Scheduling of Remote Monitoring for Peritoneal Dialysis Patients.

Peritoneal dialysis (PD) is performed as a home-based treatment and in this context, telemedicine has been proven helpful for improving clinicians' surveillance and maintaining PD patients in their home setting. The new e-health devices make remote patient monitoring (RPM) for automated peritoneal dialysis (APD) treatment possible, evaluating the data at the end of every treatment and adapting the prescription at distance if necessary. This paper aims to share a method for improving clinical surveillance and enabling PD patients to receive their treatment at home. In the present case series, we delineate the clinical protocol of the Vicenza PD Center regarding patient characteristics, timing, and the purpose of the APD-RPM. We present the Vicenza PD Center's experience, illustrating its application through three case reports as exemplars. Telemedicine helps to carefully allocate healthcare resources while removing the barriers to accessing care. However, there is a risk of data overload, as some data might not be analyzed because of an increased workload for healthcare professionals. A proactive physician's attitude towards the e-health system has to be supported by clinical instructions and legislative rules. International and national guidelines may suggest which patients should be candidates for RPM, which parameters should be monitored, and with what timing. According to our experience, we suggest that the care team should define a workflow that helps in formulating a correct approach to RPM, adequately utilizing resources. The workflow has to consider the different needs of patients, in order to assure frequent remote control for incident or unstable patients, while prevalent and stable patients can perform their home treatment more independently, helped by periodic and deferred clinical supervision.

Blood transfusion reactions and risk of acute kidney injury and major adverse kidney events.

BACKGROUND: Blood transfusion reactions may have a negative impact on organ function. It is unknown whether this association holds true for acute kidney injury (AKI). Therefore, we conducted a cohort study to assess the association between transfusion reactions and the incidence of AKI and major adverse kidney events. METHODS: In this retrospective cohort study, we included patients who received transfusion of blood products during hospitalization at the Hospital Civil of Guadalajara. We analyzed them according to the development of transfusion reactions, and the aim was to assess the association between transfusion reactions and AKI during long-term follow-up. RESULTS: From 2017 to 2021, 81,635 patients received a blood product transfusion, and 516 were included in our study. The most common transfusion was red blood cell packaging (50.4%), fresh frozen plasma (28.7%) and platelets (20.9%); of the 516 patients, 129 (25%) had transfusion reactions. Patients who had transfusion reactions were older and had more comorbidities. The most common type of transfusion reaction was allergic reaction (70.5%), followed by febrile nonhemolytic reaction (11.6%) and anaphylactoid reaction (8.5%). Most cases were considered mild. Acute kidney injury was more prevalent among those who had transfusion reactions (14.7%) than among those who did not (7.8%), p = < 0.01; those with AKI had a higher frequency of diabetes, vasopressors, and insulin use. Transfusion reactions were independently associated with the development of AKI (RR 2.1, p = < 0.02). Major adverse kidney events were more common in those with transfusion reactions. The mortality rate was similar between subgroups. CONCLUSION: In our retrospective cohort of patients who received blood product transfusions, 25% experienced transfusion reactions, and this event was associated with a twofold increase in the probability of developing AKI and some of the major adverse kidney events during long follow-up.

Work, marriage and premature birth: the socio-medicalisation of pregnancy in state socialist East-Central Europe.

Reproductive health in state socialism is usually viewed as an area in which the broader contexts of women's lives were disregarded. Focusing on expert efforts to reduce premature births, we show that the social aspects of women's lives received the most attention. In contrast to typical descriptions emphasising technological medicalisation and pharmaceuticalisation, we show that expertise in early socialism was concerned with socio-medical causes of prematurity, particularly work and marriage. The interest in physical work in the 1950s evolved towards a focus on psychological factors in the 1960s and on broader socio-economic conditions in the 1970s. Experts highlighted marital happiness as conducive to healthy birth and considered unwed women more prone to prematurity. By the 1980s, social factors had faded from interest in favour of a bio-medicalised view. Our findings are based on a rigorous comparative analysis of medical journals from Hungary, Poland, Czechoslovakia and East Germany.

Saving newborns, defining livebirth: The struggle to reduce infant mortality in East-Central Europe in comparative and transnational perspectives, 1945-1965.

