Hypertrophic cardiomyopathy secondary to tacrolimus therapy in a kidney transplant patient: A case report and focused review of the literature.

Calcineurin inhibitors have become a pillar of immunosuppressive treatment in solid organ transplant recipients. Several case reports have shown hypertrophic and dilated cardiomyopathy as an adverse effect to tacrolimus therapy. We present the case of a kidney transplant recipient woman who developed hypertrophic cardiomyopathy due to tacrolimus therapy.

Retos de las unidades renales frente a la pandemia por el virus SARS-CoV-2 / Challenges of renal facilities facing SARS-CoV-2 virus pandemic

Resumen Introducción: frente a la actual pandemia causada por el virus SARS CoV-2 se deben tomar acciones proactivas encaminadas a desarrollar estrategias que preparen a las unidades renales para atender un número inusual de pacientes. Objetivo: revisar de forma narrativa los estudios que reporten experiencias en unidades renales para el manejo de pacientes con COVID-19 y proporcionar evidencia de los planes de acción a desarrollar por cada equipo de una unidad de diálisis. Materiales y métodos: se realizó una revisión de literatura en MEDLINE, Scopus y LILACS con los términos "chronic kidney disease AND Covid", "dialysis AND Covid", "renal unit AND Covid". La búsqueda no se limitó por fecha de publicación, por idioma, ni por diseño del estudio. Resultados: se encontraron 27 publicaciones, de las cuales se incluyeron 7 que contenían recomendaciones para el manejo de pacientes con COVID-19 en las unidades renales. Conclusión: las estrategias de mitigación en las unidades renales deben estar encaminadas hacia la detección temprana de los pacientes con COVID-19, el control de la transmisión y la protección del personal de salud. Se recomienda conformar un equipo de trabajo que lidere las actividades; diseñar un programa de educación para personal de salud, pacientes y familiares; gestionar una adecuada planeación del recurso humano ante el riesgo que se vea afectado por COVID-19; proveer suficientes insumos y equipos de protección personal, y delimitar áreas específicas para pacientes con COVID-19 y sin la enfermedad.

Abstract Introduction: In light of the current pandemic caused by SARS CoV-2, the hemodyalisis facilities should take proactive measures to develop strategies that will allow it to provide service to an unusually larger amount of patients with high risk of contagion. Objectives: Narrative review about Covid-19 and renal facilities experience and strategies should be tailored towards the early detection of patients with Covid-19, transmission control and protection for healthcare providers. Methods: A literature review was performed using MEDLINE, Scopus and LILACS, search terms included "chronic kidney disease AND Covid", "dialysis AND Covid", "renal unit AND Covid", the search result was no limited by date, language and study design. Results: The search resulted in 27 total articles after screening 7 articles were selected for full text assesment those included the strategies of treatment against Covid-19 in renal facilities. Conclusion: It is recommended that within the strategies, development of a team who leads all hemodyalisis facilities activities and services should be specified; it is also recommended to include educational programs for all health care providers, patients, as well as family members. An appropriate plan for health care providers affected by Covid-19. Sufficient provision of resources and personal protective equipment, implementation of boundaries for specific areas for patients affected by Covid-19 and patients without it.

Determination of acidity constants at 37 °C through the internal standard capillary electrophoresis (IS-CE) method: internal standards and application to polyprotic drugs.

This work provides the pKa at the biorelevant temperature of 37 °C for a set of compounds proposed as internal standards for the internal standard capillary electrophoresis (IS-CE) method. This is a high throughput method that allows the determination of the acidity constants of compounds in a short time, avoiding the exact measurement of the pH of the buffers used. pH electrode calibration at 37 °C can be avoided too. In order to anchor the pKa values obtained through the IS-CE method in the pH scale, the acidity constant at 37 °C of some of the standards has been determined also by the reference potentiometric method. In general, a decrease in the pKa value is observed when changing the temperature from 25 to 37 °C, and the magnitude of the change depends on the nature of the compounds. Once the pKa values at 37 °C of the internal standards have been established, the method is applied to the determination of the acidity constants of seven polyprotic (5 diprotic and 2 triprotic) drugs. The obtained mobility-pH profiles show well-defined curves, and the fits provide precise pKa values. Due to the lack of reference data at 37 °C only the pKa values of labetalol can be compared to values from the literature, and a very good agreement is observed.

A review of surgical robots for spinal interventions.

BACKGROUND: This study aimed to describe the state of the art in surgical robotics for spinal interventions, a challenging problem for which robots can provide valuable assistance. METHODS: Multiple electronic databases were searched for articles published during the last 10 years (2002-2012). Results were refined by defined inclusion criteria. RESULTS: A total of 18 different robots were found. Among them, five are commercially available systems: one specifically designed for spinal surgery, one for percutaneous needle-based interventions, two are radiosurgical systems with reported applications on the spine and another is a commercial robot which has been experimentally tested on spinal surgery. The remaining projects are research prototypes which are still on validation stages. CONCLUSIONS: A comprehensive state of the art is presented, showing that spinal robotic surgery is still at an early stage of development but with great potential for improvement.