SEM Serum Research Articles

Oral magnesium supplementation does not affect insulin sensitivity in people with insulin-treated type 2 diabetes and a low serum magnesium: a randomised controlled trial

Aims/hypothesisHypomagnesaemia has been associated with insulin resistance and an increased risk of type 2 diabetes. Whether magnesium supplementation improves insulin sensitivity in people with type 2 diabetes and a low serum magnesium level is unknown.MethodsUsing a randomised, double-blind (both participants and investigators were blinded to the participants’ treatment sequences), placebo-controlled, crossover study design, we compared the effect of oral magnesium supplementation (15 mmol/day) for 6 weeks with that of matched placebo in individuals with insulin-treated type 2 diabetes (age ≥18 years, BMI 18–40 kg/m2, HbA1c <100 mmol/mol [11.3%], serum magnesium ≤0.79 mmol/l). Participants were recruited from the outpatient clinic and through advertisements. Randomisation to a treatment sequence order was done using a randomisation list. We used block randomisation and the two possible treatment sequences were evenly distributed among the trial population. The primary outcome was the mean glucose infusion rate during the final 30 min of a hyperinsulinaemic–euglycaemic clamp (i.e. M value). Secondary outcomes included variables of glucose control, insulin need, BP, lipid profile and hypomagnesaemia-related symptoms during follow-up.ResultsWe recruited 14 participants (50% women, 100% White, mean ± SD age 67±6 years, BMI 31±5 kg/m2, HbA1c 58±9 mmol/mol [7.4±0.9%]) with insulin-treated type 2 diabetes. Magnesium supplementation increased both mean ± SEM serum magnesium level (0.75±0.02 vs 0.70±0.02 mmol/l, p=0.016) and urinary magnesium excretion (magnesium/creatinine ratio, 0.23±0.02 vs 0.15±0.02, p=0.005), as compared with placebo. The M value of the glucose clamp did not differ between the magnesium and placebo study arms (4.6±0.5 vs 4.4±0.6 mg kg−1 min−1, p=0.108). During the 6 weeks of treatment, continuous glucose monitoring outcomes, HbA1c, insulin dose, lipid profile and BP also did not differ, except for a lower HDL-cholesterol concentration after magnesium compared with placebo (1.14±0.08 vs 1.20±0.09 mmol/l, p=0.026). Symptoms potentially related to hypomagnesaemia were similar for both treatment arms.Conclusions/interpretationDespite an albeit modest increase in serum magnesium concentration, oral magnesium supplementation does not improve insulin sensitivity in people with insulin-treated type 2 diabetes and low magnesium levels.Trial registrationEudraCT number 2021-001243-27.FundingThis study was supported by a grant from the Dutch Diabetes Research Foundation (2017–81–014).Graphical

Effect of PGF2α treatments during early corpus luteum development on circulating progesterone concentrations and ovulation in breeding-age Holstein heifers

The objective of this study was to test the effect of low circulating concentrations of progesterone (P4) on pre-ovulatory follicle development in heifers as part of an overarching objective to develop a model to understand this phenomenon in dairy cattle without the confounding factors of lactation. Holstein heifers between 12 and 13 mo of age were pre-synchronized to ensure all heifers were on d 6 of the estrous cycle at the start of the Ovsynch program. Only heifers with CL regression and ovulation to the following pre-treatment strategy were used in the study: 0.5 mg cloprostenol (PGF2α), 2 d later, 0.1 mg GnRH, 6 d later, GnRH (G1; 1st GnRH of Ovsynch). Heifers (n = 159) responding to pre-treatment were randomly assigned to 4 groups and completed the Ovsynch program: high P4 control (HPC), low P4 control (LPC; PGF2α 24 h after G1), PG2 (PGF2α 24 and 48 h after G1) and PG3 (PGF2α 24, 48, and 96 h after G1). Only heifers that had ovulation to G1 remained in the study. Blood samples were collected in all heifers on d 7 (n = 157) and in a subset of heifers on d 1, 2, 3, 4 (n = 82) after G1 to measure serum P4. Pre-ovulatory follicle size at G1 (13.0 ± 0.1 mm; P = 0.53) and mean serum P4 24 h after G1 (d 1; 3.62 ± 0.11 ng/mL; P = 0.46) did not differ among treatments. HPC heifers had greater (P < 0.001) mean serum P4 compared to LPC, PG2 and PG3 on d 2, 3, 4, and 7. On d 2, 3 and 4, mean serum P4 of LPC, PG2 and PG3 heifers did not differ (P > 0.10). On d 7, LPC heifers had greater (P < 0.001) serum P4 compared to PG2 and PG3 heifers. Mean ± SEM serum P4 on d 7 after G1 was 8.43 ± 0.39, 2.55 ± 0.36, 1.58 ± 0.20, and 1.21 ± 0.15 ng/mL for HPC, LPC, PG2, and PG3, respectively. Percentage of heifers with P4 < 0.50 ng/mL on d 7 was greater (P < 0.05) for LPC, PG2 and PG3 (27, 32 and 26%, respectively) compared to HPC (0%). A greater (P < 0.05) proportion of heifers ovulated before G2 in the LPC, PG2 and PG3 than in the HPC. For heifers that ovulated after G2, low serum concentrations of P4 in LPC, PG2 and PG3 induced double ovulations in 6/97 heifers after the final GnRH of Ovsynch compared to 0/33 in HPC. In summary, PGF2α treatments during early CL development reduced circulating P4 concentrations 7 d after G1 compared with both HPC and LPC. However, it did not effectively control CL and follicle function to be utilized as a model to test high vs. low serum P4 on fertility parameters in Holstein heifers.

