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Query: UMLS:C0009443 (cold)
 92,137 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim was to measure concentrations of total mercury, total arsenic, lead and cadmium in common edible fresh fish and shellfish from various areas of the Adriatic Sea. Estimates of intake of these elements were made through seafood consumption by the general population. Samples were either wet digested for mercury and arsenic, or dry ashed for lead and cadmium analysis. Mercury was measured by cold vapour atomic absorption spectrometry (CV AAS) and arsenic, lead and cadmium by electrothermal atomic absorption spectrometry (ET AAS). Quality control procedures of analytical methods, which included analyses of dogfish muscle-certified reference material DORM-2, confirmed the acceptability of methods. The highest mercury and arsenic concentrations were found in hake (Merluccius merluccius) and the lowest in mackerel (Scomber scombrus). The respective values in hake were 0.373 +/- 0.075 and 23.3 +/- 3.6, and in mackerel 0.153 +/- 0.028 and 1.06 +/- 0.29 mg x kg(-1) fresh weight (mean +/- SD). Lead and cadmium concentrations were about 10 times higher in shellfish than in analysed fish. The highest lead and cadmium concentrations were found in mussel (Mytilus galloprovincialis) and the lowest in hake. Respective lead and cadmium values in mussel were 0.150 +/- 0.009 and 0.142 +/- 0.017, and in hake were 0.007 +/- 0.004 and 0.002 +/- 0.001 mg x kg(-1) fresh weight. The concentrations of analysed elements were below acceptable levels for human consumption set by the Croatian Ministry of Health, except for total arsenic. The estimated intake of those trace elements included in this study through seafood consumption by the general population did not exceed the provisional tolerable weekly intake recommended by the Joint FAO/WHO Expert Committee on Food Additives.
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PMID:Mercury, arsenic, lead and cadmium in fish and shellfish from the Adriatic Sea. 1262 48

Among the factors causing intradialytic haemodynamic instability, dialysate temperature has been shown to play a relevant role. An improved cardiovascular response during isolated ultrafiltration or with cooled dialysate has been described in the past. Cold dialysate may increase the external heat loss compensating for the increase in core temperature, thus avoiding vasodilatation, but it also increases myocardial contractility. However, a better haemodynamic response to dialysis treatment has long been known in convective therapies as well, and the hypothesis of a leading role for thermal balance is under discussion. In conventional haemofiltration (HF), venous blood cooling is expected, on the basis of the infusate temperature and the filtration fraction. In on-line HF, the infusate temperature and its volume may have a different impact on thermal balance depending on the site of infusion (pre- or post-dialyser). In an in vitro study comparing haemodialysis (HD) (conventional HD, dialysate 37 degrees C; and cold HD, dialysate 35.5 degrees C) with HF (pre- and post-dilution, 37 degrees C), we observed a more negative thermal balance with cold HD (-130 kJ/h) and with post-dilution HF (-75 kJ/h). The beneficial pressor effects of HF have been confirmed even in on-line HF, which actually has very few differences in the thermal balance compared with conventional HD (dialysate 37 degrees C). In on-line HF, the amount of warm infusion, often exceeding the blood flow, makes the achievement of a negative thermal balance highly unlikely. Thus, there is not sufficient evidence that vascular stability in on-line HF is solely related to different thermal energy balances. Other factors playing a relevant role in the cardiocirculatory response to convective dialysis should thus be considered.
Nephrol Dial Transplant 2003 Aug
PMID:Thermal balance in convective therapies. 1295 29

We study the incidence of delayed graft function (DGF) in a group of 3365 renal transplant recipient patients from various Spanish centres, its clinical consequences, and the evolution in time (transplants performed in 1990, 1994 and 1998) of the factors that determine its presence. The incidence of DGF remained constant in the 3 years studied (30.4, 30.8 and 29.2%, respectively) when contrasting the following factors involved in the establishment of DGF were studied: body mass of recipient, donor age, non-heart beating donation, type of replacement treatment in the pre-transplant period, time of vascular anastomosis and time of cold ischaemia. DGF was not associated with graft or patient survival. In the transplants performed with elderly donors, the cold ischaemia time was associated with greater incidence of DGF, and the latter with less survival of the graft when censored for death. The presence of DGF was significantly associated with acute rejection, cytomegalovirus infection, worse renal function and arterial hypertension at 3 months post-transplantation. In conclusion, the incidence of DGF remained stable in our patients over the years studied and, although not directly, it can affect graft survival as it is associated with acute rejection, arterial hypertension and worse renal graft function. A shortening of ischaemia times may reduce the incidence of DGF and improve transplant results.
Nephrol Dial Transplant 2004 Jun
PMID:The influence of delayed graft function. 1519 33

