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A Rius

Publications and source records attributed to A Rius.

6 recordsLinked to original sources

[Monitoring hemodialysis dose with ionic dialisance in on-line hemodiafiltration].

Until now, with the ionic dialysance measurement, it has been possible to determine hemodialysis dose in each session of hemodialysis (HD) and in the conventional hemofiltration (HDF) but not in the modality of on-line HDF. Recently it is possible with a new biosensor that allows to measure the dose in on-line HDF. The aim of this study was to evaluate the value of this biosensor in different dialysis situations comparing the dialysis dose measured in blood in comparison with the values obtained from the sensor. We have analysed 192 hemodialysis sessions performed in 24 patients, 15 male and 9 female, mean age of 70.2 +/- 12 years, included in on-line HDF. All treatments were done using 4008H (Fresenius) monitor equipped with on-line clearance monitoring (OCM), that measure, with non invasive monitoring, the effective ionic dialysance equivalent to urea clearance. Every patient received eight dialysis sessions: one with dialysate flow (Qd) 500 ml/min, two with HD and Qd 800 ml/min and five with on-line HDF. Other habitual haemodialysis parameters were no changed, dialysis time 200 +/- 63 min (135-300) and blood flow 421 +/- 29 ml/min (350-450). Initial and final ionic dialysance values (K), final Kt, Kt/V measured with OCM using V of Watson, and Kt/V determined in blood pre and postdialysis concentrations of urea (Daugirdas second generation), were measured. The mean of initial K was 251 +/- 21 ml/min and the final K was 234 +/- 24 ml/min. The Kt measured with OCM was 50.6 +/- 17 L, 51.2 +/- 17 in men and 49.7 +/- 16 in women. The V (Watson) was 34.5 +/- 6 L. The Kt/V measured with the Kt of OCM and V was 1,499 +/- 0.54 and Kt/V measured in blood samples was 1,742 +/- 0.58. The correlation between both values was 0.956. The Kt was different according to dialysis modality used: in HD and Qd 500 was 44.7 +/- 15 L, in HD and Qd 800 was 50.7 +/- 17 and in on-line HDF (22.1 +/- 7 L of reposition volume), was 51.8 +/- 17 L. The Kt/V from blood samples also shows variation: in HD and QD 500 was 1.60 +/- 0.55, in HD and Qd 800 was 1,726 +/- 0.56 and in on-line HDF was 1,776 +/- 0.59. In this study has been observed a close correlation between the new biosensor OCM with the measures obtained from the blood samples. For this reason this sensor it is useful in all modalities of dialysis treatment, included on-line HDF. The sensor was able to discriminate the efficacy of different dialysis modalities used in this study.

Adult↗

Panic anxiety, under the weather?

The relationship between weather conditions and psychiatric disorders has been a continuous subject of speculation due to contradictory findings. This study attempts to further clarify this relationship by focussing on specific conditions such as panic attacks and non-panic anxiety in relation to specific meteorological variables. All psychiatric emergencies attended at a general hospital in Barcelona (Spain) during 2002 with anxiety as main complaint were classified as panic or non-panic anxiety according to strict independent and retrospective criteria. Both groups were assessed and compared with meteorological data (wind speed and direction, daily rainfall, temperature, humidity and solar radiation). Seasons and weekend days were also included as independent variables. Non-parametric statistics were used throughout since most variables do not follow a normal distribution. Logistic regression models were applied to predict days with and without the clinical condition. Episodes of panic were three times more common with the poniente wind (hot wind), twice less often with rainfall, and one and a half times more common in autumn than in other seasons. These three trends (hot wind, rainfall and autumn) were accumulative for panic episodes in a logistic regression formula. Significant reduction of episodes on weekends was found only for non-panic episodes. Panic attacks, unlike other anxiety episodes, in a psychiatric emergency department in Barcelona seem to show significant meteorotropism. Assessing specific disorders instead of overall emergencies or other variables of a more general quality could shed new light on the relationship between weather conditions and behaviour.

Adult↗

[Improvement of nutritional status in patients with short daily on-line hemodiafiltration].

