High-Volume Peritoneal Dialysis in Acute Kidney Injury: Indications and Limitations

Background and objectives Peritoneal dialysis is still used for AKI in developing countries despite concerns about its limitations. The objective of this study was to explore the role of high-volume peritoneal dialysis in AM patients in relation to metabolic and fluid control, outcome, and risk factors associated with death.Design, setting, participants, & measurements A prospective study was performed on 204 AKI patients who were assigned to high-volume peritoneal dialysis (prescribed Kt/V=0.60/session) by flexible catheter and cycler; 150 patients (80.2%) were included in the final analysis.Results Mean age was 63.8 +/- 15.8 years, 70% of patients were in the intensive care unit, and sepsis was the main etiology of AKI (54.7%). BUN and creatinine levels stabilized after four sessions at around 50 and 4 mg/dl, respectively. Fluid removal and nitrogen balance increased progressively and stabilized around 1200 ml and -1 g/d after four sessions, respectively. Weekly delivered Kt/V was 3.5 +/- 0.68. Regarding AKI outcome, 23% of patients presented renal function recovery, 6.6% of patients remained on dialysis after 30 days, and 57.3% of patients died. Age and sepsis were identified as risk factors for death. In urine output, increase of 1 g in nitrogen balance and increase of 500 ml in ultrafiltration after three sessions were identified as protective factors.Conclusions High-volume peritoneal dialysis is effective for a selected AKI patient group, allowing adequate metabolic and fluid control. Age, sepsis, and urine output as well as nitrogen balance and ultrafiltration after three high-volume peritoneal dialysis sessions were associated significantly with death. Clin J Am Soc Nephrol 7: 887-894, 2012. doi: 10.2215/CJN.11131111

Superovulation in mares: Limitations and perspectives

Superovulation is an important tool for routine use in equine embryo transfer (ET) in order to reduce the costs and to enhance the efficiency of ET programs. Satisfactory superovulatory answers (2-7 ovulations) have been reported in mares treated with Equine Pituitary Extract (EPE) and more recently using a commercial Equine FSH. However, embryo recovery rates have been inconsistent and below expectations (20-50% embryos/ovulation). Recent studies have shown that superovulatory treatment leads to disturbances in oocyte maturation and transport, especially in mares with a high ovarian response. Higher and more consistent embryo recovery rates per ovulation have been observed in mares treated with lower doses of EPE. This paper presents a review of recent studies related to superovulation in mares.

pH-cycling models for in vitro evaluation of the efficacy of fluoridated dentifrices for caries control: strengths and limitations

Despite a plethora of in situ studies and clinical trials evaluating the efficacy of fluoridated dentifrices on caries control, in vitro pH cycling models are still broadly used because they mimic the dynamics of mineral loss and gain involved in caries formation. This paper critically reviews the current literature on existing pH-cycling models for the in vitro evaluation of the efficacy of fluoridated dentifrices for caries control, focusing on their strengths and limitations. A search was undertaken in the MEDLINE electronic journal database using the keywords "pH-cycling", "demineralization", "remineralization", "in vitro", "fluoride", "dentifrice". The primary outcome was the decrease of demineralization or the increase of remineralization as measured by different methods (e. g.: transverse microradiography) or tooth fluoride uptake. Inclusion of studies, data extraction and quality assessment were undertaken independently and in duplicate by two members of the review team. Disagreements were solved by discussion and consensus or by a third party. One hundred and sixteen studies were included, of which 42 addressed specifically the comparison of dentifrices using different pH-cycling models. The other studies included meta-analysis or reviews, data about the effect of different fluoride sources on de-remineralization, different methods for analysis de-remineralization and chemical variables and characteristics of dental hard tissues that might have influence on de-remineralization processes. Generally, the studies presented ability to detect known results established by clinical trials, to demonstrate dose-related responses in the fluoride content of the dentifrices, and to provide repeatability and reproducibility between tests. In order to accomplish these features satisfactorily, it is mandatory to take into account the type of substrate and baseline artificial lesion, as well as the adequate response variables and statistical approaches to be used. This critical review of literature showed that the currently available pH-cycling models are appropriate to detect dose-response and pH-response of fluoride dentifrices, and to evaluate the impact of new active principles on the effect of fluoridated dentifrices, as well as their association with other anti-caries treatments.

Photosynthetic limitations caused by different rates of water-deficit induction in Glycine max and Vigna unguiculata

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Fish assemblage structure and aquatic pollution in a Brazilian stream: some limitations of diversity indices and models for environmental impact studies

The aim of this study was to describe and quantify the effect of aquatic pollution on the fish assemblage structure of the Corumbatai River (Brazil), by comparing two sites with different water quality characteristics. The results revealed that abundance of individuals was low at the polluted site (B). However, the two sites did not differ significantly in species richness (total and average). This fact contradicts theories stating that portions where the transverse area of the channel is larger should present a higher biological richness. It was also observed that the ichthyofauna of site B had higher evenness, and, consequently, a tendency to a higher diversity than that at site A. This demonstrates that diversity estimates should be used cautiously in environmental impact studies, as they do not necessarily indicate better conditions of communities living in more preserved environments.

