44 results on '"G. Strippoli"'
Search Results
2. ECOPHYSIOLOGICAL RESPONSE TO WATER STRESS AND REGULATION OF GENE EXPRESSION FOR A 9-CIS-EPOXYCAROTENOID DIOXYGENASE IN VITIS VINIFERA L. 'ITALIA'
- Author
-
Donato Antonacci, C. De Giovanni, Monica Marilena Miazzi, Antonio Blanco, G. Strippoli, V. Di Rienzo, Salvatore Camposeo, Cinzia Montemurro, Valentina Fanelli, Giustina Pellegrini, and Gaetano Alessandro Vivaldi
- Subjects
Regulation of gene expression ,Candidate gene ,Stomatal conductance ,fungi ,Zeaxanthin epoxidase ,food and beverages ,Plant physiology ,Horticulture ,Biology ,chemistry.chemical_compound ,chemistry ,Gene expression ,Botany ,biology.protein ,Abscisic acid ,Gene - Abstract
Abscisic acid (ABA) is associated with regulating plant adaptive responses to various environmental stresses. In particular, drought stress signals are transmitted through at least two pathways: one is abscisic acid (ABA)-dependent, and the other is ABA-independent. In the first case, drought stress increases the cellular ABA levels, which induces the expression of drought stress-responsive genes, such as 9-cis-epoxycarotenoid dioxygenase (NCED) and zeaxanthin epoxidase (ZEP). These genes belong to the carotenoid biosynthesis scenario. To date, most research of grapevines has focused on the physiological mechanisms of ABA during fruit ripening. Our interest is on studying the role of NCED and ZEP genes as candidate genes exhibiting up-regulation upon drought-stressed conditions. At the same time, several plant physiological parameters, such as leaf water status (?l), net assimilation rate (A), stomatal conductance (gs), transpiration rate (E), and soil water potential (?s), were monitored. To explain the complex molecular pattern undergoing these physiological changes, we investigated the levels of expression of one candidate gene encoding for VvNCED1. The results provided evidence of a different transcriptional pattern of the gene between the control and stressed plants, leading to a major accumulation of NCED1 transcripts in the stressed plants.
- Published
- 2015
3. 254 Induction and maintenance treatment of proliferative lupus nephritis: an updated cochrane review
- Author
-
Lorna Henderson, Robert S Flanc, A.C. Webster, Suetonia C. Palmer, G. Strippoli, Matthew A Roberts, Allison Tong, David J. Tunnicliffe, Philip Masson, J.C. Craig, and Davinder Singh-Grewal
- Subjects
medicine.medical_specialty ,business.industry ,Lupus nephritis ,Azathioprine ,medicine.disease ,Tacrolimus ,Evidence quality ,Maintenance therapy ,Internal medicine ,Toxicity ,Immunology ,medicine ,In patient ,business ,Kidney disease ,medicine.drug - Abstract
Background and aims Pharmacological treatments have improved survival in lupus nephritis. However, intravenous cyclophosphamide as first-line therapy has considerable toxicity and lacks evidence of efficacy to prevent end-stage kidney disease. The comparative efficacy of newer strategies compared with intravenous cyclophosphamide remains unclear. Methods We updated a random-effects meta-analysis of randomised controlled trials on induction and maintenance therapy for proliferative lupus nephritis. Evidence quality was assessed using GRADE. Results 59 trials (4465 participants) were eligible, including nine new trials. Compared with intravenous cyclophosphamide, mycophenolate mofetil (MMF) incurred similar risks of complete remission, mortality, or major infection, while risks of alopecia and ovarian failure were lower (Table 1) (evidence quality=moderate). There was no evidence combined MMF and tacrolimus had different effects on complete remission or major infection than intravenous cyclophosphamide (Table 1) (evidence quality=low-very low). In maintenance therapy (Table 2), MMF decreased risks of disease relapse compared to azathioprine (evidence quality=moderate), although there was no evidence of different effects between maintenance therapies on mortality, end-stage kidney disease, or major infection (evidence quality = very low –low). Conclusions MMF is as effective as intravenous cyclophosphamide in inducing remission in patients with proliferative lupus nephritis, with lower risks of alopecia and ovarian failure, although comparative effects of treatment on end-stage kidney disease and mortality remain uncertain. MMF is the most effective maintenance treatment to prevent relapse.
- Published
- 2017
4. DIALYSIS VASCULAR ACCESS
- Author
-
N. Fontsere, G. Mestres, M. Burrel, M. Barrufet, X. Montana, M. Arias, R. Ojeda, F. Maduell, J. M. Campistol, P. Nagaraja, D. Rees, T. Husein, J. Chess, C.-C. Lin, W.-C. Yang, M. Khosravi, H. Kandil, J. Cross, S. Hopkins, S. Collier, D. Lopes, S. Pereira, A. M. Gomes, A. Ventura, V. Martins, J. Seabra, T. C. Rothuizen, F. Damanik, M. J. T. Visser, T. Lavrijsen, M. A. J. Cox, L. Moroni, T. J. Rabelink, J. I. Rotmans, C. Cardozo, J. Donate, A. Soriano, M. Muros, M. Pons, J. Mensa, J. F. Navarro-Gonzalez, A. Wijewardane, A. Murley, S. Powers, C. Allen, J. Baharani, T. Wilmink, M. Esenturk, M. Zengin, M. Dal, N. Tahtal, K. Shibata, T. Shinzato, H. Satta, M. Nishihara, N. Koguchi, T. Kuji, S. Kawata, T. Kaneda, G. Yasuda, J. Scrivano, L. Pettorini, T. Rutigliano, G. M. Ciavarella, L. De Biase, G. Punzo, P. Mene, N. Pirozzi, W. El Haggan, K. Belazrague, S. Ehoussou, V. Foucher, M. El Salhy, G. Ouellet, J. Davis, P. Caron, M. Leblanc, F. Romitelli, L. Fazzari, G. Ortu, E. Di Stasio, G. Loizzo, S. M. Vigano, G. Bacchini, E. Rocchi, V. Sala, G. Pontoriero, K. Letachowicz, T. Go biowski, M. Kusztal, W. Letachowicz, W. Weyde, M. Klinger, L. Hollingsworth, R. Roca-Tey, R. Samon, O. Ibrik, A. Roda, J. C. Gonzalez-Oliva, R. Martinez-Cercos, J. Viladoms, C. J. Renaud, E. K. Lim, T. Y. Seow, H. S. Teh, J. Tosic, A. Jankovic, P. Djuric, V. Radovic Maslarevic, J. Popovic, N. Dimkovic, A. Kazantzi, K. Trigka, F. Buono, S. Laurino, G. Toriello, R. Di Luccio, A. Galise, Y. O. Kim, S. A. Yoon, Y. S. Kim, S. J. Choi, J. W. Min, M. A. Cheong, M. Asano, K. Oguchi, A. Saito, Y. Onishi, Y. Yamamoto, S. Fukuhara, T. Akiba, T. Akizawa, K. Kurokawa, M. Guedes Marques, J. Ibeas, P. Maia, P. Ponce, K. Y. Chang, H. S. Park, H. W. Kim, B. S. Choi, C. W. Park, C. W. Yang, D. C. Jin, E. Likaj, S. Seferi, G. Caco, E. Petrela, M. Barbullushi, A. Idrizi, N. Thereska, C. Lomonte, F. Casucci, P. Libutti, P. Lisi, C. Basile, P. Ancarani, G. Valsuani, L. Cavallo, D. Parodi, C. Lorusso, C. Renaud, B. C. Lai, S. Tho, L. Yeoh, C. Botelho, A. Yankovoy, S. Alexandr, A. Smoliacov, V. Stepanov, C. Parker, P. Davies, S. Taylor, A. Mikhail, J. Gubensek, V. Persic, B. Vajdic, R. Ponikvar, J. Buturovic-Ponikvar, U. Hadimeri, A. V. Warme, B. Stegmayr, S. Suvakov, T. Damjanovic, S. Bajcetic, V. Radovic-Maslarevic, T. Simic, M. Rroji, H. L. Chua, H. Kanda, S. L. See, N. C. Liew, K. Tsuchida, T. Tomo, M. Fukasawa, S. Kawashima, J. Minakuchi, V. Thanaraj, A. Dhaygude, K. Ikeda, G. Forneris, P. Cecere, M. Pozzato, M. Trogolo, A. Vallero, P. Mesiano, D. Roccatello, L. Keskin, J. R. Casey, C. S. Hanson, W. C. Winkelmayer, J. Craig, S. Palmer, G. Strippoli, A. Tong, D. Ferrara, S. Scamarda, L. Bernardino, L. Amico, M. C. Lorito, f. Incalcaterra, L. Visconti, G. Visconti, F. Valenza, F. D'Amato, A. Di Napoli, L. Tazza, S. Chicca, E. Lapucci, P. Silvestri, D. Di Lallo, P. Michelozzi, and M. Davoli
- Subjects
Transplantation ,medicine.medical_specialty ,Nephrology ,business.industry ,Vascular access ,medicine ,Intensive care medicine ,Dialysis (biochemistry) ,business - Published
- 2014
5. SAT-079 INTERVENTIONS FOR NON-MELANOMA SKIN CANCERS IN RECIPIENTS OF A SOLID-ORGAN TRANSPLANT: A META-ANALYSIS OF RANDOMISED TRIALS OF CANCER-SPECIFIC INTERVENTIONS AND IMMUNOSUPPRESSION REGIMES
- Author
-
G. Strippoli, E. Y. Chung, and S. Palmer
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Psychological intervention ,Cancer ,Immunosuppression ,medicine.disease ,Nephrology ,Meta-analysis ,Internal medicine ,medicine ,Solid organ transplantation ,business ,Non melanoma - Published
- 2019
6. Sprouts seasonal elongation of two olive cultivars in a high-density orchard
- Author
-
Gaetano Alessandro Vivaldi, G. Strippoli, Francesco Contò, and Salvatore Camposeo
- Subjects
Agronomy ,Plant morphology ,Crop yield ,Shoot ,food and beverages ,General Medicine ,Cultivar ,Orchard ,Elongation ,Biology ,Cropping system ,Plant stem - Abstract
The new high-density cropping systems (>1200 trees ha-1) represent a very interesting proposal for olive orchard profitability. It is crucial to know the morphology and the dynamics of sprout elongation of a cultivar in order to fully assess its suitability for a high-density olive orchard. For this reason we planned a research on two cultivars, Coratina and Arbequina, in a high-density orchard. The apical sprouts elongation of Arbequina early stopped at fruit set without a further step, while Coratina showed a little growth flux after pit hardening. Similar trends showed the lateral proleptic sprouts. Only the sylleptic sprouts of both cultivars had a second period of activity. In all cases, the sprouts elongation finished at the end of summer, when oil accumulation started. Coratina showed higher apical shoot growth and internodes mean length than Arbequina. On the contrary, Coratina showed lower lateral proleptic shoot growth and nodes number than Arbequina, but the same internodes mean length. No significant differences were observed between cultivars for growth, nodes number and internodes mean length of sylleptic shoots. The differences observed between the two cultivars could be explained considering their different vigour. The introduction of this innovative cropping system is allowed to register a considerable reduction of production costs. The result is a considerable increase in the economic performance of the olive grove and a consequent reduction in the unit cost for kg of oil. These data are very useful for varietal choice and field management in high-density orchards and then for new olive breeding programs.
- Published
- 2013
7. Ecophysiological response to irrigation of two olive cultivars grown in a high-density orchard
- Author
-
G. Strippoli, Gaetano Alessandro Vivaldi, and Salvatore Camposeo
- Subjects
Irrigation ,Stomatal conductance ,Agronomy ,Environmental science ,General Medicine ,Leaf water ,Cultivar ,Water-use efficiency ,Orchard ,Water use ,Transpiration - Abstract
High-density oliveculture system needs irrigation and introduces new cultivars in new environments. So the evaluation of varietal ecophysiological response to irrigation is a crucial topic. For this reason it was planned a research on two cultivars, Coratina and Arbequina, trained according to high-density system. In 2009 the irrigation was conducted according to the conventional management by applying an irrigation frequency of 4 days. The leaf water potentials reached values similar to the limits reported for the recovery within 48 hours. However, plants showed a leaf water status and gas exchange recovery just after 24 hours from watering. The results highlighted some varietal differences: Arbequina showed a better response to irrigation, while Coratina performed a higher water use efficiency by a lower leaf transpiration.
