Određivanje postotka pozitivnosti na PRA kod muških bolesnika s kroničnom bubrežnom bolešću tehnikom protočne citometrije

The antibodies directed against human leukocyte antigen (HLA) molecules, which play a crucial role in allograft histocompatibility, are called anti-HLA antibodies. Anti-HLA antibodies against foreign HLA molecules may be present in patients with chronic kidney disease even before transplantation. The panel reactive antibody (PRA) test is used to measure the renal transplant candidate’s immune sensitivity to HLA molecules other than their own HLA molecules by assessing the diversity of anti-HLA antibodies in the blood of these patients. This study aimed to determine the PRA values and the percentage of PRA positivity of Turkish male patients with chronic kidney disease (CKD), who had not been sensitized by the major known causes (those with no history of organ or tissue transplantation, those with no history of blood transfusion), who had not been diagnosed with any autoimmune diseases, and who had not been under immunosuppressive treatment. The study included 60 male patients aged over 18 years. All of the patients were followed up with a diagnosis of CKD at the Nephrology Clinic, Internal Medicine Department, Akdeniz University Medical Faculty Hospital. None of the patients included in the study was sensitized by a known mechanism previously (they did not have blood transfusion or organ transplantation). Glomerular filtration rate (GFR) levels of all patients were below the level of 60 mL/min/1.73 m2. Patient data including their age information, etiology of CKD, accompanying diseases, and information about dialysis modalities were recorded. HLA antibody percentage was determined by the flow cytometry technique. Statistical data analysis was performed by using SPSS 22.0 (Statistical Package for Social Sciences, Version 22.0). The values of p less than 0.05 were considered statistically significant. Twenty patients were receiving dialysis treatment due to end-stage renal disease. Of the 60 patients included in the study, 25% showed PRA positivity; 28.3% of all study patients were found to be positive for anti-HLA class I antibodies and 26.7% of all study patients were found to be positive for anti-HLA class II antibodies on separate analysis for anti-HLA class I and anti-HLA class II antibody positivity. When the patients were categorized as PRA negative and PRA positive in two groups, there were no differences between the groups according to mean age, percentage of hemodialysis patients, percentage of peritoneal dialysis patients and presence of accompanying chronic diseases (such as hypertension, type 2 diabetes mellitus, hyperlipidemia, nephrolithiasis, coronary artery disease). In addition to this, evaluation of the GFR levels showed that the PRA positive group contained a significantly higher percentage of end-stage renal disease patients (GFR <15 mL/min/1.73 m2) as compared with the PRA negative group. Detailed analysis of the percentages of PRA levels in the PRA positive patients, which was carried out to determine the degree of sensitization, showed that the PRA values were over 80% in 11.77% of the patients positive for anti-HLA class I antibodies. On the other hand, PRA values were within the range of 15%-80% in 88.23% of the patients who had anti-HLA class II antibodies. The PRA values were below 80% in all of the patients positive for anti-HLA class II antibodies and those positive for both anti-HLA class I and class II antibodies. In conclusion, PRA levels of the candidates for kidney transplantation should always be measured to assess their state of sensitization before transplantation, even though they have no risk factors known to cause anti-HLA antibody development.Protutijela usmjerena protiv molekula humanog leukocitnog antigena (human leukocyte antigen, HLA), koji ima bitnu ulogu u histokompatibilnosti alografta, nazivaju se anti-HLA protutijela. Anti-HLA protutijela protiv molekula stranog antigena mogu biti prisutne u bolesnika s kroničnom bubrežnom bolešću (KBB) čak i prije transplantacije. Test panela reaktivnih protutijela (panel reactive antibody, PRA) rabi se za mjerenje imunosne osjetljivosti kandidata za transplantaciju bubrega na druge molekule HLA osim onih vlastitih kroz procjenu raznolikosti anti-HLA protutijela u krvi ovih bolesnika. Cilj ovog istraživanja bio je utvrditi vrijednosti PRA i postotak pozitivnosti na PRA kod muških turskih bolesnika s KBB koji nisu bili senzibilizirani glavnim poznatim uzrocima (oni bez anamneze transplantacije organa ili tkiva, oni bez anamneze transfuzije krvi), koji nisu imali dijagnozu bilo kakve autoimune bolesti i koji nisu uzimali imunosupresivnu terapiju. U istraživanje je bilo uključeno 60 muških bolesnika u dobi iznad 18 godina. Svi bolesnici praćeni su s dijagnozom KBB u Nefrološkoj ambulanti Klinike za unutarnje bolesti, Sveučilišna bolnica Akdeniz. Svi bolesnici uključeni u istraživanje nisu bili prethodno senzibilizirani poznatim mehanizmima, odnosno nisu primili transfuziju krvi ili transplantaciju organa. Stopa glomerularne filtracije (glomerular filtration rate, GFR) kod svih je bolesnika bila ispod razine od 60 mL/min/1,73 m2. Zabilježeni su sljedeći podatci svakog bolesnika: dob, etiologija KBB, prateće bolesti, podatci o vrsti dijalize. Postotak HLA protutijela utvrđen je tehnikom protočne citometrije. Statistička analiza podataka provedena je pomoću SPSS 22.0, a vrijednosti p manje od 0,05 smatrane su statistički značajnima. Od svih bolesnika 20 ih je primalo liječenje dijalizom zbog zadnjeg stadija bubrežne bolesti. Od 60 bolesnika uključenih u istraživanje 25% ih je imalo nalaz pozitivan na PRA. Zasebna analiza na anti-HLA protutijela I. i II. klase pokazala je da je 28,3% bolesnika pozitivno na anti-HLA protutijela I. klase, a 26,7% bolesnika na anti-HLA protutijela II. klase. Kad su bolesnici podijeljeni u dvije skupine pozitivnih i negativnih na PRA nije bilo razlika između dviju skupina u dobi, postotku bolesnika na hemodijalizi, postotku bolesnika na peritonejskoj dijalizi i prisutnosti pratećih kroničnih bolesti (npr. hipertenzija, dijabetes melitus tip 2, hiperlipidemija, nefrolitijaza, bolest koronarnih arterija). Uz to, procjena razina GFR pokazala je da je u skupini bolesnika pozitivnih na PRA bio značajno viši postotak bolesnika sa zadnjim stadijem bubrežne bolesti (GFR <15 mL/min/1,73 m2) u usporedbi sa skupinom bolesnika negativnih na PRA. Podrobna analiza postotaka razina PRA kod bolesnika pozitivnih na PRA, koja je provedena kako bi se utvrdio stupanj senzibilizacije, pokazala je vrijednosti PRA iznad 80% u 11,77% bolesnika pozitivnih na anti-HLA protutijela I. klase. S druge strane, kod 88,23% bolesnika s HLA protutijelima II. klase vrijednosti PRA bile su u rasponu od 15% do 80%. Vrijednosti PRA ispod 80% utvrđene su kod svih bolesnika pozitivnih na anti-HLA protutijela II. klase i onih pozitivnih na anti-HLA protutijela I. i II. klase. Zaključno, razine PRA kod kandidata za transplantaciju bubrega treba uvijek izmjeriti kako bi se procijenio njihov status senzibilizacije prije transplantacije, čak i onda kad nemaju nikakvih rizičnih čimbenika koji bi uzrokovali razvoj anti-HLA protutijela

