Differences In Blood Urea Nitrogen Research Articles

Optimizing the connection of CRRT and ECMO lines with additional pressure regulator on the therapeutic effect, filter life, and incidence of complications.

Extracorporeal membrane oxygenation (ECMO) is used for severe cardiopulmonary failure, with veno-arterial ECMO for cardiogenic shock and veno-venous ECMO for acute respiratory failure. ECMO's application has expanded to ICUs, emergency departments, and operating rooms. ECMO patients are at high risk for complications, including acute kidney injury (AKI), often requiring renal replacement therapy (RRT), posing significant management challenges. From August 2015 to June 2022, 120 patients were cured with veno-venous ECMO (n = 60) or veno-arterial ECMO (VA-ECMO, n = 60) combined with CRRT in our hospital. In the control group (n = 60), the input end (arterial end) of CRRT was connected to the ECMO oxygenator. The reinfusion end (venous end) of CRRT was connected to the oxygenator of ECMO for CRRT + ECMO treatment. In the experimental group (n = 60), the input end (arterial end) of CRRT was connected to the oxygenator of ECMO, and an additional pressure regulating device was installed on the connection of the 2 lines. The observation indexes including clinical therapeutic effect, clinical therapeutic effect, the incidence of complications, and the incidence of complications were compared. There was a notable decrease in serum creatinine, and the differences in blood urea nitrogen, procalcitonin, and C-reactive protein after operation were statistically significant (P < .05). The filter use time in the study group was notably longer (P < .01). There exhibited no remarkable difference in the incidences of bleeding, thrombosis, numbness of hands and feet, metabolic alkalosis, disseminated intravascular coagulation, organ dysfunction syndrome, hyperbilirubinemia, and infection. This study demonstrates that additional pressure regulation devices are installed at the line connection between the CRRT input end and the CRRT return end to ensure that the flow rate of ECMO does not affect the CRRT treatment. ECMO and CRRT provide a safe pressure range so that the ECMO line can be safely connected to the CRRT machine at physiological pressure, reducing the occurrence of complications related to CRRT machine interruption and improving the efficiency of CRRT without affecting the efficiency of ECMO, ensuring patient safety.

THE EFFECT OF GIVING NATURAL GUARD ESSENTIAL OIL IN DRINKING WATER ON BLOOD UREA NITROGEN LEVELS, CREATININE, AND AMINOTRANSFERASE IN BROILERS

To increase growth and feed efficiency, we can use feed additives through feed or drinking water, one of which is the use of essential oils. NATURALGUARD is a mixture of natural oils, namely pine oil (Pinus sp.), lavender (Lavandula sp.), and eucalyptus oil (Eucalyptus sp.) which contains active compounds as immunomodulators, antibacterials, antioxidants, anti-inflammatory, antifungal and antiviral. This study aims to determine the level of Blood Urea Nitrogen (BUN), Creatinine, Aspartate Aminotransferase (AST), and Alanine Aminotransferase (ALT) in broilers after being given NATURALGUARD via drinking water. This study used a completely randomized design with a total sample of 24 broiler CP-707 strain, with four treatments and six replications. The treatment applied was P0 as a control without giving NATURALGUARD, P1 P2, and P3 were given NATURALGUARD at doses of 1, 2, and 4 g/L respectively, adlibitum for 30 days. At the end of the study, 3 mL of blood sample was taken via the pectoral vein aseptically, and then a blood serum examination was carried out. The research results showed that the highest mean BUN level was at P0 (8.9 mg/dL) and the lowest was at P1 (5.2 mg/dL), the highest creatinine was at P3 (1.08 mg/dL) and the lowest was at P0 and P1 (1, 0 mg/dL), AST was highest at P0 (273 µ/L) and lowest at P2 (220 µ/L), and ALT was highest at P0 (7.5 µ/L) and lowest at P3 (5.48 µ/ L). Statistical results showed no significant differences in BUN, creatinine, AST, and ALT levels in all treatment groups. It was concluded that NATURALGUARD as feed additive at doses of 1, 2, and 4 g/L via drinking water is safe to be used in broilers.

138 Sire Differences for Blood Urea Nitrogen (BUN) in Hereford Cattle

Abstract Excess Nitrogen excretion is a growing concern worldwide within animal agriculture, and blood urea nitrogen (BUN; mg/dL) is known as a predictor of nitrogen excretion in cattle. The objective of this study was to determine sire differences in BUN within a population of Hereford steers. Steers (n = 74) were born between March and June of 2021 from a reference sire herd for The American Hereford Association in Western Nebraska. Sixteen different Hereford sires from The American Hereford Association reference sire program produced offspring used in this study. The steers entered an on-site feed intake unit and were fed a finishing diet consisting predominantly of corn, corn distiller grain, and corn silage. Animals were subjected to a 21-d warm-up period with a 55-d individual feed intake test period. Blood samples were collected on day 43 of the test period. Blood samples were then centrifuged to extract serum. The Urea Nitrogen (BUN) Colorimetric Detection Kit by Invitrogen was used for the assay. The average BUN concentration for all animals in this study was (0.492 ± 0.061 mg/dL). A generalized linear regression model was used to determine sire differences in BUN concentrations. Factors considered were sire and pen group. The sire with lowest least squared mean progeny BUN concentration estimate was (0.0362 ± 0.08 mg/dL; n = 4), and the highest was (0.605 ± 0.03 mg/dL; n = 7). Sire differences (P &amp;lt; 0.05; r2 = 0.36) were found to be important sources of variation as evidenced by its r2; however, pen group (P = 0.65; r2 &amp;lt; 0.05) appeared to have little impact on variation. The differences in sires indicate genetic differences could be leveraged to reduce excess nitrogen excretion in cattle populations.