- Published
- 2013
8. Epidemiology and outcome research in CKD 5D
- Author
-
L. Coentrao, C. Ribeiro, C. Santos-Araujo, R. Neto, M. Pestana, W. Kleophas, A. Karaboyas, Y. LI, J. Bommer, R. Pisoni, B. Robinson, F. Port, G. Celik, B. Burcak Annagur, M. Yilmaz, T. Demir, F. Kara, K. Trigka, P. Dousdampanis, N. Vaitsis, S. Aggelakou-Vaitsi, K. Turkmen, I. Guney, F. Turgut, L. Altintepe, H. Z. Tonbul, E. Abdel-Rahman, P. Sclauzero, G. Galli, G. Barbati, M. Carraro, G. O. Panzetta, M. Van Diepen, M. Schroijen, O. Dekkers, F. Dekker, A. Sikole, G. Severova- Andreevska, L. Trajceska, S. Gelev, V. Amitov, S. Pavleska- Kuzmanovska, H. Rayner, R. Vanholder, M. Hecking, B. Jung, M. Leung, F. Huynh, T. Chung, S. Marchuk, M. Kiaii, L. Er, R. Werb, C. Chan-Yan, M. Beaulieu, P. Malindretos, P. Makri, G. Zagkotsis, G. Koutroumbas, G. Loukas, E. Nikolaou, M. Pavlou, E. Gourgoulianni, M. Paparizou, M. Markou, E. Syrgani, C. Syrganis, J. Raimann, L. A. Usvyat, V. Bhalani, N. W. Levin, P. Kotanko, X. Huang, P. Stenvinkel, A. R. Qureshi, U. Riserus, T. Cederholm, P. Barany, O. Heimburger, B. Lindholm, J. J. Carrero, J. H. Chang, J. Y. Sung, J. Y. Jung, H. H. Lee, W. Chung, S. Kim, J. S. Han, K. Y. Na, A. Fragoso, A. Pinho, A. Malho, A. P. Silva, E. Morgado, P. Leao Neves, N. Joki, Y. Tanaka, M. Iwasaki, S. Kubo, T. Hayashi, Y. Takahashi, K. Hirahata, Y. Imamura, H. Hase, C. Castledine, J. Gilg, C. Rogers, Y. Ben-Shlomo, F. Caskey, J. S. Sandhu, G. S. Bajwa, S. Kansal, J. Sandhu, A. Jayanti, M. Nikam, L. Ebah, A. Summers, S. Mitra, J. Agar, A. Perkins, R. Simmonds, A. Tjipto, S. Amet, V. Launay-Vacher, M. Laville, A. Tricotel, C. Frances, B. Stengel, J.-Y. Gauvrit, N. Grenier, G. Reinhardt, O. Clement, N. Janus, L. Rouillon, G. Choukroun, G. Deray, A. Bernasconi, R. Waisman, A. P. Montoya, A. A. Liste, R. Hermes, G. Muguerza, R. Heguilen, E. L. Iliescu, V. Martina, M. A. Rizzo, P. Magenta, L. Lubatti, G. Rombola, M. Gallieni, C. Loirat, H. Mellerio, M. Labeguerie, B. Andriss, E. Savoye, M. Lassale, C. Jacquelinet, C. Alberti, Y. Aggarwal, J. Baharani, S. Tabrizian, S. Ossareh, M. Zebarjadi, P. Azevedo, F. Travassos, I. Frade, M. Almeida, J. Queiros, F. Silva, A. Cabrita, R. Rodrigues, C. Couchoud, J. Kitty, S. Benedicte, C. Fergus, C. Cecile, B. Sahar, V. Emmanuel, J. Christian, E. Rene, H. Barahimi, M. Mahdavi-Mazdeh, M. Nafar, M. Petruzzi, M. De Benedittis, M. Sciancalepore, L. Gargano, P. Natale, M. C. Vecchio, V. Saglimbene, F. Pellegrini, G. Gentile, P. Stroumza, L. Frantzen, M. Leal, M. Torok, A. Bednarek, J. Dulawa, E. Celia, R. Gelfman, J. Hegbrant, C. Wollheim, S. Palmer, D. W. Johnson, P. J. Ford, J. C. Craig, G. F. Strippoli, M. Ruospo, B. El Hayek, B. Hayek, E. Baamonde, E. Bosch, J. I. Ramirez, G. Perez, A. Ramirez, A. Toledo, M. M. Lago, C. Garcia-Canton, M. D. Checa, B. Canaud, B. Lantz, A. Granger-Vallee, P. Lertdumrongluk, N. Molinari, J. Ethier, M. Jadoul, B. Gillespie, C. Bond, S. Wang, T. Alfieri, P. Braunhofer, B. Newsome, M. Wang, B. Bieber, M. Guidinger, L. Zuo, X. Yu, X. Yang, J. Qian, N. Chen, J. Albert, Y. Yan, S. Ramirez, M. Beresan, A. Lapidus, M. Canteli, A. Tong, B. Manns, J. Craig, G. Strippoli, M. Mortazavi, B. Vahdatpour, S. Shahidi, A. Ghasempour, D. Taheri, S. Dolatkhah, A. Emami Naieni, M. Ghassami, M. Khan, K. Abdulnabi, P. Pai, M. Vecchio, M. A. Muqueet, M. J. Hasan, M. A. Kashem, P. K. Dutta, F. X. Liu, L. Noe, T. Quock, N. Neil, G. Inglese, M. Motamed Najjar, B. Bahmani, A. Shafiabadi, J. Helve, M. Haapio, P.-H. Groop, C. Gronhagen-Riska, P. Finne, R. Sund, M. Cai, S. Baweja, A. Clements, A. Kent, R. Reilly, N. Taylor, S. Holt, L. Mcmahon, M. Carter, F. M. Van der Sande, J. Kooman, R. Malhotra, G. Ouellet, E. L. Penne, S. Thijssen, M. Etter, A. Tashman, A. Guinsburg, A. Grassmann, C. Barth, C. Marelli, D. Marcelli, G. Von Gersdorff, I. Bayh, L. Scatizzi, M. Lam, M. Schaller, T. Toffelmire, Y. Wang, P. Sheppard, L. Neri, V. A. Andreucci, L. A. Rocca-Rey, S. V. Bertoli, D. Brancaccio, G. De Berardis, G. Lucisano, D. Johnson, A. Nicolucci, C. Bonifati, S. D. Navaneethan, V. Montinaro, M. Zsom, A. Bednarek-Skublewska, G. Graziano, J. N. Ferrari, A. Santoro, A. Zucchelli, G. Triolo, S. Maffei, S. De Cosmo, V. M. Manfreda, L. Juillard, A. Rousset, F. Butel, S. Girardot-Seguin, T. Hannedouche, M. Isnard, Y. Berland, P. Vanhille, J.-P. Ortiz, G. Janin, P. Nicoud, M. Touam, E. Bruce, B. Grace, P. Clayton, A. Cass, S. Mcdonald, Y. Furumatsu, T. Kitamura, N. Fujii, S. Ogata, H. Nakamoto, K. Iseki, Y. Tsubakihara, C.-C. Chien, J.-J. Wang, J.-C. Hwang, H.-Y. Wang, W.-C. Kan, N. Kuster, L. Patrier, A.-S. Bargnoux, M. Morena, A.-M. Dupuy, S. Badiou, J.-P. Cristol, J.-M. Desmet, V. Fernandes, F. Collart, N. Spinogatti, J.-M. Pochet, M. Dratwa, E. Goffin, J. Nortier, D. S. Zilisteanu, M. Voiculescu, E. Rusu, C. Achim, R. Bobeica, S. Balanica, T. Atasie, S. Florence, S. Anne-Marie, L. Michel, C. Cyrille, A. Strakosha, N. Pasko, S. Kodra, N. Thereska, A. Lowney, E. Lowney, R. Grant, M. Murphy, L. Casserly, T. O' Brien, W. D. Plant, J. Radic, D. Ljutic, V. Kovacic, M. Radic, K. Dodig-Curkovic, M. Sain, I. Jelicic, T. Hamano, C. Nakano, S. Yonemoto, A. Okuno, M. Katayama, Y. Isaka, M. Nordio, A. Limido, M. Postorino, M. Nichelatti, M. Khil, I. Dudar, V. Khil, I. Shifris, M. Momtaz, A. R. Soliman, M. I. El Lawindi, P. Dzekova-Vidimliski, S. Pavleska-Kuzmanovska, I. Nikolov, G. Selim, T. Shoji, R. Kakiya, N. Tatsumi-Shimomura, Y. Tsujimoto, T. Tabata, H. Shima, K. Mori, S. Fukumoto, H. Tahara, H. Koyama, M. Emoto, E. Ishimura, Y. Nishizawa, and M. Inaba
- Subjects
Transplantation ,medicine.medical_specialty ,Nephrology ,business.industry ,Epidemiology ,Medicine ,business ,Intensive care medicine ,Outcome (game theory) - Published
- 2012
9. Clinical Nephrology - Epidemiology II
- Author
-
H. Agnes, P. Kalman, A. Jozsef, B. Henrik, I. Mucsi, K. Kamata, T. Sano, S. Naito, T. Okamoto, C. Okina, M. Kamata, J. Murano, K. Kobayashi, M. Uchida, T. Aoyama, Y. Takeuchi, Y. Nagaba, H. Sakamoto, C. Torino, V. Panuccio, A. Clementi, M. Garozzo, G. Bonanno, R. Boito, G. Natale, T. Cicchetti, A. Chippari, D. Logozzo, G. Alati, S. Cassani, A. Sellaro, G. D'arrigo, G. Tripepi, A. Roberta, M. Postorino, F. Mallamaci, C. Zoccali, E. Buonanno, S. Brancaccio, V. Fimiani, P. Napolitano, R. Spadola, L. Morrone, B. DI Iorio, D. Russo, A. Betriu, M. Martinez-Alonso, T. Vidal, J. Valdivielso, E. Fernandez, F. Bernadette, B. Jean-Baptiste, L. Frimat, N. D. Madala, G. P. Thusi, N. Sibisi, B. G. Mazibuko, A. G. H. Assounga, N.-C. Tsai, H.-H. Wang, Y.-C. Chen, C.-C. Hung, S.-J. Hwang, H.-C. Chen, P. Branco, T. Adragao, R. Birne, A. R. Martins, R. Vizinho, A. Gaspar, M. J. Grilo, J. D. Barata, D. Bonhorst, P. Adragao, J. S. Kim, J. W. Yang, M. K. Kim, S. O. Choi, B. G. Han, N. Nathalie, E. Sunny, G. Glorieux, B. Daniela, B. Fellype, L. Sophie, L. Horst D, M. Ziad, V. Raymond, M. Yanai, K. Okada, K. Takeuchi, K. Nitta, S. Takahashi, M. Morena, I. Jaussent, A. Halkovich, A.-M. Dupuy, A.-S. Bargnoux, L. Chenine, H. Leray-Moragues, K. Klouche, H. Vernhet, B. Canaud, J.-P. Cristol, A. Shutov, V. Serov, J. Kuznetsova, M. Menzorov, D. Serova, L. Petrescu, A. Zugravu, C. Capusa, S. Stancu, S. Cinca, C. Anghel, D. Timofte, L. Medrihan, D. Ionescu, G. Mircescu, T.-W. Hsu, K.-L. Kuo, S.-C. Hung, D.-C. Tarng, S. Lee, I. Kim, D. Lee, H. Rhee, S. Song, E. Seong, I. Kwak, M. Holzmann, C. Gardell, A. Jeppsson, U. Sartipy, Y. Solak, M. I. Yilmaz, K. Caglar, M. Saglam, H. Yaman, A. Sonmez, H. U. Unal, M. Gok, A. Gaipov, M. Kayrak, T. Eyileten, S. Turk, A. Vural, L. DI Lullo, F. Floccari, R. Rivera, A. Granata, A. D'amelio, F. Logias, G. Otranto, M. Malaguti, A. Santoboni, F. Fiorini, T. Connor, D. Oygar, D. Nitsch, D. Gale, R. Steenkamp, G. H. Neild, P. Maxwell, I. Louise Hogsbro, B. Redal-Baigorri, B. Sautenet, J. M. Halimi, A. Caille, P. Goupille, B. Giraudeau, Y. Oguz, M. Yenicesu, H. Cetinkaya, Y. Ishimoto, T. Ohki, M. Sugahara, T. Kanemitsu, M. Kobayashi, L. Uchida, N. Kotera, S. Tanaka, T. Sugimoto, N. Mise, N. Miyazaki, J. Matsumoto, I. Murata, G. Yoshida, K. Morishita, H. Ushikoshi, K. Nishigaki, S. Ogura, S. Minatoguchi, R. Harvey, A. Ala, D. Banerjee, C. Farmer, J. Irving, H. Hobbs, T. Wheeler, B. Klebe, P. Stevens, G. Selim, O. Stojceva-Taneva, L. Tozija, N. Stojcev, S. Gelev, P. Dzekova-Vidimliski, S. Pavleska, A. Sikole, A. R. Qureshi, M. Evans, M. Stendahl, K. G. Prutz, C. G. Elinder, K. Tamagaki, H. Kado, M. Nakata, T. Kitani, N. Ota, R. Ishida, E. Matsuoka, Y. Shiotsu, M. Ishida, Y. Mori, M. Christelle, N. Rognant, D. Evelyne, F. Sophie, J. Laurent, L. Maurice, R. Silverwood, M. Pierce, D. Kuh, C. Savage, C. Ferro, D. G. Moniek, M. De Goeij, H. Nynke, O. Gurbey, R. Joris, D. Friedo, P. Clayton, B. Grace, A. Cass, S. Mcdonald, V. Lorenzo, M. Martin Conde, A. Dusso, J. M. Valdivielso, D. P. Roggeri, G. Cannella, M. Cozzolino, S. Mazzaferro, P. Messa, D. Brancaccio, R. De Souza Faria, N. Fernandes, J. Lovisi, M. Moura Marta, M. Reboredo, B. Do Vale Pinheiro, M. Bastos, F. Hundt, S. Pabst, C. Hammerstingl, T. Gerhardt, D. Skowasch, R. Woitas, A. A. Lopes, L. F. Silva, C. M. Matos, M. S. Martins, F. A. Silva, G. B. Lopes, F. Pizzarelli, P. Dattolo, S. Michelassi, C. Rossi, S. Bandinelli, M. Mieth, R. Mass, L. Ferrucci, S. Parisi, S. Arduino, R. Attini, F. Fassio, M. Biolcati, A. Pagano, C. Bossotti, M. Ferraresi, P. Gaglioti, T. Todros, G. B. Piccoli, T. M. Salgado, B. Arguello, S. I. Benrimoj, F. Fernandez-Llimos, P. Bailey, C. Tomson, Y. Ben-Shlomo, A. Santoro, P. Rucci, M. Mandreoli, F. Caruso, M. Corradini, M. Flachi, D. Gibertoni, A. Rigotti, G. Russo, M. Fantini, H. S. Mahapatra, S. Choudhury, G. Buxi, N. Sharma, Y. Gupta, V. Sekhar, N. Yanagisawa, M. Ando, A. Ajisawa, K. Tsuchiya, O. Janusz, M. Mikolaj, M. Jacek, R. Boleslaw, S. Prakash, R. Coffin, J. Schold, D. Einstadter, S. Stark, D. Rodgers, M. Howard, A. Sehgal, S. Palmer, A. Tong, B. Manns, J. Craig, M. Ruospo, L. Gargano, G. Strippoli, M. Vecchio, M. Petruzzi, M. De Benedictis, F. Pellegrini, Y. Ohno, E. Ishimura, T. Naganuma, K. Kondo, W. Fukushima, K. Mui, M. Inaba, Y. Hirota, X. Sun, S. Jiang, H. Gu, Y. Chen, C. XI, X. Qiao, X. Chen, E. Daher, G. S. Junior, C. N. Jacinto, R. S. Pimentel, G. B. R. Aguiar, C. B. Lima, R. C. Borges, L. P. C. Mota, J. V. L. Melo, S. A. Melo, V. T. Canamary, M. Alves, S. M. H. A. Araujo, Y. K. Huang, K. Rogacev, B. Cremers, A. Zawada, S. Seiler, N. Binder, P. Ege, G. Grosse-Dunker, I. Heisel, F. Hornof, J. Jeken, N. Rebling, C. Ulrich, B. Scheller, M. Bohm, D. Fliser, G. H. Heine, B. Robinson, M. Wang, B. Bieber, R. Fluck, P. G. Kerr, B. Wikstrom, M. Krishnan, A. Nissenson, R. L. Pisoni, S. Mykleset, T. B. Osthus, B. Waldum, I. Os, J. Buttigieg, A. Cassar, J. Farrugia Agius, M. Hara, M. Yamato, K. Yasuda, and K. Sasaki
