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Exercise training-induced changes in exerkine concentrations may be relevant to the metabolic control of type 2 diabetes mellitus patients:A systematic review and meta-analysis of randomized controlled trials

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Journal of Sport and Health Science 2023年第2期12卷 147-157页

作者： Antonio García-Hermoso Robinson Ramírez-Vélez Javier Díez Arantxa González Mikel Izquierdo Navarrabiomed Public University of Navarra(UPNA)Health Research Institute of Navarra(IdiSNA)University Hospital of NavarraPamplona 310008Spain CIBER of Frailty and Healthy Aging(CIBERFES) Carlos Ⅲ Institute of HealthMadrid 28029Spain Institute for Health Research of Navarra(IDISNA) Pamplona 31008Spain Program of Cardiovascular Diseases Center for Applied Medical ResearchUniversity of NavarraPamplona 31008Spain centre for Biomedical Research in Cardiovascular Disease Network Carlos Ⅲ Institute of HealthMadrid 28029Spain Departments of nephrology and Cardiology University of Navarra ClinicPamplona 31008Spain

Background:This study investigates the effects of exercise training on exerkines in patients with type 2 diabetes mellitus to determine the optimal exercise ***:A systematic search for relevant studies was performed in 3 *** controlled trials investigating the effects of exercise training on at least one of the following exerkines were included:adiponectin,apelin,brain-derived neurotrophic factor,fetuin-A,fibroblast growth factor-21,follistatin,ghrelin,interleukin(IL)-6,IL-8,IL-10,IL-15,IL-18,leptin,myostatin,omentin,resistin,retinol-binding protein 4,tumor necrosis factor-α,and ***:Forty randomized controlled trials were selected for data extraction(n=2160).Exercise training induces changes in adiponectin,fetuin-A,fibroblast growth factor-21,IL-6,IL-10,leptin,resistin,and tumor necrosis factor-a levels but has no significant effects on apelin,IL-18,and ghrelin compared to *** exercise training favored large and positive changes in pooled exerkines(i.e.,an overall effect size calculated from several exerkine s)(Hedge’s g=1.02,95%confidence interval(95%CI):0.76-1.28),which in turn were related to changes in glycated hemoglobin(mean difference(MD)=-0.81%,95%CI:-0.95%to-0.67%),fasting glucose(MD=-23.43 mg/dL,95%CI:-30.07 mg/dL to-16.80 mg/dL),waist circumference(MD=-3.04 cm,95%CI:-4.02 cm to-2.07 cm),and body mass(MD=-1.93 kg,95%CI:-2.00 kg to-1.86 kg).Slightly stronger effects were observed with aerobic,resistance,or high-intensity interval protocols at moderate-to vigorous-intensity and with programs longer than 24 weeks that comprise at least 3 sessions per week and more than 60 min per ***:Exercise training represents an anti-inflammatory therapy and metabolism-improving strategy with minimal side effects for patients with type 2 diabetes mellitus.

关键词： Adipokines Exercise training Hepatokines Myokines

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Diuretic combinations in critically ill patients with respiratory failure:A systematic review and meta-analysis

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World Journal of Critical Care Medicine 2022年第3期11卷 178-191页

作者： Jean Maxime Côté Nadir Goulamhoussen Blaithin A McMahon Patrick T Murray Division of nephrology Department of MedicineCentre Hospitalier de l'Universitéde MontréalMontréal H2X0C1QuébecCanada Division of nephrology Department of MedicineMedical University of South CarolinaCharlestonSC 29425United States Department of Medicine School of MedicineUniversity College DublinDublin D078NNIreland

BACKGROUND In patients with respiratory failure,loop diuretics remain the cornerstone of the treatment to maintain fluid balance,but resistance is *** To determine the efficacy and safety of common diuretic combinations in critically ill patients with respiratory *** We searched MEDLINE,Embase,Cochrane Library and PROSPERO for studies reporting the effects of a combination of a loop diuretic with another class of diuretic.A meta-analysis using mean differences(MD)with 95%confidence interval(CI)was performed for the 24-h fluid balance(primary outcome)and the 24-h urine output,while descriptive statistics were used for safety *** Nine studies totalling 440 patients from a total of 6510 citations were *** compared to loop diuretics alone,the addition of a second diuretic is associated with an improved negative fluid balance at 24 h[MD:-1.06 L(95%CI:-1.46;-0.65)],driven by the combination of a thiazide plus furosemide[MD:-1.25 L(95%CI:-1.68;-0.82)],while no difference was observed with the combination of a loop-diuretic plus acetazolamide[MD:-0.40 L(95%CI:-0.96;0.16)]or spironolactone[MD:-0.65 L(95%CI:-1.66;0.36)].Heterogeneity was high and the report of clinical and safety endpoints varied across *** Based on limited evidence,the addition of a second diuretic to a loop diuretic may promote diuresis and negative fluid balance in patients with respiratory failure,but only when using a *** larger trials to evaluate the safety and efficacy of such interventions in patients with respiratory failure are required.

