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Occult Adrenal Insufficiency in Patients with Chronic Renal Disease
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作者 Kamel El-Reshaid Abdulmohsen Al-Bader Hossameldin Tawfik Sallam 《International Journal of Clinical Medicine》 CAS 2024年第8期375-381,共7页
Background: Addison’s disease is a rare disorder of the adrenal cortex that leads to inadequate production of cortisol initially followed by aldosterone and androgens. Its manifestations are usually slow and non-spec... Background: Addison’s disease is a rare disorder of the adrenal cortex that leads to inadequate production of cortisol initially followed by aldosterone and androgens. Its manifestations are usually slow and non-specific with potential for life-threatening adrenal crisis following hypermetabolic demands (infection, trauma, surgery). Patients: Over the past 10 years, 19 CRD-patients were diagnosed with occult PAI in our center. Results: Unprovoked hypotension was the most common manifestations of occult PAI and was the unmasking event in 11 (58%). It was without significant cardiac and/or severe systemic sepsis and was refractory to isotonic saline infusions. Equal number of the remaining patients (n = 2) presented with persistent and inexplicable electrolytes abnormalities viz. 1) hyponatremia despite restricted oral fluid intake, lack of dehydration and massive fluid overload, as well as 2) hyperkalemia despite potassium-restricted diet, hyperkalemic drugs and adequate therapy with Furosemide and low-potassium dialysis-baths. On the other hand, similar proportions presented with unprovoked 3) progressive weight loss, decrease appetite and cachexia as well as 4) frequent hypoglycemic attacks. All patients were treated and were medically stable after 29 (2 - 60) months of follow up. Autoantibodies to 21-hydroxylase enzyme were positive in 16 (90%). At diagnosis, and subsequent follow up, only 7 patients (37%) had multi-endocrine dysfunction of whom 2 with type 1 and 5 with type 2. Conclusion: High index of suspicion should be exerted in diagnosis of PAI in patients with CRD, since its clinical picture is similar to CRD manifestations and complications. In those patients, confirmatory tests and specific management can save their lives. . 展开更多
关键词 Addison’s Disease Autoimmune Adrenalitis Chronic renal Disease Multiple Endocrine Dysfunctions Primary Adrenal insufficiency
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Clinical Features of Renal Insufficiency due to Multiple Myeloma and Related Risk Factors 被引量:1
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作者 刘雪梅 徐金兰 +1 位作者 官旭华 刘丽秋 《The Chinese-German Journal of Clinical Oncology》 CAS 2005年第1期47-49,68,共4页
Objective: To study clinical features of the patients with multiple myeloma(MM) accompanied by renal insufficiency and investigate the related risk factors of renalimpairment. Methods: A control study of clinical char... Objective: To study clinical features of the patients with multiple myeloma(MM) accompanied by renal insufficiency and investigate the related risk factors of renalimpairment. Methods: A control study of clinical characteristics was performed between 91 patientswith renal insufficiency due to MM and 165 patients with normal renal function in MM during the sameperiod. The data were statistically analyzed by chi-square test and logistic regression analysis.Results: Renal insufficiency was the initial presentation in 48 (52.7%) of the 91 patients, and 30(62.5%) of the 48 patients were misdiagnosed. The prognosis of group with renal insufficiency wassignificantly poorer than that of group with normal renal function: mortality in 3 months, 3months-1 year was 26/91 vs 14/165 (P 【 0.0001), 14/91 vs 12/165 (P 【 0.05) respectively, andpatients survived 】 1 year was 18/91 vs 95/165 (P 【 0.0001). The incidence of hypercalcemia,hyperuricemic, severe anemia, high serum M-protein concentration and lytic bone lesions weresignificantly higher in renal insufficiency group than those in control group (P 【 0.05). Logisticregression analysis identified 5 risk factors of renal impairment, including, severe anemia(Exp(β)=13.819, P 【 0.0001), use of nephrotoxic drugs (Exp(β)=6.217, P = 0.001), high serumM-protein concentration (Exp(β) = 5.026, P = 0.001), male (Exp(β)=3.745, P=0.006), andhypercalcemia (Exp(β)=3A72, P=0.006), but age, serum density of uric acid, type of serum M-protein,and Bence Jones proteinuria were not significantly associated with renal insufficiency. Conclusion:Renal insufficiency was a common early complication of MM, which often resulted in misdiagnosis.The status of these patients tended to be very bad, with many other complications, when MM wasdiagnosed, so their prognosis was poor. The occurrence of renal insufficiency in patients with MMand hypercalcemia, severe anemia, high serum M-protein concentration, especially use of nephrotoxicdrugs should be alert. 展开更多
关键词 multiple myeloma renal insufficiency clinical feature risk factor
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Expression of HO-1 in Chronic Renal Insufficiency Rat Kidney and Implication 被引量:2
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作者 刘晓城 杨成 何晓峰 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2003年第3期271-274,共4页
