Clinical Efficacy of SARS-CoV-2 Vaccination in Hemodialysis Patients.

Introduction: The COVID-19 pandemic is a global public health problem. Patients with end-stage renal disease on hemodialysis are at a higher risk of infection and mortality than the general population. Worldwide, a vaccination campaign has been developed that has been shown to reduce severe infections and deaths in the general population. However, there are currently limited data on the clinical efficacy of vaccinations in the hemodialysis population. Methods: A national multicenter observational cohort was performed in Chile to evaluate the clinical efficacy of anti-SARS-CoV-2 vaccination in end-stage renal disease patients on chronic hemodialysis from February 2021 to August 2021. In addition, the BNT162b2 (Pfizer-BioNTech) and CoronaVac (Sinovac) vaccines were evaluated. The efficacy of vaccination in preventing SARS-CoV-2 infection, hospitalizations, and deaths associated with COVID-19 was determined. Results: A total of 12,301 patients were evaluated; 10,615 (86.3%) received a complete vaccination (2 doses), 490 (4.0%) received incomplete vaccination, and 1196 (9.7%) were not vaccinated. During follow-up, 1362 (11.0%) patients developed COVID-19, and 150 died (case fatality rate: 11.0%). The efficacy of the complete vaccination in preventing infection was 18.1% (95% confidence interval [CI]:11.8-23.8%), and prevention of death was 66.0% (95% CI:60.6-70.7%). When comparing both vaccines, BNT162b2 and CoronaVac were effective in reducing infection and deaths associated with COVID-19. Nevertheless, the BNT162b2 vaccine had higher efficacy in preventing infection (42.6% vs. 15.0%) and deaths (90.4% vs. 64.8%) compared to CoronaVac. Conclusion: The results of our study suggest that vaccination against SARS-CoV-2 in patients on chronic hemodialysis was effective in preventing infection and death associated with COVID-19.

Adulto mayor y políticas públicas em Chile / The aged and the public health in Chile

El objective de este capitulo es presenter a la Dirección Nacional del Adulto Mayor que es um servicio del Estado de Chile que tiene como función garantizar y promover los derechos exigibles de las personas mayores y la generación de um sistema de protección social, además de elaborar la Política Nacional del Adulto Mayor.

Hipokalemia, hipovolemia y repercusión electrocardiográfica secundarias a ingesta prolongada de furosemida: Caso clínico / Hypokalemia, hypovolemia and electrocardiographic changes due to furosemide abuse: Report of one case

Hypokalemia (serum K+ < 3.5 mEq/1) is a potentially serious adverse effect of diuretic ingestión. We report a 27 year-old woman admitted with muscle weakness, a serum potassium of 2.0 mEq/1, metabolic alkalosis and EKG abnormalities simulating cardiac ischemia, that reverted with potassium chloride administration. She admitted high dose furosemide self-medication for edema. Glomerular filtration rate, tubular sodium reabsortion, potassium secretion, the renin-aldosterone system, total body water distribution and capillary permeability, were studied sequentially until 90 days after her admission. There was hyperactivity of the renin-aldosterone axis, reduction in extracellular and intracellular volumes, normal capillary permeability and high sodium tubular reabsorption, probably explained by a "rebound" salt retention associated with her decreased extracellular volume.

[Hypokalemia, hypovolemia and electrocardiographic changes due to furosemide abuse. Report of one case]. / Hipokalemia, hipovolemia y repercusión electrocardiográfica secundarias a ingesta prolongada de furosemida: Caso clínico.

Hypokalemia (serum K+ < 3.5 mEq/1) is a potentially serious adverse effect of diuretic ingestion. We report a 27 year-old woman admitted with muscle weakness, a serum potassium of 2.0 mEq/1, metabolic alkalosis and EKG abnormalities simulating cardiac ischemia, that reverted with potassium chloride administration. She admitted high dose furosemide self-medication for edema. Glomerular filtration rate, tubular sodium reabsorption, potassium secretion, the renin-aldosterone system, total body water distribution and capillary permeability, were studied sequentially until 90 days after her admission. There was hyperactivity of the renin-aldosterone axis, reduction in extracellular and intracellular volumes, normal capillary permeability and high sodium tubular reabsorption, probably explained by a "rebound" salt retention associated with her decreased extracellular volume.

Efeito do estresse físico no processamento das informaçöes visuais periféricas: comparaçäo entre esportistas e näo esportistas / Effect of physical stress on peripheric visual information processing: comparison between athletes and non-athletes

O presente estudo teve como objetivo determinar em que medida a visao horizontal periférica de indivíduos classificados como esportistas e nao esportistas é alterado pelo aumento progressivo do estresse físico induzido por um trabalho em bicicleta ergométrica, mantendo uma carga foveal. A amostragem foi constituída por 59 indivíduos alunos universitários de ambos os sexos com visao normal, com ou sem correçao, dos quais 25 sao esportistas e 34 nao esportistas. O desenho experimental contemplou a formaçao de um campo visual horizontal periférico segundo os protocolos de Davids (1987, 1988) e Oliva Aravena (1990). Os grupos foram medidos num ginásio com uma luminosidade de 850 lux. Para a análise dos dados foram utilizadas a estatística descritiva e inferencial, teste Manova e o teste de Friedman. Os resultados obtidos permitem afirmar que os espostistas apresentam (p<0,01) uma sensibilidade da visao horizontal periférica maior que os nao esportistas, nas capacidades perceptivas visuais, detecçao e reconhecimento, sob estresse físico. Além disso, comprovou-se que as cargas de trabalho progressiva - leve, submáxima e máxima - têm influência significativa (DET p<0,05 e REC p<0,001) na sensibilidade da visao horizontal periférica.

Percepçäo visual horizontal em jogadores de basquetebol de alto rendimento, segundo sua funçäo / Horizontal visual perception in basketball players of high level, according to their functions

Esta pesquisa teve como objetivo identificar e comparar o grau de sensibilidade da percepçao visual horizontal (PVH) ou visao periférica (VP), em jogadores de basquetebol de alto rendimento do sexo masculino e categorizados de acordo com a sua funçao na quadra, ou seja: armadores, laterais e pivôs. Foram testados 21 jogadores com visao normal ou corrigida que participam da Liga Nacional de Basquetebol e que têm sido selecionados para a representaçao nacional do Brasil entre os anos de 1986 e 1990. Os atletas foram medidos num ginásio com uma luminosidade de 850 lux, utilizando-se uma quadra de basquetebol regulamentar, e estimulados pelo acendimento de diferentes lâmpadas a cores de 40w, por um tempo de 520ms, controlados pelo sistema eletrônico, sem movimento ocular nem movimento de cabeça, com uma carga foveal de 40 passes de peito. Para análise dos dados decodificados, empregou-se uma Manova one-way e anova one-way com um nível de significância a .05. Os resultados indicaram que existe diferença estatiscamente significante, especificamente entre as funçoes Armador e Pivô e entre Lateral e Pivô. Quanto aos Erros de Reconhecimento (EREC) nao se detectou diferença significativa entre as funçoes.