Effect of acute gold nanorods on reproductive function in male albino rats: histological, morphometric, hormonal, and redox balance parameters.

In this study, we investigated the effect of acute administration of gold nanorods (AuNRs) on testicular function, sexual hormones, and oxidative stress parameters in male albino rats. Forty mature male albino rats were divided into two equal groups (n = 20/each). The first group received 1 ml saline solution intraperitoneally (i.p.). The second group received single i.p. injection of 75 µg 50 nm AuNRs/kg/bwt. Five rats from each group were sacrificed on days 1, 3, 7, and 14 post treatment and blood samples were collected for hormonal and biochemical analysis. Testes were collected from each group at each time point for histopathology, morphometric, and transmission electron microscope analyses of testis and epididymis. Results indicated that i.p. injection of AuNRs did not produce any histopathological changes. Morphometric analysis of testicular samples revealed that the height of lining epithelium was significantly (P < 0.05) higher in AuNR group on days 3 and 14 post treatment, and the minor axis of seminiferous tubules was higher (P < 0.05) in AuNR-injected rats than in control group. For the epididymis, the number of spermatozoa was significantly (P < 0.05) higher on days 7 and 14 after AuNR injection when compared with control rats. AuNRs were not detected by TEM at all time points of the experiment. Serum analysis demonstrated that total and free testosterone values significantly (P < 0.05) increased on days 1, 3, 7, and 14 post AuNR injection. LH was higher (P < 0.05) in AuNRs-injected rats on days 3, 7, and 14 post injection, while FSH values were higher (P < 0.05) in AuNR group on days 3 and 14. Malondialdehyde significantly (P < 0.05) decreased on days 3, 7, and 14 in AuNR group, while catalase, glutathione peroxidase, and superoxide dismutase values were significantly (P < 0.05) elevated on days 3, 7, and 14 in AuNRs-injected rats compared with control group. In conclusion, intraperitoneal injection of 50 nm AuNRs is safe on the reproductive function and has an antioxidant action.

Predictive parameters of arteriovenous fistula functional maturation in a population of patients with end-stage renal disease.

INTRODUCTION: With increasing numbers of patients diagnosed with ESRD, arteriovenous fistula (AVF) maturation has become a major factor in improving both dialysis related outcomes and quality of life of those patients. Compared to other types of access it has been established that a functional AVF access is the least likely to be associated with thrombosis, infection, hospital admissions, secondary interventions to maintain patency and death. AIM: Study of demographic factors implicated in the functional maturation of arteriovenous fistulas. Also, to explore any possible association between preoperative haematological investigations and functional maturation. METHODS: We performed a retrospective chart review of all patients with ESRD who were referred to the vascular service in the University Hospital of Limerick for creation of vascular access for HD. We included patients with primary AVFs; and excluded those who underwent secondary procedures. RESULTS: Overall AVF functional maturation rate in our study was 53.7% (52/97). Female gender showed significant association with nonmaturation (P = 0.004) and was the only predictor for non-maturation in a logistic regression model (P = 0.011). Patients who had history of renal transplant (P = 0.036), had relatively lower haemoglobin levels (P = 0.01) and were on calcium channel blockers (P = 0.001) showed better functional maturation rates. CONCLUSION: Female gender was found to be associated with functional non-maturation, while a history kidney transplant, calcium channel-blocker agents and low haemoglobin levels were all associated with successful functional maturation. In view of the conflicting evidence in the literature, large prospective multi-centre registry-based studies with well-defined outcomes are needed.

One-stage vs. two-stage brachio-basilic arteriovenous fistula for dialysis access: a systematic review and a meta-analysis.

INTRODUCTION: A brachiobasilic arteriovenous fistula (BB-AVF) can provide access for haemodialysis in patients who are not eligible for a more superficial fistula. However, it is unclear whether one- or two-stage BB-AVF is the best option for patients. AIM: To systematically assess the difference between both procedures in terms of access maturation, patency and postoperative complications. METHODS: Online search for randomised controlled trials (RCTs) and observational studies that compared the one-stage versus the two-stage technique for creating a BB-AVF. RESULTS: Eight studies were included (849 patients with 859 fistulas), 366 created using a one-stage technique, while 493 in a two-stage approach. There was no statistically significant difference between the two groups in the rate of successful maturation (Pooled risk ratio = 0.95 [0.82, 1.11], P = 0.53). Similarly, the incidence of postoperative haematoma (Pooled risk ratio = 0.73 [0.34, 1.58], P = 0.43), wound infection (Pooled risk ratio = 0.77 [0.35, 1.68], P = 0.51) and steal syndrome (Pooled risk ratio = 0.65 [0.27, 1.53], P = 0.32) were statistically comparable. CONCLUSION: Although more studies seem to favour the two-stage BVT approach, evidence in the literature is not sufficient to draw a final conclusion as the difference between the one-stage and the two-stage approaches for creation of a BB-AVF is not statistically significant in terms of the overall maturation rate and postoperative complications. Patency rates (primary, assisted primary and secondary) were comparable in the majority of studies. Large randomised properly conducted trials with superior methodology and adequate sub-group analysis are needed before making a final recommendation.