After World War II, infant mortality rates started dropping steeply. We show how this was accomplished in socialist countries in East-Central Europe. Focusing on the two postwar decades, we explore comparatively how medical experts in Poland, Hungary, Czechoslovakia, and East Germany saved fragile newborns. Based on an analysis of medical journals, we argue that the Soviet Union and its medical practices had only a marginal influence; the four countries followed the recommendations of the World Health Organization instead, despite not being members. Importantly, we analyze the expert clashes over definitions of livebirth, which impact infant mortality statistics. We analyze the divergent practices and negotiations between countries: since the infant mortality rate came to represent the level of socioeconomic advancement, its political significance was paramount. Analyzing the struggle to reduce infant mortality thus helps us understand how socialist countries positioned themselves within the transnational framework while being members of the "socialist bloc."

Systolic Blood Pressure and the Risk of Kidney Replacement Therapy and Mortality in Patients with Chronic Kidney Disease Stages 4-5.

INTRODUCTION: In patients with chronic kidney disease stages 4 and 5 (CKD stages 4-5) without dialysis and arterial hypertension, it is unknown if the values of systolic blood pressure (SBP) considered in control (<120 mm Hg) are associated with kidney replacement therapy (KRT) and mortality. METHODS: In this retrospective cohort study, hypertensive CKD stages 4-5 patients attending the Renal Health Clinic at the Hospital Civil de Guadalajara were enrolled. We divided them into those that achieved SBP <120 mm Hg (controlled group) and those who did not (>120 mm Hg), the uncontrolled group. Our primary objective was to analyze the association between the controlled group and KRT; the secondary objective was the mortality risk and if there were subgroups of patients that achieved more benefit. Data were analyzed using Stata software, version 15.1. RESULTS: During 2017-2022, a total of 275 hypertensive CKD stages 4-5 patients met the inclusion criteria for the analysis: 62 in the controlled group and 213 in the uncontrolled group; mean age 61 years; 49.82% were male; SBP was significantly lower in the controlled group (111 mm Hg) compared to the uncontrolled group (140 mm Hg); eGFR was similar between groups (20.41 mL/min/1.73 m2). There was a tendency to increase the mortality risk in the uncontrolled group (HR 6.47 [0.78-53.27]; p = 0.082) and an association by the Kaplan-Meir analysis (Log-rank p = 0.043). The subgroup analysis for risk of KRT in the controlled group revealed that patients ≥61 years had a lower risk of KRT (HR 0.87 [95% CI, 0-76-0.99]; p = 0.03, p of interaction = 0.005), but no differences were found in the subgroup analysis for mortality. In a follow-up of 1.34 years, no association was found in the risk of KRT according to the controlled or uncontrolled groups in a multivariate Cox analysis. CONCLUSION: In a retrospective cohort of patients with CKD stages 4-5 and hypertension, SBP >120 mm Hg was not associated with risk of KRT but could be associated with the risk of death. Clinical trials are required in this group of patients to demonstrate the impact of reaching the SBP goals recommended by the KDIGO guidelines.

A probabilistic approach for the study of epidemiological dynamics of infectious diseases: Basic model and properties.

The dynamics of epidemiological phenomena associated to infectious diseases have long been modelled taking different approaches. However, recent pandemic events exposed many areas of opportunity to improve the existing models. We develop a stochastic model based on the idea that transitions between epidemiological stages are alike sampling processes that may involve more than one subset of the population or may be mostly dependent on time intervals defined by pathological or clinical criteria. We apply the model to simulate epidemics, analyse the final distribution of the case fatality ratio, and define a basic reproductive number to determine the existence of a probabilistic phase transition for the dynamics. The resulting modelling scheme is robust, easy to implement, and can readily lend itself for extensions aimed at answering questions that emerge from close examination of data trends, such as those emerging from the COVID-19 pandemic, and other infectious diseases.

New insights into microbial interactions and putative competitive mechanisms during the hydrogen production from tequila vinasses.