Simple reaction time in 8–9-year old children environmentally exposed to PCBs

Simple reaction time (SRT) has been studied in children exposed to polychlorinated biphenyls (PCBs), with variable results. In the current work we examined SRT in 146 boys and 161 girls, aged 8.53±0.65 years (mean±SD), exposed to PCBs in the environment of eastern Slovakia. We divided the children into tertiles with regard to increasing PCB serum concentration. The mean±SEM serum concentration of the sum of 15 PCB congeners was 191.15±5.39, 419.23±8.47, and 1315.12±92.57ng/g lipids in children of the first, second, and third tertiles, respectively. We created probability distribution plots for each child from their multiple trials of the SRT testing. We fitted response time distributions from all valid trials with the ex-Gaussian function, a convolution of a normal and an additional exponential function, providing estimates of three independent parameters μ, σ, and τ. μ is the mean of the normal component, σ is the standard deviation of the normal component, and τ is the mean of the exponential component. Group response time distributions were calculated using the Vincent averaging technique. A Q-Q plot comparing probability distribution of the first vs. third tertile indicated that deviation of the quantiles of the latter tertile from those of the former begins at the 40th percentile and does not show a positive acceleration. This was confirmed in comparison of the ex-Gaussian parameters of these two tertiles adjusted for sex, age, Raven IQ of the child, mother's and father's education, behavior at home and school, and BMI: the results showed that the parameters μ and τ significantly (p≤0.05) increased with PCB exposure. Similar increases of the ex-Gaussian parameter τ in children suffering from ADHD have been previously reported and interpreted as intermittent attentional lapses, but were not seen in our cohort. Our study has confirmed that environmental exposure of children to PCBs is associated with prolongation of simple reaction time reflecting impairment of cognitive functions.

Evaluation of glomerular filtration rate in cats with reduced renal mass and administered meloxicam and acetylsalicylic acid

To determine whether administration of meloxicam or acetylsalicylic acid alters glomerular filtration rate (GFR) in cats with renal azotemia. 6 young adult cats. 3 sexually intact male cats and 3 sexually intact female cats had surgically reduced renal mass and azotemia comparable to International Renal Interest Society chronic kidney disease stages 2 and 3. Renal function was evaluated by measurement of serum creatinine concentration, urinary clearance of exogenously administered creatinine, and the urine protein-to-creatinine concentration ratio (UP:C). Measurements taken in cats receiving placebo at the beginning and end of the study were compared with results obtained at the end of 7 days of treatment with either meloxicam (0.2 mg/kg, SC, on day 1; 0.1 mg/kg, SC, on days 2 to 7) or acetylsalicylic acid (20 mg/kg, PO, on days 1, 4, and 7). No significant treatment effects on urinary clearance of exogenously administered creatinine, serum creatinine concentration, or UP:C were detected. Mean ± SEM serum creatinine concentration and urinary clearance of exogenously administered creatinine measurements following 7 days of treatment with meloxicam (serum creatinine concentration, 2.67 ± 0.17 mg/dL; urinary clearance of exogenously administered creatinine, 1.34 ± 0.08 mL/min/kg) and acetylsalicylic acid (serum creatinine concentration, 2.62 ± 0.12 mg/dL; urinary clearance of exogenously administered creatinine, 1.35 ± 0.07 mL/min/kg) were not significantly different from the mean baseline values for these variables (serum creatinine concentration, 2.77 ± 0.14 mg/dL; urinary clearance of exogenously administered creatinine, 1.36 ± 0.07 mL/min/kg). Neither meloxicam nor acetylsalicylic acid had a measurable effect on urinary clearance of exogenously administered creatinine, serum creatinine concentration, or UP:C. These results are consistent with the hypothesis that GFR of euvolemic cats with normal or reduced renal function is not dependent on cyclooxygenase function.

