Limited sampling strategies to estimate glomerular filtration rate in cats with low, normal and high glomerular filtration rates

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Plasma symmetric dimethylarginine and creatinine concentrations and glomerular filtration rate in cats with normal and decreased renal function

Background Glomerular filtration rate (GFR) is the gold standard in assessing renal function but is impractical. Serum creatinine (sCr) has limited sensitivity in identifying early chronic kidney disease (CKD), whereas symmetric dimethylarginine (SDMA) has been commercialized as more accurate biomarker. Studies comparing SDMA and sCr with GFR in cats are limited. Objectives To further investigate the diagnostic performance of SDMA in nonazotemic and azotemic cats. Animals Forty-nine client-owned cats: 17 cats with CKD, 15 cats with diabetes mellitus (DM), and 17 healthy cats. Methods Retrospective study using spare blood samples from cats with documented sCr and GFR results for SDMA analysis. Diagnostic performances of SDMA and sCr were evaluated using correlation coefficients, sensitivities, specificities, and receiver operator characteristic curves. Results Compared to healthy cats and cats with DM, CKD cats had significantly higher SDMA(plasma) (26.7 +/- 9.9 mu g/dL) and sCr (249.7 +/- 71.6 mu mol/L [2.8 +/- 0.8 mg/dL]; both P < .001) values. SDMA(plasma) (tau(B) = -0.57; P < .001) and sCr (tau(B) = -0.56; P < .001) were significantly correlated with GFR. SDMA(plasma) (tau(B) = 0.52; P < .001) had a significant relationship with sCr. SDMA(plasma) and sCr had similar sensitivity (76%-94% and 71%-88%, respectively) in detecting reduced renal function. Creatinine had higher specificity (94%-96%) than SDMA(plasma) (75%-76%) (P < .05). Conclusion and Clinical Importance In this study of azotemic and nonazotemic cats, SDMA was a reliable marker to identify decreased GFR. However, superiority of SDMA over sCr could not be confirmed

Compatibility of the French white certificate program to fulfil the objective of energy savings claimed by the Energy Service Directive

International audienceThe Commission has proposed a Directive on the promotion of end-use efficiency and energy services (ESD) to enhance the cost-effective and efficient end-use of energy in Member States. According to the Directive, the Member States shall adopt and aim to achieve an overall national indicative energy savings target of 9% (or beyond) in 2016. This target is to be reached by way of energy services and other energy efficiency measures. The French National Energy Efficiency Action Plan to comply with the ESD includes a White Certificates scheme (or FWC) as one of the important measures to fulfil the target. As the accountings of energy savings in the FWC scheme and in the ESD are different (e.g. lifetime-cumulated and discounted kWh for FWC and annual kWh for ESD), an analysis of the compliance of both methodologies and a comparison of the assessed savings are necessary. In this paper, we evaluate the compliance with the ESD requirements of two different end-use actions (insulation, heating boiler) included in the FWC scheme. This is done through the concrete case of certificates filed by EDF. The main objective of this evaluation is to assess the contribution of the savings of these FWC actions to the target of the ESD. Finally, general conclusions are drawn about the use of a White Certificates scheme as a monitoring and evaluation tool for the ESD purpose

Project management case analysis in technology companies

Este artículo tiene como objetivo identificar y analizar tres empresas tecnológicas como Google, Globant y Zemoga, a través del reconocimiento de unas variables comunes de la metodología de Gestión de Proyectos evidenciadas en cada empresa. Entre las variables a destacar están: la innovación, la metodología de gestión de proyectos, la estructura organizacional, el trabajo en equipo, la complejidad y la cultura organizacional. Este análisis de las variables muestra como el ambiente de trabajo y los incentivos a la innovación dentro de la organización, pueden generar una relación simbiótica entre los empleados y la empresa lo que aumenta las probabilidades de tener éxito en la ejecución de proyectos.This article attempts to identify and analyze success technological companies like Google, Globant and Zemoga by recognizing some common variables of the Project Management model of each one. The variables to stand out are: innovation, methodology for project management, organizational structure, teamwork, complexity and organizational culture. This analysis recognizes common strengths in project management and highlight what elements can lead to successful management in technology companies

Assessment of glomerular filtration rate in dogs

Glomerular filtration rate (GFR) is considered as the best indicator of renal function. Its determination is clinically useful to diagnose early stage of subclinical chronic renal failure (CRF). GFR can be estimated indirectly by measuring plasma creatinine levels, but this method is not sensitive enough to detect early stage CRF. Direct measurement of GFR are based on the determination of urine or plasma clearance of an appropriate marker, but most of these methods cannot be used in routine practice. Plasma exogenous creatinine clearance test (PECCT), recently developed and validated, is easy to use in veterinary medecine. Besides its clinical interest, it should improve our understanding of the pharmacokinetics of creatinine, which remains the most commonly tested marker in medical biology.Le débit de filtration glomérulaire (DFG) est considéré comme le meilleur indicateur de la fonction rénale. Sa détermination offre un intérêt clinique pour le diagnostic précoce de l'insuffisance rénale chronique (IRC) subclinique chez le chien. Le DFG peut être estimé de façon indirecte par la mesure de la concentration plasmatique de la créatinine. Cette approche est cependant peu sensible pour dépister les stades précoce de l'IRC. Les méthodes directes de mesure reposent sur la détermination de la clairance rénale ou plasmatique d'un marqueur approprié, mais ne sont pas utilisables pour la plupart en pratique courante. Le test de la clairance plasmatique de la créatinine exogène, récemment développé et validé, est facile à mettre en oeuvre en médecine vétérinaire. Outre son intérêt clinique, il devrait également permettre une meilleure compréhension de la pharmacocinétique de la créatinine qui reste le marqueur le plus dosé en biologie médicale

