Acute effect of citrate bath on postdialysis alkalaemia

AbstractIntroductionThe correction of metabolic acidosis caused by renal failure is achieved by adding bicarbonate during dialysis. In order to avoid the precipitation of calcium carbonate and magnesium carbonate that takes place in the dialysis fluid (DF) when adding bicarbonate, it is necessary to add an acid, usually acetate, which is not free of side effects. Thus, citrate appears as an advantageous alternative to acetate, despite the fact that its acute effects are not accurately known.ObjectiveTo assess the acute effect of a dialysis fluid containing citrate instead of acetate on acid-base balance and calcium-phosphorus metabolism parameters.Material and methodsA prospective crossover study was conducted with twenty-four patients (15 male subjects and 9 female subjects). All patients underwent dialysis with AK-200-Ultra-S monitor with SoftPac® dialysis fluid, made with 3 mmol/L of acetate and SelectBag Citrate®, with 1 mmol/L of citrate and free of acetate. The following were measured before and after dialysis: venous blood gas monitoring, calcium (Ca), ionic calcium (Cai), phosphorus (P) and parathyroid hormone (PTH).ResultsDifferences (p<0.05) were found when using the citrate bath (C) compared to acetate (A) in the postdialysis values of: pH, C: 7.43 (0.04) vs. A: 7.47 (0.05); bicarbonate, C: 24.7 (2.7) vs. A: 27.3 (2.1) mmol/L; base excess (BEecf), C: 0.4 (3.1) vs. A: 3.7 (2.4) mmol/L; corrected calcium (Cac), C: 9.8 (0.8) vs. A: 10.1 (0.7) mg/dL; and Cai, C: 1.16 (0.05) vs. A: 1.27 (0.06) mmol/L. No differences were found in either of the parameters measured before dialysis.ConclusionDialysis with citrate provides better control of postdialysis acid-base balance, decreases/avoids postdialysis alkalaemia, and lowers the increase in Cac and Cai. This finding is of special interest in patients with predisposing factors for arrhythmia and patients with respiratory failure, carbon dioxide retention, calcifications and advanced liver disease

Thematic Trends in Complementary and Alternative Medicine Applied in Cancer-Related Symptoms

Purpose: The main goal of this study is to discover the scientific evolution of Cancer-Related Symptoms in Complementary and Alternative Medicine research area, analyzing the articles indexed in the Web of Science database from 1980 to 2013. Design/Methodology/Approach: A co-word science mapping analysis is performed under a longitudinal framework (1980 to 2013). The documental corpus is divided into two subperiods, 1980–2008 and 2009–2013. Thus, the performance and impact rates, and conceptual evolution of the research field are shown. Findings: According to the results, the co-word analysis allows us to identify 12 main thematic areas in this emerging research field: anxiety, survivors and palliative care, meditation, treatment, symptoms and cancer types, postmenopause, cancer pain, low back pain, herbal medicine, children, depression and insomnia, inflammation mediators, and lymphedema. The different research lines are identified according to the main thematic areas, centered fundamentally on anxiety and suffering prevention. The scientific community can use this information to identify where the interest is focused and make decisions in different ways. Research limitation: Several limitations can be addressed: 1) some of the Complementary and Alternative Medicine therapies may not have been included; 2) only the documents indexed in Web of Science are analyzed; and 3) the thematic areas detected could change if another dataset was considered. Practical implications: The results obtained in the present study could be considered as an evidence-based framework in which future studies could be built. Originality/value: Currently, there are no studies that show the thematic evolution of this research area

Pd-(L)1 inhibitors as monotherapy for the first-line treatment of non-small-cell lung cancer patients with high pd-l1 expression : A network meta-analysis

Altres ajuts: RocheProgrammed cell death-ligand 1 (PD-L1) has emerged as a potential biomarker for selec-tion of patients more likely to respond to immunotherapy and as a prognostic factor in non-small cell lung cancer (NSCLC). In this network meta-analysis, we aimed to evaluate the efficacy of first-line anti-PD-(L)1 monotherapy in advanced NSCLC patients with high PD-L1 expression (≥50%) compared to platinum-based chemotherapy. We also evaluated efficacy outcomes according to tumor mutational burden (TMB). To that end, we conducted a systematic review. Six clinical trials with 2111 patients were included. In head-to-head comparisons, immunotherapy showed a significant improvement in progression-free survival (PFS: HRpooled = 0.69, 95% CI: 0.52-0.90, p = 0.007), overall survival (OS: HRpooled = 0.69, 95% CI: 0.61-0.78; p < 0.001) and overall response rate (ORR) (Risk ratio (RR)pooled = 1.354, 95% CI: 1.04-1.762, p = 0.024). In the assessment of relative efficacy for PFS through indirect comparisons, pembrolizumab (results from KEYNOTE-024) ranked highest followed by cemiplimab and atezolizumab, with statistical significance determined for some of the drugs. In terms of OS, cemiplimab ranked highest followed by atezolizumab and pembrolizumab, although non-significant OS was determined for these drugs. In conclusion, PD-(L)1 inhibitor mon-otherapy improves efficacy outcomes in the first line setting of advanced NSCLC patients with high PD-L1 expression. Evaluations with longer follow up are still needed to determine the superiority of any specific drug

