RESUMO
BACKGROUND: Recent studies suggest that the phosphaturic hormone fibroblast growth factor 23 (FGF23) is involved in regulation of renal sodium excretion and blood pressure. There is evidence of both direct effects via regulation of the sodium-chloride symporter (NCC) in the distal tubule, and indirect effects through interactions with the renin-angiotensin-aldosterone system. However, clinical data on the association between FGF23 and renal sodium regulation is lacking. Herein, we investigated the associations of FGF23 with renal sodium handling and blood pressure in non-dialysis CKD patients. METHODS: This was a cross-sectional study encompassing 180 CKD patients Stage 1-5, undergoing renal biopsy. Plasma intact FGF23, 24-h urinary sodium excretion, fractional excretion of sodium (FENa) and blood pressure were measured at baseline. The association between FGF23 and renal sodium handling was explored by multivariate regression analysis. RESULTS: The median age was 52.8 years, 60.6% were men and the median estimated glomerular filtration rate (eGFR) was 50.6 mL/min/1.73 m2. In univariate analysis, FGF23 was positively associated with FENa (Spearman's rho = 0.47; P < 0.001) and systolic blood pressure (rho = 0.17, P < 0.05), but not with plasma sodium, 24-h urinary sodium excretion or mean arterial blood pressure. The association between FGF23 and FENa remained significant after adjustment for potential confounders (multivariable adjusted ß coefficient 0.60, P < 0.001). This association was stronger among the 107 individuals with eGFR <60 mL/min/1.73 m2 (ß = 0.47, P = 0.04) and in the 73 individuals on any diuretics (ß = 0.88, P < 0.001). Adjustment for measured GFR instead of eGFR did not alter the relationship. CONCLUSIONS: FGF23 is independently associated with increased FENa in non-dialysis CKD patients. These data do not support the notion that FGF23 causes clinically significant sodium retention. Further studies are warranted to explore the mechanism underlying this association.
Assuntos
Fatores de Crescimento de Fibroblastos/metabolismo , Insuficiência Renal Crônica/urina , Sódio/urina , Adulto , Idoso , Pressão Sanguínea , Estudos Transversais , Feminino , Fator de Crescimento de Fibroblastos 23 , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/patologia , Sódio/sangueRESUMO
PURPOSE: The use of cementless, modular, distally fixed stem in hip revision arthroplasty has increased during the last decades. We aimed to analyze the early and late postoperative complications, re-operation rate, and survival rate of the MP stem operated at our county hospital with relatively limited caseload. METHODS: In this retrospective study, we included 132 hips operated with MP stem between January 2007-2014. An independent observer reviewed patients' medical records in July 2015 (18-102 months postoperatively, median 52.5) to collect the following data: age, sex, American Society of Anesthesiologists (ASA) class, body mass index, indication of revision, type of operation, early and late complications, re-operation rate, and mortality during study period. RESULTS: The commonest indication for MP stem operation was aseptic loosening (72%). We found early and late postoperative complications in 29% of cases. The most common complication was prosthetic dislocation (8%), followed by intra-operative peri-prosthetic fracture (5%). The commonest indication for MP re-operation was soft tissue revision for infection (7%) followed by closed reduction for prosthetic dislocation (6%). We found no correlation between the age, sex, ASA class, and type of operation and the re-operation risk. Only one prosthesis was extracted giving a survival rate for 99% for the study period. CONCLUSION: This study showed good results of the MP prosthesis with reasonable complication and re-operation rates and negligible extraction rate, indicating the good performance of this implant even when used in the setting of a county hospital with limited caseload.
Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/instrumentação , Falha de Prótese , Reoperação , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia de Quadril/métodos , Feminino , Fraturas do Fêmur/etiologia , Fraturas do Fêmur/cirurgia , Luxação do Quadril/etiologia , Luxação do Quadril/cirurgia , Hospitais com Baixo Volume de Atendimentos , Humanos , Complicações Intraoperatórias/cirurgia , Masculino , Pessoa de Meia-Idade , Fraturas Periprotéticas/etiologia , Fraturas Periprotéticas/cirurgia , Estudos Retrospectivos , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/cirurgia , Taxa de SobrevidaRESUMO
Data on the impact of donor-to-recipient laterality on kidney transplantation are lacking. This study evaluated the impact of donor-to-iliac fossa laterality and the site of venous anastomosis on operating time and surgical outcome. This retrospective single-center study analyzed 1262 deceased donor adult kidney transplants into pristine iliac fossa. Multivariable linear and logistic regression analyses were used to identify variables with an impact on operating time and surgical complications. Operating time was shorter by 11 min in median for transplantations into the right iliac fossa compared to the left iliac fossa (p < 0.001). Operating time in left-to-right donor-to-recipient combination was shorter by 17 min in median if venous anastomoses were performed on the caval vein or common iliac vein as compared to anastomoses to the external iliac vein (p < 0.001). Overall, the shortest operating times (median 112.5 min) were achieved in left-to-right donor-to-recipient combinations with venous anastomosis to the caval or common iliac vein, without an increase in surgical complications. Kidney transplantation into the right iliac fossa with anastomosis to the caval vein or the common iliac vein saves operating time and reduces thrombotic complications. Acceptance of a left donor kidney is likely to further reduce operating time.
Assuntos
Ílio , Transplante de Rim , Adulto , Humanos , Estudos Retrospectivos , Ílio/cirurgia , Rim/irrigação sanguínea , Rim/cirurgia , Anastomose CirúrgicaRESUMO
Nutrients supplied via seabird guano increase primary production in some coastal ecosystems. A similar process may occur in the open ocean. To investigate this directly, we first measured bulk and leachable nutrient concentrations in guano sampled in the North Atlantic. We found that guano was strongly enriched in phosphorus, which was released as phosphate in solution. Nitrogen release was dominated by reduced forms (ammonium and urea) whilst release of nitrate was relatively low. A range of trace elements, including the micronutrient iron, were released. Using in-situ bioassays, we then showed that supply of fresh guano to ambient seawater increases phytoplankton biomass and photochemical efficiencies. Based on these results, modelled seabird distributions, and known defecation rates, we estimate that on annual scales guano is a minor source of nutrients for the surface North Atlantic. However, on shorter timescales in late spring/summer it could be much more important: Estimates of upper-level depositions of phosphorus by seabirds were three orders of magnitude higher than modelled aerosol deposition and comparable to diffusion from deeper waters.
Assuntos
Ecossistema , Nitrogênio , Animais , Nitrogênio/análise , Água do Mar , Fitoplâncton , Fósforo , Aves , Oceano AtlânticoRESUMO
This laboratory study explored the concept of whether irradiated male-only releases are more or equally efficient as releases of both irradiated males and females in the context of using the sterile insect technique/inherited sterility (SIT/IS) for the management of the European grapevine moth Lobesia botrana. The current study examined the mating competitiveness of 150-Gy-treated L. botrana male and female moths or 150-Gy-treated male moths only, with untreated moths in laboratory cages. Our results showed that the release of both sexes significantly increased the competitiveness value (C) and the biological efficiency index (BE) as compared with male-only release, and this was independent of the male to untreated male ratio. Moreover, a single release of 150-Gy-treated and untreated males and females at a 1:1:10:10 ratio (untreated male:untreated female: treated male:treated female) significantly reduced egg hatch, and the number of first-generation offspring (F1) was small. The emergence of F2-moths per untreated F1 male and female moth was low, but these undesired fertile moths should be eliminated in order to achieve effective control. The results presented herein provide useful information on the impact of 150-Gy-treated male-only, versus releases of both treated males and females on untreated moths, which is essential to managing L. botrana populations with SIT/IS.
