Creatinine Phosphokinase Research Articles

Analysis and Prediction of Risk Factors for Heart Failure

Abstract. Heart failure is a grave and progressive illness. It is associated with multiple risk factors such as age and other possible factors. Accurately identifying and quantifying these risk factors is critical to developing personalized prevention and treatment strategies. However, it is difficult for common patients to predict heart failure without the professional diagnosis of doctors, and relying on human resources to predict heart failure is more subjective. This study proposes a method to evaluate and predict the factors related to heart failure based on multiple body indicators by using random forest algorithm. The random forest prediction model was applied to assess the correlation between multiple medical indicators such as creatinine phosphokinase (CPK), serum creatinine (SCR), ejection fraction (EF), age and heart failure. CPK was found to be the most associated with heart failure. In addition, increasing follow-up period can also effectively monitor heart failure progression in patients. In this high dimension prediction problem, the prediction effect of random forest is better, and the overall accuracy is higher. The approach used in this research is important for forecasting the risk of heart failure, enhancing the survival rates of patients, and alleviating the burden on healthcare systems.

Understanding the Role of Type I Interferons in Cutaneous Lupus and Dermatomyositis: Toward Better Therapeutics.

A 29-year-old female presented to a rheumatology-dermatology clinic with a pruritic rash that began 6 months prior, after a viral illness. She had previously been diagnosed with eczema and treated with antihistamines and topical steroids without improvement. She also noted fatigue, hair loss, and severe scalp pruritus. Physical examination was notable for violaceous periorbital edema, scaly erythematous papules on the metacarpophalangeal joints of bilateral hands, dilated capillaries of the proximal nail folds, scaly plaques on bilateral elbows, and excoriated erythematous plaques on upper chest, back and hips. The patient reported no muscle weakness, and strength testing and creatinine phosphokinase were normal. Magnetic resonance imaging of the thigh showed no evidence of inflammation or edema. Antibody testing was negative. A diagnosis of clinically amyopathic dermatomyositis was made. Computed tomography scans of the chest, abdomen and pelvis, colonoscopy, and mammogram showed no evidence of cancer. The patient was initiated on methotrexate. Her cutaneous manifestations persisted with debilitating intractable pruritus, and thus, she was transitioned to mycophenolate mofetil, again with minimal improvement. Intravenous immunoglobulin was not approved by insurance given the lack of muscle involvement in her disease. This patient's case highlights a common clinical scenario in rheumatology and dermatology and raises several important issues related to the immunologic underpinnings of cutaneous lupus erythematosus (CLE) and dermatomyositis (DM): What is the role of type I interferon (IFN) in triggering skin disease in CLE and DM? What is the role of IFN in the pathogenesis of skin inflammation in CLE and DM? Can we apply what we know about IFN-targeted therapeutics in CLE and DM to develop better treatments for skin disease?

Mitigating effects of agmatine on myocardial infarction in rats subjected to isoproterenol.

Isoproterenol (ISO) usage is limited by its potential for cardiotoxicity. We sought to investigate the potential of agmatine in mitigating ISO-induced cardiotoxicity. Agmatine (100mg/kg/day) was intraperitoneally administered to Wistar rats for 7days in the presence or absence of cardiotoxicity induced by subcutaneous injection of ISO (85mg/kg) on the sixth and seventh days. ECG parameters, lactate dehydrogenase (LDH), malondialdehyde (MDA), and creatinine phosphokinase (CPK) were investigated. Changes in cardiac tissue were also investigated using H&E staining. The heart weight/body weight ratio increased in ISO-treated rats. In the agmatine + ISO group, the increased heart rate observed in ISO-treated rats was reversed (317.2 ± 10.5 vs 452.2 ± 10.61, P < 0.001). Agmatine ameliorated the change in PR, RR, and ST intervals and the QRS complex, which was reduced by ISO. Treatment with saline, ISO, and agmatine had no significant effect on papillary muscle stimulation (P > 0.05). The administration of agmatine to ISO-receiving group could mitigate several parameters when compared to ISO-receiving group including increasing papillary muscle contraction (0.83 vs 0.71 N/M2 respectively, P < 0.01), decreasing LDH levels (660ng/ml vs 1080ng/ml, respectively, P < 0.05), decreasing CPK levels (377 U/l vs 642 U/l, respectively, P < 0.05) and decreasing MDA levels (20.32µM/l vs 46.83µM/l, P < 0.001). Coadministration of agmatine and ISO is capable of ameliorating ISO cardiotoxicity by antioxidant effects and controlling the hemostasis of calcium in myocytes.

