46 research outputs found
Adenosine and dialysis hypotension
No full textIn this issue, Imai et al. report the results of a double-blind placebo-controlled study on the effect of an adenosine A1 receptor antagonist, FK352, on the incidence of dialysis hypotension in hypotension-prone patients. This Commentary discusses the use of selective adenosine A1 receptor antagonists for the prevention of dialysis hypotension from the perspective of the potential role of adenosine in its pathogenesis
Effects of relative blood volume-controlled hemodialysis on blood pressure and volume status in hypertensive patients
No full textIn hypertensive hemodialysis (HD) patients, dry weight reduction to normalize blood pressure (BP) often results in increased frequency of HD hypotension. Because HD with blood volume tracking (BVT) has been shown to improve intra-HD hemodynamic stability, we performed a prospective, randomized study to test whether BVT is more effective than standard hemodialysis (SHD) in the management of hypertension by dry weight reduction. After a run-in period of 4 weeks on SHD, 28 patients were randomly assigned for a 12-week treatment period with either SHD (n = 14) or BVT (n = 14). The mean pre-HD and post-HD weight did not change over time in either group. In the BVT group, pre-HD systolic and diastolic BP decreased on average 22.5 mm Hg and 8.3 mm Hg, respectively (both p < 0.05), whereas BP did not change in the SHD group. Extracellular water and cardiothoracic ratio decreased significantly (all p < 0.05) in the BVT group but not in the SHD group. Brain natriuretic peptide levels declined only in the BVT group, without reaching statistical significance. The frequency of HD hypotensive episodes decreased significantly (p < 0.05) in the BVT group and was unchanged in the SHD group. HD with BVT was associated with a significant reduction in pre-HD BP. At the same time, the frequency of intra-HD hypotensive episodes decreased. Although the mean weight did not change, the reductions in cardiothoracic ratio and extracellular water suggest that HD with BVT resulted in optimization of volume status
L'autre: essentiel pour le moi? Stratégies de survie aux traumatismes caribéens
No full textIn my Master thesis I focus on the novels Le Livre d’Emma and Un Alligator nommé Rosa, by Canadian-Haitian author Marie-Célie Agnant. The protagonists, Emma Bratte and Antoine Guibert are both traumatized; Emma by slavery, the Middle Passage, and the curse that pursues the black woman, Antoine by the murder of his family by the “fillettes-lalos”, who were part of “les militaires volontaires”, a branch of the armed forces under Haitian tyrant François Duvalier’s regime. In these novels the relations between history and memory, and memory and identity are problematized through the issue of trauma. The acts of telling and testifying also take a central role. The main characters are enraged by the trauma and injustices they have experienced (and still experience) and wish to unveil by way of their accounts (testimony) and counter-histories (memory). They are trapped in the past, incapable of confronting let alone transcending their traumas. Their being trapped in the past and/or in their traumatic experiences prevents them from constructing a “self” beyond the trauma and victimhood. Memorial traces (after Édouard Glissant’s “La Trace”) become important, as they are used by the protagonists to (re)construct the past and to construct an identity. The concept of “narration de soi” or narrative identity by Paul Ricoeur is important in relation to this, as it helps us understand how we construct our identities. A relation to an Other is essential, as he/she listens to the stories the traumatized person tells, confirms the identity the traumatized person constructs while telling, and can help transform their traumas into an “élan vital”. The central question of my thesis is “Which strategies do Agnant’s characters have (or develop) to construct an identity beyond trauma?”
