Contrast-induced nephropathy.

Radiological procedures utilizing intravascular iodinated contrast media are being widely applied for both diagnostic and therapeutic purposes and represent one of the main causes of contrast-induced nephropathy (CIN) and hospital-acquired renal failure. Due to the lack of any effective treatment, prevention of this iatrogenic disease, which is associated with significant in-hospital and long-term morbidity and mortality and increased costs, is the key strategy. However, prevention of CIN continues to elude clinicians and is a major concern during percutaneous coronary interventions (PCI), as patients undergoing these procedures often have multiple comorbidities. The purpose of this article is to examine the pathophysiology, risk factors, and clinical course of CIN, as well as the most recent studies dealing with its prevention and potential therapeutic interventions, especially during PCI

Immediate replacement of fishing with dairying by the earliest farmers of the NE Atlantic archipelagos

The appearance of farming, from its inception in the Near East around 12 000 years ago, finally reached the northwestern extremes of Europe by the fourth millennium BC or shortly thereafter. Various models have been invoked to explain the Neolithization of northern Europe; however, resolving these different scenarios has proved problematic due to poor faunal preservation and the lack of specificity achievable for commonly applied proxies. Here, we present new multi-proxy evidence, which qualitatively and quantitatively maps subsistence change in the northeast Atlantic archipelagos from the Late Mesolithic into the Neolithic and beyond. A model involving significant retention of hunter–gatherer–fisher influences was tested against one of the dominant adoptions of farming using a novel suite of lipid biomarkers, including dihydroxy fatty acids, ω-(o-alkylphenyl)alkanoic acids and stable carbon isotope signatures of individual fatty acids preserved in cooking vessels. These new findings, together with archaeozoological and human skeletal collagen bulk stable carbon isotope proxies, unequivocally confirm rejection of marine resources by early farmers coinciding with the adoption of intensive dairy farming. This pattern of Neolithization contrasts markedly to that occurring contemporaneously in the Baltic, suggesting that geographically distinct ecological and cultural influences dictated the evolution of subsistence practices at this critical phase of European prehistory

Navigating the Academic Job Search for Environmental Engineers: Guidance for Job Seekers and Mentors

Students and postdoctoral associates interested in tenure-track environmental engineering positions have limited resources to aid them. The Student Services Committee (SSC) of the Association of Environmental Engineering and Science Professors (AEESP) organized a workshop to fill some of the need. Newly hired faculty and experienced search committee and department chairs shared information on how to create competitive applications. Students and postdoctoral associates were also provided with individualized feedback on their faculty application packages. Survey data were collected for all participants, and these data are presented in this paper along with tips shared during the workshop and information collected from the literature. The objective of this paper is to share that information (1) to inform applicants (students and postdoctoral associates) about the academic job search process, and (2) to inform mentors about how to mentor applicants. Survey responses revealed that participants felt they learned valuable information about the job search process. They found the personalized feedback on application packages to be the most helpful activity; other mentors are encouraged to provide similar personalized feedback. A wiki website component included in the workshop was effective at engaging the participants and helped broaden the impact beyond the workshop attendees. Key lessons learned by comparing workshop results with literature were the importance of fit, the unique diversity of environmental engineering, mentoring and networking, Ph.D. planning sessions, being informed, and becoming a more skilled candidate. The recommendations presented in this paper can be used by students, postdoctoral associates, and their mentors to facilitate the candidate’s path toward academia

