Cómo mejorar la hipotensión sintomática en hemodiálisis: diálisis fría vs diálisis isotérmica / How can we improve sythomatic hypotension in hemodiaysis patients: Cold dialysis Vs isothermic dialysis

Introducción: La hipotensión sintomática es la complicación aguda más frecuente que afecta a los pacientes durante las sesiones de hemodiálisis. Varios trabajos han demostrado que el uso de baja temperatura en el baño de diálisis protege de esta hipotensiónen pacientes susceptibles de ella. En nuestro estudio, analizamos si la prevención de la reacción hipertérmica de la sesión de hemodiálisis tendría una respuestafavorable en la estabilidad hemodinámica de los pacientes permitiéndoles una buena tolerancia.Métodos: Analizamos el efecto del control de temperatura del dializado en la estabilidad hemodinámica de pacientes predispuestos a hipotensión sintomática ennuestro centro. En la fase de screening seleccionamos aquellos pacientes que tuvieron más de tres episodios hipotensivos en las 12 sesiones del mes. Posteriormente los mismos pacientes pasaron a las siguientes dos fases de 4 semanas cada una. En la fase 1, ajustamos la temperatura del baño a 36º C de forma constante para las 12 sesiones (diálisis fría) y en la segunda fase, utilizamos un (Blood Temperature Monitor; FreseniusMedical Care, Bad Homberg, Germany), que permite mantener constante la temperatura corporal (diálisis isotérmica). Resultados: Nueve pacientes fueron incluidos yfinalizaron el estudio. Durante la fase de screening la sustracción media fue del 4 ± 1% del 16 mmHg ± 16 a 80 ± peso seco, disminuyendo la tensión arterial mediadesde 99 (p < 1,7 sesiones de 12 ± 0,001) y presentando hipotensión sintomática en 5,0. Tanto en la fase 1 como en la 2 observamos un descenso de los tratamientos 1,7 ±1,6 y 2,8 ± 1,7 versus 2,7 ± complicados con hipotensión sintomática (5,0 p < 0,01). Ambas técnicas: Diálisis fría tanto como diálisis isotérmica fueron bien toleradas por los pacientes. Conclusión: Los resultados muestran que un control activo de la temperatura corporal puede mejorar de forma significativa la tolerancia intradialítica en pacientespredispuestos a la hipotensión sintomática (AU)

Background: Symptomatic hypotension is the most frequent acute complication affecting patients during chronic hemodialysis treatment sessions. Many reports have demonstrated that the use of cool dialysate has a protective effect on blood pressure duringhemodialysis treatments. In the present study, we investigated whether preventing the hyperthermic response had favourable effects on hemodynamic stability during the hemodialysis procedure while affording good tolerance to patients.Methods:We investigated the effect of thermal control of dialysate on hemodynamic stability in hypotensionpronepatients in our center. Patients were eligible for the study if they had symptomatic hypotensive episodes (> 3/12 session/month) during the screening phase. The studywas designed with two phases for the same selected patients and two treatment arms, each phase lasting 4 weeks. In the first phase, we adjusted dialysate temperature on 36 ºC for 12 sessions (cold dialysis) and in the second phase we used a device allowing theregulation of thermal balance (Blood Temperature Monitor; Fresenius Medical Care, Bad Homberg, Germany), that keep body temperature unchanged (isothermic dialysis). Results: Nine HD patients were enrolled and completed the study. During the screening 1% of dry weight, and blood pressure ± phase the mean ultrafiltration was 4 16 mmHg (p ± 16 to 80 ± decreased from 99 < 1.7 sessions of 12 ± 0.001). In 5.0 treatments were complicated by hypotension. In the first and second phase we observed a decrease of complicated treatments with symptomatic hypotension 1.7; p ± 1.6 y 2.8 ± 1.7 versus 2.7 ± (5.0 < 0.01). Both procedures: Cold dialysis and Isothermic dialysis was well tolerated by patients. Conclusion: Results show that active control of body temperature can significantly improve intradialytic tolerance in hypotension-prone patients (AU)

[How can we improve symptomatic hypotension in hemodialysis patients: cold dialysis vs isothermic dialysis]. / Cómo mejorar la hipotensión sintomática en hemodiálisis: diálisis fría versus diálisis isotérmica.

BACKGROUND: Symptomatic hypotension is the most frequent acute complication affecting patients during chronic hemodialysis treatment sessions. Many reports have demonstrated that the use of cool dialysate has a protective effect on blood pressure during hemodialysis treatments. In the present study, we investigated whether preventing the hyperthermic response had favourable effects on hemodynamic stability during the hemodialysis procedure while affording good tolerance to patients. METHODS: We investigated the effect of thermal control of dialysate on hemodynamic stability in hypotension-prone patients in our center. Patients were eligible for the study if they had symptomatic hypotensive episodes (> 3/12session/ month) during the screening phase. The study was designed with two phases for the same selected patients and two treatment arms, each phase lasting 4 weeks. In the first phase, we adjusted dialysate temperature on 36 masculineC for 12 sessions (cold dialysis) and in the second phase we used a device allowing the regulation of thermal balance (Blood Temperature Monitor; Fresenius Medical Care, Bad Homberg, Germany), that keep body temperature unchanged (isothermic dialysis). RESULTS: Nine HD patients were enrolled and completed the study. During the screening phase the mean ultrafiltration was 4 1% of dry weight, and blood pressure decreased from 9916 to 8016 mm Hg (p<0.001). In 5.01.7 sessions of 12 treatments were complicated by hypotension. In the first and second phase we observed a decrease of complicated treatments with symptomatic hypotension (5.01.7 versus 2.71.6 y 2.81.7; p<0.01). Both procedures: Cold dialysis and Isothermic dialysis was well tolerated by patients. CONCLUSION: Results show that active control of body temperature can significantly improve intradialytic tolerance in hypotension-prone patients.

Deltamethrin: uses and environmental safety.

Deltamethrin is a photostable pyrethroid providing valuable insecticidal activity against a large number of pests. Since it has potential uses for crop, cattle, and human health protection, extensive research work was done to evaluate its safety. Protection against insect pests in agriculture requires safety not only for applicators, but also for honey bees, nontarget insects and other arthorpods, mammals and birds in the wild and terrestrial fauna. Protection against vectors of harmful or endemic diseases involves direct treatment of waters with resulting risks for aquatic fauna. Extensive preharvest and postharvest use of a single pesticide demands thorough knowledge of residues on each crop and how they are affected by food processing. These various topics were considered in order to assess the safety of this new insecticide.

Forced volatilization or sweep extraction of organochlorine pesticide from vegetable extracts.

CONCLUSIONS: Selective partition by vapor solvent sweeping, on borosilicate wool, of organochlorine pesticides from fruit and vegetable extracts in the present apparatus and with the present technique provides sufficient cleanup for subsequent electron capture detector analysis. Amounts of organochlorine pesticides from 0.02 to 0.1 p.p.m. in fruits and vegetables are quantitatively recovered and can be analyzed by this method. This study, like those of GUNTHERet. al. (2,3) with organochlorine pesticide residues in butterfat and in alfalfa and of STORHERR and WATTS (4) with organophosphate pesticides in several fruits and vegetables confirms that forced volatilization cleanup is a promising method.