Mean Creatinine Concentration Research Articles

Antioxidant and phytochemical profiling of ethanol leaf extract of Ficus pachyneura and derived fractions

A total of 16, 18-weeks old chickens with mean weight 1.99±0.12 kg (1.85-2.30kg) were used to compare the serum biochemical characteristics of four chicken genotypes (breeds/strains) from south-eastern part of Nigeria. The chickens were grouped based on their genotypes (breeds/strain) in a Completely Randomized Design for the four-week study. The genotypes (breeds) considered were Black Australorp (BA), Isa Brown (IB), Noiler (NOI) and Local chicken (LC) at 4 chickens per genotype. At the end of the experiment, four (4) birds per genotype were drawn and their blood samples analysed for serum biochemical studies. The mean total cholesterol (TC), triaceylglycerol (TAG) and very low density lipoprotein cholesterol (VLDL-C) concentrations of local chicken (LC) were significantly (P < 0.05) higher than the Isa brown (IB) values. Similarly, the mean blood urea nitrogen (BUN) concentrations of LC was significantly (P < 0.05) higher than the Noiler value. The mean high density lipoprotein cholesterol (HDL-C) of black Australorp (BA) was significantly (P < 0.05) higher than the value of Noiler but showed no significant (p > 0.05) difference when compared to the values of IB and LC. There were however no significant (p > 0.05) variations in the mean low density lipoprotein cholesterol (LDL-C), total bilirubin, direct bilirubin, indirect bilirubin and creatinine concentrations among all the breeds investigated. In conclusion, the results obtained in this study will be helpful in creating a baseline data on biochemical profiles of indigenous and exotic chicken breeds in Nigeria which in turn can be used for assessing the health status of these birds, improving desirable breeds/traits and designing appropriate breeding strategies for indigenous poultry birds in the country.

Evaluations of the effect of genetic variations on the serum renal function markers, bilirubin and lipid profile of laying domestic fowls

A total of 16, 18 weeks old chickens with mean weight 1.99±0.12 kg (1.85-2.30kg) were used to compare the serum biochemical characteristics of four chicken genotypes (breeds/strains) from south-eastern part of Nigeria. The chickens were grouped based on their genotypes (breeds/strain) in a Completely Randomized Design for the four-week study. The genotypes (breeds) considered were Black Australorp (BA), Isa Brown (IB), Noiler (NOI) and Local chicken (LC) at 4 chickens per genotype. At the end of the experiment, four (4) birds per genotype were drawn and their blood samples analysed for serum biochemical studies. The mean total cholesterol (TC), triaceylglycerol (TAG) and very low density lipoprotein cholesterol (VLDL-C) concentrations of local chicken (LC) were significantly (P < 0.05) higher than the Isa brown (IB) values. Similarly, the mean blood urea nitrogen (BUN) concentrations of LC was significantly (P < 0.05) higher than the Noiler value. The mean high density lipoprotein cholesterol (HDL-C) of black Australorp (BA) was significantly (P < 0.05) higher than the value of Noiler but showed no significant (p > 0.05) difference when compared to the values of IB and LC. There were however no significant (p > 0.05) variations in the mean low density lipoprotein cholesterol (LDL-C), total bilirubin, direct bilirubin, indirect bilirubin and creatinine concentrations among all the breeds investigated. In conclusion, the results obtained in this study will be helpful in creating a baseline data on biochemical profiles of indigenous and exotic chicken breeds in Nigeria which in turn can be used for assessing the health status of these birds, improving desirable breeds/traits and designing appropriate breeding strategies for indigenous poultry birds in the country..

Lipid metabolism and renal function markers in obese adolescents.