The expression, activity and clinical implication of heme oxygenase-1 (HO-1) in the chronic renal insufficiency (CRI) rat kidney and its mechanism were investigated The 5/6 nephrectomized rats were assigned to sham ... The expression, activity and clinical implication of heme oxygenase-1 (HO-1) in the chronic renal insufficiency (CRI) rat kidney and its mechanism were investigated The 5/6 nephrectomized rats were assigned to sham operation group, CRI group and Hemin group At the 8th week after second operation, blood pressure, urinary protein, serum creatinine(Scr) and BUN were measured Renal pathologic changes were observed The activity of HO and contents of erythropoietin (EPO) in serum and renal tissue were determined Immunohistochemistry was used to detect the expression and distribution of HO-1 in the CRI rat kidney As compared with CRI group, the urinary protein, blood pressure, Scr and BUN in Hemin group were reduced significantly ( P< 0 05) The glomerular mesangial proliferation, inflammatory cellular infiltration of renal interstitium and interstitial fibrosis were ameliorated significantly Immunohistochemistry and measurement of HO-1 activity revealed that the expression and activity of HO-1 was decreased in renal tissues and increased in serum in CRI group as compared with normal rats HO-1 distributed mainly in tubular epithelial cells The EPO contents in Hemin group were significantly higher than in CRI group Through up-regulating the EPO level in serum and renal tissues, HO-1 retards the progression of CRI 展开更多
关键词 heme oxygenase-1 chronic renal insufficiency HEMIN ERYTHROPOIETIN
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Update on adrenal insufficiency in patients with liver cirrhosis 被引量:11
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作者 Anca Trifan Stefan Chiriac Carol Stanciu 《World Journal of Gastroenterology》 SCIE CAS 2013年第4期445-456,共12页
Liver cirrhosis is a major cause of mortality worldwide,often with severe sepsis as the terminal event.Over the last two decades,several studies have reported that in septic patients the adrenal glands respond inappro... Liver cirrhosis is a major cause of mortality worldwide,often with severe sepsis as the terminal event.Over the last two decades,several studies have reported that in septic patients the adrenal glands respond inappropriately to stimulation,and that the treatment with corticosteroids decreases mortality in such patients.Both cirrhosis and septic shock share many hemodynamic abnormalities such as hyperdynamic circulatory failure,decreased peripheral vascular resistance,increased cardiac output,hypo-responsiveness to vasopressors,increased levels of proinflammatory cytokines [interleukine(IL)-1,IL-6,tumor necrosis factor-alpha] and it has,consequently,been reported that adrenal insufficiency(AI) is common in critically ill cirrhotic patients.AI may also be present in patients with stable cirrhosis without sepsis and in those undergoing liver transplantation.The term hepato-adrenal syndrome defines AI in patients with advanced liver disease with sepsis and/or other complications,and it suggests that it could be a feature of liver disease per se,with a dif-ferent pathogenesis from that of septic shock.Relative AI is the term given to inadequate cortisol response to stress.More recently,another term is used,namely "critical illness related corticosteroid insufficiency" to define "an inadequate cellular corticosteroid activity for the severity of the patient's illness".The mechanisms of AI in liver cirrhosis are not completely understood,although decreased levels of high-density lipoprotein cholesterol and high levels of proinflammatory cytokines and circulatory endotoxin have been suggested.The prevalence of AI in cirrhotic patients varies widely according to the stage of the liver disease(compensated or decompensated,with or without sepsis),the diagnostic criteria defining AI and the methodology used.The effects of corticosteroid therapy on cirrhotic patients with septic shock and AI are controversial.This review aims to summarize the existing published information regarding AI in patients with liver cirrhosis. 展开更多
关键词 Liver CIRRHOSIS ADrenal insufficiency SEPTIC shock CORTICOSTEROID therapy
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Evaluation of primary adrenal insufficiency secondary to tuberculous adrenalitis with computed tomography and magnetic resonance imaging:Current status 被引量:9
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作者 Yu-Cheng Huang Yu-Lian Tang +3 位作者 Xiao-Ming Zhang Nan-Lin Zeng Rui Li Tian-Wu Chen 《World Journal of Radiology》 CAS 2015年第10期336-342,共7页
As one kind of infectious diseases of adrenal gland, adrenal tuberculosis can result in a life-threatening disorder which is called primary adrenal insufficiency(PAI) due to the destruction of adrenal cortex. Computed... As one kind of infectious diseases of adrenal gland, adrenal tuberculosis can result in a life-threatening disorder which is called primary adrenal insufficiency(PAI) due to the destruction of adrenal cortex. Computed tomography(CT) and magnetic resonance imaging(MRI) play significant roles in the diagnosis of this etiology of PAI based on the CT and MRI appearances of the adrenal lesions. In this mini-review, we intend to study the CT and MRI features of adrenal tuberculosis, which could be helpful to both endocrinologist and radiologist to establish a definitive diagnosis for adrenal tuberculosis resulting in PAI. 展开更多
