Acute kidney disease following COVID-19 vaccination: a single-center retrospective study

BackgroundRare cases of de novo or relapsed kidney diseases associated with vaccination against coronavirus disease 2019 (COVID-19) have been increasingly reported. The aim of this study was to report the incidence, etiologies, and outcomes of acute kidney disease (AKD) following COVID-19 vaccination.MethodsThis retrospective study extracted cases from renal registry of a single medical center from 1 March 2021 to 30 April 2022, prior to the significant surge in cases of the Omicron variant of COVID-19 infection in Taiwan. Adult patients who developed AKD after COVID-19 vaccination were included. We utilized the Naranjo score as a causality assessment tool for adverse vaccination reactions and charts review by peer nephrologists to exclude other causes. The etiologies, characteristics, and outcomes of AKD were examined.ResultsTwenty-seven patients (aged 23 to 80 years) with AKD were identified from 1,897 vaccines (estimated rate of 13.6 per 1000 patient-years within the renal registry). A majority (77.8%) of vaccine received messenger RNA-based regimens. Their median (IQR) Naranjo score was 8 (6-9) points, while 14 of them (51.9%) had a definite probability (Naranjo score ≥ 9). The etiologies of AKD included glomerular disease (n = 16) consisting of seven IgA nephropathy, four anti-neutrophil cytoplasmic antibodies-associated glomerulonephritis (AAN), three membranous glomerulonephritis, two minimal change diseases, and chronic kidney disease (CKD) with acute deterioration (n = 11). Extra-renal manifestations were found in four patients. Over a median (IQR) follow-up period of 42 (36.5–49.5) weeks, six patients progressed to end-stage kidney disease (ESKD).ConclusionBesides glomerulonephritis (GN), the occurrence of AKD following COVID-19 vaccination may be more concerning in high-risk CKD patients receiving multiple doses. Patients with the development of de novo AAN, concurrent extra-renal manifestations, or pre-existing moderate to severe CKD may exhibit poorer kidney prognosis

Clinical Efficacy and Post-Treatment Seromarkers Associated with the Risk of Hepatocellular Carcinoma among Chronic Hepatitis C Patients

This follow-up study enrolled chronic hepatitis C patients to evaluate the treatment efficacy and to identify post-treatment seromarkers associated with risk of hepatocellular carcinoma (HCC) among patients with a sustained virological response (SVR) or nonsustained virological response (NSVR). A total of 4639 patients who received pegylated interferon and ribavirin during 2004–2013 were followed until December 2014. HCC was confirmed through health examinations and data linkage with a national database. A total of 233 HCC cases were reported after 26,163 person-years of follow-up, indicating an incidence of 8.9 per 1000 person-years: 6.9 for SVR and 21.6 for NSVR per 1000 person-years. The associated risk of HCC in patients with SVR was 0.37 (0.22–0.63) for those without cirrhosis and 0.54 (0.31–0.92) for those with cirrhosis compared with their respective counterparts with NSVR. Among patients with SVR, advanced age, male gender, cirrhosis, decreased platelet count, and increased aspartate aminotransferase and α-fetoprotein levels were associated with HCC (p < 0.001). The treatment of chronic hepatitis C patients before they developed cirrhosis showed a higher efficacy than did the treatment of those who had already developed cirrhosis. Patients with SVR may still have a risk of HCC and need to be regularly monitored

The impact of underground economy and financial development on economic growth：a panel data analysis