To investigate the relationship of renal function markers and lipid metabolism parameters in obese adolescents. The study comprised 76 children aged 11-17 years, hospitalised due to: obesity (group I - 19 children) or obesity accompanied by obesity-induced hypertension (group II - 30 children) or normosthenic children with a diagnosed tension headaches (control group - 27 children). A subgroup with metabolic syndrome (MS - 16 children) was also separated. Renal function was assessed on the basis of: serum creatinine concentration, glomerular filtration rate estimated using Schwartz eqation (eGFR), determination of plasma and urinary neutrophil gelatinase-associated lipocalin and cystatin C. On the basis of statistical analysis, it was checked whether renal function markers depend on lipid metabolism parameters. In the study groups mean creatinine concentrations were significantly higher and eGFR values significantly lower than in the control group, but they remained within norm. Differences in plasma and urinary neutrophil gelatinase-associated lipocalin concentrations were not significant. Mean cystatin C concentrations were significantly higher in the group of obese children. Multiple linear regression analysis showed that the most important predictor was: LDL-C for urinary neutrophil gelatinase-associated lipocalin (R2 = 0.42) and TG for eGFR (R2 = 0.44) concentrations in group I; cholesterol for creatinine concentrations in MS group (R2 = 0.44). Renal function of the obese adolescents included in the study was normal and the associations with lipid metabolism were poorly expressed.

Method for spot urine normalization by 40K in a radiation emergency

In this study, to assess the internal radiation dose in radiation emergencies, the variability of spot urine normalization methods is studied using 40K measurement results. The mean creatinine concentration and the mean 40K activity concentration in the spot urine samples studied were 139 mg dL−1 and 106 Bq kg−1, respectively. The results indicate that the 40K activity concentration method can be used to complement the method used for normalizing the creatinine concentration in spot urine in a radiological emergency.

The Increase in Circulating Levels of Pro-Inflammatory Chemokines, Cytokines, and Complement C5 in Canines with Impaired Kidney Function.

Chronic low-grade inflammation is a key contributor to the progression of kidney disease. The release of cytokines and other pro-inflammatory proteins may further contribute to detrimental kidney health by increasing interstitial edema and renal fibrosis. The aim of the present study was to investigate the inflammatory markers in canines who developed renal disease naturally and were diagnosed with renal disease either during life or following necropsy, as assessed by a veterinarian. RNA was isolated from canine blood obtained at necropsy and stored as bioarchived samples from ten canines with renal disease (9.6–14.7 yr) and ten controls (10.1–14.8 yr). At the time of death, the mean blood creatinine concentration and BUN were elevated in dogs with renal disease compared to control (both p < 0.01). Samples were assessed for changes in gene expression using the Canine cytokine RT2 Profiler PCR Array for inflammation. There was a significant increase in C-C Motif Chemokine Ligand 16 (CCL16), C-X-C Motif Chemokine Ligand 5 (CXCL5), Interleukin 16 (IL-16), and Complement Component 5 (C5) (all p < 0.05 vs. con). In addition, there was also a statistically non-significant increase in 49 genes and a down-regulation in 35 genes from a panel of total 84 genes. Pro-inflammatory genes including CCL16, CXCL5, IL-16, and C5 can all contribute to renal inflammation and fibrosis through different signaling pathways and may lead to a progressive impairment of kidney function. Blockade of their activation may be important in ameliorating the initiation and/or the progression of renal disease.

Long-Term Efficacy of T3 Analogue Triac in Children and Adults With MCT8 Deficiency: A Real-Life Retrospective Cohort Study.

ContextPatients with mutations in thyroid hormone transporter MCT8 have developmental delay and chronic thyrotoxicosis associated with being underweight and having cardiovascular dysfunction.ObjectiveOur previous trial showed improvement of key clinical and biochemical features during 1-year treatment with the T3 analogue Triac, but long-term follow-up data are needed.MethodsIn this real-life retrospective cohort study, we investigated the efficacy of Triac in MCT8-deficient patients in 33 sites. The primary endpoint was change in serum T3 concentrations from baseline to last available measurement. Secondary endpoints were changes in other thyroid parameters, anthropometric parameters, heart rate, and biochemical markers of thyroid hormone action.ResultsFrom October 15, 2014 to January 1, 2021, 67 patients (median baseline age 4.6 years; range, 0.5-66) were treated up to 6 years (median 2.2 years; range, 0.2-6.2). Mean T3 concentrations decreased from 4.58 (SD 1.11) to 1.66 (0.69) nmol/L (mean decrease 2.92 nmol/L; 95% CI, 2.61-3.23; P < 0.0001; target 1.4-2.5 nmol/L). Body-weight-for-age exceeded that of untreated historical controls (mean difference 0.72 SD; 95% CI, 0.36-1.09; P = 0.0002). Heart-rate-for-age decreased (mean difference 0.64 SD; 95% CI, 0.29-0.98; P = 0.0005). SHBG concentrations decreased from 245 (99) to 209 (92) nmol/L (mean decrease 36 nmol/L; 95% CI, 16-57; P = 0.0008). Mean creatinine concentrations increased from 32 (11) to 39 (13) µmol/L (mean increase 7 µmol/L; 95% CI, 6-9; P < 0.0001). Mean creatine kinase concentrations did not significantly change. No drug-related severe adverse events were reported.ConclusionsKey features were sustainably alleviated in patients with MCT8 deficiency across all ages, highlighting the real-life potential of Triac for MCT8 deficiency.

