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Daugaard Lamont posted an update 6 months, 2 weeks ago
Gut dysbiosis precedes clinic symptoms in rheumatoid arthritis (RA) and has been implicated in the initiation and persistence of RA. The early treatment of RA is critical to better clinical outcome especially for joint destruction. Although dietary interventions have been reported to be beneficial for RA patients, it is unclear to whether diet-induced gut microbiome changes can be a preventive strategy to RA development. Here, we investigated the effect of a high fiber diet (HFD) rich with resistant starch (RS) on collagen-induced arthritis (CIA) and gut microbial composition in mice. RS-HFD significantly reduced arthritis severity and bone erosion in CIA mice. The therapeutic effects of RS-HFD were correlated with splenic regulatory T cell (Treg) expansion and serum interleukin-10 (IL-10) increase. The increased abundance of Lactobacillus and Lachnoclostridium genera concomitant with CIA were eliminated in CIA mice fed the RS-HFD diet. Notably, RS-HFD also led to a predominance of Bacteroidetes, and increasee, indicating that RS-rich diet might be a promising therapy especially in the early stage of RA.Native arteriovenous fistula is the best available vascular access for hemodialysis in end-stage renal failure. It is characterized by higher patency rates and lower rates of morbidity, mortality and complication compared to prosthetic bypass grafts and central venous catheters. Aneurysmal complications remain the main complications of these access with a high risk of rupture and fatal hemorrhage. Their management varies from case to another and several methods are reported in the literature. We describe a case of an atypical localization of a juxta-anastomotic venous aneurysm in the anatomical snuffbox, treated by resection with proximal reimplantation of the cephalic vein at the wrist.
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe and rare adverse drug reaction. Several drugs are known to induce DRESS. Furosemide, a sulfonamide loop diuretic drug, is known to induce hypersensitive reactions such as bullous eruptions, acute generalized exanthematous pustulosis and lichenoid eruptions, but rarely DRESS. We describe herein a case of furosemide-induced DRESS that recurred after bumetanide administration.
A 67-year-old man was admitted to the nephrology department for hypertension, gout and chronic renal failure. He received a multidrug therapy including captopril, nifedipine, allopurinol and furosemide. Six weeks after starting this treatment, he developed a maculopapular itchy and edematous skin reaction, facial edemaand fever. The laboratory findings showed 2200/mm
of eosinophils (20%). Creatinine clearance decreased from 18.9 to 14.4mL/min. Lactate dehydrogenase was at 600IU/L (normal range 190-390IU/L). Chest X-ray showed an interstitial lung injury. Skin biopsy findings were in accordance with a hypersensitive reaction. Furosemide was withdrawn and symptoms resolved completely three weeks later. A patch test with furosemide performed six weeks later was negative. The patient was given bumetanide, another sulfonamide loop diuretic, with recurrence of symptoms two months later. Bumetanide was withdrawn with a complete resolution of both clinical and biological symptoms within three weeks.
We add to the literature another case of furosemide-induced DRESS with the particularity of cross reactivity with bumetanide.
We add to the literature another case of furosemide-induced DRESS with the particularity of cross reactivity with bumetanide.In order to increase the pool of organ donors, kidney transplantation from very old-donors, notably aged more than 70, is increasing. Compared to the United States, where the use of these grafts does not reach 5%, in France it reaches over 20%. selleck chemicals llc Kidney aging is determined by a progressive glomerusclerosis, interstitial fibrosis, and nephrosclerosis, responsible of a linear decrease of glomerular filtration rate with time. Aging in kidney transplantation goes along also with an increased immunogenicity and risk of ischemia-reperfusion injuries. Hence, the prognosis of these transplantations is worse than those from younger donors, even though it remains better than dialysis. Data is lacking on risk factors of graft loss in this specific population. Hypothermic perfusion machine, pre-implantation kidney biopsy, dual kidney transplantation and immunosuppressive strategies have been evaluated to improve the long-term prognosis of these grafts.
Uremic pruritus is very common in hemodialysis or renal failure patients, there were lots of available treatments such as gabapentin, pregabalin, ondansetron, etc. However, there is no quantified study comparing these treatments together, it is impossible to conduct a clinical trial involving so many treatments, so we conduct a network meta-analysis to compare them.
We collected mean difference and standard error of visual analogue scale data as outcome. In total we collected 15articles, 15articles, 1180subjects and 6treatments included to this study.
In these comparisons, gabapentin showed the largest effect MD 5.19, 95%CI , anti-histamine MD 4.65, 95%CI and pregabalin MD 4.62, 95%CI showed a similar effect. Opioid pathway related treatment also showed a significant but not so large effect MD 2.45, 95%CI . Ondansetron and Doxepin didn’t show a significant improvement among placebo, the overall quantifying heterogeneity I
=43.1%. There is no statically difference between gabapentin, pregabalin and anti-histamine treatments.
So we conclude that gabapentin, pregabalin and anti-histamine has a similar efficacy on pruritus control.
So we conclude that gabapentin, pregabalin and anti-histamine has a similar efficacy on pruritus control.
Urolithiasis in a kidney transplanted patient is an uncommon but complex urological complication. Its potential severity comes from its occurrence on a solitary kidney and on a field of immunosuppression. The aim of our study is to assess the incidence, characteristics and course of urolithiasis in our series.
A retrospective study was performed. We included kidney transplanted patients between November 2002and November 2019and presenting lithiasis during their follow-up. Clinical, biological and radiological data were collected as well as lithiasis disease related data. The management of and patient’s evolution were also specified.
Seven of 416kidney transplanted patients developed lithiasis during their follow-up with an incidence of 1.6%. The mean age at lithiasis diagnosis was 36.5years , the sex ratio was 1.3. They developed stones after mean follow-up of 67months . The stones’ size varied from 2to 18mm. Treatment was alkalisation in 3cases, extracorporeal lithotripsy in 2cases, a double J stent in 3cases and pyelolithotomy in 2cases.
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