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1.
Int J Mol Sci ; 24(18)2023 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-37762085

RESUMEN

Oral ferric citrate hydrate (FCH) is effective for iron deficiencies in hemodialysis patients; however, how iron balance in the body affects iron absorption in the intestinal tract remains unclear. This prospective observational study (Riona-Oral Iron Absorption Trial, R-OIAT, UMIN 000031406) was conducted at 42 hemodialysis centers in Japan, wherein 268 hemodialysis patients without inflammation were enrolled and treated with a fixed amount of FCH for 6 months. We assessed the predictive value of hepcidin-25 for iron absorption and iron shift between ferritin (FTN) and red blood cells (RBCs) following FCH therapy. Serum iron changes at 2 h (ΔFe2h) after FCH ingestion were evaluated as iron absorption. The primary outcome was the quantitative delineation of iron variables with respect to ΔFe2h, and the secondary outcome was the description of the predictors of the body's iron balance. Generalized estimating equations (GEEs) were used to identify the determinants of iron absorption during each phase of FCH treatment. ΔFe2h increased when hepcidin-25 and TSAT decreased (-0.459, -0.643 to -0.276, p = 0.000; -0.648, -1.099 to -0.197, p = 0.005, respectively) in GEEs. FTN increased when RBCs decreased (-1.392, -1.749 to -1.035, p = 0.000) and hepcidin-25 increased (0.297, 0.239 to 0.355, p = 0.000). Limiting erythropoiesis to maintain hemoglobin levels induces RBC reduction in hemodialysis patients, resulting in increased hepcidin-25 and FTN levels. Hepcidin-25 production may prompt an iron shift from RBC iron to FTN iron, inhibiting iron absorption even with continued FCH intake.


Asunto(s)
Compuestos Férricos , Hepcidinas , Humanos , Compuestos Férricos/farmacología , Ferritinas , Hierro , Estudios Prospectivos , Diálisis Renal
2.
Sleep Med ; 82: 159-164, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33933720

RESUMEN

OBJECTIVES: To investigate the relationship between differences in weekday-to-weekend sleep habits and stress responses in a working population. METHODS: This cross-sectional study used data from university workers on sleep habits, differences in sleep duration between weekdays and weekends, and each midpoint of the sleep phase on weekdays and weekends. Social jetlag was defined as the difference in the midpoint of the sleep phase between weekdays and weekends. In addition, the Brief Job Stress Questionnaire assessed stress responses and stress-related factors. To examine sleep-related factors affecting stress responses, regression analysis was performed with adjustments for age, sex, and stress-related factors. RESULTS: Analyzed were 2,739 participants. Sleep duration differences obtained by subtracting sleep duration on weekdays from that on weekends, social jetlag, and weekday sleep duration were significantly associated with an increased risk of stress responses in a univariate linear regression model. Adjusting for age, sex, job stressors, and stressor buffering factors did not change this trend. However, when additionally adjusting for all sleep parameters, only sleep duration differences and weekday sleep duration were significantly associated with stress responses (ß 0.67 [95% CI 0.24, 1.10], p = 0.002), (-0.66 [-1.20, -0.13], p = 0.015). CONCLUSIONS: This study provided further evidence that weekday sleep duration and weekday-to-weekend sleep duration differences were independently associated with stress responses even when considering stress-related factors. However, social jetlag was not clearly associated with stress responses. Our findings highlighted the necessity of securing sufficient sleep for stress management and mental health promotion in a working population.


Asunto(s)
Síndrome Jet Lag , Sueño , Estudios Transversales , Humanos , Japón/epidemiología , Factores de Tiempo
3.
Clin Exp Nephrol ; 20(5): 808-814, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26677857