- Subjects
Transplantation ,medicine.medical_specialty ,Acute coronary syndrome ,business.industry ,Red blood cell distribution width ,medicine.disease ,Sudden death ,Uremia ,Nephrology ,Diabetes mellitus ,Internal medicine ,Heart failure ,medicine ,Cardiology ,Endothelial dysfunction ,business ,Kidney disease - Published
- 2012
10. Cellular mechanisms involved in iso-osmotic high K+ solutions-induced contraction of the estrogen-primed rat myometrium
- Author
-
Francisco M. Pinto, G. Strippoli, R. Marthan, Pilar Ausina, Jean-Pierre Savineau, Charles Advenier, M.L. Candenas, and M.M. Trujillo
- Subjects
medicine.medical_specialty ,Contraction (grammar) ,Phosphatidylinositols ,Indo-1 ,omega-Conotoxins ,General Biochemistry, Genetics and Molecular Biology ,Potassium Chloride ,Uterine Contraction ,chemistry.chemical_compound ,Internal medicine ,Extracellular ,medicine ,Animals ,Inositol ,Enzyme Inhibitors ,General Pharmacology, Toxicology and Pharmaceutics ,Sodium orthovanadate ,Arachidonic Acid ,Uterus ,Myometrium ,Estrogens ,General Medicine ,Rats ,EGTA ,Calphostin C ,Endocrinology ,chemistry ,Quinacrine ,Calcium ,Female ,Calcium Channels ,Muscle Contraction - Abstract
The aim of the present study was to investigate the mechanisms involved in the contraction evoked by iso-osmotic high K+ solutions in the estrogen-primed rat uterus. In Ca2+-containing solution, iso-osmotic addition of KCl (30, 60 or 90 mM K+) induced a rapid, phasic contraction followed by a prolonged sustained plateau (tonic component) of smaller amplitude. The KCl (60 mM)-induced contraction was unaffected by tetrodotoxin (3 microM), omega-conotoxin MVIIC (1 microM), GF 109203X (1 microM) or calphostin C (3 microM) but was markedly reduced by tissue treatment with neomycin (1 mM), mepacrine (10 microM) or U-73122 (10 microM). Nifedipine (0.01-0.1 microM) was significantly more effective as an inhibitor of the tonic component than of the phasic component. After 60 min incubation in Ca2+-free solution containing 3 mM EGTA, iso-osmotic KCl did not cause any increase in tension but potentiated contractions evoked by oxytocin (1 microM), sodium orthovanadate (160 micrM) or okadaic acid (20 microM) in these experimental conditions. In freshly dispersed myometrial cells maintained in Ca2+-containing solution and loaded with indo 1, iso-osmotic KCl (60 mM) caused a biphasic increase in the intracellular Ca2+ concentration ([Ca2+]i). In cells superfused for 60 min in Ca2+-free solution containing EGTA (1 mM), KCl did not increase [Ca2+]i. In Ca2+-containing solution, KCl (60 mM) produced a 76.0 +/- 16.2% increase in total [3H]inositol phosphates above basal levels and increased the intracellular levels of free arachidonic acid. These results suggest that, in the estrogen-primed rat uterus, iso-osmotic high K+ solutions, in addition to their well known effect on Ca2+ influx, activate other cellular processes leading to an increase in the Ca2+ sensitivity of the contractile machinery by a mechanism independent of extracellular Ca2+.
- Published
- 2000
11. Dysfonction sexuelle chez les femmes traitées par hémodialyse : une étude transversale multinationale
- Author
-
G. Strippoli, D. Del Castillo, J.C. Craig, Marco Scaldapane, Miguel C. Leal, Patrizia Natale, Paul Stroumza, Marinella Ruospo, V. Saglimbene, Luc Frantzen, Ruben Gelfman, and Suetonia C. Palmer
- Subjects
Nephrology - Abstract
Introduction La dysfonction sexuelle est tres repandue chez les femmes atteintes de maladies renales chroniques avec une prevalence d’environ 80 %. Nous avons cherche a evaluer les correlations des differents domaines de la fonction sexuelle (desir, l’excitation, lubrification, orgasme, satisfaction et douleur) chez les femmes traitees par hemodialyse. Patients et methodes Nous avons mene une etude multinationale, transversale chez les femmes traitees par hemodialyse iterative au sein d’un reseau de dialyse en Europe et en Amerique du Sud. La fonction sexuelle de la femme a ete evaluee grâce au questionnaire : Female Sexual Function Index (FSFI). Les scores les plus faibles representaient une plus grande dysfonction sexuelle. Les correlations de chaque domaine ont ete identifiees par regression lineaire multivariee. Seules les femmes qui ont declare etre sexuellement actives ont ete incluses. Resultats Sur 1309 femmes, 659 (50,3 %) ont fourni des reponses completes au FSFI. Les femmes en liste d’attente pour une greffe renale et celles avec un partenaire ont les scores plus eleves. Les femmes souffrant d’hypertension ou menopausees ont les scores plus faibles. Discussion Les patientes avec un traitement antihypertenseur associent une hausse des scores pour l’excitation, la lubrification et l’orgasme respectivement [variation moyenne (IC 95 %) de 0,37 (de 0,09 a 0,66), 0,35 (0,01 a 0,68), 0,35 (0,01 a 0,68)]. Les femmes recevant des medicaments anxiolytiques ont rapporte moins de douleur [−0,40 (−0,01 a −0,80−)] et de desir [−0,20 (−0,41− a 0)]. Les femmes moins instruites ont rapporte des niveaux inferieurs d’excitation, de lubrification et d’orgasme. Chez les femmes declarant etre sexuellement actives (n = 232) les symptomes depressifs ont ete associes a des scores plus faible. Conclusion Les femmes traitees par dialyse rapportent des experiences differentes de la dysfonction sexuelle en lien avec l’education, la depression et traitement de l’anxiete. Les comorbidites peuvent egalement jouer un role dans la fonction sexuelle. Ces donnees suggerent qu’une etude plus approfondie de l’impact de la dysfonction sexuelle sur le bien-etre du patient en dialyse est justifiee.
- Published
- 2015
12. Parodontite et mortalité totale et cardiovasculaire chez le patient hémodialysé : ORAL-D, une étude de cohorte multinationale
- Author
-
P. Stroumza, L. Frantzen, S. Trendel, and G. Strippoli
- Subjects
Nephrology - Published
- 2014
13. Reply
- Author
-
S. Palmer and G. Strippoli
- Subjects
Transplantation ,Nephrology - Published
- 2008
14. Antiviral treatment after solid organ transplantation – Authors' reply
- Author
-
Angela C Webster, Elisabeth M Hodson, Jonathan C. Craig, Cheryl A Jones, and G. Strippoli
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,General Medicine ,Antiviral treatment ,Solid organ transplantation ,business - Published
- 2005
15. An analysis of the mechanisms involved in the okadaic acid-induced contraction of the estrogen-primed rat uterus.
- Author
-
E, Arteche, G, Strippoli, G, Loirand, P, Pacaud, L, Candenas, C, Molt J, L, Souto, J, Fernandez, M, Norte, D, Martn J, and P, Savineau J
- Abstract
The contractile effect of okadaic acid (OA) and its derivatives was investigated in the rat uterus. OA (20 microM) induced a transient contraction which, after plateauing, slowly decreased. The structurally related compound okadanol (20 microM) failed to induce any significant contraction. Conversely, the synthetic compound methyl okadaate (20 microM) and the naturally occurring ester 7'-hydroxy-4'-methyl-2'-methylen-hept-4'(E)-enyl okadaate (20 microM) were as active as the free acid. The OA-induced contraction was unaffected in the presence of neomycin (5 mM), mepacrine (30 microM), 1-[N,O-bis(1,5-isoquinolinesulfonyl)-N-methyl-L-tyrosyl]-4-phenylpiperaz ine (10 microM), calphostin C (3 microM) and 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine (30 microM). The calmodulin inhibitor N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide hydrochloride (100 microM) did not modify the amplitude of the OA-induced contraction but significantly increased the rate of tension decay. The myosin light chain kinase inhibitor 1-(5-chloronaphthalene-1-sulfonyl)-1H-hexahydro-1,4-diazepine hydrochloride (1 mM) significantly reduced the peak amplitude of the contraction. Staurosporine (0.03-0.1 microM) did not modify the contractile component of the OA-induced response but inhibited the subsequent decrease in tension. In freshly dispersed myometral cells loaded with the fluorescent Ca++ indicator indo 1, OA did not produce any significant increase in [Ca++]i. OA (5- to 90-min contact) also failed to modify the intracellular levels of arachidonic acid, compared with basal values. These data suggest that in the rat uterus 1) the contractile effect of OA (20 microM) is specifically mediated by inhibition of protein phosphatases type 1 and/or 2A and is related to a direct interaction with the contractile machinery; 2) the decreasing phase of the OA-induced mechanical response could be mediated by a staurosporine-sensitive protein kinase different from protein kinase C.