关键词 PRIMARY ADrenal insufficiency TUBERCULOSIS ADrenal
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Adrenal insufficiency in patients with decompensated cirrhosis 被引量:3
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作者 Apostolos KA Karagiannis Theodora Nakouti +1 位作者 Chrysoula Pipili Evangelos Cholongitas 《World Journal of Hepatology》 CAS 2015年第8期1112-1124,共13页
Adrenal reserve depletion and overstimulation of the hypothalamus-pituitary-adrenal(HPA) axis are causes for adrenal insufficiency(AI) in critically ill individuals. Cirrhosis is a predisposing condition for AI in cir... Adrenal reserve depletion and overstimulation of the hypothalamus-pituitary-adrenal(HPA) axis are causes for adrenal insufficiency(AI) in critically ill individuals. Cirrhosis is a predisposing condition for AI in cirrhotics aswell. Both stable cirrhotics and liver transplant patients(early and later after transplantation) have been reported to present AI. The mechanisms leading to reduced cortisol production in cirrhotics are the combination of low cholesterol levels(the primary source of cortisol), the increased cytokines production that overstimulate and exhaust HPA axis and the destruction of adrenal glands due to coagulopathy. AI has been recorded in 10%-82% cirrhotics depending on the test used to evaluate adrenal function and in 9%-83% stable cirrhotics. The similarity of those proportions support the assumption that AI is an endogenous characteristic of liver disease. However, the lack of a gold standard method for AI assessment and the limitation of precise thresholds in cirrhotics make difficult the recording of the real prevalence of AI. This review aims to summarize the present data over AI in stable, critically ill cirrhotics and liver transplant recipients. Moreover, it provides information about the current knowledge in the used diagnostic tools and the possible effectiveness of corticosteroids administration in critically ill cirrhotics with AI. 展开更多
关键词 Critically ILL CIRRHOSIS ADrenal insufficiency CORTICOSTEROID
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Low-molecular-weight dextran for optical coherence tomography may not be protective against kidney injury in patients with renal insufficiency 被引量:1
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作者 Toru Misawa Tomoyo Sugiyama +11 位作者 Yoshihisa Kanaji Masahiro Hoshino Masao Yamaguchi Masahiro Hada Tatsuhiro Nagamine Kai Nogami Yumi Yasui Eisuke Usui Tetsumin Lee Taishi Yonetsu Tetsuo Sasano Tsunekazu Kakuta 《World Journal of Nephrology》 2021年第2期8-20,共13页
BACKGROUND Low-molecular-weight dextran(LMWD)is considered a safe alternative to contrast media for blood displacement during optical coherence tomography(OCT)imaging.AIM To investigate whether the use of LMWD for OCT... BACKGROUND Low-molecular-weight dextran(LMWD)is considered a safe alternative to contrast media for blood displacement during optical coherence tomography(OCT)imaging.AIM To investigate whether the use of LMWD for OCT is protective against kidney injury in patients with advanced renal insufficiency.METHODS In this retrospective cohort study,we identified 421 patients with advanced renal insufficiency(estimated glomerular filtration rate<45 mL/min/1.73 m2)who underwent coronary angiography or percutaneous coronary intervention;79 patients who used additional LMWD for OCT imaging(LMWD group)and 342 patients who used contrast medium exclusively(control group).We evaluated the differences between these two groups and performed a propensity score-matched subgroup comparison.RESULTS The median total volume of contrast medium was 133.0 mL in the control group vs 140.0 mL in the LMWD group.Although baseline renal function was not statistically different between these two groups,the LMWD group demonstrated a strong trend toward the progression of renal insufficiency as indicated by the greater change in serum creatinine level during the 1-year follow-up compared with the control group.Patients in the LMWD group experienced worsening renal function more frequently than patients in the control group.Propensity score matching adjusted for total contrast media volume consistently indicated a trend toward worsening renal function in the LMWD group at the 1-year follow-up.Delta serum creatinine at 1-year follow-up was significantly greater in the LMWD group than that in the control group[0.06(-0.06,0.29)vs-0.04(-0.23,0.08)mg/dL,P=0.001],despite using similar contrast volume.CONCLUSION OCT using LMWD may not be protective against worsening renal function in patients with advanced renal insufficiency. 展开更多
关键词 Coronary artery disease Kidney injury Contrast media DEXTRAN Optical coherence tomography renal insufficiency
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Post-cardiac arrest syndrome:Mechanisms and evaluation of adrenal insufficiency 被引量:5
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作者 Athanasios Chalkias Theodoros Xanthos 《World Journal of Critical Care Medicine》 2012年第1期4-9,共6页
