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Diabetes, Metabolic Syndrome and... 2023Recent advances in perirenal adipose tissue (PAT) highlighted that PAT might involve in the pathogenesis of chronic inflammatory and dysfunctional metabolic diseases....
OBJECTIVE
Recent advances in perirenal adipose tissue (PAT) highlighted that PAT might involve in the pathogenesis of chronic inflammatory and dysfunctional metabolic diseases. This study assessed the association between perirenal fat thickness (PrFT) and metabolic dysfunction-associated fatty liver disease (MALFD) in type 2 diabetes mellitus (T2DM).
METHODS
This study comprised 867 eligible participants with T2DM. Trained reviewers collected anthropometric and biochemical measurements. The diagnosis of MAFLD was based on the latest international expert consensus statement. PrFT and fatty liver were evaluated by computed tomography. The visceral fat area (VFA) and subcutaneous fat area (SFA) were measured by bioelectrical impedance analysis. The non-alcoholic fatty liver disease fibrosis score (NFS) and fibrosis-4 (FIB-4) index were used to assess progressive liver fibrosis in MAFLD.
RESULTS
Overall, the prevalence of MAFLD was 62.3% in T2DM. The PrFT in the MAFLD group was statistically increased than in the non-MAFLD group ( < 0.05). Correlation analysis showed that PrFT was significantly correlated with dysfunctional metabolic factors like body mass index, waist circumference, triglycerides, high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, uric acid, and insulin resistance. Multiple regression analysis revealed that PrFT was positively correlated with NFS (=0.146, <0.001) and FIB-4 (=0.082, =0.025) in the MAFLD. In contrast, PrFT was negatively correlated with CT (=-0.188, <0.001). Furthermore, PrFT was also significantly associated with MAFLD independent of VFA and SFA, the OR (95% CI) was 1.279 (1.191-1.374). Meanwhile, PrFT also had a good identifying value for MAFLD as VFA. The area under the curve (95% CI) value of PrFT identifying MAFLD was 0.782 (0.751-0.812). The optimal cut-off value of PrFT was 12.6mm, with a sensitivity of 77.8% and specificity of 70.8%.
CONCLUSION
PrFT was independently associated with MAFLD, NFS, and FIB-4 and showed a similar identifying value for MAFLD as VFA, which suggested that PrFT can be used as an alternative index to VFA.
PubMed: 37405319
DOI: 10.2147/DMSO.S415477 -
Diabetes, Metabolic Syndrome and... 2022Visceral obesity is independently associated with hypovitaminosis D. Perirenal fat is a visceral fat type active in performing endocrine functions. However, the...
BACKGROUND
Visceral obesity is independently associated with hypovitaminosis D. Perirenal fat is a visceral fat type active in performing endocrine functions. However, the relationship between perirenal fat thickness (PrFT) and serum 25-hydroxy vitamin D [25(OH)D] is unclear. The aim of this study is to investigate the relationship between serum 25(OH)D and PrFT in patients with metabolic syndrome (MS) in the community.
METHODS
From May to September 2020, 332 MS subjects in Qinfengyuan and Dongfang communities in Taiyuan City, China were enrolled in an MS survey. All the participants completed the questionnaire survey and physical examination, and their fasting blood samples were collected for biochemical examination. Abdominal ultrasonography was performed to measure the perirenal fat thickness.
RESULTS
The mean serum 25(OH)D level for the 332 MS subjects was 13.5 ng/mL, the proportions of vitamin D deficiency [serum 25(OH)D < 20 ng/mL] and insufficiency [serum 25(OH)D = 20-29.9 ng/mL] were 60.8% (202) and 24.4% (81), respectively. Among the hypovitaminosis D [serum 25(OH)D < 30 ng/mL] subjects, the prevalence of abdominal obesity (waist circumference ≥ 90cm for men and ≥ 80cm for women) is 61.1%. Pearson correlation analysis showed that lg25(OH)D was significantly and negatively associated with body mass index (BMI), waist circumference (W), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), insulin resistance index (HOMA-IR), uric acid (UA)) and PrFT (all P<0.05), and positively correlated with high-density lipoprotein cholesterol (HDL-C) (P<0.05). Multivariate analysis showed that PrFT and HOMA-IR were independently correlated with 25(OH)D.
