Screening of vascular calcifications in patients with end-stage renal diseases

Abstract. Vascular calcifications (VC) are a major contributor to the massively increased mortality in hemodialysis (HD) patients. The present study aimed to detect arterial media and intima calcifications in HD patients and to evaluate potential risk factors. 214 patients aged 59.0 ± 11.0 years on HD for 6.39 ± 4.59 years were studied. VC were scored based on to plain radiographs. Potential risk factors were assessed. Out of the 214 patients studied, only 14% did not display any detectable VC. Using plain radiographs calcifications could be detected in 136 (63.6%) patients. Calcified plaques on carotid arteries were detected in 168 (78.4%) patients. There was the highest frequency of patients with the most pronounced calcifications. Calcifications of heart valves were detected in 89 (44.1%) patients. Univariante analysis indicate that risk to develop VC is present in older patients, patients with longer dialysis vintage, thicker intima media, higher lumen diameter and mitral valve calcifications. Multivariate multinomial logistic regression analysis revealed these factors as independent predictors of VC in dialysis patients. Our data confirm a high prevalence of VC in HD patients, their association with older ages, longer dialysis vintage, and presence of valvular calcifications and early markers of atherosclerosis

Отсылочные нормы таможенного права в таможенных кодексах ТС/EAЭC и EC: сравнительный анализ практики применения

Актуальность темы исследования обусловлена необходимостью универсального изучения отсылочных норм, так как это является одним из неотъемлемых элементов научного анализа правоприменительного и правотворческого процессов.В процессе исследования была рассмотрена структура ТК ТС и ТК ЕАЭС,были выделены основные изменения, изучен правотворческий и правоприменительный процесс использования отсылочного способа изложения элементов норм права, проанализирована динамика и характер использования отсылочных норм права в таможенных кодексах ТС, ЕАЭС и ЕС 2000-х - 2010-х годов, были определены перспективы развития отсылочных норм права в таможенном законодательстве государств-членов ЕАЭС.The relevance of the research topic is due to the need for universal study of reference rules, as this is one of the integral elements of the scientific analysis of law enforcement and law-making processes. During the study, the structure of the CC of the CU and CC of the EAEU was considered, the main changes were identified, the law-making and law enforcement process of using the reference method of presenting the elements of the law, analyzed the dynamics and nature of the use of reference rules of law in the Customs Codes of the CU, EAEU and the EU of the 2000s-2010s, the prospects for the development of reference rules of law in the customs legislation of the EAEU member states were determined

Sodium thiosulphate and progression of vascular calcification in end-stage renal disease patients: a double-blind, randomized, placebo-controlled study

Background. Sodium thiosulphate (NaTS) is mostly used in haemodialysis (HD) patients with calcific uraemic arteriolopathy. This double-blind, randomized, placebo-controlled study assessed the effect of NaTS on progression of cardiovascular calcifications in HD patients. Methods. From 65 screened patients, we recruited 60 patients with an abdominal aorta Agatston calcification score >= 100. Thirty patients were randomized to receive NaTS 25 g/1.73m(2) and 30 patients to receive 100mL of 0.9% sodium chloride intravenously during the last 15 min of HD over a period of 6 months. The primary endpoint was the absolute change of the abdominal aortic calcification score. Results. The abdominal aortic calcification score and calcification volume of the abdominal aorta increased similarly in both treatment groups during the trial. As compared with the saline group, patients receiving NaTS exhibited a reduction of their iliac artery calcification score (-137 +/- 641 versus 245 +/- 755; P = 0.049), reduced pulse wave velocity (9.6 +/- 2.7 versus 11.4 +/- 3.6; P = 0.000) and a lower carotid intima-media thickness (0.77 +/- 0.1 versus 0.83 +/- 00.17; P = .033) and had better preservation of echocardiographic parameters of left ventricular hypertrophy. No patient of the NaTS group developed new cardiac valve calcifications during the trial as compared with 8 of 29 patients in the saline group. By univariate analysis, NaTS therapy was the only predictor of not developing new valvular calcifications. No adverse events possibly related to NaTS infusion were noted. Conclusions. While NaTS failed to retard abdominal aortic calcification progress, it positively affected calcification progress in iliac arteries and heart valves as well as several other cardiovascular functional parameters