Increased intra-abdominal pressure (IAP) during laparoscopy adversely affects kidney function. The mechanism underlying this phenomenon is largely unknown. This study was designed to investigate the involvement of endothelin (ET)-1 and nitric oxide (NO) systems in IAP-induced renal dysfunction. Rats were subjected to IAP of 14 mmHg for 1 h, followed by a deflation for 60 min (recovery). Four additional groups were pretreated with 1) ABT-627, an ET(A) antagonist; 2) A-192621, an ET(B) antagonist; 3) nitroglycerine; and 4) N(G)-nitro-L-arginine methyl ester, a NO synthase inhibitor, before IAP. Urine flow rate (V), absolute Na+ excretion (U(Na)V), glomerular filtration rate (GFR), and renal plasma flow (RPF) were determined. Significant reductions in kidney function and hemodynamics were observed when IAP was applied. V decreased from 8.1 +/- 1.0 to 5.8 +/- 0.5 microl/min, U(Na)V from 1.08 +/- 0.31 to 0.43 +/- 0.10 microeq/min, GFR from 1.84 +/- 0.12 to 1.05 +/- 0.06 ml/min (-46.9 +/- 2.7% from baseline), and RPF from 8.62 +/- 0.87 to 3.82 +/- 0.16 ml/min (-54 +/- 3.5% from baseline). When the animals were pretreated with either ABT-627 or A-192621, given alone or combined, the adverse effects of IAP on GFR, RPF, V, and U(Na)V were significantly augmented. When the animals were pretreated with nitroglycerine, the adverse effects of pneumoperitoneum on GFR and RPF were substantially improved. In contrast, pretreatment with N(G)-nitro-L-arginine methyl ester remarkably aggravated pneumoperitoneum-induced renal dysfunction. In conclusion, decreased renal excretory function and hypofiltration are induced by increased IAP. These effects are related to impairment of renal hemodynamics and could be partially ameliorated by pretreatment with nitroglycerine and aggravated by NO and ET blockade.
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http://dx.doi.org/10.1152/ajpregu.00691.2007 | DOI Listing |
JAMA Netw Open
January 2025
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
Importance: Ultraprocessed foods (UPF), characterized as shelf-stable but nutritionally imbalanced foods, pose a public health crisis worldwide. In adults, UPF consumption is associated with increased obesity risk, but findings among children are inconsistent.
Objectives: To examine the associations among UPF intake, anthropometric adiposity indicators, and obesity status in Canadian children.
Crit Care Explor
February 2025
Division of Critical Care Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Importance: While corticosteroid administration in septic shock has been shown to result in faster shock reversal and lower short-term mortality, the role of corticosteroids in the management of cardiogenic shock (CS) remains unexplored.
Objectives: Determine the impact of corticosteroid administration on 90-day mortality (primary outcome) in patients admitted to a critical care unit with CS.
Design, Setting, And Participants: In this retrospective cohort study, we used the critical care database of Medical Information Mart for Intensive Care-IV, and included all adult patients diagnosed with CS excluding repeated admissions, patients with adrenal insufficiency, those receiving baseline corticosteroids, and those requiring extracorporeal life support.
Indian J Pediatr
January 2025
Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Objectives: To compare six doses of intrapleural streptokinase (SK) vs. the conventional three doses in children with empyema.
Methods: In this randomized controlled trial, children with empyema received intrapleural streptokinase, either twice daily for 3 d (total 6 doses); or once daily for 3 d (total 3 doses).
Curr Environ Health Rep
January 2025
AJ Drexel Autism Institute, Drexel University, Philadelphia, USA, PA.
Purpose Of Review: Per- and polyfluoroalkyl substances (PFAS) are persistent chemicals with many modern applications, leading to widespread contamination and universal human exposure. PFAS exposure during early life is of particular concern, given susceptibility of the developing fetal and infant brain to toxic exposures. This review aims to synthesize current evidence, discuss methodological challenges, and highlight research gaps to guide future studies on the impact of PFAS on neurodevelopment.
View Article and Find Full Text PDFSupport Care Cancer
January 2025
Faculty of Physical Therapy and Rehabilitation, Department of Fundamental Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
Purpose: The aim of this study is to investigate the additional effects of the Knack maneuver and comprehensive lifestyle recommendations to pelvic floor muscle training (PFMT) in individuals with post-prostatectomy urinary incontinence (PP-UI).
Methods: Seventy-one individuals with symptom of PP-UI were included. Individuals were randomly assigned to study groups (Group I: PFMT + Knack + Comprehensive Lifestyle Recommendations, Group II: PFMT + Knack, Group III: PFMT alone).
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