This study aimed to characterize the prokaryotic community and putative microbial interactions involved in hydrogen (H2) production during the dark fermentation (DF) process, applying principal components analysis (PCA) to correlate changes in operational, physicochemical, and biological variables. For this purpose, a continuous stirred-tank reactor-type digester fed with tequila vinasses was operated at 24, 18, and 12 h of hydraulic retention times (HRTs) to apply organic loading rates of 20, 36, and 54 g-COD L-1 d-1, corresponding to stages I, II, and III, respectively. Results indicated high population dynamics for Archaea during the DF process toward a decrease in total sequences from 6299 to 99. Concerning the Bacteria community, lactic acid bacteria (LAB) were dominant reaching a relative abundance of 57.67%, while dominant H2-producing bacteria (HPB) decreased from 25.76% to 21.06% during stage III. Putative competitive exclusion mechanisms such as competition for substrates, bacteriocins production, and micronutrient depletion carried out by Archaea and non-H2-producing bacteria (non-HPB), especially LAB, could negatively impact the dominance of HPB such as Ethanoligenens harbinense and Clostridium tyrobutyricum. As a consequence, low maximal volumetric H2 production rate (672 mL-H2 L-1 d-1) and yield (3.88 mol-H2 assimilated sugars-1) were obtained. The global scenario obtained by PCA correlations suggested that C. tyrobutyricum positively impacted H2 molar yield through butyrate fermentation using the butyryl-CoA:acetate CoA transferase pathway, while the most abundant HPB E. harbinense decreased its relative abundance at the shortest HRT toward the dominance of non-HPB. This study provides new insights into the microbial interactions and helps to better understand the DF performance for H2 production using tequila vinasses as substrate. KEY POINTS: • E. harbinense and C. tyrobutyricum were responsible for H2 production. • Clostridiales used acetate and butyrate fermentations for H2 production. • LAB won the competition for sugars against Clostridiales during DF. • Putative bacteriocins production and micronutrients depletion could favor LAB.

Prokaryotic population dynamics and interactions in an AnSBBR using tequila vinasses as substrate in co-digestion with acid hydrolysates of Agave tequilana var. azul bagasse for hydrogen production.

AIMS: The purpose of this study was to characterize the prokaryotic community and putative microbial interactions between H2 -producing bacteria (HPB) and non-HPB using two anaerobic sequencing batch biofilm reactors (AnSBBRs) fed with tequila vinasses in co-digestion with acid hydrolysates of Agave tequilana var. azul bagasse (ATAB). METHODS AND RESULTS: Two AnSBBRs were operated for H2 production to correlate changes in physicochemical and biological variables by principal component analysis (PCA). Results indicated that H2 yield was supported by Ethanoligenens harbinense and Clostridium tyrobutyricum through the PFOR pathway. However, only E. harbinense was able to compete for sugars against non-HPB. Competitive exclusion associated with competition for sugars, depletion of essential trace elements, bacteriocin production and resistance to inhibitory compounds could be carried out by non-HPB, increasing their relative abundances during the dark fermentation (DF) process. CONCLUSIONS: The global scenario obtained by PCA correlated the decrease in H2 production with the lactate:acetate molar ratio in the influent. At the beginning of co-digestion, this ratio had the minimum value considered for a net gain of ATP. This fact could cause the reduction of the relative abundance of C. tyrobutyricum. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first study that demonstrated the feasibility of H2 production by Clostridiales from acid hydrolysates of ATAB in co-digestion with tequila vinasses.

Outcomes of Conversion from Sleeve Gastrectomy to Roux-en-Y Gastric Bypass Due to GERD-a Retrospective Analysis of 35 Patients.

BACKGROUND: Sleeve gastrectomy (SG) has become one of the most performed bariatric procedures worldwide. Its main weaknesses are weight regain and gastroesophageal reflux disease (GERD). Conversion to Roux-en-Y gastric bypass (RYGB) is considered the gold standard to manage GERD and related symptoms. METHODS: Retrospective evaluation from a prospective bariatric surgery database of all our institution's patients converted from SG to RYGB due to GERD between January 2010 and December 2018. Clinical characteristics and workups before SG and before and after RYGB were analyzed. RESULTS: During the study period, 35 patients needed a conversion to RYGB, due to GERD or GERD-related symptoms. Mean age was 48.6 years, 85.7% were women, and mean BMI was 31.4 kg/m2. The interval between SG and RYGB was in a range 7 to 70 months (mean 33 months). All conversions were completed laparoscopically, associating a hiatoplasty in 45.7% of cases. A complete remission of symptoms was observed in 74% of patients, some improvement in 20%, and no relief in 6%. There were 3 cases of hiatal hernia persistence and 2 of recidivism. Only 1 patient presented pathological pHmetry, while moderate esophagitis was demonstrated in 2 patients. CONCLUSIONS: Conversion to RYGB was effective in almost all patients. Pathological acid exposure and hiatal hernias seem to be the main findings prior to conversion, justifying an exhaustive examination and aggressive approach to the hiatus. Due to the insufficient correlation between symptoms and findings on morphological and functional tests, actively searching for signs of GERD is advisable.

