Alteraciones del metabolismo calcio-fósforo y osteodistrofia renal en pacientes con insuficiencia renal crónica : influencia del tratamiento con hemodiálisis, derivados 1 alfa hidroxilados de la vitamina D, paratiroidectomía y trasplante renal

Tesis inéditas de la Universidad Complutense de Madrid, Facultad de Medicina, 1981.Fac. de MedicinaTRUEProQuestpu

Resistencias a los antibióticos: búsqueda de alternativas en la preparación de dosis seminales en la especie porcina

Hoy en día la inseminación artificial es la técnica más empleada en la reproducción porcina. Para la preparación de dosis seminales se suele recurrir al uso de antibióticos con el fin de evitar el crecimiento bacteriano que podría producir una disminución de la calidad seminal y con ello de la fertilidad en la cerda. Sin embargo, el aumento de las resistencias microbianas ha promovido la búsqueda de diferentes alternativas como pueden ser la centrifugación coloidal, aceites esenciales, péptidos antimicrobianos o incluso otras bacterias que produzcan un efecto probiótico al limitar la proliferación de aquellas que son patógenas. A pesar de que estas alternativas se están empezando a utilizar en la producción porcina, todavía es necesario determinar si estas opciones van a ser capaces de preservar la calidad de las dosis seminales y de controlar el crecimiento microbiano en el modelo productivo actual.<br /

Biología y control de la Vespa velutina

En 2014 se obtienen los primeros registros de la avispa asiática (Vespa velutina Lepeletier, 1836) en Europa, concretamente en Francia. Unos años después se empiezan a encontrar nidos y ejemplares en diferentes puntos de España. En este documento se examinan los aspectos relevantes sobre esta especie, tales como su biología, ecología, origen y dispersión y su impacto a nivel ecológico, social, económico y sanitario. Además, se realiza un análisis de las publicaciones realizadas de carácter científico, así como protocolos, estrategias de control y posible erradicación de la avispa asiática a nivel estatal y autonómico. La rápida invasión de esta especie ha despertado un gran interés entre los científicos ya que todavía se están estudiando aspectos importantes de su biología y ecología que puedan facilitar el control de la población. Finalmente, teniendo en cuenta que la erradicación de la Vespa velutina es casi imposible, se explica el beneficio que podría aportar su presencia. <br /

Metformin-Associated Acute Kidney Injury and Lactic Acidosis

Objectives. Metformin is the preferred oral antidiabetic agent for type 2 diabetes. Lactic acidosis is described as a rare complication, usually during an acute kidney injury (AKI). Material and Methods. We conducted a prospective observational study of metformin-associated AKI cases during four years. 29 cases were identified. Previous renal function, clinical data, and outcomes were recorded. Results. An episode of acute gastroenteritis precipitated the event in 26 cases. Three developed a septic shock. Three patients died, the only related factor being liver dysfunction. More severe metabolic acidosis hyperkalemia and anemia were associated with higher probabilities of RRT requirement. We could not find any relationship between previous renal dysfunction and the outcome of the AKI. Conclusions. AKI associated to an episode of volume depletion due to gastrointestinal losses is a serious complication in type 2 diabetic patients on metformin. Previous renal dysfunction (mild-to-moderate CKD) has no influence on the severity or outcome

Fabry Nephropathy: An Evidence-Based Narrative Review.

Fabry disease (FD) is a rare, X-linked disorder caused by mutations in the GLA gene encoding the enzyme α-galactosidase A. Complete or partial deficiency in this enzyme leads to intracellular accumulation of globotriaosylceramide (Gb3) and other glycosphingolipids in many cell types throughout the body, including the kidney. Progressive accumulation of Gb3 in podocytes, endothelial cells, epithelial cells, and tubular cells contribute to the renal symptoms of FD, which manifest as proteinuria and reduced glomerular filtration rate leading to renal insufficiency. A correct diagnosis of FD, although challenging, has considerable implications regarding treatment, management, and counseling. The diagnosis may be confirmed by demonstrating the enzyme deficiency in males and by identifying the specific GLA gene mutation in male and female patients. Treatment with enzyme replacement therapy, as part of the therapeutic strategy to prevent complications of the disease, may be beneficial in stabilizing renal function or slowing its decline, particularly in the early stages of the disease. Emergent treatments for FD include the recently approved chaperone molecule migalastat for patients with amenable mutations. The objective of this report is to provide an updated overview on Fabry nephropathy, with a focus on the most relevant aspects of its epidemiology, diagnosis, pathophysiology, and treatment options.S

Trisomy 8, A Cytogenetic Abnormality In Myelodysplastic Syndromes, Is Constitutional Or Not?

Isolated trisomy 8 is not considered presumptive evidence of myelodysplastic syndrome (MDS) in cases without minimal morphological criteria. One reason given is that trisomy 8 (+8) can be found as a constitutional mosaicism (cT8M). We tried to clarify the incidence of cT8M in myeloid neoplasms, specifically in MDS, and the diagnostic value of isolated +8 in MDS. Twenty-two MDS and 10 other myeloid neoplasms carrying +8 were studied. Trisomy 8 was determined in peripheral blood by conventional cytogenetics (CC) and on granulocytes, CD3+ lymphocytes and oral mucosa cells by fluorescence in situ hybridization (FISH). In peripheral blood CC, +8 was seen in 4/32 patients. By FISH, only one patient with chronic myelomonocytic leukemia showed +8 in all cell samples and was interpreted as a cT8M. In our series +8 was acquired in all MDS. Probably, once discarded cT8M by FISH from CD3+ lymphocytes and non-hematological cells, +8 should be considered with enough evidence to MDS

Safety of intravenous ferric carboxymaltose versus oral iron in patients with nondialysis-dependent CKD: an analysis of the 1-year FIND-CKD trial.

Background: The evidence base regarding the safety of intravenous (IV) iron therapy in patients with chronic kidney disease (CKD) is incomplete and largely based on small studies of relatively short duration. Methods: FIND-CKD (ClinicalTrials.gov number NCT00994318) was a 1-year, open-label, multicenter, prospective study of patients with nondialysis-dependent CKD, anemia and iron deficiency randomized (1:1:2) to IV ferric carboxymaltose (FCM), targeting higher (400-600 µg/L) or lower (100-200 µg/L) ferritin, or oral iron. A post hoc analysis of adverse event rates per 100 patient-years was performed to assess the safety of FCM versus oral iron over an extended period. Results: The safety population included 616 patients. The incidence of one or more adverse events was 91.0, 100.0 and 105.0 per 100 patient-years in the high ferritin FCM, low ferritin FCM and oral iron groups, respectively. The incidence of adverse events with a suspected relation to study drug was 15.9, 17.8 and 36.7 per 100 patient-years in the three groups; for serious adverse events, the incidence was 28.2, 27.9 and 24.3 per 100 patient-years. The incidence of cardiac disorders and infections was similar between groups. At least one ferritin level ≥800 µg/L occurred in 26.6% of high ferritin FCM patients, with no associated increase in adverse events. No patient with ferritin ≥800 µg/L discontinued the study drug due to adverse events. Estimated glomerular filtration rate remained the stable in all groups. Conclusions: These results further support the conclusion that correction of iron deficiency anemia with IV FCM is safe in patients with nondialysis-dependent CKD