Early Diagnostic Value of KIM-1, NGAL, and NLR in Acute Kidney Injury Caused by Diquat Poisoning

Background. The kidney is the main excretory organ after diquat absorption. Acute kidney injury (AKI) is a common complication in diquat poisoning patients. Objectives. To identify the value of combined detection of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and neutrophil-lymphocyte ratio (NLR) in the early diagnosis of diquat-induced AKI. Materials and Methods. The retrospective cohort study included 42 diquat poisoning patients. Results. Forty-two patients with diquat poisoning were included, of which 20 had fulminant poisoning (47.6%). At admission (0 h), levels of KIM-1, NGAL, NLR, and acute physiology and chronic health evaluation (APACHE) II scores in the fulminant poisoning group were higher than that of the moderate to severe poisoning group ( P &lt; 0.05), and they were all higher than in the control group ( P &lt; 0.05), while blood urea nitrogen (BUN) and uric acid (UA) levels did not significantly differ across the three groups ( P &gt; 0.05). At 12 h and 24 h, the levels of KIM-1, NGAL, NLR, UA, BUN, and APACHE II scores of patients in the fulminant poisoning group were higher than those in the moderate to severe poisoning group ( P &lt; 0.05), 12 h were higher than 0 h, and 24 h were higher than 12 h ( P &lt; 0.05). Among 42 patients with diquat poisoning, 28 had AKI (66.7%). At 0 h, the AKI group had higher levels of KIM-1, NGAL, NLR, and APACHE II scores than in the non-AKI (NAKI) group ( P &lt; 0.05), while there was no significant difference in BUN and UA levels between the two groups ( P &gt; 0.05). At 12 h and 24 h, the levels of KIM-1, NGAL, NLR, UA, BUN, and APACHE II scores in the AKI group were higher than those in the NAKI group ( P &lt; 0.05), 12 h were higher than 0 h, and 24 h were higher than 12 h ( P &lt; 0.05). KIM-1, NGAL, and NLR are independent risk markers for AKI in diquat poisoning patients. At admission (0 h), the combined application of KIM-1, NGAL, and NLR’s sensitivity, specificity, and area under the curve (AUC) for predicting AKI in diquat poisoning patients was 0.893, 0.859, and 0.903, respectively. Conclusions. KIM-1, NGAL, and NLR can be employed as early diagnostic indicators for the clinical prediction of AKI in diquat poisoning patients. Our findings may help clinicians reduce the occurrence of AKI.

Radioprotective Effects of Melatonin on Gamma Radiation- Induced Tissue Damage in Rats

&#x0D; &#x0D; Background &amp; Objective: Gamma rays are widely used in medicine despite their harmful effects on health. Our study evaluated the protective effects of melatonin on kidney, heart, and liver tissues.&#x0D; &#x0D; Materials &amp; Methods: Seventy-two adult male Wistar rats were categorized into nine groups. Groups 2 and 3 only received whole-body γ-ray irradiation (WBI) (2.0 Gy), no melatonin, interval time (IT) 8hr and 24hr. Groups 4 and 5 received WBI (8.0 Gy, no melatonin, 8hr and 24hr). Groups 6 and 7 received melatonin at 60 minutes (min) before WBI(2.0 Gy). Groups 8 and 9 received melatonin before WBI(8.0 Gy). All the rats were sacrificed 8 or 24 h after the experiments for laboratory and histopathological analysis. Serum levels of Blood Urea Nitrogen(BUN), Creatinine (Cr), Lactate dehydrogenase (LDH), Potassium (K), Gamma-glutamyl Transferase (GGT), Serum Glutamic-Oxaloacetic Transaminase(SGOT), Serum Glutamic-Pyruvic Transaminase(SGPT), Alkaline Phosphatase(ALP), c-reactive protein(CRP), Troponine(TPO) and histological features of liver, heart and kidney tissues were assessed. Statistical analysis was performed by One-Way ANOVA.&#x0D; &#x0D; Results: Our data did not indicate significant differences in BUN, Cr, K, and CRP between groups with or without melatonin treatment (P&gt;0.05); but differences were significant for LDH, GGT, SGOT, SGPT, ALP, and TPO (P&lt;0.05). The results showed that radiation-induced histopathological effects on the liver, heart, and kidneys were mitigated in the groups six to nine.&#x0D; &#x0D; Conclusion: The existence of significant differences in serum levels of LDH, GGT, SGOT, SGPT, ALP, and TPO in groups(6 to 9) and amelioration of the histopathological effects of irradiation on the liver, heart, and kidneys in the groups six to nine showed that the melatonin(100 mg/kg) is able to protect the body in gamma-radiation(2.0 Gy and 8.0 Gy).&#x0D; &#x0D;

The nitrogen load is affected by high protein provision according to kidney function in critically ill patients.

