Effect of selective angiotensin antagonists on the antidiuresis produced by angiotensin-(1-7) in water-loaded rats

In the present study we evaluated the nature of angiotensin receptors involved in the antidiuretic effect of angiotensin-(1-7) (Ang-(1-7)) in water-loaded rats. Water diuresis was induced in male Wistar rats weighing 280 to 320 g by water load (5 ml/100 g body weight by gavage). Immediately after water load the rats were treated subcutaneously with (doses are per 100 g body weight): 1) vehicle (0.05 ml 0.9% NaCl); 2) graded doses of 20, 40 or 80 pmol Ang-(1-7); 3) 200 nmol Losartan; 4) 200 nmol Losartan combined with 40 pmol Ang-(1-7); 5) 1.1 or 4.4 nmol A-779; 6) 1.1 nmol A-779 combined with graded doses of 20, 40 or 80 pmol Ang-(1-7); 7) 4.4 nmol A-779 combined with graded doses of 20, 40 or 80 pmol Ang-(1-7); 8) 95 nmol CGP 42112A, or 9) 95 nmol CGP 42112A combined with 40 pmol Ang-(1-7). The antidiuretic effect of Ang-(1-7) was associated with an increase in urinary Na+ concentration, an increase in urinary osmolality and a reduction in creatinine clearance (CCr: 0.65 ± 0.04 ml/min vs 1.45 ± 0.18 ml/min in vehicle-treated rats, P<0.05). A-779 and Losartan completely blocked the effect of Ang-(1-7) on water diuresis (2.93 ± 0.34 ml/60 min and 3.39 ± 0.58 ml/60 min, respectively). CGP 42112A, at the dose used, did not modify the antidiuretic effect of Ang-(1-7). The blockade produced by Losartan was associated with an increase in CCr and with an increase in sodium and water excretion as compared with Ang-(1-7)-treated rats. When Ang-(1-7) was combined with A-779 there was an increase in CCr and natriuresis and a reduction in urine osmolality compared with rats treated with Ang-(1-7) alone. The observation that both A-779, which does not bind to AT1 receptors, and Losartan blocked the effect of Ang-(1-7) suggests that the kidney effects of Ang-(1-7) are mediated by a non-AT1 angiotensin receptor that is recognized by Losartan.

Signal transduction induced in Trypanosoma cruzi metacyclic trypomastigotes during the invasion of mammalian cells

Penetration of Trypanosoma cruzi into mammalian cells depends on the activation of the parasite's protein tyrosine kinase and on the increase in cytosolic Ca2+ concentration. We used metacyclic trypomastigotes, the T. cruzi developmental forms that initiate infection in mammalian hosts, to investigate the association of these two events and to identify the various components of the parasite signal transduction pathway involved in host cell invasion. We have found that i) both the protein tyrosine kinase activation, as measured by phosphorylation of a 175-kDa protein (p175), and Ca2+ mobilization were induced in the metacyclic forms by the HeLa cell extract but not by the extract of T. cruzi-resistant K562 cells; ii) treatment of parasites with the tyrosine kinase inhibitor genistein blocked both p175 phosphorylation and the increase in cytosolic Ca2+ concentration; iii) the recombinant protein J18, which contains the full-length sequence of gp82, a metacyclic stage surface glycoprotein involved in target cell invasion, interfered with tyrosine kinase and Ca2+ responses, whereas the monoclonal antibody 3F6 directed at gp82 induced parasite p175 phosphorylation and Ca2+ mobilization; iv) treatment of metacyclic forms with phospholipase C inhibitor U73122 blocked Ca2+ signaling and impaired the ability of the parasites to enter HeLa cells, and v) drugs such as heparin, a competitive IP3-receptor blocker, caffeine, which affects Ca2+ release from IP3-sensitive stores, in addition to thapsigargin, which depletes intracellular Ca2+ compartments and lithium ion, reduced the parasite infectivity. Taken together, these data suggest that protein tyrosine kinase, phospholipase C and IP3 are involved in the signaling cascade that is initiated on the parasite cell surface by gp82 and leads to Ca2+ mobilization required for target cell invasion.