Rather than simply exploring trauma, Agnant also examines what comes after trauma. In her novels, she creates a Haitian “réseau de traces”. Whereas recent Haitian history is much talked about and explored by Haitian authors in their novels, the colonial period sometimes seems absent. Agnant provides new perspectives and adds a new corpus by integrating these parts of history into her corpus
Celtis dioica Moore 1911
No full text<p> <i>Celtis dioica</i> Moore (1911: 204).</p> <p> <b>Type:</b> — AFRICA. Southern Rhodesia [currently Zimbabwe], Chirinda forest, 8 October 1906, fl., <i>C.F.M. Swynnerton 108</i> (<b>lectotype, designated here</b>, BM barcode 000757267!; isolectotypes B barcode 10 0057862!, BM barcode 000757266!, K barcode 001291906!, K barcode 001291907!, K barcode 000243040!, K barcode 000442487!).</p> <p> <b>Nomenclatural notes:</b> —When describing <i>C. dioica</i>, Moore (1911: 205) cited collection “n. 108” without specifying the collector and herbarium in which specimens were conserved. Even if the author has not mentioned the collector and the herbarium of deposit, this information can be obtained in this same publication. Moore (1911: 15) mentions that the collections belong to C.F.M. Swynnerton and that the types are deposited in BM. Moore (1911) mentioned the number of the collector, and the herbarium of deposit for the type material (BM herbarium), however, because there are two sheets in BM. We therefore designate the specimen in Herb. BM with barcode 000757267 as lectotype (ICN Art. 9.3), because this specimen is the only one with leaves, flowers, and fruits.</p> <p> <b>Taxonomic notes:</b> —Synonym of <i>Sparrea gomphophylla</i> (Fu <i>et al.</i> 2022).</p>Published as part of <i>Zamengo, Henrique Borges, Chamorro, Debora, Gaglioti, André Luiz & Pederneiras, Leandro Cardoso, 2023, Nomenclatural revision of the names of Celtis (Cannabaceae) described for Africa, and lectotypification of one Asian name, pp. 205-223 in Phytotaxa 603 (3)</i> on page 210, DOI: 10.11646/phytotaxa.603.3.1, <a href="http://zenodo.org/record/8166665">http://zenodo.org/record/8166665</a>
Pitfalls when comparing COVID-19-related outcomes across studies-lessons learnt from the ERACODA collaboration
No full textContains fulltext :
232487.pdf (Publisher’s version ) (Open Access)Reported outcomes, such as incidence rates of mortality and intensive care unit admission, vary widely across epidemiological coronavirus disease 2019 (COVID-19) studies, including in the nephrology field. This variation can in part be explained by differences in patient characteristics, but also methodological aspects must be considered. In this review, we reflect on the methodological factors that contribute to the observed variation in COVID-19-related outcomes and their risk factors that are identified in the various studies. We focus on issues that arose during the design and analysis phase of the European Renal Association COVID-19 Database (ERACODA), and use examples from recently published reports on COVID-19 to illustrate these issues
Clinical triage of patients on kidney replacement therapy presenting with COVID-19: an ERACODA registry analysis
No full textRationale & Objective. Patients on kidney replacement therapy (KRT) are at a very high risk of COVID-19. Triage pathway for KRT patients presenting with varying severity of COVID-19 illness remains ill-defined. We studied clinical characteristics of patients at initial and subsequent hospital presentations and its impact on patient outcomes.
Study Design, Setting, Participants. European Renal Association COVID-19 Database (ERACODA) was analysed for clinical and laboratory features of 1423 KRT patients with COVID-19 either hospitalized or non-hospitalized during first presentation and those representing after non-admission at initial triage. Predictors of outcomes (Hospitalisation, 28-day mortality) were determined for those not hospitalized at first presentation.
Results. Amongst 1423 KRT patients with COVID-19 (Hemodialysis=1017/Transplant=406), 25% (n=355) were not hospitalized at first presentation (30% Hemodialysis/13% Transplant). Of these non-hospitalized patients, 10% (n=36) re-presented second time, with a 5-day median interval between two presentations (Interquartile interval 2-7 days). Patients who re-presented had worsening respiratory symptoms, a fall in oxygen saturation (97% vs. 90%) and rise in C-reactive protein between attendances (26 vs. 73 mg/L). Patients on second presentation were older (72 vs. 63 years), had early respiratory symptoms and lung imaging abnormalities compared with those who did not return second time. The 28-day mortality for those admitted at first or second presentations was not significantly different (25% vs. 29%, p=0.6). Higher age, prior smoking history, higher clinical frailty score and self-reported shortness of breath at first presentation, were identified as predictors of mortality in those discharged at initial triage.