Adequate protein delivery is recommended in the acute phase of critical illness with kidney dysfunction. However, the influence of the protein and nitrogen loads has not yet been clarified. Patients admitted to the intensive care unit were included. In the former period, patients received standard care (0.9 g/kg/day protein). In the latter, patients received the intervention of active nutrition therapy with high protein delivery (1.8 g/kg/day protein). Fifty patients in the standard care group and 61 in the intervention group were examined. Maximum blood urea nitrogen (BUN) on days 7-10 were 27.9 (17.3, 38.6) vs 33 (26.3, 51.8) (mg/dl) (p = 0.031). The maximum difference in BUN increased [31.3 (22.8, 55) vs 50 (37.3, 75.9) mg/dl (p = 0.047)] when patients were limited to an estimated glomerular filtration rate (eGFR) <50 ml/min/1.73 m2. This difference increased further when patients were limited to eGFR <30 ml/min/1.73 m2. No significant differences were observed in maximum Cre or in the use of RRT. In conclusion, the provision of 1.8 g/kg/day protein was associated with an increase in BUN in critically ill patients with kidney dysfunction; however, it was tolerated without the need for RRT.

251 A Combination of Dietary Isoleucine and Valine Above Recommended Levels Improves the Growth and Alters the Metabolites Profile in Pigs fed with Very low Protein Diets

Abstract Very low-protein (VLP) diets are beneficial for reducing the nitrogen excretion from swine production, but these diets depress the performance of pigs while supplemented with first four limiting amino acids (FFL; i.e. Lys, Met, Thr and Trp). The objective of this study was to investigate the effect of supplementation of Val and Ile above NRC (2012) levels on performance, thermal radiation and blood metabolites of pigs fed with VLP diets. Three-week-old weaned barrows (n = 40) were assigned to: positive control (PC): normal protein diet; negative control (NC): VLP diet containing FFL at NRC levels; HV: NC with Val above NRC; HI: NC with Ile above NRC; HVI: NC with both Val and Ile above NRC. After 5 weeks of data collection, blood samples were collected. Univariate GLM with Tukey post-hoc test was used to analyze the data (SPSS). Pigs fed with NC had a decreased average daily gain (ADG) and average daily feed intake (ADFI) compared with PC (P&amp;lt; 0.05). HVI pigs had less ADG than PC, but greater ADG than NC (P&amp;lt; 0.05). ADFI of pigs fed with HVI was similar to PC and it was greater than NC (P&amp;lt; 0.05). HVI pigs had a higher thermal radiation than NC (P&amp;lt; 0.05). While HVI pigs had greater blood glucose than PC and NC at baseline (P&amp;lt; 0.05), no differences among these groups were observed on postprandial blood glucose concentration. HVI pigs had less blood triglycerides than PC. All groups increased the blood cholesterol compared with PC (P&amp;lt; 0.05). There were no differences in blood urea nitrogen (BUN) for NC vs. PC; however, pigs fed with HVI reduced the BUN compared with NC (P&amp;lt; 0.05). In conclusion, supplementation of Val and Ile greater than NRC into VLP diets partially restored the performance and fully recovered the ADFI, reduced the blood triglycerides and BUN, and improved the glucose tolerance.

Evaluation of N-(6-[18F]Fluoropyridin-3-yl)glycine PET renography to detect renal function progression in a rat model of diabetic nephropathy

ObjectiveGiven the limitation of biomarkers to predict the renal function progression in diabetic nephropathy, N-(6-[18F]Fluoropyridin-3-yl)glycine (6-[18F]FPyGly) was used to evaluate renal function progression in a rat model of diabetic nephropathy. MethodsTwenty male Sprague-Dawley rats were randomly divided into four groups, including the healthy control group (HC group), diabetic nephropathy group (DNM group), routine diet treated diabetic nephropathy group (RDNM group), and high fat/high sucrose -diet-fed diabetic nephropathy group (HDNM group). All renal function parameters were determined from animal PET renograms. P and Tmax represent the curve peak counts and the time to the curve peak counts of 6-[18F]FPyGly in kidneys after injection, C1/2 and the 15 min/Peak ratio represent the time from peak to 1/2 peak in the clearance phase, and the ratio of the curve counts at 15 min to the curve peak counts. ResultsP, Tmax, C1/2, and 15 min/peak ratio of each rat were significantly correlated with S-Cr, BUN. There were significant differences in Tmax, P, serum creatinine (SCr), and blood urea nitrogen (BUN) levels between HC and DNM groups. P and the 15 min/Peak ratio were significantly different among DNM, RDNM, and HDNM groups, while Tmax and C1/2 were only significantly different between DNM and RDNM or HDNM groups. There only was a significant difference in BUN between the DNM and HDNM groups. ConclusionThe renal function parameters P, Tmax, C1/2 and 15 min/peak value obtained by dynamic renal imaging based on 6-[18F]FPyGly could reflect changes of renal function in rats, which had a good correlation with SCr and BUN, and showed more efficient in the diagnosis of diabetic nephropathy and renal function classification than SCr and BUN.