Influence of acute renal failure on the mononuclear phagocytic system

Several studies show the ability of macrophages to remove particles injected into the bloodstream. This function seems to be increased in the presence of acute renal failure. The objective of the present study was to assess the phagocytic function of the main organs (spleen, liver and lung) of the mononuclear phagocytic system in renal and postrenal failures. Fifteen rats (250-350 g) were divided into three groups (N = 5): group I - control; group II - ligature of both ureters, and group III - bilateral nephrectomy. On the third postoperative day, all animals received an iv injection of 1 ml/kg 99mTc sulfur colloid. Blood samples were collected for the assessment of plasma urea, creatinine, sodium, and potassium concentrations and arterial gasometry. Samples of liver, spleen, lung and blood clots were obtained and radioactivity was measured. Samples of liver, spleen, lung and kidney were prepared for routine histopathological analysis. Plasma urea, creatinine and potassium concentrations in groups II and III were higher than in group I (P<0.05). Plasma sodium concentrations in groups II and III were lower than in group I (P<0.05). Compensated metabolic acidosis was observed in the presence of postrenal failure. Group II animals showed a lower level of radioactivity in the spleen (0.98) and lung (2.63), and a higher level in the liver (105.51) than control. Group III animals showed a lower level of radioactivity in the spleen (11.94) and a higher level in the liver (61.80), lung (11.30) and blood clot (5.13) than control. In groups II and III liver steatosis and bronchopneumonia were observed. Renal and postrenal failures seem to interfere with blood clearance by the mononuclear phagocytic system.

Silicon-containing species in used lube oil re-refining

Nowadays, the re-refining of the used lube oils has gained worldwide a lot of attention due to the necessity for added environmental protection and increasingly stringent environmental legislation. One of the parameters determining the quality of the produced base oils is the composition of feedstock. Estimation of the chemical composition of the used oil collected from several European locations showed that the hydrocarbon structure of the motor oil is changed insignificantly during its operation and the major part of the changes is accounted for with depleted oil additives. In the lube oil re-refining industry silicon, coming mainly from antifoaming agents, is recognized to be a contaminant generating undesired solid deposits in various locations in the re-refining units. In this thesis, a particular attention was paid to the mechanism of solid product formation during the alkali treatment process of silicon-containing used lube oils. The transformations of a model siloxane, tetramethyldisiloxane (TMDS), were studied in a batch reactor at industrially relevant alkali treatment conditions (low temperature, short reaction time) using different alkali agents. The reaction mechanism involving solid alkali metal silanolates was proposed. The experimental data obtained demonstrated that the solids were dominant products at low temperature and short reaction time. The liquid products in the low temperature reactions were represented mainly by linear siloxanes. The prolongation of reaction time resulted in reduction of solids, whereas both temperature and time increase led to dominance of cyclic products in the reaction mixture. Experiments with the varied reaction time demonstrated that the concentration of cyclic trimer being the dominant in the beginning of the reaction diminished with time, whereas the cyclic tetramer tended to increase. Experiments with lower sodium hydroxide concentration showed the same effect. In addition, a decrease of alkali agent concentration in the initial reaction mixture accelerated TMDS transformation reactions resulting in solely liquid cyclic siloxanes yields. Comparison of sodium and potassium hydroxides applied as an alkali agent demonstrated that potassium hydroxide was more efficient, since the activation energy in KOH presence was almost 2-fold lower than that for sodium hydroxide containing reaction mixture. Application of potassium hydroxide for TMDS transformation at 100° C with 3 hours reaction time resulted in 20 % decrease of solid yields compared to NaOH-containing mixture. Moreover, TMDS transformations in the presence of sodium silanolate applied as an alkali agent led to formation of only liquid products without formation of the undesired solids. On the basis of experimental data and the proposed reaction mechanism, a kinetic model was developed, which provided a satisfactory description of the experimental results. Suitability of the selected siloxane as a relevant model of industrial silicon-containing compounds was verified by investigation of the commercially available antifoam agent in base-catalyzed conditions.

