Background
This retrospective real-world study used data from two registries, International Pediatric Peritoneal Dialysis Network (IPPN) and International Pediatric Hemodialysis Network (IPHN), to ...characterize the efficacy and safety of continuous erythropoietin receptor activator (C.E.R.A.) in pediatric patients with chronic kidney disease (CKD) on peritoneal dialysis (PD) or hemodialysis (HD).
Methods
IPPN and IPHN collect prospective data (baseline and every 6 months) from pediatric PD and HD centers worldwide. Demographics, clinical characteristics, dialysis information, treatment, laboratory parameters, number and causes of hospitalization events, and deaths were extracted for patients on C.E.R.A. treatment (IPPN: 2007–2021; IPHN: 2013–2021).
Results
We analyzed 177 patients on PD (median age 10.6 years) and 52 patients on HD (median age 14.1 years) who had ≥ 1 observation while being treated with C.E.R.A. The median (interquartile range IQR) observation time under C.E.R.A. exposure was 6 (0–12.5) and 12 (0–18) months, respectively. Hemoglobin concentrations were stable over time; respective means (standard deviation) at last observation were 10.9 (1.7) g/dL and 10.4 (1.7) g/dL. Respective median (IQR) monthly C.E.R.A. doses at last observation were 3.5 (2.3–5.1) µg/kg, or 95 (62–145) µg/m
2
and 2.1 (1.2–3.4) µg/kg, or 63 (40–98) µg/m
2
. Non-elective hospitalizations occurred in 102 (58%) PD and 32 (62%) HD patients. Seven deaths occurred (19.8 deaths per 1000 observation years).
Conclusions
C.E.R.A. was associated with efficient maintenance of hemoglobin concentrations in pediatric patients with CKD on dialysis, and appeared to have a favorable safety profile. The current analysis revealed no safety signals.
Graphical abstract
A higher resolution version of the Graphical abstract is available as
Supplementary information
This study was designed to investigate the expression of HPV16 L1-protein in biopsies of oral mucosa samples. The expression of HPV16 L1 protein was investigated in biopsies taken from oral mucosa ...from patients who required pathological diagnosis of oral lesions. Seventy-two samples were incubated with anti-L1 protein monoclonal antibodies and protein detection was revealed with diaminobenzidine. Expression of L1 protein was performed by a pathologist blinded for tissue diagnosis under light microscopy. Most of the lesions of oral mucosa were present in lining mucosa (75 %) and the most frequent lesion were mucocele (n = 17, 23.6 %), epithelial hyperplasia (n = 6, 8.33 %), fibroma (n = 5, 6.9 %) and inflammatory hyperplasia (n = 5, 6.9 %). L1 protein expression was observed only in five (6.9 %) samples (two squamous cell carcinomas, two epithelial hyperplasia, and one gingival hyperplasia). We concluded that L1 expression in oral biopsies presented a low frequency in oral mucosal biopsies samples.
Introducción: El estudio de las actitudes hacia la homosexualidad y homoparentalidad ha empleado múltiples mecanismos para recolectar y analizar datos cuantitativos y cualitativos. En este artículo, ...se analizan los comentarios en redes sociales públicas que se suscitaron ante el estreno y la polémica alrededor de la escena de un beso entre dos mujeres en la película ‘Lightyear’ estrenada en 2022. El objetivo de este artículo fue identificar las actitudes y argumentos que las personas proveen para estar a favor o en contra de la homosexualidad y la homoparentalidad. Metodología: Se identificaron los medios de comunicación digitales y escritos en Ecuador que publicaron noticias alrededor de la película. Una vez identificadas las noticias, se extrajo una muestra de 707 comentarios y se procedió a realizar un análisis de contenido. Resultados: 335 comentarios fueron en contra, 23 a favor. Se identificaron 7 temas: resguardo a la infancia, aspectos sociales, imposición y adoctrinamiento, doble moral, argumentos religiosos, ambigüedad actitudinal, y reproducción biológica y naturaleza. Los argumentos revelan una alta preocupación por el bienestar de los niños que se relacionan con creencias relativas al origen de la orientación sexual, el rol de los adultos de cuidar a los niños contra lo que se considera anormal, así como el papel de las familias de filtrar el contenido que sus hijos deben ver. Discusión y conclusiones: Existe rechazo hacia la homosexualidad y la homoparentalidad que se fundamenta en visiones negativas de la diversidad sexual y familiar, teorías socialmente difundidas sobre la orientación sexual, el rol de la familia y el desarrollo de los niños.
Maternal sepsis Escobar, María Fernanda; Echavarría, María Paula; Zambrano, María Andrea ...