Probiotics improve renal function, glucose, lipids, inflammation and oxidative stress in diabetic kidney disease: a systematic review and meta-analysis

Aims The role of probiotics in the management of diabetic kidney disease (DKD) has been shown. Several current trials are investigating the effect of probiotics, which are widely used to modulate biomarkers of renal function, glucose, lipids, inflammation and oxidative stress in patients with DKD. However, their findings are controversial. This study aimed to systematically evaluate the impact of probiotics on patients with DKD via meta-analysis. Methods PubMed, The Cochrane Library, Web of Science, Scopus, Embase, China National Knowledge Infrastructure, Chinese Wanfang Database and Chinese VIP Database were searched for relevant studies from the establishment of these databases to September 2021. The pooled results evaluated the impact of probiotics on renal function, glucose, lipids, inflammation and oxidative stress indicators in patients with DKD. Additionally, subgroup analysis was performed based on intervention duration, probiotic dose and probiotic consumption patterns, respectively. Results Ten trials that included 552 participants were identified for analysis. Compared with the controls, probiotics significantly decreased serum creatinine (Scr) [WMD = −0.17 mg/dL; 95%CI = −0.29, −0.05; p = 0.004], blood urea nitrogen (BUN) [WMD = −1.36 mg/dL; 95%CI = −2.20, −0.52; p = 0.001], cystatin C (Cys C) [WMD = −29.50 ng/mL; 95%CI = −32.82, −26.18; p < 0.00001], urinary albumin/creatinine ratio (UACR) [WMD = −16.05 mg/g; 95%CI = −27.12, −4.99; p = 0.004] and natrium (Na) [WMD = −0.94 mmol/L; 95%CI = −1.82, −0.05; p = 0.04] in patients with DKD. Enhanced glycemic control was observed in patients with DKD receiving probiotics compared with controls, as demonstrated by reduced levels of fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), homeostasis model of assessment-estimated insulin resistance (HOMA-IR), and increased quantitative insulin sensitivity check index (QUICKI). Probiotics affected lipid metabolism parameters with decreasing triglycerides (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) levels in patients with DKD. Probiotics could also could improve inflammation and oxidative stress by decreasing high-sensitivity C-reactive protein (hs-CRP), plasma malondialdehyde (MDA), total antioxidant capacity (TAC), glutathione (GSH) and nitric oxide (NO). Additionally, subgroup analysis showed that those who received multiple species probiotics had a statistically significant difference in BUN, FPG, HOMA-IR, high-density lipoprotein cholesterol (HDL-c), MDA, TAC, and NO. Meanwhile, Scr, LDL-c, HDL-c, MDA, and TAC were ameliorated when the intervention duration was more than eight weeks and BUN, FPG, HOMA-IR, and MDA were improved when the probiotic dose was greater than four billion CFU/day. Conclusions Our analysis revealed that probiotics could delay the progression of renal function injury, improve glucose and lipid metabolism, and reduce inflammation and oxidative stress in patients with DKD. Subgroup analysis showed that intervention duration, probiotic dose and probiotic consumption patterns had an effect of probiotics on outcomes.

The Effects of Febuxostat on Urine NGAL and Urine KIM-1 in Patients with Hyperuricemia.

Retrospective analysis of the effects of febuxostat on urine neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in patients with hyperuricemia was performed. From January 2018 to June 2018, there were 45 patients with asymptomatic hyperuricemia in the outpatient or inpatient of Changzhou Second People's Hospital, which were divided into the febuxostat group (25 cases) and the control group (20 cases). We collected the patients' baseline indicators and testing indicators after three months of treatment, including blood urea nitrogen, blood creatinine, blood uric acid, urine microalbumin, urine NGAL, urine KIM-1, and other indicators. The subjects in both groups were given lifestyle intervention, instructed to drink more water, and given a low-purine diet. The patients in the febuxostat group took febuxostat 40 mg/D or 80 mg/D. We used SPSS 25.0 statistical software for statistical analysis. Baseline indexes between the febuxostat group and the control group and indexes after treatment between two groups were both performed by independent sample t-test, and paired t-test was used for self-comparison between the groups before and after treatment. There was no significant difference in age, sex, body mass index (BMI), urea nitrogen, creatinine, uric acid, urine microalbumin/creatinine, urine NGAL/creatinine, and urine KIM-1/creatinine between the two groups before treatment (P > 0.05). Compared with before treatment, after 3 months of intervention, the levels of serum uric acid, urine microalbumin/creatinine, urine NGAL/creatinine, and urine KIM-1/creatinine were significantly decreased in the febuxostat group (P < 0.05), while the changes of blood urea nitrogen, serum creatinine, and epidermal growth factor receptor (eGFR) were not statistically significant (P > 0.05). After 3 months of intervention, the control group had no significant changes in blood urea nitrogen, creatinine, eGFR, uric acid, microalbumin/creatinine, urine NGAL/creatinine, and urine KIM-1/creatinine (P > 0.05). After 3 months of intervention, compared with the control group, the serum uric acid, microalbumin/creatinine, urine NGAL/creatinine, and urine KIM-1/creatinine were significantly decreased in the febuxostat group (P < 0.05), but there was no significant difference in blood urea nitrogen, creatinine, and eGFR (P > 0.05). Febuxostat can reduce urine NGAL/creatinine and urine KIM-1/creatinine levels in patients with hyperuricemia and has the protective effects on renal tubular injury caused by hyperuricemia, which can provide evidences for the early prevention and treatment of asymptomatic hyperuricemia.