Seeking an Initial-Weight-Independent Metric in a Mediterranean Cohort of Gastric Bypass Patients: the %AWL Revisited.

BACKGROUND: Most relative weight-loss metrics follow the formula "Weight loss(%) = 100 · (Initial BMI - Final BMI) / (Initial BMI-a)," where a is the reference point that defines the metric. The percentage of total weight loss (%TWL, a = 0) and percentage of excess weight loss (%EWL, a = 25) are influenced by a patient's initial weight. Recently, the percentage of alterable weight loss metric (%AWL, a = 13) has been reported to produce initial-weight-independent outcomes. OBJECTIVES: This study aimed to replicate the methodology used for %AWL determination in a Mediterranean cohort of bariatric patients. SETTINGS: Multicenter study in 10 large hospitals in Spain. METHODS: Two large prospective databases were retrospectively searched for all primary laparoscopic gastric bypass patients with 2 years of follow-up. Outcomes at nadir were expressed and analyzed with 26 different metrics (a from 0 to 25), looking for the metric whose outcomes produced (1) the lowest coefficient of variation, (2) no differences between initially lighter and heavier patients, and (3) no correlation with patients' initial BMI. RESULTS: A cohort of 1793 patients was stratified into 4 gender-age groups: younger women (YW, n = 733), older women (OW, n = 674), younger men (YM, n = 197), and older men (OM, n = 189). The calculations suggested an optimal reference point of 18 kg/m2, defining a new metric (percentage of Mediterranean alterable weight loss, %MAWL). When %TWL, %EWL, %AWL, and %MAWL were tested on the whole sample, only %MAWL produced initial-weight-independent results. CONCLUSIONS: In our Mediterranean cohort of patients, a reference point of 18 (and not 13) yielded initial-weight-independent outcomes.

Synthesis of covalent bonding MWCNT-oligoethylene linezolid conjugates and their antibacterial activity against bacterial strains.

Nowadays, infectious diseases caused by drug-resistant bacteria have become especially important. Linezolid is an antibacterial drug active against clinically important Gram positive strains; however, resistance showed by these bacteria has been reported. Nanotechnology has improved a broad area of science, such as medicine, developing new drug delivery and transport systems. In this work, several covalently bounded conjugated nanomaterials were synthesized from multiwalled carbon nanotubes (MWCNTs), a different length oligoethylene chain (S n ), and two linezolid precursors (4 and 7), and they were evaluated in antibacterial assays. Interestingly, due to the intrinsic antibacterial activity of the amino-oligoethylene linezolid analogues, these conjugated nanomaterials showed significant antibacterial activity against various tested bacterial strains in a radial diffusion assay and microdilution method, including Gram negative strains as Escherichia coli (11 mm, 6.25 µg mL-1) and Salmonella typhi (14 mm, ≤0.78 µg mL-1), which are not inhibited by linezolid. The results show a significant effect of the oligoethylene chain length over the antibacterial activity. Molecular docking of amino-oligoethylene linezolid analogs shows a more favorable interaction of the S 2-7 analog in the PTC of E. coli.

Differential Expression of Maize and Teosinte microRNAs under Submergence, Drought, and Alternated Stress.

Submergence and drought stresses are the main constraints to crop production worldwide. MicroRNAs (miRNAs) are known to play a major role in plant response to various stresses. In this study, we analyzed the expression of maize and teosinte miRNAs by high-throughput sequencing of small RNA libraries in maize and its ancestor teosinte (Zea mays ssp. parviglumis), under submergence, drought, and alternated stress. We found that the expression patterns of 67 miRNA sequences representing 23 miRNA families in maize and other plants were regulated by submergence or drought. miR159a, miR166b, miR167c, and miR169c were downregulated by submergence in both plants but more severely in maize. miR156k and miR164e were upregulated by drought in teosinte but downregulated in maize. Small RNA profiling of teosinte subject to alternate treatments with drought and submergence revealed that submergence as the first stress attenuated the response to drought, while drought being the first stress did not alter the response to submergence. The miRNAs identified herein, and their potential targets, indicate that control of development, growth, and response to oxidative stress could be crucial for adaptation and that there exists evolutionary divergence between these two subspecies in miRNA response to abiotic stresses.