CONCLUSION
In screening MS patients, approximately 85% of the community MS patients in Taiyuan had hypovitaminosis D; in which 3/5 is abdominal obesity. PrFT is an independent risk factor for hypovitaminosis D in MS subjects.
PubMed: 35911500
DOI: 10.2147/DMSO.S371445 -
Minerva Urologica E Nefrologica = the... Aug 2017The aim of this study was to investigate the feasibility and safety of tubeless minimally-invasive percutaneous nephrolithotomy (MPCNL) in a randomized controlled trial. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The aim of this study was to investigate the feasibility and safety of tubeless minimally-invasive percutaneous nephrolithotomy (MPCNL) in a randomized controlled trial.
METHODS
Patients receiving MPCNL from September 2014 to November 2015 were selected according to inclusion and exclusion criteria after nephrolithotomy and divided into study group (tubeless MPCNL) and control group (standard MPCNL) by random number table. A total of 62 patients were included (N.=31 each), and there was no significant difference in age, gender and calculus size between the two groups (P>0.05). All operations were carried out by the same surgeon. The evaluation indexes included postoperative pain, hemoglobin (Hb) drop, incidence of fever, perirenal leakage/hematoma incidence and length of stay, etc. Independent sample t-test was used for comparison of measurement data, and rank-sum test was adopted for comparison of skewed-distributed data. χ2 test was used for comparison of enumeration data.
RESULTS
Significant difference was shown in Visual Analogue Scale (VAS) of pain and average length of stay after surgery between the two groups (P<0.01), but there was no significant difference in postoperative Hb drop, calculus clearance rate and incidence of perirenal seepage/hematoma or fever.
CONCLUSIONS
The strictly chosen tubeless MPCNL is safe and feasible, and can reduce postoperative pain and other discomforts, shorten length of stay and maybe a probable choice for patients.
Topics: Adult; Aged; Female; Humans; Length of Stay; Male; Middle Aged; Nephrolithotomy, Percutaneous; Pain Measurement; Pain, Postoperative; Treatment Outcome; Urinary Calculi
PubMed: 27583658
DOI: 10.23736/S0393-2249.16.02700-4 -
Journal of Veterinary Diagnostic... Mar 2022Three calves were submitted to the Iowa State University Veterinary Diagnostic Laboratory for diagnostic evaluation following an abrupt increase in morbidity and...
Three calves were submitted to the Iowa State University Veterinary Diagnostic Laboratory for diagnostic evaluation following an abrupt increase in morbidity and mortality in a calf herd associated with epistaxis and widespread hemorrhage. Each of the submitted calves had moderate-to-severe hemorrhage within various tissues and body cavities, including the thymus, subcutaneous region of the neck, mediastinum, lungs, pericardial sac, heart, spleen, perirenal fat, urinary bladder, and skeletal muscle, including the diaphragm. An anticoagulant rodenticide screen was performed on the livers of each calf. Significant concentrations of chlorophacinone were detected at 4.2, 3.6, and 2.9 ppm in liver. Multiple piles and an open pail of white powdery material were present within the facility in which the calves were housed and were identified as the sources of chlorophacinone. Acute hemorrhage and death occurred in fourteen 1.5-mo-old, crossbred calves following ingestion of the vitamin K antagonist chlorophacinone.
Topics: Animals; Anticoagulants; Cattle; Cattle Diseases; Hemorrhage; Indans; Rodenticides
PubMed: 35000500
DOI: 10.1177/10406387211069369 -
BMC Veterinary Research Jan 2023The study assessed the effect of smectites (bentonite and zeolite) used as natural sorbents in the diet of pigs on feed digestibility, health parameters, the severity of...