Characteristics and In-Hospital Outcomes of Patients With Myocardial Infarction With Non-Obstructive Coronary Arteries - Insights From the Real-World JAMIR Database.

Few studies have investigated the clinical characteristics and in-hospital outcomes of patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) using real-world databases in the coronary intervention era. We conducted a retrospective analysis of 22,236 patients (mean [±SD] age 68±13 years, 23.4% female) enrolled in the Japan Acute Myocardial Infarction Registry (JAMIR) between 2011 and 2016. Based on urgent coronary angiography findings, 286 (1.3%) patients were diagnosed as MINOCA, and the remaining 21,950 (98.7%) as MI with obstructive coronary artery disease (MI-CAD). MINOCA patients were characterized by younger age, fewer coronary risk factors, lower rate of ST-elevation myocardial infarction, lower Killip classification, and lower peak creatinine phosphokinase levels than MI-CAD patients. In-hospital all-cause mortality did not differ between the MINOCA and MI-CAD groups (5.2% vs. 5.7%, respectively; P=0.82). Comparing cause-specific mortality, non-cardiac mortality was higher in the MINOCA than MI-CAD group (4.2% vs. 1.6%; P<0.01). Importantly, non-cardiac death was more prevalent among elderly (≥65 years) than younger (<65 years) patients in the MI-CAD group, whereas this trend was not observed in the MINOCA group. Analysis of the real-world JAMIR database revealed a relatively high prevalence of non-cardiac death among MINOCA patients, underscoring the need for comprehensive management to improve disease prognosis, particularly in younger patients.

Intermittent hemodialysis as a rewarming strategy for severe hypothermia in patients without renal failure: a case report

This case report highlights the effective use of intermittent hemodialysis (IHD) in warming a 71-year-old female patient with severe hypothermia who presented with a rectal temperature of 25 °C and signs of hemodynamic instability. The patient, found unconscious after prolonged exposure to cold exacerbated by alcohol consumption, initially showed some improvement in core temperature through active external rewarming methods. However, soon, her temperature plateaued at 27 °C. Patient was deemed unsuitable for extracorporeal membrane oxygenation (ECMO) or cardiopulmonary bypass (CPB) due to her age, and urgent IHD was initiated. This approach resulted in a stable increase in core temperature at approximately 2.0 °C/hr, along with normalization of lactic acidosis, creatinine phosphokinase, and correction of electrolyte imbalances, culminating in her full recovery and discharge after seven days in the hospital.After reviewing this case alongside similar ones from before, this case report highlights the efficacy and safety of IHD as an efficient, readily available, and less invasive method for rewarming moderate to severe hypothermic patients who are hemodynamically unstable patients but do not have cardiac arrest or renal dysfunction. IHD is especially useful when less invasive cooling devices (Artic Sun/ CoolGard) are not available or more invasive extracorporeal life support options (ECMO/ CPB) are either not indicated or unavailable. IHD can also help improve concurrent electrolyte imbalances and/or toxin buildup. The report further emphasizes the necessity of monitoring for potential complications, such as post-dialysis hypophosphatemia and rebound hyperkalemia, following successful rewarming.

The role of nemolizumab in the treatment of atopic dermatitis for the adult population.

Atopic dermatitis (AD) often requires long-term treatment that may be associated with adverse effects. This review aims to characterize nemolizumab as a treatment for AD in adults. A literature search was performed to assess nemolizumab's role in moderate-to-severe AD in adults. Currently, clinical trials are being conducted to evaluate the clinical efficacy, safety profile and optimal dosing of nemolizumab for adults with moderate-to-severe AD. The most common adverse effects include nasopharyngitis, AD exacerbation and increased blood creatinine phosphokinase. Recent data from clinical trials suggest nemolizumab may be an acceptable treatment in adults with moderate-to-severe AD.

