मध्यकालीन हिन्दी-गुजराती रामकाव्यों का तुलनात्मक अध्ययन

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Examining the Association of Environmental Degradation and Poor Cardiovascular and/or Respiratory Health Outcomes in a Disadvantaged Community

Air pollution is associated with poor cardiovascular and/or respiratory health outcomes. The poor air quality in certain communities due to the emission of toxic air pollutants from industries and major roadways has been a growing concern. The main objective of this study was to examine whether residential proximity to environmental air pollution sources, individual-level risk factors (age, gender, and body mass index (BMI)) and number of years at same residence are associated with observed poor cardiovascular and/or respiratory health outcomes in the residents of Southeast community in Newport News, Virginia. Logistic regression was conducted to assess this association using the self-reported demographic and health outcomes data from the surveys completed by the residents of the community. Exposure to air pollution was calculated as distance in miles between each geocoded residential address and source of air pollution using geographic information system (GIS) tools and then Lakes Environmental Screen ViewTM, which as a user-friendly interface for US EPA SCREEN3 was used to model ground level concentration of pollutants released from Toxic Release Inventory (TRI ) reporting industries present in the community at each residential address. A significant negative correlation was observed between the predicted concentration of pollutants from industries and distance of residence from the industries. Of 224 residents, 39.7% reported the presence of cardiovascular and/or respiratory health outcomes and 51.8% had BMI in the overweight or obese category. Results of the logistic regression model reported no significant association with residential proximity to environmental pollution sources. Some of the study limitations such as the size of the study community as well as the absence of real-time air monitoring stations could be contributing factors for the observing this lack of association. For individual-level factor, significant positive association was observed between obesity (OR = 3.03; 95% CI = (1.37 – 6.71); p = 0.01) and poor cardiovascular and/or respiratory health outcomes. And although not statistically significant, higher prevalence rates of poor cardiovascular and/or respiratory health outcomes were observed in residents living at the same residence of ≥ 15 years compared to those living of \u3c 15 years at same location

New 1,2,3-Triazole Containing Polyesters via

High-molecular-weight AA-BB-type aliphatic polyesters were synthesized via Cu(I)-catalyzed click step-growth polymerization (SGP) following a new synthetic strategy. The synthesis was performed between diyne and diazide monomers in an organic solvent as one pot process using three components and two stages. The dipropargyl esters of dicarboxylic acids (component 1) were used as diyne monomers, di-(bromoacetic acid)-alkylene diesters (component 2) were used as precursors of diazide monomers, and sodium azide (component 3) was used for generating diazide monomers. The SGP was carried out in two steps: at Step  1 dibromoacetates interacted with two moles of sodium azide resulting in diazide monomers which interacted in situ with diyne monomers at Step  2 in the presence of Cu(I) catalyst. A systematic study was done for optimizing the multiparameter click SGP in terms of the solvent, duration of both Step  1 and Step  2, solution concentration, catalyst concentration, catalyst and catalyst activator (ligand) nature, catalyst/ligand mole ratio, and temperature of both steps of the click SGP. As a result, high-molecular-weight (MW up to 74 kDa) elastic film-forming click polyesters were obtained. The new polymers were found suitable for fabricating biodegradable nanoparticles, which are promising as drug delivery containers in nanotherapy

Успешная хирургическая коррекция расслоения восходящего отдела аорты у пациента с трансплантированной почкой

