A subset of low density granulocytes is associated with vascular calcification in chronic kidney disease patients

Inflammation is central to chronic kidney disease (CKD) pathogenesis and vascular outcomes, but the exact players remain unidentified. Since low density granulocytes (LDGs) are emerging mediators in inflammatory conditions, we aimed to evaluate whether LDGs may be altered in CKD and related to clinical outcomes as biomarkers. To his end, LDGs subsets were measured in peripheral blood by flow cytometry and confocal microscopy in 33 CKD patients undergoing peritoneal dialysis and 15 healthy controls (HC). Analyses were replicated in an additional cohort. DEF3 (marker of early granulopoiesis) gene expression on PBMCs was quantified by qPCR. Total CD15+ LDGs and both CD14lowCD16+ and CD14−CD16− subsets were expanded in CKD. The relative frequency of the CD14−CD16− subpopulation was higher among the CD15+ pool in CKD. This alteration was stable over-time. The increased CD14−CD16−CD15+ paralleled Kauppila scores and DEF3 expression, whereas no association was found with CD14lowCD16+ CD15+. Both subsets differed in their CD11b, CD10, CD35, CD31, CD62L, IFNAR1 and CD68 expression, FSC/SSC features and nuclear morphology, pointing to different origins and maturation status. In conclusion, LDGs were expanded in CKD showing a skewed distribution towards a CD14−CD16−CD15+ enrichment, in association with vascular calcification. DEF3 expression in PBMC can be a marker of LDG expansion.Fil: Rodríguez Carrio, Javier. Hospital Universitario Central de Asturias. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA). Bone and Mineral Research Unit; España. Universidad de Oviedo; EspañaFil: Carrillo López, Natalia. Hospital Universitario Central de Asturias; EspañaFil: Ulloa, Catalina. Hospital Universitario Central de Asturias; EspañaFil: Seijo, Mariana. Hospital Universitario Central de Asturias; España. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; ArgentinaFil: Rodríguez García, Minerva. Hospital Universitario Central de Asturias; EspañaFil: Rodríguez Suárez, Carmen. Hospital Universitario Central de Asturias; EspañaFil: Díaz-Corte, Carmen. Hospital Universitario Central de Asturias; EspañaFil: Cannata Andía, Jorge B.. Universidad de Oviedo; España. Hospital Universitario Central de Asturias; EspañaFil: Suárez, Ana. Universidad de Oviedo; EspañaFil: Dusso, Adriana. Hospital Universitario Central de Asturias; Españ

Effectiveness and safety of the early use of Surfacen ® in preterms new-born with syndrome of respiratory difficulty

Se realizó un estudio en el servicio de Neonatología del Hospital General Docente de Guantánamo “Dr. Agostinho Neto” con el objetivo de evaluar la efectividad y seguridad del inicio temprano del uso del Surfacen® en recién nacidos pretérminos en el período octubre de 2010 hasta agosto de 2011. Se evaluaron 81 recién nacidos, de estos 9 cumplieron con los criterios de inclusión. Las variables estudiadas fueron: necesidad de ventilación prolongada, tiempo total de ventilación, complicaciones de la ventilación, estadía en la unidad de cuidados intensivos y eventos adversos. Se encontró que el 66.6 % estuvo ventilándose menos de 7 días. La estadía en Unidad de Cuidados Intensivos fue como promedio 14 días. Los eventos adversos acontecidos no tuvieron relación de causalidad con el producto en investigación y sólo en uno de los casos esta condujo a la muerte.A study is done in the service of Neonatology at the General Hospital of Guantánamo with the target to evaluate the effectiveness and safety of the early beginning of the use of the Surfacen ® in new-born preterms from October, 2010 to August, 2011. 81 newborn babies are evaluated, of these 9 of them were  integrated  with the inclusion criteria. The studied variables are: need for long ventilation, entire ventilation time, complications of the ventilation, demurrage in the intensive care unit and adverse events. It was  found that 66.6 % of them were  ventilated less than 7 days. The demurrage in Intensive care unit was like an average in  14 days. The happened adverse events have not  causality relation with the product in investigation and only in one of the cases was drove to the death

