, luteolin, and quercetin-3-O-galactoside-7-O-rhamnoside-(2 -> 1)-O-beta-D-arabinopyranoside were characterized. Luteolin gave better growth inhibition against M. smegmatis (MIC 250 mu g/ml) than corilagin, ellagic acid, and gallic acid (MIC 500-1000 mu g/ml). Our study justifies the use of C. hartmannianum in Sudanese folk medicine against prolonged cough that could be related to TB infection. This study demonstrates that C. hartmannianum should be explored further for new anti-TB drug scaffolds and antibiotic adjuvants.Peer reviewe
Correlation Between Neutrophil-Lymphocyte Ratio, Platelets-Lymphocyte Ratio, and High-Resolution CT in Patients with COVID-19
No full textBackground: COVID-19 is a highly infectious disease that necessitates simple and rapid methods for recognising severe patients. Aims: To correlate between chest lesions in CT, neutrophil-lymphocyte ratio (NLR), and platelets-lymphocytes ratio in patients with COVID-19, and to detect their cut-off values as an early warning of severe COVID-19 in Egyptian patients. Subjects and Methods: A cross-sectional study included 100 adult patients with COVID-19 attending Ahmed Maher Teaching Hospital, Cairo, Egypt. Clinical, laboratory, and radiological assessments were done. They were classified according to their CT grades into three groups: seven patients with a normal chest CT, 45 non-severe cases, and 48 severe cases. Results: Dyspnoea was the most common symptom among the severe cases (79.2%) and fever among non-severe cases (71.1%), while cough (85.7%) was the most common among cases with a normal CT. The age, NLR, C-reactive protein (CRP), and D-dimer of severe cases were significantly the highest, while the absolute lymphocytes were significantly the lowest. Highly significant positive correlations were found between CT grades with D-dimer, NLR, and CRP; significant positive correlation was found with age; and significant negative correlation with CT. Using receiver operating characteristic analysis, areas under the curve of D-dimer, NLR, age, CRP, ferritin, and platelet-lymphocyte ratio were 0.760, 0.698, 0.640, 0.627, 0.614, and 0.595, respectively. The optimal cut-off value of NLR was 2.50 with 0.74 specificity, 0.61 sensitivity, and 67.5 accuracy. Conclusion: NLR is a reliable and easy-to-use predictor of COVID-19 severity. NLR (>2.5) should prompt prescription of a chest CT as it could reveal essential lesions that influence further management
Univariate risk predictors of COVID-19 mortality.
No full textUnivariate risk predictors of COVID-19 mortality.</p
Generalized linear nodels for risk predictors of COVID-19 mortality.
No full textGeneralized linear nodels for risk predictors of COVID-19 mortality.</p
Demographic characteristics and comorbidities (n = 3712).
No full textDemographic characteristics and comorbidities (n = 3712).</p
Baseline vital signs and laboratory parameters (n = 3712).
No full textBaseline vital signs and laboratory parameters (n = 3712).</p