Cardiac arrest is one of the leading causes of death and represents maximal stress in humans. After restoration of spontaneous circulation, post-cardiac arrest syndrome is the predominant disorder in survivors. Beside... Cardiac arrest is one of the leading causes of death and represents maximal stress in humans. After restoration of spontaneous circulation, post-cardiac arrest syndrome is the predominant disorder in survivors. Besides the post-arrest brain injury, the post-resuscitation myocardial stunning, and the systemic ischemia/reperfusion response, this syndrome is characterized by adrenal insufficiency, a disorder that often remains undiagnosed. The pathophysiology of adrenal insufficiency has not been elucidated. We performed a comprehensive search of three medical databases in order to describe the major pathophysiological disturbances which are responsible for the occurrence of the disorder. Based on the available evidence, this article will help physicians to better evaluate and understand the hidden yet deadly post-cardiac arrest adrenal insufficiency. 展开更多
关键词 ADrenal insufficiency CARDIAC ARREST Postresuscitation period Post-cardiac ARREST SYNDROME
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Diagnostic values of questionnaires of Convergence Insufficiency Symptom Survey and College of Optometrists Vision Development Quality of Life in the screening of convergence insufficiency
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作者 Ling Xiong Qian Chen Ye Wu 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第5期904-908,共5页
AIM:To compare and analyse the diagnostic efficacy of the College of Optometrists Vision Development Quality of Life Questionnaire(COVD-QOL)and the Convergence Insufficiency Symptom Survey(CISS)in detecting convergenc... AIM:To compare and analyse the diagnostic efficacy of the College of Optometrists Vision Development Quality of Life Questionnaire(COVD-QOL)and the Convergence Insufficiency Symptom Survey(CISS)in detecting convergence insufficiency and to compare their diagnostic value in clinical applications.METHODS:Using the diagnostic test method,62 adult patients with convergence insufficiency(age:24.74±3.75y)and 62 normal participants(age:23.61±3.13y)who visited the Optometry Clinic of West China Hospital of Sichuan University from April 2021 to January 2023 were included.All subjects completed the CISS and COVD-QOL.Statistical analysis of the sensitivity and specificity of the CISS and COVD-QOL and comparison and joint experimental analysis of their diagnostic efficacy were performed.RESULTS:The sensitivity of the CISS and COVD-QOL for convergence insufficiency was 64.5%and 71.0%,respectively,while the specificity was 96.8%and 67.7%,respectively.Compared to the CISS alone,the combination of the CISS and COVD-QOL demonstrated lower sensitivity and specificity.The areas under the receiver operating characteristic curve of CISS,COVD-QOL and CISS combined with COVD-QOL were 0.806,0.694 and 0.782,respectively.CONCLUSION:Considering the low sensitivity of the CISS and the low specificity of the COVD-QOL,it is recommended to supplement these questionnaires with other screening tests for the detection of convergence insufficiency. 展开更多
关键词 convergence insufficiency symptom survey College of Optometrists Vision Development Quality of Life Questionnaire convergence insufficiency ASTHENOPIA
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Double-Blind, Parallel Group Study to Compare the Clinical Effectiveness of Calcium Dobesilate 500 mg BID vs. Calcium Dobesilate LP 1 g OD, in Patients with Chronic Venous Insufficiency of the Lower Limbs
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作者 Ramón Téllez Méndez Maria González Yibirin David Rincón Matute 《International Journal of Clinical Medicine》 CAS 2024年第5期211-223,共13页
Background: Chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities due to venous hypertension (VH. The prevalence is between 5% - 30%. CVI is associated with o... Background: Chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities due to venous hypertension (VH. The prevalence is between 5% - 30%. CVI is associated with older age, smoking, lower extremity trauma, presence of an arteriovenous shunt, and elevated estrogen levels. All patients should be initially treated with conservative management. Venoactive drugs like calcium dobesilate are useful. Objectives: The primary objective compared the clinical improvement in patients with CVI, grades 0 - 3 of the CEAP classification of chronic venous disease, produced by two formulations of calcium dobesilate: calcium dobesilate LP 1 g OD vs calcium dobesilate 500 mg BID, immediate release. The secondary objective assessed the side effects of both formulations. Method: All patients took one tablet and one capsule at 7 am, and one capsule at 7 pm, for 8 weeks. One group received dobesilate 1 g OD and the other group received dobesilate 500 md BID. They were evaluated after 15, 30 and 60 days of treatment, using the symptom evaluation scale. Results: In both groups, there was a significant decrease in the symptom score after 15 days. Four patients in the Dobesilate OD group: had adverse effects, which did not require suspension of treatment. In the BID dobesilate group, there was one therapeutic failure, and one case of gastric discomfort. Conclusions: Prolonged-release Calcium dobesilate 1 g OD is as effective as calcium dobesilate 500 mg BID for the treatment of patients with chronic venous insufficiency. 展开更多
关键词 Chronic Venous insufficiency (CVI) Calcium Dobesilate CEAP Classification Adverse Effects Treatment Adherence
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Chronic venous insufficiency, could it be one of the missing pieces in the puzzle of treating pain?