BACKGROUND
The study assessed the effect of smectites (bentonite and zeolite) used as natural sorbents in the diet of pigs on feed digestibility, health parameters, the severity of anatomo-histological changes in organs, and the accumulation of volatile pollutants in organs.
MATERIAL AND METHODS
The study was conducted using fattening pigs (crossbreds from multiple breeds) assigned to three groups - a control (C) and two experimental groups (A and B), with 240 pigs in each group (3 replicates × 80). The animals in group C received a standard complete diet, while groups A and B received diets with 1.5% composed smectite sorbents. The feed and faeces were analysed for content of dry matter, crude ash, crude protein, ether extract, and crude fibre. The content of P was determined using a Helios Alpha UV-VIS spectrophotometer. Whole blood was analysed for haematological parameters and serum for biochemical parameters. Tissue samples were collected for analysis of volatile substances and histological analysis. After slaughter, samples of the lungs, liver, kidneys and jejunum were collected for morphological evaluation, and samples of the perirenal fat, liver, kidneys, lungs and brain for headspace gas chromatography (GC) to determine the levels of volatile toxic substances.
RESULTS
A statistical increase in the digestibility of crude fibre and an increase in that of P were observed in both experimental groups (A and B) in comparison to the control. The whole blood and serum of the pigs from the control group had statistically significantly higher levels of creatinine, urea, and Mg and a higher WBC count compared to both experimental groups (A and B).
CONCLUSIONS
The feed additives were not shown to have a negative effect on the health parameters analysed or on accumulation of pollutants in selected tissues. No significant effect on the digestibility of most nutrients was observed; only an increase in the digestibility of crude fibre and a decrease in P digestibility were noted in the experimental groups.
Topics: Swine; Animals; Digestion; Diet; Nutrients; Feces; Jejunum; Animal Feed; Animal Nutritional Physiological Phenomena
PubMed: 36609375
DOI: 10.1186/s12917-022-03563-3 -
BioMed Research International 2022Obesity induced by excessive nutrients can cause fatty liver and metabolic dysfunction, which leads to hepatic dysfunction and local/systemic inflammatory responses....
BACKGROUND
Obesity induced by excessive nutrients can cause fatty liver and metabolic dysfunction, which leads to hepatic dysfunction and local/systemic inflammatory responses. Previously, we analyzed the antioxidant, antilipotoxicity, and anti-inflammatory effects of protein hydrolysates in vitro. The aim of the present study is to investigate the antiobesity and hepatoprotective effects of protein hydrolysates derived from (PHPB) in an obese mouse model.
METHODS
For this in vivo study, 40 mice were included and divided into four groups: (1) normal diet group, (2) high-fat-diet (ctrl(-)) group, (3) high-fat-diet and silymarin-treated (ctrl(+)) group, and (4) high-fat-diet and PHPB-treated group. After 6 weeks of treatment, body weight and the amount of daily food intake were observed. Moreover, the major organs and blood of animals were collected for the analysis of serum chemistry, histopathological examination, and obesity- and inflammation-related gene expressions.
RESULTS
The body weight and the amount of daily food intake significantly decreased in the PHPB-treated group compared with those in the ctrl(-) group. The levels of serum ALT, AST, ALP, creatinine, blood urea nitrogen, glucose, bilirubin, total cholesterol, TG, low-density lipoprotein, IL-6, TNF-, and IGF-1 significantly reduced in the PHPB-treated group, whereas the serum free fatty acid, albumin, high-density lipoprotein, and adiponectin concentrations increased. In the analysis of weight of the liver, kidney, lungs, spleen, and fat tissues (from epididymal, perirenal, and mesentery tissues), the PHPB-treated group showed decreased values compared with the ctrl(-) group. In the histopathological analysis, the PHPB-treated group showed significantly reduced macrovesicular fatty change and inflammatory cell infiltration in the liver, and the size of the adipocyte in the epididymis also significantly decreased. The obesity- and inflammation-related gene (IL-6, TNF-, IGF-1, leptin, AP2/FABP4, AMPK-2, 3AR, and PPAR-) expressions in the liver and epididymal adipose tissue were reduced in the PHPB-treated group.
