Radiation exposure in dialysis access-related procedures decreases with increase in number of procedures performed by the interventional nephrologist

An appreciation of the inherent risks with radiation exposure to patients and to the physician performing the procedure and the staff is urgently needed. The objective of this study is to assess radiation exposure to both patients and interventional nephrologists performing procedures and see any trends in the procedure and fluoroscopy times over a 2-year period. A total of 400 procedures performed at our vascular access center by a new to practice interventional nephrologist were recorded and retrospectively analyzed. Fluoroscopic time and procedure time for various procedures over the course of 2 years were recorded. This data were subsequently separated into eight groups (four quarters per year) based on the date of the procedure. Our study demonstrates a decrease in mean and median fluoroscopy times and procedure times for newly trained interventional with gain in number of procedures. The mean fluoroscopy time for the first two quarters was 5 minutes and 4 seconds, and the median was 3 minutes and 37 seconds. The mean procedure time for the first two quarters was 38 minutes, and the median was 32 minutes. The mean fluoroscopy time for the last two quarters was 1 minute and 54 seconds, and the median was 1 minute and 26 seconds. The mean procedure time for the last two quarters was 27 minutes, and the median was 21 minutes. In conclusion, gain of experience by the practicing Interventional Nephrologist from performing an increasing number of procedures leads to decreased procedure times and fluoroscopy times, which lowers the risk of radiation.     

Hazardous Drinking and HIV Sexual Risk Behaviors Among Injection Drug Users in Developing and Transitional Countries

Studies in North America and Western Europe have reported an association between hazardous drinking and HIV sexual risk behaviors among injection drug users (IDUs). However, we lack such studies from developing and transitional countries, where different cultural norms and contexts of drinking may change this association. We used a multi-site study using standard survey instruments and methods to examine whether hazardous drinking is associated with HIV sexual risk behaviors (defined as unprotected sex and having multiple sex partners) among IDUs in 12 cities across different developing and transitional countries. Data were collected from May 1999 to November 2003. In individual site analyses, hazardous drinking was associated with increased HIV risk behaviors in 10 cities. Mixed effects models of the multi-site data, also, showed an association of hazardous drinking and HIV sexual risk behaviors. These findings in the context of the high prevalence of drinking in many sites point to the importance of addressing alcohol use in HIV education and prevention policy for IDUs.     

F. Clinical Renal Pharmacology and Therapeutics

Literature Survey

F. Clinical Renal Pharmacology and Therapeutics     

Eosinophil cell: pray tell us what you do!

PURPOSE OF REVIEW: We will review the role of the eosinophil as an innate immune cell. There have been recent advances in the regulatory mechanisms of the eosinophil, in terms of priming and migration. Additionally, we will discuss certain pulmonary diseases that are associated with eosinophilia. RECENT FINDINGS: Rapid binding of immunoglobulin A-coated beads can prime the eosinophil cell in the trafficking process. Tissue factor has been shown to be expressed within eosinophil granules. It is believed to serve as a critical eosinophil mediator within the peripheral bloodstream. Interleukin-8 serves as a chemoattractant through IL8RA and IL8RB receptors, but patients with an IL8RA-B ht2 have peripheral eosinophilia. Interleukin-10 and eotaxin correlate with eosinophilia and an active infection prior to therapy. After therapy, interleukin-5 and 6 correlated appropriately with eosinophilia. A wide differential diagnosis exists for peripheral eosinophilia. One study has shown that 86 out of 103 patients with unknown causes for peripheral eosinophilia had positive toxocara enzyme-linked immunosorbent assay results. SUMMARY: The effect of the cytotoxic eosinophil cell is not only harmful to foreign invaders within the body, but through an intricate immunological pathway, eosinophils can become detrimental to the host organs.     

An agarose spot chemotaxis assay for chemokine receptor antagonists

Introduction

Chemokines are important players in directing the migration of cancer cells as part of the metastatic process. The aim of this study is to develop an easy-to-perform, reliable, and inexpensive assay for rapid analysis of anti-chemotactic activity of chemokine antagonists under a number of experimental conditions.

Methods

An agarose spot containing the chemokine chemoattractant is applied to a glass petri dish. Live cells in a media, both with and without a chemokine antagonist, are added to the dish and, following cell adhesion, the migration under the agarose spot is observed and analysed by microscopy.

Results

In the absence of CXCL12 in the agarose, no migration under the agarose spot is detected. In the presence of CXCL12, significant migration under the agarose spot is observed which can be retarded if a neutralising monoclonal antibody or a small molecule antagonist is added to the media.

Discussion

This experimental configuration is a reliable, inexpensive and easy-to-perform chemotaxis assay, which enables assessment of the activity of CXCR4 antagonists.