RESUMO
The sterile insect technique/inherited sterility (SIT/IS) has been suggested as an eco-friendly control tactic for area-wide integrated pest management approaches in order to control the European grapevine moth, Lobesia botrana. This study assessed the effects of an irradiation dose of 150 Gy administered to newly emerged female moths on their egg laying behaviour and mating ability at different ages at mating. Moreover, the effects of multiple mating on the mating ability of treated females, pattern of sperm precedence in twice-mated females and the flight response of treated and untreated males to treated and untreated calling females were also investigated. Females treated with 150 Gy initiated calling in a way similar to untreated females. When treated females were paired with untreated males, the mean number of eggs oviposited per female during 6 days was reduced (59.6 and 82.8 eggs/female, respectively), as was their mating ability and multiple mating compared with untreated females. The proportion of offspring fertilized by the second of the two males to mate with the female or last-male sperm precedence (P2 value) constituted 97% of the eggs, suggesting that the second male mate fathered the most offspring. The outcome of this work could be viewed as an integrated approach for improving effectiveness and enabling successful implementation of a SIT/IS program against L. botrana.
RESUMO
Agricultural wastes have great potential for the removal of heavy metal ions from aqueous solution. The contamination of water by toxic heavy metals is a worldwide environmental problem. Unlike organic pollutants, the majority of which are susceptible to biological degradation, heavy metals do not degrade into harmless end products. Discharges containing cadmium, in particular, are strictly controlled because of the highly toxic nature of this element and its tendency to accumulate in the tissues of living organisms. This work aims to develop inexpensive, highly available, effective metal ion adsorbents from natural wastes as alternatives to existing commercial adsorbents. In particular, Tamrix articulata wastes were modified chemically by esterification with maleic acid to yield a carboxyl-rich adsorbent. The adsorption behavior of treated Tamrix articulata wastes toward cadmium ions in aqueous solutions in a batch system has been studied as a function of equilibration time, adsorbent dose, temperature and pH. Results showed that the maximum adsorption capacity was 195.5 mg/g in a pH 4 solution at 30 °C with a contact time of 120 min, an initial concentration of 400 mg/L and an adsorbent dose of 0.3 g/L. The kinetic data were analyzed using pseudo-first-order and pseudo-second-order kinetic models. It was shown that the adsorption of cadmium could be described by a pseudo-second-order equation. The experimental data were also analyzed using the Langmuir and Freundlich models of adsorption. Thermodynamic parameters such as ΔG°, ΔH° and ΔS° have been evaluated and it has been found that the sorption process was spontaneous and exothermic in nature. From all of our data, we conclude that the treated Tamrix articulata wastes investigated in this study showed good potential for cadmium removal from aqueous solutions.
Assuntos
Agricultura , Cádmio/isolamento & purificação , Resíduos/análise , Adsorção , Biodegradação Ambiental , Concentração de Íons de Hidrogênio , Cinética , Maleatos/química , Microscopia Eletrônica de Varredura , Temperatura , Termodinâmica , Fatores de TempoRESUMO
Efficacy of treated sodium alginate (TSA) and activated carbon fibre (ACF) for aqueous Pb(II) uptake was comparatively investigated. By employing FTIR, SEM, EDX, XRD, point of zero charges and surface area measurements, the available functional groups, morphology, crystallinity, surface charge and surface areas of both adsorbents were respectively elucidated. The Pb(II) uptake performance of both adsorbents was also studied via batch mode at varied process conditions. The experimental isotherm and kinetic data for both adsorbents were best fitted to nonlinear forms of Langmuir and pseudo-first-order models, respectively. Similarly, intraparticle diffusion was the sole controlling mechanism. Despite the huge variation in the surface area, TSA (7.8 m2/g) with high carboxyl content (395.6 meq-COOH/100 g of sample) performed better by all standards than the ACF (975 m2/g). This finding showed that although the surface area of a given adsorbent is a key indicator of its adsorptive performance, the inherent surface functional groups play a superior role. The experimentally derived maximum adsorption capacities of 221.25 mg/g (for TSA) and 183.34 mg/g (for ACF) were recorded at an equilibrium time of 30 min and 45 min, respectively. Therefore, TSA and ACF demonstrated effectiveness for aqueous Pb (II) sequestration.