CONCLUSIONS
Overall, the results of this study suggest that the protein hydrolysates that derived from produce antiobesity and hepatoprotective effects via anti-inflammatory activities.
Topics: Adipose Tissue; Animals; Anti-Obesity Agents; Diet, High-Fat; Disease Models, Animal; Fatty Liver; Inflammation; Insulin-Like Growth Factor I; Interleukin-6; Liver; Male; Mice; Mice, Inbred C57BL; Mice, Obese; Obesity; Plant Extracts; Protein Hydrolysates; Tumor Necrosis Factor-alpha
PubMed: 35386305
DOI: 10.1155/2022/4492132 -
Polski Przeglad Chirurgiczny Jun 2021An ongoing debate concerns the need for routine placement of prophylactic intra-abdominal drains following kidney transplantation. <br/><br/>Aim: We... (Meta-Analysis)
Meta-Analysis
An ongoing debate concerns the need for routine placement of prophylactic intra-abdominal drains following kidney transplantation. <br/><br/>Aim: We conducted a systematic review and meta-analysis to determine whether such an approach brings any advantages in the prevention of perirenal transplant fluid collection, surgical site infection, lymphocele, hematoma, urinoma, wound dehiscence, graft loss, and need for reoperation. <br/><br/>Methods: We conducted a random-effects meta-analysis of non-randomized studies of intervention comparing drained and drain-free adult renal graft recipients regarding perirenal transplant fluid collection and other wound complications. ROBINS-I tool and funnel plot asymmetry analysis were used to assess the risk of bias. <br/><br/>Results: Five studies at moderate to critical risk of bias were included. A total of 2094 renal graft recipients were evaluated. Our analysis revealed no significant differences between drained and drain-free patients regarding perirenal transplant fluid collection (pooled odds ratio [OR], 0.77; 95% confidence interval [CI], 0.28-2.17; I 2 = 72%), surgical site infection (OR, 1.64; 95% CI, 0.11-24.88; I 2 = 80%), lymphocele (OR, 0.61; 95% CI, 0.02-15.27; I 2 = 0%), hematoma (OR, 0.71; 95% CI, 0.12-3.99; I 2 = 71%), and wound dehiscence (OR, 0.75; 95% CI, 0.21-2.70; I 2 = 0%). There was insufficient data concerning urinoma, graft loss, and need for reoperation. <br/><br/>Conclusions: The available evidence is weak. Our findings show that the use of intra-abdominal drains after kidney transplantation seems to have neither beneficial nor harmful effects on perirenal transplant fluid collection and other wound complications. The present study does not support the routine placement of surgical drains after kidney transplantation. <i>In this systematic review and meta-analysis we summarize the most up-to-date evidence for and against the routine use of intra-abdominal drain following renal transplantation.</i>.
Topics: Adult; Drainage; Hematoma; Humans; Kidney Transplantation; Reoperation; Surgical Wound Infection
PubMed: 34515654
DOI: 10.5604/01.3001.0014.9166 -
BMC Nephrology Jun 2021Spontaneous perirenal hemorrhage is relatively uncommon but may be life-threatening. There are some challenges in early diagnosis due to the lack of specific... (Review)
Review
BACKGROUND
Spontaneous perirenal hemorrhage is relatively uncommon but may be life-threatening. There are some challenges in early diagnosis due to the lack of specific presentations.
CASE PRESENTATION
We report a case of spontaneous perirenal hemorrhage in a newly diagnosed systemic lupus erythematosus patient who initially presented with non-specific flank pain. Weakness and unstable vital signs were noted on admission. Abdominal ultrasonography and computed tomography revealed a sizable perirenal hematoma over the left retroperitoneal cavity. Renal arteriography identified active extravasation of contrast media from a distant branch of the left renal artery, and selective embolization effectively obliterated the bleeding spot. After cessation of bleeding, the patient received intensive immunosuppressive therapy for acute kidney injury and encephalopathy due to lupus. Her mental status recovered successfully, and she was withdrawn from short-term hemodialysis.