The Values of CA-125, Progesterone, ß-HCG and Estradiol in the Early Prediction of Ectopic Pregnancy

To explore the diagnostic value and measurement of serum CA-125, the single measurement of progesterone (P), ß-HCG, and estradiol (E2) in the early diagnosis of ectopic pregnancy. Serum levels of CA-125, progesterone, ß-HCG and estradiol were measured by Enzyme Linked Immuno Sorbent Assay (ELISA) techniques in 40 symptomatic women with ectopic pregnancy and 24 women with normal intrauterine pregnancy during gestational age of 4-10 weeks at Al-Kadhmiya Teaching Hospital, Baghdad, Iraq, between November 2010 and June 2011. The mean ±SEM serum levels of CA-125, progesterone, ß-HCG, and estradiol in patients with ectopic pregnancies (16.51±2.39U/ml; 2.54±0.47ng/ml; 72.75±12.27mIU/ml; 13.4±2.14pg/ml; respectively) were significantly lower than the levels in normal intrauterine pregnancies (74.25±18.5U/ml; 28.36±3.7ng/ml; 249.54±18.0mIU/ml; 112.7±23.6pg/ml; respectively). When using a CA-125 concentration of 20.5 U/ml as a cut-off value for the diagnosis of ectopic pregnancy, sensitivity was 75.7%, specificity 100%, the positive predictive value was 100% and the negative predictive value 71.4%. The measurement of CA-125 and progesterone levels is useful in discriminating ectopic from normal gestations.

Pharmacokinetics of tramadol and metabolites O-desmethyltramadol and N-desmethyltramadol in adult horses

To determine the pharmacokinetics of tramadol and its metabolites O-desmethyltramadol (ODT) and N-desmethyltramadol (NDT) in adult horses. 12 mixed-breed horses. Horses received tramadol IV (5 mg/kg, over 3 minutes) and orally (10 mg/kg) with a 6-day washout period in a randomized crossover design. Serum samples were collected over 48 hours. Serum tramadol, ODT, and NDT concentrations were measured via high-performance liquid chromatography and analyzed via noncompartmental analysis. Maximum mean ± SEM serum concentrations after IV administration for tramadol, ODT, and NDT were 5,027 ± 638 ng/mL, 0 ng/mL, and 73.7 ± 12.9 ng/mL, respectively. For tramadol, half-life, volume of distribution, area under the curve, and total body clearance after IV administration were 2.55 ± 0.88 hours, 4.02 ± 1.35 L/kg, 2,701 ± 275 h x ng/mL, and 30.1 ± 2.56 mL/min/kg, respectively. Maximal serum concentrations after oral administration for tramadol, ODT, and NDT were 238 ± 41.3 ng/mL, 86.8 ± 17.8 ng/mL, and 159 ± 20.4 ng/mL, respectively. After oral administration, half-life for tramadol, ODT, and NDT was 2.14 ± 0.50 hours, 1.01 ± 0.15 hours, and 2.62 ± 0.49 hours, respectively. Bioavailability of tramadol was 9.50 ± 1.28%. After oral administration, concentrations achieved minimum therapeutic ranges for humans for tramadol (> 100 ng/mL) and ODT (> 10 ng/mL) for 2.2 ± 0.46 hours and 2.04 ± 0.30 hours, respectively. Duration of analgesia after oral administration of tramadol might be < 3 hours in horses, with ODT and the parent compound contributing equally.

Cidofovir May Be Deleterious in BK Virus-Associated Nephropathy

Cidofovir May Be Deleterious in BK Virus-Associated Nephropathy

Calcium, parathyroid hormone, oxytocin and pH profiles in the whelping bitch

Despite the high prevalence of primary uterine inertia in whelping bitches, the underlying pathogenesis remains unclear. The objectives were to i) determine serum concentrations of total calcium, ionized calcium (iCa), parathyroid hormone (PTH), and blood pH in normally whelping bitches throughout the peri-parturient period; and ii) investigate relationships among iCa, PTH, and acid-base status, and the role that they and oxytocin may have in the underlying pathogenesis of canine uterine inertia. Bitches were randomly selected from a population of German Shepherd Dog bitches with a history of uncomplicated parturition (Group 1; n=10), and from a population of Labrador bitches with a clinical history of an increased incidence of uterine inertia and stillbirths (Group 2; n=20). Jugular blood samples were collected daily from -4 d to the onset of whelping (t=0h), and then every 4h until the last pup was born. Overall, bitches from Group 2 had higher mean±SEM serum concentrations of PTH (4.72±2.45pmol/L, P<0.001), lower iCa (1.31±0.08pmol/L, P<0.05), and higher venous pH (7.41±0.03, P<0.005) than bitches from Group 1 (2.9±1.44pmol/L, 1.38±0.06mmol/L, and 7.33±0.02, respectively) during the periparturient period. However, there was no significant difference between Groups 1 and 2 for serum oxytocin concentrations during the periparturient period (45.5±40 and 65.5±82pg/mL). We inferred that low iCa resulting from a rising pH and decreasing PTH during the periparturient period may have contributed to decreased uterine contractility and increased risk of stillbirths. Therefore, manipulating the cationic/anionic difference in diets of pregnant bitches, similar to the bovine model for hypocalcamia, may reduce the incidence of stillbirths in the bitch.