Fetal development of regulatory mechanisms for body fluid homeostasis

The balance of body fluids is critical to health and the development of diseases. Although quite a few review papers have shown that several mechanisms, including hormonal and behavioral regulation, play an important role in body fluid homeostasis in adults, there is limited information on the development of regulatory mechanisms for fetal body fluid balance. Hormonal, renal, and behavioral control of body fluids function to some extent in utero. Hormonal mechanisms including the renin-angiotensin system, aldosterone, and vasopressin are involved in modifying fetal renal excretion, reabsorption of sodium and water, and regulation of vascular volume. In utero behavioral changes, such as fetal swallowing, have been suggested to be early functional development in response to dipsogens. Since diseases, such as hypertension, can be traced to fetal origin, it is important to understand the development of fetal regulatory mechanisms for body fluid homeostasis in this early stage of life. This review focuses on fetal hormonal, behavioral, and renal development related to regulation of body fluids in utero.

Role of 11β-hydroxysteroid dehydrogenase 2 renal activity in potassium homeostasis in rats with chronic renal failure

Aldosterone concentrations vary in advanced chronic renal failure (CRF). The isozyme 11β-hydroxysteroid dehydrogenase 2 (11β-HSD2), which confers aldosterone specificity for mineralocorticoid receptors in distal tubules and collecting ducts, has been reported to be decreased or normal in patients with renal diseases. Our objective was to determine the role of aldosterone and 11β-HSD2 renal microsome activity, normalized for glomerular filtration rate (GFR), in maintaining K+ homeostasis in 5/6 nephrectomized rats. Male Wistar rats weighing 180-220 g at the beginning of the study were used. Rats with experimental CRF obtained by 5/6 nephrectomy (N = 9) and sham rats (N = 10) were maintained for 4 months. Systolic blood pressure and plasma creatinine (Pcr) concentration were measured at the end of the experiment. Sodium and potassium excretion and GFR were evaluated before and after spironolactone administration (10 mg·kg-1·day-1 for 7 days) and 11β-HSD2 activity on renal microsomes was determined. Systolic blood pressure (means ± SEM; Sham = 105 ± 8 and CRF = 149 ± 10 mmHg) and Pcr (Sham = 0.42 ± 0.03 and CRF = 2.53 ± 0.26 mg/dL) were higher (P < 0.05) while GFR (Sham = 1.46 ± 0.26 and CRF = 0.61 ± 0.06 mL/min) was lower (P < 0.05) in CRF, and plasma aldosterone (Pald) was the same in the two groups. Urinary sodium and potassium excretion was similar in the two groups under basal conditions but, after spironolactone treatment, only potassium excretion was decreased in CRF rats (sham = 0.95 ± 0.090 (before) vs 0.89 ± 0.09 µEq/min (after) and CRF = 1.05 ± 0.05 (before) vs 0.37 ± 0.07 µEq/min (after); P < 0.05). 11β-HSD2 activity on renal microsomes was lower in CRF rats (sham = 0.807 ± 0.09 and CRF = 0.217 ± 0.07 nmol·min-1·mg protein-1; P < 0.05), although when normalized for mL GFR it was similar in both groups. We conclude that K+ homeostasis is maintained during CRF development despite normal Pald levels. This adaptation may be mediated by renal 11β-HSD2 activity, which, when normalized for GFR, became similar to that of control rats, suggesting that mineralocorticoid receptors maintain their aldosterone selectivity.