Deletion of STAT3 from Foxd1 cell population protects mice from kidney fibrosis by inhibiting pericytes trans-differentiation and migration.

Signal transduction and activator of transcription 3 (STAT3) is a key transcription factor implicated in the pathogenesis of kidney fibrosis. Although Stat3 deletion in tubular epithelial cells is known to protect mice from fibrosis, vFoxd1 cells remains unclear. Using Foxd1-mediated Stat3 knockout mice, CRISPR, and inhibitors of STAT3, we investigate its function. STAT3 is phosphorylated in tubular epithelial cells in acute kidney injury, whereas it is expanded to interstitial cells in fibrosis in mice and humans. Foxd1-mediated deletion of Stat3 protects mice from folic-acid- and aristolochic-acid-induced kidney fibrosis. Mechanistically, STAT3 upregulates the inflammation and differentiates pericytes into myofibroblasts. STAT3 activation increases migration and profibrotic signaling in genome-edited, pericyte-like cells. Conversely, blocking Stat3 inhibits detachment, migration, and profibrotic signaling. Furthermore, STAT3 binds to the Collagen1a1 promoter in mouse kidneys and cells. Together, our study identifies a previously unknown function of STAT3 that promotes kidney fibrosis and has therapeutic value in fibrosis.

Cranial Electrotherapy Stimulation to Improve the Physiology and Psychology Response, Response-Ability, and Sleep Efficiency in Athletes with Poor Sleep Quality.

Athletes often have poor sleep quality before a competition. Sleep quality can stabilize mood and improve sports performance. The randomized controlled study explored the effects of cranial electrotherapy stimulation (CES) on the physiology, psychology, response-ability, and sleep quality of athletes who had poor sleep quality before a competition. Athletes who had poor sleep quality (Pittsburgh Sleep Quality Scale score > 5) and had a competition in less than 2 months were recruited. The athletes were grouped into the CES group, which received a 2-week CES treatment (n = 20, age = 21.55 ± 2.26 years), and a placebo group (n = 20, age = 21.05 ± 1.46 years), which received a 2-week sham CES treatment. We performed biochemical analysis, a simple reaction time test, choice reaction time tests, the Profile of Mood States, heart rate variability (HRV), and an Actigraphy activity recorder to measure outcomes before and after the interventions. Our results revealed no significant differences in blood urea nitrogen, creatine phosphate, testosterone, cortisol, and saliva pH between and within groups (p > 0.05). Significant decreases in negative mood states (i.e., anger, tension, and depression) and choice reaction time in the CES group were noted (p < 0.05), moreover, the anger, tension, and depression mood decreased from 0.36 ± 0.45 (95% CI = 0.16–0.55), 1.62 ± 0.97 (95% CI = 1.19–2.04), and 1.67 ± 1.06 (95% CI = 1.20–2.13) to 0.11 ± 0.20 (95% CI = 0.02–0.19, p = 0.03), 1.12 ± 0.74 (95% CI = 0.79–1.44, p = 0.04), and 0.81 ± 0.75 (95% CI = 0.48–1.13, p = 0.001), respectively. Additionally, choice reaction time was decreased from 420.85 ± 41.22 ms (95% CI = 402.78–438.91) to 399.90 ± 36.71 ms (95% CI = 383.81–415.98, p = 0.04) and was also noted in the CES group. For HRV, and Actigraphy activity for sleep measure, the low-frequency (LF)/high-frequency (HF) ratios changed from 1.80 ± 1.39 (95% CI = 1.19–2.40) to 1.21 ± 0.73 (95% CI = 0.89–1.53, p = 0.10), and sleep efficiency decreased from 87.94 ± 6.76% (95% CI = 84.97–90.90) to 81.75 ± 9.62% (95% CI = 77.53–85.96, p = 0.02) in the CES group. The change in LF/HF after the trial were found between CES and placebo groups (p < 0.05). Yet, the decrease in sleep efficiency in the placebo group were noted (p < 0.05). However, we found that the regression line for sleep efficiency was decreased less during the study while using CES. The CES intervention could reduce negative emotions, improve choice reaction times, enhance the parasympathetic and sympathetic nerve activity imbalances, and slow sleep efficiency deterioration. Regardless, small effect sizes of the application of CES on psychology response, response-ability, and sleep efficiency were concluded in athletes with poor sleep quality before a competition.

