Impact of radical nephrectomy on renal functional outcome in patients with no other co-morbidity as determined by 24-h urinary creatinine clearance

Introduction: Renal cell carcinoma (RCC) accounts for 3% of all adult tumors. The mainstay of treatment of RCCs in the past has remained radical nephrectomy (RN). Studies have found a higher cumulative incidence of development of chronic renal insufficiency in patients undergoing RN for RCC. Objectives: To determine the frequency of decrease in 24-h urinary creatinine clearance (CrCl) as an indicator of functional decline after nephrectomy for RCC. Subjects and methods: A total of 103 patients of RCC undergoing RN were included in the study. Patients’ 24-h urinary CrCls were measured pre-nephrectomy and 3 months post-nephrectomy. The patients’ demographic and tumor characteristics were noted from case files. Data was analyzed by using SPSS version 15.0. Results: There were 61 (59.2%) males and 42 (40.8%) females with a mean age of 60.12 ± 8.88 years. The mean maximum tumor diameter was 8.5 ± 2.6 cm. The mean preoperative serum creatinine in the study group was 1.01 ± 0.24 mg/dl, while the mean 3-month postoperative serum creatinine was 1.29 ± 0.46 mg/dl. The mean preoperative CrCl measured in this study was 112.02 ± 6.04 ml/min/1.73 m2, while the 3-month postoperative value was 102.94 ± 14.10 ml/min/1.73 m2, a mean decrease of 9.08 ml/min/1.73 m2. The decrease in CrCl was identified in 34 (33%) patients. No association was found between the measured functional decline and the patients’ age and gender and stage of the disease. Conclusion: The results from this study show that RN is associated with a decrease in CrCl in one third of the study population. Therefore it is recommended that patients undergoing RN should be strictly monitored for occult renal failure and managed promptly to prevent serious morbidity of frank renal failure

Enhanced production of active photosynthetic and biochemical molecules in Silybum marianum L. using biotic and abiotic elicitors in hydroponic culture

Elicitors are stressors that activate secondary pathways that lead to the increased production of bioactive molecules in plants. Different elicitors including the fungus Aspergillus niger (0.2 g/L), methyl jasmonate (MeJA, 100 µM/L), and silver nanoparticles (1 µg/L) were added, individually and in combination, in a hydroponic medium. The application of these elicitors in hydroponic culture significantly increased the concentration of photosynthetic pigments and total phenolic contents. The treatment with MeJA (methyl jasmonate) (100 µM/L) and the co-treatment of MeJA and AgNPs (silver nanoparticles) (100 µM/L + 1 µg/L) exhibited the highest chlorophyll a (29 µg g−1 FW) and chlorophyll b (33.6 µg g−1 FW) contents, respectively. The elicitor MeJA (100 µM/L) gave a substantial rise in chlorophyll a and b and total chlorophyll contents. Likewise, a significant rise in carotenoid contents (9 µg/g FW) was also observed when subjected to meJA (100 µM/L). For the phenolic content, the treatment with meJA (100 µM/L) proved to be very effective. Nevertheless, the highest production (431 µg/g FW) was observed when treated with AgNPs (1 µg/L). The treatments with various elicitors in this study had a significant effect on flavonoid and lignin content. The highest concentration of flavonoids and lignin was observed when MeJA (100 mM) was used as an elicitor, following a 72-h treatment period. Hence, for different plant metabolites, the treatment with meJA (100 µM/L) and a co-treatment of MeJA and AgNPs (100 µM/L + 1 µg/L) under prolonged exposure times of 120–144 h proved to be the most promising in the accretion of valuable bioactive molecules. The study opens new insights into the use of these elicitors, individually or in combination, by using different concentrations and compositions.</p