- Published
- 1997
16. Haemodiafiltration versus haemodialysis for kidney failure: an individual patient data meta-analysis of randomised controlled trials.
- Author
-
Vernooij RWM, Hockham C, Strippoli G, Green S, Hegbrant J, Davenport A, Barth C, Canaud B, Woodward M, Blankestijn PJ, and Bots ML
- Abstract
Background: High-dose haemodiafiltration has been shown, in a randomised clinical trial, to result in a 23% lower risk of mortality for patients with kidney failure when compared with conventional high-flux haemodialysis. Nevertheless, whether treatment effects differ across subgroups, whether a dose-response relationship with convection volume exists, and the effects on cause-specific mortality remain unclear. The aim of this individual patient data meta-analysis was to compare the effects of haemodiafiltration and standard haemodialysis on all-cause and cause-specific mortality., Methods: On July 17, 2024, we searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for randomised controlled trials, published from database inception, comparing online haemodiafiltration versus haemodialysis designed to measure mortality outcomes. The primary outcome was all-cause mortality. Hazard ratios were generated using Cox proportional hazards regression models reporting hazard ratios and 95% CIs. Subgroup analyses based on predefined patient characteristics and dose-response analyses using natural splines for convection volume were performed. This analysis is registered with PROSPERO (CRD42024511514)., Findings: Five trials (n=4153 patients; 2070 receiving haemodialysis and 2083 receiving haemodiafiltration) were eligible for inclusion in this analysis. After a median follow-up of 30 months (IQR 24-36), all-cause mortality occurred in 477 patients (23·3%) treated with haemodiafiltration compared with in 559 patients (27·0%) treated with haemodialysis (hazard ratio 0·84 [95% CI 0·74-0·95]). No evidence of a differential effect across subgroups was noted. A graded relationship between convection volume and mortality risk was apparent: as the volume increased, the mortality risk decreased., Interpretation: Compared with haemodialysis, online haemodiafiltration reduces all-cause mortality in people with kidney failure. Results do not differ across patient and treatment characteristics and the risk reduction appears to be dose-dependent. In conclusion, the present analysis strengthens the notion that haemodiafiltration can be considered as a superior alternative to the present standard (ie, haemodialysis)., Funding: European Commission Research and Innovation, Horizon 2020., Competing Interests: Declaration of interests AD reports honoraria for lectures from Fresenius Medical Care, travel support by Nipro Corporation, and is a committee member of the European Renal Association Renal Nutrition Working Group. BC is a former employee of Fresenius Medical Care and Chief Executive Officer of MTX Consult. CB is an employee at B Braun. GS reports honoraria for lectures from Fresensius Medical Care. JH serves on the Board of Directors of NorrDia. MW reports consulting fees from Freeline. PJB reports honoraria for lectures from Fresenius Medical Care, and funding within the HORIZON 2020 programme (grant agreement 754803); payments to participating organisations and people within the CONVINCE study were handled by the University Medical Center Utrecht. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)
- Published
- 2024
- Full Text
- View/download PDF
17. Sodium-glucose co-transporter 2 inhibitors for all-cause and cardiovascular death in people with different stages of CKD: A systematic review and meta-analysis.
- Author
-
Karagiannidis AG, Theodorakopoulou MP, Alexandrou ME, Iatridi F, Karkamani E, Anastasiou V, Mykoniatis I, Kamperidis V, Strippoli G, and Sarafidis P
- Abstract
Background: Sodium-glucose co-transporter-2 inhibitors (SGLT2is) reduce cardiovascular risk in people with diabetes and established cardiovascular disease, but emerging studies in chronic kidney disease (CKD) have inconsistent results. In this systematic review, we evaluate the effects of SGLT2is on cardiovascular mortality in people with CKD as a whole and across subgroups stratified by baseline kidney function and among people at low, moderate, high and very high risk according to KDIGO- CKD classification system., Methods: Literature search was conducted in PubMed/MEDLINE, Cochrane/CENTRAL, Scopus and Web of Science up to 30 November 2023. We included randomized controlled trials assessing the effect of SGLT2is on cardiovascular mortality in people with CKD. Secondary outcomes included all-cause mortality and major adverse cardiac events (MACE)., Results: Eleven studies (n = 83,203 participants) were included. In people with CKD, treatment with SGLT2is compared to placebo reduced the risk of cardiovascular death by 14% (hazard ratio [HR] .86; 95%CI .79-.94), all-cause death by 15% (HR .85; 95%CI .79-.91) and MACEs by 13% (HR .87; 95%CI .81-.93). A consistent treatment effect was observed across eGFR-subgroups (≥60 mL/min/1.73 m
2 : HR .82, 95%CI .65-1.02; <60 mL/min/1.73 m2 : HR .86, 95%CI .77-.96, p-subgroup difference = .68) and KDIGO risk-categories (low, moderate, high and very high) (p-subgroup difference = .69) for cardiovascular death; reduction in the risk of all-cause death tended to be greater in the highest KDIGO risk categories. A consistent treatment effect on cardiovascular mortality was observed for different SGLT2is agents studied. Sensitivity analysis for cardiovascular mortality endpoint including studies in diabetic people yielded similar results (HR .86; 95%CI .77-.97)., Conclusions: Treatment with SGLT2is led to a significant reduction in the risk of cardiovascular and all-cause mortality in people with different CKD stages. These findings support the use of SGLT2is as an adjunct cardiovascular protective therapy in CKD., Prospero Registration Number: PROSPERO registration number: CRD42022382863., (© 2024 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)- Published
- 2024
- Full Text
- View/download PDF
18. Frequent hemodialysis versus standard hemodialysis for people with kidney failure: Systematic review and meta-analysis of randomized controlled trials.
- Author
-
Natale P, Green SC, Rose M, Bots ML, Blankestijn PJ, Vernooij RWM, Gerittsen K, Woodward M, Hockham C, Cromm K, Barth C, Davenport A, Hegbrant J, Sarafidis P, Das P, Wanner C, Nissenson AR, Sautenet B, Török M, and Strippoli G
- Subjects
- Humans, Randomized Controlled Trials as Topic, Kidney Failure, Chronic complications, Kidney Failure, Chronic mortality, Kidney Failure, Chronic psychology, Kidney Failure, Chronic therapy, Quality of Life, Renal Dialysis methods
- Abstract
Background: Frequent hemodialysis provided more than three times per week may lower mortality and improve health-related quality of life. Yet, the evidence is inconclusive. We evaluated the benefits and harms of frequent hemodialysis in people with kidney failure compared with standard hemodialysis., Methods: We performed a systematic review of randomized controlled trials including adults on hemodialysis with highly sensitive searching in MEDLINE, Embase, CENTRAL, and Google Scholar on 3 January 2024. Data were pooled using random-effects meta-analysis. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. We adjudicated evidence certainty using GRADE., Results: From 11,142 unique citations, only seven studies involving 518 participants proved eligible. The effects of frequent hemodialysis on physical and mental health were imprecise due to few data. Frequent hemodialysis probably had uncertain effect on death from all cause compared with standard hemodialysis (relative risk 0.79, 95% confidence interval 0.33-1.91, low certainty evidence). Data were not reported for death from cardiovascular causes, major cardiovascular events, fatigue or vascular access., Conclusion: The evidentiary basis for frequent hemodialysis is incomplete due to clinical trials with few or no events reported for mortality and cardiovascular outcome measures and few participants in which patient-reported outcomes including health-related quality of life and symptoms were reported., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Natale et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2024
- Full Text
- View/download PDF
19. Understanding patient needs and predicting outcomes in IgA nephropathy using data analytics and artificial intelligence: a narrative review.
- Author
-
Schena FP, Manno C, and Strippoli G
- Abstract
This narrative review explores two case scenarios related to immunoglobulin A nephropathy (IgAN) and the application of predictive monitoring, big data analysis and artificial intelligence (AI) in improving treatment outcomes. The first scenario discusses how online service providers accurately understand consumer preferences and needs through the use of AI-powered big data analysis. The author, a clinical nephrologist, contemplates the potential application of similar methodologies, including AI, in his medical practice to better understand and meet patient needs. The second scenario presents a case study of a 20-year-old man with IgAN. The patient exhibited recurring symptoms, including gross haematuria and tonsillitis, over a 2-year period. Through histological examination and treatment with renin-angiotensin system blockade and corticosteroids, the patient experienced significant improvement in kidney function and reduced proteinuria over 15 years of follow-up. The case highlights the importance of individualized treatment strategies and the use of predictive tools, such as AI-based predictive models, in assessing treatment response and predicting long-term outcomes in IgAN patients. The article further discusses the collection and analysis of real-world big data, including electronic health records, for studying disease natural history, predicting treatment responses and identifying prognostic biomarkers. Challenges in integrating data from various sources and issues such as missing data and data processing limitations are also addressed. Mathematical models, including logistic regression and Cox regression analysis, are discussed for predicting clinical outcomes and analysing changes in variables over time. Additionally, the application of machine learning algorithms, including AI techniques, in analysing big data and predicting outcomes in IgAN is explored. In conclusion, the article highlights the potential benefits of leveraging AI-powered big data analysis, predictive monitoring and machine learning algorithms to enhance patient care and improve treatment outcomes in IgAN., Competing Interests: The authors have no conflicts of interests to disclose., (© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.)
- Published
- 2023
- Full Text
- View/download PDF
20. Patient experiences of continuous glucose monitoring and sensor-augmented insulin pump therapy for diabetes: A systematic review of qualitative studies.
- Author
-
Natale P, Chen S, Chow CK, Cheung NW, Martinez-Martin D, Caillaud C, Scholes-Robertson N, Kelly A, Craig JC, Strippoli G, and Jaure A
- Subjects
- Humans, Blood Glucose, Blood Glucose Self-Monitoring, Continuous Glucose Monitoring, Quality of Life, Insulin Infusion Systems, Patient Outcome Assessment, Insulin therapeutic use, Hypoglycemic Agents therapeutic use, Diabetes Mellitus, Type 1 drug therapy, Hyperinsulinism, Insulins
- Abstract
Aims: Blood glucose control is central to the management of diabetes, and continuous glucose monitoring (CGM) improves glycemic control. We aimed to describe the perspectives of people with diabetes using CGM., Materials and Methods: We performed a systematic review of qualitative studies., Results: Fifty-four studies involving 1845 participants were included. Six themes were identified: gaining control and convenience (reducing pain and time, safeguarding against complications, achieving stricter glucose levels, and sharing responsibility with family); motivating self-management (fostering ownership, and increasing awareness of glycemic control); providing reassurance and freedom (attaining peace of mind, and restoring social participation); developing confidence (encouraged by the endorsement of others, gaining operational skills, customizing settings for ease of use, and trust in the device); burdened with device complexities (bewildered by unfamiliar technology, reluctant to rely on algorithms, overwhelmed by data, frustrated with malfunctioning and inaccuracy, distressed by alerts, and bulkiness of machines interfering with lifestyle); and excluded by barriers to access (constrained by cost, lack of suppliers)., Conclusions: CGM can improve self-management and confidence in patients managing diabetes. However, the technical issues, uncertainty in readings, and cost may limit the uptake. Education and training from the health professionals may help to reduce the practical and psychological burden for better patient outcomes., (© 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)
- Published
- 2023
- Full Text
- View/download PDF
21. Perspectives of Nephrologists on Gender Disparities in Access to Kidney Transplantation.
- Author
-
Natale P, Hecking M, Kurnikowski A, Scholes-Robertson N, Carrero JJ, Wong G, Strippoli G, and Jaure A
- Subjects
- Male, Humans, Female, Nephrologists, Kidney Transplantation
- Abstract
Background: Gender disparities in access to kidney transplantation are apparent, with women being up to 20% less likely to receive kidney transplant compared with men across different settings and socioeconomic backgrounds. We aimed to describe nephrologists' perspectives on gender disparities in access to kidney transplantation., Methods: Fifty-one nephrologists (55% women) from 22 countries participated in semistructured interviews from October 2019 to April 2020. We analyzed the transcripts thematically., Results: We identified three themes: caregiving as a core role (coordinators of care for partners, fulfilling family duties over own health, maternal protectiveness, and inherent willingness and generosity), stereotyping and stigma (authority held by men in decision making, protecting the breadwinner, preserving body image and appearance, and safeguard fertility), social disadvantage and vulnerability (limited information and awareness, coping alone and lack of support, disempowered by language barriers, lack of financial resources, and without access to transport)., Conclusions: Gender disparities in access to kidney transplantation are perceived by nephrologists to be exacerbated by gender norms and values, stigma and prejudice, and educational and financial disadvantages that are largely encountered by women compared with men across different socioeconomic settings., (Copyright © 2023 by the American Society of Nephrology.)