关键词： Respiratory failure Diuretics Fluid management Furosemide Thiazide Systematic review

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Robot-assisted kidney transplantation:Is it getting ready for prime time?

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World Journal of Transplantation 2022年第7期12卷 163-174页

作者： Vincenzo Li Marzi Alessio Pecoraro Maria Lucia Gallo Leonardo Caroti Adriano Peris Graziano Vignolini Sergio Serni Riccardo Campi Department of Minimally Invasive and Robotic Urologic Surgery Careggi University HospitalUniversity of FlorenceFlorence 50134Italy nephrology Unit Careggi HospitalFlorence 50134Italy Intensive Care Unit and Regional ECMO Referral centre Careggi HospitalFlorence 50134Italy Department of Minimally Invasive and Robotic Urologic Surgery University of FlorenceFlorence 50134Italy Department of Experimental and Clinical Medicine University of FlorenceFlorence 50134Italy

Kidney transplantation(KT)is the treatment of choice for patients with end-stage renal disease,providing a better survival rate and quality of life compared to *** the progress in the medical management of KT patients,from a purely surgical standpoint,KT has resisted innovations during the last 50 ***,robot-assisted KT(RAKT)has been proposed as an alternative approach to open surgery,especially due to its potential benefits for fragile and immunocompromised *** was not until 2014 that the role of RAKT has found value thanks to the pioneering Vattikuti Urology Institute-Medanta collaboration that conceptualized and developed a new surgical technique for RAKT following the Idea,Development,Exploration,Assessment,Long-term follow-up recommendations for introducing surgical innovations into real-life *** the last years,mirroring the Vattikuti-Medanta technique,several centers developed RAKT program worldwide,providing strong evidence about the safety and the feasibility of this ***,the majority of RAKT are still performed in the living donor setting,as an“eligible”procedure,while only a few centers have realized KT through a robotic approach in the challenging scenario of cadaver *** addition,despite the spread of minimally-invasive(predominantly robotic)surgery worldwide,many KTs are still performed in an open *** of the type of incision employed by surgeons,open KT may lead to nonnegligible risks of wound complications,especially among obese ***,the assessment for KT should consider not only the added surgical technical challenges but also the higher risk of postoperative *** this context,robotic surgery could offer several benefits,including providing a better exposure of the surgical field and better instrument maneuverability,as well as the possibility to integrate other technological nuances,such as the use of intraoperative fluorescence vascular imagi

关键词： Deceased donors Living donors Kidney transplantation Minimally invasive surgery Robotics

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The molecular pathogenic role of inflammatory stress in dysregulation of lipid homeostasis and hepatic steatosis

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Genes & Diseases 2014年第1期1卷 106-112页

作者： Yaxi Chen Zac Varghese Xiong Z.Ruan centre for Lipid Research Key Laboratory of Molecular Biology on Infectious DiseasesMinistry of EducationChongqing Medical UniversityChongqingChina John Moorhead Research Laboratory Centre for NephrologyUniversity College London Medical SchoolRoyal Free CampusLondonUK

Non-alcoholic Fatty Liver Disease(NAFLD)is becoming the leading cause of chronic liver injury in developed countries and *** systemic inflammation plays a decisive role and is fundamental in the progression of NAFLD from simple steatosis(SS)toward higher risk nonalcoholic steatohepatitis(NASH)***,the exact mechanisms by which inflammation leading to NASH are incompletely *** this review,we focus the role of the cross talk between inflammation and lipid homeostasis on the progression of NAFLD.

关键词： Ectopic lipid deposition Inflammation Lipid homeostasis Lipid redistribution Non-alcoholic fatty liver disease

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Recurrence of primary hyperoxaluria after kidney transplantation： the report of two cases

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Chinese Medical Journal 2009年第22期122卷 2794-2797页

作者： SHANG Ming-hua JUN Hua FAN Yu ZHANG Zheng WANG Ling GU Li-jie HE Zhi-yan YUAN Wei-jie Department of nephrology First People's Hospital Shanghai Jiao Tong University Shanghai 200080 China Shanghai Organs Transplantation centre Department of Radiology (He ZY) First People's Hospital Shanghai Jiao Tong University Shanghai 200080 China

Primary hyperoxaluria （PH） is a rare autosoma recessive disorder of glyoxylate metabolism in which specific hepatic enzyme deficiencies result in overproduction of oxalate. Because oxalate is excreted exclusively by the kidney, hyperoxaluria leads to calcium oxalate nephrolithiasis, nephrocalcinosis, and renal failure. PH are considered rare with a prevalence of 0.1-0.2 per 106 population.2 PH was misdiagnosed in some cases initially and unfortunately a case may not be detected until the post-transplant period by allograft biopsy.