Survival with low- and high-flux dialysis

FUNDING COSMOS is sponsored by the Bone and Mineral Research Unit (Hospital Universitario Central de Asturias), SAFIM (Sociedad Asturiana Fomento Investigaciones O´ seas), the European Renal Association–European Dialysis and Transplant Association, the National Program of I þ D þ I 2008–2011 and Instituto de Salud Carlos III (ISCIII), the ISCIII Retic REDinREN (RD06/0016/1013, RD12/0021/0023 and RD16/ 0009/0017), the ISCIII (ICI14/00107, PI17/00384 and PI20/ 00633), Fondo Europeo de Desarrollo Regional (FEDER), Plan Estatal de I þ D þ I 2013–2016, Plan de Ciencia, Tecnologia e Innovacion 2013–2017 y 2018–2022 del Principado de Asturias (GRUPIN14-028, IDI-2018-000152), Fundacio´n Renal I ´nigo A ~ ´ lvarez de Toledo (FRIAT) and the Spanish Society of Nephrology (Estudio Estrate´gico de la SEN). Logistics (meetings, secretarial help, printing of materials, development of website for data entry, etc.) have been financially supported by AMGEN Europe and FRIAT. The authors are not aware of any additional relationships, funding or financial holdings that might be perceived as affecting the objectivity of this study. COSMOS participating centres: see Supplementary Appendix.Background. Besides advances in haemodialysis (HD), mortality rates are still high. The effect of the different types of HD membranes on survival is still a controversial issue. The aim of this COSMOS (Current management Of Secondary hyperparathyroidism: a Multicentre Observational Study) analysis was to survey, in HD patients, the relationship between the use of conventional low- or high-flux membranes and all-cause and cardiovascular mortality. Methods. COSMOS is a multicentre, open-cohort, 3-year prospective study, designed to evaluate mineral and bone disorders in the European HD population. The present analysis included 5138 HD patients from 20 European countries, 3502 randomly selected at baseline (68.2%), plus 1636 new patients with <1 year on HD (31.8%) recruited to replace patients who died, were transplanted, switched to peritoneal dialysis or lost to follow-up by other reasons. Cox-regression analysis with timedependent variables, propensity score matching and the use of an instrumental variable (facility-level analysis) were used. Results. After adjustments using three different multivariate models, patients treated with high-flux membranes showed a lower all-cause and cardiovascular mortality risks fhazard ratio (HR) = 0.76 [95% confidence interval (CI) 0.61-0.96] and HR = 0.61 (95% CI 0.42-0.87), respectivelyg, that remained significant after matching by propensity score for all-cause mortality (HR = 0.69, 95% CI 0.52-0.93). However, a facility-level analysis showed no association between the case-mix-adjusted facility percentage of patients dialysed with high-flux membranes and all-cause and cardiovascular mortality. Conclusions. High-flux dialysis was associated with a lower relative risk of all-cause and cardiovascular mortality. However, dialysis facilities using these dialysis membranes to a greater extent did not show better survival.publishersversionpublishe

Pharmaceutical and Botanical Management of Pain Associated with Psychopathology: A Narrative Review

Generally, pain can be described as an unpleasant sensory or emotional experience associated with tissue damage. Chronic pain has become a public health problem because among 35 and 75% of the world population has shown the symptom. In particular, neuropathic pain has shown high comorbidity disorders such as anxiety and depression. Conventional therapies for treating pain include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, tricyclic antidepressants, anticonvulsants, and opioids, which usually cause some side effects such as gastritis, headache, liver and kidney toxicity, and drug dependence. Conventional pharmaceuticals also tend to be expensive, and they cannot be easily afforded in developing countries, which have led to the use of natural products as an alternative treatment. In this chapter, we reviewed the current research of natural products for pain treatment. We also describe preclinical studies that assess the effect of some natural products on pain therapy, phytochemistry research, toxicity, adverse effects, and biosecurity. We also describe how conventional pain is managed and the possible use of compounds obtained from vegetable species for pain treatment