Analysis of the environmental degradation effects on the cables of La Arena bridge (Spain)

After nearly 25 years of service, some of the wires of the tendons of ?La Arena? bridge (Spain) started to exhibit the effects of environmental degradation processes. ?La Arena? is cable-stayed bridge with 6 towers and a reference span between towers of about 100 meters. After a maintenance inspection of the bridge, evidences of corrosion were detected in some of the galvanized wires of the cables. A more in-deep analysis of these wires revealed that many of them exhibited loss of section due to the corrosion process. In order to clarify the causes of this degradation event and to suggest some remedial actions, an experimental program was designed. This program consisted of tensile and fatigue tests on some strand samples of the bridge together with a fractographic analysis of the fracture surfaces of the wires, its galvanized layer thickness and some hydrogen measurements (hydrogen embrittlement could be another effect of the environmental degradation process).Once the type and extension of the flaws in the wires was characterized, a structural integrity assessment of the strands was performed with the aim of quantifying the margins until failure and establishing some maintenance recommendations

Algunas notas sobre el original de imprenta La culebra de oro. Para algunos [ca. 1637] de Matías de los Reyes

Nowadays, the study of the preserved document that was used as the original copy for the press is the most accurate way to estimate the work methodology carried out in printing houses during the hand-press period. In that case, the analysis of the handwritten text La culebra de oro. Para algunos, in contrast with the subsequent printed book, shows that the text was manipulated in the Juan Sánchez’s widow printing house in order to adapt it to the available space in the page. These changes had nothing to do with the writer, Matías de los Reyes.La conservación de testimonios originales de imprenta constituye, hasta el momento, la vía más certera de aproximación al método de trabajo consumado en los talleres impresores durante el período de la imprenta manual. En este caso, el análisis del texto manuscrito del original de imprenta La culebra de oro. Para algunos, en contraste con el subsiguiente impreso, demuestra que en el madrileño taller de la viuda de Juan Sánchez el texto fue manipulado en repetidas ocasiones con la finalidad de adaptarlo al espacio disponible en la caja de escritura. Tales modificaciones textuales, como se verá, no tuvieron nada que ver con la mano de su autor, Matías de los Reyes

La Alpujarra. Paisaje cultural

La presente Unidad Didáctica va dirigida a escolares de educación secundaria siguiendo el currículo básico del Real Decreto 1631/2006, de 29 de diciembre, por el que se establecen las enseñanzas mínimas correspondientes a la Educación Secundaria Obligatoria, (BOE de 5-1-2007) y Orden de 10-8-2007, por la que se desarrolla el currículo correspondiente a la Educación Secundaria Obligatoria en Andalucía. (BOJA de 30-8-2007), con lo cual las actividades se adaptan al alumnado cuya edad esté comprendida entre 12 y 16 años. La UD debe entenderse como una herramienta de formación personal, y de adquisición de conocimientos relacionados con el territorio en el que viven, con el objetivo de proporcionar autonomía personal para acceder a aprendizajes futuros y facilitadora del desarrollo integral de la persona.Las actividades no deben restringirse a una acción puntual, ni considerarlas como una actividad extraescolar y lúdica, ya que el objetivo es incluir dichas temáticas relacionadas con el territorio de la Alpujarra en el temario general del curso y de manera transversal en las diferentes asignaturas.La Unidad Didáctica “La Alpujarra, Paisaje Cultural” se ha realizado en el marco del proyecto europeo “MEditerranean MOuntainous LAndscapes. una aproximación histórica al patrimonio cultural basada en los agrosistemas tradicionales” financiado por el Séptimo Programa Marco de Investigación, Desarrollo Tecnológico y Demostración de la Unión Europea, bajo el acuerdo de subvención nº613265

Artificial Intelligence to evaluate the impact of COVID-19 disease on the elderly

Resumen del trabajo presentado a las II Jornadas Científicas PTI+ Salud Global, celebradas en Valencia del 5 al 6 de octubre de 2022.Peer reviewe

The gut microbiota, a hallmark of human aging, could implicate risk and effect of COVID19 in the elderly

Resumen del trabajo presentado a las II Jornadas Científicas PTI+ Salud Global, celebradas en Valencia del 5 al 6 de octubre de 2022.Peer reviewe

Longitudinal study of the immune response after

Resumen del trabajo presentado a las II Jornadas Científicas PTI+ Salud Global, celebradas en Valencia del 5 al 6 de octubre de 2022.Peer reviewe

Ahora / Ara

La cinquena edició del microrelatari per l’eradicació de la violència contra les dones de l’Institut Universitari d’Estudis Feministes i de Gènere «Purificación Escribano» de la Universitat Jaume I vol ser una declaració d’esperança. Aquest és el moment en el qual les dones (i els homes) hem de fer un pas endavant i eliminar la violència sistèmica contra les dones. Ara és el moment de denunciar el masclisme i els micromasclismes començant a construir una societat més igualitària. Cadascun dels relats del llibre és una denúncia i una declaració que ens encamina cap a un món millor