关键词： primary hyperoxaluri kidney transplantation renal osteodystrophy

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ANCA-Associated Vasculitides—An Update

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Health 2014年第14期6卷 1767-1779页

作者： Johanna Kegel Torsten Kirsch Department of nephrology and Hypertension Centre for Internal Medicine Hannover Medical School Hannover Germany

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides are characterized by destruction of small vessels, granulomatous inflammation of the respiratory tract and necrotizing glomerulonephritis. This review describes the clinical diagnosis and therapy as well as the patho-physiology of ANCA-associated vasculitides with a specific focus on the interplay of ANCAs with activated neutrophils and the deleterious pathophysiological consequences of neutrophil-endothelium interaction.

关键词： Vasculitis Anti-Neutrophil Cytoplasmic Antibodies Neutrophils

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Some Oxidative Stress Biomarkers among Patients with Prostate Cancer in Sokoto, North Western Nigeria

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Open Journal of Blood Diseases 2022年第3期12卷 60-78页

作者： Osaro Erhabor Asmau Muhammad Hussaini Abdullahi Abdulwahab-Ahmed Michael Retsky Tosan Erhabor Department of Haematology School of Medical Laboratory Science Usmanu Danfodiyo University Sokoto Nigeria TETFUND centre of Excellence Institute of Urology and Nephrology UDU/UDUTH Sokoto Nigeria University College London London UK Medical Laboratory Science Council of Nigeria Abuja Nigeria

Globally, prostate cancer (PCa) is the most common malignancy and the second leading cause of cancer-related death in men. It is a significant contributor to the burden of diseases and affects over a million men. This study investigated the levels of malondialdehyde and plasma total antioxidant capacity among patients with prostate cancer in Sokoto. This case-control study was conducted among 28 confirmed prostate cancer patients attending the Urology clinics in Usmanu Danfodiyo University Teaching Hospital and Sokoto Specialist Hospital in North Western Nigeria. Twenty-eight age-matched healthy males were monitored as controls. Determination of Total Antioxidant Capacity (TAC) was determined using Ferric Reducing Antioxidant Power (FRAP) reagent while the Malondialdehyde in serum was determined as a conjugate with Thiobarbituric acid (TBA) acid. Data were collected using a semi-structured interviewer-administered questionnaire. Data were processed using SPSS version 20 and results were reported as Mean ± Standard deviation. The malondialdehyde level was significantly increased (p < 0.0001) among subjects with prostate cancer (0.215 ± 0.06) compared to controls (0.073 ± 0.04). The plasma total antioxidant capacity decreased significantly among the subjects (247.9 ± 63.3) compared to controls (743.3 ± 104.40) (p < 0.0001). The findings from this indicated a high Malondialdehyde (lipid peroxidation indicator) and low levels of Total Antioxidant Capacity among prostate cancer patients as evidence of redox imbalance. Subjects in monogamous relationships compared to polygamous, rural dwellers, farmers, individuals of Hausa ethnicity and subjects who reported no family history of the disease were more predisposed to prostate cancer. Further epidemiological studies are needed to determine the predisposing factors and the potential role of these markers in the diagnosis, prognosis and management of prostate cancer patients in Sokoto in particular and Nigeria in general. We

关键词： Some Oxidative Stress Biomarkers Prostate Cancer Sokoto North Western Nigeria

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BMI and Risk Factors of Underweight and Obesity in HIV Subjects in Eastern Nigeria

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World Journal of AIDS 2016年第1期6卷 8-15页

作者： Ernest Ndukaife Anyabolu Division of nephrology Department of Medicine Imo State University Teaching Hospital Orlu Nigeria Division of nephrology Department of Medicine Federal Medical Centre Owerri Nigeria