Serum 25-hydroxyvitamin D is independently associated with high-density lipoprotein cholesterol and the metabolic syndrome in men and women

Low vitamin D status has been associated with markers of cardiovascular diseaserisk. This cross-sectional study assessed the relationships between serum 25-hydroxyvitamin D [25(OH)D] and selected markers for cardiovascular disease risk, including metabolic syndrome and its components, in adult men and women. Fasting blood samples, anthropometric measurements, and blood pressure were assessed in 257 men and women. Dietary intake was assessed with food frequency and dietary supplement questionnaires. Total vitamin D intake and that from dietary supplements were significantly associated with increasing serum 25(OH)D tertile (both P < .001). Mean±SEM serum high-density lipoprotein cholesterol (HDL-C) increased in a graded fashion (P < .001) from the lowest (48.4±1.8mg/dL) to the highest (62.3±2.1mg/dL) 25(OH)D tertile. The relationship between 25(OH)D and HDL-C remained significant (P < .001) after adjustment for established determinants of the HDL-C, with each 10-ng/mL increase in 25(OH)D associated with a 4.2-mg/dL increase in HDL-C concentration. Serum triglycerides (P=.008), waist circumference (P < .001), and body mass index (P < .001) showed graded, inverse relationships with 25(OH)D tertile, and the prevalence of metabolic syndrome decreased significantly from the lowest to the highest 25(OH)D tertile (31%, 14%, and 10%, respectively, Pfor trend=.001). Lower serum 25(OH)D is associated with the metabolic syndrome and adverse values for some metabolic syndrome risk factors, particularly the HDL-C concentration. Research is warranted to assess whether increasing vitamin D intake will improve the metabolic cardiovascular risk factor profile.

Serum 25-Hydroxyvitamin D is an Independent Predictor of High-Density Lipoprotein Cholesterol and Metabolic Syndrome in Men and Women

Objective: This cross-sectional study assessed the relationships between serum 25(OH)D and selected markers for cardiovascular disease risk, including the metabolic syndrome and its components, in men and women. Methods: Fasting blood samples, anthropometric measurements, and blood pressure were assessed in 257 men and women. Dietary intake and physical activity were assessed with the Harvard Food Frequency Questionnaire, the Stanford 7-day Physical Activity Recall Questionnaire, and questionnaires designed to assess dietary supplement use and sun exposure. Data were collected over a 7-week period in August and September 2008. Results: Total vitamin D intake and intake from dietary supplements were strongly associated with serum 25(OH)D tertile (both P , 0.001). Mean 6 SEM values for serum 25(OH)D were 29.7 6 0.4, 39.8 6 0.3, and 52.1 6 0.8 ng/ml in the first through third tertiles, respectively. Mean 6 SEM serum high-density lipoprotein cholesterol (HDL-C) concentration increased in a graded fashion (P , .001) from the lowest (48.4 6 1.8 mg/dl) to the highest (62.3 6 2.1 mg/dl) 25(OH)D tertile. This relationship remained significant (P , .001) after adjustment for established determinants of the HDL-C concentration (age, sex, waist circumference, body mass index, physical activity, alcohol consumption, cigarette smoking), with each 10 ng/ml increase in 25(OH)D associated with a 4.2 mg/dl increase in HDL-C concentration. Serum triglycerides (P 5 .008), waist circumference (P , .001), and body mass index (P , .001) showed graded, inverse relationships with 25(OH)D tertile, and the prevalence of metabolic syndrome decreased significantly from the lowest to the highest tertile of 25(OH)D (31%, 14%, and 10%, respectively, P for trend 5 0.001). The relationship with serum triglycerides was no longer significant in multivariate models, but waist circumference (P, .001) and metabolic syndrome (P, .01) remained significantly associated with serum 25(OH)D concentration after adjustment for demographic and lifestyle factors (age, sex, physical activity, alcohol consumption, cigarette smoking). Conclusion: A lower serum 25(OH)D level is associated with the metabolic syndrome and less favorable values for some metabolic syndrome risk factors, particularly the HDL-C concentration. Research is warranted to assess whether increasing vitamin D intake will improve the metabolic cardiovascular risk factor profile.

Serum inhibin B concentration as a prognostic factor for prediction of sperm retrieval in testis biopsy of patients with azoospermia.