- Published
- 2023
- Full Text
- View/download PDF
22. The Impact of the COVID-19 Pandemic on Patients With CKD: Systematic Review of Qualitative Studies.
- Author
-
Natale P, Zhang J, Scholes-Robertson N, Cazzolli R, White D, Wong G, Guha C, Craig J, Strippoli G, Stallone G, Gesualdo L, and Jaure A
- Subjects
- Adult, Humans, Pandemics, Communicable Disease Control, Qualitative Research, COVID-19, Renal Insufficiency, Chronic epidemiology, Renal Insufficiency, Chronic therapy, Renal Insufficiency, Chronic psychology
- Abstract
Rationale & Objective: COVID-19 disproportionately affects people with comorbidities, including chronic kidney disease (CKD). We describe the impact of COVID-19 on people with CKD and their caregivers., Study Design: A systematic review of qualitative studies., Setting & Study Populations: Primary studies that reported the experiences and perspectives of adults with CKD and/or caregivers were eligible., Search Strategy & Sources: MEDLINE, Embase, PsycINFO, CINAHL searched from database inception to October 2022., Data Extraction: Two authors independently screened the search results. Full texts of potentially relevant studies were assessed for eligibility. Any discrepancies were resolved by discussion with another author., Analytical Approach: A thematic synthesis was used to analyze the data., Results: Thirty-four studies involving 1,962 participants were included. Four themes were identified: exacerbating vulnerability and distress (looming threat of COVID-19 infection, intensifying isolation, aggravating pressure on families); uncertainty in accessing health care (overwhelmed by disruption of care, confused by lack of reliable information, challenged by adapting to telehealth, skeptical about vaccine efficacy and safety); coping with self-management (waning fitness due to decreasing physical activity, diminishing ability to manage diet, difficulty managing fluid restrictions, minimized burden with telehealth, motivating confidence and autonomy); and strengthening sense of safety and support (protection from lockdown restrictions, increasing trust in care, strengthened family connection)., Limitations: Non-English studies were excluded, and inability to delineate themes based on stage of kidney and treatment modality., Conclusions: Uncertainty in accessing health care during the COVID-19 pandemic exacerbated vulnerability, emotional distress, and burden, and led to reduced capacity to self-manage among patients with CKD and their caregivers. Optimizing telehealth and access to educational and psychosocial support may improve self-management and the quality and effectiveness of care during a pandemic, mitigating potentially catastrophic consequences for people with CKD., Plain-Language Summary: During the COVID-19 pandemic, patients with chronic kidney disease (CKD) faced barriers and challenges to accessing care and were at an increased risk of worsened health outcomes. To understand the perspectives about the impact of COVID-19 among patients with CKD and their caregivers, we conducted a systematic review of 34 studies involving 1,962 participants. Our findings demonstrated that uncertainty in accessing care during the COVID-19 pandemic exacerbated the vulnerability, distress, and burden of patients and impaired their abilities for self-management. Optimizing the use of telehealth and providing education and psychosocial services may mitigate the potential consequences for people with CKD during a pandemic., (Copyright © 2023 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
23. Acetazolamide for metabolic alkalosis complicating respiratory failure with chronic obstructive pulmonary disease or obesity hypoventilation syndrome: a systematic review.
- Author
-
Bemand TJ, Chatoor R, Natale P, Strippoli G, and Delaney A
- Subjects
- Humans, Acetazolamide therapeutic use, Obesity Hypoventilation Syndrome complications, Pulmonary Disease, Chronic Obstructive complications, Pulmonary Disease, Chronic Obstructive drug therapy, Alkalosis, Respiratory Insufficiency drug therapy, Respiratory Insufficiency etiology
- Abstract
Background: Metabolic alkalosis may lead to respiratory inhibition and increased need for ventilatory support or prolongation of weaning from ventilation for patients with chronic respiratory disease. Acetazolamide can reduce alkalaemia and may reduce respiratory depression., Methods: We searched Medline, EMBASE and CENTRAL from inception to March 2022 for randomised controlled trials comparing acetazolamide to placebo in patients with chronic obstructive pulmonary disease, obesity hypoventilation syndrome or obstructive sleep apnoea, hospitalised with acute respiratory deterioration complicated by metabolic alkalosis. The primary outcome was mortality and we pooled data using random-effects meta-analysis. Risk of bias was assessed using the Cochrane RoB 2 (Risk of Bias 2) tool, heterogeneity was assessed using the I
2 value and χ2 test for heterogeneity. Certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology., Results: Four studies with 504 patients were included. 99% of included patients had chronic obstructive pulmonary disease. No trials recruited patients with obstructive sleep apnoea. 50% of trials recruited patients requiring mechanical ventilation. Risk of bias was overall low to some risk. There was no statistically significant difference with acetazolamide in mortality (relative risk 0.98 (95% CI 0.28 to 3.46); p=0.95; 490 participants; three studies; GRADE low certainty) or duration of ventilatory support (mean difference -0.8 days (95% CI -7.2 to 5.6); p=0.36; 427 participants; two studies; GRADE: low certainty)., Conclusion: Acetazolamide may have little impact on respiratory failure with metabolic alkalosis in patients with chronic respiratory diseases. However, clinically significant benefits or harms are unable to be excluded, and larger trials are required., Prospero Registration Number: CRD42021278757., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)- Published
- 2023
- Full Text
- View/download PDF
24. Range and Consistency of Cardiovascular Outcomes Reported by Clinical Trials in Kidney Transplant Recipients: A Systematic Review.
- Author
-
Wilson GJ, Van K, O'Lone E, Tong A, Craig JC, Sautenet B, Budde K, Forfang D, Gill J, Herrington WG, Jafar TH, Johnson DW, Krane V, Levin A, Malyszko J, Rossignol P, Sawinski D, Scholes-Robertons N, Strippoli G, Wang A, Winkelmayer WC, Hawley CM, and Viecelli AK
- Abstract
Cardiovascular disease is a major cause of morbidity and mortality in kidney transplant recipients. Trial evidence to improve cardiovascular outcomes is limited by inconsistent reporting of outcomes, which may also lack patient-relevance. This study aimed to assess the range and consistency of cardiovascular outcomes reported by contemporary trials in kidney transplant recipients., Methods: A systematic review of all randomized controlled trials involving adult kidney transplant recipients that reported at least 1 cardiovascular outcome from January 2012 to December 2019 was performed, including Embase, MEDLINE, Cochrane, and ClinicalTrials.gov electronic databases. Trial characteristics were extracted and all levels of specification of the cardiovascular outcome measures reported were analyzed (the measure definition, metric' and method of aggregation). Measures assessing a similar aspect of cardiovascular disease were categorized into outcomes., Results: From 93 eligible trials involving 27 609 participants, 490 outcome measures were identified. The outcome measures were grouped into 38 outcomes. A cardiovascular composite was the most common outcome reported (40 trials, 43%) followed by cardiovascular mortality (42%) and acute coronary syndrome (31%). Cardiovascular composite was also the most heterogeneous outcome with 77 measures reported followed by cardiovascular mortality (n = 58) and inflammatory biomarkers (n = 51). The most common cardiovascular composite outcome components reported were major cardiovascular events (18 trials), stroke unspecified (11 trials), and myocardial infarction unspecified (10 trials)., Conclusions: There is substantial heterogeneity in cardiovascular outcome reporting in kidney transplant trials., (Copyright © 2022 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
- Published
- 2022
- Full Text
- View/download PDF
25. Validation of a Core Patient-Reported Outcome Measure for Fatigue in Patients Receiving Hemodialysis: The SONG-HD Fatigue Instrument.
- Author
-
Ju A, Teixeira-Pinto A, Tong A, Smith AC, Unruh M, Davison SN, Dapueto J, Dew MA, Fluck R, Germain MJ, Jassal SV, Obrador GT, O'Donoghue D, Viecelli AK, Strippoli G, Ruospo M, Timofte D, Sharma A, Au E, Howell M, Costa DSJ, Anumudu S, Craig JC, and Rutherford C
- Subjects
- Adolescent, Adult, Aged, Factor Analysis, Statistical, Female, Humans, Longitudinal Studies, Male, Middle Aged, Psychometrics, Reproducibility of Results, Visual Analog Scale, Young Adult, Fatigue etiology, Patient Reported Outcome Measures, Renal Dialysis adverse effects
- Abstract
Background and Objectives: Fatigue is a very common and debilitating symptom and identified by patients as a critically important core outcome to be included in all trials involving patients receiving hemodialysis. A valid, standardized measure for fatigue is needed to yield meaningful and relevant evidence about this outcome. This study validated a core patient-reported outcome measure for fatigue in hemodialysis., Design, Setting, Participants, & Measurements: A longitudinal cohort study was conducted to assess the validity and reliability of a new fatigue measure (Standardized Outcomes in Nephrology-Hemodialysis Fatigue [SONG-HD Fatigue]). Eligible and consenting patients completed the measure at three time points: baseline, a week later, and 12 days following the second time point. Cronbach α and intraclass correlation coefficient were calculated to assess internal consistency, and Spearman rho was used to assess convergent validity. Confirmatory factor analysis was also conducted. Hemodialysis units in the United Kingdom, Australia, and Romania participated in this study. Adult patients aged 18 years and over who were English speaking and receiving maintenance hemodialysis were eligible to participate. Standardized Outcomes in Nephrology-Hemodialysis, the Visual Analog Scale for fatigue, the 12-Item Short Form Survey, and Functional Assessment of Chronic Illness Therapy-Fatigue were used., Results: In total, 485 participants completed the study across the United Kingdom, Australia, and Romania. Psychometric assessment demonstrated that Standardized Outcomes in Nephrology-Hemodialysis is internally consistent (Cronbach α =0.81-0.86) and stable over a 1-week period (intraclass correlation coefficient =0.68-0.74). The measure demonstrated convergence with Functional Assessment of Chronic Illness Therapy-Fatigue and had moderate correlations with other measures that assessed related but not the same concept (the 12-Item Short Form Survey and the Visual Analog Scale). Confirmatory factor analysis supported the one-factor model., Conclusions: SONG-HD Fatigue seems to be a reliable and valid measure to be used in trials involving patients receiving hemodialysis., (Copyright © 2020 by the American Society of Nephrology.)
- Published
- 2020
- Full Text
- View/download PDF
26. Identifying critically important cardiovascular outcomes for trials in hemodialysis: an international survey with patients, caregivers and health professionals.