Acerca de la enfermedad por reflujo gastroesofágico en un paciente con un IMC 30 kg/m2 y gastroplastia vertical endoscópica previa: indicación para un bypass gástrico de una anastomosis / Gastroesophageal reflux disease in a patient with a BMI of 30 kg/m2 and previous endoscopic sleeve gastroplasty: Indication for a one-anastomosis gastric bypass

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Evolución clínica de pacientes en hemodiálisis en tratamiento con oxihidróxido sucroférrico / Clinical evolution of patients treated with sucroferric oxyhydroxide in hemodialysis

Resumen Introducción: la hiperfosfatemia es una complicación común de la enfermedad renal crónica (ERC) y empeora progresivamente a medida que disminuye la función renal. Actualmente disponemos de diversas moléculas farmacéuticas para su tratamiento. Dentro de ellas, existen quelantes que contienen hierro, como es el caso del oxihidróxido sucroférrico. Su uso se ha extendido fundamentalmente entre pacientes en hemodiálisis, en sustitución de otros quelantes. Objetivo: describir la tolerabilidad, la aparición de efectos secundarios, la adherencia terapéutica y las cifras de fósforo sérico en pacientes en tratamiento con oxihidróxido sucroférrico en nuestro centro. Materiales y métodos: se analizaron 5 pacientes de la unidad de hemodiálisis del Servicio de Nefrologia del Hospital Universitario de Burgos, España, en el periodo comprendido entre enero de 2017 a mayo de 2018, todos ellos en tratamiento con oxihidróxido sucroférrico. Se evaluaron las concentraciones plasmáticas de fósforo, calcio y hormona paratiroidea durante el tratamiento con oxihidróxido sucroférrico, además de los efectos secundarios y las causas de abandono. El análisis de los datos se realizó mediante el software estadístico IBM SPSS 22 con un intervalo de confianza del 95 %. Se evaluaron las posibles diferencias con el análisis de la t-Student. Resultados: se evidenció una reducción media del 12,27 % de la hiperfosforemia y una reducción en el número de comprimidos diarios del 15,79 %, con buena tolerancia del fármaco en todos los casos. No se evidenció reducción estadísticamente significativa en los niveles plasmáticos de calcio, ni de hormona paratiroidea (PTH). Conclusiones: el oxihidróxido sucroférrico es un fármaco bien tolerado, que generó una disminución de los niveles séricos de fósforo en la población estudiada. Sin embargo, dado el bajo número de casos analizados, no es posible recomendar el uso terapéutico de este fármaco como primera línea de tratamiento de la hiperfosforemia.

Abstract Introduction: Hyperphosphatemia is a common complication of CKD and progressively worsens as renal function decreases. Currently we have several pharmaceutical molecules for its treatment. Among them, there are chelators that contain iron, as is the case of sucroferric oxyhydroxide. Its use has been extended mainly among those on hemodialysis, replacing other chelators. Objective: Describe the tolerability, the appearance of side effects, therapeutic adherence and serum phosphorus levels in patients undergoing treatment with sucroferric oxyhydroxide in our center. Materials and methods: Five patients were analyzed from the hemodialysis unit of the Nephrology Service of the University Hospital of Burgos, from January 2017 to May 2018, all of them under treatment with sucroferric oxyhydroxide. Plasma concentrations of phosphorus, calcium and parathyroid hormone were evaluated during treatment with sucroferric oxyhydroxide, in addition to side effects and causes of abandonment. For the analysis of the data, they were processed using the IBM SPSS 22 statistical software with a confidence interval of 95%. Possible differences were evaluated with the t-Student analysis. Results: There was an average reduction of 12.27% in hyperphosphataemia and a reduction in the number of daily tablets of 15.79%, with good tolerance of the drug in all cases. There was no statistically significant reduction in plasma levels of calcium or parathyroid hormone (PTH). Conclusions: Sucroferric oxyhydroxide is a well-tolerated drug, which generated a decrease in serum phosphorus levels in the population studied. However, given the low number of cases analyzed, it is not possible to recommend the therapeutic use of this drug as the first line of treatment for hyperphosphatemia.

One-step nucleic acid amplification for intraoperative analysis of sentinel lymph node in papillary thyroid carcinoma.

