Pérdidas proteicas peritoneales en niños portadores de síndrome nefrótico en diálisis peritoneal / Peritoneal protein loss in children suffering from nephrotic syndrome undergoing peritoneal dialysis

Primary Nephrotic Syndrome (NS) responds favorably to steroids in 80-90 percent of cases. Most corticoresistant (CR) patients evolve into Chronic Renal Failure (CRF), Of unknown origin, a permeability factor in these patient's serum has been reported, with some known effects in membranes including the peritoneum. Objective: To evaluate peritoneal protein loss in CR children on Chronic Peritoneal Dialysis (CPD). Patients and Methods: Four year retrospective analysis. Group 1 included 9 CR children, Group 2 was a control group of 10 children with CRF of other causes on CPD. Children in both groups were comparable in age, gender, weight, body surface, duration of CPD, concentration of solution, modality and dose of dialysis. Both groups were evaluated at 1, 6 and 12 months after admission. Results: No differences were observes in biochemical parameters: creatinine, urea nitrogen, calcium, phosphorus. PTH (Parathyroid hormone) was significantly higher in the control group (164 +/- 144 vs 564 +/- 454 pg/dl p < 0,05), albumin was lower in NS patients at the beginning (2.27 +/- 0.63 gr/dl vs 3.62 +/- 1.45 gr/dl p < 0,05) and end (2.8 +/- 0.5 gr/ dl vs 3.9 +/- 0.86 gr/dl, p < 0,05) of the evaluation. Peritoneal protein loss was significantly larger in the index group at the beginning (3,41 +/- 2,01 vs 1,76 +/- 1,45 gr/m7dia), and end (4,27 +/- 3,47 vs 1,66 +/-1,31 gr/m7dia, (p < 0.05) of the evaluation. The same happened with urinary loss: while there was no difference in protein intake, peritoneal KtV or total KtV between groups, residual KtV was significantly lower among NS patients at the end of the study, suggesting an earlier drop in residual renal function. No differences were observed in rates of peritonitis between groups in the study period. Conclusion: Peritoneal protein loss in CPD children with NS are significantly larger than other patients in CPD, suggesting a possible systemic permeability factor in these patients.

El Síndrome Nefrótico primario (SN) responde favorablemente a corticoides en un 80-90 por ciento de los casos. Los pacientes cortico resistentes (SNCR) evolucionan, en su gran mayoría, a insuficiencia renal crónica (IRC). De etiología desconocida, se ha reportado la presencia de un factor de permeabilidad (FP) en el suero de estos pacientes, con algunos efectos conocidos a nivel de otras membranas biológicas, incluyendo el peritoneo. Objetivo: Evaluar las pérdidas proteicas vía peritoneo en niños con SNCR en diálisis peritoneal crónica (DP). Pacientes y Método: Análisis retrospectivo de 4 años (2003-2007), Se incluyeron 9 pacientes portadores de SNCR (grupo 1), y un grupo control de 10 niños en DP portadores de IRC por otra etiología (grupo 2). Se evaluó a los 2 grupos al mes 1 y 6 ó 12 de su ingreso. Los grupos fueron comparables respecto a edad, sexo, peso, superficie corporal, tiempo en DP, concentración de dextrosa utilizada, modalidad dialítica y dosis de diálisis. Resultados: No se observó diferencias de los parámetros bioquímicos (creatinina, nitrógeno ureico, calcio, fósforo). La hormona paratiroidea (PTH) fue significativamente mayor en el grupo control (164 +/- 144 vs 564 +/- 454 pg/dl p < 0,05), y la albúmina fue menor en los pacientes con SN al inicio (2,27 +/- 0,63 gr/dl vs 3,62 +/- 1,45 gr/dl p < 0,05) y al final de la evaluación (2,8 +/- 0,5 gr/dl vs 3,9 +/- 0,86 gr/dl, p < 0,05). Las pérdidas proteicas peritoneales fueron significativamente mayores en el grupo 1 vs el grupo 2 al ingreso: 3,41 +/- 2,01 vs 1,76 +/- 1,45 gr/m²/día, y al final de la evaluación: 4,27 +/- 3,47 vs 1,66 +/-1,31 gr/m²/día, (p < 0,05) respectivamente. Lo mismo ocurrió con las pérdidas urinarias. No hubo diferencias en la ingesta proteica, KtV peritoneal ni KtV total entre los grupos, mientras que el KtV residual fue significativamente menor en los pacientes nefróticos al término del estudio, sugiriendo una caída más precoz de la función renal residual. Tampoco...

Impacto en las áreas de desempeño ocupacional como consecuencia de una fobia social / Impact of social phobia in occupational performance’s areas

Dentro de los trastornos de ansiedad se encuentra la fobia social, cuya sintomatología se caracteriza por: angustia anticipatoria, ansiedad de exposición y evitación, frente a las situaciones sociales. Considerando las características de la patología, la hipótesis de esta investigación es que la fobia social provoca un impacto en la ocupación de las personas afectadas, y por ende en las áreas de desempeño, lo cual repercute negativamente en la calidad de vida de los individuos. Los objetivos del trabajo son por un lado determinar cómo se alteran las áreas de desempeño ocupacional en personas con fobia social. Además, se desea también establecer funciones del Terapeuta Ocupacional en el tratamiento de personas con este trastorno. Se trata de una investigación de tipo cualitativo utilizando una entrevista semi estructurada para la recolección de datos y a través del relato de historia de vida, se determinan ejes de análisis para comprender el impacto de la Fobia Social.

Social phobia is included on the anxiety disorders group, with symptoms like: advance anguish, exposure anxiety and avoidance, in all social situations. Considering symptoms of this disorder, research’s hypothesis is social phobia affects patient’s occupations and therefore performance’s areas, which strikes in a negative way on his or her life’s quality. The aims of the work are on the one hand to determine how there are altered the areas of occupational performance in persons by social phobia. In addition, one wants to establish also functions of the Occupational Therapist in the persons' treatment with this disorder. It is a question of an research of qualitative type using an interview semi constructed for the compilation of information and across the statement of history of life, axes of analysis decide to understand the impact of the Social Phobia.

The influence of pH in the hydrolytic stage of anaerobic digestion of the organic fraction of urban solid waste.

The influence of the pH in the first stage, the hydrolytic stage, of the anaerobic digestion of the organic fraction of urban solid waste in a two phase anaerobic reactor was studied. The reactor was fed with a solution of the organic fraction of urban solid residues containing 5 to 7% solids. Four reactors with a working volume of 3 L were used, the experiments were done at three controlled pHs; 6, 7, and 8, and one with free pH, the temperature was keep at 37 degrees C in all the experiments. The higher degradation of TSS and VSS was obtained in the reactors operated at pH 7 and 8; 75% degradation of TSS and 85% degradation of VSS. The volatile fatty acids were determined at the different pH conditions, no significant differences were found, and as was expected, the acetic acid was found at the higher value among them (from 25 to 29 g/L). According to the results obtained it is possible to conclude that in the case of the hydrolytic stage of the anaerobic digestion of the organic fraction of urban solid waste it is not necessary to control the pH, the pH is kept stable by the buffer effect of the protein residues and other macromolecules present in the residue.