RESUMEN

BACKGROUND: The aim of the study is to elucidate whether parathyroid hormone (PTH) levels after parathyroidectomy affect the prognosis of patients with secondary hyperparathyroidism. SUBJECTS AND METHODS: Two hundred and ninety-five patients, who underwent PTx without autotransplantation from July 1998 to December 2011, were divided into the low (n = 148) and high (n = 147) PTH groups, using the median value of each mean value of intact PTH after surgery (16.6 pg/mL). After observation for 5.00 years, we evaluated demographic factors, influences of postoperative mineral metabolism, magnitude of uremia, and vitamin D receptor activators on their prognosis, with the multivariate Cox proportional hazard model. RESULTS: While overall survival rates in the high and low PTH groups were 54.9 and 74.2 %, respectively (P = 0.1500), cardiovascular survival rates were 71.6 and 94.4 %, respectively (P = 0.0256). The hazard ratio for cardiovascular mortality in the high PTH group (≥16.6 pg/mL) was 3.132 (P = 0.0470), and those in groups with the median age more than 59 years and with cardiovascular disease were 2.654 (P = 0.0589) and 3.377 (P = 0.0317), respectively. The intact PTH level 6 days after surgery and the mean postoperative intact PTH value showed a strong correlation (Spearman ρ = 0.9007, P < 0.0001, y = 0.4725x + 30.395, R 2 = 0.51798). CONCLUSION: The present study suggests that maintaining low PTH levels after parathyroidectomy reduces cardiovascular mortality and improves the prognosis. Total parathyroidectomy (more than 4 glands) without autotransplantation seems to be one of the treatment options for managing severe secondary hyperparathyroidism.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Hiperparatiroidismo Secundario/cirugía , Hormona Paratiroidea/sangre , Paratiroidectomía , Diálisis Renal , Insuficiencia Renal Crónica/terapia , Anciano , Biomarcadores/sangre , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/mortalidad , Supervivencia sin Enfermedad , Regulación hacia Abajo , Femenino , Humanos , Hiperparatiroidismo Secundario/sangre , Hiperparatiroidismo Secundario/diagnóstico , Hiperparatiroidismo Secundario/mortalidad , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Análisis Multivariante , Paratiroidectomía/efectos adversos , Paratiroidectomía/mortalidad , Modelos de Riesgos Proporcionales , Factores Protectores , Diálisis Renal/efectos adversos , Diálisis Renal/mortalidad , Insuficiencia Renal Crónica/sangre , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/mortalidad , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
4.
J Nephrol ; 25(5): 755-63, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22135031

RESUMEN

BACKGROUND AND AIMS: To compare the prognosis of chronic hemodialysis patients with or without parathyroidectomy. METHODS: Among 158 chronic hemodialysis patients who underwent total parathyroidectomy between July 1998 and April 2009, 88 patients were matched with 88 controls for sex, age, underlying disease and prior dialysis history. Then a retrospective evaluation of their prognosis was performed over a median observation period of 4.41 years. RESULTS: The overall survival rate was 90.4% in the parathyroidectomy group and 67.4% in the control group. The cardiovascular death-free survival rate was 94.6% in the parathyroidectomy group and 76.3% in the control group. During observation, intact parathyroid hormone was measured every 6 months, and its average serum level was 37 ± 92 ng/L in the total parathyroidectomy group versus 274 ± 233 ng/L in the control group (p=0.0001). The total parathyroidectomy group had a significantly lower corrected calcium level and higher serum albumin level. Multivariate analysis revealed that parathyroidectomy, atrial fibrillation and serum albumin were significant factors for both total and cardiovascular mortality. CONCLUSION: Total parathyroidectomy was associated with better survival, probably due to decreased cardiovascular mortality.


Asunto(s)
Hiperparatiroidismo Secundario/cirugía , Paratiroidectomía , Diálisis Renal/efectos adversos , Adulto , Anciano , Biomarcadores/sangre , Calcio/sangre , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/mortalidad , Supervivencia sin Enfermedad , Femenino , Humanos , Hiperparatiroidismo Secundario/sangre , Hiperparatiroidismo Secundario/etiología , Hiperparatiroidismo Secundario/mortalidad , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Análisis Multivariante , Hormona Paratiroidea/sangre , Paratiroidectomía/efectos adversos , Paratiroidectomía/mortalidad , Diálisis Renal/mortalidad , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Albúmina Sérica/metabolismo , Tasa de Supervivencia , Factores de Tiempo , Resultado del Tratamiento
5.
Gan To Kagaku Ryoho ; 37(5): 935-7, 2010 May.
Artículo en Japonés | MEDLINE | ID: mdl-20495333