Objective Lymphadenectomy in papillary thyroid carcinoma (PTC) is controversial. It is indicated whenever metastases have been proven before or during surgery and as a prophylactic treatment in high-risk patients. However, 30-50% of cN0 patients become pN1 postoperatively. In PTC, selective-sentinel-lymph-node-biopsy (SLNB) with conventional intraoperative analysis is 8% false negative. One-step nucleic acid amplification (OSNA) is a molecular technique which allows real-time detection of mRNA encoding for cytokeratin 19. OSNA has been introduced in intraoperative analysis of several tumors to reduce false-negative rates and distinguish micrometastasis from macrometastasis. Our objective was to evaluate the impact of the introduction of OSNA in the intraoperative evaluation of the sentinel node (SN) in PTC. Design We analyzed a series of 35 patients subjected to SLNB. Methods All the dissected nodes, SN and non-SN, were evaluated with OSNA and cytology. Results We obtained a total of 110 SN. SLNB proved positive in 14 patients (40%) with cytology and in 23 (65.7%) with OSNA (P < 0.001). In the 29 patients with subsequent lymphadenectomy we obtained 360 lymph nodes ((52 positive in cytology (14.4%) and 107 in OSNA (29.7%)). Lymphadenectomy proved positive in 16 patients according to cytology (55%) and in 24 according to OSNA (83%) (P = 0002). The majority of patients with micrometastasis in SN showed only micrometastasis in lymphadenectomy. Conclusions The present study shows selective-sentinel-lymph-node-biopsy with one-step nucleic acid amplification technique to be feasible in papillary thyroid carcinoma. The quantitative nature of one-step nucleic acid amplification paves the way toward a more personalized surgical approach, limiting lymphadenectomy to patients with intraoperative evidence of macrometastasis in the sentinel node.

Sarcoma de Kaposi intestinal en paciente trasplantado renal / Intestinal KaposiÆs Sarcoma in renal transplant patient

El sarcoma de Kaposi (SK) es una neoplasia vascular, en la cual podemos distinguir cuatro formas clínicas: la clásica o mediterránea, endémica o africana, asociada al VIH y la iatrogénica. Sus manifestaciones clínicas más frecuentes son las lesiones mucocutáneas y afectación de ganglios linfáticos si bien puede cursar con afectación a nivel visceral. Presentamos a continuación el caso de un paciente trasplantado renal que fue diagnosticado de un sarcoma de Kaposi intestinal, sin lesiones cutáneas asociadas

Kaposi's sarcoma (KS) is a vascular neoplasm, in which we can distinguish four clinical forms: the classic or Mediterranean, endemic or African, associated with HIV and iatrogenic. Its most frequent clinical manifestations are mucocutaneous lesions and lymph node involvement, although it may manifest with involvement at the visceral level. We present the case of a renal transplant patient who was diagnosed with an intestinal Kaposi's sarcoma, with no associated cutaneous lesions

Investigation of EBT3 radiochromic film's response to humidity.

PURPOSE: The aim of this work is to investigate the effects of immersing EBT3 radiochromic film in water and to evaluate its contribution to the total uncertainty in dose determination. MATERIALS AND METHODS: We used 3 cm × 3 cm EBT3 radiochromic films irradiated in the range of 0-70 Gy to study the impact of water immersion on the change in net optical density. These films were placed in a water container for a period of 24 h. The net optical density was measured before (0 h) and after of the immersion in water (1, 3, 6, 12, 18, and 24 h). The absorbance spectrum of the EBT3 radiochromic film was measured at 0 h and 24 h after immersion in water. The uncertainty in dose determination due to the effects of keeping the EBT3 radiochromic film submerged in water at 0, 1, and 24 h were recorded in the red, green, and blue channels. RESULTS: We observed an increase in the net optical density as an effect on the film due to its immersion in water. The penetration of the water at the edges of the radiochromic film was observed to be a function of time during which the film remained in the water. On the other hand, the penetration of water at the edges of the film was found to be independent of irradiation dose. CONCLUSIONS: EBT3 radiochromic film is found more resistant to water penetration through the edges than its predecessors. However, there is evidence that suggest that liquid water damage the Nylon cover layer of the film by changing its optical properties. Therefore, it is recommended to build a new calibration curve for radiochromic films for a specific situation involving dose measurements in liquid water.