American journal of obstetrics & gynecology MFM,
08/2020, Letnik:
2, Številka:
3
Journal Article
Recenzirano
Maternal sepsis is "a life-threatening condition defined as an organ dysfunction caused by an infection during pregnancy, delivery, puerperium, or after an abortion," with the potential to save ...millions of lives if a proper approximation is made. Undetected or poorly managed maternal infections can lead to sepsis, death, or disability for the mother, and an increased likelihood of early neonatal infection and other adverse outcomes. Physiological, immunologic, and mechanical changes that occur in pregnancy make pregnant women more susceptible to infections than nonpregnant women and may obscure signs and symptoms of infection and sepsis, resulting in a delay in the recognition and treatment of sepsis. Prioritization of the creation and validation of tools that allow the development of clear and standardized diagnostic criteria of maternal sepsis and septic shock, according to the changes inherent to pregnancy, correspond to highly effective strategies to reduce the impact of these conditions on maternal health worldwide. After an adequate diagnostic approach, the next goal is achieving stabilization, trying to stop the progression from sepsis to septic shock, and improving tissue perfusion to limit cell dysfunction. Management protocol implementation during the first hour of treatment will be the most important determinant for the reduction of maternal mortality associated with sepsis and septic shock.
Introducción: Las Unidades de Cuidado Intensivo (UCI) son servicios especializados en la atención de pacientes críticos. La hospitalización de una paciente afecta directamente el estado de salud de ...sus familiares, por lo tanto, se requiere de una intervención psicoeducativa que reduzca el efecto ocasionado en las familias favoreciendo el afrontamiento y la adaptación. Objetivo: Determinar los componentes con mayor consenso entre expertos para operacionalizar la intervención psicoeducativa que mejore el afrontamiento y la adaptación en familiares de pacientes hospitalizados en la UCI. Método: Estudio primario, cuantitativo y descriptivo, realizado a través de la técnica Delphi, por medio una única ronda entre profesionales de la salud con experiencia mayor a dos años en atención de pacientes críticos o investigación en esta área. Resultados: Se obtuvieron 14 ítems distribuidos de la siguiente manera: matriz de componentes (3 ítems) y protocolo de la intervención (11 ítems). El 7.14% de los ítems logró un consenso total, el 85.7% aceptable y solo el 7.14% de los ítems no alcanzó un consenso. Discusión: Los componentes, actividades y acciones propuestas en la intervención psicoeducativa a través de la matriz de componentes como el protocolo de intervención, según el consenso de expertos es pertinente, congruente, factible y genera impacto, lo cual permite mejorar el afrontamiento y adaptación de familiares de pacientes hospitalizados en UCI. Conclusiones: La intervención requiere ser validada por medio de una prueba piloto y un estudio cuasi-experimental que permita medir el impacto de éstos resultados.
Acute leukemias (AL) are aggressive neoplasms with high mortality rates. Metabolomics and oxidative status have emerged as important tools to identify new biomarkers with clinical utility. To ...identify the metabolic differences between healthy individuals (HI) and patients with AL, a multiplatform untargeted metabolomic and lipidomic approach was conducted using liquid and gas chromatography coupled with quadrupole-time-of-flight mass spectrometry (LC-QTOF-MS or GC-QTOF-MS). Additionally, the total antioxidant capacity (TAC) was measured. A total of 20 peripheral blood plasma samples were obtained from patients with AL and 18 samples from HI. Our analysis revealed 135 differentially altered metabolites in the patients belonging to 12 chemical classes; likewise, the metabolic pathways of glycerolipids and sphingolipids were the most affected in the patients. A decrease in the TAC of the patients with respect to the HI was evident. This study conducted with a cohort of Colombian patients is consistent with observations from other research studies that suggest dysregulation of lipid compounds. Furthermore, metabolic differences between patients and HI appear to be independent of lifestyle, race, or geographic location, providing valuable information for future advancements in understanding the disease and developing more global therapies.
Individual tree attributes, such as stem volume and biomass, are usually predicted by using traditional field-derived allometric models. However, these models are derived from data collected from ...small areas and lack a level of detail of tree components (e.g., stem, branches, and leaves). Remote sensing techniques such as the Quantitative Structure Modelling (QSM) applied on high-density LiDAR data emerge as a promising solution for obtaining extensive and detailed tree attribute estimates. We used a high-density LiDAR data on board of a Unmanned Aerial Vehicle (UAV) to evaluate the performance of the QSM approach in estimating field-derived individual tree attributes such as the diameter at breast height (dbh), tree height (ht), and volume (v), as well as the stem (SAGB), branch (BAGB), and total (TAGB) aboveground biomass of eucalyptus trees. QSM was used in two different approaches: (i) using dbh and h derived from QSM and then applied into the field-based equations for estimation of volume and (ii) deriving tree volume directly from QSM. In general, all fitted models using the QSM approach were satisfactory, but with a slight tendency of over-estimation of dbh (9.33%), ht (12.40%), v-QSM1 (26.35%), v-QSM2 (26.66%), TAGB (27.08%), SAGB (25.57%), and BAGB (20.08%). Non-significant differences were noticed when estimating the dbh, tree volume, stem, and aboveground biomass. Despite the overestimation, this study indicates that using the QSM approach to estimate individual tree attributes from UAV-LiDAR is a promising alternative to support the decision-making process regarding forest management activities, especially when considering tree architecture and biomass components.