Living-donor liver transplantation (LDLT) in adults has been expanded after becoming the standard for children in many transplant centres. Advantages of LDLT include thorough donor screening, optimization of timing for transplantation and minimal cold ischaemia time. However, the risk of donor morbidity and mortality must be considered. The preoperative evaluation of the donor typically is performed in consecutive stages. Specific donor considerations in LDLT are thrombosis and embolism, hepatic mass and hepatic steatosis. After complete evaluation, only a small proportion of potential donors are satisfactory candidates. The evaluation protocol for LDLT recipients in most centres is not different from that of cadaveric transplantation. More experience and the development of specific selection and evaluation criteria will further increase the benefit for the recipient and decrease the risk of the donor.
Nephrol Dial Transplant 2004 Jul
PMID:Living-donor liver transplantation: evaluation of donor and recipient. 1524 Aug 43

The aetiology of primary graft non-function and dysfunction is unknown but most likely involves Kupffer cell-dependent reperfusion injury; however, reasons for transplant failure are complex and involve organ retrieval, preservation and transplantation. Important factors include the donor's condition, cold and warm ischaemic times, operative complications in the recipient, the immune status of the recipient and surgical experience. The donor operation and surgical technique also have an effect on outcome after transplantation. This is important, since surgical organ manipulation of the liver during harvest cannot be prevented completely with standard procedures. This is especially true during organ harvest for living-donor liver transplantation and split-liver transplantation in general. Most recently, an experimental setting has conclusively demonstrated that gentle in situ organ manipulation by touching, retracting and moving liver lobes gently during harvest dramatically reduces survival after transplantation via Kupffer cell-dependent mechanisms. These mechanisms involve disturbances of hepatic microcirculation, a hypermetabolic state of the liver, hypoxia and almost complete denudation of endothelial lining cells. Glycine, a non-essential, non-toxic amino acid, which prevents activation of Kupffer cells, prevented all effects of harvest-related injury to the liver when given before transplantation. Based on these data, intravenous glycine has been administered to patients before reperfusion of their liver transplant. Both serum transaminases and the rate of primary non-function have been dramatically reduced, compared with historic controls. These preliminary clinical results with glycine before reperfusion are promising for further improvement of the overall outcome after liver transplantation.
Nephrol Dial Transplant 2004 Jul
PMID:New aspects on reperfusion injury to liver--impact of organ harvest. 1524 Aug 46

Cold hemagglutinin disease is a cold autoimmune hemolytic anemia (cAIHA) caused by an autoantibody, such as IgM, directed against the I-antigen present on the surface of erythrocytes. Cold exposure can activate this system causing hemolysis, hemagglutination, microvascular thrombosis, or acrocyanosis. Thus, surgical procedures requiring hypothermia, such as coronary artery bypass surgery, present a significant problem in patients with cAIHA. The purpose of this study was to evaluate the safety and effectiveness of cryofiltration apheresis (CFA), used as a last resort, for the treatment of cAIHA. Effectiveness was evaluated by clinical assessment and laboratory evaluations of cold agglutinin titer, immunoglobulins, and other plasma proteins. Safety was evaluated by vital signs, monitoring, and laboratory measurements of complements, hematology and blood chemistry. Five patients with cAIHA were treated by CFA using the cryoglobulin (CG) filter (Pall Medical, Ann Arbor, MI, USA). Four patients received only one CFA procedure, while one patient received four CFA treatments. The cold agglutinin titers were fairly low, ranging from 1 : 1 to 1 : 2048. However, a wide thermal amplitude(4-37 degrees C) was observed in most patients. Two out of five patients responded favorably with reduction in titer. The two responders had acute forms of cAIHA with serum positive for cryoglobulins. The three non-responders had chronic forms of cAIHA with negative cryoglobulins. CFA effectively removed cryoprotein precipitates while conserving other plasma components. The CG filter was biocompatible with no complement activation or observed complications due to CFA or CG filter. While the mechanism of action in treating this type of patient population with CFA is unknown, the plausible theories are discussed.
Ther Apher Dial 2004 Oct
PMID:A last resort modality using cryofiltration apheresis for the treatment of cold hemagglutinin disease in a Veterans Administration hospital. 1566 35

We carried out a prospective study of the safety and efficacy of daclizumab combined with triple immunosuppression in adult recipients of at least one HLA-mismatched cadaveric renal allograft. All studied patients received the same immunosuppression: a daclizumab infusion of 1 mg/kg immediately before transplantation, and at 2, 4, 6, and 8 weeks following the transplantation. Infusion of cyclosporine (CsA) (0.08 mg/kg/h) was started at the time of the operation and continued by CsA microemulsion (CsA-Neoral), 3 mg/kg twice daily on day 2, methylprednisolone, 0.4 mg/kg intravenously at operation, and mycophenolate mofetil started on day 1. The dose of CsA-Neoral was adjusted to maintain target blood trough levels. Oral methylprednisolone was tapered by 4 mg per week to achieve a maintenance dose of 0.08 mg/kg/day. Fifty-five patients, with a mean age of 48 +/- 11 years, were studied. Six of them received a second renal allograft. The mean donor age was 38 +/- 14 years. Mean cold ischemia time was 19.5 +/- 6.5 h, mean value of HLA-antigen mismatches was 2.7 +/- 0.9, mean latest PRA value was 3 +/- 7%. Fifteen patients experienced delayed graft function. During a follow-up period of 3 months three acute rejection episodes occurred. One patient died because of systemic aspergillosis. After 3 months mean serum creatinine was 104 +/- 38 micromol/L. Five renal allografts failed, one of them due to rejection. Patient and graft survival was 98.2% and 90.9%, respectively. Daclizumab with this triple therapy represents safe and efficient immunosuppression strategy, demonstrated with low incidence of early acute rejection episodes and an acceptable adverse event profile in cadaveric renal allograft recipients.
Ther Apher Dial 2005 Jun
PMID:Prevention of early acute rejection with daclizumab and triple immunosuppression in cadaveric renal allograft recipients. 1596 3