This study was conducted to determine if serum inhibin B concentration can predict spermatogenesis in azoospermic infertile men. This cross-sectional study included 70 patients with male-factor infertility referred to Alvand and Vali-e-Asr Infertility Centers, Tehran, Iran. All patients had azoospermia. Standard evaluation consisted of history and physical examination with extreme attention to sexual history and testis examination including testis size, consistency, and presence of varicocele. Laboratory evaluation done for all cases consisted of FSH, testosterone, LH, prolactin, and inhibin B. Testis biopsy was performed in all cases with acceptable testis volume and FSH. The mean inhibin B level was compared in groups with positive and negative sperm retrieval. The mean+/-SEM age of 70 azoospermic patients was 32.1+/-6.2 (range: 20 - 50) years. All couples had primary infertility with a mean+/-SEM duration of infertility of 74.3+/-7.7 months. The mean+/-SEM testicular volume was 10.14+/-0.75 mL. The mean+/-SEM FSH and LH levels were 17.55+/-1.68, and 11.33+/-0.99 mIU/mL, respectively. The mean+/-SEM serum prolactin and testosterone levels were 308.77+/-17.35 and 5.45+/-0.91 ng/dL, respectively. The mean+/-SEM serum inhibin B concentration was 138.23+/-28.58 (range: 15 - 1500) pg/mL. Sperm was not retrieved in 82% of the patients; in 13% of the cases, biopsy revealed spermatogenesis. The mean+/-SEM serum FSH level of positive and negative groups was 9.78+/-2.13 and 22.56+/-2.46 mIU/mL, respectively (P<0.05). The mean serum LH, prolactin, and testosterone levels were not statistically different between the two groups. The mean+/-SEM serum inhibin B was 129+/-45.46, and 158.93+/-47.24 pg/mL in positive and negative groups, respectively (P>0.05). Inhibin B concentration is not an appropriate predicting factor for testicular spermatogenesis.

The Epidemic of Chronic Kidney Disease in Patients Referred to a Hematologist for Anemia.

NHANES survey estimates the prevalence of CKD to be approximately 11% in the general population and 25% in the population over 65 years of age, and the prevalence of Chronic Kidney Disease (CKD) associated anemia approaches 75% in Stage 5 CKD. Despite the high prevalence of CKD, and its strong association with anemia, many patients diagnosed with anemia and referred to a hematologist for evaluation frequently have the diagnosis of CKD overlooked, especially if one is using a serum creatinine to assess renal function. A more accurate method of assessing renal function and to appropriately stage CKD is the use of an estimated glomerular filtration rate (eGFR) utilizing the modified MDRD equation. With the realization that CKD clearly has become known as a significant magnifier of cardiovascular risk (CVR), the importance of making the diagnosis of CKD has become quite apparent. Hypothesis: Patients referred to a hematologist for evaluation of anemia represent a population enriched with CKD. A retrospective chart audit was performed on patients being referred to a hematology practice from community physicians for the evaluation of anemia from January 2004 through December 31, 2005. All patients with a prior knowledge of CKD and a history of malignancy or myelodysplastic process were excluded from the study. The cohort consisted of 256 patients (37.5 % male and 62.5 % female) with a mean age of 67.56 ± 15.9 years. The mean serum creatinine was 1.16 ± .74 mg/dL with a mean calculated GFR by the modified MDRD (4 variable) equation of 69.9 ± 34.2 ml/min/1.73 m2.The mean ± SEM serum creatinine by stage of CKD in our patient population is: Stage 1: 0.67 ± 0.14 mg/dL, Stage 2: 0.92 ± 0.15 mg/dL, Stage 3: 1.40 ± 0.29 mg/dL, Stage 4: 2.23 ± 0.53 mg/dL, and Stage 5: 5.2 ± 2.89 mg/dL. Conservatively, we defined CKD as GFR <60 as urinalysis, imaging, or biopsy data were not available. In conclusion, an astounding 42.2 % of patients referred to a hematologist for the evaluation of anemia have CKD as compared to an estimated prevalence of 11 % in the general population reported by K/DOQI. Not only were these patients not aware of their diagnosis of CKD, but, of note also is the fact that 5.1 % were not aware of the presence of advanced CKD (GFR < 30) and 4 patients had Stage 5 CKD without awareness. 55.8 % of the patients over the age of 65 with anemia have CKD as compared to an estimated 25 % of the general population over the age of 65. This information stresses the need to assess all anemia patients for CKD and to appropriately stage them. Given the well accepted association between CKD and CVR, physicians caring for these patients can then stress the need for aggressive pursuit of both traditional and non traditional risk factor reduction to circumvent the significant CVR that is present in this population.Prevalence of Abnormal Renal Function by GFRFrequencyPercentGFR > 90 (Normal /K/DOQI* Stage 1)5119.9GFR 89 - 60 (K/DOQI Stage 2)9737.9GFR 59 - 30 (K/DOQI Stage 3)9537.1GFR 29 - 15 (K/DOQI Stage 4)93.5GFR < 15 (K/DOQI Stage 5)41.6*K/DOQI = National Kidney Foundation's Kidney Disease Outcome Quality Initiative