Value of serum muscular creatinine phosphokinase levels in patients with adenomyosis as a non-invasive diagnostic marker.

In the present study, we aimed to compare serum CK-MM levels in patients with and without adenomyosis and to investigate whether CK-MM level can be a non-invasive marker for myometrial damage due to adenomyosis. Our study was a prospective case-control study in a tertiary center and consisted of 40 patients with a clinical/ultrasonographic diagnosis of adenomyosis and 40 patients without a clinical/ultrasonographic diagnosis of adenomyosis as the control group based on recently published morphological uterus sonographic assessment (MUSA) criteria. Individuals of similar age who signed a voluntary consent form were included in our study. Demographic, clinical, and laboratory findings of the patients in both groups were recorded. Blood serum samples were used for the determination of serum CK-MM levels of the participants in our study. The samples were analyzed by using the human CK-MM enzyme-linked immunosorbent assay (ELISA) kit. In our study, the mean serum CK-MM level was 16.2 ± 21.7 (ng/dL) in patients with adenomyosis and 2.6 ± 2.2 (ng/dL) in patients without adenomyosis. Serum CK-MM level was statistically significantly higher in the patient group with adenomyosis than in the control group (p < 0.001). The CK-MM threshold value of 3.43 ng/mL, with a sensitivity of 82.5% and specificity of 85%, has been found to be a valuable distinguishing level in patients with and without adenomyosis. In this study, we demonstrated that serum CK-MM can be used as a non-invasive diagnostic method in patients with adenomyosis. As the number of studies around this subject in the literature is insufficient, larger studies are needed to use CK-MM as a diagnostic marker in adenomyosis.

Dengue rhabdomyolysis successfully treated with hemoperfusion using CytoSorb® in combination with continuous renal replacement therapy: a case report

BackgroundDengue fever is a mosquito-borne viral infection with a broad spectrum of clinical manifestations. Expanded dengue syndrome includes unusual manifestations that do not fall into the categories of dengue fever, dengue hemorrhagic fever, or dengue shock syndrome. Rhabdomyolysis causing acute renal failure in dengue is one such unusual manifestation, the pathophysiology of which is incompletely understood.Case presentationWe describe a 21-year-old Sri Lankan man with dengue fever who developed severe rhabdomyolysis and acute kidney injury with extremely high creatinine phosphokinase levels (> 2 million U/L). Management of this patient was challenging as his creatinine phosphokinase kept rising with persistent anuria despite hydration, intermittent hemodialysis, and, later, continuous venovenous hemodiafiltration. Further therapeutic options were explored, and CytoSorb® adsorber was added as an adjunct to continuous venovenous hemodiafiltration, following which we observed a marked reduction in his creatinine phosphokinase and myoglobin levels over the next 12 hours and complete renal recovery over the next 5 weeks.ConclusionWe report a rare case of significant rhabdomyolysis secondary to dengue infection leading to acute kidney injury. Continuous venovenous hemodiafiltration performed with the hemofilter Pecopen 140 was ineffective, and the addition of CytoSorb® adsorber as an adjunct therapy to continuous venovenous hemodiafiltration may have a potential benefit in removing high-molecular-weight proteins such as myoglobin.

Evaluation of infrared thermography, arterial Doppler ultrasound, and Doppler echocardiography in healthy adult dogs exposed to a single session of Whole-body vibration at different frequencies

