Chinese J Physiol
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Tuberculous peritonitis is a devastating complication of peritoneal dialysis (PD). Presentations of tuberculous peritonitis range from the common wet ascitic form to the rare fibroadhesive form, which is clinically indistinguishable from encapsulating peritoneal sclerosis. We describe a 76-year-old man on continuous ambulatory PD for three months developing wet ascitic form of tuberculous peritonitis. ⋯ A rare fibroadhesive form of tuberculous peritonitis associated with the paradoxical response to antituberculous therapy was considered by excluding noncompliance, drug resistance and adverse effects, and other concomitant infections. After surgical enterolysis and continuation of antituberculous treatment, he recovered uneventfully. Our case might be the first report regarding paradoxical deterioration to antituberculous treatment in dialysis patients.
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Randomized Controlled Trial
"Inflammatory response to colloids compared to crystalloid priming in cardiac surgery patients with cardiopulmonary bypass".
"Cardiac surgery with cardiopulmonary bypass (CPB) induces a systemic inflammatory response syndrome that may contribute to postoperative morbidity and mortality. We investigated the in-flammatory responses to colloids compared to crystalloid priming in cardiac surgery patients with cardiopulmonary bypass. Thirty patients undergoing coronary artery bypass grafting (CABG) preparing for CPB were randomized into Ringer's solution (RS), 10% hydroxyethyl starch (HES) or 25% human albumin (HA) group. Serum concentrations of tumor necrosis factor-α (TNF-α), interleukin-1 β (IL-1β ), interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured before CPB, at the end of CPB and 1, 6 and 12 h after CPB. Serum C-reactive protein (CRP) was determined pre-operatively and then daily for 2 days. Body-weight gain was significantly decreased on the day after surgery in the HES group than in the RS group. Volume priming in CPB for CABG patients using HA or HES preparation had less tendency for intense inflammatory response with lower levels of TNF-α, IL-1 β , IL-6 and higher levels of IL-10 compared to patients treated with RS. HES prime had lower levels of circulating CRP than in patients treated with HA or Ringer prime on the second post-operative day. Our data indicate that volume priming using colloid during CPB in CABG patients might exert beneficial effects on inflammatory responses."
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Comparative Study
A comparison of anthropometric and training characteristics among recreational male Ironman triathletes and ultra-endurance cyclists.
"The physique of Ironman triathletes was considered to be similar to that of cyclists. We intended to investigate differences and similarities in anthropometry and training between 83 Ironman triathletes competing in a qualifier for 'Ironman Hawaii' and 84 ultra-endurance cyclists competing in a qualifier for the 'Race across America'. The anthropometric and training characteristics were compared between these two groups of athletes; associations of anthropometric and training characteristics with race time were investigated using bi- and multi-variate analysis. ⋯ The abdominal (P = 0.003) and the iliacal (P = 0.02) skin-fold thicknesses, percent body fat (P = 0.001) and cycling speed during training (P = 0.01) were related to cycling split time in the Ironman race. For the ultra-cyclists, percent body fat (P = 0.04) was related to race time. We concluded that anthropometry and training of Ironman triathletes were different when compared to ultra-endurance cyclists."
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Case Reports
Profound urinary protein loss and acute renal failure caused by cyclooxygenase-2 inhibitor.
Cumulative evidence has shown that nonsteroidal anti-inflammatory drugs (NSAIDs) can induce acute renal failure and nephrotic-range proteinuria. Cyclooxygenase-2 (COX-2) inhibitors have less nephrotoxicity; however, recent data indicate that they may cause the same renal problems as NSAIDs do. ⋯ Renal function and nephrotic syndrome in this patient resolved completely after discontinuation of celecoxib and treatment with methylprednisolone. Clinicians should keep high index of suspicions in patients developing nephrotic syndrome and acute renal failure after taking COX-2 inhibitors since secondary MCD responds well to timely cessation of COX-2 inhibitors and administration of steroid therapy.
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Although astringinin administration under adverse circulatory conditions is known to be protective, the mechanism by which astringinin produces the salutary effects remains unknown. We hypothesize that astringinin administration in males following trauma-hemorrhage decreases cytokine production and protects against hepatic injury. Male Sprague-Dawley rats underwent trauma-hemorrhage (mean blood pressure: 40 mmHg for 90 min, then resuscitation). ⋯ In astringinin-treated (0.3 mg/kg) rats subjected to trauma-hemorrhage, there were significant improvements in liver myeloperoxidase (MPO) activity (237.80 +/- 45.89 vs. 495.95 +/- 70.64 U/mg protein, P < 0.05), interleukin-6 (IL-6) levels (218.54 +/- 34.52 vs. 478.60 +/- 76.21 pg/mg protein, P < 0.05), cytokine-induced neutrophil chemoattractant (CINC)-1 (88.32 +/- 20.33 vs. 200.70 +/- 32.68 pg/mg protein, P < 0.05), CINC-3 (110.83 +/- 26.63 vs. 290.14 +/- 76.82 pg/mg protein, P < 0.05) and intercellular adhesion molecule (ICAM)-1 concentrations (1,868.5 +/- 211.5 vs. 3,645.0 +/- 709.2 pg/mg protein, P < 0.05), as well as in histology. Results show that astringinin significantly attenuates proinflammatory responses and hepatic injury after trauma-hemorrhage. In conclusion, the salutary effects of astringinin administration on attenuation of hepatic injury following trauma-hemorrhage are likely due to reduction of pro-inflammatory mediator levels.