本文旨在研究地下經濟規模與金融發展對實質人均GDP成長率之影響。我們使用二種不同金融發展資料，分別為私部門信貸規模及股市成交值規模。使用的資料型式為追蹤資料，時間由西元1981年至2008年，國家共22個，其中有14個已開發國家，8個開發中國家。模型部分共採用三種型式，首先為一般線性模型，其次為納入地下經濟規模與金融發展交互作用之非線性模型，最後則是門檻迴歸模型。 結果顯示，在一般線性模型中，地下經濟規模及私部門信貸規模對實質人均GDP成長率的影響並不顯著，而股市成交值規模對實質人均GDP成長率有顯著正面影響。 而在納入地下經濟規模與金融發展之交互作用項後，私部門信貸規模與地下經濟規模的交互作用項對實質人均GDP成長率有顯著負面影響，而股市成交值規模與地下經濟規模之交互作用項對實質人均GDP成長率有負面影響，但不顯著。由上面的結果，我們推斷地下經濟規模與實質人均GDP成長率可能存在著非線性的關係。 在門檻迴歸中，若把顯著水準設在10%，我們發現納入私部門信貸規模與股市成交值規模的模型存在顯著的門檻效果。在門檻迴歸中，若把私部門信貸規模或是股市成交值規模當作門檻變數，當金融發展程度低時，地下經濟規模對實質人均GDP成長率有顯著正面影響，而當金融發展程度高時，地下經濟規模對實質人均GDP成長率的影響並不顯著。 總結來說，我們建議低度金融發展國家適度的允許地下部門發展，因為政府無法干預地下部門，因此地下部門的營運較有效率，適度允許反而有助於提高資本投資的效率，進而促進實質人均GDP成長率。相反地，我們建議高度金融發展國家的政府應限制地下部門的發展。This paper focuses on linear effects and nonlinear effects of underground economy and financial development on the growth rate of real GDP per capita. Utilizing two alternative measures of financial development, including the size of private credit and stock trade. The analysis relies on a sample of 22 countries for the period 1981-2008, including 14 developed countries and 8 developing countries. We use three different models, including linear model, nonlinear regression with a cross-term and panel threshold model. The results show that in the linear model, underground economy and private credit have no significant impact on the growth rate of real GDP per capita, but stock trade has a significant positive impact on the growth rate of real GDP per capita. Moreover, the interaction between private credit and underground economy has a significant negative impact on the growth rate of real GDP per capita, on the other hand, the interaction between stock trade and underground economy has an insignificant negative impact on the growth rate of real GDP per capita. Hence, we speculate there have a nonlinear effect between underground economy and the growth rate of real GDP per capita. In the panel threshold model, if the level of significance is set in 10%, we find that the model with private credit and stock trade have threshold effect, it implies that the sample can be split into two regimes: High degree of financial development and Low degree of financial development. Underground economy has a significant positive impact on the growth rate of real GDP per capita when private credit is low, so does stock trade. In conclusion, we suggest that it may be optimal for countries with a less developed formal financial sector to accept more tax evasion, because it accelerates the efficiency in capital investment and then facilates the growth rate of real GDP per capita. On the contrary, countries with a more developed formal financial sector should impose more tax compliance

Physical Activity and Health-Related Quality of Life of Patients on Hemodialysis with Comorbidities: A Cross-Sectional Study

Patients on hemodialysis with multiple comorbidities have limited physical activity, resulting in poor health, low activity participation, and low quality of life. Accordingly, the nursing care provided to such patients should include regular physical activity training programs. Therefore, this cross-sectional descriptive study investigated whether patients on hemodialysis with and without comorbidities have different levels of physical activity and health-related quality of life (HRQoL); the correlations among the comorbidities, physical activity, and HRQoL of the two cohorts were also assessed. The 36-Item Short-Form Health Survey version 2 and International Physical Activity Questionnaire were employed to collect data from 120 patients on hemodialysis. An independent samples t-test and univariate and multivariate linear regression analyses were conducted. The overall HRQoL of patients with comorbidities was lower than that of patients without comorbidities (p = 0.008). Compared with patients who participated in low-intensity physical activity, the overall HRQoL of patients who participated in moderate-intensity physical activity was higher (p &lt; 0.001). The overall HRQoL of patients with comorbidities who participated in low-intensity physical activity was lower than that of those who participated in moderate-intensity physical activity (p &lt; 0.001). Moderate-intensity physical activity was correlated with higher HRQoL for patients with comorbidities. This finding supports the implementation of effective physical activity intervention measures. Furthermore, it supports the promotion of patient self-management and the implementation of regular exercise programs and lifestyle changes, and patients on hemodialysis can benefit from the future management of physical activities