This study aimed to evaluate the infrared thermography, arterial Doppler ultrasound, and Doppler echocardiography in healthy adult dogs exposed to a single Whole-body vibration (WBV) at different frequencies. Sixteen (16) healthy crossbreed dogs males of ages 1 to 5 years, weighing 16.3 to 24.5 kg were enrolled in the study. The dogs were exposed to a single WBV session at frequencies of 30 Hz (5 min), 40 Hz (5 min), and 50 Hz (5 min) with intervals between each frequency exposure of 10 min. The cutaneous temperature, arterial Doppler ultrasound, and Doppler echocardiography were evaluated 10 min before the WBV session, between each frequency, and 1 min after the last frequency. The cutaneous temperature of the regions of the superficial gluteal muscle and biceps femoris muscle of both hind limbs was obtained with an infrared camera. Resistive indexes of carotid and femoral arteries were determined using Doppler ultrasound, and Doppler echocardiography was used to assess the end-systolic volume and end-diastolic volume, heart rate, aortic blood flow velocity, and pulmonary artery flow velocity. Clinical parameters, complete blood count, and serum biochemical (alanine aminotransferase, creatinine, and creatine phosphokinase) were evaluated 10 min before and 60 min after the end of the WBV session. Statistically significant differences were not found in any of the variables among the time points. In conclusion, the protocol of increasing vibration frequencies (30, 40, and 50 Hz) at short-period WBV can be considered appropriate since no change occurred in the parameters evaluated.

Reported Adverse Events in a Multicenter Cohort of Patients Ages 6-18 Years with Cystic Fibrosis and at Least One F508del Allele Receiving Elexacaftor/Tezacaftor/Ivacaftor

The objective of this study was to describe reported adverse events (AEs) associated with elexacaftor/tezacaftor/ivacaftor (ETI) in a pediatric sample with cystic fibrosis (CF) aged 6-18years, with at least one F508del variant, followed at multiple Italian CF centers. This was a retrospective, multicenter, observational study. All children receiving ETI therapy from October 2019 to December 2023 were included. We assessed the prevalence and type of any reported potential drug-related AEs, regardless of discontinuation necessity. Persistent AEs were defined as those continuing at the end of the observation period. Among 608 patients on ETI, 109 (17.9%) reported at least 1 AE. The majority (n=85, 77.9%) were temporary, with a median duration of 11days (range 1-441days). Only 7 (1.1%) patients permanently discontinued treatment, suggesting good overall safety of ETI. The most common AEs leading to discontinuation were transaminase elevations (temporary 14.1%, persistent 25.9%) and urticaria (temporary 41.2%, persistent 7.4%). Creatinine phosphokinase elevation was uncommon. No significant differences in AEs were observed based on sex, age groups (6-11 vs 12-18years), or genotype. Pre-existing CF-related liver disease was associated with an increased risk of transaminase elevations. We identified significant variability in the percentage of reported AEs (ANOVA P value .026). This real-world study highlights significant variability in reported AEs. Our findings suggest that ETI is a safe and well-tolerated therapy in children and adolescents with CF. However, further long-term safety and effectiveness investigations are warranted.

Effects of statin use on serum creatinine phosphokinase levels in normal thyroid function.

Statins are common lipid-lowering agents used in dyslipidemia. However, they increase serum creatinine phosphokinase (CPK) levels. Currently, there are no studies on the effect of thyroid-stimulating hormone (TSH) levels on CPK levels after statin administration. Therefore, this study aimed to investigate CPK level alterations after statin administration according to TSH quartiles in participants with euthyroidism. This retrospective analysis included 25,047 patients with euthyroidism. CPK levels were measured before and 6 months after statin administration. Normal TSH levels were divided into four quartiles, and the CPK levels and proportions of patients with normal CPK levels after statin administration for each TSH quartile were evaluated. The baseline CPK level was significantly higher in the lowest TSH quartile (Q1) compared to the other quartiles but decreased after statin administration. Thus, the difference between the CPK levels and the other quartile groups was not significant. The proportion of patients with normal CPK levels was also significantly lowest in Q1 before statin administration; however, no significant difference was noted in the ratio among each group after statin administration. These findings were consistent with the findings of the analysis according to statin intensity. In patients in the lowest TSH quartile of the normal TSH range, the CPK level decreased, and the proportion of normal CPK levels increased significantly after statin administration. However, similar changes were not observed in other TSH quartiles. Therefore, further studies are required to mechanistically confirm these conclusions.

Pancreas Preservation: Hypothermic Oxygenated Perfusion to Improve Graft Reperfusion.

