ObjectiveA meta-analysis was conducted to investigate the efficacy and safety of three main iron chelators, namely, deferoxamine (DFO), deferiprone (DFP) and deferasirox (DFX) for thalassemia major (TM) patients. MethodsRandomized controlled trials comparing mono-therapy DFO, DFP, DFX and combined DFP with DFO therapy in TM patients from January 1990 to December 2012 were searched and selected. Two independent authors assessed data from extracted randomized trials for efficacy and safety in the measurements of serum ferritin (SF), live iron concentration (LIC), myocardial iron content (MIC), left ventricular ejection fraction (LVEF) and adverse events (AEs).ResultsSixteen studies were selected. In the comparison of DFP versus DFO treatment groups, a significant difference was revealed on MIC and LVEF (P=0.01 and P=0.007, respectively) but not on SF or LIC level (P=0.65 and P=0.37, respectively). In comparing combined therapy (DFP plus DFO) versus DFO, a significant difference was shown on MIC and LVEF measurements (P<0.00001 and P=0.003, respectively), but not on SF or LIC levels (P=0.93 and P=0.62, respectively). Moreover, the combined DFP with DFO treatment had significantly higher risk than DFO treatment (RR 1.46 with 95%CI 1.04 to 2.04). When comparing DFX with DFO, a significant difference was shown on the SF level (P=0.003), and there was no difference between DFX and DFO in safety evaluation (RR 1.53 with 95%CI 0.31 to 7.49).ConclusionFindings indicated that the most effective and safe iron chelators remains to be proven, and further large-scale, long-term studies are needed.
Purpose: To compare the efficiency and safety of 3-week and 6-week duration of double-J stent placement in patients who received a kidney transplant. Patients and Methods: Post-transplant recipients were divided into two groups. The duration of double-J stent placement was 6 weeks in group 1 (n = 186) and 3 weeks in group 2 (n = 179). Both groups received similar antibiotics and immunosuppressants. The double-J stents were removed cystoscopically under local anesthesia. The patients were followed up for at least 3 months. Urological complications were recorded, including urinary leakage, obstruction, and urinary tract infections. Results: There were no severe urological complications in both groups. Duration of 3 weeks was as effective as 6 weeks in preventing urological complications such as urinary leak and stenoses. There was no significant difference between the two groups in average duration of macroscopic hematuria, incidents of malposition of double-J stent and calculus formation in or around the stent. Compared with group 1, patients in group 2 had a lower incidence of urinary irritation and fewer urinary tract infection episodes. Conclusions: A shorter duration of double-J stent placement in renal transplantation recipients does not increase urological complications. In addition, it may decrease urinary tract infection and urinary irritation.
The dispersion of a layered iron(III)-(oxy)hydroxide intercalated with dodecanoate (oxGR C12 , Fe 3 III O 2.18 (OH) 3.13 (C 12 H 23 O 2 ) 0.56 (SO 4 ) 0.47 ; derived from the corresponding layered iron(II)-iron(III)hydroxide) in 0.1 M sodium hydroxide results in delamination of oxGR C12 with formation of separate planar layers of iron(III)-(oxy)hydroxides, here termed single sheet iron-(oxy)hydroxides (SSI). Delamination is confirmed by powder X-ray diffraction while Fourier transform infrared spectroscopy reveals the removal of dodecanoate from the parent compound. Atomic force microscopy shows that SSI has a thickness of 1 nm and the lateral size ranging from 100 to 200 nm. The observed thickness of SSI is double the thickness of the iron(III)-(oxy)hydroxide layers (0.48 nm) which is attributed to water layers adsorbed on both sides of SSI. The SSI shows a high tendency to aggregate. High resolution transmission electron microscopy and selected area electron diffraction confirm that SSI inherits the in-plane crystal structure from its parent layered compound. Both the hyperfine parameters and the X-ray absorption spectrum show a similar local iron coordination in SSI before and after delamination. The extended X-ray absorption fine structure spectra also show that the FeO 6 octahedron has expanded to some extent (1-2%) after delamination. O1s X-ray photoelectron spectra of SSI reveal extensive deprotonation of hydroxyl groups in SSI, reflecting a layer charge reversal during delamination. To the best of our knowledge, this is the first report on planar 2D nanosheets of iron-(oxy)hydroxide with the thickness of 1 nm.
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