Correlation between Physical Activity and Psychological Distress in Patients Receiving Hemodialysis with Comorbidities: A Cross-Sectional Study

Comorbidities cause psychological distress to patients on hemodialysis and cause their physical function to deteriorate. This study aims to examine whether physical patterns are associated with anxiety, depression and fatigue among patients with and without comorbidities who are on hemodialysis. To this end, a cross-sectional survey was administered to 120 patients on hemodialysis. Data were collected using the International Physical Activity Questionnaire&mdash;Short Form, Beck Depression Inventory&mdash;Second Edition, Beck Anxiety Inventory, and Brief Fatigue Inventory&mdash;Taiwan Version. An independent sample t test and generalized linear model analyses were conducted. The results revealed that patients with comorbidities exhibited more severe levels of depression (p &lt; 0.001), anxiety (p &lt; 0.001), and fatigue (p = 0.010) than patients without comorbidities. Additionally, patients on hemodialysis with a high physical activity level (&ge;600 metabolic equivalent of task per min/week) exhibited less depression (B = &minus;4.03; p &lt; 0.001; 95% confidence interval [CI] = &minus;6.04, &minus;2.03) and anxiety (B = &minus;2.64; p = 0.002; 95% CI = &minus;4.27, &minus;1.00) severity than those with a low physical activity level; those who engaged in weekly physical activities exhibited less fatigue severity (B = &minus;1.17; p = 0.001; 95% CI = &minus;1.84, &minus;0.49) and fatigue interference (B = &minus;0.61; p = 0.015; 95% CI = &minus;1.10, &minus;0.12). For patients on hemodialysis, having comorbidities was correlated with more severe levels of depression, anxiety, and fatigue. Weekly moderate-intensity physical activities were revealed to be correlated with less severity levels of depression, anxiety, and fatigue. The study findings aid the development of interventions for promoting physical activity among patients on hemodialysis to prevent the exacerbation of complications caused by comorbidities and psychological distress

Ulinastatin Alone Does Not Reduce Caspase 3-mediated Apoptosis in Protease-positive Aeromonas hydrophilia-induced Sepsis

To evaluate the effect of ulinastatin, a protease inhibitor, on survival and apoptosis in protease-positive Aeromonas hydrophilia (PPAH)-induced sepsis. Methods: Thirty mice were randomly allocated to receive intraperitoneal injection of either phosphate buffered saline (PBS) (control mice, n = 10) or PPAH (PPAH mice, n = 20). After 30 minutes, control mice received an additional intraperitoneal PBS injection, 10 PPAH mice received intraperitoneal PBS injection (non-treated PPAH mice), and the remaining 10 PPAH mice received an intraperitoneal injection of ulinastatin (ulinastatin-treated PPAH mice). Results: Survival at 24 hours was 100% in control mice, and 35% (p 0.05), respectively. The thymus weight (mg) decreased significantly in PPAH mice (51.1 ± 14.9) compared to control mice (69.7 ± 14.4; p 0.05) and non-treated PPAH mice (50.4 ± 16). The thymus gland cell count reduced significantly in PPAH mice (8.1 ± 4.7 × 107) compared to control mice (12.8 ± 6.6 × 107; p 0.05). Caspase 3-mediated apoptosis was not detectable in control mice in contrast to the pronounced manifestation in PPAH mice. Conclusion: PPAH-induced sepsis has a high mortality that is related to lymphocyte apoptosis. Ulinastatin alone does not significantly reduce caspase 3-mediated lymphocyte apoptosis. [J Formos Med Assoc 2007; 106(2):97-104