The clinical standard for pancreas preservation for transplantation is static cold storage (SCS). Oxygenation during preservation has been shown to be advantageous in clinical studies. This study evaluates the efficiency of different oxygenation modalities during hypothermic pancreas preservation. Thirty-two porcine pancreases were procured in a controlled donation after circulatory death model and were divided to be preserved in 8 groups: (1) SCS, (2) hypothermic machine perfusion (HMP), (3) hypothermic oxygenated machine perfusion (HOPE) with 21% oxygen, (4) HOPE and 100%, (5) SCS and oxygen carrier, M101, (6) HMP and M101, (7) HOPE 21% and M101, and (8) HOPE 100% and M101. All the groups underwent 24 h of hypothermic preservation, followed by 2 h of normothermic reperfusion. Oxygen partial pressures were assessed using parenchymal probes. Perfusion parameters, perfusate samples, and tissue biopsies were analyzed. This study showed that HMP was linked to higher tissue oxygen partial pressures, lower succinate levels, and better reperfusion parameters. Furthermore, the addition of M101 to either SCS or HMP was associated with lower succinate and creatinine phosphokinase accumulation, suggesting a protective effect against ischemia. Our research has demonstrated the efficacy of machine perfusion in hypothermic conditions in providing oxygen to the pancreas during preservation and conditioning the pancreatic microvasculature for reperfusion during transplantation. Furthermore, the addition of M101 suggests a protective effect on the graft from ischemia.

Pressure ulcers related to prone positioning: a pandemic amidst a pandemic.

To explore the epidemiology and risk factors associated with the development of pressure ulcers (PUs) in patients receiving prone positioning (PP) ventilatory therapy; to compare the inflammatory status of patients who develop PUs with those who do not; and to describe the experience and useful findings that have allowed us to improve the management of these patients to reduce the incidence of PUs. An observational, descriptive and longitudinal study was conducted, where sociodemographic and laboratory data were collected from patients who were hospitalised and required PP ventilatory therapy in critical care areas (CCA) during the months of May-October 2020. From the total number of patients who required PP during their CCA stay (n=240), 202 (84.2%) developed a PU. The four most frequent areas where a PU appeared were: the head and neck (n=115); the pinna (n=21); the torso (n=21); and the lower limbs (n=21). Patients who developed PU were more frequently males with higher initial levels of creatinine phosphokinase and ferritin. The incidence for each month of follow-up decreased from 8.3% to 5.8%. Regardless of the intervention, a multidisciplinary approach is required to optimise the prevention and treatment of these wounds. While PUs are often the result of other medical conditions or poor health status in general, the vast majority of PUs are avoidable.

Impacts of Serum Creatinine Phosphokinase on Heart, Diabetes and Anaemia Patients

Impacts of Serum Creatinine Phosphokinase on Heart, Diabetes and Anaemia Patients

PSIV-A-11 Potential of black soldier fly (Hermetia illucens) larvae frass as a functional ingredient for nursery pigs

