Survival following parathyroidectomy among United States dialysis patients

Survival following parathyroidectomy among United States dialysis patients.BackgroundSecondary hyperparathyroidism (SHPTH) is highly prevalent among persons with end-stage renal disease (ESRD). SHPTH has been linked to uremic bone disease, vascular calcification, and a higher risk of death. Parathyroidectomy (PTX) can dramatically reduce parathyroid hormone (PTH) and phosphate levels; however, the relationship between PTX and survival is not known.MethodsWe conducted an observational matched cohort study utilizing data from the United States Renal Database System (USRDS) in which 4558 patients undergoing a first PTX while on hemodialysis or peritoneal dialysis were individually matched by age, race, gender, cause of ESRD, dialysis duration, prior transplantation status, and dialysis modality to 4558 control patients who did not undergo PTX. Patients were followed from the date of PTX until they died or were lost to follow-up.ResultsThe 30-day postoperative mortality rate following PTX was 3.1%. Long-term relative risks of death among patients undergoing PTX were estimated to be 10% to 15% lower than those of matched control patients not undergoing surgery. Survival curves between the 2 groups crossed 587 days following PTX. Median survival was 53.4 months (95% CI: 51.2–56.4) in the PTX group, and 46.8 months (95% CI: 44.7–48.9) in the control group.ConclusionPTX was associated with higher short-term, and lower long-term, mortality rates among U.S. patients receiving chronic dialysis. Measures to attenuate SHPTH may play an important role in reducing mortality among patients with end-stage renal disease

Exploring epilepsy attendance at the emergency department and interventions which may reduce unnecessary attendances: A scoping review

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.Background: Repeat attendances to emergency departments for seizures, impacts on the individual and burdens health care systems. We conducted a review to identify implementable measures which improve the management of people with epilepsy reducing healthcare costs and their supportive evidence. Methods: A scoping review design using suitable search strategy as outlined by PRISMA-ScR was used to examine seven databases: MEDLINE, EMBASE, CINAHL, AMED, PsychINFO, HMIC and BNI. A manual search of the COCHRANE database and citation searching was also conducted. A thematic analysis was conducted to explore the context and reasons of emergency department attendance for seizures, particularly repeat attendances and the strategies and measures deployed to reduce repeat attendances. Results: Twenty-nine reports were included, comprising of a systematic review, a randomised control study, a multi-method study, quantitative studies (n = 17), qualitative studies (n = 6), an audit, a survey and a quality improvement project. Thematic analysis identified four broad areas for reducing repeat attendances. These were developing care pathways, conducting care and treatment reviews, providing educational interventions and role of ambulance staff. Conclusion: The findings indicate varied reasons for attendance at ED following seizure, including mental health and knowledge of seizure management and lack of education. Implementations of care pathways in ED have been found to reduce admission related costs.LivaNova US

High spin band structures in doubly-odd 194^{194}Tl

The high-spin states in odd-odd $^{194}$Tl nucleus have been studied by populating them using the $^{185,187}$Re($^{13}$C, xn) reactions at 75 MeV of beam energy. $\gamma-\gamma$ coincidence measurement has been performed using the INGA array with a digital data acquisition system to record the time stamped data. Definite spin-parity assignment of the levels was made from the DCO ratio and the IPDCO ratio measurements. The level scheme of $^{194}$Tl has been extended up to 4.1 MeV in excitation energy including 19 new gamma ray transitions. The $\pi h_{9/2} \otimes \nu i_{13/2}$ band, in the neighboring odd-odd Tl isotopes show very similar properties in both experimental observables and calculated shapes. Two new band structures, with 6-quasiparticle configuration, have been observed for the first time in $^{194}$Tl. One of these bands has the characteristics of a magnetic rotational band. The cranked shell model calculations, using a deformed Woods-Saxon potential, have been performed to obtain the total Routhian surfaces in order to study the shapes of the bands and the band crossing in $^{194}$Tl. The semiclassical formalism has been used to describe the magnetic rotational band.Comment: Accepted for publication in Physical Review

Cytisus scoparius link - A natural antioxidant

BACKGROUND: Recent investigations have shown that the antioxidant properties of plants could be correlated with oxidative stress defense and different human diseases. In this respect flavonoids and other polyphenolic compounds have gained the greatest attention. The plant Cytisus scoparius contains the main constituent of flavone and flavonals. The present study was undertaken to evaluate the in vitro antioxidant activities of extract of aerial part of Cytisus scoparius. METHODS: The plant extract was tested for DPPH (1, 1-diphenyl, 2-picryl hydrazyl) radical scavenging, nitric oxide radical scavenging, superoxide anion radical scavenging, hydroxyl radical scavenging, antilipid peroxidation assay, reducing power and total phenol content. RESULTS: The extract exhibited scavenging potential with IC(50 )value of 1.5 μg/ml, 116.0 μg/ml and 4.7 μg/ml for DPPH, nitric oxide and superoxide anion radicals. The values were found to lesser than those of vitamin C, rutin, and curcumin, as standards. The extract showed 50% protection at the dose of 104.0 μg/ml in lipid peroxidation induced by Fe(2+)/ ascorbate system in rat liver microsomal preparation. There is decrease in hydroxyl radical generation with IC(50 )value of 27.0 μg/ml when compared with standard vitamin E. The reducing power of the extract depends on the amount of extract. A significant amount of polyphenols could be detected by the equivalent to 0.0589 μg of pyrocatechol from 1 mg of extract. CONCLUSION: The results obtained in the present study indicate that hydro alcoholic extract of aerial part of Cytisus scoparius is a potential source of natural antioxidants