Daily dialysis have showed excellent results because a higher frequency of dialysis is more physiological and it decreases the fluctuation of liquid, solutes and electrolytes. Improvement of certain causes of anorexia such as postdialysis fatigue, reduction in fluid overload, uremic milieu, medium and large-sized molecule removal could be observed with daily dialysis. The aim of this study was to evaluate nutritional parameters when thrice weekly on-line hemodiafiltration (OL-HDF) were switched to daily OL-HDF. 24 patients have been studied. Eight patients, 6 males and 2 females, mean age of 65.9 +/- 14 years, on thrice weekly 4 to 5 hours OL-HDF were switched to 2 to 2.5 hours six times per week. Dialysis parameters were the same in both periods and only frequency and dialysis time were changed. Other sixteen patients, mean age of 68.4 +/- 14 years, were a control group which dialysis parameters were maintained. Clinical and biochemical outcome were carried out over twelve months. Daily OL-HDF group: Dry weight increased from 67.8 +/- 8 kg at baseline to 68.5 +/- 8 kg after three months, 69.3 +/- 8 kg after six months (NS), 69.5 +/- 8 kg after nine months (p < 0.05) and 70.8 +/- 8 (p < 0.01) after one year. Mean nPCR increased from 0.93 +/- 0.2 g/kg/d on baseline to 1.18 +/- 0.3 after three moths (P < 0.0-5), 1.13 +/- 0.2 after six months (NS), 1.06 +/- 0.2 after nine months (NS) and 1.10 +/- 0.2 after twelve months (NS). There were no significant changes in serum protein, albumin, prealbumin, transferrin, total cholesterol, HDL-c, LDL-c and triglycerides (TG). There were no changes in control group. Mean dry weight was 62.3 +/- 9 kg at baseline and 62.1 +/- 10 kg after one year. Mean nPCR was 0.97 +/- 0.2 g/kg/d on baseline and 1.03 +/- 0.2 g/kg/d after one year. Neither there were changes in serum protein, albumin, transferrin, total cholesterol, HDL-c, LDL-c and TG. Improvement in nutrition status has been observed with the change from thrice weekly OL-HDF to short daily OL-HDF. Increased appetite and protein intake was accompanied by a dry body weight increase of three kg after twelve months.

Adult↗

[ST segment elevation during exercise test and perfusion scintigraphy in patients without infarction].

BACKGROUND: The features of perfusion scintigraphy in patients who show exercise-induced ST-segment elevation in the absence of previous infarction have been assessed in only a few reports. Therefore, we have evaluated our experience in a wide review of exercise 201-thallium scintigraphies. METHODS: 16,620 exercise 201-thallium scintigraphies, carried out between 1986 and 1993, have been retrospectively reviewed. Fourteen patients (0.8/1000) without previous infarction who were evaluated for chest pain showed ST-segment elevation. In all patients coronary arteriography was also available. RESULTS: Five patients were free from significant coronary artery stenoses, 6 had one-vessel disease, 2 had two-vessel disease, and the remaining patient had three-vessel disease. In 8 patients ST-segment elevation (up to 3-24 mm) was inferior, in 5 anterior and in 1 lateral. The radionuclide was injected during ST-segment elevation in 10 cases and before such elevation (which developed in the postexercise phase) in 4. In 3 out of these 4, which had angiographically normal coronary arteries, the scintigraphy was negative. In all cases where thallium-201 was injected during ST elevation, severe perfusion defects were detected corresponding to the localization of ST elevation. In the 4 patients with critical coronary stenoses, thallium-201 redistribution after 3 hours was partial. CONCLUSIONS: In patients without previous infarction and with exercise-induced ST-segment elevation, very severe perfusion defects are detected when the radionuclide has been injected during the crisis. Thallium-201 redistribution after 3 hours was not total in patients with fixed critical stenoses. When radionuclide injection preceded the crisis, the result of the scintigraphy was in agreement with the coronary anatomy.

Adult↗

[Evaluation of methods to calculate dialysis dose in daily hemodialysis].

UNLABELLED: Daily dialysis has shown excellent clinical results because a higher frequency of dialysis is more physiological. Different methods have been described to calculate dialysis dose which take into consideration change in frequency. The aim of this study was to calculate all dialysis dose possibilities and evaluate the better and practical options. Eight patients, 6 males and 2 females, on standard 4 to 5 hours thrice weekly on-line hemodiafiltration (S-OL-HDF) were switched to daily on-line hemodiafiltration (D-OL-HDF) 2 to 2.5 hours six times per week. Dialysis parameters were identical during both periods and only frequency and dialysis time of each session were changed. Time average concentration (TAC), time average deviation (TAD), normalized protein catabolic rate (nPCR), Kt/V, equilibrated Kt/V (eKt/V), equivalent renal urea clearance (EKR), standard Kt/V (stdKt/V), urea reduction ratio (URR), hemodialysis product and time off dialysis were measured. Daily on-line hemodiafiltration was well accepted and tolerated. Patients maintained the same TAC although TAD decreased from 9.7 +/- 2 in baseline to a 6.2 +/- 2 mg/dl after six months, p < 0.01. No significant changes were observed in weekly Kt/V and eKt/V throughout the study. However EKR, stdKt/V and weekly URR were increased during D-OL-HDF in 24-34%, 46% and 50%, respectively. Hemodialysis product was raised in a 95% and time off dialysis was reduced to half. CONCLUSION: Dialysis frequency is an important urea kinetic parameter which there are to take in consideration. It's necessary to use EKR, stdKt/V or weekly URR to calculate dialysis dose for an adequate comparison between different frequency dialysis schedules.

Aged↗