Abstract Frass is the leftover material from the production of black soldier fly larvae (BSFL), which includes chitin-containing exoskeleton shedding, small, processed larvae, leftover dietary substrate, and larvae excrement. A total of 120 nursery pigs (initial body weight of 6.85 ± 0.10 kg) weaned at 21 d of age were used in a 6-wk study to evaluate the effect of increasing dietary levels of frass on growth performance, diarrhea score, and serological indices. Pigs were randomly assigned within sex and body weight blocks to 1 of 3 dietary treatments using 30 pens (4 pigs/pen; 10 replicates/treatment). Diets were prepared from a common basal and fed in 3 dietary phases of 2 wk each and included: 1) a control diet based primarily on corn and soybean meal; 2) the control with 3% added frass; and 3) the control with 6% added frass. On d 4, 7, and 14, individual fecal samples were obtained using fecal loops and were evaluated on a scale of 1 to 5 representing hard, normal, soft, watery soft, and watery liquid feces, respectively. Blood samples were collected on d 42 from 1 median pig per pen for the analysis of serum chemistry. Data were analyzed using the mixed model procedures as a randomized complete block design using linear and quadratic contrast comparisons to determine the effects of frass. Supplementation of frass linearly increased average daily gain (ADG) from d 7 to 14 (P = 0.044; 347.9, 378.8, and 396.8 g/d for 0, 3, and 6% frass, respectively), and tended to linearly increase ADG during Phase 1 (P = 0.079; 265.1, 284.8, and 298.6 g/d). No differences were observed for final body weight (P ≥ 0.146; 29.90, 31.48, and 30.70 kg for 0, 3, and 6% frass, respectively), and overall ADG, average daily feed intake (ADFI), or gain to feed ratio (G:F). Diarrhea scores increased (P &amp;lt; 0.001) from d 4 (2.96) to d 7 (4.20) and then decreased (P &amp;lt; 0.001) on d 14 (3.69). Inclusion of frass at 6% had a decreased diarrhea score compared with 3% frass on d 7 (P = 0.029), but pigs fed 6% frass had a greater diarrhea score (P = 0.038) than pigs fed the control diet on d 14. However, scores were indicative of diarrhea for all treatments on d 7 and 14. Serum concentrations of total protein, albumin, globulin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, γ-glutamyltranspeptidase, urea N, creatinine, glucose, Ca, P, Mg, K, Na, Cl, triglycerides, amylase, cholesterol, and creatine phosphokinase measured on d 42 were not different (P &amp;gt; 0.093) between treatments. All serological analytical results were generally within normal expected ranges. In conclusion, these findings suggest that dietary inclusion of frass may improve growth performance of nursery pigs, especially during the early stages of the nursery period.

A clinical survey on methadone poisoning: Predisposing factors and clinical expression

Background and aims: Ongoing methadone intoxication parallels the generalization of the implemented addiction cession programs, as well as the necessity to sustain an effectively durable addiction treatment course. This study aimed to investigate the predisposing factors and clinical features of methadone intoxication. Methods: During a one-year period (March 2018 to March 2019), patients admitted for methadone intoxication were investigated retrospectively. Demographic data, the consumed methadone dose, electrocardiogram findings, and the level of creatinine phosphokinase (CPK) at admission were collected and entered into a statistical analyzing platform (SPSS version 22) for further statistical testing. Results: Seventy-five eligible patients were investigated. The mean age was 23.63±16.66, 66.7% were male, and 15 patients were children. The unemployment status led to an increased methadone poisoning (MP) incidence (P&lt;0.05). The incidences of an increased CPK or QT segment prolongation were 17% and 7%, respectively. There was not any statistical correlation between the incidence of MP, the demographic and clinical data, as well as the used methadone dose. Moreover, the duration of the QT segment was not statistically influenced by the CPK. Conclusion: MP incidence seems to be influenced by social status. The increase in CPK and QT prolongation was not influenced by the methadone dose. It seems that more studies are required to further investigate the risk and prognostic factors of MP.

Attenuative role of didymin against paraquat prompted cardiotoxicity in albino rats

Paraquat (PQ) an herbicide that is commonly used to remove undesirable grasses. However, PQ also causes cardiac damage through reactive oxygen species (ROS) production. Didymin (DYD) is a dietary flavone, present in citrus fruits and campanula. DYD displays multiple therapeutic activities i.e., anti-oxidant, hepatoprotective, neuroprotective and free radical salvaging. Therefore, the present study was planned to explore the ameliorative effect of DYD against PQ instigated cardiac damage. 24 rats were separated into 4 groups, control, PQ administered PQ + DYD co-administered orally and DYD only administered group. PQ intoxication significantly reduced anti-oxidants including (SOD, GST, GSH, CAT, GPx and GSR activities, while increasing malondialdehyde (MDA) and ROS levels. PQ intoxication escalated the level of cardiac injury marker i.e., creatine kinase myoglobin binding (CK-MB), troponin, creatinine phosphokinase (CPK) and lactate dehydrogenase (LDH). PQ also augmented inflammatory markers i.e., (TNF-α, IL-1β, NF-κB, IL-6 levels and COX-2 activity). Moreover, PQ intoxication escalated the apoptotic proteins levels (Bax, Caspase-3 and Caspase-9), while decreasing Bcl-2 level. PQ intoxication also prompted histomorphological anomalies in the heart of rats. Conversely, DYD therapy restored all the anomalies and structural abnormalities owing to its cardioprotective potentials.