Assessment of the correlation of commonly used laboratory tests with clinical activity, renal involvement and treatment of systemic small-vessel vasculitis with the presence of ANCA antibodies

BackgroundThe aim of the study was to assess the correlation of commonly used laboratory tests with clinical activity, degree of kidney involvement and treatment of systemic small-vessel vasculitis with the presence of ANCA antibodies.MethodsThe study included 28 patients with active AAV (BVAS ≥ 3). The following tests were performed: MPO-ANCA, PR3-ANCA, peripheral blood count, ESR, CRP, procalcitonin, creatinine, GFR, urea, albumin, fibrinogen, d-dimer, components of the C3 and C4 complement systems, urinalysis with sediment evaluation and diurnal proteinuria. The assessments were conducted twice: at study entry (A0) and after 6 months (A6) (BVAS = 0).ResultsAt the time of inclusion in the study, the mean creatinine concentration was 3.39 mg/dl (GFR 33.17 ml/min/1.73 m²), after achieving remission in 11 patients (39.3 %) GFR remained below 30 ml/min/1.73 m², 4 patients (14.3 %) continued renal replacement therapy, and 3 patients (10.7 %) with advanced renal failure died. Microscopic hematuria occurred in 80.9 % of the studied population, withdrew in most patients, strongly correlated with renal involvement p < 0.001 and was not related to disease severity p = 0.147. CRP, ESR, fibrinogen, d-dimer, albumin and hemoglobin in the peripheral blood showed a strong correlation with the clinical activity of AAV and well identified severe patients. High procalcitonin concentrations correlated with a severe form of the disease, pulmonary involvement with respiratory failure and alveolar hemorrhage (mean 3.41 ng/ml, median 0.91 ng/ml, SD 7.62, p = 0.000), and were associated with the occurrence of infectious complications and the need to administer antibiotic therapy. ANCA antibodies were useful in the evaluation of patients with AAV, the amount of antibodies did not correlate with the severity of vasculitis (p = 0.685) and the results in many patients did not match the expected assumptions.ConclusionsCRP, ESR, fibrinogen, d-dimers, albumin and hemoglobin in the peripheral blood correlate well with the activity of vasculitis and identify severe patients. The resolution of microscopic hematuria suggests remission of the disease in the renal area. Procalcitonin may be slightly increased in patients with active AAV without infection, high concentrations are strongly associated with infectious complications. ANCA antibodies should always be interpreted in the context of the observed clinical symptoms.

Efficacy of LDL apheresis for the treatment of cholesterol crystal embolism: A prospective, controlled study.

This study was performed to evaluate the efficacy and safety of LDL apheresis (LDL-A) for the treatment of cholesterol crystal embolism (CCE) after cardiovascular procedures. We conducted a prospective multicenter study of 34 patients with CCE and 15 historical control patients. The present participants underwent six sessions of LDL-A for 4 weeks and underwent medical therapy with corticosteroids and statins. The mean creatinine concentration and estimated glomerular filtration rate at baseline were 3.82 ± 2.29 mg/dL and 17.8 ± 9.9mL/min/1.73 m2 , respectively. The prevalence of maintenance dialysis at 24 weeks was significantly lower in the present participants than in the historical controls (3.1% vs. 40.0%, respectively; p < 0.0001), but the mortality rate at 24 weeks was comparable (19% vs. 33%, respectively). Although 45 adverse events occurred in 23 participants, there were no unexpected adverse events. LDL-A for CCE reduces the prevalence of maintenance dialysis 24 weeks later and is well tolerated. This study was registered in the Japan Registry of Clinical Trials (jRCTs022180029) and clinicaltrials.gov (NCT01726868).