Cardiovascular disease is the leading cause of death in patients with a transplanted kidney and in graft loss. We present the first clinical case of successful surgical correction of ascending aortic dissection (DeBakey type I) in a young patient with a functioning kidney graft. The patient underwent the first cadaveric kidney transplantation (KTx), which was complicated by acute humoral rejection and suboptimal graft function. High blood pressure, anemia, elevated blood levels of triglycerides, phosphorus, parathyroid hormone, and uric acid were recorded. A repeat KTx was performed five years later; the patient’s condition and kidney function were satisfactory. Three years later,the patient started experiencing severe pain along the thoracic and lumbar spine; his blood creatinine level was 408 μmol/L. Computed tomography and echocardiography diagnosed DeBakey type I aortic dissection (AD) with critical narrowing of the true aortic lumen at certain levels, dissection of aortic branches. Aortic resection surgery with prosthetic replacement of the ascending aorta according to David procedure with reimplantation of coronary artery orifices according to Kouchoukos technique, prosthetic replacement of the aortic arch with debranching of brachiocephalic artery and left common carotid artery were successfully performed as planned under endotracheal anesthesia, cardiopulmonary bypass and selective pharmacological cold cardioplegia. The peculiarities of the course, possible causes and outcomes of surgical correction of thoracic AD in the patient are discussed.Сердечно-сосудистые заболевания – ведущая причина высокой смертности пациентов с трансплантированной почкой и потери трансплантата. Представляем первое клиническое наблюдение успешной хирургической коррекции расслоения восходящего отдела аорты (I типа по DeBakey) у молодого пациента с функционирующим почечным трансплантатом. Пациент перенес первую трансплантацию трупной почки, осложнившуюся острым гуморальным отторжением и неоптимальной функцией трансплантата. Регистрировались артериальная гипертония, анемия, повышенные уровни в крови триглицеридов, фосфора, паратиреоидного гормона, мочевой кислоты. Повторная трансплантация почки выполнена через пять лет, состояние пациента и функция почки были удовлетворительными. Через три года появились сильнейшие боли по ходу грудного и поясничного отделов позвоночника, креатинин крови 408 мкмоль/л. По результатам компьютерной томографии и эхокардиографии диагностировано расслоение аорты I типа по DeBakey с критическим сужением истинного просвета аорты на отдельных уровнях, расслоением ветвей аорты. В условиях эндотрахеальной анестезии, искусственного кровообращения и селективной фармакохолодовой кардиоплегии в плановом порядке успешно выполнена операция резекции аорты с протезированием восходящего отдела аорты по методике Дэвида с реимплантацией устьев коронарных артерий по Кочукос, протезирование дуги аорты с дебранчиногом плечеголовного ствола и левой общей сонной артерии. Обсуждаются особенности течения, возможные причины и результат хирургической коррекции расслоения грудной аорты у пациента

Humoral pathogenesis ischemia / reperfusion injury factors in renal transplantation

In the literature review provide the current conception of domestic and foreign authors on the humoral pathogenetic mechanisms of ischemic and reperfusion injury of renal allograft. It also provides a brief overview of methods of extracorporeal detoxification for the prevention and correction of ischemia and reperfusion injury of the graft.В обзоре литературы освещено современное представление отечественных и иностранных авторов о гуморальных патогенетических механизмах ишемического и реперфузионного повреждений почечного трансплантата. Также приводится краткий обзор возможностей методов экстракорпоральной детоксикации по предотвращению и коррекции ишемического и реперфузионного повреждения трансплантата

ОСТРЫЙ БАКТЕРИАЛЬНЫЙ ТУБУЛОИНТЕРСТИЦИАЛЬНЫЙ НЕФРИТ ПОЧЕЧНОГО АЛЛОТРАНСПЛАНТАТА С КЛИНИЧЕСКОЙ КАРТИНОЙ БАКТЕРИЕМИЧЕСКОГО ШОКА

Herein we present the clinical case, which demonstrates the difficulties of the differential diagnosis of renal allograft damage. The importance of using of modern methods of diagnosis and treatment of urinary system in- fection after cadaveric kidney transplantation: computed tomography, graft tissue biopsy and timely application of the extracorporeal endotoxin selective adsorption are emphasized. Представлено клиническое наблюдение, наглядно демонстрирующее трудности дифференциальной диа- гностики при поражениях почечного трансплантата. Подчеркивается значимость использования совре- менных методов диагностики и лечения гнойно-септического осложнения после аллотрансплантации трупной почки, а именно: РКТ, пункционной биопсии ткани трансплантата и своевременного примене- ния метода экстракорпоральной селективной адсорбции эндотоксина.

СНИЖЕНИЕ ТЯЖЕСТИ ИШЕМИЧЕСКОГО И РЕПЕРФУЗИОННОГО ПОВРЕЖДЕНИЯ ПОЧЕЧНОГО ТРАНСПЛАНТАТА ПРИ ПОМОЩИ СОЧЕТАННОЙ ПЛАЗМОФИЛЬТРАЦИИ И АДСОРБЦИИ