Serum creatine kinase response to exercise during dexamethasone-induced insulin resistance in Quarter Horses with polysaccharide storage myopathy

To determine effects of dexamethasone on insulin sensitivity, serum creatine kinase (CK) activity 4 hours after exercise, and muscle glycogen concentration in Quarter Horses with polysaccharide storage myopathy (PSSM). 4 adult Quarter Horses with PSSM. A 2 x 2 crossover design was used with dexamethasone (0.08 mg/kg) or saline (0.9% NaCl) solution administered IV every 48 hours. Horses were exercised on a treadmill daily for 3 wk/treatment with a 2-week washout period between treatments. Serum CK activity was measured daily 4 hours after exercise. At the end of each treatment period, serum cortisol concentrations were measured, a hyperinsulinemic euglycemic clamp (HEC) technique was performed, and muscle glycogen content was determined. Mean +/- SEM serum cortisol concentration was significantly lower after 48 hours for the dexamethasone treatment (0.38 +/- 0.08 mg/dL), compared with the saline treatment (4.15 +/- 0.40 mg/dL). Dexamethasone significantly decreased the rate of glucose infusion necessary to maintain euglycemia during the HEC technique, compared with the saline treatment. Muscle glycogen concentrations and mean CK activity after exercise were not altered by dexamethasone treatment, compared with the saline treatment. Dexamethasone significantly reduced whole-body insulin-stimulated glucose uptake in Quarter Horses with PSSM after a 3-week period but did not diminish serum CK response to exercise or muscle glycogen concentrations in these 4 horses. Therefore, a decrease in glucose uptake for 3 weeks did not appear to alleviate exertional rhabdomyolysis in these horses. It is possible that long-term treatment may yield other results.

Evaluation of Intravenous Immunoglobulin as an Agent to Lower Allosensitization and Improve Transplantation in Highly Sensitized Adult Patients with End-Stage Renal Disease

Reported are the reduction of anti-HLA antibody levels and improvement of transplant rates by intravenous immunoglobulin (IVIG) in a randomized, double-blind, placebo-controlled clinical trial. Between 1997 and 2000, a total of 101 adult patients with ESRD who were highly sensitized to HLA antigens (panel reactive antibody [PRA] > or =50% monthly for 3 mo) enrolled onto an NIH-sponsored trial (IG02). Patients received IVIG or placebo. Subjects received IVIG 2 g/kg monthly for 4 mo or an equivalent volume of placebo with additional infusions at 12 and 24 mo after entry if not transplanted. If transplanted, additional infusions were given monthly for 4 mo. Baseline PRA levels were similar in both groups. However, IVIG significantly reduced PRA levels in study subjects compared with placebo. Sixteen IVIG patients (35%) and eight placebo patients (17%) were transplanted. Rejection episodes occurred in 9 of 17 IVIG and 1 of 10 placebo subjects. Seven graft failures occurred (four IVIG, three placebo) among adherent patients with similar 2-yr graft survival rates (80% IVIG, 75% placebo). With a median follow-up of 2 yr after transplant, the viable transplants functioned normally with a mean +/- SEM serum creatinine of 1.68 +/- 0.28 for IVIG versus 1.28 +/- 0.13 mg/dl for placebo. Adverse events rates were similar in both groups. We conclude that IVIG is better than placebo in reducing anti-HLA antibody levels and improving transplantation rates in highly sensitized patients with ESRD. Transplant rates for highly sensitized patients with ESRD awaiting kidney transplants are improved with IVIG therapy.

Liver function tests in HIV-1 infected asymptomatic patients and HIV-1 AIDS patients without hepatomegaly in Lagos, Nigeria

Hepatic functions were assessed by serum assays of albumin (ALB), total protein (TP), total bilirubin (TB), conjugated bilirubin (CB), serum activities of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP) and gamma – glutamyl transferase (GGT) in 51 HIV-1AIDS patients, 38 HIV-1 infected asymptomatic patients and 56 age and sex matched healthy HIV negative controls. The mean ± SEM serum ALB concentration of 23.5 ± 1.2 g/L in AIDS patients was significantly lower (p Key Words: HIV-1 infected asymptomatic patient, AIDS, Hepatic functions Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005: 40-45

Maternal serum levels of tumor necrosis factor-α and interleukin-2 receptor in threatened abortion: a comparison with normal and pathologic pregnancies