Role of α2-adrenoceptors in the lateral parabrachial nucleus in the control of body fluid homeostasis

Central α2-adrenoceptors and the pontine lateral parabrachial nucleus (LPBN) are involved in the control of sodium and water intake. Bilateral injections of moxonidine (α2-adrenergic/imidazoline receptor agonist) or noradrenaline into the LPBN strongly increases 0.3 M NaCl intake induced by a combined treatment of furosemide plus captopril. Injection of moxonidine into the LPBN also increases hypertonic NaCl and water intake and reduces oxytocin secretion, urinary sodium, and water excreted by cell-dehydrated rats, causing a positive sodium and water balance, which suggests that moxonidine injected into the LPBN deactivates mechanisms that restrain body fluid volume expansion. Pretreatment with specific α2-adrenoceptor antagonists injected into the LPBN abolishes the behavioral and renal effects of moxonidine or noradrenaline injected into the same area, suggesting that these effects depend on activation of LPBN α2-adrenoceptors. In fluid-depleted rats, the palatability of sodium is reduced by ingestion of hypertonic NaCl, limiting intake. However, in rats treated with moxonidine injected into the LPBN, the NaCl palatability remains high, even after ingestion of significant amounts of 0.3 M NaCl. The changes in behavioral and renal responses produced by activation of α2-adrenoceptors in the LPBN are probably a consequence of reduction of oxytocin secretion and blockade of inhibitory signals that affect sodium palatability. In this review, a model is proposed to show how activation of α2-adrenoceptors in the LPBN may affect palatability and, consequently, ingestion of sodium as well as renal sodium excretion.

Application of mathematical models for the prediction of adsorption isotherms in solid mixture for mango powder refreshment

Solid mixtures for refreshment are already totally integrated to the Brazilian consumers' daily routine, because of their quick preparation method, yield and reasonable price - quite lower if compared to 'ready-to-drink' products or products for prompt consumption, what makes them economically more accessible to low-income populations. Within such a context, the aim of this work was to evaluate the physicochemical and mineral composition, as well as the hygroscopic behavior of four different brands of solid mixture for mango refreshment. The BET, GAB, Oswim and Henderson mathematical models were built through the adjustment of experimental data to the isotherms of adsorption. Results from the physiochemical evaluation showed that the solid mixtures for refreshments are considerable sources of ascorbic acid and reductor sugar; and regarding mineral compounds, they are significant sources of calcium, sodium and potassium. It was also verified that the solid mixtures for refreshments of the four studied brands are considered highly hygroscopic.

Kulutuselektroniikan akkujen tekniset ominaisuudet ja markkinaosuudet 2015

Työssä tutkittiin kirjallisuustyönä akkuteknologian nykytilaa ja markkinoita kulutuselektroniikan osalta. Työssä tehtiin myös katsaus potentiaalisiin tulevaisuuden akkuteknologioihin. Työssä havaittiin, että kulutuselektroniikassa ainoat suuresti käytetyt akkutyypit ovat nikkelimetallihybridi- (NiMH) ja litiumioniakut (Li-ion). Tärkeimpänä ominaisuutena kulutuselektroniikassa akuilla yleensä pidetään kapasiteettia, jossa Li-ion akut ovat selvästi parempia jopa kaksinkertaisen energiatiheyden takia. Li-ion akuilla voidaan saavuttaa myös moninkertainen käyttöikä lataussykleinä ja moninkertainen purkausvirta, riippuen käytetystä katodimateriaalista. NiMH akuilla etuna on lähinnä halvempi hinta ja parempi turvallisuus. Toisaalta myös pieni jännite voidaan laskea hyväksi puoleksi, koska NiMH akuilla voidaan korvata kertakäyttöisiä alkaliparistoja. Vuonna 2012 Li-ion akkuja myytiin kapasiteetissa mitattuna jopa kahdeksan kertaa enemmän kuin NiMH akkuja ja myyntimäärien ennustetaan myös kasvavan tulevaisuudessa. Liion akkujen myyntimääristä suurin osa oli kulutuselektroniikan käyttökohteisiin ja jopa kaksi kolmasosaa oli kannettavien tietokoneiden ja kännyköiden akkuja. Uusia akkuteknologioita ja Li-ion akkujen parannuksia on paljon kehitteillä, mutta suurimman potentiaalin ja myös suuret ongelmat kaupallistumiseen omaa litium-ilma akut. Lyhyemmällä aikavälillä potentiaalisia teknologioita ovat litium-rikki akut, sekä nykyisiin Li-ion akkuihin kehitteillä olevat anodimateriaalit kuten esim. pii ja alumiini/titaani, joiden ongelmiin on löydetty ratkaisuja nanoteknologiasta.