RESUMEN

A 70-year-old male visited the hospital with a complaint of stomachache. Hydronephrosis was observed in the right kidney, and further examination confirmed a diagnosis of metastatic cancer limited to the bladder and rectovesical pouch after surgery for differentiated gastric cancer. Chemotherapy using paclitaxel(PTX)/S-1 was initiated. One course included 14 days of administration of S-1 (100 mg/body) followed by a 7-day interval, and the administration of PTX (60 mg/body) on the 1st and 15th days. General malaise developed after 4 courses, the dose of S-1 was reduced (80 mg/body), and PTX was administered only on the 1st day. CT conducted 9 months after the start of chemotherapy revealed the disappearance of ascites, decreased thickness of the bladder wall, and reduced size of the tumor in the rectovesical pouch. No new distal metastasis or peritoneal metastatic nodule has been observed, and there has been no tendency toward exacerbation for one year after the initial diagnosis. PTX/S-1 was suggested to be an effective treatment for metastatic cancer limited to the bladder and rectovesical pouch after surgery for differentiated gastric cancer.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ácido Oxónico/uso terapéutico , Paclitaxel/uso terapéutico , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/patología , Tegafur/uso terapéutico , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Anciano , Diferenciación Celular , Combinación de Medicamentos , Humanos , Masculino , Ácido Oxónico/administración & dosificación , Paclitaxel/administración & dosificación , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/cirugía , Tegafur/administración & dosificación , Tomografía Computarizada por Rayos X , Neoplasias de la Vejiga Urinaria/diagnóstico por imagen , Neoplasias de la Vejiga Urinaria/secundario
6.
Nihon Hoshasen Gijutsu Gakkai Zasshi ; 61(3): 392-400, 2005 Mar 20.
Artículo en Japonés | MEDLINE | ID: mdl-15815558

RESUMEN

The absorbed dose conversion factor for X-rays at the water phantom surface has been obtained from the measured spectra. These measurements have been made at tube voltages of 60 kV to 120 kV and field sizes ranging from 5 x 5 cm(2) to 30 x 30 cm(2) with and without additional 2 mm aluminium filtration. A small silicon diode detector with little angular dependence was used for this measurement. The absorbed dose conversion factor obtained was 0.03-0.43% smaller than that obtained from the primary X-ray spectrum. The difference was large for high-voltage and heavily filtered X-rays. As field size increases, the conversion factor decreases, but the decrease is slight when field size exceeds 20 x 20 cm(2). The absorbed dose conversion factor obtained from the primary or surface X-ray spectrum is 0.4-1.8% larger than that obtained from the effective energy of primary X-rays. The difference is large in high-voltage X-rays and decreases slightly with increases in field size.


Asunto(s)
Fantasmas de Imagen , Dosis de Radiación , Radiometría/métodos , Agua , Dispersión de Radiación
7.
Phys Med Biol ; 47(7): 1205-17, 2002 Apr 07.
Artículo en Inglés | MEDLINE | ID: mdl-11996064

RESUMEN

Backscattered x-ray spectra at the water surface have been measured by using a small silicon diode detector. The measurements have been made at tube voltages 60 kV to 120 kV (HVL 2.4-6.1 mm Al) and field sizes 5 x 5 cm2 to 30 x 30 cm2. The measured spectra are corrected for detector distortion and for the angular dependence of detector efficiency. The obtained backscattered spectrum has a lower mean energy and a narrower shape than the primary spectrum. The ratio of the mean energy of the backscattered spectrum to that of the primary spectrum is between 0.83 and 0.94. The ratio of the spectrum width at 10% of the continuous spectrum maximum is between 0.65 and 0.78. The change of spectral shape due to the field size is slight. In the high-voltage spectra, the peak due to the Compton scattering of tungsten Kalpha x-rays is observed. The backscatter factors (BSFs) calculated from the obtained spectra show a satisfactory agreement with other studies. The difference between the BSF defined as the ratio of air kerma and the BSF defined as the ratio of water kerma is also calculated; the maximum difference is 0.43%. The empirical equation showing the relation between the two BSFs is presented.


Asunto(s)
Dispersión de Radiación , Aluminio/metabolismo , Método de Montecarlo , Fantasmas de Imagen , Fotones , Radiometría , Dosificación Radioterapéutica , Agua/química , Rayos X
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