The impact of creatinine reference value: Normalization of urinary drug concentrations.

Many illicit drug users attempt to manipulate urine drug testing; dilution is one of the methods. In screening tests, false-negative results below the cut-off values can create positive results after creatinine normalization. This study aimed to evaluate the impact of a creatinine reference value on the normalization of the drug concentration in diluted urine. The study focused on 25630 cases and the following information: gender, age, urine collection time, drug screening test results, creatinine concentration (CR), and confirmation analysis result. Mean CR value was 143.71±83.68mg/dl. There was a significant difference between CR and gender (p=0.03). The mean CR for women was lower than that for men. The correlation between age and CR was not significant (r=-0.08, p=0.00). However, after grouping the sample into age groups of 10years, there was a significant difference between age groups and mean CR (p=0.00). The mean CR was significantly lower in the 0-9year age group (n=34) than in the 20-29year age group (n=10943). According to the urine specimen collection time, CR levels during the early hours of the day (06:00-06:59) were lower than those during the remaining hours (p=0.00). The highest converted drug-negative to drug-positive results were obtained from 153.23mg/dl CR reference value. Reference CR values were evaluated according to gender, age, and urine collection time. Different rates of positive results were obtained for each reference value. There is no published local creatinine value for spot urine samples in many countries, including Turkey. This will be useful to develop appropriate normalization models when reporting drug test results.

PRESENTATION, MANAGEMENT, AND OUTCOME OF POSTERIOR URETHRAL VALVES IN WESTERN RAJASTHAN

Introduction: Posterior urethral valve (PUV) is the most common cause of bladder outlet obstruction and renal insufciency in male children. The aim of this study was to evaluate the presentation, management, challenges, and outcome of the disease in a Western Rajasthan tertiary health institution. Methods: In a retro-prospective study, 26 male children were included from November 2017 to March 2020 at Dr. S.N.Medical college, Jodhpur. Diagnosis was conrmed by voiding cysto-urethrography (VCUG). Results: A total of 26 patients were managed for PUV.The mean age of presentation was 3.45 years with 65.8% of the patients presenting after 1 year. Voiding dysfunction noted in 23(88.4%) patients was the most common presentation. Most common nding on physical examination was palpable bladder 15(57.6%) while UTI noted in 15 (57.6%) patients was most common complication. Abdominal sonography revealed dilated posterior urethra in 10(38.4%) cases, while VCUG revealed a dilated posterior urethra in 19 (75%) cases.The creatinine value at presentation ranged from 0.4-4.5 mg/dl with a mean of 1.10 ± 0.95 mg/dl. Valve ablation with a diathermy bugbee electrode &amp; holmium laser provided relief of obstructions in the 23 (88.4%) patients who underwent the procedure without immediate complication. The period of follow-up ranged between 1 weeks to 2 years with a mean of 8.2 months. There was sustained improvement in urine stream, reduction in the mean creatinine concentration and incidence of UTI during follow-up. Conclusion: Many patients with PUVpresented late within the reviewed period. Valve ablation provided relief of obstruction in most of the cases. Efforts at improving awareness among general population and early diagnosis and referral among the health team should be encouraged. There is a need to counsel parents on the need for long-term follow-up

Endocrine profiles and kidney function markers of apparently healthy pregnant and lactating Duroc sows

This experiment was carried out to evaluate the effects of reproductive activities (pregnancy and lactation) on certain serum endocrine profiles and kidney function markers of Duroc sows. Thirty (30) sexually matured cycling apparently healthy Duroc sows and eight (8) Duroc boars (38 pigs), of mean weight 55.36±0.48 kg, aged between13and 15 months were used for this study. The sows (30) were randomly assigned to five groups (A to E) of six sows per group in a completely randomized design (CRD). Group A: Nonpregnant (control), Group B: Early gestation (38 days), Group C: Mid gestation (78 days), Group D: Late gestation (110 days) and Group E: Post gestation (7 days postpartum). The mean serum progesterone (P4) concentration of group D sows was significantly (p&lt;0.05) increased when compared to group E. The mean serum thyroxine (T4) concentration of group D sows (3rd trimester) was significantly (p&lt;0.05) increased when compared to groups C and E. The mean blood urea nitrogen (BUN) concentration of the treated group (C) was significantly (p&lt;0.05) higher when compared to group B. The mean creatinine concentration of group D was significantly (p&lt;0.05) higher when compared to groups E, B and the control. The mean BUN/CRT ratio of group B sows was significantly (p&lt;0.05) higher when compared to groups C, D, E and the control. There were, however, no significant variations (p&gt;0.05) in the mean oestradiol (E2), cortisol (C), creatinine (CRT) concentrations and BUN/CRT ratio among all the groups. In conclusion, the serum endocrine and kidney function markers of Duroc sows in this study were significantly influenced by gestation. This study has established reference values of the endocrine profiles and kidney function markers of Duroc sows during gestation that are consistent with normal health.

