[Guidelines for automated manual infusion: a practical way of prescribing postdilution on-line hemodiafiltration]. / Pauta de infusión manual automatizada: una forma práctica de prescribir la hemodiafiltración on-line posdilucional.

Post-dilution on-line hemodiafiltration (OL-HDF) is the most efficient infusion mode to obtain maximum clearances of uremic toxins, with a recommended manual infusion flow (Qi) of 25% of the blood flow with the main limitation that causes alarms by hemoconcentration throughout the session. Recent technical advances allow automatic prescription of Qi if hematocrit and total protein (TP) values are specified. As these analytical results are not possible to obtain in each dialysis session, a practical way to prescribe Qi is to make an automatic prescription adjusting the hematocrit and total protein values at the beginning of the session to obtain the manual prescription required and we will call it automatic-manual prescription. The aim of this study was to compare manual Qi with automatic-manual Qi in postdilution OL-HDF. 30 patients (16 men and 14 women), 59.9 +/- 15 years old, in hemodialysis program for 50.1 +/- 67 months were included. Every patient underwent four OL-HDF sessions, two with manual Qi (4008-S and 5008 monitors) and two with automatic-manual Qi (A-M), one with the same Qi and one with manual Qi +20 (A-M+20). The same usual dialysis parameters were maintained: helixone dialyzer, dialysis time of 266 +/- 39 minutes, blood flow of 420 +/- 36. Recirculation, Kt and intradialysis alarms were measured at each session. No significant differences in the fistula recirculation or dialysis dose measured using Kt. Total infusion volume was 24.9 +/- 4 (4008 S), 23.4 +/- 4 L (5008) with manual Qi, 23.6 +/- 4 L (A-M) Qi (NS) and 25.8 +/- 5 L (A-M+20). Only 14% of patients had no incidents. The number of alarms was significantly higher with manual prescription 55 alarms with 4008 and 40 with 5008 vs. AM (11) p < 0.01) and A-M+20 (16 alarms) We concluded that automatic-manual Qi is a practical way for post-dilutional OL-HDF prescription where the same efficiency and total reinfusion volume with an important reduction of intradialysis alarms are obtained, allowing to rise Qi by 20% without increasing intradialysis alarms.

Dentin bond strength of fluoride-releasing materials.

PURPOSE: To evaluate the shear bond strength to dentin of fluoride-releasing materials. MATERIALS AND METHODS: Human, noncarious extracted permanent molars stored in distilled water were used. Flat buccal and lingual dentin surfaces were ground wet on 600-grit silicon carbide paper. The teeth were then distributed at random into four groups of 5 teeth (10 surfaces) each: Group 1: Fuji II LC; Group 2: Vitremer; Group 3: VariGlass; Group 4: Dyract. Cylindrical samples of the glass ionomers were prepared in plastic molds and bonded to the dentin surface according to the manufacturers' instructions. All samples were placed in distilled water for 24 hours, thermocycled for 500 cycles in distilled water at 5 degrees C and 55 degrees C and sheared with an Instron at a crosshead speed of 0.5 mm/minute. RESULTS: In MPa: Group 1: 15.96 +/- 3.28; Group 2: 9.70 +/- 2.43; Group 3: 13.48 +/- 3.35; Group 4: 21.14 +/- 5.32. ANOVA revealed that Dyract had a significantly higher bond strength than all the other products tested (P < 0.0001). Vitremer had a significantly lower bond strength. Fuji II LC had no significant difference from VariGlass. Fracture patterns, examined with the SEM, were cohesive within the cement for all groups.

Engineering aspects of extracorporeal photochemotherapy.

Photopheresis is a new extracorporeal photochemotherapy in which the patient's blood or certain blood fraction is exposed to light in the presence of a light-activatable drug. The major engineering elements involved for better system design and patient treatment, such as system model, cell separation, irradiation, and energy measurement, are discussed.