4 resultados para Dialysis Technique Failure

em Archivo Digital para la Docencia y la Investigación - Repositorio Institucional de la Universidad del País Vasco


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[ES] A fin de garantizar el aprovechamiento deun recurso renovable como la madera, en un momento de retroceso forestal y escasez de materiales, los habitantes de la provincia de Guipúzcoa, ante lo exiguo de su territorio, arbitraron un sistema que permitió combinar las necesidades y demandas de actividades tan dispares como la ganadería, el consumo doméstico, la siderurgia o la construcción naval. El presente artículo pretende analizar el origen, desarrollo y desaparición de los trasmochos guiados y describir su técnica en el territorio guipuzcoano. A falta de mayores evidencias, parece que la técnica del trasmochado o desmochado guiado inició su andadura en la Baja Edad Media, aunque hasta las primeras décadas del siglo XVI no existen datos documentales de su utilización en territorio guipuzcoano. Su generalización en todo el territorio guipuzcoano no parece producirse definitivamente hasta finales del siglo XVII, aunque para entonces se venía aplicando en la costa y el sector oriental de la reclamaciones de las autoridades reales y territoriales, la obligación de dejar horca y pendón se encontró con la oposición de carboneros y ferrones, quienes trasmochaban los árboles pero sin guiarlos, perjudicando de ese modo a las autoridades e intereses de la Marina Real. Precisamente el incumplimiento de las ordenanzas fue lo que provocó la aparición de dos modelos, con usos diferenciados: trasmochos sin guiar y trasmochos guiados. A lo largo del siglo XIX dicha técnica se fue perdiendo, coincidiendo con la paulatina desaparición de la construcción naval en madera.

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Background: Poor outcomes of invasive candidiasis (IC) are associated with the difficulty in establishing the microbiological diagnosis at an early stage. New scores and laboratory tests have been developed in order to make an early therapeutic intervention in an attempt to reduce the high mortality associated with invasive fungal infections. Candida albicans IFA IgG has been recently commercialized for germ tube antibody detection (CAGTA). This test provides a rapid and simple diagnosis of IC (84.4% sensitivity and 94.7% specificity). The aim of this study is to identify the patients who could be benefited by the use of CAGTA test in critical care setting. Methods: A prospective, cohort, observational multicentre study was carried out in six medical/surgical Intensive care units (ICU) of tertiary-care Spanish hospitals. Candida albicans Germ Tube Antibody test was performed twice a week if predetermined risk factors were present, and serologically demonstrated candidiasis was considered if the testing serum dilution was >= 1: 160 in at least one sample and no other microbiological evidence of invasive candidiasis was found. Results: Fifty-three critically ill non-neutropenic patients (37.7% post surgery) were included. Twenty-two patients (41.5%) had CAGTA-positive results, none of them with positive blood culture for Candida. Neither corrected colonization index nor antifungal treatment had influence on CAGTA results. This finding could corroborate that the CAGTA may be an important biomarker to distinguish between colonization and infection in these patients. The presence of acute renal failure at the beginning of the study was more frequent in CAGTA-negative patients. Previous surgery was statistically more frequent in CAGTA-positive patients. Conclusions: This study identified previous surgery as the principal clinical factor associated with CAGTA-positive results and emphasises the utility of this promising technique, which was not influenced by high Candida colonization or antifungal treatment. Our results suggest that detection of CAGTA may be important for the diagnosis of invasive candidiasis in surgical patients admitted in ICU.

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190 p.