The renal blood flow reserve in healthy humans and patients with atherosclerotic renovascular disease measured by positron emission tomography using [O-15]H2O

Background: Microvascular function plays an important role in ARVD (atherosclerotic renovascular disease). RFR (renal flow reserve), the capacity of renal vasculature to dilate, is known to reflect renal microvascular function. In this pilot study, we assessed PET (positron emission tomography)-based RFR values of healthy persons and renal artery stenosis patients.Seventeen patients with ARVD and eight healthy subjects were included in the study. Intravenous enalapril 1 mg was used as a vasodilatant, and the maximum response (blood pressure and RFR) to it was measured at 40 min. Renal perfusion was measured by means of oxygen-15-labeled water PET. RFR was calculated as a difference of stress flow and basal flow and was expressed as percent [(stress blood flow - basal blood flow)/basal blood flow] x 100%.Results: RFR of the healthy was 22%. RFR of the stenosed kidneys of bilateral stenosis patients (27%) was higher than that of the stenosed kidneys of unilateral stenosis patients (15%). RFR of the contralateral kidneys of unilateral stenosis patients was 21%. There was no difference of statistical significance between RFR values of ARVD subgroups or between ARVD subgroups and the healthy. In the stenosed kidneys of unilateral ARVD patients, stenosis grade of the renal artery correlated negatively with basal (p = 0.04) and stress flow (p = 0.02). Dispersion of RFR values was high.Conclusions: This study is the first to report [O-15]H2O PET-based RFR values of healthy subjects and ARVD patients in humans. The difference between RFR values of ARVD patients and the healthy did not reach statistical significance perhaps because of high dispersion of RFR values. [O-15]H2O PET is a valuable non-invasive and quantitative method to evaluate renal blood flow though high dispersion makes imaging challenging. Larger studies are needed to get more information about [O-15]H2O PET method in evaluation of renal blood flow

Terveydenhuollon kansalliset laaturekisteripilotit loppusuoralla

Pilottiprojektin tulokset laaturekisterien toiminnan organisoimisesta kannustavat ­jatkamaan työtä moniammatillisesti ja pitkäjänteisesti. Kansallinen koordinaatio on välttämätöntä laatu- ja vaikuttavuustiedon vertailukelpoisuuden ja hyödyntämisen varmistamiseksi

The agencement of industrial branch life assurance

Agencements are arrangements endowed with the capacity of acting in different ways depending upon how they are configured. In advocating the term 'agencement' Callon's aim is to signal the close interweaving of words and actions and thus jettison the more Austinian associations of performativity. Agencement calls attention to the various processes by which economic actors, both human and non-human, are endowed with the fixtures, fittings and devices necessary to conduct themselves in particular ways. Thus depending upon how things are arranged or configured, disinterested or selfish, calculative or non-calculative, individual or collective agencies become possible. This model works well to describe the emergence of markets for industrial branch life assurance in the UK from the nineteenth century. Companies like the Prudential and the Pearl reacted to the conflicts, crises and controversies in the commercial market and the competition between socialised and privatised or prudentialist insurance models with Industrial Branch Assurance. This claimed to provide security for the thrifty poor by employing an army of agents whose weekly premium collections helped impose the discipline of thrift and security. Through the notion of agencement, the effect of hybrid combinations of human bodies, material equipment, technical devices and cognitive processes in creating a sustainable market for a peculiarly expensive financial savings product targeted at the working classes thrift is exposed