Torsemide Versus Furosemide After Continuous Renal Replacement Therapy Due to Acute Renal Failure in Cardiac Surgery Patients

Acute renal failure (ARF) usually develops in 5% to 30% of patients undergoing heart surgery and is associated with a more complicated clinical evolution course and with an excessive mortality of up to 80%. The objective of this study was to verify the frequency of ARF in postoperative coronary artery bypass surgery with and without cardiopulmonary bypass, by the evaluation of renal function markers' performance [ plasma creatinine, plasma urea, urinalysis, fractional excretion of sodium, creatinine clearance and Alpha‐glutathione S‐transferase (α‐GST)], besides to verify possible relations between clinical variables involved in postoperative heart surgery and the occurrence of renal insufficiency.     

A Bayesian Sequential Design for Clinical Trials With Time-to-Event Outcomes

Abstract

There is increasing interest in Bayesian group sequential design because of its potential to improve efficiency in clinical trials, to shorten drug development time, and to enhance statistical inference precision without undermining the clinical trial’s integrity or validity. We propose a Bayesian sequential design for clinical trials with time-to-event outcomes and use alpha spending functions to control the overall Type I error rate. Bayes factor is adapted for decision-making at interim analyses. Algorithms are presented to make decision rules and to calculate power of the proposed tests. Sensitivity analysis is implemented to evaluate the impact of different choices of prior parameters on choosing critical values. The power of tests, the expected event size of the proposed design, and the quality of estimators are studied through simulations, and compared with the frequentist group sequential design. Simulations show that at fixed total number of events, the proposed design can achieve greater power and require smaller expected event size when appropriate priors are chosen, compared with the frequentist group sequential design. The feasibility of the proposed design is further illustrated on a real dataset. Supplementary materials for this article are available online.     

Étude d’une population d’enfants porteurs de paralysie cérébrale : description de caractéristiques cliniques potentiellement corrélées à la morbidité respiratoire

ObjectiveDescribe the history of respiratory morbidity in a population of 30 children with cerebral palsy and to link this development with different clinical signs that may have an impact on lung function. The prospects of such a study would identify some clinical criteria, risk markers for respiratory pathologies, easy to detect outside a hospital setting.MethodsData collection from folder items of each child: health record, nursing records, medical and paramedical folder, and gathering additional information by questionnaires to speech therapists and educators.ResultsIt appears that the more children with cerebral palsy are severely affected in their motor skills, the more they have substantial respiratory history. Children who belong to category 5 on the scale of Gross Motor Function Classification System (GMF-CS) present the following common characteristics: more episodes of inflammations and/or infections of the upper and lower airways than children having lower quotes GMF-CS, postural weakness of the trunk (100%), control deficits of breath and speech (100%), deficits in motor control and sensory integration of the buccal cavity, pharynx and larynx, characterized by impaired swallowing (100%), salivary leakage (100%), a suitable diet and risk of aspiration in 8 of 9 cases, an underweight in 7 of 9 cases. Children of categories GMF-CS below do not include all these features so significantly. However, some children rated 4 have some of these features added.ConclusionChildren with cerebral palsy do not seem all equal faced to respiratory events; the motor and nutritional characteristics identified in our work should be studied as part of a prospective cohort study in order to determine their relevance or not as a respiratory disease risk factor disabling on medium-term. The final aim would be to develop the preventive aspect of the respiratory care of children with cerebral palsy.     

A comparison of the nutrient content of uncooked and cooked lean from New Zealand beef and lamb

The composition in terms of proximate analysis, cholesterol, vitamins, minerals, and fatty acids of the lean tissue of 17 beef cuts and 18 lamb cuts was determined on within-cut composite samples (each containing lean tissue from at least 7 animals), following the knife-separation of raw and cooked cuts into lean, fat, and bone. Composite lean samples for 4 beef cuts and 4 lamb cuts were also analysed for amino-acid composition. For analysis, different cuts were the experimental unit as individual animal data were not available. The composition of lean from beef and lamb was shown to be highly desirable with a high nutrient density (mg/kJ) for many nutrients. Although lean from beef and lamb were very similar in many respects, several significant differences were detected. Changes in composition with cooking were largely eliminated when considered on a dry-matter basis, but proportions of the n-3 and n-6 polyunsaturated fatty acids increased with cooking (P < 0.05). The amino acid composition was similar for lean from beef and lamb but showed small deviations from recommended patterns for human nutrition with branched chain amino acids being limiting.     

Detection of fast neutrons from shielded nuclear materials using a semiconductor alpha detector

The response of a semiconductor alpha detector to fast (>1 MeV) neutrons was investigated by using measurements and simulations. A polyethylene converter was placed in front of the detector to register recoil protons generated by elastic collisions between neutrons and hydrogen nuclei of the converter. The developed prototype equipment was tested with shielded radiation sources. The low background of the detector and insensitivity to high-energy gamma rays above 1 MeV are advantages when the detection of neutron-emitting nuclear materials is of importance. In the case of a ²⁵²Cf neutron spectrum, the intrinsic efficiency of fast neutron detection was determined to be 2.5×10⁻⁴, whereas three-fold greater efficiency was obtained for a ²⁴¹AmBe neutron spectrum.     