A 23-year-old comatose man was presented in the emergency room. He had been working inside a building under construction on a hot summer's day. His core body temperature was 42.1 degrees C and he was diagnosed with heat stroke. Urgent cooling procedures, including applying cold vapor to the patient's skin, a gastric lavage with cold water and an intravenous cold saline infusion, were not completely successful and his body temperature remained above 40 degrees C. Because his high temperature was refractory to conventional cooling procedures and we suspected that acute renal failure (ARF) by rhabdomyolysis would develop, we applied hemodialysis (HD) using cold dialysate (initially 30 degrees C and later 35 degrees C), followed by continuous hemodiafiltration (CHDF) with cold dialysate (35 degrees C) at a high flow rate of 18,000 mL per hour. The patient's body temperature fell below 38.0 degrees C within 3 h and was kept below 38.0 degrees C. Continuous hemodiafiltration was continued for one week. During the first week, the patient suffered from multiple organ failure (MOF) involving renal failure, as well as the failure of heart, liver, lung, and central nervous systems. Disseminated intravascular coagulation also developed. However, by virtue of cold CHDF, he almost recovered 3 weeks after the onset, except for remaining mild liver and renal dysfunction. In severe heat stroke, cold HD and high flow, cold CHDF should be a therapeutic choice for cooling and treatment of MOF. Considering mild liver and renal dysfunction still remained, this case suggested these procedures should be initiated at the very beginning of the treatment of severe heat stroke.
Ther Apher Dial 2005 Oct
PMID:Heat stroke with multiple organ failure treated with cold hemodialysis and cold continuous hemodiafiltration: a case report. 1620 19

In this retrospective study, we evaluated the impact of automated peritoneal dialysis (APD) on initial graft function after cadaveric renal transplantation. Each patient on APD was matched for donor age, donor serum creatinine, and cold ischemia time with one control patient on HD. The study sample consisted of 67 cases and 67 controls. The rate of delayed graft function--defined as a need for dialysis within the first week following renal transplantation-was 16% in the APD group and 10% in the HD group [p = nonsignificant (NS)]. The proportion of patients with a creatinine clearance below 10 mL/min 6 days after renal transplantation was 7% in the APD group and 3% in the HD group. Of the 67 APD patients, 12 had slow graft function as compared with 13 of the 67 HD patients (p=NS). Weight changes 3 days after transplantation were +2.1% +/- 3.7% of dry weight in HD patients and -0.1% +/- 4.6% of dry weight in APD patients (p < 0.05). The total amount of fluid infused during the surgical procedure was similar in the two groups (55.8 +/- 14.3 mL/kg vs. 60.7 +/- 14.8 mL/kg). Compared with HD, APD was not associated with a lower rate of delayed graft function.
Adv Perit Dial 2005
PMID:Impact of automated peritoneal dialysis on initial graft function after renal transplantation. 1668 93

The analytical method for determining the concentration of mercury in fish by thermal decomposition, amalgamation/ atomic absorption spectrophotometry was thoroughly studied. Specific issues addressed were accurate modeling of instrumental response, the use of quartz and nickel boats, carryover effects, software limitations, and troubleshooting. The DMA-80 Direct Mercury Analyzer instrument was calibrated using a total of 22 points, and the resultant curves statistically analyzed. At minimum, second-order polynomials were required to adequately model the data. TORT-2 standard reference material was analyzed in both quartz and nickel boats and found to give equivalent performance in both types of vessels and well within the 95% confidence interval. DOLT-3 standard reference material also yielded values well within the 95% confidence interval, but the DORM-2 standard reference material did not. Carryover effects were found to be minimal with a new catalyst tube but increased with catalyst age. Blanks should be run after the analysis of high mercury content samples; however, when the catalyst has aged, two blanks are required to reduce apparent mercury signals to nominal blank values. Comparable results between thermal decomposition, amalgamation/atomic absorption spectrophotometry and cold-vapor atomic absorption spectrophotometry were demonstrated. The feasibility of using this instrument to analyze hair was also explored and found to be suitable. Software problems and limitations have been noted when attempting to implement a high-throughput methodology. Instrumental drift was found to be minimal when operated over long periods. Blank values can provide important diagnostic indicators.
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PMID:A detailed study of thermal decomposition, amalgamation/ atomic absorption spectrophotometry methodology for the quantitative analysis of mercury in fish and hair. 1713 17


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