438 research outputs found

    Insuficiencia renal en un varón de 23 años con colitis ulcerosa tratada con 5-aminosalicilato

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    Caso clínico Se presenta el caso de un varón de 23 años, diagnosticado de colitis ulcerosa (CU) en agosto 2016 durante un brote moderado y recibió 5-aminosalicilato (5-ASA; mesalazina) 4800 mg/día, rápidamente logró la remisión de la enfermedad. Cuando se realizó el diagnóstico su función renal era normal (creatinina 0, 8 mg/dl). Después de la remisión sintomática, la dosis de 5-ASA se redujo a 1500 mg/día. Un año después, en una consulta programada, tuvo otro brote leve-moderado de CU, lo que llevó a un aumento en la dosis de 5-ASA (4500 mg/día). En este momento, los resultados analíticos demostraron un aumento en la creatinina sérica a 1, 8 mg/dl, esto se interpretó como consecuencia de la deshidratación por diarrea durante la actividad de la CU. Tres semanas después, la enfermedad alcanzó rápidamente la remisión clínica y se reanudó la dosis anterior de 5-ASA. Cuatro meses después, en remisión clínica completa presentó una creatinina sérica de 1, 5 mg/dl, por tanto, la dosis de mesalazina se redujo (1000 mg/día) para mantener la creatinina estable. Ocho meses después, su creatinina aumentó dos veces a 3 mg/dl y el paciente estaba asintomático. En la exploración física, se encontraba eupneico, normocoloreado, consciente y orientado. La presión arterial era 100/60 mmHg, la frecuencia cardiaca de 80 lpm, la SaO2 del 99% y la temperatura de 36 °C. La exploración abdominal era normal y la puño-percusión renal era negativa..

    Mean reversion in annual earnings and its implications for security valuation

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    This article documents the long-horizon mean reverting character of annual earnings and tests the implications of such mean reversion for security valuation. First, both theory-based and nonparametric measures of earnings persistence decrease as the estimation order increases, revealing 40 percent less long-horizon persistence than expected under the commonly used random walk model. Second, the return responses to the earnings shocks are more closely related across firms to the higher-order measures of persistence that reflect significant long-horizon mean reversion. Third, the persistence measure derived from classical valuation theory outperforms the generic measure in explaining the return responses. Taken as a whole, these results provide evidence for significant mean reversion in the higher-order properties of earnings and for the stock market incorporating these properties in a manner consistent with classical valuation theory.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47883/1/11156_2005_Article_BF01082663.pd

    A pharmacokinetics and safety phase 1/1b study of oral ixazomib in patients with multiple myeloma and severe renal impairment or end-stage renal disease requiring haemodialysis.

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    Renal impairment (RI) is a major complication of multiple myeloma (MM). This study aimed to characterize the single-dose pharmacokinetics (PK) of the oral proteasome inhibitor, ixazomib, in cancer patients with normal renal function [creatinine clearance (CrCl) ≥90 ml/min; n = 20), severe RI (CrCl <30 ml/min; n = 14), or end-stage renal disease requiring haemodialysis (ESRD; n = 7). PK and adverse events (AEs) were assessed after a single 3 mg dose of ixazomib. Ixazomib was highly bound to plasma proteins (~99%) in all renal function groups. Unbound and total systemic exposures of ixazomib were 38% and 39% higher, respectively, in severe RI/ESRD patients versus patients with normal renal function. Total ixazomib concentrations were similar in pre- and post-dialyser samples collected from ESRD patients; therefore, ixazomib can be administered without regard to haemodialysis timing. Except for anaemia, the incidence of the most common AEs was generally similar across groups, but grade 3 and 4 AEs were more frequent in the severe RI/ESRD groups versus the normal group (79%/57% vs. 45%), as were serious AEs (43%/43% vs. 15%). The PK and safety results support a reduced ixazomib dose of 3 mg in patients with severe RI/ESRD

    Transformative Sea-level Rise Research and Planning: Establishing a University, Tribal, and Community Partnership for a Resilient California North Coast