Assessment of Some Biochemical Changes in Wistar Rats Following Administration of Three Polyherbal Preparations Repurposed for COVID-19

Background and Aims: The current pandemic known as Coronavirus Disease-19 (COVID-19) is a significant public health menace. Currently, there is no specific treatment for this disease, although some medicinal agents are under investigation. Some published articles have reported Severe Acute Respiratory Distress Syndrome Coronavirus-2 (SARS CoV-2) involvement in other organs, including the liver and kidneys, which can impair the metabolism and excretion of the medications taken to treat the disease. This study evaluated the effects of 3 herbal mixtures on some biochemical parameters of the liver and kidney of laboratory animals.&#x0D; Methods: Liver enzymes such as serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, albumin and total serum protein were quantified. Urea, creatinine and bilirubin (total and direct) were also evaluated. These parameters were determined for all three polyherbal combinations (CoV Pla-1, CoV Pla-2, CoV Pla-3).&#x0D; Results: The extracts did not produce any mortality up to 5000 mg/kg per oral. Results showed that the polyherbal extracts (CoV Pla-1, CoV Pla-2 CoV Pla-3) did not cause any significant changes in ALT, AST, ALP, compared to control. The mean values of urea showed an insignificant (P&gt;0.05) decrease across all test doses in the three extracts, compared to the control. In the current study, the mean creatinine concentration showed slight decrease across all three extracts. Total protein was observed to be lower in CoV Pla-1 and CoV Pla-2, and increased in CoV Pla-3, though these changes were not statistically significant. Serum albumin decreased at the low and intermediate doses for the three polyherbal extracts in an insignificant manner compared to control.&#x0D; Conclusion: The results obtained in this study indicate that the extracts did not cause significant changes in biochemical parameters evaluated and support their use in the treatment of Covid-19.

Urine Concentration Does Not Affect Biochemical Testing for Non-adherence.

Hypertension is one of the most important modifiable risk factor causing cardiovascular disease. Unfortunately, non-adherence to antihypertensive medications is frequently observed in hypertensive patients and can lead to an increase in morbidity and mortality. Until recently, there was no robust clinical method to objectively diagnose non-adherence. Recently, the detection of medications in urine or blood by mass spectrometry techniques such as liquid chromatography-tandem mass spectrometry (LC–MS-MS) has been accepted as the diagnostic method of choice for the detection of non-adherence. Despite this, it is unclear whether the concentration of urine can affect the detection of medications in urine. Therefore, this study aimed to assess the effect of urine concentration on detection of antihypertensive medications by LC–MS-MS in which urine creatinine is used as an independent marker of urine concentration. Biochemical adherence results for 22 different medications (1,709 prescriptions) in 463 different subjects were converted to an adherence score. The adherence score was defined as the ratio of the total number of subjects in which the drug was detected to the total number of subjects to whom the drug was prescribed. The adherence scores for each medication were correlated with urine creatinine concentration for each medication. Non-adherence was observed in 47.1% of samples with a mean urine creatinine concentration of these samples of 9.4 ± 7.1 mmol/L. There was no significant difference between the urine creatinine concentrations in the detected vs non-detected groups for each of the 22 medications. Furthermore, there are no differences in adherence scores across the urine creatinine concentration. This is the first study to demonstrate that urine creatinine concentration does not affect the results of the adherence screening by LC–MS-MS.

Urine creatinine concentration and urine protein-to-creatinine ratios in healthy nonracing Greyhounds.