Thermoacclimatory variations in the activities of enzymes implicated in ion transport in the rainbow trout, salmo gairdneri

Two groups of rainbow trout were acclimated to 20 , 100 , and 18 o C. Plasma sodium, potassium, and chloride levels were determined for both. One group was employed in the estimation of branchial and renal (Na+-K+)-stimulated, (HC0 3-)-stimulated, and CMg++)-dependent ATPase activities, while the other was used in the measurement of carbonic anhydrase activity in the blood, gill and kidney. Assays were conducted using two incubation temperature schemes. One provided for incubation of all preparations at a common temperature of 2S oC, a value equivalent to the upper incipient lethal level for this species. In the other procedure the preparations were incubated at the appropriate acclimation temperature of the sampled fish. Trout were able to maintain plasma sodium and chloride levels essentially constant over the temperature range employed. The different incubation temperature protocols produced different levels of activity, and, in some cases, contrary trends with respect to acclimation temperature. This information was discussed in relation to previous work on gill and kidney. The standing-gradient flow hypothesis was discussed with reference to the structure of the chloride cell, known thermallyinduced changes in ion uptake, and the enzyme activities obtained in this study. Modifications of the model of gill lon uptake suggested by Maetz (1971) were proposed; high and low temperature models resulting. In short, ion transport at the gill at low temperatures appears to involve sodium and chloride 2 uptake by heteroionic exchange mechanisms working in association w.lth ca.rbonlc anhydrase. G.l ll ( Na + -K + ) -ATPase and erythrocyte carbonic anhydrase seem to provide the supplemental uptake required at higher temperatures. It appears that the kidney is prominent in ion transport at low temperatures while the gill is more important at high temperatures. 3 Linear regression analyses involving weight, plasma ion levels, and enzyme activities indicated several trends, the most significant being the interrelationship observed between plasma sodium and chloride. This, and other data obtained in the study was considered in light of the theory that a link exists between plasma sodium and chloride regulatory mechanisms.

Étude des collisions proton-proton dans l’expérience ATLAS avec les détecteurs ATLAS-MPX

Les seize détecteurs MPX constituant le réseau ATLAS-MPX ont été placés à différentes positions dans le détecteur ATLAS et sa averne au CERN dans le but de mesurer en emps réel les champs de radiation produits ar des particules primaires (protons des faisceaux) et des particules secondaires (kaons, pions, g, protons) issues des collisions proton-proton. Des films de polyéthylène (PE) et de fluorure de lithium (6LiF) recouvrent les détecteurs afin d’augmenter leur sensibilité aux neutrons produits par les particules primaires et secondaires interagissant avec les matériaux présents dans l’environnement d’ATLAS. La reconnaissance des traces laissées par les particules dans un détecteur ATLAS-MPX se fait à partir des algorithmes du logiciel MAFalda (“Medipix Analysis Framework”) basé sur les librairies et le logiciel d’analyse de données ROOT. Une étude sur le taux d’identifications erronées et le chevauchement d’amas a été faite en reconstruisant les activités des sources 106Ru et 137Cs. L’efficacité de détection des neutrons rapides a été mesurée à l’aide des sources 252Cf et 241AmBe (neutrons d’énergie moyenne de 2.13 et 4.08 MeV respectivement). La moyenne des efficacités de détection mesurées pour les neutrons produits par les sources 252C f et 241AmBe a été calculée pour les convertisseurs 6LiF et PE et donnent (0.8580 ± 0.1490)% et (0.0254 ± 0.0031)% pour LiF et (0.0510 ± 0.0061)% et (0.0591 ± 0.0063)% pour PE à bas et à haut seuil d’énergie respectivement. Une simulation du calcul de l’efficacité de détection des neutrons dans le détecteur MPX a été réalisée avec le logiciel GEANT4. Des données MPX correspondant aux collisions proton-proton à 2.4 TeV et à 7 TeV dans le centre de masse ont été analysées. Les flux détectés d’électrons et de photons sont particulièrement élevés dans les détecteurs MPX01 et MPX14 car ils sont plus près du point de collision. Des flux de neutrons ont été estimés en utilisant les efficacités de détection mesurées. Une corrélation avec la luminosité du LHC a été établie et on prédit que pour les collisions à 14 TeV dans le centre de masse et avec une luminosité de 10^34 cm-1*s-1 il y aura environ 5.1x10^8 ± 1.5x10^7 et 1.6x10^9 ± 6.3x10^7 particules détectées par les détecteurs MPX01 et MPX14 respectivement.