Argininic acid alters markers of cellular oxidative damage in vitro: Protective role of antioxidants

We, herein, investigated the in vitro effects of argininic acid on thiobarbituric acid-reactive substances (TBA-RS), total sulfhydryl content and on the activities of antioxidant enzymes such as catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the blood, kidney and liver of 60-day-old rats. We also verified the influence of the antioxidants (each at 1.0 mM) trolox and ascorbic acid, as well as of N^G-nitro-l-arginine methyl ester (L-NAME) at 1.0 mM, a nitric oxide synthase inhibitor, on the effects elicited by argininic acid on the parameters tested. The liver, renal cortex and renal medulla were homogenized in 10 vol (1:10w/v) of 20 mM sodium phosphate buffer, pH 7.4, containing 140 mM KCl; and erythrocytes and plasma were prepared from whole blood samples obtained from rats. For in vitro experiments, the samples were pre-incubated for 1 h at 37 °C in the presence of argininic acid at final concentrations of 0.1, 1.0 and 5.0 μM. Control experiments were performed without the addition of argininic acid. Results showed that argininic acid (5.0 μM) enhanced CAT and SOD activities and decreased GSH-Px activity in the erythrocytes, increased CAT and decreased GSH-Px activities in the renal cortex and decreased CAT and SOD activities in the renal medulla of 60-day-old rats, as compared to the control group. Antioxidants and/or L-NAME prevented most of the alterations caused by argininic acid on the oxidative stress parameters evaluated. Data suggest that argininic acid alters antioxidant defenses in the blood and kidney of rats; however, in the presence of antioxidants and L-NAME, most of these alterations in oxidative stress were prevented. These findings suggest that oxidative stress may be make an important contribution to the damage caused by argininic acid in hyperargininemic patients and that treatment with antioxidants may be beneficial in this pathology.     

Analysis of K-<Emphasis Type="Italic">ras</Emphasis> Codon 12 Mutation in Flat and Nodular Variants of Serrated Adenoma in the Colon

PURPOSE: The developmental process of serrated adenomas is obscure, and the importance of genetic alterations has not been elucidated clearly. The possibility that the developmental process and genetic alterations of serrated adenomas could differ from those of ordinary tubular adenomas was explored in this work. METHODS: Serrated adenomas were obtained by endoscopic resection (n = 57) and divided into two groups: flat (n = 10) and nodular (n = 47). Mutation of the K-ras gene was analyzed by enriched polymerase chain reaction–enzyme-linked mini-sequence assay, which can detect not only the presence of a mutation but also the mutation type of K-ras codon 12 with high sensitivity. Methylation-specific polymerase chain reaction was performed with specific primers for the DNA repair gene O6-methylguanine-DNA methyltransferase. RESULTS: Serrated adenomas located in the rectum were more likely to have a K-ras mutation (9/12, 75 percent), whereas serrated adenomas of the flat type were less likely to have one (1/10, 10 percent). Furthermore, nodular serrated adenomas that occurred in the rectum possessed a high frequency of K-ras gene codon 12 point mutation (8/10, 80 percent) despite an overall frequency of 46.8 percent (22/47). A mutation of the K-ras codon 12 gene was detected in 23 (40.4 percent) of 57 serrated adenomas. Three types of point mutations of codon 12 were detected, with the mutation of GAT being observed most frequently. CONCLUSIONS: This study shows that development of nodular serrated adenomas may depend on the mutation of the K-ras codon 12 gene, whereas development of flat serrated adenomas may not. Additionally, serrated adenomas that occur in the rectum are closely related to the mutation of the K-ras codon 12 gene. K-ras mutations in serrated adenomas may be unaffected by the epigenetic silencing of O6-methylguanine-DNA methyltransferase by promoter hypermethylation.     

碘[131I]美妥昔单抗注射液与肝动脉化疗栓塞术治疗原发性肝癌的对比研究

目的 对比分析碘[131I]美妥昔单抗注射液与肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗原发性肝癌(primary liver cancer,PLC)的临床疗效.方法 根据治疗方法的不同将PLC患者分为TACE组(n=31)和碘[131I]美妥昔单抗组(n=32).TACE组行TACE治疗,碘[131I]美妥昔单抗组经肝动脉途径灌注碘[131I]美妥昔单抗注射液,治疗3个月后对两组甲胎蛋白(AFP)转阴率、肿瘤缩小率及生存期进行比较,并观察不良反应发生情况,随访至2015年8月.结果 治疗3个月后,碘[131I]美妥昔单抗组AFP转阴率及肿瘤缩小率略高于TACE组,但差异无统计学意义(P＞0.05);治疗期间两组均无明显不良反应;截止到随访结束,TACE组生存率为19.4％(6/31),碘[131I]美妥昔单抗组为43.8％ (14/32),碘[131I]美妥昔单抗组生存率高于TACE组,且差异有统计学意义(P＜0.05).结论 对于PLC的治疗,碘[131I]美妥昔单抗注射液在提高AFP转阴率、肿瘤缩小率及生存率方面优于TACE.