High Incidence of Adverse Outcomes in Haemodialysis Patients with Diabetes with or without Diabetic Foot Syndrome: A 5-Year Observational Study in Lleida, Spain

Background: We evaluated whether, in subjects receiving haemodialysis (HD), the presence of diabetic foot syndrome (DFS) was associated with increased mortality compared with subjects with diabetes mellitus (DM) without DFS and with non-diabetic subjects. Methods: Retrospective, observational study in 220 subjects followed for six years. We calculated and compared the frequency and 5-year cumulative incidence of all-cause mortality, cardiovascular (CV) mortality, CV events, major adverse CV events (MACE), and new foot ulcer (FU) or amputation. We also examined prognostic factors of all-cause and CV mortality based on baseline characteristics. Results: DM patients had a 1.98 times higher probability of all-cause mortality than those without DM (p = 0.001) and 2.42 times higher likelihood of CV mortality and new FU or amputation (p = 0.002 and p = 0.008, respectively). In the DM cohort, only the risk of a new FU or amputation was 2.69 times higher among those with previous DFS (p = 0.021). In patients with DM, older age was the only predictor of all-cause and CV mortality (p = 0.001 and p = 0.014, respectively). Conclusions: Although all-cause and CV mortality were increased on HD subjects with DM, the presence of DFS did not modify the excess risk. Additional studies are warranted to further explore the impact of DFS in subjects with DM undergoing HD

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Form in Johannes Brahms\'s piano works: Variations on a theme by Haendel.

Enquanto Schoenberg considerou Brahms um \"progressista\", parte de seus contemporâneos - por exemplo, Wagner - o classificava como conservador. A razão para tal rótulo era o apreço que Brahms tinha pelas formas clássicas e barrocas. Diferente dos outros românticos, estatisticamente o allegro de sonata é o procedimento composicional mais recorrente em todos os movimentos de sua obra. Além disso, chegou a dominar com maestria a arte de escrever fugas, cânones e outros gêneros barrocos, incorporando-os na sua linguagem musical com naturalidade. Este trabalho vem apresentar como a obra pianística de Brahms se situa perante seus contemporâneos - mais especificamente com relação à forma - e quais as motivações pessoais e sociais que o fizeram adotar essa postura estética. Um breve resumo de suas obras é apresentado seguido de uma análise das Variações sobre um tema de Haendel para demonstrar como sua obra dialoga com o arcaico e o moderno, sendo ao mesmo tempo antiga, clássica e romântica.Schoenberg once said Brahms was a \"progressive\", while his contemporaries - Wagner, for instance - would classify him as a conservative. The main reason for that was that Brahms enjoyed classic and baroque forms. Apart from the other romantic composers, allegro de sonata is statistically the most recurring compositional procedure in all movements of his output. Besides, he conquered how to write fugues, canons and other baroque genres, inserting them naturally in his musical language. This thesis presents how Brahms\'s piano works relate with those of his contemporaries - more specifically regarding form - and what was his personal and social motivation to adopt this aesthetical position. A brief about his works will be presented followed by an analysis of Variations on a theme by Haendel, in order to demonstrate how his output makes a dialogue with the old and modern, being at the same time antique, classic and romanti

High Incidence of Adverse Outcomes in Haemodialysis Patients with Diabetes with or without Diabetic Foot Syndrome : A 5-Year Observational Study in Lleida, Spain

Background: We evaluated whether, in subjects receiving haemodialysis (HD), the presence of diabetic foot syndrome (DFS) was associated with increased mortality compared with subjects with diabetes mellitus (DM) without DFS and with non-diabetic subjects. Methods: Retrospective, observational study in 220 subjects followed for six years. We calculated and compared the frequency and 5-year cumulative incidence of all-cause mortality, cardiovascular (CV) mortality, CV events, major adverse CV events (MACE), and new foot ulcer (FU) or amputation. We also examined prognostic factors of all-cause and CV mortality based on baseline characteristics. Results: DM patients had a 1.98 times higher probability of all-cause mortality than those without DM (p = 0.001) and 2.42 times higher likelihood of CV mortality and new FU or amputation (p = 0.002 and p = 0.008, respectively). In the DM cohort, only the risk of a new FU or amputation was 2.69 times higher among those with previous DFS (p = 0.021). In patients with DM, older age was the only predictor of all-cause and CV mortality (p = 0.001 and p = 0.014, respectively). Conclusions: Although all-cause and CV mortality were increased on HD subjects with DM, the presence of DFS did not modify the excess risk. Additional studies are warranted to further explore the impact of DFS in subjects with DM undergoing HD

Antibiofilm, Antifouling, and Anticorrosive Biomaterials and Nanomaterials for Marine Applications

Formation of biofilms is one of the most serious problems affecting the integrity of marine structures both onshore and offshore. These biofilms are the key reasons for fouling of marine structures. Biofilm and biofouling cause severe economic loss to the marine industry. It has been estimated that around 10% of fuel is additionally spent when the hull of ship is affected by fouling. However, the prevention and control treatments for biofilms and biofouling of marine structures often involve toxic materials which pose severe threat to the marine environment and are strictly regulated by international maritime conventions. In this context, biomaterials for the treatment of biofilms, fouling, and corrosion of marine structures assume much significance. In recent years, due to the technological advancements, various nanomaterials and nanostructures have revolutionized many of the biological applications including antibiofilm, antifouling, and anticorrosive applications in marine environment. Many of the biomaterials such as furanones and some polypeptides are found to have antibiofilm, antifouling, and anticorrosive potentials. Many of the nanomaterials such as metal (titanium, silver, zinc, copper, etc.) nanoparticles, nanocomposites, bioinspired nanomaterials, and metallic nanotubes were found to exhibit antifouling and anticorrosive applications in marine environment. Both biomaterials and nanomaterials have been used in the control and prevention of biofilms, biofouling, and corrosion in marine structures. In recent years, the biomaterials and nanomaterials were also characterized to have the ability to inhibit bacterial quorum sensing and thereby control biofilm formation, biofouling, and corrosion in marine structures. This chapter would provide an overview of the biomaterials from diverse sources and various category of nanomaterials for their use in antibiofilm, antifouling, and anticorrosion treatments with special reference to marine applications