Квадратура в стінопису XVIII століття у Східній Галичині на тлі західноєвропейського мистецтва бароко

Background : Systemic hypertension and proteinuria are frequent complications in dogs with Cushing's syndrome and do not always resolve after treatment of hypercortisolism. Therefore, dogs with Cushing's syndrome may be at risk for renal dysfunction before and after treatment. Hypothesis/Objectives : To assess renal function in dogs with ACTH-dependent hyperadrenocorticism (ADHAC) before and after treatment. Animals : A total of 19 dogs with ADHAC and 12 control dogs. Methods : Renal function was assessed before and at 1, 3, 6, and 12 similar to months after treatment. Twelve dogs were treated with trilostane and 7 dogs by transsphenoidal hypophysectomy. Routine renal markers were measured and urinary albumin (uALB), immunoglobulin G (uIgG), and retinol-binding protein (uRBP) were assessed by ELISA. Urinary N-acetyl-beta-D-glucosaminidase (uNAG) was determined colorimetrically. All urinary markers were indexed to urinary creatinine concentration (c). Plasma clearance of creatinine (Clcreat), exo-iohexol (Clexo), and endo-iohexol (Clendo) was used to measure glomerular filtration rate (GFR). Data were analyzed using a general linear model. Results : Serum creatinine and urea concentrations increased post-treatment, but remained within reference ranges. Plasma Clcreat and Clendo were significantly lower post-treatment, whereas Clexo was not different. Urinary protein-to-creatinine ratio (UPC), uALB/c, uIgG/c, and uRBP/c were decreased post-treatment, but at 12 similar to months 5/13 dogs remained proteinuric. Urinary NAG/c did not change significantly. Conclusions and clinical importance : A decrease in GFR and persistent proteinuria post-treatment may warrant the clinician's attention. Future research including renal histopathology of dogs with persistent proteinuria or low GFR is needed to further assess renal outcome

Comparison of the Effectiveness of Four Bariatric Surgery Procedures in Obese Patients with Type 2 Diabetes: A Retrospective Study

Aim. The aim of the present retrospective study was to evaluate the efficacy of four bariatric surgical procedures to induce diabetes remission and lower cardiovascular risk factors in diabetic obese patients. Moreover, the influence of surgery on weight evolution in the diabetic population was compared with that observed in a nondiabetic matched population. Methods. Among 970 patients who were operated on in our center since 2001, 81 patients were identified as type 2 diabetes. Laparoscopic adjustable gastric banding (GB), intervention type Mason (MA), gastric bypass (RYGB), and sleeve gastrectomy (SG) were performed, respectively, in 25%, 17%, 28%, and 30% of this diabetic population. Results. The resolution rate of diabetes one year after surgery was significantly higher after SG than GB (62.5% versus 20%, P < 0.01), but not significantly different between SG and RYGB. In terms of LDL-cholesterol reduction, RYGB was equivalent to SG and superior to CGMA or GB. Considering the other cardiovascular risk factors, there was no significant difference according to surgical procedures. The weight loss was not statistically different between diabetic and nondiabetic matched patients regardless of the surgical procedures used. Conclusion. Our data confirm that the efficacy of surgery to treat diabetes is variable among the diverse procedures and SG might be an interesting option in this context

The neuropeptide 26RFa in the human gut and pancreas: potential involvement in glucose homeostasis

International audienc

Prognostic value of right ventricular dilatation on computed tomography pulmonary angiogram for predicting adverse clinical events in severe COVID-19 pneumonia

BackgroundRight ventricle dilatation (RVD) is a common complication of non-intubated COVID-19 pneumonia caused by pro-thrombotic pneumonitis, intra-pulmonary shunting, and pulmonary vascular dysfunction. In several pulmonary diseases, RVD is routinely measured on computed tomography pulmonary angiogram (CTPA) by the right ventricle-to-left ventricle (LV) diameter ratio &gt; 1 for predicting adverse events.ObjectiveThe aim of the study was to evaluate the association between RVD and the occurrence of adverse events in a cohort of critically ill non-intubated COVID-19 patients.MethodsBetween February 2020 and February 2022, non-intubated patients admitted to the Amiens University Hospital intensive care unit for COVID-19 pneumonia with CTPA performed within 48 h of admission were included. RVD was defined by an RV/LV diameter ratio greater than one measured on CTPA. The primary outcome was the occurrence of an adverse event (renal replacement therapy, extracorporeal membrane oxygenation, 30-day mortality after ICU admission).ResultsAmong 181 patients, 62% (n = 112/181) presented RVD. The RV/LV ratio was 1.10 [1.05–1.18] in the RVD group and 0.88 [0.84–0.96] in the non-RVD group (p = 0.001). Adverse clinical events were 30% and identical in the two groups (p = 0.73). In Receiving operative curves (ROC) analysis, the RV/LV ratio measurement failed to identify patients with adverse events. On multivariable Cox analysis, RVD was not associated with adverse events to the contrary to chest tomography severity score &gt; 10 (hazards ratio = 1.70, 95% CI [1.03–2.94]; p = 0.04) and cardiovascular component (&gt; 2) of the SOFA score (HR = 2.93, 95% CI [1.44–5.95], p = 0.003).ConclusionRight ventricle (RV) dilatation assessed by RV/LV ratio was a common CTPA finding in non-intubated critical patients with COVID-19 pneumonia and was not associated with the occurrence of clinical adverse events