The influence of salt intake on the metabolic acidosis of chronic renal failure

The influence of dietary salt on the levels of plasma bicarbonate and on the characteristics of bicarbonate reabsorption was studied in experimental chronic renal failure. Chronic renal failure was produced in rats by sequential partial nephrectomies. The control group received a diet constant in salt content throughout the progression of renal failure; the other group (PRNa), at each stage of renal failure, received salt intake reduced in direct proportion to the fall in glomerular filtration rate (GFR). In the steady state, the quantities of urinary sodium closely approximated intake in obth groups of animals. The adaptive increased natriuresis per nephron exhibited by the control animals was prevented in the PRNa animals. The PRNa group had (a) higher plasma bicarbonate levels, (b) increased bicarbonate thresholds, and (c) increased maximal tubular reabsorptive capacity for bicarbonate. As renal failure progresses, dietary salt can become a determining factor of the levels at which plasma bicarbonate is maintained. Proportional reduction of dietary salt results in bicarbonate conservation in rats with experimental progressive renal failure.     

Improvement of the imaging quality by a non-uniform attenuation correction system in cardiac SPECT

A non-uniform attenuation correction system has been purchased recently by the Department of Nuclear Medicine of the University Hospital in Salamanca to be used in a dual-detector Picker Axis gammacamera. This system is based on the generation of an attenuation map from each patient using a transmission scan with and without the patient using two Ba-133 sources. At present, this system is only available for a 102 configuration between the detectors so its use is restricted to cardiac single photon emission computed tomography (SPECT). The aim of this work has been to evaluate improvement of the image quality of this attenuation correction system by doing three different tests (evaluation of the recovery coefficient, activity concentration ratio and attenuation residual error). After analyzing all the tests, the results for the non-uniform attenuation correction system have been favorable compared to the conventional correction method employed in the clinical practice.     

Toxic hepatitis caused by nimesulide, presentation of a new case and review of the literature

Nimesulide is a potent non-steroidal anti-inflammatory drug. It is a new, selective cyclooxygenase-2 inhibitor with few adverse effects on the gastrointestinal system. We present a case of hepatotoxicity in which other possible causes of liver damage were excluded. A biochemical pattern of cholestasis was predominant. Evolution was favorable after the drug was stopped and enzymatic alterations progressively returned to normal. The cases reported to date are reviewed. The precise mechanism by which nimesulide produces liver damage is not known but it is probably caused by an idiosyncratic reaction. Because of the severity of the hepatitis described in some cases, treatment should be stopped when liver dysfunction is detected and the patients should be closely monitored.     

The "Trauma Signature:" understanding the psychological consequences of the 2010 Haiti earthquake

The 2010 Haiti earthquake was one of the most catastrophic episodes in history, leaving 5% of the nation's population killed or injured, and 19% internally displaced. The distinctive combination of earthquake hazards and vulnerabilities, extreme loss of life, and paralyzing damage to infrastructure, predicts population-wide psychological distress, debilitating psychopathology, and pervasive traumatic grief. However, mental health was not referenced in the national recovery plan. The limited MHPSS services provided in the first eight months generally lacked coordination and empirical basis.There is a need to customize and coordinate disaster mental health assessments, interventions, and prevention efforts around the novel stressors and consequences of each traumatic event. An analysis of the key features of the 2010 Haiti earthquake was conducted, defining its "Trauma Signature" based on a synthesis of early disaster situation reports to identify the unique assortment of risk factors for post-disaster mental health consequences. This assessment suggests that multiple psychological risk factors were prominent features of the earthquake in Haiti. For rapid-onset disasters, Trauma Signature (TSIG) analysis can be performed during the post-impact/pre-deployment phase to target the MHPSS response in a manner that is evidence-based and tailored to the event-specific exposures and experiences of disaster survivors. Formalization of tools to perform TSIG analysis is needed to enhance the timeliness and accuracy of these assessments and to extend this approach to human-generated disasters and humanitarian crises.