Efectos cardiovasculares de concentraciones bajas de sodio en la solución de hemodiálisis en pacientes con insuficiencia renal cronica

Introducción. Las soluciones de hemodiálisis (HD) tienen una concentración estándar de sodio (Na) 139 mEq/L la cual no permite perder sodio por difusión llevando incluso a balance positivo de Na perpetuando la sensación de sed, hipertensión, hipertrofia ventricular y elevadas ganancias de peso interdialítica. Objetivo. Determinar cuales son los efectos cardiovasculares con el uso soluciones de HD con concentraciones de Na de 132 mEq/L en pacientes con insuficiencia renal crónica (IRC) de la unidad renal RTS cardioinfantil entre agosto 2008 y enero 2009. Métodos. Se realizo un estudio aleatorizado controlado, con doble enmascaramiento, inicialmente una fase de lavado de las concentraciones de sodio de 2 semanas y luego aleatorización en bloques en dos grupos, realizando la intervención durante 8 semanas. Resultados. Se evaluó 82 pacientes de los cuales ingresaron a la intervención 64, distribuidos al grupo de intervención 31 y al grupo control 33 pacientes. Hubo un aumento de la presión de pulso en el grupo de intervención y disminución de la sensación de sed y ganancia de peso interdialítica. Los hallazgos ecocardiográficos mostraron disminución del diámetro de la vena cava inferior en los dos grupos y disminución del volumen telediastólico del ventrículo izquierdo. Se presentaron más eventos adversos en el grupo de intervención. Discusión. Los resultados difieren de la literatura por tener un mayor número de diabéticos en el grupo control y por el tiempo de intervención. No se pueden sacar conclusiones con respecto al aumento de la presión de pulso ni a la disminución del diámetro de la vena cava inferior en HD. Conclusión. La solución de HD con concentración de Na de 132 mEq/L no disminuye la presión arterial, ni el consumo de medicamentos antihipertensivos, sin embargo disminuye la sensación de sed y la ganancia de peso interdialítica.

Efecto de ajuste del flujo dializante (Qd) sobre la eficacia en hemodialisis a pacientes de bajo peso

Introducción: Las guías KDOQI del 2006 utilizan patrón de adecuación de diálisis el Kt/V, donde V es volumen de distribución de la úrea, pacientes de bajo peso tienen menor agua corporal total, menor V, que podrían reducir el requerimiento de Qd sin afectar la eficiencia de la diálisis. Objetivo: Evaluar el efecto sobre la adecuación de hemodiálisis que produce la reducción del Qd en pacientes con peso menor o igual a 60 kg . Metodología: Se incluyeron pacientes con Enfermedad Renal crónica en hemodiálisis de forma regular con peso menor o igual a 60 Kg de la unidad renal, para evaluar dos períodos I y II, se continuaron los parámetros de la terapia, con descenso del Qd para el segundo período . Las variables fueron recolectadas de forma directa por los investigadores de la historia clínica . Los valores así obtenidos serían comparados mediante prueba t para variables relacionadas o pareadas, y significancia estadística de la prueba inferior a 0,05. Resultados: Se incluyeron 61 pacientes, el 60.7% sexo femenino, promedio de edad 57,3 años (DE 14,8). Edad promedio de los hombres 60,1 (DE 13,9) y de las mujeres fue de 55,9 (DE 15,4). No se encontraron diferencias estadísticamente significativas para las variables Kt/V y Hb, con descenso significativo del P. (p 0.015) Conclusiones: Este estudio demuestra que se logra una adecuada terapia con Qd inferiores a los estándares tradicionales, con 400ml /min en pacientes de bajo peso, siempre y cuando se mantengan los demás parámetros de suplencia renal.

