Distal renal tubular acidosis in lymphoplasmacytic lymphoma Waldenström’s macroglobulinemia: a case report

We present a case of distal renal tubular acidosis and acute renal insufficiency in a patient with Waldenström’s macroglobulinemia. Distal renal tubular acidosis has been described in hypergammaglobulinemia, but not in patients with Waldenström’s macroglobulinemia. To our knowledge, this is the first report to describe a possible association between distal renal tubular acidosis and Waldenström’s macroglobulinemia. Our case also emphasizes the importance of prompt recognition of distal renal tubular acidosis in patients with Waldenström’s macroglobulinemia because of its metabolic disturbances and potentially life threatening complications

Cardio-renal syndrome [version 1; referees: 3 approved]

Cardio-renal syndrome is a commonly encountered problem in clinical practice. Its pathogenesis is not fully understood. The purpose of this article is to highlight the interaction between the cardiovascular system and the renal system and how their interaction results in the complex syndrome of cardio-renal dysfunction. Additionally, we outline the available therapeutic strategies to manage this complex syndrome

Sustainable Waste Tire Derived Carbon Material as a Potential Anode for Lithium-Ion Batteries

The rapidly growing automobile industry increases the accumulation of end-of-life tires each year throughout the world. Waste tires lead to increased environmental issues and lasting resource problems. Recycling hazardous wastes to produce value-added products is becoming essential for the sustainable progress of society. A patented sulfonation process followed by pyrolysis at 1100 °C in a nitrogen atmosphere was used to produce carbon material from these tires and utilized as an anode in lithium-ion batteries. The combustion of the volatiles released in waste tire pyrolysis produces lower fossil CO2 emissions per unit of energy (136.51 gCO2/kW·h) compared to other conventional fossil fuels such as coal or fuel–oil, usually used in power generation. The strategy used in this research may be applied to other rechargeable batteries, supercapacitors, catalysts, and other electrochemical devices. The Raman vibrational spectra observed on these carbons show a graphitic carbon with significant disorder structure. Further, structural studies reveal a unique disordered carbon nanostructure with a higher interlayer distance of 4.5 Å compared to 3.43 Å in the commercial graphite. The carbon material derived from tires was used as an anode in lithium-ion batteries exhibited a reversible capacity of 360 mAh/g at C/3. However, the reversible capacity increased to 432 mAh/g at C/10 when this carbon particle was coated with a thin layer of carbon. A novel strategy of prelithiation applied for improving the first cycle efficiency to 94% is also presented

The impact of systems-of-care on pharmacoinvasive management with streptokinase: The subgroup analysis of the TN-STEMI programme

Objectives: We evaluated the impact of implementation of the TN-STEMI programme on various characteristics of the pharmacoinvasive group by comparing clinical as well as angiographic outcomes between the pre- and post-implementation groups. Methods: The TN-STEMI programme involved 2420 patients of which 423 patients had undergone a pharmacoinvasive strategy of reperfusion. Of these, 407 patients had a comprehensive blinded core-lab evaluation of their angiograms post-lysis and clinical evaluation of various parameters including time-delays and adverse cardio- and cerebro-vascular events at 1 year. Streptokinase was used as the thrombolytic agent in 94.6% of the patients. Results: In the post-implementation phase, there was a significant improvement in ‘First medical contact (FMC)-to-ECG’ (11 vs. 5 min, p < 0.001) and ‘Lysis-to-angiogram’ (98.3 vs. 18.2 h, p < 0.001) times. There was also a significant improvement in the number of coronary angiograms performed within 24 h (20.7% vs. 69.3%, p < 0.001). The ‘Time-to-FMC’ (160 vs. 135 min, p = 0.07) and ‘Total ischemic time’ (210 vs. 176 min, p = 0.22) also showed a decreasing trend. IRA patency rate (70.2% vs. 86%, p < 0.001) and thrombus burden (TIMI grade 0: 49.1% vs. 73.4%, p < 0.001) were superior in this group. The MACCE rates were similar except for fewer readmissions (29.8% vs. 12.6%, p = 0.0002) and target revascularizations at 1 year (4.8% vs. none, p = 0.002) in the post-implementation group. Conclusion: The implementation of a system-of-care (hub-and-spoke model) in the pharmacoinvasive group of the TN-STEMI programme demonstrated shorter lysis-to-angiogram times, better TIMI flow patterns and lower thrombus burden in the post-implementation phase

Interleukin-6 Is a Risk Factor for Atrial Fibrillation in Chronic Kidney Disease: Findings from the CRIC Study.

Atrial fibrillation (AF) is the most common sustained arrhythmia in patients with chronic kidney disease (CKD). In this study, we examined the association between inflammation and AF in 3,762 adults with CKD, enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. AF was determined at baseline by self-report and electrocardiogram (ECG). Plasma concentrations of interleukin(IL)-1, IL-1 Receptor antagonist, IL-6, tumor necrosis factor (TNF)-α, transforming growth factor-β, high sensitivity C-Reactive protein, and fibrinogen, measured at baseline. At baseline, 642 subjects had history of AF, but only 44 had AF in ECG recording. During a mean follow-up of 3.7 years, 108 subjects developed new-onset AF. There was no significant association between inflammatory biomarkers and past history of AF. After adjustment for demographic characteristics, comorbid conditions, laboratory values, echocardiographic variables, and medication use, plasma IL-6 level was significantly associated with presence of AF at baseline (Odds ratio [OR], 1.61; 95% confidence interval [CI], 1.21 to 2.14; P = 0.001) and new-onset AF (OR, 1.25; 95% CI, 1.02 to 1.53; P = 0.03). To summarize, plasma IL-6 level is an independent and consistent predictor of AF in patients with CKD