Background and Objectives: Human immunodeficiency virus infection (HIV) is a global healthcare problem. Progression of HIV infection is commonly associated with decreasing weight. In the early phases of HIV infection, factors associated with weight changes are not completely known. This study evaluated the body mass index (BMI) and its potential risk factors in drug-naive HIV subjects in Owerri, Eastern Nigeria. Methodology: This was a cross-sectional study of HIV subjects. BMI was determined. Relevant investigations were performed. Potential risk factors of BMI were analyzed at different BMI categories. Association of variables with BMI and the strength of variables to predict BMI, underweight and obesity were determined. Results: The mean BMI of the HIV subjects was 26.2 ± 5.4 kg/m2. Underweight was present in 24 (6.1%), overweight in 150 (38.4%) and obesity in 84 (21.5%) of the HIV subjects. High spot urine creatinine (SUCr), high 24-hour urine osmolality (24HUOsm), high serum cholesterol and high hemoglobin predicted BMI in HIV subjects. Low 24HUOsm predicted under weight, whereas low 24-hour urine protein (24 HUP) and high 24HUOsm predicted obesity in HIV subjects. Conclusion: The prevalence of underweight was low (6.1%), overweight high (38.4%) and obesity high (21.5%) in HIV subjects. High SUCr, high 24HUOsm, high serum cholesterol and high hemoglobin were predictors of BMI in HIV subjects. Low 24HUOsm was a predictor of underweight, while low 24HUP and high 24HUOsm were predictors of obesity in HIV subjects. Abnormalities of serum lipids, renal function, and anemia were common in HIV subjects who were underweight and in those obese. Underweight HIV subjects should be evaluated at the early stages for dyslipidemia, renal damage and anemia.

关键词： HIV BMI Underweight and Obesity Prevalence Predictors Nigeria

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Unusual circadian hypertension associated with polydipsia

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Journal of Geriatric Cardiology 2016年第11期13卷 932-934页

作者： Jurgen M Bohlender Jurg Nussberger Department of nephrology Hypertension and Clinical Pharmacology Inselspital Bern University Hospital Freiburgstr. 4 Bern Switzerland Department of Medicine Division of Angiology and Hypertension Centre Hospitalier Universitaire Vaudois (CHUV) Rue du Bugnon 46 Lausanne Switzerland

Healthy people are usually capable of handling a large variability of water and sodium intake efficiently by adjusting urinary volume up to 50-fold and osmolality up to 35-fold without notable changes of blood pressure (BP). This is accomplished by the rapid and variable secretion of antidiuretic hormone controlling renal free water clearance and a variable renal sodium excretion under the powerful control of the renin-angiotensin-aldosterone system. Both mechanisms and others, e.g., neuronal, maintain a normal salt and water homeostasis and help protect the brain and other organs against deleterious volume changes. Therefore, drinking large amounts of fluids normally does not lead to significant BP rises and polydipsia is not a usual cause of acute or chronic hypertension to be considered in the routine workup of hypertensive patients.

关键词：高血压昼夜渗透压尿量

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Variability of Serum Concentration of Calcium, Phosphate and Parathyroid Hormone Depending on Time of Blood Draw for Patients on Nocturnal Home Hemodialysis

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Open Journal of nephrology 2012年第4期2卷 65-71页

作者： Nasim Shahbazi Pierre A. Brown Ayub Akbari Deborah L. Zimmerman Department of Medicine Division of Nephrology Ottawa Hospital Ottawa Canada Department of Medicine Division of Nephrology Ottawa Hospital Ottawa Canada Kidney Research centre of the Ottawa Hospital Research Institute Ottawa Canada Department of Medicine Division of Nephrology Thunder Bay Regional Health Sciences Centre Thunder Bay Canada

Background: Guidelines for patients treated with conventional hemodialysis patients have been written for target serum levels for calcium (Ca), phosphate (PO4) and intact parathyroid hormone (iPTH). No guidelines exist for nocturnal home hemodialysis (NHHD) patients for target values or timing of the blood sample draw. We undertook a prospective cohort study to examine the variability in pre, post and clinic (post-post) serum values for Ca, PO4, and iPTH in NHHD patients to determine if timing of blood draw could affect clinical decisions. Methods: Twenty prevalent NHHD patients collected blood pre and post their usual NHHD session with an additional blood sample drawn in clinic (post-post). Median and interquartile range of pre, post and clinic (post-post) values of iPTH, PO4 and Ca were calculated and compared with Freidman/Wilcoxon test. Serum concentrations were also categorized according to Canadian Society of nephrology (CSN) guidelines target values for pre and clinic (post-post) samples. The proportion of patients that would be categorized differently by clinic (post-post) samples was determined. Results: There was a significant difference between pre-serum values compared to post and clinic (post-post) values. Overall, iPTH, PO4 and Ca values would be misclassified in 25%, 70% and 50% respectively if blood was drawn at the clinic visit (post-post) compared to pre-HD as per CSN guidelines. Conclusions: Although no specific guideline has been written for NHHD patients, to ensure consistency of management compared to in-centre HD patients, lab values should be drawn pre-HD until clinical evidence suggests that the recommendations should be different for NHHD.

关键词： Nocturnal Hemodialysis Calcium Phosphate Parathyroid Hormone

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