Effects of higher protein formula with improved fat blend on growth, feeding tolerance and nutritional biomarkers in preterm infants: A double-blind, randomized, controlled clinical trial

Preterm formulas containing greater protein:energy ratio are beneficial for non-breastfed infants, since protein is critical for promoting catch-up growth and synthesis of lean body mass. Additionally, formulas containing enriched sn-2 palmitate (sn-2) and reduced medium chain triglycerides (MCTs) may support better feeding tolerance and nutrient utilization. The objective of this randomized, controlled, double-blinded clinical trial is to evaluate growth, feeding tolerance and nutritional biomarkers of preterm infants with birth weight ≤2000g and gestational age ≤33wks from one neonatal unit in Vietnam receiving experimental formula (EF, n=80) containing higher protein level of 3.4g/100kcal and improved fat blend with enriched sn-2 and modified level of MCTs or isocaloric control formula (CF, n=80) containing protein level of 2.9g/100kcal and standard fat blend. The differences in weight gain (g/d; primary endpoint) from day 1 (D1) of full enteral feeding (FEF) until D21 between groups was evaluated for non-inferiority (margin=-2.5g/d) and superiority (margin=0g/d). Mean weight gain was 3.09g/d greater in EF than CF; the lower limit of 95% CI (0.31g/d) exceeded both non-inferiority and superiority margins. There was no significant difference in length-for-age and head circumference-for-age z-score. By D79, the mean change in weight-for-age z-scores from D1 in EF group (+0.76 SDs) surpassed the criteria for catch-up growth (+0.67 SDs). Infants in the EF group (vs. CF) tended to have softer stools (EF=3.2±0.59 vs. CF=3.4±0.58; P=0.07) based on 5-point scale (1=watery, 5=hard). Difference in blood urea nitrogen and biomarkers for bone mineral status (i.e., plasma phosphorus, alkaline phosphatase and urinary calcium/phosphorus ratio) between EF and CF on FEF Day 21 reached statistical significance (P<0.05) but all mean values stayed within normal clinical ranges for both groups. Preterm formula with greater protein:energy ratio and new fat blend is safe, nutritionally suitable, well-tolerated, and improves catch-up weight gain of preterm infants. Clinical trial registry identifier is NCT03055052 (ClinicalTrials.gov).

Effects of Levosimendan on Systemic Perfusion in Patients with Low Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Score: Experience from a Single Center in Taiwan.

Patients with cardiogenic shock have a high risk of mortality. Intravenous levosimendan can provide pharmacologic inotrope support. We aimed to investigate the effect of levosimendan in patients with extremely severe cardiogenic shock and low Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) score with or without mechanical circulatory support. From January 2017 to May 2019, 24 patients with INTERMACS 1-4 were enrolled in this retrospective study. All patients had systemic malperfusion and were treated with levosimendan. Biochemistry data related to systemic perfusion were recorded and compared before and at 24 and 72 hours after levosimendan administration. Echocardiography and Kansas City Cardiomyopathy Questionnaire (KCCQ) were completed 2 months later to assess left ventricular ejection fraction (LVEF) and quality of life (QoL), respectively. Arterial pressure and heart rate did not significantly differ before and after levosimendan administration. Atrial fibrillation and ventricular premature complex increased without significance. The dose of inotropes could be significantly tapered down. There were no significant differences in blood urea nitrogen, creatinine, and lactate levels. Urine output significantly increased (p = 0.018), and liver-related enzymes improved but without significance. B-type natriuretic peptide significantly decreased (p = 0.007) at 24 hours after levosimendan administration. Echocardiography showed significantly improved LVEF 2 months later (22.43 ± 8.13% to 35.87 ± 13.4%, p = 0.001). KCCQ showed significantly improved physical activity and greater relief of symptoms (p = 0.003). The survival-to-discharge rate was 75%. We observed a decrease in B-type natriuretic peptide, better urine output, and alleviated hepatic injury in the levosimendan group. Most patients who survived without transplantation had significantly improved LVEF and better QoL after levosimendan administration.

The Effect of Pluchea indica (L.) Less. Tea on Blood Glucose and Lipid Profile in People with Prediabetes: A Randomized Clinical Trial.

