There is a lack of systematic nephrographic studies on epidemic nephritis (EN). We studied 10 patients with EN using [99Tcm]MAG3 gamma camera nephrography and followed up 9 of them 22-68 days later when they had clinically recovered. Variables for renal clearance of [99Tcm]MAG3 and the retention of radioactivity in the kidneys and blood were calculated. In all patients renal function was impaired acutely. There was marked reconstitution of renal function in the control studies. [99Tcm]MAG3 clearance was inversely related to serum creatinine. On visual inspection the nephrograms showed no focal changes. Nephrography was more sensitive than sonography at identifying renal impairment. [99Tcm]MAG3 nephrography is a sensitive method for identifying renal involvement and reconstitution of renal function in EN. It may be a valuable adjunct to the diagnostic arsenal, especially in nonendemic areas where EN occurs only sporadically and where there may be diagnostic uncertainty in patients presenting acutely with EN.
The study objective was to describe the pharmacokinetics of azidothymidine (AZT) in a large population of early, asymptomatic human immunodeficiency virus (HIV)-infected individuals. The study design was a multicenter, prospective, descriptive single-dose pharmacokinetic study. Each of 66 fasting, male, HIV-infected homosexuals older than 18 years of age and in CDC classifications II, III, and IVC2 received a single 400-mg oral dose of AZT with subsequent pharmacokinetic measurements performed during an 8-h period for AZT and its major metabolite, glucuronylazidothymidine (GAZT). Results were obtained in 65 patients (36 smokers, 29 nonsmokers), of whom 3 were noted to have hepatic dysfunction. In those with normal hepatic function, the following parameters were described: AZT, area under the curve (AUC) +/- SD, 9.9 +/- 5.7 microM.h, maximum concentration (Cmax) +/- SD, 7.3 +/- 4.7 microM; time to maximum concentration (Tmax) +/- SD, 0.93 +/- 0.42 h, and half-life (t1/2) +/- SD, 1.0 +/- 0.8 h. Corresponding values for GAZT were: AUC +/- SD 35.7 +/- 10.3 microM.h, Cmax +/- SD 21.3 +/- 7.3 microM, Tmax +/- SD 1.2 +/- 0.50 h, t1/2 +/- SD 0.98 +/- 0.62 h, No significant differences were found in comparisons of study site, CDC classification of disease, smokers versus nonsmokers, and in patients with hepatic dysfunction, although a higher AUC and earlier Cmax for AZT was noted in the latter group. It is concluded that AZT pharmacokinetics are similar in patients with early asymptomatic HIV disease when compared with previous reports in patients with later disease.(ABSTRACT TRUNCATED AT 250 WORDS)
Controversy exists surrounding the contribution of fitness and adiposity as determinants of the Metabolically Healthy Overweight(MHO) phenotype in youth. This study investigated the independent contribution of cardiorespiratory fitness and adiposity to the MHO phenotype among overweight and obese youth.
This cross-sectional study included 108 overweight and obese youth classified as MHO (no cardiometabolic risk factors) or non-MHO (=1 cardiometabolic risk factor), based on age- and gender specific cut-points for fasting glucose, triglycerides, high-density lipoprotein cholesterol, systolic and diastolic blood pressure, and hepaticsteatosis.
Twenty-five percent of overweight and obese youth were classified as MHO. This phenotype was associated with lower BMIz-score (BMI z-score: 1.8 ± 0.3 vs 2.1 ± 0.4, P = .02) and waist circumference (99.7 ± 13.2 vs 106.1 ± 13.7 cm, P = .04) compared with non-MHO youth. When matched for fitness level and stratified by BMI z-score (1.6 ± 0.3 vs 2.4 ± 0.2), the prevalence of MHO was four fold higher in the low BMI z-score group (27% vs 7%; P = .03).Multiple logistic regression analyses revealed that the best predictor of MHO was the absence of hepatic steatosis even after adjusting for waist circumference (odds ratio 0.57, 95% confidence interval 0.40–0.80) or BMI z-score (odds ratio 0.59, 95% confidence interval 0.43–0.80).
The MHO phenotype was present in 25% of overweight and obese youth and is strongly associated with lower levels of adiposity,and the absence of hepatic steatosis, but not with cardiorespiratory fitness.