Efecto del flujo del dializado sobre la ganancia interdialítica en hemodiálisis crónica (Estudio FLUGAIN)

Objetivos: Determinar si existe diferencia en la ganancia interdialítica entre los pacientes al ser tratados con flujo de dializado (Qd) de 400 mL/min y 500 mL/min. Diseño: Se realizó un estudio de intervención, cruzado, aleatorizado, doble ciego en pacientes con enfermedad renal crónica en hemodiálisis para determinar diferencias en la ganancia de peso interdialítica entre los pacientes tratados con flujo de dializado (Qd) de 400 ml/min y 500 ml/min. Pacientes: Se analizaron datos de 46 pacientes en hemodiálisis crónica con Qd de 400 ml/min y 45 con Qd de 500 ml/min. Análisis: La prueba de hipótesis para evaluar diferencias en la ganancia interdialítica y las otras variables entre los grupos se realizó mediante la prueba T para muestras pareadas. Para el análisis de correlación se calculó el coeficiente de Pearson. Resultados: No hubo diferencia significativa en ganancia interdialítica usando Qd de 400 ml/min vs 500 ml/min (2.37 ± 0.7 vs 2.41 ± 0.6, p=0.41) ni en Kt/V (1.57 ± 0.25 vs 1.59 ± 0.23, p = 0.45), potasio (4.9 ± 1.1 vs 5.1 ± 1.0, p=0.45), fosforo (4.5 ± 1.2 vs 4.4 ± 1.2, p=0.56) o hemoglobina (11.3 ± 1.8 vs 11.3 ± 1.6, p=0.96). Conclusiones: En pacientes con peso ≤ 65 Kg el uso de Qd de 400 ml/min no se asocia con menor ganancia interdialítica de peso. No hay diferencia en la eficiencia de diálisis lo que sugiere que es una intervención segura a corto plazo.

Soluciones hipertónicas en trauma craneoencefálico: revisión sistemática de la literatura

El traumatismo craneoencefálico, es la epidemia silenciosa de nuestra época, que genera gastos en salud, en países como Estados Unidos, cercanos a los 60 billones de dólares anuales, y cerca de 400 billones en rehabilitación de los discapacitados. El pilar del manejo médico del trauma craneoencefálico moderado o severo, es la osmoterapia, principalmente con sustancias como el manitol y las soluciones hipertónicas. Se realizó la revisión de 14 bases de datos, encontrando 4657754 artículos, quedando al final 40 artículos después de un análisis exhaustivo, que se relacionaban con el manejo de la hipertensión endocraneana y terapia osmótica. Resultados: Se compararon diferentes estudios, encontrando gran variabilidad estos, sin homogenización en los análisis estadísticos, y la poca rigurosidad no permitieron, la recolección de datos y la comparación entre los diferentes estudios, no permitió realizar el meta-análisis y por esto se decidió la realización de una revisión sistemática de la literatura. Se evidenció principalmente tres cosas: la primera es la poca rigurosidad con la que se realizan los estudios clínicos; la segunda, es que aún falta mucha más investigación principalmente, la presencia de estudios clínicos aleatorizados multicéntricos, que logren dar una sólida evidencia y que genere validez científica que se requiere, a pesar de la evidencia clara en la práctica clínica; la tercera es la seguridad para su uso, con poca presencia de complicaciones para las soluciones salinas hipertónicas.