Conclusions. The study provides evidence that KRT patients with COVID-19 and mild pulmonary abnormalities with lack of pulmonary insufficiency can be safely discharged, with vigilance of respiratory symptoms, especially in those with risk factors for poor outcomes. Our findings support a risk-stratified clinical approach to admissions and discharges of KRT patients presenting with COVID-19, to aid clinical triage and optimise resource utilisation during the ongoing pandemic
Monitoring van de effecten van de verruiming 48'/43': MOVE-rapport 8, Deel B: Hoofdrapport
No full textIn 1995 kwamen Vlaanderen en Nederland overeen dat de vaargeul naar Antwerpen verruimd zou worden tot 48/43/38 voet. Dit betekent dat schepen met een maximale diepgang van 48 voet (1 voet is circa 0,3 meter) in één getij naar Antwerpen kunnen varen en dat schepen met een maximale diepgang van 43 voet in één getij vanuit Antwerpen de Westerschelde af kunnen varen. Schepen met een diepgang van 38 voet kunnen onafhankelijk van het getij op de Westerschelde varen. Het verruimingsverdrag voorziet naast de verruimingswerkzaamheden ook in wrakkenberging, aanleg van geulwandverdedigingen en een natuurcompensatieprogramma. Tussen juli 1997 en juli 1998 is deze vaarwegverruiming in de Westerschelde (kortweg de verruiming 48\u92/43\u92) uitgevoerd. Dit rapport beschrijft de evaluatie van de effecten van deze verruiming en de bijbehorende bagger-, stort- en zandwinstrategie. Beide evaluaties zijn gebaseerd op meetgegevens die ondermeer in het kader van het project MOVE (Monitoring Verruiming Westerschelde) zijn verzameld. MOVE is in 1996 door de beheerder van de Westerschelde, Rijkswaterstaat Directie Zeeland, opgezet en wordt in 2006 afgerond met een eindevaluatie. De MOVE evaluatierapportage 2003 is een tussenevaluatie en heeft de volgende doelstellingen: 1 Het signaleren van ontwikkelingen in de Westerschelde om daarmee de effecten van de verruiming 48\u92/43\u92 te evalueren. 2 Het evalueren van de effecten van de bagger-, stort- en zandwinstrategie. Hieronder staan de belangrijkste conclusies van de MOVE evaluatie 2003: - Waterstanden in het oostelijk deel zijn veranderd zoals verwacht - Morfologie, van met name platen en ondiep water, is veranderd, maar anders dan verwacht - Het MOVE Fysisch denkmodel lijkt te kloppen m.b.t. waterbeweging, maar niet voor de morfologie - Er zijn (nog) geen effecten t.g.v. verruiming 48'/43' waarneembaar m.b.t. biologie/ecologie - De waterkwaliteit is waarschijnlijk niet beïvloed door de verruiming 48'/43' - Behoud van het meergeulenstelsel bij het huidige vaarwegonderhoud is nog mogelijk - Er is geen relatie gevonden tussen de omvang van het onderhoudsbaggerwerk van de drempel en de omvang van het gestorte materiaal nabij de drempel - De toename van omvang onderhoudsbaggerwerk is vooral een gevolg van vaarwegverbreding - Westerschelde blijkt een zandexporterend systeem te zijn gewordenZeemov
COVID-19 Pandemic Waves and Mortality Among Patients on Kidney Replacement Therapy
No full textCOVID-19; Dialysis; MortalityCOVID-19; Diálisis: MortalidadCOVID-19; Diàlisi; MortalitatThis work was supported with unrestricted grants from European Renal Association (ERA), Nierstichting (Dutch Kidney Foundation), Baxter, and Sandoz unrestricted research grants
