1,721,291 research outputs found
Decongestion in patients with advanced chronic kidney disease coexisting with heart failure
No full textHeart failure (HF) and chronic kidney disease (CKD) are closely interconnected conditions. Congestion, a central element in HF and CKD pathophysiology, progresses from haemodynamic changes to pulmonary oedema, with asymptomatic pulmonary congestion and an isolated increase in brain natriuretic peptide (BNP) as an intermediate step. Management strategies include sodium restriction, diuretics and emerging technologies for fluid monitoring. Diuretics, while essential, present challenges such as resistance and side effects, necessitating combination therapies and alternatives, like SGLT-2 inhibitors and, in special cases, ultrafiltration. Personalized approaches are critical to improving clinical outcomes in HF and CKD
Advanced chronic kidney disease coexisting with heart failure: navigating patients' management
No full textChronic kidney disease (CKD) and heart failure (HF) are interrelated, mutually exacerbating conditions. HF in patients with moderate to severe CKD poses unique clinical problems. Indeed, considerations related to specific concomitant derangements, such as vascular calcification, inflammation, and proteinuria, inform and demand personalized treatment strategies. Pharmacological interventions, including renin–angiotensin system antagonists, sodium-glucose cotransporter 2 (SGLT2) inhibitors and novel mineralocorticoid receptor blockers are valuable in managing these complex conditions, although frequently difficult or impossible to use in advanced kidney disease. Precision medicine, innovative treatments, and the incorporation of digital health tools, artificial intelligence, remote monitoring, and advanced imaging techniques into patient care are redesigning the scenario of HF associated with CKD. AI-driven predictive analytics for early detection of decompensation, telemedicine for remote consultations, and electronic health records with decision-support systems. These innovations enhance personalized treatment, improve early intervention, and optimize disease management, ultimately leading to better outcomes for patients with HF and CKD. Collaborative care models are being implemented and evaluated to advance the management of such conditions. Thus, the integration of novel therapeutic approaches and personalized medicine holds promise for improving patient outcomes, while ongoing research is essential to enabling innovation in this area. Here we review the current management of concomitant kidney disease and HF, highlighting areas for proposed future refinements
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Management of membranoproliferative glomerulonephritis: Evidence-based recommendations
No full textManagement of membranoproliferative glomerulonephritis: Evidence-based recommendations. Idiopathic membranoproliferative glomerulonephritis (MPGN) is one of the least common types of GN. This article critically evaluates the literature and generates evidence-based recommendations for the management of idiopathic MPGN. For all age groups, for idiopathic MPGN with normal renal function and asymptomatic nonnephrotic range proteinuria, no specific therapy is necessary (grades B and C). Close follow-up every three to four months, with specific attention to renal function, proteinuria, and blood pressure control, is recommended. In children with MPGN and nephrotic syndrome and/or impaired renal function, a trial of steroids is warranted (grade A). The best data suggest high-dose, alternate-day steroids for a period of 6 to 12 months (40 mg/m2 on alternate days). If no benefit is seen, discontinuation with close follow-up and attention to conservative treatment (that is, blood pressure control, use of agents to reduce proteinuria, and correction of metabolic abnormalities) is recommended. In adults with MPGN, impaired renal function, and/or nephrotic-range proteinuria, a trial of aspirin (325mg daily), dipyridamole (75 to 100 mg tid), or a combination of the two for 12 months is reasonable (grade B). Again, if no benefits are seen, the treatment should be stopped. Attention to factors known to delay the progression of renal decline and close follow-up should be part of the treatment plan (grades B and C)
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Anemia and left ventricular hypertrophy in chronic kidney disease populations: A review of the current state of knowledge
No full textAnemia and left ventricular hypertrophy in chronic kidney disease populations: A review of the current state of knowledge. The increasing awareness of the high prevalence of cardiovascular disease (CVD) in the dialysis population has led clinical nephrologists and researchers to focus their attention on processes and factors that are present in patients prior to dialysis. It is clear that many of the risk factors for kidney disease and cardiovascular disease are similar: This may account for the high prevalence of CVD within the dialysis population. However, it is evident that there are unique risk factors for CVD that are present in patients with chronic kidney disease (CKD). These unique uremia-related risk factors for CVD include anemia, hyperparathyroidism, abnormalities of mineral metabolism, and acidosis. Of note, the association of anemia, or lower levels of hemoglobin, have been consistently described in all populations with kidney disease. Left ventricular hypertrophy has long been known as an independent risk factor for death and CV events, in both the dialysis and general populations. There have been accumulating data that LVH and left ventricular (LV) growth occur prior to dialysis in patients with kidney disease, and that the prevalence of LVH in that group of patients is caused by, conventional risk factors for LVH (e.g., hypertension) as well as nonconventional risk factors such as anemia.1-4
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