Serum creatinine concentrations are higher in Greyhounds when compared with nonsighthound breeds. Greyhounds might also have higher urine creatinine concentrations compared with other breeds, which could affect urine protein-to-creatinine ratio (UPC) references. We aimed to determine the UPC reference intervals (RIs) in healthy nonracing Greyhounds and compare this with UPC values in a group of healthy nonsighthounds and with the current International Renal Interest Society (IRIS) guidelines. The study used an observational cross-sectional design, involving clinically healthy, nonracing Greyhounds (n=98) and nonsighthound dogs of similar weight, age, and sex (n=24). Packed cell volumes, total solids, urine protein concentrations, serum and urine creatinine concentrations, urine specific gravity (USG) measurements, and UPCs were determined. Linear regression was used to compare urine creatinine and urine protein concentrations, relative to theUSG measurements, between Greyhound and nonsighthound groups. Greyhound UPC RIs were determined using nonparametric methods and compared with UPC values in nonsighthounds and current IRIS guidelines. Mean urine creatinine concentrations, adjusted for USGs, were approximately 22% higher in Greyhounds compared with nonsighthounds (P=.002). Mean urine protein concentration (P=.46) and UPC (P=.1) were not significantly different between Greyhounds and nonsighthounds. The upper limit of the Greyhound UPC RI was 0.20 or 0.42, depending on whether strict or moderate exclusion criteria were applied, respectively. Greyhounds have higher urine creatinine concentrations than nonsighthounds. Although the suggested RI for UPCs in Greyhounds is slightly lower than the cut-offs recommended in generic canine IRIS guidelines, this difference is not likely to be clinically significant.

OR01-05 Long-Term Efficacy of T3 Analogue Triac in MCT8 Deficiency

Background: MCT8 deficiency is a severe disorder caused by mutations in the thyroid hormone transporter MCT8. MCT8 deficiency is characterized by severe intellectual and motor disability and high serum T3 concentrations that result in thyrotoxic symptoms in peripheral tissues. This predisposes to substantial morbidity and mortality. Preclinical studies showed that the T3 analogue Triac can bypass defective MCT8 at the cellular level. Recently, we reported the results of an international multicenter trial, in which biochemical and clinical outcomes improved in patients with MCT8 deficiency who were treated with Triac for 12 months (1). However, long-term follow-up data of patients with MCT8 deficiency treated with Triac are lacking, particularly in young children. Therefore, we aimed to investigate the long-term efficacy of Triac therapy in a worldwide cohort of patients with MCT8 deficiency. Methods: We investigated the efficacy of oral Triac treatment in pediatric (n=78) and adult (n=5) patients with MCT8 deficiency in 20 countries. Triac dose was titrated according a predefined dose-escalation scheme aiming to normalize serum T3 concentrations (target 1.4-2.5 nmol/L). Thyroid function tests and biochemical markers of thyroid hormone action in peripheral tissues (SHBG, creatine kinase, creatinine) were measured at baseline and during control visits. Findings: In total, 83 patients with a median baseline age of 5 years (range 6 months – 66 years) were treated, including 24 patients aged 0-2.5 years and 17 patients aged 2.5-5 years. They were treated with Triac during 144 patient years, of whom the follow-up time was >5 years in 9 patients and 2-5 years in 22 patients. Mean dose was 45 µg/kg/day (range 11-107 µg/kg/day). Once a stable dose was achieved, no further dose adjustments were needed.Mean serum T3 concentrations decreased from 5.02 to 1.94 nmol/L (normal 1.4 – 2.5 nmol/L). SHBG concentrations improved from 238 to 204 nmol/L (normal 40-140 nmol/L). Mean creatine kinase and creatinine concentrations improved from 113 to 140 U/L (normal <230 U/L) and from 32 to 38 µmol/L (normal 31-68 μmol/L), respectively. No drug-related severe adverse events were reported. Interpretation: Triac is a safe treatment that results in sustainable improvements of the severe thyrotoxic state in pediatric and adult patients with MCT8 deficiency.

Detection of DNA adduct 8-hydroxy-2'-deoxyguanosine (8-OHdG) as a toxicity bioindicator to the effects of nickel on Ni-Cr alloy prosthesis users.

