Obituary

Volume: XVI

Effect of remote ischaemic conditioning on contrast-induced nephropathy in patients undergoing elective coronary angiography (ERICCIN): rationale and study design of a randomised single-centre, double-blind placebo-controlled trial.

Contrast-induced nephropathy (CIN), an acute kidney injury resulting from the administration of intravascular iodinated contrast media, is an important cause of morbidity/mortality following coronary angiographic procedures in high-risk patients. Despite preventative measures intended to mitigate the risk of CIN, there remains a need for an effective intervention. Remote ischaemic conditioning (RIC), where non-injurious ischaemia is applied to an arm prior to the administration of contrast, has shown promise in attenuating CIN but its effectiveness in preserving long-term renal function is unknown, which will be studied as part of the effect of remote ischaemic conditioning against contrast-induced nephropathy (ERICCIN) trial. ( http://Controlled-trials.com Identifier: ISRCTN49645414.) METHODS: The ERICCIN trial is a single-centre, randomised double-blinded placebo-controlled trial which plans to recruit 362 patients who are at risk of CIN, defined by pre-existent renal impairment (estimated glomerular filtration rate 25 % of eGFR, or rise of creatinine of >44 μmol/l) at 48 h. A key secondary endpoint will be whether RIC impacts upon persistent renal impairment over the 3-month follow-up period. Additional secondary endpoints include the measurement of serum neutrophil gelatinase-associated lipocalin and urinary albumin at 6, 48 h and 3 months following administration of contrast

Impact of point-of-care pre-procedure creatinine and eGFR testing in patients with ST segment elevation myocardial infarction undergoing primary PCI: The pilot STATCREAT study

Background: Contrast-induced acute kidney injury (CI-AKI) is a recognised complication during primary PCI that affects short and long term prognosis. The aim of this study was to assess the impact of point-of-care (POC) pre-PPCI creatinine and eGFR testing in STEMI patients. Methods 160 STEMI patients (STATCREAT group) with pre-procedure POC testing of Cr and eGFR were compared with 294 consecutive retrospective STEMI patients (control group). Patients were further divided into subjects with or without pre-existing CKD. Results: The incidence of CI-AKI in the whole population was 14.5% and not different between the two overall groups. For patients with pre-procedure CKD, contrast dose was significantly reduced in the STATCREAT group (124.6 ml vs. 152.3 ml, p = 0.015). The incidence of CI-AKI was 5.9% (n = 2) in the STATCREAT group compared with 17.9% (n = 10) in the control group (p = 0.12). There was no difference in the number of lesions treated (1.118 vs. 1.196, p = 0.643) or stents used (1.176 vs. 1.250, p = 0.78). For non-CKD patients, there was no significant difference in contrast dose (172.4 ml vs. 158.4 ml, p = 0.067), CI-AKI incidence (16.7% vs. 13.4%, p = 0.4), treated lesions (1.167 vs. 1.164, p = 1.0) or stents used (1.214 vs. 1.168, p = 0.611) between the two groups. Conclusions: Pre-PPCI point-of-care renal function testing did not reduce the incidence of CI-AKI in the overall group of STEMI patients. In patients with CKD, contrast dose was significantly reduced, but a numerical reduction in CI-AKI was not found to be statistically significant. No significant differences were found in the non-CKD group

Water is Medicine : Reimagining Water Security through Tr’ondëk Hwëch’in Relationships to Treated and Traditional Water Sources in Yukon, Canada

There is growing acknowledgement that the material dimensions of water security alone are inadequate; we also need to engage with a broader set of hydrosocial relationships. Indeed, more holistic approaches are needed to explain Indigenous peoples’ relationships to water including the use of traditional water sources such as mountain creeks and springs. In this paper, we seek to reimagine water security through a case study of Tr’ondëk Hwëch’in’s relationships to both treated and traditional water sources throughout the First Nation’s traditional territory in Yukon, Canada. Through community-based research including interviews with Elders and other community members, we examine the importance of traditional water sources for meeting important health requirements including physical, spiritual and cultural wellbeing. This intervention contributes to ongoing debates about what it means to secure safe and affordable water in three key ways: First, we argue that Indigenous water relations invite a shift towards more a holistic understanding of water security; second, we contend that settler colonial politics should be understood as a root cause of water insecurity; finally, we explore how Two-Eyed Seeing can be applied as an alternative to the ‘integration’ of Western scientific and Indigenous approaches to drinking water.Arts, Faculty ofLaw, Peter A. Allard School ofScience, Faculty ofNon UBCGender, Race, Sexuality and Social Justice, Institute forResources, Environment and Sustainability (IRES), Institute forReviewedFacult

A statistical approach for determining subsurface thermal structure from sea surface temperature in the northeast Pacific Ocean.

Bathythermograph data acquired from the research vessel USNS SILAS BENT along a meridional track in the Northeast Pacific during September 1977 were statistically analyzed to determine possible associations between the subsurface thermal structures and sea surface temperature. Strongly correlated variables (thermocline gradients, mixed layer depth, and locations of the seasonal and main thermoclines) within the vertical temperature profile were used in linear regression methods to form empirical relationships. The generated equations then are utilized to define the subsurface thermal structure from only an input of sea surface temperature. Comparison tests with temporally and spatially removed BT data were conducted with results indicating successful application within a water mass domain with uniformly changing characteristics.Naval Ocean Systems Center under work order N6600183WR00043http://archive.org/details/statisticalappro00howeNaval Ocean Systems Center under work order N6600183WR00043Lieutenant, United States NavyApproved for public release; distribution is unlimited