Comparison of quality-of-care measures in U.S. patients with end-stage renal disease secondary to lupus nephritis vs. other causes

BACKGROUND: Patients with end-stage renal disease (ESRD) due to lupus nephritis (LN-ESRD) may be followed by multiple providers (nephrologists and rheumatologists) and have greater opportunities to receive recommended ESRD-related care. We aimed to examine whether LN-ESRD patients have better quality of ESRD care compared to other ESRD patients. METHODS: Among incident patients (7/05–9/11) with ESRD due to LN (n = 6,594) vs. other causes (n = 617,758), identified using a national surveillance cohort (United States Renal Data System), we determined the association between attributed cause of ESRD and quality-of-care measures (pre-ESRD nephrology care, placement on the deceased donor kidney transplant waitlist, and placement of permanent vascular access). Multivariable logistic and Cox proportional hazards models were used to estimate adjusted odds ratios (ORs) and hazard ratios (HRs). RESULTS: LN-ESRD patients were more likely than other ESRD patients to receive pre-ESRD care (71% vs. 66%; OR = 1.68, 95% CI 1.57-1.78) and be placed on the transplant waitlist in the first year (206 vs. 86 per 1000 patient-years; HR = 1.42, 95% CI 1.34–1.52). However, only 24% had a permanent vascular access (fistula or graft) in place at dialysis start (vs. 36%; OR = 0.63, 95% CI 0.59–0.67). CONCLUSIONS: LN-ESRD patients are more likely to receive pre-ESRD care and have better access to transplant, but are less likely to have a permanent vascular access for dialysis, than other ESRD patients. Further studies are warranted to examine barriers to permanent vascular access placement, as well as morbidity and mortality associated with temporary access, in patients with LN-ESRD

Use of beneficial bacteria and their secondary metabolites to control grapevine pathogen diseases

Grapevine is one of the most important economic crops yielding berries, wine products as well as derivates. However, due to the large array of pathogens inducing diseases on this plant, considerable amounts of pesticides—with possible negative impact on the environment and health—have been used and are currently used in viticulture. To avoid negative impacts of such products and to ensure product quality, a substantial fraction of pesticides needs to be replaced in the near future. One solution can be related to the use of beneficial bacteria inhabiting the rhizo- and/or the endosphere of plants. These biocontrol bacteria and their secondary metabolites can reduce directly or indirectly pathogen diseases by affecting pathogen performance by antibiosis, competition for niches and nutrients, interference with pathogen signaling or by stimulation of host plant defenses. Due to the large demand for biocontrol of grapevine diseases, such biopesticides, their modes of actions and putative consequences of their uses need to be described. Moreover, the current knowledge on new strains from the rhizo- and endosphere and their metabolites that can be used on grapevine plants to counteract pathogen attack needs to be discussed. This is in particular with regard to the control of root rot, grey mould, trunk diseases, powdery and downy mildews, pierce’s disease, grapevine yellows as well as crown gall. Future prospects on specific beneficial microbes and their secondary metabolites that can be used as elicitors of plant defenses and/or as biocontrol agents with potential use in a more sustainable viticulture will be further discussed

Pattern of duplex doppler ultra sound scans in Jos University Teaching Hospital

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Renal ultrasound indices in Jos

This work was aimed at establishing ultrasonographic renal parameters that could serve as ready references for the sonographer. It was a prospective study carried out at the Jos University Teaching Hospital from January 1st 2003 to December 31st 2003. One hundred randomly selected patients who met the inclusion criteria were scanned. There were 61 and 39 males and females respectively (male: Female ratio of 1.6:1), with an age range of 1085yrs. The kidneys had a mean bipolar length of 10.0 ± 1.0cm, width of 4.2 ± 0.6, anteroposterior diameter of 2.8 ± 0.8cm and mean cortical thickness of 1.4 ± 0.4 No statistically significant difference in renal dimensions was found between the right and left kidneys (p>0.2), between the sexes (p>0.8) and no difference amongst the agegroups studied (p>0.7). Importantly too, the renal dimensions in Jos fall within quoted international reference values with declining renal dimensions from the age of 60years. Keywords: renal, ultrasound, size Highland Medical Research Journal Vol. 3(2) 2005: 116-12

Flavonoid Glycosides From The Leaves Of Daniellia oliveri

Four flavonoid glycoside: Rutin, Quercitin-3/-O-methyl-3-O-α-rhamnopyranosyl-(→)-β-D-glucopyranoside (Narcissin), Quercitrin and Quercimeritrin were isolated from the n-butanol soluble portion of the aqueous part of the ethanolic extract of the leaves of the plant Daniellia oliveri. The structures of these compounds were determined by spectroscopic techniques. Key words: Daniellia oliveri, Fabaceae, Flavonoid glycoside: Narcissin, Quercitrin, Quercimeritrin, rutin Nig. J. Nat. Prod. and Med. Vol.8 2004: 67-6