Eficacia de la n-acetilcisteína en nefropatía inducida por contraste en pacientes con alteración renal previa: meta-análisis. (METACIAKI)

INTRODUCCIÓN: Se define lesión renal aguda inducida por contraste (CIAKI), al deterioro de la función renal en las 48 horas posteriores a la administración de radiofármacos. Para prevenir este evento se han estudiado diversas intervenciones clínicas, como la administración de N-Acetilcisteina (NAC), previa al procedimiento diagnóstico. Meta-análisis anteriores comparan diferentes intervenciones clínicas para prevenir CIAKI sin resultados concluyentes. El presente meta-análisis analiza la evidencia de la eficacia la administración de NAC previa al procedimiento diagnóstico para prevenir CIAKI en pacientes con nefropatía previa. METODOLOGÍA: Se analizaron por 3 revisores independientes estudios ECCA, en población con nefropatía, en inglés, español, portugués, italiano, alemán y francés tanto publicados como de literatura gris, en donde se comparara NAC versus hidratación o placebo. RESULTADOS: Los estudios encontrados fueron publicados entre el año 2000 y 2010. Se analizaron 37 reportes con 6.022 pacientes. La correlación intraclase para tres observadores fue kappa r=0.97 [IC95% 0.93-0.99]). Los pacientes con nefropatía a quienes se les administró NAC previo al procedimiento tuvieron un 34% menos de probabilidad de hacer falla renal aguda, con OR ajustado por sesgo de publicación de 0.66 [IC95% 0.50-0.88] con un p de 0.002. Al realizar análisis de sensibilidad por la escala de Jadad, se encuentra que los resultados en los estudios con baja calidad no son significativos (p=0.202). CONCLUSION: Los resultados soportan la asociación entre el tratamiento preventivo con N-Acetilcisteina y una menor frecuencia de lesión renal aguda inducida por medio de contraste en pacientes nefrópatas.

Mathematical Programming

Exam questions and solutions for a third year mathematical programming course.

Programming & Software

An overview of programming and software development.

Programming Principles: Starting Out

In this lecture we describe the structure of the Programming Principles course at Southampton, look at the definitions and paradigms of programming, and take a look ahead to the key things that we will be covering in the weeks ahead.

Programming Principles: Introduction to Java

In this lecture we look at key concepts in Java: how to write, compile and run Java programs, define a simple class, create a main method, and use if/else structures to define behaviour.

Programming Principles: Variables, Primitives, Objects and Scope

In this session we look more closely at the way that Java deals with variables, and in particular with the differences between primitives (basic types like int and char) and objects. We also take an initial look at the scoping rules in Java, which dictate the visibility of variables in your program

Programming Principles: Computational Thinking

In this session we look at how to think systematically about a problem and create a solution. We look at the definition and characteristics of an algorithm, and see how through modularisation and decomposition we can then choose a set of methods to create. We also compare this somewhat procedural approach, with the way that design works in Object Oriented Systems,

Programming Principles: Methods

In this session we look at how to create more powerful objects through more powerful methods. We look at parameters and call by value vs. call by reference; return types; and overloading.

Programming Principles: Encapsulation and Constructors

In this session we look at the public and protected keywords, and the principle of encapsulation. We also look at how Constructors can help you initialise objects, while maintaining the encapsulation principle.

Programming Principles: Loops and Arrays

In this session we look at the different types of loop in the Java language, and see how they can be used to iterate over Arrays.

Programming Principles: Collections and Iterators

In this session we look at how we can use collection objects like ArrayList as a more advanced type of array. We also introduce the idea of generics (forcing a collection to hold a particular type) and see how Java handles the autoboxing and unboxing of primitives. Finally we look at Iterators, a common design pattern for dealing with iteration over a collection.

Programming Principles: The Java Library

In this session we point you at the Java Library, and go into some more details on how Strings work. We also introduce the HashMap class (a very useful type of collection).

Programming Principles: Testing and Debugging

In this session we look at the sorts of errors that occur in programs, and how we can use different testing and debugging strategies (such as unit testing and inspection) to track them down. We also look at error handling within the program and at how we can use Exceptions to manage errors in a more sophisticated way. These slides are based on Chapter 6 of the Book 'Objects First with BlueJ'

Programming Principles: Software Design

In this session we look at some of the basics of good code design, including avoiding duplication and designing for loose coupling and high cohesion.

Programming Principles: Super and Sub-classes

In this session we introduce inheritance - one of the cornerstone concepts of object oriented programming. We look at how to define super and sub-classes, how to maintain encapsulation using the super() constructor, and why it is useful to use substitution to hold references to sub-classes in references typed as their super-class.