- Author
-
O'Lone E, Howell M, Viecelli AK, Craig JC, Tong A, Sautenet B, Herrington WG, Herzog CA, Jafar TH, Jardine M, Krane V, Levin A, Malyszko J, Rocco MV, Strippoli G, Tonelli M, Wang AY, Wanner C, Zannad F, Winkelmayer WC, and Wheeler DC
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Cardiovascular Diseases etiology, Cardiovascular Diseases pathology, Female, Humans, International Agencies, Male, Middle Aged, Prognosis, Quality of Life, Renal Dialysis adverse effects, Surveys and Questionnaires, Survival Rate, Systematic Reviews as Topic, Young Adult, Cardiovascular Diseases mortality, Caregivers statistics & numerical data, Clinical Trials as Topic standards, Health Personnel statistics & numerical data, Patients statistics & numerical data, Renal Dialysis mortality
- Abstract
Background: Cardiovascular disease (CVD) is a major contributor to morbidity and mortality in people on hemodialysis (HD). Cardiovascular outcomes are reported infrequently and inconsistently across trials in HD. This study aimed to identify the priorities of patients/caregivers and health professionals (HPs) for CVD outcomes to be incorporated into a core outcome set reported in all HD trials., Methods: In an international online survey, participants rated the absolute importance of 10 cardiovascular outcomes (derived from a systematic review) on a 9-point Likert scale, with 7-9 being critically important. The relative importance was determined using a best-worst scale. Likert means, medians and proportions and best-worst preference scores were calculated for each outcome. Comments were thematically analyzed., Results: Participants included 127 (19%) patients/caregivers and 549 (81%) HPs from 53 countries, of whom 530 (78%) completed the survey in English and 146 (22%) in Chinese. All but one cardiovascular outcome ('valve replacement') was rated as critically important (Likert 7-9) by all participants; 'sudden cardiac death', 'heart attack', 'stroke' and 'heart failure' were all rated at the top by patients/caregivers (median Likert score 9). Patients/caregivers ranked the same four outcomes as the most important outcomes with mean preference scores of 6.2 (95% confidence interval 4.8-7.5), 5.9 (4.6-7.2), 5.3 (4.0-6.6) and 4.9 (3.6-6.3), respectively. The same four outcomes were ranked most highly by HPs. We identified five themes underpinning the prioritization of outcomes: 'clinical equipoise and potential for intervention', 'specific or attributable to HD', 'severity or impact on the quality of life', 'strengthen knowledge and education', and 'inextricably linked burden and risk'., Conclusions: Patients and HPs believe that all cardiovascular outcomes are of critical importance but consistently identify sudden cardiac death, myocardial infarction, stroke and heart failure as the most important outcomes to be measured in all HD trials., (© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
27. Establishing Core Cardiovascular Outcome Measures for Trials in Hemodialysis: Report of an International Consensus Workshop.
- Author
-
O'Lone E, Viecelli AK, Craig JC, Tong A, Sautenet B, Herrington WG, Herzog CA, Jafar TH, Jardine M, Krane V, Levin A, Malyszko J, Rocco MV, Strippoli G, Tonelli M, Wang AYM, Wanner C, Zannad F, Winkelmayer WC, and Wheeler DC
- Subjects
- Clinical Trials as Topic methods, Education methods, Health Personnel standards, Humans, Internationality, Outcome Assessment, Health Care methods, Patient Participation methods, Renal Dialysis methods, Societies, Medical standards, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Clinical Trials as Topic standards, Consensus, Education standards, Outcome Assessment, Health Care standards, Renal Dialysis standards
- Abstract
Cardiovascular disease (CVD) affects more than two-thirds of patients receiving hemodialysis and is the leading cause of death in this population, yet CVD outcomes are infrequently and inconsistently reported in trials in patients receiving hemodialysis. As part of the Standardised Outcomes in Nephrology-Haemodialysis (SONG-HD) initiative, we convened a consensus workshop to discuss the potential use of myocardial infarction and sudden cardiac death as core outcome measures for CVD for use in all trials in people receiving hemodialysis. Eight patients or caregivers and 46 health professionals from 15 countries discussed selection and implementation of the proposed core outcome measures. Five main themes were identified: capturing specific relevance to the hemodialysis population (acknowledging prevalence, risk, severity, unique symptomology, and pathophysiology), the dilemmas in using composite outcomes, addressing challenges in outcome definitions (establishing a common definition and addressing uncertainty in the utility of biomarkers in hemodialysis), selecting a meaningful metric for decision making (to facilitate comparison across trials), and enabling and incentivizing implementation (by ensuring that cardiologists are involved in the development and integration of the outcome measure into registries, trial design, and reporting guidelines). Based on these themes, participants supported the use of myocardial infarction and sudden cardiac death as core outcome measures of CVD to be reported in all hemodialysis trials., (Copyright © 2020 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
28. Statistics and data analyses-a new educational series for nephrologists.
- Author
-
Saglimbene V, Strippoli G, Craig JC, and Wong G
- Subjects
- Data Analysis, Humans, Nephrologists, Kidney Failure, Chronic, Nephrology
- Published
- 2020
- Full Text
- View/download PDF
29. Topical medical therapy and ocular perfusion pressure in open angle glaucoma: a systematic review and meta-analysis.
- Author
-
Rennie G, Wilkinson A, White A, Ruospo M, Teixeira-Pinto A, and Strippoli G
- Subjects
- Administration, Topical, Humans, Randomized Controlled Trials as Topic, Treatment Outcome, Antihypertensive Agents administration & dosage, Antihypertensive Agents adverse effects, Antihypertensive Agents pharmacology, Antihypertensive Agents therapeutic use, Glaucoma, Open-Angle drug therapy, Intraocular Pressure drug effects
- Abstract
Objective: We compared the benefits and harms of topical interventions for ocular perfusion pressure in open angle glaucoma. Methods: We searched the databases MEDLINE, EMBASE and CENTRAL for randomized controlled trials comparing topical hypotensive agents in glaucoma. Of the 9433 citations identified, 10 randomized controlled trials were included. We summarized data using random effects meta-analysis for post-treatment mean ocular perfusion pressure and using relative risk for adverse events. Results: Ten trials (416 patients) were included. The quality of included trials was low to moderate. There was a higher post-treatment ocular perfusion pressure with bimatoprost compared to timolol (1 trial, 32 patients, mean difference - 4.00 mmHg, 95% confidence interval -7.01 to -0.99, p = .009); heterogeneity was not significant ( I
2 = 41%, χ2 = 13.55, p = .09). Prostaglandins as a class had higher post-treatment mean ocular perfusion pressure compared to alternative interventions (5 trials, 147 patients, mean difference 2.19 mmHg, 95% confidence interval 0.67-3.70, p = .005); heterogeneity in the subgroup analysis was not significant ( I2 = 10%, χ2 = 4.47, p = .35). Adverse events were found to be significant in only one of the studies comparing latanoprost to brimonidine, relative risk 3.67 (standard error 0.59, p = .03). Conclusions: We identified low to moderate quality evidence describing post-intervention mean ocular perfusion pressure in open angle glaucoma. Bimatoprost increases mean ocular perfusion pressure when compared to timolol. As a class, prostaglandins increase mean ocular perfusion pressure. Prostaglandins may provide beneficial ocular perfusion pressure profiles compared to alternative agents.- Published
- 2019
- Full Text
- View/download PDF
30. Renal transplant outcomes and de novo donor-specific anti-human leukocyte antigen antibodies: a systematic review.
- Author
-
Sharma A, Lewis JR, Lim WH, Palmer S, Strippoli G, Chapman JR, Alexander SI, Craig JC, and Wong G
- Subjects
- Graft Survival immunology, Humans, Graft Rejection immunology, HLA Antigens immunology, Kidney immunology, Kidney Failure, Chronic surgery, Kidney Transplantation methods, Tissue Donors
- Abstract
Background: Pre-transplant donor-specific anti-human leukocyte antigen antibodies (DSAs) are known risk factors for acute rejection and reduced graft survival after kidney transplantation. DSAs may also develop de novo DSAs (dnDSAs) after transplantation but the clinical implications of these antibodies remain uncertain., Methods: We undertook a systematic review of observational studies that examined the association between dnDSAs and graft and patient outcomes (through August 2017) with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system of reporting used to assess the quality of evidence available., Results: Thirty-six studies involving 10 535 transplant recipients were eligible. There was moderate quality evidence that transplant recipients who developed dnDSAs had increased risks of acute antibody-mediated rejection (AMR) [relative risk (RR) 9.66; 95% confidence interval (CI) 6.79-13.73, 16 studies, n = 4174]. For all other outcomes, the evidence was low to very low due to moderate-high heterogeneity and low study quality (acute cellular rejection, RR 2.92; 95% CI 2.16-3.94, 22 studies, n = 4991, low-quality evidence; chronic AMR and transplant glomerulopathy RR 6.78; 95% CI 4.31-10.66, 3 studies, n = 1617, very low-quality evidence; and graft loss RR 4.95; 95% CI 3.81-6.43, 19 studies, n = 5473, low-quality evidence). Meta-regression indicated that deceased kidney donation (R2 = 1.00, P < 0.001) and region of study conduction (R2 = 0.50, P = 0.005) modified associations between dnDSAs and outcomes., Conclusions: dnDSAs are associated with increased risks of adverse graft and patient outcomes after kidney transplantation, but estimation uncertainty of the augmented risks exist due to limitations such as heterogeneity within the existing literature. Therapeutic interventions targeted to eliminate or prevent these antibodies evaluated in randomized controlled trials are needed to establish whether dnDSAs are causal to transplantation outcomes.
- Published
- 2018
- Full Text
- View/download PDF
31. Cardiovascular Outcomes Reported in Hemodialysis Trials.
- Author
-
O'Lone E, Viecelli AK, Craig JC, Tong A, Sautenet B, Roy D, Herrington WG, Herzog CA, Jafar T, Jardine M, Krane V, Levin A, Malyszko J, Rocco MV, Strippoli G, Tonelli M, Wang AYM, Wanner C, Zannad F, Winkelmayer WC, Webster AC, and Wheeler DC
- Subjects
- Cardiovascular Diseases mortality, Humans, Kidney Failure, Chronic mortality, Kidney Failure, Chronic therapy, Renal Dialysis, Cardiovascular Diseases complications, Kidney Failure, Chronic complications, Outcome Assessment, Health Care
- Abstract
Patients on long-term hemodialysis are at very high risk for cardiovascular disease but are usually excluded from clinical trials conducted in the general population or in at-risk populations. There are no universally agreed cardiovascular outcomes for trials conducted specifically in the hemodialysis population. In this review, we highlight that trials reporting cardiovascular outcomes in hemodialysis patients are usually of short duration (median 3 to 6 months) and are small (59% of trials have <100 participants). Overall, the cardiovascular outcomes are very heterogeneous and may not reflect outcomes that are meaningful to patients and clinicians in supporting decision making, as they are often surrogates of uncertain clinical importance. Composite outcomes used in different trials rarely share the same components. In a field in which a single trial is often insufficiently powered to fully assess the clinical and economic impact of interventions, differences in outcome reporting across trials make the task of meta-analysis and interpretation of all the available evidence challenging. Core outcome sets are now being established across many specialties in health care to prevent these problems. Through the global Standardized Outcomes in Nephrology-Hemodialysis initiative, cardiovascular disease was identified as a critically important core domain to be reported in all trials in hemodialysis. Informed by the current state of reporting of cardiovascular outcomes, a core outcome measure for cardiovascular disease is currently being established with involvement of patients, caregivers, and health professionals. Consistent reporting of cardiovascular outcomes that are critically important to hemodialysis patients and clinicians will strengthen the evidence base to inform care in this very high-risk population., (Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
32. Neurocognitive and Educational Outcomes in Children and Adolescents with CKD: A Systematic Review and Meta-Analysis.
- Author
-
Chen K, Didsbury M, van Zwieten A, Howell M, Kim S, Tong A, Howard K, Nassar N, Barton B, Lah S, Lorenzo J, Strippoli G, Palmer S, Teixeira-Pinto A, Mackie F, McTaggart S, Walker A, Kara T, Craig JC, and Wong G
- Subjects
- Adolescent, Attention, Child, Executive Function, Humans, Kidney Transplantation psychology, Memory, Observational Studies as Topic, Renal Dialysis psychology, Severity of Illness Index, Educational Status, Intelligence, Renal Insufficiency, Chronic psychology, Renal Insufficiency, Chronic therapy
- Abstract
Background and Objectives: Poor cognition can affect educational attainment, but the extent of neurocognitive impairment in children with CKD is not well understood. This systematic review assessed global and domain-specific cognition and academic skills in children with CKD and whether these outcomes varied with CKD stage., Design, Setting, Participants, & Measurements: Electronic databases were searched for observational studies of children with CKD ages 21 years old or younger that assessed neurocognitive or educational outcomes. Risk of bias was assessed using a modified Newcastle-Ottawa scale. We used random effects models and expressed the estimates as mean differences with 95% confidence intervals stratified by CKD stage., Results: Thirty-four studies (25 cross-sectional, n =2095; nine cohort, n =991) were included. The overall risk of bias was high because of selection and measurement biases. The global cognition (full-scale intelligence quotient) of children with CKD was classified as low average. Compared with the general population, the mean differences (95% confidence intervals) in full-scale intelligence quotient were -10.5 (95% confidence interval, -13.2 to -7.72; all CKD stages, n =758), -9.39 (95% confidence interval, -12.6 to -6.18; mild to moderate stage CKD, n =582), -16.2 (95% confidence interval, -33.2 to 0.86; dialysis, n =23), and -11.2 (95% confidence interval, -17.8 to -4.50; transplant, n =153). Direct comparisons showed that children with mild to moderate stage CKD and kidney transplants scored 11.2 (95% confidence interval, 2.98 to 19.4) and 10.1 (95% confidence interval, -1.81 to 22.0) full-scale intelligence quotient points higher than children on dialysis. Children with CKD also had lower scores than the general population in executive function and memory (verbal and visual) domains. Compared with children without CKD, the mean differences in academic skills ( n =518) ranged from -15.7 to -1.22 for mathematics, from -9.04 to -0.17 for reading, and from -14.2 to 2.53 for spelling., Conclusions: Children with CKD may have low-average cognition compared with the general population, with mild deficits observed across academic skills, executive function, and visual and verbal memory. Limited evidence suggests that children on dialysis may be at greatest risk compared with children with mild to moderate stage CKD and transplant recipients., (Copyright © 2018 by the American Society of Nephrology.)