CONCLUSIONS
Spontaneous perirenal hemorrhage in the condition of systemic lupus erythematosus was a rare clinical entity with life-threatening potential. Early accurate diagnosis of spontaneous renal hemorrhage requires both detailed clinical examination and radiologic studies. Interventional embolization is essential and effective for both diagnosis and treatment. A high index of suspicion is necessary to avoid missing this potentially fatal syndrome, especially in patients with an increased risk of bleeding.
Topics: Acute Kidney Injury; Adult; Brain Diseases; Combined Modality Therapy; Embolization, Therapeutic; Female; Glucocorticoids; Hematoma; Humans; Immunosuppressive Agents; Kidney Diseases; Lupus Erythematosus, Systemic; Methylprednisolone; Renal Replacement Therapy; Rupture, Spontaneous
PubMed: 34107924
DOI: 10.1186/s12882-021-02424-9 -
Cureus Nov 2023Hemorrhagic complications arising from anticoagulant use are a well-recognized concern in clinical practice. This case study presents an 84-year-old woman with multiple...
Hemorrhagic complications arising from anticoagulant use are a well-recognized concern in clinical practice. This case study presents an 84-year-old woman with multiple cardiovascular risk factors, including atrial fibrillation, who developed a perirenal hematoma after just five doses of enoxaparin, prescribed for stroke prevention. The patient exhibited altered mental status and abdominal pain, prompting imaging studies revealing the hematoma. This case highlights the importance of vigilance in patients at risk for bleeding complications, especially in the initial days of anticoagulant therapy. Diagnostic imaging, particularly CT scans or ultrasound, is crucial for early detection. Management strategies range from discontinuing anticoagulants to potential interventions like anticoagulation reversal, angiography, or surgery. The decision to resume anticoagulation presents a challenge and requires a personalized approach based on patient factors. This case underscores the need for continued vigilance, early diagnosis, and evidence-based decisions in managing patients on anticoagulants, emphasizing the necessity for further research to establish clear guidelines in such complex clinical scenarios.
PubMed: 38111438
DOI: 10.7759/cureus.48986 -
Oncotarget Apr 2017Laparoscopic cryoablation (LCA) and percutaneous cryoablation(PCA) have been used on patients with small renal masses(SRMs) for many years. However, clinical studies... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Laparoscopic cryoablation (LCA) and percutaneous cryoablation(PCA) have been used on patients with small renal masses(SRMs) for many years. However, clinical studies assessing their feasibility and safety have reported contradictory outcomes. This systematic evaluation was performed to obtain comprehensive evidence with regard to the feasibility and safety of PCA compared with LCA.
METHODS
A systematic search of Embase, Pubmed, Medline, the Cochrane Library were performed to identify studies that compared LCA with PCA were published up to Mar 2016. Outcomes of interest included perioperative, pathologic variables, and complications.
RESULTS
Thirteen studies estimating LCA versus PCA were included for meta-analysis. Patients undergoing PCA were significantly older(WMD = -0.16 years; P = 0.01) and patients with posterior tumors were significantly prefer undergoing PCA than LCA(OR = 0.23; P = 0.0007), whereas patients with anterior tumors were significantly prefer undergoing LCA(OR = 3.82; P = 0.02). although PCA was associated with shorter hospital stay(WMD = 1.17 days; P < 0.0001) and higher incidence rate of perirenal hematoma(OR = 0.18; P < 0.0001). All the other analyzed parameters were similar, regardless of the surgical approach.
CONCLUSIONS
Patients undergoing PCA have shorter hospital stay and PCA was more frequently used in older patients and posterior tumors. Whereas LCA was associated with lower incidence rate of perirenal hematoma. Further multicenter, prospective and long-term follow-up RCTs are required to verify these findings.
Topics: Cryosurgery; Humans; Kidney Neoplasms; Laparoscopy; Odds Ratio; Postoperative Complications; Treatment Outcome; Tumor Burden
PubMed: 28199973
DOI: 10.18632/oncotarget.15273