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作者 Min Cheol Chang 《World Journal of Clinical Cases》 SCIE 2024年第1期232-235,共4页
Pain is a common complaint among patients seeking medical care.If left un-treated,pain can become chronic,significantly affecting patients’quality of life.An accurate diagnosis of the underlying cause of pain is cruc... Pain is a common complaint among patients seeking medical care.If left un-treated,pain can become chronic,significantly affecting patients’quality of life.An accurate diagnosis of the underlying cause of pain is crucial for effective treatment.Chronic venous insufficiency(CVI)is frequently overlooked by pain physicians.Moreover,many pain physicians lack sufficient knowledge about CVI.CVI is a common condition resulting from malfunctioning or damaged valves in lower limb veins.Symptoms of CVI,ranging from mild to severe,include pain,heaviness,fatigue,itching,swelling,skin color changes,and ulcers in the lower limbs.Recently,it has become more widely known that these symptoms can be attributed to CVI.Even slight or mild CVI can cause related symptoms.Pain physicians primarily consider neuromusculoskeletal disorders when assessing patients with leg pain,and often neglect the possibility of CVI.In clinical practice,when pain physicians encounter patients with unresolved leg pain,they must assess whether the patients exhibit symptoms of CVI and conduct tests to differ-entiate CVI from other potential causes. 展开更多
关键词 PAIN Chronic venous insufficiency Diagnosis Treatment VEIN
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Cardiovascular disease and renal insufficiency:special considerations with cardiac surgery 被引量:1
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作者 Colin Lenihan Donal Reddan 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2005年第3期157-163,共7页
Cardiovascular disease is an important cause of mortality in the chronic kidney disease (CKD) population. This review discusses cardiac surgery in the CKD population and considers ostoperative acute renal failure (ARF... Cardiovascular disease is an important cause of mortality in the chronic kidney disease (CKD) population. This review discusses cardiac surgery in the CKD population and considers ostoperative acute renal failure (ARF). CKD patients have worse outcomes following coronary artery bypass grafting (CABG) and cardiac valvular surgery than the general population. However,surgical revascularization is an effective treatment for coronary artery disease (CAD) in this population and may be associated with improved survival over percutaneous intervention (PCI) in advanced CKD. Cardiac surgery in the CKD population requires careful perioperative planning and management. Acute renal failure (ARF) is a serious complication following cardiac surgery, occurring in 1 to 8% of cases. Management of postoperative ARF is largely supportive and emphasis is placed on preoperative risk stratification and prevention. 展开更多
关键词 chronic KIDNEY DISEASE (CKD) CARDIOVASCULAR DISEASE cardiac surgery acute renal failure (ARF)
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Application of mesenchymal stem cell therapy for premature ovarian insufficiency: Recent advances from mechanisms to therapeutics
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作者 Hang-Qi Hu Xi-Yan Xin +4 位作者 Yu-Tian Zhu Rui-Wen Fan Hao-Lin Zhang Yang Ye Dong Li 《World Journal of Stem Cells》 SCIE 2024年第1期1-6,共6页
The incidence of premature ovarian insufficiency(POI)is increasing worldwide,particularly among younger women,posing a significant challenge to fertility.In addition to menopausal symptoms,POI leads to several complic... The incidence of premature ovarian insufficiency(POI)is increasing worldwide,particularly among younger women,posing a significant challenge to fertility.In addition to menopausal symptoms,POI leads to several complications that profoundly affect female reproductive function and overall health.Unfortunately,current clinical treatment strategies for this condition are limited and often yield unsatisfactory outcomes.These approaches typically involve hormone repla-cement therapy combined with psychological support.Recently,mesenchymal stem cell(MSC)therapies for POI have garnered considerable attention in global research.MSCs can restore ovarian reproductive and endocrine functions through diverse mechanisms,including controlling differentiation,promoting angiogenesis,regulating ovarian fibrosis,inhibiting apoptosis,enhancing autocrine and paracrine effects,suppressing inflammation,modulating the immune system,and genetic regulation.This editorial offers a succinct summary of the application of MSC therapy in the context of POI,providing evidence for groundbreaking medical approaches that have potential to enhance reproductive health and overall well-being for women. 展开更多
关键词 Mesenchymal stem cell therapy Mechanism Premature ovarian insufficiency THERAPEUTIC WOMEN
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Maligned non-steroidal anti-inflammatory drugs:Misunderstanding of their safety profile in patients with renal insufficiency 被引量:1