Previous studies have suggested that exposure to Ni from Ni-Cr alloys can affect the human body through oxidative stress. The present study discusses the effect of nickel from Ni-Cr alloy prostheses on the formation of DNA Adduct 8-Hydroxy-2′-Deoxyguanosine (8-OHdG), evaluated based on creatinine and 8-OHdG concentrations in urine, determined with LC-MS/MS, for a Ni-Cr alloy user group and a never-user control group. The mean creatinine and 8-OHdG concentrations were not significantly different between the test groups, although highest levels were observed for the in the Ni-Cr user group. It is suggested that samples with relatively high creatinine and/or 8-OHdG levels are further studied in more detail for stability of concentrations and for the effect of contributing factors.

Real-life safety of atrial flutter ablation in the era of NOACs. The French Global Flutter Study

Cavotricuspid isthmus (CTI) radiofrequency ablation (RFA) is considered a first-line therapy to achieve rhythm control in patients with typical atrial flutter (AFL). Determine the incidence and risk factors for developing bleeding complications in patients takingnon-vitamin K anticoagulants (NOAC) versus vitamin K antagonists (VKA) and undergoing an atrial flutter catheter ablation in everyday clinical practice. It is a multicenter, observational, prospective study of patients with AFL undergoing a CTI RFA. Eligible patients had been taking apixaban (2.5 or 5 mg twice daily), rivaroxaban (15 or 20 mg once daily), dabigatran (110 or 150 twice daily) or VKA for ≥ 3 weeks before the procedure, and were followed for 30 days afterwards. A total of 477 patients, 69,7 ± 10.9 [interquartile range 29, 96] years, 80% male, mean CHA2DS2-VASc score 2.4 ± 1.5 were enrolled at 25 academic/nonacademic centres in France. 84 patients (17.6%) were receiving rivaroxaban (68 patients on 20 mg/day, and 16 patients on 15 mg/day). 89 (18.6%) patients were receiving dabigatran 65 patients on 300 mg/day and 24 on 220 mg/day. 244 (51.15%) patients were receiving apixaban (210 on 10 mg/day, and 34 patients on 5 mg/day). 60 (12.57) patients were receiving VKA. The mean INR before procedure was 2.7 ± 1.8. The most prevalent concomitant disorders were hypertension (53%), diabetes (20%) and vascular disease 87 (18%). Mean creatinine concentration was 98 ± 45micromol/L, median weight was 84 ± 18 kg and mean creatinine clearance (Cockcroft-Gault) was 80 ± 33 mL/min. Overall, 28 patients were switched to unfractionated heparin or enoxaparin. The median duration of switch was 6 ± 14 hours. Complications were reported at 30 days, and included only 1 (1.6%) bleeding event in patient receiving VKA (hematoma). Every day practice of AFL ablation in patients receiving NOACs is safe. No complications were reported in these patients on NOACs.

Hematobiochemical and Immunological Responses of Rats Treated with Multi-strain Probiotics and Infected with Trypanosoma brucei.

The effects of treatment with probiotics on the immunological and hematobiochemical changes in Trypanosoma brucei infection were investigated. Probiotic strains used are Bifidobacterium BB-12, Lactobacillus acidophilus LA-5, Lactobacillus delbrueckii LBY-27, Lactobacillus paracasei LC-01, and Streptococcus thermophilus STY-31. Thirty rats randomly assigned to five groups were used in the experiment. Groups A to C received 1 × 109 CFU, 5 × 109 CFU, and 10 × 109 CFU of the multi-strain probiotics daily and respectively from day 0 post-supplementation (PS) to termination. Group D and E were the infected and uninfected controls respectively. On day seven PS, groups A to D were challenged intraperitoneally with approximately 1 × 106 trypanosomes. Parasitemia, nitric oxide level, hematobiochemical parameters, and antibody titer to heterologous antigen stimulation were monitored post-infection. By days 7 and 16 PS, probiotics-treated groups had significantly lower (p < 0.05) mean creatinine concentration than the controls; however, on day 7 PS, there were no significant variations in the leukocyte counts (LC), total erythrocyte counts (TEC), and the packed cell volume (PCV) in all experimental groups. Following infection, by day 16 PS, the pre-patent period, parasitemia levels, and antibody titer were similar in all infected groups. Furthermore, the probiotics-treated groups and the infected control had significantly lower PCV, TEC, and LC values when compared to the uninfected control, and probiotics treated groups (A and C) had only marginally lower nitric oxide levels than the infected control. Treatment with the probiotic strains gave a creatinine-lowering effect, was innocuous to the hematopoietic system, but was not sufficiently immunostimulatory in trypanosomosis.