Assuntos
Chumbo/isolamento & purificação , Poluentes Químicos da Água/isolamento & purificação , Purificação da Água/métodos , Adsorção , Alginatos/química , Fibra de Carbono/química , Carvão Vegetal/química , Fenômenos Químicos , Concentração de Íons de Hidrogênio , Cinética , Microscopia Eletrônica de Varredura , Espectrometria por Raios X , Espectroscopia de Infravermelho com Transformada de Fourier , Propriedades de Superfície , Difração de Raios XRESUMO
Approximately half of the freshwater discharged from the Greenland and Antarctic Ice Sheets enters the ocean subsurface as a result of basal ice melt, or runoff draining via the grounding line of a deep ice shelf or marine-terminating glacier. Around Antarctica and parts of northern Greenland, this freshwater then experiences prolonged residence times in large cavities beneath floating ice tongues. Due to the inaccessibility of these cavities, it is unclear how they moderate the freshwater associated supply of nutrients such as iron (Fe) to the ocean. Here, we show that subglacial dissolved Fe export from Nioghalvfjerdsbrae (the '79°N Glacier') is decoupled from particulate inputs including freshwater Fe supply, likely due to the prolonged ~162-day residence time of Atlantic water beneath Greenland's largest floating ice-tongue. Our findings indicate that the overturning rate and particle-dissolved phase exchanges in ice cavities exert a dominant control on subglacial nutrient supply to shelf regions.
RESUMO
Trace metals and macronutrients play key roles in marine biogeochemical processes. Despite their higher availability, no reliable information is available on their ecological role in the hypersaline waters of NW Arabian Gulf. The present study identifies their synergistic effect on environmental characteristics and autotrophic biomass in the shallow coastal and offshore waters, off Kuwait on a seasonal basis. Surface water samples collected along four predefined transects were analyzed for physico-chemical and biological variables during summer (n=27) and winter (n=27) seasons. Multivariate analyses revealed clear spatial and seasonal trends, and identified the best suit of environmental variables responsible for the seasonal variability in phytoplankton biomass. Using statistically derived supply to demand ratios, carbon-trace metal stoichiometry, and bioavailability of trace metals, we propose possible growth regulating factors for phytoplankton on a seasonal basis in the NW Arabian Gulf, off Kuwait. This is the first report on trace metals from the entire Arabian Gulf, using clean techniques and multivariate statistical approach.
Assuntos
Monitoramento Ambiental/métodos , Metais/análise , Fitoplâncton/crescimento & desenvolvimento , Água do Mar/química , Oligoelementos/análise , Biomassa , Clima Desértico , Kuweit , Análise Multivariada , Salinidade , Estações do Ano , SolubilidadeRESUMO
Owing to the increasing demand for rehabilitation services, robotics have been engaged in addressing the drawbacks of conventional rehabilitation therapy. This paper focuses on the modelling and control of a three-link lower limb exoskeleton for gait rehabilitation that is restricted to the sagittal plane. The exoskeleton that is modelled together with a human lower limb model is subjected to a number of excitations at its joints while performing a joint space trajectory tracking, to investigate the effectiveness of the proposed controller in compensating disturbances. A particle swarm optimised active force control strategy is proposed to facilitate disturbance rejection of a conventional proportional-derivative (PD) control algorithm. The simulation study provides considerable insight into the robustness of the proposed method in attenuating the disturbance effect as compared to the conventional PD counterpart without compromising its tracking performance. The findings from the study further suggest its potential employment on a lower limb exoskeleton.