Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study)

Introduction: Contrast-induced nephropathy is a common complication of radiographic procedures. Different measures have been used to avoid this damage, but the evidence is controversial. New investigations are required to clarify it. We investigated the efficacy and safety of sodium bicarbonate solution compared with sodium chloride solution to prevent contrast induced nephropathy in patients with or at risk of renal dysfunction. Methods: A prospective, single-center, randomized clinical trial conducted from May 1, 2007 to February 8, 2008. Inpatients in a tertiary center, scheduled to undergo a procedure with the nonionic radiographic contrast agent iohexol. There were 220 patients with serum creatinine levels of at least 1.2 mg/dL (106.1 µmol/L) and/or type 2 diabetics, who were randomized to receive an infusion of sodium chloride (n = 113) or sodium bicarbonate (n = 107) before and after contrast dye administration. The intervention were "A" group received 1 ml/kg/hour of normal saline solution, starting 12 hours before and continuing 12 hours after iohexol contrast. "B" group received 3 ml/kg of sodium bicarbonate solution (150 mEq/L) one hour prior to procedure and then drip rate was decreased to 1 ml/kg/hour until 6 hours post procedure. Our main outcome measure was change in serum creatinine. Results: The mean creatinine value after the procedure was 1.26 mg/dL in the saline group and 1.22 mg/dL in the bicarbonate group (mean difference: 0.036; CI 95%: -0.16 to 0.23, p = 0.865). The diagnosis of contrast-induced nephropathy, defined by increase in serum creatinine on 25% or more within 2 days after administration of radiographic contrast, was done in twelve patients (12%) in the bicarbonate group and eighth patients (7.1%) in the saline group (RR: 1.68, CI 95%: 0.72 to 3.94). Conclusion: Our investigation showed that there were no differences between normal saline solution (extended infusion) vs. bicarbonate solution for nephroprotection.

Contrast-induced nephropathy after computed tomography

Introduction: Contrast induced nephropathy is the third most prevalent preventable cause of acute kidney injury in hospitalized patients. It defined as an absolute increase in serum creatinine ≥ 0.5 mg/dL and relative ≥ 25% increase. Objective: We studied the risk factors to intravenous injection contrast nephropathy after computed tomography. Methods: We studied 400 patients prospectively. Results: The incidence of contrast induced nephropathy, with an absolute or a relative increase were 4.0% and 13.9%, respectively. Diabetes and cardiac failure were independent risk factors for CIN a relative increase de serum creatinine (O.R.: 3.5 [95% CI: 1.92-6.36], p < 0.01, 2.61 [95% CI: 1.14-6.03%], p < 0.05, respectively). Conclusions: We showed association between uses of intravenous injection contrast after computed tomography with acute injury renal, notably with diabetes and heart failure.

Democracy over governance

Varieties of institutional economics are available to evaluate varieties of capitalism. These methodologies dig behind preferences and technology to arrive at the ground on which agents make choices. The individual is at the foundation of these edifices, neoclassical and otherwise. Consequently, the denouement of all these models is that the market knows best in the absence of effective counterfactuals. A natural corollary is that the task of the government is to set effective mechanisms in place in order to approach the best outcomes. In contrast, we propose a framework which contends with the modern economy as an aggregate that evolves in historical time. Problems like effective demand failures are endemic to capitalist economies. Therefore, systematic State intervention is essential to their functioning. In particular, political economy teaches us that intervention must be in the interest of wage earners. In contrast to the earlier model, the fabric of norms and conventions that facilitate the growth and development of economies must emerge from the consciousness and practices of the working class.

Cours de construction ; 1re-2e parties, 1-2. Cours de construction destiné aux conducteurs et employés des Ponts et chaussées, agents-voyers, architectes, garde-mines, employés des compagnies de chemins de fer, entrepreneurs, maîtres ouvriers (charpentiers, menuisiers, serruriers, maçons, tailleurs de pierre, etc.), et à toutes les personnes s'occupant de travaux à un titre quelconque. Matériaux de construction et leur emploi / par Gustave Oslet,...

Collection : Encyclopédie théorique et pratique des connaissances civiles et militaires ; partie 1, livre 6

Cours de construction ; 1re-2e parties, 1-2. Cours de construction destiné aux conducteurs et employés des Ponts et chaussées, agents-voyers, architectes, garde-mines, employés des compagnies de chemins de fer, entrepreneurs, maîtres ouvriers (charpentiers, menuisiers, serruriers, maçons, tailleurs de pierre, etc.), et à toutes les personnes s'occupant de travaux à un titre quelconque. Traité de géodésie / par Gustave Oslet,...

Collection : Encyclopédie théorique et pratique des connaissances civiles et militaires ; partie 1, livre 6

Bulletin consulaire français : recueil des rapports commerciaux adressés au Ministère des affaires étrangères par les agents diplomatiques de France à l'étranger

1887/01 (VOL13)-1887/06.

Bulletin consulaire français : recueil des rapports commerciaux adressés au Ministère des affaires étrangères par les agents diplomatiques de France à l'étranger

1881 (A1881).

Bulletin consulaire français : recueil des rapports commerciaux adressés au Ministère des affaires étrangères par les agents diplomatiques de France à l'étranger

1887/07 (VOL13)-1887/12.

Bulletin consulaire français : recueil des rapports commerciaux adressés au Ministère des affaires étrangères par les agents diplomatiques de France à l'étranger

1885 (A1885).

Bulletin consulaire français : recueil des rapports commerciaux adressés au Ministère des affaires étrangères par les agents diplomatiques de France à l'étranger

1877 (A1877).

Bulletin consulaire français : recueil des rapports commerciaux adressés au Ministère des affaires étrangères par les agents diplomatiques de France à l'étranger

1883 (A1883).

Bulletin consulaire français : recueil des rapports commerciaux adressés au Ministère des affaires étrangères par les agents diplomatiques de France à l'étranger

1878 (A1878).

Bulletin consulaire français : recueil des rapports commerciaux adressés au Ministère des affaires étrangères par les agents diplomatiques de France à l'étranger

1885 (A1885,VOL10).

Bulletin consulaire français : recueil des rapports commerciaux adressés au Ministère des affaires étrangères par les agents diplomatiques de France à l'étranger

1880 (A1880).

Bulletin consulaire français : recueil des rapports commerciaux adressés au Ministère des affaires étrangères par les agents diplomatiques de France à l'étranger

1879 (A1879).