La Restless Legs Syndrome aumenta il rischio cardiovascolare e la mortalità a breve termine nei pazienti emodializzati

Abstract Restless legs syndrome (RLS) is a sensori-motor neurological disorder characterzed by paraesthesia, dysaesthesia and irresistibile urge to move the legs especially at night. Its prevalence is much higher among dialysis patients at 12 to 62% compared to 3 to 9% in the general population. In our study we investigated the association between RLS and cardiovascular events risk and laboratory parameters in End-stage kidney disease (ESKD) patients on dialysis. We studied 100 ESKD patients undergoing hemodialysis that were enrolled in an 18-months prospective observational study. The main outcomes were the association of RLS with new cardiovascular events and cardiovascular mortality. RLS affected 31% of the study population. It was associated with female gender, gradual reduction in residual dieresis, lower albumin (P=0.039) and inflammation, but not the dialysis parameters spKt/V and URR. During observation, 47% of patients experienced new cardiovascular events (64.5% with and 39.1% without RLS; P=0.019). Mortality was 20.0% in all patients, 32.3% in those with and 14.5% in patients without RLS (P=0.04). This study confirmed the high prevalence of RLS among dialysis patients and the associations between the severity of RLS and the risk of new cardiovascular events and higher short-term mortality. Abstract Restless legs syndrome (RLS) is a sensori-motor neurological disorder characterzed by paraesthesia, dysaesthesia and irresistibile urge to move the legs especially at night. Its prevalence is much higher among dialysis patients at 12 to 62% compared to 3 to 9% in the general population. In our study we investigated the association between RLS and cardiovascular events risk and laboratory parameters in End-stage kidney disease (ESKD) patients on dialysis. We studied 100 ESKD patients undergoing hemodialysis that were enrolled in an 18-months prospective observational study. The main outcomes were the association of RLS with new cardiovascular events and cardiovascular mortality. RLS affected 31% of the study population. It was associated with female gender, gradual reduction in residual dieresis, lower albumin (P=0.039) and inflammation, but not the dialysis parameters spKt/V and URR. During observation, 47% of patients experienced new cardiovascular events (64.5% with and 39.1% without RLS; P=0.019). Mortality was 20.0% in all patients, 32.3% in those with and 14.5% in patients without RLS (P=0.04). This study confirmed the high prevalence of RLS among dialysis patients and the associations between the severity of RLS and the risk of new cardiovascular events and higher short-term mortality.

La goutte et la feuille. Transfigurations de la beauté naturelle dans la littérature européenne: Chateaubriand, Hölderlin et Leopardi.

La goutte et la feuille . Transfigurations de la beauté naturelle dans la littérature européenne : Chateaubriand , Hölderlin et Leopardi . La thèse se présente comme une étude morphologique de l'esthétique de la nature à la fin de 18 ans. Siècle. Le dénominateur commun est une étude comparative des paradigmes scientifiques et des images symboliques utilisés dans la littérature européenne . Sous ce point de vue la thèse identifie les formes originaires de la goutte et de la feuille comme un point de contact entre des moments culturels distincts, même si entrelacés. Un passage particulièrement important du travail est l'analyse structurelle du paysage . Le paysage est le point culminant d'accès aux secrets de l'écriture romantique. Le paysage commence avec la représentation classique du jardin édénique et se termine avec la forêt exotique américaine. Celle-ci est décrite par Chateaubriand, en tant qu’objet d’une KOINONIE stylistique à l’immensité sublime du désert et l'océan . Hölderlin place avec la beauté naturelle devient une harmonie secrète et sombre dans l'inconscient symbolique de l'âme humaine . Leopardi est l'auteur du désenchantement , et pourtant il est encore capable de pressentir empathiquement la mesure de l’imagination envers la beauté naturelle. Avec Léopards , cependant, s’accomplit la séparation finale entre l’EPOS de la beauté naturelle et l’ETHOS de la nature . Cette dernière est une grandeur morale, et au fait elle représente le moment de la dissolution nihiliste, notamment magnitude de l’esthétique typiquement romantique . Après Chateaubriand , Leopardi , et Hölderlin beauté naturelle ne seront plus transfigurant .