Lactobacillus plantarum and Lactobacillus helveticus modulate SIRT1, Caspase3 and Bcl-2 in the testes of high-fructose-fed rats

Background and Aims: The influence of a high-fructose diet and probiotics on the male reproductive system and the testicular apoptotic pathway has been poorly documented. In this study, we aimed to investigate the influence of Lactobacillus plantarum and Lactobacillus helveticus supplementation on apoptotic factors such as sirtuin1, caspase3 and bcl-2 on the testicular tissue of high-fructose-fed rats. Methods: Fructose was given to the rats as a 20% solution in drinking water for 15 weeks. Gene expressions were established by real-time PCR. Protein levels were determined by Western blot analysis. Results: Fructose consumption did not change mRNA expression of SIRT1, but did resulted in a decreased protein level. Dietary fructose reduced bcl-2 mRNA and protein expressions, whereas no changes were observed in the gene and protein expression levels of factor caspase-3. Both Lactobacillus supplementations increased SIRT1 protein expression without changing the mRNA levels in fructose-fed rats. The supplementations with both probiotics produced a significant downregulation on caspase3 mRNA and protein levels. Bcl-2 proetin level increases with both probiotics supplementation while, mRNA level did not show difference in L.plantarum, but increased in L. helveticus supplementation. Conclusion: Treatments with L.plantarum and L.helveticus can reduce testicular apoptosis induced by dietary high-fructose in rats via suppressing caspase3 and promoting sirt1 and bcl-2 protein expressions

