Stent placement for renal arterial stenosis: where do we stand? A meta-analysis

PURPOSE: To perform a meta-analysis of renal arterial stent placement in comparison with renal percutaneous transluminal angioplasty (PTA) in patients with renal arterial stenosis. MATERIALS AND METHODS: Studies dealing with renal arterial stent placement (14 articles; 678 patients) and renal PTA (10 articles; 644 patients) published up to August 1998 were selected. A random-effects model was used to pool the data. RESULTS: Renal arterial stent placement proved highly successful, with an initial adequate performance in 98% and major complications in 11%. The overall cure rate for hypertension was 20%, whereas hypertension was improved in 49%. Renal function improved in 30% and stabilized in 38% of patients. The restenosis rate at follow-up of 6-29 months was 17%. Stent placement had a higher technical success rate and a lower restenosis rate than did renal PTA (98% vs 77% and 17% vs 26%, respectively; P <.001). The complication rate was not different between the two treatments. The cure rate for hypertension was higher and the improvement rate for renal function was lower after stent placement than after renal PTA (20% vs 10% and 30% vs 38%, respectively; P <.001). CONCLUSION: Renal arterial stent placement is technically superior and clinically comparable to renal PTA alone

Validity of the Patient Experiences and Satisfaction with Medications (PESaM) Questionnaire

Background: This study assessed the validity and reliability of the generic module of the recently developed Patient Experiences and Satisfaction with Medications (PESaM) questionnaire in a sample of patients in the Netherlands. Methods: The generic module of the PESaM questionnaire consists of 18 items related to the domains effectiveness, side effects and ease of use of medications. It assesses patients’ experiences regarding the impact of the medication on daily life, health and satisfaction. In 2017, the PESaM questionnaire was sent out to idiopathic pulmonary fibrosis patients using pirfenidone or nintedanib, atypical haemolytic uraemic syndrome patients receiving eculizumab and patients using tacrolimus after kidney transplantation. Mean scores for each domain were calculated applying a scoring algorithm. Construct validity and reliability were assessed using recommended methods. Results: 188 participants completed the generic module, of whom 48% used pirfenidone, 36% nintedanib, 11% tacrolimus and 5% eculizumab. The generic module has good structural properties. Internal consistency values of the domains were satisfactory (i.e. Cronbach’s coefficient alpha above 0.7). Confirmatory factor analysis provided further evidence for construct validity, with good convergent and discriminant validity. The PESaM questionnaire also showed different scores for patients using different medications, in line with expectations, and was therefore able to differentiate between patient groups. Test–retest reliability of the items and domains were rated as moderate to fair (i.e. intraclass coefficients ranged between 0.18 and 0.76). Conclusions: The PESaM questionnaire is a unique patient-reported outcome measure evaluating patient experiences and satisfaction with medications. It has been developed in conjunction with patients, ensuring coverage of domains and issues relevant from the patient’s perspective. This study has shown promising validity of the generic module of the PESaM questionnaire. Further research is recommended to assess reliability in greater detail as well as the responsiveness of the measure. Trial registration: The study

Sterculia MALVACEAE

A diagnostic description of the genus Sterculia (Malvaceae) is given with special emphasis on the occurrence of succulence amongst its species. The geographical distribution is outlined, together with a selection of important literature, and an explanation of the etymology of the name. This is followed by a short summary of its position in the phylogeny of the family and of the past and present classification in a phylogenetic context. The succulent features present amongst the species of the genus are shortly explained as to morphology and anatomy. This is followed by a synoptical treatment of the five succulent species of the genus, complete with typification details, full synonymy, geographical and ecological data, a diagnostic description, and, where applicable, notes on phylogenetic placement and relationships, as well as economic and/or horticultural importance

Brachychiton MALVACEAE

A diagnostic description of the genus Brachychiton (Malvaceae) is given with special emphasis on the occurrence of succulence amongst its species. The geographical distribution is outlined, together with a selection of important literature, and an explanation of the etymology of the name. This is followed by a short summary of its position in the phylogeny of the family and of the past and present classification in a phylogenetic context. The succulent features present amongst the species of the genus are shortly explained as to morphology and anatomy. This is followed by a synoptical treatment of the four succulent species of the genus, complete with typification details, full synonymy, geographical and ecological data, a diagnostic description, and, where applicable, notes on phylogenetic placement and relationships, as well as economic and/or horticultural importance

The effects of B-sitosterol (BSS) and B-sitosterol glucoside (BSSG) mixture on selected immune parameters of marathon runners: Inhibition of post marathon immune suppression and inflammation

A pilot study was undertaken to investigate the effects of the intake of capsules containing the plant sterols and sterolins (BSS:BSSG mixture) on selected immune parameters of volunteers participating in an ultra-marathon in Cape Town, South Africa. Those runners having received active capsules (n = 9) showed less neutrophilia, lymphopenia and leukocytosis when compared to their counterparts having received placebo capsules (n = 8): the placebo treated individuals showed significant increases in their total white blood cell numbers as well as in their neutrophils (p = 0.03 and 0.03 respectively). Furthermore, statistically significant increases within lymphocyte subsets were observed in the runners having received the active capsules: CD3+ cells increased (p = 0.02) as did CD4+ cells (p = 0.03). In parallel, the BSS:BSSG capsules decreased the plasma level of IL6 in the runners using the active capsules (p = 0.08) and significantly decreased the cortisol: DHEAs ratio (p = 0.03), suggesting that these volunteers had less of an inflammatory response and were less immune suppressed during the post-marathon recovery period. These findings justify further investigations into the use of the phytosterols to prevent the subtle immunosuppression associated with excessive physical stress.Articl