Objective: Diabetes mellitus and dyslipidemia are currently increasing dramatically, and conventional medicine in the treatment of them has limited efficacies and serious adverse effects. Pluchea indica (L.) Less. tea (PIT) is widely consumed as a health-promoting drink in Southeast Asia. This study aimed to investigate whether P. indica tea has antidyslipidemic and antihyperglycemic effects and toxicity in humans. Design: A randomized clinical trial. Setting/Location: Nakhonratchasima, Thailand. Participants: Forty-five participants with prediabetes. Interventions: Participants were randomized to receive placebo tea, 1.5 g of PIT, and 1.5 g Camellia sinensis tea (green tea, CST) once daily for 12 weeks. Outcome Measurements: The oral glucose tolerance test (OGTT), total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), blood urea nitrogen (BUN), creatinine, alanine transaminase (ALT), alkaline phosphatase (ALP), and complete blood count (CBC) before and after treatment were investigated. Results: The results showed that PIT significantly ameliorated hyperglycemia and significantly lower serum TG (109.22 ± 5.21 mg/dL) and LDL-C (122.20 ± 3.67 mg/dL) than placebo (145.56 ± 8.18 and 142.07 ± 8.58 mg/dL, respectively) (p < 0.05). Moreover, PIT exhibited serum TG (109.22 ± 5.21 mg/dL) significantly lower than CST (124.38 ± 4.70 mg/dL) (p < 0.05). In addition, the serum HDL-C of PIT (57.56 ± 3.05 mg/dL) was significantly higher than the placebo (46.44 ± 2.47 mg/dL) (p < 0.05). Furthermore, the toxicity testing showed that no significant difference in BUN, creatinine, ALT, ALP, and CBC of PIT-treated group compared with the placebo (p > 0.05). Conclusions: These results suggest that PIT may ameliorate hyperglycemia and dyslipidemia in prediabetes people. It may not be toxic to the kidney, liver, and blood. So, PIT has the potential to develop to be a health-promoting tea or herbal medicine for hyperglycemia and dyslipidemia prevention.

Periodontitis aggravates renal inflammatory response in a mouse model of renal fibrosis.

To assess the effects of periodontitis on renal interstitial fibrosis in a mouse model. Thirty C57BL/6 male mice were divided into control, periodontitis (PD), unilateral ureteral ligation (UUO) and PD+UUO groups. Unilateral ureteral ligation was performed 6days after periodontitis. After 2weeks, all mice were sacrificed, and samples were collected for the assessment of gene expression, immune cells, biochemical indicators and renal pathology. Expression of tumour necrosis factor-α, interleukin-1β, and Ly6G in the kidneys in the PD+UUO group was significantly greater than in the UUO group. The percentage of CD11b+ Ly6G+ cells was significantly higher in the PD+UUO than in the UUO group. Fibrotic areas in the kidneys in the PD+UUO group were slightly, but not significantly, greater than those in the UUO group. Kidneys from the PD+UUO group showed markedly higher gene expression of matrix metalloproteinase-9, but not α-smooth muscle actin or collagen I, than those in the UUO group. There were no significant differences in blood urea nitrogen, serum creatinine and uric acid between the PD+UUO and UUO groups. Periodontitis increases the renal inflammatory response without showing a significant influence on renal interstitial fibrosis or renal function in the UUO mouse model.

NEFROPROTECTOR EFFECT OF CURCUMIN (CURCUMA LONGA) AND VITAMIN E (α-TOCOPHEROL) IN WISTAR STRAIN RATS AFTER CISPLATIN TREATMENT

Objective: To analyze the effect of curcumin and vitamin E on kidney function and inflammatory response of Wistar strain rats that received cisplatin. Material &amp; Methods: An experimental laboratory study with a post-test only control design, using male Wistar strain rats (Rattus norwegicus). Rats were randomized using the simple randomized sampling method. Samples were treated with cisplatin 5 mg/kg (positive control group), vitamin E 100 mg/kg, curcumin 100 mg/kg body, and a combination of both (treatment group), to evaluate its effect on and kidney function and inflammatory response as measured by tumor necrosis factor-α (TNF-α), blood urea nitrogen (BUN) and serum creatinine. Results: There were differences in TNF-α levels in the positive control group (cisplatin 5 mg/kg) against each treatment group (p&lt;0.05). Further analysis showed that there was a significant difference between the treatment group that received vitamin E and curcumin from the treatment group that received a combination of both (P&lt;0.05). In addition, there were differences in BUN and serum creatinine levels in the positive control group (cisplatin 5 mg/kg) against each treatment group (p&lt;0.05). However, there was no significant difference in BUN levels in the treatment group that received vitamin E with the treatment group that received curcumin or a combination of both (p&gt;0.05). No differences were found in serum creatinine levels between treatment groups receiving vitamin E, curcumin, or a combination of both. Conclusion: Vitamin E 100 mg/kg, curcumin 100 mg/kg, and the combination of both have a nephroprotector feature in Wistar rats exposed to cisplatin.

Effect of dexmedetomidine on perioperative hemodynamics and organ protection in children with congenital heart disease: A randomized controlled trial.