Aim: to evaluate the effectiveness of coupled plasma filtration and adsorption (CPFA) in reducing the severity of the renal graft ischemic and reperfusion injury. Materials and methods: shortand long-term results of renal transplantation in 33 pairs of recipients were analyzed. The patients were divided into two groups: in 33 recipients of the study group we performed CPFA in the early postoperative period. In the comparison group in 33 recipients with paired grafts CPFA was not performed. Results. The proportion of patients with good initial and delayed graft functions in the two groups was the same. In patients with delayed graft function from the study group a significantly greater rate of creatinine and urea decrease and glomerular filtration rate (GFR) increase than in patients of the comparison group were observed. Among patients with good initial graft function the differences between the groups were not significant. We have also analyzed long-term results of the transplantations: patients who received CPFA in the early postoperative period had lower levels of creatinine, urea and daily proteinuria and higher GFR in 1 year time. Thus, as a result of CPFA in the early postoperative period the improvement of graft function and graft survival prognosis can be expected in the long-term. Цель исследования: оценить эффективность сочетанной плазмофильтрации и адсорбции (СПФА) в снижении тяжести ишемического и реперфузионного повреждения почечного трансплантата. Материалы и методы: проанализированы ближайшие и отдаленные результаты трансплантации почки у 33 пар реципиентов. Пациенты разделены на две группы: у 33 реципиентов основной группы проводили СПФА в раннем послеоперационном периоде. У 33 реципиентов группы сравнения, получивших парные почки, СПФА не проводили. Результаты. Доли больных с хорошей начальной и отсроченной функцией трансплантата в двух группах не различались. У пациентов основной группы с отсроченной функцией трансплантата был отмечен значительно больший темп снижения уровня азотемии и роста скорости клубочковой фильтрации (СКФ), чем у больных группы сравнения. Среди больных с хорошей начальной функцией трансплантата различия между группами были не такими значительными. При анализе отдаленных результатов отмечено, что у больных, получивших СПФА в раннем послеоперационном периоде, через год после трансплантации функция трансплантата была лучше: ниже уровни азотемии и суточной протеинурии, выше СКФ. Таким образом, в результате применения СПФА в раннем послеоперационном периоде можно ожидать улучшения функции в долгосрочной перспективе и улучшения прогноза выживаемости трансплантата.

The European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report 2016 : a summary

Background. This article summarizes the ERA-EDTA Registry's 2016 Annual Report, by describing the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 2016 within 36 countries. Methods. In 2017 and 2018, the ERA-EDTA Registry received data on patients undergoing RRT for ESRD in 2016 from 52 national or regional renal registries. In all, 32 registries provided individual patient data and 20 provided aggregated data. The incidence and prevalence of RRT and the survival probabilities of these patients were determined. Results. In 2016, the incidence of RRT for ESRD was 121 per million population (pmp), ranging from 29 pmp in Ukraine to 251 pmp in Greece. Almost two-thirds of patients were men, over half were aged >= 65 years and almost a quarter had diabetes mellitus as their primary renal diagnosis. Treatment modality at the start of RRT was haemodialysis for 84% of patients. On 31 December 2016, the prevalence of RRT was 823 pmp, ranging from 188 pmp in Ukraine to 1906 pmp in Portugal. In 2016, the transplant rate was 32 pmp, varying from 3 pmp in Ukraine to 94 pmp in the Spanish region of Catalonia. For patients commencing RRT during 2007-11, the 5-year unadjusted patient survival probability on all RRT modalities combined was 50.5%. For 2016, the incidence and prevalence of RRT were higher among men (187 and 1381 pmp) than women (101 and 827 pmp), and men had a higher rate of kidney transplantation (59 pmp) compared with women (33 pmp). For patients starting dialysis and for patients receiving a kidney transplant during 2007-11, the adjusted patient survival probabilities appeared to be higher for women than for men.Peer reviewe

Supplemented ERA-EDTA Registry data evaluated the frequency of dialysis, kidney transplantation, and comprehensive conservative management for patients with kidney failure in Europe

The aims of this study were to determine the frequency of dialysis and kidney transplantation and to estimate the regularity of comprehensive conservative management (CCM) for patients with kidney failure in Europe. This study uses data from the ERA-EDTA Registry. Additionally, our study included supplemental data from Armenia, Germany, Hungary, Ireland, Kosovo, Luxembourg, Malta, Moldova, Montenegro, Slovenia and additional data from Israel, Italy, Slovakia using other information sources. Through an online survey, responding nephrologists estimated the frequency of CCM (i.e. planned holistic care instead of kidney replacement therapy) in 33 countries. In 2016, the overall incidence of replacement therapy for kidney failure was 132 per million population (pmp), varying from 29 (Ukraine) to 251 pmp (Greece). On 31 December 2016, the overall prevalence of kidney replacement therapy was 985 pmp, ranging from 188 (Ukraine) to 1906 pmp (Portugal). The prevalence of peritoneal dialysis (114 pmp) and home hemodialysis (28 pmp) was highest in Cyprus and Denmark respectively. The kidney transplantation rate was nearly zero in some countries and highest in Spain (64 pmp). In 28 countries with five or more responding nephrologists, the median percentage of candidates for kidney replacement therapy who were offered CCM in 2018 varied between none (Slovakia and Slovenia) and 20% (Finland) whereas the median prevalence of CCM varied between none (Slovenia) and 15% (Hungary). Thus, the substantial differences across Europe in the frequency of kidney replacement therapy and CCM indicate the need for improvement in access to various treatment options for patients with kidney failure.Peer reviewe