A novel liposomal drug delivery system for PMMA bone cements

The population in developed countries is ageing and the number of people experiencing joint-related conditions, such as osteoarthritis, is expected to increase. Joint replacements are currently the most effective treatment for severe joint conditions and although many of these procedures are successful, infection developing after the procedure is still an issue, requiring complex and expensive revisions. Whilst incorporating a powdered antibiotic within the bone cement can reduce infection rates, the powder frequently agglomerates, resulting in poor antibiotic release characteristics and compromised mechanical performance of the cement. To overcome these issues, a novel delivery system consisting of antibiotic-loaded nano-sized liposomes was developed for inclusion into polymethyl methacrylate (PMMA) bone cement. This system was tested in a commercial cement (Palacos R) and consistently delivered a higher percentage (22%) of the incorporated antibiotic when compared to the powdered antibiotic cement (9%), meaning less antibiotic needs to be incorporated than with conventional cement. The novel system resulted in a controlled and gradual release of antibiotic over a longer, 30-day period and enhanced the toughness, bending strength and Vickers hardness of the cement, without altering its polymerization or molecular structure. This new material has the potential to significantly reduce infections in cemented joint replacements leading to enhanced patient quality of life and reduced healthcare costs

Dissociation of the diurnal variation of aldosterone and cortisol in anephric subjects

Dissociation of the diurnal variation of aldosterone and cortisol in anephric subjects. Diurnal variation of plasma aldosterone and cortisol concentration in man was studied in 13 anephric subjects and 7 normal subjects. All subjects were ambulatory and active throughout the study except during an 8-hour sleep period. Six anephric subjects received Kayexalate® (sodium polystyrene sulfonate) during the studies to prevent potassium accumulation and increase in plasma potassium concentration. Diurnal variation of plasma aldosterone concentration with peak and nadir concentrations at 12:00 noon and 12:00 midnight respectively was demonstrated in the studies on normal subjects. Changes in plasma aldosterone concentration were not significantly correlated with changes in plasma cortisol concentration but were highly correlated with changes in PRA (P < 0.001). There was a highly significant correlation between plasma aldosterone and potassium concentration in the anephric subjects studied without Kayexalate® administration (P < 0.001). In the anephric subjects who received Kayexalate®, plasma aldosterone and potassium concentration remained stable, and no correlation could be demonstrated. No diurnal variation of plasma aldosterone concentration could be demonstrated in either group of anephric subjects, whereas plasma cortisol concentration varied as in the studies on normal subjects. Conclusion. Diurnal variation of plasma aldosterone concentration is dependent on continued stimulation by the renin-angiotensin system. Loss of this stimulation has no demonstrable effect on the diurnal variation of plasma cortisol concentration.Dissociation des variations nycthémérales de l'aldostérone et du cortisol chez les sujets anéphriques. Les variations nycthémérales de l'aldostérone et du cortisol plasmatiques chez l'homme ont été étudiées chez 13 sujets anéphriques et 7 sujets normaux. Tous les sujets étaient ambulatoires excepté pendant une période de sommeil de 8 heures. Six sujets anéphriques receivaient du Kayexalate® (sodium polystyrene sulfonate) afin d'empêcher une accumulation de potassium et une augmentation de la kaliémie. Des variations nycthémérales de l'aldostéronémie avec un pic et un nadir à midi et minuit, respectivement, ont été observées chez les sujets normaux. Les modifications de l'aldostéronémie ne sont pas significativement corrélées avec les modifications du cortisol plasmatique mais très corrélées avec celles de PRA (P < 0,001). Il existe une corrélation très significative entre l'aldostéronémie et la kaliémie chez les sujets anéphriques étudiés en dehors de l'administration de Kayexalate (P < 0,001). Chez les sujets anéphriques recevant du Kayexalate l'aldostéronémie et la kaliémie sont stables et aucune corrélation n'est obtenue. Aucune variation nycthémérale de l'aldostéronémie n'a été observé dans les groupes de sujets anéphriques alors que la concentration de cortisol plasmatique varie comme chez les sujets normaux. Il peut être conclu de ces études que les variations nycthémérales de l'aldostéronémie dépendent de la stimulation par le système rénine-angiotensine. La perte de cette stimulation n'a pas d'effet sur la cortisolémie

Renal function during rofecoxib therapy in patients with metastatic cancer: retrospective analysis of a prospective phase II trial

German Clinical Trials Register DRKS: DRKS0000011