Background:This study aimed to investigate the effects of dexmedetomidine (Dex) on hemodynamics and organ protection in congenital heart disease (CHD) children who underwent open-heart surgery under cryogenic cardiopulmonary bypass.Methods:Ninety children were randomly allocated to group C (0.9% saline 0.2 μg/kg/hour), group D1 (Dex 0.2 μg/kg/hour), and group D2 (Dex 0.4 μg/kg/hour) (n = 30 per group). All participants received fentanyl, propofol and 1% sevoflurane for anesthesia induction. Hemodynamic data were measured from T0 (before the induction) to T7 (30 minutes after extubation). The difference of arterial internal jugular vein bulbar oxygen difference and cerebral oxygen extraction ratio were calculated according to Fick formula. Enzyme-linked immunosorbent assay was performed to detect the serum myocardial, brain and kidney injury markers. The incidence of acute kidney injury (AKI) was calculated by serum creatinine level. Tracheal extubation time, postoperative pain score and emergence agitation score were also recorded.Results:Compared with group C, group D1, and D2 exhibited reduction in hemodynamic parameters, myocardial and brain injury indicators, and tracheal extubation time. There were no significant differences in blood urea nitrogen and neutrophil gelatinase-associated lipocalin or incidence of AKI among the 3 groups. Besides, the incidence of tachycardia, nausea, vomiting and moderate agitation, and the FLACC scale in group D1 and D2 were lower than those in group C. Moreover, Dex 0.4 g/kg/hour could further reduce the dosage of fentanyl and dopamine compared with Dex 0.2 g/kg/hour.Conclusions:Dex anesthesia can effectively maintain hemodynamic stability and diminish organ injuries in CHD children.

236 Effects of mitoquinol during acute heat stress exposure in growing pigs

Abstract Objectives were to determine the effects of mitoquinol (MitoQ) on performance, metabolism, and inflammation during acute heat stress (HS) in growing pigs. Crossbred barrows (n=32; 59±1 kg BW) where blocked by BW and randomly assigned to 1 of 4 therapeutic-environmental treatments: 1) thermoneutral (TN) control (n=8; TNCtl), 2) TN and MitoQ (n=8; TNMitoQ), 3) HS control (n=8; HSCtl), or 4) HS and MitoQ (n=8; HSMitoQ). The trial consisted of two experimental periods (P). During P1 (2d), pigs were fed ad libitum and housed in TN conditions (20.6±0.1°C). During P2 (24h), HSCtl and HSMitoQ pigs were exposed to continuous HS (35.2±0.03°C); while TNCtl and TNMitoQ remained in TN conditions. Mitoquinol was orally administered twice daily (0700 and 1800 h; 40 mg/d) during P1 and P2. Pigs exposed to HS had increased rectal temperature, skin temperature, and respiration rate (1.46°C, 6.79°C, and 101 bpm, respectively; P&amp;lt; 0.01) compared to their TN counterparts. Acute HS markedly decreased feed intake (67%; P&amp;lt; 0.01). Additionally, HS pigs lost BW compared to their TN counterparts (-4.7 vs. +1.6 kg, respectively; P&amp;lt; 0.01); however, the reduction in BW was less severe in HSMitoQ compared to HSCtl pigs (-3.85 vs. -5.50 kg, respectively; P&amp;lt; 0.01). Circulating glucose increased in HSMitoQ relative to HSCtl pigs (15%; P=0.04). Non-esterified fatty acid (NEFA) concentrations were increased in HS compared to TN pigs (P&amp;lt; 0.01), although this difference was influenced by increased NEFA in HSCtl relative to HSMitoQ pigs (251 vs. 142 μEq/L; P&amp;lt; 0.01). Insulin:feed intake tended to increase in HS relative to TN pigs (P=0.09). Overall, no differences in blood urea nitrogen or cell blood counts were observed across treatments (P &amp;gt;0.10). In conclusion, acute HS exposure negatively altered animal performance and metabolism; however, administering MitoQ appeared to ameliorate the HS response.

Impact of twice- or three-times-weekly maintenance hemodialysis on patient outcomes

Aim:Maintenance hemodialysis (MHD) frequency is associated with survival and complication rates. Achieving the optimal balance between healthcare, quality of life (QOL), and medical costs is challenging. We compared complications, inflammatory status, nutritional status, and QOL between patients with different MHD frequencies.Material and Methods:This was a multicenter randomized trial of patients treated between May 2011 and August 2017 at 3 tertiary hospitals in Wenzhou. Patients were grouped according to their treatment schedule over 1 year: twice-weekly or 3-times-weekly. Complications, biochemistry parameters, and QOL (KDQOL-SFTM 1.3 scale) were assessed.Results:One hundred forty patients were included aged 29 to 68 years (mean age, 50.9 ± 4.3 years). There were no significant differences in infection, heart failure, or cerebral hemorrhage complications between the 2 groups (P = .664). Pre-dialysis hemoglobin, high-sensitivity C-reactive protein, serum albumin, total cholesterol, triglyceride, calcium, phosphate, parathyroid hormone, and ejection fraction were similar in both groups (P > .05). After 1 year of MHD, both groups exhibited significant improvements in these parameters (all P < .05) with no significant differences between groups. Serum creatinine, blood urea nitrogen (BUN), and weekly standard hemodialysis treatment adequacy did not improve after treatment (all P > .05), although a difference in BUN was observed between the 2 groups (P < .001). QOL was superior in the twice-weekly group than in the 3-times-weekly group (all P < .05), except for social support, which was slightly better in the 3-times-weekly group than in the twice-weekly group.Conclusions:Twice- and 3-times-weekly MHD resulted in comparable inflammatory and nutritional clinical outcomes and adverse events. QOL was better for the twice-weekly schedule. Even for patients with economic constraints, twice- or 3-times-weekly MHD should be selected with caution after consideration of BUN levels at baseline.