P1899Heparin and low-molecular-weight heparin switch associated with an increase in bleeding complications in patients on apixaban undergoing catheter ablation: The AMPER ABLATION study

Abstract Background The aim of this study was to identify the factors associated with bleeding complications in patients taking apixaban and undergoing a catheter ablation in everyday clinical practice. Methods AMPER ABLATION is a multicenter, observational, prospective study of patients with non valvular atrial fibrillation (AF) undergoing a catheter ablation. Eligible patients had been taking apixaban (2.5 or 5 mg twice daily) for ≥3 weeks before the procedure, and were followed for 30 days afterwards. Results A total of 595 patients (65 [interquartile range 59, 72] years, 67% male, mean CHA2DS2-VASc score 1.85±1.37) were enrolled at 25 academic/nonacademic centers in France; 524 patients (88%) were receiving apixaban 10 mg/day and 71 (12%) 5 mg/day. 323 patients (54%) underwent an AF ablation, and 272 (46%) an atrial flutter (AFL) ablation. The most prevalent concomitant disorders were hypertension (51% of patients), diabetes (15%) and vascular disease (10%). Mean creatinine concentration was 1.06±0.28 mg/dL, median weight was 83±18 kg and mean creatinine clearance (Cockcroft-Gault) was 82±34 mL/min. The management of apixaban in the periprocedural period was left to the investigator's preference. Overall, 264 patients were switched to unfractionated heparin or enoxaparin (238 for AF ablations and 26 for AFL ablations). The median duration of switch was 29 hours. Complications were reported at 30 days, and included 12 bleeding events (1 tamponade needing drainage, 1 pericardial effusion without drainage, 7 International Society on Thrombosis and Haemostasis [ISTH] non major bleedings for AF ablations and 1 pericardial effusion without drainage, and 2 ISTH non major bleedings for AFL ablations) and 1 embolic event (non disabling stroke for an AF ablation). Comparing patients with and without a bleeding event revealed a higher rate of heparin or low-molecular-weight heparin (LMWH) switching in patients with a bleeding event (60% vs 35%; p=0.02). A switch to heparin or LMWH was the only factor associated with an increase rate of bleeding (odds ratio 2.5; [CI 95%; 1.1, 7.1]; p=0.01). Conclusion Heparin or LMWH switch in the periprocedural AF and AFL-ablation period is associated with an increased rate of bleeding complications at 30 days. Acknowledgement/Funding Financial support from BMS

Creatinine excretion in consecutive urine samples after controlled ingestion of water.

Highly diluted urine is among the most commonly observed factors affecting the validity of urine testing for drug abuse. A minimum creatinine concentration of 20mg/dL urine has been proposed as a marker for dilution of a urine sample. This study investigates the effect of water consumption on creatinine concentration, as well as its effect on specific gravity and osmolality. In this study, 22 subjects (17 women and 5 men) were included to determine the influence of sex and weight on the impact of excessive water consumption on these markers of urine dilution. The subjects consumed 0.5L, 1.0L, and 1.5L of water, respectively, within 15minutes. The mean minimum creatinine concentrations (Jaffé reaction) for the void 2 hours after fluid intake were 60.4mg/dL, 15.8mg/dL, and 10.9mg/dL for the respective ingested volumes of water. Mean creatinine concentrations excreted by men were significantly higher than those excreted by women. Participants with a weight below 60kg tended to excrete lower urine creatinine concentrations. 50% of the volunteers with a BMI<20kg/m2 and 20% of the volunteers with a BMI>20kg/m2 exhibited creatinine concentrations below the threshold value of 20mg/dL. A similar pattern was established for gravity and osmolality. Due to its simple determination, creatinine may be preferred over specific gravity or osmolality. In order to evaluate the internal dilution of a urine sample for legally defensible drug testing, it may be necessary to account for sex and body weight.