Renal Replacement Therapy in Austere Environments

Myoglobinuric renal failure is the classically described acute renal event occurring in disaster environments—commonly after an earthquake—which most tests the ingenuity and flexibility of local and regional nephrology resources. In recent decades, several nephrology organizations have developed response teams and planning protocols to address disaster events, largely focusing on patients at risk for, or with, acute kidney injury (AKI). In this paper we briefly review the epidemiology and outcomes of patients with dialysis-requiring AKI after such events, while providing greater focus on the management of the end-stage renal disease population after a disaster which incapacitates a pre-existing nephrologic infrastructure (if it existed at all). “Austere” dialysis, as such, is defined as the provision of renal replacement therapy in any setting in which traditional, first-world therapies and resources are limited, incapacitated, or nonexistent

Blueprint for the Dissemination of Evidence-Based Practices in Health Care

Proposes strategies for better dissemination of best practices through quality improvement campaigns, including campaigns aligned with adopting organizations' goals, practical implementation tools and guides, and networks to foster learning opportunities

The solar wind ionic charge states during the Ulysses pole-to-pole pass

We analyze and compare the ionic charge composition data for different types of the solar wind which the Solar Wind Ion Composition Spectrometer on Ulysses observed during the pole-to-pole pass of its primary mission. The implications on the electron temperature, electron density and ion outflow velocity from the corresponding solar wind source regions are also discussed. We find that the electron temperature in the source region of the slow solar wind is higher than that in the coronal hole. We also find a possible north-south asymmetry in the electron temperature that may be correlated to the north-south asymmetry in the solar wind speed found in the SWOOPS/Ulysses data. Based on our data without clear constraints from other coronal observations, it is found that the electron density may be higher, or the heavy ion outflow velocities may be lower toward lower heliographic latitude. © 1999 American Institute of Physics.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87726/2/491_1.pd

Gene expression profiling of aging reveals activation of a p53-mediated transcriptional program

BACKGROUND: Aging has been associated with widespread changes at the gene expression level in multiple mammalian tissues. We have used high density oligonucleotide arrays and novel statistical methods to identify specific transcriptional classes that may uncover biological processes that play a central role in mammalian aging. RESULTS: We identified 712 transcripts that are differentially expressed in young (5 month old) and old (25-month old) mouse skeletal muscle. Caloric restriction (CR) completely or partially reversed 87% of the changes in expression. Examination of individual genes revealed a transcriptional profile indicative of increased p53 activity in the older muscle. To determine whether the increase in p53 activity is associated with transcriptional activation of apoptotic targets, we performed RT-PCR on four well known mediators of p53-induced apoptosis: puma, noxa, tnfrsf10b and bok. Expression levels for these proapoptotic genes increased significantly with age (P < 0.05), while CR significantly lowered expression levels for these genes as compared to control fed old mice (P < 0.05). Age-related induction of p53-related genes was observed in multiple tissues, but was not observed in young SOD2(+/- )and GPX4(+/- )mice, suggesting that oxidative stress does not induce the expression of these genes. Western blot analysis confirmed that protein levels for both p21 and GADD45a, two established transcriptional targets of p53, were higher in the older muscle tissue. CONCLUSION: These observations support a role for p53-mediated transcriptional program in mammalian aging and suggest that mechanisms other than reactive oxygen species are involved in the age-related transcriptional activation of p53 targets

CD103 Expression Is Required for Destruction of Pancreatic Islet Allografts by CD8+ T Cells

The mechanisms by which CD8 effector populations interact with epithelial layers is a poorly defined aspect of adaptive immunity. Recognition that CD8 effectors have the capacity to express CD103, an integrin directed to the epithelial cell-specific ligand E-cadherin, potentially provides insight into such interactions. To assess the role of CD103 in promoting CD8-mediated destruction of epithelial layers, we herein examined the capacity of mice with targeted disruption of CD103 to reject pancreatic islet allografts. Wild-type hosts uniformly rejected islet allografts, concomitant with the appearance of CD8+CD103+ effectors at the graft site. In contrast, the majority of islet allografts transplanted into CD103−/− hosts survived indefinitely. Transfer of wild-type CD8 cells into CD103−/− hosts elicited prompt rejection of long-surviving islet allografts, whereas CD103−/− CD8 cells were completely ineffectual, demonstrating that the defect resides at the level of the CD8 cell. CD8 cells in CD103−/− hosts exhibited normal effector responses to donor alloantigens in vitro and trafficked normally to the graft site, but strikingly failed to infiltrate the islet allograft itself. These data establish a causal relationship between CD8+CD103+ effectors and destruction of graft epithelial elements and suggest that CD103 critically functions to promote intragraft migration of CD8 effectors into epithelial compartments

Structure and magnetic property of potassium intercalated pentacene: observation of superconducting phase in KxC22H14

We report the results from systematic investigations on the structure and magnetic properties of potassium intercalated pentacene as a function of potassium content, K x C22H14 (1  ≤  x  ≤  3). Synchrotron radiation powder x-ray diffraction technique revealed that there are two different stable phases can be obtained via potassium intercalation, namely, K1C22H14 phase and K3C22H14 phase. Structural phase transition was induced when the potassium content was increased to the nominal value x  =  3. This phase transition is accompanied by drastic change in their magnetic property, where those samples with compositions K1C22H14 shows ferromagnetic behavior and those with near K3C22H14 lead to observation of superconductivity with transition temperature, T c, of 4.5 K. It is first time that superconductivity was observed in linear oligoacenes. Both magnetization study and synchrotron radiation powder x-ray diffraction clearly indicates that the superconducting phase belong to K3C22H14 as a result of phase transition from triclinic to monoclinic structure induced by chemical doping

Contemporary evidence: baseline data from the D2B Alliance

© 2008 Bradley et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens