Percutaneous soft tissue release performed using a blunt cannula in rabbits with chronic collagenase-induced Achilles tendinopathy

Background

This study investigated the effects of percutaneous soft tissue release (PSTR) performed using a blunt cannula on (1) the inflammatory cells-count, (2) expressions of calcitonin gene-related peptide (CGRP) and (3) substance P (SP) in rabbits with chronic phase of collagenase-induced Achilles tendinopathy.

The association of nighttime sleep duration and quality with chronic kidney disease in middle-aged and older Chinese: a cohort study

ObjectiveThis cohort study aimed to assess the associations between sleep duration and quality with the risk of incident chronic kidney disease (CKD) in middle-aged and older Chinese.MethodsWe used the 2011 and 2015 surveys of the China Health and Retirement Longitudinal Study (CHARLS). Nighttime sleep duration was categorized into five groups: ≤4, (4–6], (6–8], (8–10], and >10 h/night. Sleep quality was assessed by restless days in the past week (<1, 1–2, 3–4, and 5–7 days/week). Multivariate logistic regression was used to assess the association between sleep duration and quality with incident CKD.ResultsA total of 11,339 participants free of CKD at baseline were included in this study. After four years follow-up, the incidence of CKD was 7.8%. There was a “U-shaped” association between sleep duration and risk of CKD. Compared to 6–8 h of nighttime sleep duration, those who slept ≤4 h/night (RR: 1.639, 95% CI: 1.287–2.087) or >10 h/night (RR: 2.342, 95% CI: 1.007–5.451) had increased risk of developing CKD after adjustment for confounders. Participants with 5–7 restless days per week had significantly increased risk of CKD (adjusted RR: 1.686, 95% CI: 1.352–2.102), compared to those who rarely or never had a restless sleep.ConclusionsExtreme nighttime sleep duration and poor sleep quality were associated with increased risk of CKD in middle-aged and older Chinese. Obtaining an optimal nighttime sleep duration and better sleep quality might reduce the risk of CKD.     

Adult groin hernias

A groin hernia is a common presenting complaint for adults and surgical repair is usually recommended. Patients may present with swelling or pain in the groin and one should be cognisant of the surgical emergency of a strangulating or obstructing hernia. A careful history and examination will help determine differential diagnoses and with planning the potential approach for repair. Surgical techniques have developed in recent years with a swing towards favouring laparoscopy in the elective patient. For both open and laparoscopic approaches, there are recognized techniques to consider. It is crucial to have a clear understanding of the anatomy in order to develop the skills required for accurate dissection, reduction and repair. Complications, although rare, can lead to severe morbidity. Laparoscopy has the advantage of reducing postoperative chronic pain but requires greater skill and experience to perform successfully. This chapter outlines the key considerations and surgical techniques for groin hernia repair and should be used in conjunction with practical training.     

Routine Laboratory Testing Every 4 Versus Every 6 Weeks for Patients on Maintenance Hemodialysis: A Quality Improvement Project

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Neuroimaging the pain network – Implications for treatment

In this chapter, we provide an overview of neuroimaging studies in chronic pain. We start with an introduction about the phenomenology of pain. In the following section, the application of functional and structural imaging techniques is shown in selected chronic pain syndromes (chronic back pain, fibromyalgia syndrome (FMS), phantom limb pain, and complex regional pain syndrome (CRPS)), and commonalities and peculiarities of imaging correlates across different types of chronic pain are discussed. We conclude this chapter with implications for treatments, with focus on behavioral interventions, sensory and motor trainings, and mirror and motor imagery trainings.     

Is stenting for atherosclerotic renal stenosis an effective technique?

IntroductionOne of the treatments for renal artery stenosis is endovascular intervention, but its effectiveness is controversial. The present study aims to analyze the experience of a working group in the endovascular treatment of selected patients with severe obstructive atherosclerotic lesions of the renal arteries, and to characterize early and late results.MethodsThis is a retrospective study of symptomatic patients with atherosclerotic renal artery stenosis who underwent endoluminal therapy between May 12, 1999 and March 12, 2015 at two institutions. Statistical analysis was performed using the PASW Statistics program.ResultsA total of 99 patients were treated, mean age 66 years and 76.8% male. The mean degree of stenosis measured by renal Doppler echocardiography was 83% and 64.6% were ostial lesions. Mean preoperative creatinine level was higher than the postoperative mean: 1.3 vs. 1.2 mg/dl (p=0.014). The number of antihypertensive drugs in the preoperative period was higher than in the postoperative period: 2.0 vs. 1.3 (p=0.001). The mean follow-up was 40 months (0-164). The mean peak systolic velocity over time in the postoperative period was 77 cm/s (40-250). The restenosis rate was 8%, and 30-day mortality was 0%.ConclusionsThe results demonstrated that the endovascular technique has a beneficial effect on blood pressure and renal function in selected patients, and is a safe technique associated with a high rate of technical success and few complications.     

La cafeína atenúa daño hepático y mejora signos neurológicos en un modelo de encefalopatía hepática con ratas

Introduction and aimsCirrhosis is the common outcome of liver diseases. It can be decompensated and lead to the development of complications, such as encephalopathy. Hyperammonemia that develops due to liver dysfunction is etiopathologically related to hepatic encephalopathy. Caffeine increases the activity of the urea cycle in the liver, augmenting ammonia degradation. By antagonizing adenosine receptors, it also has a hepatoprotective effect, impeding the formation of fibrosis, as well as having a stimulating effect on the central nervous system. The present study analyzed the effects of caffeine on the progression of cholestatic liver fibrosis and hepatic encephalopathy.Materials and methodsAn experimental model of cholestatic liver fibrosis, through common bile duct ligature, and of hepatic encephalopathy, through the administration of a high-protein diet, was constructed. Male Wistar rats (n = 32) were equally divided into 4 groups. The experiment lasted 28 days, with the administration of 50 mg/kg/day of caffeine. Laboratory tests, histologic analyses of the liver and encephalon, open field tests (OFTs), and daily behavioral analyses were carried out.ResultsThe ligated animals treated with caffeine had lower mean transaminase levels and improved histologic aspects of the liver and encephalon. The untreated ligated animals were clearly lethargic and apathetic at the last week of the experiment, confirmed by reduced exploratory activity during the OFT.ConclusionCaffeine improved the microarchitecture of the liver and encephalon of the cirrhotic animals and prevented the decrease in exploratory behavior of the animals during the OFT.     

Actualización de las recomendaciones de medidas de prevención y aislamiento frente al SARS-CoV-2 en las unidades de diálisis: un posicionamiento de la Sociedad Española de Nefrología

SARS-CoV-2 pandemic has changed across the last 2 years. The development and approval of SARS-CoV-2 vaccines and the emergence of new variants has opened up a new scenario. On this regard, Spanish Society of Nephrology (S.E.N.) Council considers that an update of the previous recommendations should be performed. In the present statement, and taking into account the current epidemiological situation, are included updated recommendations of protection and isolation for patients on dialysis programs.