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  • 1
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To investigate coagulation inhibitors and abnormalities of the homocysteine metabolism, which are related to an increased thrombotic risk, as risk factors for placental vasculopathy.Design A case-control study comparing nonpregnant women with an obstetric history of placental vasculopathy (study group) with nonpregnant women (control group) matched for age and occupation.Setting Obstetric outpatient clinic in the University Hospital Nijmegen.Sample One hundred and one women in the study group and 92 women in a control group.Methods Determinations in blood samples of homocysteine concentrations; the occurrence of 677 C→T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene; protein C activities; activated protein C resistance ratios; concentrations of free protein S antigen; antithrombin III activities; and the occurrence of factor V Leiden mutation.Results Increased risk for placental vasculopathy was found in the study group with elevated homocysteine (odds ratio 2.28, 95% CI 1.18–4.39), MTHFR mutation (odds ratio 3.29, 95% CI 1.03–10.5), decreased activated protein C resistance ratio (odds ratio 2.46, 95% CI 1.06–5.72) and protein C (odds ratio 2.01, 95% CI 1.11–3.65). Any combination of two risk factors in the same individual resulted in a 3.40 (95% CI 1.80–6.42) higher relative risk for placental vasculopathy; combinations of three risk factors in a 6.83 (95% CI 1.52–30.7) higher risk.Conclusions The thrombotic risk factors decreased levels of activated protein C resistance ratios and protein C, elevated homocysteine and the MTHFR 677 C→T mutation are likely risk factors for placental vasculopathy. Combinations of these risk factors in one individual resulted in synergistic increase of risk.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-198X
    Keywords: Key words Icodextrin ; Peritoneal dialysis ; Ultrafiltration ; Metabolism ; Dialysis adequacy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Icodextrin use in adults provides sustained ultrafiltration (UF) in long-term dwells. No information is available on UF and metabolism in children. In 11 children, a volume of 1,049±138 ml/m2 of the study fluid (1.36% glucose, 7.5% icodextrin, 3.86% glucose) was administered for 12 h. Net UF with icodextrin (339±147 ml/1.73 m2) did not differ from UF with 3.86% glucose (450±306 ml/1.73 m2, P=0.53) and was higher than UF with 1.36% glucose (–87±239 ml/1.73 m2, P=0.003). Icodextrin added 0.52±0.07 to the weekly Kt/V. Over 6 weeks, icodextrin was used for 12-h daytime dwell. Total icodextrin reached a steady-state level of 2.91±1.22 g/l at 2 weeks. The main icodextrin metabolites were maltose, maltotriose, and maltotetraose. After 2 weeks, steady state levels were 2.02±0.66 mmol/l, 1.46±0.35 mmol/l, and 0.45±0.12 mmol/l. No icodextrin or metabolites were detectable 4 weeks after the study. We conclude that 7.5% icodextrin is capable of maintaining UF during 12-h dwell in children and is comparable to UF obtained with 3.86% glucose. Steady-state levels of icodextrin and metabolites were reached at 2 weeks and disappeared after the study.
    Type of Medium: Electronic Resource
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