Purification-Concentration Process of Zn(II), Ni(II) and Cd(II) Using Liquid Membrane with Different Carriers

AbstractHeavy metals are toxic to human beings and organisms. Industrial effluents drawn from different industries such as dyeing, mining, electroplating, nuclear power operations, aerospace and battery manufacturing processes are highly contaminated with heavy metals and create a major environmental problem to their discharge into land. Liquid membrane is considered as a low-cost method for treating wastes. Purification-concentration process using liquid membrane containing different extractants as carriers considered to be the most effective technique for the removal of heavy metals from wastewaters. This study primarily focuses on the extraction–reextraction in order to design a purification-contraction process using liquid membrane to remove different heavy metals (Zn, Ni, and Cd) and metal ions from aqueous solutions for industrial application. In order to design and optimize a transport process for industrial application, the effect of transport conditions has been studied. Moreover, it is important to study the influence of different parameters such as: the acidity, nature and concentration of the carriers, the time of transportation

Tannery effluent treatment by nanofiltration, reverse osmosis and chitosan modified membranes

UID/QUI/50006/2019The objective of this work is to develop an appropriate technology for environmentally sound membrane-based purification of a tannery effluent assuring, simultaneously, the recovery of chromium, considered as the most hazardous inorganic water pollutant extensively used in leather tanning. A comparison between the permeate fluxes obtained during treatment of a synthetic tannery effluent through nanofiltration (NF270 and NF90 membranes) and reverse osmosis (BW30 and SW30) membranes was first performed. Then, a dedicated polymeric membrane was prepared by coating chitosan (cs) on a polyethersulfone (PES) microfiltration membrane (cs-PES MFO22) support. The resulting membrane was characterized by Fourier Transforms Infrared Spectroscopy Attenuated Total Reflectance (FTIR-ATR), Emission Scanning Electronic Microscopy (SEM) to confirm the process of surface modification and cross-linking of chitosan with glutaraldehyde. This membrane was found to be highly effective for chromium removal (>99%), which was more than eight times higher in reference to monovalent cations (e.g., Na+ and K+) and more than six times higher in reference to the divalent cations (Mg2+ and Ca2+) studied. The reverse osmosis permeate conforms to local Algerian regulations regarding being discharged directly into the natural environment (in this case, Reghaia Lake) or into urban sewers linked to wastewater biological treatment stations. While the SW30 membrane proved to be the most effective for purification of the tannery effluent, the chitosan modified membrane proved to be appropriate for recovery of chromium from the reverse osmosis concentrate.publishersversionpublishe

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Religious tolerance in Oman: addressing religious prejudice through educational intervention

This paper examines the impact of a school-based intervention entitled ‘Our Brothers and Sisters in Humanity’ on 10th grade female Omani students’ religious tolerance. A questionnaire was administered before and after an intervention to a sample of 241 girls, of whom 116 were in the experimental group and 125 in the control group. A semi-structured interview was conducted before and after the intervention with 16 participants, of whom 8 were from the experimental group and 8 from the control group. Analysis of the quantitative data in the postintervention round reveals that there are statistically significant differences between the experimental group and the control group in favour of the experimental group in religious tolerance. Similarly the experimental group shows greater tolerance when compared to the control group in post-intervention interviews. The study suggests that religion is one of the most salient components of Omani pupils’‘identity’. The participants use religion to define their relations with, and determine their tolerance of, those who hold different religious beliefs. However, we conclude that education that capitalises on the perceived similarities between religions can be a means to suppress intolerance

Omani girls’ conceptions of gender equality: Addressing socially constructed sexist attitudes through educational intervention

This paper is based on a quasi-experimental study which examines the effects of a school-based intervention on Omani girls’ attitudes towards the notion of gender equality. A questionnaire was administered before and after the intervention to 241 girls (116 in the experimental group; 125 in the control group). A semi-structured interview was conducted before and after the intervention with 16 participants (eight from the experimental group; eight from the control group). Analysis of quantitative data in the post-intervention round revealed statistically significant differences between the two groups in attitudes towards gender equality in favour of the experimental group. Similarly, the analysis of qualitative data from the post-intervention round showed that the experimental group differed significantly from the control group in its attitudes towards women’s roles and gender equality. The paper concludes by emphasising the critical role that education can play in challenging and transforming prejudicial and discriminatory attitudes