Objective: We evaluated tumor necrosis factor-α (TNF-α) and interleukin-2 (IL-2) receptor levels in patients with threatened abortion and compared the levels with normal and pathologic pregnancies.Design: A prospective, nonrandomized, case-control study.Setting: Academic research setting.Patient(s): Twenty-two patients with threatened abortion, 18 patients with pathologic pregnancies, 20 healthy pregnant women, and 20 nonpregnant women.Intervention(s): Maternal serum TNF-α and IL-2 receptor levels were measured with a solid-phase, two-site chemiluminescent enzyme immunometric assay method.Main Outcome Measure(s): TNF-α and IL-2 receptor levels.Result(s): The mean ± SEM maternal serum IL-2 receptor level for patients with threatened abortion was 481.3 ± 35.7 U/mL, compared with 426.5 ± 22.4 U/mL in the normal pregnant group. There was no statistically significant difference in the mean ± SEM serum TNF-α level between the patients with threatened abortion and those with normal pregnancies (16.1 ± 2.7 pg/mL vs. 10.9 ± 0.8 pg/mL). The mean ± SEM maternal serum IL-2 receptor level was significantly higher in patients with pathologic pregnancies than in those with normal pregnancies (506.2 ± 27.6 U/mL vs. 426.5 ± 22.4 U/mL). The mean ± SEM maternal serum TNF-α level was significantly higher in patients with pathologic pregnancies than in those with threatened abortion (39.2 ± 9.5 pg/mL vs. 16.1 ± 2.7 pg/mL) and normal pregnancies (39.2 ± 9.5 pg/mL vs. 10.9 ± 0.8 pg/mL).Conclusion(s): In comparison with normal pregnancies, maternal serum IL-2 receptor and TNF-α levels were not significantly increased in patients with threatened abortion with good outcome.

Expression of the c-met proto-oncogene and its ligand, hepatocyte growth factor, in Hodgkin disease

AbstractThe receptor for hepatocyte growth factor (HGF) is a transmembrane tyrosine kinase that is encoded by the proto-oncogene c-met. Recently, c-MET was detected in Reed-Sternberg (RS) cells from Epstein-Barr virus–positive (EBV+) Hodgkin disease (HD). The c-MET, EBER-1, and LMP-1 expression in 45 lymph node biopsies and 12 bone marrow biopsies obtained from patients with HD was analyzed. In addition, HGF levels in serum samples from 80 healthy individuals and 135 HD patients in different phases of disease. In all 45 lymph node and 12 bone marrow samples examined, RS cells expressed c-MET but not HGF+. These results were independent of the EBV infection. Interestingly, several HGF+ dendritic-reticulum cells were found scattered around c-MET+ RS cells. The mean ± SEM serum HGF levels in HD patients at diagnosis and at the time of relapse were 1403 ± 91 (95% confidence interval [CI], 1221-1585) and 1497 ± 242 pg/mL (95% CI, 977-2017), respectively. HGF values were significantly higher than those of healthy individuals (665 ± 28 pg/mL; 95% CI, 600-721; and P < .001 for both groups of patients) and of HD patients in remission (616 ± 49 pg/mL; 95% CI, 517-714; andP < .001 for both groups of patients). A significant correlation was found between serum HGF levels and B symptoms at diagnosis (P = .014). In conclusion, this study indicates that HGF and c-MET constitute an additional signaling pathway between RS cells and the reactive cellular background, thereby affecting adhesion, proliferation, and survival of RS cells. Furthermore, the serum concentration of HGF in HD patients may be a useful tool in monitoring the status of disease.

Outcomes of Atherosclerotic Renal Artery Stenosis Managed Without Revascularization

To determine how often patients with renal artery stenosis (RAS) managed without revascularization progress to accelerated hypertension and/or renal failure. We examined the outcomes of 68 patients (mean +/- SEM age, 71.8 +/- 0.9 years) with high-grade (>70%) RAS identified between 1989 and 1993 who were treated without renal revascularization for at least 6 months after angiography. The time to last follow-up averaged 38.9 +/- 2.8 months. Other vascular beds were affected in 66 of the 68 patients. End points were revascularization, nephrectomy, dialysis, or death. The mean +/- SEM serum creatinine level rose from 1.4 +/- 0.1 to 2.0 +/- 0.2 mg/dL (P<.001). Mean +/- SEM blood pressure did not change (157 +/- 3/83+/-2 vs 155 +/- 3/79 +/- 2 mm Hg), but the need (mean +/- SEM) for medication increased from 1.6+/-0.1 to 1.9+/-0.1 drugs (P=.02). Four patients (5.8%) eventually underwent renal revascularization for refractory hypertension (1 patient), for progressive stenosis (1 patient), and during aortic reconstruction (2 patients). One additional patient underwent nephrectomy to improve blood pressure control. Five others (7.4%) developed end-stage renal disease (ESRD) for reasons other than progressive vascular disease, namely, diabetes (3 patients), atheroemboli (1 patient), and contrast toxicity without RAS progression (1 patient). In 1 further case, the reason for ESRD was unknown, and it may have been caused by vascular occlusion. During follow-up, 19 patients died of unrelated causes, including myocardial infarction and stroke. These data indicate that antihypertensive medication requirements increased and renal function deteriorated modestly in a subset of patients with atherosclerotic RAS managed initially without vascular intervention. Many achieved stable blood pressure for many years. Deterioration of renal function and mortality risk were greatest in patients with bilateral stenosis or stenosis to a solitary functioning kidney. These results reinforce the need for meticulous follow-up for disease progression but underscore the role of competing risks and high mortality from other cardiovascular diseases, which primarily determine the outcomes in patients with RAS and widespread atherosclerotic disease.