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作者 Bruce M Rothschild 《World Journal of Rheumatology》 2018年第1期1-4,共4页
Non-steroidal anti-inflammatory drugs have a fundamental and pivotal position in management of many of the disorders managed by rheumatologists.Promulgation of a false perspective of their toxicity has compromised our... Non-steroidal anti-inflammatory drugs have a fundamental and pivotal position in management of many of the disorders managed by rheumatologists.Promulgation of a false perspective of their toxicity has compromised our ability to advise our patients and participate in the management of their disorders. The literature sources, from which the false perspective derives, do not accurately reflect safety and fail to address the value of appropriate drug use monitoring.We, as rheumatologists, must stand up and proactively address engrained misconceptions-if we are to be able to continue to provide safe, effective care for our patients. 展开更多
关键词 NON-STEROIDAL ANTI-INFLAMMATORY DRUGS renal function Safety TOXICITY
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Significance of oxidative stress and antioxidant capacity tests as biomarkers of premature ovarian insufficiency: A case control study
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作者 Kaoru Kakinuma Toshiyuki Kakinuma 《World Journal of Clinical Cases》 SCIE 2024年第3期479-487,共9页
BACKGROUND Premature ovarian insufficiency(POI)is a condition that causes secondary amenorrhea owing to ovarian hypofunction at an early stage.Early follicular depletion results in intractable infertility,thereby cons... BACKGROUND Premature ovarian insufficiency(POI)is a condition that causes secondary amenorrhea owing to ovarian hypofunction at an early stage.Early follicular depletion results in intractable infertility,thereby considerably reducing the quality of life of females.Given the continuum in weakened ovarian function,progressing from incipient ovarian failure(IOF)to transitional ovarian failure and further to POI,it is necessary to develop biomarkers for predicting POI.The oxidative stress states in IOF and POI were comprehensively evaluated via oxidative stress[diacron-reactive oxygen metabolites(d-ROMs)]test and anti-oxidant capacity[biological antioxidant potential(BAP)].METHODS Females presenting with secondary amenorrhea over 4 mo and a follicle stimulating hormone level of>40 mIU/mL were categorized into the POI group.Females presenting with a normal menstrual cycle and a follicle stimulating hormone level of>10.2 mIU/mL were categorized into the IOF group.Healthy females without ovarian hypofunction were categorized into the control group.Among females aged<40 years who visited our hospital from January 2021 to June 2022,we recruited 11 patients into both POI and IOF groups.For the potential antioxidant capacity,the relative oxidative stress index(BAP/d-ROMs×100)was calculated,and the oxidative stress defense system was comprehensively evaluated.RESULTS d-ROMs were significantly higher in the POI and IOF groups than in the control group,(478.2±58.7 U.CARR,434.5±60.6 U.CARR,and 341.1±35.1 U.CARR,respectively)(U.CARR is equivalent to 0.08 mg/dL of hydrogen peroxide).However,no significant difference was found between the POI and IOF groups.Regarding BAP,no significant difference was found between the control,IOF,and POI groups(2078.5±157.4μmol/L,2116.2±240.2μmol/L,and 2029.0±186.4μmol/L,respectively).The oxidative stress index was significantly higher in the POI and IOF groups than in the control group(23.7±3.3,20.7±3.6,and 16.5±2.1,respectively).However,no significant difference was found between the POI and IOF groups.CONCLUSION High levels of oxidative stress suggest that evaluating the oxidative stress state may be a useful indicator for the early detection of POI. 展开更多
关键词 Premature ovarian insufficiency Oxidative stress Diacron-reactive oxygen metabolites test Biological antioxidant potential INFERTILITY BIOMARKER
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Surgical and non-surgical risk factors affecting the insufficiency of ileocolic anastomosis after first-time surgery in Crohn’s disease patients
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作者 Jaroslaw Cwaliński Filip Lorek +5 位作者 Łukasz Mazurkiewicz MichałMazurkiewicz Wojciech Lizurej Jacek Paszkowski Hanna Cholerzyńska Wiktoria Zasada 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第10期3253-3260,共8页