Potentialities and practical limitations of absolute neutron dosimetry using thin films of uranium and thorium applied to the fission track dating

Neutron dosimetry using natural uranium and thorium thin films makes possible that mineral dating by the fission-track method can be accomplished, even when poor thermalized neutron facilities are employed. In this case, the contributions of the fissions of (235)U, (238)U and (232)Th induced by thermal, epithermal and fast neutrons to the population of tracks produced during irradiation are quantified through the combined use of natural uranium and thorium films.If the Th/U ratio of the sample is known, only one irradiation (where the sample and the films of uranium and thorium are present) is necessary to perform the dating. However, if that ratio is unknown, it can be determined through another irradiation where the mineral to be dated and both films are placed inside a cadmium box.Problems related with film manufacturing and calibration are discussed. Special attention is given to the utilization of thin films having very low uranium content. The problems faced suggest that it may be better to substitute these films by uranium doped standard glasses calibrated with thicker uranium films (thickness greater than 1.5 x 10(13) mu m).

Documenting the advantages and limitations of different classes of molecular markers in a well-established phylogeographic context: lessons from the Iberian endemic Golden-striped salamander, Chioglossa lusitanica (Caudata: Salamandridae)

Previous analyses of mitochondrial (mt)DNA and allozymes covering the range of the Iberian endemic golden-striped salamander, Chioglossa lusitanica, suggested a Pleistocene split of the historical species distribution into two population units (north and south of the Mondego river), postglacial expansion into the northernmost extant range, and secondary contact with neutral diffusion of genes close to the Mondego river. We extended analysis of molecular variation over the species range using seven microsatellite loci and the nuclear P-fibrinogen intron 7 (beta-fibint7). Both microsatellites and beta-fibint7 showed moderate to high levels of population structure, concordant with patterns detected with mtDNA and allozymes; and a general pattern of isolation-by-distance, contrasting the marked differentiation of two population groups suggested by mtDNA and allozymes. Bayesian multilocus analyses showed contrasting results as populations north and south of the Douro river were clearly differentiated based on microsatellites, whereas allozymes revealed differentiation north and south of the Mondego river. Additionally, decreased microsatellite variability in the north supported the hypothesis of postglacial colonization of this region. The well-documented evolutionary history of C. lusitanica, provides an excellent framework within which the advantages and limitations of different classes of markers can be evaluated in defining patterns of population substructure and inferring evolutionary processes across distinct spatio-temporal scales. The present study serves as a cautionary note for investigations that rely on a single type of molecular marker, especially when the organism under study exhibits a widespread distribution and complex natural history. (C) 2008 The Linnean Society of London, Biological Journal of the Linnean Society, 2008, 95, 371-387.

Limitations of trust management schemes in VANET and countermeasures

Vehicular networks ensure that the information received from any vehicle is promptly and correctly propagated to nearby vehicles, to prevent accidents. A crucial point is how to trust the information transmitted, when the neighboring vehicles are rapidly changing and moving in and out of range. Current trust management schemes for vehicular networks establish trust by voting on the decision received by several nodes, which might not be required for practical scenarios. It might just be enough to check the validity of incoming information. Due to the ephemeral nature of vehicular networks, reputation schemes for mobile ad hoc networks (MANETs) cannot be applied to vehicular ad hoc networks (VANET). We point out several limitations of trust management schemes for VANET. In particular, we identify the problem of information cascading and oversampling, which commonly arise in social networks. Oversampling is a situation in which a node observing two or more nodes, takes into consideration both their opinions equally without knowing that they might have influenced each other in decision making. We show that simple voting for decision making, leads to oversampling and gives incorrect results. We propose an algorithm to overcome this problem in VANET. This is the first paper which discusses the concept of cascading effect and oversampling effects to ad hoc networks. © 2011 IEEE.

Limitations of enamel microabrasion technique applied in a pediatric patient: case report

Enamel microabrasion is a non-invasive method that removes intrinsic and superficial defects from teeth aimed to improve dental esthetic with minimal loss of dental tissue. This case presentation describes the attempt for teeth color correction utilizing that conservative technique in a young girl whose upper central incisor presented an opaque white stain. Scanning electron microscopy (SEM) was conducted in order to illustrate the glasslike luster and a smooth texture of microabraded enamel surface. The correct diagnosis of defect is a difficult task, when consider this conservative approach.

Unfavorable iliac artery anatomy causing access limitations during endovascular abdominal aortic aneurysm repair: application of the endoconduit technique

Endovascular aneurysm repair (EVAR) is already considered the first choice treatment for abdominal aortic aneurysms (AAA). Several different strategies have been used to address limitations to arterial access caused by unfavorable iliac artery anatomy. The aim of this report is to illustrate the advantages and limitations of each option and present the results of using the internal endoconduit technique and the difficulties involved.