- Published
- 2018
- Full Text
- View/download PDF
33. [Census of the renal and dialysis units by Italian Society of Nephrology: nephrologist's workload for renal patient assistance in Italy (2014-2015)].
- Author
-
Quintaliani G, Di Luca M, Di Napoli A, Viglino G, Postorino M, Amore A, Andrulli S, Bellasi A, Brunori G, Buongiorno E, Castellino S, D'Amelio A, De Nicola L, Gesualdo L, Di Landro D, Feriozzi S, Strippoli G, Teatini U, and Santoro A
- Subjects
- Humans, Italy epidemiology, Prevalence, Records, Renal Insufficiency epidemiology, Societies, Medical, Time Factors, Workforce, Ambulatory Care Facilities organization & administration, Ambulatory Care Facilities statistics & numerical data, Censuses, Hemodialysis Units, Hospital organization & administration, Hemodialysis Units, Hospital statistics & numerical data, Nephrology statistics & numerical data, Renal Dialysis statistics & numerical data, Renal Insufficiency therapy, Workload
- Abstract
Background: Given the public health challenge and burden of chronic kidney disease, the Italian Society of Nephrology (SIN) promoted acensusof the renal and dialysis units to analyse structural and human resources, organizational aspects, activities and workload referring to theyear 2014., Methods: An online questionnaire, including 64 items exploring structural and human resources, organization aspects, activities and epidemiological data referred to 2014, was sent to chiefs of any renal or dialysis unit., Results: Renal and dialysis activity was performed by over 2718 physicians (45 pmp). The management of the acute renal failure was one of the most frequent activities in the public renal units (12,206 patients in ICU and 140.00 dialysis sessions). There were performed about 9000 AV fistulas and 1700 central vascular catheters insertions. In the census, there are a lot of data regarding organization, workforce and workload of the renal unit in Italy. The benchmark data derived from this census show interesting comparisons between centres, regions and groups of regions. These data realised the clinical management of renal disease in Italy.
- Published
- 2016
34. [Census of the renal and dialysis units by Italian Society of Nephrology: structure and organization for renal patient assistance in Italy (2014-2015)].
- Author
-
Quintaliani G, Di Luca M, Di Napoli A, Viglino G, Postorino M, Amore A, Andrulli S, Bellasi A, Brunori G, Buongiorno E, Castellino S, D'Amelio A, De Nicola L, Gesualdo L, Di Landro D, Feriozzi S, Strippoli G, Teatini U, and Santoro A
- Subjects
- Humans, Italy, Records, Societies, Medical, Time Factors, Ambulatory Care Facilities organization & administration, Censuses, Hemodialysis Units, Hospital organization & administration, Nephrology, Renal Dialysis statistics & numerical data, Renal Insufficiency therapy
- Abstract
Background: Given the public health challenge and burden of chronic kidney disease, the Italian Society of Nephrology (SIN) promoted a census of the renal and dialysis units to analyse structural and human resources, organizational aspects, activities and workload referring to the year 2014., Methods: An online questionnaire, including 64 items exploring structural and human resources, organization aspects, activities and epidemiological data referred to 2014, was sent to chiefs of any renal or dialysis unit., Results: 615 renal units were identified. From these 615 units, 332 were public renal centres (of which 318 centres answered to the census) and 283 were private dialysis centres (of which 113 centres answered to the census). The results show 6 public renal units pmp. Renal biopsies were 4624 (81 pmp). The nephrology beds are about 41 pmp. There are 7.304 nurses working in HD wards, 1.692 in the nephrology wards and only 613 for outpatients clinics. The benchmark data derived from this census show interesting comparisons between centres, regions and groups of regions. These data realised the clinical management of renal disease in Italy.
- Published
- 2016
35. Serum testosterone levels and clinical outcomes in male hemodialysis patients.
- Author
-
Bello AK, Stenvinkel P, Lin M, Hemmelgarn B, Thadhani R, Klarenbach S, Chan C, Zimmerman D, Cembrowski G, Strippoli G, Carrero JJ, and Tonelli M
- Subjects
- Aged, Biomarkers blood, Cohort Studies, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Renal Dialysis psychology, Treatment Outcome, Quality of Life psychology, Renal Dialysis methods, Testosterone blood
- Abstract
Background: Studies linking low serum testosterone concentration to adverse clinical outcomes in hemodialysis patients have been relatively small. We investigated the role of testosterone in adverse outcomes and quality of life in an incident cohort of male Canadian hemodialysis patients., Study Design: A prospectively designed multicenter observational study using data from the Canadian Kidney Disease Cohort Study (CKDCS)., Setting & Participants: Male patients initiating hemodialysis therapy since February 14, 2005, in 3 Canadian centers serving ethnically diverse populations were studied (N = 623)., Predictor: Serum testosterone levels using the International Society of Andrology, International Society for the Study of the Aging Male, and European Association of Urology cutoffs (low, <231 ng/dL; borderline, 231-346 ng/dL; normal, >346 ng/dL)., Outcomes: All-cause mortality, fatal and nonfatal cardiovascular (CV) events, and Health Utility Index (HUI)-assessed health-related quality of life., Measurements: Participants completed a structured interview on demographics and medical history and an HUI questionnaire (version 3). Routine laboratory test results captured into the study database, and serum testosterone measured within 3 months after initiation of the baseline hemodialysis session., Results: During a median follow-up of 20 (range, 1-81) months, 166 (27%) died and 98 (20%) had a CV event. Mean serum testosterone level was 234.1 ± 146.1 (SD) ng/dL. Higher serum testosterone levels were associated with significantly decreased unadjusted risk of death (HR per 10-ng/dL increase, 0.58; 95% CI, 0.37-0.90). There was a statistically significant trend for higher all-cause mortality with low serum testosterone levels in adjusted analyses (P < 0.001). Higher levels of log-transformed testosterone were associated with significantly higher HUI scores (P for trend <0.001), and low levels of serum testosterone were associated significantly with lower HUI scores (P for trend <0.001). Although there was a significant trend in the unadjusted risk of CV events among participants with low serum testosterone levels (P < 0.001), the risk was no longer significant after adjustment for age. There was no significant interaction with age and serum testosterone level tested as continuous variables (P = 0.07)., Limitations: A short follow-up period and serum testosterone measured on a single occasion., Conclusions: Low serum testosterone concentration may be a modifiable risk factor for adverse outcomes and poor quality of life in male hemodialysis patients. This hypothesis should be tested in randomized controlled trials., (Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
36. Impact of fluid intake in the prevention of urinary system diseases: a brief review.
- Author
-
Lotan Y, Daudon M, Bruyère F, Talaska G, Strippoli G, Johnson RJ, and Tack I
- Subjects
- Evidence-Based Medicine, Humans, Renal Insufficiency, Chronic physiopathology, Renal Insufficiency, Chronic prevention & control, Risk Factors, Urinary Bladder Neoplasms physiopathology, Urinary Bladder Neoplasms prevention & control, Urinary Tract Infections prevention & control, Urolithiasis physiopathology, Urolithiasis prevention & control, Urologic Diseases epidemiology, Urologic Diseases physiopathology, Drinking, Urologic Diseases prevention & control, Water-Electrolyte Balance
- Abstract
We are often told that we should be drinking more water, but the rationale for this remains unclear and no recommendations currently exist for a healthy fluid intake supported by rigorous scientific evidence. Crucially, the same lack of evidence precludes the claim that a high fluid intake has no clinical benefit. The aim of this study is to describe the mechanisms by which chronic low fluid intake may play a crucial role in the pathologies of four key diseases of the urinary system: urolithiasis, urinary tract infection, chronic kidney disease and bladder cancer. Although primary and secondary intervention studies evaluating the impact of fluid intake are lacking, published data from observational studies appears to suggest that chronic low fluid intake may be an important factor in the pathogenesis of these diseases.
- Published
- 2013
- Full Text
- View/download PDF
37. The effect of folic acid based homocysteine lowering on cardiovascular events in people with kidney disease: systematic review and meta-analysis.
- Author
-
Jardine MJ, Kang A, Zoungas S, Navaneethan SD, Ninomiya T, Nigwekar SU, Gallagher MP, Cass A, Strippoli G, and Perkovic V
- Subjects
- Aged, Dietary Supplements, Female, Humans, Male, Randomized Controlled Trials as Topic, Risk Factors, Cardiovascular Diseases prevention & control, Folic Acid therapeutic use, Hyperhomocysteinemia prevention & control, Kidney Diseases complications
- Abstract
Objective: To systematically review the effect of folic acid based homocysteine lowering on cardiovascular outcomes in people with kidney disease., Design: Systematic review and meta-analysis., Data Sources: Medline, Embase, the Cochrane Library, and ClinicalTrials.gov to June 2011., Study Selection: Randomised trials in people with non-dialysis dependent chronic kidney disease or end stage kidney disease or with a functioning kidney transplant reporting at least 100 patient years of follow-up and assessing the effect of folic acid based homocysteine lowering therapy. No language restrictions were applied., Data Extraction: Two reviewers independently extracted data on study setting, design, and outcomes using a standardised form. The primary endpoint was cardiovascular events (myocardial infarction, stroke, and cardiovascular mortality, or as defined by study author). Secondary endpoints included the individual composite components, all cause mortality, access thrombosis, requirement for renal replacement therapy, and reported adverse events, including haematological and neurological events. The effect of folic acid based homocysteine lowering on outcomes was assessed with meta-analysis using random effects models., Results: 11 trials were identified that reported on 4389 people with chronic kidney disease, 2452 with end stage kidney disease, and 4110 with functioning kidney transplants (10,951 participants in total). Folic acid based homocysteine therapy did not prevent cardiovascular events (relative risk 0.97, 95% confidence interval 0.92 to 1.03, P = 0.326) or any of the secondary outcomes. There was no evidence of heterogeneity in subgroup analyses, including those of kidney disease category, background fortification, rates of pre-existing disease, or baseline homocysteine level. The definitions of chronic kidney disease varied widely between the studies. Non-cardiovascular events could not be analysed as few studies reported these outcomes., Conclusions: Folic acid based homocysteine lowering does not reduce cardiovascular events in people with kidney disease. Folic acid based regimens should not be used for the prevention of cardiovascular events in people with kidney disease.
- Published
- 2012
- Full Text
- View/download PDF
38. [Are there differences in the treatment of kidney patients if they are admitted to general medicine vs nephrology units? Yes, and they are significant].
