Importance of Frailty in Kidney Transplant Recipients.

BACKGROUND: Frailty is a persistent chronic inflammatory syndrome present in many patients with chronic kidney disease. After kidney transplant (KT), it has been associated with complications such as delayed graft function, hospital readmission, or poorer KT survival. PURPOSE: To assess the impact of frailty on the results of KT. METHODS: Longitudinal prospective study of 65 patients included on the waiting list (WL) between October 2019 and October 2021. We used the FRAIL scale and recorded clinical characteristics, including demographic, dependency scales, and analytical parameters at the moment of the inclusion on the WL and at months 3 and 12 after KT. RESULTS: The mean age was 58 years old, and 70% of KT were men. The comorbidity burden was 26% diabetes, 83% hypertension, and 12% ischemic heart disease. Forty patients (61.5%) presented ≥1 point on the FRAIL scale, and 25 (38.4%) were robust. Frail patients (FRAIL score≥3) had a higher Charlson comorbidity index at the time of KT, a lower Barthel index, and a lower quality of life measured by KDQOL-36. No significant differences were observed in other variables, such as days of admission, surgical complications, or delayed graft function. There were 3 graft losses censored for death and 4 deaths, all in frail or prefrail patients. These patients had lower graft survival (P = .164) and patient survival (P = .096). At 12 months post KT, frailty improved in 67% of patients evaluated. CONCLUSION: Frailty is a common condition among patients on the WL, leading to poorer quality of life, greater dependency, and a higher risk of graft loss and mortality. Frailty conditions can be reversed in many patients after KT.

Ionic liquid mixtures--an analysis of their mutual miscibility.

The use of ionic liquid mixtures (IL-IL mixtures) is being investigated for fine solvent properties tuning of the IL-based systems. The scarce available studies, however, evidence a wide variety of mixing behaviors (from almost ideal to strongly nonideal), depending on both the structure of the IL components and the property considered. In fact, the adequate selection of the cations and anions involved in IL-IL mixtures may ensure the absence or presence of two immiscible liquid phases. In this work, a systematic computational study of the mixing behavior of IL-IL systems is developed by means of COSMO-RS methodology. Liquid-liquid equilibrium (LLE) and excess enthalpy (H(E)) data of more than 200 binary IL-IL mixtures (including imidazolium-, pyridinium-, pyrrolidinium-, ammonium-, and phosphonium-based ILs) are calculated at different temperatures, comparing to literature data when available. The role of the interactions between unlike cations and anions on the mutual miscibility/immiscibility of IL-IL mixtures was analyzed. On the basis of proposed guidelines, a new class of immiscible IL-IL mixtures was reported, which only is formed by imidazolium-based compounds.

Vida cotidiana de la mujer rural en la etapa de climaterio / Daily life of climacteric women in rural areas

Resumen:

Objetivo: existe escasa información respecto a la vida cotidiana de las mujeres rurales en la etapa de climaterio. Comprender esta cotidianidad fue el objetivo de esta investigación fenomenológica bajo el análisis de la hermenéutica heideggeriana. Material y método: los sujetos de estudio fueron 19 mujeres en etapa de climaterio residentes en la zona rural del sur de Veracruz, México. La recopilación de datos se obtuvo a través de entrevistas en profundidad. Se realizó análisis vago y mediano, y análisis hermenéutico. Resultados: lo que la mujer expresa en su vida cotidiana, es el modo de la presencia impersonal. Vive siendo inauténtica. Por otra parte la extrema violencia en que se desenvuelve el Dasein hace que se impregne de angustia y se manifieste en el no-ser; es decir, el ser-para-la muerte. Es necesario que se implemente el cuidado profesional de enfermería a la mujer en este proceso, a través de la expresión del ser-con.

Interactions of ionic liquids and acetone: thermodynamic properties, quantum-chemical calculations, and NMR analysis.

The interactions between ionic liquids (ILs) and acetone have been studied to obtain a further understanding of the behavior of their mixtures, which generally give place to an exothermic process, mutual miscibility, and negative deviation of Raoult's law. COSMO-RS was used as a suitable computational method to systematically analyze the excess enthalpy of IL-acetone systems (>300), in terms of the intermolecular interactions contributing to the mixture behavior. Spectroscopic and COSMO-RS results indicated that acetone, as a polar compound with strong hydrogen bond acceptor character, in most cases, establishes favorable hydrogen bonding with ILs. This interaction is strengthened by the presence of an acidic cation and an anion with dispersed charge and non-HB acceptor character in the IL. COSMO-RS predictions indicated that gas-liquid and vapor-liquid equilibrium data for IL-acetone systems can be finely tuned by the IL selection, that is, acting on the intermolecular interactions between the molecular and ionic species in the liquid phase. NMR measurements for IL-acetone mixtures at different concentrations were also carried out. Quantum-chemical calculations by using molecular clusters of acetone and IL species were finally performed. These results provided additional evidence of the main role played by hydrogen bonding in the behavior of systems containing ILs and HB acceptor compounds, such as acetone.

El cuidado de sí. Consecuencias para la enfermería en la salud de la mujer en etapa de climaterio / Self-care. Implications for nursing in women’s health in climacteric phase

Resumen:

En el contexto mundial actual, la esperanza de vida de la población ha aumentado de manera considerable, situación que se refleja en el grupo de mujeres en etapa de climaterio. Este proceso, a veces tan complejo para algunas féminas, requiere de cuidado por parte del profesional de enfermería. En función de esa necesidad, se analizó el concepto “cuidado de sí” a partir de las propuestas filosóficas de Martin Heidegger y Michel Foucault. La reflexión de este concepto permite al profesional de enfermería un acercamiento profesional más humanizado a partir de la comprensión del modo de ser propio de cada mujer y, asimismo, redimensionar la perspectiva de cuidado hacia las mujeres en climaterio, ya que lo que se promueve bajo este concepto es el desarrollo del cuidado cotidiano hacia ellas mismas como producto de una decisión propia y reflexiva.