Management of sodium disorders during continuous haemofiltration

In patients with acute kidney injury and concomitant severe hyponatraemia or hypernatraemia, rapid correction of the serum Na+ concentration needs to be avoided. The present paper outlines the principles of how to adjust the Na+ concentration in the replacement fluid during continuous renal replacement therapy to prevent rapid changes of the serum Na+ concentration

Gallbladder Cancer Incidence Among American Indians and Alaska Natives, US, 1999–2004

BACKGROUND. Gallbladder cancer (GBC) is rare; however, it disproportionately affects the American Indian and Alaska Natives (AI/AN) population. The purpose of the study was to characterize GBC among AI/AN in the US population. METHODS. Cases of GBC diagnosed between 1999 and 2004 and collected by state-based cancer registries were included. Registry records were linked with Indian Health Service (IHS) administration records to decrease race misclassification of AI/AN. GBC rates and/or percent distributions for AI/AN and non-Hispanic whites (NHW) were calculated by sex, IHS region, age, and stage for all US counties and IHS Contract Health Service Delivery Area (CHSDA) counties, in which approximately 56% of US AI/AN individuals reside. RESULTS. In CHSDA counties, the GBC incidence rate among AI/AN was 3.3 per 100,000, which was significantly higher than that among NHW (P \u3c .05). Rates varied widely among IHS regions and ranged from 1.5 in the East to 5.5 in Alaska. Rates were higher among AI/AN females than males in all regions, except the Northern Plains. Higher percentages of GBC were diagnosed among AI/AN aged CONCLUSIONS. To the authors’ knowledge to date, this is the most comprehensive study of GBC incidence among AI/AN in the US. The accurate characterization of GBC in this population could help inform the development of interventions aimed at reducing morbidity and mortality from this diseas

Heparin algorithm for anticoagulation during continuous renal replacement therapy

Premature circuit clotting is a problem during continuous renal replacement therapy. We describe an algorithm for individualised anticoagulation with unfractionated heparin based on the patient's risk of bleeding and previous circuit life. The algorithm allows effective and safe nurse-led anticoagulation during continuous renal replacement therapy

Experiência de cárie e utilização do serviço público odontológico por escolares: estudo descritivo em Arroio do Padre, Rio Grande do Sul, 2013

OBJETIVO: descrever a utilização do serviço público odontológico e os índices de ceo-d e CPO-D no município de Arroio do Padre-RS, Brasil. MÉTODOS: estudo descritivo censitário com todos os residentes nas idades de cinco e 12 anos, em 2013; foram realizados exames bucais e aplicado questionário junto aos responsáveis. RESULTADOS: participaram do estudo 50 escolares, 22 com cinco e 28 com 12 anos de idade; as médias de ceo-d e CPOD foram de 3,9 e 1,3 respectivamente; na dentição decídua (ceo-d), houve predomínio do componente cariado (82%), e na permanente (CPO-D), o predomínio foi do componente obturado (65%); do total, 19 escolares apresentaram dentes cariados no momento do exame e destes, 13 haviam consultado com dentista da unidade básica de saúde. CONCLUSÃO: a maioria dos escolares apresentava história de cárie, possivelmente atribuída - em parte - à pouca exposição ao flúor, baixa escolaridade dos pais e pouca valorização da dentição decídua