BACKGROUND Crohn's disease(CD)often necessitates surgical intervention,particularly when it manifests in the terminal ileum and ileocecal valve.Despite undergoing radical surgery,a subset of patients experiences r... BACKGROUND Crohn's disease(CD)often necessitates surgical intervention,particularly when it manifests in the terminal ileum and ileocecal valve.Despite undergoing radical surgery,a subset of patients experiences recurrent inflammation at the anasto-motic site,necessitating further medical attention.AIM To investigate the risk factors associated with anastomotic insufficiency following ileocecal resection in CD patients.METHODS This study enrolled 77 patients who underwent open ileocolic resection with pri-mary stapled anastomosis.Patients were stratified into two groups:Group I co-mprised individuals without anastomotic insufficiency,while Group II included patients exhibiting advanced anastomotic destruction observed endoscopically or those requiring additional surgery during the follow-up period.Surgical and non-surgical factors potentially influencing anastomotic failure were evaluated in both cohorts.RESULTS Anastomotic insufficiency was detected in 12 patients(15.6%),with a mean time interval of 30 months between the initial surgery and recurrence.The predomi-nant reasons for re-intervention included stenosis and excessive perianastomotic lesions.Factors associated with a heightened risk of anastomotic failure encompassed prolonged postoperative obstruction,anastomotic bleeding,and clinically confirmed micro-leakage.Additionally,patients in Group II exhibited preoperative malnutrition and early recurrence of symptoms related to CD.CONCLUSION Successful surgical outcomes hinge on the attainment of a fully functional anastomosis,optimal metabolic status,and clinical remission of the underlying disease.Vigilant endoscopic surveillance following primary resection facilitates the timely identification of anastomotic failure,thereby enabling noninvasive interventions. 展开更多
关键词 Crohn’s disease Ileocolic resection Anastomotic insufficiency Endoscopic surveillance SURGERY Risk factors
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Atherosclerosis in elderly patients with renal insufficiency
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作者 Sandeep S.Soman 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2005年第3期143-156,共14页
IntroductionAs people age,cardiovascular structure and function change and this is superimposed on by specific pathophysiologic disease mechanism.In addition to lipid levels,diabetes,sedentary lifestyle,and genetic fa... IntroductionAs people age,cardiovascular structure and function change and this is superimposed on by specific pathophysiologic disease mechanism.In addition to lipid levels,diabetes,sedentary lifestyle,and genetic factors that are known risks for coronary disease,hypertension,and stroke - the quintessential cardiovascular (CV) diseases related to atherosclerosis within our society - advancing age unequivocally confers the major risk.(Fig.1) Mortality due to cardiovascular disease is more than any other disease and creates enormous costs for the health care system.The main underlying problem in cardiovascular disease is atherosclerosis,a process that obstructs major arteries with lipid deposits and cell accumulation.1 Decreased kidney function (estimated GFR<70 mL/min/1.73 m2) is an independent risk factor for cardiovascular disease and all-cause mortality in the general population. 展开更多
关键词 Atherosclerosis in elderly patients with renal insufficiency CKD HDL LDL ESRD
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Unroofed coronary sinus,left-sided superior vena cava and mitral insufficiency:A case report and review of the literature
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作者 Fouad Bitar Ziad Bulbul +4 位作者 Yehya Jassar Rana Zareef Jennifer Abboud Mariam Arabi Fadi Fouad Bitar 《World Journal of Cardiology》 2024年第10期595-603,共9页
BACKGROUND Unroofed coronary sinus(UCS)is a rare subtype of atrial septal defect.It is frequently associated with a persistent left superior vena cava and is often part of a more intricate cardiac malformation.CASE SU... BACKGROUND Unroofed coronary sinus(UCS)is a rare subtype of atrial septal defect.It is frequently associated with a persistent left superior vena cava and is often part of a more intricate cardiac malformation.CASE SUMMARY This report describes a rare case of an adolescent patient with UCS featuring atrial situs solitus,absence of the right superior vena cava and a persistent left superior vena cava draining into the left atrium consistent with total unroofing of the coronary sinus.This was associated with concurrent severe mitral insufficiency secondary to redundant and prolapsing leaflets,and a substantial left-to-right shunt across the coronary sinus orifice.A comprehensive examination of the existing literature is included,shedding light on the diagnostic challenges of UCS and describing the available surgical options within the context of mitral valve surgery.CONCLUSION UCS is a complex condition requiring careful consideration of associated anomalies and a tailored surgical approach. 展开更多
关键词 Unroofed coronary sinus Mitral insufficiency Single left superior vena cava Surgical options Absent right superior vena cava Case report
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Heparin-induced thrombocytopenia in renal insufficiency undergoing dialysis and percutaneous coronary intervention after acute myocardial infarction:A case report
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作者 Jing Wang Song-Bai Deng Qiang She 《World Journal of Cardiology》 2020年第12期634-641,共8页