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    Sea-level rise (SLR) is and will continue to be a pressing issue in the rural, North Coast region of California, especially since nearby Wigi (or Humboldt Bay) is experiencing one of the fastest rates of relative SLR on the U.S. West Coast. In this paper, we argue that SLR presents a transformative opportunity to rekindle environmental relationships and reshape the future of the California North Coast and beyond. As the preeminent higher education institution of the region, Cal Poly Humboldt has the responsibility to be a leader in education, research, and planning for climate resilience. We describe efforts of the Cal Poly Humboldt Sea Level Rise Institute to establish a university-Tribal-community partnership that braids together different approaches and ways of knowing to develop research and planning that supports a resilient California North Coast. Since Wigi is projected to experience the effects of SLR sooner than the rest of the state, the North Coast region is poised to act as an incubator for new ideas and solutions, including Indigenous knowledge systems, and to play a role in influencing equitable, resilient, and transformative SLR adaptation processes in other parts of the state and the world. This will require developing programming and expertise in specific disciplinary areas, but, more importantly, will require the development of opportunities and spaces for various disciplines, ways of knowing, and sectors (e.g. Tribal nations, academia, government, NGOs, private companies, and community groups) to converge and bring the best of what they have to address climate-induced challenges and opportunities

    Trece tratamientos de la insuficiencia renal aguda secundaria a mieloma múltiple con filtros de high cut off

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    Introduction Multiple myeloma (MM) is a haematological tumour that is characterised by uncontrolled proliferation of plasma cells and a significant volume of serum free light chains (sFLCs), which can cause acute renal failure due to intratubular precipitation, resulting in cast nephropathy. Acute renal failure is a complication that can arise in more than 20% of patients with multiple myeloma, half of which will require dialysis. Methods We report our experience with 13 patients who were treated with dialysis using high cut off filters (HCO) between July 2011 and February 2015. A total of 6 consecutive 6-hour sessions were performed using a 2.1 m2 HCO filter (Theralite® by Gambro®). Afterwards, further 6-hour sessions were continued on alternate days. Results A total of 151 sessions were conducted, with an average of 11.6 sessions per patient (range 6-27). The treatment proved to be effective in removing both kappa and lambda sFLCs, resulting in a 93.7% fall in sFLCs by the end of treatment. The average reduction was 57.7% per dialysis session. 10 out of the 13 cases recovered sufficient renal function to become independent of dialysis. There were no major changes in albumin levels using an infusion protocol of 2 50-mL vials of 20% albumin at the end of the dialysis session. Conclusions Combination treatment with chemotherapy and long dialysis with HCO filters was effective in reducing the sFLC levels and recovering sufficient renal function in 77% of cases. With HCO filters, significant cost savings are achieved, contrary to what was previously believed

    Full Spectrum Archaeology

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    Full Spectrum Archaeology (FSA) is an aspiration stemming from the convergence of archaeology’s fundamental principles with international heritage policies and community preferences. FSA encompasses study and stewardship of the full range of heritage resources in accord with the full range of associated values and through the application of treatments selected from the full range of appropriate options. Late modern states, including British Columbia, Canada, nominally embrace de jure heritage policies consonant with international standards yet also resist de facto heritage management practice grounded in professional ethics and local values and preferences. In response, inheritor communities and their allies in archaeology are demonstrating the benefits of FSA and reclaiming control over cultural heritage. Archaeology and heritage management driven by altruistic articulation of communal, educational, scientific and other values further expose shortcomings and vulnerabilities of late modern states as well as public goods in and from FSA

    Anticipated impact of the 2009 Four Corners raid and arrests

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    Archaeological looting on United States federal land has been illegal for over a century. Regardless, the activity has continued in the Four Corners region. This paper discusses how the 1979 Archaeological Resources Protection Act (ARPA) can be viewed as sumptuary law, and within a sumptuary context, subversion can be anticipated. An analysis of 1986 and June 2009 federal raids in the Four Corners will exemplify this point by identifying local discourses found in newspapers both before and after each raid, which demonstrate a sumptuary effect. Ultimately, this paper concludes that looting just adapted, rather than halted, after each federal raid and that understanding this social context of continued local justification and validation of illegal digging is a potential asset for cultural resource protection
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