IMPACT OF GLOBAL ECONOMIC DISPARITIES ON PRACTICES AND OUTCOMES OF CHRONIC PERITONEAL DIALYSIS IN CHILDREN: INSIGHTS FROM THE INTERNATIONAL PEDIATRIC PERITONEAL DIALYSIS NETWORK REGISTRY

Background, Objectives, and Methods: The number of patients on chronic peritoneal dialysis (CPD) is increasing rapidly on a global scale. We analyzed the International Pediatric Peritoneal Dialysis Network (IPPN) registry, a global database active in 33 countries spanning a wide range in gross national income (GNI), to identify the impact of economic conditions on CPD practices and outcomes in children and adolescents.

Impact of Global Economic Disparities on Practices and Outcomes of Chronic Peritoneal Dialysis in Children: Insights from the International Pediatric Peritoneal Dialysis Network Registry

♦ Background, Objectives, and Methods: The number of patients on chronic peritoneal dialysis (CPD) is increasing rapidly on a global scale. We analyzed the International Pediatric Peritoneal Dialysis Network (IPPN) registry, a global database active in 33 countries spanning a wide range in gross national income (GNI), to identify the impact of economic conditions on CPD practices and outcomes in children and adolescents. ♦ Results: We observed close associations of GNI with the fraction of very young patients on dialysis, the presence and number of comorbidities, the prevalence of patients with unexplained causes of end-stage kidney disease, and the rate of culture-negative peritonitis. The prevalence of automated PD increased with GNI, but was 46% even in the lowest GNI stratum. The GNI stratum also affected the use of biocompatible peritoneal dialysis fluids, enteral tube feeding, calcium-free phosphate binders, active vitamin D analogs, and erythropoiesis-stimulating agents (ESAs). Patient mortality was strongly affected by GNI (hazard ratio per $10 000: 3.3; 95$18 000) had higher serum parathyroid hormone (PTH) and lower serum calcium, and achieved lower hemoglobin concentrations. No impact of GNI was observed with regard to CPD technique survival or peritonitis incidence. ♦ Conclusions: We conclude that CPD is practiced successfully, albeit with major regional variation related to economic differences, in children around the globe. The variations encompass the acceptance of very young patients and those with associated comorbidities to chronic dialysis programs, the use of automated PD and expensive drugs, and the diagnostic management of peritonitis. These variations in practice related to economic difference do not appear to affect PD technique survival; however, economic conditions seem to affect mortality on dialysis and standardized height, a marker of global child morbidity

Colostomy in children on chronic peritoneal dialysis

This study aimed to evaluate outcome of children on chronic peritoneal dialysis (PD) with a concurrent colostomy

Hyponatremia: a new predictor of mortality in patients with Shiga toxin-producing Escherichia coli hemolytic uremic syndrome

(1) Evaluate mortality rate in patients with Shiga toxin-producing Escherichia coli hemolytic uremic syndrome, (2) determine the leading causes of death, and (3) identify predictors of mortality at hospital admission. We conducted a multicentric, observational, retrospective, cross-sectional study. It included patients under 18 years old with Shiga toxin-producing Escherichia coli hemolytic uremic syndrome hospitalized between January 2005 and June 2016. Clinical and laboratory data were obtained from the Argentine National Epidemiological Surveillance System of Hemolytic Uremic Syndrome. Clinical and laboratory variables were compared between deceased and non-deceased patients. Univariate and multivariate analyses were performed. ROC curves and area under the curve were obtained. Seventeen (3.65%) out of the 466 patients died, being central nervous system involvement the main cause of death. Predictors of death were central nervous system involvement, the number of days since the beginning of diarrhea to hospitalization, hyponatremia, high hemoglobin, high leukocyte counts, and low bicarbonate concentration on admission. In the multivariate analysis, central nervous system involvement, sodium concentration, and hemoglobin were independent predictors. The best cut off for sodium was ≤ 128 meq/l and for hemoglobin ≥ 10.8 g/dl. Mortality was low in children with Shiga toxin-producing Escherichia coli hemolytic uremic syndrome, being central nervous system involvement the main cause of death. The best mortality predictors found were central nervous system involvement, hemoglobin, and sodium concentration. Hyponatremia may be a new Shiga toxin-producing Escherichia coli hemolytic uremic syndrome mortality predictor.Facultad de Ciencias Veterinaria

Research and practice on masonry cross vaults A review

[EN] Masonry cross vaults, which began to be built in Europe in the times of the Roman Empire and reached heights of extraordinary splendor during the Gothic Period, are part of an impressive architectural heritage, which stand in need of evaluation, maintenance and repairs or renovation. Nowadays, the requirements of preservation and conservation of the historical heritage call for a strategy oriented on the description of the structural behaviour from different characteristic perspectives without neglecting the functional, architectonic and structural features. The present paper is intended to discuss the different research approaches adopted by several authors during the past and to show how numerical simulations in conjunction with experimental studies can provide the tools for the quantification of the damages produced by a variety of different critical events. To this scope, this paper includes an extensive and somewhat ambitious review, dealing with a wide variety of aspects, such as: (a) a bibliometric study, (b) classification of the types of cross vaults, (c) structural behavior, (d) types of failures and damage, (e) numerical simulation, (f) experimental testing, (g) monitoring, and (h) retrofitting. The review is expected to be of great interest for architects and engineers working in the field of evaluating and retrofitting the architectural heritage, as well as to those researchers who would find it useful to have at hand in a single document the most important advances made in the field of masonry cross vaults in recent years.This work was carried out within the SIMAX Project (BIA2014-59036-R) financed by the Spanish Ministry for the Economy, Industry and Competitiveness. The authors wish to express their gratitude to the collaborators and participants of the SIMAX Project: Juan J. Moragues, Teresa M. Pellicer, Ignacio Paya-Zaforteza, Ignazio Floris, Manuel Buitrago, Benjamin Torres, Salvador Ivorra, David Bru, Michele Betti, Lorenzo Papini, Eugenio Pellis, Mercedes Gomez-Ferrer and Gabriele Milani. The first author (Elisa Bertolesi) would like to thank the Universitat Politecnica de Valencia for funding received for her postdoctoral grant (PAID-10-17).Bertolesi, E.; Adam, JM.; Rinaudo, P.; Calderón García, PA. (2019). Research and practice on masonry cross vaults A review. Engineering Structures. 180:67-88. https://doi.org/10.1016/j.engstruct.2018.10.085S678818

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

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Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field