BACKGROUND Heparin-induced thrombocytopenia(HIT)is a rare complication of heparin therapy,and is characterized by arteriovenous thrombosis and bleeding events.The incidence of HIT after percutaneous coronary intervent... BACKGROUND Heparin-induced thrombocytopenia(HIT)is a rare complication of heparin therapy,and is characterized by arteriovenous thrombosis and bleeding events.The incidence of HIT after percutaneous coronary intervention(PCI)in patients with myocardial infarction complicated with renal failure is rarely reported.CASE SUMMARY We report a 73-year-old man with acute myocardial infarction and renal failure who underwent hemodialysis and PCI,and developed a progressive decline in platelets and subcutaneous hemorrhage of both upper limbs after heparin treatment.In addition to a gradual decrease in platelets,the patient’s 4T's score was 7,and HIT antibody was positive,confirming the diagnosis of HIT.CONCLUSION Patients receiving heparin combined with antiplatelet therapy should be monitored closely,especially for their platelet count.In the case of thrombocytopenia,HIT should be highly suspected.When the diagnosis of HIT is confirmed,timely individualized treatment should be delivered. 展开更多
关键词 THROMBOCYTOPENIA HEPARIN Percutaneous coronary intervention Myocardial infarction Chronic renal insufficiency Case report
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Protective Effects of Mongolian Medicine Borantunggal on Rats with Chronic Renal Insufficiency
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作者 Baoyincang Bailongtang +2 位作者 Baotuya Wuyunsiqin Monghjirgal 《Medicinal Plant》 CAS 2023年第1期41-47,共7页
[Objectives]To observe the protective effects of Mongolian medicine Borantunggal on rats with chronic renal insufficiency.[Methods]Male Wister rats were gavaged with 50 mg/kg/d adenine for 12 consecutive weeks,and wer... [Objectives]To observe the protective effects of Mongolian medicine Borantunggal on rats with chronic renal insufficiency.[Methods]Male Wister rats were gavaged with 50 mg/kg/d adenine for 12 consecutive weeks,and were intervened with positive control drug Niaoduqing and three groups of different doses of Mongolian medicine Borantunggal.The rats general state,such as body posture,hair color,activity status,renal function,thyroid gland,adrenal gland,and gonadal hormone levels,expression levels of inflammatory mediators,α-smooth muscle actin(α-SMA)and nuclear factor-κB(P65)in renal tissue,and histopathological changes of rat kidney were observed before and after treatment.[Results]The recovery of the general state of rats with chronic renal insufficiency in the low dose group after intervention with Mongolian medicine Borantunggal was the most obvious.Compared with the model group,the level of CRE in the low dose Mongolian medicine group decreased,and the difference was statistically significant(P<0.05).Compared with the normal group,the 24-h urinary protein in the low dose Mongolian medicine group had a declining trend,but the difference was not statistically significant(P>0.05).The urea level in low,medium and high dose Mongolian medicine groups showed a declining trend,and the effect of low dose Mongolian medicine was better.Compared with the model group,the feed intake of the low dose Mongolian medicine group had an increasing trend,while P and TCHO also had a declining trend.Compared with the model group,the levels of LH and COR in the low,medium and high dose Mongolian medicine groups decreased significantly,and the difference was statistically significant(P<0.05).The levels of T,T3 and T4 were significantly increased,the difference was statistically significant(P<0.05),and the effect of low dose Mongolian medicine was better.Compared with the model group,the levels of IL-6,TNF-αand HIF-1 in the low,medium and high dose Mongolian medicine groups were significantly reduced,and the difference was statistically significant(P<0.05).The levels of TGF-β1 and Ang II in the low dose Mongolian medicine group were significantly reduced,and the difference was statistically significant(P<0.05).The level of TGF-β1 in the medium and high dose Mongolian medicine groups decreased,and the difference was statistically significant(P<0.05).The expression of NF-κB P65 andα-SMA proteins in the low dose Mongolian medicine group showed a declining trend,which was better than Niaoduqing.[Conclusions]Mongolian medicine Borantunggal has significant protective and preventive effects on rats with adenine-induced chronic renal insufficiency.In particular,the dose of 0.31 kg/d had the most significant protective effect.Its action mechanism may be related to regulating hormone levels in the body,improving renal function,reducing renal inflammatory response,reducing the"three highs"in the kidney,and inhibiting renal tubular epithelial cell-to-mesenchymal transition and deposition of extracellular matrix(ECM). 展开更多
关键词 Chronic renal insufficiency Mongolian medicine Borantunggal ADENINE renal protection Endocrine disorder
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