Ethnicity effect on the serum lipid profile in persons with spinal cord injury

Objective: The potential effect of ethnicity on the serum lipid profile and lipoprotein(a) [Lp(a)] was studied in a population with chronic spinal cord injury (SCI). Study Design: The distribution and correlates of high density lipoprotein (HDL) cholesterol and Lp(a) were studied in a population of 600 subjects with chronic SCI. Results: Mean ± SEM serum HDL cholesterol was significantly higher in the African American group than in the white and Latino groups (47 ± 1 vs 40 ± 1 and 38 ± lmg/dL, p < .0001, respectively). The African American group had a lower serum total to HDL cholesterol ratio than white and Latino groups (4.46 ± .153 vs 5.18 ± .168 and 5.40 ± .140mg/dL, p <.01, respectively). Mean serum Lp(a) levels were significantly higher in the African American group than in Latino or white groups (29 ± 2 vs 18 ± 1 and 15 ± lmg/dL, p < .0001, respectively). Age, duration of SCI, and level and completeness of lesion had no significant effect on serum Lp(a) level. Conclusions: In a population with chronic SCI, those in the African American group had the highest serum HDL cholesterol concentrations, the lowest serum total to HDL cholesterol ratios, and elevated levels of serum Lp(a) compared with the Latino and white groups. In a population of individuals with chronic SCI, ethnicity was shown to have a major effect on serum lipids and may be used to assist in the determination of cardiovascular risk.

The ovarian follicular wave pattern and induction of ovulation in the mated and non-mated one-humped camel (Camelus dromedarius)

Ovarian follicular wave patterns were studied ultrasonographically in three groups of dromedary. Group 1 camels (n = 20) were teased daily with a vasectomized male but mating was prevented; group 2 camels (n = 8) ran freely with a vasectomized male camel for 10 h each day and group 3 camels (n = 8) were kept completely separate from any males. In a second experiment (n = 63), when the diameter of the dominant follicle reached 0.5-0.9 cm, 1.0-1.9 cm, 2.0-2.9 cm or > 3 cm, the camel was given one of three treatments to induce ovulation: (i) natural mating; (ii) 20 micrograms of the GnRH analogue, buserelin; or (iii) 3000 iu hCG. The ovaries were re-scanned regularly to monitor ovulation, and daily blood samples were assayed for progesterone and oestradiol concentrations. The follicular cycle was divisible into a growth phase (10.5 +/- 0.5 days), a mature phase (7.6 +/- 0.8 days) and a regression phase (11.9 +/- 0.8 days). The dominant follicle reached a mean +/- SEM maximum diameter of 2.0 +/- 0.1 cm (range 1.5-2.5 cm) in 34 cycles (52%) before it began to regress. In the other 32 cycles (48%), however, the dominant follicle continued to grow to 4.2 +/- 0.2 cm (range 4.0-6.0 cm) before regression commenced. Group 2 camels were mated when their follicles reached 1.3 +/- 0.1 cm in diameter and the mean interval between successive matings was 13.8 +/- 1.0 days. Mean +/- SEM serum concentrations of oestradiol reached peak values at 39.0 +/- 1.8 pg ml-1, when the dominant follicle measured 1.7 +/- 0.1 cm and, after ovulation, mean serum concentrations of progesterone reached peak values at 2.6 +/- 0.3 ng ml-1 on day 8, before decreasing to < 1 ng ml-1 by day 10 or 11. When the dominant follicle measured 0.5-0.9 cm in diameter, 70%, 60% and 60% of them ovulated in response to mating, or treatment with buserelin or hCG, respectively. These ovulation rates increased to 85% (mating), 81% (buserelin) and 67% (hCG) when the follicle measured 1-1.9 cm, but they decreased again to 12.5% (mating), 29% (buserelin) and 13% (hCG) when the diameter had increased to 2.0-2.9 cm at the time of treatment. No follicles measuring > 3.0 cm ovulated in response to any of the treatments. These results indicated that the optimum time to mate or attempt to induce ovulation in the female dromedary is when the growing follicle measures 0.9-1.9 cm in diameter.