Prognostic impact and predictors of persistent renal dysfunction in acute kidney injury after percutaneous coronary intervention for acute myocardial infarction.

This study aimed to evaluate the prognostic impact and predictors of persistent renal dysfunction in acute kidney injury (AKI) after an emergency percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). A total of 877 patients who underwent emergency PCI for AMI were examined. AKI was defined as serum creatinine (SCr) ≥ 0.3mg/dL or ≥ 50% from baseline within 48h after PCI. Persistent AKI was defined as residual impairment of SCr ≥ 0.3mg/dL or ≥ 50% from baseline 1month after the procedure. The primary outcome was the composite endpoints of death, myocardial infarction, hospitalization for heart failure, stroke, and dialysis. AKI and persistent AKI were observed in 82 (9.4%) and 25 (2.9%) patients, respectively. Multivariate Cox proportional hazards analysis demonstrated that persistent AKI, but not transient AKI, was an independent predictor of primary outcome (hazard ratio, 4.99; 95% confidence interval, 2.30-10.8; P < 0.001). Age > 75years, left ventricular ejection fraction < 40%, a high maximum creatinine phosphokinase MB level, and bleeding after PCI were independently associated with persistent AKI. Persistent AKI was independently associated with worse clinical outcomes in patients who underwent emergency PCI for AMI. Advanced age, poor cardiac function, large myocardial necrosis, and bleeding were predictors of persistent AKI.

Combination of Binary Particle Swarm Optimization (BPSO) and Multilayer Perceptron (MLP) for Survival Prediction of Heart Failure Patients

Heart failure is a dangerous condition in which the heart cannot pump blood effectively and can lead to death. To improve this treatment, it needs methods to predict patient survival. This paper proposed combining wrapping features, namely Binary particle swarm optimization (BPSO) and a multilayer perceptron (MLP) classifier called BPSO-MLP. BPSO is used to determine the most relevant feature subset, and MLP is used to calculate its fitness. The experiment used a public dataset containing the medical records of 299 heart failure patients. This dataset comprises 13 features: age, anemia, high blood pressure, creatinine phosphokinase (CPK), diabetes, ejection fraction, platelets, gender, serum creatinine, serum sodium, smoking, time, and death events. The experiment results showed that the proposed method could produce an accuracy of up to 91.11%. The proposed method can increase accuracy by 8.89% compared to MLP (without BPSO). The addition of this wrapping feature has a significant influence on the accuracy results.

Subchronic exposure to fenpyroximate causes multiorgan toxicity in Wistar rats by disrupting lipid profile, inducing oxidative stress and DNA damage

Background Fenpyroximate (FEN) is an acaricide that inhibits the complex I of the mitochondrial respiratory chain in mites. Data concerning mammalian toxicity of this acaricide are limited; thus the aim of this work was to explore FEN toxicity on Wistar rats, particularly on cardiac, pulmonary, and splenic tissues and in bone marrow cells. Methods rats were treated orally with FEN at 1, 2, 4, and 8 mg/Kg bw for 28 days. After treatment, we analyzed lipid profile, oxidative stress and DNA damage in rat tissues. Results FEN exposure increased creatinine phosphokinase (CPK) and lactate dehydrogenase (LDH) activities, elevated total cholesterol (T-CHOL), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) concentrations, while decreasing high-density lipoprotein cholesterol (HDL-C). It inhibited acetylcholinesterase (AChE) activity, enhanced lipid peroxidation, protein oxidation, and modulated antioxidant enzymes activities (superoxide dismutase, catalase, glutathione peroxidase, and glutathione S-transferase). Comet assay indicated that FEN induced a dose-dependent DNA damage, contrasting with the micronucleus test showing no micronuclei formation. Nonetheless, FEN exhibited cytotoxicity to bone marrow cells, as evidenced by a reduction in the number of immature erythrocytes among total cells. Conclusion FEN appears to carry out its genotoxic and cytotoxic activities most likely through an indirect pathway that involves oxidative stress.