- Author
-
Quintaliani G, Gambirasio C, and Strippoli G
- Subjects
- Evidence-Based Medicine, Hemodialysis Units, Hospital standards, Hospital Units organization & administration, Humans, Italy, Kidney Diseases therapy, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic mortality, Needs Assessment standards, Quality of Health Care standards, Risk Assessment, Survival Analysis, Time Factors, Clinical Competence standards, Internal Medicine standards, Kidney Failure, Chronic therapy, Nephrology standards, Physician's Role, Renal Dialysis standards
- Abstract
The care provided by a nephrologist is fundamental because the nephrologist is able to prevent, recognize and treat the many and complex factors of comorbidity inherent in chronic kidney disease at its various stages. The nephrologist also has the important task of delaying the start of dialysis for as long as possible. Delaying dialysis slightly, even just one year for each patient, will have ethical, social and economic advantages that should be duly weighed and carefully evaluated when adopting organizational models of care involving nephrology. The nephrologist bases his work on the clinical competence acquired and maintained through appropriate training programs based on CME courses and, above all, daily clinical practice that, in order to be truly educational, must reach a sufficient volume of activity to guarantee the best possible outcome to the patient.
- Published
- 2010
39. Proteinuria and clinical outcomes in hypertensive patients.
- Author
-
Maione A, Annemans L, and Strippoli G
- Subjects
- Antihypertensive Agents economics, Antihypertensive Agents therapeutic use, Blood Pressure drug effects, Cardiovascular Diseases complications, Cardiovascular Diseases epidemiology, Cardiovascular Diseases mortality, Cost of Illness, Health Care Costs, Humans, Hypertension economics, Kidney Diseases complications, Kidney Diseases epidemiology, Kidney Diseases mortality, Proteinuria etiology, Proteinuria mortality, Treatment Outcome, Hypertension complications, Proteinuria drug therapy
- Abstract
This narrative review focuses on outcomes related to proteinuria in hypertension (HT), and also examines the role of current and future therapeutic strategies. Proteinuria is an independent marker of renal and cardiovascular (CV) disease in hypertensive populations, particularly in high-risk groups such as diabetic patients. Effective blood pressure (BP) control and proteinuria management are associated with significant improvements in the risk of key adverse outcomes, although a causative relationship needs careful assessment. Available antihypertensives have varying effects on proteinuria reduction. Drugs affecting the renin system offer antiproteinuric and renoprotective effects that are probably at least partially independent of their BP effects. Economic evaluations of these interventions confirm their cost-saving benefits relative to other antihypertensives, but outcomes-based research is needed in some settings.
- Published
- 2009
- Full Text
- View/download PDF
40. Usefulness of coronary flow reserve measured by echocardiography to improve the identification of significant left anterior descending coronary artery stenosis assessed by multidetector computed tomography.
- Author
-
Pizzuto F, Voci P, Bartolomucci F, Puddu PE, Strippoli G, Broglia L, and Rossi P
- Subjects
- Adult, Aged, Aged, 80 and over, Coronary Angiography methods, Coronary Stenosis diagnostic imaging, Coronary Stenosis physiopathology, Female, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Neural Networks, Computer, ROC Curve, Sensitivity and Specificity, Tomography, X-Ray Computed methods, Coronary Stenosis diagnosis, Coronary Vessels diagnostic imaging, Echocardiography, Doppler, Fractional Flow Reserve, Myocardial
- Abstract
Multidetector computed tomography (MDCT) detects coronary artery disease. However, an overestimation of coronary artery stenosis and artifacts can prevent accurate identification of significant coronary narrowing. The combination of MDCT with coronary flow reserve (CFR), the hyperemic/baseline peak flow velocity ratio, measured by transthoracic Doppler echocardiography might be helpful. We studied 144 consecutive patients with CFR and quantitative coronary angiography, obtained using both MDCT and invasive coronary angiography (reference method). It was hypothesized that the CFR might provide an incremental value to MDCT in detecting significant (> or =70%) left anterior descending (LAD) coronary artery stenosis. A CFR cutoff of <2 was used to discriminate significant stenosis. CFR was feasible in 141 (98%) of 144 patients, and MDCT was feasible in 131 (91%) of 144 patients (p <0.02). In a univariate model, the prediction of significant LAD stenosis was slightly, but significantly (p <0.0001), better with CFR (sensitivity 90%, specificity 96%, positive predictive value 84%, negative predictive value 97%, and diagnostic accuracy 94%, chi-square = 97.5) than with MDCT (sensitivity 80%, specificity 93%, positive predictive value 71%, negative predictive value 95%, diagnostic accuracy 90%, chi-square = 63.2). When the findings from transthoracic Doppler echocardiography and MDCT agreed, the diagnostic accuracy increased (96%; chi-square = 86.1, p <0.0001). In a multivariate prediction of significant LAD stenosis using a logistic neural network, CFR overshadowed MDCT, and the area under the receiver operating curve was 0.99. Of the 13 patients missed by MDCT, the diagnostic accuracy of transthoracic Doppler echocardiography to predict significant LAD stenosis was 100%. Thus, CFR could improve the diagnostic accuracy of MDCT to detect significant LAD stenosis.
- Published
- 2009
- Full Text
- View/download PDF
41. [The usefulness of Cochrane systematic reviews in nephrology].
- Author
-
Di Micco L, Manno C, Cianciaruso B, and Strippoli G
- Subjects
- Humans, Kidney Diseases therapy, Nephrology, Review Literature as Topic
- Abstract
Systematic reviews (SRs) of the literature are clinical research studies carried out according to rigorous methodological criteria. They are aimed at searching, critically appraising and summarizing all studies with similar characteristics that address the same research question. The Cochrane Collaboration is the main institution that coordinates the production of SRs. The Cochrane Renal Group is one of the 50 research groups of the Cochrane Collaboration and is in charge of SRs in nephrology. This group compiled the Renal Health Library, an annually updated collection of SRs (Cochrane and not) and randomized controlled trials in nephrology, dialysis and renal transplantation. We searched the Renal Health Library to identify SRs useful to answer clinical questions in patients with renal disease and/or following kidney transplant. The SRs identified were summarized and the results were expressed as relative risk, weighted mean difference, standardized mean difference, and 95% confidence intervals. Since the number of randomized controlled trials is quite large and SRs are a reliable summary of the scientific evidence, their distribution is of paramount importance. Here we show several clinical cases where related SRs in the Renal Health Library provide useful guidance for treatment.
- Published
- 2009
42. Urticaria and angioedema in renal cell cancer patients treated with IL-2.
- Author
-
Logan TF, Strippoli G, and Levine MI
- Subjects
- Aged, Carcinoma, Renal Cell complications, Female, Humans, Kidney Neoplasms complications, Male, Middle Aged, Angioedema chemically induced, Carcinoma, Renal Cell drug therapy, Interleukin-2 adverse effects, Kidney Neoplasms drug therapy, Urticaria chemically induced
- Abstract
Interleukin-2 therapy has produced significant improvement in a proportion of patients with renal cell cancer. Dermatologic side effects, such as erythema, have been very common. However, we could find only 2 reports of urticaria in the medical literature. Here, we report 8 patients with renal cell cancer who developed urticaria in association with interleukin-2 therapy. The hives tended to occur at the end of a treatment cycle. Skin tests with IL-2 were negative in two patients. Urticaria did not worsen or consistently occur with repeated courses of interleukin-2 and anaphylaxis was not observed in any patient. Six of the 8 patients previously had urticaria unrelated to IL-2 therapy.
- Published
- 2007
- Full Text
- View/download PDF
43. Cellular mechanisms involved in iso-osmotic high K+ solutions-induced contraction of the estrogen-primed rat myometrium.
- Author
-
Trujillo MM, Ausina P, Savineau JP, Marthan R, Strippoli G, Advenier C, Pinto FM, and Candenas ML
- Subjects
- Animals, Arachidonic Acid metabolism, Calcium Channels drug effects, Calcium Channels metabolism, Enzyme Inhibitors pharmacology, Estrogens physiology, Female, Muscle Contraction drug effects, Myometrium drug effects, Phosphatidylinositols metabolism, Quinacrine pharmacology, Rats, Uterine Contraction drug effects, Uterus physiology, omega-Conotoxins pharmacology, Calcium metabolism, Muscle Contraction physiology, Myometrium physiology, Potassium Chloride metabolism, Uterine Contraction physiology
- Abstract
The aim of the present study was to investigate the mechanisms involved in the contraction evoked by iso-osmotic high K+ solutions in the estrogen-primed rat uterus. In Ca2+-containing solution, iso-osmotic addition of KCl (30, 60 or 90 mM K+) induced a rapid, phasic contraction followed by a prolonged sustained plateau (tonic component) of smaller amplitude. The KCl (60 mM)-induced contraction was unaffected by tetrodotoxin (3 microM), omega-conotoxin MVIIC (1 microM), GF 109203X (1 microM) or calphostin C (3 microM) but was markedly reduced by tissue treatment with neomycin (1 mM), mepacrine (10 microM) or U-73122 (10 microM). Nifedipine (0.01-0.1 microM) was significantly more effective as an inhibitor of the tonic component than of the phasic component. After 60 min incubation in Ca2+-free solution containing 3 mM EGTA, iso-osmotic KCl did not cause any increase in tension but potentiated contractions evoked by oxytocin (1 microM), sodium orthovanadate (160 micrM) or okadaic acid (20 microM) in these experimental conditions. In freshly dispersed myometrial cells maintained in Ca2+-containing solution and loaded with indo 1, iso-osmotic KCl (60 mM) caused a biphasic increase in the intracellular Ca2+ concentration ([Ca2+]i). In cells superfused for 60 min in Ca2+-free solution containing EGTA (1 mM), KCl did not increase [Ca2+]i. In Ca2+-containing solution, KCl (60 mM) produced a 76.0 +/- 16.2% increase in total [3H]inositol phosphates above basal levels and increased the intracellular levels of free arachidonic acid. These results suggest that, in the estrogen-primed rat uterus, iso-osmotic high K+ solutions, in addition to their well known effect on Ca2+ influx, activate other cellular processes leading to an increase in the Ca2+ sensitivity of the contractile machinery by a mechanism independent of extracellular Ca2+.
- Published
- 2000
- Full Text
- View/download PDF
44. An analysis of the mechanisms involved in the okadaic acid-induced contraction of the estrogen-primed rat uterus.
- Author
-
Arteche E, Strippoli G, Loirand G, Pacaud P, Candenas L, Moltó JC, Souto L, Fernandez J, Norte M, Martín JD, and Savineau JP
- Subjects
- Animals, Arachidonic Acid metabolism, Calcium metabolism, Female, In Vitro Techniques, Protein Kinases physiology, Rats, Rats, Wistar, Estrogens pharmacology, Okadaic Acid pharmacology, Uterine Contraction drug effects
- Abstract
The contractile effect of okadaic acid (OA) and its derivatives was investigated in the rat uterus. OA (20 microM) induced a transient contraction which, after plateauing, slowly decreased. The structurally related compound okadanol (20 microM) failed to induce any significant contraction. Conversely, the synthetic compound methyl okadaate (20 microM) and the naturally occurring ester 7'-hydroxy-4'-methyl-2'-methylen-hept-4'(E)-enyl okadaate (20 microM) were as active as the free acid. The OA-induced contraction was unaffected in the presence of neomycin (5 mM), mepacrine (30 microM), 1-[N,O-bis(1,5-isoquinolinesulfonyl)-N-methyl-L-tyrosyl]-4-phenylpiperaz ine (10 microM), calphostin C (3 microM) and 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine (30 microM). The calmodulin inhibitor N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide hydrochloride (100 microM) did not modify the amplitude of the OA-induced contraction but significantly increased the rate of tension decay. The myosin light chain kinase inhibitor 1-(5-chloronaphthalene-1-sulfonyl)-1H-hexahydro-1,4-diazepine hydrochloride (1 mM) significantly reduced the peak amplitude of the contraction. Staurosporine (0.03-0.1 microM) did not modify the contractile component of the OA-induced response but inhibited the subsequent decrease in tension. In freshly dispersed myometral cells loaded with the fluorescent Ca++ indicator indo 1, OA did not produce any significant increase in [Ca++]i. OA (5- to 90-min contact) also failed to modify the intracellular levels of arachidonic acid, compared with basal values. These data suggest that in the rat uterus 1) the contractile effect of OA (20 microM) is specifically mediated by inhibition of protein phosphatases type 1 and/or 2A and is related to a direct interaction with the contractile machinery; 2) the decreasing phase of the OA-induced mechanical response could be mediated by a staurosporine-sensitive protein kinase different from protein kinase C.
- Published
- 1997
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.